bluuebunny/crossref_metadata_2025 huggingface dataset:
Persistence of the Effects of the COVID-19 Lockdown on Sleep: A Longitudinal Study
Authors: Gorgoni Maurizio , Scarpelli Serena , Mangiaruga Anastasia , Alfonsi Valentina , Bonsignore Maria R. , Fanfulla Francesco , Ferini-Strambi Luigi , Nobili Lino , Plazzi Giuseppe , De Gennaro Luigi ,   on behalf of the Board of the Italian Association of Sleep Medicine (AIMS)
Published: November 2021

The effects of the COVID-19 pandemic on sleep have been widely documented, but longitudinal evaluations during different phases of the “COVID-19 era” are needed to disentangle the specific consequences of the r145estrictive measures on sleep variables. The aim of this study was to assess the immediate effect of the lockdown’s end on sleep and sleep-related dimensions in an Italian sample, also considering the stress and depressive symptoms. We used an online survey to longitudinally collect data on sociodemographic, environmental, clinical, sleep, and sleep-related variables in two time points: during and immediately after the lockdown. The final sample included 102 participants. The large prevalence of poor sleep quality, clinically relevant pre-sleep arousal, and depressive symptoms, as well as poor sleep quality and pre-sleep arousal score observed during the lockdown, remained stable after its end. On the other hand, the prevalence of moderate-to-severe event-related stress and intrusive symptom scores exhibited a drastic reduction after the end of home confinement. Both bedtime and rise time were anticipated after the lockdown, while sleep quality exhibited only a trend of post-lockdown sleep disturbance reduction. Our findings point to a reduced stress level (specific for the intrusive symptomatology) after the end of the lockdown and persistence of sleep problems, suggesting two non-mutually exclusive hypotheses: (a) the strict restrictive measures are not the main cause of sleep problems during the pandemic and (b) home confinement induces long-lasting effects on sleep observable after its end, and a longer period of time might be needed to observe an improvement.
Single-Cell RNA-Seq Analysis Reveals the Acquisition of Cancer Stem Cell Traits and Increase of Cell–Cell Signaling during EMT Progression
Authors: Bocci Federico , Zhou Peijie , Nie Qing
Published: November 2021

Intermediate cell states (ICSs) during the epithelial–mesenchymal transition (EMT) are emerging as a driving force of cancer invasion and metastasis. ICSs typically exhibit hybrid epithelial/mesenchymal characteristics as well as cancer stem cell (CSC) traits including proliferation and drug resistance. Here, we analyze several single-cell RNA-seq (scRNA-seq) datasets to investigate the relation between several axes of cancer progression including EMT, CSC traits, and cell–cell signaling. To accomplish this task, we integrate computational methods for clustering and trajectory inference with analysis of EMT gene signatures, CSC markers, and cell–cell signaling pathways, and highlight conserved and specific processes across the datasets. Our analysis reveals that “standard” measures of pluripotency often used in developmental contexts do not necessarily correlate with EMT progression and expression of CSC-related markers. Conversely, an EMT circuit energy that quantifies the co-expression of epithelial and mesenchymal genes consistently increases along EMT trajectories across different cancer types and anatomical locations. Moreover, despite the high context specificity of signal transduction across different cell types, cells undergoing EMT always increased their potential to send and receive signals from other cells.
Stringent Base Specific and Optimization-Free Multiplex Mediator Probe ddPCR for the Quantification of Point Mutations in Circulating Tumor DNA
Authors: Schlenker Franziska , Kipf Elena , Deuter Max , Höffkes Inga , Lehnert Michael , Zengerle Roland , von Stetten Felix , Scherer Florian , Wehrle Julius , von Bubnoff Nikolas , Juelg Peter , Hutzenlaub Tobias , Borst Nadine
Published: November 2021

There is an increasing demand for optimization-free multiplex assays to rapidly establish comprehensive target panels for cancer monitoring by liquid biopsy. We present the mediator probe (MP) PCR for the quantification of the seven most frequent point mutations and corresponding wild types (KRAS and BRAF) in colorectal carcinoma. Standardized parameters for the digital assay were derived using design of experiments. Without further optimization, the limit of detection (LoD) was determined through spiking experiments with synthetic mutant DNA in human genomic DNA. The limit of blank (LoB) was measured in cfDNA plasma eluates from healthy volunteers. The 2-plex and 4-plex MP ddPCR assays showed a LoB of 0 copies/mL except for 4-plex KRAS G13D (9.82 copies/mL) and 4-plex BRAF V600E (16.29 copies/mL) and allele frequencies of 0.004% ≤ LoD ≤ 0.38% with R2 ≥ 0.98. The quantification of point mutations in patient plasma eluates (18 patients) during follow-up using the 4-plex MP ddPCR showed a comparable performance to the reference assays. The presented multiplex assays need no laborious optimization, as they use the same concentrations and cycling conditions for all targets. This facilitates assay certification, allows a fast and flexible design process, and is thus easily adaptable for individual patient monitoring.
Molecular Markers to Predict Prognosis and Treatment Response in Uterine Cervical Cancer
Authors: Fleischmann Maximilian , Chatzikonstantinou Georgios , Fokas Emmanouil , Wichmann Jörn , Christiansen Hans , Strebhardt Klaus , Rödel Claus , Tselis Nikolaos , Rödel Franz
Published: November 2021

