bluuebunny/crossref_metadata_2025 huggingface dataset:
Impact of Working Environment on Job Satisfaction: Findings from a Survey of Japanese Dental Hygienists
Authors: Okada Ayako , Ohara Yuki , Yamamoto Yuko , Nomura Yoshiaki , Hosoya Noriyasu , Hanada Nobuhiro , Takei Noriko
Published: March 2021

In Japan, there is currently a shortage of dental hygienists. The number of dental hygienists as a workforce at dental clinical practice is not sufficient. Several factors affect career retention and job satisfaction of hygienists and these factors are considered to correlate with each other to construct networks. The aim of this study was to present a structural model of job satisfaction of Japanese dental hygienists and to determine the characteristics of unmotivated hygienists. The Japan Dental Hygienists’ Association has conducted a survey on their working environments every five years since 1981. Questionnaires were sent to all members of the association (16,113) and 8932 answers were returned. The data of 3807 active dental hygienists who worked at clinics were analyzed. Items associated with job satisfaction were derived from two latent variables, namely, the intrinsic psychosocial factors for the value of the work and extrinsic employment advantage. Based on the structural equation modeling, the association of value was higher than that of advantage. Most of the hygienists wished to continue working as dental hygienists. More than 60% felt their work required a high level of expertise. The value of the profession is deeply rooted in job satisfaction, motivation, and job retention of Japanese dental hygienists. Working environments where dental hygienists make great use of their specialized skills can lead to high career retention which prevent them from taking career breaks.
Evaluation of Fluid Loss and Customary Fluid Intake among a Selected Group of Young Swimmers: A Preliminary Field Study
Authors: Wiśniewski Damian , Śliwicka Ewa , Malik Jakub , Durkalec-Michalski Krzysztof
Published: March 2021

This study aimed to assess fluid loss (FL) and customary fluid intake (FI) during a training session, and the relationship between FL and total body water (TBW) content in a selected group of young swimmers. The study involved 17 (seven females, 10 males) individuals whose anthropometric and body composition analyses and FI during training units were carried out. The total average FI and total actual FL oscillated around 531 mL and −513 mL for the whole study group (469 mL and −284 mL for females, 574 mL and −674 mL for males). The dependent and independent sample t-tests, the Cohen’s d effect size and Pearson’s correlation coefficient were analysed. Significant differences were observed between pre-workout and post-workout body weights after training without FI in the whole group (66.5 kg vs. 66.0 kg, p < 0.001, d = 0.06), in females (61.2 kg vs. 60.9 kg, p = 0.015, d = 0.04) and males (70.3 kg vs. 69.6 kg, p < 0.001, d = 0.9). For the TBW content and fat-free mass (FFM) before and after training, significant differences were observed only in males (TBW: 43.8 L vs. 43.2 L, p = 0.002, d = 0.14; and 62.4% vs. 61.7%, p < 0.001, d = 0.36; FFM: 59.8 kg vs. 59.1 kg, p = 0.002, d = 0.12). Moreover, the relationship between the actual FL and TBW before training was observed in the whole (mL vs. %: r = −0.64, p = 0.006; mL vs. L: r = −0.84, p < 0.001) and the male group (mL vs. L: r = −0.73, p = 0.017). These results indicated FL in young swimmers during training and the relationship between FL and pre-training TBW content, which suggests that it is important to also pay special attention to effective hydration procedures before and during training in aquatic environments.
Roma Socioeconomic Status Has a Higher Impact on Smoking Behaviour than Genetic Susceptibility
Authors: Merzah Mohammed , Kósa Zsigmond , Sándor János , Natae Shewaye , Pikó Péter , Ádány Róza , Fiatal Szilvia
Published: March 2021

It is a matter of speculation whether the high prevalence of smoking among Hungarian Roma (HR) is related to genetic, gene-environmental interactions or cultural factors. Our aim is to compare the genetic susceptibility and possible effects of determinants associated with smoking behaviours in the Hungarian general (HG) and Roma populations. A complex health survey including three pillars (questionnaire, physical and laboratory examinations) was carried out (NHG = 412 and NHR = 402). Risk allele frequencies of ten single-nucleotide polymorphisms (SNPs) were compared, and their combined effect was estimated by computing unweighted and weighted genetic risk scores (GRS, wGRS). The effects of genetic and environmental factors were investigated in regression analyses after confounders were introduced. Socio-economic status (SES) was calculated based on the Kuppuswamy scale 2019. Risk allele frequencies of only four SNPs were found to be different between populations (p < 0.01). Median values of GRS did not differ, while the wGRS median was slightly higher among Roma individuals (5.2 vs. 4.9; p = 0.02). Roma individuals were more likely to be heavy smokers (ORmales = 2.05, 95% CI [1.47–2.86]; ORfemales = 1.89, 95% CI [1.58–2.25]. Smokers have lower SES compared to never smokers (SES βHR = −0.039, p = 0.023; βHG = −0.010, p = 0.049). An inverse relationship was found between SES and smoking behaviours (p < 0.0001) and was found to be a better predictor of smoking behaviours than genetic susceptibility. Our study findings suggest that the high prevalence of smoking behaviours and nicotine-dependence were not revealed to have a genetic susceptibility among HR individuals; therefore, the highest efforts should be focused on targeting SES-related factors in the Roma population. Strengths of the study: This is the first study carried out to investigate and detect the most relevant factors and the possible genetic background of the extremely high prevalence of smoking based in the Roma population. Limitations of the study: No standard instrument has been used to assess the intensity of addiction to nicotine. Because of some participants’ unwillingness to define themselves as Roma, the overall HR population was not represented by the sample of this study.
Traditional Thai Massage Promoted Immunity in the Elderly via Attenuation of Senescent CD4+ T Cell Subsets: A Randomized Crossover Study
Authors: Sornkayasit Kanda , Jumnainsong Amonrat , Phoksawat Wisitsak , Eungpinichpong Wichai , Leelayuwat Chanvit
Published: March 2021

