bluuebunny/crossref_metadata_2025 huggingface dataset:
Effectiveness of Direct-Acting Antivirals in Treatment of Elderly Egyptian Chronic Hepatitis C Patients
Authors: Kamel Shimaa , Elessawy Hagar , Ashraf Ossama , Elbaz Ahmed , Dabbous Hany , El-Sayed Manal , Ali Safaa , Kamel Heba
Published: July 2021

Background: Hepatitis C virus treatment has dramatically improved by direct-acting antiviral (DAA) therapy. The aim of this study was to assess the efficacy and safety of DAA in elderly Egyptian chronic hepatitis C (CHC) patients. Methods: The study was carried out on 327 CHC elderly patients >60 years; patients were divided into 3 age subgroups (<65, 65–75 and >75 years) on DAA therapy for 12 weeks. Ninety-one patients (27.8%) were treated with dual therapy, 234 patients (71.6%) with triple therapy and 2 patients (0.6%) with quadrable therapy. Results: All patients achieved end-of-treatment virological response (100%). ALT levels normalized during therapy. The follow-up rate of sustained virological response at 12 weeks after the end of treatment (SVR12) was 100%. One hundred and two patients had missed SVR12 data due to being lost tofollow-up. Two hundred twenty-two adverse events were reported (67.8%), including anemia in 30 patients (9.1%), leucopenia in 129 patients (39.4%) and thrombocytopenia in 63 patients (19.2%). No serious side effects led to discontinuation of therapy. No hepatic decompensation was observed, and no patients died. Conclusion: Age does not influence the success of DAA treatment and all DAA regimens are well tolerated, safe and highly efficacious, even in those aged 75 years or older.
Preparation, Optimization and Evaluation of Chitosan-Based Avanafil Nanocomplex Utilizing Antioxidants for Enhanced Neuroprotective Effect on PC12 Cells
Authors: Kurakula Mallesh , Naveen N. Raghavendra , Patel Bhaumik , Manne Ravi , Patel Devang B.
Published: July 2021

(1) Introduction: in recent decades, interdisciplinary research on the utilization of natural products as “active moiety carriers” was focused on due to their superior safety profile, biodegradability, biocompatibility and the ability for sustained or controlled release activity. The nano-based neuroprotective strategy is explored as an imperative treatment for diabetic neuropathy (DN). Avanafil (AV), that selectively inhibits the degradation of cGMP-specific phosphodiesterase, thereby increasing the levels of cGMP, makes a decisive mediator for cytoprotection. (2) Methods: AVnanocomplex formulations were prepared by a modified anti-solvent precipitation method and the method was optimized by Box–Behnken design. An optimized formulation was characterized and evaluated for various in vitro parameters; (3) results:based on the desirability approach, the formulation containing 2.176 g of chitosan, 7.984 g of zein and 90% v/v ethanol concentration can fulfill the prerequisites of optimum formulation (OB-AV-NC).OB-AV-NC was characterized and evaluated for various parameters. The neuroprotective mechanism of AV was evaluated by pretreatment of PC12 cells with plain AV, avanafil nanocomplex (NC) without antioxidants (AV-NC) and with antioxidants (α-Lipoic acid LP; Ellagic Acid EA), AV-LP-EA-Nanocomplex has also shown considerable attenuation in intracellular reactive oxygen species (ROS) and lipid peroxidation with a significant increase in the PC 12 viability under HG conditions in comparison to pure AV; (4) conclusion: the nanocomplex of AV prepared to utilize natural polymers and antioxidants aided for high solubility of AV and exhibited desired neuroprotective activity.This can be one of the promisingstrategy to translate the AV nanocomplex with safety and efficacy in treating DN.
Cloning and Expression Analysis of Flavonoid 3′, 5′-Hydroxylase Gene from Brunfelsia acuminata
Authors: Li Min , Cao Yuting , Debnath Biswojit , Yang Hongjuan , Kui Xiaohua , Qiu Dongliang
Published: July 2021

The full-length cDNA sequence of F3′5′H gene from the Brunfelsia acuminata was obtained by RT-PCR and RACE, whose GenBank accession number is JQ678765. The sequence contains a 1521 bp open reading frame, 120 bp 5′UTR and 61 bp 3′UTR, encoding a total of 506 amino acids. The molecular mass of the predicted protein is 56.47 kDa with an estimated pI of 8.78, respectively. Sequence alignment showed that the amino acid sequence of F3′5′H was 91%, 87% and 84% with that of Petunia × hybrida, Nierembergia sp., Solanum tuberosum, respectively. Real-time quantitative PCR analysis showed that the expression of F3′5′H gene was different in petals of different days, which was the highest expression level on day 0 and significantly higher than other days. The results indicated that F3′5′H might play key role in flower color regulation and provide a theoretical reference for blue flower molecular breeding.
Heterozygous Nme7 Mutation Affects Glucose Tolerance in Male Rats
Authors: Šedová Lucie , Prochazka Jan , Zudová Dagmar , Bendlová Běla , Včelák Josef , Sedlacek Radislav , Šeda Ondřej
Published: July 2021

