bluuebunny/crossref_metadata_2025 huggingface dataset:
Virtual Reality as a Tool for Public Consultations in Spatial Planning and Management
Authors: Szczepańska Agnieszka , Kaźmierczak Rafał , Myszkowska Monika
Published: September 2021

Planning and management of urban space that involves the local community the process is key to optimal management of the surroundings, in line with social needs. Social isolation imposed because of the COVID-19 pandemic considerably reduces the possibility of conducting public consultations. This study hypothesized that such consultations can be carried out using new visualisation technologies in the virtual reality (VR) area. Owing to the development of new technologies, innovative services can be created which make it easier for recipients to absorb new content. To this end, the ArchitektVR application was developed, which uses enhanced reality for public consultations concerning planned land development. 3D visualisation with VR enables the presentation of various aspects of area development in a clear form, understandable to an average user with no specialist qualifications. It facilitates the presentation and creation of multiple variants/scenarios for the future shape of the area. The research assumptions were tested for a disused area of a water body. According to preliminary tests, the use of virtual reality could provide a new form of communication between decision-makers and citizens. Effective and easy-to-understand visualisations might provide encouragement to participate in local matters and enable citizens to make better decisions. 3D visualisation enabled concerned individuals to assess the potential development of a selected area fragment without an in-person visit, either in the field or to an office. This is of particular importance in relation to the COVID-19 pandemic and sanitary restrictions.
Medical Peat Waste Upcycling to Carbonized Solid Fuel in the Torrefaction Process
Authors: Świechowski Kacper , Leśniak Małgorzata , Białowiec Andrzej
Published: September 2021

Peat is the main type of peloid used in Polish cosmetic/healing spa facilities. Depending on treatment and origin, peat waste can be contaminated microbiologically, and as a result, it must be incinerated in medical waste incineration plants without energy recovery (local law). Such a situation leads to peat waste management costs increase. Therefore, in this work, we checked the possibility of peat waste upcycling to carbonized solid fuel (CSF) using torrefaction. Torrefaction is a thermal treatment process that removes microbiological contamination and improves the fuel properties of peat waste. In this work, the torrefaction conditions (temperature and time) on CSF quality were tested. Parallelly, peat decomposition kinetics using TGA and torrefaction kinetics with lifetime prediction using macro-TGA were determined. Furthermore, torrefaction theoretical mass and energy balance were determined. The results were compared with reference material (wood), and as a result, obtained data can be used to adjust currently used wood torrefaction technologies for peat torrefaction. The results show that torrefaction improves the high heating value of peat waste from 19.0 to 21.3 MJ × kg−1, peat main decomposition takes place at 200–550 °C following second reaction order (n = 2), with an activation energy of 33.34 kJ × mol−1, and pre-exponential factor of 4.40 × 10−1 s−1. Moreover, differential scanning calorimetry analysis revealed that peat torrefaction required slightly more energy than wood torrefaction, and macro-TGA showed that peat torrefaction has lower torrefaction constant reaction rates (k) than wood 1.05 × 10−5–3.15 × 10−5 vs. 1.43 × 10−5–7.25 × 10−5 s−1.
Challenges in All-DC Offshore Wind Power Plants
Authors: Follo Alessandra , Saborío-Romano Oscar , Tedeschi Elisabetta , Cutululis Nicolaos A.
Published: September 2021

As the size and distance from shore of new offshore wind power plants (OWPPs) increase, connection to shore using high-voltage (HV) direct-current (DC) technology becomes more cost-effective. Currently, every offshore wind power plant has a collection system based on medium-voltage alternating-current technology. Such systems rely on heavy and bulky low-frequency (i.e., 50 or 60 Hz) transformers: a drawback offshore, where equipment weight and space are restricted. Consequently, there is growing interest in medium-voltage direct-current collection systems, in which low-frequency transformers are replaced with DC/DC converters equipped with lighter and smaller medium-frequency transformers. However, the deployment of all-DC OWPPs still faces several challenges. Based on a very comprehensive and critical literature review, three of them are identified and discussed in this paper. The first challenge is the technological gap at component level. In this work, the DC/DC converter topologies most suitable for application to OWPPs are described and compared. The second challenge is the controllability of DC collection systems. Parallel, series and hybrid DC collection system layouts are presented and discussed. The third challenge is the compliance of all-DC OWPPs with current requirements for their connection to the onshore grids. The three challenges are discussed to highlight current research gaps and potential future directions.
Terrestrial and Aquatic Carbon Dynamics in Tropical Peatlands under Different Land Use Types: A Systematic Review Protocol
Authors: Sasmito Sigit D. , Taillardat Pierre , Fong Letisha S. , Ren Jonathan W. F. , Sundahl Hanna , Wijedasa Lahiru , Bandla Aditya , Arifin-Wong Nura , Sudarshan Ashwin Sridhar , Tarigan Suria , Taufik Muh , Ramchunder Sorain J. , Lupascu Massimo , Taylor David
Published: September 2021

