bluuebunny/crossref_metadata_2025 huggingface dataset:
The Impact of Healthcare-Associated Infections in Patients Undergoing Oncological Microvascular Head and Neck Reconstruction: A Prospective Multicentre Study
Authors: Ramos-Zayas Ana , López-Medrano Francisco , Urquiza-Fornovi Irene , Zubillaga Ignacio , Gutiérrez Ramón , Sánchez-Aniceto Gregorio , Acero Julio , Almeida Fernando , Galdona Ana , Morán María José , Pampin Marta , Cebrián José Luis
Published: April 2021

(1) Background: Healthcare-associated infections (HAIs) after head and neck free-flap reconstruction are a common postoperative complication. Risk factors for HAIs in this context and their consequences have not been adequately described. (2) Methods: Ongoing prospective multicentre study between 02/2019 and 12/2020. Demographic characteristics and outcomes were analysed, focusing on infections. (3) Results: Forty out of 65 patients (61.54%) suffered HAIs (surgical site infection: 52.18%, nosocomial pneumonia: 23.20%, bloodstream infection: 13% and urinary tract infection: 5.80%). Methicillin-resistant Staphylococcus aureus (MRSA) and resistant Pseudomonas aeruginosa, Klebsiella pneumoniae and Enterobacter cloacae were the most frequently implicated. The significant risk factors for infection were: previous radiotherapy (Odds ratio (OR): 5.42; 95% confidence interval (CI), 1.39–21.10), anaemia (OR: 8.00; 95% CI, 0.96–66.95), salvage surgery (eight out of eight patients), tracheostomy (OR: 2.86; 95% CI, 1.01–8.14), surgery duration (OR: 1.01; 95% CI, 1.00–1.02), microvascular reoperation <72 h (eight/eight) and flap loss (eight/eight). The major surgical complications were: a need to reoperate (OR: 6.89; 95% CI, 1.42–33.51), prolonged hospital admission (OR: 1.16; 95% CI, 1.06–1.27) and delay in the initiation of postoperative radiotherapy (OR: 9.07; 95% CI, 1.72–47.67). The sixth month mortality rate in patients with HAIs was 7.69% vs. 0% in patients without HAIs (p = 0.50). (4) Conclusions: HAIs were common after this type of surgery, many of them caused by resistant microorganisms. Some modifiable risk factors were identified. Infections played a role in cancer prognosis by delaying adjuvant therapy.
LAG-3 Blockade with Relatlimab (BMS-986016) Restores Anti-Leukemic Responses in Chronic Lymphocytic Leukemia
Authors: Sordo-Bahamonde Christian , Lorenzo-Herrero Seila , González-Rodríguez Ana P. , Payer Ángel R. , González-García Esther , López-Soto Alejandro , Gonzalez Segundo
Published: April 2021

The inclusion of monoclonal antibodies targeting immune checkpoints such PD-1/PD-L1 or CTLA-4 has revolutionized the landscape of anti-cancer therapy. However, PD-1 and CTLA-4 blockade failed to achieve clinical benefit in CLL, thus attention has been focused on emerging checkpoints in this malignancy. LAG-3 is an immune checkpoint receptor that negatively regulates T cell-mediated responses by inducing an hyporesponsive state, thus promoting tumor escape. Patients with chronic lymphocytic leukemia (CLL) develop a profound immune suppression that leads to lessened immunosurveillance and increased risk of developing a secondary neoplasia. In the study herein, we report the profound dysregulation of LAG-3 on leukemic cells in CLL. Likewise, natural killer (NK) and T cells showed increased LAG-3 expression, hence suggesting a role for this checkpoint in CLL-associated immunosuppression. High LAG-3 expression, as well as high levels of soluble LAG-3 (sLAG-3), correlated with adverse cytogenetics and poor outcome in patients with CLL, highlighting the clinical relevance of this immune checkpoint. Treatment of peripheral blood mononuclear cells (PBMCs) from patients with CLL with relatlimab, a new anti-LAG-3 blocking antibody currently evaluated in numerous clinical trials, depleted leukemic cells and restored NK cell- and T cell-mediated responses. Moreover, combination of LAG-3 with the immunomodulatory drug (IMiD) lenalidomide significantly increased IL-2 production by T cells and antibody-dependent cytotoxicity (ADCC) mediated by NK cells. Altogether, these data provide new insights into the potential anti-leukemic effects of relatlimab, currently in clinical trials in CLL, and provides the rationale to further investigate its combination with IMiDs for the management of hematological malignancies.
Combined Luteolin and Indole-3-Carbinol Synergistically Constrains ERα-Positive Breast Cancer by Dual Inhibiting Estrogen Receptor Alpha and Cyclin-Dependent Kinase 4/6 Pathway in Cultured Cells and Xenograft Mice
Authors: Wang Xiaoyong , Zhang Lijuan , Dai Qi , Si Hongzong , Zhang Longyun , Eltom Sakina E. , Si Hongwei
Published: April 2021