Complex metabolic conditions such as type 2 diabetes and obesity result from the interaction of numerous genetic and environmental factors. While the family of Nme proteins has been connected so far mostly to development, proliferation, or ciliary functions, several lines of evidence from human and experimental studies point to the potential involvement of one of its members, NME7 (non-metastatic cells 7, nucleoside diphosphate kinase 7) in carbohydrate and lipid metabolism. As a complete lack of Nme7 is semilethal in rats, we compared morphometric, metabolic, and transcriptomic profiles of standard diet-fed heterozygous Nme7+/− on male rats vs. their wild-type Nme7+/+ controls. Nme7+/− animals showed increased body weight, adiposity, higher insulin levels together with decreased glucose tolerance. Moreover, they displayed pancreatic islet fibrosis and kidney tubular damage. Despite no signs of overt liver steatosis or dyslipidemia, we found significant changes in the hepatic transcriptome of Nme7+/− male rats with a concerted increase of expression of lipogenic enzymes including Scd1, Fads1, Dhcr7 and a decrease of Cyp7b1 and Nme7. Network analyses suggested possible links between Nme7 and the activation of Srebf1 and Srebf2 upstream regulators. These results further support the implication of NME7 in the pathogenesis of glucose intolerance and adiposity.
Analysis of a Set of KDM5C Regulatory Genes Mutated in Neurodevelopmental Disorders Identifies Temporal Coexpression Brain Signatures
Authors: Poeta Loredana , Padula Agnese , Lioi Maria Brigida , van Bokhoven Hans , Miano Maria Giuseppina
Published: July 2021

Dysregulation of transcriptional pathways is observed in multiple forms of neurodevelopmental disorders (NDDs), such as intellectual disability (ID), epilepsy and autism spectrum disorder (ASD). We previously demonstrated that the NDD genes encoding lysine-specific demethylase 5C (KDM5C) and its transcriptional regulators Aristaless related-homeobox (ARX), PHD Finger Protein 8 (PHF8) and Zinc Finger Protein 711 (ZNF711) are functionally connected. Here, we show their relation to each other with respect to the expression levels in human and mouse datasets and in vivo mouse analysis indicating that the coexpression of these syntenic X-chromosomal genes is temporally regulated in brain areas and cellular sub-types. In co-immunoprecipitation assays, we found that the homeotic transcription factor ARX interacts with the histone demethylase PHF8, indicating that this transcriptional axis is highly intersected. Furthermore, the functional impact of pathogenic mutations of ARX, KDM5C, PHF8 and ZNF711 was tested in lymphoblastoid cell lines (LCLs) derived from children with varying levels of syndromic ID establishing the direct correlation between defects in the KDM5C-H3K4me3 pathway and ID severity. These findings reveal novel insights into epigenetic processes underpinning NDD pathogenesis and provide new avenues for assessing developmental timing and critical windows for potential treatments.
Effects of Cocoa Genotypes on Coat Color, Platelets and Coagulation Parameters in French Bulldogs
Authors: Laukner Anna , Truchet Laura , Manukjan Georgi , Schulze Harald , Langbein-Detsch Ines , Mueller Elisabeth , Leeb Tosso , Kehl Alexandra
Published: July 2021

A nonsense variant in HPS3, c.2420G>A or p.Trp807*, was recently discovered as the cause for a brown coat color termed cocoa in French Bulldogs. Here, we studied the genotype–phenotype correlation regarding coat color in HPS3 mutant dogs that carried various combinations of mutant alleles at other coat color genes. Different combinations of HPS3, MLPH and TYRP1 genotypes resulted in subtly different shades of brown coat colors. As HPS3 variants in humans cause the Hermansky–Pudlak syndrome type 3, which in addition to oculocutaneous albinism is characterized by a storage pool deficiency leading to bleeding tendency, we also investigated the phenotypic consequences of the HPS3 variant in French Bulldogs on hematological parameters. HPS3 mutant dogs had a significantly lowered platelet dense granules abundance. However, no increased bleeding tendencies in daily routine were reported by dog owners. We therefore conclude that in dogs, the phenotypic effect of the HPS3 variant is largely restricted to pigmentation. While an effect on platelet morphology is evident, we did not obtain any indications for major health problems associated with the cocoa coat color in French Bulldogs. Further studies will be necessary to definitely rule out very subtle effects on visual acuity or a clinically relevant bleeding disorder.
Fifteen Years of Continuous High-Resolution Borehole Strainmeter Measurements in Eastern Taiwan: An Overview and Perspectives
Authors: Canitano Alexandre , Mouyen Maxime , Hsu Ya-Ju , Linde Alan , Sacks Selwyn , Lee Hsin-Ming
Published: July 2021

As one of the most sensitive instruments for deformation monitoring in geophysics, borehole strainmeter has the capability to record a large spectrum of tectonic and environmental signals. Sensors are usually deployed near active faults and volcanoes and provide high-resolution continuous recordings of seismic and aseismic signals, hydrological variations (rainfall, groundwater level) and natural hazards (tropical cyclones, landslides, tsunamis). On the occasion of the 50th anniversary of the installation of the first Sacks–Evertson borehole strainmeter, in central Japan, we present an overview of the major scientific contributions and advances enabled by borehole strainmeter measurements in Taiwan since their installation in the mid 2000s. We also propose a set of future research directions that address recent challenges in seismology, hydrology and crustal strain modeling.
The Results of Applying Different Methodologies to 10 Years of Quantitative Precipitation Estimation in Catalonia Using Weather Radar
Authors: Rigo Tomeu , Llasat Maria Carmen , Esbrí Laura
Published: July 2021

