bluuebunny/crossref_metadata_2025 huggingface dataset:
The Relation between Social Capital and Academic Motivation of Students: A Study of Health Professional Education in Japan
Authors: Koyanagi Yuka , Aung Myo Nyein , Yuasa Motoyuki , Sekine Miwa , Takao Okada
Published: February 2021

Academic motivation consists of reward-based extrinsic motivation and curiosity-based intrinsic motivation. Students studying at university or college develop several new social connections with friends, classmates, and teachers, in addition to their family and community. Belonging to their networks, students acquire opinions, appreciation, trust, and norms of the society. Whether those social connections enhance the motivation of university students for academic work is a question yet to be answered in the context of health profession education in Japan. Judo-therapist education is a form of health profession education in Japan. This study aimed to measure the academic motivation and social capital (SC) of judo-therapist students in Japan, and to find the relation between social capital and academic motivation. This cross-sectional study recruited a total of 2247 students applying multi-stage sampling across Japan. A Japanese version Academic Motivation Scale (AMS) measured the learning motivation in three constructs: (1) intrinsic motivation (IM); (2) extrinsic motivation (EM); and (3) amotivation (alpha 0.94). A newly-developed 46-itemed, 4-pointed scale measured social capital (SC) in five constructs: (1) family relations, (2) on-campus friends, (3) off-campus friends, (4) classroom social capital; and (5) regional social capital (alpha 0.85). Robust regression analysis treated all constructs of SC as independent variables and IM and EM as dependent variables respectively in the three models. Among the average level of constructs, the family SC average level was the highest. Classroom SC was less than family SC and community SC was the lowest. Intrinsic motivation is positively influenced by classroom SC the most, followed by family SC, on-campus friends’ SC, and community SC. Extrinsic motivation is positively influenced by classroom SC the most, followed by family SC, on-campus friends’ SC, and community SC. Amotivation is negatively influenced by social capital constructs except external friends’ SC. In conclusion, social connections have the power to enhance the motivation of university students’ academic work within health profession education. The relations, trust and bonds developed in the classroom may allow an adult learner’s motivation to evolve into autonomous intrinsic motivation and prevent amotivation.
Calorimetric Behaviour of Electric Cables
Authors: Kaczorek-Chrobak Katarzyna , Fangrat Jadwiga , Papis Bartłomiej K.
Published: February 2021

A routine cone calorimeter procedure, the theoretical analysis method, based on a set of ignitability data from the cone calorimeter, has been performed. The five sets of ignition times at different irradiance levels were used for obtaining experimental data needed for analysis. The cone calorimeter tests were performed with horizontal specimens of the size 100 mm × 100 mm consisting of eight pieces of commercial poly(vinyl chloride) coaxial power cable. Specimen combustion was carried out under external heat flux of constant values equal to 10, 20, 30, 40 and 50 kW·m−2, respectively. Standard fire parameters and time to ignition were used for analysis. The results indicate that for each fire parameter, a rising trend with an increase in radiant heat flux has been observed. It was shown that the use of poly(vinyl chloride)-based cables is a potential fire safety hazard due to the emission of heat and a large amount of acid smoke. Quintiere’s theory has been shown as a useful tool for fire modelling by using the data from small-scale tests rather than large geometrical scale cable experiments. Large scale cable test (EN 50399) results are also presented and compared with cone calorimeter data.
Potential Influence of Sewage Phosphorus and Wet and Dry Deposition Detected in Fish Collected in the Athabasca River North of Fort McMurray
Authors: Arciszewski Tim J. , McMaster Mark E.
Published: February 2021

The health of fish is a primary indicator of ecosystem response in the Oil Sands Region of northeastern Alberta. However, industrial activity is accompanied by other stressors, such as the discharge of sewage, municipal activity, forest fires, and natural weathering and erosion of bitumen. To combat the spatial confounding influences, we examined white sucker (Catostomus commersonii) captured in the Athabasca River at sites over time (2011–2019) and included covariates to account for the possible sources of influence. The analyses suggest spatially heterogeneous influences of natural factors on fish, such as discharge and air temperature, but also the influence of sewage phosphorus and precipitation. Among the stressors examined here, precipitation may be the most complex and may include a mixture of sources including inputs from tributaries, urban activity, industrial development, and forest fires. Although suggestive, the attribution of variance and detection of changes are affected by sample sizes in some years; these analyses may have missed effects or misspecified important relationships, especially in males. Despite these limitations, the analyses suggest potential differences may be associated with precipitation and highlight the need to integrate robust information on known and suspected stressors in future monitoring of aquatic ecosystems in the oil sands region and beyond.
Experimental Study on Fire Sources for Full-Scale Fire Testing of Simple Sprinkler Systems Installed in Multiplexes
Authors: Park Jeonghwa , Kwark Jihyun
Published: February 2021