Uterine cervical cancer is one of the leading causes of cancer-related mortality in women worldwide. Each year, over half a million new cases are estimated, resulting in more than 300,000 deaths. While less-invasive, fertility-preserving surgical procedures can be offered to women in early stages, treatment for locally advanced disease may include radical hysterectomy, primary chemoradiotherapy (CRT) or a combination of these modalities. Concurrent platinum-based chemoradiotherapy regimens remain the first-line treatments for locally advanced cervical cancer. Despite achievements such as the introduction of angiogenesis inhibitors, and more recently immunotherapies, the overall survival of women with persistent, recurrent or metastatic disease has not been extended significantly in the last decades. Furthermore, a broad spectrum of molecular markers to predict therapy response and survival and to identify patients with high- and low-risk constellations is missing. Implementation of these markers, however, may help to further improve treatment and to develop new targeted therapies. This review aims to provide comprehensive insights into the complex mechanisms of cervical cancer pathogenesis within the context of molecular markers for predicting treatment response and prognosis.
Phytochemicals as an Alternative or Integrative Option, in Conjunction with Conventional Treatments for Hepatocellular Carcinoma
Authors: Rodriguez Sheryl , Skeet Kristy , Mehmetoglu-Gurbuz Tugba , Goldfarb Madeline , Karri Shri , Rocha Jackelyn , Shahinian Mark , Yazadi Abdallah , Poudel Seeta , Subramani Ramadevi
Published: November 2021

Hepatocellular carcinoma (HCC) is the most abundant form of liver cancer. It accounts for 75–85% of liver cancer cases and, though it ranks globally as the sixth most common cancer, it ranks second in cancer-related mortality. Deaths from HCC are usually due to metastatic spread of the cancer. Unfortunately, there are many challenges and limitations with the latest HCC therapies and medications, making it difficult for patients to receive life-prolonging care. As there is clearly a high demand for alternative therapy options for HCC, it is prudent to turn to plants for the solution, as their phytochemicals have long been used and revered for their many medicinal purposes. This review explores the promising phytochemical compounds identified from pre-clinical and clinical trials being used either independently or in conjunction with already existing cancer therapy treatments. The phytochemicals discussed in this review were classified into several categories: lipids, polyphenols, alkaloids, polysaccharides, whole extracts, and phytochemical combinations. Almost 80% of the compounds failed to progress into clinical studies due to lack of information regarding the toxicity to normal cells and bioavailability. Although large obstacles remain, phytochemicals can be used either as an alternative or integrative therapy in conjunction with existing HCC chemotherapies. In conclusion, phytochemicals have great potential as treatment options for hepatocellular carcinoma.
Synthetic Optimization and MAPK Pathway Activation Anticancer Mechanism of Polyisoprenylated Cysteinyl Amide Inhibitors
Authors: Tawfeeq Nada , Jin Yonghao , Lamango Nazarius S.
Published: November 2021

Abnormalities of the MAPK pathway play vital roles in cancer initiation and progression. RAS GTPases that are key upstream mediators of the pathway are mutated in 30% of human cancers. Polyisoprenylated cysteinyl amide inhibitors (PCAIs) were designed as potential targeted therapies against the RAS-driven cancers. The current study reports on the optimization of the PCAIs and the determination of their mechanisms of action in KRAS-mutant cancer cells. They display ClogP values ranging from 3.01 to 6.35, suppressing the viabilities of KRAS-mutant MDA-MB-231, A549, MIA PaCa-2, and NCI-H1299 cells in 2D and 3D cultures with EC50 values of 2.2 to 6.8, 2.2 to 7.6, 2.3 to 6.5 and 5.0 to 14 µM, respectively. When A549 cells were treated with the PCAIs, NSL-YHJ-2-27, for 48 h, no significant difference was observed in the levels of total or phosphorylated B- and C-Raf proteins. However, at 5 µM, it stimulated the phosphorylation of MEK1/2, ERK1/2, and p90RSK by 84%, 59%, and 160%, respectively, relative to controls. A non-farnesylated analog, NSL-YHJ-2-62, did not elicit similar effects. These data reveal that effects on the RAS-MAPK signaling axis most likely contribute to the anticancer effects of the PCAIs, possibly through the proapoptotic isoforms of p90RSK. The PCAIs may thus have the potential to serve the unmet therapeutic needs of patients with aberrant hyperactive G-protein signaling.
Fascin in Gynecological Cancers: An Update of the Literature
Authors: Gupta Ishita , Vranic Semir , Al-Thawadi Hamda , Al Moustafa Ala-Eddin
Published: November 2021

Fascin is an actin-binding protein that is encoded by the FSCN1 gene (located on chromosome 7). It triggers membrane projections and stimulates cell motility in cancer cells. Fascin overexpression has been described in different types of human cancers in which its expression correlated with tumor growth, migration, invasion, and metastasis. Moreover, overexpression of fascin was found in oncovirus-infected cells, such as human papillomaviruses (HPVs) and Epstein-Barr virus (EBV), disrupting the cell–cell adhesion and enhancing cancer progression. Based on these findings, several studies reported fascin as a potential biomarker and a therapeutic target in various cancers. This review provides a brief overview of the FSCN1 role in various cancers with emphasis on gynecological malignancies. We also discuss fascin interactions with other genes and oncoviruses through which it might induce cancer development and progression.
Glycyrrhizin as a Nitric Oxide Regulator in Cancer Chemotherapy
Authors: Kim Minsu , Park Seok Chan , Lee Dong Yun
Published: November 2021

