bluuebunny/crossref_metadata_2025 huggingface dataset:
A Review on Catalytic Co-Pyrolysis of Biomass and Plastics Waste as a Thermochemical Conversion to Produce Valuable Products
Authors: Mo Fujin , Ullah Habib , Zada Noor , Shahab Asfandyar
Published: July 2023

In order to satisfy the increasing need for renewable chemicals and fuels, it is important to replace petroleum-based products with alternative feedstocks. Lignocellulosic biomass is considered to be the most capable alternative source for producing sustainable biofuels. Catalytic co-pyrolysis (CCP) is a process that involves simultaneously pyrolyzing biomass and plastics to produce a combination of liquid and gaseous products, such as bio-oil and syngas. Catalysts are used to raise the reaction degree and the selectivity of the co-pyrolysis process, with the choice of catalyst dependent on the physico-chemical features of the feedstock. Catalytic pyrolysis is a useful method for producing high-quality biofuels directly from biomass, although it typically yields a modest amount of aromatic hydrocarbons (HCs) and a large amount of coke, even with highly effective catalysts. Adding a co-reactant high in hydrogen to the CCP process can significantly increase the yield of aromatics while reducing coke formation. The use of CCP can help to address the environmental issues related to waste plastic disposal and improve energy security. This review article thoroughly discusses the process and mechanism of catalytic co-pyrolysis, the influence of plastics on the process, and how the addition of plastics can improve the quality and output of bio-oil while reducing the production of oxygenated compounds and coke. The importance of various catalysts (such as biochar, activated carbon, and acid and base catalysts) in improving the production and quality of obtained products is also compared and discussed.
A Comprehensive Model Assessment of China’s Forestry and Climate Change
Authors: Zhang Ying , Obuobi Bright , Hwarari Delight , Zhang Zhiguang
Published: July 2023

The relationship between maximizing forest revenue and reducing environmental pollution has been a challenging one. It is every country’s responsibility to protect its forest reserves and mitigate climate change. Studies on the relationship between forest economic models and climate change are limited, and most of them focus on maximizing forestry products. This study aims at filling the gaps and makes scientific contributions by providing a detailed account of various economic models and their correlations with climate change, as well as identifying the ecological footprint of forest products, fossil fuel consumption, forest cover, foreign direct investment, economic growth, and population in terms of carbon dioxide (CO2) emissions. In this study, we observed that most forest economic models focus on forest profit maximization and disregard climate impact. The empirical results suggest that the ecological footprint of forest products increases CO2 emissions. In addition, forest cover helps to reduce CO2 emissions. A case study of China’s tremendous growth and the associated CO2 emissions levels reported a recent decrease in such levels, largely due to an increase in forest cover. Although these findings are not exhaustive, they provide new insights into forestry economic models and the impact of climate change, offering theoretical and practical implications for future reference and forest governance.
The Early- to Latewood Transition Phenology Is Asynchronous between the Different Parts of Abies forrestii var. smithii in Jiaozi Mountain, Yunnan, China
Authors: Wang Wenli , Zhu Mingyang , Lin Lin , Yang Ziyu , Yao Fenjie
Published: July 2023

Phenological synchronicity of different tree parts and habitats can provide valuable insights into the physiological relationships and regulatory factors of different phenologies. The earlywood (EW) to latewood (LW) transition of the xylem is a critical process closely related to the key functions and physiological processes of trees. This study investigated the phenology phase of the EW–LW transition in branches and stems of Smith fir (Abies forrestii var. smithii Viguié & Gaussen) along an altitude gradient (3600 m, 3800 m, and 4000 m) in Jiaozi Mountain, Yunnan, China, in 2021. The study aimed to test the hypothesis that branches transition earlier than stems, but the elevation does not affect the transition time. We monitored the EW–LW transition dates weekly using microcores and then correlated them to the climatic conditions and developmental processes. Our findings revealed that the EW–LW transition timing varied among the different parts of the tree but was synchronized across the different elevations. Furthermore, the transition always occurred earlier in branches than in the stem, but the difference narrowed with increasing altitude. The EW–LW transition was mainly influenced by photoperiod, which plays a crucial role as a signaling factor. Additionally, the tree crown was more sensitive to environmental changes than the stem. The transition time of stems was less sensitive to environmental factors than that of branches. Therefore, our results suggest that the earlywood to latewood transition is regulated by developmental factors, and the photoperiod may indirectly regulate the developmental process of trees as a signaling factor, thus regulating the earlywood to latewood transition time. Our study provides new insights into the developmental regulation and climate sensitivity of tree ring formation.
Isolation and Optimal Fermentation Conditions of Bacillus licheniformis SFD-Y5 for a New Douchi Fibrinolytic Enzyme Producer
Authors: Yao Mingjing , Ma Chunmin , Bian Xin , Yang Yang , Xu Yue , Wu Qiaoyan , Xu Xinyu , Li Lulu , Zhang Na , Tian Yanjun
Published: July 2023

