bluuebunny/crossref_metadata_2025 huggingface dataset:
The Mutational Landscape of Acute Myeloid Leukaemia Predicts Responses and Outcomes in Elderly Patients from the PETHEMA-FLUGAZA Phase 3 Clinical Trial
Authors: Ayala Rosa , Rapado Inmaculada , Onecha Esther , Martínez-Cuadrón David , Carreño-Tarragona Gonzalo , Bergua Juan , Vives Susana , Algarra Jesus , Tormo Mar , Martinez Pilar , Serrano Josefina , Herrera Pilar , Ramos Fernando , Salamero Olga , Lavilla Esperanza , Gil Cristina , López Lorenzo Jose , Vidriales María , Labrador Jorge , Falantes José , Sayas María , Paiva Bruno , Barragán Eva , Prosper Felipe , Sanz Miguel , Martínez-López Joaquín , Montesinos Pau ,   on behalf of the Programa para el Estudio de la Terapeutica en Hemopatias Malignas (PETHEMA) Cooperative Study Group
Published: May 2021

We sought to predict treatment responses and outcomes in older patients with newly diagnosed acute myeloid leukemia (AML) from our FLUGAZA phase III clinical trial (PETHEMA group) based on mutational status, comparing azacytidine (AZA) with fludarabine plus low-dose cytarabine (FLUGA). Mutational profiling using a custom 43-gene next-generation sequencing panel revealed differences in profiles between older and younger patients, and several prognostic markers that were useful in young patients were ineffective in older patients. We examined the associations between variables and overall responses at the end of the third cycle. Patients with mutated DNMT3A or EZH2 were shown to benefit from azacytidine in the treatment-adjusted subgroup analysis. An analysis of the associations with tumor burden using variant allele frequency (VAF) quantification showed that a higher overall response was associated with an increase in TET2 VAF (odds ratio (OR), 1.014; p = 0.030) and lower TP53 VAF (OR, 0.981; p = 0.003). In the treatment-adjusted multivariate survival analyses, only the NRAS (hazard ratio (HR), 1.9, p = 0.005) and TP53 (HR, 2.6, p = 9.8 × 10−7) variants were associated with shorter overall survival (OS), whereas only mutated BCOR (HR, 3.6, p = 0.0003) was associated with a shorter relapse-free survival (RFS). Subgroup analyses of OS according to biological and genomic characteristics showed that patients with low–intermediate cytogenetic risk (HR, 1.51, p = 0.045) and mutated NRAS (HR, 3.66, p = 0.047) benefited from azacytidine therapy. In the subgroup analyses, patients with mutated TP53 (HR, 4.71, p = 0.009) showed a better RFS in the azacytidine arm. In conclusion, differential mutational profiling might anticipate the outcomes of first-line treatment choices (AZA or FLUGA) in older patients with AML. The study is registered at ClinicalTrials.gov as NCT02319135.
Perceptions of Family-Level Social Factors That Influence Health Behaviors in Latinx Adolescents and Young Adults at High Risk for Type 2 Diabetes
Authors: Soltero Erica G. , Navabi Neeku , Castro Felipe G. , Ayers Stephanie L. , Mendez Jenny , Thompson Deborah I. , Shaibi Gabriel Q.
Published: May 2021

Given that health behaviors occur within the context of familial social relationships, a deeper understanding of social factors that influence health behaviors in Latinx families is needed to develop more effective diabetes prevention programming. This qualitative study identified perceived family-level social factors that influence health behaviors in Latinx adolescents (12–16 years; N = 16) and young adults (18–24 years; N = 15) with obesity and explored differences in perceptions across sex and age. Participants completed an in-depth interview that was recorded, transcribed, and coded using thematic content analysis. Emergent themes central to health behaviors included: perceived parental roles and responsibilities, perceived family social support for health behaviors, and familial social relationships. Mom’s role as primary caregiver and dad’s role as a hard worker were seen as barriers to engaging in health behaviors among adolescent females and young adults, males and females. Adolescents perceived receiving more support compared to young adults and males perceived receiving more support compared to females. Health behaviors in both age groups were shaped through early familial social interactions around physical activity. These insights suggest that traditional gender roles, social support, and social interaction around health behaviors are critical components for family-based diabetes prevention programs in high-risk Latinx youth and young adults.
Childhood Obesity in Serbia on the Rise
Authors: Marković Lidija , Đorđić Višnja , Trajković Nebojša , Božić Predrag , Halaši Szabolcs , Cvejić Dragan , Ostojić Sergej M.
Published: May 2021

The aim of the study was to examine changes in obesity prevalence among primary school children in Serbia between 2015 and 2019 rounds of the national WHO European Childhood Obesity Surveillance Initiative (COSI-Serbia). Cross-sectional studies were conducted in 2015 and 2019. The nationally representative samples of primary school children were measured for body height and weight, following the COSI protocol. Body Mass Index was calculated, and the IOTF and WHO definitions were used to classify children as overweight or obese. Participants were children of both sexes aged 7.00–8.99 years (n = 6105). Significant differences in overweight (obesity included) prevalence between two COSI rounds were identified regardless of definitions applied. According to the WHO definitions, prevalence of overweight and obesity combined increased in 7–9-year-old children in Serbia from 30.7% in 2015 to 34.8% in 2019 (z = −3.309, p < 0.05), and according to the IOTF standards, the increase from 22.8% to 30% was registered (z = −6.08, p = 0.00). The childhood overweight/obesity rate is increasing in Serbia, which places monitoring and surveillance of children’s nutritional status high on the public health agenda.
Taxonomy, Conservation, and the Future of Native Aquatic Snails in the Hawaiian Islands
Authors: Christensen Carl C. , Hayes Kenneth A. , Yeung Norine W.
Published: May 2021