The high concentrations of individual phytochemicals in vitro studies cannot be physiologically achieved in humans. Our solution for this concentration gap between in vitro and human studies is to combine two or more phytochemicals. We screened 12 phytochemicals by pairwise combining two compounds at a low level to select combinations exerting the synergistic inhibitory effect of breast cancer cell proliferation. A novel combination of luteolin at 30 μM (LUT30) and indole-3-carbinol 40 μM (I3C40) identified that this combination (L30I40) synergistically constrains ERα+ breast cancer cell (MCF7 and T47D) proliferation only, but not triple-negative breast cancer cells. At the same time, the individual LUT30 and I3C40 do not have this anti-proliferative effect in ERα+ breast cancer cells. Moreover, this combination L30I40 does not have toxicity on endothelial cells compared to the current commercial drugs. Similarly, the combination of LUT and I3C (LUT10 mg + I3C10 mg/kg/day) (IP injection) synergistically suppresses tumor growth in MCF7 cells-derived xenograft mice, but the individual LUT (10 mg/kg/day) and I3C (20 mg/kg/day) do not show an inhibitory effect. This combination synergistically downregulates two major therapeutic targets ERα and cyclin dependent kinase (CDK) 4/6/retinoblastoma (Rb) pathway, both in cultured cells and xenograft tumors. These results provide a solid foundation that a combination of LUT and I3C may be a practical approach to treat ERα+ breast cancer cells after clinical trials.
Cancer Essential Genes Stratified Lung Adenocarcinoma Patients with Distinct Survival Outcomes and Identified a Subgroup from the Terminal Respiratory Unit Type with Different Proliferative Signatures in Multiple Cohorts
Authors: Ho Kuo-Hao , Huang Tzu-Wen , Liu Ann-Jeng , Shih Chwen-Ming , Chen Ku-Chung
Published: April 2021

Background: Heterogeneous features of lung adenocarcinoma (LUAD) are used to stratify patients into terminal respiratory unit (TRU), proximal-proliferative (PP), and proximal-inflammatory (PI) subtypes. A more-accurate subtype classification would be helpful for future personalized medicine. However, these stratifications are based on genes with variant expression levels without considering their tumor-promoting roles. We attempted to identify cancer essential genes for LUAD stratification and their clinical and biological differences. Methods: Essential genes in LUAD were identified using genome-scale CRIPSR screening of RNA sequencing data from Project Achilles and The Cancer Genome Atlas (TCGA). Patients were stratified using consensus clustering. Survival outcomes, genomic alterations, signaling activities, and immune profiles within clusters were investigated using other independent cohorts. Findings: Thirty-six genes were identified as essential to LUAD, and there were used for stratification. Essential gene-classified clusters exhibited distinct survival rates and proliferation signatures across six cohorts. The cluster with the worst prognosis exhibited TP53 mutations, high E2F target activities, and high tumor mutation burdens, and harbored tumors vulnerable to topoisomerase I and poly(ADP ribose) polymerase inhibitors. TRU-type patients could be divided into clinically and molecularly different subgroups based on these essential genes. Conclusions: Our study showed that essential genes to LUAD not only defined patients with different survival rates, but also refined preexisting subtypes.
Radiation for Oligometastatic Lung Cancer in the Era of Immunotherapy: What Do We (Need to) Know?
Authors: Peeters Stephanie T. H. , Van Limbergen Evert J. , Hendriks Lizza E. L. , De Ruysscher Dirk
Published: April 2021

Oligometastatic cancer is recognized as a separate entity within the spectrum of metastatic disease. It was suggested that patients with oligometastatic disease can obtain long-term survival by giving local ablative therapy (LAT) to all visible disease locations. However, the true extent from which metastatic cancer should be called “oligometastatic” is unknown, although a consensus definition for oligometastatic disease is proposed by research organizations, such as the EORTC (maximum of five metastases in three organs). Different states of the oligometastatic disease are defined, such as synchronous vs. metachronous, oligopersistent vs. oligoprogressive disease. All clinical trials including patients with non-small cell lung cancer (NSCLC) are small and most are not randomized. Two small randomized phase II trials on synchronous disease showed an improvement in progression free survival, with the addition of LAT, and one also demonstrated an overall survival benefit. Immune checkpoint inhibitors (ICI) were not part of the treatment in these trials, while ICI significantly improved long-term outcomes of patients with metastatic NSCLC. Radiotherapy might improve the prognosis of patients treated with ICI because of its immunostimulatory effects and the possibility to eradicate metastatic deposits. Here, we summarize the data for adding ablative radiotherapy to the treatment of oligometastatic NSCLC, especially in the ICI era, and discuss the challenges of combined treatment.
Next Generation Therapeutics for the Treatment of Myelofibrosis
Authors: Tremblay Douglas , Mascarenhas John
Published: April 2021

