bluuebunny/crossref_metadata_2025 huggingface dataset:
Botulinum Neurotoxin-C Detection Using Nanostructured Porous Silicon Interferometer
Authors: Kumar Dashananda Nanda , Baider Zina , Elad Daniel , Blum Shlomo E. , Shtenberg Giorgi
Published: August 2021

Botulinum neurotoxins (BoNT) are the most potent toxins, which are produced by Clostridium bacteria and cause the life-threatening disease of botulism in all vertebrates. Specifically, animal botulism represents a serious environmental and economic concern in animal production due to the high mortality rates observed during outbreaks. Despite the availability of vaccines against BoNT, there are still many outbreaks of botulism worldwide. Alternative assays capable of replacing the conventional in vivo assay in terms of rapid and sensitive quantification, and the applicability for on-site analysis, have long been perused. Herein, we present a simple, highly sensitive and label-free optical biosensor for real-time detection of BoNT serotype C using a porous silicon Fabry–Pérot interferometer. A competitive immunoassay coupled to a biochemical cascade reaction was adapted for optical signal amplification. The resulting insoluble precipitates accumulated within the nanostructure changed the reflectivity spectra by alternating the averaged refractive index. The augmented optical performance allowed for a linear response within the range of 10 to 10,000 pg mL−1 while presenting a detection limit of 4.8 pg mL−1. The practical aspect of the developed assay was verified using field BoNT holotoxins to exemplify the potential use of the developed optical approach for rapid bio-diagnosis of BoNT. The specificity and selectivity of the assay were successfully validated using an adjacent holotoxin relevant for farm animals (BoNT serotype D). Overall, this work sets the foundation for implementing a miniaturized interferometer for routine on-site botulism diagnosis, thus significantly reducing the need for animal experimentation and shortening analysis turnaround for early evidence-based therapy.
Comparison of Accuracies between Real-Time Nonrigid and Rigid Registration in the MRI–US Fusion Biopsy of the Prostate
Authors: Hwang Sung Il , Ahn Hyungwoo , Lee Hak Jong , Hong Sung Kyu , Byun Seok-Soo , Lee Sangchul , Choe Gheeyoung , Park Jun-Sung , Son Yuri
Published: August 2021

Magnetic resonance imaging (MRI) is increasingly important in the detection and localization of prostate cancer. Regarding suspicious lesions on MRI, a targeted biopsy using MRI fused with ultrasound (US) is widely used. To achieve a successful targeted biopsy, a precise registration between MRI and US is essential. The purpose of our study was to show any decrease in errors using a real-time nonrigid registration technique for prostate biopsy. Nineteen patients with suspected prostate cancer were prospectively enrolled in this study. Registration accuracy was calculated by the measuring distance of corresponding points by rigid and nonrigid registration between MRI and US, and compared for rigid and nonrigid registration methods. Overall cancer detection rates were also evaluated by patient and by core. Prostate volume was measured automatically from MRI and manually from US, and compared to each other. Mean distances between the corresponding points in MRI and US were 5.32 ± 2.61 mm for rigid registration and 2.11 ± 1.37 mm for nonrigid registration (p < 0.05). Cancer was diagnosed in 11 of 19 patients (57.9%), and in 67 of 266 biopsy cores (25.2%). There was no significant difference in prostate-volume measurement between the automatic and manual methods (p = 0.89). In conclusion, nonrigid registration reduces targeting errors.
Why Should Clinical Autopsies Continue to Exist?
Authors: Ramos Simone Gusmão , Ottaviani Giulia , Peres Luiz Cesar , Rattis Bruna Amanda Cruz , Leão Patricia Santos , Akel Thamiris Nadaf , Ussem Leticia , Prado Caio Antonio Campos , Moises Elaine Christine Dantas , Grimm Lilian Christiane Andrade , Dias Eliane Pedra
Published: August 2021

At some point in history, medicine was integrated with pathology, more precisely, with pathological anatomy [...]
Feasibility and Implementation of a Deep Learning MR Reconstruction for TSE Sequences in Musculoskeletal Imaging
Authors: Herrmann Judith , Koerzdoerfer Gregor , Nickel Dominik , Mostapha Mahmoud , Nadar Mariappan , Gassenmaier Sebastian , Kuestner Thomas , Othman Ahmed E.
Published: August 2021

Magnetic Resonance Imaging (MRI) of the musculoskeletal system is one of the most common examinations in clinical routine. The application of Deep Learning (DL) reconstruction for MRI is increasingly gaining attention due to its potential to improve the image quality and reduce the acquisition time simultaneously. However, the technology has not yet been implemented in clinical routine for turbo spin echo (TSE) sequences in musculoskeletal imaging. The aim of this study was therefore to assess the technical feasibility and evaluate the image quality. Sixty examinations of knee, hip, ankle, shoulder, hand, and lumbar spine in healthy volunteers at 3 T were included in this prospective, internal-review-board-approved study. Conventional (TSES) and DL-based TSE sequences (TSEDL) were compared regarding image quality, anatomical structures, and diagnostic confidence. Overall image quality was rated to be excellent, with a significant improvement in edge sharpness and reduced noise compared to TSES (p < 0.001). No difference was found concerning the extent of artifacts, the delineation of anatomical structures, and the diagnostic confidence comparing TSES and TSEDL (p > 0.05). Therefore, DL image reconstruction for TSE sequences in MSK imaging is feasible, enabling a remarkable time saving (up to 75%), whilst maintaining excellent image quality and diagnostic confidence.
Preparing Laboratories for Interconnected Health Care
Authors: Bietenbeck Andreas , Streichert Thomas
Published: August 2021

