bluuebunny/crossref_metadata_2025 huggingface dataset:
COVID-19, Non-Communicable Diseases, and Behavioral Factors in the Peruvian Population ≥ 15 Years: An Ecological Study during the First and Second Year of the COVID-19 Pandemic
Authors: Canorio Jordan , Sánchez Flor , Ramírez-Soto Max Carlos
Published: September 2022

A range of health-related and behavioral risk factors are associated with COVID-19 incidence and mortality. In the present study, we assess the association between incidence, mortality, and case fatality rate due to COVID-19 and the prevalence of hypertension, obesity, overweight, tobacco and alcohol use in the Peruvian population aged ≥15 years during the first and second year of the COVID-19 pandemic. In this ecological study, we used the prevalence rates of hypertension, overweight, obesity, tobacco, and alcohol use obtained from the Encuesta Demográfica y de Salud Familiar (ENDES) 2020 and 2021. We estimated the crude incidence and mortality rates (per 100,000 habitants) and case fatality rate (%) of COVID-19 in 25 Peruvian regions using data from the Peruvian Ministry of Health that were accurate as of 31 December 2021. Spearman correlation and lineal regression analysis was applied to assess the correlations between the study variables as well as multivariable regression analysis adjusted by confounding factors affecting the incidence and mortality rate and case fatality rate of COVID-19. In 2020, adjusted by confounding factors, the prevalence rate of obesity (β = 0.582; p = 0.037) was found to be associated with the COVID-19 mortality rate (per 100,000 habitants). There was also an association between obesity and the COVID-19 case fatality rate (β = 0.993; p = 0.014). In 2021, the prevalence of obesity was also found to be associated with the COVID-19 mortality rate (β = 0.713; p = 0.028); however, adjusted by confounding factors, including COVID-19 vaccination coverage rates, no association was found between the obesity prevalence and the COVID-19 mortality rate (β = 0.031; p = 0.895). In summary, Peruvian regions with higher obesity prevalence rates had higher COVID-19 mortality and case fatality rates during the first year of the COVID-19 pandemic. However, adjusted by the COVID-19 vaccination coverage, no association between the obesity prevalence rate and the COVID-19 mortality rate was found during the second year of the COVID-19 pandemic.
Understanding Health Literacy among University Health Science Students of Different Nationalities
Authors: Bánfai-Csonka Henrietta , Bánfai Bálint , Jeges Sára , Betlehem József
Published: September 2022

An adequate level of health literacy is essential for clear communication between patients and health care workers. The internationalization of universities is increasing in the field of health care. The aims of our research were to measure (1) the level of health literacy and its correlation among university students and (2) the relationship between the different instruments measuring health literacy. A cross-sectional study was conducted in the 2020/2021 academic year. The questionnaire included questions on sociodemographic status, study data, health status, and health literacy level. According to the HLS-EU-Q16 health literacy questionnaire, more than half of the students had a limited HL level in disease prevention (52.4%) and health promotion (58.4%) subindexes. Nationality was found to be an influencing factor (p < 0.001). According to the NVS, 80.1% of the students had an adequate HL level. A significant correlation was found between the results and nationality (p = 0.005). None of the Chew questions demonstrated a correlation with nationality (q1 p = 0.269, q2 p = 0.368, q3 p = 0.528). Nationality is a key factor in the level of subjective and functional health literacy. We need to measure both types of levels to see the real results.
Prevalence and Distribution of Hard Ticks and Their Associated Risk Factors in Sheep and Goats from Four Agro-Climatic Zones of Khyber Pakhtunkhwa (KPK), Pakistan
Authors: Iqbal Zubaria , Kayani Amjad Rashid , Akhter Ali , Qayyum Mazhar
Published: September 2022

Hard ticks are blood-sucking ectoparasites infesting all types of domestic ruminants throughout the world and serve as vectors in the dissemination of a wide variety of pathogens. Sheep and goat farming is a vital economic source for resource-poor farming communities in the Khyber Pakhtunkhwa (KPK) province of Pakistan. Aim: The aim of present study is to study the epidemiological profile of ticks in various agro-climatic zones of KPK. Materials and Methods: A total of 1500 (882 sheep and 618 goats) of all age groups and sexes were examined for the presence of ticks belonging to six districts in four agro-climatic zones of KPK province, Pakistan. Non-probability sampling was undertaken based on animal hosts’ selection, collection of hard ticks, and epidemiological parameters. Ticks collected from sheep and goats were identified phenotypically using standard keys. Results: The results revealed that Rhipicephalus microplus (36.2%) was the predominant tick species followed by Hyalomma anatolicum (25.2%), Hyalomma trancatum (18.1%), Hyalomma aegyptium (11.3%), Hyalomma asiaticum (6.9%), and Haemephysalis bispinosa (2.4%). Different epidemiological parameters showed that weather, humidity, and host age negatively affect (p < 0.05) tick load while temperatures (Minimum and Maximum), sunshine (hrs), and precipitation positively affected (p < 0.05) tick load. Host sex only showed a positive association with tick load (p > 0.05). The highest value of tick diversity index (H) 0.36748 was noted for Hyalomma anatolicum as this tick species was commonly distributed in three agro-climatic zones except in the Suleiman Piedmont zone, while Haemaphysalis bispinosa has the lowest diversity index (0.0334) as it was only found in the Central Valley Plains zone of KPK. The Shannon diversity index of tick diversity was highest at Barikot while the lowest index value was at Kabal (2.407). Similarly, a higher Simpson’s diversity index was at Barikot (0.9554) and the lowest hard index was noted at Takht bai (2.874). The dominance index showed that the tick species were more dominant at Takht bai (0.1251), while the lowest dominance was at Barikot (0.04465). Conclusions: It has been concluded that tick diversity and distribution, abundance, reproduction, development, and survival depend on prevailing climatic conditions. The present study would not only help to identify the tick species but also facilitate in devising effective control measures to minimize the transmission pathogens in sheep and goats being reared in the various agro-climatic zones of KPK province, Pakistan.
Oral Health Behaviours, Knowledge, and Literacy of Expectant Mothers: A Cross-Sectional Study among Maternity Ward Patients
Authors: Chawłowska Ewelina , Karasiewicz Monika , Lipiak Agnieszka , Staszewski Rafał , Cofta Mateusz , Biskupska Maria , Giernaś Bogusz , Zawiejska Agnieszka
Published: September 2022

