bluuebunny/crossref_metadata_2025 huggingface dataset:
Colorectal Cancer Progression Is Potently Reduced by a Glucose-Free, High-Protein Diet: Comparison to Anti-EGFR Therapy
Authors: Skibbe Kerstin , Brethack Ann-Kathrin , Sünderhauf Annika , Ragab Mohab , Raschdorf Annika , Hicken Maren , Schlichting Heidi , Preira Joyce , Brandt Jennifer , Castven Darko , Föh Bandik , Pagel René , Marquardt Jens U. , Sina Christian , Derer Stefanie
Published: November 2021

To enable rapid proliferation, colorectal tumor cells up-regulate epidermal growth factor receptor (EGFR) signaling and aerobic glycolysis, resulting in substantial lactate release into the tumor microenvironment and impaired anti-tumor immune responses. We hypothesized that a nutritional intervention designed to reduce aerobic glycolysis may boost the EGFR-directed antibody (Ab)-based therapy of pre-existing colitis-driven colorectal carcinoma (CRC). CRC development was induced by azoxymethane (AOM) and dextran sodium sulfate (DSS) administration to C57BL/6 mice. AOM/DSS-treated mice were fed a glucose-free, high-protein diet (GFHPD) or an isoenergetic control diet (CD) in the presence or absence of an i.p. injection of an anti-EGFR mIgG2a or respective controls. AOM/DSS-treated mice on a GFHPD displayed a reduced systemic glucose metabolism associated with reduced oxidative phosphorylation (OXPHOS) complex IV expression and diminished tumor loads. Comparable but not additive to an anti-EGFR-Ab therapy, the GFHPD was accompanied by enhanced tumoral goblet cell differentiation and decreased colonic PD-L1 and splenic CD3ε, as well as PD-1 immune checkpoint expression. In vitro, glucose-free, high-amino acid culture conditions reduced proliferation but improved goblet cell differentiation of murine and human CRC cell lines MC-38 and HT29-MTX in combination with down-regulation of PD-L1 expression. We here found GFHPD to systemically dampen glycolysis activity, thereby reducing CRC progression with a similar efficacy to EGFR-directed antibody therapy.
HLA Expression in Relation to HLA Type in Classic Hodgkin Lymphoma Patients
Authors: Tan Geok Wee , Jiang Peijia , Nolte Ilja M. , Kushekhar Kushi , Veenstra Rianne N. , Hepkema Bouke G. , Jarrett Ruth F. , van den Berg Anke , Diepstra Arjan
Published: November 2021

Several human leukocyte antigen (HLA) alleles are strongly associated with susceptibility to classic Hodgkin lymphoma (cHL), also in subgroups stratified for presence of the Epstein–Barr virus (EBV). We tested the hypothesis that the pressure on cHL tumour cells to lose HLA expression is associated with HLA susceptibility alleles. A meta-analysis was carried out to identify consistent protective and risk HLA alleles in a combined cohort of 839 cHL patients from the Netherlands and the United Kingdom. Tumour cell HLA expression was studied in 338 cHL cases from these two cohorts and correlated to the presence of specific susceptibility HLA alleles. Carriers of the HLA-DRB1*07 protective allele frequently lost HLA class II expression in cHL overall. Patients carrying the HLA-DRB1*15/16 (DR2) risk allele retained HLA class II expression in EBV− cHL and patients with the HLA-B*37 risk allele retained HLA class I expression more frequently than non-carriers in EBV+ cHL. The other susceptibility alleles showed no significant differences in expression. Thus, HLA expression by tumour cells is associated with a subset of the protective and risk alleles. This strongly suggests that HLA associations in cHL are related to peptide binding capacities of specific HLA alleles.
A Novel Four-Gene Prognostic Signature for Prediction of Survival in Patients with Soft Tissue Sarcoma
Authors: Wu Changwu , Gong Siming , Osterhoff Georg , Schopow Nikolas
Published: November 2021

Soft tissue sarcomas (STS), a group of rare malignant tumours with high tissue heterogeneity, still lack effective clinical stratification and prognostic models. Therefore, we conducted this study to establish a reliable prognostic gene signature. Using 189 STS patients’ data from The Cancer Genome Atlas database, a four-gene signature including DHRS3, JRK, TARDBP and TTC3 was established. A risk score based on this gene signature was able to divide STS patients into a low-risk and a high-risk group. The latter had significantly worse overall survival (OS) and relapse free survival (RFS), and Cox regression analyses showed that the risk score is an independent prognostic factor. Nomograms containing the four-gene signature have also been established and have been verified through calibration curves. In addition, the predictive ability of this four-gene signature for STS metastasis free survival was verified in an independent cohort (309 STS patients from the Gene Expression Omnibus database). Finally, Gene Set Enrichment Analysis indicated that the four-gene signature may be related to some pathways associated with tumorigenesis, growth, and metastasis. In conclusion, our study establishes a novel four-gene signature and clinically feasible nomograms to predict the OS and RFS. This can help personalized treatment decisions, long-term patient management, and possible future development of targeted therapy.
Low Lymphocyte-to-Monocyte Ratio Is the Potential Indicator of Worse Overall Survival in Patients with Renal Cell Carcinoma and Venous Tumor Thrombus
Authors: Zapała Łukasz , Kunc Michał , Sharma Sumit , Biernat Wojciech , Radziszewski Piotr
Published: November 2021