In an increasingly interconnected health care system, laboratory medicine can facilitate diagnosis and treatment of patients effectively. This article describes necessary changes and points to potential challenges on a technical, content, and organizational level. As a technical precondition, electronic laboratory reports have to become machine-readable and interpretable. Terminologies such as Logical Observation Identifiers Names and Codes (LOINC), Nomenclature for Properties and Units (NPU), Unified Code for Units of Measure (UCUM), and SNOMED-CT can lead to the necessary semantic interoperability. Even if only single “atomized” results of the whole report are extracted, the necessary information for correct interpretation must be available. Therefore, interpretive comments, e.g., concerns about an increased measurement uncertainty must be electronically attached to every affected measurement result. Standardization of laboratory analyses with traceable standards and reference materials will enable knowledge transfer and safe interpretation of laboratory analyses from multiple laboratories. In an interconnected health care system, laboratories should strive to transform themselves into a data hub that not only receives samples but also extensive information about the patient. On that basis, they can return measurement results enriched with high-quality interpretive comments tailored to the individual patient and unlock the full potential of laboratory medicine.
Delivering Music Education Training for Non-Specialist Teachers through Effective Partnership: A Kodály-Inspired Intervention to Improve Young Children’s Development Outcomes
Authors: Ibbotson Lindsay , See Beng Huat
Published: August 2021

A priority area identified by the Department of Education (England) and the Economic Social and Research Council is the development of teachers, especially in primary music education where the limited opportunities for training offered by teacher training providers have raised concerns. This paper reports on an evaluation of a collaborative partnership training of non-specialist teachers, using a Kodály-inspired pedagogy to teach music in a classroom setting. Participants included 54 teachers (and 1492 pupils, aged 5–6), selected from 55 schools, as part of a large randomised control trial (RCT) in the north of England. This paper presents findings from a qualitative study that was conducted alongside the RCT, but which was not part of the RCT itself or the RCT’s implementation and process evaluation. Results from the study, which include a pre-post survey of teachers, focus group interviews and reflective journals, suggest promising effects on teachers’ pedagogical skills, their self-efficacy and competence, and children’s self-confidence and disposition for learning.
Impact of COVID-19 Restrictions on the Social-Emotional Wellbeing of Preschool Children and Their Families
Authors: Linnavalli Tanja , Kalland Mirjam
Published: August 2021

In the spring of 2020, as a result of the lockdown caused by the COVID-19 pandemic, many children dropped out of daycare and early education in Finland, and parents had to balance work and childcare for months. The wellbeing of families during the lockdown has been studied to some extent, but few studies have focused on children under school age. In May 2020, we sent a survey to the 82 families originally recruited in our study on supporting social-emotional development in early childhood education units, which had been interrupted by the pandemic. Twenty families responded to questionnaires about the impacts of the lockdown on the wellbeing of the children and their parents. Parents reported a decline in children’s prosocial behavior compared to the time before the pandemic and assessed that the children who stayed at home were lonelier than children who remained in daycare. Otherwise, being at home or in care was not associated with children’s physical or mental wellbeing. Parents had experienced increased mental strain and increased problems in marital relationships and the disruption of children’s participation in daycare was associated with deterioration in the parent–child relationship. Due to the small sample size, these results should be interpreted with caution.
Robust Formation Maintenance Methods under General Topology Pursuit of Multi-Agents Systems
Authors: Ansart Antoine , Juang Jyh-Ching , Ramachandran Karthi Gilari
Published: August 2021

In this article, methods of formation maintenance for a group of autonomous agents under ageneral topology scheme are discussed. Unlike rendezvous or geometric formation, general topology pursuit allows the group of agents to autonomously form trochoid patterns, which are useful in civilian and military applications. However, this type of topology is established by designing a marginally stable system that may be sensitive to parameter variations. To account for this drawback of stability, linear fixed-gains are turned into a dynamical version in this paper. By implementing a disturbance observer controller, systems are shown to maintain their formation despite the disturbances or uncertainties. Comparison in the effectiveness of the presented method with model reference adaptive control and integral sliding mode control under the uncertainties of the gains is also conducted. The capabilities of controllers are demonstrated and supported through simulations.
An Improved Meteor Echo Recognition Algorithm for SuperDARN HF Radar
Authors: Li Guangming , Yan Jingye , Lan Ailan
Published: August 2021

