bluuebunny/crossref_metadata_2025 huggingface dataset:
A New Precision Minimally Invasive Method of Glial Scar Simulation in the Rat Spinal Cord Using Cryoapplication
Authors: Telegin Georgii B. , Minakov Alexey N. , Chernov Aleksandr S. , Kazakov Vitaly A. , Kalabina Elena A. , Manskikh Vasily N. , Asyutin Dmitry S. , Belogurov Alexey A. , Gabibov Alexander G. , Konovalov Nikolay A. , Spallone Aldo
Published: July 2021

According to the World Health Organization, every year worldwide up to 500,000 people suffer a spinal cord injury (SCI). Various animal biomodels are essential for searching for novel protocols and therapeutic approaches for SCI treatment. We have developed an original model of post-traumatic spinal cord glial scarring in rats through cryoapplication. With this method the low-temperature liquid nitrogen is used for the cryodestruction of the spinal cord tissue. Forty-five Sprague Dawley (SD) non-linear male rats of the Specific-pathogen-free (SPF) category were included in this experimental study. A Th13 unilateral hemilaminectomy was performed with dental burr using an operating microscope. A specifically designed cryogenic probe was applied to the spinal cord for one minute through the created bone defect. The animals were euthanized at different time points ranging from 1 to 60 days after cold-induced injury. Their Th12-L1 vertebrae with the injured spinal cord region were removed “en bloc” for histological examination. Our data demonstrate that cryoapplication producing a topical cooling around−20°C, caused a highly standardized transmural lesion of the spinal cord in the dorsoventral direction. The lesion had an “hour-glass” shape on histological sections. During the entire study period (days 1-60 of the post-trauma period), the necrotic processes and the development of the glial scar (lesion evolution) were contained in the surgically approached vertebral space (Th13). Unlike other known experimental methods of SCI simulation (compression, contusion, etc.), the proposed technique is characterized by minimal invasiveness, high precision, and reproducibility. Also, histological findings, lesion size, and postoperative clinical course varied only slightly between different animals. An original design of the cryoprobe used in the study played a primary role in the achieving of these results. The spinal cord lesion's detailed functional morphology is described at different time points (1–60 days) after the produced cryoinjury. Also, changes in the number of macrophages at distinct time points, neoangiogenesis and the formation of the glial scar's fibrous component, including morphodynamic characteristics of its evolution, are analyzed. The proposed method of cryoapplication for inducing reproducible glial scars could facilitate a better understanding of the self-recovery processes in the damaged spinal cord. It would be evidently helpful for finding innovative approaches to the SCI treatment.
Prognostic Significance of Signet-Ring Cell Components in Patients With Gastric Carcinoma of Different Stages
Authors: Dong Xiaoyuan , Sun Guorui , Qu Hui , He Qingsi , Hao Zhaofan
Published: July 2021

Background: Gastric carcinoma (GC), which contains signet ring cell (SRC) components are frequently observed in postoperative pathological assessment. This study aims to study the prognostic significance of SRC components in GC patients.

Methods: From 2003 to 2017, surgically resected primary GC patients were retrospectively reviewed. All enrolled patients were divided into three groups according to the proportion of SRC. The overall survival (OS) and disease-free survival (DFS) of GC patients with different tumor stages were analyzed.

Results: Patients with SRC or mixed-SRC were more associated with female, younger age, middle or lower third of the stomach, larger tumor, higher pN stage, and more lymphovascular invasion. For GC patients in stage I, multivariate survival analysis showed that age >60, SRC components >50%, and pT stage were independent prognostic factors for OS (all p < 0.05). The 5-year OS of patients with SRC were higher than that of patients with pure adenocarcinoma (p = 0.021). For GC patients in stage II/III, multivariate survival analysis showed that age >60, SRC proportion, surgical types, Borrmann's type, pT stage, pN stage, and lymphovascular invasion were independent prognostic factors for OS (all p < 0.05). The 5-year OS/DFS of patients with SRC were lower than that of patients with pure adenocarcinoma (p < 0.001).

Conclusions: SRC seemed to be a favorable prognostic factor in GC patients in stage I. However, for GC patients in stage II/III, the SRC components were associated with poor prognosis, independent of other clinicopathological factors.
Bisegmentectomy 7–8 for Small-for-Size Remanant Liver for Cirrhotic Patients Under Right Hemi-hepatectomy With Hepatocellular Carcinoma: A Case-Matched Comparative Study
Authors: Wang Xishu , Lei Yongrong , Huan Hongbo , Chen Shu , Ma Kuansheng , Feng Kai , Lau Wan Yee , Xia Feng
Published: July 2021

Aim: To compare the short- and long-term treatment outcomes of bisegmentectomy 7–8 vs. right hepatectomy for patients with hepatocellular carcinoma and cirrhosis.

Methods: Thirty six cirrhotic HCC patients with infiltration of right hepatic vein in segments 7–8 underwent bisegmentectomy 7–8 for small-for-size remanant liver under right hemi-hepatectomy. Its outcome was compared with a case-matched control group of cirrhotic HCC patients who underwent right hemi-hepatectomy during the study period.