Chemotherapy is used widely for cancer treatment; however, the evolution of multidrug resistance (MDR) in many patients limits the therapeutic benefits of chemotherapy. It is important to overcome MDR for enhanced chemotherapy. ATP-dependent efflux of drugs out of cells is the main mechanism of MDR. Recent studies have suggested that nitric oxide (NO) can be used to overcome MDR by inhibiting the ATPase function of ATP-dependent pumps. Several attempts have been made to deliver NO to the tumor microenvironment (TME), however there are limitations in delivery. Glycyrrhizin (GL), an active compound of licorice, has been reported to both reduce the MDR effect by inhibiting ATP-dependent pumps and function as a regulator of NO production in the TME. In this review, we describe the potential role of GL as an NO regulator and MDR inhibitor that efficiently reduces the MDR effect in cancer chemotherapy.
Homogeneity Assessment of Asphalt Concrete Base in Terms of a Three-Dimensional Air-Launched Ground Penetrating Radar
Authors: Zhang Xiaomeng , Han Wenyang , Chen Luchuan , Zhang Zhengchao , Xue Zhichao , Wei Jincheng , Yan Xiangpeng , Hu Guiling
Published: November 2021

Obtaining the required homogeneity, including uniform thickness and density, is very crucial for controlling the quality of flexible asphalt layers. Although non-destructive testing (NDT) methods are time-saving and less labor-intensive, they only provide indirect measurement data under testing area conditions and strongly depend on the explanations by prediction models. In this study, in terms of the three-dimensional air-launched Ground Penetrating Radar (GPR) technique, the dielectric constant of asphalt concrete base with dry conditions in pavements was detected and calculated by different methods (the Coring Method, Reflection Amplitudes Method and Common Mid-Point Method). According to the calculated dielectric constant, the thickness and density of asphalt concrete base were further calculated and assessed. Comparing with the Coring Method, the Common Mid-Point Method was recommended to calculate dielectric constants in order to obtain reliable thickness of asphalt pavement base. Among the Birefringence, Boettcher, Linearity indicator, and Rayleigh models, the Rayleigh model was suggested to predict the density, and the predicted density exhibited a good correlation coefficient with the measured one. Furthermore, by choosing these proper calculation methods, an assessment was successfully conducted to evaluate homogeneity of a constructed field pavement in practice.
Quantitative Characterization of the γ’ Phase Distribution in the Large-Scale Area of the Second-Generation Nickel-Based Single Crystal Blade DD5
Authors: Wan Weihao , Li Dongling , Zhou Qingqing , Zeng Qiang , Xue Xin , Shi Hui , Wang Haizhou
Published: November 2021

Nickel-based single crystal superalloy blades have excellent high-temperature performance as the hot end part of the aero-engine turbine. The most important strengthening phase in the single crystal blade is the γ’ phase, and its morphology and size distribution directly affect the high temperature performance of the single crystal blade. In this work, scanning electron microscopy (SEM) was used to obtain the microscopic images of the γ’ phase in multiple large continuous fields of view in the transverse sections of single crystal blades, and the quantitative statistical characterization of the γ’ phase was performed by image segmentation method based on deep learning. The 20 μm × 20 μm region was selected from the primary dendrite arm, the secondary dendrite arm, and the interdendrite to statistically analyze the γ’ phases. The statistical results show that the average size of the γ’ phase at the position of the interdendrite is significantly larger than the average size of the γ’ phase at the position of the dendrite; the sizes of the γ’ phase at the primary dendrite arm, the secondary dendrite arm and the interdendrite all obey the normal distribution; about 3.17 × 107 γ’ phases are counted in 20 positions in the 5 transverse sections of the single crystal blade in a total area of 5 mm2, and the size, geometric morphology and area fraction of all γ’ phases are respectively counted. In this work, the quantitative parameters of the γ’ phases at 4 different positions of the section of the single crystal superalloy DD5 blade were compared, the size and area fraction of the γ’ phases at the leading edge and the trailing edge were smaller, and the shape of the γ’ phase of the leading edge and the trailing edge is closer to the cube.
Impact of COVID-19 on Radiation Oncology, an Austrian Experience
Authors: Mangesius Julian , Arnold Christoph Reinhold , Seppi Thomas , Mangesius Stephanie , Brüggl Mario , Eichberger Paul , Ganswindt Ute
Published: November 2021

The COVID-19 pandemic has an unprecedented impact on cancer treatment worldwide. We aimed to evaluate the effects of the pandemic on the radiation treatment of patients in order to provide data for future management of such crises. We compared the number of performed radiotherapy sessions of the pandemic period from February 2020 until May 2021 with those of 2018 and 2019 for reference. At our department, no referred patients had to be rejected or postponed, nor any significant changes in fractionation schedules implemented. Nevertheless, there was a substantial drop in overall radiotherapy sessions in 2020 following the first incidence wave of up to −25% (in June) in comparison to previous years. For breast cancer, a maximum decline of sessions of −45% (July) was recorded. Only a short drop of prostate cancer sessions (max −35%, May) followed by a rebound (+42%, July) was observed. Over the investigated period, a loss of 4.4% of expected patients never recovered. The severe impact of COVID-19 on cancer treatment, likely caused by retarded diagnosis and delayed interdisciplinary co-treatment, is reflected in a lower count of radiotherapy sessions. Radiation oncology is a crucial cornerstone in upholding both curative treatment options and treatment capacity during a pandemic.
Entropy-Based Combined Metric for Automatic Objective Quality Assessment of Stitched Panoramic Images
Authors: Okarma Krzysztof , Chlewicki Wojciech , Kopytek Mateusz , Marciniak Beata , Lukin Vladimir
Published: November 2021

