bluuebunny/crossref_metadata_2025 huggingface dataset:
Thermal Spike Responses and Structure Evolutions in Lithium Niobate on Insulator (LNOI) under Swift Ion Irradiation
Authors: Han Xinqing , Liu Cong , Zhang Meng , Huang Qing , Wang Xuelin , Liu Peng
Published: July 2022

Irradiating solid materials with energetic ions are extensively used to explore the evolution of structural damage and specific properties in structural and functional materials under natural and artificial radiation environments. Lithium niobate on insulator (LNOI) technology is revolutionizing the lithium niobate industry and has been widely applied in various fields of photonics, electronics, optoelectronics, etc. Based on 30 MeV 35Cl and 40Ar ion irradiation, thermal spike responses and microstructure evolution of LNOI under the action of extreme electronic energy loss are discussed in detail. Combining experimental transmission electron microscopy characterizations with numerical calculations of the inelastic thermal spike model, discontinuous and continuous tracks with a lattice disorder structure in the crystalline LiNbO3 layer and recrystallization in the amorphous SiO2 layer are confirmed, and the ionization process via energetic ion irradiation is demonstrated to inherently connect energy exchange and temperature evolution processes in the electron and lattice subsystems of LNOI. According to Rutherford backscattering/channeling spectrometry and the direct impact model, the calculated track damage cross–section is further verified, coinciding with the experimental observations, and the LiNbO3 layer with a thickness of several hundred nanometers presents track damage behavior similar to that of bulk LiNbO3. Systematic research into the damage responses of LNOI is conducive to better understanding and predicting radiation effects in multilayer thin film materials under extreme radiation environments, as well as to designing novel multifunctional devices.
Technical Performance, Overall Accuracy and Complications of EUS-Guided Interventional Procedures: A Dynamic Landscape
Authors: Cherciu Harbiyeli Irina Florina , Constantin Alina , Cazacu Irina Mihaela , Burtea Daniela Elena , Gheorghe Elena Codruța , Popescu Carmen Florina , Bejinariu Nona , Georgescu Claudia Valentina , Pirici Daniel , Ungureanu Bogdan Silviu , Copăescu Cătălin , Săftoiu Adrian
Published: July 2022

Endoscopic ultrasound (EUS) gained wide acceptance as the diagnostic and minimally invasive therapeutic approach for intra-luminal and extraluminal gastrointestinal, as well as various non-gastrointestinal lesions. Since its introduction, EUS has undergone substantial technological advances. This multi-centric study is a retrospective analysis of a prospectively maintained database of patients who underwent EUS for the evaluation of lesions located within the gastrointestinal tract and the proximal organs. It aimed to extensively assess in dynamic the dual-center EUS experience over the course of the past 20 years. Hence, we performed a population study and an overall assessment of the EUS procedures. The performance of EUS-FNA/FNB in diagnosing pancreatic neoplasms was evaluated. We also investigated the contribution of associating contrast-enhanced ultrasound imaging (CE-EUS) with EUS-FNA/FNB for differentiating solid pancreatic lesions or cystic pancreatic lesions. A total of 2935 patients undergoing EUS between 2002–2021 were included, out of which 1880 were diagnostic EUS and 1052 EUS-FNA/FNB (80% FNA and 20% FNB). Therapeutic procedures performed included endoscopic transmural drainage of pancreatic fluid collections, celiac plexus block and neurolysis, while diagnostic EUS-like CE-EUS (20%) and real-time elastography (12%) were also conducted. Most complications occurred during the first 7 days after EUS-FNA/FNB or pseudocyst drainage. EUS and the additional tools have high technical success rates and low rates of complications. The EUS methods are safe, cost effective and indispensable for the diagnostic or therapeutic management in gastroenterological everyday practice.
Current Undergraduate Dental Implantology Teaching in UK
Authors: Hare Arminder , Bird Samantha , Wright Simon , Ucer Cemal , Khan Rabia Sannam
Published: July 2022

Dental Implants are a popular treatment option for tooth replacement, with documented long-term success and survival rates of more than 95% over a period of 10 years. However, incorporating dental implantology into an undergraduate dental curriculum has issues associated. Therefore, the aim of this research was to examine and evaluate current undergraduate dental implantology education in the UK, investigate the amount of time allocated to this subject and analyse the barriers that are currently impeding the development of the programmes. An online questionnaire hosted by Online Surveys was designed, piloted, and sent to 16 dental schools providing undergraduate education in the UK. Ethical approval was gained from The University of Salford to conduct the study. Out of the 16 dental schools contacted, eight questionnaire responses were received, hence a response rate of 50% was achieved. The hours dedicated to the implant teaching programme varied from 3 h to 25 h, with a mean average of 11 h. It was identified from the results that no teaching of dental implantology was conducted in year 2; 12% of the schools responded that the subject was taught in year 1, 37% in year 3, 75% in year 4 and 50% in year 5. The methods used to deliver the programme were mainly lecture-based teaching, with only one dental school allowing students to place implants on patients. The main barriers to progression of the programme were financial (75%), followed by time limitations imposed by the curriculum (37%) and liability insurance (37%). However, there appears to be a consensus that further training beyond bachelor’s degree level is required to teach implantology effectively.
Tooth Agenesis Patterns in Orofacial Clefting Using Tooth Agenesis Code: A Meta-Analysis
Authors: Howe Brian J. , Pendleton Chandler , Withanage Miyuraj Harishchandra Hikkaduwa , Childs Christopher A. , Zeng Erliang , van Wijk Arjen , Hermus Ruurd , Padilla Carmencita , Hecht Jacqueline T. , Poletta Fernando A. , Orioli Iêda M. , Buxó-Martínez Carmen J. , Deleyiannis Frederic , Vieira Alexandre R. , Butali Azeez , Valencia-Ramirez Consuelo , Restrepo Muñeton Claudia , Wehby George L. , Weinberg Seth M. , Marazita Mary L. , Moreno Uribe Lina M. , Xie Xian-Jin
Published: July 2022

