bluuebunny/crossref_metadata_2025 huggingface dataset:
Understanding the Shifts of Microbial Community and Metabolite Profile From Wheat to Mature Daqu
Authors: Zhang Yuandi , Shen Yi , Cheng Wei , Wang Xi , Xue Yansong , Chen Xiaoxue , Han Bei-Zhong
Published: July 2021

Wheat-originated microbes play an important role in shaping the quality of high-temperature Daqu which is commonly used as a starter for producing sauce-flavor Baijiu. However, the shifts of microbiota from raw material to fresh Daqu and then to mature Daqu remain unclear. Hence, in the present study, the inner and outer of fresh and mature Daqu were collected to explore the correlation between microbiota and metabolites as well as the source of the microbiota in Daqu. Results indicated that the activities of amylase and protease between the inner and outer of fresh Daqu varied significantly while both parts became similar after maturation. The predominant bacteria shifted from Saccharopolyspora (outer) and Staphylococcus (inner) to Kroppenstedtia (both outer and inner), while the predominant fungi shifted from Thermoascus (both outer and inner) to Byssochlamys (outer) and Fusarium (inner). A combining analysis of headspace solid-phase micro extraction-gas chromatography-mass spectrometry, headspace gas chromatography-ion mobility spectrometry, and nuclear magnetic resonance was employed to detect the metabolites. The network analysis was conducted to perform the relationships between microbes and metabolites. The results showed that the bacteria, especially Saccharopolyspora, Bacillus, and Acinetobacter, had a strong correlation with the productions of esters, amino acids and their derivatives, and sugars and their derivatives, while most fungi such as Thermoascus, were negatively correlated with the phenylalanine, trimethylamine n-oxide, and isovalerate. SourceTracker analysis indicated that wheat was the important source of the Daqu microbiota, especially, the microorganisms in the inner of Daqu might be the drivers of the microbial succession during maturation. This study provided a comprehensive exploration to understand the microbial sources and shifts in high-temperature Daqu during maturation.
The Multi-Domain Intervention Trial in Older Adults With Diabetes Mellitus for Prevention of Dementia in Japan: Study Protocol for a Multi-Center, Randomized, 18-Month Controlled Trial
Authors: Sugimoto Taiki , Araki Atsushi , Fujita Hiroki , Honda Keiko , Inagaki Nobuya , Ishida Takeshi , Kato Junichi , Kishi Minoru , Kobayashi Kazuki , Kouyama Kunichi , Noma Hisashi , Ohishi Mitsuru , Satoh-Asahara Noriko , Shimada Hiroyuki , Sugimoto Kazuhiro , Suzuki Susumu , Takeya Yasushi , Tamura Yoshiaki , Tokuda Haruhiko , Umegaki Hiroyuki , Watada Hirotaka , Yamada Yuichiro , Sakurai Takashi
Published: July 2021

Background: The Japan-Multi-domain Intervention Trial for Prevention of Dementia in Older Adults with Diabetes (J-MIND-Diabetes) is an 18-month, multi-centered, open-labeled, randomized controlled trial designed to identify whether multi-domain intervention targeting modifiable risk factors for dementia could prevent the progression of cognitive decline among older adults with type 2 diabetes mellitus (T2DM). This manuscript describes the study protocol for the J-MIND-Diabetes trial.

Materials and Methods: Subjects of this trial will comprise a total of 300 T2DM outpatients aged 70–85 years with mild cognitive impairment. Subjects will be centrally randomized into intervention and control groups at a 1:1 allocation ratio using the stratified permuted-block randomization methods. The intervention group will participate in multi-domain intervention programs aimed at: (1) management of metabolic and vascular risk factors; (2) physical exercise and self-monitoring of physical activity; (3) nutritional guidance; and (4) social participation. The control group will receive usual T2DM care and general instructions on dementia prevention. The primary and secondary outcomes will be assessed at baseline, at 6- and 18-month follow-up. The primary outcome is change from baseline at 18 months in a global composite score combining several neuropsychological domains, including global cognitive function, memory, attention, executive function, processing speed and language. Secondary outcomes include: (1) cognitive changes in neuropsychological tests; (2) changes in geriatrics assessments; (3) metabolic control and diabetic complications; (4) changes in blood and urinary markers.

Discussion: This trial will be the first trial to demonstrate the effectiveness of multi-domain intervention in preventing cognitive decline in older adults with T2DM at increased risk of dementia in Japan.

Trial Registration: UMIN000035911; Registered on the University Hospital Medical Information Network Clinical Trials Registry (UMIN-CTR) 18 February 2019. (https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000040908).
Selective Functional Network Changes Following tDCS-Augmented Language Treatment in Primary Progressive Aphasia
Authors: Tao Yuan , Ficek Bronte , Wang Zeyi , Rapp Brenda , Tsapkini Kyrana
Published: July 2021

Objective

Transcranial direct current stimulation (tDCS) has shown promising results when used as an adjunct to behavioral training in neurodegenerative diseases. However, the underlying neural mechanisms are not understood and neuroimaging evidence from pre/post treatment has been sparse. In this study, we examined tDCS-induced neural changes in a language intervention study for primary progressive aphasia (PPA), a neurodegenerative syndrome with language impairment as the primary clinical presentation. Anodal tDCS was applied to the left inferior frontal gyrus (LIFG). To evaluate the hypothesis that tDCS promotes system segregation, analysis focused on understanding tDCS-induced changes in the brain-wide functional network connectivity of the targeted LIFG.

