bluuebunny/crossref_metadata_2025 huggingface dataset:
Mobile Health Interventions Addressing Childhood and Adolescent Obesity in Sub-Saharan Africa and Europe: Current Landscape and Potential for Future Research
Authors: Reddy Priscilla , Dukhi Natisha , Sewpaul Ronel , Ellahebokus Mohammad Ali Afzal , Kambaran Nilen Sunder , Jobe William
Published: March 2021

Child and adolescent overweight is a growing public health problem globally. Europe and low and middle-income (LMIC) countries in Sub-Saharan Africa provide sufficiently suitable populations to learn from with respect to the potential for mobile health (mHealth) interventions in this area of research. The aim of this paper is to identify mHealth interventions on prevention and treatment of childhood and adolescent obesity in Sub-Saharan Africa and Sweden and report on their effects, in order to inform future research in this area. A search of peer-reviewed publications was performed using PubMed, ScienceDirect, EBSCOhost, and Scopus. The search included all articles published up to August 2019. The search strings consisted of MeSH terms related to mHealth, overweight or obesity, children, adolescents or youth and individual countries in Europe and Sub-Saharan Africa. Second, a combination of free-text words; mobile phone, physical activity, exercise, diet, weight, BMI, and healthy eating was also used. Seven studies were reported from Europe and no eligible studies from Sub-Saharan Africa. The results of this narrative review indicate a lack of research in the development and testing of mHealth interventions for childhood and adolescent obesity. There is a need for an evidence base of mHealth interventions that are both relevant and appropriate in order to stem the epidemic of overweight and obesity among children and adolescents in these countries. Uptake of such interventions is likely to be high as there is high penetrance of mobile phone technology amongst adolescents, even within poor communities in Africa.
Soft Origami Optical-Sensing Actuator for Underwater Manipulation
Authors: Shen Zhong , Zhao Yafei , Zhong Hua , Tang Kailuan , Chen Yishan , Xiao Yin , Yi Juan , Liu Sicong , Wang Zheng
Published: March 2021

Soft robots are ideal for underwater manipulation in sampling and other servicing applications. Their unique features of compliance, adaptability, and being naturally waterproof enable robotic designs to be compact and lightweight, while achieving uncompromized dexterity and flexibility. However, the inherent flexibility and high nonlinearity of soft materials also results in combined complex motions, which creates both soft actuator and sensor challenges for force output, modeling, and sensory feedback, especially under highly dynamic underwater environments. To tackle these limitations, a novel Soft Origami Optical-Sensing Actuator (SOSA) with actuation and sensing integration is proposed in this paper. Inspired by origami art, the proposed sensorized actuator enables a large force output, contraction/elongation/passive bending actuation by fluid, and hybrid motion sensing with optical waveguides. The SOSA design brings two major novelties over current designs. First, it involves a new actuation-sensing mode which enables a superior large payload output and a robust and accurate sensing performance by introducing the origami design, significantly facilitating the integration of sensing and actuating technology for wider applications. Secondly, it simplifies the fabrication process for harsh environment application by investigating the boundary features between optical waveguides and ambient water, meaning the external cladding layer of traditional sensors is unnecessary. With these merits, the proposed actuator could be applied to harsh environments for complex interaction/operation tasks. To showcase the performance of the proposed SOSA actuator, a hybrid underwater 3-DOFs manipulator has been developed. The entire workflow on concept design, fabrication, modeling, experimental validation, and application are presented in detail as reference for wider effective robot-environment applications.
RNA Sequencing Analysis of Metopolophium dirhodum (Walker) (Hemiptera: Aphididae) Reveals the Mechanism Underlying Insecticide Resistance
Authors: Gao Haifeng , Zhu Xun , Li Guangkuo , Liu Enliang , Shen Yuyang , Zhao Sifeng , Ge Feng
Published: March 2021

Xinjiang (XJ) and Ningxia (NX) provinces are important agricultural regions in western China. Aphids are one kind of the most devastating pests in both the provinces. Aphids are typical phloem-feeding insects distributed worldwide and can severely damage crops. In this study, two representative Metopolophium dirhodum (Walker) (Hemiptera: Aphididae) populations were collected from the typical agricultural regions of XJ and NX, respectively for a high-throughput transcriptome sequencing analysis. A total of 5,265 differentially expressed genes (DEGs) were identified. The functional annotation of DEGs and the identification of enriched pathways indicated many of the DEGs are involved in processes related to energy metabolism, development, and insecticide resistance. Furthermore, an investigation of insecticide toxicity revealed the NX population is more resistant to insecticide treatments than the XJ population. Thus, the transcriptome data generated in present study can be used for functional gene characterization relevant to aphid development, metabolism, environmental adaptation, and insecticide resistance.
Bacteriophage-Based Methods for Detection of Viable Mycobacterium avium subsp. paratuberculosis and Their Potential for Diagnosis of Johne's Disease
Authors: Grant Irene R.
Published: March 2021

