bluuebunny/crossref_metadata_2025 huggingface dataset:
Leveraging Multivariable Linear Regression Analysis to Identify Patients with Anterior Cruciate Ligament Deficiency Using a Composite Index of the Knee Flexion and Muscle Force
Authors: Li Haoran , Huang Hongshi , Ren Shuang , Rong Qiguo
Published: February 2023

Patients with anterior cruciate ligament (ACL) deficiency (ACLD) tend to have altered lower extremity kinematics and dynamics. Clinical diagnosis of ACLD requires more objective and convenient evaluation criteria. Twenty-five patients with ACLD before ACL reconstruction and nine healthy volunteers were recruited. Five experimental jogging data sets of each participant were collected and calculated using a musculoskeletal model. The resulting knee flexion and muscle force data were analyzed using a t-test for characteristic points, which were the time points in the gait cycle when the most significant difference between the two groups was observed. The data of the characteristic points were processed with principal component analysis to generate a composite index for multivariable linear regression. The accuracy rate of the regression model in diagnosing patients with ACLD was 81.4%. This study demonstrates that the multivariable linear regression model and composite index can be used to diagnose patients with ACLD. The composite index and characteristic points can be clinically objective and can be used to extract effective information quickly and conveniently.
Radiomics-Based Machine Learning Model for Predicting Overall and Progression-Free Survival in Rare Cancer: A Case Study for Primary CNS Lymphoma Patients
Authors: Destito Michela , Marzullo Aldo , Leone Riccardo , Zaffino Paolo , Steffanoni Sara , Erbella Federico , Calimeri Francesco , Anzalone Nicoletta , De Momi Elena , Ferreri Andrés J. M. , Calimeri Teresa , Spadea Maria Francesca
Published: February 2023

Primary Central Nervous System Lymphoma (PCNSL) is an aggressive neoplasm with a poor prognosis. Although therapeutic progresses have significantly improved Overall Survival (OS), a number of patients do not respond to HD–MTX-based chemotherapy (15–25%) or experience relapse (25–50%) after an initial response. The reasons underlying this poor response to therapy are unknown. Thus, there is an urgent need to develop improved predictive models for PCNSL. In this study, we investigated whether radiomics features can improve outcome prediction in patients with PCNSL. A total of 80 patients diagnosed with PCNSL were enrolled. A patient sub-group, with complete Magnetic Resonance Imaging (MRI) series, were selected for the stratification analysis. Following radiomics feature extraction and selection, different Machine Learning (ML) models were tested for OS and Progression-free Survival (PFS) prediction. To assess the stability of the selected features, images from 23 patients scanned at three different time points were used to compute the Interclass Correlation Coefficient (ICC) and to evaluate the reproducibility of each feature for both original and normalized images. Features extracted from Z-score normalized images were significantly more stable than those extracted from non-normalized images with an improvement of about 38% on average (p-value < 10−12). The area under the ROC curve (AUC) showed that radiomics-based prediction overcame prediction based on current clinical prognostic factors with an improvement of 23% for OS and 50% for PFS, respectively. These results indicate that radiomics features extracted from normalized MR images can improve prognosis stratification of PCNSL patients and pave the way for further study on its potential role to drive treatment choice.
Newborns from Mothers Who Intensely Consumed Sucralose during Pregnancy Are Heavier and Exhibit Markers of Metabolic Alteration and Low-Grade Systemic Inflammation: A Cross-Sectional, Prospective Study
Authors: Aguayo-Guerrero José Alfredo , Méndez-García Lucía Angélica , Manjarrez-Reyna Aarón Noe , Esquivel-Velázquez Marcela , León-Cabrera Sonia , Meléndez Guillermo , Zambrano Elena , Ramos-Martínez Espiridión , Fragoso José Manuel , Briones-Garduño Juan Carlos , Escobedo Galileo
Published: February 2023

Robust data in animals show that sucralose intake during gestation can predispose the offspring to weight gain, metabolic disturbances, and low-grade systemic inflammation; however, concluding information remains elusive in humans. In this cross-sectional, prospective study, we examined the birth weight, glucose and insulin cord blood levels, monocyte subsets, and inflammatory cytokine profile in 292 neonates at term from mothers with light sucralose ingestion (LSI) of less than 60 mg sucralose/week or heavy sucralose intake (HSI) of more than 36 mg sucralose/day during pregnancy. Mothers in the LSI (n = 205) or HSI (n = 87) groups showed no differences in age, pregestational body mass index, blood pressure, and glucose tolerance. Although there were no differences in glucose, infants from HSI mothers displayed significant increases in birth weight and insulin compared to newborns from LSI mothers. Newborns from HSI mothers showed a substantial increase in the percentage of inflammatory nonclassical monocytes compared to neonates from LSI mothers. Umbilical cord tissue of infants from HSI mothers exhibited higher IL-1 beta and TNF-alpha with lower IL-10 expression than that found in newborns from LSI mothers. Present results demonstrate that heavy sucralose ingestion during pregnancy affects neonates’ anthropometric, metabolic, and inflammatory features.
Environmental Applications of Zeolites: Hydrophobic Sn-BEA as a Selective Gas Sensor for Exhaust Fumes
Authors: Jendrlin Martin , Grand Julien , Lakiss Louwanda , Dubray Florent , Bazin Philippe , El Fallah Jaafar , Mintova Svetlana , Zholobenko Vladimir
Published: February 2023