Methods

Resting-state fMRI data were obtained from 32 participants with PPA before and after receiving a written naming therapy, accompanied either by tDCS or sham stimulation. We focused on evaluating changes in the global connectivity of the stimulated LIFG-triangularis (LIFG-tri) region given its important role in lexical processing. Global connectivity was indexed by the graph-theoretic measureparticipation coefficient(PC) which quantifies a region’s level of system segregation. The values before and after treatment were compared for each condition (tDCS or Sham) as well as with age-matched healthy controls (n= 19).

Results

Higher global connectivity of the LIFG-tri before treatment was associated with greater dementia severity. After treatment, the tDCS group showed a significant decrease in global connectivity whereas the Sham group’s did not change, suggesting specific neural effects induced by tDCS. Further examination revealed that the decrease was driven by reduced connectivity between the LIFG-tri and regions outside the perisylvian language area, consistent with the hypothesis that tDCS enhances the segregation of the language system and improves processing efficiency. Additionally, we found that these effects were specific to the LIFG-tri and not observed in other control regions.

Conclusion

TDCS-augmented language therapy in PPA increased the functional segregation of the language system, a normalization of the hyper-connectivity observed before treatment. These findings add to our understanding of the nature of tDCS-induced neural changes in disease treatment and have applications for validating treatment efficacy and designing future tDCS and other non-invasive brain stimulation (NIBS) treatments.
Laser-Induced Apoptosis of Corticothalamic Neurons in Layer VI of Auditory Cortex Impact on Cortical Frequency Processing
Authors: Saldeitis Katja , Jeschke Marcus , Budinger Eike , Ohl Frank W. , Happel Max F. K.
Published: July 2021

Corticofugal projections outnumber subcortical input projections by far. However, the specific role for signal processing of corticofugal feedback is still less well understood in comparisonto the feedforward projection. Here, we lesioned corticothalamic (CT) neurons in layers V and/or VI of the auditory cortex of Mongolian gerbils by laser-induced photolysis to investigate their contribution to cortical activation patterns. We have used laminar current-source density (CSD) recordings of tone-evoked responses and could show that, particularly, lesion of CT neurons in layer VI affected cortical frequency processing. Specifically, we found a decreased gain of best-frequency input in thalamocortical (TC)-recipient input layers that correlated with the relative lesion of layer VI neurons, but not layer V neurons. Using cortical silencing with the GABAa-agonist muscimol and layer-specific intracortical microstimulation (ICMS), we found that direct activation of infragranular layers recruited a local recurrent cortico-thalamo-cortical loop of synaptic input. This recurrent feedback was also only interrupted when lesioning layer VI neurons, but not cells in layer V. Our study thereby shows distinct roles of these two types of CT neurons suggesting a particular impact of CT feedback from layer VI to affect the local feedforward frequency processing in auditory cortex.
Processed Multiparameter Electroencephalogram-Guided General Anesthesia Management Can Reduce Postoperative Delirium Following Carotid Endarterectomy: A Randomized Clinical Trial
Authors: Xu Na , Li Li-Xia , Wang Tian-Long , Jiao Li-Qun , Hua Yang , Yao Dong-Xu , Wu Jie , Ma Yan-Hui , Tian Tian , Sun Xue-Li
Published: July 2021

Background: Patients undergoing carotid endarterectomy (CEA) for severe carotid stenosis are vulnerable to postoperative delirium, a complication frequently associated with poor outcome. This study investigated the impact of processed electroencephalogram (EEG)-guided anesthesia management on the incidence of postoperative delirium in patients undergoing CEA.

Methods: This single-center, prospective, randomized clinical trial on 255 patients receiving CEA under general anesthesia compared the outcomes of patient state index (PSI) monitoring [SEDLine Brain Function Monitor (Masimo, Inc, Irvine, CA)] (standard group, n = 128) with PSI combined with density spectral array(DSA) -guided monitoring (intervention group, n = 127) to reduce the risk of intraoperative EEG burst suppression. All patients were monitored by continuous transcranial Doppler ultrasound (TCD) and near-infrared spectroscopy (NIRS) to avoid perioperative cerebral hypoperfusion or hyperperfusion. According to the surgical process, EEG suppression time was calculated separately for three stages: S1 (from anesthesia induction to carotid artery clamping), S2 (from clamping to declamping), and S3 (from declamping to the end of surgery). The primary outcome was incidence of postoperative delirium according to the Confusion Assessment Method algorithm during the first 3 days post-surgery, and secondary outcomes were other neurologic complications and length of hospital stay.

Results: There were no episodes of cerebral hypoperfusion or hyperperfusion according to TCD and NIRS monitoring in either group during surgery. The incidence of postoperative delirium within 3 days post-surgery was significantly lower in the intervention group than the standard group (7.87 vs. 28.91%, P < 0.01). In the intervention group, the total EEG suppression time and the EEG suppression time during S2 and S3 were shorter (Total, 0 “0” vs. 0 “1.17” min, P = 0.04; S2, 0 “0” vs. 0 “0.1” min, P < 0.01; S3, 0 “0” vs. 0 “0” min, P = 0.02). There were no group differences in incidence of neurologic complications and length of postoperative hospital stay.

Conclusion: Processed electroencephalogram-guided general anesthesia management, consisting of PSI combined with DSA monitoring, can significantly reduce the risk of postoperative delirium in patients undergoing CEA. Patients, especially those exhibiting hemodynamic fluctuations or receiving surgical procedures that disrupt cerebral perfusion, may benefit from the monitoring of multiple EEG parameters during surgery.