Freshwater systems are among the most threatened habitats in the world and the biodiversity inhabiting them is disappearing quickly. The Hawaiian Archipelago has a small but highly endemic and threatened group of freshwater snails, with eight species in three families (Neritidae, Lymnaeidae, and Cochliopidae). Anthropogenically mediated habitat modifications (i.e., changes in land and water use) and invasive species (e.g., Euglandina spp., non-native sciomyzids) are among the biggest threats to freshwater snails in Hawaii. Currently, only three species are protected either federally (U.S. Endangered Species Act; Erinna newcombi) or by Hawaii State legislation (Neritona granosa, and Neripteron vespertinum). Here, we review the taxonomic and conservation status of Hawaii’s freshwater snails and describe historical and contemporary impacts to their habitats. We conclude by recommending some basic actions that are needed immediately to conserve these species. Without a full understanding of these species’ identities, distributions, habitat requirements, and threats, many will not survive the next decade, and we will have irretrievably lost more of the unique books from the evolutionary library of life on Earth.
New Treatment Option for Clinical and Subclinical Mastitis in Dairy Cows Using Acoustic Pulse Technology (APT)
Authors: Leitner Gabriel , Papirov Eduard , Gilad Dan , Haran Doron , Arkin Oded , Zuckerman Alon , Lavon Yaniv
Published: May 2021

The effect of acoustic pulse technology (APT) on recovery, culling, milk yield, and economic benefits for 118 cows with subclinical mastitis was compared with a no-treatment control (59 vs. 59), and another 118 APT-treated cows with clinical mastitis were compared with antibiotic-treated controls (59 vs. 59). Recovery was defined as a decrease in somatic cell count (SCC) to <250 × 103 cells/mL in at least two out of three monthly milk recordings after treatments. For the subclinically infected cows, APT treatment resulted in 65.5% recovery, 0% culling, and additional milk yield of 2.74 L/cow per day compared to 35.6% recovery and 5.1% culling in the no-treatment controls. For the clinically infected cows, APT treatment resulted in 67.8% recovery, 6.8% culling, and additional milk yield of 3.9 L/cow per day compared to 35.6% recovery and 32.2% culling in the antibiotic-treated group. Bacteriological analysis was run for 95 (80%) cows with clinical mastitis (APT-46; AB-49). For cows with Escherichia coli infection, 85.7% (18/21) treated with APT recovered vs. 17.6% (3/17) in the antibiotic-treated group; for cows with streptococcal infection, 66.0% (12/18) in the APT-treated group recovered vs. 44.4% (8/18) in the antibiotic-treated group.
Impact of Coronavirus Outbreaks on Science and Society: Insights from Temporal Bibliometry of SARS and COVID-19
Authors: Gupta Ramya , Prasad Abhishek , Babu Suresh , Yadav Gitanjali
Published: May 2021

A global event such as the COVID-19 crisis presents new, often unexpected responses that are fascinating to investigate from both scientific and social standpoints. Despite several documented similarities, the coronavirus pandemic is clearly distinct from the 1918 flu pandemic in terms of our exponentially increased, almost instantaneous ability to access/share information, offering an unprecedented opportunity to visualise rippling effects of global events across space and time. Personal devices provide “big data” on people’s movement, the environment and economic trends, while access to the unprecedented flurry in scientific publications and media posts provides a measure of the response of the educated world to the crisis. Most bibliometric (co-authorship, co-citation, or bibliographic coupling) analyses ignore the time dimension, but COVID-19 has made it possible to perform a detailed temporal investigation into the pandemic. Here, we report a comprehensive network analysis based on more than 20,000 published documents on viral epidemics, authored by over 75,000 individuals from 140 nations in the past one year of the crisis. Unlike the 1918 flu pandemic, access to published data over the past two decades enabled a comparison of publishing trends between the ongoing COVID-19 pandemic and those of the 2003 SARS epidemic to study changes in thematic foci and societal pressures dictating research over the course of a crisis.
High Heat Treatment of Goat Cheese Milk. The Effect on Sensory Profile, Consumer Acceptance and Microstructure of Cheese
Authors: Miloradovic Zorana , Tomic Nikola , Kljajevic Nemanja , Levic Steva , Pavlovic Vladimir , Blazic Marijana , Miocinovic Jelena
Published: May 2021