The purpose of the study was to determine the influence of lymphocyte-to-monocyte ratio (LMR), platelet-to-lymphocyte ratio (PLR), and neutrophil-to-lymphocyte ratio (NLR) values on the prognosis in patients with renal cell carcinoma (RCC) and venous tumor thrombus. The respective data of 91 patients treated with radical surgery in the years 2012–2021 in 2 tertiary referral urological centers were retrieved from local medical databases. Mean calculated 3-year overall survival (OS) reached 70% (mean follow-up 35.3 months). The association between lower LMR and the presence of tumor necrosis (p = 0.0004) was observed. Amongst systemic inflammatory markers, only LMR was selected as the sensitive marker predicting death with a calculated cut-off value of 2.53. OS was decreased in patients presenting with low LMR when compared to the high LMR group (39% vs. 82%, p = 0.0011). Neither NLR nor PLR were associated with survival rates. In multivariate analysis, LMR was identified as the independent prognostic factor (HR = 0.20, 95% CI 0.07–0.55, p = 0.001). Low values of LMR (<2.53) are independently connected with poorer OS in patients with RCC and coexisting tumor thrombus. The incorporation of the hematological variables into the prognostic model greatly increased its accuracy in predicting survival in the distinctive subpopulation of patients with RCC.
Etching Patterns of Self-Etching Primers in Relation to Shear Bond Strength on Unground Enamel Samples
Authors: Brauchli Lorenz , Steineck Markus
Published: November 2021

It was the intention of the study to evaluate the etching effects of several self-etching primers on unground enamel and their relevance for shear bond strength testing. Seven self-etching primers (Clearfil SE, Futurabond NR, M-Bond, One Coat, Optibond, Transbond SEP+, Xeno III) and a conventional 35% phosphoric gel acid were applied to bovine incisors according to the manufacturer’s instructions. All specimens were analyzed by electron microscopy. A visual four-step grading was used for the characterization of the macroscopic (5000×) and microscopic (20,000×) etching patterns. In addition, shear bond strength for all the products was tested with an Instron 3344 after 1000 thermocycles between 5 °C and 55 °C. Statistical analysis was carried out using Kruskal–Wallis with Dunn’s post-test and Pearson’s correlation coefficient. Very strong etching patterns with well-defined prisms were found for the conventional etching, Transbond SEP+, and to a lesser degree, for Xeno III. Clearfil SE and Futurabond NR revealed moderate etching patterns, and M-Bond, One Coat, and Optibond revealed very weak etching patterns. The bond strength correlated well with the etching patterns. The highest shear strength was obtained with conventional etching and Transbond SEP+, followed by Clearfil SE. Moderate shear bond strengths were found for Xeno III, Futurabond NR, One Coat, and M-Bond, and the lowest were found with Optibond.
Role-Aware Information Spread in Online Social Networks
Authors: Bartal Alon , Jagodnik Kathleen M.
Published: November 2021

Understanding the complex process of information spread in online social networks (OSNs) enables the efficient maximization/minimization of the spread of useful/harmful information. Users assume various roles based on their behaviors while engaging with information in these OSNs. Recent reviews on information spread in OSNs have focused on algorithms and challenges for modeling the local node-to-node cascading paths of viral information. However, they neglected to analyze non-viral information with low reach size that can also spread globally beyond OSN edges (links) via non-neighbors through, for example, pushed information via content recommendation algorithms. Previous reviews have also not fully considered user roles in the spread of information. To address these gaps, we: (i) provide a comprehensive survey of the latest studies on role-aware information spread in OSNs, also addressing the different temporal spreading patterns of viral and non-viral information; (ii) survey modeling approaches that consider structural, non-structural, and hybrid features, and provide a taxonomy of these approaches; (iii) review software platforms for the analysis and visualization of role-aware information spread in OSNs; and (iv) describe how information spread models enable useful applications in OSNs such as detecting influential users. We conclude by highlighting future research directions for studying information spread in OSNs, accounting for dynamic user roles.
Assumption-Free Derivation of the Bell-Type Criteria of Contextuality/Nonlocality
Authors: Dzhafarov Ehtibar N.
Published: November 2021

Bell-type criteria of contextuality/nonlocality can be derived without any falsifiable assumptions, such as context-independent mapping (or local causality), free choice, or no-fine-tuning. This is achieved by deriving Bell-type criteria for inconsistently connected systems (i.e., those with disturbance/signaling), based on the generalized definition of contextuality in the contextuality-by-default approach, and then specializing these criteria to consistently connected systems.
Conditional Deep Gaussian Processes: Multi-Fidelity Kernel Learning
Authors: Lu Chi-Ken , Shafto Patrick
Published: November 2021