The single polarization C-Band weather radar network of the Meteorological Service of Catalonia covers the entire region (32,000 km2), which allows it to apply a series of corrections that improve preliminary estimations of the rainfall field (hourly and daily). In addition, an automatic re-processing using automatic weather stations helps to incorporate ground-based information. The last process of the quantitative precipitation estimation (QPE) is running the end-product again eight days later, when the data have been reviewed and corrected in the case of detecting anomalies in the radar or gauge data. These corrections are applied operationally, with the fields generated and stored automatically. The QPE fields are generated in the GeoTIFF format, allowing easy use with multiple applications and simplifying processes such as quality control. In this way, the analysis of a 10 year period of GeoTIFF QPE daily data compared with ground rainfall values is introduced. The results help to understand different points regarding the functioning of the network such as the dependance on the type of precipitation and the seasonality. In addition, the description of a heavy rainfall episode (22 October 2019) shows the variations and improvements in the different products. The main conclusions refer to how using GeoTIFF combined with point data (rain gauges), it is possible to ensure simple but effective quality control of an operational radar network.
Introduction—Special Issue “Dystopian Scenarios in Contemporary Australian Narrative”
Authors: Herrero Dolores , Royo-Grasa Pilar
Published: July 2021

The main aim of this Special Issue is to expose how a variety of contemporary Australian dystopias delve into a number of worrying global issues, thus making it clear that our contemporary world is already corroborating and bearing witness to a number of futuristic nightmares [...]
The Economic Burden Associated with the Management of Different Stages of Breast Cancer: A Retrospective Cost of Illness Analysis in Saudi Arabia
Authors: Alghamdi Ahmed , Balkhi Bander , Alqahtani Shahad , Almotairi Hamoud
Published: July 2021

Globally, breast cancer management is associated with a heavy economic burden, but its impact in Saudi Arabia has not been fully quantified. The aim of this study was to estimate the economic burden of breast cancer management at various disease stages, in Saudi Arabia, from a payer perspective. We conducted a retrospective, multicenter cost of illness study in two governmental healthcare centers from January to December 2018, using the data of 300 patients at different breast cancer stages. A micro-costing, bottom-up method was used, and descriptive and inferential statistics were analyzed. The total estimated cost for treating breast cancer during the study period was $13.345 million USD, with the average cost per patient ranging from $14,249 USD in stage I to $81,489 USD in stage IV (p < 0.001). Medication cost was the main driver of total healthcare spending, followed by hospitalization and diagnostic tests. The cost of targeted therapy drugs represented 67% of the total medication costs, mostly driven by trastuzumab-based regimens. The economic burden of breast cancer management in Saudi Arabia is substantial and increases significantly with disease advancement. Early detection screening programs, evaluating the value of highly expensive interventions, and considering biosimilars, may contribute toward cost savings.
A Short Mindfulness Retreat for Students to Reduce Stress and Promote Self-Compassion: Pilot Randomised Controlled Trial Exploring Both an Indoor and a Natural Outdoor Retreat Setting
Authors: Djernis Dorthe , O’Toole Mia S. , Fjorback Lone O. , Svenningsen Helle , Mehlsen Mimi Y. , Stigsdotter Ulrika K. , Dahlgaard Jesper
Published: July 2021

Here, we developed and examined a new way of disseminating mindfulness in nature to people without meditation experience, based on the finding that mindfulness conducted in natural settings may have added benefits. We evaluated a 5-day residential programme aiming to reduce stress and improve mental health outcomes. We compared an indoor and an outdoor version of the programme to a control group in a pilot randomised controlled trial (RCT). Sixty Danish university students experiencing moderate to high levels of stress were randomised into a residential mindfulness programme indoors (n = 20), in nature (n = 22), or a control group (n = 18). Participants completed the Perceived Stress Scale and the Self-Compassion Scale (primary outcomes) along with additional secondary outcome measures at the start and end of the program and 3 months after. Stress was decreased with small to medium effect sizes post-intervention, although not statistically significant. Self-compassion increased post-intervention, but effect sizes were small and not significant. At follow-up, changes in stress were not significant, however self-compassion increased for both interventions with medium-sized effects. For the intervention groups, medium- to large-sized positive effects on trait mindfulness after a behavioural task were found post-intervention, and small- to medium-sized effects in self-reported mindfulness were seen at follow-up. Connectedness to Nature was the only outcome measure with an incremental effect in nature, exceeding the control with a medium-sized effect at follow-up. All participants in the nature arm completed the intervention, and so did 97% of the participants in all three arms. Overall, the results encourage the conduct of a larger-scale RCT, but only after adjusting some elements of the programme to better fit and take advantage of the potential benefits of the natural environment.
The Effect of Post-Graduate Year Training on the Self-Efficacy and Emotional Traits of Physicians Facing the COVID-19 Pandemic
Authors: Chen Chih-Hung , Cheng Ya-Hui , Shen Yuan-Chi , Kung Chia-Te , Chien Peng-Chen , Hsieh Ching-Hua
Published: July 2021