Clinical Trial Registration:www.ClinicalTrials.gov, identifier: NCT03622515.
Neuromuscular and Neuroendocrinological Features Associated With ZC4H2-Related Arthrogryposis Multiplex Congenita in a Sicilian Family: A Case Report
Authors: Piccolo Gianluca , d'Annunzio Giuseppe , Amadori Elisabetta , Riva Antonella , Borgia Paola , Tortora Domenico , Maghnie Mohamad , Minetti Carlo , Gitto Eloisa , Iacomino Michele , Baldassari Simona , Fiorillo Chiara , Zara Federico , Striano Pasquale , Salpietro Vincenzo
Published: July 2021

Wieacker-Wolff syndrome (WWS) is an X-linked Arthrogryposis Multiplex Congenita (AMC) disorder associated with broad neurodevelopmental impairment. The genetic basis of WWS lies in hemizygous pathogenic variants in ZC4H2, encoding a C4H2 type zinc-finger nuclear factor abundantly expressed in the developing human brain. The main clinical features described in WWS families carrying ZC4H2 pathogenic variants encompass having a short stature, microcephaly, birth respiratory distress, arthrogryposis, hypotonia, distal muscle weakness, and broad neurodevelopmental delay. We hereby report a Sicilian family with a boy clinically diagnosed with WWS and genetically investigated with exome sequencing (ES), leading to the identification of a c.593G>A (p. R198Q) hemizygous pathogenic variant in the ZC4H2 gene. During the first year of life, the onset of central hypoadrenalism led to recurrent hypoglycemic events, which likely contributed to seizure susceptibility. Also, muscle biopsy studies confirmed a pathology of the muscle tissue and revealed peculiar abnormalities of the neuromuscular junction. In conclusion, we expand the phenotypic spectrum of the WWS-related neurodevelopmental disorders and discuss the role of ZC4H2 in the context of the potential neuroendocrinological and neuromuscular features associated with this condition.
Cell-Type-Specific Gene Expression in Developing Mouse Neocortex: Intermediate Progenitors Implicated in Axon Development
Authors: Bedogni Francesco , Hevner Robert F.
Published: July 2021

Cerebral cortex projection neurons (PNs) are generated from intermediate progenitors (IPs), which are in turn derived from radial glial progenitors (RGPs). To investigate developmental processes in IPs, we profiled IP transcriptomes in embryonic mouse neocortex, using transgenic Tbr2-GFP mice, cell sorting, and microarrays. These data were used in combination with in situ hybridization to ascertain gene sets specific for IPs, RGPs, PNs, interneurons, and other neural and non-neural cell types. RGP-selective transcripts (n = 419) included molecules for Notch receptor signaling, proliferation, neural stem cell identity, apical junctions, necroptosis, hippo pathway, and NF-κB pathway. RGPs also expressed specific genes for critical interactions with meningeal and vascular cells. In contrast, IP-selective genes (n = 136) encoded molecules for activated Delta ligand presentation, epithelial-mesenchymal transition, core planar cell polarity (PCP), axon genesis, and intrinsic excitability. Interestingly, IPs expressed several “dependence receptors” (Unc5d, Dcc, Ntrk3, and Epha4) that induce apoptosis in the absence of ligand, suggesting a competitive mechanism for IPs and new PNs to detect key environmental cues or die. Overall, our results imply a novel role for IPs in the patterning of neuronal polarization, axon differentiation, and intrinsic excitability prior to mitosis. Significantly, IPs highly express Wnt-PCP, netrin, and semaphorin pathway molecules known to regulate axon polarization in other systems. In sum, IPs not only amplify neurogenesis quantitatively, but also molecularly “prime” new PNs for axogenesis, guidance, and excitability.
Hip-Spine Syndrome in Patients With Spinal Cord Injuries: Hyperlordosis Associated With Severe Hip Flexion Contracture
Authors: Rhee Isaac , Do Woo Sung , Park Kun-Bo , Park Byoung Kyu , Kim Hyun Woo
Published: July 2021

Aim: Spinal cord injury (SCI)-related flaccid paralysis may result in a debilitating hyperlordosis associated with a progressive hip flexion contracture. The aim of this study was to evaluate the correction of hip flexion contractures and lumbar hyperlordosis in paraplegic patients that had a history of spinal cord injuries.

Methods: A retrospective review was performed on 29 hips of 15 consecutive patients who underwent corrective surgeries for severe hip flexion deformity from 2006 to 2018. The mean age at surgery was 10.1 years (2.7 to 15.8), and the mean follow-up was 68 months (7 to 143). Relevant medical, surgical, and postoperative information was collected from the medical records and radiographs.

Results: Improvements were seen in the mean hip flexion contracture (p < 0.001) with 100% hip correction at surgery and 92.1% at the latest follow-up. Mean lumbar lordosis decreased (p = 0.029) while the mean Cobb angle increased (p = 0.001) at the latest follow up. Functional score subdomains of the Spinal Cord Independence Measure, Functional Independence Measure, and modified Barthel activities of daily living (ADL) scores remained the same at the final follow-up.