Results: The study group consisted of 36 patients and the control group 36 patients selected from 1,526 patients matched with age, tumor size, tumor location, and Pugh-Child staging. There were no significant differences between the two groups in operative parameters and in perioperative main complications which included hemorrhage, bile leakage, ascites, pleural effusion, and liver failure. The overall morbidity rate and morbidity rate classified according to Clavien's classification were similar. There was no in-hospital mortality or 90 day post-operative mortality. The mean follow-up was 30 and 32 months for the study group and control group, respectively. The disease free survival rate (DFS) for the study group was just significantly better than the control group. The median DFS was 24 months for the study group and 8 months for the control group (P = 0.049). Meanwhile, the median cumulative overall survival was 35 months for the study group and 27 months for the control group (P = 0.494).

Conclusion: Bisegmentectomy 7–8 was safe and feasible for selected cirrhosis patients, and did not increase the perioperative risk and inferior long-term overall survival outcomes. It extended the indications for liver resection in patients with borderline volumes of future liver remnant for HCC cirrhotic liver.
Apego y comprensión del sí mismo: ser padre pensando en el cerebro
Authors: Siegel Daniel J.
Published: July 2021

Basándose en los recientes hallazgos de la neurobiología y la investigación sobre el apego, este artículo explica cómo las relaciones interpersonales afectan directamente al desarrollo del cerebro y aporta un enfoque gradual de cómo llegar a una comprensión más profunda de la propia experiencia vital de los padres que les ayude a educar a hijos resilientes.
Neurobiología de la autorregulación afectiva, patrones de apego y compatibilidad en la relación terapeuta-paciente
Authors: Cid Luis , Corbella Sergi
Published: July 2021

Este artículo presenta una aproximación a los efectos terapéuticos de la relación terapeuta-paciente (y más concretamente de la alianza terapéutica) desde los conocimientos científicos actuales sobre la influencia de las relaciones de apego en la neurobiología de la autorregulación afectiva.
Cuando la dependencia es la solución (de momento)
Authors: Armas Blanca
Published: July 2021

Muchas pueden ser las precondiciones para una relación de dependencia particularmente para una mujer, entre ellas: el inicio de una relación de pareja en edad evolutivamente prematura; una maternidad también prematura, una falta de recursos personales, económicos y laborales; una falta de diferenciación respecto a la familia de origen y una prematura parentalización. Todas éstas y otras circunstancias se dan en el caso que se presenta en este artículo.
Aprendizajes sobre psicoterapia transcultural, obtenidos desde la asociación oasis de ayuda psicológica al inmigrante
Authors: Cobos Ana
Published: July 2021

Las experiencias vividas desde una concreta asociación de ayuda psicológica al inmigrante han permitido –si bien en forma limitada y parcial– realizar una serie de aprendizajes sobre la psicología y psicoterapia relacionadas con la inmigración tales como: dificultades prácticas del encuadre, importancia de la intervención grupal (tanto preventiva como curativa), la relevancia del tratamiento de la angustia y el fomento de los recursos internos). Por otro lado, esa experiencia nos cuestiona la dudosa validez de una utilización indiscriminada de instrumentos de diagnóstico, de los rasgos que estructuran la relación terapéutica, de los elementos de juicio sobre las propias metas y dinámica del proceso y de los instrumentos a emplear en el proceso. A la vez, nos confirma la necesidad del enfoque transcultural para el tratamiento con el colectivo de inmigrantes y para el propio crecimiento profesional y humano del psicoterapeuta.
La relación asistencial con inmigrantes y otros grupos con estrés crónico y exclusión social: la relación terapéutica extendida o ampliada
Authors: Achotegui Joseba
Published: July 2021

Hemos señalado en este texto cómo en las situaciones de estrés crónico y exclusión social la relación terapéutica se halla modificada, ya que las demandas del paciente abarcan aspectos que van más allá de lo médico y psicológico e incluyen peticiones de protección y ayuda social, de ahí el concepto de “relación terapéutica extendida”. No tener en cuenta estos aspectos de la relación asistencial conduce con frecuencia al abandono del tratamiento, algo muy frecuente en inmigrantes, minorías y grupos excluidos socialmente. Se señala cómo esta relación terapéutica extendida se caracteriza desde el lado del paciente por la hostilidad y las somatizaciones y desde la perspectiva del profesional por los sentimientos de impotencia y frustración e incluso el burn out. Finalmente se señalan indicaciones terapéuticas para mejorar la intervención en estos casos, desde la perspectiva de la relación emocional, el manejo del tiempo y del espacio terapéutico, los aspectos culturales y los aspectos sociales.
An Integrated Deep Learning and Belief Rule-Based Expert System for Visual Sentiment Analysis under Uncertainty
Authors: Zisad Sharif Noor , Chowdhury Etu , Hossain Mohammad Shahadat , Islam Raihan Ul , Andersson Karl
Published: July 2021

Visual sentiment analysis has become more popular than textual ones in various domains for decision-making purposes. On account of this, we develop a visual sentiment analysis system, which can classify image expression. The system classifies images by taking into account six different expressions such as anger, joy, love, surprise, fear, and sadness. In our study, we propose an expert system by integrating a Deep Learning method with a Belief Rule Base (known as the BRB-DL approach) to assess an image’s overall sentiment under uncertainty. This BRB-DL approach includes both the data-driven and knowledge-driven techniques to determine the overall sentiment. Our integrated expert system outperforms the state-of-the-art methods of visual sentiment analysis with promising results. The integrated system can classify images with 86% accuracy. The system can be beneficial to understand the emotional tendency and psychological state of an individual.
A 7-Year Climatology of Warm-Sector Heavy Rainfall over South China during the Pre-Summer Months
Authors: Chen Tao , Zhang Da-Lin
Published: July 2021