Deep Gaussian Processes (DGPs) were proposed as an expressive Bayesian model capable of a mathematically grounded estimation of uncertainty. The expressivity of DPGs results from not only the compositional character but the distribution propagation within the hierarchy. Recently, it was pointed out that the hierarchical structure of DGP well suited modeling the multi-fidelity regression, in which one is provided sparse observations with high precision and plenty of low fidelity observations. We propose the conditional DGP model in which the latent GPs are directly supported by the fixed lower fidelity data. Then the moment matching method is applied to approximate the marginal prior of conditional DGP with a GP. The obtained effective kernels are implicit functions of the lower-fidelity data, manifesting the expressivity contributed by distribution propagation within the hierarchy. The hyperparameters are learned via optimizing the approximate marginal likelihood. Experiments with synthetic and high dimensional data show comparable performance against other multi-fidelity regression methods, variational inference, and multi-output GP. We conclude that, with the low fidelity data and the hierarchical DGP structure, the effective kernel encodes the inductive bias for true function allowing the compositional freedom.
An Improved K-Means Algorithm Based on Evidence Distance
Authors: Zhu Ailin , Hua Zexi , Shi Yu , Tang Yongchuan , Miao Lingwei
Published: November 2021

The main influencing factors of the clustering effect of the k-means algorithm are the selection of the initial clustering center and the distance measurement between the sample points. The traditional k-mean algorithm uses Euclidean distance to measure the distance between sample points, thus it suffers from low differentiation of attributes between sample points and is prone to local optimal solutions. For this feature, this paper proposes an improved k-means algorithm based on evidence distance. Firstly, the attribute values of sample points are modelled as the basic probability assignment (BPA) of sample points. Then, the traditional Euclidean distance is replaced by the evidence distance for measuring the distance between sample points, and finally k-means clustering is carried out using UCI data. Experimental comparisons are made with the traditional k-means algorithm, the k-means algorithm based on the aggregation distance parameter, and the Gaussian mixture model. The experimental results show that the improved k-means algorithm based on evidence distance proposed in this paper has a better clustering effect and the convergence of the algorithm is also better.
School Middle Leaders and Change Management: Do They Need to Be More on the “Balcony” than the Dance Floor?
Authors: Gear Rebekah Charlotte , Sood Krishan Kumar
Published: November 2021

The term “middle leader” in the context of English education has evolved into an overarching title to describe a leadership position for practitioners who have school wide responsibilities in addition to their classroom duties. Such responsibilities can consist of pastoral leadership; curriculum leadership; leadership of additional student support; leadership of a team or phase and leadership of a specific school improvement priority. Educational middle leadership is founded on the notion of bringing together the duty of contributing to a strategic leadership remit whilst remaining firmly within the role of a classroom practitioner. It is argued that this ‘space’ for middle leadership is due to the increasingly hierarchical organisational structures of schools; consequently, being viewed as the ‘middle layer’. However, it is often unclear how much real authority or autonomy middle leaders have either to act strategically or make leadership decisions for their school. Despite many studies having previously explored the impact of senior leadership in improving school systems through deploying varied leadership styles, there is an absence in literature underpinning what constitutes effective strategic middle leadership. This study explored and interrogated the strategic ability of middle leadership, to contribute to this discourse. It critically reflected on the effectiveness of middle leadership, in a small-scale context, when making sustainable curriculum changes to a primary school’s maths curriculum. The research methodology adopted was an autoethnographic approach. It used a documentary method, that consisted of a reflective journal, kept by the first researcher, who was also a maths curriculum middle leader within an English primary school. The reflective journal was used as an authenticated document for elucidation and analysis. The main findings suggested that collective leadership was appropriate for this research context. The study further evidenced the reality of how personal, yet important understanding leadership cultures are, in all levels of leadership. The conclusion pointed to the direction of middle leaders being more successful if they were strategic, and therefore must both find and develop systems that assist them to be located on the “balcony” rather than only the dance floor.
A Review of Supercapacitors: Materials Design, Modification, and Applications
Authors: Yaseen Muhammad , Khattak Muhammad Arif Khan , Humayun Muhammad , Usman Muhammad , Shah Syed Shaheen , Bibi Shaista , Hasnain Bakhtiar Syed Ul , Ahmad Shah Masood , Khan Abbas , Shah Nasrullah , Tahir Asif Ali , Ullah Habib
Published: November 2021

Supercapacitors (SCs) have received much interest due to their enhanced electrochemical performance, superior cycling life, excellent specific power, and fast charging–discharging rate. The energy density of SCs is comparable to batteries; however, their power density and cyclability are higher by several orders of magnitude relative to batteries, making them a flexible and compromising energy storage alternative, provided a proper design and efficient materials are used. This review emphasizes various types of SCs, such as electrochemical double-layer capacitors, hybrid supercapacitors, and pseudo-supercapacitors. Furthermore, various synthesis strategies, including sol-gel, electro-polymerization, hydrothermal, co-precipitation, chemical vapor deposition, direct coating, vacuum filtration, de-alloying, microwave auxiliary, in situ polymerization, electro-spinning, silar, carbonization, dipping, and drying methods, are discussed. Furthermore, various functionalizations of SC electrode materials are summarized. In addition to their potential applications, brief insights into the recent advances and associated problems are provided, along with conclusions. This review is a noteworthy addition because of its simplicity and conciseness with regard to SCs, which can be helpful for researchers who are not directly involved in electrochemical energy storage.
How Does the World View China’s Carbon Policy? A Sentiment Analysis on Twitter Data
Authors: Xiang Ning , Wang Limao , Zhong Shuai , Zheng Chen , Wang Bo , Qu Qiushi
Published: November 2021