Peatlands are both responding to and influencing climate change. While numerous studies on peatland carbon dynamics have been published in boreal and temperate regions for decades, a much smaller yet growing body of scientific articles related to tropical peatlands has recently been published, including from previously overlooked regions such as the Amazonian and Congo basins. The recent recognition of tropical peatlands as valuable ecosystems because of the organic carbon they accumulate in their water-saturated soils has occurred after most of them have been drained and degraded in Southeast Asia. Under disturbed conditions, their natural carbon storage function is shifted to an additional carbon source to the atmosphere. Understanding the effect of land-use change and management practices on peatlands can shed light on the driving variables that influence carbon emissions and can model the magnitude of emissions in future degraded peatlands. This is of primary importance as other peatland-covered regions in the tropics are at risk of land-use and land-cover changes. A systematic review that synthesizes the general understanding of tropical peatland carbon dynamics based on the published literature is much needed to guide future research directions on this topic. Moreover, previous studies of biogeochemical cycling in tropical peatlands have largely focused on terrestrial stocks and fluxes with little attention given to document lateral and downstream aquatic export through natural and artificial drainage channels. Here, we present a systematic review protocol to describe terrestrial and aquatic carbon dynamics in tropical peatlands and identify the influence of land-use change on carbon exchange. We described a set of literature search and screening steps that lay the groundwork for a future synthesis on tropical peatlands carbon cycling. Such an evidence-based synthesis using a systematic review approach will help provide the research community and policymakers with consistent science-based guidelines to set and monitor emissions reduction targets as part of the forestry and land-use sector.
Bromelain, a Group of Pineapple Proteolytic Complex Enzymes (Ananas comosus) and Their Possible Therapeutic and Clinical Effects. A Summary
Authors: Varilla Carolina , Marcone Massimo , Paiva Lisete , Baptista Jose
Published: September 2021

Bromelain is a complex combination of multiple endopeptidases of thiol and other compounds derived from the pineapple fruit, stem and/or root. Fruit bromelain and stem bromelain are produced completely distinctly and comprise unique compounds of enzymes, and the descriptor “Bromelain” originally referred in actuality to stem bromelain. Due to the efficacy of oral administration in the body, as a safe phytotherapeutic medication, bromelain was commonly suited for patients due to lack of compromise in its peptidase efficacy and the absence of undesired side effects. Various in vivo and in vitro studies have shown that they are anti-edematous, anti-inflammatory, anti-cancerous, anti-thrombotic, fibrinolytic, and facilitate the death of apoptotic cells. The pharmacological properties of bromelain are, in part, related to its arachidonate cascade modulation, inhibition of platelet aggregation, such as interference with malignant cell growth; anti-inflammatory action; fibrinolytic activity; skin debridement properties, and reduction of the severe effects of SARS-Cov-2. In this paper, we concentrated primarily on the potential of bromelain’s important characteristics and meditative and therapeutic effects, along with the possible mechanism of action.
Low-Protein Diet: History and Use of Processed Low-Protein Rice for the Treatment of Chronic Kidney Disease
Authors: Watanabe Shaw , Ohtsubo Ken’ichi
Published: September 2021

The epidemiology of chronic kidney disease (CKD) shows increasing trends in prevalence and mortality and has become the leading health problem worldwide. Reducing the amount of proteins ingested from rice is an easy way to control the total intake of proteins, saving energy sources, particularly in rice-eating countries. In Japan, low-protein white rice had been developed, but the taste and function were not satisfactory for CKD patients. We reviewed the brief history of low-protein dietary therapy for renal diseases and the recent development of low-protein processed brown rice (LPBR). The new LPBR is characterized by a low-protein content, the same energy content as white rice, low potassium and phosphorus contents, and high amounts of dietary fibers, γ-oryzanol, and antioxidant activity. Dietary fibers and γ-oryzanol would stabilize intestinal microbiota and improve uremic dysbiosis and leaky gut syndrome. All these features suggest that the health benefits of LPBR extend to preventing CKD progression and enhancing the quality of life (QOL) of patients with CKD.
Analysis of Codon Usage Patterns of Six Sequenced Brachypodium distachyon Lines Reveals a Declining CG Skew of the CDSs from the 5′-ends to the 3′-ends
Authors: Wang Jianyong , Lin Yujing , Xi Mengli
Published: September 2021

Brachypodium distachyon, a new monocotyledonous model plant, has received wide attention in biological research due to its small genome and numerous genetic resources. Codon usage bias is an important feature of genes and genomes, and it can be used in transgenic and evolutionary studies. In this study, the nucleotide compositions and patterns of codon usage bias were calculated using Codon W. Additionally, an ENC plot, Parity rule 2 and correspondence analyses were used to explore the major factors influencing codon usage bias patterns. The numbers of hydrogen bonds and skews were used to analyze the GC trend in the 5′-ends of the coding sequences. The results showed that minor differences in the codon usage bias patterns were revealed by the ENC plot, Parity rule 2 and correspondence analyses. The analyses of the CG-skew and the number of hydrogen bonds showed a declining trend in the number of cytosines at the 5′-ends of the CDSs (from the 5′-ends to the 3′-ends), indicating that GC may play a major role in codon usage bias. In addition, our results laid a foundation for the study of codon usage bias patterns in Brachypodium genus and suggested that the GC plays a major role in determining these patterns.
RNF213 c.14576G>A Is Associated with Intracranial Internal Carotid Artery Saccular Aneurysms
Authors: Murai Yasuo , Ishisaka Eitaro , Watanabe Atsushi , Sekine Tetsuro , Shirokane Kazutaka , Matano Fumihiro , Nakae Ryuta , Tamaki Tomonori , Koketsu Kenta , Morita Akio
Published: September 2021