In view of the limited predictability of heavy rainfall (HR) events and the limited understanding of the physical mechanisms governing the initiation and organization of the associated mesoscale convective systems (MCSs), a composite analysis of 58 HR events over the warm sector (i.e., far ahead of the surface cold front), referred to as WSHR events, over South China during the months of April to June 2008~2014 is performed in terms of precipitation, large-scale circulations, pre-storm environmental conditions, and MCS types. Results show that the large-scale circulations of the WSHR events can be categorized into pre-frontal, southwesterly warm and moist ascending airflow, and low-level vortex types, with higher frequency occurrences of the former two types. Their pre-storm environments are characterized by a deep moist layer with >50 mm column-integrated precipitable water, high convective available potential energy with the equivalent potential temperature of ≥340 K at 850 hPa, weak vertical wind shear below 400 hPa, and a low-level jet near 925 hPa with weak warm advection, based on atmospheric parameter composite. Three classes of the corresponding MCSs, exhibiting peak convective activity in the afternoon and the early morning hours, can be identified as linear-shaped, a leading convective line adjoined with trailing stratiform rainfall, and comma-shaped, respectively. It is found that many linear-shaped MCSs in coastal regions are triggered by local topography, enhanced by sea breezes, whereas the latter two classes of MCSs experience isentropic lifting in the southwesterly warm and moist flows. They all develop in large-scale environments with favorable quasi-geostrophic forcing, albeit weak. Conceptual models are finally developed to facilitate our understanding and prediction of the WSHR events over South China.
New Target for Precision Medicine Treatment of Giant-Cell Tumor of Bone: Sunitinib Is Effective in the Treatment of Neoplastic Stromal Cells with Activated PDGFRβ Signaling
Authors: Mahdal Michal , Neradil Jakub , Mudry Peter , Paukovcekova Silvia , Staniczkova Zambo Iva , Urban Jiri , Macsek Peter , Pazourek Lukas , Tomas Tomas , Veselska Renata
Published: July 2021

Giant-cell tumor of bone (GCTB) is an intermediate type of primary bone tumor characterized by locally aggressive growth with metastatic potential. The aim of this study was to identify new druggable targets among the cell signaling molecules involved in GCTB tumorigenesis. Profiles of activated signaling proteins in fresh-frozen tumor samples and tumor-derived cell lines were determined using phosphoprotein arrays. Analysis of the obtained data revealed epidermal growth factor receptor (EGFR) and platelet-derived growth factor receptor beta (PDGFRβ) as potential targets, but only the PDGFR inhibitor sunitinib caused a considerable decrease in stromal cell viability in vitro. Furthermore, in the case of a 17-year-old patient suffering from GCTB, we showed that the addition of sunitinib to the standard treatment of GCTB with the monoclonal antibody denosumab resulted in the complete depletion of multinucleated giant cells and mononuclear stromal cells in the tumor tissue. To summarize, the obtained data showed that a specific receptor tyrosine kinase (RTK) signaling pattern is activated in GCTB cells and plays an important role in the regulation of cell proliferation. Thus, activated RTKs and their downstream signaling pathways represent useful targets for precision treatment with low-molecular-weight inhibitors or with other types of modern biological therapy.
Current Aspects and Future Considerations of EGFR Inhibition in Locally Advanced and Recurrent Metastatic Squamous Cell Carcinoma of the Head and Neck
Authors: Patel Bhamini , Saba Nabil F.
Published: July 2021

Recurrent metastatic (RM) and locally advanced (LA) squamous cell carcinoma of the head and neck (SCCHN) are devasting disease states with limited therapeutic options and poor overall survival. Targeting the epidermal growth factor receptor (EGFR) is one area that has helped improve outcomes in this disease. Anti-EGFR based therapies have been shown to improve overall survival and mitigate the significant toxicities incurred from standard radiation, chemotherapy, and/or surgical options. Cetuximab, the most well-studied anti-EGFR monoclonal antibody, has demonstrated a positive impact on outcomes for RM and LA SCCHN. However, the development of early resistance to cetuximab highlights the need for a wider arsenal of therapy for RM and LA diseases. The use of immune checkpoint inhibitors has recently transformed the treatment of recurrent SCCHN. Drugs such as pembrolizumab and nivolumab have demonstrated success in recent clinical trials and have been approved for the treatment of advanced disease. Given the positive results of both EGFR targeted agents and immune checkpoint inhibitors, ongoing trials are studying their synergistic effects.
Quantitative Assessment of the Echogenicity of a Breast Tumor Predicts the Response to Neoadjuvant Chemotherapy
Authors: Dobruch-Sobczak Katarzyna Sylwia , Piotrzkowska-Wróblewska Hanna , Karwat Piotr , Klimonda Ziemowit , Markiewicz-Grodzicka Ewa , Litniewski Jerzy
Published: July 2021