Bacteriophage-based methods for detecting Mycobacterium avium subsp. paratuberculosis (MAP) are a potential new approach for diagnosis of Johne's disease (JD). The basis of these tests is a mycobacteriophage (D29) with a lytic lifecycle that is able to infect a range of Mycobacterium spp., not just MAP. When added to a test sample, the phages will bind to and infect mycobacterial cells present. If the host mycobacterial cells are viable, the phages will take over the metabolic machinery of the cells to replicate and produce multiple copies of themselves (phage amplification), before weakening the host cell walls by enzyme action and causing cell lysis. Cell lysis releases the host cell contents, which will include ATP, various enzymes, mycobacterial host DNA and progeny D29 phages; all of which can become the target of subsequent endpoint detection methods. For MAP detection the released host DNA and progeny phages have principally been targeted. As only viable mycobacterial cells will support phage amplification, if progeny phages or host DNA are detected in the test sample (by plaque assay/phage ELISA or qPCR, respectively) then viable mycobacteria were present. This mini-review will seek to: clearly explain the basis of the phage-based tests in order to aid understanding; catalog modifications made to the original plaque assay-based phage amplification assay (FASTPlaqueTB™) over the years; and summarize the available evidence pertaining to the performance of the various phage assays for testing veterinary specimens (bovine milk, blood and feces), relative to current JD diagnostic methods (culture, fecal PCR, and blood-ELISA).
Case Report: Successful Management of Refractory Keratomycosis in an Alpaca Using Penetrating Keratoplasty and Combination Antifungal Therapy (Caspofungin 0.5% and Terbinafine 1%)
Authors: Foote Braidee C. , Smith Joe S. , Bowden Anna Catherine , Allbaugh Rachel A. , Sebbag Lionel
Published: March 2021

Fungal keratitis is a common disease in certain parts of the world and affects several species, including equids, camelids, and homo sapiens, leading to blindness or loss of the eye if the infection is not adequately controlled. Reports of clinical use of antifungals caspofungin and terbinafine are limited across both veterinary and human medical literature. The alpaca presented in this case demonstrates that deep keratomycosis can be caused byScopulariopsis brevicaulisandFusarium verticillioides, two previously unreported fungi to cause keratomycosis in camelids. This report demonstrates successful management with a combination of surgery and topical ophthalmic treatment with caspofungin 0.5% solution and terbinafine 1% dermatologic cream, after initially failing treatment with topical voriconazole 1% solution. Combination therapy appears more effective than monotherapy with some fungal organisms, and synergy between antifungal agents is thought to play a role in the success of combination therapy. Surgery to remove the bulk of the fungal infection is especially helpful in cases that fail initial medical therapy.
Incidence of Cholangitis and Sepsis Associated with Percutaneous Transhepatic Cholangiography in Pediatric Liver Transplant Recipients
Authors: Sansotta Naire , De Luca Ester , Nicastro Emanuele , Tebaldi Alessandra , Ferrari Alberto , D’Antiga Lorenzo
Published: March 2021

Background. Percutaneous transhepatic cholangiography (PTC) is an established treatment in the management of biliary strictures. The aim of our study was to determine the incidence of PTC-related infectious complications in transplanted children, and identify their precise aetiol-ogy. Methods. We retrospectively reviewed all PTC performed from January 2017 to October 2020 in our center. Before the procedure, all patients received antibiotic prophylaxis defined as first line, while second line was used in case of previously microbiological isolation. Cholangitis was defined as fever (>38.5°) and elevated inflammatory markers after PTC, while sepsis included hemodynamic instability in addition to cholangitis. Results. One hundred and fifty-seven PTCs from 50 pediatric recipients were included. The overall incidence of cholangitis and sepsis after PTC was 44.6% (70/157) and 3.2% (5/157), respectively, with no fatal events. Blood cultures yielded positive results in 15/70 cases (21.4%). Enterococcus faecium and Pseudomonas aeruginosa were the most common isolated pathogens. Multidrug-resistant (MDR) pathogens were found in 11/50 patients (22%). Conclusion. PTC is associated with a relatively high rate of post-procedural cholangitis, although with low rate of sepsis and no fatal events. Blood cultures allowed to find a precise aetiology in roughly a quarter of the cases, showing prevalence of Enterococcus faecium and Pseudomonas aeruginosa.
Nanomotion Detection-Based Rapid Antibiotic Susceptibility Testing
Authors: Kasas Sandor , Malovichko Anton , Villalba Maria Ines , Vela María Elena , Yantorno Osvaldo , Willaert Ronnie G.
Published: March 2021

Rapid antibiotic susceptibility testing (AST) could play a major role in fighting multidrug-resistant bacteria. Recently, it was discovered that all living organisms oscillate in the range of nanometers and that these oscillations, referred to as nanomotion, stop as soon the organism dies. This finding led to the development of rapid AST techniques based on the monitoring of these oscillations upon exposure to antibiotics. In this review, we explain the working principle of this novel technique, compare the method with current ASTs, explore its application and give some advice about its implementation. As an illustrative example, we present the application of the technique to the slowly growing and pathogenic Bordetella pertussis bacteria.
Measurement of Thinned Water-Cooled Wall in a Circulating Fluidized Bed Boiler Using Ultrasonic and Magnetic Methods
Authors: Lee Jinyi , Choe Eunho , Pham Cong-Thuong , Le Minhhuy
Published: March 2021