Fires are accidents that can cause numerous human casualties in multiplexes. The simple sprinkler systems applied in South Korea employ sprinklers to protect people against residential fires, as specified by the National Fire Protection Association (NFPA) standard 13D. Therefore, it is necessary to evaluate the fire control performance of multiplexes, which are at a greater risk than residential facilities. This study aims to verify the fire control performance of simple sprinklers in multiplexes and to develop a fire source that can be used as a protocol for testing fire suppression methods. The fire source was evaluated by using a 3 MW large-scale calorimeter (ISO 13784). The proposed fire source for multiplexes was applied in various forms according to the application methods, with ignition sources including cotton wick, wood crib, and heptane, and then the fire tests were conducted.
Dynamics of Explosions in Cylindrical Vented Enclosures: Validation of a Computational Model by Experiments
Authors: Ogunfuye Samuel , Sezer Hayri , Kodakoglu Furkan , Farahani Hamed Farmahini , Rangwala Ali S. , Akkerman V’yacheslav
Published: February 2021

Recent explosions with devastating consequences have re-emphasized the relevance of fire safety and explosion research. From earlier works, the severity of the explosion has been said to depend on various factors such as the ignition location, type of a combustible mixture, enclosure configuration, and equivalence ratio. Explosion venting has been proposed as a safety measure in curbing explosion impact, and the design of safety vent requires a deep understanding of the explosion phenomenon. To address this, the Explosion Venting Analyzer (EVA)—a mathematical model predicting the maximum overpressure and characterizing the explosion in an enclosure—has been recently developed and coded (Process Saf. Environ. Prot. 99 (2016) 167). The present work is devoted to methane explosions because the natural gas—a common fossil fuel used for various domestic, commercial, and industrial purposes—has methane as its major constituent. Specifically, the dynamics of methane-air explosion in vented cylindrical enclosures is scrutinized, computationally and experimentally, such that the accuracy of the EVA predictions is validated by the experiments, with the Cantera package integrated into the EVA to identify the flame speeds. The EVA results for the rear-ignited vented methane-air explosion show good agreement with the experimental results.
Bacterial Fertilizers Based on Rhizobium laguerreae and Bacillus halotolerans Enhance Cichorium endivia L. Phenolic Compound and Mineral Contents and Plant Development
Authors: Jiménez-Gómez Alejandro , García-Estévez Ignacio , Escribano-Bailón M. Teresa , García-Fraile Paula , Rivas Raúl
Published: February 2021

Today there is an urgent need to find new ways to satisfy the current and growing food demand and to maintain crop protection and food safety. One of the most promising changes is the replacement of chemical fertilizers with biofertilizers, which include plant root-associated beneficial bacteria. This work describes and shows the use of B. halotolerans SCCPVE07 and R. laguerreae PEPV40 strains as efficient biofertilizers for escarole crops, horticultural species that are widely cultivated. An in silico genome study was performed where coding genes related to plant growth promoting (PGP) mechanisms or different enzymes implicated in the metabolism of phenolic compounds were identified. An efficient bacterial root colonization process was also analyzed through fluorescence microscopy. SCCPVE07 and PEPV40 promote plant development under normal conditions and saline stress. Moreover, inoculated escarole plants showed not only an increase in potassium, iron and magnesium content but also a significant improvement in protocatechuic acid, caffeic acid or kaempferol 3-O-glucuronide plant content. Our results show for the first time the beneficial effects in plant development and the food quality of escarole crops and highlight a potential and hopeful change in the current agricultural system even under saline stress, one of the major non-biological stresses.
Quantifying Drivers of Forecasted Returns Using Approximate Dynamic Factor Models for Mixed-Frequency Panel Data
Authors: Defend Monica , Min Aleksey , Portelli Lorenzo , Ramsauer Franz , Sandrini Francesco , Zagst Rudi
Published: February 2021

This article considers the estimation of Approximate Dynamic Factor Models with homoscedastic, cross-sectionally correlated errors for incomplete panel data. In contrast to existing estimation approaches, the presented estimation method comprises two expectation-maximization algorithms and uses conditional factor moments in closed form. To determine the unknown factor dimension and autoregressive order, we propose a two-step information-based model selection criterion. The performance of our estimation procedure and the model selection criterion is investigated within a Monte Carlo study. Finally, we apply the Approximate Dynamic Factor Model to real-economy vintage data to support investment decisions and risk management. For this purpose, an autoregressive model with the estimated factor span of the mixed-frequency data as exogenous variables maps the behavior of weekly S&P500 log-returns. We detect the main drivers of the index development and define two dynamic trading strategies resulting from prediction intervals for the subsequent returns.
Novel Variants in the CLCN1, RYR2, and DCTN1 Found in Elderly Japanese Dementia Patients: A Case Series
Authors: Hori Atsushi , Ai Tomohiko , Isshiki Miwa , Motoi Yumiko , Yano Kouji , Tabe Yoko , Hattori Nobutaka , Miida Takashi
Published: February 2021