The beneficial physiological effects of traditional Thai massage (TTM) have been previously documented. However, its effect on immune status, particularly in the elderly, has not been explored. This study aimed to investigate the effects of multiple rounds of TTM on senescent CD4+ T cell subsets in the elderly. The study recruited 12 volunteers (61–75 years), with senescent CD4+ T cell subsets, who received six weekly 1-h TTM sessions or rest, using a randomized controlled crossover study with a 30-day washout period. Flow cytometry analysis of surface markers and intracellular cytokine staining was performed. TTM could attenuate the senescent CD4+ T cell subsets, especially in CD4+28null NKG2D+ T cells (n = 12; p < 0.001). The participants were allocated into two groups (low < 2.75% or high ≥ 2.75%) depending on the number of CD4+28null NKG2D+ T cells. After receiving TTM over 6 sessions, the cell population of the high group had significantly decreased (p < 0.001), but the low group had no significant changes. In conclusion, multiple rounds of TTM may promote immunity through the attenuation of aberrant CD4+ T subsets. TTM may be provided as a complementary therapy to improve the immune system in elderly populations.
Psychological and Situational Variables Associated with Objective Knowledge on Water-Related Issues in a Northern Spanish City
Authors: Andrade Elena , Seoane Gloria , Vila-Tojo Sergio , Gómez-Román Cristina , Sabucedo Jose-Manuel
Published: March 2021

This study brings together the level of objective knowledge on water-related issues and other variables of psychological and situational nature. A random sample of 459 participants was employed, selected proportionally based on sex and age. In this sample, knowledge on the water-related issues tended to be low, particularly related to the direct source of water in the household, the type of services involved in the management, and consumption itself. In order to understand both the relationship with knowledge on water and the relative importance of all the other factors, a regression model was formulated. The highest standardised effect was for sex, followed by occupation, political leaning, and water-related emotions. The best level of knowledge was attained if the residents were male, if they were actively employed or unemployed, if their political leaning was towards the left, and if they demonstrated greater emotional involvement with the water use. Consequently, the design of programmes would need to consider that the information flow must be greater for citizens as a whole, particularly for certain groups such as women and students. It should contribute to the realistic perception of water as a problem and to seek emotional involvement.
Community Use of Face Masks against the Spread of COVID-19
Authors: Bubbico Luciano , Mastrangelo Giuseppe , Larese-Filon Francesca , Basso Paolo , Rigoli Roberto , Maurelli Martina , Ferlito Salvatore , Capelli Marco , Gisabella Claudio , Javanbakht Mohammad , Bellizzi Saverio , Cegolon Luca
Published: March 2021

The role of face masks to prevent and control COVID-19 is critical, especially since asymptomatic or pre-symptomatic infected individuals can shed high loads of SARS-CoV-2 in the surrounding environment. In addition to being a two-way barrier to protect against virions droplets both in terms of “source control” (for the benefits of the community) and “physical protection” (for wearer), face masks also allow maintaining physiological temperatures and humidity of the nasal cavity and mouth, independently from the external environmental conditions. Beyond compromising the viral transmission speed, exposure to cold environments could have a detrimental effect on the host’s susceptibility to SARS-CoV-2. The innate human immune system becomes in fact weaker with cooler nose temperatures and thus more vulnerable to viral replication. Furthermore, there is evidence that warm, humid climates are associated with reduced spread of SARS-CoV-2, while cold dry conditions favor its stability and transmissibility. In the early stage of a viral infection, a physiological body temperature in the upper airways supports the innate immune system, endorsing the muco-ciliary clearance, inhibiting, or deactivating any first settlement of viruses. Face masks are therefore strongly recommended also outdoors, especially under cold weather conditions, not only as a physical barrier against the transmission of SARS-CoV-2, but also to prevent the rapid cooling of the nasal mucosa and the inhibition of the human innate defense of the upper airways.
Why the Par Value of Share Matters to Investors
Authors: Dudycz Tadeusz , Brycz Bogumiła
Published: March 2021

The purpose of the study is the analysis of the relationship between the par value (also known as nominal value or face value) and the parameters influencing a company’s financing. Additionally, the utility of the par value as a manipulation tool for equity offerings is examined. The study is based on a sample of IPO firms which went public on the Warsaw Stock Exchange. The study finds that an excess supply of shares has a negative impact on their valuation. In contrast, decreasing the par value prompts perceptual biases among investors beneficial to the success of the issuance. Moreover, share capital is found to be a useful signaling tool to improve the company’s position on the financial market.
Spatial-Planning-Based Ecosystem Adaptation (SPBEA): A Concept and Modeling of Prone Shoreline Retreat Areas
Authors: Sutrisno Dewayany , Darmawan Mulyanto , Rahadiati Ati , Helmi Muhammad , Yusmur Armaiki , Hashim Mazlan , Shih Peter Tian-Yuan , Qin Rongjun , Zhang Li
Published: March 2021