Conclusion: For paraplegic SCI patients, we found an association between treating the hip flexion contracture and indirect correction of their lumbar hyperlordosis. We recommend the surgeon carefully examine the hip pathology when managing SCI-related spinal deformities, especially increased lumbar lordosis.
Case Report: Uroenteric Fistula in a Pediatric-en-bloc Kidney Transplant Manifests as Deceptive Watery Diarrhea and Normal Anion Gap Acidosis
Authors: Al Barbandi Malek , Defreitas Marissa J. , Infante Juan C. , Morsi Mahmoud , Arroyo Parejo Drayer Patricia A. , Katsoufis Chryso P. , Seeherunvong Wacharee , Chandar Jayanthi , Burke George W. , Abitbol Carolyn L.
Published: July 2021

Introduction: The diagnosis of a post–surgical uroenteric fistula can be challenging and may be delayed for months after symptoms begin. A normal anion gap metabolic acidosis has been reported in up to 100% of patients after ureterosigmoidostomy, and bladder substitution using small bowel and/or colonic segments. Here, we describe a rare case of a pediatric patient who developed a uroenteric fistula from the transplant ureters into the small bowel, after an en-bloc kidney transplantation resulting in profound acidosis and deceptive watery diarrhea.

Case Presentation: The patient is an 8-year-old girl with end stage kidney disease (ESKD) secondary to focal segmental glomerulosclerosis. Through a right retroperitoneal approach, she underwent a right native nephrectomy and a pediatric deceased donor en-bloc kidney transplant including two separate ureters. One month later, she had a renal allograft biopsy for suspected rejection. During the week after the biopsy, she experienced abdominal pain followed by watery diarrhea and metabolic acidosis requiring continuous bicarbonate/acetate infusions. An extensive gastro-intestinal evaluation for the cause of the diarrhea including endoscopy was inconclusive. The urine output decreased to <500 ml daily; although, the kidney function remained normal. After 2 weeks of unexplained watery diarrhea a magnetic resonance urogram with contrast was performed which demonstrated extravasation of urine from both ureters with fistulization into the small bowel. She underwent corrective surgery which identified the fistulous tract, which was resected and both ureters were re-implanted. The diarrhea and acidosis resolved, and she has maintained normal renal allograft function for over 1 year.

Conclusion: An important aspect in the early diagnosis of a uroenteric fistula is the sudden onset of severe hyperchloremic metabolic acidosis that results when urine is diverted into the intestinal tract. The mechanism is similar to that described in cases of urinary diversions and/or bladder augmentation using the intestine. Important diagnostic tools are the measurements of solute excretion and pH in the urine as compared to the “watery diarrhea” or bowel output.

Summary: We describe a case of a uroenteric fistula in a pediatric-en-bloc kidney transplant patient that went undiagnosed for almost 3 weeks due to the deceptive nature of the watery diarrhea which was actually urine. A uroenteric fistula should be considered in the differential diagnosis of diarrhea and hyperchloremic metabolic acidosis as a complication of kidney transplant. The simultaneous comparison of stool and urine pH and solute excretions may lead to the diagnosis, appropriate imaging and surgical intervention.
NeoAPACHE II. Relationship Between Radiographic Pulmonary Area and Pulmonary Hypertension, Mortality, and Hernia Recurrence in Newborns With CDH
Authors: Amodeo Ilaria , Pesenti Nicola , Raffaeli Genny , Macchini Francesco , Condò Valentina , Borzani Irene , Persico Nicola , Fabietti Isabella , Bischetti Giulia , Colli Anna Maria , Ghirardello Stefano , Gangi Silvana , Colnaghi Mariarosa , Mosca Fabio , Cavallaro Giacomo
Published: July 2021

Congenital diaphragmatic hernia is a rare disease with high mortality and morbidity due to pulmonary hypoplasia and pulmonary hypertension. The aim of the study is to investigate the relationship between radiographic lung area and systolic pulmonary artery pressure (sPAP) on the first day of life, mortality, and hernia recurrence during the first year of life in infants with a congenital diaphragmatic hernia (CDH). A retrospective data collection was performed on 77 CDH newborns. Echocardiographic sPAP value, deaths, and recurrence cases were recorded. Lung area was calculated by tracing the lung's perimeter, excluding mediastinal structures, and herniated organs, on the preoperative chest X-ray performed within 24 h after birth. Logistic and linear regression analyses were performed. Deceased infants showed lower areas and higher sPAP values. One square centimeter of rising in the total, ipsilateral, and contralateral area was associated with a 22, 43, and 24% reduction in mortality risk. sPAP values showed a decreasing trend after birth, with a maximum of 1.84 mmHg reduction per unitary increment in the ipsilateral area at birth. Recurrence patients showed lower areas, with recurrence risk decreasing by 14 and 29% per unit increment of the total and ipsilateral area. In CDH patients, low lung area at birth reflects impaired lung development and defect size, being associated with increased sPAP values, mortality, and recurrence risk.

Clinical Trial Registration: The manuscript is an exploratory secondary analysis of the trial registered at ClinicalTrials.gov with identifier NCT04396028.
The ED50 and ED95 of Prophylactic Norepinephrine for Preventing Post-Spinal Hypotension During Cesarean Delivery Under Combined Spinal-Epidural Anesthesia: A Prospective Dose-Finding Study
Authors: Xu Wenping , Drzymalski Dan Michael , Ai Ling , Yao Hanqing , Liu Lin , Xiao Fei
Published: July 2021

Background: Hypotension commonly occurs with spinal anesthesia during cesarean delivery. Norepinephrine is an alternative to phenylephrine which can be used to prevent or treat hypotension, with better maintained cardiac output and less bradycardia. However, an appropriate initial prophylactic infusion dose of norepinephrine remains unclear. The aim of this study was to describe the dose-response relationship of prophylactic norepinephrine infusion during cesarean delivery under combined spinal-epidural anesthesia.