Myelofibrosis is a myeloproliferative neoplasm characterized by splenomegaly, constitutional symptoms, bone marrow fibrosis, and a propensity towards transformation to acute leukemia. JAK inhibitors are the only approved therapy for myelofibrosis and have been successful in reducing spleen and symptom burden. However, they do not significantly impact disease progression and many patients are ineligible due to coexisting cytopenias. Patients who are refractory to JAK inhibition also have a dismal survival. Therefore, non-JAK inhibitor-based therapies are being explored in pre-clinical and clinical settings. In this review, we discuss novel treatments in development for myelofibrosis with targets outside of the JAK-STAT pathway. We focus on the mechanism, preclinical rationale, and available clinical efficacy and safety information of relevant agents including those that target apoptosis (navitoclax, KRT-232, LCL-161, imetelstat), epigenetic modulation (CPI-0610, bomedemstat), the bone marrow microenvironment (PRM-151, AVID-200, alisertib), signal transduction pathways (parsaclisib), and miscellaneous agents (tagraxofusp. luspatercept). We also provide commentary on the future of therapeutic development in myelofibrosis.
Influence of Hypothermic Storage Fluids on Mesenchymal Stem Cell Stability: A Comprehensive Review and Personal Experience
Authors: Ścieżyńska Aneta , Soszyńska Marta , Szpak Patrycja , Krześniak Natalia , Malejczyk Jacek , Kalaszczyńska Ilona
Published: April 2021

Mesenchymal stem cells have generated a great deal of interest due to their potential use in regenerative medicine and tissue engineering. Examples illustrating their therapeutic value across various in vivo models are demonstrated in the literature. However, some clinical trials have not proved their therapeutic efficacy, showing that translation into clinical practice is considerably more difficult and discrepancies in clinical protocols can be a source of failure. Among the critical factors which play an important role in MSCs’ therapeutic efficiency are the method of preservation of the stem cell viability and various characteristics during their storage and transportation from the GMP production facility to the patient’s bedside. The cell storage medium should be considered a key factor stabilizing the environment and greatly influencing cell viability and potency and therefore the effectiveness of advanced therapy medicinal product (ATMP) based on MSCs. In this review, we summarize data from 826 publications concerning the effect of the most frequently used cell preservation solutions on MSC potential as cell-based therapeutic medicinal products.
Characterization of Speech and Language Phenotype in GLUT1DS
Authors: Zanaboni Martina Paola , Pasca Ludovica , Villa Barbara Valeria , Faggio Antonella , Grumi Serena , Provenzi Livio , Varesio Costanza , De Giorgis Valentina
Published: April 2021

Background: To analyze the oral motor, speech and language phenotype in a sample of pediatric patients with GLUT 1 transporter deficiency syndrome (GLUT1DS). Methods: eight Italian-speaking children with GLUT1DS (aged 4.6–15.4 years) in stable treatment with ketogenic diet from a variable time underwent a specific and standardized speech and language assessment battery. Results: All patients showed deficits with different degrees of impairment in multiple speech and language areas. In particular, orofacial praxis, parallel and total movements were the most impaired in the oromotor domain; in the speech domain patients obtained a poor performance in the diadochokinesis rate and in the repetition of words that resulted as severely deficient in seven out of eight patients; in the language domain the most affected abilities were semantic/phonological fluency and receptive grammar. Conclusions: GLUT1DS is associated to different levels of speech and language impairment, which should guide diagnostic and therapeutic intervention. Larger population data are needed to identify more precisely a speech and language profile in GLUT1DS patients.
Physical Activity Levels among Preschool-Aged Children in Family Child Care Homes: A Comparison between Hispanic and Non-Hispanic Children Using Accelerometry
Authors: Kang Augustine W. , Gans Kim M. , von Ash Tayla , Castagneri Danielle , Dionne Laura , Tovar Alison , Risica Patricia M.
Published: April 2021

Obesity prevalence among Hispanic children is twice that of non-Hispanic white children; Hispanic children may also engage in less physical activity (PA) compared to non-Hispanic white children. A large number of U.S. preschool-aged children are cared for in Family Child Care Homes (FCCH), yet few studies have examined PA levels and ethnicity differences in PA levels among these children. We examine baseline data from a cluster-randomized trial (Healthy Start/Comienzos Sanos) to improve food and PA environments in FCCHs. Children aged 2-to-5-years (n = 342) wore triaxial accelerometers for two days in FCCHs. Variables examined include percentage of time (%) spent in sedentary, and light, moderate, and vigorous PA. The full dataset (n = 342) indicated sedentary behavior 62% ± 11% of the time and only 10% ± 5% of the time spent in moderate-to-vigorous PA. Among children in the upper-median half of wear-time (n = 176), Hispanic children had significantly greater % sedentary time vs. Non-Hispanic children (66.2% ± 8.3% vs. 62.6% ± 6.9%, p = 0.007), and lower % light PA (25.4% ± 6.3% vs. 27.7% ± 4.9%, p = 0.008) and moderate PA (5.5% ± 2.1% vs. 6.4% ± 2.2%, p = 0.018). Our results highlight that PA levels were lower among our sample compared to previous studies, and that Hispanic children were more sedentary and less active compared to non-Hispanic white children.
A Procalcitonin and C-Reactive Protein-Guided Clinical Pathway for Reducing Antibiotic Use in Children Hospitalized with Bronchiolitis
Authors: Barbieri Elisa , Rossin Sara , Giaquinto Carlo , Da Dalt Liviana , Dona’ Daniele
Published: April 2021