Environmental monitoring of pollutants, such as NOx and COx, which can be facilitated by a range of gas sensors, is of considerable fundamental and practical importance. This work has been focused on the synthesis and evaluation of zeolite β with tin (Sn-BEA) and dealuminated β (DeAl-BEA) zeolites. The zeolite samples have been extensively investigated by IR, UV-VIS and NMR spectroscopy, XRD, TGA, and N2 adsorption-desorption. The prepared Sn-BEA sample is characterised by the submicron particle size, an almost defect-free structure, and high hydrophobicity. Sensors containing selective microporous layers based on Sn-BEA and DeAl-BEA zeolites have been prepared and extensively tested. Both the Sn-BEA and DeAl-BEA zeolites have been deposited in thin films and evaluated as gas sensors for CO, CO2, NO, and NO2 in the presence of water vapour at room temperature. The Sn-BEA zeolite-based sensor showed high selectivity towards NO2, while the DeAl-BEA is selective towards CO2 and NO2.
Low-Molecular-Weight Gels as Smart Materials for the Enhancement of Antioxidants Activity
Authors: Toronyi Aneta Ácsová , Giuri Demetra , Martiniakova Silvia , Tomasini Claudia
Published: February 2023

Antioxidants are important substances used in the cosmetic and pharmaceutical fields that are able to block free radicals. These compounds can be incorporated into formulations for many reasons, such as release over time or preservation of the formulation activity and applicability. In the present study, a low-molecular-weight gel made with Boc-L-DOPA(Bn)2-OH was studied as suitable material to host antioxidants and improve their activity. The solvent change (DMSO/H2O) in combination with temperature was the technological procedure for the preparation of the gel. Two different antioxidants were tested: (1) α-tocopherol and (2) postbiotics. The antioxidant activity of α-tocopherol and of the postbiotics in the gel, measured by the (2,2-diphenyl-1-picryl-hydrazyl radical (DPPH) assay, showed higher values than those in the pure solvent. The antioxidant activity of the gel with 0.8 w/v% of gelator and α-tocopherol in the concentration range of 5–100 µM was 2.7–1.1 times higher on average than in the pure solvent. In the case of both postbiotics, the biggest difference was observed at 30% of postbiotics in the gel with 0.5% of a gelator, when the antioxidant activity was 4.4 to 4.7 times higher than that in the pure solvent.
Factors Affecting the Performance of Small and Medium Enterprises Regarding the Sustainable Development Goals—The Case of Foreign Direct Investment Firms in Vietnam
Authors: Thu Nguyen Thi Phuong , Xuan Vu Ngoc
Published: February 2023

The owners of SMEs in Vietnam mainly focus on business performance in the short term. In recent years, FDI firms have demonstrated interest in both business efficiency and sustainable development. These issues have attracted the attention of scientists and policy makers in Vietnam. Therefore, this study aimed to determine the factors affecting the performance of small and medium enterprises in Vietnam regarding the Sustainable Development Goals (SDGs). Using the latest published survey data up to March 2022 for food and beverage, wood and steel foreign direct investment enterprises, combined with a data envelope analysis model in step one and Tobit regression in step two, the results from this quantitative study are as follows: (1) the production efficiency index of Vietnamese FDI enterprises ranges from 82.5% to 89% depending on the industry (assuming variable output to scale); (2) the factors financial leverage, renewable consumption, scale and operating time are related to the performance of FDI enterprises, and have a positive effect on performance; and (3) financial leverage and renewable consumption can generally boost a firm’s performance in the case of FDI SMEs in the food and beverage, wood and steel industries. This research also suggests some solutions to achieve the Sustainable Development Goads (SDGs) in the FDI SMEs of Vietnam.
Relationship between FDI Inflows and Export Performance: An Empirical Investigation by Considering Structural Breaks
Authors: Ahmed Sayed Farrukh , Mohsin A. K. M. , Hossain Syed Far Abid
Published: February 2023

The present study examines the relationship between FDI inflows and export performance in Bangladesh by considering the issue of structural breaks utilizing annual time-series data from 1972 to 2019. In the study, unit root tests were conducted without (ADF test and PP test) and with (ZA test and LP test) the presence of probable structural breaks in the dataset. A Johansen test of co-integration was employed to determine whether the variables were co-integrated. The VECM was used for determining the sources of causation and the directions of the causal relationships between the variables. Since all the variables were integrated of order one, I(1), with breaks (confirmed by ZA and LP unit root tests), a Johansen test of co-integration was applied to identify whether the variables were co-integrated. The results of the Johansen co-integration test confirmed that three variables (LRGDPGR, LRFDI, and LREX) have a long-run equilibrium relationship or cointegrating relation. Finally, the VECM suggests the evidence of a positive and unidirectional causal relation from REX to RFDI in Bangladesh. An important uniqueness of this study lies in its application of the methodological issues of incorporating structural breaks, which could have significant implications for investigating the said relationship.
Advancements in Microalgal Biorefinery Technologies and Their Economic Analysis and Positioning in Energy Resource Market
Authors: Chanana Ishita , Kaur Parneet , Kumar Lokender , Kumar Pradeep , Kulshreshtha Sourabh
Published: February 2023