In this paper, a nondestructive inspection system is proposed to detect and quantitatively evaluate the size of the near- and far-side damages on the tube, membrane, and weld of the water-cooled wall in the fluidized bed boiler. The shape and size of the surface damages can be evaluated from the magnetic flux density distribution measured by the magnetic sensor array on one side from the center of the magnetizer. The magnetic sensors were arrayed on a curved shape probe according to the tube’s cross-sectional shape, membrane, and weld. On the other hand, the couplant was doped to the water-cooled wall, and a thin film was formed thereon by polyethylene terephthalate. Then, the measured signal of the flexible ultrasonic probe was used to detect and evaluate the depth of the damages. The combination of the magnetic and ultrasonic methods helps to detect and evaluate both near and far-side damages. Near-side damages with a minimum depth of 0.3 mm were detected, and the depth from the surface of the far-side damage was evaluated with a standard deviation of 0.089 mm.
Development of Tolerance-Based Performance Prediction Technology and Optimization of Actuator Design Factors of a Magnet Vertical Magnetization of AVAS
Authors: Lee Hyun-Ju , Ko Dong-Shin , Hur Deog-Jae
Published: March 2021

With the increasing proliferation of electric and hydrogen vehicles, noises to recognize the driving status at low speeds are legalized, so a virtual engine sound generator is required, and slimming is required for packaging it in vehicles. This study investigates an optimization method for improving the electromagnetic force performance and slimming of the magnetic circuit for the permanent magnet structure for the vertical magnetization of the actuator for the acoustic vehicle alerting system (AVAS) of a vehicle and the probabilistic optimization of manufacturing tolerance management. To investigate the impact of the design parameters of the magnetic circuit structure on the electromagnetic force performance and slimming, we performed an independent analysis based on a single variable and investigated the characteristic variations based on multiple variables using a full factorial design and derived a performance prediction regression model using the central composite design of response surface methodology, including the curvature effect, by adding a center point to verify and consider the nonlinear characteristics. Consequently, four effective design parameters were determined to analyze the electromagnetic force performance and slimming of the vertical magnetization structure of the AVAS actuator—permanent magnet thickness, magnetic force collecting plate thickness, yoke position, and yoke thickness. We then performed statistical analysis using Monte Carlo simulation and proposed an optimization management level of 3σ with excellent process capability as the design application tolerance that can occur in the manufacturing process of each design parameter, whereby the confidence level of electromagnetic force performance and slimming improved from 99.46% to 99.73% and 97.62% to 99.73%, respectively.
SENIOR: An Intelligent Web-Based Ecosystem to Predict High Blood Pressure Adverse Events Using Biomarkers and Environmental Data
Authors: López Bernal Sergio , Martínez Valverde Javier , Huertas Celdrán Alberto , Martínez Pérez Gregorio
Published: March 2021

Web platforms are gaining relevance in eHealth, where they ease the interaction between patients and clinician. However, some clinical fields, such as the cardiovascular one, still need more effort because cardiovascular diseases are the principal cause of death and medical resources expenditure worldwide. The lack of daily control is the main reason hypertension is a current health problem, and medical web services could improve this situation. To face this challenge, this work proposes a novel intelligent web-based ecosystem, called SENIOR, capable of predicting adverse blood pressure events. The innovation of the SENIOR ecosystem relies on a wearable device measuring patient’s biomarkers such as blood pressure, a mobile application acquiring patient’s information, and a web platform consulting environmental services, processing data, and predicting blood pressure. The second contribution of this work is to consider novel environmental features based on the users’ location, such as climate and pollution data, to increase the knowledge about known variables affecting hypertension. Finally, our last contribution is a proof of concept with several machine learning algorithms predicting blood pressure values both in real-time and future temporal windows within one day has demonstrated the suitability of SENIOR.
Ohmic Heating in the Food Industry: Developments in Concepts and Applications during 2013–2020
Authors: Alkanan Zina T. , Altemimi Ammar B. , Al-Hilphy Asaad R. S. , Watson Dennis G. , Pratap-Singh Anubhav
Published: March 2021

Various technologies have been evaluated as alternatives to conventional heating for pasteurization and sterilization of foods. Ohmic heating of food products, achieved by passage of an alternating current through food, has emerged as a potential technology with comparable performance and several advantages. Ohmic heating works faster and consumes less energy compared to conventional heating. Key characteristics of ohmic heating are homogeneity of heating, shorter heating time, low energy consumption, and improved product quality and food safety. Energy consumption of ohmic heating was measured as 4.6–5.3 times lower than traditional heating. Many food processes, including pasteurization, roasting, boiling, cooking, drying, sterilization, peeling, microbiological inhibition, and recovery of polyphenol and antioxidants have employed ohmic heating. Herein, we review the theoretical basis for ohmic treatment of food and the interaction of ohmic technology with food ingredients. Recent work in the last seven years on the effect of ohmic heating on food sensory properties, bioactive compound levels, microbial inactivation, and physico-chemical changes are summarized as a convenient reference for researchers and food scientists and engineers.
Laser Microdissection of Specific Stem-Base Tissue Types from Olive Microcuttings for Isolation of High-Quality RNA
Authors: Velada Isabel , Menéndez Esther , Teixeira Rita Teresa , Cardoso Hélia , Peixe Augusto
Published: March 2021