The SuperDARN HF radars can be used for meteor observation and inversion of mid-upper atmosphere neutral wind using observed meteor echo Doppler velocities. Aiming at the problem that the extraction of meteor echo based on echo power, Doppler velocity and spectral width is rough and contains ionospheric echo, this paper optimizes the extraction algorithm of meteor echo. Based on the AgileDARN HF radar’s digital characteristics, the observation method of meteor echo was improved, and we designed a meteor observation mode without changing the hardware system: using a meteor observation with a 7.5 km range resolution and a 2 s integration time, we extracted the Doppler characteristics of different echo types at meteor echo ranges; according to these features, the extraction algorithm of meteor echo was optimized. By analyzing the measured data, the characteristics of diurnal variation, power distribution, Doppler velocity distribution and spectral width distribution of meteor echo extracted by the optimization algorithm were obtained. The meteor echo characteristics obtained by the improved algorithm are more consistent with the theoretical analysis; thus, the improved algorithm is better than the SuperDARN high frequency radar meteor echo extraction algorithm and has good performance. The meteor echo extraction algorithm presented in this paper can extract the meteor echo more accurately, so that the atmospheric neutral wind can be retrieved more accurately. At the same time, the proposed algorithm is not only applicable to AgileDARN HF radar meteor observation mode data, but also to AgileDARN and SuperDARN normal mode data, which is beneficial to expand the data application of SuperDARN radars.
An Area- and Energy-Efficient 16-Channel, AC-Coupled Neural Recording Analog Frontend for High-Density Multichannel Neural Recordings
Authors: Kim Hyeon-June , Park Younghoon , Eom Kyungsik , Park Sung-Yun
Published: August 2021

We present an AC-coupled modular 16-channel analog frontend with 1.774 fJ/c-s∙mm2 energy- and area-product for a multichannel recording of broadband neural signals including local field potentials (LFPs) and extracellular action potentials (EAPs). To achieve such a small area- and energy-product, we employed an operational transconductance amplifier (OTA) with local positive feedback, instead of a widely-used folded cascode OTA (FC-OTA) or current mirror OTA for conventional neural recordings, while optimizing the design parameters affecting performance, power, and area trade-offs. In addition, a second pole was strategically introduced in the LNA to reduce the noise bandwidth without an in-channel low-pass filter. Compared to conventional works, the presented method shows better performance in terms of noise, power, and area usages. The performance of the fabricated 16-channel analog frontend is fully characterized in a benchtop and an in vitro setup. The 16-channel frontend embraces LFPs and EAPs with 4.27 μVrms input referred noise (0.5–10 kHz) and 53.17 dB dynamic range, consuming 3.44 μW and 0.012 mm2 per channel. The channel figure of merit (FoM) of the prototype is 147.87 fJ/c-s and the energy-area FoM (E-A FoM) is 1.774 fJ/c-s∙mm2.
Extending a Trust model for Energy Trading with Cyber-Attack Detection
Authors: Andrade Rui , Wannous Sinan , Pinto Tiago , Praça Isabel
Published: August 2021

This paper explores the concept of the local energy markets and, in particular, the need for trust and security in the negotiations necessary for this type of market. A multi-agent system is implemented to simulate the local energy market, and a trust model is proposed to evaluate the proposals sent by the participants, based on forecasting mechanisms that try to predict their expected behavior. A cyber-attack detection model is also implemented using several supervised classification techniques. Two case studies were carried out, one to evaluate the performance of the various classification methods using the IoT-23 cyber-attack dataset; and another one to evaluate the performance of the developed trust mode.
Assessment of Hybrid Solvent—Membrane Configurations for Post-Combustion CO2 Capture for Super-Critical Power Plants
Authors: Cormos Calin-Cristian , Petrescu Letitia , Cormos Ana-Maria , Dinca Cristian
Published: August 2021

The reduction of fossil CO2 emissions from key relevant industrial processes represents an important environmental challenge to be considered. To enable large-scale deployment of low carbon technologies, a significant research and development effort is required to optimize the CO2 capture systems. This work assesses various hybrid solvent-membrane configurations for post-combustion decarbonization of coal-based super-critical power plants. As an illustrative chemical solvent, Methyl-Di-Ethanol-Amine was assessed. Various membrane unit locations were assessed (e.g., top absorber, before absorber using either compressor or vacuum pump). All investigated designs have a 1000 MW net power output with a 90% decarbonization ratio. Benchmark concepts with and without carbon capture using either reactive gas-liquid absorption or membrane separation technology were also evaluated to have a comparative assessment. Relevant evaluation tools (e.g., modeling, simulation, validation, thermal integration, etc.) were employed to assess the plant performance indicators. The integrated evaluation shows that one hybrid solvent-membrane configuration (membrane unit located at the top of absorption column) performs better in terms of increasing the overall net plant efficiency than the membrane-only case (by about 1.8 net percentage points). In addition, the purity of captured CO2 stream is higher for hybrid concepts than for membranes (99.9% vs. 96.3%). On the other hand, the chemical scrubbing concept has superior net energy efficiency than investigated hybrid configurations (by about 1.5–3.7 net percentage points).
Shelf-Life of Half-Shell Mussel (Mytilus edulis) as Affected by Pullulan, Acidic Electrolyzed Water, and Stable Chlorine Dioxide Combined Ice-Glazing during Frozen Storage
Authors: Gao Yuanpei , Jiang Huili , Lv Dandan , Benjakul Soottawat , Zhang Bin
Published: August 2021