Dementia has an enormous impact on medical and financial resources in aging societies like Japan. Diagnosis of dementia can be made by physical and mental examinations, imaging tests, and findings of high abnormal proteins in cerebrospinal fluids. In addition, genetic tests can be performed in neurodegenerative diseases such as Alzheimer’s disease (AD), frontotemporal dementia (FTD), and Parkinson’s disease (PD). In this case series, we presented three cases of dementia with unknown causes who carry novel variants in the genes associated with neurodegenerative diseases. Three patients (Patients 1, 2, and 6) were found by screening 18 dementia patients using a gene panel including 63 genes. The age of onset for Patient 1 was 74 years old, and his father had PD and mother had AD. The age of onset for Patient 2 was 75 years old, and her mother had AD. The age of onset for Patient 6 was 83 years old, and her father, two sisters, and daughter had dementia. The Mini-Mental State Examination produced results of 20, 15, and 22, respectively. The suspected diagnosis by neurological examinations and imaging studies for Patients 1 and 2 was AD, and for Patient 6 was FTD. Patient 1 was treated with donepezil; Patient 2 was treated with donepezil and memantine; and Patient 6 was treated with donepezil, galantamine, and rivastigmine. The three rare variants identified were: CLCN1, encoding a chloride channel, c.2848G>A:p.Glu950Lys (Patient 1); RYR2, encoding a calcium releasing ryanodine receptor, c.13175A>G:p.Lys4392Arg (Patient 2); and DCTN1, encoding a subunit of dynactin, c. 3209G>A:p.Arg1070Gln (Patient 6). The detected variants were interpreted according to the American College of Medical Genetics (ACMG) guidelines. The minor allele frequency for each variant was 0.025%, 0.023%, and 0.0004% in East Asians, respectively. The DCTN1 variant found in Patient 6 might be associated with FTD. Although none of them were previously reported in dementia patients, all variants were classified as variants of unknown significance (VUS). Our report suggests that results of genetic tests in elderly patients with dementia need to be carefully interpreted. Further data accumulation of genotype–phenotype relationships and development of appropriate functional models are warranted.
The Effect of High-Intensity Power Training on Habitual, Intervention and Total Physical Activity Levels in Older Adults with Type 2 Diabetes: Secondary Outcomes of the GREAT2DO Randomized Controlled Trial
Authors: Mosalman Haghighi Marjan , Mavros Yorgi , Kay Shelley , Simpson Kylie A. , Baker Michael K. , Wang Yi , Zhao Ren Ru , Meiklejohn Jacinda , Climstein Mike , O’Sullivan Anthony J. , De Vos Nathan , Baune Bernhard T. , Blair Steven N. , Simar David , Singh Nalin , Schlicht Jeffrey , Fiatarone Singh Maria A.
Published: February 2021

Background: We examined the effect of power training on habitual, intervention and total physical activity (PA) levels in older adults with type 2 diabetes and their relationship to metabolic control. Materials and Methods: 103 adults with type 2 diabetes were randomized to receive supervised power training or sham exercise three times/week for 12 months. Habitual, intervention, and total PA, as well as insulin resistance (HOMA2-IR) and glycosylated hemoglobin (HbA1c), were measured. Results: Participants were aged 67.9 ± 5.5 yrs, with well-controlled diabetes (HbA1c = 7.1%) and higher than average habitual PA levels compared to healthy peers. Habitual PA did not change significantly over 12 months (p = 0.74), and there was no effect of group assignment on change over time in habitual PA over 0–6 (p = 0.16) or 0–6–12 months (p = 0.51). By contrast, intervention PA, leg press tonnage and total PA increased over both 6- and 12-month timepoints (p = 0.0001), and these changes were significantly greater in the power training compared to the sham exercise group across timepoints (p = 0.0001). However, there were no associations between changes in any PA measures over time and changes in metabolic profile. Conclusion: Structured high-intensity power training may be an effective strategy to enhance overall PA in this high-risk cohort.
On Something Like an Operational Virtuality
Authors: Wilson Alexander
Published: February 2021

We outline here a certain history of ideas concerning the relation between intuitions and their external verification and consider its potential for detrivializing the concept of virtuality. From Descartes and Leibniz onward to 19th-century geometry and the concept of “invariant” that it shares with 19th-century psychology, we follow the thread of what might be informally called an “operational” conception of the virtual, an intuition progressively developed in the 20th century from of group theoretical thinking into “functorial” thinking (in the context of category theory), and eventually intuitions for the concept of “univalence” (homotopy type theory) and its implications for the meaning of equality and identity. At each turn, skeptical arguments haunt this history’s modes of exteriorization, proof, and verification; we consider the later Wittgenstein’s worries concerning rule following and the apparent unbridgeable gap between formal theory and informal practice. We show how the development of mathematical intuitions and formalisms in the last century and the discovery of deep connection between intuitionistic logic and computation have begun to respond to some of these concerns and favour a conception of virtuality that is operational, constructive, pragmatic, and hospitible to scientific detrivialization.
Trust in Intensive Care Patients, Family, and Healthcare Professionals: The Development of a Conceptual Framework Followed by a Case Study
Authors: Lemmers Anne Lotte , van der Voort Peter H. J.
Published: February 2021