In the energy sector, bioenergy has been utilized as a replacement for non-renewable resources. Due to the depletion of resources, mankind may face adversities in the future. To overcome these challenges, sustainable and reliable bioenergy-based alternatives are to be used. Bioenergy sources are bio-based alternatives that have become acceptable in society for their renewability, sustainability, and environmentally friendly characteristics, but they still lag in the energy market due to their less cost-effective output of upstream and downstream processing in comparison with age-old fossil fuels. This review provides a detailed overview of their techno-economic and life cycle assessment, their positioning and competition in the energy market, and the strategies that might assist them in overcoming the market challenges. Microalgal bioenergy products have been lifting their market positioning at a slower rate that is almost unnoticeable, but their assistance in becoming a better solution against adversities of energy resource depletion in the future makes them quite promising. The new research alternatives for microalgal biomass conversion in biorefinery products for bioenergy production, which are based on combating pollution and reuse of waste products, along with the strategic application for combating the energy market competition, have also been highlighted.
Effect of Hyaluronic Acid and Kappa-Carrageenan on Milk Properties: Rheology, Protein Stability, Foaming, Water-Holding, and Emulsification Properties
Authors: Sutariya Suresh G. , Salunke Prafulla
Published: February 2023

Hyaluronic acid (HA) is now widely known for its ability to bind water and impart texture. The combined effects of HA and kappa-carrageenan (KC) have not yet been investigated, though. In this study, we looked at the synergistic effects of HA and KC (concentrations of 0.1 and 0.25%, and ratios of 85:15, 70:30, and 50:50 for each concentration) on the rheological properties, heat stability, protein phase separation, water-holding capacity, emulsification properties, and foaming properties of skim milk. When HA and KC were combined in various ratios with a skim milk sample, this resulted in lesser protein phase separation and a higher water-holding capacity than when HA and KC were utilized separately. Similarly, for the sample with a 0.1% concentration, the combination of HA + KC blends demonstrated a synergistic impact with greater emulsifying activity and stability. The samples with a concentration of 0.25% did not exhibit this synergistic effect, and the emulsifying activity and stability were mostly due to the HA’s higher emulsifying activity and stability at 0.25% concentration. Similarly, for rheological (apparent viscosity, consistency coefficient K, and flow behavior index n) and foaming properties, the synergistic effect of the HA + KC blend was not readily apparent; rather, these values were mostly due to an increase in the amount of KC in the HA + KC blend ratios. When HC-control and KC-control samples were compared to various HA + KC mix ratios, there was no discernible difference in the heat stability. With the added benefits of protein stability (reduced phase separation), increased water-holding capacity, improved emulsification capabilities, and foaming abilities, the combination of HA + KC would be highly helpful in many texture-modifying applications.
Impacts of Utensil Conditions on Consumer Perception and Acceptance of Food Samples Evaluated under In-Home Testing during the COVID-19 Pandemic
Authors: Singh Asmita , Seo Han-Seok
Published: February 2023

Sensory professionals are looking for alternative ways to conduct laboratory sensory testing, especially central location testing (CLT), during the COVID-19 pandemic. One way could be conducting CLTs at home (i.e., in-home testing). It is questionable whether food samples under in-home testing should be presented in uniform utensils, as it does so under laboratory sensory testing. This study aimed to determine whether utensil conditions could affect consumer perception and acceptance of food samples evaluated under in-home testing. Sixty-eight participants (40 females and 28 males) prepared chicken-flavored ramen noodle samples and evaluated them for attribute perception and acceptance, under two utensil conditions, using either their utensils (“Personal”) or uniform utensils provided (“Uniform”). Participants also rated their liking of forks/spoons, bowls, and eating environments, respectively, and attentiveness to sensory evaluation under each utensil condition. Results of the in-home testing showed that participants liked ramen noodle samples and their flavors under the “Personal” condition significantly more than under the “Uniform” condition. Ramen noodle samples evaluated under the “Uniform” condition were significantly higher in terms of saltiness than those evaluated under the “Personal” condition. Participants liked forks/spoons, bowls, and eating environments used under the “Personal” condition significantly more than those used under the “Uniform” condition. While overall likings of ramen noodle samples, evaluated under the “Personal” condition, significantly increased with an increase in hedonic ratings of forks/spoons or bowls, such significant correlations were not observed under the “Uniform” condition. In other words, providing uniform utensils (forks, spoons, and bowls) to participants in the in-home testing can reduce the influences of utensils on consumer likings of ramen noodle samples evaluated at home. In conclusion, this study suggests that sensory professionals should consider providing uniform utensils when they want to focus solely on consumer perception and acceptance of food samples by minimizing influences of environmental contexts, especially utensils, in the “in-home” testing.
Perceptions of Food among College Students in the Field of Food Science: A Food Sustainability Approach
Authors: de Moraes Prata Gaspar Maria Clara , Soar Claudia , Aguilera Mari , Gomez Maria Clara , Celorio-Sardà Ricard , Comas-Basté Oriol , Larrea-Killinger Cristina , Vidal-Carou M. Carmen
Published: February 2023