Background: Taiwan implemented the post-graduate year (PGY) training to reform the medical education system to provide holistic medical care after severe acute respiratory syndrome in 2003. In late 2019, COVID-19 quickly spread across the globe and became a pandemic crisis. This study aimed to investigate whether the establishment of the PGY training had positive effects on the self-efficacy and emotional traits of medical workers. Methods: One hundred and ten physicians, including PGY, residents, and visiting staff, were investigated using the General Self-Efficacy Scale (GSES) and Emotional Trait and State Scale (ETSS), and their feedback and suggestions were collected. An exploratory factor analysis was done to reduce the factor dimensions using the varimax rotation method, which was reduced to four factors: “the ability to cope with ease”, “proactive ability”, “negative emotion”, and “positive emotion”. A comparison with and without PGY training when facing the COVID-19 pandemic was conducted. Results: Those who had received PGY training (n = 77) were younger, had a lower grade of seniority, and had less practical experience than those who had not received PGY (n = 33). Those who had received PGY training had significantly higher scores for the factors “ability to cope with ease”, “proactive ability”, and “positive emotion” than those who had not received PGY training. Conclusion: The study revealed that PGY training may have had positive effects on the personal self-efficacy and emotional traits of physicians coping with the COVID-19 pandemic.
CAR-T Cell Therapy for the Treatment of ALL: Eradication Conditions and In Silico Experimentation
Authors: Valle Paul , Coria Luis , Plata Corina , Salazar Yolocuauhtli
Published: July 2021

In this paper, we explore the application of Chimeric Antigen Receptor (CAR) T cell therapy for the treatment of Acute Lymphocytic Leukaemia (ALL) by means of in silico experimentation, mathematical modelling through first-order Ordinary Differential Equations and nonlinear systems theory. By combining the latter with systems biology on cancer evolution we were able to establish a sufficient condition on the therapy dose to ensure complete response. The latter is illustrated across multiple numerical simulations when comparing three mathematically formulated administration protocols with one of a phase 1 dose-escalation trial on CAR-T cells for the treatment of ALL on children and young adults. Therefore, both our analytical and in silico results are consistent with real-life scenarios. Finally, our research indicates that tumour cells growth rate and the killing efficacy of the therapy are key factors in the designing of personalised strategies for cancer treatment.
Identification of Pre-1950 Synthetic Organic Pigments in Artists’ Paints. A Non-Invasive Approach Using Handheld Raman Spectroscopy
Authors: Pause Rika , van der Werf Inez Dorothé , van den Berg Klaas Jan
Published: July 2021

There is little information on the actual use of early synthetic organic pigments (SOPs) in art objects, especially those from before 1950. Their presence can, however, pose a challenge to conservation because their chemical composition, as well as their lightfastness and sensitivity to solvents, are often unknown. Here, a study on the non-invasive identification of SOPs in historic pre-1950 varnished paint-outs from artists’ materials manufacturer Royal Talens is presented. The paints were analysed using a handheld Raman device. Spectra were evaluated by recording the spectra of the same samples with a benchtop instrument. This study demonstrated that the identification of SOPs in varnished oil paints with a non-invasive approach is possible and rather straightforward. The handheld Raman device allowed us to identify fourteen SOPs from eight pigment classes. Besides the occurrence of expected and the known SOPs of this time period, there were also some surprising results, like the detection of the triarylcarbonium pigments PG2 and PB8, and the monoazo Mordant Yellow 1.
Viral Load Difference between Symptomatic and Asymptomatic COVID-19 Patients: Systematic Review and Meta-Analysis
Authors: Zuin Marco , Gentili Valentina , Cervellati Carlo , Rizzo Roberta , Zuliani Giovanni
Published: July 2021

We conducted a systematic review and meta-analysis to investigate the possible difference in the SARS-CoV-2 viral load between asymptomatic and symptomatic COVID-19 patients. Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed in abstracting data and assessing validity. We searched MEDLINE, Scopus, Web of Science and Google Scholar for all investigations in the English language, reporting data on the threshold cycle (Ct) from real-time RT-PCR assays for the RNA-dependent RNA polymerase (RdRp), envelope (E) and nucleocapsid (N) SARS-CoV-2 genes in asymptomatic and symptomatic COVID-19 patients. Results: Overall, 703 COVID-19 patients (553 symptomatic and 150 asymptomatic) were analyzed. Five investigations reported the mean age of patients, evidencing that asymptomatic patients were younger than symptomatic patients (34.0 vs. 40.3 years, respectively). Pooled data regarding the levels of expression of the RdRp gene revealed no significant difference between symptomatic and asymptomatic subjects. Similarly, no differences were observed comparing the mean Ct values for the E and N genes. Based on real-time RT-PCR data, no differences exist in the viral load between symptomatic and asymptomatic COVID-19 subjects considering Ct values for RdRp, E and N genes’ expression. Asymptomatic subjects may represent a reservoir of the infection and significantly contribute to the maintenance of the pandemic.
The Impact of Government Subsidies on the Low-Carbon Supply Chain Based on Carbon Emission Reduction Level
Authors: Li Biao , Geng Yong , Xia Xiqiang , Qiao Dan
Published: July 2021