Higher plants are composed of different tissue and cell types. Distinct cells host different biochemical and physiological processes which is reflected in differences in gene expression profiles, protein and metabolite levels. When omics are to be carried out, the information provided by a specific cell type can be diluted and/or masked when using a mixture of distinct cells. Thus, studies performed at the cell- and tissue-type level are gaining increasing interest. Laser microdissection (LM) technology has been used to isolate specific tissue and cell types. However, this technology faces some challenges depending on the plant species and tissue type under analysis. Here, we show for the first time a LM protocol that proved to be efficient for harvesting specific tissue types (phloem, cortex and epidermis) from olive stem nodal segments and obtaining RNA of high quality. This is important for future transcriptomic studies to identify rooting-competent cells. Here, nodal segments were flash-frozen in liquid nitrogen-cooled isopentane and cryosectioned. Albeit the lack of any fixatives used to preserve samples’ anatomy, cryosectioned sections showed tissues with high morphological integrity which was comparable with that obtained with the paraffin-embedding method. Cells from the phloem, cortex and epidermis could be easily distinguished and efficiently harvested by LM. Total RNA isolated from these tissues exhibited high quality with RNA Quality Numbers (determined by a Fragment Analyzer System) ranging between 8.1 and 9.9. This work presents a simple, rapid and efficient LM procedure for harvesting specific tissue types of olive stems and obtaining high-quality RNA.
Establishment of a Patient-Derived Xenograft Model of Colorectal Cancer in CIEA NOG Mice and Exploring Smartfish Liquid Diet as a Source of Omega-3 Fatty Acids
Authors: Samdal Helle , Olsen Lene C , Grøn Knut S , Røyset Elin S , Høiem Therese S , Nervik Ingunn , Sætrom Pål , Wibe Arne , Schønberg Svanhild A , Pettersen Caroline H H
Published: March 2021

Cancer patient-derived xenografts (PDXs) better preserve tumor characteristics and microenvironment than traditional cancer cell line derived xenografts and are becoming a valuable model in translational cancer research and personalized medicine. We have established a PDX model for colorectal cancer (CRC) in CIEA NOG mice with a 50% engraftment rate. Tumor fragments from patients with CRC (n = 5) were engrafted in four mice per tumor (n = 20). Mice with established PDXs received a liquid diet enriched with fish oil or placebo, and fatty acid profiling was performed to measure fatty acid content in whole blood. Moreover, a biobank consisting of tissue and blood samples from patients was established. Histology, immunohistochemistry and in situ hybridization procedures were used for staining of tumor and xenograft tissue slides. Results demonstrate that key histological characteristics of the patients’ tumors were retained in the established PDXs, and the liquid diets were consumed as intended by the mice. Some of the older mice developed lymphomas that originated from human Ki67+, CD45+, and EBV+ lymphoid cells. We present a detailed description of the process and methodology, as well as possible issues that may arise, to refine the method and improve PDX engraftment rate for future studies. The established PDX model for CRC can be used for exploring different cancer treatment regimes, and liquid diets enriched with fish oil may be successfully delivered to the mice through the drinking flasks.
Superior Adaptations in Adolescent Runners Using Heart Rate Variability (HRV)-Guided Training at Altitude
Authors: Bahenský Petr , Grosicki Gregory J.
Published: March 2021

We evaluated the efficacy of heart rate variability (HRV)-guided training in adolescent athletes during a 2-week, high altitude (≈1900 m) training camp. Sixteen middle- and long-distance runners (4 female/12 male, 16.9 ± 1.0 years, 65.44 ± 4.03 mL·kg−1·min−1) were divided into 2 matched groups, both of which received the same training plan, but one of which acquired postwaking HRV values that were used to tailor the training prescription. During the camp, seven athletes in the HRV-guided group combined for a total of 32 training adjustments, whereas there were only 3 runners combined for 14 total training adjustments in the control group. A significant group by time interaction (p < 0.001) for VO2max was driven by VO2max improvements in the HRV group (+2.8 mL·kg−1·min−1, +4.27%; pBonf = 0.002) that were not observed in the control condition (+0.8 mL·kg−1·min−1, +1.26%; pBonf = 0.643). After returning from the camp, all athletes in the HRV group set a personal best, and six out of eight achieved their best positions in the National Championship, whereas only 75% of athletes in the control group set a personal best and five out of eight achieved their best positions in the National Championship. These data provide evidence in support of HRV-guided training as a way to optimize training prescriptions in adolescent athletes.
Fingerprint of Nature—Skin Penetration Analysis of a Stinging Nettle PlantCrystals Formulation
Authors: Knoth Daniel , Alnemari Reem M. , Wiemann Sabrina , Keck Cornelia M. , Brüßler Jana
Published: March 2021