Quality assessment of stitched images is an important element of many virtual reality and remote sensing applications where the panoramic images may be used as a background as well as for navigation purposes. The quality of stitched images may be decreased by several factors, including geometric distortions, ghosting, blurring, and color distortions. Nevertheless, the specificity of such distortions is different than those typical for general-purpose image quality assessment. Therefore, the necessity of the development of new objective image quality metrics for such type of emerging applications becomes obvious. The method proposed in the paper is based on the combination of features used in some recently proposed metrics with the results of the local and global image entropy analysis. The results obtained applying the proposed combined metric have been verified using the ISIQA database, containing 264 stitched images of 26 scenes together with the respective subjective Mean Opinion Scores, leading to a significant increase of its correlation with subjective evaluation results.
Field Test of Superheater Pipes Vibration Caused by Sound Energy in the 235 MWe Circulating Fluidized Bed Boiler
Authors: Mirek Paweł
Published: November 2021

This paper presents the results of measurements of vibrations of the pipes of the steam superheater installed in the convection pass of the 235 MWe Circulating Fluidized Bed boiler (CFB) induced using sonic soot blowers of the Nirafon NI-100 type. The measurements were made using two ICP Triaxial 356A16 accelerometers allowing the analysis of accelerations in the maximum range of ±490 m/s2. Simultaneously with vibration measurements, the sound pressure level was recorded using the G.R.A.S. 40BH high-pressure microphone. The measurements and spectral analysis of the recorded signals showed that the acoustic wave of 148 dB is safe for the steam superheater pipes causing vibrations of maximum amplitude not exceeding 1 mm. The field tests confirmed the supposition that the dominant mechanism for cleaning the surfaces of the superheater’s heating pipes are not pipe vibrations, but the breakage of cohesion forces between dust particles.
Applying a Model of Technology Diffusion to Quantify the Potential Benefit of Improved Energy Efficiency in Data Centres
Authors: Coyne Bryan , Denny Eleanor
Published: November 2021

Data centres are a key infrastructure for the global digital economy, helping enable the EU “Digital Decade” by 2030. In 2015, data centres were estimated to consume 2.5% of EU electricity demand. In Ireland, the concentrated presence of data centres could consume 37% of national electricity demand by 2028. The uncertainty of data centre facility-level energy efficiency paired with the need to achieve a low-carbon economy pose significant challenge for generation and transmission network planning. This is the first paper to apply a model of technology diffusion with a national forecast of changes in Irish data centre electricity demand through more efficient liquid cooling. The methodology serves as a technology-agnostic resource for practitioners performing forecasts under uncertainty with limited information. Results suggest that technology adoption could lower national electricity demand by 0.81% if adopted by new plant from 2019 to 2028. Savings rise to 3.16% over the same period if adopted by new and existing data centres. Adoption would also lower related emissions by 4.70% and 23.04% over the same period across both scenarios, respectively. Results highlight substantial potential electricity and associated emissions savings available in the sector and suggest policy options to support a transition towards a low-carbon economy.
Litterfall and Element Return in an Abies faxoniana Forest in Tibet—A Five-Year Study
Authors: Wu Weiting , Zhang Yabei , Wang Lifeng , Zhou Yu , Chen Yamei , He Shuqin , Zhang Jian , Liu Yang
Published: November 2021

Forest litter is the main contributor to soil fertility and the main carrier of circulating material and energy in forest ecosystems. Abies faxoniana (Minjiang fir) is one of the dominant species in alpine forest ecosystems. Its litter input plays important roles in soil organic matter formation and biogeochemical cycles in these ecosystems, but the annual litterfall pattern and its components remain largely unknown. To determine the litter input and nutrient return of A. faxoniana, we measured the litterfall and element (carbon (C), nitrogen (N), phosphorus (P), potassium (K), calcium (Ca), sodium (Na), magnesium (Mg), aluminium (Al), iron (Fe), and manganese (Mn)) contents of different litter components (branches, leaves and epiphytes) from 2016 to 2020. The results showed that the annual litterfall in the A. faxoniana forest ranged from 2055.96 to 5384.15 kg·ha−1·a−1, and the average mass proportions of branches, leaves and epiphytes were 30.12%, 62.18% and 7.7%, respectively. The litterfall yield varied significantly with time and component; not only was the yield of litter in the nongrowing season higher than that in the growing season, but it also exhibited dramatic interannual variations. We also found that time had significant effects on the contents of all elements except for Ca in the litter. The return and input amounts of each element followed the same dynamics, which closely resembled a bimodal pattern. Moreover, there was significant interannual variability in the returned amounts of each element. The ranges of annual returns of C, N and P were 744.80~2275.12, 19.80~59.00 and 1.03~2.81 kg·ha−1·a−1, respectively. The ranges of annual returns of K, Ca, Na, Mg, Al, Fe and Mn were 0.91~2.00, 7.04~18.88, 0.13~0.58, 0.33~1.20, 0.55~2.29, 0.41~1.37 and 0.16~0.48 kg·ha−1·a−1, respectively, reflecting a seasonal double-peak pattern. These results have important implications for understanding the biogeochemical cycles and material migration processes in alpine forest ecosystems.
The Biogeography of Forest Soil Microbial Functional Diversity Responds to Forest Types across Guangxi, Southwest China
Authors: Peng Wanxia , Wang Feng , Song Tongqing , Tan Qiujin , Du Hu , Zeng Fuping , Wang Kelin , Zhang Hao , Zeng Zhaoxia
Published: November 2021