Intensive care patients experience anxiety, pain, uncertainty, and total dependency. In general, it is important to develop trust between the healthcare professionals (HCPs), patients, and their family. Trust building in the ICU setting is challenging because of the time sensitivity of decision making and the dependency of patients on health care professionals. The objectives of this study are the development of a trust framework and then to use this framework in a case study in the intensive care. In three steps we developed a comprehensive trust framework from the literature concerning trust. First, we identified the elements of trust. Second, we adapted and integrated the dimensions to six concepts to construct the trust framework. Third, these concepts are incorporated into a comprehensive trust framework. In a case study we explored the facilitators and barriers within this framework in eight semi-open interviews with healthcare professionals and eight patients or partners. Trust was first explored inductively and then deductively. We showed that HCPs, patients, and family have largely the same perspective regarding the facilitators of trust, in which communication emerged as the most important one. Other facilitators are maintaining an open feedback culture for HCPs and being aware of patients’ physical and informational privacy. Patients want to be approached as an individual with individual needs. Dishonesty and differences in values and norms were the most important barriers. To contribute to a positive perception of health delivery and to avoid conflicts between HCP and patients or their family we formulated five practical recommendations.
External Validation of the Acute Kidney Injury Risk Prediction Score for Critically Ill Surgical Patients Who Underwent Major Non-Cardiothoracic Surgery
Authors: Trongtrakul Konlawij , Patumanond Jayanton , Phairatwet Piyarat , Sawawiboon Chaiwut , Chitsomkasem Anusang , Kurathong Sathit , Prommoon Surasee , Trakarnvanich Thananda , Phinyo Phichayut
Published: February 2021

Background: Acute kidney injury (AKI) is a common complication encountered in an intensive care unit (ICU). In 2020, the AKI prediction score was developed specifically for critically ill surgical patients who underwent major non-cardiothoracic surgeries. This study aimed to externally validate the AKI prediction score in terms of performance and clinical utility. Methods: External validation was carried out in a prospective cohort of patients admitted to the ICU of the Faculty of Medicine Vajira Hospital between September 2014 and September 2015. The endpoint was AKI within seven days following ICU admission. Discriminative ability was based on the area under the receiver operating characteristic curves (AuROC). Calibration and clinical usefulness were evaluated. Results: A total of 201 patients were included in the analysis. AKI occurred in 37 (18.4%) patients. The discriminative ability dropped from good in the derivation cohort, to acceptable in the validation cohort (0.839 (95%CI 0.825–0.852) vs. 0.745 (95%CI 0.652–0.838)). No evidence of lack-of-fit was identified (p = 0.754). The score had potential clinical usefulness across the range of threshold probability from 10 to 50%. Conclusions: The AKI prediction score showed an acceptable discriminative performance and calibration with potential clinical usefulness for predicting AKI risk in surgical patients who underwent major non-cardiothoracic surgery.
Postural Sway in Older Patients with Sagittal Imbalance and Young Adults during Local Vibratory Proprioceptive Stimulation
Authors: Ito Tadashi , Sakai Yoshihito , Yamazaki Kazunori , Ito Yohei , Kawai Keitaro , Kato Yoshiji , Sugiura Hideshi , Morita Yoshifumi
Published: February 2021

This study aimed to assess differences in somatosensory control strategies between older patients with sagittal imbalance and young adults during postural tasks. The center of pressure displacement in 27 older patients with sagittal imbalance and 27 young adults was determined upon standing blindfolded on a balance board. Vibratory stimulation at 56 to 100 Hz was applied bilaterally to the gastrocnemius and soleus muscles (GS) and lumbar multifidus to evaluate the contributions of proprioceptive signals to postural control. Data of older patients and young adults were compared using the Mann–Whitney U-test or independent sample t-tests. Compared with the young adults, the older patients were significantly more reliant on the GS (p < 0.005) for their postural control and showed a higher relative proprioceptive weighting ratio (RPW) (p = 0.038). The postural strategy adopted by the older patients depended on the level of proprioceptive stimulation applied to the GS, and the postural control strategy of the ankle correlated with RPW. Overall, this study identifies RPW as a novel measure of postural strategy in older patients with sagittal imbalance and provides an understanding of strategies used to maintain balance, which may assist in developing preventative measures to reduce the risk of falls.
Impact of Obstructive Sleep Apnea on In-Hospital Outcomes of Patients with Non-ST Elevation Myocardial Infarction
Authors: Isa Sakiru Oyetunji , Adegbala Oluwole , Buhari Olajide , Khan Mahin , Adekolujo Orimisan , Adekolujo Oyebimpe , Munir Ahmad , Hassan Mustafa
Published: February 2021

Background: Obstructive sleep apnea (OSA) is one of the most common breathing disorders. There are uncertainties about its impact on the in-hospital outcomes of patients who suffer acute coronary syndromes. We studied the largest publicly available all-payer inpatient healthcare database in the United States (National Inpatient Sample) to determine the effects of obstructive sleep apnea on the in-hospital outcomes of patients admitted with non-ST elevation myocardial infarction (NSTEMI). Methods: All adult patients (age ≥ 18) admitted primarily for NSTEMI between September 2010 and September 2015 were identified in the National Inpatient Sample. They were then categorized into those with OSA and those without OSA. The main outcome was in-hospital mortality. Propensity scoring and logistic regression models were created to determine the outcomes. Results: There were 1,984,432 patients with NSTEMI (weighted estimates), 123,551 (6.23%) of who had diagnosed OSA while 1,860,881 (93.77%) did not. In-hospital mortality was significantly lower in the OSA group [2.61% vs. 3.53%, adjusted odd ratio (aOR) 0.73 and confidence interval (CI) (0.66–0.81)]. Patients with OSA were also less likely to require coronary artery bypass surgery: 13.85% and 12.77% (p-value 0.0003). The patients with OSA had higher mean hospital costs compared to the patients who did not have OSA: $17,326 vs. $16,984, adjusted mean ratio (aMR) 1.02; CI (1.01–1.02). Conclusion: In-hospital mortality was lower in NSTEMI patients with diagnosed OSA compared to patients without diagnosed OSA. This appears to contrast with the widely recognized adverse effects of OSA on the cardiovascular system.
Digital Artifacts and Landscapes. Experimenting with Placemaking at the Impero Project
Authors: Sebastiani Alessandro
Published: February 2021