The complex concept of food sustainability has become crucial in all spheres of life. Dietitians, food scientists, and technologists are in a unique position to promote sustainability in food systems. However, the perceptions of food sustainability among food science professionals and college students are under-researched, particularly in Spain. The aim of this study was therefore to analyze perceptions related to food and to food sustainability in a sample of Human Nutrition and Dietetics (HND) and Food Science and Technology (FST) students in Barcelona (Spain). An exploratory and descriptive cross-sectional study was carried out using qualitative and quantitative methodology and convenience sampling. Two focus groups and an online questionnaire were conducted (300 participants completed the survey, 151 from HND and 149 from FST). Although the students expressed concern about food sustainability, their dietary choices were primarily associated with or influenced by taste/pleasure and health/nutrition. The issue of sustainability seemed more internalized by women than men, whereas the generalized conception of a sustainable diet was essentially based on environmental aspects, with socioeconomic dimensions largely overlooked. The concept of sustainability should be promoted among food science students in all its multidimensionality, and actions need to be implemented that bring sustainability closer to students’ social practices, which should be incorporated into all university education and that is taught by professors duly trained in the subject.
Effect of Coagulant and Treatment Conditions on the Gelation and Textural Properties of Acidic Whey Tofu
Authors: Guan Ziyu , Zhang Jie , Zhang Shitong , He Yun , Li Yadi , Regenstein Joe M. , Xie Yuan , Zhou Peng
Published: February 2023

This study aimed to investigate the properties of acidic whey tofu gelatin generated from two acidic whey coagulants by pure fermentation of Lactiplantibacillus paracasei and L. plantarum, as well as the characteristics of acidic whey tofu. The optimal holding temperature and the amount of coagulants added were determined based on the pH, water-holding capacity, texture, microstructure, and rheological properties of tofu gelation. Then, the differences in quality between tofu produced by pure bacterial fermentation and by natural fermentation were investigated under optimal tofu gelatin preparation conditions. The tofu gelatin presented the best texture at 37 °C with a 10% addition of coagulants fermented by both L. paracasei and L. plantarum. Under these conditions, the coagulant produced by the fermentation of L. plantarum resulted in a shorter formation time and stronger tofu gelatin compared with that produced from L. paracasei. Tofu produced by the fermentation of L. paracasei had higher pH, less hardness, and a rougher network structure, whereas tofu produced by the fermentation of L. plantarum was closer to tofu produced by natural fermentation in terms of pH, texture, rheology, and microstructure.
Visual Representation of Red Wine Color: Methodology, Comparison and Applications
Authors: Fan Shuyue , Liu Caiyun , Li Yunkui , Zhang Yu
Published: February 2023

A visual and easy-to-implement representation approach of red wine color is proposed in this work. The wine color under standard conditions, called feature color, was reproduced in the form of a circular spot. The feature color was further decomposed into two orthogonal aspects, the chromatic and light–dark components, characterized in the form of chromaticity distribution plane and lightness distribution plane, respectively. The color characterization of wine samples showed that this method well represented the color characteristics and can provide intuitive visual perception of wine color, in a way that is more reliable and convenient than the photographic method. The applications for monitoring the color evolution during winery and laboratory fermentation and the age discrimination of 175 commercial red wines suggest that this visual method is effective for color management and control of wine during fermentation and aging. The proposed method is a convenient way to present, store, convey, understand, analyze and compare the color information of wines.
Visualization of Sugar Content Distribution of White Strawberry by Near-Infrared Hyperspectral Imaging
Authors: Seki Hayato , Ma Te , Murakami Haruko , Tsuchikawa Satoru , Inagaki Tetsuya
Published: February 2023

In this study, an approach to visualize the spatial distribution of sugar content in white strawberry fruit flesh using near-infrared hyperspectral imaging (NIR-HSI; 913–2166 nm) is developed. NIR-HSI data collected from 180 samples of “Tochigi iW1 go” white strawberries are investigated. In order to recognize the pixels corresponding to the flesh and achene on the surface of the strawberries, principal component analysis (PCA) and image processing are conducted after smoothing and standard normal variate (SNV) pretreatment of the data. Explanatory partial least squares regression (PLSR) analysis is performed to develop an appropriate model to predict Brix reference values. The PLSR model constructed from the raw spectra extracted from the flesh region of interest yields high prediction accuracy with an RMSEP and R2p values of 0.576 and 0.841, respectively, and with a relatively low number of PLS factors. The Brix heatmap images and violin plots for each sample exhibit characteristics feature of sugar content distribution in the flesh of the strawberries. These findings offer insights into the feasibility of designing a noncontact system to monitor the quality of white strawberries.
Abstract Univariate Neural Network Approximation Using a q-Deformed and λ-Parametrized Hyperbolic Tangent Activation Function
Authors: Anastassiou George A.
Published: February 2023