Despite the lack of evidence that bronchodilators, corticosteroids, and antibiotics are useful in treating bronchiolitis, their use is still widespread. This study aimed to determine the consumption of antibiotics for bronchiolitis before and after a procalcitonin-guided clinical pathway (CP) implementation. In December 2019, a CP for lower respiratory tract infection management was implemented at the Department of Women’s and Children’s Health at Padua University Hospital. This was a pre-post, quasi-experimental study that assessed the changes in the treatment of bronchiolitis during two bimesters preceding the CP implementation (pre-period: January 2018–February 2018 and January 2019–February 2019) and during the bimester after CP implementation (post-period January 2020–February 2020). After the CP implementation, there was a significant reduction in antibiotic prescriptions from 36.2% to 12.5% (p = 0.036) in patients hospitalized for bronchiolitis. Co-amoxiclav treatment, the antibiotic most commonly administered, decreased from 66.6% to 33.3%. Among outpatients’ bronchiolitis episodes, a statistically significant decrease in beta2-agonists’ use (from 18.0% to 4.4%, pre and post periods) and a quasi-significant decrease in corticosteroid use (from 8.0% to 0% pre and post periods) were observed. An evidence-based CP supported by educational lectures was associated with significant changes in the physicians’ prescribing habits.
Karstic Landscapes Are Foci of Species Diversity in the World’s Third-Largest Vertebrate Genus Cyrtodactylus Gray, 1827 (Reptilia: Squamata; Gekkonidae)
Authors: Grismer Lee , Wood Perry , Poyarkov Nikolay , Le Minh , Karunarathna Suranjan , Chomdej Siriwadee , Suwannapoom Chatmongkon , Qi Shuo , Liu Shuo , Che Jing , Quah Evan , Kraus Fred , Oliver Paul , Riyanto Awal , Pauwels Olivier , Grismer Jesse
Published: April 2021

Karstic landscapes are immense reservoirs of biodiversity and range-restricted endemism. Nowhere is this more evident than in the world’s third-largest vertebrate genus Cyrtodactylus (Gekkonidae) which contains well over 300 species. A stochastic character mapping analysis of 10 different habitat preferences across a phylogeny containing 344 described and undescribed species recovered a karst habitat preference occurring in 25.0% of the species, whereas that of the other eight specific habitat preferences occurred in only 0.2–11.0% of the species. The tenth category—general habitat preference—occurred in 38.7% of the species and was the ancestral habitat preference for Cyrtodactylus and the ultimate origin of all other habitat preferences. This study echoes the results of a previous study illustrating that karstic landscapes are generators of species diversity within Cyrtodactylus and not simply “imperiled arks of biodiversity” serving as refugia for relics. Unfortunately, the immense financial returns of mineral extraction to developing nations largely outweighs concerns for biodiversity conservation, leaving approximately 99% of karstic landscapes with no legal protection. This study continues to underscore the urgent need for their appropriate management and conservation. Additionally, this analysis supports the monophyly of the recently proposed 31 species groups and adds one additional species group.
Finite-Sample Bounds on the Accuracy of Plug-In Estimators of Fisher Information
Authors: Cao Wei , Dytso Alex , Fauß Michael , Poor H. Vincent
Published: April 2021

Finite-sample bounds on the accuracy of Bhattacharya’s plug-in estimator for Fisher information are derived. These bounds are further improved by introducing a clipping step that allows for better control over the score function. This leads to superior upper bounds on the rates of convergence, albeit under slightly different regularity conditions. The performance bounds on both estimators are evaluated for the practically relevant case of a random variable contaminated by Gaussian noise. Moreover, using Brown’s identity, two corresponding estimators of the minimum mean-square error are proposed.
IEC-61850-Based Communication for Integrated EV Management in Power Systems with Renewable Penetration
Authors: Ustun Taha Selim , Hussain S. M. Suhail , Syed Mazheruddin H. , Dambrauskas Paulius
Published: April 2021

As the number of EVs increases, their impact on electrical systems will be substantial. Novel management schemes are needed to manage the electrical load they require when charging. Literature is rich with different techniques to manage and control this effect on the grid by controlling and optimizing power flow. Although these solutions heavily rely on communication lines, they mostly treat communication as a black box. It is important to develop communication solutions that can integrate EVs, charging stations (CSs), and the rest of the grid in an interoperable way. A standard approach would be indispensable as there are different EV models manufactured by different companies. The IEC 61850 standard is a strong tool used for developing communication models for different smart grid components. However, it does not have the necessary models for implementing smart EV management schemes that coordinate between EVs and CSs. In this paper, these missing links are addressed through the development of corresponding models and message mapping. A hardware-in-the-loop test is performed to validate the communication models and cross-platform operation. Then, a co-simulation environment is used to perform a combined study of communication and the power system components. The developed communication model helps integrate the EVs to a centralized, coordinated voltage control scheme. These models can be used to run extensive impact studies where different domains of smart grids need to be considered simultaneously. The main contribution of this paper is the development of smartgrid communication solutions for enabling successful information exchanges.
Enhancing the Specific Power of a PEM Fuel Cell Powered UAV with a Novel Bean-Shaped Flow Field
Authors: Toghyani Somayeh , Atyabi Seyed Ali , Gao Xin
Published: April 2021