Mussel (Mytilus edulis) is an economic shellfish with a high nutritional value. Due to the high amount of protein and fat, fresh mussels are susceptible to spoilage during storage. In the present study, how a combination of pullulan, acidic electrolyzed water (AEW), and stable chlorine dioxide (ClO2) ice-glazing treatments affect the quality of mussels was investigated during 90 days of frozen storage. The results indicate that the combined glazing treatment effectively maintained the mussel muscle quality during storage mainly due to its air barrier actions. Mussel samples coated with AEW and ClO2 showed lower aerobic plate counts than other groups, resulting from the strong antibacterial action of AEW and ClO2. After 90 days of frozen storage, the mussel glazed with a combination of AEW, ClO2, and pullulan solutions showed better texture properties, higher content of myofibrillar proteins, higher Ca2+-ATPase activity, and more SH groups than the other glazing treatments. The water-holding capacity and SEM observations showed that the pullulan glazing efficiently inhibited the physical damage caused by the frozen and long-term storage, which mainly contributed to the high amount of hydrophilic hydroxyl groups in the muscle tissues. The present study supports the use of a combination of cryoprotectants for extending the shelf-life of frozen mussel products during long-term storage.
Optimization and Validation of a New Microbial Inhibition Test for the Detection of Antimicrobial Residues in Living Animals Intended for Human Consumption
Authors: Serrano María Jesús , Mata Luis , García-Gonzalo Diego , Antón Alejandra , Razquin Pedro , Condón Santiago , Pagán Rafael
Published: August 2021

Even though antibiotics are necessary in livestock production, they can be harmful not only due to their toxicity, but also in view of their contribution to the emergence of antimicrobial resistance. Screening tests based on microbial growth inhibition appeared to be useful tools to prevent its entry into the food chain. They have nevertheless been traditionally carried out post mortem, leading to great economical loss and harm to the environment in case a positive sample is found. Hence, the objective was to evaluate the use of a screening test as an ante mortem alternative for the detection of antibiotic residues in meat: thus, Explorer®-Blood test was optimized and validated. After adapting the procedure for matrix preparation, the assay parameters were assessed from 344 antibiotic-free blood serum samples. Limits of Detection (LoDs) were defined by spiking blood serum with several of the most common antimicrobials used in veterinary practice. LoDs were similar to those obtained for meat and were at or below the maximum residue limits set by EU legislation for muscle. Analyses of in vivo injected samples, previously characterized by LC-MS/MS, demonstrated the method’s accuracy and proved that Explorer®-Blood can be considered a suitable alternative to conventional post mortem screening methods.
Characterization of the Psychrotrophic Lactic Acid Bacterium Leuconostoc gelidum subsp. aenigmaticum LS4 Isolated from Kimchi Based on Comparative Analyses of Its Genomic and Phenotypic Properties
Authors: Mun So Yeong , Seo Ye Jin , Chang Hae Choon
Published: August 2021

With the aim of developing a new food starter culture, twenty-three psychrotrophic lactic acid bacteria (LAB) were isolated from 16 kimchi samples. One strain, Leuconostoc gelidum subsp. aenigmaticum LS4, which had typical psychrotrophic characteristics, was selected, and its phenotypic and genomic properties as a starter culture were investigated. The complete genome of L. aenigmaticum LS4 consisted of one circular chromosome (1,988,425 bp) and two plasmids (19,308 bp and 11,283 bp), with a guanine–cytosine content of 36.8%. L. aenigmaticum LS4 could grow at 5 °C but not at 37 °C, and maximum cell growth was obtained at 15~25 °C. L. aenigmaticum LS4 did not show any harmful characteristics such as hemolysis, undesirable enzyme activities, biogenic amine production, or antibiotic resistance. L. aenigmaticum LS4 was investigated for its suitability for technological processes (pH, temperature and NaCl treatment). L. aenigmaticum LS4 exhibited strong antimicrobial activity caused by the production of organic acids and bacteriocin, and it produced an exopolysaccharide composed of glucose with a molecular weight of 3.7 × 106 Da. Furthermore, L. aenigmaticum LS4 improved the organoleptic qualities of kimchi juice. Our results indicate that L. aenigmaticum LS4 could be used as a functional starter culture for food (vegetable or fruit) fermentation at low temperatures.
A Systematic and a Scoping Review on the Psychometrics and Clinical Utility of the Volume-Viscosity Swallow Test (V-VST) in the Clinical Screening and Assessment of Oropharyngeal Dysphagia
Authors: Riera Stephanie A. , Marin Sergio , Serra-Prat Mateu , Tomsen Noemí , Arreola Viridiana , Ortega Omar , Walshe Margaret , Clavé Pere
Published: August 2021

(1) Background: The volume-viscosity swallow test (V-VST) is a clinical tool for screening and diagnosis of oropharyngeal dysphagia (OD). Our aims were to examine the clinical utility of the V-VST against videofluoroscopy (VFS) or fiberoptic endoscopic evaluation of swallow (FEES) and to map the V-VST usage with patients at risk of OD across the years since it was described for the first time, carrying a systematic and a scoping review. (2) Methods: We performed both a systematic review (SR) including studies that look at the diagnostic test accuracy, and a scoping review (ScR) with articles published from September 2008 to May 2020. Searches were done in different databases, including PubMed and EMBASE from September 2008 until May 2020, and no language restrictions were applied. A meta-analysis was done in the SR to assess the psychometric properties of the V-VST. Quality of studies was assessed by Dutch Cochrane, QUADAS, GRADE (SR), and STROBE (ScR) criteria. The SR protocol was registered on PROSPERO (registration: CRD42020136252). (3) Results: For the diagnostic accuracy SR: four studies were included. V-VST had a diagnostic sensitivity for OD of 93.17%, 81.39% specificity, and an inter-rater reliability Kappa = 0.77. Likelihood ratios (LHR) for OD were 0.08 (LHR–) and 5.01 (LHR+), and the diagnostic odds ratio for OD was 51.18. Quality of studies in SR was graded as high with low risk of bias. In the ScR: 34 studies were retrieved. They indicated that V-VST has been used internationally to assess OD’s prevalence and complications. (4) Conclusions: The V-VST has strong psychometric properties and valid endpoints for OD in different phenotypes of patients. Our results support its utility in the screening and clinical diagnosis and management of OD.
Attempts of Physical Refining of Sterol-Rich Sunflower Press Oil to Obtain Minimally Processed Edible Oil
Authors: García-González Aída , Velasco Joaquín , Velasco Leonardo , Ruiz-Méndez M. Victoria
Published: August 2021