Maternal knowledge, literacy, and behaviours in the area of oral health may greatly influence the risk of caries and the oral health status of children from the youngest age. Thus, the aim of the study was to investigate paediatric oral health knowledge and literacy as well as maternal oral health behaviours and outcomes among expectant mothers. A cross-sectional study was undertaken among 400 pregnant inpatients aged 17–48 years (mean age 29.5 ± 5.3 years) in 31 public maternity wards in the Wielkopolska region, Poland. An anonymous, self-designed questionnaire was prepared on the basis of current oral health recommendations. Pregnancy complications were reported by 195 (48.8%), and permanent tooth extractions by 158 (39.5%) women. Knowledge and literacy scores were associated with, among other things, maternal education, selected oral hygiene practices, and reported extractions of permanent teeth. Although participants had some correct information regarding oral health, they had insufficient awareness of caries as an infectious disease and of the appropriate timing for the child’s first dental visit. Their self-assessment of oral health status and belief that they were under dental care tended to be overly optimistic, given their self-reported outcomes. These aspects should be considered in future health education efforts among expectant women.
Association of Metabolically Healthy Obesity and Glomerular Filtration Rate among Male Steelworkers in North China
Authors: Yu Miao , Zhang Shengkui , Wang Lihua , Feng Hongman , Li Xiaoming , Wu Jianhui , Yuan Juxiang
Published: September 2022

This study aims to investigate the association between metabolically healthy obesity (MHO) and the early stages of renal dysfunction and whether systemic inflammation affects the study’s outcome. Male steelworkers in northern China were investigated in this cross-sectional survey (n = 6309). A decrease in estimated glomerular filtration rate (eGFR) was used as the primary outcome, which was defined as an eGFR of ≤89 mL/min/1.73 m2. A BMI ≥ 25 kg/m2 was used to determine obesity. In the definition of metabolic health, the absence of metabolic syndrome components is considered metabolically healthy. An assessment of inflammation was carried out using a surrogate marker called high-sensitivity C-reactive protein (hs-CRP). The adjusted odds ratio (OR) and confidence intervals (CIs) were estimated using the multivariable logistic regression model. After adjusting for hs-CRP, MHO (OR = 1.97; 95% CI: 1.21 to 3.21) was significantly associated with decreased eGFR compared to metabolically healthy non-obesity (MHNO). With the MHNO/hs-CRP ≤ 0.01 mg/dL group as a reference, the OR was 2.17 (95% CI: 1.17 to 4.02) for decreased eGFR in the group with MHO/hs-CRP > 0.01 mg/dL. MHO is associated with renal dysfunction at an early stage. To some degree, this risk can be explained by the level of inflammation.
Impact of Different Resistance Training Protocols on Balance, Quality of Life and Physical Activity Level of Older Women
Authors: Leitão Luis , Venturini Gabriela R. O. , Junior Ricardo Pace , Monteiro Estêvão Rios , Telles Luiz Guilherme , Araújo Gleisson , Novaes Jefferson , Tavares Carlos , Marques-Neto Sílvio , Mazini Mauro
Published: September 2022

Background: Physical activity (PA) and physical fitness are key factors for quality of life (QoL) for older women. The aging process promotes the decrease in some capacities such as strength, which affect the activities of daily life. This loss of strength leads to a reduction in balance and an increased risk of falls as well as a sedentary lifestyle. Resistance Training (RT) is an effective method to improve balance and strength but different RT protocols can promote different responses. Power training has a higher impact on the performance of activities of daily life. Therefore, our study aimed to analyze if different RT protocols promote individual responses in balance, QoL and PA levels of older women and which are more effective for the older women. Methods: Ninety-four older women were divided into four RT groups (relative strength endurance training, SET; Traditional strength training, TRT; absolute strength training, AST; power training, PWT) and one control group (CG). Each RT group performed a specific protocol for 16 weeks. At baseline and after 8 and 16 weeks, we assessed balance through the Berg balance scale; PA levels with a modified Baecke questionnaire and QoL with World Health Organization Quality of Life—BREF (WHOQOL-BREF) and World Health Organization Quality of Life—OLD module (WHOQOL-OLD). Results: Balance improved after 16 weeks (baseline vs. 16 weeks; p < 0.05) without differences between all RT groups. PWT (2.82%) and TRT (3.48%) improved balance in the first 8 weeks (baseline vs. 8 weeks; p < 0.05). PA levels increased in PWT, TRT and AST after 16 weeks (baseline vs. 16 weeks; p < 0.05). Conclusion: All RT protocols improved PA levels and QoL after 16 weeks of training. For the improvement of balance, QoL and PA, older women can be subjected to PWT, AST and SET, and not be restricted to TRT.
Does Energy Efficiency Realize Energy Conservation in the Iron and Steel Industry? A Perspective of Energy Rebound Effect
Authors: Wu Rongxin , Lin Boqiang
Published: September 2022