The aim of the study was to improve monitoring the treatment response in breast cancer patients undergoing neoadjuvant chemotherapy (NAC). The IRB approved this prospective study. Ultrasound examinations were performed prior to treatment and 7 days after four consecutive NAC cycles. Residual malignant cell (RMC) measurement at surgery was the standard of reference. Alteration in B-mode ultrasound (tumor echogenicity and volume) and the Kullback-Leibler divergence (kld), as a quantitative measure of amplitude difference, were used. Correlations of these parameters with RMC were assessed and Receiver Operating Characteristic curve (ROC) analysis was performed. Thirty-nine patients (mean age 57 y.) with 50 tumors were included. There was a significant correlation between RMC and changes in quantitative parameters (KLD) after the second, third and fourth course of NAC, and alteration in echogenicity after the third and fourth course. Multivariate analysis of the echogenicity and KLD after the third NAC course revealed a sensitivity of 91%, specificity of 92%, PPV = 77%, NPV = 97%, accuracy = 91%, and AUC of 0.92 for non-responding tumors (RMC ≥ 70%). In conclusion, monitoring the echogenicity and KLD parameters made it possible to accurately predict the treatment response from the second course of NAC.
A Proposed Dedicated Breast PET Lexicon: Standardization of Description and Reporting of Radiotracer Uptake in the Breast
Authors: Miyake Kanae K. , Kataoka Masako , Ishimori Takayoshi , Matsumoto Yoshiaki , Torii Masae , Takada Masahiro , Satoh Yoko , Kubota Kazunori , Satake Hiroko , Yakami Masahiro , Isoda Hiroyoshi , Ikeda Debra M. , Toi Masakazu , Nakamoto Yuji
Published: July 2021

Dedicated breast positron emission tomography (dbPET) is a new diagnostic imaging modality recently used in clinical practice for the detection of breast cancer and the assessment of tumor biology. dbPET has higher spatial resolution than that of conventional whole body PET systems, allowing recognition of detailed morphological attributes of radiotracer accumulation within the breast. 18F-fluorodeoxyglucose (18F-FDG) accumulation in the breast may be due to benign or malignant entities, and recent studies suggest that morphology characterization of 18F-FDG uptake could aid in estimating the probability of malignancy. However, across the world, there are many descriptors of breast 18F-FDG uptake, limiting comparisons between studies. In this article, we propose a lexicon for breast radiotracer uptake to standardize description and reporting of image findings on dbPET, consisting of terms for image quality, radiotracer fibroglandular uptake, breast lesion uptake.
Detection of Malicious Software by Analyzing Distinct Artifacts Using Machine Learning and Deep Learning Algorithms
Authors: Ashik Mathew , Jyothish A. , Anandaram S. , Vinod P. , Mercaldo Francesco , Martinelli Fabio , Santone Antonella
Published: July 2021

Malware is one of the most significant threats in today’s computing world since the number of websites distributing malware is increasing at a rapid rate. Malware analysis and prevention methods are increasingly becoming necessary for computer systems connected to the Internet. This software exploits the system’s vulnerabilities to steal valuable information without the user’s knowledge, and stealthily send it to remote servers controlled by attackers. Traditionally, anti-malware products use signatures for detecting known malware. However, the signature-based method does not scale in detecting obfuscated and packed malware. Considering that the cause of a problem is often best understood by studying the structural aspects of a program like the mnemonics, instruction opcode, API Call, etc. In this paper, we investigate the relevance of the features of unpacked malicious and benign executables like mnemonics, instruction opcodes, and API to identify a feature that classifies the executable. Prominent features are extracted using Minimum Redundancy and Maximum Relevance (mRMR) and Analysis of Variance (ANOVA). Experiments were conducted on four datasets using machine learning and deep learning approaches such as Support Vector Machine (SVM), Naïve Bayes, J48, Random Forest (RF), and XGBoost. In addition, we also evaluate the performance of the collection of deep neural networks like Deep Dense network, One-Dimensional Convolutional Neural Network (1D-CNN), and CNN-LSTM in classifying unknown samples, and we observed promising results using APIs and system calls. On combining APIs/system calls with static features, a marginal performance improvement was attained comparing models trained only on dynamic features. Moreover, to improve accuracy, we implemented our solution using distinct deep learning methods and demonstrated a fine-tuned deep neural network that resulted in an F1-score of 99.1% and 98.48% on Dataset-2 and Dataset-3, respectively.
Community-Based Importance and Quantification of Ecosystem Services, Disservices, Drivers, and Neotropical Dry Forests in a Rural Colombian Municipality
Authors: Tovar Tique Yuli Paola , Escobedo Francisco J. , Clerici Nicola
Published: July 2021