Methods: We performed a prospective, randomized, double-blinded dose-finding study. One hundred patients undergoing elective cesarean delivery were randomly assigned to receive an infusion of norepinephrine at 0, 0.025, 0.05, 0.075 or 0.1 μg/kg/min initiated immediately after intrathecal injection of 10 mg bupivacaine combined with 5 µg sufentanil. An effective dose was considered when there was no hypotension (systolic blood pressure < 90 mm Hg or < 80% of baseline) during the time period from injection of intrathecal local anesthetic to delivery of the neonate. The primary aim was to determine the dose-response relationship of norepinephrine to prevent spinal anesthesia-induced hypotension. The median effective dose (ED50) and 95% effective dose (ED95) for norepinephrine were calculated utilizing probit analysis.

Results: The proportion of patients with hypotension was 80, 70, 40, 15 and 5% at norepinephrine doses of 0, 0.025, 0.05, 0.075 and 0.1 μg/kg/min, respectively. The ED50 and ED95 were 0.042 (95% CI, 0.025–0.053) µg/kg/min and 0.097 (95% CI, 0.081–0.134) µg/kg/min, respectively. There were no differences in the Apgar scores (p = 0.685) or umbilical arterial pH (p = 0.485) measurements of the newborns among the treatment groups.

Conclusion: A norepinephrine infusion of 0.1 μg/kg/min as an initial starting dose was effective for the prevention of spinal-induced hypotension.
The THO/TREX Complex Component RAE2/TEX1 Is Involved in the Regulation of Aluminum Resistance and Low Phosphate Response in Arabidopsis
Authors: Zhu Yi-Fang , Guo Jinliang , Zhang Yang , Huang Chao-Feng
Published: July 2021

The C2H2-type zinc finger transcription factor SENSITIVE TO PROTON RHIZOTOXICITY 1 (STOP1) plays a critical role in aluminum (Al) resistance and low phosphate (Pi) response mainly through promoting the expression of the malate transporter-encoding gene ARABIDOPSIS THALIANA ALUMINUM ACTIVATED MALATE TRANSPORTER 1 (AtALMT1). We previously showed that REGULATION OF ATALMT1 EXPRESSION 3 (RAE3/HPR1), a core component of the THO/TREX complex, is involved in the regulation of nucleocytoplasmic STOP1 mRNA export to modulate Al resistance and low Pi response. Here, we report that RAE2/TEX1, another core component of the THO complex, is also involved in the regulation of Al resistance and low Pi response. Mutation of RAE2 reduced the expression of STOP1-downstream genes, including AtALMT1. rae2 was less sensitive to Al than rae3, which was consistent with less amount of malate secreted from rae3 roots than from rae2 roots. Nevertheless, low Pi response was impaired more in rae2 than in rae3, suggesting that RAE2 also regulates AtALMT1-independent pathway to modulate low Pi response. Furthermore, unlike RAE3 that regulates STOP1 mRNA export, mutating RAE2 did not affect STOP1 mRNA accumulation in the nucleus, although STOP1 protein level was reduced in rae2. Introduction of rae1 mutation into rae2 mutant background could partially recover the deficient phenotypes of rae2. Together, our results demonstrate that RAE2 and RAE3 play overlapping but distinct roles in the modulation of Al resistance and low Pi response.
Exploring the Perceived Impact of the COVID-19 Pandemic Social Distancing Measures on Athlete Wellbeing: A Qualitative Study Utilising Photo-Elicitation
Authors: Woodford Lindsay , Bussey Lauren
Published: July 2021

Countries all over the globe have implemented mandatory social distancing measures in an attempt to suppress and control the spread of the Coronavirus disease (COVID-19). This enforced period of isolation, disruption to normal training routines and competition cancellation, could be having an adverse effect on the mental health and wellbeing of athletes. This study sought to explore the perceived impact of the COVID-19 social distancing measures on athlete wellbeing. Fourteen elite athletes who were unable to train or compete due to government imposed lockdown measures were recruited to participate in this qualitative study. Utilising the photo elicitation method, participants were asked to take a series of photographs that represented their experiences as athletes living in lockdown. These photographs were used to guide discussions in follow up unstructured interviews. Reflexive inductive thematic analysis identified three main themes that captured athletes’ experience of social distancing measures and the implications for their wellbeing: (1) threats to wellbeing; (2) adapting routines and maintaining motivation; and (3) reflecting on participation in competitive elite sport. The initial sudden loss of sport in the athlete’s lives posed a threat to their wellbeing, but over the duration of the lockdown period the athletes developed numerous strategies to protect their wellbeing. Furthermore, their time away from sport encouraged them to reflect on their athletic identity and to make life changes that would protect their wellbeing during the rest of the lockdown period and when they returned to sport. A number of immediate practical recommendations are offered for athlete support personnel working with athletes during the crisis, these include developing self-care strategies and social networks, adapting routines, setting new goals and encouraging the pursuit of dual-careers. Future research is encouraged to investigate how practitioners can deliver effective psychological support through tele-consulting, and to consider whether their support is best focused on therapeutic counselling or mental skills training during the pandemic.
Using Peer Support to Strengthen Mental Health During the COVID-19 Pandemic: A Review
Authors: Suresh Rahul , Alam Armaghan , Karkossa Zoe
Published: July 2021

Background: The coronavirus (COVID-19) pandemic has had a significant impact on society's overall mental health. Measures such as mandated lockdowns and physical distancing have contributed to higher levels of anxiety, depression, and other metrics indicating worsening mental health. Peer support, which is peer-to-peer provided social and emotional support, is an underutilized and effective mental health resource that can potentially be used to ameliorate mental health during these times.