A mutation in RNF213 (c.14576G>A), a gene associated with moyamoya disease (>80%), plays a role in terminal internal carotid artery (ICA) stenosis (>15%) (ICS). Studies on RNF213 and cerebral aneurysms (AN), which did not focus on the site of origin or morphology, could not elucidate the relationship between the two. However, a report suggested a relationship between RNF213 and AN in French-Canadians. Here, we investigated the relationship between ICA saccular aneurysm (ICA-AN) and RNF213. We analyzed RNF213 expression in subjects with ICA-AN and atherosclerotic ICS. Cases with a family history of moyamoya disease were excluded. AN smaller than 4 mm were confirmed as AN only by surgical or angiographic findings. RNF213 was detected in 12.2% of patients with ICA-AN and 13.6% of patients with ICS; patients with ICA-AN and ICS had a similar risk of RNF213 mutation expression (odds ratio, 0.884; 95% confidence interval, 0.199–3.91; p = 0.871). The relationship between ICA-AN and RNF213 (c.14576G>A) was not correlated with the location of the ICA and bifurcation, presence of rupture, or multiplicity. When the etiology and location of AN were more restricted, the incidence of RNF213 mutations in ICA-AN was higher than that reported in previous studies. Our results suggest that strict maternal vessel selection and pathological selection of AN morphology may reveal an association between genetic mutations and ICA-AN development. The results of this study may form a basis for further research on systemic vascular diseases, in which the RNF213 (c.14576G>A) mutation has been implicated.
Myocardial Deformation Analysis in MYBPC3 and MYH7 Related Sarcomeric Hypertrophic Cardiomyopathy—The Graz Hypertrophic Cardiomyopathy Registry
Authors: Höller Viktoria , Seebacher Heidelis , Zach David , Schwegel Nora , Ablasser Klemens , Kolesnik Ewald , Gollmer Johannes , Waltl Gert , Rainer Peter P. , Verheyen Sarah , Zirlik Andreas , Verheyen Nicolas
Published: September 2021

Accumulating evidence suggests that individuals with sarcomeric hypertrophic cardiomyopathy (HCM) carrying MYH7 mutations may have a worse prognosis than MYBPC3 mutation carriers. Myocardial deformation analysis is superior to standard echocardiography in detecting subtle myocardial dysfunction and scar formation, but studies evaluating the association with HCM genotype are scarce. We therefore aimed to compare myocardial strain parameters between MYBPC3 and MYH7 mutation carriers with proven HCM. Participants of the prospective Graz HCM Registry carrying at least one causative mutation in MYBPC3 (n = 39) or MYH7 (n = 18) were enrolled. MYBPC3 mutation carriers were older, predominantly male and more often treated with an implantable cardioverter-defibrillator (39% vs. 0%; p = 0.002). Using analyses of covariance, there were no significant differences between MYBPC3 and MYH7 mutation carriers with regard to left ventricular global longitudinal strain (estimated marginal means ± standard deviation: −16.9 ± 0.6% vs. −17.3 ± 0.9%; p = 0.807) and right ventricular 6-segments endocardial strain (−24.3 ± 1.0% vs. 26.3 ± 1.5%; p = 0.285). Our study suggests, that myocardial deformation analysis may not be helpful in concluding on the underlying HCM genotype, and vice versa.
DEAD-Box RNA Helicases and Genome Stability
Authors: Cargill Michael , Venkataraman Rasika , Lee Stanley
Published: September 2021

DEAD-box RNA helicases are important regulators of RNA metabolism and have been implicated in the development of cancer. Interestingly, these helicases constitute a major recurring family of RNA-binding proteins important for protecting the genome. Current studies have provided insight into the connection between genomic stability and several DEAD-box RNA helicase family proteins including DDX1, DDX3X, DDX5, DDX19, DDX21, DDX39B, and DDX41. For each helicase, we have reviewed evidence supporting their role in protecting the genome and their suggested mechanisms. Such helicases regulate the expression of factors promoting genomic stability, prevent DNA damage, and can participate directly in the response and repair of DNA damage. Finally, we summarized the pathological and therapeutic relationship between DEAD-box RNA helicases and cancer with respect to their novel role in genome stability.
Formalin-Fixed and Paraffin-Embedded Samples for Next Generation Sequencing: Problems and Solutions
Authors: Cazzato Gerardo , Caporusso Concetta , Arezzo Francesca , Cimmino Antonietta , Colagrande Anna , Loizzi Vera , Cormio Gennaro , Lettini Teresa , Maiorano Eugenio , Scarcella Vincenza , Tarantino Paola , Marrone Maricla , Stellacci Alessandra , Parente Paola , Romita Paolo , De Marco Aurora , Venerito Vincenzo , Foti Caterina , Ingravallo Giuseppe , Rossi Roberta , Resta Leonardo
Published: September 2021