Goat cheeses from high heat treated milk (HHTM: 80 °C/5 min (E1) and 90 °C/5 min (E2)), could be regarded as new products, compared to their analogues made from commonly pasteurized milk (65 °C/30 min (C)). Descriptive analysis and consumer tests with a hedonic scale and JAR scale were part of the product development process. The use of scanning electron microscopy enabled deeper insight into the flavor and texture of the cheeses. In all cheese variants, goaty flavor was mildly pronounced. Young HHTM cheeses also had a pronounced whey and cooked/milky flavor. Consumers found such flavor ‘too intensive’. Unlike the control variant, HHTM cheeses were not described as ‘too hard’. Such improvement in texture was found to be a result of fine, highly branched microstructure, sustained over the course of ripening time and highly incorporated milk fat globules inside the cheese mass. Cluster analysis showed that the largest group of consumers (47.5%) preferred E2 cheese. Although consumers found that most of the cheeses were ‘too salty’, this excess did not decrease their overall acceptance. Neither microstructure analysis nor descriptive sensory analysis of goat white brined cheeses produced from high heat treated milk has been done before.
Chemical Analysis Combined with Multivariate Statistical Methods to Determine the Geographical Origin of Milk from Four Regions in China
Authors: Zhao Ruting , Su Meicheng , Zhao Yan , Chen Gang , Chen Ailiang , Yang Shuming
Published: May 2021

Traceability of milk origin in China is conducive to the implementation of the protection of regional products. In order to distinguish milk from different geographical distances in China, we traced the milk of eight farms in four neighboring provinces of China (Inner Mongolia autonomous region, Hebei, Ningxia Hui autonomous and Shaanxi), and multivariate data analysis was applied to the data including elemental analysis, stable isotope analysis and fatty acid analysis. In addition, orthogonal partial least squares discriminant analysis (OPLS-DA) is used to determine the optimal classification model, and it is explored whether the combination of different technologies is better than a single technical analysis. It was confirmed that in the inter-provincial samples, the combination of the two techniques was better than the analysis using a single technique (fatty acids: R2 = 0.716, Q2 = 0.614; fatty acid-binding isotopes: R2 = 0.760, Q2 = 0.635). At the same time, milk produced by farms with different distances of less than 11 km in each province was discriminated, and the discriminant distance was successfully reduced to 0.7 km (Ningxia Hui Autonomous Region: the distance between the two farms was 0.7 km, R2 = 0.771, Q2 = 0.631). For short-distance samples, the combination multiple technologies are not completely superior to a single technique, and sometimes, it is easy to cause model over-fitting.
Development of a Simplified Portion Size Selection Task
Authors: Pink Aimee E. , Cheon Bobby K.
Published: May 2021

Portion size is an important determinant of energy intake and the development of easy to use and valid tools for measuring portion size are required. Standard measures, such as ad libitum designs and currently available computerized portion selection tasks (PSTs), have several limitations including only being able to capture responses to a limited number of foods, requiring participants’ physical presence and logistical/technical demands. The objective of the current study was to develop and test robust and valid measures of portion size that can be readily prepared by researchers and be reliably utilized for remote online data collection. We developed and tested two simplified PSTs that could be utilized online: (1) portion size images presented simultaneously along a horizontal continuum slider and (2) multiple-choice images presented vertically. One hundred and fifty participants (M = 21.35 years old) completed both simplified PSTs, a standard computerized PST and a series of questionnaires of variables associated with portion size (e.g., hunger, food item characteristics, Three Factor Eating Questionnaire). We found average liking of foods was a significant predictor of all three tasks and cognitive restraint also predicted the two simplified PSTs. We also found significant agreement between the standard PST and estimated portion sizes derived from the simplified PSTs when accounting for average liking. Overall, we show that simplified versions of the standard PST can be used online as an analogue of estimating ideal portion size.
Alpha-Actinin-3 Deficiency Might Affect Recovery from Non-Contact Muscle Injuries: Preliminary Findings in a Top-Level Soccer Team
Authors: Rodas Gil , Moreno-Pérez Víctor , Del Coso Juan , Florit Daniel , Osaba Lourdes , Lucia Alejandro
Published: May 2021

There are recent data suggesting an association between the R577X polymorphism (rs1815739) in the gene encoding α-actinin-3 (ACTN3) and the risk of musculoskeletal injuries. The purpose of this study was to analyze the association of rs1815739 with risk of, and recovery time from non-contact soft-tissue muscle injuries in professional soccer players. Forty-six (22 male and 24 female) players from a top-level professional soccer team were assessed during five consecutive seasons: the genotype distribution was: RR, 41.3%; RX, 47.8%; and XX, 10.9%. There was a trend towards a higher risk of muscle injury associated with the XX genotype (p = 0.092, with no injury-free XX player during the 5-year study period) and a significant genotype effect for the time needed to return to play (p = 0.044, with the highest value shown for the XX genotype, i.e., 36 ± 26 days, vs. 20 ± 10 and 17 ± 12 days for RR and RX, respectively). In conclusion, the XX genotype might be associated not only with a higher risk of non-contact muscle injuries, but also of recovery time from these conditions. However, more research in larger cohorts is needed to confirm this preliminary hypothesis.
Impacts of the Type I Toxin–Antitoxin System, SprG1/SprF1, on Staphylococcus aureus Gene Expression
Authors: Chlebicka Kinga , Bonar Emilia , Suder Piotr , Ostyn Emeline , Felden Brice , Wladyka Benedykt , Pinel-Marie Marie-Laure
Published: May 2021