Individuals with orofacial clefting (OFC) have a higher prevalence of tooth agenesis (TA) overall. Neither the precise etiology of TA, nor whether TA occurs in patterns that differ by gender or cleft type is yet known. This meta-analysis aims to identify the spectrum of tooth agenesis patterns in subjects with non-syndromic OFC and controls using the Tooth Agenesis Code (TAC) program. An indexed search of databases (PubMed, EMBASE, and CINAHL) along with cross-referencing and hand searches were completed from May to June 2019 and re-run in February 2022. Additionally, unpublished TAC data from 914 individuals with OFC and 932 controls were included. TAC pattern frequencies per study were analyzed using a random effects meta-analysis model. A thorough review of 45 records retrieved resulted in 4 articles meeting eligibility criteria, comprising 2182 subjects with OFC and 3171 controls. No TA (0.0.0.0) was seen in 51% of OFC cases and 97% of controls. TAC patterns 0.2.0.0, 2.0.0.0, and 2.2.0.0 indicating uni- or bi-lateral missing upper laterals, and 16.0.0.0 indicating missing upper right second premolar, were more common in subjects with OFC. Subjects with OFC have unique TA patterns and defining these patterns will help increase our understanding of the complex etiology underlying TA.
Precision Measurement System of High-Frequency Signal Based on Equivalent-Time Sampling
Authors: Zang Xiaoxuan , Zhao Jianting , Lu Yunfeng , He Qing
Published: July 2022

A high frequency periodic signal measurement system based on equivalent sampling method is developed. A high-speed sampling voltage tracking circuit, the core component of the system, is described in detail. The circuit can transform the amplitude corresponding to different phase points of the signal undertest into the equivalent DC level through successive approximation of multiple periods. The measurement system designed in this paper completes digital sampling with high accuracy only by connecting the low-cost voltage tracking circuit to the existing commercial instruments, such as two-channel waveform generator and high-precision digital multimeter, which makes the method easy to be generalized. The special structure of the sampling tracking circuit greatly reduces the influence of random noise and time jitter on the measurement results. The experimental results show that the non-linearity error of the system is as low as 0.002%, the bandwidth can reach 200 MHz, and the uncertainty of measuring the RMS of AC voltage with peak value of ±1 V and frequency of 10 kHz, 100 kHz and 1 MHz can reach 2.8 × 10−4 V, 4.6 × 10−4 V and 2.0 × 10−4 V (k = 2), respectively.
Signals Recognition by CNN Based on Attention Mechanism
Authors: Tian Feng , Wang Li , Xia Meng
Published: July 2022

Automatic modulation recognition is a key technology in non-collaborative communication. However, it is affected by complex electromagnetic environments, leading to low recognition accuracy. To address this problem, this paper develops a ResNext signal recognition model based on an attention mechanism. Firstly, a channel, including additive Gaussian white noise (AWGN), Rician multipath fading, and clock offset, is created to simulate the complex electromagnetic environment, and transmission-impaired modulated signals with various signal-to-noise ratios (SNRs) are synthesized as a dataset. Secondly, using parallel stacked residual blocks of the same topology, instead of the residual blocks of ResNet, and introducing the attention layer (CBAM), the types of feature extraction are enriched without significantly increasing the parameter order of magnitude and avoiding the over-fitting phenomenon caused by depth deepening. The results show that the signal recognition method, based on the improved neural network framework, outperformed other deep learning methods, and the recognition rate obtained of 10 different modulation types of signals was above 90% at SNRs greater than 0 dB. The proposed signal recognition method achieved accurate recognition in complex electromagnetic environments.
Exploring the Optimal Feature Combination of Tree Species Classification by Fusing Multi-Feature and Multi-Temporal Sentinel-2 Data in Changbai Mountain
Authors: Wang Mingchang , Li Mingjie , Wang Fengyan , Ji Xue
Published: July 2022

Tree species classification is crucial for forest resource investigation and management. Remote sensing images can provide monitoring information on the spatial distribution of tree species and multi-feature fusion can improve the classification accuracy of tree species. However, different features will play their own unique role. Therefore, considering various related factors about the growth of tree species such as spectrum information, texture structure, vegetation phenology, and topography environment, we fused multi-feature and multi-temporal Sentinel-2 data, which combines spectral features with three other types of features. We combined different feature-combinations with the random forest method to classify Changbai Mountain tree species. Results indicate that topographic features participate in tree species classification with higher accuracy and more efficiency than phenological features and texture features, and the elevation factor possesses the highest importance through the Mean Decrease in Gini (MDG) method. Finally, we estimated the area of the target tree species and analyzed the spatial distribution characteristics by overlay analysis of the Classification 3 result and topographic features (elevation, slope, and aspect). Our findings emphasize that topographic factors have a great influence on the distribution of forest resources and provide the basis for forest resource investigation.
Metabolic Profiling of Bulgarian Potato Cultivars
Authors: Tomlekova Nasya , Mladenov Petko , Dincheva Ivayla , Nacheva Emilya
Published: July 2022