This paper describes the public archaeology approach and placemaking experiment at the Etruscan and Roman site of Podere Cannicci in Tuscany (Italy), drawing from the previous experience at three other archaeological sites along the Tyrrhenian coast. After three years of excavations at the IMPERO Project (Interconnected Mobility of People and Economy along the River Ombrone), the team has begun a side project to develop new strategies for communicating the results of the research. These include, but are not limited to, an app which displays augmented reality and 3D reconstructions of both the site and the material culture. The project uses digital narratives to engage local communities and scholars in the interpretation and reconstruction of ancient landscapes along with the middle valley of the Ombrone river. This approach also has the potential to support and sustain local tourism, providing an original experience for visitors. Moreover, the solution allows people from all over the world to be connected with the ongoing research and its results, as everything will be published on a dedicated website.
Consequences of a Delayed Diagnosis of Kaposi’s Sarcoma: A Case Report of Disseminated Infection
Authors: Bertolucci Leonardo Henrique , Rossatto Ribas Carolina , Mullich Flesch Ellen , Aurélio Knebel Balbinot Lisiane , Ramos Fabiano
Published: February 2021

Kaposi’s Sarcoma (KS), first reported by Dr [...]
Innovating Occupational Safety Training: A Scoping Review on Digital Games and Possible Applications in Agriculture
Authors: Vigoroso Lucia , Caffaro Federica , Micheletti Cremasco Margherita , Cavallo Eugenio
Published: February 2021

Digital games have been successfully applied in different working sectors as an occupational safety training method, but with a very limited application in agriculture. In agriculture and other productive sectors, unintentional injuries tend to occur with similar dynamics. A literature review was carried out to understand how occupational risks are addressed during game-based safety training in different productive sectors and how this can be transferred to agriculture. Literature about “serious game” and “gamification” as safety training methods was searched in WEB OF SCIENCE, SCOPUS, PUBMED and PsycINFO databases. In the forty-two publications retained, the computer was identified as the most adopted game support, whereas “points”, “levels”, “challenges” and “discovery” were the preferred game mechanics. Moreover, an association can be detected between the game mechanics and the elements developed in the game. Finally, during the game assessment, much positive feedback was collected and the games proved to be able to increase the operators’ skills and safety knowledge. In light of the results, insights are provided to develop an effective, satisfying and engaging safety game training for workers employed in agriculture. Games can be best used to learn and they are certain to improve over the next few years.
The Role of Stress in Breast Cancer Incidence: Risk Factors, Interventions, and Directions for the Future
Authors: Bowen Deborah , Fernandez Poole Senaida , White Mary , Lyn Rodney , Flores Debra , Haile Helen , Williams David
Published: February 2021

Stress is a common belief among breast cancer patients and the public to explain variation in breast cancer incidence. Epidemiological studies interrogating the relationship between stress and cancer have reported mixed results. The impact of the topic and the lack of consensus has sparked this review of the literature to investigate gaps in knowledge and identify areas of research. We first present a brief summary of the biopsychosocial model generally used to conduct research on stress. We then divide the overview of the literature into areas of research focus. These include the role of distressing life events in breast cancer incidence, the role of adverse childhood events in later breast cancer incidence, the importance of race and socioeconomic status (SES) as social determinants of breast cancer incidence, and the specific role of chronic stress in relation to breast cancer. For each topic, we discuss the potential of stress as a risk factor and possible intervention strategies that could reduce the effects of stress. We then identify further research questions to be probed to fill the gaps in knowledge. We conclude with a discussion of future research directions for stress research as it relates to breast cancer incidence.
Factors That Influence Use of a Patient Portal by Health Professionals
Authors: Janssen Anna , Keep Melanie , Selvadurai Hiran , Kench Andrea , Hunt Sharon , Simonds Sharon , Marshall Tracey , Hatton Lucy , Dalla-Pozza Luciano , McCullagh Cheryl , Shaw Tim
Published: February 2021

Patient portals are websites or apps that provide patients with tools to manage healthcare appointments, access their health records, and communicate with clinicians. Patient portals have been demonstrated to be beneficial for improving communication between patients/carers and their healthcare team in a range of health settings. However, there is limited research on the barriers and enablers for implementing patient portals from the perspective of health professionals and healthcare teams, particularly in a paediatric setting. This study aimed to understand healthcare teams’ experiences of using a patient portal and, using the Unified Theory of Acceptance and Use of Technology (UTAUT) framework, explore the barriers and enablers to ongoing use. Participants were 11 health professionals participating in the pilot of a patient portal for patients/carers in paediatric care. Data were collected using semi-structured interviews. Analysis of the interview data identified nine themes about implementing a patient portal in paediatric care, all of which aligned with the four constructs of the UTAUT. This study identified that barriers and enablers of the uptake of a patient portal by health professionals in a paediatric context aligned with the UTAUT framework. Value for the patient, improved workflow, and adequate technical and implementation support were highlighted by participants.
Household Air Pollution from Biomass Fuel for Cooking and Adverse Fetal Growth Outcomes in Rural Sri Lanka
Authors: Vakalopoulos Alicia , Dharmage Shyamali C. , Dharmaratne Samath , Jayasinghe Pasan , Lall Olivia , Ambrose Isabella , Weerasooriya Rohan , Bui Dinh S. , Yasaratne Duminda , Heyworth Jane , Bowatte Gayan
Published: February 2021