One of the marketing challenges of unmanned aerial vehicles (UAVs) for various applications is enhancing flight durability. Due to the superior characteristics of proton exchange membrane fuel cells (PEMFCs), they have the potential to reach a longer flight time and higher payload. In this regard, a numerical assessment of a UAV air-cooled PEMFC is carried out using a three-dimensional (3-D), multiphase, and non-isothermal model on three flow fields, i.e., unblocked bean-shaped, blocked bean-shaped, and parallel. Then, the results of single-cell modeling are generalized to the PEMFC stack to provide the power of 2.5 kW for a UAV. The obtained results indicate that the strategy of rising air stoichiometry for cooling performs well in the unblocked bean-shaped design, and the maximum temperature along the channel length reaches 331.5 K at the air stoichiometric of 30. Further, it is found that the best performance of a 2.5 kW PEMFC stack is attained by the bean-shaped design without blockage, of which its volume and mass power density are 1.1 kW L−1 and 0.2 kW kg−1, respectively. It is 9.4% lighter and 6.9% more compact than the parallel flow field. Therefore, the unblocked bean-shaped design can be a good option for aerial applications.
Robust Inverse Optimal Control for a Boost Converter
Authors: Villegas-Ruvalcaba Mario , Gurubel-Tun Kelly , Coronado-Mendoza Alberto
Published: April 2021

The variability of renewable energies and their integration into the grid via power electronics demands the design of robust control algorithms. This work incorporates two techniques to ensure the stability of a boost converter through its state equations, implementing the inverse optimal control and the gain-scheduling technique for robust control settings. In such a way that, under a single adjustment, it is capable of damping different changes such as changes in the parameters, changes in the load, the input voltage, and the reference voltage. On the other hand, inverse optimal control is based on a discrete-time control Lyapunov function (CLF), and CLF candidate depends on fixed parameters that are selected to obtain the solution for inverse optimal control. Once these parameters have been found through heuristic or artificial intelligence methods, the new proposed methodology is capable of obtaining a robust optimal control scheme, without having to search for new parameters through other methods, since these are sometimes sensitive changes and many times the process of a new search is delayed. The results of the approach are simulated using Matlab, obtaining good performance of the proposed control under different operation conditions. Such simulations yielded errors of less than 1% based on the voltage reference, given the disturbances caused by changes in the input variables, system parameters, and changes in the reference. Thus, applying the new methodology, the stability of our system was preserved in all cases.
Determination of the Selected Wells Operational Power with Borehole Heat Exchangers Operating in Real Conditions, Based on Experimental Tests
Authors: Piotrowska-Woroniak Joanna
Published: April 2021

On the basis of experimental studies, the operational power of four borehole heat exchangers (BHE) under real conditions was determined. The research was carried out in 2018–2019. The theoretical power of the BHE was verified with its operating power. The amount of thermal energy absorbed from the ground by individual BHEs, the operating temperatures obtained at the inlet and outlet of the exchanger, the annual brine flow rate, and the average operating power of the tested wells in two heating seasons were compared and analyzed. Both in 2018 and 2019, none of the examined exchangers achieved an average unit capacity of a well. The aim of the work is to verify the specific ground thermal efficiency indicators adopted for the design of the lower heat source, determined using the computational method and the TRT test with data obtained on the basis of experimental tests. The differences between the results of the tests of the operating parameters of the analyzed BHEs were shown. The data obtained in real conditions is valuable in the research and development of the BHE system.
Monitoring the Indoor Air Quality: A Case Study of Passive Cooling from Historical Hypogeal Rooms
Authors: Laurini Eleonora , De Vita Mariangela , De Berardinis Pierluigi
Published: April 2021

Attaining a good level of internal comfort is possible by controlling various parameters. Among all, the thermo-hygrometric comfort and the indoor air quality are of fundamental importance. This research is developed with the aim of verifying the indoor air quality following the installation of a passive cooling device in a historic building located in the province of L’Aquila in the municipality of Poggio Picenze in climatic zone E. This research aims to verify the functioning of a ventilation duct installed between the hypogeal and the second level of the structure that was installed to obtain air recirculation by exploiting the inertial potential of the hypogeal room. The first phase of the research was aimed at thermo-hygrometric monitoring using sensors installed on-site and controlled remotely in order to verify the operation of the device. The second-phase object of this text was useful in investigating the acquired indoor air quality level.
Coordinated Control Strategy and Validation of Vehicle-to-Grid for Frequency Control
Authors: Yoo Yeong , Al-Shawesh Yousef , Tchagang Alain
Published: April 2021

The increased penetration of renewable energy sources (RES) and electric vehicles (EVs) is resulting in significant challenges to the stability, reliability, and resiliency of the electrical grid due to the intermittency nature of RES and uncertainty of charging demands of EVs. There is a potential for significant economic returns to use vehicle-to-grid (V2G) technology for peak load reduction and frequency control. To verify the effectiveness of the V2G-based frequency control in a microgrid, modeling and simulations of single- and multi-vehicle-based primary and secondary frequency controls were conducted to utilize the integrated components at the Canadian Centre for Housing Technology (CCHT)-V2G testing facility by using MATLAB/Simulink. A single-vehicle-based model was validated by comparing empirical testing and simulations of primary and secondary frequency controls. The validated conceptual model was then applied for dynamic phasor simulations of multi-vehicle-based frequency control with a proposed coordinated control algorithm for improving frequency stability and facilitating renewables integration with V2G-capable EVs in a microgrid. This proposed model includes a decentralized coordinated control of the state of charge (SOC) and charging schedule for five aggregated EVs with different departure times and SOC management profiles preferred by EV drivers. The simulation results showed that the fleet of 5 EVs in V2B/V2G could effectively reduce frequency deviation in a microgrid.
Decarbonization of Residential Building Energy Supply: Impact of Cogeneration System Performance on Energy, Environment, and Economics
Authors: Cheekatamarla Praveen K.
Published: April 2021