Type I toxin–antitoxin (TA) systems are widespread genetic modules in bacterial genomes. They express toxic peptides whose overexpression leads to growth arrest or cell death, whereas antitoxins regulate the expression of toxins, acting as labile antisense RNAs. The Staphylococcus aureus (S. aureus) genome contains and expresses several functional type I TA systems, but their biological functions remain unclear. Here, we addressed and challenged experimentally, by proteomics, if the type I TA system, the SprG1/SprF1 pair, influences the overall gene expression in S. aureus. Deleted and complemented S. aureus strains were analyzed for their proteomes, both intracellular and extracellular, during growth. Comparison of intracellular proteomes among the strains points to the SprF1 antitoxin as moderately downregulating protein expression. In the strain naturally expressing the SprG1 toxin, cytoplasmic proteins are excreted into the medium, but this is not due to unspecific cell leakages. Such a toxin-driven release of the cytoplasmic proteins may modulate the host inflammatory response that, in turn, could amplify the S. aureus infection spread.
Attitude toward Aging Mediates the Relationship between Personality and Mental Health in Older Adults
Authors: Bedaso Teshome Sirak , Han Buxin
Published: May 2021

This study aimed to examine attitude toward aging as a potential mediator of the relationship between personality factors and mental health in terms of depression and life satisfaction among older adults. A cross-sectional study was conducted with 438 Ethiopian elderly individuals aged 60 to 69. The results of the regression-based path analysis showed that after adjusting for demographic data, the relationship between agreeableness and depression in older adults was partially mediated by attitude toward aging. Likewise, attitude toward physical change due to aging and psychological growth subscales jointly mediated the correlation between neuroticism and depression. However, a significant direct path between neuroticism and depression persisted. On the contrary, openness had no significant direct association with depression apart from an indirect through psychosocial loss. The link between life satisfaction and agreeableness as well as openness to experience were partially mediated by psychosocial loss. Therefore, a person’s attitude toward aging and personality characteristics should be taken into consideration while designing interventions for managing mental health issues among older adults.
Short-Term Learning Effects of a Cardiopulmonary Resuscitation Program with Focus on the Relationship between Learning Effect and Trainees’ Perceived Competence
Authors: Akizuki Kazunori , Koeda Hideki
Published: May 2021

High-quality education and training are essential for effectively improving the quality of cardiopulmonary resuscitation (CPR); however, the relationship between the acquisition of motor skills and learners’ psychological characteristic has not been investigated fully. Therefore, we investigated the relationship between intrinsic motivation for training, self-efficacy for CPR, and CPR skill acquisition through training. Twenty health sciences undergraduate students participated in a 3-hour basic life support course. Their chest compression skills were assessed before and after the course. The main outcome of this study was the chest compression score, with changes in the score from pretest to posttest regarded as the short-term learning effects from training. The chest compression score was significantly higher after the course (median 53.5%, interquartile range [IQR] 39.8–83.0) than before the course (median 14.0%, IQR 0–43.3, p < 0.001). Furthermore, we found a significant correlation between perceived competence after the training and changes in the chest compression score from pretest to posttest (r = 0.483, p = 0.031), but other psychological indices did not correlate with changes in the chest compression score. A significant correlation was noted between trainees’ perceived competency and the short-term learning effects of CPR training. We suggest instructors focus on psychological components of training, including trainees’ perceived competence.
Factors Associated with Influenza Vaccination Uptake among U.S. Adults: Focus on Nativity and Race/Ethnicity
Authors: Jang Sou Hyun , Kang JaHyun
Published: May 2021

To support implementation strategies for upcoming influenza (flu) vaccinations for foreign-born and racial/ethnic minority groups, we analyzed the 2018 National Health Interview Survey (NHIS) database and performed logistic regression to examine the factors associated with, and the interaction between nativity and race/ethnicity in directing flu vaccination rates during the past 12 months (n = 25,045). As a result, we found nativity and race/ethnicity were associated with flu vaccination rates; foreign-born and non-Hispanic black respondents were less likely to take the vaccine than U.S.-born and non-Hispanic white respondents. The odds ratios were largest for the elderly, those working in the healthcare industry, those with health insurance, and those with a usual source of care (ORs = 3.058, 2.871, 2.317, and 2.342, respectively), suggesting that access to healthcare resources is critical for the uptake of the flu vaccine. There was a significant interaction effect between nativity and race/ethnicity. For improving flu vaccination rates, more support is necessary for foreign-born people and racial/ethnic minorities who have lower health insurance rates and usual sources of care than U.S.-born people and non-Hispanic whites, and thus are less able to adequately access healthcare resources in a timely manner.
Methodology to Investigate Indigenous Solid Waste Systems and Practices in the Rural Areas Surrounding Maseru (Kingdom of Lesotho)
Authors: Senekane Mpinane Flory , Makhene Agnes , Oelofse Suzan
Published: May 2021