Ecosystem-based adaptation to climate change impacts, such as shoreline retreat, has been promoted at the international, national, and even local levels. However, among scientists, opinions about how to implement it in spatial-planning practices are varied. Science-based environmental factors, human wellbeing, and sustainable development can be strengthened by developing spatial-planning-based ecosystem adaptations (SPBEAs). Therefore, this article aims to assess how the SPBEA model can be developed within an area prone to shoreline retreat. A coastal area of the Sayung subdistrict in Central Java, Indonesia, was selected as a study area because it has experienced a massive shoreline retreat. A multicriteria analysis (MCA) method was employed for developing the model by using the geographic information system (GIS) technique of analysis, divided into three steps: the fishpond zone determination, which involved the analytical hierarchy process (AHP) method in the process of model development; the fishpond site determination; SPBEA fishpond site development. The results show that the SPBEA model is the best practice solution for combatting shoreline retreat because of tidal waves and/or sea-level rise. The spatial site management should empower the coastal protection zone and the sustainable fishpond zone by implementing a silvofishery approach.
Spatio-Temporal Visual Analysis for Urban Traffic Characters Based on Video Surveillance Camera Data
Authors: Zou Haochen , Cao Keyan , Jiang Chong
Published: March 2021

Urban road traffic spatio-temporal characters reflect how citizens move and how goods are transported, which is crucial for trip planning, traffic management, and urban design. Video surveillance camera plays an important role in intelligent transport systems (ITS) for recognizing license plate numbers. This paper proposes a spatio-temporal visualization method to discover urban road vehicle density, city-wide regional vehicle density, and hot routes using license plate number data recorded by video surveillance cameras. To improve the accuracy of the visualization effect, during data analysis and processing, this paper utilized Internet crawler technology and adopted an outlier detection algorithm based on the Dixon detection method. In the design of the visualization map, this paper established an urban road vehicle traffic index to intuitively and quantitatively reveal the traffic operation situation of the area. To verify the feasibility of the method, an experiment in Guiyang on data from road video surveillance camera system was conducted. Multiple urban traffic spatial and temporal characters are recognized concisely and efficiently from three visualization maps. The results show the satisfactory performance of the proposed framework in terms of visual analysis, which will facilitate traffic management and operation.
Crime against Businesses: Temporal Stability of Hot Spots in Mexicali, Mexico
Authors: Denegri Fabiola , Ley-García Judith
Published: March 2021

In developing countries, crime is a serious problem that affects the operation and viability of firms. Offenses such as vandalism, robbery, and theft raise the operating costs of firms and imposes on them indirect costs. The literature on spatial analysis of crime is vast; however, relatively little research has addressed business crime, especially in developing countries’ cities. Spatial and temporal analysis of crime concentration represents a basic input for the design and implementation of appropriate prevention and control strategies. This article explores the spatial concentration and stability of thefts committed against commercial establishments in the city of Mexicali, Mexico, from 2009 to 2011 using the Gini coefficient, Lorenz curve, and decile maps. Results revealed that thefts were highly concentrated in a small percentage of urban basic geostatistical areas. Moreover, a portion of these areas were classified as having the highest deciles of thefts (hot spots) and remained in this group throughout the period. In both cases, the relationship between crime and place was close to the 80/20 rule, or the Pareto principle.
Antagonism between PTP1B and PTK Mediates Adults’ Insulin-Like Signaling Regulation of Egg Diapause in the Migratory Locust
Authors: Li Shuang , Wang Jie , Cui Dongnan , Hao Kun , Chen Jun , Tu Xiongbing , Zhang Zehua
Published: March 2021

Diapause is a physiological development arrest state that helps insects to adapt to seasonality and overcome adverse environmental conditions. Numerous reports have indicated that insulinlike and fork head transcription factor (FOXO) are involved in the regulation of diapause in insects. However, the upstream modulators of the insulin-like signaling pathway (ISP) involved in diapause regulation are still unknown. Here, we used RNAi and an inhibitor to treat PTK and PTP1B in adult tissues and injected Prx V or RNAi Prx V under both short and long photoperiod conditions and monitored effects on the expression of ISP genes, the phosphorylation levels for IR and IRS, the activity of NADPH oxidase, the accumulation of reactive oxygen species (ROS) and energy metabolism, seeking to identify both proteins and broader cellular metabolism influences on diapause regulation. We found that under short photoperiod conditions PTP1B in female adults induces egg diapause, whereas PTK in female adults inhibits egg diapause. Intriguingly, we also found that the antioxidant enzyme Prx V is a negative regulator of NADPH oxidizing reaction and apparently decreases ROS production and NADPH-OX activity. In contrast, all the eggs laid by adults that were treated with a series of knockdown or purified-protein injection experiments or inhibitor studies and that were reared under long photoperiod conditions hatched successfully. Thus, our results suggest a mechanism wherein diapause-related proteins (PTP1B, PTK, and Prx V) of female adults are the upstream modulators that regulate offspring eggs’ diapause process through the insulin-like signaling pathway under short photoperiod conditions.
Antihypertensives’ Rock around the Clock
Authors: Rahić Ognjenka , Tucak Amina , Sirbubalo Merima , Hindija Lamija , Hadžiabdić Jasmina
Published: March 2021

