bluuebunny/crossref_metadata_2025 huggingface dataset:
Systematic Review of RCTs Assessing the Effectiveness of mHealth Interventions to Improve Statin Medication Adherence: Using the Behaviour-Change Technique Taxonomy to Identify the Techniques That Improve Adherence
Authors: Bond Zoe , Scanlon Tanya , Judah Gaby
Published: September 2021

Statin non-adherence is a common problem in the management of cardiovascular disease (CVD), increasing patient morbidity and mortality. Mobile health (mHealth) interventions may be a scalable way to improve medication adherence. The objectives of this review were to assess the literature testing mHealth interventions for statin adherence and to identify the Behaviour-Change Techniques (BCTs) employed by effective and ineffective interventions. A systematic search was conducted of randomised controlled trials (RCTs) measuring the effectiveness of mHealth interventions to improve statin adherence against standard of care in those who had been prescribed statins for the primary or secondary prevention of CVD, published in English (1 January 2000–17 July 2020). For included studies, relevant data were extracted, the BCTs used in the trial arms were coded, and a quality assessment made using the Risk of Bias 2 (RoB2) questionnaire. The search identified 17 relevant studies. Twelve studies demonstrated a significant improvement in adherence in the mHealth intervention trial arm, and five reported no impact on adherence. Automated phone messages were the mHealth delivery method most frequently used in effective interventions. Studies including more BCTs were more effective. The BCTs most frequently associated with effective interventions were “Goal setting (behaviour)”, “Instruction on how to perform a behaviour”, and “Credible source”. Other effective techniques were “Information about health consequences”, “Feedback on behaviour”, and “Social support (unspecified)”. This review found moderate, positive evidence of the effect of mHealth interventions on statin adherence. There are four primary recommendations for practitioners using mHealth interventions to improve statin adherence: use multifaceted interventions using multiple BCTs, consider automated messages as a digital delivery method from a credible source, provide instructions on taking statins, and set adherence goals with patients. Further research should assess the optimal frequency of intervention delivery and investigate the generalisability of these interventions across settings and demographics.
Physical and Mental Disabilities among the Gender-Diverse Population Using the Behavioral Risk Factor Surveillance System, BRFSS (2017–2019): A Propensity-Matched Analysis
Authors: Pharr Jennifer R. , Batra Kavita
Published: September 2021

This propensity-matched analysis utilized the publicly available Behavioral Risk Factor Surveillance System (2017–2019) data to compare the burden of disabilities among transgender/non-binary (TGNB) and cisgender groups. The groups were matched (1:1 ratio) on demographic variables using Nearest Neighborhood Matching. Categorical variables were compared among groups using a Chi-square analysis to test differences in the proportions. Multivariate logistic regression analysis was fit to predict the likelihood of the physical and mental disabilities among the TGNB group compared with the cisgender group while controlling for healthcare access factors, income, and employment. Survey weights were included in the model to account for the complex survey design. In a weighted sample of 664,103 respondents, only 2827 (0.4%) self-identified as TGNB. In the matched sample, a higher proportion of the TGNB group belonged to the low-income group (39.5% vs. 29.8%, p < 0.001), were unable to work (12.5% vs. 8.6%, p < 0.001), and delayed care due to cost barriers (19.0% vs. 12.4%, p < 0.001). Compared with the cisgender group, the odds of having difficulty making decisions were 1.94 times higher (95% CI: 1.67–2.27) and odds of difficulty walking were 1.38 times higher (95% CI: 1.19, 1.59) among the TGNB group. Additionally, the TGNB group had 59.8% higher adjusted odds ratio (aOR) (aOR 1.598, 95% Confidence interval (CI): 1.256, 2.034) of experiencing difficulty dressing and 83.3% higher odds (aOR 1.833, 95% CI: 1.533, 2.191) in having difficulty doing things alone. The findings of this study advocate for developing policies and interventions to deliver culturally competent care to the TGNB population with disabilities.
Palliative and End-of-Life Care Service Models: To What Extent Are Consumer Perspectives Considered?
Authors: Rumbold Bruce , Aoun Samar
Published: September 2021

This article presents evidence found in a search of national and international literature for patient preferences concerning settings in which to receive palliative care and the appropriateness of different models of palliative care. The purpose was to inform end-of-life care policy and service development of the Western Australian Department of Health through a rapid review of the literature. It was found that consumer experience of palliative care is investigated poorly, and consumer contribution to service and policy design is limited and selective. Most patients experience a mix of settings during their illness, and evidence found by the review has more to do with qualities and values that will contribute to good end-of-life care in any location. Models of care do not make systematic use of the consumer data that are available to them, although an increasingly common theme is the need for integration of the various sources of care supporting dying people. It is equally clear that most integration models limit their attention to end-of-life care provided by health services. Transitions between settings merit further attention. We argue that models of care should take account of consumer experience not by incorporating generalised evidence but by co-creating services with local communities using a public health approach.
Automated ECG Interpretation—A Brief History from High Expectations to Deepest Networks
Authors: Macfarlane Peter W. , Kennedy Julie
Published: September 2021