Vegetation and soil have spatial distributions at different scales, while the spatial distribution of soil microorganisms and factors driving their distribution are still unclear. We aimed to reveal the spatial pattern of microbial functional diversity and to identify its drivers in forest soils at a regional scale. Here, we performed an investigation of microbes across several forest types covering an area of 236,700 km2 in Guangxi, southwest China. We examined a total of 185 samples for soil microbial functional diversity using Biolog EcoPlates. The soil microbial functional diversity had strong spatial heterogeneity across the Guangxi region. The distribution of microorganisms in forest soils was mainly determined by total nitrogen, available N, and C:N ratio, and stand age. We found that coniferous forests, especially pine forest, exhibited lower functional diversity, but the reverse was true for deciduous broadleaf forest/mixed evergreen and deciduous broadleaf forest. Our findings suggested that a heterogeneous distribution of microbial functional diversity in forest soils is related to forest types in Guangxi, China. In conclusion, high soil microbial functional diversity is favored in subtropical forests with looser soil structure, lower soil C:N ratio, greater total soil nitrogen and available nitrogen concentration, and broad-leaved tree species.
Composed Indicator of Community Forest Governance in San Miguel Topilejo, Mexico City
Authors: Aguilar-Martínez Susana , Valtierra-Pacheco Esteban
Published: November 2021

Community Forest Governance is a process of building agreements and decision-making about rules and norms for the use and access to forest resources of common use. The main objective of this study was to know the level of governance about the management and conservation of the forest of the agrarian community of San Miguel Topilejo, in Southern Mexico City. A survey was applied to a representative sample of 58 community members. The level of governance is determined by a composed indicator that includes criteria and specific indicators of social capital, collective action, and local organization. The main finding shows that social capital is low because there is little cohesion between community members. Community collective action shows a lack of cooperation and coordination to enforce norms and sanctions in the use of forest resources. The level of organization is low because the structure of positions and roles is very basic and not specialized. The conclusion is that the level of governance is low because this community has no clear common objectives, there is a lack of well-established norms and sanctions, and there is a lack of involvement of owners in the decision-making process and management of forest resources of common use.
Association of a Total Cholesterol Polygenic Score with Cholesterol Levels and Pathological Biomarkers across the Alzheimer’s Disease Spectrum
Authors: Nilsson Nathalie I. V. , Picard Cynthia , Labonté Anne , Köbe Theresa , Meyer Pierre-François , Villeneuve Sylvia , Auld Daniel , Poirier Judes ,   for the PREVENT-AD Research Group,   Alzheimer’s Disease Neuroimaging Initiative
Published: November 2021

Midlife hypercholesterolemia is a well-known risk factor for sporadic Alzheimer’s disease (AD), and like AD, it is highly influenced by genetics with heritability estimates of 32–63%. We thus hypothesized that genetics underlying peripheral blood total cholesterol (TC) levels could influence the risk of developing AD. We created a weighted polygenic score (TC-PGS) using summary data from a meta-analysis of TC genome-wide association studies for evaluation in three independent AD-related cohorts spanning pre-clinical, clinical, and pathophysiologically proved AD. APOE-ε4 variant was purposely included in the analysis as it represents an already well-established genetic risk factor for both AD and circulating TC. We could vastly improve the performance of the score when considering p-value thresholds for inclusion in the score, sex, and statin use. This optimized score (p-value threshold of 1 × 10−6 for inclusion in the score) explained 18.2% of the variance in TC levels in statin free females compared to 6.9% in the entire sample and improved prediction of hypercholesterolemia (receiver operator characteristics analysis revealed area under the curve increase from 70.8% to 80.5%). The TC-PGS was further evaluated for association with AD risk and pathology. We found no association between the TC-PGS and either of the AD hallmark pathologies, assessed by cerebrospinal fluid levels of Aβ-42, p-Tau, and t-Tau, and 18F-NAV4694 and 18F-AV-1451 positron emission tomography. Similarly, we found no association with the risk of developing amyloid pathology or becoming cognitively impaired in individuals with amyloid pathology.
Spatial Analysis of COVID-19 Vaccination: A Scoping Review
Authors: Mollalo Abolfazl , Mohammadi Alireza , Mavaddati Sara , Kiani Behzad
Published: November 2021