Potatoes (Solanum tuberosum L.) are the fourth most economically important crop in the world. They have a short period of vegetation and are an excellent source of carbohydrates, amino acids, vitamins, organic acids, minerals and phenolics as antioxidant substances. Potato can be a major dietary source of various bioactive compounds. In this study, we applied gas chromatography coupled with mass spectrometry (GC-MS) metabolite profiling to classify eight Bulgarian potato cultivars bred in the Maritsa Vegetable Crops Research Institute (VCRI), Plovdiv, according to their metabolite contents. Altogether, we determine their flavonoids/phenolics to evaluate their nutritive quality for the breeding program with the target of determining strong health-promoting compounds. The “Kalina” cultivar is highlighted as the best one with the highest number of metabolites, containing 14 out of the 26 evaluated; it was selected as the highest-quality cultivar, compared with the other seven cultivars studied. According to the grouping of the cultivars in principal component analysis PCA, their positive distribution is explained mainly by them having the highest contents of aminobutyric and isocitric acids, methionine and alanine and lower levels of fumaric acid, pyroglutamic acid and glycine, in contrast to the cultivars distributed negatively, which had high contents of carbohydrates and relatively low contents of most of the amino acids. The highest number of amino acids was found in the cultivar “Kalina”, followed by “Perun” and “Bor”. The highest number of carbohydrates was found in “Pavelsko” and “Iverce”, while the prominent accumulation of organic acids was found in “Kalina”, “Bor” and “Rozhen”. The highest number of flavonoids in the flesh of the tubers was found in the cultivars “Nadezhda” and “Pavelsko”, followed by “Bor”. The highest ratio of flavonoids/phenolics in the flesh was found in “Pavelsko” and in “Nadezhda”, followed by “Iverce”.
Role of Short Chain Fatty Acids to Counteract Inflammatory Stress and Mucus Production in Human Intestinal HT29-MTX-E12 Cells
Authors: Giromini Carlotta , Baldi Antonella , Rebucci Raffaella , Lanzoni Davide , Policardi Martina , Sundaram Tamil selvi , Purup Stig
Published: July 2022

Short chain fatty acids (SCFAs), especially butyrate (BUT), are known to promote intestinal health, but their role in the protection of intestinal barrier integrity is poorly characterized. The aim of the study was to set up an in vitro model of human colon epithelium using HT29-MTX-E12 cells to delineate the potential role of SCFAs under stress conditions. Accordingly, the HT29-MTX-E12 cells were differentiated for 42 days and subsequently exposed to dextran sulphate sodium (DSS). Further, the effects of BUT or its mixture with acetate and propionate (SCFAs-MIX) were tested to study proliferation, epithelial integrity and mucus production. The results showed that the concentration of 10% DSS for 24 h decreased the TEER about 50% compared to the control in HT29-MTX-E12 cells. The pre-treatment on HT29-MTX-E12 cells with BUT or SCFAs-MIX at specific concentrations significantly (p < 0.05) reduced the DSS-induced damage on epithelial cell integrity and permeability. Further, the treatment with specific concentrations of BUT and SCFAs-MIX for 24 h significantly promoted ZO-1, MUC2 and MUC5AC mRNA expression (p < 0.005). The present study demonstrated the suitability of HT29-MTX-E12 cells treated with DSS as an in vitro stress model of inflammatory bowel disease, which enabled us to understand the effect of bioactive SCFAs on the intestinal barrier.
The Effect of Partial Substitution of Beef Tallow on Selected Physicochemical Properties, Fatty Acid Profile and PAH Content of Grilled Beef Burgers
Authors: Onopiuk Anna , Kołodziejczak Klaudia , Szpicer Arkadiusz , Marcinkowska-Lesiak Monika , Wojtasik-Kalinowska Iwona , Stelmasiak Adrian , Poltorak Andrzej
Published: July 2022

The objective of this study was to analyze the impact of partial replacement of beef tallow with sunflower, canola, linseed, olive oil and milk fat on physical properties, oxidation stability, fatty acid profile and PAHs (polycyclic aromatic hydrocarbons) content of beef burgers. Studies have shown a strong relationship between the fatty acid profile and the PAH content (especially of the heavy PAHs). The partial replacement of beef tallow with oils and milk fat (MF) contributed to a change in the fatty acid profile and a reduction in the hardness of the burgers. The highest PAH content was found in samples with canola oil (CO), which had the highest levels of monounsaturated fatty acids (MUFA), and in the control group (CON) without fat substitution, which had the highest levels of saturated fatty acids (SFA) and trans conformations. Substitution of animal fat with vegetable oils contributed to a change in the color of the burgers’ surface, as there was a statistically significant increase in the L* color component and a decrease in the a* component. The burgers with canola oil (CO) and linseed oil (LO) were the most susceptible to oxidation, whereas the burgers with reduced fat content (CON_LOW FAT) were the most stable in terms of oxidation, where the malondialdehyde (MDA) content was 32.8% lower compared with the control group (CON). The studies confirm that partial replacement of beef tallow with vegetable oils and milk fat and reduction in fat content in burgers to be grilled can be an effective way to change their fatty acid profile and reduce the cyclization reaction of organic compounds leading to the formation of PAH. Correlation coefficient analysis showed that there is a relationship between fatty acid profile and the presence of selected PAHs in grilled beef burgers. The results of this study indicate that replacing beef tallow with vegetable oils is a promising approach in designing meat products with controlled PAH content.
Food-Grade Microencapsulation Systems to Improve Protection of the Epigallocatechin Gallate
Authors: Ralaivao Mathis , Lucas Jade , Rocha Fernando , Estevinho Berta N.
Published: July 2022