The aim of this study was to investigate the impact of biomass fuel for cooking on adverse fetal growth outcomes in Sri Lanka. A cross-sectional study of mothers recruited at maternity clinics in rural communities in Sri Lanka’s Central Province was undertaken. Data pertaining to household air pollution and fetal growth parameters were collected using an interviewer-administered questionnaire. Logistic regression models, adjusted for potential confounders, were used to evaluate the impact of biomass fuel for cooking on low birth weight (LBW) and small for gestational age (SGA) parameters. Findings showed that exposure to biomass cooking fuels during pregnancy was associated with an increased risk of LBW adjusted odds ratio (aOR) 2.74 (95% CI 1.08–6.96) and SGA (aOR: 1.87, 95% CI 1.03–3.41) compared with the use of clean energy. The risk of LBW was highest for traditional biomass stoves compared to improved biomass stoves (aOR: 3.23, 95% 1.17–8.89) and biomass use in kitchens without a chimney compared to kitchens with a chimney (aOR: 4.63, 95% 1.54–13.93). Similar trends were observed for SGA.
Stability of the Communication Function Classification System among Children with Cerebral Palsy in South Korea
Authors: Park Eun-Young
Published: February 2021

Interest in the prognosis of skill levels has been an important issue among children with cerebral palsy (CP). This study aimed to verify the stability of the Communication Function Classification System (CFCS) in 2- to 18-year-old children with CP. Data collected from 171 children with CP who received rehabilitation therapy in hospitals or attended special elementary schools in South Korea were reviewed. They were divided into two groups, children <4 years and children ≥4 years. Participants were evaluated over 1-year and 2-year intervals from the first rating. Agreement between the three measurements and the weighted kappa were analyzed. At the 1-year interval, results demonstrated a high agreement rate of the CFCS in children ≥4 years old, and during the 2-year interval the study revealed a low agreement rate in children aged 2–4 years. The results indicated the stability of the CFCS in children ≥4 years old but some change of the CFCS in 2- to 4-year-old children. Moreover, the findings suggested that the change of the CFCS varied with time and age. Based on these results, it is recommended that the CFCS assessments be performed periodically, especially among 2- to 4-year-old children with CP.
CRISPR Deletion of a SVA Retrotransposon Demonstrates Function as a cis-Regulatory Element at the TRPV1/TRPV3 Intergenic Region
Authors: Price Emma , Gianfrancesco Olympia , Harrison Patrick T. , Frank Bernhard , Bubb Vivien J. , Quinn John P.
Published: February 2021

SINE-VNTR-Alu (SVA) retrotransposons are a subclass of transposable elements (TEs) that exist only in primate genomes. TE insertions can be co-opted as cis-regulatory elements (CREs); however, the regulatory potential of SVAs has predominantly been demonstrated using bioinformatic approaches and reporter gene assays. The objective of this study was to demonstrate SVA cis-regulatory activity by CRISPR (clustered regularly interspaced short palindromic repeats) deletion and subsequent measurement of direct effects on local gene expression. We identified a region on chromosome 17 that was enriched with human-specific SVAs. Comparative gene expression analysis at this region revealed co-expression of TRPV1 and TRPV3 in multiple human tissues, which was not observed in mouse, highlighting key regulatory differences between the two species. Furthermore, the intergenic region between TRPV1 and TRPV3 coding sequences contained a human specific SVA insertion located upstream of the TRPV3 promoter and downstream of the 3′ end of TRPV1, highlighting this SVA as a candidate to study its potential cis-regulatory activity on both genes. Firstly, we generated SVA reporter gene constructs and demonstrated their transcriptional regulatory activity in HEK293 cells. We then devised a dual-targeting CRISPR strategy to facilitate the deletion of this entire SVA sequence and generated edited HEK293 clonal cell lines containing homozygous and heterozygous SVA deletions. In edited homozygous ∆SVA clones, we observed a significant decrease in both TRPV1 and TRPV3 mRNA expression, compared to unedited HEK293. In addition, we also observed an increase in the variability of mRNA expression levels in heterozygous ∆SVA clones. Overall, in edited HEK293 with SVA deletions, we observed a disruption to the co-expression of TRPV1 and TRPV3. Here we provide an example of a human specific SVA with cis-regulatory activity in situ, supporting the role of SVA retrotransposons as contributors to species-specific gene expression.
Targeting GRK5 for Treating Chronic Degenerative Diseases
Authors: Marzano Federica , Rapacciuolo Antonio , Ferrara Nicola , Rengo Giuseppe , Koch Walter J. , Cannavo Alessandro
Published: February 2021