This article traces the development of automated electrocardiography from its beginnings in Washington, DC around 1960 through to its current widespread application worldwide. Changes in the methodology of recording ECGs in analogue form using sizeable equipment through to digital recording, even in wearables, are included. Methods of analysis are considered from single lead to three leads to twelve leads. Some of the influential figures are mentioned while work undertaken locally is used to outline the progress of the technique mirrored in other centres. Applications of artificial intelligence are also considered so that the reader can find out how the field has been constantly evolving over the past 50 years.
The Origins of the Postgraduate Programs on Cultural Heritage Knowledge, Management, Conservation, and Communication in Italy: A Vision of the Past as Engine for the Next Future
Authors: Benedetti Benedetto , Abbondandolo Ilaria , Gaiani Marco
Published: September 2021

A discriminating, multi-disciplinary knowledge is a necessary expertise that all the actors who operate in the management, conservation, and communication of Cultural Heritage (CH) must have. They are, therefore, expected to be seriously prepared in many fields. However, a proper training program for them, which effectively combines humanistic studies with scientific ones, is difficult to be arranged when there is lack of comprehensive perspective in the education system. This paper introduces the experiences of the postgraduate programs that were established for many years at the Scuola Normale Superiore in Pisa, Italy. Through a calibrated mixture of theoretical background and practical applications taught by high-profile scholars, those programs proved to be effective in the preparation of figures later dealing with the CH at different levels. The clear organization of those specialized lectures, the innovation introduced with hands-on practical case studies and the adoption of state-of-the-art techniques, led to an educational paradigm that is still efficient, whose outcomes also demonstrated how it can be inspiring for future high-level learning programs, which must be oriented towards fostering an aware preparation for leading operators involved in the conservation and dissemination of CH.
De-Historicizing (Mainstream) Ottoman Historiography on Tanzimat and Tahdith: Jus Gentium and Pax Britannica Violate Osmanli Sovereignty in Arabia
Authors: Al-Kassimi Khaled
Published: September 2021

The (secular-humanist) philosophical theology governing (positivist) disciplines such as International Law and International Relations precludes a priori any communicative examination of how the exclusion of Arab-Ottoman jurisprudence is necessary for the ontological coherence of jurisprudent concepts such as society and sovereignty, together with teleological narratives constellating the “Age of Reason” such as modernity and civilization. The exercise of sovereignty by the British Crown—in 19th and 20th century Arabia—consisted of (positivist) legal doctrines comprising “scientific processes” denying Ottoman legal sovereignty, thereby proceeding to “order” societies situated in Dar al-Islam and “detach” Ottoman-Arab subjects from their Ummah. This “rational exercise” of power by the British Crown—mythologizing an unbridgeable epistemological gap between a Latin-European subject as civic and an objectified Ottoman-Arab as despotic—legalized (regulatory) measures referencing ethno/sect-centric paradigms which not only “deported” Ottoman-Arab ijtihad (Eng. legal reasoning and exegetic hermeneutics) from the realm of “international law”, but also rationalized geographic demarcations and demographic alterations across Ottoman-Arab vilayets. Both inter-related disciplines, therefore, affirm an “exclusionary self-image” when dealing with “foreign epistemologies” by transforming “cultural difference” into “legal difference”, thus suing that it is in the protection of jus gentium that “recognized sovereigns” exercise redeeming measures on “Turks”, “Moors”, or “Arabs”. It is precisely the knowledge lost ensuing from such irreflexive “positivist image” that this legal-historical research seeks to deconstruct by moving beyond a myopic analysis claiming Ottoman-Arab ‘Umran (Eng. civilization) as homme malade (i.e., sick man); or that the Caliphate attempted but failed to become reasonable during the 18th and 19th century because it adhered to Arab-Islamic philosophical theology. Therefore, this research commits to deconstructing “mainstream” Ottoman historiography claiming that tanzimat (Eng. reorganization) and tahdith (Eng. modernization) were simply “degenerative periods” affirming the temporal “backwardness” of Ottoman civilization and/or the innate incapacity of its epistemology in furnishing a (modern) civil society.
Contributions of Human Activities and Climatic Variability to Changes in River Rwizi Flows in Uganda, East Africa
Authors: Onyutha Charles , Nyesigire Resty , Nakagiri Anne
Published: September 2021

This study employed Soil and Water Assessment Tool (SWAT) to analyze the impacts of climate variability and human activities on River Rwizi flows. Changes in land use and land cover (LULC) types from 1997 to 2019 were characterized using remotely sensed images retrieved from Landsat ETM/TM satellites. SWAT was calibrated and validated over the periods 2002–2008 and 2009–2013, respectively. Correlation between rainfall and river flow was analyzed. By keeping the optimal values of model parameters fixed while varying the LULC maps, differences in the modeled flows were taken to reflect the impacts of LULC changes on rainfall–runoff generation. Impacts due to human activities included contributions from changes in LULC types and the rates of water abstracted from the river as a percentage of the observed flow. Climate variability was considered in terms of changes in climatic variables such as rainfall and evapotranspiration, among others. Variability of rainfall was analyzed with respect to changes in large-scale ocean-atmosphere conditions. From 2000 to 2014, the portion of River Rwizi catchment area covered by cropland increased from 23.0% to 51.6%, grassland reduced from 63.3% to 37.8%, and wetland decreased from 8.1% to 4.7%. Nash–Sutcliffe Efficiency values for calibration and validation were 0.60 and 0.71, respectively. Contributions of human activities to monthly river flow changes varied from 2.3% to 23.5%. Impacts of human activities on the river flow were on average found to be larger during the dry (14.7%) than wet (5.8%) season. Using rainfall, 20.9% of the total river flow variance was explained. However, climate variability contributed 73% of the river flow changes. Rainfall was positively and negatively correlated with Indian Ocean Dipole (IOD) and Niño 3, respectively. The largest percentages of the total rainfall variance explained by IOD and Niño 3 were 12.7% and 9.8%, respectively. The magnitude of the correlation between rainfall and IOD decreased with increasing lag in time. These findings are relevant for developing River Rwizi catchment management plans.
Towards AI-Enabled Multimodal Diagnostics and Management of COVID-19 and Comorbidities in Resource-Limited Settings
Authors: Daramola Olawande , Nyasulu Peter , Mashamba-Thompson Tivani , Moser Thomas , Broomhead Sean , Hamid Ameera , Naidoo Jaishree , Whati Lindiwe , Kotze Maritha J. , Stroetmann Karl , Osamor Victor Chukwudi
Published: September 2021