Epigallocatechin gallate (EGCG) is a catechin and one of the most abundant polyphenols in green tea, and it is under research for its potential benefit to human health and for its potential to be used in disease treatments, such as for cancer. However, the effectiveness of polyphenols depends on preserving their bioactivity, stability, and bioavailability. The EGCG was microencapsulated by a spray-drying process, using different biopolymers as encapsulating agents (gum arabic, modified chitosan and sodium alginate), in order to overcome some of the limitations of this compound. The microparticles showed a diameter around 4.22 to 41.55 µm (distribution in volume) and different morphologies and surfaces, depending on the encapsulating agent used. The EGCG release was total, and it was achieved in less than 21 min for all the formulations tested. The EGCG encapsulation efficiency ranged between 78.5 and 100.0%. The release profiles were simulated and evaluated using three kinetic models: Korsmeyer–Peppas (R2: 0.739–0.990), Weibull (R2: 0.963–0.994) and Baker–Lonsdale (R2: 0.746–0.993). The Weibull model was the model that better adjusted to the experimental EGCG release values. This study proves the success of the EGCG microencapsulation, using the spray-drying technique, opening the possibility to insert dried EGCG microparticles in different food and nutraceutical products.
Ice-Template Crosslinked PVA Aerogels Modified with Tannic Acid and Sodium Alginate
Authors: De la Cruz Lucía G. , Abt Tobias , León Noel , Wang Liang , Sánchez-Soto Miguel
Published: July 2022

With the commitment to reducing environmental impact, bio-based and biodegradable aerogels may be one approach when looking for greener solutions with similar attributes to current foam-like materials. This study aimed to enhance the mechanical, thermal, and flame-retardant behavior of poly(vinyl alcohol) (PVA) aerogels by adding sodium alginate (SA) and tannic acid (TA). Aerogels were obtained by freeze-drying and post-ion crosslinking through calcium chloride (CaCl2) and boric acid (H3BO3) solutions. The incorporation of TA and SA enhanced the PVA aerogel’s mechanical properties, as shown by their high compressive specific moduli, reaching up to a six-fold increase after crosslinking and drying. The PVA/TA/SA aerogels presented a thermal conductivity of 0.043 to 0.046 W/m·K, while crosslinked ones showed higher values (0.049 to 0.060 W/m·K). Under TGA pyrolytic conditions, char layer formation reduced the thermal degradation rate of samples. After crosslinking, a seven-fold decrease in the thermal degradation rate was observed, confirming the high thermal stability of the formed foams. Regarding flammability, aerogels were tested through cone calorimetry. PVA/TA/SA aerogels showed a significant drop in the main parameters, such as the heat release rate (HRR) and the fire growth (FIGRA). The ion crosslinking resulted in a further reduction, confirming the improvement in the fire resistance of the modified compositions.
Rock Magnetism of Lapilli and Lava Flows from Cumbre Vieja Volcano, 2021 Eruption (La Palma, Canary Islands): Initial Reports
Authors: Parés Josep M. , Vernet Eva , Calvo-Rathert Manuel , Soler Vicente , Bógalo María-Felicidad , Álvaro Ana
Published: July 2022

We present initial rock magnetic results for both lava flows and lapilli produced by the 2021 eruption of the Cumbre Vieja, La Palma (Canary Islands). Samples were taken during the eruption to minimize early alteration and weathering of the rocks and tephra. Standard procedures included progressive alternating field and thermal demagnetization, hysteresis curves, thermomagnetic experiments, progressive acquisition of isothermal remanent magnetization (IRM), and First-Order Reversal Curves (FORCs). Overall, our observations, including low to medium unblocking temperatures, isothermal remanent magnetization to 1 Tesla, and the abundance of wasp-waist hysteresis loops, strongly suggest the presence of Ti-rich titanomagnetites as the main remanence carriers in both lava flows and lapilli, in addition to some hematite as well. Whereas the former has been directly seen (SEM), hematite is elusive with nonmagnetic-based methods. Rock magnetic data, on a Day plot, also reveal that the magnetic grain size tends to be larger in the lava flows than in the lapilli.
Implementation and Acceptance of Information and Communication Technology Incorporated into Long-Term Care
Authors: Chiang Yi-Cheng , Hsieh Yin-Chia , Wu Fan
Published: July 2022

Every country in the world is facing serious demographic aging, since the average life expectancy is consistently increasing. Agencies involved in the implementation of caregiving through long-term care institutions can develop more convenient approaches using information and communication technology to enhance overall efficiency. Communication technology has enabled the strengthening of physiological instruments, improving the efficiency and quality of services, while integrating management systems for optimum efficiency. This work conducted empirical studies, collecting responses to questionnaires from residents and caregivers in five institutions located in the south of Taiwan. The PZB model, proposed by Parasuraman, Zeithaml, and Berry, was used to construct the questionnaire to analyze the service quality following the incorporation of information and communication technology. The results of the empirical study show that 34% and 63% of the relatives of the residents agreed and strongly agreed that the system was practical and convenient, respectively. As for the caregivers, 77% of them agreed or strongly agreed that the system was mobile, practical, and convenient, and they agreed that the system could significantly increase working efficiency, reduce waiting time, and improve administration for chronic diseases among care-home residents.
Max Weber and the End of the ‘Metaphysics of State’
Authors: Adair-Toteff Christopher
Published: July 2022