Over the years, increasing information has been asked of the pathologist: we have moved from a purely morphological diagnosis to biomolecular and genetic studies, which have made it possible to implement the use of molecular targeted therapies, such as anti-epidermal growth factor receptor (EGFR) molecules in EGFR-mutated lung cancer, for example. Today, next generation sequencing (NGS) has changed the approach to neoplasms, to the extent that, in a short time, it has gained a place of absolute importance and diagnostic, prognostic and therapeutic utility. In this scenario, formaldehyde-fixed and paraffin-embedded (FFPE) biological tissue samples are a source of clinical and molecular information. However, problems can arise in the genetic material (DNA and RNA) for use in NGS due to fixation, and work is being devoted to possible strategies to reduce its effects. In this paper, we discuss the applications of FFPE tissue samples in the execution of NGS, we focus on the problems arising with the use of this type of material for nucleic acid extraction and, finally, we consider the most useful strategies to prevent and reduce single nucleotide polymorphisms (SNV) and other fixation artifacts.
MYO5A Frameshift Variant in a Miniature Dachshund with Coat Color Dilution and Neurological Defects Resembling Human Griscelli Syndrome Type 1
Authors: Christen Matthias , de le Roi Madeleine , Jagannathan Vidhya , Becker Kathrin , Leeb Tosso
Published: September 2021

A 1-month-old, female, smooth-haired miniature Dachshund with dilute color and neurological defects was investigated. The aim of this study was to characterize the clinical signs, histopathological changes and underlying genetic defect. The puppy had visible coat color dilution and was unable to hold its head on its own or to remain in a stable prone position for an extended period. Histopathological examination revealed an accumulation of clumped melanin and deposition of accumulated keratin within the hair follicles, accompanied by dermal pigmentary incontinence. These dermatological changes were compatible with the histopathology described in dogs with an MLPH-related dilute coat color. We sequenced the genome of the affected dog and compared the data to 795 control genomes. MYO5A, coding for myosin VA, was investigated as the top functional candidate gene. This search revealed a private homozygous frameshift variant in MYO5A, XM_022412522.1:c.4973_4974insA, predicted to truncate 269 amino acids (13.8%) of the wild type myosin VA protein, XP_022268230.1:p.(Asn1658Lysfs*28). The genotypes of the index family showed the expected co-segregation with the phenotype and the mutant allele was absent from 142 additionally genotyped, unrelated Dachshund dogs. MYO5A loss of function variants cause Griscelli type 1 syndrome in humans, lavender foal in horses and the phenotype of the dilute mouse mutant. Based on the available data, together with current knowledge on other species, we propose the identified MYO5A frameshift insertion as a candidate causative variant for the observed dermatological and neurological signs in the investigated dog.
Adverse Perinatal and Early Life Outcomes following 15q11.2 CNV Diagnosis
Authors: Chu Fu-Chieh , Shaw Steven W. , Lee Chien-Hong , Lo Liang-Ming , Hsu Jenn-Jeih , Hung Tai-Ho
Published: September 2021

The copy number variation (CNV) of 15q11.2, an emerging and common condition observed during prenatal counseling, is encompassed by four highly conserved and non-imprinted genes—TUBGCP5, CYFIP1, NIPA1, and NIPA2—which are reportedly related to developmental delays or general behavioral problems. We retrospectively analyzed 1337 samples from genetic amniocentesis for fetal CNV using microarray-based comparative genomic hybridization analysis between January 2014 and December 2019. 15q11.2 CNV showed a prevalence of 1.5% (21/1337). Separately, 0.7% was noted for 15q11.2 BP1–BP2 microdeletion and 0.8% for 15q11.2 microduplication. Compared to the normal array group, the 15q11.2 BP1–BP2 microdeletion group had more cases of neonatal intensive care unit transfer, an Apgar score of <7 at 1 min, and neonatal death. Additionally, the group was symptomatic with developmental delays and had more infantile deaths related to congenital heart disease (CHD). Our study makes a novel contribution to the literature by exploring the differences in the adverse perinatal outcomes and early life conditions between the 15q11.2 CNV and normal array groups. Parent-origin gender-based differences may help in the prognosis of the fetal phenotype; development levels should be followed up in the long term and echocardiography should be offered prenatally and postnatally for the prevention of a delayed diagnosis of CHD.
Empirical Evidence for Latitude and Altitude Variation of the In Situ Cosmogenic 26Al/10Be Production Ratio
Authors: Halsted Christopher T. , Bierman Paul R. , Balco Greg
Published: September 2021

We assess if variations in the in situ cosmogenic 26Al/10Be production ratio expected from nuclear physics are consistent with empirical data, knowledge critical for two-isotope studies. We do this using 313 samples from glacially transported boulders or scoured bedrock with presumed simple exposure histories in the Informal Cosmogenic-nuclide Exposure-age Database (ICE-D) from latitudes between 53°S to 70°N and altitudes up to 5000 m above sea level. Although there were small systematic differences in Al/Be ratios measured in different laboratories, these were not significant and are in part explained by differences in elevation distribution of samples analyzed by each laboratory. We observe a negative correlation between the 26Al/10Be production ratio and elevation (p = 0.0005), consistent with predictions based on the measured energy dependence of nuclear reaction cross-sections and the spatial variability in cosmic-ray energy spectra. We detect an increase in the production ratio with increasing latitude, but this correlation is significant only in a single variate model, and we attribute at least some of the correlation to sample elevation bias because lower latitude samples are typically from higher elevations (and vice versa). Using 6.75 as the 26Al/10Be production ratio globally will bias two-isotope results at higher elevations and perhaps higher latitudes. Data reported here support using production rate scaling that incorporates such ratio changes, such as the LSDn scheme, to minimize such biases.
The Epidemiologic Characteristics of Malignant Mesothelioma Cases in Korea: Findings of the Asbestos Injury Relief System from 2011–2015
Authors: Kwon Soon-Chan , Lee Sung-Soo , Kang Min-Sung , Huh Da-An , Lee Yong-Jin
Published: September 2021