To improve low-carbon technology, the government has shifted its strategy from subsidizing low-carbon products (LCP) to low-carbon technology. To analyze the impact of government subsidies based on carbon emission reduction levels on different entities in the low-carbon supply chain (LCSC), game theory is used to model the provision of government subsidies to low-carbon enterprises and retailers. The main findings of the paper are that a government subsidy strategy based on carbon emission reduction levels can effectively drive low-carbon enterprises to further reduce the carbon emissions. The government’s choice of subsidy has the same effect on the LCP retail price per unit, the sales volume, and the revenue of low-carbon products per unit. When the government subsidizes the retailer, the low-carbon product wholesale price per unit is the highest. That is, low-carbon enterprises use up part of the government subsidies by increasing the wholesale price of low-carbon products. The retail price of low-carbon products per unit is lower than the retail price of low-carbon products in the context of decentralized decision making, but the sales volume and revenue of low-carbon products are greater in the centralized decision-making. The cost–benefit-sharing contract could enable the decentralized decision model to achieve the same level of profit as the centralized decision model.
Occupational Health: Does Compliance with Physical Activity Recommendations Have a Preventive Effect on Musculoskeletal Symptoms in Computer Workers? A Cross-Sectional Study
Authors: Moreira Sara , Ferreira Maria Salomé , Criado Maria Begoña , Machado Jorge , Mesquita Cristina , Lopes Sofia , Santos Paula Clara
Published: July 2021

A lack of physical activity in computer workers (CW) can contribute to the development of musculoskeletal symptoms (MSS). Aim: (i) Evaluate MSS over a 12 month and 7 days period, (ii) determine physical activity (PA) levels and compliance with World Health Organization (WHO) PA recommendations, and (iii) assess the relationship between compliance with WHO PA recommendations and MSS. Methods: A cross-sectional observational study comprising 119 computer workers. The Nordic Musculoskeletal Questionnaire (NMQ) was used to evaluate the MSS and the International Physical Activity Questionnaire (IPAQ) was used to analyse the perception of the level of PA. Results: MSS occurred in the lumbar region (56.3%), neck (43.7%), and shoulders (39.5%). 44.7% of the participants reported a low level of PA. The percentage of compliance was similar among women and men (62.2% vs. 58.5%, respectively). Negative correlations were found between pain intensity and metabolic equivalent values. The participants who followed the WHO PA recommendations reported a lower frequency of MSS compared to those who did not, but the differences were not statistically significant. Conclusion: It was possible to conclude that computer workers presented a higher frequency of MSS in the lower back, neck, and shoulders. Regarding the level of PA, participants were mostly classified as low. Participants who followed the WHO PA recommendations reported lower MSS than those who did not. This finding could be important in obtaining successful programs that promote health-oriented physical activity in this group of workers.
Italians Are the Fastest 3000 m Open-Water Master Swimmers in the World
Authors: Seffrin Aldo , Lira Claudio A. B. , Vancini Rodrigo L. , Santos Douglas A. T. , Moser Cathia , Villiger Elias , Rosemann Thomas , Knechtle Beat , Hill Lee , Andrade Marilia S.
Published: July 2021

Background: It is well known that athletes originating from a specific region or country can master specific sports disciplines (e.g., East-African runners in long-distance running). In addition, physical and athletic performance are the result of an interaction between genetic, environmental and epigenetic factors. However, little is known about on what determines sports success and performance for long-distance master swimmers such as origin. The aim of the study was to investigate the participation and performance trends of elite master open-water swimmers competing in the World Championships (WC) in 3000 m open-water swimming between 1986 and 2019. Methods: A total of 9247 valid participants were analyzed using generalized linear models (GLMs) with a gamma probability distribution and log link function. Resultsː Most of the starters were from Italy (1646 participations), followed by the United States of America (USA) (1128 participations) and Germany (959 participations). Swimmers from Italy were significantly faster than swimmers from Canada, Germany, USA, Great Britain and also from all other countries grouped (p < 0.005). The age group from 35–39 years old was significantly faster than athletes from age groups of 25–29 years old, 30–34 years old, 40–44 years old, 45–49 years old and 50–54 years old (p < 0.005). The percentage of local athletes in WC was 36% and varied from 36% (Italy, 2004) to 43 % (Germany), 53% (Italy, 2012) and up to 68 % (USA, 1992). Conclusions: Swimmers from Italy were the faster and the most numerous starters during this period of 27 years and 15 editions all over the world in 3000 m master open-water swimming.
A Multivariate Age-Structured Stochastic Model with Immunization Strategies to Describe Bronchiolitis Dynamics
Authors: López-Lacort Mónica , Corberán-Vallet Ana , Santonja Gómez Francisco J.
Published: July 2021

Bronchiolitis has a high morbidity in children under 2 years old. Respiratory syncytial virus (RSV) is the most common pathogen causing the disease. At present, there is only a costly humanized monoclonal RSV-specific antibody to prevent RSV. However, different immunization strategies are being developed. Hence, evaluation and comparison of their impact is important for policymakers. The analysis of the disease with a Bayesian stochastic compartmental model provided an improved and more natural description of its dynamics. However, the consideration of different age groups is still needed, since disease transmission greatly varies with age. In this work, we propose a multivariate age-structured stochastic model to understand bronchiolitis dynamics in children younger than 2 years of age considering high-quality data from the Valencia health system integrated database. Our modeling approach combines ideas from compartmental models and Bayesian hierarchical Poisson models in a novel way. Finally, we develop an extension of the model that simulates the effect of potential newborn immunization scenarios on the burden of disease. We provide an app tool that estimates the expected reduction in bronchiolitis episodes for a range of different values of uptake and effectiveness.
Disparities in Methods Used to Determine Microplastics in the Aquatic Environment: A Review of Legislation, Sampling Process and Instrumental Analysis
Authors: Halfar Jan , Brožová Kateřina , Čabanová Kristina , Heviánková Silvie , Kašpárková Alena , Olšovská Eva
Published: July 2021