Although homeostasis is a commonly accepted concept, there is incontrovertible evidence that biological processes and functions are variable and that variability occurs in cycles. In order to explain and understand dysregulation, which has not been embraced by homeostatic principles, the allostatic model has emerged as the first serious challenge to homeostasis, going beyond its homeostatic roots. Circadian rhythm is the predominant variation in the body, and it is a pattern according to which many physiological and pathological events occur. As there is strong experimental and clinical evidence that blood pressure fluctuations undergo circadian rhythm, there is equally strong evidence that targeted time therapy for hypertension provides a better outcome of the disease. The research has gone even further throughout the development and approval process for the use of pulsatile drug release systems, which can be considered as an option for an even more convenient dosage regimen of the medicines needed.
Non-Criteria Manifestations of Juvenile Antiphospholipid Syndrome
Authors: Miyamae Takako , Kawabe Tomohiro
Published: March 2021

Antiphospholipid syndrome (APS) is a systemic autoimmune disorder mainly characterised by increased risks of thrombosis and pregnancy morbidity and persistent positive test results for antiphospholipid antibodies (aPLs). The criteria for diagnosing juvenile APS have yet to be validated, while the Sydney classification criteria do not contain several non-thrombotic clinical manifestations associated with the presence of aPLs. As such, difficulties have been encountered in the diagnosis of patients who have no certain thrombotic occlusions. Moreover, extra-criteria manifestations (i.e., clinical manifestations not listed in the classification criteria), including neurologic manifestations (chorea, myelitis and migraine), haematologic manifestations (thrombocytopenia and haemolytic anaemia), livedo reticularis, nephropathy and valvular heart disease have been reported, which suggests that the clinical spectrum of aPL-related manifestations extends beyond that indicated in the classification criteria. Studies have demonstrated that more than 40% of children with aPLs demonstrated non-thrombotic aPL-related clinical manifestations alone. Moreover, our results showed that the pathogenesis of non-criteria manifestations is characterised by “APS vasculopathy”. The present review introduces the characteristics and findings of non-criteria manifestations observed in juvenile APS.
Active Travel and Mild Cognitive Impairment among Older Adults from Low- and Middle-Income Countries
Authors: Smith Lee , Veronese Nicola , López-Sánchez Guillermo F. , Yang Lin , Pizzol Damiano , Butler Laurie T. , Barnett Yvonne , Felez-Nobrega Mireia , Jacob Louis , Shin Jae Il , Tully Mark A. , Gorely Trish , Oh Hans , Koyanagi Ai
Published: March 2021

Active travel may be an easily achievable form of physical activity for older people especially in low- and middle-income countries (LMICs), but there are currently no studies on how this form of physical activity is associated with a preclinical state of dementia known as mild cognitive impairment (MCI). Therefore, we aimed to investigate the association between active travel and MCI among adults aged ≥50 years from six LMICs. Cross-sectional, community-based data from the World Health Organization’s Study on Global Ageing and Adult Health were analyzed. The definition of MCI was based on the National Institute on Ageing-Alzheimer’s Association criteria. Active travel (minutes/week) was assessed with questions of the Global Physical Activity Questionnaire (GPAQ) and presented in tertiles. Multivariable logistic regression analysis was conducted to assess the association between active travel and MCI. Data on 32715 people aged ≥50 years (mean age 62.4 years; 52.1% females) were analyzed. Compared to the highest tertile of active travel, the lowest tertile was associated with 1.33 (95%CI = 1.14–1.54) times higher odds for MCI overall. This association was particularly pronounced among those aged ≥65 years (OR = 1.70; 95%CI = 1.32–2.19) but active travel was not associated with MCI among those aged 50–64 years. In conclusion, low levels of active travel were associated with a significantly higher odds of MCI in adults aged ≥65 years in LMICs. Promoting active travel among people of this age group in LMICs via tailored interventions and/or country-wide infrastructure investment to provide a safe environment for active travel may lead to a reduction in MCI and subsequent dementia.
Mitochondrial Syndromes Revisited
Authors: Orsucci Daniele , Caldarazzo Ienco Elena , Rossi Andrea , Siciliano Gabriele , Mancuso Michelangelo
Published: March 2021

In the last ten years, the knowledge of the genetic basis of mitochondrial diseases has significantly advanced. However, the vast phenotypic variability linked to mitochondrial disorders and the peculiar characteristics of their genetics make mitochondrial disorders a complex group of disorders. Although specific genetic alterations have been associated with some syndromic presentations, the genotype–phenotype relationship in mitochondrial disorders is complex (a single mutation can cause several clinical syndromes, while different genetic alterations can cause similar phenotypes). This review will revisit the most common syndromic pictures of mitochondrial disorders, from a clinical rather than a molecular perspective. We believe that the new phenotype definitions implemented by recent large multicenter studies, and revised here, may contribute to a more homogeneous patient categorization, which will be useful in future studies on natural history and clinical trials.
Impact of Antibiotic Therapy and Metabolic Parameters in Non-Small Cell Lung Cancer Patients Receiving Checkpoint Inhibitors
Authors: Castello Angelo , Rossi Sabrina , Toschi Luca , Lopci Egesta
Published: March 2021