G protein-coupled receptors (GPCRs) are the largest family of cell-surface receptors and they are responsible for the transduction of extracellular signals, regulating almost all aspects of mammalian physiology. These receptors are specifically regulated by a family of serine/threonine kinases, called GPCR kinases (GRKs). Given the biological role of GPCRs, it is not surprising that GRKs are also involved in several pathophysiological processes. Particular importance is emerging for GRK5, which is a multifunctional protein, expressed in different cell types, and it has been found located in single or multiple subcellular compartments. For instance, when anchored to the plasma membrane, GRK5 exerts its canonical function, regulating GPCRs. However, under certain conditions (e.g., pro-hypertrophic stimuli), GRK5 translocates to the nucleus of cells where it can interact with non-GPCR-related proteins as well as DNA itself to promote “non-canonical” signaling, including gene transcription. Importantly, due to these actions, several studies have demonstrated that GRK5 has a pivotal role in the pathogenesis of chronic-degenerative disorders. This is true in the cardiac cells, tumor cells, and neurons. For this reason, in this review article, we will inform the readers of the most recent evidence that supports the importance of targeting GRK5 to prevent the development or progression of cancer, cardiovascular, and neurological diseases.
Tryptophan Metabolism via Kynurenine Pathway: Role in Solid Organ Transplantation
Authors: Zulpaite Ruta , Miknevicius Povilas , Leber Bettina , Strupas Kestutis , Stiegler Philipp , Schemmer Peter
Published: February 2021

Solid organ transplantation is a gold standard treatment for patients suffering from an end-stage organ disease. Patient and graft survival have vastly improved during the last couple of decades; however, the field of transplantation still encounters several unique challenges, such as a shortage of transplantable organs and increasing pool of extended criteria donor (ECD) organs, which are extremely prone to ischemia-reperfusion injury (IRI), risk of graft rejection and challenges in immune regulation. Moreover, accurate and specific biomarkers, which can timely predict allograft dysfunction and/or rejection, are lacking. The essential amino acid tryptophan and, especially, its metabolites via the kynurenine pathway has been widely studied as a contributor and a therapeutic target in various diseases, such as neuropsychiatric, autoimmune disorders, allergies, infections and malignancies. The tryptophan-kynurenine pathway has also gained interest in solid organ transplantation and a variety of experimental studies investigating its role both in IRI and immune regulation after allograft implantation was first published. In this review, the current evidence regarding the role of tryptophan and its metabolites in solid organ transplantation is presented, giving insights into molecular mechanisms and into therapeutic and diagnostic/prognostic possibilities.
Factors Driving Users’ Engagement in Patient Social Network Systems
Authors: Puspitasari Ira , Fauzi Shukor Sanim Mohd , Ho Cheng-Yuan
Published: February 2021

Participatory medicine and e-health help to promote health literacy among non-medical professionals. Users of e-health systems actively participate in a patient social network system (PSNS) to share health information and experiences with other users with similar health conditions. Users’ activities provide valuable healthcare resources to develop effective participatory medicine between patients, caregivers, and medical professionals. This study aims to investigate the factors of patients’ engagement in a PSNS by integrating and modifying an existing behavioral model and information system model (i.e., affective events theory (AET) and self-determination theory (SDT)). The AET is used to model the structure, the affective aspects of the driven behavior, and actual affective manifestation. The SDT is used to model interest and its relations with behavior. The data analysis and model testing are based on structural equation modeling, using responses from 428 users. The results indicate that interest and empathy promote users’ engagement in a PSNS. The findings from this study suggest recommendations to further promote users’ participation in a PSNS from the sociotechnical perspective, which include sensitizing and constructive engagement features. Furthermore, the data generated from a user’s participation in a PSNS could contribute to the study of clinical manifestations of disease, especially an emerging disease.
Distributional Patterns of Aquatic Empididae (Diptera) along an Elevational Diversity Gradient in a Low Mountain Range: An Example from Central Europe
Authors: Słowińska Iwona , Jaskuła Radomir
Published: February 2021

The two subfamilies Hemerodromiinae and Clinocerinae, also known as aquatic dance flies, are a group of small predatory insects occurring mainly in mountainous areas and the northern temperate. However, very little is known about distribution patterns for most of the species. Habitat preferences for 40 aquatic empidid species were analysed in the Pieniny Mts., Poland. Forty-six sampling sites from a major part of this relatively low mountain massif (400–770 m) were chosen, for which 17 micro and macrohabitat environmental variables were measured including both abiotic (altitude, stream mean width and depth, and shading) and biotic factors (13 dominant plant communities). Here we show that numerous studied aquatic Empididae were characterized by unique habitat preferences and were restricted to the foothills or the lower montane zone with only a few species characterized by wider elevational distribution. Chelifera pectinicauda, C. flavella, C. subangusta and Phyllodromia melanocephala (Hemerodromiinae), and Clinocera appendiculata, C. fontinalis, C. wesmaeli, Dolichocephala guttata, D. oblongoguttata, Kowarzia plectrum, Wiedemannia jazdzewskii, and W. thienemanni (Clinocerinae) were clearly associated with the highest altitudes and shaded areas while W. bistigma, W. lamellata, W. phantasma, and W. tricuspidata (Clinocerinae) were clearly associated with the lower elevated, wider stream valleys overgrown by willow brakes. Species richness and diversity decreased along elevational gradient with the hump-shaped diversity pattern noted for the subfamily Clinocerinae. The altitude, size of river/stream as well as the type of plant community were found as the most important factors in the distribution of the studied aquatic empidid species. The present study is the first one focused on elevational diversity gradient and habitat preferences of Hemerodromiinae and Clinocerinae of central Europe, and one of only a few in the world.
Antennal and Behavioral Responses of Drosophila suzukii to Volatiles from a Non-Crop Host, Osyris wightiana
Authors: Liu Yan , Cui Zhihao , Shi Mi , Kenis Marc , Dong Wenxia , Zhang Feng , Zhang Jinping , Xiao Chun , Chen Li
Published: February 2021