Electrical and thermal loads of residential buildings present a unique opportunity for onsite power generation, and concomitant thermal energy generation, storage, and utilization, to decrease primary energy consumption and carbon dioxide intensity. This approach also improves resiliency and ability to address peak load burden effectively. Demand response programs and grid-interactive buildings are also essential to meet the energy needs of the 21st century while addressing climate impact. Given the significance of the scale of building energy consumption, this study investigates how cogeneration systems influence the primary energy consumption and carbon footprint in residential buildings. The impact of onsite power generation capacity, its electrical and thermal efficiency, and its cost, on total primary energy consumption, equivalent carbon dioxide emissions, operating expenditure, and, most importantly, thermal and electrical energy balance, is presented. The conditions at which a cogeneration approach loses its advantage as an energy efficient residential resource are identified as a function of electrical grid’s carbon footprint and primary energy efficiency. Compared to a heat pump heating system with a coefficient of performance (COP) of three, a 0.5 kW cogeneration system with 40% electrical efficiency is shown to lose its environmental benefit if the electrical grid’s carbon dioxide intensity falls below 0.4 kg CO2 per kWh electricity.
Global Energy Production Computation of a Solar-Powered Smart Home Automation System Using Reliability-Oriented Metrics
Authors: Rotar Raul , Jurj Sorin Liviu , Susany Robert , Opritoiu Flavius , Vladutiu Mircea
Published: April 2021

This paper presents a modified global energy production computation formula that replaces the traditional Performance Ratio (PR) with a novel Solar Reliability Factor (SRF) for mobile solar tracking systems. The SRF parameter describes the reliability and availability of a dual-axis solar tracker, which powers a smart home automation system entirely by using clean energy. By applying the SRF in the global energy production formula of solar tracking systems, we can predict the energy generation in real time, allowing proper energy management of the entire smart home automation system. Regarding static deployed Photovoltaic (PV) systems, the PR factor is preserved to compute the power generation of these devices accurately. Experimental results show that the energy production computation constantly fluctuates over several days due to the SRF parameter variation, showing a 26.11% reduction when the dual-axis solar tracker’s availability is affected by system errors and maximum power generation when the solar tracking device is operating in optimal conditions.
Comparative Adhesive Bonding of Wood Chemically Modified with Either Acetic Anhydride or Butylene Oxide
Authors: Frihart Charles R. , Brandon Rishawn , Ibach Rebecca E. , Hunt Christopher G. , Gindl-Altmutter Wolfgang
Published: April 2021

Determining adhesive bond performance for chemically modified wood is important not only for its commercial utility but also for understanding wood bond durability. Bulking modifications occupy space inside the cell wall, limiting the space available for water. We used two bulking modifications on yellow poplar (Liriodendron tulipifera L.): acetylation (Ac), which bulks and converts a wood hydroxyl group to an ester, while butylene oxide (BO) also bulks the wood but preserves a hydroxyl group. Both result in lower water uptake; however, the loss of the hydroxyl group with Ac reduces the wood’s ability to form hydrogen and other polar bonds with the adhesives. On the other hand, the BO reaction replaces a hydroxyl group with another one along a hydrocarbon chain; thus, this product may not be harder to bond than the unmodified wood. We investigated how these chemical modifications of wood affect bond performance with four adhesives: resorcinol-formaldehyde (RF), melamine-formaldehyde (MF), emulsion polymer isocyanate (EPI), and epoxy. The ASTM D 905 bond shear strength for both dry and wet samples showed that the BO results were quite similar to the unmodified wood, but the MF and EPI performed poorly on Ac-modified wood, in contrast to the results with RF and epoxy.
Mapping Floods in Lowland Forest Using Sentinel-1 and Sentinel-2 Data and an Object-Based Approach
Authors: Gašparović Mateo , Klobučar Damir
Published: April 2021

The impact of floods on forests is immediate, so it is necessary to quickly define the boundaries of flooded areas. Determining the extent of flooding in situ has shortcomings due to the possible limited spatial and temporal resolutions of data and the cost of data collection. Therefore, this research focused on flood mapping using geospatial data and remote sensing. The research area is located in the central part of the Republic of Croatia, an environmentally diverse area of lowland forests of the Sava River and its tributaries. Flood mapping was performed by merging Sentinel-1 (S1) and Sentinel-2 (S2) mission data and applying object-based image analysis (OBIA). For this purpose, synthetic aperture radar (SAR) data (GRD processing level) were primarily used during the flood period due to the possibility of all-day imaging in all weather conditions and flood detection under the density of canopy. The pre-flood S2 imagery, a summer acquisition, was used as a source of additional spectral data. Geographical information system (GIS) layers—a multisource forest inventory, habitat map, and flood hazard map—were used as additional sources of information in assessing the accuracy of and interpreting the obtained results. The spectral signature, geometric and textural features, and vegetation indices were applied in the OBIA process. The result of the work was a developed methodological framework with a high accuracy and speed of production. The overall accuracy of the classification is 94.94%. Based on the conducted research, the usefulness of the C band of the S1 in flood mapping in lowland forests in the leaf-off season was determined. The paper presents previous research and describes the SAR parameters and characteristics of floodplain forest with a significant impact on the accuracy of classification.
Microbial Growth Study on Pork Loins as Influenced by the Application of Different Antimicrobials
Authors: Vargas David A. , Miller Markus F. , Woerner Dale R. , Echeverry Alejandro
Published: April 2021