Introduction: In the current study, we aimed to assess the impact of antibiotics (ATB) and metabolic parameters on clinical outcome of non-small cell lung carcinoma (NSCLC) patients treated with immune checkpoint inhibitors (ICI). Methods: Data from fifty NSCLC patients referred for ICI between December 2015 and May 2019 were analyzed. All patients underwent 18F-fluorodeoxyglucose positron emission tomography computed tomography (18F-FDG PET/CT) and contrast-enhanced CT at baseline and for response assessment after 6–8 weeks. Patients who received ATB within 1 month before or after the first dose of ICI were compared with those who did not. Response assessment according to iRECIST and EORTC was evaluated, as well as progression-free survival (PFS) and overall survival (OS). For semi-quantitative parameters, we computed metabolic tumor volume (MTV), total lesion glycolysis (TLG) and their variations (∆). Results: Twenty NSCLC cases of 50 (40%) had received ATB. Patients receiving ATB had a higher number of metastases (p = 0.046), and were associated with an elevated tumor burden, expressed by TLG (687 vs. 235.3, p = 0.007) and MTV (125.6 vs. 40.6, p = 0.002), compared to no-ATB patients. According to iRECIST, progressive disease rate was significantly higher for ATB group (64.7% vs. 27.6%, p = 0.029). Likewise, PFS was shorter for ATB compared to no-ATB (median 4.1 vs. 12.4 months, p = 0.004), while no difference for OS was detected. On multivariate analysis, the effect of ATB remained significant for poor PFS along with performance status (ECOG ≥ 1), and ∆SUVmax. Conclusions: ATB therapy seems to be associated with a worse treatment response, PFS, and higher metabolic tumor burden in NSCLC patients treated with ICI.
Root Canal Filling Quality Comparison of a Premixed Calcium Silicate Endodontic Sealer and Different Carrier-Based Obturation Systems
Authors: Pérez-Alfayate Ruth , Mercade Montse , Algar-Pinilla Juan , Cisneros-Cabello Rafael , Foschi Federico , Cohen Stephen
Published: March 2021

Background: The number of voids within the root canal obturation is a relevant parameter to describe the quality of the technique, as well as to predict long-term prognosis. The aim of this study was to evaluate the quality of root canal obturation in curved root canals filled with Thermafil, GuttaCore, GuttaFusion and lateral compaction with AH Plus and EndoSequence BC sealer, by means of percentage of gutta-percha and sealer filled area. Methods: 200 curved canals of mandibular molars were divided in five groups (n = 40). Each specimen was evaluated at 3, 6 and 9 mm from the apex. A total of 600 samples were analyzed. Obturation was performed with either Thermafil (TH), GuttaCore (GC), GuttaFusion (GF) or lateral compaction (LC), using AH Plus as sealer. In another group EndoSequence BC sealer (BC) was used. Subgroups (n = 20) were made depending on the use of sonic activation during the placement of the sealer. The percentage of total obturation material was analyzed as an indirect measurement of percentage of voids. Results: GF showed a better performance at the apical level, while GC showed the higher percentage of total obturation at the coronal area. No differences were observed for the activation of sealers in any of the groups. Statistical analysis was performed by using two-way ANOVA. Statistical significance was set at CI: 95% (p < 0.05). Conclusions: Sonic activation of sealers did not show any benefit to avoid the presence of voids within obturation of curved canals. Following the manufacturer recommendations, we found that TH did not show benefits when applied to curved canals.
The Role of Light Kappa and Lambda Chains in Heart Function Assessment in Patients with AL Amyloidosis
Authors: Czyżewska Emilia , Wiśniewska Agnieszka , Waszczuk-Gajda Anna , Ciepiela Olga
Published: March 2021

There are reports indicating that myocardial dysfunction in systemic immunoglobulin light chain amyloidosis (AL amyloidosis) stems not only from the amyloid deposit in the organ but also the cardiotoxicity of the amyloid precursor free light chains (FLCs) circulating in the blood. The aim of the study is to analyze the role of sFLC κ and λ in the assessment of heart involvement and the degree of myocardial damage in AL amyloidosis. The study involved 71 patients diagnosed with primary AL amyloidosis. The relationship between sFLC concentrations and cardiac biochemical and echocardiographic parameters was assessed. The median concentrations of N-terminal pro b-type natriuretic peptide(NT-proBNP) and troponin I (TnI) were significantly higher in patients with amyloids formed from monoclonal λ chains compared to patients with monoclonal κ proliferation. In patients with heart involvement by amyloids formed from monoclonal FLC, the study demonstrated a statistically significant positive correlation between the concentration of monoclonal antibody λ chain and TnI (R = 0.688; p < 0.05), NT-proBNP (R = 0.449; p < 0.05), and the value of diastolic dimension of the interventricular septum (IVS; R = 0.496, p < 0.05). The above data indicate that the presence of monoclonal λ chains in patients with AL amyloidosis may be associated with more severe damage to cardiomyocytes and dysfunction of the myocardium.
Bacterial Re-Colonization Occurs Early after Lung Transplantation in Cystic Fibrosis Patients
Authors: Holm Anna Engell , Schultz Hans Henrik Lawaetz , Johansen Helle Krogh , Pressler Tania , Lund Thomas Kromann , Iversen Martin , Perch Michael
Published: March 2021