In this work, we perform univariate approximation with rates, basic and fractional, of continuous functions that take values into an arbitrary Banach space with domain on a closed interval or all reals, by quasi-interpolation neural network operators. These approximations are achieved by deriving Jackson-type inequalities via the first modulus of continuity of the on hand function or its abstract integer derivative or Caputo fractional derivatives. Our operators are expressed via a density function based on a q-deformed and λ-parameterized hyperbolic tangent activation sigmoid function. The convergences are pointwise and uniform. The associated feed-forward neural networks are with one hidden layer.
Enamel Phenotypes: Genetic and Environmental Determinants
Authors: Wright John Timothy
Published: February 2023

Dental enamel is a specialized tissue that has adapted over millions of years of evolution to enhance the survival of a variety of species. In humans, enamel evolved to form the exterior protective layer for the crown of the exposed tooth crown. Its unique composition, structure, physical properties and attachment to the underlying dentin tissue allow it to be a resilient, although not self-repairing, tissue. The process of enamel formation, known as amelogenesis, involves epithelial-derived cells called ameloblasts that secrete a unique extracellular matrix that influences the structure of the mineralizing enamel crystallites. There are over 115 known genetic conditions affecting amelogenesis that are associated with enamel phenotypes characterized by either a reduction of enamel amount and or mineralization. Amelogenesis involves many processes that are sensitive to perturbation and can be altered by numerous environmental stressors. Genetics, epigenetics, and environment factors can influence enamel formation and play a role in resistance/risk for developmental defects and the complex disease, dental caries. Understanding why and how enamel is affected and the enamel phenotypes seen clinically support diagnostics, prognosis prediction, and the selection of treatment approaches that are appropriate for the specific tissue defects (e.g., deficient amount, decreased mineral, reduced insulation and hypersensitivity). The current level of knowledge regarding the heritable enamel defects is sufficient to develop a new classification system and consensus nosology that effectively communicate the mode of inheritance, molecular defect/pathway, and the functional aberration and resulting enamel phenotype.
Treatment for Locally Resectable Stage IIIC1 Cervical Cancer: A Retrospective, Single-Institution Study
Authors: Kashima Yoko , Murakami Kosuke , Miyagawa Chiho , Takaya Hisamitsu , Kotani Yasushi , Nakai Hidekatsu , Matsumura Noriomi
Published: February 2023

According to the revision of the FIGO 2018 staging system, cervical cancer with pelvic lymph node metastases was changed to stage IIIC1. We retrospectively analyzed the prognosis and complications of locally resectable (classified as T1/T2 by TNM classification of the Union for International Cancer Control) stage IIIC1 cervical cancer. A total of 43 patients were divided into three groups: surgery with chemotherapy (CT) (ope+CT group) (T1; n = 7, T2; n = 16), surgery followed by concurrent chemoradiotherapy (CCRT), or radiotherapy (RT) (ope+RT group) (T1; n = 5, T2; n = 9), and CCRT or RT alone (RT group) (T1; n = 0, T2; n = 6). In T1 patients, recurrence was observed in three patients, but there was no difference among the treatment groups, and no patients died. In contrast, in T2 patients, recurrence and death were observed in nine patients (8 in ope+CT; 1 in ope+RT), and recurrence-free survival and overall survival were lower in the ope+CT group (p = 0.02 and 0.04, respectively). Lymphedema and dysuria were more common in the ope+RT group. A randomized controlled trial comparing CT and CCRT as an adjuvant therapy after surgery in T1/T2 patients, including those with pelvic lymph node metastases, is currently underway. However, our data suggest that performing CT alone after surgery in T2N1 patients is likely to worsen the prognosis.
Real-World Analysis on the Characteristics, Therapeutic Paths and Economic Burden for Patients Treated for Glaucoma in Italy
Authors: Perrone Valentina , Formica Dario , Piergentili Benedetta , Rossetti Luca , Degli Esposti Luca
Published: February 2023

This real-world analysis was performed on administrative databases to evaluate characteristics, therapies, and related economic burden of glaucoma in Italy. Adults with at least 1 prescription for ophthalmic drops (ATC class S01E: antiglaucoma preparations, miotics) during data availability period (January 2010−June 2021) were screened, then patients with glaucoma were included. First date of ophthalmic drops prescription was the index date. Included patients had at least 12 months of data availability before index-date and afterwards. Overall, 18,161 glaucoma-treated patients were identified. The most frequent comorbidities were hypertension (60.2%), dyslipidemia (29.7%) and diabetes (17%). During available period, 70% (N = 12,754) had a second-line therapy and 57% (N = 10,394) a third-line therapy, predominantly ophthalmic drugs. As first-line, besides 96.3% patients with ophthalmic drops, a small proportion reported trabeculectomy (3.5%) or trabeculoplasty (0.4%). Adherence to ophthalmic drops was found in 58.3% patients and therapy persistence reached 78.1%. Mean total annual cost per patient was €1,725, mostly due to all-cause drug expenditure (€800), all-cause hospitalizations (€567) and outpatient services (€359). In conclusion, glaucoma-treated patients were mostly in monotherapy ophthalmic medications, with an unsatisfying adherence and persistence (<80%). Drug expenditures were the weightiest item among healthcare costs. These real-life data suggest that further efforts are needed to optimize glaucoma management.
Patient Satisfaction with Healthcare Services and the Techniques Used for its Assessment: A Systematic Literature Review and a Bibliometric Analysis
Authors: Ferreira Diogo Cunha , Vieira Inês , Pedro Maria Isabel , Caldas Paulo , Varela Miguel
Published: February 2023