A conceptual artificial intelligence (AI)-enabled framework is presented in this study involving triangulation of various diagnostic methods for management of coronavirus disease 2019 (COVID-19) and its associated comorbidities in resource-limited settings (RLS). The proposed AI-enabled framework will afford capabilities to harness low-cost polymerase chain reaction (PCR)-based molecular diagnostics, radiological image-based assessments, and end-user provided information for the detection of COVID-19 cases and management of symptomatic patients. It will support self-data capture, clinical risk stratification, explanation-based intelligent recommendations for patient triage, disease diagnosis, patient treatment, contact tracing, and case management. This will enable communication with end-users in local languages through cheap and accessible means, such as WhatsApp/Telegram, social media, and SMS, with careful consideration of the need for personal data protection. The objective of the AI-enabled framework is to leverage multimodal diagnostics of COVID-19 and associated comorbidities in RLS for the diagnosis and management of COVID-19 cases and general support for pandemic recovery. We intend to test the feasibility of implementing the proposed framework through community engagement in sub-Saharan African (SSA) countries where many people are living with pre-existing comorbidities. A multimodal approach to disease diagnostics enabling access to point-of-care testing is required to reduce fragmentation of essential services across the continuum of COVID-19 care.
A Simplified and High Accuracy Algorithm of RSSI-Based Localization Zoning for Children Tracking In-Out the School Buses Using Bluetooth Low Energy Beacon
Authors: Sakphrom Siraporn , Suwannarat Korakot , Haiges Rina , Funsian Krit
Published: September 2021

To avoid problems related to a school bus service such as kidnapping, children being left in a bus for hours leading to fatality, etc., it is important to have a reliable transportation service to ensure students’ safety along journeys. This research presents a high accuracy child monitoring system for locating students if they are inside or outside a school bus using the Internet of Things (IoT) via Bluetooth Low Energy (BLE) which is suitable for a signal strength indication (RSSI) algorithm. The in/out-bus child tracking system alerts a driver to determine if there is a child left on the bus or not. Distance between devices is analyzed for decision making to affiliate the zone of the current children’s position. A simplified and high accuracy machine learning of least mean square (LMS) algorithm is used in this research with model-based RSSI localization techniques. The distance is calculated with the grid size of 0.5 m × 0.5 m similar in size to an actual seat of a school bus using two zones (inside or outside a school bus). The averaged signal strength is proposed for this research, rather than using the raw value of the signal strength in typical works, providing a robust position-tracking system with high accuracy while maintaining the simplicity of the classical trilateration method leading to precise classification of each student from each zone. The test was performed to validate the effectiveness of the proposed tracking strategy which precisely shows the positions of each student. The proposed method, therefore, can be applied for future autopilot school buses where students’ home locations can be securely stored in the system used for references to transport each student to their homes without a driver.
Growing Jatropha (Jatropha curcas L.) as a Potential Second-Generation Biodiesel Feedstock
Authors: Neupane Dhurba , Bhattarai Dwarika , Ahmed Zeeshan , Das Bhupendra , Pandey Sharad , Solomon Juan K. Q. , Qin Ruijun , Adhikari Pramila
Published: September 2021

Dwindling supplies of fossil fuels and their deleterious impacts on human health and the global environment have intensified the search for substitute energy sources. Biodiesel has been identified as a promising renewable energy substitute for diesel fuel due to several comparable and sustainable properties. However, approximately 95% of biodiesel is derived from edible oil crops, threatening the current food supplies. Therefore, the biodiesel production potential from inexpensive, non-edible, and non-conventional bioenergy crops, such as Jatropha (Jatropha curcas L.), has attracted the attention of many researchers, policymakers, and industries globally. Jatropha is considered to be the second-generation biofuel feedstocks for biodiesel production. However, sustainable biodiesel generation from J. curcas oil has not yet been attained, owing to different socio-economic, ecological, and technical factors. This study aimed to synthesize the information from the existing literature on the present status and to identify the knowledge gaps for future research on Jatropha by providing comprehensive information regarding its origin and distribution, morphology, phenology, and reproduction, genetic diversity, its productivity, oil content, and fatty acid composition, the methodology used for extracting biodiesel, and agronomic, economic, and environmental aspects of biodiesel production. The germplasm screening of J. curcas and the exploration of its adaptability and agronomic potential across diverse climates are highly desired to promote this crop as an alternative biofuel crop, particularly in arid and semi-arid regions. Moreover, future research should focus on developing, optimizing, and modernizing the technologies involving seed collection, the processing of seeds, oil extraction, and the production of biodiesel.
Ethno-Veterinary Survey and Quantitative Study of Medicinal Plants with Anthelmintic Potential Used by Sheep and Goat Breeders in the Cotton Zone of Central Benin (West Africa)
Authors: Dansou Christian Cocou , Olounladé Pascal Abiodoun , Konmy Basile Saka Boni , Songbé Oriane , Arigbo Kisito Babatoundé , Aboh André Boha , Lagnika Latifou , Hounzangbé-Adoté Sylvie Mawulé
Published: September 2021