The energy rebound effect may weaken the impact of energy efficiency improvement on energy consumption. Therefore, the rebound effect is an important consideration in energy and environmental policies. This study takes the iron and steel industry as the research object, which is a large energy consumption sector in China, and the improved technique is used to estimate the energy rebound effect. The study constructs the dynamic energy efficiency utilizing provincial data from 2000 to 2019. The energy rebound effect from factor substitution and output expansion is then calculated. The research further discusses regional differences in the energy rebound effect. The results indicate that the technical progress of the iron and steel industry promotes energy efficiency improvements. The eastern region shows the best energy efficiency performance, followed by the central area, and the western region performs the worst in energy efficiency. The industrial energy rebound effect is 0.4297, which partially offsets the energy reduction caused by energy efficiency improvements. Factor substitution and output growth produce the industrial energy rebound effect. Furthermore, the rebound effect exhibits distinct geographical features. The policy suggestions are finally proposed to mitigate the industrial rebound effect and achieve energy and carbon reductions.
First Trimester of Pregnancy as the Sensitive Period for the Association between Prenatal Mosquito Coil Smoke Exposure and Preterm Birth
Authors: Liu Xin-Chen , Strodl Esben , Huang Li-Hua , Lu Qing , Liang Yang , Chen Wei-Qing
Published: September 2022

Mosquito coils are efficient mosquito repellents and mosquito coil smoke (MCS) contributes to indoor air pollution. However, no prior population-based study has investigated whether prenatal MCS exposure is a risk factor for preterm birth (PTB) and whether exposure to MCS in different trimesters of pregnancy is associated with different levels of risk. The sample involved 66,503 mother–child dyads. Logistic regression models were used to examine the relationships between prenatal MCS exposure during different trimesters of pregnancy and PTB. We found that prenatal MCS exposure was associated with a greater likelihood of PTB (OR = 1.12, 95%CI: 1.05–1.20). The prenatal MCS exposure during the first trimester was associated with 1.17 (95%CI: 1.09–1.25) times the odds of being PTB, which was higher than exposure during the second trimester (OR = 1.11, 95%CI: 1.03–1.19) and during the third trimester (OR = 1.08, 95%CI: 1.01–1.16). In the stratified analysis, prenatal MCS exposure significantly increased PTB risk among girls but not among boys. Our results indicated that maternal MCS exposure during pregnancy was associated with PTB and that the first trimester might be the sensitive period. In light of these findings, public health interventions are needed to reduce prenatal exposure to MCS, particularly during the first trimester of pregnancy.
Analysis of Association between Adolescents’ Food Habits and Body Mass Change in a Population-Based Sample: Diet and Activity of Youth during COVID-19 (DAY-19) Study
Authors: Kołota Aleksandra , Głąbska Dominika
Published: September 2022

The COVID-19 pandemic may have contributed to food habit changes, including some negative ones that may increase the risk of overweight and obesity. The aim of the study was to analyze the association between adolescents’ food habits, body mass change, as well as physical activity level in a population-based sample within the Diet and Activity of Youth during COVID-19 (DAY-19) Study. The DAY-19 Study was conducted in a cohort of 1333 students (aged 10–16 years) recruited in schools after stratified random quota sampling of primary schools (sampling counties within voivodeships and schools within counties) in June 2020. The food habits were assessed for the period of the COVID-19 pandemic and the period before the COVID-19 pandemic while using Adolescent Food Habits Checklist (AFHC). The body mass changes were assessed based on body weight and height for the period of the COVID-19 pandemic and the period before the COVID-19 pandemic while using Polish growth reference values. The physical activity changes were assessed based on the subjective assessment of adolescents. It was stated that for female adolescents declaring body mass gain during the COVID-19 pandemic the highest AFHC purchase scores (healthy purchase habits) (p < 0.0001) were accompanied by the lowest AFHC consumption score (unhealthy consumption habits) (p < 0.0001), as well as for female adolescents declaring physical activity decrease during the COVID-19 pandemic the highest AFHC purchase scores (healthy purchase habits) were observed (p = 0.0333). It was stated that for male adolescents declaring physical activity increased during the COVID-19 pandemic, the highest AFHC consumption scores (healthy consumption habits) were observed (p = 0.0003). In the case of a majority of participants, the general food habits were unchanged, which was observed mainly for food habits associated with food preparation. More food habits changes associated with the COVID-19 pandemic resulting in body mass changes were observed in females than in male adolescents. Body mass gain during the COVID-19 pandemic in adolescents may have resulted from unhealthy consumption habits, accompanied by decreased physical activity, in spite of the fact that this sub-group presented healthy purchase habits, which was observed especially for female adolescents.
Web-Based Patient-Reported Outcomes for ENT Patients—Evaluation of the Status Quo, Patients’ View, and Future Perspectives
Authors: Wald Theresa , Zebralla Veit , Boege Maren , Kunz Viktor , Neumuth Thomas , Dietz Andreas , Wichmann Gunnar , Wiegand Susanne
Published: September 2022