Patient satisfaction with healthcare provision services and the factors influencing it are be-coming the main focus of many scientific studies. Assuring the quality of the provided services is essential for the fulfillment of patients’ expectations and needs. Thus, this systematic review seeks to find the determinants of patient satisfaction in a global setting. We perform an analysis to evaluate the collected literature and to fulfill the literature gap of bibliometric analysis within this theme. This review follows the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) approach. We conducted our database search in Scopus, Web of Science, and PubMed in June 2022. Studies from 2000–2021 that followed the inclusion and exclusion criteria and that were written in English were included in the sample. We ended up with 157 articles to review. A co-citation and bibliographic coupling analysis were employed to find the most relevant sources, authors, and documents. We divided the factors influencing patient satisfaction into criteria and explanatory variables. Medical care, communication with the patient, and patient’s age are among the most critical factors for researchers. The bibliometric analysis revealed the countries, institutions, documents, authors, and sources most productive and significant in patient satisfaction.
Nurses’ Perception Regarding the Quality of Communication between Nurses and Physicians in Emergency Departments in Saudi Arabia: A Cross Sectional Study
Authors: Daheshi Nawal , Alkubati Sameer A. , Villagracia Hazel , Pasay-an Eddieson , Alharbi Ghadeer , Alshammari Farhan , Madkhali Norah , Alshammari Bushra
Published: February 2023

Background: One of the defining characteristics of safe and highly reliable patient care is effective team communication. It is becoming increasingly crucial to improve communication among healthcare team members since social and medical conditions change quickly. Main aim: The present study seeks to assess nurses’ perception of the quality of communications between physicians and nurses and associated factors in the emergency departments of selected government hospitals in Saudi Arabia. Methods: A cross-sectional study was carried out in five hospitals in Jazan and three hospitals in Hail City, Saudi Arabia, on a convenience sample of 250 nurses total using self-administered questionnaires. Independent sample t-tests and one-way ANOVA were used for the data analysis. Ethical considerations were adhered to throughout the conduct of the study. Results: The mean score of all domains of nurses’ perceptions of the quality of nurse–physician communication in emergency departments was 60.14 out of 90. The highest mean score was observed in the openness subdomain, followed closely by relevance and satisfaction, with mean percentages of 71.65% and 71.60%, respectively. Age, level of education, years of experience, and job position had significant positive correlations with nurses’ perceptions of the quality of nurse–physician communication. (p = 0.002, 0.016, 0.022, and 0.020, respectively). Post hoc tests showed that nurses older than 30, those with diplomas, those with more than 10 years’ experience, and those in supervisory positions had more positive perceptions of the quality of nurse–physician communication. On the other hand, there was no significant difference in the mean scores of quality of nurse–physician communication with regard to participants’ sex, marital status, nationality, and working hours (p > 0.05). Multiple linear regression showed that none of the independent factors affected the nurses’ perceptions of the quality of nurse–physician communication in emergency departments (p > 0.05). Conclusions: Overall, the quality of communication between nurses and physicians was not satisfactory. Future research should be meticulously planned, using validated outcome measures, that will capture and reflect the goals of communication among healthcare teams.
Responses of High Carbon Dioxide Concentration on Postharvest Quality of Fresh Fig Fruit during Storage
Authors: Dogan Adem , Erkan Mustafa
Published: February 2023

The aim of this study was to determine the effects of high CO2 with the constant O2 level on the postharvest quality of fig cv. Bursa Siyahi. For this purpose, the atmospheric compositions of 3% O2 + 10% CO2 (PA-1), 3% O2 + 15% CO2 (PA-2), 3% O2 + 20% CO2 (PA-3), and 21% O2 + 0.03% CO2 (RA) were tested under a palliflex controlled atmosphere (PA) storage system at 0°C for 28 days. At the end of the storage, weight loss increased during the storage period, but this increase slowed down in all tested PAs compared to RA. PA-1 and PA-2 delayed softening while PA-3 accelerated this process. There were no side effects in fruits stored under PAs for taste. The lowest total microorganism and decay rates were found in PA-2 and PA-3. The fig fruits stored under PAs had higher sugar and organic acid contents compared to the figs stored under the RA. Respiration rate decreased in all PAs compared to the RA. Ethylene productions increased with senescence in all atmospheres, but PA-3 inhibited this increase. Consequently, 15% CO2 (PA-2) can be used to maintain postharvest quality of Bursa Siyahi fresh fig for 28 days at 0 °C.
Development and Validation of the Breastfeeding Literacy Assessment Instrument (BLAI) for Obstetric Women
Authors: Valero-Chillerón María Jesús , Vila-Candel Rafael , Mena-Tudela Desirée , Soriano-Vidal Francisco Javier , González-Chordá Víctor M. , Andreu-Pejo Laura , Antolí-Forner Aloma , Durán-García Lledó , Vicent-Ferrandis Miryam , Andrés-Alegre María Eugenia , Cervera-Gasch Águeda
Published: February 2023