Few studies analyze people’s preferences for ecosystem services (ES), disservices (ED) and drivers of change in less populated, tropical municipalities. Understanding such preferences and needs by the community and stakeholder groups before actually assessing, modelling, and measuring the supply of ES is key for decision-making and planning in municipalities, as well as for the conservation of nearby neotropical dry forests. We studied these dynamics in a small rural municipality in Colombia with limited data availability using semi-structured interviews and surveys, as well as ES-proxies and geospatial analyses. We then analyzed the supply and importance of two community identified ES and one ED from adjacent neotropical dry forests during 2005–2017. We found that respondents recognized air purification and food production as the most important ES. Increased temperatures and fires were the most important ED, while fires were also identified as an important driver of change. Air purification, via pollutant deposition to forest cover, remained approximately constant (116 ton/year), while food production (49 ton/ha) and fire occurrence, an ED, increased. Findings show how transdisciplinary research and participatory knowledge co-production among local communities, researchers and land management institutions can improve governance, decision making, policy uptake and planning efforts.
Single Nucleotide Polymorphism Discovery and Genetic Differentiation Analysis of Geese Bred in Poland, Using Genotyping-by-Sequencing (GBS)
Authors: Grzegorczyk Joanna , Gurgul Artur , Oczkowicz Maria , Szmatoła Tomasz , Fornal Agnieszka , Bugno-Poniewierska Monika
Published: July 2021

Poland is the largest European producer of goose, while goose breeding has become an essential and still increasing branch of the poultry industry. The most frequently bred goose is the White Kołuda® breed, constituting 95% of the country’s population, whereas geese of regional varieties are bred in smaller, conservation flocks. However, a goose’s genetic diversity is inaccurately explored, mainly because the advantages of the most commonly used tools are strongly limited in non-model organisms. One of the most accurate used markers for population genetics is single nucleotide polymorphisms (SNP). A highly efficient strategy for genome-wide SNP detection is genotyping-by-sequencing (GBS), which has been already widely applied in many organisms. This study attempts to use GBS in 12 conservative goose breeds and the White Kołuda® breed maintained in Poland. The GBS method allowed for the detection of 3833 common raw SNPs. Nevertheless, after filtering for read depth and alleles characters, we obtained the final markers panel used for a differentiation analysis that comprised 791 SNPs. These variants were located within 11 different genes, and one of the most diversified variants was associated with the EDAR gene, which is especially interesting as it participates in the plumage development, which plays a crucial role in goose breeding.
Diagnosis of Fetal Alcohol Spectrum Disorders (FASDs): Guidelines of Interdisciplinary Group of Polish Professionals
Authors: Okulicz-Kozaryn Katarzyna , Maryniak Agnieszka , Borkowska Magdalena , Śmigiel Robert , Dylag Katarzyna Anna
Published: July 2021

(1) Background: Considerable prevalence in Poland and serious health consequences of prenatal alcohol exposure indicated the need to develop national guidelines for the diagnosis of fetal alcohol spectrum disorders (FASDs). It was assumed that the guidelines must be in line with international standards but adjusted to the Polish context. (2) Methods: Work on recommendations was carried out by an interdisciplinary team of Polish specialists. Its first stage was to assess the usefulness in our country of the U.S. and Canadian guidelines. In the second stage, after several rounds of discussions, a consensus was achieved. (3) Results: The Polish guidelines for diagnosing FASD cover the following issues: 1. distinguished diagnostic categories; 2. diagnostic procedure; 3. assessment of prenatal exposure to alcohol; 4. assessment of sentinel facial dysmorphias; 5. assessment of body weight, height, and head circumference; 6. neurodevelopmental assessment. An important element of the recommendation is appendices containing practical tools that are useful in the diagnostic procedure. (4) Conclusions: National guidelines may improve the quality and standardization of FASD diagnosis in Poland, but their practical utility has to be monitored.
Factors Associated with Clostridioides (Clostridium) Difficile Infection and Colonization: Ongoing Prospective Cohort Study in a French University Hospital
Authors: Khanafer Nagham , Vanhems Philippe , Bennia Sabrina , Martin-Gaujard Géraldine , Juillard Laurent , Rimmelé Thomas , Argaud Laurent , Martin Olivier , Huriaux Laetitia , Marcotte Guillaume , Hernu Romain , Floccard Bernard , Cassier Pierre , Group Study
Published: July 2021

Introduction: Clostridioides (Clostridium) difficile can be isolated from stool in 3% of healthy adults and in at least 10% of asymptomatic hospitalized patients. C. difficile, the most common cause of hospital-acquired infectious diarrhea in the developed world, has re-emerged in recent years with increasing incidence and severity. In an effort to reduce the spread of the pathogen, published recommendations suggest isolation and contact precautions for patients suffering from C. difficile infection (CDI). However, asymptomatic colonized patients are not targeted by infection control policies, and active surveillance for colonization is not routinely performed. Moreover, given the current changes in the epidemiology of CDI, particularly the emergence of new virulent strains either in the hospital or community settings, there is a need for identification of factors associated with colonization by C. difficile and CDI. Methods and analysis: We are carrying out a prospective, observational, cohort study in Edouard Herriot Hospital, Hospices Civils de Lyon, a 900-bed university hospital in Lyon, France. All consecutive adult patients admitted on selected units are eligible to participate in the study. Stool samples or rectal swabs for C. difficile testing are obtained on admission, every 3–5 days during hospitalization, at the onset of diarrhea (if applicable), and at discharge. Descriptive and logistic regression analyses will be completed to mainly estimate the proportion of asymptomatic colonization at admission, and to evaluate differences between factors associated with colonization and those related to CDI. Ethics: The study is conducted in accordance with the ethical principles of the Declaration of Helsinki, French law, and the Good Clinical Practice guidelines. The study protocol design was approved by the participating units, the ethics committee and the hospital institutional review board (Comité de protection des personnes et Comission Nationale de l’Informatique et des Libertés; N°: 00009118). Dissemination: The results of this study will be disseminated by presenting the findings locally at each participating ward, as well as national and international scientific meetings. Findings will be shared with interested national societies crafting guidelines in CDI.
Medicolegal Causation Investigation of Bacterial Endocarditis Associated with an Oral Surgery Practice Using the INFERENCE Approach
Authors: Meilia Putri Dianita Ika , Zeegers Maurice P. , Herkutanto  , Freeman Michael D.
Published: July 2021