Background: Patient-reported outcomes (PRO) assess disease burden and indicate unmet needs. Home-based electronic PRO measures (ePROMs) can support tumor aftercare (TAC). Creating an ePROM is the next step after implementing the software “OncoFunction” to assess PROs during TAC of head- and neck-cancer patients (HNC). Therefore, internet use and perception on ePROMs of ENT and TAC patients were evaluated. Methods: From May–July 2020, ENT patients at a high-volume outpatient department aged >18 without need for emergency treatment were invited to complete a questionnaire concerning internet use and access, hardware, and opinion on the chances, requirements, and designs of ePROMs. Results: 415 questionnaires were evaluated; 46.3% of the respondents visited the common consultation hour (CCH) and 44.3% TAC; 71.9% were internet users, being younger than non-internet users; and 36.4% of TAC patients were non-internet users and 16.3% of them were without a web-enabled device. Significant differences existed in age and assessment of future perspectives between internet-/non-internet users and TAC/CCH patients, respectively. Regarding the design of ePROMs, patients preferred quarterly and short surveys. Data safety and feedback were important. Conclusions: ePROMs are not suitable for everyone because of missing internet access and experience. A tailored approach to implement ePROMs in TAC is needed.
Typology of Victimization against Women on Adolescent Girls in Three Contexts: Dating Offline, Dating Online, and Sexual Harassment Online
Authors: Díaz-Aguado María José , Martínez-Arias Rosario , Falcón Laia
Published: September 2022

Defining the typologies of adolescent girls in relation to different types of victimization against women could be very useful for prevention. Almost all the typologies previously elaborated on this topic define the typologies from situations of dating victimization. This study used cluster analysis to establish for the first time a typology of adolescent girl victimization against women that included dating violence offline, dating violence online, and sexual harassment online outside a relationship by means of a comparative analysis of behavior between those who had suffered this violence and the population at large. The participants were 3.532 Spanish teenage girls aged 14–18 with experience of relationships with boys. Three discrete, identifiable types were obtained: the first group (63.8%), non-victim girls; the second group (29.4%), victims of sexual harassment online outside a relationship but with a low incidence of dating victimization; the third group (6.8%), victims in the three contexts. The logistic regression analysis showed that risky sexual behavior online was the main risk condition for inclusion in the second and third groups (compared to the non-victim group), followed by low self-esteem (for the second group) and age (for both groups). Other variables that also contributed to predicting membership victim groups were health complaints, feminine gender role stress, justification of male dominance and violence, visiting risky websites, and problematic internet use. These results show the importance of including the prevention of such problems in order to eradicate violence against women in adolescence who have grown up with digital technologies.
Emotional Response in the Elderly to Sports Materials
Authors: Fernández-Truan Juan Carlos , Machado Arenós Cristina María
Published: September 2022

This research aims to understand the effectiveness of the material resources used by 365 elderly people who perform physical activities in Seville (Spain), based on the sensations that the use of these objects gave them. A descriptive design was used through a questionnaire validated by the Delphi method with 10 pre-selected experts. The results showed the existence of significant relationships between the emotions generated in the elderly and the handling of different materials. This is essential for the planning of physical activities for this type of user in order to achieve greater motivation and continuity.
Psychological, Psychosocial and Obstetric Differences between Spanish and Immigrant Mothers: Retrospective Observational Study
Authors: Martínez Herreros María Carmen , Rodríguez Muñoz María Fe , Izquierdo Méndez Nuria , Olivares Crespo María Eugenia
Published: September 2022

This study analyzed the influence of psychological and psychosocial factors of pregnant women at an obstetric level. The possible differences between Spaniards and immigrants were studied. This was a retrospective observational study. The sample has been divided into two study cohorts, one consisting of Spanish pregnant women and one consisting of foreign pregnant women. Both completed the Revised Postpartum Depression Predictors Inventory and the Patient Health Questionnaire-9. A total of 15.9% of Spanish women and 23.2% of immigrants had depressive symptoms. Immigrants claim to have less support at the partner, family, and friendship levels than Spaniards. Moreover, 16.4% of Spaniards vs. 8.1% of immigrants had pregnancy complications; Cesarean section was performed in 16.2% of Spaniards vs. 7.9% of immigrants. A greater number of premature births were detected in immigrants than in Spaniards. Access to universal healthcare is a protective factor against socioeconomic and cultural conditions affecting the mental and obstetrical health of immigrants.
The Immunological and Hormonal Responses to Competitive Match-Play in Elite Soccer Players
Authors: Morgans Ryland , Orme Patrick , Bezuglov Eduard , Di Michele Rocco , Moreira Alexandre
Published: September 2022