Most cystic fibrosis (CF) patients referred for lung transplantation are chronically infected with Gram-negative opportunistic pathogens. It is well known that chronic infections in CF patients have a significant impact on lung-function decline and survival before transplantation. The rate and timing of re-colonization after transplantation have been described, but the impact on survival after stratification of bacteria is not well elucidated. We did a single-center retrospective analysis of 99 consecutive CF patients who underwent lung transplantation since the beginning of the Copenhagen Lung Transplant program in 1992 until October 2014. Two patients were excluded due to re-transplantation. From the time of CF diagnosis, patients had monthly sputum cultures. After transplantation, CF-patients had bronchoscopy with bronchoalveolar lavage at 2, 4, 6 and 12 weeks and 6, 12, 18 and 24 months after transplantation, as well as sputum samples if relevant. Selected culture results prior to and after transplantation were stored. We focused on colonization with the most frequent bacteria: Pseudomonas aeruginosa (PA), Stenotrophomonas maltophilia (SM), Achromobacter xylosoxidans (AX) and Burkholderia cepacia complex (BCC). Pulsed-field gel electrophoresis (PFGE) was used to identify clonality of bacterial isolates obtained before and after lung transplantation. Time to re-colonization was defined as the time from transplantation to the first positive culture with the same species. Seventy-three out of 97 (75%) had sufficient culture data for analyses with a median of 7 (1–91) cultures available before and after transplantation. Median colonization-free survival time was 23 days until the first positive culture after transplantation. After 2 years, 59 patients (81%) were re-colonized, 33 (48.5%) with PA, 7 (10.3%) with SM, 12 (17.6%) with AX, and 7 (10.3%) with BCC. No difference in survival was observed between the patients colonized within the first 2 years and those not colonized. Re-colonization of bacteria in the lower airways occurred at a median of 23 days after transplantation in our cohort. In our patient cohort, survival was not influenced by re-colonization or bacterial species.
What Is Asthma?
Authors: García-Marcos Luis
Published: March 2021

Asthma is… [...]
Oral Manifestations in Melanoma Patients Treated with Target or Immunomodulatory Therapies
Authors: Dika Emi , Lambertini Martina , Gouveia Bruna , Mussi Martina , Marcelli Emanuela , Campione Elena , Gurioli Carlotta , Melotti Barbara , Alessandrini Aurora , Ribero Simone
Published: March 2021

Background: BRAF (v-raf murine sarcoma viral oncogene homolog B1) and MEK (mitogen activated protein kinase) inhibitors, as well as immunotherapy against cytotoxic T-lymphocyte-associated antigen 4 (CTLA-4) and the programmed cell death 1 (PD-1) receptor and its ligand (PD-L1), have shown good results in improving the disease-free survival of patients with metastatic melanoma (MM). The aim of this review is to summarize the main oral adverse events (oAEs) occurring in patients undergoing target or immunotherapy. We proposed two separate sections: oAEs during the treatment with (1) target therapies with BRAF and MEK inhibitors and tyrosine kinase inhibitors (gingival hyperplasia, pigmentation disorders, squamo-proliferative lesions) and (2) immunotherapies with CTLA-4 or PD1 inhibitors (lichenoid reactions, immuno-bullous reactions, xerostomia and other reactions). Adverse events frequently include oAEs, although these are often misdiagnosed and under-reported. Indeed, the oral cavity is not routinely evaluated during clinical practice. The symptomatology related to oAEs is significant since it may represent the first manifestation of a severe systemic reaction, possibly leading to difficulties in nutrition with a consequent impact on patients’ quality of life. A careful examination of the oral cavity is recommended during the evaluation of oncologic patients in order to promptly detect the onset of new manifestations.
Breakthrough Mucormycosis Developing on Mucorales-Active Antifungals Portrays a Poor Prognosis in Patients with Hematologic Cancer
Authors: Axell-House Dierdre B. , Wurster Sebastian , Jiang Ying , Kyvernitakis Andreas , Lewis Russell E. , Tarrand Jeffrey J. , Raad Issam I. , Kontoyiannis Dimitrios P.
Published: March 2021