Spatial analysis of COVID-19 vaccination research is increasing in recent literature due to the availability of COVID-19 vaccination data that usually contain location components. However, to our knowledge, no previous study has provided a comprehensive review of this research area. Therefore, in this scoping review, we examined the breadth of spatial and spatiotemporal vaccination studies to summarize previous findings, highlight research gaps, and provide guidelines for future research. We performed this review according to the five-stage methodological framework developed by Arksey and O’Malley. We screened all articles published in PubMed/MEDLINE, Scopus, and Web of Science databases, as of 21 September 2021, that had employed at least one form of spatial analysis of COVID-19 vaccination. In total, 36 articles met the inclusion criteria and were organized into four main themes: disease surveillance (n = 35); risk analysis (n = 14); health access (n = 16); and community health profiling (n = 2). Our findings suggested that most studies utilized preliminary spatial analysis techniques, such as disease mapping, which might not lead to robust inferences. Moreover, few studies addressed data quality, modifiable areal unit problems, and spatial dependence, highlighting the need for more sophisticated spatial and spatiotemporal analysis techniques.
An Ergonomic Assessment of Different Postures and Children Risk during Evacuations
Authors: Jia Xiaohu , Zhang Bo , Gao Xiaoyu , Zhou Jiaxu
Published: November 2021

Crawling is recommended for avoiding high heat and toxic fumes and for obtaining more breathable air during evacuations. Few studies have evaluated the effects of crawling on physical joints and velocity, especially in children. Based on motion capture technology, this study proposes a novel method of using wearable sensors to collect exposure (e.g., mean duration, frequency) on children’s joints to objectively quantify the impacts of different locomotion methods on physical characteristics. An on-site experiment was conducted in a kindergarten with 28 children (13 boys and 15 girls) of different ages (4–6 years old) who traveled up to 22 m in three different postures: upright walking (UW), stoop walking (SW), and knee and hand crawling (KHC). The results showed that: (1) The level of joint fatigue for KHC was heavier than bipedal walking (p < 0.05), which was evidenced by higher mean duration and frequency. There was no significant difference between UW and SW (p > 0.05). (2) The physical characteristics of the children in the different postures observed in this study were different (p < 0.05). The ankle was more fatigued than other joints during bipedal walking. Unlike infants, the wrists and hips of the children became fatigued while crawling. The key actions flexion/extension are more likely to induce joint fatigue vs. other actions. (3) Crawling velocity was significantly slower than the bipedal velocities, and UW was 10.6% faster than SW (p < 0.05). The bipedal walking velocity started to decrease after the children had travelled up to 13 m, while the KHC velocity started to decrease after traveling up to 11.6 m. (4) In a severe fire, the adoption of SW is suggested, as the evacuees can both evacuate quickly and avoid overworking their joints. (5) There were no significant differences in the age (p > 0.05) and gender (p > 0.05) of the children on the joints in any of the three postures. To conclude, KHC causes more damage to body joints compared to bipedal walking, as evidenced by higher exposure (mean duration, frequency), whereas UW and SW are similar in terms of the level of joint fatigue. The above findings are expected to provide a useful reference for future applications in the children’s risk assessment and in the prevention design of buildings.
The Blood Lead Levels of Children and the Loss of Ca2+ from Neurons Owing to Lead
Authors: Duan Yifei , Shi Hua , Jiang Yongmei
Published: November 2021

In order to understand current blood lead levels (BLLs), we investigated the BLLs of children in Sichuan Province from 2011 to 2020. We then monitored the treatment effects of calcium in children with high BLLs to assess their treatment status. Finally, we explored the effects of lead on Ca2+ through in-situ experiments. Whole blood samples were used for BLL tests. The BLLs of 76,362 children aged 0–7 years were measured using atomic absorption spectrometry. The median BLL was 35 μg/L (interquartile range: 28–47). The BLLs were significantly higher in boys than in girls (p < 0.001). The BLLs generally decreased annually and increased with age. The overall prevalence of BLLs ≥ 100 μg/L was 1.20%. The children with high BLLs received subsequent check-ups, and the median time required for effective treatment was 18 months. We observed that lead exposure led to a gradual and persistent loss of Ca2+ levels in neurons of mice brain slices, and the effect did not subside immediately even after the lead was removed. China has made rapid progress in pediatric healthcare, but the treatment status remains unsatisfactory. Because lead causes an irreversible loss of Ca2+, there is an urgent need to develop new standardized treatments to reduce the treatment duration.
Validation of a Virtual Assistant for Improving Medication Adherence in Patients with Comorbid Type 2 Diabetes Mellitus and Depressive Disorder
Authors: Roca Surya , Lozano María Luisa , García José , Alesanco Álvaro
Published: November 2021

Virtual assistants are programs that interact with users through text or voice messages simulating a human-based conversation. The development of healthcare virtual assistants that use messaging platforms is rapidly increasing. Still, there is a lack of validation of these assistants. In particular, this work aimed to validate the effectiveness of a healthcare virtual assistant, integrated within messaging platforms, with the aim of improving medication adherence in patients with comorbid type 2 diabetes mellitus and depressive disorder. For this purpose, a nine-month pilot study was designed and subsequently conducted. The virtual assistant reminds patients about their medication and provides healthcare professionals with the ability to monitor their patients. We analyzed the medication possession ratio (MPR), measured the level of glycosylated hemoglobin (HbA1c), and obtained the patient health questionnaire (PHQ-9) score in the patients before and after the study. We also conducted interviews with all participants. A total of thirteen patients and five nurses used and evaluated the proposed virtual assistant using the messaging platform Signal. Results showed that on average, the medication adherence improved. In the final interview, 69% of the patients agreed with the idea of continuing to use the virtual assistant after the study.
Impact of the Work Environment on Patients’ Safety as Perceived by Nurses in Poland—A Cross-Sectional Study
Authors: Malinowska-Lipień Iwona , Micek Agnieszka , Gabryś Teresa , Kózka Maria , Gajda Krzysztof , Gniadek Agnieszka , Brzostek Tomasz , Fletcher Jason , Squires Allison
Published: November 2021