This study aimed to examine the salivary immunoglobulin A (s-IgA) and salivary cortisol (s-Cort) responses to competitive matches in elite male soccer players. Data were collected for 19 players (mean ± SD, age: 26 ± 4 years; weight: 80.5 ± 8.1 kg; height: 1.83 ± 0.07 m; body-fat 10.8 ± 0.7%) from a Russian Premier League team throughout a 6-week period during the 2021–2022 season. Physical match loads were measured through an optical tracking system. s-IgA and s-Cort were assessed one day before each match (MD − 1), 60-min before kick-off, 30-min post-match, and 48-h post-match (MD + 2). At 60-min before kick-off, s-IgA values were lower than at MD − 1 (90% CI difference 15.7–71.3 μg/mL). Additionally, compared to 60-min before kick-off, s-IgA was higher at 30-min post-match (90% CI difference 1.8–57.8 μg/mL) and at MD + 2 (90% CI difference 5.4–60.5 μg/mL). At 30-min post-match, s-Cort was higher than at 60-min before kick-off (90% CI difference 4.84–7.86 ng/mL), while on MD + 2 s-Cort was higher than at 60-min before kick-off (90% CI difference 0.76–3.72 ng/mL). Mixed model regressions revealed that longer playing time and total distance covered, and higher number of high-intensity accelerations, involved smaller s-IgA differences between 30-min post-match and 60-min before kick-off, and between 60-min before kick-off and MD + 2. Additionally, greater high-intensity and sprint distances, and a higher number of high-intensity and maximal accelerations, involved smaller s-Cort differences between 60-min before kick-off and MD + 2. In conclusion, the present results demonstrate that using salivary monitoring combined with match load may be a useful tool to monitor individual mucosal immunity and hormonal responses to match-play and the subsequent recovery periods in elite soccer players.
Planetary Health Education and Capacity Building for Healthcare Professionals in a Global Context: Current Opportunities, Gaps and Future Directions
Authors: Asaduzzaman Muhammad , Ara Rifat , Afrin Sadia , Meiring James E. , Saif-Ur-Rahman K. M.
Published: September 2022

The emerging concept of planetary health needs to be discussed in a more organized and sustainable way within the global public health and healthcare disciplines. Therefore, planetary health should be considered a cardinal component of the global academic framework for healthcare professionals. The availability of related curricula and courses is crucial to equip health professionals in this relatively new discipline of planetary health. In this review article, we aimed to explore published articles and online databases of courses to summarize the available planetary health education opportunities and discussions for health professionals, to identify the gaps in resource allocation and to suggest future recommendations. We observed a visible resource inequity in the global south with the lack of a universal planetary health module for healthcare professionals. Additionally, there is minimal inclusion of allied health disciplines in this learning process. We therefore recommend a dedicated network of motivated healthcare professionals and regional hubs with an agenda to ensure a comprehensive, uniform, and inclusive planetary health education curriculum and practice.
Rooming-In and Breastfeeding Duration in First-Time Mothers in a Modern Postpartum Care Center
Authors: Wu Hsiao-Ling , Lu Der-Fa , Tsay Pei-Kwei
Published: September 2022

Uncertainty concerning the associations between rooming-in and breastfeeding duration remains at postpartum care centers. This cross-sectional study investigated the associations between the rooming-in policy and continual exclusive breastfeeding among first-time mothers at a postpartum center. Of the 160 participants, only 12.5% (n = 20) implemented full rooming-in. At 3-month follow-up, 85% (n = 17) of those individuals were exclusively breastfeeding. At the same time point, no participant practicing partial rooming-in (n = 140) was exclusively breastfeeding. The generalized estimating equation analysis indicated that full (24 h) rooming-in was statistically associated with continual exclusive breastfeeding 1 month postpartum (odds ratio (OR) = 0.90, p < 0.001) and 3 months postpartum (OR = 0.73, p < 0.001). Significant factors associated with a first-time mother’s willingness to practice full rooming-in included vaginal delivery, a prenatal decision to practice breastfeeding, and undergoing prenatal classes on both rooming-in and breastfeeding. Success with continual exclusive breastfeeding in the postpartum period is dependent on full rooming-in. The findings serve as a reference for promoting exclusive breastfeeding for the first 6 months, as recommended by the World Health Organization.
Discrete Event Simulation Model for Cost-Effectiveness Evaluation of Screening for Asymptomatic Patients with Lower Extremity Arterial Disease
Authors: Kamenský Vojtěch , Rogalewicz Vladimír , Gajdoš Ondřej , Donin Gleb
Published: September 2022

Lower limb ischemic disease (LEAD) affects a significant portion of the population, with most patients being asymptomatic. Patient screening is necessary because LEAD patients have an increased risk of occurrence of other cardiovascular events and manifestations of disease, in terms of leg symptoms such as intermittent claudication, critical limb ischemia, or amputation. The aim of this work was to evaluate the cost-effectiveness of screening using ABI diagnostics in asymptomatic patients and its impact on limb symptoms associated with LEAD. A discrete event simulation model was created to capture lifetime costs and effects. Costs were calculated from the perspective of the health care payer, and the effects were calculated as QALYs. A cost-effectiveness analysis was performed to compare ABI screening examination and the situation without such screening. A probabilistic sensitivity analysis and scenario analysis were carried out to evaluate the robustness of the results. In the basic setting, the screening intervention was a more expensive intervention, at a cost of CZK 174,010, compared to CZK 70,177 for the strategy without screening. The benefits of screening were estimated at 14.73 QALYs, with 14.46 QALYs without screening. The final ICER value of CZK 389,738 per QALY is below the willingness to pay threshold. Likewise, the results of the probabilistic sensitivity analysis and of the scenario analysis were below the threshold of willingness to pay, thus confirming the robustness of the results. In conclusion, ABI screening appears to be a cost-effective strategy for asymptomatic patients aged 50 years when compared to the no-screening option.
The Financial/Accounting Impact of FFP on Participating in European Competitions: An Analysis of the Spanish League
Authors: Calahorro-López Alberto , Ratkai Melinda , Vena-Oya Julio
Published: September 2022