China has recently put forth an ambitious plan to achieve carbon peak around 2030 and carbon neutrality around 2060. However, there are quite a few differences regarding the public views about China’s carbon policy between the Chinese people and the people from other countries, especially concerning the doubt of foreign people about the fidelity of China’s carbon policy goals. Based on Twitter data related to China’s carbon policy topics from 2008 to 2020, this study shows the inter- and intra-annual trends in the count of tweets about China’s carbon policy, conducts sentiment analysis, extracts top frequency words from different attitudes, and analyzes the impact of China’s official Twitter accounts on the global view of China’s carbon policy. Our results show: (1) the global attention to China’s carbon policy gradually rises and occasionally rises suddenly due to important carbon events; (2) the proportion of Twitter users with negative sentiment about China’s carbon policy has increased rapidly and has exceeded the proportion of Twitter users with positive sentiment since 2019; (3) people in developing countries hold more positive or neutral attitudes towards China’s carbon policy, while developed countries hold more negative attitudes; (4) China’s official Twitter accounts serve to improve the global views on China’s carbon policy.
Non-Coaxially Rotating Motion in Casson Martial along with Temperature and Concentration Gradients via First-Order Chemical Reaction
Authors: Jabbar Noman , Hafeez Muhammad Bilal , Askar Sameh , Nazir Umar
Published: November 2021

The effect of non-coaxial rotation on the transport of mass subjected to first-order chemical reaction is studied analytically. The effects of thermal radiation, buoyancy, constructive and destructive chemical reactions along with Casson fluid in rotating frame are discussed. Time evolution of primary and secondary velocities, energy and solute particles are analyzed. The behavior of flow under the variation of intensity of magnetic field is also investigated. Evolutionary behavior of primary velocity is opposite to the evolutionary behavior of secondary velocity. The impact of buoyant force on primary velocity is opposite to the role of buoyant force on the secondary velocity. The evolutionary behavior of temperature is also examined and a remarkable enhancement in temperature is noticed. Thermal radiation causes the fluid to be cooled down as heat energy is escaped by thermal radiation. Evolutionary behavior of concentration is also analyzed and an increasing of concentration versus time is noted. Destructive chemical reaction results a remarkable reduction in the concentration and vice versa for generative chemical reaction.
Enhanced Short-Term Load Forecasting Using Artificial Neural Networks
Authors: Arvanitidis Athanasios Ioannis , Bargiotas Dimitrios , Daskalopulu Aspassia , Laitsos Vasileios M. , Tsoukalas Lefteri H.
Published: November 2021

The modernization and optimization of current power systems are the objectives of research and development in the energy sector, which is motivated by the ever-increasing electricity demands. The goal of such research and development is to render power electronic equipment more controllable, to ensure maximal use of current circuits, system flexibility and efficiency, as well as the relatively easy integration of renewable energy resources at all voltage levels. The current revolution in communication technologies and the Internet of Things (IoT) offers us an opportunity to supervise and regulate the power grid, in order to achieve more reliable, efficient, and cost-effective services. One of the most critical aspects of efficient power system operation is the ability to predict energy load requirements, i.e., load forecasting. Load forecasting is essential for balancing demand and supply and for determining electricity prices. Typically, load forecasting has been supported through the use of Artificial Neural Networks (ANNs), which, once trained on a set of data, can predict future loads. The accuracy of the ANNs’ prediction depends on the quality and availability of the training data. In this paper, we propose novel data pre-processing strategies, which we apply to the data used to train an ANN, and subsequently evaluate the quality of the predictions it produces, to demonstrate the benefits gained. The proposed strategies and the obtained results are illustrated using consumption data from the Greek interconnected power system.
Dead or Alive: Drivers of Wind Mortality Initiate Multiple Disturbance Regime in a Temperate Primeval Mountain Forest
Authors: Vašíčková Ivana , Šamonil Pavel , Kašpar Jakub , Román-Sánchez Andrea , Chuman Tomáš , Adam Dušan
Published: November 2021

The driving forces of tree mortality following wind disturbances of mountain mixed European temperate forests belongs among issues not comprehensively resolved. Hence, we aimed to elucidate the key factors of tree resistance to historical severe disturbance events in the Boubínský Primeval Forest, one of the oldest forest reserves in the Czech Republic. By using spatially explicit tree census, dendrochronological and soil data, we study spatial and temporal patterns of past disturbances and mathematically compared selected characteristics of neighboring trees that were killed by a severe storm in 2017 and those that remained undisturbed. The tendency of trees toward falling was primarily driven edaphically, limiting severe events non-randomly to previously disturbed sites occupied by hydromorphic soils and promoting the existence of two spatially-separated disturbance regimes. While disturbed trees usually recruited in gaps and experienced only one severe release event, surviving trees characteristically regenerated under the canopy and were repeatedly released. Despite the fact that disturbed trees tended to reach both lower ages and dimensions than survivors, they experienced significantly higher growth rates. Our study indicates that slow growth with several suppression periods emerged as the most effective tree strategy for withstanding severe windstorms, dying of senescence in overaged life stage. Despite the selective impact of the Herwart storm on conifer population, we did not find any difference in species sensitivity for most characteristics studied. We conclude that the presence of such ancient, high-density wood trees contributes significantly to the resistance of an entire stand to severe storms.
Growth Recovery and Phenological Responses of Juvenile Beech (Fagus sylvatica L.) Exposed to Spring Warming and Late Spring Frost
Authors: Vander Mijnsbrugge Kristine , Malanguis Jessa May , Moreels Stefaan , Lauwers Amy , Thomaes Arno , De Keersmaeker Luc , Vandekerkhove Kris
Published: November 2021