Plastic particles smaller than 5 mm, i.e., microplastics, have been detected in a number of environments. The number of studies on microplastics in marine environments, fresh water, wastewater, the atmosphere, and the human body are increasing along with a rise in the amounts of plastic materials introduced into the environment every year, all contributing to a range of health and environmental issues. Although the use of primary microplastics has been gradually reduced by recent legislation in many countries, new knowledge and data on these problems are needed to understand the overall lifecycle of secondary microplastics in particular. The aim of this review is to provide unified information on the pathways of microplastics into the environment, their degradation, and related legislation, with a special focus on the methods of their sampling, determination, and instrumental analysis. To deal with the health and environmental issues associated with the abundance of microplastics in the environment, researchers should focus on agreeing on a uniform methodology to determine the gravity of the problem through obtaining comparable data, thus leading to new and stricter legislation enforcing more sustainable plastic production and recycling, and hopefully contributing to reversing the trend of high amounts of microplastics worldwide.
Impact of COVID-19 Pandemic on Sleep Quality, Stress Level and Health-Related Quality of Life—A Large Prospective Cohort Study on Adult Danes
Authors: Didriksen Maria , Werge Thomas , Nissen Janna , Schwinn Michael , Sørensen Erik , Nielsen Kaspar R. , Bruun Mie T. , Banasik Karina , Hansen Thomas F. , Erikstrup Christian , Ostrowski Sisse R. , Jennum Poul J. , Hjalgrim Henrik , Ullum Henrik , Pedersen Ole B.
Published: July 2021

The everyday lives of Danish inhabitants have been affected by the COVID-19 pandemic, e.g., by social distancing, which was employed by the government in March 2020 to prevent the spread of SARS-CoV-2. Moreover, the pandemic has entailed economic consequences for many people. This study aims to assess changes in physical and mental health-related quality of life (MCS, PCS), in stress levels, and quality of sleep during the COVID-19 pandemic and to identify factors that impact such changes, using a prospective national cohort study including 26,453 participants from the Danish Blood Donor Study who answered a health questionnaire before the pandemic and during the pandemic. Descriptive statistics, multivariable linear and multinomial logistic regression analyses were applied. A worsening of MCS and quality of sleep was found, and an overall decrease in stress levels was observed. PCS was decreased in men and slightly increased in women. The extent of health changes was mainly affected by changes in job situation, type of job, previous use of anti-depressive medication and the participants’ level of personal stamina. Thus, living under the unusual circumstances that persisted during the COVID-19 pandemic has had a negative impact on the health of the general population. This may, in time, constitute a public health problem.
Can a Knee Brace Prevent ACL Reinjury: A Systematic Review
Authors: Marois Bianca , Tan Xue Wei , Pauyo Thierry , Dodin Philippe , Ballaz Laurent , Nault Marie-Lyne
Published: July 2021

This systematic review aimed to investigate whether the use of a knee brace when returning to sport (RTS) could prevent a second injury after anterior cruciate ligament reconstruction (ACLR). This study was registered with the PROSPERO database and followed PRISMA guidelines. A systematic search of PubMed, Ovid Medline, Ovid All EBM Reviews, Ovid Embase, EBSCO Sportdiscus and ISI Web of Science databases for meta-analysis, randomized controlled trials and prospective cohort studies published before July 2020 was undertaken. The inclusion criteria were: (1) Comparing with and without a brace at RTS, (2) follow up of at least 18 months after ACLR, (3) reinjury rates included in the outcomes. Two reviewers independently extracted the data. Quality appraisal analyses were performed for each study using the Cochrane Collaboration tools for randomized and nonrandomized trials. A total of 1196 patients in three studies were included. One study showed a lower rate of reinjury when wearing a knee brace at RTS. One study found the knee brace to have a significant protective effect for younger patients (≤17 years). The effectiveness of knee bracing when RTS remains ambiguous. Current data cannot support that using a knee brace when RTS will decrease the rate of reinjury after ACL reconstruction.
Effects of 1 Year of Lifestyle Intervention on Institutionalized Older Adults
Authors: Magistro Daniele , Carlevaro Fabio , Magno Francesca , Simon Martina , Camp Nicola , Kinrade Noel , Zecca Massimiliano , Musella Giovanni
Published: July 2021