This paper analyses the impact of Financial Fair Play (FFP) on clubs’ finances and on the relationship between them and clubs’ sporting outcomes in the Spanish league. To this end, financial ratios and accounting variables obtained from the clubs’ own annual accounts, published from 2004 to 2019, are analysed, and the Mann–Whitney test is used to describe which differences are significant. The objective is threefold: firstly, we describe the financial/accounting structures of Spanish league football clubs, showing how both their financial statements and ratios have evolved after the application of this law, providing evidence of whether FFP is an adequate tool to guarantee the long-term viability and sustainability of football clubs, as intended by the UEFA. Secondly, we show the relationship between financial/accounting performance and sporting results. Thirdly, the paper looks at whether FFP has impacted the gap between the top clubs and the rest. The results show that, after the implementation of FFP, clubs’ financial/accounting health has improved, and a change in their efficiency in this regard can be observed. Although FFP is a tool that achieves the objective for which it was created, the possibility that the gap between the elite clubs and the rest may be increasing should not be ignored.
Reverse Difference Network for Highlighting Small Objects in Aerial Images
Authors: Ni Huan , Chanussot Jocelyn , Niu Xiaonan , Tang Hong , Guan Haiyan
Published: September 2022

The large-scale variation issue in high-resolution aerial images significantly lowers the accuracy of segmenting small objects. For a deep-learning-based semantic segmentation model, the main reason is that the deeper layers generate high-level semantics over considerably large receptive fields, thus improving the accuracy for large objects but ignoring small objects. Although the low-level features extracted by shallow layers contain small-object information, large-object information has predominant effects. When the model, using low-level features, is trained, the large objects push the small objects aside. This observation motivates us to propose a novel reverse difference mechanism (RDM). The RDM eliminates the predominant effects of large objects and highlights small objects from low-level features. Based on the RDM, a novel semantic segmentation method called the reverse difference network (RDNet) is designed. In the RDNet, a detailed stream is proposed to produce small-object semantics by enhancing the output of RDM. A contextual stream for generating high-level semantics is designed by fully accumulating contextual information to ensure the accuracy of the segmentation of large objects. Both high-level and small-object semantics are concatenated when the RDNet performs predictions. Thus, both small- and large-object information is depicted well. Two semantic segmentation benchmarks containing vital small objects are used to fully evaluate the performance of the RDNet. Compared with existing methods that exhibit good performance in segmenting small objects, the RDNet has lower computational complexity and achieves 3.9–18.9% higher accuracy in segmenting small objects.
ProTstab2 for Prediction of Protein Thermal Stabilities
Authors: Yang Yang , Zhao Jianjun , Zeng Lianjie , Vihinen Mauno
Published: September 2022

The stability of proteins is an essential property that has several biological implications. Knowledge about protein stability is important in many ways, ranging from protein purification and structure determination to stability in cells and biotechnological applications. Experimental determination of thermal stabilities has been tedious and available data have been limited. The introduction of limited proteolysis and mass spectrometry approaches has facilitated more extensive cellular protein stability data production. We collected melting temperature information for 34,913 proteins and developed a machine learning predictor, ProTstab2, by utilizing a gradient boosting algorithm after testing seven algorithms. The method performance was assessed on a blind test data set and showed a Pearson correlation coefficient of 0.753 and root mean square error of 7.005. Comparison to previous methods indicated that ProTstab2 had superior performance. The method is fast, so it was applied to predict and compare the stabilities of all proteins in human, mouse, and zebrafish proteomes for which experimental data were not determined. The tool is freely available.
Epilepsy Characteristics in Neurodevelopmental Disorders: Research from Patient Cohorts and Animal Models Focusing on Autism Spectrum Disorder
Authors: Chakraborty Sukanya , Parayil Rrejusha , Mishra Shefali , Nongthomba Upendra , Clement James P.
Published: September 2022

Epilepsy, a heterogeneous group of brain-related diseases, has continued to significantly burden society and families. Epilepsy comorbid with neurodevelopmental disorders (NDDs) is believed to occur due to multifaceted pathophysiological mechanisms involving disruptions in the excitation and inhibition (E/I) balance impeding widespread functional neuronal circuitry. Although the field has received much attention from the scientific community recently, the research has not yet translated into actionable therapeutics to completely cure epilepsy, particularly those comorbid with NDDs. In this review, we sought to elucidate the basic causes underlying epilepsy as well as those contributing to the association of epilepsy with NDDs. Comprehensive emphasis is put on some key neurodevelopmental genes implicated in epilepsy, such as MeCP2, SYNGAP1, FMR1, SHANK1-3 and TSC1, along with a few others, and the main electrophysiological and behavioral deficits are highlighted. For these genes, the progress made in developing appropriate and valid rodent models to accelerate basic research is also detailed. Further, we discuss the recent development in the therapeutic management of epilepsy and provide a briefing on the challenges and caveats in identifying and testing species-specific epilepsy models.
Sustainable Production of Biosurfactant from Agro-Industrial Oil Wastes by Bacillus subtilis and Its Potential Application as Antioxidant and ACE Inhibitor
Authors: Ciurko Dominika , Czyżnikowska Żaneta , Kancelista Anna , Łaba Wojciech , Janek Tomasz
Published: September 2022