Max Weber ended the metaphysics of the state just as Nietzsche had ended the meta-physics of being. However, Weber was building on the theories of the historian Heinrich von Treitschke and the constitutional scholar Georg Jellinek. Weber replaced Jellinek’s legal formalism and Treitschke’s nationalism with a new type of politics. This was the politics of responsibility, which eliminated the metaphysical concept of the state and was replaced by a dynamic approach to legitimate political leadership.
Development and Validation of the Mexican Public Open Spaces Tool (MexPOS)
Authors: Medina Catalina , Hernández Annel , Hermosillo-Gallardo Maria E. , Gómez Gámez Célida I. , Resendiz Eugen , Morales Maricruz , Nieto Claudia , Moreno Mildred , Barquera Simón
Published: July 2022

Public open spaces (POS) are “publicly owned spaces such as parks, green areas, squares, marketplaces, streets and highways which are of public access”. Some attributes could increase or decrease participants’ attendance. Thus, reliable and valid audit tools are needed in order to measure these attributes. This study aimed to develop and validate a tool to assess POS features within the Mexico City context. The Mexican Public Open Spaces Tool (MexPOS) was developed based on (1) two validated POS audit tools, (2) several visits to the POS, (3) pilot testing, and (4) multiple work sessions with a group of specialists. The original tool included 181 items divided into nine sections. Trained personnel visited and evaluated 944 POS in Mexico City. An exploratory factor analysis was performed to examine the construct validity of the items and the relationship between the subscales. The final model resulted in seven factors: (1) Food and Wellness Environment (α = 0.15), (2) Maintenance (α = 0.81), (3) Amenities (α = 0.72), (4) Legibility (α = 0.59), (5) Security (α = 0.48), (6) Perceived Environment (α = 0.65), and (7) Urban Environment (α = 0.58). Our study highlights the relevance of using a validated tool to measure POS characteristics related to participants’ attendance to help assess infrastructure improvements and identify priority areas for changing socio-urban environments for physical activity.
Detection and Concentration of Neonicotinoids and Other Pesticides in Honey from Honey Bee Colonies Located in Regions That Differ in Agricultural Practices: Implications for Human and Bee Health
Authors: Ponce-Vejar Gilda , Ramos de Robles S. Lizette , Macias-Macias José Octavio , Petukhova Tatiana , Guzman-Novoa Ernesto
Published: July 2022

This is a preliminary study conducted to analyze the presence and concentration of pesticides in honey obtained from honey bee colonies located in two regions with managed ecosystems that differ in the intensity and technification of agricultural practices. Fourteen pesticides at variable concentrations were detected in 63% of the samples analyzed. The pesticides most frequently found at higher concentrations were insecticides (neonicotinoids, followed by organophosphates), herbicides, and fungicides. The number, frequency, and concentration of pesticides were higher in samples collected from hives located where intensive and highly-technified agriculture is practiced. Forty-three percent of the samples from that zone had residues of imidacloprid, compared with only 13% of the samples from the less-technified zone. Furthermore, 87.5% of those samples had imidacloprid concentrations that were above sublethal doses for honey bees (>0.25 ng/g) but that are not considered hazardous to human health by the European Commission. The results of this study suggest that honey can be used as a bioindicator of environmental contamination by pesticides, which highlights the need to continue monitoring contaminants in this product to determine the risks of pesticide impacts on pollinator health, on ecosystems, and on their potential implications to human health and other non-target organisms.
An In Toto Approach to Radon Dispersion Modelling from a South African Gold Mine Tailings
Authors: Komati Frank , Ntwaeaborwa Martin , Strydom Rian
Published: July 2022

The USA Environmental Protection Agency’s (EPA) Industrial Source Complex Short Term 3 (ISCST3) dispersion modelling code was used to evaluate radon transport and the effects of local variations around tailings dam using a Gaussian plume model. The tailings dam was modelled as point, flat ground and top level, total emitting surface area (true geometry) and volume source geometries. The true area geometry was considered as the baseline source geometry. To improve the accuracy of the model predictions as compared to traditional approaches, the true geometry area source term was corrected to account for cracks and fissures on the tailings and the geometry of tailings dam was modelled by considering all emitting surfaces as sources. Compared to the baseline, the model overpredicted the flat ground area source by up to 274% and underpredicted the top-level area source by up to 50%. The volume emission source was overpredicted by up to 300% in 60% of the modelling runs and underpredicted by 55% in 40% of the volume model runs. While the top-level area source term produced lower concentrations at near-field ground-level receptors, accounting for the wakes effect increased the radon concentrations from the top-level area source of the tailings dam by up to 239%. From the modelling results, the highest concentration predicted by the model from the true geometry source was found to be 0.843 Bq m−3, which corresponds to the dose of 0.012 mSv/y to the public due to radon from the tailings. This value is less than the 1 mSv/y dose constraint stipulated by the National Nuclear Regulator.
A Qualitative Study on the Position and Role of Volunteers in Integrated Care—An Example of Palliative Care in Croatia
Authors: Vočanec Dorja , Lončarek Karmen , Banadinović Maja , Sović Slavica , Džakula Aleksandar
Published: July 2022