The socio-economic and health consequences of our ageing population are well documented, with older adults living in long-term care facilities amongst the frailest possessing specific and significant healthcare and social care needs. These needs may be exacerbated through the sedentary behaviour which is prevalent within care home settings. Reducing sedentary time can reduce the risk of many diseases and improve functional health, implying that improvements in health may be gained by simply helping older adults substitute time spent sitting with time spent standing or in light-intensity ambulation. This study identified the impact of 1 year of lifestyle intervention in a group of older adults living in a long-term care setting in Italy. One hundred and eleven older adults (mean age, 82.37 years; SD = 10.55 years) participated in the study. Sixty-nine older adults were in the intervention group (35 without severe cognitive decline and 34 with dementia) and 42 older adults were in the control group. Data on physical functioning, basic activities of daily living (BADL) and mood were collected 4 times, before, during (every four months) and after the 1 year of intervention. The lifestyle intervention focused on improving the amount of time spent every week in active behaviour and physical activity (minimum 150 min of weekly activities). All participants completed the training program and no adverse events, related to the program, occurred. The intervention group showed steady and significant improvements in physical functioning and a stable situation in BADL and mood following the intervention in older adults with and without dementia, whilst the control group exhibited a significant decline over time. These results suggest that engagement in a physical activity intervention may benefit care home residents with and without dementia both physically and mentally, leading to improved social care and a reduced burden on healthcare services.
Association of Tooth Scaling with Acute Myocardial Infarction and Analysis of the Corresponding Medical Expenditure: A Nationwide Population-Based Study
Authors: Kao Yi-Wei , Shia Ben-Chang , Chiang Huei-Chen , Chen Mingchih , Wu Szu-Yuan
Published: July 2021

Accumulating evidence has shown a significant correlation between periodontal diseases and systemic diseases. In this study, we investigated the association between the frequency of tooth scaling and acute myocardial infarction (AMI). Here, a group of 7164 participants who underwent tooth scaling was compared with another group of 7164 participants without tooth scaling through propensity score matching to assess AMI risk by Cox’s proportional hazard regression. The results show that the hazard ratio of AMI from the tooth scaling group was 0.543 (0.441, 0.670) and the average expenses of AMI in the follow up period was USD 265.76, while the average expenses of AMI in follow up period for control group was USD 292.47. The tooth scaling group was further divided into two subgroups, namely A and B, to check the influence of tooth scaling frequency on AMI risk. We observed that (1) the incidence rate of AMI in the group without any tooth scaling was 3.5%, which is significantly higher than the incidence of 1.9% in the group with tooth scaling; (2) the tooth scaling group had lower total medical expenditures than those of the other group because of the high medical expenditure associated with AMI; and (3) participants who underwent tooth scaling had a lower AMI risk than those who never underwent tooth scaling had. Therefore, the results of this study demonstrate the importance of preventive medicine.
Peripherally Inserted Central Catheter Placement in a Cardiology Ward: A Focus Group Study of Nurses’ Perspectives
Authors: Salgueiro-Oliveira Anabela , Bernardes Rafael A. , Adriano David , Serambeque Beatriz , Santos-Costa Paulo , Sousa Liliana B. , Gama Fernando , Barroca Rita , Braga Luciene M. , Graveto João , Parreira Pedro
Published: July 2021

Intravenous therapy administration through peripheral venous catheters is one of the most common nursing procedures performed in clinical contexts. However, peripherally inserted central catheters (PICC) remain insufficiently used by nurses and can be considered a potential alternative for patients who need aggressive intravenous therapy and/or therapy for extended periods. The purpose of this study was to understand nurses’ perspectives about PICC implementation in their clinical practice. As part of an action-research project, three focus groups were developed in June 2019 with nineteen nurses of a cardiology ward from a Portuguese tertiary hospital. From the content analysis, two main categories emerged: ‘nursing practices’ and ‘patients’. Nurses considered PICC beneficial for their clinical practice because it facilitates maintenance care and catheter replacement rates. Moreover, nurses suggested that, since there is a need for specific skills, the constitution of vascular access teams, as recommended by international guidelines, could be an advantage. Regarding patient benefits, nurses highlighted a decrease in the number of venipunctures and also of patient discomfort, which was associated with the number of peripheral venous catheters. Infection prevention was also indicated. As an emerging medical device used among clinicians, peripherally inserted central catheters seem to be essential to clinical practice.
The Oxygen Transport Triad in High-Altitude Pulmonary Edema: A Perspective from the High Andes
Authors: Zubieta-Calleja Gustavo , Zubieta-DeUrioste Natalia
Published: July 2021

Acute high-altitude illnesses are of great concern for physicians and people traveling to high altitude. Our recent article “Acute Mountain Sickness, High-Altitude Pulmonary Edema and High-Altitude Cerebral Edema, a View from the High Andes” was questioned by some sea-level high-altitude experts. As a result of this, we answer some observations and further explain our opinion on these diseases. High-Altitude Pulmonary Edema (HAPE) can be better understood through the Oxygen Transport Triad, which involves the pneumo-dynamic pump (ventilation), the hemo-dynamic pump (heart and circulation), and hemoglobin. The two pumps are the first physiologic response upon initial exposure to hypobaric hypoxia. Hemoglobin is the balancing energy-saving time-evolving equilibrating factor. The acid-base balance must be adequately interpreted using the high-altitude Van Slyke correction factors. Pulse-oximetry measurements during breath-holding at high altitude allow for the evaluation of high altitude diseases. The Tolerance to Hypoxia Formula shows that, paradoxically, the higher the altitude, the more tolerance to hypoxia. In order to survive, all organisms adapt physiologically and optimally to the high-altitude environment, and there cannot be any “loss of adaptation”. A favorable evolution in HAPE and pulmonary hypertension can result from the oxygen treatment along with other measures.
What Affects Quality of Life for People with Type 1 Diabetes?: A Cross-Sectional Observational Study
Authors: Cho Mi-Kyoung , Kim Mi-Young
Published: July 2021