Investigating causation is a primary goal in forensic/legal medicine, aiming to establish the connection between an unlawful/negligent act and an adverse outcome. In malpractice litigation involving a healthcare-associated infection due to a failure of infection prevention and control practices, the medicolegal causal analysis needs to quantify the individual causal probabilities to meet the evidentiary requirements of the court. In this paper, we present the investigation of the most probable cause of bacterial endocarditis in a patient who underwent an invasive procedure at a dental/oral surgical practice where an outbreak of bacterial endocarditis had already been identified by the state Department of Health. We assessed the probability that the patient’s endocarditis was part of the outbreak versus that it was an unrelated sporadic infection using the INFERENCE (Integration of Forensic Epidemiology and the Rigorous Evaluation of Causation Elements) approach to medicolegal causation analysis. This paper describes the step-by-step application of the INFERENCE approach to demonstrate its utility in quantifying the probability of causation. The use of INFERENCE provides the court with an evidence-based, transparent, and reliable guide to determine liability, causation, and damages.
Impact of Digitalization on Customers’ Well-Being in the Pandemic Period: Challenges and Opportunities for the Retail Industry
Authors: Akram Umair , Fülöp Melinda Timea , Tiron-Tudor Adriana , Topor Dan Ioan , Căpușneanu Sorinel
Published: July 2021

Order increases, supply chain disruptions, changing customer behavior, store closures, and more that have been caused by the coronavirus epidemic (COVID-19) will undoubtedly affect the online commerce forms of business. The coronavirus pandemic has a significant impact on digitalization and customer experience and well-being in mobile commerce. Since the beginning of the coronavirus pandemic, online sales and the number of online shoppers using wireless internet-enabled devices have increased tremendously. The article develops, an experimental study that captures COVID-19 and digital commerce’s impact in terms of customers’ experience and well-being during the pandemic period. The study explores the synergy between technology evolution and the effects of the COVID-19 pandemic on customers’ behavior based on survey data collection and the technology acceptance model (TAM). The results reveal that, for millennials, digital commerce seems to be the typical way of shopping and paying in the pandemic period since the oldest generations adopted in a smaller proportion the use of mobile devices for shopping and payments. Besides, retailers are confronted with great challenges raised by millennials’ expectations. The result confirms four of the six hypotheses based on the technology acceptance model (TAM). As a result, it shows that the easiness of use, trust, mobility, and customer involvement influences the behavioral intention of the customer to use mobile commerce, and that usefulness and customization does not influence the behavioral intention.
Perioperative Hypothermia in Children
Authors: Nemeth Marcus , Miller Clemens , Bräuer Anselm
Published: July 2021

Background: First described by paediatric anaesthesiologists, perioperative hypothermia is one of the earliest reported side effects of general anaesthesia. Deviations from normothermia are associated with numerous complications and adverse outcomes, with infants and small children at the highest risk. Nowadays, maintenance of normothermia is an important quality metric in paediatric anaesthesia. Methods: This review is based on our collection of publications regarding perioperative hypothermia and was supplemented with pertinent publications from a MEDLINE literature search. Results: We provide an overview on perioperative hypothermia in the paediatric patient, including definition, history, incidence, development, monitoring, risk factors, and adverse events, and provide management recommendations for its prevention. We also summarize the side effects and complications of perioperative temperature management. Conclusions: Perioperative hypothermia is still common in paediatric patients and may be attributed to their vulnerable physiology, but also may result from insufficient perioperative warming. An effective perioperative warming strategy incorporates the maintenance of normothermia during transportation, active warming before induction of anaesthesia, active warming during anaesthesia and surgery, and accurate measurement of core temperature. Perioperative temperature management must also prevent hyperthermia in children.
The Effect of Structured Exercise on Short-Term Memory Subsystems: New Insight on Training Activities
Authors: Ottoboni Giovanni , Ceciliani Andrea , Tessari Alessia
Published: July 2021

It has been shown that exercise positively affects cognitive abilities, such as frontal functions and long-term memory processes. We tried to understand whether different exercises (i.e., an open-skill activity, a team game, vs. a closed-skill activity, a circuit) might specifically influence different short-term-memory (STM) subsystems of working memory. We examined the effect of a single bout of open- and closed-skill exercises on three STM tasks (i.e., verbal, visuo-spatial, and motor) in children attending the 3rd and 4th classes at primary school. One group was tested before and after (T0 and T1) an Italian class (control group), one group before and after 30-min exercise on a circuit, and one group before and after 30-min of a team game. The control group presented no improvement. The open-skill activity improved short-term memory performance in all the participants at T1 (p < 0.001 for children attending the 3rd class, and p = 0.007 for children attending the 4th class). In contrast, closed-skill activity improved short-term memory performance in older children (those attending the 4th class; p = 0.046) at T1. Importantly, this finding was found in a school setting and might have ecological validity. Therefore, the exercise protocol here used might help to structure specific training activities for both normal children and those with learning deficits to positively improve short-term memory abilities.
Doctor–Patient Communication in Primary Health Care: A Mixed-Method Study in Fiji
Authors: Chandra Swastika , Mohammadnezhad Masoud
Published: July 2021