This study presents the diversity of anthelmintic plants in the cotton zone of Central Benin. The aim was to identify the medicinal anthelmintic plants used by small ruminant breeders in cotton zone of Central Benin to treat gastrointestinal parasites. Three hundred and sixty breeders were selected during individual semi-structured face-to-face interviews. Different quantitative indices of cultural importance were calculated in order to determine the level of use of plant species. Jaccard similarity index (JI) was calculated and Pearson’s correlation was determined for Use Value (UV) and Relative Frequency of Citation (RFC). In this study, a total of 99 medicinal species, of which 63 have anthelmintic potential, were listed, including Khaya senegalensis, Launaea taraxacifolia, Napoleonaea vogelii, Momordica charantia and Vernonia amygdalina, which all had UV and RFC above 20%. Each of them had a Fidelity Level above 50% and an Informant Agreement Rate (IAR) value close to one. Pearson’s correlation showed a significant correlation between RFC and UV with r = 0.94, and the studies were clearly independent (IJ < 50%). This study showed that the cotton zone of Central Benin represents 4% of the total flora of Benin, with many anthelmintic plants such as Launaea taraxacifolia and Napoleonaea vogelii that require further investigation.
Psychosocial and Behavioral Factors in Awake Bruxism—Self-Report versus Ecological Momentary Assessment
Authors: Emodi-Perlman Alona , Manfredini Daniele , Shalev Tamar , Bracci Alessandro , Frideman-Rubin Pessia , Eli Ilana
Published: September 2021

The issue of psychosocial factors and concurrent conditions associated with AB is a relatively new approach in the study of Awake Bruxism (AB). In the present study a population of 84 dental students were assessed for probable AB with two modes of AB assessment: Single point self-report (SR) and ecological momentary assessment through a designated smartphone application (BA). The two assessment modes were compared with regard to their ability to phenotype subjects as far as the following psychosocial and behavioral variables are concerned: Gender; depression; somatization; oral behaviors; chronic pain and associated pain symptoms in the head, neck and scapula. Two-way ANOVA showed main effect of SR for the following variables: Chronic Pain Intensity score (F(1,49) = 6.441, p < 0.02), migraine/headache (F(1,81) = 7.396, p < 0.01), pain in neck (F(1,81) = 6.726, p < 0.05), pain in scapula (F(1,81) = 8.546, p < 0.005) and the oral behaviors of pushing the tongue forcefully against the teeth (F(1,81) = 5.222, p < 0.05) and inserting the tongue between the upper and lower teeth (F(1,81) = 5.344, p < 0.03). The effect of SR on the habit of chewing gum was borderline (F(1,81) = 3.369, p = 0.07). Main effect of BA was found for depression (F(1,81) = 6.049, p < 0.05), while the effect of BA on somatization was borderline (F(1,81) = 3.657, p = 0.059). An interaction between SR and BA groups could be observed for the behavior of biting, chewing or playing with the tongue, cheeks or lips (F(1,81) = 4.117, p < 0.05). The results suggest that a combination of a single-point self-report referring to the past 30 days, and an ecological momentary assessment supplying information about the actual timing of the report, can help us to better assess AB, as well as increase our ability to define the phenotype of subjects with AB as far as psychosocial and behavioral factors are concerned.
Sustainable Innovations in the Food Industry through Artificial Intelligence and Big Data Analytics
Authors: Sharma Saurabh , Gahlawat Vijay Kumar , Rahul Kumar , Mor Rahul S , Malik Mohit
Published: September 2021

The agri-food sector is an endless source of expansion for nourishing a vast population, but there is a considerable need to develop high-standard procedures through intelligent and innovative technologies, such as artificial intelligence (AI) and big data. This paper addresses the research concerning AI and big data analytics in the food industry, including machine learning, artificial neural networks (ANNs), and various algorithms. Logistics, supply chain, marketing, and production patterns are covered along with food sub-sector applications for artificial intelligence techniques. It is found that utilization of AI techniques and the intelligent optimization algorithm also leads to significant process and production management. Thus, digital technologies are a boon for the food industry, where AI and big data have enabled us to achieve optimum results in realtime.
Early Gestational Diabetes Mellitus: Diagnostic Strategies and Clinical Implications
Authors: Bhattacharya Saptarshi , Nagendra Lakshmi , Krishnamurthy Aishwarya , Lakhani Om J. , Kapoor Nitin , Kalra Bharti , Kalra Sanjay
Published: September 2021