Background: PlantCrystals are a new concept to produce plant-based formulations. Their principle is based on the diminution of parts of or whole plants. In this study, the effect of a surfactant on stinging nettle leaf PlantCrystals was investigated. Secondly, the contents of bulk material and the PlantCrystals formulation were compared. In addition, for the very first time, the skin penetration of PlantCrystals was investigated. Methods: Stinging nettle leaves were milled with high-pressure homogenization. Sizes were analyzed via light microscopy and static light scattering. To investigate the effect of the milling, the flavonoid and total carotenoid content were determined, and the antioxidant capacity of the formulation was measured via total polyphenol content and DPPH (1,1-diphenyl-2-picrylhydrazyl) assay. Finally, the impact on skin penetration was investigated. Results: Size analysis showed a stabilizing effect of the surfactant, and the chemical analysis revealed higher flavonoid and polyphenol contents for PlantCrystals. The penetration of the formulation into the stratum corneum was shown to be promising; PlantCrystals possessed a visually perceived higher fluorescence and homogeneity compared to the bulk material. Conclusion: The concept of PlantCrystals improved the availability of valuable constituents and the penetration efficacy. The utilization of the natural chlorophyll fluorescence for skin penetration analysis of plant-based formulations proved itself highly effective.
Exploring the Influence of Milling Parameters on the Wet Mechanochemical Synthesis of Mg-Al Layered Double Hydroxides
Authors: Barnard Brenda , Labuschagné Frederick
Published: March 2021

The synthesis of Mg-Al layered double hydroxide (LDH) was explored, through a one-step wet mechanochemical route, with the use of a NETZSCH LME 1 horizontal bead mill. Raw materials selected comprised of a mixture of metallic oxides/hydroxides promoting green synthesis. The research aims to expand on the understanding of the wet mechanochemical synthesis of Mg-Al LDH through variation in milling and synthesis parameters. The selected parameters investigated were rotational speed, retention time, solids loading, bead size and jacket water inlet temperature. Samples were collected, filtered and dried at 60 °C for 12 h. Unless stated otherwise, or under investigation, parameters were kept constant at pre-selected conditions adapted from existing literature. LDH synthesis was deemed to occur successfully at elevated jacket water temperatures of 50 °C and longer retention times. It was noted that Al(OH)3 XRD peak reduction occurred readily for increased rotational speeds and residence times, regardless of system temperature. MgO was deemed to react more readily at elevated temperatures. It was proposed that the amorphitisation and mechanochemical activation of Al(OH)3 contributed to its dissolution providing the relevant Al3+ ions necessary for Mg2+ isomorphic substitution. Increasing the system temperature promoted the hydration of MgO, with the absence of Mg(OH)2 attributed to its contribution as an intermediate phase prior to LDH formation.
TCP Acknowledgment Optimization in Low Power and Embedded Devices
Authors: Statkus Arūnas , Paulikas Šarūnas , Krukonis Audrius
Published: March 2021

Paper investigates transport control protocol (TCP) acknowledgment (ACK) optimization in low power or embedded devices to improve their performance on high-speed links by limiting the ACK rate. Today the dominant protocol for interconnecting network devices is the TCP and it has a great influence on the entire network operation if the processing power of network devices is exhausted to the processing data from the TCP stack. Therefore, on high-speed not congested networks the bottleneck is no longer the network link but low-processing power network devices. A new ACK optimization algorithm has been developed and implemented in the Linux kernel. Proposed TCP stack modification minimizes the unneeded technical expenditure from TCP flow by reducing the number of ACKs. The results of performed experiments show that TCP ACK rate limiting leads to the noticeable decrease of CPU utilization on low power devices and an increase of TCP session throughput but does not impact other TCP QoS parameters, such as session stability, flow control, connection management, congestion control or compromises link security. Therefore, more resources of the low-power network devices could be allocated for high-speed data transfer.
Effect of Lactobacillus rhamnosus on Physicochemical Properties of Fermented Plant-Based Raw Materials
Authors: Masiá Carmen , Geppel Asger , Jensen Poul Erik , Buldo Patrizia
Published: March 2021

To overcome texture and flavor challenges in fermented plant-based product development, the potential of microorganisms is generating great interest in the food industry. This study examines the effect of Lactobacillus rhamnosus on physicochemical properties of fermented soy, oat, and coconut. L. rhamnosus was combined with different lactic acid bacteria strains and Bifidobacterium. Acidification, titratable acidity, and viability of L. rhamnosus and Bifidobacterium were evaluated. Oscillation and flow tests were performed to characterize rheological properties of fermented samples. Targeted and untargeted volatile organic compounds in fermented samples were assessed, and sensory evaluation with a trained panel was conducted. L. rhamnosus reduced fermentation time in soy, oat, and coconut. L. rhamnosus and Bifidobacterium grew in all fermented raw materials above 107 CFU/g. No significant effect on rheological behavior was observed when L. rhamnosus was present in fermented samples. Acetoin levels increased and acetaldehyde content decreased in the presence of L. rhamnosus in all three bases. Diacetyl levels increased in fermented oat and coconut samples when L. rhamnosus was combined with a starter culture containing Streptococcus thermophilus and with another starter culture containing S. thermophilus, L. bulgaricus and Bifidobacterium. In all fermented oat samples, L. rhamnosus significantly enhanced fermented flavor notes, such as sourness, lemon, and fruity taste, which in turn led to reduced perception of base-related attributes. In fermented coconut samples, gel firmness perception was significantly improved with L. rhamnosus. The findings suggest that L. rhamnosus can improve fermentation time and sensory perception of fermented plant-based products.
Food Choice and Waste in University Dining Commons—A Menus of Change University Research Collaborative Study
Authors: Wiriyaphanich Tiffany , Guinard Jean-Xavier , Spang Edward , Amsler Challamel Ghislaine , Valgenti Robert T. , Sinclair Danielle , Lubow Samantha , Putnam-Farr Eleanor
Published: March 2021