Solid waste management (SWM) is the greatest challenge facing environmental protection and human wellbeing in the rural communities of Maseru (Kingsom of Lesotho). A lack of formal waste management (WM) systems in rural areas of Maseru have resulted in different indigenous systems and practices of SWM. Direct observation and descriptive designs will be employed. This is a mixed methods study of qualitative, quantitative and, non-experimental. We obtained data sets from existing official census and statistics of Maseru. We sampled 693 participants from total population of 6917. We received ethical clearance from Research Ethics committee of Health Sciences at the University of Johannesburg, we recruited six field workers. We have preventive equipment (sanitizers, masks, and sterile latex gloves) for COVID-19 infections in place; we have specific design on caps, masks and bags that will identify field workers as they collect data. We will train field workers, administer questionnaires, interview, and observe participants. STATKON will analyse data. The research will share the results with the Ministry of Environment and the community in Lesotho. The results will also be used to educate the rural communities on improved WM. Where weaknesses are identified, mitigation measures can be evaluated and implemented to rectify the negative aspects and improve the systems and practices. The rural communities face challenges such as waste collection services and sanitation facilities and this fact points out that there is a gap in SWM, which favours the existence of indigenous systems and practice of SWM.
Patient Clothing as a Healing Environment: A Qualitative Interview Study
Authors: Kam Seonju , Yoo Youngsun
Published: May 2021

Patients’ emotional responses to the hospital environment can be considered as important as medical technology and equipment. Therefore, this study investigated their experiences to determine whether the pattern using hospital identity (HI) elements, a widely used design method for patient clothing in university hospitals, can affect their emotional response and contribute to healing. It aimed to identify whether controlling the motif characteristics, arrangement, and spacing in this pattern design, and the direction between motifs, could be a method to design patient clothing for healing. To investigate patients’ emotional response and suggestions for patient clothing design, an interview-based qualitative approach was used. In-depth interviews were conducted with 12 patients discharged from Kyung Hee University Hospital Medical Center (KHUMC), Seoul. The interview questions consisted of two parts. One part featured questions about participants’ emotional responses to the medical environment and their latest patient clothing experience, and the other featured questions about their emotional response to, and suggestions for, the healing expression of pattern design using HI. The results confirmed that the motif characteristics, arrangement, and spacing, and the direction between motifs, influenced patients’ positive emotions and contributed to the healing effect. Therefore, when the HI elements of a medical institution are applied in the design of patient clothing with the characteristics of a healing design, patients perceive this as providing stability and comfort. The design of patient clothing becomes a medium that not only builds the brand image of medical institutions, but also enhances the quality of medical services centered on patient healing.
Barriers and Facilitators for Physical Activity in Adults with Type 2 Diabetes Mellitus: A Scoping Review
Authors: Vilafranca Cartagena Mireia , Tort-Nasarre Glòria , Rubinat Arnaldo Esther
Published: May 2021

The treatment of Type 2 Diabetes Mellitus (DM2) comprises physical activity (PA), diet, and medication. PA provides important benefits for people with diabetes. However, the majority of patients with DM2 do not attain the recommended levels of PA. Despite the evidence of the benefits to health of engaging in PA, the recommendations have not been fully translated into clinical improvements. Using a scoping review, this study aimed to identify the factors that influence levels of physical activity in adults with DM2. Eighteen studies published from 2009–2020 were identified by a search of relevant systematic databases between March 2019 and December 2020. The scoping review was carried out in accordance with the model defined by Arksey and O’Malley. The synthesis revelated sociodemographic characteristics, and six components—personal, motivation, social, mental, clinical, and self-efficacy—were identified as factors. Those that were most frequently identified were motivation and social support. In conclusion, these results should be considered to implement strategies to encourage people with DM2 to engage in physical exercise and thus improve the management of their condition.
Short-Term Effects of Balance Training with Stroboscopic Vision for Patients with Chronic Ankle Instability: A Single-Blinded Randomized Controlled Trial
Authors: Kim Kyung-Min , Estudillo-Martínez María D. , Castellote-Caballero Yolanda , Estepa-Gallego Alejandro , Cruz-Díaz David
Published: May 2021

Chronic Ankle Instability (CAI) is one of the most common musculoskeletal dysfunctions. Stroboscopic vision (SV) training has been deemed to enhance somatosensorial pathways in this population group; nevertheless, until recently no studies have addressed the additional effects of this treatment option to the traditional therapeutic approach. Methods: To evaluate the effectiveness of a partial visual deprivation training protocol in patients with CAI, a randomized controlled trial was carried out. Patients with CAI (n = 73) were randomized into either a balance training, SV training, or a control (no training) group. For participants assigned into training groups, they received 18 training sessions over 6 weeks. The primary outcome was dynamic balance as measured by the Star Excursion Balance Test assessed at baseline and after 6 weeks of intervention. Secondary outcome measures included ankle dorsiflexion range of motion, self-reported instability feeling, and ankle functional status. Results: Better scores in stroboscopic training and balance training groups in all outcome measures were observed in comparison with the control group with moderate to large effect sizes. Stroboscopic training was more effective than neuromuscular training in self-reported instability feeling (cohen’s d = 0.71; p = 0.042) and anterior reach distance of the star excursion balance test (cohen’s d = 1.23; p = 0.001). Conclusions: Preliminary findings from the effects of SV Stroboscopic training in patients with CAI, suggest that SV may be beneficial in CAI rehabilitation.
Burnout Impact of COVID-19 Pandemic on Health-Care Professionals at Assiut University Hospitals, 2020
Authors: Elghazally Shimaa A. , Alkarn Atef F. , Elkhayat Hussein , Ibrahim Ahmed K. , Elkhayat Mariam Roshdy
Published: May 2021