The microbial conversion of agro-industrial oil wastes into biosurfactants shows promise as a biomass refinery approach. In this study, Bacillus subtilis #309 was applied to produce surfactin using rapeseed and sunflower cakes, the most common oil processing side products in Europe. Studies of the chemical composition of the substrates were performed, to determine the feasibility of oil cakes for surfactin production. Initially, screening of proteolytic and lipolytic activity was performed to establish the capability of B. subtilis #309 for substrate utilization and hence effective surfactin production. B. subtilis #309 showed both proteolytic and lipolytic activity. The process of surfactin production was carefully analyzed by measurement of the surfactin concentration, pH, surface tension (ST) and emulsification index (E24). The maximal surfactin concentration in the sunflower and rapeseed cake medium reached 1.19 ± 0.03 and 1.45 ± 0.09 g/L, respectively. At the same time, a progressive decrease in the surface tension and increase in emulsification activity were observed. The results confirmed the occurrence of various surfactin homologues, while the surfactin C15 was the dominant one. Finally, the analysis of surfactin biological function exhibited antioxidant activity and significant angiotensin-converting enzyme (ACE)-inhibitory activity. The half-maximal inhibitory concentration (IC50) value for ACE inhibition was found to be 0.62 mg/mL for surfactin. Molecular docking of the surfactin molecule to the ACE domains confirmed its inhibitory activity against ACE. Several interactions, such as hydrophobic terms, hydrogen bonds and van der Waals interactions, were involved in the complex stabilization. To the best of our knowledge, this is the first report describing the effect of a lipopeptide biosurfactant, surfactin, produced by B. subtilis for multifunctional properties in vitro, namely the ACE-inhibitory activity and the antioxidant properties, using different assays, such as 2,2-azinobis (3-ethyl-benzothiazoline-6-sulfonic acid (ABTS), 2,2-diphenyl-1-picrylhydrazyl (DPPH) and ferric reducing antioxidant power (FRAP). Thus, the ACE-inhibitory lipopeptide biosurfactant shows promise to be used as a natural antihypertensive agent.
A Single Aspergillus fumigatus Gene Enables Ergothioneine Biosynthesis and Secretion by Saccharomyces cerevisiae
Authors: Doyle Sean , Cuskelly Daragh D. , Conlon Niall , Fitzpatrick David A. , Gilmartin Ciara B. , Dix Sophia H. , Jones Gary W.
Published: September 2022

The naturally occurring sulphur-containing histidine derivative, ergothioneine (EGT), exhibits potent antioxidant properties and has been proposed to confer human health benefits. Although it is only produced by select fungi and prokaryotes, likely to protect against environmental stress, the GRAS organism Saccharomyces cerevisiae does not produce EGT naturally. Herein, it is demonstrated that the recombinant expression of a single gene, Aspergillus fumigatus egtA, in S. cerevisiae results in EgtA protein presence which unexpectedly confers complete EGT biosynthetic capacity. Both High Performance Liquid Chromatography (HPLC) and LC–mass spectrometry (MS) analysis were deployed to detect and confirm EGT production in S. cerevisiae. The localisation and quantification of the resultant EGT revealed a significantly (p < 0.0001) larger quantity of EGT was extracellularly present in culture supernatants than intracellularly accumulated in 96 h yeast cultures. Methionine addition to cultures improved EGT production. The additional expression of two candidate cysteine desulfurases from A. fumigatus was thought to be required to complete EGT biosynthesis, namely AFUA_2G13295 and AFUA_3G14240, termed egt2a and egt2b in this study. However, the co-expression of egtA and egt2a in S. cerevisiae resulted in a significant decrease in the observed EGT levels (p < 0.05). The AlphaFold prediction of A. fumigatus EgtA 3-Dimensional structure illuminates the bidomain structure of the enzyme and the opposing locations of both active sites. Overall, we clearly show that recombinant S. cerevisiae can biosynthesise and secrete EGT in an EgtA-dependent manner which presents a facile means of producing EGT for biotechnological and biomedical use.
Molecular Characterization of a Rare Case of Monozygotic Dichorionic Diamniotic Twin Pregnancy after Single Blastocyst Transfer in Preimplantation Genetic Testing (PGT)
Authors: Brouillet Sophie , Mereuze Sandie , Ranisavljevic Noémie , Chauveau Claire , Hamamah Samir , Cattin Julie , Verebi Camille , Cabrol Christelle , Ishmukhametova Aliya , Girardet Anne , Anahory Tal , Willems Marjolaine
Published: September 2022

Preimplantation genetic testing (PGT) is widely used to select unaffected embryos, increasing the odds of having a healthy baby. During the last few decades, it was accepted that monozygotic dichorionic diamniotic twin pregnancies occurred from the embryo splitting before Day 3 postfertilization according to Corner’s dogma. Hence, the occurrence of a dichorionic diamniotic twin pregnancy after a single blastocyst transfer was considered a dizygotic pregnancy resulting from blastocyst transfer and concurrent natural fertilization. In our study, we have provided for the first time molecular proof that a single blastocyst transfer can result in a monozygotic dichorionic diamniotic twin pregnancy, invalidating Corner’s dogma. In this case, we recommend systematically assessing the genetic status of dichorionic twins after single blastocyst transfer using prenatal diagnosis to exclude the risk from a potential concurrent spontaneous pregnancy and to ensure that both fetuses are unaffected. To achieve this goal, we have developed here an innovative noninvasive prenatal diagnosis by exclusion of paternal variants with droplet digital PCR, maximizing the reliability of genetic diagnosis. Further multicentric prospective studies using genetic testing are now required to establish the rate of blastocyst splitting leading to dichorionic pregnancy in PGT and to identify the risk factors.
Inhibitory Activities of Rare Ginsenoside Rg4 on Cecal Ligation and Puncture-Induced Sepsis
Authors: Kim Go Oun , Kim Nayeon , Song Gyu Yong , Bae Jong-Sup
Published: September 2022