The purpose of this multi-campus research was to investigate the relationships of food type and personal factors with food choice, consumption, and waste behaviors of college students at all-you-care-to-eat dining facilities. The amount of food taken and wasted was indirectly measured in units relative to the plate size using before and after photos taken by the diners themselves. Animal protein and mixed dishes (e.g., stir fry, sandwich) took up more of diners’ plate space and these items were correlated to both greater hedonic appeal as well as a higher likelihood of the item being pre-plated. Greater confidence in liking an item before choosing it was correlated to a larger portion being taken. Finally, increased satisfaction with the meal and frequency of visiting the dining commons was correlated to less food waste. Understanding these potential food choice drivers can help dining facilities better target healthier meals to diners while reducing food waste.
Pediatric Adapted Liking Survey (PALS) with Tailored Nutrition Education Messages: Application to a Middle School Setting
Authors: Hildrey Rachel , Karner Heidi , Serrao Jessica , Lin Carolyn A. , Shanley Ellen , Duffy Valerie B.
Published: March 2021

We tested the feasibility of a school-based, liking-based behavioral screener (Pediatric Adapted Liking Survey (PALS)) and message program to motivate healthy diet and activity behaviors. Students, recruited from middle- (n = 195) or low-income (n = 310) schools, online-reported: likes/dislikes of foods/beverages and physical/sedentary activities, scored into healthy behavior indexes (HBI); perceived food insecurity; and sleep indicators. Students received tailored motivating or reinforcing messages (aligned with behavior change theories) and indicated their willingness to improve target behaviors as well as program feasibility (acceptability; usefulness). Although HBIs averaged lower in the lower versus middle-income school, frequencies of food insecurity were similar (39–44% of students). Students in both schools reported sleep concerns (middle-income school—43% reported insufficient hours of sleep/night; low-income school—55% reported excessive daytime sleepiness). Students across both schools confirmed the PALS acceptability (>85% agreement to answering questions quickly and completion without help) and usefulness (≥73% agreed PALS got them thinking about their behaviors) as well as the tailored message acceptability (≥73% reported the messages as helpful; learning new information; wanting to receive more messages) and usefulness (73% reported “liking” to try one behavioral improvement). Neither message type nor response varied significantly by food insecurity or sleep measures. Thus, this program feasibly delivered students acceptable and useful messages to motivate healthier behaviors and identified areas for school-wide health promotion.
Effects of a Lifestyle Intervention on Health-Promoting Behavior, Psychological Distress and Reproductive Health of Overweight and Obese Female College Students
Authors: Nho Ju-Hee , Chae Soo-Wan
Published: March 2021

This study aimed to examine the effect of a lifestyle intervention (LSI) on overweight or obese female university students. Participants: A total of 53 overweight or obese female college students participated. This study was conducted from May to December 2017 in Jeonbuk Province, South Korea. A quasi-experimental design using a non-equivalent control group pretest-posttest was used. The LSI consisted of providing health information, individual health counseling, lifestyle monitoring, and effective support based on the interaction model of client health behavior, which was implemented for 12 weeks. Significant group differences were found in health-promoting behavior, psychological distress, reproductive health, body weight, body fat, and triglyceride level among participants. LSIs are effective in improving health-promoting behavior, psychological distress, reproductive health, and body composition. Therefore, healthcare providers should develop and apply LSIs through interaction for overweight or obese female college students.
Biomarker-Oriented Therapy in Bladder and Renal Cancer
Authors: Scholtes Mathijs P. , Alberts Arnout R. , Iflé Iris G. , Verhagen Paul C. M. S. , van der Veldt Astrid A. M. , Zuiverloon Tahlita C. M.
Published: March 2021

Treatment of patients with urothelial carcinoma (UC) of the bladder or renal cancer has changed significantly during recent years and efforts towards biomarker-directed therapy are being investigated. Immune checkpoint inhibition (ICI) or fibroblast growth factor receptor (FGFR) directed therapy are being evaluated for non-muscle invasive bladder cancer (NMIBC) patients, as well as muscle-invasive bladder cancer (MIBC) patients. Meanwhile, efforts to predict tumor response to neoadjuvant chemotherapy (NAC) are still ongoing, and genomic biomarkers are being evaluated in prospective clinical trials. Currently, patients with metastatic UC (mUC) are usually treated with second-line ICI, while cisplatin-ineligible patients with programmed death-ligand 1 (PD-L1) positive tumors can benefit from first-line ICI. Platinum-relapsed UC patients harboring FGFR2/3 mutations can be treated with erdafitinib, while enfortumab vedotin has emerged as a novel third-line treatment option for mUC. In metastatic (clear cell) renal cell carcinoma (RCC), ICI was first introduced as second-line treatment after vascular endothelial growth factor receptor—tyrosine kinase inhibition (VEGFR-TKI). Currently, ICIs have also been introduced as first-line treatment in metastatic RCC. Although there is no evidence up to now for beneficial adjuvant treatment after surgery with VEGFR-TKIs in high-risk non-metastatic RCC, several trials are underway investigating the potential beneficial effect of ICIs in this setting.
Malware Detection Based on Code Visualization and Two-Level Classification
Authors: Moussas Vassilios , Andreatos Antonios
Published: March 2021