New phytosterol (PS)-enriched sunflower seeds, which are higher in campesterol and ∆7-stigmastenol, have recently been developed. Crude oils obtained from these new sunflower seeds in 2015 and 2017 were used in this study. Oils extracted only by press (PO) and with subsequent solvent extraction (SO) were characterized. Physical refining (PhR) was used to obtain edible PO by minimal processing and to keep the PS levels as high as possible. Oils obtained by chemical processing were also studied for comparative purposes. Different bleaching treatments were examined to reduce the contents of phospholipids in the PO to levels required for PhR (<10 mg kg−1). Phosphorous levels in PO from 2015 (9–12 mg kg−1) were reduced to optimal levels by bleaching with 0.1% Trisyl and 1% Tonsil 278 FF. Contrarily, treatments with Trisyl and Tonsil (278 FF or 114 FF) were not sufficient to reduce the higher levels in PO from 2017 (15–36 mg/kg−1), thereby they were subjected to chemical refining (ChR). The PhR applied to PO from 2015 did not lead to substantial changes in the composition and total content of PS. In contrast, losses of up to approximately 30% of total PS were found owing to ChR, although the oils preserved their unique PS profiles.
The Neglected Involvement of Organic Matter in Forming Large and Rich Hydrothermal Orogenic Gold Deposits
Authors: Gaboury Damien
Published: August 2021

Orogenic gold deposits have provided most of gold to humanity. These deposits were formed by fluids carrying dissolved gold at temperatures of 200–500 °C and at crustal depths of 4–12 km. The model involves gold mobilization as HS− complexes in aqueous solution buffered by CO2, with gold precipitation following changes in pH, redox activity (fO2), or H2S activity. In this contribution, the involvement of carbonaceous organic matter is addressed by considering the formation of large and/or rich orogenic gold deposits in three stages: the source of gold, its solubilization, and its precipitation. First, gold accumulates in nodular pyrite within carbonaceous-rich sedimentary rocks formed by bacterial reduction of sulfates in seawater in black shales. Second, gold can be transported as hydrocarbon-metal complexes and colloidal gold nanoparticles for which the hydrocarbons can be generated from the thermal maturation of gold-bearing black shales or from abiotic origin. The capacity of hydrocarbons for solubilizing gold is greater than those of aqueous fluids. Third, gold can be precipitated efficiently with graphite derived from fluids containing hydrocarbons or by reducing organic-rich rocks. Black shales are thus a key component in the formation of large and rich orogenic gold deposits from the standpoints of source, transport, and precipitation. Unusual CO2-rich, H2O-poor fluids are documented for some of the largest and richest orogenic gold deposits, regardless of their age. These fluids are interpreted to result from chemical reactions involving hydrocarbon degradation, hence supporting the fundamental role of organic matter in forming exceptional orogenic gold deposits.
Spatial Disparities in Access to Healthcare Professionals in Sichuan: Evidence from County-Level Data
Authors: Zhang Ning , Ning Wei , Xie Tao , Liu Jinlin , He Rongxin , Zhu Bin , Mao Ying
Published: August 2021

As a southwestern province of China, Sichuan is confronted with geographical disparities in access to healthcare professionals because of its complex terrain, uneven population distribution and huge economic gaps between regions. With 10-year data, this study aims to explore the county-level spatial disparities in access to different types of healthcare professionals (licensed doctors, registered nurses, pharmacists, technologists and interns) in Sichuan using temporal and spatial analysis methods. The time-series results showed that the quantity of all types of healthcare professionals increased, especially the registered nurses, while huge spatial disparities exist in the distribution of healthcare professionals in Sichuan. The local Moran’s I calculations showed that high–high clusters (significantly high healthcare professional quantity in a group of counties) were detected in Chengdu (capital of Sichuan) and relatively rich areas, while low–low clusters (significantly low healthcare professional quantity in a group of counties) were usually found near the mountain areas, namely, Tsinling Mountains and Hengduan Mountains. The findings may deserve considerations in making region-oriented policies in educating and attracting more healthcare professionals to the disadvantaged areas.
Evaluation of Groundwater Resources in Minor Plio-Pleistocene Arenaceous Aquifers in Central Italy
Authors: Di Curzio Diego , Rusi Sergio , Di Giovanni Alessia , Ferretti Emanuele
Published: August 2021