Global change increases the risk of extreme climatic events. The impact of extreme temperature may depend on the tree species and also on the provenance. Ten provenances of Fagus sylvatica L. were grown in a common garden environment in Belgium and subjected to different temperature treatments. Half of the one year old seedlings were submitted to a high thermal stress in the spring of the first year, and all plants were exposed to a late spring frost in the second year. The high-temperature treated plants displayed reduced growth in the first year, which was fully compensated (recovery with exact compensation) in the second year for radial growth and in the third year for height growth. Frost in the spring of the second year damaged part of the saplings and reduced their growth. The frost damaged plants regained the pre-stress growth rate one year later (recovery without compensation). The high temperature treatment in the first year and the frost damage in the second year clearly influenced the phenological responses in the year of the event and in the succeeding year. Little population differentiation was observed among the provenances for growth and for phenological responses. Yet, a southern provenance, a non-autochthonous provenance (original German provenance that was planted in Belgium about a century ago) and a more continental provenance flushed earlier than the local Atlantic provenances in the year of the frost event, resulting in more frost damage. Some caution should therefore be taken when translocating provenances as an anticipation of the predicted climate warming.
Stackelberg Population Dynamics: A Predictive-Sensitivity Approach
Authors: Mojica-Nava Eduardo , Ruiz Fredy
Published: November 2021

Hierarchical decision-making processes traditionally modeled as bilevel optimization problems are widespread in modern engineering and social systems. In this work, we deal with a leader with a population of followers in a hierarchical order of play. In general, this problem can be modeled as a leader–follower Stackelberg equilibrium problem using a mathematical program with equilibrium constraints. We propose two interconnected dynamical systems to dynamically solve a bilevel optimization problem between a leader and follower population in a single time scale by a predictive-sensitivity conditioning interconnection. For the leader’s optimization problem, we developed a gradient descent algorithm based on the total derivative, and for the followers’ optimization problem, we used the population dynamics framework to model a population of interacting strategic agents. We extended the concept of the Stackelberg population equilibrium to the differential Stackelberg population equilibrium for population dynamics. Theoretical guarantees for the stability of the proposed Stackelberg population learning dynamics are presented. Finally, a distributed energy resource coordination problem is solved via pricing dynamics based on the proposed approach. Some simulation experiments are presented to illustrate the effectiveness of the framework.
The Genetics of Inherited Cholestatic Disorders in Neonates and Infants: Evolving Challenges
Authors: Jeyaraj Rebecca , Bounford Kirsten McKay , Ruth Nicola , Lloyd Carla , MacDonald Fiona , Hendriksz Christian J. , Baumann Ulrich , Gissen Paul , Kelly Deirdre
Published: November 2021

Many inherited conditions cause cholestasis in the neonate or infant. Next-generation sequencing methods can facilitate a prompt diagnosis in some of these cases; application of these methods in patients with liver diseases of unknown cause has also uncovered novel gene-disease associations and improved our understanding of physiological bile secretion and flow. By helping to define the molecular basis of certain cholestatic disorders, these methods have also identified new targets for therapy as well patient subgroups more likely to benefit from specific therapies. At the same time, sequencing methods have presented new diagnostic challenges, such as the interpretation of single heterozygous genetic variants. This article discusses those challenges in the context of neonatal and infantile cholestasis, focusing on difficulties in predicting variant pathogenicity, the possibility of other causal variants not identified by the genetic screen used, and phenotypic variability among patients with variants in the same genes. A prospective, observational study performed between 2010–2013, which sequenced six important genes (ATP8B1, ABCB11, ABCB4, NPC1, NPC2 and SLC25A13) in an international cohort of 222 patients with infantile liver disease, is given as an example of potential benefits and challenges that clinicians could face having received a complex genetic result. Further studies including large cohorts of patients with paediatric liver disease are needed to clarify the spectrum of phenotypes associated with, as well as appropriate clinical response to, single heterozygous variants in cholestasis-associated genes.
An Elderly COVID-19 Patient with Community-Acquired Legionella and Mycoplasma Coinfections: A Rare Case Report
Authors: Alhuofie Sari T. S.
Published: November 2021

The combination of severe acute respiratory syndrome corona virus-2 (SARS-CoV-2) infection and other respiratory pathogens is a real challenge for health care systems in terms of diagnosis, treatment, and management. Most of the reported bacterial coinfections among SARS-CoV-2 patients are hospital-acquired infections that occurred after several days of hospitalization. Little is known about the incidence of community-acquired atypical bacterial coinfections with SARS-CoV-2. In this work, we report on a rare case of an elderly SARS-CoV-2 patient with underdiagnosed bacterial coinfections who received care in the medical ward for 23 days then was discharged home. Retrospective serological investigation revealed positivity for Legionella pneumophila and Mycoplasma pneumoniae, indicating double community-acquired atypical bacterial coinfections that were in agreement with clinical manifestations that patients showed at his admission to the hospital. Screening for possible community-acquired respiratory co-pathogens among elderly SARS-CoV-2 patients is critical for effective treatment and management.
Routines, Time Dedication and Habit Changes in Spanish Homes during the COVID-19 Lockdown. A Large Cross-Sectional Survey
Authors: Navas-Martín Miguel Ángel , López-Bueno José Antonio , Oteiza Ignacio , Cuerdo-Vilches Teresa
Published: November 2021