Preexisting diabetes mellitus (DM) should be ruled out early in pregnancy in those at risk. During screening, a significant proportion of women do not reach the threshold for overt DM but fulfill the criteria used for diagnosing conventional gestational DM (cGDM). There is no consensus on the management of pregnancies with intermediate levels of hyperglycemia thus diagnosed. We have used the term early gestational DM (eGDM) for this condition and reviewed the currently available literature. Fasting plasma glucose (FPG), oral glucose tolerance test, and glycated hemoglobin (HbA1c) are the commonly employed screening tools in early pregnancy. Observational studies suggest that early pregnancy FPG and Hba1c correlate with the risk of cGDM and adverse perinatal outcomes. However, specific cut-offs, including those proposed by the International Association of the Diabetes and Pregnancy Study Group, do not reliably predict the development of cGDM. Emerging data, though indicate that FPG ≥ 92 mg/dL (5.1 mmol/L), even in the absence of cGDM, signals the risk for perinatal complication. Elevated HbA1c, especially a level ≥ 5.9%, also correlates with the risk of cGDM and worsened outcome. HbA1c as a diagnostic test is however besieged with the usual caveats that occur in pregnancy. The studies that explored the effects of intervention present conflicting results, including a possibility of fetal malnutrition and small-for-date baby in the early treatment group. Diagnostic thresholds and glycemic targets in eGDM may differ, and large multicenter randomized controlled trials are necessary to define the appropriate strategy.
Clinically Distinct Subtypes of Acute Kidney Injury on Hospital Admission Identified by Machine Learning Consensus Clustering
Authors: Thongprayoon Charat , Vaitla Pradeep , Nissaisorakarn Voravech , Mao Michael A. , Genovez Jose L. Zabala , Kattah Andrea G. , Pattharanitima Pattharawin , Vallabhajosyula Saraschandra , Keddis Mira T. , Qureshi Fawad , Dillon John J. , Garovic Vesna D. , Kashani Kianoush B. , Cheungpasitporn Wisit
Published: September 2021

Background: We aimed to cluster patients with acute kidney injury at hospital admission into clinically distinct subtypes using an unsupervised machine learning approach and assess the mortality risk among the distinct clusters. Methods: We performed consensus clustering analysis based on demographic information, principal diagnoses, comorbidities, and laboratory data among 4289 hospitalized adult patients with acute kidney injury at admission. The standardized difference of each variable was calculated to identify each cluster’s key features. We assessed the association of each acute kidney injury cluster with hospital and one-year mortality. Results: Consensus clustering analysis identified four distinct clusters. There were 1201 (28%) patients in cluster 1, 1396 (33%) patients in cluster 2, 1191 (28%) patients in cluster 3, and 501 (12%) patients in cluster 4. Cluster 1 patients were the youngest and had the least comorbidities. Cluster 2 and cluster 3 patients were older and had lower baseline kidney function. Cluster 2 patients had lower serum bicarbonate, strong ion difference, and hemoglobin, but higher serum chloride, whereas cluster 3 patients had lower serum chloride but higher serum bicarbonate and strong ion difference. Cluster 4 patients were younger and more likely to be admitted for genitourinary disease and infectious disease but less likely to be admitted for cardiovascular disease. Cluster 4 patients also had more severe acute kidney injury, lower serum sodium, serum chloride, and serum bicarbonate, but higher serum potassium and anion gap. Cluster 2, 3, and 4 patients had significantly higher hospital and one-year mortality than cluster 1 patients (p < 0.001). Conclusion: Our study demonstrated using machine learning consensus clustering analysis to characterize a heterogeneous cohort of patients with acute kidney injury on hospital admission into four clinically distinct clusters with different associated mortality risks.
Universal Access to Advanced Imaging and Healthcare Protection: UHC and Diagnostic Imaging
Authors: Cappabianca Pietro , Russo Gaetano Maria , Atripaldi Umberto , Gallo Luigi , Rocco Maria Paola , Pasceri Giovanni , Karaboue Michele A. A. , Angioi Silvia , Cappabianca Salvatore , Reginelli Alfonso
Published: September 2021

Universal Health Coverage (UHC) is a set of principles adopted by the World Health Organization (WHO) aimed to guarantee access to primary care for the entire world population through a range of essential health services without neglecting the diagnostic aspect. Italy is one of the signatory states, which means that diagnostic services should be appropriated and exigible throughout the national territory equally. Our research analyzed and identified the main criticalities in terms of age, territorial distribution, and technological and health appropriateness of installed Computed Tomography (CT) needed to meet the principles of UHC. Data analyzed in our study were published by Assobiomedica at the end of 2016 and by COCIR, which included and investigated the installed fleet of diagnostic equipment in the Italian sanitary system and in various European countries. The 6th point of the Alma Ata Declaration defines the concept of “primary health care”, which includes the importance of the diagnostic phase in the Italian health care system to provide Essential Levels of Assistance (LEA). It is clear from our studies that the technology at the national level is not adequate to satisfy the UHC principles or the European criteria, with negative effects on the diagnostic standards and on advanced screenings. This study conducted on the installed CTs in Italy at the end of 2016 confirms the persistence of progressive aging that has been recorded for several years in the health facilities of the country and suggests incentive policies for the replacement of obsolete equipment, which represent a form of investment rather than a cost, due to the nature of the expenditure itself, one-off and amortizable over time.
Edge Control in the Computer-Controlled Optical Surface
Authors: Yin Lianmin , Hu Hao , Guan Chaoliang , Dai Yifan , Li Zelong
Published: September 2021

The computer-controlled optical surface (CCOS) can process good optical surfaces, but its edge effect greatly affects its development and application range. In this paper, based on the two fundamental causes of the CCOS’s edge effect—namely the nonlinear variation of edge pressure and the unreachable edge removal—a combined polishing method of double-rotor polishing and spin-polishing is proposed. The model of the combined polishing method is established and theoretically analyzed. Combined with the advantages of double-rotor polishing and spin-polishing, the combined polishing process can achieve full-aperture machining without pressure change. Finally, the single-crystal silicon sample with a diameter of 100 mm is polished by the combined polishing process. The results show that, compared with the traditional CCOS polishing, the residual error of the sample after the combined polishing process is more convergent, and the edge effect is effectively controlled.
Experimental Study on Diesel Engine Emission Characteristics Based on Different Exhaust Pipe Coating Schemes
Authors: Zhao Keqin , Lou Diming , Zhang Yunhua , Fang Liang , Tang Yuanzhi
Published: September 2021