Volunteers have been present in palliative care since its inception. With the development of palliative care systems, their role and position are changing. Given growing long-term care needs and limited resources in health and social care, volunteers are becoming an important resource in meeting these needs. In Croatia, palliative care has been developing as an integrated care model since 2014. To assess the position and the role of volunteers, we analyzed legislative documents from healthcare and social care and conducted a focus group with volunteers in palliative care. We found that volunteers provide support from the social aspect of care, for the patient and the family. The formal palliative care system involves them as partners in the provision of care, even though this cooperation is informal. The main determinants of their activities are an individualized approach, flexibility, a community presence, and project funding. In conclusion, these determinants allow them to react quickly to identified needs, but with them come some uncertainties of their sustainability. Their activities could indicate what needs to be integrated between health and social care and in what areas. Volunteers both fill in gaps in the system and are ahead of the system, and by doing this they develop new processes around identified unmet needs.
Health-Related Quality of Life and Perceived Burden of Informal Caregivers of Patients with Rare Diseases in Selected European Countries
Authors: Valcárcel-Nazco Cristina , Ramallo-Fariña Yolanda , Linertová Renata , Ramos-Goñi Juan Manuel , García-Pérez Lidia , Serrano-Aguilar Pedro
Published: July 2022

Most of rare disease (RD) patients are assisted in their homes by their family as informal caregivers, causing a substantial burden among family members devoted to care. The role of informal caregivers has been associated with increased levels of stress, poor physical/mental health and impaired HRQOL. The present study assessed the impact on HRQOL and perceived burden of long-term informal caregiving, as well as the inter-relationships of individuals affected by different RD in six European countries, taking advantage of the data provided by the BURQOL-RD project (France, Germany, Italy, Spain, Sweden and UK). Correlation analysis was used to explore the relation between caregiver HRQOL and caregiver burden (Zarit Burden Interview). Multinomial logistic regression models were used to explore the role of explanatory variables on each domain of caregivers HRQOL measured by EQ-5D. Caregivers’ HRQOL is inversely correlated with burden of caring. Mobility dimension of EQ-5D was significantly associated with patients age, time devoted to care by secondary caregivers, patient gender and patient utility index. Patients’ age, burden scores and patient utility index significantly predict the capacity of caregivers to perform activities of daily living. Employed caregivers are less likely of reporting ‘slight problems’ in pain/discomfort dimensions than unemployed caregivers. The EQ-5D instrument is sensitive to measure differences in HRQOL between caregivers with different levels of burden of care.
Spatiotemporal Evolution of Non-Grain Production of Cultivated Land and Its Underlying Factors in China
Authors: Zhu Zhiyuan , Dai Zhenzhong , Li Shilin , Feng Yongzhong
Published: July 2022

Food security is the foundation of development. We comprehensively characterized the spatiotemporal patterns of non-grain production (NGP) areas in China and elucidated the underlying factors driving NGP. Our objectives were to map NGP on cultivated land (NGPCL) in China, and to quantify its spatiotemporal patterns, to investigate the factors underlying NGP spatial differentiation, and to provide a scientific basis for developing NGP management policies and reference points for protecting cultivated land in other countries. We mapped NGPCL in China from 2000 to 2018 using remote sensing and geographic information system data. The spatiotemporal evolution of the NGP rate (NGPR) was also investigated. The dominant factors driving NGP progression and associated interactions were identified using geographic detectors. From 2000 to 2018, the NGPR gradually decreased from 63.02% to 52.82%. NGPR was high in the west and low in the east, and its spatial differentiation and clustering patterns were statistically significant. Precipitation, temperature, altitude, and soil carbon content were the dominant factors affecting the spatial differentiation in NGPR. The interaction between these factors enhanced the spatial differentiation.
E-Learning Satisfaction, Stress, Quality of Life, and Coping: A Cross-Sectional Study in Italian University Students a Year after the COVID-19 Pandemic Began
Authors: Cofini Vincenza , Perilli Enrico , Moretti Annalucia , Bianchini Valeria , Perazzini Matteo , Muselli Mario , Lanzi Sabrina , Tobia Loreta , Fabiani Leila , Necozione Stefano
Published: July 2022

(1) Background: The objective was to investigate e-learning satisfaction in a sample of university students by evaluating quality of life, stress sociality, and coping. (2) Methods: This was an online survey involved 471 students attending the University of L′Aquila from June to July 2021. The primary goal was estimating the e-learning satisfaction as measured by the E-learning Satisfaction Scale, while the secondary outcomes were studying its relationship with demographic factors, the perception of quality of life, sociality, stress, and coping strategies using a hierarchical regression model. (3) Results: A total of 136 participants were males (29%); the mean age was 25 years. The results revealed that the satisfaction score was 30.6, and the mean stress level was 19.4. Students suffered psychologically and physically for 14 days a month. The sociality score was 36. With respect to coping strategies, students reported higher scores for “Acceptance” (6.0), “Active coping” (6.2), and “Planning” (6.4). E-learning satisfaction was significantly related to age and course attendance. It was positively associated with the social presence score and coping strategies such as self-blame and religion, while it was inversely related to stress and unhealthy days. (4) Conclusions: The students revealed a positive propensity to use e-learning despite the end of quarantine. Sociality, stress, quality of life, and coping seemed to play an important role in student′s e-learning satisfaction.
Behavioral Patterns of Supply and Demand Sides of Health Services for the Elderly in Sustainable Digital Transformation: A Mixed Methods Study
Authors: Zhou Siyu , Ni Ziling , Ogihara Atsushi , Wang Xiaohe
Published: July 2022