(1) Background: The purpose of this study was to investigate the epidemiological characteristics of malignant mesothelioma in Korea by investigating cases compensated under the asbestos injury relief system. (2) Methods: A total of 407 compensated cases between 2011 and 2015 were reviewed using medical records and resident registrations in order to investigate the dates of diagnosis and death. Asbestos exposure and patients’ general characteristics were investigated through face-to-face interviews. The standardized incidence ratio was calculated as the number of observations from 2005 to 2014 per exposure region in Korea, using the mid-annual population of each region in 2009 as the standard population. (3) Results: Among the 407 cases, 65.1% were male. The pleura and peritoneum were affected in 76.9% and 23.1% of cases, respectively. For peritoneal mesothelioma, the median survival duration was longer (p = 0.005), and the proportion of affected women was higher than that in pleural mesothelioma. The standardized incidence ratio (95% CI) by province of primary exposure was Chungnam 3.33 (2.51–4.35), Ulsan 1.85 (0.97–3.21), and Seoul 1.32 (1.06–1.63). (4) Conclusions: Although the representativeness of the data is limited, it is sufficient to assume the epidemiologic characteristics of malignant mesothelioma, help improve the compensation system, and contribute to future policies.
Economic Burden of Depressive Symptoms Conditions among Middle-Aged and Elderly People with Hypertension in China
Authors: Wu Yun , Zhao Dongbao , Guo Jianwei , Lai Yingsi , Chen Lijin , Jin Sihui , Huang Yixiang
Published: September 2021

People with hypertension are more prone to incur depressive symptoms, while depressive symptoms have an obvious influence on the healthy functioning, treatment, and management of hypertensive patients. However, there have been limited studies on the association between depression and the economic burden of hypertension. We used data from the 2018 China Health and Retirement Longitudinal Study (CHARLS) to estimate the additional annual direct and indirect economic burden of depressive symptoms among middle-aged and elderly hypertensive patients with a multivariable regression model. The depressive symptoms were associated with substantial additional direct and indirect economic burden. Compared with non-co-MHDS (non-co-morbid hypertension and depressive symptoms) patients, the direct economic burden of lower co-MHDS (co-morbid hypertension and depressive symptoms) patients and higher co-MHDS patients increased 1887.4 CNY and 5508.4 CNY, respectively. For indirect economic burden, the lower co-MHDS patients increased 331.2 CNY and the higher co-MHDS patients increased 636.8 CNY. Both direct and indirect economic burden were incremental with the aggravation of depressive symptoms. The results showed depressive symptoms increased total healthcare costs by increasing the utilization and expenditure of primary healthcare services. Depressive symptoms also led to economic loss of productivity, especially for agricultural workers. This study highlights the importance of mental healthcare for hypertensive patients.
Menstrual Cycle Hormonal Changes and Energy Substrate Metabolism in Exercising Women: A Perspective
Authors: Hackney Anthony C.
Published: September 2021

This article discusses the research supporting that the hormonal changes across the menstrual cycle phases affect a woman’s physiology during exercise, specifically addressing aspects of energy substrate metabolism and macro-nutrient utilization and oxidation. The overarching aim is to provide a perspective on what are the limitations of earlier research studies that have concluded such hormonal changes do not affect energy metabolism. Furthermore, suggestions are made concerning research approaches in future studies to increase the likelihood of providing evidence-based data in support of the perspective that menstrual cycle hormonal changes do affect energy metabolism in exercising women.
Can New ENZIAN Score 2020 Represent a Staging System Improving MRI Structured Report?
Authors: Manganaro Lucia , Celli Veronica , Dolciami Miriam , Ninkova Roberta , Ercolani Giada , Ciulla Sandra , De Vito Corrado , Rizzo Stefania Maria , Porpora Maria Grazia , Catalano Carlo
Published: September 2021

Structured reporting systems for endometriotic disease are gaining a central role in diagnostic imaging: our aim is to evaluate applicability and the feasibility of the recent ENZIAN score (2020) assessed by MRI. A total of 60 patients with suspected tubo–ovarian/deep endometriosis were retrospectively included in our study according to the following criteria: availability of MR examination; histopathological results from laparoscopic or surgical treatment; patients were not assuming estro-progestin or progestin therapy. Three different readers (radiologists with 2-, 5-, and 20-years of experience in pelvic imaging) have separately assigned a score according to the ENZIAN score (revised 2020) for all lesions detected by magnetic resonance imaging (MRI). Our study showed a high interobserver agreement and feasibility of the recent ENZIAN score applied to MRI; on the other hand, our experience highlighted some limitations mainly due to MRI’s inability to assess tubal patency and mobility, as required by the recent score (2020). In view of the limitations which arose from our study, we propose a modified MRI-ENZIAN score that provides a complete structured reporting system, more suitable for MRI. The high interobserver agreement of the recent ENZIAN score applied to MRI confirms its validity as a complete staging system for endometriosis, offering a shared language between radiologists and surgeons.
Analysis of German BSE Surveillance Data: Estimation of the Prevalence of Confirmed Cases versus the Number of Infected, but Non-Detected, Cattle to Assess Confidence in Freedom from Infection
Authors: Greiner Matthias , Selhorst Thomas , Balkema-Buschmann Anne , Johnson Wesley , Müller-Graf Christine , Conraths Franz
Published: September 2021