Cardiovascular disease (CVD) has become the leading cause of death, and it is critical to develop new functional foods to prevent intravascular thrombosis, the key cause of CVD. Fermented soy-based food is a good choice because of its native fibrinolytic enzyme (FE) activity. In this study, a strain that can produce a new type of fibrinolytic enzyme was selected from Chinese Douchi and identified as Bacillus licheniformis SFD-Y5 by molecular biology experiments and physiological and biochemical experiments. Single factor experiments combined with statistical experiments, including Plackett–Burman experiment, steepest ascent experiment and RSM (Box–Behnken design), were used to optimize the fermentation of FE by B. licheniformis SFD-Y5. The final FE activity was 2434.45 ± 28.49 IU/mL under optimal conditions, which is the highest FE activity produced by wild B. licheniformis so far. Further studies showed that Y5 FE is a serine metalloproteinase with good stability at alkaline pHs (pH 8.0–11.0). The results of our study could lay a foundation for the future production, molecular modification and further application in functional foods of Y5 FE.
Application of Synthetic Biology Approaches to High-Yield Production of Mycosporine-like Amino Acids
Authors: Singh Varsha K. , Jha Sapana , Rana Palak , Gupta Amit , Singh Ashish P. , Kumari Neha , Mishra Sonal , Singh Prashant R. , Jaiswal Jyoti , Sinha Rajeshwar P.
Published: July 2023

Ultraviolet (UV) radiation reaching the Earth’s surface is a major societal concern, and therefore, there is a significant consumer demand for cosmetics formulated to mitigate the harmful effects of UV radiation. Synthetic sunscreens being formulated to block UV penetration include inorganic metal oxide particles and organic filters. Lately, organic UV-absorbing compounds are manufactured from non-renewable petrochemicals and, as a result, there is a need to develop a sustainable manufacturing process for efficient, high-level production of a naturally occurring group of UV-absorbing compounds, namely mycosporine-like amino acids (MAAs), for use as a sunscreen additive to skincare products. Currently, the commercial production of MAAs for use in sunscreens is not a viable proposition due to the low yield and the lack of fermentation technology associated with native MAA-producing organisms. This review summarizes the biochemical properties of MAAs, the biosynthetic gene clusters and transcriptional regulations, the associated carbon-flux-driving processes, and the host selection and biosynthetic strategies, with the aim to expand our understanding on engineering suitable cyanobacteria for cost-effective production of natural sunscreens in future practices.
Parallel Bootstrap-Based On-Policy Deep Reinforcement Learning for Continuous Fluid Flow Control Applications
Authors: Viquerat Jonathan , Hachem Elie
Published: July 2023

The coupling of deep reinforcement learning to numerical flow control problems has recently received considerable attention, leading to groundbreaking results and opening new perspectives for the domain. Due to the usually high computational cost of fluid dynamics solvers, the use of parallel environments during the learning process represents an essential ingredient to attain efficient control in a reasonable time. Yet, most of the deep reinforcement learning literature for flow control relies on on-policy algorithms, for which the massively parallel transition collection may break theoretical assumptions and lead to suboptimal control models. To overcome this issue, we propose a parallelism pattern relying on partial-trajectory buffers terminated by a return bootstrapping step, allowing a flexible use of parallel environments while preserving the on-policiness of the updates. This approach is illustrated on a CPU-intensive continuous flow control problem from the literature.
High Nutritional Quality of Human-Induced Pluripotent Stem Cell-Generated Proteins through an Advanced Scalable Peptide Hydrogel 3D Suspension System
Authors: Xu Shan , Qi Guangyan , Durrett Timothy P. , Li Yonghui , Liu Xuming , Bai Jianfa , Chen Ming-Shun , Sun Xiuzhi (Susan) , Wang Weiqun
Published: July 2023