The aging transformation of digital health services faces issues of how to distinguish influencing factors, redesign services, and effectively promote measures and policies. In this study, in-depth interviews were conducted, and grounded theory applied to open coding, main axis coding, and selective coding to form concepts and categories. Trajectory equifinality modeling clarified the evolution logic of digital transformation. Based on the theory of service ecology, a digital health service aging model was constructed from the “macro–medium–micro” stages and includes governance, service, and technology transformation paths. The macro stage relies on organizational elements to promote the institutionalization of management and guide the transformation of governance for value realization, including the construction of three categories: mechanism, indemnification, and decision-making. The meso stage relies on service elements to promote service design and realize service transformation that is suitable for aging design, including the construction of three categories: organization, resources, and processes. The micro stage relies on technical elements to practice experiencing humanization, including the construction of three categories: target, methods, and evaluation. These results deepen the understanding of the main behaviors and roles of macro-organizational, meso-service, and micro-technical elements in digital transformation practice and have positive significance for health administrative agencies to implement action strategies.
A Proposal of Cognitive Intervention in Patients with Alzheimer’s Disease through an Assembling Game: A Pilot Study
Authors: Navarro-Martos Remedios , Nieto-Escamez Francisco
Published: July 2022

(1) Background: Alzheimer’s disease is an irreversible brain disease, and current treatments are aimed at fighting cognitive decline. We have explored the feasibility of a game-based intervention for people with moderate Alzheimer’s disease; (2) Methods: Six participants, five women and one man, were recruited from a day center to participate in a five-week study, which included a re- and post-evaluation with the Montreal Cognitive Assessment (MoCA) and INECO Frontal Screening (IFS) tests. Three participants were assigned to the control group and three others to the experimental one. Both groups performed a play activity consisting of assembling a pie toy. Participants in the experimental group were asked to make a pie matching a sample after a time interval. Control group participants were asked to freely assemble a pie without the matching component; (3) Results: Patients were shown to be motivated during such an activity during the nine sessions. The experimental group showed a significant increase in IFS scores when comparing the post- and pre-intervention assessments. No significant differences were observed in MoCA scores; (4) The intervention created a social and emotional climate suitable to maintaining participants’ satisfaction and motivation, as well as to developing executive function while promoting positive emotions.
Tumor Necrosis Factor-Related Apoptosis-Inducing Ligand (TRAIL): A Novel Biomarker for Prognostic Assessment and Risk Stratification of Acute Pulmonary Embolism
Authors: Yu Haixu , Rong Wei , Yang Jie , Lu Jie , Ma Ke , Liu Zhuohui , Yuan Hui , Xu Lei , Li Yulin , Jing Zhi-Cheng , Du Jie
Published: July 2022

Background: Tumor necrosis factor (TNF)-related apoptosis-inducing ligand (TRAIL) is associated with poor prognosis in cardiovascular diseases. However, the predictive value of TRAIL for the short-term outcome and risk stratification of acute pulmonary embolism (PE) remains unknown. Methods: This study prospectively included 151 normotensive patients with acute PE. The study outcome was a composite of 30-day adverse events, defined as PE-related death, shock, mechanical ventilation, cardiopulmonary resuscitation, and major bleeding. Results: Overall, nine of 151 (6.0%) patients experienced 30-day adverse composite events. Multivariable logistic regression showed that TRAIL was an independent predictor of study outcome (OR 0.19 per SD; 95% CI 0.04–0.90). An ROC curve revealed that TRAIL’s area under the curve (AUC) was 0.83 (95% CI 0.76–0.88). The optimal cut-off value for TRAIL was 18 pg/mL, with a sensitivity, specificity, negative predictive value, positive predictive value, positive likelihood ratio, and negative likelihood ratio of 89%, 69%, 99%, 15%, 2.87, and 0.16, respectively. Compared with the risk stratification algorithm outlined in the 2019 ESC guidelines, our biomarker-based risk stratification strategy (combining TRAIL and hs-cTnI) has a similar risk classification effect. Conclusion: Reduced plasma TRAIL levels predict short-term adverse events in normotensive patients with acute PE. The combination of the 2019 ESC algorithm and TRAIL aids risk stratification in normotensive patients with acute PE.
Artificial Intelligence in Cardiology—A Narrative Review of Current Status
Authors: Koulaouzidis George , Jadczyk Tomasz , Iakovidis Dimitris K. , Koulaouzidis Anastasios , Bisnaire Marc , Charisopoulou Dafni
Published: July 2022

Artificial intelligence (AI) is an integral part of clinical decision support systems (CDSS), offering methods to approximate human reasoning and computationally infer decisions. Such methods are generally based on medical knowledge, either directly encoded with rules or automatically extracted from medical data using machine learning (ML). ML techniques, such as Artificial Neural Networks (ANNs) and support vector machines (SVMs), are based on mathematical models with parameters that can be optimally tuned using appropriate algorithms. The ever-increasing computational capacity of today’s computer systems enables more complex ML systems with millions of parameters, bringing AI closer to human intelligence. With this objective, the term deep learning (DL) has been introduced to characterize ML based on deep ANN (DNN) architectures with multiple layers of artificial neurons. Despite all of these promises, the impact of AI in current clinical practice is still limited. However, this could change shortly, as the significantly increased papers in AI, machine learning and deep learning in cardiology show. We highlight the significant achievements of recent years in nearly all areas of cardiology and underscore the mounting evidence suggesting how AI will take a central stage in the field.
Immune Checkpoint Inhibitors and Mismatch Repair Status in Advanced Endometrial Cancer: Elective Affinities
Authors: Rizzo Alessandro
Published: July 2022