Many countries chose to establish social distancing as lockdowns after the COVID-19 outbreak. Households had to adapt their day-to-day lifestyles to new circumstances, affecting routines and time dedication to tasks. This national study was carried out to find out how the confinement by COVID-19 affected Spanish households on the perceived habit changes during this period, in relation to their socio-demographic characteristics and household composition. An online questionnaire was launched during the COVID-19 lockdown, from 30 April to 22 June 2020. Descriptive statistics were analyzed, stratified by gender, on time dedication, routine, home leaving, and habit change variables. Chi-square tests were used to explore the relations of significance with socio-demographic characteristics and home composition. All contrast analyses were performed for a 95% confidence level (significance considered for p < 0.05). In total, 1673 respondents participated from different age groups, educational level, employment status and household composition. Sixty percent of respondents maintained their routines. A third tried to establish a new one, being related to women, young people, not a university student, and living with others, including minors. Regarding dedication to tasks, adults aged 35–54 years, with more cohabitants, especially women, devoted themselves intensively to the home or to care, while those under 35 were dedicated more to rest, leisure, television or reading. People with university studies were more related to teleworking. The frequency of going outside was related to gender, age, educational level and living with elders, specifically for grocery shopping and taking out garbage. Changes in habits, routines and time dedication in confinement were strongly linked to the sociodemographic and coexistence conditions in Spanish homes. The greatest impacts were suffered by women, people with children, and adults between 35–54 years of age, especially on care and domestic chores.
Associations of Childcare Arrangements with Adiposity Measures in a Multi-Ethnic Asian Cohort: The GUSTO Study
Authors: Wong Beverly Wen-Xin , Toh Jia Ying , Sugianto Ray , Chia Airu , Tint Mya Thway , Yuan Wen Lun , Padmapriya Natarajan , Lança Carla , Saw Seang-Mei , Lee Yung Seng , Shek Lynette Pei-Chi , Tan Kok Hian , Yap Fabian , Godfrey Keith M. , Chong Yap-Seng , Müller-Riemenschneider Falk , Eriksson Johan G. , Chan Shiao-Yng , Chong Mary Foong-Fong
Published: November 2021

Childcare arrangements shape behavioural patterns that influence the risk of childhood obesity. However, little is known of its influence on childhood obesity in Singapore. We aim to examine the associations between childcare arrangements at the age of 5 years and childhood adiposity at age 6 years. Children from the GUSTO study were grouped into three childcare arrangements at age 5: full-time centre-based childcare (FC), partial centre-based with parental care (PCP), and partial centre-based with non-parents (grandparents and domestic helpers) as caregivers (PCN). Diet, physical activity and sedentary behaviour information were collected at age 5, while anthropometric measurements were collected at age 6. Associations were analysed using multivariable regression models. Among 540 children, those in PCN had higher BMI z-scores (β: 0.34; 95% CI: 0.01, 0.66), greater sum of skinfold thicknesses (mm) (β: 3.75; 95% CI: 0.53, 6.97) and were 3.55 times (95% CI: 1.78, 7.05) more likely to be overweight/obese than those in FC. Adiposity measures in PCP children did not differ from those in FC. PCN children were reported to have more screen time and greater fast-food intake. Children in PCN tended to have higher adiposity measures. Greater engagement of non-parental caregivers should be considered in interventions targeting child obesity.
A Peer-Based Educational Intervention Effects on SARS-CoV-2 Knowledge and Attitudes among Polish High-School Students
Authors: Ganczak Maria , Pasek Oskar , Duda-Duma Łukasz , Komorzycka Julia , Nowak Karol , Korzeń Marcin
Published: November 2021

To support high school students to develop knowledge they need to adhere to control measures during the pandemic, a peer-based educational intervention on SARS-CoV-2 was developed and its impact was evaluated. Multistage random sampling was used. The 50 min peer-based intervention was conducted by final year medical students. Baseline and post-intervention knowledge and attitudes were assessed. Significance was tested by McNemar’s/Wilcoxon rank tests. Of 518 participants (mean age 17.8 years ± 0.43), 81.0% did not receive any school-based education on SARS-CoV-2. After intervention, the knowledge score improved from 65.2% to 81.6%, attitudes from 63.2% to 70.8% (both p < 0.0001). The effect size after the intervention compared to pre-intervention showed moderate improvement of knowledge, but not attitudes (d = 0.46 and d = 0.18, respectively). Pre- and post-intervention, females, students in non-science programs, living in cities < 250,000 inhabitants had lower knowledge, while fewer males, non-science program students, living in smaller cities presented positive attitudes. Before intervention, 67.0% students correctly named SARS-CoV-2 preventive methods and 73.6% were concerned COVID-19 is a serious disease; these improved after intervention (to 80.1% and 86.3%; p < 0.0001). The intervention was not very successful in increasing the intent to vaccinate for COVID-19 (pre-intervention 52.9%, post-intervention 56.4%; p < 0.007). Peer-based teaching for high school students can be effective in increasing SARS-CoV-2 knowledge and awareness. More efforts are needed to improve attitudes and enhance acceptance of vaccination against COVID-19.
Exposure Worry: The Psychological Impact of Perceived Ionizing Radiation Exposure in British Nuclear Test Veterans
Authors: Collett George , Young William R. , Martin Wendy , Anderson Rhona M.
Published: November 2021