Background: burnout syndrome is a serious and growing problem among medical staff. Its adverse outcomes not only affect health-care providers’ health, but also extend to their patients, resulting in bad-quality care. The COVID-19 pandemic puts frontline health-care providers at greater risk of psychological stress and burnout syndrome. Objectives: this study aimed to identify the levels of burnout among health-care professionals currently working at Assiut University hospitals during the COVID-19 pandemic. Methods: the current study adopted an online cross-sectional design using the SurveyMonkey® website for data collection. A total of 201 physicians were included and the Maslach Burnout Inventory (MBI) scale was used to assess the three burnout syndrome dimensions: emotional exhaustion, depersonalization, and reduced personal accomplishment. Results: about one-third, two-thirds, and one-quarter of the respondents had high emotional exhaustion, high depersonalization, and low personal accomplishment, respectively. Younger, resident, and single physicians reported higher burnout scores. The personal accomplishment score was significantly higher among males. Those working more than eight hours/day and dealing with COVID-19 patients had significantly higher scores. Conclusion: during the COVID-19 pandemic, a high prevalence of burnout was recorded among physicians. Age, job title, working duration, and working hours/day were significant predictors for burnout syndrome subscale results. Preventive and interventive programs should be applied in health-care organizations during pandemics.
Incidence of Surgical Site Infections in Multicenter Study—Implications for Surveillance Practice and Organization
Authors: Różańska Anna , Rosiński Jerzy , Jarynowski Andrzej , Baranowska-Tateno Katarzyna , Siewierska Małgorzata , Wójkowska-Mach Jadwiga ,   Polish Society of Hospital Infections Team
Published: May 2021

Introduction: WHO core components of healthcare-associated infections (HAIs) prevention and control include their surveillance system. In Poland, there are no widespread multi-center infection surveillance networks based on continuous, targeted, active methodology. One of the most important form of HAIs are surgical site infections (SSIs). The aim of this study was to analyze the incidence of SSIs, in the context of seasonal differentiation. Seasonal differentiation could be connected with weather conditions, but it also can be affected by personnel absence due to holidays and furlough. The second aspect may influence organization of work and increased absenteeism may contribute to lowering the quality of patient care. Healthcare associated infections are the phenomenon which can be especially affected by such factors. Methods: The data used originate from the targeted, active surveillance reports obtained from the six years period, based on the ECDC recommendations. Results: Highest incidence rates of SSIs were found after operations performed in June and August, equal to 1.8% and 1.5% respectively and the lowest in October was 0.8%. These differences were statistically significant: for June incidence: OR 1.6, 95% CI 1.03–2.5, p = 0.015. Another approach showed a significant difference between the level of incidence in the period from November to January together with from June to August (1.35%), comparing to the rest of the year (1.05%). Also the rates of enterococcal and Enterobacterales infections were significantly higher for the period comprising months from November till January and from June to August. In Poland these are periods of increased number of absences associated with summer, national and religious holidays. Conclusions: Our results show that the short-term surveillance data limited to several days or months are not sufficient to obtain a valuable description of the epidemiological situation due to HAI. Efforts should be undertaken in order to implement wide net of hospital acquired infections, including SSI on the country level.
Occupational Exposures and Environmental Health Hazards of Military Personnel
Authors: Geretto Marta , Ferrari Marco , De Angelis Roberta , Crociata Filippo , Sebastiani Nicola , Pulliero Alessandra , Au William , Izzotti Alberto
Published: May 2021

Background: Military personnel are frequently exposed to environmental pollutants that can cause a variety of diseases. Methods: This review analyzed publications regarding epidemiological and biomonitoring studies on occupationally-exposed military personnel. Results: The exposures include sulfur mustard, organ chlorines, combustion products, fuel vapors, and ionizing and exciting radiations. Important factors to be considered are the lengths and intensities of exposures, its proximity to the sources of environmental pollutants, as well as confounding factors (cigarette smoke, diet, photo-type, healthy warrior effect, etc.). Assessment of environmental and individual exposures to pollutants is crucial, although often omitted, because soldiers have often been evaluated based on reported health problems rather than on excessive exposure to pollutants. Biomarkers of exposures and effects are tools to explore relationships between exposures and diseases in military personnel. Another observation from this review is a major problem from the lack of suitable control groups. Conclusions: This review indicates that only studies which analyzed epidemiological and molecular biomarkers in both exposed and control groups would provide evidence-based conclusions on exposure and disease risk in military personnel.
A Review of the Involvement of Partners and Family Members in Psychosocial Interventions for Supporting Women at Risk of or Experiencing Perinatal Depression and Anxiety
Authors: Noonan Maria , Jomeen Julie , Doody Owen
Published: May 2021

A maternal experience of perinatal mental health conditions can have serious short- and long-term consequences for child development and family relationships. Women with perinatal depression and/or anxiety are primarily supported by their partner/spouse and family. The aim of this review was to synthesise data from studies that have examined the inclusion of partners or family members in psychosocial interventions for women at risk of or experiencing perinatal depression and/or anxiety. A systematic search of five databases was conducted to identify literature published between 2010 and 2020. Nine empirical studies met the eligibility criteria and were independently assessed by two authors using the National Heart, Lung and Blood Institute Quality Assessment Tools and data were extracted and narratively synthesised guided by TIDieR (Template for Intervention Description and Replication) checklist. Eligible studies detailed diverse interventions facilitated by a variety of programme facilitators, with no central model of intervention or study outcome measures evident across the studies. All studies except one reported a significant change in maternal depression and anxiety scores. The interventions had limited evaluation of the woman’s, partner’s or family member’s experiences of involvement in the intervention. Further research is required to firmly establish the effectiveness of co-designed interventions to support the sustainable integration of such interventions into routine perinatal mental health services.
Mining Eco-Efficiency Measurement and Driving Factors Identification Based on Meta-US-SBM in Guangxi Province, China
Authors: Li Yonglin , Zuo Zhili , Xu Deyi , Wei Yi
Published: May 2021