The use of antimicrobials in the pork industry is critical in order to ensure food safety and, at the same time, extend shelf life. The objective of the study was to determine the impact of antimicrobials on indicator bacteria on pork loins under long, dark, refrigerated storage conditions. Fresh boneless pork loins (n = 36) were split in five sections and treated with antimicrobials: Water (WAT), Bovibrom 225 ppm (BB225), Bovibrom 500 ppm (BB500), Fit Fresh 3 ppm (FF3), or Washing Solution 750 ppm (WS750). Sections were stored for 1, 14, 28, and 42 days at 2–4 °C. Mesophilic and psychrotrophic aerobic bacteria (APC-M, APC-P), lactic acid bacteria (LAB-M), coliforms, and Escherichia coli were enumerated before intervention, after intervention, and at each storage time. All bacterial enumeration data were converted into log10 for statistical analysis, and the Kruskal–Wallis test was used to find statistical differences (p < 0.05). Initial counts did not differ between treatments, while, after treatment interventions, treatment WS750 did not effectively reduce counts for APC-M, APC-P, and coliforms (p < 0.01). BB500, FF3, and WS750 performed better at inhibiting the growth of indicator bacteria when compared with water until 14 days of dark storage.
Common Variation in Cytoskeletal Genes Is Associated with Conotruncal Heart Defects
Authors: Musfee Fadi I. , Agopian A. J. , Goldmuntz Elizabeth , Hakonarson Hakon , Morrow Bernice E. , Taylor Deanne M. , Tristani-Firouzi Martin , Watkins W. Scott , Yandell Mark , Mitchell Laura E.
Published: April 2021

There is strong evidence for a genetic contribution to non-syndromic congenital heart defects (CHDs). However, exome- and genome-wide studies conducted at the variant and gene-level have identified few genome-wide significant CHD-related genes. Gene-set analyses are a useful complement to such studies and candidate gene-set analyses of rare variants have provided insight into the genetics of CHDs. However, similar analyses have not been conducted using data on common genetic variants. Consequently, we conducted common variant analyses of 15 CHD candidate gene-sets, using data from two common types of CHDs: conotruncal heart defects (1431 cases) and left ventricular outflow tract defects (509 cases). After Bonferroni correction for evaluation of multiple gene-sets, the cytoskeletal gene-set was significantly associated with conotruncal heart defects (βS = 0.09; 95% confidence interval (CI) 0.03–0.15). This association was stronger when analyses were restricted to the sub-set of cytoskeletal genes that have been observed to harbor rare damaging genotypes in at least two CHD cases (βS = 0.32, 95% CI 0.08–0.56). These findings add to the evidence linking cytoskeletal genes to CHDs and suggest that, for cytoskeletal genes, common variation may contribute to the risk of CHDs.
The Consequences of Budding versus Binary Fission on Adaptation and Aging in Primitive Multicellularity
Authors: Isaksson Hanna , Conlin Peter L. , Kerr Ben , Ratcliff William C. , Libby Eric
Published: April 2021

Early multicellular organisms must gain adaptations to outcompete their unicellular ancestors, as well as other multicellular lineages. The tempo and mode of multicellular adaptation is influenced by many factors including the traits of individual cells. We consider how a fundamental aspect of cells, whether they reproduce via binary fission or budding, can affect the rate of adaptation in primitive multicellularity. We use mathematical models to study the spread of beneficial, growth rate mutations in unicellular populations and populations of multicellular filaments reproducing via binary fission or budding. Comparing populations once they reach carrying capacity, we find that the spread of mutations in multicellular budding populations is qualitatively distinct from the other populations and in general slower. Since budding and binary fission distribute age-accumulated damage differently, we consider the effects of cellular senescence. When growth rate decreases with cell age, we find that beneficial mutations can spread significantly faster in a multicellular budding population than its corresponding unicellular population or a population reproducing via binary fission. Our results demonstrate that basic aspects of the cell cycle can give rise to different rates of adaptation in multicellular organisms.
Digital and Economic Determinants of Healthcare in the Crisis-Affected Population in Afghanistan: Access to Mobile Phone and Socioeconomic Barriers
Authors: Noh Jin-Won , Im Yu-Mi , Kim Kyoung-Beom , Kim Min Hee , Kwon Young Dae , Cha Jiho
Published: April 2021