Quantitative risk assessments for Bovine spongiform encephalopathy (BSE) necessitate estimates for key parameters such as the prevalence of infection, the probability of absence of infection in defined birth cohorts, and the numbers of BSE-infected, but non-detected cattle entering the food chain. We estimated three key parameters with adjustment for misclassification using the German BSE surveillance data using a Gompertz model for latent (i.e., unobserved) age-dependent detection probabilities and a Poisson response model for the number of BSE cases for birth cohorts 1999 to 2015. The models were combined in a Bayesian framework. We estimated the median true BSE prevalence between 3.74 and 0.216 cases per 100,000 animals for the birth cohorts 1990 to 2001 and observed a peak for the 1996 birth cohort with a point estimate of 16.41 cases per 100,000 cattle. For birth cohorts ranging from 2002 to 2013, the estimated median prevalence was below one case per 100,000 heads. The calculated confidence in freedom from disease (design prevalence 1 in 100,000) was above 99.5% for the birth cohorts 2002 to 2006. In conclusion, BSE surveillance in the healthy slaughtered cattle chain was extremely sensitive at the time, when BSE repeatedly occurred in Germany (2000–2009), because the entry of BSE-infected cattle into the food chain could virtually be prevented by the extensive surveillance program during these years and until 2015 (estimated non-detected cases/100.000 [95% credible interval] in 2000, 2009, and 2015 are 0.64 [0.5,0.8], 0.05 [0.01,0.14], and 0.19 [0.05,0.61], respectively).
Estimation of Lifetime QALYs Based on Lifestyle Behaviors
Authors: Noto Shinichi , Saito Shota , Shiroiwa Takeru , Fukuda Takashi
Published: September 2021

Various lifestyle behaviors have been known to affect health-related quality of life (HRQL) and life expectancy. However, the impact on quality-adjusted life years (QALYs), which can be used for health economics, has not been clarified. The purpose of this study was to estimate the impact of lifestyle behaviors on lifetime QALYs. We first examined the relationship between lifestyle behaviors and HRQL as measured by the EQ-5D-5L among 4000 participants via a web-based survey. The results of multiple regression analysis showed that physical activity and sleep were significantly related to HRQL. Therefore, we used microsimulation to estimate QALYs from physical activity and sleep, which were determined to be significant in the regression analysis. The results showed that there was a difference of 3.6 QALYs between the recommended lifestyle scenario (23.4 QALYs; 95%CI 3.6 to 35.1) and the non-recommended lifestyle scenario (19.8 QALYs; 95%CI 3.1 to 31.6). This difference was greater in the younger age group than in the older age group. The results also indicated a large difference in QALYs between physical activity and sleep. These findings may provide a significant suggestion for future health promotion measures.
Mass Gathering Medicine in Soccer Leagues: A Review and Creation of the SALEM Tool
Authors: Khan Anas A. , Sabbagh Abdulrahman Y. , Ranse Jamie , Molloy Michael S. , Ciottone Gregory R.
Published: September 2021

Potential risks for public health incidents, outbreaks, and casualties are inferred at association football events, especially if event organizers have not taken appropriate preventative measures. This review explores the potential risks imposed by mass gathering (MG) football events, with particular emphasis on tools and methodologies to manage the risks of football MG events. Effective planning and implementation of MGs along with the mitigation of risks related to people’s health require special attention to all potential threats, especially in frequent and recurring MG events such as football leagues. The well-being of all participants can be compromised by ignoring a single risk. Healthcare systems should cooperate with all stakeholders and organizations who are involved in MG management and response. Provision of services during MG or a disaster must be performed by trained personnel or entities that have full access to available resources in accessible publicly known locations at the MG event site. Several MG assessment tools were developed worldwide; however, to adapt to the Saudi context, SALEM tool was developed to provide a guide for MG planning and assessment. SALEM assesses the risks of MG events with scores that help to categorize the risk of MG events by offering recommendations for required resources.
An Animation- Versus Text-Based Computer-Tailored Game Intervention to Prevent Alcohol Consumption and Binge Drinking in Adolescents: Study Protocol
Authors: Lima-Serrano Marta , Fernández-León Pablo , Mercken Liesbeth , Martínez-Montilla José Manuel , de Vries Hein
Published: September 2021

The purpose of this paper is to describe the protocol for the design, implementation, and evaluation of an animation- versus text-based computer tailoring game intervention aimed at preventing alcohol consumption and binge drinking (BD) in adolescents. A cluster-randomized controlled trial (CRCT) is carried out in students aged 14–19 enrolled in 24 high schools from Andalusia (Spain), which are randomized either to experimental (EC-1, EC-2) or waiting-list control conditions (CC). EC-1 receives an online intervention (Alerta Alcohol) with personalized health advice, using textual feedback and several gamification techniques. EC-2 receives an improved version (Alerta Alcohol 2.0) using animated videos and new gamification strategies. Both programs consist of nine sessions (seven taking place at high school and two at home): session 1 or baseline, sessions 2 and 3 that provide tailored advice based on the I-Change Model; sessions 4, 5, 7, and 8 are booster sessions, and sessions 6 and 9 are follow-up questionnaires at six and twelve months. The CC completes the baseline and the evaluation questionnaires. The primary outcome is BD within 30 days before post-test evaluations, and as secondary outcomes we assess other patterns of alcohol use. The findings should help the development of future alcohol drinking prevention interventions in adolescents.
Determinants of Preventive Behaviors for COVID-19 in Japan
Authors: Kosugi Motoko
Published: September 2021