From a clinical perspective, effective and efficient communication is part of a strategy to ensure doctors are providing high-quality care to their patients. Despite the positive impact of effective doctor–patient communication on health outcomes, limited information is available on this in Fiji. This study was carried out to determine the current patients’ perception of doctors’ communication behaviour and identify factors affecting the doctor–patient communication in Fiji. This mixed-method study was conducted in the outpatient setting of three randomly selected health centres in the Suva Subdivision, Fiji. For the quantitative phase, systematic random sampling was used to select the 375 participants who completed the structured questionnaire; of those, 20 participants were selected for the qualitative interview. From the patients’ perception, 45.6% of them perceived doctors’ communication behaviour as good, 53.6% as fair, and 0.8% as poor communication behaviour. Qualitative findings highlight factors such as the attitude of the doctors, their approach, their interaction with the patients, and them providing an explanation as important factors during doctor–patient communication. In Fiji, the majority of patients perceived doctors’ communication behaviour as fair to good and the doctors’ skills were important for effective doctor–patient communication. This study highlighted the importance of doctor–patient communication and suggested that doctors might not be practicing patient-centred care and communication; thus, they need to upgrade their patient-centred communication skills.
The Association between Physical Activity and Selected Parameters of Psychological Status and Dementia in Older Women
Authors: Cisek-Woźniak Angelika , Mruczyk Kinga , Wójciak Rafał W.
Published: July 2021

Physical activity has an unquestionable impact on broadly understood human health. One interesting issue related to this is the importance of movement on mental health and cognitive functioning. Research shows that regular physical activity improves the cognitive functioning of adults and people with mental disorders. Regular physical activity can be an important and powerful protective factor in cognitive impairment and dementia in the elderly, and exercise is an important non-pharmacological treatment for mild cognitive impairment or neurodegenerative diseases. This study aims to present the impact of physical activity on selected cognitive functions in physically active women over 60 years of age. The research was carried out in a group of 110 generally healthy women from the area of western Poland over 60 years of age, who were divided into four groups based on the intensity of their physical activity. A pedometer (sport watch) and a physical activity diary were used to measure physical activity. Body Mass Index was assessed. Selected cognitive functions were assessed using the MMSE test, motor and psychomotor skills were measured, and Luria’s auditory memory test and recall test, a clock drawing test, and a GDS test were performed. There were statistically significant relationships between the level of physical activity and the effectiveness of cognitive processes. These results show that about 5000 steps a day is enough to see a positive effect on the mental health and cognitive functioning of this group of the elderly population. The women had an average BMI of 28.1 ± 4.7. BMI, indicating an overweight condition (over 30 kg/m2), was observed in 31% of women. The results of this study lead the authors to conclude that physical activity positively influences cognitive function and can be recommended for all seniors who do not have other serious comorbidities that would prevent them from playing sports.
Economic Burden of Stroke Disease: A Systematic Review
Authors: Rochmah Thinni Nurul , Rahmawati Indana Tri , Dahlui Maznah , Budiarto Wasis , Bilqis Nabilah
Published: July 2021

Globally, one of the main causes of non-communicable disease as a cause of death every year is stroke. The objective of this study was to analyze the burden in consequence of stroke. This research used a systematic review method. Furthermore, a search for articles was carried out in June–July 2020. Four databases were used to search articles from 2015 to 2020. Eligible studies were identified, analyzed, and reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. The inclusion criteria were prospective cost studies, retrospective cost studies, database analysis, mathematical models, surveys, and COI studies that assess burden of stroke in primary and referral healthcare (hospital-based). The results showed that from four databases, 9270 articles were obtained, and 13 articles were qualified. A total of 9270 articles had the identified search keywords, but only 13 articles met the set criteria for inclusion. The criteria for inclusion were stroke patients, the economic burden of stroke disease based on cost of illness method, which is approximately equal to USD 1809.51–325,108.84 (direct costs 86.2%, and indirect costs 13.8%). Those that used the health expenditure method did not present the total cost; instead, only either direct or indirect cost of health expenditure were reported. For most hospital admissions due to stroke, LOS (length of stay) was the dominant cost. The high economic burden to manage stroke justifies the promotion and preventive efforts by the policymakers and motivates the practice of healthy lifestyles by the people.
The Effectiveness of Active Screen Method in Ion Nitriding Grade 5 Titanium Alloy
Authors: Frączek Tadeusz , Prusak Rafał , Ogórek Marzena , Skuza Zbigniew
Published: July 2021