Potential psychological issues faced by British nuclear test veterans have been under-researched. This study assessed the prevalence of clinically relevant anxiety in British nuclear test veterans and aimed to explore experiences of worry and the broader psychological impact of the British nuclear weapons testing programme. The Geriatric Anxiety Inventory (Short-Form) was completed by 89 British nuclear test veterans (33.7% met the criteria for clinically relevant anxiety). Nineteen veterans then participated in semi-structured interviews. Thematic analysis of the data generated three themes. The first theme highlighted how worry was relevant only in a few cases (four) generally regarding their grandchildren’s health, but the guilt in those who perceive responsibility for family health conditions also appeared to be a pertinent issue. The second theme highlighted the anger towards authorities resulting from perceived negligence and deception. The third theme highlighted the relevance of how certain life events across the life course influence the potential psychological impact. This study suggests that guilt must be considered in (potentially) exposed individuals whose family members experience health conditions, which may exacerbate distress. It also suggests the importance that authorities ensure transparency when dealing with any radiological exposure scenario to reduce the potential for anger.
Remotely Supervised Exercise during the COVID-19 Pandemic versus in-Person-Supervised Exercise in Achieving Long-Term Adherence to a Healthy Lifestyle
Authors: García Pérez de Sevilla Guillermo , Barceló Guido Olga , De la Cruz María de la Paz , Fernández Ascensión Blanco , Alejo Lidia B. , Ramírez Goercke María Isabel , Pérez-Ruiz Margarita
Published: November 2021

The World Health Organization’s global action plan on workers’ health establishes that occupational health services should carry out lifestyle interventions within the workplace, to prevent the development of non-communicable diseases. The objective of the study was to compare adherence to a healthy lifestyle six months after completion of a multi-component intervention with remotely supervised physical activity during the COVID-19 pandemic versus a multi-component intervention with in-person supervised physical exercise before the COVID-19 pandemic in university employees with unhealthy habits and predisposed to change. A prospective cohort study following the “Strengthening the Reporting of Observational studies in Epidemiology” (STROBE) guidelines was conducted, with two arms. Each multi-component intervention lasted for 18 weeks, and consisted of education on healthy habits, Mediterranean Diet (MedDiet)-based workshops, and a physical exercise program. Twenty-one middle-aged sedentary university employees with poor adherence to the MedDiet completed the study. Six months after completion of the intervention, both groups increased physical activity levels, adherence to the MedDiet, eating habits, health-promoting lifestyle, health responsibility, and health-related quality of life. There were no differences between groups in any of the variables analyzed. Therefore, remotely supervised physical exercise could be adequate to achieve long-term adherence to a healthy lifestyle in the same way as conventional face-to-face intervention, at least in a population willing to change.
Seroprevalence of SARS-CoV-2 in a Large Cohort of Italian Police Officers
Authors: Garbarino Sergio , Domnich Alexander , Costa Elisabetta , Giberti Irene , Mosca Stefano , Belfiore Cristiano , Ciprani Fabrizio , Icardi Giancarlo
Published: November 2021

Certain professional categories are at a high occupational exposure to COVID-19. The aim of this survey was to quantify the seroprevalence of SARS-CoV-2 among police officers in Italy and identify its correlates. In this cross-sectional study, a nationally representative sample of State police employees was tested for IgG and IgM before the start of the National vaccination campaign. A total of 10,535 subjects (approximately 10% of the total workforce) participated in the study. The overall seroprevalence was 4.8% (95% CI: 4.4–5.3%). However, seropositivity was unevenly distributed across the country with a clear (p < 0.001) North–South gradient. In particular, the seroprevalence was 5.6 times higher in northern regions than in southern regions (9.0% vs. 1.6%). Most (71.2%) seropositive subjects reported having no recent symptoms potentially attributable to SARS-CoV-2 infection. Previous dysosmia, dysgeusia, and influenza-like illness symptoms were positive predictors of being seropositive. However, the prognostic value of dysosmia depended (p < 0.05) on both sex and prior influenza-like illness. The baseline seroprevalence of SARS-CoV-2 in police employees is considerable. A significant risk of occupational exposure, frequent asymptomatic cases and the progressive waning of neutralizing antibodies suggest that the police workers should be considered among the job categories prioritized for the booster COVID-19 vaccine dose.
Benchmarks for Needed Psychiatric Beds for the United States: A Test of a Predictive Analytics Model
Authors: Hudson Christopher G.
Published: November 2021