Since endometrial cancers (ECs) are frequently TMB-H and MSI-H/dMMR tumors, this element has provided the rationale for testing immune checkpoint inhibitors (ICIs), which have recently emerged as a potential game-changer. However, several questions remain to be addressed, including the identification of patients who may benefit from the addition of ICIs as well as those who do not need immunotherapy. In the current paper, we provide an overview of the clinical development of immunotherapy in advanced or recurrent EC, discussing the role of MMR and the “elective affinities” between ICIs and this predictive biomarker in this setting.
Performance of Screening Strategies for Latent Tuberculosis Infection in Patients with Inflammatory Bowel Disease: Results from the ENEIDA Registry of GETECCU
Authors: Riestra Sabino , Taxonera Carlos , Zabana Yamile , Carpio Daniel , Chaparro María , Barrio Jesús , Rivero Montserrat , López-Sanroman Antonio , Esteve María , de Francisco Ruth , Bastida Guillermo , García-López Santiago , Mañosa Miriam , Martin-Arranz María Dolores , Pérez-Calle José Lázaro , Guardiola Jordi , Muñoz Fernando , Arranz Laura , Cabriada José Luis , García-Sepulcre Mariana Fe , Navarro Mercè , Montoro-Huguet Miguel Ángel , Ricart Elena , Bermejo Fernando , Calvet Xavier , Piqueras Marta , Garcia-Planella Esther , Márquez Lucía , Mínguez Miguel , Van Domselar Manuel , Bujanda Luis , Aldeguer Xavier , Sicilia Beatriz , Iglesias Eva , Alcaín Guillermo , Pérez-Martínez Isabel , Rolle Valeria , Castaño-García Andrés , P. Gisbert Javier , Domènech Eugeni ,   on behalf of the ENEIDA registry from GETECCU
Published: July 2022

(1) Aims: Patients receiving antitumor necrosis factor (anti-TNF) therapy are at risk of developing tuberculosis (TB), usually due to the reactivation of a latent TB infection (LTBI). LTBI screening and treatment decreases the risk of TB. This study evaluated the diagnostic performance of different LTBI screening strategies in patients with inflammatory bowel disease (IBD). (2) Methods: Patients in the Spanish ENEIDA registry with IBD screened for LTBI between January 2003 and January 2018 were included. The diagnostic yield of different strategies (dual screening with tuberculin skin test [TST] and interferon-ץ-release assay [IGRA], two-step TST, and early screening performed at least 12 months before starting biological treatment) was analyzed. (3) Results: Out of 7594 screened patients, 1445 (19%; 95% CI 18–20%) had LTBI. Immunomodulator (IMM) treatment at screening decreased the probability of detecting LTBI (20% vs. 17%, p = 0.001). Regarding screening strategies, LTBI was more frequently diagnosed by dual screening than by a single screening strategy (IGRA, OR 0.60; 95% CI 0.50–0.73, p < 0.001; TST, OR 0.76; 95% CI 0.66–0.88, p < 0.001). Two-step TST increased the diagnostic yield of a single TST by 24%. More cases of LTBI were diagnosed by early screening than by routine screening before starting anti-TNF agents (21% [95% CI 20–22%] vs. 14% [95% CI 13–16%], p < 0.001). The highest diagnostic performance for LTBI (29%) was obtained by combining early and TST/IGRA dual screening strategies in patients without IMM. (4): Conclusions: Both early screening and TST/IGRA dual screening strategies significantly increased diagnostic performance for LTBI in patients with IBD, with optimal performance achieved when they are used together in the absence of IMM.
Can Thyroid Screening in the First Trimester Improve the Prediction of Gestational Diabetes Mellitus?
Authors: Milovanović Zagorka , Filimonović Dejan , Soldatović Ivan , Karadžov Orlić Nataša
Published: July 2022

This study aimed to evaluate the clinical utility of the subclinical hypothyroidism (SCH) marker, elevated thyroid-stimulating hormone (TSH) and thyroid antibodies in their ability to predict subsequent gestational diabetes mellitus (GDM). In a prospective clinical trial, 230 pregnant women were screened for thyroid function during the first trimester of pregnancy. Increased TSH levels with normal free thyroxine (fT4) were considered SCH. The titers of thyroid peroxidase antibody (anti TPO Ab) at >35 IU/mL and thyroglobulin antibody (anti Tg Ab) at >115 IU/mL were considered as antibodies present. According to the OGTT results, the number of pregnant women with GDM showed the expected growth trend, which was 19%. Two groups of pregnant women were compared, one with GDM and the other without. Increased TSH levels and the presence of thyroid antibodies showed a positive correlation with the risk of GDM. TSH levels were significantly higher in pregnant women with GDM, p = 0.027. In this study, 25.6% of pregnant women met the diagnostic criteria for autoimmune thyroiditis. Hashimoto’s thyroiditis was significantly more common in GDM patients, p < 0.001. Through multivariate logistic regression, it was demonstrated that patient age, TSH 4 IU/mL, and anti TPO Ab > 35 IU/mL are significant predictors of gestational diabetes mellitus that may improve first-trimester pregnancy screening performance, AUC: 0.711; 95% CI: 0.629–0.793.