The study assessed the effect of ion nitriding on the properties of the surface layer of Grade 5 titanium alloy used, among others, in medicine. Titanium and its alloys have low hardness and insufficient wear resistance in conditions of friction which limits the use of these materials. The improvement of these properties is only possible by the appropriate modification of the surface layer of these alloys. The ion nitriding process was carried out in a wide temperature range, i.e., 530–590 °C, and in the time range 5–17 h. Two variants of nitriding were applied: cathodic (conventional) nitriding and nitriding using the active screen method. The research results presented in this article allow for stating that each of the applied nitriding variants improves the analysed properties (nitrogen diffusion depth, hardness, wear resistance, microstructure analysis and surface topography) of the surface layers in relation to the material before nitriding. The hardness increased in every nitriding variant (the use of the additional active screen increased the hardness to 1021 HK0.025). The greatest increase in titanium abrasion resistance was found for surfaces after cathodic nitriding with an active screen. Each of the applied nitriding variants resulted in surface development.
Towards Efficient Luminescent Solar Energy Concentrator Using Cuprorivaite Infrared Phosphor (CaCuSi4O10)—Effect of Dispersing Method on Photoluminescence Intensity
Authors: Sobik Piotr , Jeremiasz Olgierd , Nowak Paweł , Sala Agata , Pawłowski Bartłomiej , Kulesza-Matlak Grażyna , Sypień Anna , Drabczyk Kazimierz
Published: July 2021

Cuprorivaite, also known as Egyptian blue (EB), CaCuSi4O10, has been utilized as an important blue pigment for thousands of years. It shows a 430–800 nm broad excitation band and an intense 910–920 nm near-infrared (NIR) emission peak at room temperature. The application that motivates the current research is for luminescent solar concentrator (LSC) usage. Current technology for this purpose relies on high near-infrared reflectance. This article addresses the investigation of the relationship between dispersing methods and photoluminescence (PL) intensity. Mechanical grinding methods investigated in the study were: horizontal bead mill, exfoliation and three-roll mill. The initial aim of the study was to verify if the proposed methods do not damage PL. To the surprise of the authors, three-roll mill treatment enhanced PL by nearly 50% without altering the morphology of the powder. An X-ray diffraction study suggested slight alterations in the crystal lattice.
Structure and Superconductivity of Tin-Containing HfTiZrSnM (M = Cu, Fe, Nb, Ni) Medium-Entropy and High-Entropy Alloys
Authors: Gačnik Darja , Jelen Andreja , Krnel Mitja , Vrtnik Stanislav , Luzar Jože , Koželj Primož , van Midden Marion , Zupanič Erik , Wencka Magdalena , Meden Anton , Hu Qiang , Guo Sheng , Dolinšek Janez
Published: July 2021

In an attempt to incorporate tin (Sn) into high-entropy alloys composed of refractory metals Hf, Nb, Ti and Zr with the addition of 3d transition metals Cu, Fe, and Ni, we synthesized a series of alloys in the system HfTiZrSnM (M = Cu, Fe, Nb, Ni). The alloys were characterized crystallographically, microstructurally, and compositionally, and their physical properties were determined, with the emphasis on superconductivity. All Sn-containing alloys are multi-phase mixtures of intermetallic compounds (in most cases four). A common feature of the alloys is a microstructure of large crystalline grains of a hexagonal (Hf, Ti, Zr)5Sn3 partially ordered phase embedded in a matrix that also contains many small inclusions. In the HfTiZrSnCu alloy, some Cu is also incorporated into the grains. Based on the electrical resistivity, specific heat, and magnetization measurements, a superconducting (SC) state was observed in the HfTiZr, HfTiZrSn, HfTiZrSnNi, and HfTiZrSnNb alloys. The HfTiZrSnFe alloy shows a partial SC transition, whereas the HfTiZrSnCu alloy is non-superconducting. All SC alloys are type II superconductors and belong to the Anderson class of “dirty” superconductors.
One Step In-Situ Synthesis of Zinc Oxide Nanoparticles for Multifunctional Cotton Fabrics
Authors: Javed Asif , Wiener Jakub , Tamulevičienė Asta , Tamulevičius Tomas , Lazauskas Algirdas , Saskova Jana , Račkauskas Simas
Published: July 2021

Zinc oxide nanoparticles (ZnO NPs) have acquired great significance in the textile sector due to their impressive efficiency and multifold utilization, such as antimicrobials, UV protection, photo catalytic activity, and self-cleaning. The aim of this work is in-situ growth of ZnO NPs on 100% cotton fabrics with the one-step hydrothermal method for preparation of multifunctional textile with UV protecting, antibacterial, and photo catalytic properties. Sodium hydroxide (NaOH) and Zinc nitrate hexahydrate [Zn(NO3)2·6H2O] were used as reactants for the growth of zinc oxide on the 100% cotton fabrics. The loaded amount of Zn contents on the cotton fabric was determined by using induced coupled plasma atomic emission spectroscopy (ICP-AES). The surface morphological characterization of deposited ZnO NPs was examined, employing scanning electron microscopy (SEM), X-ray powder diffraction (XRD) and, Fourier- transform infrared spectroscopy (FTIR). The characterization results showed the presence of ZnO NPs on cotton fabrics having hexagonal wurtzite crystalline structure. The synthesized ZnO NPs on fabrics exhibited promising results for antibacterial, UV protection, and photo catalytic performance.