Sepsis is an uncontrolled response to inflammatory infection and is associated with high levels of mortality and morbidity. Rg4 is a rare ginsenoside mainly found in the leaves of Panax ginseng C. A. Meyer and the major protopanaxatriol-type ginsenoside of black ginseng. In this study, we determined whether Rg4 affects cecal ligation and puncture (CLP)-induced sepsis. Animals were separated into the following six groups: control group, CLP-operated group, CLP plus maslinic acid (MA), and CLP plus Rg4 (5, 10, or 15 mg/kg). Survival rate, body weight changes, inflammatory cytokines, and histological analyses were assessed. Human endothelial cells were activated with the high-mobility group box 1 (HMGB1) protein and Rg4. Cell viability was determined using the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay. Enzyme-linked immunosorbent assay (ELISA) and Western blot analysis were used to assess inflammation and gene expression, respectively. After CLP surgery, the Rg4-administered group exhibited a higher survival rate and body weight compared with the untreated control group. Rg4 treatment reduced cytokine levels, including tumor necrosis factor (TNF)-α and interleukin (IL)-1β, as well as nitric oxide (NO) levels and renal inflammation. After Rg4 treatment of HMGB1-activated cells, the expressions of toll-like receptor (TLR) 4 and TNF-α were decreased, and the activation of phosphoinositide 3-kinase (PI3K)/AKT signaling increased cell viability. In summary, Rg4 inhibited inflammation and exhibited a protective effect against CLP-induced sepsis, thereby reinforcing cell survival against septic responses.
Myofibrillar Lattice Remodeling Is a Structural Cytoskeletal Predictor of Diaphragm Muscle Weakness in a Fibrotic mdx (mdx Cmah−/−) Model
Authors: Ritter Paul , Nübler Stefanie , Buttgereit Andreas , Smith Lucas R. , Mühlberg Alexander , Bauer Julian , Michael Mena , Kreiß Lucas , Haug Michael , Barton Elisabeth , Friedrich Oliver
Published: September 2022

Duchenne muscular dystrophy (DMD) is a degenerative genetic myopathy characterized by complete absence of dystrophin. Although the mdx mouse lacks dystrophin, its phenotype is milder compared to DMD patients. The incorporation of a null mutation in the Cmah gene led to a more DMD-like phenotype (i.e., more fibrosis). Although fibrosis is thought to be the major determinant of ‘structural weakness’, intracellular remodeling of myofibrillar geometry was shown to be a major cellular determinant thereof. To dissect the respective contribution to muscle weakness, we assessed biomechanics and extra- and intracellular architecture of whole muscle and single fibers from extensor digitorum longus (EDL) and diaphragm. Despite increased collagen contents in both muscles, passive stiffness in mdx Cmah−/− diaphragm was similar to wt mice (EDL muscles were twice as stiff). Isometric twitch and tetanic stresses were 50% reduced in mdx Cmah−/− diaphragm (15% in EDL). Myofibrillar architecture was severely compromised in mdx Cmah−/− single fibers of both muscle types, but more pronounced in diaphragm. Our results show that the mdx Cmah−/− genotype reproduces DMD-like fibrosis but is not associated with changes in passive visco-elastic muscle stiffness. Furthermore, detriments in active isometric force are compatible with the pronounced myofibrillar disarray of the dystrophic background.
Phylogenetic and Transcriptional Analyses of the HSP20 Gene Family in Peach Revealed That PpHSP20-32 Is Involved in Plant Height and Heat Tolerance
Authors: Lian Xiaodong , Wang Qiuping , Li Tianhao , Gao Hongzhu , Li Huannan , Zheng Xianbo , Wang Xiaobei , Zhang Haipeng , Cheng Jun , Wang Wei , Ye Xia , Li Jidong , Tan Bin , Feng Jiancan
Published: September 2022

The heat shock protein 20 (HSP20) proteins comprise an ancient, diverse, and crucial family of proteins that exists in all organisms. As a family, the HSP20s play an obvious role in thermotolerance, but little is known about their molecular functions in addition to heat acclimation. In this study, 42 PpHSP20 genes were detected in the peach genome and were randomly distributed onto the eight chromosomes. The primary modes of gene duplication of the PpHSP20s were dispersed gene duplication (DSD) and tandem duplication (TD). PpHSP20s in the same class shared similar motifs. Based on phylogenetic analysis of HSP20s in peach, Arabidopsis thaliana, Glycine max, and Oryza sativa, the PpHSP20s were classified into 11 subclasses, except for two unclassified PpHSP20s. cis-elements related to stress and hormone responses were detected in the promoter regions of most PpHSP20s. Gene expression analysis of 42 PpHSP20 genes revealed that the expression pattern of PpHSP20-32 was highly consistent with shoot length changes in the cultivar ‘Zhongyoutao 14’, which is a temperature-sensitive semi-dwarf. PpHSP20-32 was selected for further functional analysis. The plant heights of three transgenic Arabidopsis lines overexpressing PpHSP20-32 were significantly higher than WT, although there was no significant difference in the number of nodes. In addition, the seeds of three over-expressing lines of PpHSP20-32 treated with high temperature showed enhanced thermotolerance. These results provide a foundation for the functional characterization of PpHSP20 genes and their potential use in the growth and development of peach.