The thermal insulation performance of exhaust pipes coated with various materials (basalt and glass fiber materials) under different braiding forms (sleeve, winding and felt types) and the effects on the emission characteristics of diesel engines were experimentally studied through engine bench tests. The results indicated that the thermal insulation performance of basalt fiber was higher than that of glass fiber, and more notably advantageous at the early stage of the diesel engine idle cold phase. The average temperature drop during the first 600 s of the basalt felt (BF) pipe was 2.6 °C smaller than that of the glass fiber felt (GF) pipe. Comparing the different braiding forms, the temperature decrease in the felt-type braided material was 2.6 °C and 2.9 °C smaller than that in the sleeve- and winding-type braided materials, respectively. The basalt material was better than the glass fiber material regarding the gaseous pollutant emission reduction performance, especially in the idling cold phase of diesel engines. The NOx conversion rate of the BF pipe was 7.4% higher than that of the GF pipe, and the hydrocarbon (HC) conversion rate was 2.3% higher than that of the GF pipe, while the CO conversion rate during the first 100 s was 24.5% higher than that of the GF pipe. However, the particulate matter emissions were not notably different.
Danofloxacin Treatment Alters the Diversity and Resistome Profile of Gut Microbiota in Calves
Authors: Beyi Ashenafi Feyisa , Brito-Goulart Debora , Hawbecker Tyler , Slagel Clare , Ruddell Brandon , Hassall Alan , Dewell Renee , Dewell Grant , Sahin Orhan , Zhang Qijing , Plummer Paul J.
Published: September 2021

Fluoroquinolones, such as danofloxacin, are used to control bovine respiratory disease complex in beef cattle; however, little is known about their effects on gut microbiota and resistome. The objectives were to evaluate the effect of subcutaneously administered danofloxacin on gut microbiota and resistome, and the composition of Campylobacter in calves. Twenty calves were injected with a single dose of danofloxacin, and ten calves were kept as a control. The effects of danofloxacin on microbiota and the resistome were assessed using 16S rRNA sequencing, quantitative real-time PCR, and metagenomic Hi-C ProxiMeta. Alpha and beta diversities were significantly different (p < 0.05) between pre-and post-treatment samples, and the compositions of several bacterial taxa shifted. The patterns of association between the compositions of Campylobacter and other genera were affected by danofloxacin. Antimicrobial resistance genes (ARGs) conferring resistance to five antibiotics were identified with their respective reservoirs. Following the treatment, some ARGs (e.g., ant9, tet40, tetW) increased in frequencies and host ranges, suggesting initiation of horizontal gene transfer, and new ARGs (aac6, ermF, tetL, tetX) were detected in the post-treatment samples. In conclusion, danofloxacin induced alterations of gut microbiota and selection and enrichment of resistance genes even against antibiotics that are unrelated to danofloxacin.
A Multi-Point Surveillance for Antimicrobial Resistance Profiles among Clinical Isolates of Gram-Negative Bacteria Recovered from Major Ha’il Hospitals, Saudi Arabia
Authors: Said Kamaleldin B. , Alsolami Ahmed , Khalifa Amany M. , Khalil Nuha A. , Moursi Soha , Osman Abuzar , Fahad Dakheel , Rakha Ehab , Rashidi Musleh , Moussa Safia , Bashir Abdelhafiz I. , Alfouzan Fayez , Hammam Sahar , Taha Taha E. , Al-hazimi Awdah , Al Jadani Ahmed ,   On behalf of the Ha’il COM Research Unit Group
Published: September 2021

The devastating nosocomial resistance is an on-going global concern. Surveillance of resistance is crucial for efficient patient care. This study was aimed to conduct a surveillance in four major Ha’il Hospitals from September to December 2020. Using a multipoint program, records of 621 non-duplicate Gram-negative cultures were tested across 21 drugs belonging to different categories. Major species were Klebsiella pneumoniae (n = 187, 30%), E. coli (n = 151, 24.5%), Pseudomonas aeruginosa, (n = 84, 13.6%), Acinetobacter baumannii (n = 82, 13.3%), and Proteus mirabilis (n = 46, 7%). Based on recent resistance classifications, A. baumanni, P. aeruginosa, and enteric bacteria were defined as pan-resistant, extremely resistant, and multi-drug resistant, respectively. A. baumannii (35%) and K. pneumoniae (23%) dominated among coinfections in SARS-CoV2 patients. The “other Gram-negative bacteria” (n = 77, 12.5%) from diverse sources showed unique species-specific resistance patterns, while sharing a common Gram-negative resistance profile. Among these, Providencia stuartii was reported for the first time in Ha’il. In addition, specimen source, age, and gender differences played significant roles in susceptibility. Overall infection rates were 30% in ICU, 17.5% in medical wards, and 13.5% in COVID-19 zones, mostly in male (59%) senior (54%) patients. In ICU, infections were caused by P. mirabilis (52%), A. baumannii (49%), P. aeruginosa (41%), K. pneumoniae (24%), and E. coli (21%), and most of the respiratory infections were caused by carbapenem-resistant A. baumannii and K. pneumoniae and UTI by K. pneumoniae and E. coli. While impressive IC, hospital performances, and alternative treatment options still exist, the spread of resistant Gram-negative bacteria is concerning especially in geriatric patients. The high selective SARS-CoV2 coinfection by A. baumannii and K. pneumoniae, unlike the low global rates, warrants further vertical studies. Attributes of resistances are multifactorial in Saudi Arabia because of its global partnership as the largest economic and pilgrimage hub with close social and cultural ties in the region, especially during conflicts and political unrests. However, introduction of advanced inter-laboratory networks for genome-based surveillances is expected to reduce nosocomial resistances.
Co-Inoculation of Organic Potato with Fungi and Bacteria at High Disease Severity of Rhizoctonia solani and Streptomyces spp. Increases Beneficial Effects
Authors: Papp Orsolya , Kocsis Tamás , Biró Borbála , Jung Timea , Ganszky Daniel , Abod Éva , Tirczka Imre , Tóthné Bogdányi Franciska , Drexler Dóra
Published: September 2021