Malware creators generate new malicious software samples by making minor changes in previously generated code, in order to reuse malicious code, as well as to go unnoticed from signature-based antivirus software. As a result, various families of variations of the same initial code exist today. Visualization of compiled executables for malware analysis has been proposed several years ago. Visualization can greatly assist malware classification and requires neither disassembly nor code execution. Moreover, new variations of known malware families are instantly detected, in contrast to traditional signature-based antivirus software. This paper addresses the problem of identifying variations of existing malware visualized as images. A new malware detection system based on a two-level Artificial Neural Network (ANN) is proposed. The classification is based on file and image features. The proposed system is tested on the ‘Malimg’ dataset consisting of the visual representation of well-known malware families. From this set some important image features are extracted. Based on these features, the ANN is trained. Then, this ANN is used to detect and classify other samples of the dataset. Malware families creating a confusion are classified by a second level of ANNs. The proposed two-level ANN method excels in simplicity, accuracy, and speed; it is easy to implement and fast to run, thus it can be applied to antivirus software, smart firewalls, web applications, etc.
Diagnosis of Pancreatic Ductal Adenocarcinoma by Immuno-Positron Emission Tomography
Authors: González-Gómez Ruth , Pazo-Cid Roberto A. , Sarría Luis , Morcillo Miguel Ángel , Schuhmacher Alberto J.
Published: March 2021

Diagnosis of pancreatic ductal adenocarcinoma (PDAC) by current imaging techniques is useful and widely used in the clinic but presents several limitations and challenges, especially in small lesions that frequently cause radiological tumors infra-staging, false-positive diagnosis of metastatic tumor recurrence, and common occult micro-metastatic disease. The revolution in cancer multi-“omics” and bioinformatics has uncovered clinically relevant alterations in PDAC that still need to be integrated into patients’ clinical management, urging the development of non-invasive imaging techniques against principal biomarkers to assess and incorporate this information into the clinical practice. “Immuno-PET” merges the high target selectivity and specificity of antibodies and engineered fragments toward a given tumor cell surface marker with the high spatial resolution, sensitivity, and quantitative capabilities of positron emission tomography (PET) imaging techniques. In this review, we detail and provide examples of the clinical limitations of current imaging techniques for diagnosing PDAC. Furthermore, we define the different components of immuno-PET and summarize the existing applications of this technique in PDAC. The development of novel immuno-PET methods will make it possible to conduct the non-invasive diagnosis and monitoring of patients over time using in vivo, integrated, quantifiable, 3D, whole body immunohistochemistry working like a “virtual biopsy”.
Valproic Acid-Induced Liver Injury: A Case-Control Study from a Prospective Pharmacovigilance Program in a Tertiary Hospital
Authors: Meseguer Enrique S. , Elizalde Mikel U. , Borobia Alberto M. , Ramírez Elena
Published: March 2021

Introduction: Valproic acid (VPA) is an antiepileptic drug extensively used for treating partial and generalised seizures, acute mania and as prophylaxis for bipolar disorder. Drug-induced liver injury (DILI) persists as a significant issue related to fatal outcomes by VPA. The aim of this study was to increase our knowledge about this condition and to better identify patients affected. Methods: We conducted an observational retrospective case-control study that identified cases of DILI by VPA from the Pharmacovigilance Programme from our Laboratory Signals at La Paz University Hospital from January 2007 to December 2019. From the Therapeutic VPA Monitoring program, two control groups were assigned, VPA-tolerant patients and the other with patients who developed mild VPA-related liver injury but who did not meet the DILI criteria, matched for date, age and sex. Results: A total of 60 patients were included in the study: 15 cases of DILI, 30 VPA-tolerant controls and 15 controls with mild liver injury. Mean age for the cases was 45.7 years, 4 (26.7%) were women and 5 (33.34%) were children under 18 years, of them 3 (20%) were fatal. Polytherapy with other antiepileptic drugs (p = 0.047) and alcohol consumption (p < 0.001) were associated with a greater risk of developing DILI by VPA. A diagnosis of epileptic seizure was more frequently related to DILI when compared with the VPA-tolerant controls (p < 0.001). The cases developed hepatocellular liver injury (p < 0.001), while the mild hepatic damage controls had a higher rate of cholestatic liver injury (p < 0.001). The laboratory lactate dehydrogenase values were statistically higher (even at baseline) in patients with DILI than in both control groups (p = 0.033 and p = 0.039). Conclusions: VPA hepatotoxicity remains a considerable problem. This study offers interesting findings for characterising VPA-induced liver injury and at-risk patients.
Indication of Liver Transplantation for Hepatocellular Carcinoma Should Be Reconsidered in Case of Microvascular Invasion and Multilocular Tumor Occurrence
Authors: Gundlach Jan-Paul , Schmidt Stephan , Bernsmeier Alexander , Günther Rainer , Kataev Victor , Trentmann Jens , Schäfer Jost Philipp , Röcken Christoph , Becker Thomas , Braun Felix
Published: March 2021