Despite recent progress in Afghanistan’s health system from the support of international donors and NGOs, protracted conflicts combined with a series of natural disasters have continued to present substantial health risks. Extreme poverty has still aggravated social determinants of health and financial barriers to healthcare. Little is known about the context-specific factors influencing access to healthcare in the crisis-affected population. Using a subset of data from ‘Whole of Afghanistan Assessment (WoAA) 2019’, this study analyzed 31,343 households’ data, which was collected between 17 July and 19 September 2019 throughout all 34 provinces in Afghanistan. The outcome measured was access to care in the healthcare facility, and multivariable binary logistic regression models were used to identify the specific factors associated with access to healthcare. Of 31,343 households exposed to complex emergencies in Afghanistan, 10,057 (32.1%) could not access healthcare facilities when one was needed in last three months. The access to healthcare was significantly associated with displacement status, economic factors such as employment status or total monthly income, and the distance to healthcare facilities. Significant increase in healthcare access was associated with factors related to communication and access to information, such as awareness of humanitarian assistance availability and mobile phone with a SIM card, while disability in cognitive function, such as memory or concentration, was associated with poorer healthcare access. Our findings indicate that the crisis-affected population remains vulnerable in access to healthcare, despite the recent improvements in health sectors. Digital determinants, such as access to mobile phone, need to be addressed along with the healthcare barriers related to poverty and household vulnerabilities. The innovative humanitarian financing system using mobile communication and cash transfer programs would be considerable for the conflict-affected but digitally connected population in Afghanistan.
The Effects of Emergency Room Violence toward Nurse′s Intention to Leave—Resilience as a Mediator
Authors: Li Jui-Hsuan , Chen Ta-Wei , Lee Hsiu-Fang , Shih Whei-Mei
Published: April 2021

(1) Background: Healthcare workplace violence has been a focused issue in the whole world. The rate of the occurrence is pretty high in every country. The emergency room is a high risk and high frequency place for violence to occur. Under the medical service demands from people, it is quite easy to bring about conflicts. This leads to serious physical and mental harm to nurses. When suffering from physical and mental injuries, resilience is a protective factor away from negative influence. It is rare to explore and study how the nurses’ resilience ability, workplace violence and turnover intention are related. Thus, the aim of this study is to understand resilience as a mediator effect in emergency nurses toward the workplace violence. (2) Methods: A cross-sectional survey study was used to collect information from emergency room nurses of a medical center in northern Taiwan. There were 132 samples in total. Three research instruments were included as follows: Hospital Workplace Violence Prevention Questionnaire, Connor-Davidson Resilience Scale, and Turnover Intention Scale. Statistical analysis using t-test, ANOVA, Correlation, as well as Sobel test were used in this study. (3) Results: The results revealed that the average age was 29.5 ± 5.6. Almost 58% of nurses experienced workplace violence. Twelve percent of nurse had experienced physical violence and 53.8% had experienced mental violence. There was significant relationship between shift personnel and religious believers. To the people who suffered physical violence, there was a significant relationship between emergency room working years and the total working years. There was significant difference between those who had suffered mental violence and religious believers. Female nurses suffered mental violence to a much higher extent than male nurses. There was a significant relationship between nurses’ working years, the total working years, resilience, and turnover intention. Resilience was not the mediator for workplace violence toward turnover intention in this study. (4) Conclusions: The outcome of this study suggested that on an individual level, nurses can enhance self-protection and communication skills to decrease workplace violence. For emergency environment settings, designing a good working environment, visitors’ restriction, avoiding working alone, and enhancing supervising alarm system are recommended. As for hospital administrators, fitness for work and to set up a project team is necessary. These can be references in planning prevention on workplace violence and promoting quality of workplace and patient safety in the future.
Disability-Free Life Expectancy among People Over 60 Years Old by Sex, Urban and Rural Areas in Jiangxi Province, China
Authors: Wang Shengwei , Hu Songbo , Wang Pei , Wu Yuhang , Liu Zhitao , Zheng Huilie
Published: April 2021

Objective: To estimate and compare age trends and the disability-free life expectancy (DFLE) of the population over 60 years old in 2018 in Jiangxi Province, China, by sex and urban–rural areas. Methods: The model life table was employed to estimate the age-specific mortality rate by sex and urban–rural areas, based on the Summary of Health Statistics of Jiangxi Province in 2018 and the Sixth National Health Service survey of Jiangxi Province. DFLE and its ratio to life expectancy (LE) were obtained by the Sullivan method. Results: In 2018, the DFLE among people over 60 is 17.157 years for men and is 19.055 years for women, accounting for 89.7% and 86.5% of their LE respectively. The DFLE/LE of men is higher than that of women at all ages. LE and DFLE are higher for the population in urban areas than in rural areas. For women, DFLE/LE is higher in urban areas than in rural areas (except at ages 75 and 80). Urban men have a higher DFLE/LE than rural men (except at age 85). The difference in DFLE between men and women over 60 years is 1.898 years, of which 2.260 years are attributable to the mortality rate, and 0.362 years are due to the disability-free prevalence. In addition, the difference in DFLE between urban–rural elderly over 60 years old is mostly attributed to the mortality rate by gender (male: 0.902/1.637; female: 0.893/1.454), but the impact of the disability-free rate cannot be ignored either (male: 0.735/1.637; female: 0.561/1.454). Conclusions: The increase in DFLE is accompanied by the increase in LE, but with increased age, DFLE/LE gradually decreases. With advancing age, the effect of disability on elderly people becomes more severe. The government administration must implement some preventive actions to improve health awareness and the life quality of the elderly. Rural elderly; rural women in particular, need to be paid more attention and acquire more health care.