The hilly landscape of the Periadric area in Central Italy is characterized by mainly marly–clayey foredeep basin deposits (Plio–Pleistocene age). These lithotypes are generally considered aquicludes, if compared with the regional limestone aquifers of Apennines. However, a coarsening upward trend characterizes the upper portion of this stratigraphic sequence, with arenaceous deposits and even conglomerates on the top. From a geomorphological viewpoint, the areas with coarser outcrops show a flat shape and sub-vertical slopes, like boundaries. At the base of these scarps, springs can be found at the interface between coarse and fine deposits, whereas these arenaceous bodies are actual aquifers. Until now, the hydrodynamics and hydrochemical features of this kind of aquifer have not been investigated deeply, because they have always been considered a worthy water resource. However, they could play a crucial role in integrated water management, especially to cope with climate changes and drought periods. Considering these, the main purpose of this study was to investigate from a hydrogeological point of view and to assess the groundwater quantity and quality. Five examples throughout the Abruzzo region were considered. For evaluation and comparisons between water resources, the water volume that infiltrates yearly at each squared kilometer of an aquifer (Mm3/y/km2) was applied. This value was calculated through three different approaches to provide a recharge estimation for this kind of aquifer that is as exhaustive and representative as possible. The results allowed us to characterize the hydrogeological model and to quantify the resources between 0.1 and 0.16 Mm3/y/km2, to be suitable for multi–purpose utilization.
Identification of Sources and Transformations of Nitrate in the Intense Human Activity Region of North China Using a Multi-Isotope and Bayesian Model
Authors: Ren Chaobin , Zhang Qianqian , Wang Huiwei , Wang Yan
Published: August 2021

Nitrate (NO3−) contamination in water is an environmental problem of widespread concern. In this study, we combined the stable isotopes of NO3− (δ15N and δ18O) and water (δ2H and δ18O) with a Bayesian mixing model (SIAR) to identify the sources and transformation of NO3− in groundwater and rivers in the Ye River basin of North China. The results showed that the mean NO3− concentrations in groundwater were 133.5 and 111.7 mg/L in the dry and flood seasons, respectively, which exceeded the required Chinese drinking water standards for groundwater (88.6 mg/L) (GB14848-2017). This suggests that groundwater quality has been severely impacted by human activity. Land use significantly affected the concentration of NO3− in the Ye River basin (p < 0.05). However, the NO3− concentrations in groundwater and river water had no obvious temporal variation (p > 0.05). The principal mode of nitrogen transformation for both groundwater and river water was nitrification, whereas denitrification did not significantly affect the isotopic compositions of NO3−. The sources of NO3− mainly originated from sewage and manure, soil nitrogen, and NH4+ in fertilizer for groundwater and from sewage and manure for the river water. According to the SIAR model, the primary sources of nitrate found in groundwater and river were sewage and manure in the Ye River basin. The proportional contributions of sewage and manure to nitrate contamination of groundwater and river were 58% and 48% in the dry season and 49% and 54% in the flood season, respectively. Based on these results, we suggest that the local government should enhance the sewage treatment infrastructure, construct an effective waste storage system to collect manure, and pursue a scientific fertilization strategy (such as soil formula fertilization) to increase the utilization rate of nitrogen fertilizer and prevent nitrate levels from increasing further.
Case Study of Tobacco Use among Myanmar Migrant Factory Workers in the Seafood Industry in Thailand
Authors: Charoenca Naowarut , Chaw Nan Khin Thet , Kungskulniti Nipapun , Hamann Stephen L.
Published: August 2021

Migrant workers commonly face many health disparities when they relocate to a foreign work environment. Many workers migrating to Thailand are young unskilled workers from Myanmar. In this study, we examine factors associated with Myanmar migrant workers’ smoking status and characterized smoking-related knowledge, attitudes, and behavior in one seafood factory in Thailand. This descriptive study utilized person-to-person interviews among 300 Myanmar migrants in one seafood factory in Thailand, of which 94.3% were young males between 18 and 39 years of age. Results demonstrated that 90% were current daily smokers, over 90% smoked 30–60 times per month, and 95% spent less than 500 baht (US $16) per month on smoking. About 70% of current smokers had 6–10 friends who smoked, compared with 40% of non-smokers (chi-square, p-value ≤ 0.07). Among this sample of mainly male migrant workers, smoking is very common, in part driven through social contact, but levels of dependence appear relatively low. The results suggest potential intervention approaches to reduce high smoking prevalence among this population, such as targeting young males and addressing their concerns about negative attitudes by peers to tobacco use and the unhealthful exposures of women and children in their families and the larger community.
Emerging Single-Cell Technological Approaches to Investigate Chromatin Dynamics and Centromere Regulation in Human Health and Disease
Authors: Leo Laura , Colonna Romano Nunzia
Published: August 2021

Epigenetic regulators play a crucial role in establishing and maintaining gene expression states. To date, the main efforts to study cellular heterogeneity have focused on elucidating the variable nature of the chromatin landscape. Specific chromatin organisation is fundamental for normal organogenesis and developmental homeostasis and can be affected by different environmental factors. The latter can lead to detrimental alterations in gene transcription, as well as pathological conditions such as cancer. Epigenetic marks regulate the transcriptional output of cells. Centromeres are chromosome structures that are epigenetically regulated and are crucial for accurate segregation. The advent of single-cell epigenetic profiling has provided finer analytical resolution, exposing the intrinsic peculiarities of different cells within an apparently homogenous population. In this review, we discuss recent advances in methodologies applied to epigenetics, such as CUT&RUN and CUT&TAG. Then, we compare standard and emerging single-cell techniques and their relevance for investigating human diseases. Finally, we describe emerging methodologies that investigate centromeric chromatin specification and neocentromere formation.
Robot-Assisted Intracorporeal Orthotopic Ileal Neobladder: Description of the “Shell” Technique
Authors: Bianchi Roberto , Mistretta Francesco Alessandro , Musi Gennaro , Luzzago Stefano , Morelli Michele , Lorusso Vito , Catellani Michele , Di Trapani Ettore , Cozzi Gabriele , Ferro Matteo , Bottero Danilo , Matei Deliu Victor , de Cobelli Ottavio
Published: August 2021