This study investigated the association between the quality of life (QOL) and type 1 diabetes mellitus (DM), a lifelong disease that requires constant management. A complex set of factors influence the QOL of people with type 1 DM, and understanding these factors requires further research. This research is a cross-sectional descriptive study. A survey on related variables such as acceptance of disease and efficacy for self-management of diabetes, was conducted among 111 participants with type 1 DM. The collected data were analyzed using PASW Statistics program, and factors influencing participants’ QOL were identified through hierarchical multiple regression. The study followed the Guidelines of Systematic Reporting of Examination in the STROBE checklist. The results showed that four variables exerted a significant effect on QOL (blood glucose level at hypoglycemia and complications in Model 1; efficacy for self-management of diabetes and acceptance and action in Model 2), and all the variables explained a majority of the variance in QOL. The results indicate that management of severe hypoglycemia and prevention of complications is crucial. Interventions should be developed to enhance coping abilities to improve efficacy for self-management for those with diabetes and promote their acceptance of the disease.
Characteristics and Trends of the Hospital Standardized Readmission Ratios for Pneumonia: A Retrospective Observational Study Using Japanese Administrative Claims Data from 2010 to 2018
Authors: Onishi Ryo , Hatakeyama Yosuke , Matsumoto Kunichika , Seto Kanako , Hirata Koki , Hasegawa Tomonori
Published: July 2021

Previous studies indicated that optimal care for pneumonia during hospitalization might reduce the risk of in-hospital mortality and subsequent readmission. This study was a retrospective observational study using Japanese administrative claims data from April 2010 to March 2019. We analyzed data from 167,120 inpatients with pneumonia ≥15 years old in the benchmarking project managed by All Japan Hospital Association. Hospital-level risk-adjusted ratios of 30-day readmission for pneumonia were calculated using multivariable logistic regression analyses. The Spearman’s correlation coefficient was used to assess the correlation in each consecutive period. In the analysis using complete 9-year data including 54,756 inpatients, the hospital standardized readmission ratios (HSRRs) showed wide variation among hospitals and improvement trend (r = −0.18, p = 0.03). In the analyses of trends in each consecutive period, the HSRRS were positively correlated between ‘2010–2012’ and ‘2013–2015’ (r = 0.255, p = 0.010), and ‘2013–2015’ and ‘2016–2018’ (r = 0.603, p < 0.001). This study denoted the HSRRs for pneumonia could be calculated using Japanese administrative claims data. The HSRRs significantly varied among hospitals with comparable case-mix, and could relatively evaluate the quality of preventing readmission including long-term trends. The HSRRs can be used as yet another measure to help improve quality of care over time if other indicators are examined in parallel.
Exploring Factors for Predicting Anxiety Disorders of the Elderly Living Alone in South Korea Using Interpretable Machine Learning: A Population-Based Study
Authors: Byeon Haewon
Published: July 2021

This epidemiological study aimed to develop an X-AI that could explain groups with a high anxiety disorder risk in old age. To achieve this objective, (1) this study explored the predictors of senile anxiety using base models and meta models. (2) This study presented decision tree visualization that could help psychiatric consultants and primary physicians easily interpret the path of predicting high-risk groups based on major predictors derived from final machine learning models with the best performance. This study analyzed 1558 elderly (695 males and 863 females) who were 60 years or older and completed the Zung’s Self-Rating Anxiety Scale (SAS). We used support vector machine (SVM), random forest, LightGBM, and Adaboost for the base model, a single predictive model, while using XGBoost algorithm for the meta model. The analysis results confirmed that the predictive performance of the “SVM + Random forest + LightGBM + AdaBoost + XGBoost model (stacking ensemble: accuracy 87.4%, precision 85.1%, recall 87.4%, and F1-score 85.5%)” was the best. Also, the results of this study showed that the elderly who often (or mostly) felt subjective loneliness, had a Self Esteem Scale score of 26 or less, and had a subjective communication with their family of 4 or less (on a 10-point scale) were the group with the highest risk anxiety disorder. The results of this study imply that it is necessary to establish a community-based mental health policy that can identify elderly groups with high anxiety risks based on multiple risk factors and manage them constantly.
“Suck It Up, Buttercup”: Understanding and Overcoming Gender Disparities in Policing
Authors: Angehrn Andréanne , Fletcher Amber J. , Carleton R. Nicholas
Published: July 2021

Women police officers report elevated symptoms of mental disorders when compared to men police officers. Researchers have indicated that the occupational experience of policing differs greatly among men and women. Indeed, police culture is characterized by hegemonic masculinity, which appears to negatively impact both men and women. The current study examined the contrast between the experiences of men and women police officers. Police officers (n = 17; 9 women) in Saskatchewan participated in semi-structured interviews. Thematic network analysis identified themes related to the experience of policing for both men and women police officers. There were six organizing themes identified in relation to the global theme of Gendered Experiences: (1) Discrimination; (2) Sexual Harassment; (3) Motherhood and Parental Leave; (4) Identity; (5) Stereotypically Feminine Attributes; and (6) Hegemonic Masculinity. Pervasive gender norms appear detrimental for both men and women police officers, as well as the communities they serve. The current results, coupled with the emerging disposition for progress expressed by police services, offer opportunities to develop tailored and focused interventions and policies to support police officers.