Rhizobacteria-based technologies may constitute a viable option for biological fertilization and crop protection. The effects of two microbial inoculants (1) PPS: Pseudomonas protegens, P. jessenii and Stenotrophomonas maltophilia biocontrol bacterium strains and (2) TPB: Trichoderma atroviride, Pseudomonas putida, and Bacillus subtilis fungi, bacteria biocontrol, and biofertilizer combinations were examined on potato (Solanum tuberosum L. var. Demon) in three consecutive years in irrigated organic conditions. The number of tubers showing symptoms of Streptomyces sp. and Rhizoctonia sp. was recorded. The severity of symptoms was evaluated based on the damaged tuber surface. There was a large annual variability in both the symptoms caused by soil-borne pathogens, and the effect of bio-inoculants. In the first and second year, with a stronger Rhizoctonia and Streptomyces spp. incidence, the bacterial and fungal combination of TPB inoculums with both the potential plant nutrition and biocontrol ability of the strains seemed to have a better efficiency to control the diseases. This tendency was not supported in the third year, and this may be attributed to the relatively high natural precipitation. Further studies are required to investigate the agronomic benefits of these inoculants and to tailor their application to the soil microbial characteristics and weather conditions.
Microbial Lipopeptide-Producing Strains and Their Metabolic Roles under Anaerobic Conditions
Authors: Li Jia-Yi , Wang Lu , Liu Yi-Fan , Zhou Lei , Gang Hong-Ze , Liu Jin-Feng , Yang Shi-Zhong , Mu Bo-Zhong
Published: September 2021

The lipopeptide produced by microorganisms is one of the representative biosurfactants and is characterized as a series of structural analogues of different families. Thirty-four families covering about 300 lipopeptide compounds have been reported in the last decades, and most of the reported lipopeptides produced by microorganisms were under aerobic conditions. The lipopeptide-producing strains under anaerobic conditions have attracted much attention from both the academic and industrial communities, due to the needs and the challenge of their applications in anaerobic environments, such as in oil reservoirs and in microbial enhanced oil recovery (MEOR). In this review, the fifty-eight reported bacterial strains, mostly isolated from oil reservoirs and dominated by the species Bacillus subtilis, producing lipopeptide biosurfactants, and the species Pseudomonas aeruginosa, producing glycolipid biosurfactants under anaerobic conditions were summarized. The metabolic pathway and the non-ribosomal peptide synthetases (NRPSs) of the strain Bacillus subtilis under anaerobic conditions were analyzed, which is expected to better understand the key mechanisms of the growth and production of lipopeptide biosurfactants of such kind of bacteria under anaerobic conditions, and to expand the industrial application of anaerobic biosurfactant-producing bacteria.
Anti-Biofilm Activity of Cannabigerol against Streptococcus mutans
Authors: Aqawi Muna , Sionov Ronit Vogt , Gallily Ruth , Friedman Michael , Steinberg Doron
Published: September 2021

Streptococcus mutans is a common cariogenic bacterium in the oral cavity involved in plaque formation. Previous studies showed that Cannabigerol (CBG) has bacteriostatic and bacteriocidic activity against S. mutans. The aim of the present study was to study its effect on S. mutans biofilm formation and dispersion. S. mutans was cultivated in the presence of CBG, and the resulting biofilms were examined by CV staining, MTT assay, qPCR, biofilm tracer, optical profilometry, and SEM. Gene expression was determined by real-time qPCR, extracellular polysaccharide (EPS) production was determined by Congo Red, and reactive oxygen species (ROS) were determined using DCFH-DA. CBG prevented the biofilm formation of S. mutans shown by reduced biofilm biomass, decreased biofilm thickness, less EPS production, reduced DNA content, diminished metabolic activity, and increased ROS levels. CBG altered the biofilm roughness profile, resulting in a smoother biofilm surface. When treating preformed biofilms, CBG reduced the metabolic activity of S. mutans with a transient effect on the biomass. CBG reduced the expression of various genes involved in essential metabolic pathways related to the cariogenic properties of S. mutans biofilms. Our data show that CBG has anti-biofilm activities against S. mutans and might be a potential drug for preventive treatment of dental caries.
Goat Paratuberculosis: Experimental Model for the Evaluation of Mycobacterium Persistence in Raw Milk Cheese
Authors: Pagliasso Giulia , Di Blasio Alessia , Vitale Nicoletta , Romano Angelo , Decastelli Lucia , Quasso Antonio , Ricchi Matteo , Dondo Alessandro , Pastorino Paolo , Gennero Maria Silvia , Bergagna Stefania
Published: September 2021