The mining industry is one of the pillar industries of Guangxi’s economic and social development. The output value of mining and related industries accounts for 27% of the whole district’s total industrial output value. Therefore, the mining eco-efficiency measurement in Guangxi can be of great significance for the sustainable development of Guangxi’s mining industry. This study adopted Meta-US-SBM to measure the mining eco-efficiency in Guangxi from 2008 to 2018, including economic efficiency, resource efficiency, and environmental efficiency. It used the standard deviation ellipse model to simulate the migration trend of four efficiencies in Guangxi and used GeoDetector and Tobit models to explore the internal and external factors that affect the mining eco-efficiency. The four efficiencies in Guangxi show large temporal and spatial heterogeneity, and the internal and external factors that affect the mining eco-efficiency are different. The following conclusions can be drawn. (1) Environmental efficiency and mining eco-efficiency are improving, while economic efficiency and resource efficiency are deteriorating. Cities bordering other provinces have a significantly better mining eco-efficiency than non-bordering cities. (2) The development center in Guangxi has migrated to the Beibu Gulf Economic Zone. (3) Natural resources index and mining economic scale have a great impact on the mining eco-efficiency, and with the increase of the mining economic scale, the mining eco-efficiency showed a typical “U-shaped” curve. Finally, this study put forward corresponding policy recommendations to improve the mining eco-efficiency in Guangxi from four aspects: opening-up, technological progress, regional coordination, and government control.
Race, Family Conflict and Suicidal Thoughts and Behaviors among 9–10-Year-Old American Children
Authors: Assari Shervin , Boyce Shanika , Bazargan Mohsen , Caldwell Cleopatra H.
Published: May 2021

Family conflict is known to operate as a major risk factor for children’s suicidal thoughts and behaviors (STBs). However, it is unknown whether this effect is similar or different in Black and White children. Objectives: We compared Black and White children for the association between family conflict and STBs in a national sample of 9–10-year-old American children. Methods: This cross-sectional study used data from the Adolescent Brain Cognitive Development (ABCD) study. This study included 9918 White or Black children between the ages of 9 and 10 living in married households. The predictor variable was family conflict. Race was the moderator. The outcome variable was STBs, treated as a count variable, reflecting positive STB items that were endorsed. Covariates included ethnicity, sex, age, immigration status, family structure, parental education, and parental employment, and household income. Poisson regression was used for data analysis. Results: Of all participants, 7751 were Whites, and 2167 were Blacks. In the pooled sample and in the absence of interaction terms, high family conflict was associated with higher STBs. A statistically significant association was found between Black race and family conflict, suggesting that the association between family conflict and STBs is stronger in Black than White children. Conclusion: The association between family conflict and STBs is stronger in Black than White children. Black children with family conflict may be at a higher risk of STBs than White children with the same family conflict level. These findings align with the literature on the more significant salience of social relations as determinants of mental health of Black than White people. Reducing family conflict should be regarded a significant element of suicide prevention for Black children in the US.
New Sources, Differentiation, and Therapeutic Uses of Mesenchymal Stem Cells
Authors: Park Saeyoung , Jung Sung-Chul
Published: May 2021

Mesenchymal stem cells (MSCs) are multipotent cells derived from various tissues including bone marrow and adipose tissues [...]
Regulation of Oxalate Metabolism in Spinach Revealed by RNA-Seq-Based Transcriptomic Analysis
Authors: Joshi Vijay , Penalosa Arianne , Joshi Madhumita , Rodriguez Sierra
Published: May 2021

Although spinach (Spinacia oleracea L.) is considered to be one of the most nutrient-rich leafy vegetables, it is also a potent accumulator of anti-nutritional oxalate. Reducing oxalate content would increase the nutritional value of spinach by enhancing the dietary bioavailability of calcium and other minerals. This study aimed to investigate the proposed hypothesis that a complex network of genes associated with intrinsic metabolic and physiological processes regulates oxalate homeostasis in spinach. Transcriptomic (RNA-Seq) analysis of the leaf and root tissues of two spinach genotypes with contrasting oxalate phenotypes was performed under normal physiological conditions. A total of 2308 leaf- and 1686 root-specific differentially expressed genes (DEGs) were identified in the high-oxalate spinach genotype. Gene Ontology (GO) analysis of DEGs identified molecular functions associated with various enzymatic activities, while KEGG pathway analysis revealed enrichment of the metabolic and secondary metabolite pathways. The expression profiles of genes associated with distinct physiological processes suggested that the glyoxylate cycle, ascorbate degradation, and photorespiratory pathway may collectively regulate oxalate in spinach. The data support the idea that isocitrate lyase (ICL), ascorbate catabolism-related genes, and acyl-activating enzyme 3 (AAE3) all play roles in oxalate homeostasis in spinach. The findings from this study provide the foundation for novel insights into oxalate metabolism in spinach.
Liver Lipids of Patients with Hepatitis B and C and Associated Hepatocellular Carcinoma
Authors: Haberl Elisabeth M. , Weiss Thomas S. , Peschel Georg , Weigand Kilian , Köhler Nikolai , Pauling Josch K. , Wenzel Jürgen J. , Höring Marcus , Krautbauer Sabrina , Liebisch Gerhard , Buechler Christa
Published: May 2021