The ideal balanced mental health service system presupposes that planners can determine the need for various required services. The history of deinstitutionalization has shown that one of the most difficult such determinations involves the number of needed psychiatric beds for various localities. Historically, such assessments have been made on the basis of waiting and vacancy lists, expert estimates, or social indicator approaches that do not take into account local conditions. Specifically, this study aims to generate benchmarks or estimated rates of needed psychiatric beds for the 50 U.S. states by employing a predictive analytics methodology that uses nonlinear regression. Data used were secured primarily from the U.S. Census’ American Community Survey and from the Substance Abuse and Mental Health Administration. Key predictors used were indicators of community mental health (CMH) service coverage, mental health disability in the adult population, longevity from birth, and the percentage of the 15+ who were married in 2018. The model was then used to calculate predicted bed rates based on the ‘what-if’ assumption of an optimal level of CMH service availability. The final model revealed an overall rate of needed beds of 34.9 per 100,000 population, or between 28.1 and 41.7. In total, 32% of the states provide inpatient psychiatric care at a level less than the estimated need; 28% at a level in excess of the need; with the remainder at a level within 95% confidence limits of the estimated need. These projections are in the low range of prior estimates, ranging from 33.8 to 64.1 since the 1980s. The study demonstrates the possibility of using predictive analytics to generate individualized estimates for a variety of service modalities for a range of localities.
Interactions with Arsenic: Mechanisms of Toxicity and Cellular Resistance in Eukaryotic Microorganisms
Authors: De Francisco Patricia , Martín-González Ana , Rodriguez-Martín Daniel , Díaz Silvia
Published: November 2021

Arsenic (As) is quite an abundant metalloid, with ancient origin and ubiquitous distribution, which represents a severe environmental risk and a global problem for public health. Microbial exposure to As compounds in the environment has happened since the beginning of time. Selective pressure has induced the evolution of various genetic systems conferring useful capacities in many microorganisms to detoxify and even use arsenic, as an energy source. This review summarizes the microbial impact of the As biogeochemical cycle. Moreover, the poorly known adverse effects of this element on eukaryotic microbes, as well as the As uptake and detoxification mechanisms developed by yeast and protists, are discussed. Finally, an outlook of As microbial remediation makes evident the knowledge gaps and the necessity of new approaches to mitigate this environmental challenge.
A Phenylfurocoumarin Derivative Reverses ABCG2-Mediated Multidrug Resistance In Vitro and In Vivo
Authors: Kokubo Shoji , Ohnuma Shinobu , Murakami Megumi , Kikuchi Haruhisa , Funayama Shota , Suzuki Hideyuki , Kajiwara Taiki , Yamamura Akihiro , Karasawa Hideaki , Sugisawa Norihiko , Ohsawa Kosuke , Kano Kuniyuki , Aoki Junken , Doi Takayuki , Naitoh Takeshi , Ambudkar Suresh V. , Unno Michiaki
Published: November 2021

The ATP-binding cassette subfamily G member 2 (ABCG2) transporter is involved in the development of multidrug resistance in cancer patients. Many inhibitors of ABCG2 have been reported to enhance the chemosensitivity of cancer cells. However, none of these inhibitors are being used clinically. The aim of this study was to identify novel ABCG2 inhibitors by high-throughput screening of a chemical library. Among the 5812 compounds in the library, 23 compounds were selected in the first screening, using a fluorescent plate reader-based pheophorbide a (PhA) efflux assay. Thereafter, to validate these compounds, a flow cytometry-based PhA efflux assay was performed and 16 compounds were identified as potential inhibitors. A cytotoxic assay was then performed to assess the effect these 16 compounds had on ABCG2-mediated chemosensitivity. We found that the phenylfurocoumarin derivative (R)-9-(3,4-dimethoxyphenyl)-4-((3,3-dimethyloxiran-2-yl)methoxy)-7H-furo [3,2-g]chromen-7-one (PFC) significantly decreased the IC50 of SN-38 in HCT-116/BCRP colon cancer cells. In addition, PFC stimulated ABCG2-mediated ATP hydrolysis, suggesting that this compound interacts with the substrate-binding site of ABCG2. Furthermore, PFC reversed the resistance to irinotecan without causing toxicity in the ABCG2-overexpressing HCT-116/BCRP cell xenograft mouse model. In conclusion, PFC is a novel inhibitor of ABCG2 and has promise as a therapeutic to overcome ABCG2-mediated MDR, to improve the efficiency of cancer chemotherapy.
Therapeutic Advances in Gut Microbiome Modulation in Patients with Inflammatory Bowel Disease from Pediatrics to Adulthood
Authors: Eindor-Abarbanel Adi , Healey Genelle R. , Jacobson Kevan
Published: November 2021

There is mounting evidence that the gut microbiota plays an important role in the pathogenesis of inflammatory bowel disease (IBD). For the past decade, high throughput sequencing-based gut microbiome research has identified characteristic shifts in the composition of the intestinal microbiota in patients with IBD, suggesting that IBD results from alterations in the interactions between intestinal microbes and the host’s mucosal immune system. These studies have been the impetus for the development of new therapeutic approaches targeting the gut microbiome, such as nutritional therapies, probiotics, fecal microbiota transplant and beneficial metabolic derivatives. Innovative technologies can further our understanding of the role the microbiome plays as well as help to evaluate how the different approaches in microbiome modulation impact clinical responses in adult and pediatric patients. In this review, we highlight important microbiome studies in patients with IBD and their response to different microbiome modulation therapies, and describe the differences in therapeutic response between pediatric and adult patient cohorts.