Objective: This review aims to summarize the toll that this pandemic has had on society's mental health as found in peer-reviewed literature from October 2019 to March 2021, as well as suggest the utility of peer support to address these needs.

Methods: References for this review were chosen through searches of PubMed, Web of Science, and Google Scholar for articles published between October 2019 and March 2021 that used the terms: “coronavirus,” “COVID-19,” “mental health,” “anxiety,” “depression,” “isolation,” “mental health resources,” “peer support,” “online mental health resources,” and “healthcare workers.” Articles resulting from these searches and relevant references cited in those articles were reviewed. Articles published in English, French and Italian were included.

Results: This pandemic has ubiquitously worsened the mental health of populations across the world. Peer support has been demonstrated to yield generally positive effects on the mental health of a wide variety of recipients, and it can be provided through numerous accessible mediums.

Conclusions: Peer support can overall be beneficial for improving mental health during the COVID-19 pandemic and may be an effective tool should similar events arise in the future, although the presence of a few conflicting studies suggests the need for additional research.
Combating the COVID-19 Pandemic: Experiences of the First Wave From Nepal
Authors: Basnet Buddha Bahadur , Bishwakarma Kiran , Pant Ramesh Raj , Dhakal Santosh , Pandey Nashib , Gautam Dhruba , Ghimire Archana , Basnet Til Bahadur
Published: July 2021

Unprecedented and unforeseen highly infectious Coronavirus Disease 2019 (COVID-19) has become a significant public health concern for most of the countries worldwide, including Nepal, and it is spreading rapidly. Undoubtedly, every nation has taken maximum initiative measures to break the transmission chain of the virus. This review presents a retrospective analysis of the COVID-19 pandemic in Nepal, analyzing the actions taken by the Government of Nepal (GoN) to inform future decisions. Data used in this article were extracted from relevant reports and websites of the Ministry of Health and Population (MoHP) of Nepal and the WHO. As of January 22, 2021, the highest numbers of cases were reported in the megacity of the hilly region, Kathmandu district (population = 1,744,240), and Bagmati province. The cured and death rates of the disease among the tested population are ~98.00 and ~0.74%, respectively. Higher numbers of infected cases were observed in the age group 21–30, with an overall male to female death ratio of 2.33. With suggestions and recommendations from high-level coordination committees and experts, GoN has enacted several measures: promoting universal personal protection, physical distancing, localized lockdowns, travel restrictions, isolation, and selective quarantine. In addition, GoN formulated and distributed several guidelines/protocols for managing COVID-19 patients and vaccination programs. Despite robust preventive efforts by GoN, pandemic scenario in Nepal is, yet, to be controlled completely. This review could be helpful for the current and future effective outbreak preparedness, responses, and management of the pandemic situations and prepare necessary strategies, especially in countries with similar socio-cultural and economic status.
Circular Bioeconomy Concepts—A Perspective
Authors: Tan Eric C. D. , Lamers Patrick
Published: July 2021

Circular economy concepts—including a circular bioeconomy—aim to transition the current, essentially linear, economic system to a more sustainable one. However, organizations and researchers currently define the circular economy concept differently, resulting in inconsistencies and difficulty in effectively implementing the framework. In this paper, we provide our perspective on the conceptual definitions of the circular economy, bioeconomy, and circular bioeconomy, outlining potential overlaps and differences and proposing a harmonized interpretation that stresses the importance of the carbon cycle. We conclude that the key goal of a circular economy is to slow, narrow, and close material resource loops, built on the foundation of renewable energy and non-toxic materials. Further, a sustainable bioeconomy goes beyond simply switching fossil resources with renewable, biological resources. It requires low-carbon energy inputs, sustainable supply chains, and promising disruptive conversion technologies for the sustainable transformation of renewable bioresources to high-value bio-based products, materials, and fuels. The bio-based circular carbon economy, in particular, stresses capturing atmospheric carbon via photosynthesis and exploiting this unique feature to the fullest extent possible. It sits at the intersection between the circular economy and the bioeconomy concept, resulting in a framework that focuses on closing the carbon cycle and stressing the opportunity to create an additional carbon sink capability in the technosphere by utilizing biogenic carbon for products and materials that are circulated in same or improved use cycles. Lastly, a sustainable circular bioeconomy transition will necessitate a set of consistent metrics that fit all products and industries.
Human-to-Cattle Mycobacterium tuberculosis Complex Transmission in the United States
Authors: Lombard Jason E. , Patton Elisabeth A. , Gibbons-Burgener Suzanne N. , Klos Rachel F. , Tans-Kersten Julie L. , Carlson Beth W. , Keller Susan J. , Pritschet Delora J. , Rollo Susan , Dutcher Tracey V. , Young Cris A. , Hench William C. , Thacker Tyler C. , Perea Claudia , Lehmkuhl Aaron D. , Robbe-Austerman Suelee
Published: July 2021