Background: Despite international efforts to protect and promote exclusive breastfeeding (EBF) for infants up to six months of age, global rates of EBF continue to fall short of the targets proposed by the WHO for 2025. Previous studies have shown a relationship between the level of health literacy and the duration of EBF, although this relationship was not determinant, probably due to the use of a generic health literacy questionnaire. Therefore, this study aims to design and validate the first specific breastfeeding literacy instrument. Methods: A Breastfeeding Literacy instrument was developed. Content validation was carried out by a group of 10 experts in health literacy, breastfeeding or instrument validation, obtaining a Content Validity index in Scale (S-CVI/Ave) of 0.912. A multicentre cross-sectional study was carried out in three Spanish hospitals to determine the psychometric properties (construct validity and internal consistency). The questionnaire was administered to 204 women during the clinical puerperium. Results: The Kaiser-Meier-Oklin Test (KMO = 0.924) and Bartlett’s Test of Sphericity (X2 = 3119.861; p ≤ 0.001) confirmed the feasibility of the Exploratory Factor Analysis, which explained 60.54% of the variance with four factors. Conclusions: The Breastfeeding Literacy Assessment Instrument (BLAI) consisting of 26 items was validated.
Evaluating Urban Vitality of Street Blocks Based on Multi-Source Geographic Big Data: A Case Study of Shenzhen
Authors: Wang Ziyu , Xia Nan , Zhao Xin , Gao Xing , Zhuang Sudan , Li Manchun
Published: February 2023

Urban vitality is the comprehensive form of regional development quality, sustainability, and attractiveness. Urban vitality of various regions within the cities has difference, and the quantitative evaluation of urban vitality within the cities can help guide to future city constructions. Evaluation of urban vitality needs the combination of multi-source data. Existing studies have developed index method and estimation models mainly based on geographic big data to evaluate urban vitality. This study aims to combine remote sensing data with geographic big data to evaluate urban vitality of Shenzhen at street block scale and build the estimation model by random forest method. Indexes and random forest model were built, and some further analyses were conducted. The results were: (1) urban vitality in Shenzhen was high in the coastal areas, business areas, and new towns; (2) compared to indexes, the estimation model had advantages of more accurate results, combination of various data, and the ability to analyze feature contributions; and (3) taxi trajectory, nighttime light, and housing rental data had the strongest influence on urban vitality.
Multidimensional Results and Reflections on CAR-T: The Italian Evidence
Authors: Foglia Emanuela , Garagiola Elisabetta , Ladisa Vito , Rambaldi Alessandro , Cairoli Roberto , Sammassimo Simona , Salè Emanuela Omodeo , Zinzani Pier Luigi , Esposti Marco , Alberti Luisa , Mulas Maria Franca , Melis Eleonora , Onnis Stefania , Marcias Maurizio , Satta Vittorio , Croce Davide
Published: February 2023

The present study aims at defining the economic and organizational impacts of the introduction of chimeric antigen receptor T-cell therapy (CAR-T) in Italy, for the management of diffuse large B-cell lymphoma (DLBCL) patients in third-line therapy, defining the overall level of sustainability for both hospitals and the National Healthcare System (NHS). The analysis focused on CAR-T and Best Salvage Care (in the following BSC), assuming the Italian hospital and NHS perspectives, over a 36-month time horizon. Process mapping and activity-based costing methodologies were applied to collect the hospital costs related to the BSC and CAR-T pathways, including adverse event management. Anonymous administrative data on services provided (diagnostic and laboratory examinations, hospitalizations, outpatient procedures, and therapies) to 47 third-line patients with lymphoma, as well as any organizational investments required, were collected, in two different Italian Hospitals. The economic results showed that the BSC clinical pathway required less resources in comparison with CAR-T (excluding the cost related to the therapy) (BSC: 29,558.41 vs. CAR-T: EUR 71,220.84, −58.5%). The budget impact analysis depicts that the introduction of CAR-T would generate an increase in costs ranging from 15% to 23%, without considering treatment costs. The assessment of the organizational impact reveals that the introduction of CAR-T therapy would require additional investments equal to a minimum of EUR 15,500 to a maximum of EUR 100,897.49, from the hospital perspective. Results show new economic evidence for healthcare decision makers, to optimize the appropriateness of resource allocation. The present analysis suggests the need to introduce a specific reimbursement tariff, both at the hospital and at NHS levels, since no consensus exists, at least in the Italian setting, concerning the proper remuneration for the hospitals who guarantee this innovative pathway, assuming high risks related to timely management of adverse events.
Spatial Heterogeneity and Regional Clustering of Factors Influencing Chinese Adolescents’ Physical Fitness
Authors: Tong Zihan , Kong Zhenxing , Jia Xiao , Yu Jingjing , Sun Tingting , Zhang Yimin
Published: February 2023