Background: Robot-assisted radical cystectomy (RARC) with intracorporeal neobladder (ICNB) remains a very complicated, technically demanding and time-consuming surgical procedure. In the current study we describe our robot-assisted intracorporeal “Shell” neobladder reconstruction. Methods: From January 2017 to December 2019, we performed 30 intracorporeal ileal neobladder “Shell” reconstructions. We prospectively collected demographics and clinical and pathological data and retrospectively analysed perioperative, functional and oncological outcomes. Results: No conversion to open surgery or intraoperative blood transfusion was necessary. The median whole operative time was 493 min (IQR 433–530 min), ranging from 514 min (IQR 502–554 min) recorded during the first ten procedures to 470 min (IQR 442–503 min) of the last ten. The median estimated blood loss was 400 mL (IQR 350–700 mL). The median length of stay was 11 days (IQR 10–17). Both early and late complication rates were 46.7%. The high-grade early complication rate accounted for 20%, while the high-grade late complication rate was 30%. The daytime continence rate registered was 73.3%, while night-time continence rate was 60%. Conclusions: Our results demonstrated “Shell” neobladder reconstruction as a technically feasible procedure, with good functional outcomes in tertiary referral centre. Longer follow-up and larger populations are needed to validate these preliminary results.
The Use of Titanium 3D Mini-Plates in the Surgical Treatment of Fractures of the Mandibular Condyle: A Systematic Review and Meta-Analysis of Clinical Trials
Authors: Sikora Maciej , Chęciński Maciej , Nowak Zuzanna , Chęcińska Kamila , Olszowski Tomasz , Chlubek Dariusz
Published: August 2021

Introduction: Fixing fractures of the base and neck of mandibular condyles is demanding due to the difficulties in surgical access and the various shapes of bone fragments. Classic fixation techniques assume the use of straight mini-plates, utilized for other craniofacial bone fractures. Three dimensional mini-plates may provide a reasonable alternative due to their ease of use and steadily improved mechanical properties. The multitude of different shapes of 3D mini-plates proves the need for their evaluation. Aim: This paper aims to summarize the clinical trials regarding the use of various types of 3D condylar mini-plates in terms of need for reoperation and the incidence of loosening and damage to the osteosynthetic material. Materials and Methods: A systematic review was conducted in accordance with PICOS criteria and PRISMA protocol. The risk of bias was assessed using ROBINS-I and RoB 2 Cochrane protocols. The obtained data series was analyzed for correlations (Pearson’s r) respecting statistical significance (Student’s t-test p > 0.05) and visualized using OriginLab. Results: 13 clinical trials with low overall risk of bias regarding 6 shapes of 3D mini-plates were included in the synthesis. The number of reoperations correlates with the number of fixations (r = 0.53; p = 0.015) and the total number of screw holes in the mini-plate (r = −0.45; p = 0.006). There is a strong correlation between the number of loosened osteosynthetic screws and the total number of fractures treated with 3D mini-plates (r = 0.79; p = 0.001 for each study and r = 0.99; p = 0.015 for each mini-plate shape). A correlation between the percentage of lost screws and the number of distal screw holes is weak regarding individual studies (r = −0.27; p = 0.000) and strong regarding individual mini-plate shape (r = −0.82; p = 0.001). Three cases of 3D mini-plate fractures are noted, which account for 0.7% of all analyzed fixation cases. Discussion: The reasons for reoperations indicated by the authors of the analyzed articles were: mispositioning of the bone fragments, lack of bone fragment union, secondary dislocation, and hematoma. The known screw loosening factors were poor bone quality, bilateral condylar fractures, difficulties in the correct positioning of the osteosynthetic material due to the limitations of the surgical approach, fracture line pattern, including the presence of intermediate fragments, and mechanical overload. Fractures of the straight mini-plates fixing the mandibular condyles amounts for up to 16% of cases in the reference articles. Conclusions: There is no convincing data that the number of reoperations depends on the type of 3D mini-plate used. The frequency of osteosynthetic screw loosening does not seem to depend on the 3D mini-plate’s shape. Clinical fractures of 3D mini-plates are extremely rare.
Clinical Outcomes of Early Endoscopic Transpapillary Biliary Drainage for Acute Cholangitis Associated with Disseminated Intravascular Coagulation
Authors: Sekine Akihiro , Nakahara Kazunari , Sato Junya , Michikawa Yosuke , Suetani Keigo , Morita Ryo , Igarashi Yosuke , Itoh Fumio
Published: August 2021