As of June 2021, there have been more than 13,000 deaths in Japan due to the COVID-19 pandemic. Data from the Ministry of Health, Labor, and Welfare show that the mortality rate of COVID-19 greatly varies by age. In this study, using data from a questionnaire survey, an investigation was carried out to find differences in anxiety and risk perception, attitudes toward risk, and the frequency of implementation of countermeasures to infection among age groups that are prone to a greater risk of mortality, as well as the main factors that determine the frequency of implementation. Older people, who form a high-risk group, have a stronger tendency for anxiety and cautious attitudes toward COVID-19, and they more frequently implement preventive behaviors. The results of multiple regression analysis showed that the frequency of implementation of behaviors is determined not only by anxiety, cautious attitude, risk of aggravation to oneself, and perceived effectiveness of behaviors but also by regret, altruism, and conformity. In addition, almost no age-based gap was found between the determinants, suggesting that the motivation to take infection preventive behaviors is the same regardless of age.
Improving Treatment Adherence with Integrated Patient Management for TB Patients in Morocco
Authors: Park Seup , Moon Narae , Oh Byungkwon , Park Miyeon , Kang Kilho , Sentissi Ilham , Bae Sung-Heui
Published: September 2021

In Morocco, there are challenges in the management of high-risk tuberculosis (TB) patients, including paper-based management and a shortage of healthcare workers related to TB. Additionally, TB management has not been accounted for in various patient types, which affects treatment adherence. This study aims to examine the delivery model of TB management and the outcomes of an integrated patient management system that uses a patient-centered and community-based approach, along with mobile health technology. A total of 3605 TB patients were enrolled in this program in Morocco’s five prefectures (Rabat, Salé, Kénitra, Khemisset, Skhirat–Témara) from January 2018 to December 2019. Patients were managed based on demographic characteristics, socioeconomic status, areas (rural or urban), health literacy levels, and distance to primary health centers. Our mobile health intervention “smart pillbox” was interposed with high-risk TB patients, along with patient education. The rate of successful treatment was 92.2%, which was higher than the national rate (88%). The “lost to follow-up” rate was 4.1%, which was significantly lower than the existing non-adherence rate of 7.9%. Therefore, integrated patient management for TB patients in Morocco is more effective than the existing conventional programs. This comprehensive approach provides an alternative method for countries with limited resources.
Facial Expression Processing of Children Orphaned by Parental HIV/AIDS: A Cross-Sectional ERP Study with Rapid Serial Visual Presentation
Authors: Zhao Qi , He Hui , Gu Huang , Zhao Junfeng , Chi Peilian , Li Xiaoming
Published: September 2021

Existing behavioral studies have suggested that individuals with early life stress usually show abnormal emotional processing. However, limited event-related brain potentials (ERPs) evidence was available to explore the emotional processes in children orphaned by parental HIV/AIDS (“AIDS orphans”). The current study aims to investigate whether there are behavioral and neurological obstacles in the recognition of emotional faces in AIDS orphans and also to further explore the processing stage at which the difference in facial emotion recognition exists. A total of 81 AIDS orphans and 60 non-orphan children were recruited through the local communities and school systems in Henan, China. Participants completed a computer version of the rapid serial visual presentation (RSVP) task while recording ERPs. Behavioral results showed that orphans displayed higher response accuracy and shorter reaction time than the control (ps < 0.05). As for the ERPs analysis, the attenuated amplitude of N170 (i.e., an early component sensitive to facial configuration) was observed in AIDS orphans compared to the non-orphan control with happy and neutral faces; P300 (i.e., an endogenous component for affective valence evaluation in emotional processing) also showed significant differences in parietal lobe between groups, the non-orphan control group produced larger P300 amplitudes than orphans (p < 0.05). The results suggested that compared to the control group, AIDS orphans showed impaired facial emotion recognition ability with reduced brain activation.
A Vegan Diet Is Associated with a Significant Reduction in Dietary Acid Load: Post Hoc Analysis of a Randomized Controlled Trial in Healthy Individuals
Authors: Müller Alexander , Zimmermann-Klemd Amy Marisa , Lederer Ann-Kathrin , Hannibal Luciana , Kowarschik Stefanie , Huber Roman , Storz Maximilian Andreas
Published: September 2021