The Mycobacterium tuberculosis complex (MTBC) species includes both M. tuberculosis, the primary cause of human tuberculosis (TB), and M. bovis, the primary cause of bovine tuberculosis (bTB), as well as other closely related Mycobacterium species. Zoonotic transmission of M. bovis from cattle to humans was recognized more than a century ago, but transmission of MTBC species from humans to cattle is less often recognized. Within the last decade, multiple published reports from around the world describe human-to-cattle transmission of MTBC. Three probable cases of human-to-cattle MTBC transmission have occurred in the United States since 2013. In the first case, detection of active TB disease (M. bovis) in a dairy employee in North Dakota prompted testing and ultimate detection of bTB infection in the dairy herd. Whole genome sequencing (WGS) demonstrated a match between the bTB strain in the employee and an infected cow. North Dakota animal and public health officials concluded that the employee's infection was the most likely source of disease introduction in the dairy. The second case involved a Wisconsin dairy herd with an employee diagnosed with TB disease in 2015. Subsequently, the herd was tested twice with no disease detected. Three years later, a cow originating from this herd was detected with bTB at slaughter. The strain in the slaughter case matched that of the past employee based on WGS. The third case was a 4-month-old heifer calf born in New Mexico and transported to Texas. The calf was TB tested per Texas entry requirements and found to have M. tuberculosis. Humans are the suspected source of M. tuberculosis in cattle; however, public health authorities were not able to identify an infected human associated with the cattle operation. These three cases provide strong evidence of human-to-cattle transmission of MTBC organisms and highlight human infection as a potential source of introduction of MTBC into dairy herds in the United States. To better understand and address the issue, a multisectoral One Health approach is needed, where industry, public health, and animal health work together to better understand the epidemiology and identify preventive measures to protect human and animal health.
Active Packaging of Button Mushrooms with Zeolite and Açai Extract as an Innovative Method of Extending Its Shelf Life
Authors: Hanula Monika , Pogorzelska-Nowicka Ewelina , Pogorzelski Grzegorz , Szpicer Arkadiusz , Wojtasik-Kalinowska Iwona , Wierzbicka Agnieszka , Półtorak Andrzej
Published: July 2021

As the market demand for button mushrooms is constantly growing, it is important to extend their shelf-life. Active packaging with built-in active components offers the possibility of extending the shelf life of products which are sensitive to external factors. Therefore, the aim of the present study was to check the effect of active packaging with zeolite (clinoptilolite) and aҫai extract on the bioactive compounds content, antioxidant activity, volatile compound profile, and physical quality of mushrooms subjected to storage for 28 days at 4 °C. Packing mushrooms in active packages improved their chemical characteristics by increasing antioxidant activity (p ≤ 0.001) in comparison to the conventional packaging methods. Moreover, it slowed down water loss and the browning process both on the surface and inside the mushroom. Furthermore, the results showed a strong correlation (p ≤ 0.001) between antioxidant activity, bioactive compounds content and color parameters. The obtained results suggest that the addition of the aҫai extract and zeolite into packaging material protects mushrooms from deterioration for a longer period of time. The use of active packaging to extend product shelf life can contribute to the reduction of the use of food preservatives, but also protects the environment by reducing the volume of waste.
Case Study on the Use of the Leaf-Count Method for Drip Fertigation in Outdoor Cucumber Cultivation in Reconstructed Fields Devastated by a Tsunami
Authors: Tashiro Yuki , Sato Tatsuo , Satitmunnaithum Junjira , Kinouchi Hatsumi , Li Jianlin , Tanabata Sayuri
Published: July 2021

Drip fertigation was tested in fields using a nitrogen fertilization method based on leaf increments, with the aim of increasing the cucumber yield in outdoor fields restored after the tsunami disaster in Rikuzentakata City, Iwate Prefecture, in 2011. The 2016 test site (Takata field) was restored as a paddy field, and there were problems with water retention and gravel contamination. The condition of the 2017 test site (Yonesaki field) was better than that of the 2016 site. The drip fertigation method increased cucumber yield by 93% and 27% in the Takata and Yonesaki fields, respectively, when compared to the yield from fields cultivated conventionally. Drip fertigation enables the constant supply of liquid fertilizer to the rhizosphere, and the easy application prevents the scarcity of fertilizer, especially at later stages of growth. In contrast, a real-time soil diagnosis, using the Dutch 1:2 soil–water extract method, was unsuccessful due to flooding, especially in the Takata field. As the purpose of this method is not to reduce the amount of nitrogen provided, but to increase the yield, and because it is difficult to precisely control the application of fertilizer due to precipitation, we suggest that the real-time soil diagnosis and feedback should be omitted to further simplify fertilizer application.
Antimicrobial Prescribing in the Emergency Department; Who Is Calling the Shots?
Authors: Hamill Laura M. , Bonnett Julia , Baxter Megan F. , Kreutz Melina , Denny Kerina J. , Keijzers Gerben
Published: July 2021