Although breakthrough mucormycosis (BT-MCR) is known to develop on mold-active antifungals without Mucorales activity, it can also occur while on Mucorales-active antifungals. Herein, we retrospectively compared the characteristics and outcomes of patients with hematologic malignancies (HMs) or hematopoietic stem cell transplant (HSCT) who developed BT-MCR on mold-active antifungals with or without Mucorales activity. Of the patients developing BT-MCR, 16 were on Mucorales-active antifungals (9 isavuconazole, 6 posaconazole, 1 amphotericin B), and 87 were on other mold-active agents (52 voriconazole, 22 echinocandins, 8 itraconazole, 5 echinocandin + voriconazole). Both groups were largely comparable in clinical characteristics. Patients developing BT-MCR while on Mucorales-active antifungals had higher 42-day mortality, from either symptom onset (63% versus 25%, p = 0.006) or treatment initiation (69% versus 39%, p = 0.028). In multivariate Cox regression analysis, exposure to Mucorales-active antifungals prior to BT-MCR had a hazard ratio of 2.40 (p = 0.015) for 42-day mortality from treatment initiation and 4.63 (p < 0.001) for 42-day mortality from symptom onset. Intensive care unit (ICU) admission and APACHE II score at diagnosis, non-recovered severe neutropenia, active HM, and amphotericin B/caspofungin combination treatment were additional independent predictors of 42-day mortality. In summary, BT-MCR on Mucorales-active antifungals portrays poor prognosis in HM/HSCT patients. Moreover, improvements in early diagnosis and treatment are urgently needed in these patients.
Towards Full-Fledged Inflation Targeting Monetary Policy Regime in Mauritius
Authors: Madhou Ashwin , Sewak Tayushma , Moosa Imad , Ramiah Vikash , Gerth Florian
Published: March 2021

An increasing number of emerging and developing countries have adopted or are transitioning towards full-fledged inflation targeting (FFIT) as the main monetary policy framework to anchor inflation. In this paper, we explore the FFIT regime as a means for Mauritius to achieve stable inflation, anchor inflationary expectations and establish credibility in committing monetary policy towards price stability as its primary goal. This paper reviews and highlights issues experienced with the current monetary policy framework and the challenges in transitioning towards FFIT. Given that forecasting is central to FFIT, we develop a practical model-based forecasting and policy analysis system (FPAS) to support transition to FFIT, taking into account structural features and shocks that are specific to the Mauritius economy.
Insights into Activity of Zoo Housed Asian Elephants (Elephas maximus) during Periods of Limited Staff and Visitor Presence, a Focus on Resting Behaviour
Authors: Finch Katherine , Sach Fiona , Fitzpatrick Malcolm , Rowden Lewis J.
Published: March 2021

Historically, behaviour of zoo housed species during hours of limited staff and visitor presence has been poorly studied, largely due to the lack of appropriate technology. Advances in digital monitoring equipment and facility design by European elephant holders has given researchers scope to accurately evaluate behaviour for this species over 24 hrs. Various behavioural indicators of welfare have now been identified for zoo housed elephants; however the relationship between resting behaviour and welfare experience has been an area highlighted to require additional research. Lying rest is a potential positive welfare indicator for this species, with studies suggesting that engagement in lying rest can be used to monitor both psychological and physiological wellbeing. Throughout this work we aim to give insights into the behaviour of individual Asian elephants at ZSL Whipsnade Zoo, specifically between the hours of 16:00 and 10:00. In addition to presenting the activity budgets of our study individuals during these times, we explore individual engagement in resting behaviour. Furthermore, we evaluate the social associations of our study group during rest. We provide evidence that unrelated individuals can form strong associations with conspecifics when resting and show that life history is a factor to consider when evaluating social compatibility between group members. Finally, we demonstrate the positive role that calves and juvenile individuals can play in facilitating meaningful associations between group members during rest. Our study highlights the importance of evaluating behaviour during understudied time periods in order to obtain a holistic view of individual welfare, further emphasising the importance of adopting an evidence-based approach to management for this species in zoos.
Assessing Vegetation Heritage Value: The Alentejo Central (Portugal) as a Case Study
Authors: Batista Teresa , de Mascarenhas José Manuel , Mendes Paula , Pinto-Gomes Carlos
Published: March 2021

Vegetation natural heritage can be valued in itself, but also as a habitat for many wildlife species. This study presents a methodological essay concerning the evaluation of plant heritage, applied in Central Alentejo, in the south of Portugal. This evaluation was based on the following criteria: horizontal and vertical structure of vegetation, tree cover density, rare plant species richness, phytocenotic maturity, importance as ecological corridor, historical record, scientific and educational potential and recreational potential. The vegetation heritage value (VHV) was calculated using a linear combination of the weighted criteria. In this way it was possible to identify the most interesting areas for conservation purposes. Of the 7500 km2 analyzed, 52% are natural and semi-natural areas, and of these, 18.8% have very high VHV, 70.7% have high VHV and only 10.5% average VHV. The highest VHV areas are actually included under the protected areas of Natura 2000 sites.
Appropriate Management Scale of Farmland and Regional Differences under Different Objectives in Shaanxi Province, China
Authors: Zhang Qianxi , Chen Zehui , Li Fei
Published: March 2021