The composition of diet strongly affects acid–base homeostasis. Western diets abundant in acidogenic foods (meat and cheese) and deficient in alkalizing foods (fruits and vegetables) increase dietary acid load (DAL). A high DAL has been associated with numerous health repercussions, including cardiovascular disease and type-2-diabetes. Plant-based diets have been associated with a lower DAL; however, the number of trials exploring this association is limited. This randomized-controlled trial sought to examine whether an isocaloric vegan diet lowers DAL as compared to a meat-rich diet. Forty-five omnivorous individuals were randomly assigned to a vegan diet (n = 23) or a meat-rich diet (n = 22) for 4 weeks. DAL was determined using potential renal acid load (PRAL) and net endogenous acid production (NEAP) scores at baseline and after 3 and 4 weeks, respectively. After 3 weeks, median PRAL (−23.57 (23.87)) and mean NEAPR (12.85 ± 19.71) scores were significantly lower in the vegan group than in the meat-rich group (PRAL: 18.78 (21.04) and NEAPR: 60.93 ± 15.51, respectively). Effects were mediated by a lower phosphorus and protein intake in the vegan group. Our study suggests that a vegan diet is a potential means to reduce DAL, whereas a meat-rich diet substantially increases the DAL burden.
A Novel Mutation in GP1BB Reveals the Role of the Cytoplasmic Domain of GPIbβ in the Pathophysiology of Bernard-Soulier Syndrome and GPIb-IX Complex Assembly
Authors: Barozzi Serena , Bozzi Valeria , De Rocco Daniela , Giangregorio Tania , Noris Patrizia , Savoia Anna , Pecci Alessandro
Published: September 2021

Bernard-Soulier syndrome (BSS) is an autosomal-recessive bleeding disorder caused by biallelic variants in the GP1BA, GP1BB, and GP9 genes encoding the subunits GPIbα, GPIbβ, and GPIX of the GPIb-IX complex. Pathogenic variants usually affect the extracellular or transmembrane domains of the receptor subunits. We investigated a family with BSS caused by the homozygous c.528_550del (p.Arg177Serfs*124) variant in GP1BB, which is the first mutation ever identified that affects the cytoplasmic domain of GPIbβ. The loss of the intracytoplasmic tail of GPIbβ results in a mild form of BSS, characterized by only a moderate reduction of the GPIb-IX complex expression and mild or absent bleeding tendency. The variant induces a decrease of the total platelet expression of GPIbβ; however, all of the mutant subunit expressed in platelets is correctly assembled into the GPIb-IX complex in the plasma membrane, indicating that the cytoplasmic domain of GPIbβ is not involved in assembly and trafficking of the GPIb-IX receptor. Finally, the c.528_550del mutation exerts a dominant effect and causes mild macrothrombocytopenia in heterozygous individuals, as also demonstrated by the investigation of a second unrelated pedigree. The study of this novel GP1BB variant provides new information on pathophysiology of BSS and the assembly mechanisms of the GPIb-IX receptor.
Stem Cells in Autologous Microfragmented Adipose Tissue: Current Perspectives in Osteoarthritis Disease
Authors: De Francesco Francesco , Gravina Pasquale , Busato Alice , Farinelli Luca , Soranzo Carlo , Vidal Luis , Zingaretti Nicola , Zavan Barbara , Sbarbati Andrea , Riccio Michele , Gigante Antonio
Published: September 2021

Osteoarthritis (OA) is a chronic debilitating disorder causing pain and gradual degeneration of weight-bearing joints with detrimental effects on cartilage volume as well as cartilage damage, generating inflammation in the joint structure. The etiology of OA is multifactorial. Currently, therapies are mainly addressing the physical and occupational aspects of osteoarthritis using pharmacologic pain treatment and/or surgery to manage the symptomatology of the disease with no specific regard to disease progression or prevention. Herein, we highlight alternative therapeutics for OA specifically considering innovative and encouraging translational methods with the use of adipose mesenchymal stem cells.
Tyrp1 Mutant Variants Associated with OCA3: Computational Characterization of Protein Stability and Ligand Binding
Authors: Patel Milan H. , Dolinska Monika B. , Sergeev Yuri V.
Published: September 2021

Oculocutaneous albinism type 3 (OCA3) is an autosomal recessive disorder caused by mutations in the TYRP1 gene. Tyrosinase-related protein 1 (Tyrp1) is involved in eumelanin synthesis, catalyzing the oxidation of 5,6-dihydroxyindole-2-carboxylic acid oxidase (DHICA) to 5,6-indolequinone-2-carboxylic acid (IQCA). Here, for the first time, four OCA3-causing mutations of Tyrp1, C30R, H215Y, D308N, and R326H, were investigated computationally to understand Tyrp1 protein stability and catalytic activity. Using the Tyrp1 crystal structure (PDB:5M8L), global mutagenesis was conducted to evaluate mutant protein stability. Consistent with the foldability parameter, C30R and H215Y should exhibit greater instability, and two other mutants, D308N and R326H, are expected to keep a native conformation. SDS-PAGE and Western blot analysis of the purified recombinant proteins confirmed that the foldability parameter correctly predicted the effect of mutations critical for protein stability. Further, the mutant variant structures were built and simulated for 100 ns to generate free energy landscapes and perform docking experiments. Free energy landscapes formed by Y362, N378, and T391 indicate that the binding clefts of C30R and H215Y mutants are larger than the wild-type Tyrp1. In docking simulations, the hydrogen bond and salt bridge interactions that stabilize DHICA in the active site remain similar among Tyrp1, D308N, and R326H. However, the strengths of these interactions and stability of the docked ligand may decrease proportionally to mutation severity due to the larger and less well-defined natures of the binding clefts in mutants. Mutational perturbations in mutants that are not unfolded may result in allosteric alterations to the active site, reducing the stability of protein-ligand interactions.