Numerous studies have found that organizational features connected with the work environment of nurses have a significant influence on patients’ safety. The aim of this research was to capture nurses’ opinions about patients’ safety and discern relationships with work environment characteristics. This cross-sectional study surveyed 1825 nurses. The research used questionnaire consisting of four parts: (1) covered The Practice Environment Scale of the Nursing Work Index (PES-NWI); (2) assessed the quality of nursing care and care safety; (3) contained information on the most recent duty served by the nurses and (4) captured social and demographic data of participants. The research identified strong association between patient safety assessment and work environment of nurses in the aspect of employment adequacy, cooperation between nurses and doctors, support for nurses from the managing staff, the possibility to participate in the management as well as professional promotion of nurses employed in the hospital (p < 0.001). Nurses rated patient safety higher when responsible for a smaller number of patients. Work environment factors such as proper staffing, good cooperation with doctors, support from the management, as well as professional independence are significantly related to nurses’ assessment of patients’ safety.
The Lyme Borreliosis Spatial Footprint in the 21st Century: A Key Study of Slovenia
Authors: Donša Daša , Grujić Veno Jaša , Pipenbaher Nataša , Ivajnšič Danijel
Published: November 2021

After mosquitoes, ticks are the most important vectors of infectious diseases. They play an important role in public health. In recent decades, we discovered new tick-borne diseases; additionally, those that are already known are spreading to new areas because of climate change. Slovenia is an endemic region for Lyme borreliosis and one of the countries with the highest incidence of this disease on a global scale. Thus, the spatial pattern of Slovenian Lyme borreliosis prevalence was modelled with 246 indicators and transformed into 24 uncorrelated predictor variables that were applied in geographically weighted regression and regression tree algorithms. The projected potential shifts in Lyme borreliosis foci by 2050 and 2070 were calculated according to the RCP8.5 climate scenario. These results were further applied to developing a Slovenian Lyme borreliosis infection risk map, which could be used as a preventive decision support system.
Community-Level Experiences, Understandings, and Responses to COVID-19 in Low- and Middle-Income Countries: A Systematic Review of Qualitative and Ethnographic Studies
Authors: Raymond Christopher B. , Ward Paul R.
Published: November 2021

(1) Background: COVID-19 disruptions offer researchers insight into how pandemics are at once biological and social threats, as communities struggle to construct meaning from novel challenges to their ontological status quo. Multiple epistemes, in which public health imperatives confront and negotiate locally derived knowledge and traditions, vie for legitimacy and agency, resulting in new cultural forms. (2) Methods: To investigate the context and construction of community responses, a systematic review of qualitative literature was conducted with the aim of evaluating those insights provided by empirical, social field research in low- and middle-income countries since the onset of COVID-19. Six scholarly databases were searched for empirical, qualitative, field-based, or participatory research that was published in peer-reviewed journals between December 2019 and August 2021. (3) Results: Twenty-five studies were selected for data extraction, following critical appraisal for methodological rigor by two independent reviewers, and were then analyzed thematically. Faced with unprecedented social ruptures, restrictions in social and physical mobility, and ever-looming uncertainties of infection, financial insecurity, stigma, and loss, communities worldwide reacted in multiple and complex ways. Pervasive misinformation and fear of social rejection resulted in noncompliance with pandemic sanctions, resistance, and increased isolation, allowing the spread of the disease. The meaning of, and understandings about, COVID-19 were constructed using traditional, religious, and biomedical epistemologies, which were occasionally in conflict with each other. Innovations and adaptations, through syntheses of traditional and biomedical discourses and practice, illustrated community resilience and provided models for successful engagement to improve public health outcomes. (4) Conclusion: Local context and community engagement were indispensable considerations when enacting effective public health interventions to meet the challenges of the pandemic.
Consistency Is Key When Setting a New World Record for Running 10 Marathons in 10 Days
Authors: Berger Nicolas , Cooley Daniel , Graham Michael , Harrison Claire , Campbell Georgia , Best Russ
Published: November 2021

Background: We describe the requirements and physiological changes when running 10 consecutive marathons in 10 days at the same consistent pace by a female ultra-endurance athlete. Methods: Sharon Gayter (SG) 54 yrs, 162.5 cm, 49.3 kg maximal oxygen uptake (VO2 max) 53 mL/kg−1/min−1. SG completed 42.195 km on a treadmill every day for 10 days. We measured heart rate (HR), Rating of Perceived Exertion (RPE), oxygen uptake (VO2), weight, body composition, blood parameters, nutrition, and hydration. Results: SG broke the previous record by ~2.5 h, with a cumulative completion time of 43 h 51 min 39 s. Over the 10 days, weight decreased from 51 kg to 48.4 kg, bodyfat mass from 9.1 kg to 7.2 kg (17.9% to 14.8%), and muscle mass from 23.2 kg to 22.8 kg. For all marathons combined, exercise intensity was ~60% VO2 max; VO2 1.6 ± 0.1 L.min−1/32.3 ± 1.1 mL.kg−1.min−1, RER 0.8 ± 0, HR 143 ± 4 b.min−1. Energy expenditure (EE) was 2030 ± 82 kcal/marathon, total EE for 10 days (including BMR) was 33,056 kcal, daily energy intake (EI) 2036 ± 418 kcal (20,356 kcal total), resulting an energy deficit (ED) of 12,700 kcal. Discussion: Performance and pacing were highly consistent across all 10 marathons without any substantial physiological decrements. Although overall EI did not match EE, leading to a significant ED, resulting in a 2.6 kg weight loss and decreases in bodyfat and skeletal muscle mass, this did not affect performance.
Media Agenda and Press Conferences on COVID-19 in Mexico: An Analysis of Journalists’ Questions
Authors: Aguila Sánchez Julio C. , Llano Guibarra Ninón I. , Pereyra-Zamora Pamela
Published: November 2021