Mycobacterium avium subsp. paratuberculosis (MAP) is the causative agent of chronic proliferative enteritis found in ruminants, known as paratuberculosis (PTB). The spread of PTB is increasing in countries with advanced animal husbandry practices, leading to significant economic losses. Moreover, a supposed zoonotic role of MAP in Crohn’s disease (CD) in humans has been discussed by the scientific community; however, although the association between MAP and CD has generally been accepted, it is still up for debate if MAP is the main cause of CD, a contributing factor, or merely a commensal organism for the development of CD. The aim of this study was to assess the survival of MAP during the entire production process of a traditional Italian goat’s raw milk fresh cheese, the “Robiola di Roccaverano”, assessing the survival rate and persistence of MAP in the final product. A mix of MAP field isolates from goats of the Roccaverano area and a reference ATCC strain were used to carry out milk in experimental inoculation. Samples of milk, curd and cheese were taken in two consecutive batches of production. Microbiological challenge tests, evaluated by f57-qPCR, showed a significant decrease in MAP charge during the cheesemaking process for both batches, suggesting the productive process has an impact on MAP survival.
Immunity Profiling of COVID-19 Infection, Dynamic Variations of Lymphocyte Subsets, a Comparative Analysis on Four Different Groups
Authors: Balzanelli Mario Giosuè , Distratis Pietro , Dipalma Gianna , Vimercati Luigi , Catucci Orazio , Amatulli Felice , Cefalo Angelo , Lazzaro Rita , Palazzo Davide , Aityan Sergey Khachatur , Pricolo Giancarla , Prudenzano Antonella , D’Errico Patrizia , Laforgia Rita , Pezzolla Angela , Tomassone Diego , Inchingolo Alessio Danilo , Pham Van Hung , Iacobone Donatello , Materi Giuseppe Mancusi , Scarano Antonio , Lorusso Felice , Inchingolo Francesco , Nguyen Kieu Cao Diem , Isacco Ciro Gargiulo
Published: September 2021

Background: A novel coronavirus (SARS-CoV-2)-induced pneumonia (COVID-19) emerged in December 2019 in China, spreading worldwide. The aim of the present investigation was to evaluate the immunological response and the clinical subset of peripheral lymphocyte subset alteration in COVID-19 infection. Methods: the study was conducted on four different clinical groups (n = 4; total n = 138). Each individual was assigned to different groups based on specific criteria evaluated at the admission such as fever, dyspnea, arterial blood gas analysis (ABG), oral-nasopharyngeal swab/RT-PCR, and thoracic CT-scan. Treatment was performed only after blood samples were collected from each patient (PP and PP) at day 1. The blood samples were analyzed and tested the same day (CBC and Flowcytometry). The positive–positive group (PP n = 45; F = 18/ M = 27; median age = 62.33), comprised individuals affected by COVID-19 who showed fever, dyspnea (ABG = pO2 < 60), confirmed positive by oral-nasopharyngeal swab/RT-PCR and with CT-scan showing ground-glass opacities. The negative–positive (NP; n = 37; F = 11/M = 26; median age = 75.94) or “COVID-like” group comprised individuals with fever and dyspnea (ABG = pO2 < 60), who tested negative to nasopharyngeal swab/RT-PCR, with CT-scans showing ground-glass opacities in the lungs. The negative–affected group (NA; n = 40; F = 14/M = 26; median age = 58.5) included individuals negative to COVID-19 (RT-PCR) but affected by different chronic respiratory diseases (the CT-scans didn’t show ground-glass opacities). Finally, the negative–negative group (NN; n = 16; F = 14/M = 2) included healthy patients (NN; n = 16; median age = 42.62). Data and findings were collected and compared. Results: Lymphocytes (%) cells showed a decline in COVID-19 patients. The subsets showed a significant association with the inflammatory status in COVID-19, especially with regard to increased neutrophils, T-killer, T-active, T-suppressor, and T-CD8+CD38+ in individuals belong to the either COVID-19 and Covid-like NP group. Conclusions: Peripheral lymphocyte subset alteration was associated with the clinical characteristics and progression of COVID-19. The level of sub-set cells T-lymphocytes (either high or low) and B-lymphocytes could be used as an independent predictor for COVID-19 severity and treatment efficacy.
The Multifaceted COVID-19: CT Aspects of Its Atypical Pulmonary and Abdominal Manifestations and Complications in Adults and Children. A Pictorial Review
Authors: Morelli Chiara , Francavilla Mariantonietta , Stabile Ianora Amato Antonio , Cozzolino Monica , Gualano Alessandra , Stellacci Giandomenico , Sacco Antonello , Lorusso Filomenamila , Pedote Pasquale , De Ceglie Michele , Scardapane Arnaldo
Published: September 2021

Our daily experience in a COVID hospital has allowed us to learn about this disease in many of its changing and unusual aspects. Some of these uncommon manifestations, however, appeared more frequently than others, giving shape to a multifaceted COVID-19 disease. This pictorial review has the aim to describe the radiological aspects of atypical presentations and of some complications of COVID-19 disease in adults and children and provide a simple guide for radiologists to become familiar with the multiform aspects of this disease.