Agricultural development is facing two problems: insufficient grain production and low profit of farmers. There is a contradiction between the government’s goal of increasing production and the farmer’s goal of increasing profit. Exploring the appropriate management scale of farmland under different objectives is of great significance to alleviate the conflict of interests between the government and farmers. In this study the Cobb-Douglas production function model was used to measure the appropriate management scale of farmland under different objectives in Shaanxi Province and analyze the regional differences. Under the two objectives, the appropriate management scale of the Loess Plateau was the largest in the three regions, followed by Qinba Mountains and Guanzhong Plain. Farmland area and quality were the main influencing factors for the appropriate management scale of farmland under the goal of maximizing the farmland yield, while the nonagricultural employment rate and farmland transfer rate were the main influencing factors under the goal of maximizing farmers’ profits. It is easy for Shaanxi Province to increase farmers’ profits, but more land needed to be transferred to increase farmland yield. These results suggest that in order to balance the goal of increasing yield and profit, the transfer of rural surplus labor should be promoted, and the nonagricultural employment rate should be improved. In Loess Plateau, restoring the ecological environment and enhancing the farmland quality. In Guanzhong Plain, avoiding urban land encroachment on farmland. In Qinba Mountains, developing farming techniques and moderately increasing the intensity of farmland exploit.
Spatio-Temporal Non-Stationarity and Its Influencing Factors of Commercial Land Price: A Case Study of Hangzhou, China
Authors: Garang Zhuoma , Wu Cifang , Li Guan , Zhuo Yuefei , Xu Zhongguo
Published: March 2021

Investigating the characteristics and mechanisms of the spatial and temporal variations of commercial land prices and its major subdivisions has great theoretical and practical significance in the study of urban economy and its spatial refinement management. Unlike general commodity prices, land prices are influenced by geographical location and tend to fluctuate over time. However, most scholars have not explored the influence mechanism of commercial land prices in both time and space. To help bridge this gap, this study takes the sample commercial land prices in the main urban area of Hangzhou from 2006 to 2015 as the empirical research object and investigates the spatiotemporal evolution mechanism of urban commercial land prices through a comparative analysis of the multiple regression analysis (MRA) with ordinary least squares (OLS), the geographically weighted regression (GWR), the temporally weighted regression (TWR), and the geographically and temporally weighted regression (GTWR) models. Results indicate that the land prices of land for financial facilities (Commercial Land Category 1) and commercial-business land (Commercial Land Category 2) in Hangzhou show different spatial and temporal evolutions and are influenced by the common factors of residential land price level (PL), maturity of living services (EN), and plot ratio (FRO) in the district. Meanwhile the main difference between the two influencing factors is the significant difference in sensitivity to locational centrality and industrial structure. Furthermore, we find that the spatial and temporal evolution of commercial land prices has three main mechanism: location selection, point-axis evolution, and function-promoting. Our findings will provide guidelines for scientifically guiding the coordinated development of urban land price and industrial economy and realizing the fine management and allocation of urban spatial resources.
Where Do I Allocate My Urban Allotment Gardens? Development of a Site Selection Tool for Three Cities in Benin
Authors: Sonneveld B. G. J. S. , Houessou M. D. , van den Boom G. J. M. , Aoudji A.
Published: March 2021

In the context of rapid urbanization, poorer residents in cities across low- and middle-income countries increasingly experience food and nutrition deficiencies. The United Nations has highlighted urban agriculture (UA) as a viable solution to food insecurity, by empowering the urban poor to produce their own fresh foods and make some profit from surplus production. Despite its potential role in reducing poverty and food insecurity, there appears to be little political will to support urban agriculture. This is seen in unclear political mandates that are sustained by information gaps on selection criteria for UA sites. The research reported here addresses this issue in the form of a decision-making support tool that assesses the suitability of cadastral units and informal plots for allotment gardens in urban and peri-urban areas. The tool was developed and tested for three rapidly expanding cities in Benin, a low-income country in West Africa, based on an ordered logit model that relates a set of 300 expert assessments on site suitability to georeferenced information on biophysical and socio-economic characteristics. Soil, land use, groundwater depth, vicinity to market and women’s safety were significant factors in the assessment. Scaled up across all cadastral units and informal sites, the tool generated detailed baseline maps on site suitability and availability of areas. Its capacity to support policymakers in selecting appropriate sites comes to the fore by reporting changes in site suitability under scenarios of improved soil fertility and enhanced safety for women.
Effects and Safety of Convalescent Plasma Administration in a Group of Polish Pediatric Patients with COVID-19: A Case Series
Authors: Małecki Paweł , Faltin Kamil , Mania Anna , Mazur-Melewska Katarzyna , Cwalińska Agnieszka , Zawadzka Anna , Bukowska Alicja , Lisowska Katarzyna , Graniczna Katarzyna , Figlerowicz Magdalena
Published: March 2021

Despite the enormous advances in knowledge about the SARS-CoV-2 infection, the optimal treatment for COVID-19 is still not well defined. The use of convalescent plasma seems to be a promising method of treatment but requires further evaluation. Although it is usually mild, in children with underlying chronic diseases, the course of SARS-CoV-2 infection may be very severe. We described a series of 13 pediatric patients (mean age 10.4 years, median 12) treated with convalescent plasma as a method of COVID-19 therapy. Medical history, with particular emphasis on comorbidities, clinical course, laboratory parameters, supportive treatment and virus elimination time, were analyzed. The mean hospitalization time was 22.6 days (median 20). The most common abnormalities included increased levels of C-reactive protein, D-dimer, and lymphopenia. Median time from symptom onset to convalescent plasma transfusion was 10.6 days (median 7 days). Six patients (46.2%) had a viral clearance on RT-PCR method from a nasopharyngeal swab within 3 days of transfusion, while in the remaining patients the mean elimination time was 12.1 days (median 6 days). Clinical improvement was achieved in all patients; no adverse effects were found in any of the cases. Convalescent plasma may be a promising treatment for COVID-19 in children.