Drosophila suzukii (Diptera: Drosophilidae) infests a variety of commercial fruits, including cherries and other soft-skinned fruits. After the cropping season of most cultivated crop hosts, it heavily infests the fruit of a wild host-plant, Osyris wightiana in southwest China. Here, we employ gas chromatography-electroantennographic detection (GC-EAD) together with behavioral bioassays and a trapping experiment to identify volatile semiochemicals emitted by O. wightiana that are involved in D. suzukii attraction. GC-EAD recordings of D. suzukii antenna showed responses to 13 compounds, including α-pinene, 3-methylbutyl acetate, 2-hexanol, E-β-ocimene, Z-3-hexenol, β-caryophyllene, α-humulene, and six unidentified compounds. The flies were attracted by seven individual EAD-active compounds at low doses (0.01 and 0.1 μg), but were repelled at high doses (10 and 100 μg). In a similar manner, a blend of seven EAD-active compounds at low doses (0.1 and 1 μg) was attractive to female flies, but became repulsive at high doses (10 μg). The low dose of the blend was as attractive as the fruit volatiles, although both were less attractive than the fruits. The blend attracted both female and male D. suzukii and other Drosophila flies. The percentage of D. suzukii out of all flies captured by the blend was significantly greater than that captured by the control. These results indicate that the EAD-active volatile compounds emitted by fruits of O. wightiana play an important role in D. suzukii attraction, and have the potential to be used for management of D. suzukii.
Atrioventricular Septal Defect: What Is in a Name?
Authors: Rigby Michael
Published: February 2021

Robert Anderson has made a huge contribution to almost all aspects of morphology and understanding of congenital cardiac malformations, none more so than the group of anomalies that many of those in the practice of paediatric cardiology and adult congenital heart disease now call ‘Atrioventricular Septal Defect’ (AVSD). In 1982, with Anton Becker working in Amsterdam, their hallmark ‘What’s in a name?’ editorial was published in the Journal of Thoracic and Cardiovascular Surgery. At that time most described the group of lesions as ‘atrioventricular canal malformation’ or ‘endocardial cushion defect’. Perhaps more significantly, the so-called ostium primum defect was thought to represent a partial variant. It was also universally thought, at that time, that the left atrioventricular valve was no more than a mitral valve with a cleft in the aortic leaflet. In addition to this, lesions such as isolated cleft of the mitral valve, large ventricular septal defects opening to the inlet of the right and hearts with straddling or overriding tricuspid valve were variations of the atrioventricular canal malformation. Anderson and Becker emphasised the differences between the atrioventricular junction in the normal heart and those with a common junction for which they recommended the generic name, ‘atrioventricular septal defect’. As I will discuss, over many years, they continued to work with clinical cardiologists and cardiac surgeons to refine diagnostic criteria and transform the classification and understanding of this complex group of anomalies. Their emphasis was always on accurate diagnosis and communication, which is conveyed in this review.
Tie-2, G-CSF, and Leptin as Promising Diagnostic Biomarkers for Endometrial Cancer: A Pilot Study
Authors: Roškar Luka , Klančič Teja , Knific Tamara , Rižner Tea Lanišnik , Smrkolj Špela
Published: February 2021

Preoperative determination of the extent of endometrial cancer (EC) would avoid the complications associated with radical surgery. Screening of patients’ plasma biomarkers might enable a more precise diagnosis of EC and a tailored treatment approach. This prospective case-control monocentric pilot study included 76 postmenopausal women (38 endometrioid EC patients and 38 control patients with benign gynecological conditions), and 37 angiogenic factors (AFs) were investigated as potential biomarkers for EC. AF concentrations in preoperative plasma samples were measured using Luminex xMAP™ multiplexing technology. The plasma levels of sTie-2 and G-CSF were significantly lower in EC compared to control patients, whereas the plasma levels of leptin were significantly higher in EC patients. Neuropilin-1 plasma levels were significantly higher in patients with type 2 EC (grade 3) compared to patients with lower grade cancer or controls. Follistatin levels were significantly higher in patients with lymphovascular invasion, and IL-8 plasma levels were significantly higher in patients with metastases. If validated, the plasma concentrations of the indicated AFs could represent an important additional diagnostic tool for the early detection and characterization of EC. This could guide the decision-making on the extent of surgery. Further studies with larger patient numbers are currently ongoing.