Hepatocellular carcinoma (HCC) still remains a difficult to cure malignancy. In recent years, the focus has shifted to lipid metabolism for the treatment of HCC. Very little is known about hepatitis B virus (HBV) and C virus (HCV)-related hepatic lipid disturbances in non-malignant and cancer tissues. The present study showed that triacylglycerol and cholesterol concentrations were similar in tumor adjacent HBV and HCV liver, and were not induced in the HCC tissues. Higher levels of free cholesterol, polyunsaturated phospholipids and diacylglycerol species were noted in non-tumorous HBV compared to HCV liver. Moreover, polyunsaturated phospholipids and diacylglycerols, and ceramides declined in tumors of HBV infected patients. All of these lipids remained unchanged in HCV-related HCC. In HCV tumors, polyunsaturated phosphatidylinositol levels were even induced. There were no associations of these lipid classes in non-tumor tissues with hepatic inflammation and fibrosis scores. Moreover, these lipids did not correlate with tumor grade or T-stage in HCC tissues. Lipid reprogramming of the three analysed HBV/HCV related tumors mostly resembled HBV-HCC. Indeed, lipid composition of non-tumorous HCV tissue, HCV tumors, HBV tumors and HBV/HCV tumors was highly similar. The tumor suppressor protein p53 regulates lipid metabolism. The p53 and p53S392 protein levels were induced in the tumors of HBV, HCV and double infected patients, and this was significant in HBV infection. Negative correlation of tumor p53 protein with free cholesterol indicates a role of p53 in cholesterol metabolism. In summary, the current study suggests that therapeutic strategies to target lipid metabolism in chronic viral hepatitis and associated cancers have to consider disease etiology.
Taxonomic and Gene Category Analyses of Subgingival Plaques from a Group of Japanese Individuals with and without Periodontitis
Authors: Izawa Kazuki , Okamoto-Shibayama Kazuko , Kita Daichi , Tomita Sachiyo , Saito Atsushi , Ishida Takashi , Ohue Masahito , Akiyama Yutaka , Ishihara Kazuyuki
Published: May 2021

Periodontitis is an inflammation of tooth-supporting tissues, which is caused by bacteria in the subgingival plaque (biofilm) and the host immune response. Traditionally, subgingival pathogens have been investigated using methods such as culturing, DNA probes, or PCR. The development of next-generation sequencing made it possible to investigate the whole microbiome in the subgingival plaque. Previous studies have implicated dysbiosis of the subgingival microbiome in the etiology of periodontitis. However, details are still lacking. In this study, we conducted a metagenomic analysis of subgingival plaque samples from a group of Japanese individuals with and without periodontitis. In the taxonomic composition analysis, genus Bacteroides and Mycobacterium demonstrated significantly different compositions between healthy sites and sites with periodontal pockets. The results from the relative abundance of functional gene categories, carbohydrate metabolism, glycan biosynthesis and metabolism, amino acid metabolism, replication and repair showed significant differences between healthy sites and sites with periodontal pockets. These results provide important insights into the shift in the taxonomic and functional gene category abundance caused by dysbiosis, which occurs during the progression of periodontal disease.
Nationwide Study of Drug Resistance Mutations in HIV-1 Infected Individuals under Antiretroviral Therapy in Brazil
Authors: Santos-Pereira Ana , Triunfante Vera , Araújo Pedro M. M. , Martins Joana , Soares Helena , Poveda Eva , Souto Bernardino , Osório Nuno S.
Published: May 2021

The success of antiretroviral treatment (ART) is threatened by the emergence of drug resistance mutations (DRM). Since Brazil presents the largest number of people living with HIV (PLWH) in South America we aimed at understanding the dynamics of DRM in this country. We analyzed a total of 20,226 HIV-1 sequences collected from PLWH undergoing ART between 2008–2017. Results show a mild decline of DRM over the years but an increase of the K65R reverse transcriptase mutation from 2.23% to 12.11%. This increase gradually occurred following alterations in the ART regimens replacing zidovudine (AZT) with tenofovir (TDF). PLWH harboring the K65R had significantly higher viral loads than those without this mutation (p < 0.001). Among the two most prevalent HIV-1 subtypes (B and C) there was a significant (p < 0.001) association of K65R with subtype C (11.26%) when compared with subtype B (9.27%). Nonetheless, evidence for K65R transmission in Brazil was found both for C and B subtypes. Additionally, artificial neural network-based immunoinformatic predictions suggest that K65R could enhance viral recognition by HLA-B27 that has relatively low prevalence in the Brazilian population. Overall, the results suggest that tenofovir-based regimens need to be carefully monitored particularly in settings with subtype C and specific HLA profiles.