There is often significant spatial heterogeneity in the factors influencing physical fitness in adolescents, yet less attention has been paid to this in established studies. Based on the 2018 Chinese National Student Physical Fitness Standard Test data, this study uses a multi-scale, geographically weighted regression (MGWR) model combined with a K-means clustering algorithm to construct a spatial regression model of the factors influencing adolescent physical fitness, and to investigate the degree of spatial variation in the physical fitness of Chinese adolescents from a socio-ecological perspective of health promotion. The following conclusions were drawn: the performance of the youth physical fitness regression model was significantly improved after taking spatial scale and heterogeneity into account. At the provincial scale, the non-farm output, average altitude, and precipitation of each region were strongly related to youth physical fitness, and each influencing factor generally showed a banded spatial heterogeneity pattern, which can be summarized into four types: N–S, E–W, NE–SW, and SE–NW. From the perspective of youth physical fitness, China can be divided into three regions of influence: the socio-economic-influenced region, mainly including the eastern region and some of the central provinces of China; the natural-environment-influenced region, which mainly includes the northwestern part of China and some provinces in the highland region; and the multi-factor joint-influenced region, which mainly includes the provinces in the central and northeastern regions of China. Finally, this study provides syndemic suggestions for physical fitness and health promotion for youths in each region.
Research on Spatio-Temporal Characteristics of Tourists’ Landscape Perception and Emotional Experience by Using Photo Data Mining
Authors: Yan Junxia , Yue Jiaheng , Zhang Jianfeng , Qin Peng
Published: February 2023

Mountainous scenic spots are important tourism resources, and the study of tourists’ landscape perception and emotional preference when visiting them is beneficial to the management of scenic spots in order to improve the service quality and promote the protection, development, and utilization of scenic resources. In this paper, we use the location photo data of tourists at Huangshan Mountain to extract the visual semantic information of location photos, calculate the photo sentiment value, and mine the landscape perception and sentiment preference features of tourists using DeepSentiBank image recognition model and photo visual semantic quantification method. The results show the following: (1) Huangshan tourists mainly focus on nine types of photos, with the most attention paid to the category of mountain rock landscapes and the least attention paid to the category of animal landscapes. (2) In terms of spatial distribution, the landscape types of tourist photos show the spatial characteristics of “concentrated into a belt”, “significant nucleus”, and “fragmented distribution”. The spatial variation of the emotional value of tourists’ photos is significant, and the high values are mainly distributed at the entrances and exits, interchanges, and famous attractions. (3) On a temporal scale, the type of perception of the Huangshan location photograph landscape shows a significant imbalance. The emotional values of tourists’ photos vary significantly, with a “slowly sloping straight line” type of emotional change on the seasonal scale, a “W” type of emotional change on the monthly scale, an “N” type of emotional change on the weekly scale, and an “M” type of emotional change on the hourly scale. This study attempts to explore the landscape perceptions and emotional preferences of tourists in mountainous scenic areas with new data and methods, aiming to promote the sustainable and high-quality development of mountainous scenic areas.
Longing for Touch and Quality of Life during the COVID-19 Pandemic
Authors: Hasenack Birgit , Meijer Larissa L. , Kamps Jonas C. C. , Mahon Andy , Titone Giulia , Dijkerman H. Chris , Keizer Anouk
Published: February 2023

To combat the spread of the COVID-19, regulations were introduced to limit physical interactions. This could induce a longing for touch in the general population and subsequently impact social, psychological, physical and environmental quality of life (QoL). The aim of this study was to investigate the potential association between COVID-19 regulations, longing for touch and QoL. A total of 1978 participants from different countries completed an online survey, including questions about their general wellbeing and the desire to be touched. In our sample, 83% of participants reported a longing for touch. Longing for touch was subsequently associated with a lower physical, psychological and social QoL. No association was found with environmental QoL. These findings highlight the importance of touch for QoL and suggest that the COVID-19 regulations have concurrent negative consequences for the wellbeing of the general population.
Livelihood Diversification and Residents’ Welfare: Evidence from Maasai Mara National Reserve
Authors: Sun Qi , Fu Chao , Bai Yunli , Oduor Ayub M. O. , Cheng Baodong
Published: February 2023

The contradiction between environmental protection and livelihood development is becoming increasingly serious for most protected areas in developing countries. Livelihood diversification is an efficient way to increase household income to alleviate poverty related to environmental protection. However, its impacts on household welfare in protected areas have rarely been quantitatively explored. This article investigates the determinants of four livelihood strategies in the Maasai Mara National Reserve and explores the association between livelihood diversification and household income and its heterogeneities. Based on the sustainable livelihoods framework and the information collected from 409 households through face-to-face interviews, this study adopted multivariate regression models to obtain consistent results. Results show that the determinants of the four strategies differed. Natural capital, physical capital, and financial capital had significant associations with the probability of adopting the strategy of livestock breeding. Physical capital, financial capital, human capital, and social capital were associated with the probability of adopting the joint strategy of livestock breeding and crop planting and the joint strategy of livestock breeding and off-farm activities. The probability of adopting the joint strategy of livestock breeding, crop planting, and off-farm activities was associated with all five kinds of livelihood capital except for financial capital. Diversification strategies, especially those involving off-farm activities, played greater roles in raising household income. The findings indicate that the government and management authority of Maasai Mara National Reserve should provide the households around the protected area with more off-farm employment opportunities to increase the welfare of local residents as well as to utilize natural resources appropriately, especially for those located far away from the protected area.