Objective: Inappropriate antimicrobial prescribing in the emergency department (ED) can lead to poor outcomes. It is unknown how often the prescribing clinician is guided by others, and whether prescriber factors affect appropriateness of prescribing. This study aims to describe decision making, confidence in, and appropriateness of antimicrobial prescribing in the ED. Methods: Descriptive study in two Australian EDs using both questionnaire and medical record review. Participants were clinicians who prescribed antimicrobials to patients in the ED. Outcomes of interest were level of decision-making (self or directed), confidence in indication for prescribing and appropriateness (5-point Likert scale, 5 most confident). Appropriateness assessment of the prescribing event was by blinded review using the National Antibiotic Prescribing Survey appropriateness assessment tool. All analyses were descriptive. Results: Data on 88 prescribers were included, with 61% making prescribing decisions themselves. The 39% directed by other clinicians were primarily guided by more senior ED and surgical subspecialty clinicians. Confidence that antibiotics were indicated (Likert score: 4.20, 4.35 and 4.35) and appropriate (Likert score: 4.07, 4.23 and 4.29) was similar for juniors, mid-level and senior prescribers, respectively. Eighty-five percent of prescriptions were assessed as appropriate, with no differences in appropriateness by seniority, decision-making or confidence. Conclusions: Over one-third of prescribing was guided by senior ED clinicians or based on specialty advice, primarily surgical specialties. Prescriber confidence was high regardless of seniority or decision-maker. Overall appropriateness of prescribing was good, but with room for improvement. Future qualitative research may provide further insight into the intricacies of prescribing decision-making.
Estimated Phytate Intake Is Associated with Improved Cognitive Function in the Elderly, NHANES 2013–2014
Authors: Larvie Doreen Y , Armah Seth M
Published: July 2021

Phytate, an antioxidant, may improve cognition by inhibiting iron catalyzed hydroxyl radical formation. Particularly in the elderly, this provides a potential dietary approach for mitigating age-related brain neuronal dysfunction and loss. In this study, we investigated the relationship between phytate intake and cognitive function in the elderly. We used data from the 2013–2014 National Health and Nutrition Examination Survey (NHANES) and the corresponding Food Patterns Equivalents Database (FPED). Phytate content of food groups from published data were merged with the appropriate FPED data to estimate the total phytate intake for each subject. Principal component analysis was used to develop a composite score from four cognitive function scores in NHANES data, and regression analysis was used to determine the relationship between this score and phytate intake. Median phytate intake was 0.65 (0.61, 0.71) g/day. It was low among females, non-Hispanic blacks, and people with history of at least one chronic disease (p < 0.05). In regression analysis adjusted for confounders, phytate intake was positively associated with cognitive function (β (95% CI) = 1.90 (0.73–3.07); p = 0.015). These results suggest that phytate may be associated with improved cognition, hence the need to consider including phytate-rich foods in the diet among the elderly.
Protective Effect of Red Algae (Rhodophyta) Extracts on Essential Dietary Components of Heat-Treated Salmon
Authors: Ortiz-Viedma Jaime , Aguilera José M. , Flores Marcos , Lemus-Mondaca Roberto , Larrazabal María José , Miranda José M. , Aubourg Santiago P.
Published: July 2021

Salmon paste contains nutritious components such as essential fatty acids (EPA, DHA), vitamin E and astaxanthin, which can be protected with the addition of red algae extracts. Phenolic extracts were prepared with an ethanol: water mixture (1:1) from the red seaweeds Gracilaria chilensis, Gelidium chilense, Iridaea larga, Gigartina chamissoi, Gigartina skottsbergii and Gigartina radula, obtained from the Pacific Ocean. Most algae had a high content of protein (>7.2%), fiber (>55%) and β-glucans (>4.9%), all expressed on a dry weight basis. Total polyphenols (TP), total flavonoids (TF), antioxidant (DPPH, FRAP) and antibacterial power of the extracts were measured. In addition, the nutritional components of the algae were determined. Results showed that the content of TP in the six algae varied between 2.6 and 11.3 mg EAG/g dw and between 2.2 and 9.6 for TF. Also, the extracts of G. skottsbergii, G. chamissoi, G. radula and G. chilensis showed the highest antiradical activity (DPPH, FRAP). All samples exhibited a low production of primary oxidation products, and protection of the essential components and the endogenous antioxidants tocopherols and astaxanthin, particularly in the case of G. skottsbergii, G. chamissoi, G. radula and G. chilensis. Furthermore, all algae had inhibitory activity against the tested microorganisms, coincident with their antioxidant capacity. Results show that the extracts may have future applications in the development and preservation of essential dietary components of healthy foods.
Recognition of Stress Activation by Unobtrusive Multi Sensing Setup
Authors: Zuccalà Veronica Chiara , Favilla Riccardo , Coppini Giuseppe
Published: July 2021

It is recognized that stress conditions play an important role in the definition of individual wellness and represent a major risk factor for most non-communicable diseases. Most studies focus on the evaluation of response to maximal stress conditions while a few of them reports results about the detection/monitoring of response to mild stimulations. In this study, we investigate the capability of some physiological signs and indicators (including Heart Rate, Heart Rate Variability, Respiratory Rate, Galvanic Skin Response) to recognize stress in response to moderate cognitive activation in daily life settings. To achieve this goal, we built up an unobtrusive platform to collect signals from healthy volunteers (10 subjects) undergoing cognitive activation via Stroop Color Word Test. We integrated our dataset with data from the Stress Recognition in the Automobile Drivers dataset. Following data harmonization, signal recordings in both datasets were split into five-minute blocks and a set of 12 features was extracted from each block. A feature selection was implemented by two complementary approaches: Sequential Forward Feature Selection (SFFS) and Auto-Encoder (AE) neural networks. Finally, we explored the use of Self-Organizing Map (SOM) to provide a flexible representation of an individual status. From the initial feature set we have determined, by SFFS analysis, that 2 of them (median Respiratory Rate and number peaks in Galvanic Skin Response signals) can discriminate activation statuses from resting ones. In addition, AE experiments also support that two features can suffice for recognition. Finally, we showed that SOM can provide a comprehensive but compact description of activation statuses allowing a fine prototypical representation of individual status.