Liver transplantation (LT) is routinely performed for hepatocellular carcinoma (HCC) in cirrhosis without major vascular invasion. Although the adverse influence of microvascular invasion is recognized, its occurrence does not contraindicate LT. We retrospectively analyzed in our LT cohort the significance of microvascular invasion on survival and demonstrate bridging procedures. At our hospital, 346 patients were diagnosed with HCC, 171 patients were evaluated for LT, and 153 were listed at Eurotransplant during a period of 11 years. Among these, 112 patients received LT and were included in this study. Overall survival after 1, 3 and 5 years was 86.3%, 73.9%, and 67.9%, respectively. Microvascular invasion led to significantly reduced overall (p = 0.030) and disease-free survival (p = 0.002). Five-year disease-free survival with microvascular invasion was 10.5%. Multilocular tumor occurrence with simultaneous microvascular invasion revealed the worst prognosis. In our LT cohort, predominant bridging treatment was transarterial chemoembolization (TACE) and the number of TACE significantly correlated with poorer overall survival after LT (p = 0.028), which was confirmed in multiple Cox regression analysis for overall and disease-free survival (p = 0.015 and p = 0.011). Microvascular tumor invasion is significantly associated with reduced prognosis after LT, which is aggravated by simultaneous occurrence of multiple lesions. Therefore, indication strategies for LT should be reconsidered.
Metabolomic Alteration of Oral Keratinocytes and Fibroblasts in Hypoxia
Authors: Kato Hiroko , Sugimoto Masahiro , Enomoto Ayame , Kaneko Miku , Hara Yuko , Saito Naoaki , Shiomi Aki , Ohnuki Hisashi , Izumi Kenji
Published: March 2021

The oxygen concentration in normal human tissue under physiologic conditions is lower than the atmospheric oxygen concentration. The more hypoxic condition has been observed in the cells with wound healing and cancer. Somatic stem cells reside in a hypoxic microenvironment in vivo and prefer hypoxic culture conditions in vitro. Oral mucosa contains tissue-specific stem cells, which is an excellent tissue source for regenerative medicine. For clinical usage, maintaining the stem cell in cultured cells is important. We previously reported that hypoxic culture conditions maintained primary oral keratinocytes in an undifferentiated and quiescent state and enhanced their clonogenicity. However, the metabolic mechanism of these cells is unclear. Stem cell biological and pathological findings have shown that metabolic reprogramming is important in hypoxic culture conditions, but there has been no report on oral mucosal keratinocytes and fibroblasts. Herein, we conducted metabolomic analyses of oral mucosal keratinocytes and fibroblasts under hypoxic conditions. Hypoxic oral keratinocytes and fibroblasts showed a drastic change of metabolite concentrations in urea cycle metabolites and polyamine pathways. The changes of metabolic profiles in glycolysis and the pentose phosphate pathway under hypoxic conditions in the oral keratinocytes were consistent with those of other somatic stem cells. The metabolic profiles in oral fibroblasts showed only little changes in any pathway under hypoxia except for a significant increase in the antioxidant 2-oxoglutaric acid. This report firstly provides the holistic changes of various metabolic pathways of hypoxic cultured oral keratinocytes and fibroblasts.
Temporal Trends of Bleeding Episodes during Half- vs. Standard-Dose Ticagrelor in Acute Coronary Syndrome Patients with Low Platelet Reactivity: A Randomized BLEEDING-ACS Trial
Authors: Kim Laeun , Choe Jeong Cheon , Ahn Jin Hee , Lee Hye Won , Oh Jun-Hyok , Choi Jung Hyun , Lee Han Cheol , Cha Kwang Soo , Hong Taek Jong , Jeong Young-Hoon , Park Jin Sup
Published: March 2021

To assess the temporal trends of bleeding episodes during half- vs. standard-dose ticagrelor in acute coronary syndrome (ACS) patients with low platelet reactivity (LPR) during standard-dose ticagrelor (90 mg bid). ACS Patients with LPR (<85 P2Y12 reaction units) (n = 122) were randomly assigned to receive either half-dose (45 mg bid) or standard-dose ticagrelor (90 mg bid). The primary endpoint was incidence of Bleeding Academic Research Consortium (BARC) bleeding at 1 week, 1, 3 and 6 months. Dyspnea and ischemic events were also evaluated. Bleeding episodes were most commonly observed at 1 month and then decreased over time. Half-dose ticagrelor did not reduce any BARC bleeding (odds ratio [OR] 0.900, 95% confidence interval [CI] 0.563–1.440, p = 0.661). However, serious bleeding (BARC type ≥2) occurred less often in half-dose ticagrelor (OR 0.284, 95% CI 0.088–0.921, p = 0.036). The rate of moderate-to-severe dyspnea was highest at 1 month, then decreased over time. Half-dose ticagrelor did not decrease moderate-to-severe dyspnea (Borg scale ≥ 3) (OR 1.066, 95% CI 0.322–3.530, p = 0.916). The risk of ischemic events was also similar between the groups. In conclusions, compared with standard-dose ticagrelor, half-dose ticagrelor reduced serious bleeding events during early period of dual-antiplatelet therapy in ACS patients with LPR; however, the risk of any bleeding events and dyspnea did not differ according to ticagrelor dose. Clinical registration: KCT0004640.