The impact of the COVID-19 pandemic has highlighted the need to strengthen health communication in times of crisis. This study aims to analyze the media agenda of press conferences on COVID-19 in Mexico during the first two phases of the pandemic, based on journalists’ questions. The study is based on framing theory. The method used was content analysis from a quantitative perspective. This method was explicitly applied to the final section of the conferences, which dealt with “questions from the press.” The results show that at the beginning of the pandemic, the press was more interested in the government’s management of the health crisis than in issues such as the prevention of the disease itself or the economic impact of the crisis on the country. Moreover, the main characteristic of the questions was that they were generally socially relevant. In conclusion, we found that in the media agenda of the Mexican conference, the frame of attribution of responsibility was prominent but in combination with the frames of conflict, human interest, morality, and economic consequences.
“Do Elite Sport First, Get Your Period Back Later.” Are Barriers to Communication Hindering Female Athletes?
Authors: Höök Martina , Bergström Max , Sæther Stig Arve , McGawley Kerry
Published: November 2021

Competitive female athletes perceive their hormonal cycles to affect their training, competition performance and overall well-being. Despite this, athletes rarely discuss hormonal-cycle-related issues with others. The aim of this study was to gain an in-depth understanding of the perceptions and experiences of endurance athletes and their coaches in relation to barriers to athlete–coach communication about female hormonal cycles. Thirteen Swedish national-/international-level female cross-country skiers (age 25.8 ± 3.6 y) and eight of their coaches (two women and six men; age 47.8 ± 7.5 y) completed an online survey relating to their educational background, prior knowledge about female hormonal cycles and a coach–athlete relationship questionnaire (CART-Q). They then participated in an online education session about female hormonal cycles and athletic performance before participating in semi-structured focus-group interviews. Thematic analyses revealed three main barriers to communication: knowledge, interpersonal, and structural. In addition, the results suggested that a good coach–athlete relationship may facilitate open communication about female hormonal cycles, while low levels of knowledge may hinder communication. To overcome the perceived barriers to communication, a model is proposed to improve knowledge, develop interpersonal relationships and strengthen structural systems through educational exchanges and forums for open discussion.
Managerial Responses to the Onset of the COVID-19 Pandemic in Healthcare Organizations Project Management
Authors: Bednarz Ariadna Linda , Borkowska-Bierć Marta , Matejun Marek
Published: November 2021

The goal of this study was to identify and assess the impact of the COVID-19 pandemic on project management practices in healthcare organizations, taking into account, in particular, risk analysis, project performance, organization of the work of project teams, and tendencies in future developments in project management. In order to achieve this goal, a study was conducted on 20 project managers in selected healthcare organizations in Poland. The results indicate that a systematically conducted risk analysis as part of the implemented projects enabled rapid and effective reactions during the COVID-19 pandemic. The pandemic has also significantly altered the organization of the work of project teams and, in the opinion of the research subjects, this will significantly impact future solutions for project management in healthcare organizations. The obtained results form a basis for the increase in professionalization in project management in healthcare organizations.
An Enhanced Water Solubility and Stability of Anthocyanins in Mulberry Processed with Hot Melt Extrusion
Authors: Go Eun-Ji , Ryu Byeong-Ryeol , Ryu Su-Ji , Kim Hyun-Bok , Lee Hyun-Tai , Kwon Jin-Woo , Baek Jong-Suep , Lim Jung-Dae
Published: November 2021

Mulberry fruits are rich sources of anthocyanins that exhibit beneficial biological activity. These anthocyanins become instable in an aqueous media, leading to their low bioavailability. In this study, a colloidal dispersion was produced by processing mulberry samples with hot-melt extrusion. In this process, hydrophilic polymer matrices were used to disperse the compound in an aqueous media. Mulberry samples were processed with hot-melt extrusion and in the presence of an ionization agent and sodium alginate to form mulberry-extrudate solid formulations. The particle size of mulberry-extrudate solid formulations decreased, while the total phenol content, the total anthocyanin content, and solubility increased. Fourier transform infrared spectroscopy (FT-IR) revealed that mulberry-extrudate solid formulations now contained new functional groups, such as –COOH group. We investigated whether mulberry-extrudate solid formulations had a positive impact on the stability of anthocyanins. The non-extrudate mulberry sample and mulberry-extrudate solid formulations were incubated with a simulated gastric fluid system and an intestinal fluid system. The number of released anthocyanins was determined with HPLC. We found that anthocyanins were released rapidly from non-extrudate mulberry extract. Mulberry-extrudate solid formulations contained a large number of available anthocyanins even after being incubated for 180 min in the intestinal fluid system. Thus, hot-melt extrusion enhanced water solubility and stability of anthocyanins with the prolonged release.