Acute cholangitis (AC) is often associated with disseminated intravascular coagulation (DIC), and endoscopic transpapillary biliary drainage (EBD) under endoscopic retrograde cholangiopancreatography (ERCP) is a treatment of choice. However, no evidence exists on the outcomes of EBD for AC associated with DIC. Therefore, we retrospectively evaluated the treatment outcomes of early EBD and compared endoscopic biliary stenting (EBS) and endoscopic nasobiliary drainage (ENBD). We included 62 patients who received early EBD (EBS: 30, ENBD: 32) for AC, associated with DIC. The rates of clinical success for AC and DIC resolution at 7 days after EBD were 90.3% and 88.7%, respectively. Mean hospitalization period was 31.7 days, and in-hospital mortality rate was 4.8%. ERCP-related adverse events developed in 3.2% of patients (bleeding in two patients). Comparison between EBS and ENBD groups showed that the ENBD group included patients with more severe cholangitis, and acute physiology and chronic health evaluation II score, systemic inflammatory response syndrome score, and serum bilirubin level were significantly higher in this group. However, no significant difference was observed in clinical outcomes between the two groups; both EBS and ENBD were effective. In conclusion, early EBD is effective and safe for patients with AC associated with DIC.
Impact of Hysterectomy on Quality of Life, Urinary Incontinence, Sexual Functions and Urethral Length
Authors: Skorupska Katarzyna , Wawrysiuk Sara , Bogusiewicz Michal , Miotła Pawel , Winkler Izabela , Kwiatkowska Agnieszka , Rechberger Tomasz
Published: August 2021

The aim of the study was to evaluate the influence of different types of hysterectomy on UI symptoms, quality of life and sexual functions using dedicated questionnaires. We investigated a correlation between the urethral length (UL), UI symptoms and the length of the cervix (left after LSH and SH) with sexual functions. The study enrolled 500 consecutive women referred for hysterectomy: 121 underwent VH, 171 underwent LSH, 96 underwent SH, 68 underwent TAH, and 44 underwent TLH. The patients filled in the UI-specific questionnaires and FSFI before and 12 months after hysterectomy. The UL was measured by introital ultrasound before and 12 months after hysterectomy. Before surgery, 137 out of 399 (34.3%) patients had UI symptoms; afterwards, 139 (34.8%) indicated the same (p > 0.05). There was no statistically significant difference in the UL in the patients before and after the procedure, and the cervix length did not differ between patients after LSH and SH. When the entire investigated population was analyzed, a significant improvement of the QoL was found on the IIQ-7. Hysterectomy performed due to benign diseases has effects on UI regardless of the surgical technique used. The UI symptoms improved only in the patients after LSH. The UL measured 12 months after hysterectomy did not change.
Microbiome Metabolites and Thyroid Dysfunction
Authors: Bargiel Piotr , Szczuko Małgorzata , Stachowska Laura , Prowans Piotr , Czapla Norbert , Markowska Marta , Petriczko Jan , Kledzik Jakub , Jędrzejczyk-Kledzik Alicja , Palma Joanna , Zabielska Paulina , Maciejewska-Markiewicz Dominika
Published: August 2021

Thyroid diseases are common conditions that have a negative impact on the health of all populations. The literature sheds light on the differences in the composition of the intestinal microbiota in patients suffering from thyroid diseases compared to healthy individuals. The microbiome affects the proper functioning of the thyroid gland, and the existence of the gut–thyroid axis is discussed in the context of both thyroid diseases and intestinal dysbiosis. The purpose of this review is to describe associations between the microbiome and its metabolites and thyroid dysfunction. We try to explain the role of the microbiome in the metabolism of thyroid hormones and the impact of thyroid autoimmune diseases. In addition, we raise issues related to the influence of bacterial metabolites, such as short-chain fatty acids or secondary bile acids, in the functioning of the thyroid gland. Last but not least, we explored the interactions between the gut microbiota and therapeutics and supplements typically administered to patients with thyroid diseases.
Technical Success and Mid-Term Outcomes of Endovascular Revascularization of Tibio-Peroneal Trunk Lesions
Authors: de Boer Sanne W. , van Mierlo-van den Broek Patricia A. H. , de Vries Jean-Paul P. M. , Kleiss Simone F. , Bloemsma Gijs C. , de Vries-Werson Debbie A. B. , Fioole Bram , Bokkers Reinoud P. H.
Published: August 2021

Tibio-peroneal trunk (TPT) lesions are usually categorized as ‘complex’ in anatomical classifications, which leads to the perception that endovascular therapy (EVT) will be challenging and the outcome most likely poor. This multicenter, retrospective cohort study investigates the efficacy of the EVT of TPT lesions in patients with chronic limb threatening ischemia (CLTI) or an infrapopliteal bypass at risk. The primary endpoint was limb-salvage. The secondary outcomes were technical success, freedom from clinically driven target lesion revascularization (CD-TLR), overall survival, and amputation-free survival. A total of 107 TPT lesions were treated in 101 patients. At 3 years, the limb-salvage rate was 76.4% (95% CI 66.0–86.8%). Technical success was achieved in 96.3% of cases. The freedom from CD-TLR, amputation-free survival, and overall survival at 3 years were 53.0% (95% CI 38.1–67.9%), 33.6% (95% CI 23.0–44.2%), and 47.7% (95% CI 36.1–59.3%), respectively. Reintervention significantly increased the hazard ratio for amputation by 7.65 (95% CI 2.50–23.44, p < 0.001). Our results show that the EVT of both isolated and complex TPT lesions is associated with high technical success and acceptable limb-salvage rates, with reintervention being a major risk factor for amputation. Moreover, mid-term mortality rate was relatively high. In future revisions of the anatomical grading scales, the classification of TPT lesions as highly complex should be reconsidered.