Cell-cultured protein technology has become increasingly attractive due to its sustainability and climate benefits. The aim of this study is to determine the nutritional quality of the human-induced pluripotent stem cell (hiPSC)-cultured proteins in an advanced 3D peptide hydrogel system for the highly efficient production of cell-cultured proteins. Our previous study demonstrated a PGmatrix peptide hydrogel for the 3D embedded culture of long-term hiPSC maintenance and expansion (PGmatrix-hiPSC (PG-3D)), which showed significantly superior pluripotency when compared with traditional 2D cell culture on Matrigel and/or Vitronectin and other existing 3D scaffolding systems such as Polyethylene glycol (PEG)-based hydrogels. In this study, we designed a PGmatrix 3D suspension (PG-3DSUSP) system from the PG-3D embedded system that allows scaling up a hiPSC 3D culture volume by 20 times (e.g., from 0.5 mL to 10 mL). The results indicated that the PG-3DSUSP was a competitive system compared to the well-established PG-3D embedded method in terms of cell growth performance and cell pluripotency. hiPSCs cultured in PG-3DSUSP consistently presented a 15–20-fold increase in growth and a 95–99% increase in viability across multiple passages with spheroids with a size range of 30–50 μm. The expression of pluripotency-related genes, including NANOG, OCT4, hTERT, REX1, and UTF1, in PG-3DSUSP-cultured hiPSCs was similar to or higher than that observed in a PG-3D system, suggesting continuous pluripotent maintenance. The nutritional value of the hiPSC-generated proteins from the PG-3DSUSP system was further evaluated for amino acid composition and in vitro protein digestibility. The amino acid composition of the hiPSC-generated proteins demonstrated a significantly higher essential amino acid content (39.0%) than human skeletal muscle protein (31.8%). In vitro protein digestibility of hiPSC-generated proteins was significantly higher (78.0 ± 0.7%) than that of the commercial beef protein isolate (75.7 ± 0.6%). Taken together, this is the first study to report an advanced PG-3DSUSP culture system to produce highly efficient hiPSC-generated proteins that possess more essential amino acids and better digestibility. The hiPSC-generated proteins with superior nutrition quality may be of particular significance as novel alternative proteins in food engineering and industries for future food, beverage, and supplement applications.
Energy Transfer and Destabilizing Impulse Inducing Mechanism of Coal–Rock System in Roadway through Coal Seam in Deep Zone
Authors: Li Jiazhuo , Zhou Wei , Chu Jiaqi , Ren Wentao , Dou Linming , Song Shikang
Published: July 2023

Aiming at the problem of the unclear rock burst generation mechanism and anti-impact measures of a large roadway through a coal seam in a deep panel area, taking the rock burst of a large roadway in the first panel area of Gaojiapu Coal Mine as the engineering background, this paper adopts the comprehensive research methods of theoretical analysis, experiments, numerical simulation, fragmentation fractal analysis, and field monitoring, to discuss the mechanical characteristics of the loading process of the assemblage and the energy transfer law and its difference in the deformation and failure process. The possibility and strength of the impact failure of coal under the grip of rock masses with different stiffness are related to the γ value. The smaller the γ value is, the higher the impact possibility is, and the more severe the impact degree is. The assemblage under the grip of soft rock is more prone to system instability. Energy relief and impact reduction are adopted to reduce the post-peak stiffness and elastic strain energy of the coal body in a short distance, avoid the energy transfer and concentration of the roadway surrounding the rock system under the disturbance of a long-distance dynamic load, and reduce the likelihood of impact pressure occurring and the extent to which an impact manifests.
Poly(vinyl alcohol)/Pullulan Composite Hydrogels as a Potential Platform for Wound Dressing Applications
Authors: Plugariu Ioana-Alexandra , Bercea Maria , Gradinaru Luiza Madalina , Rusu Daniela , Lupu Alexandra
Published: July 2023

Hydrogels are 3D networks with an excellent ability to retain a high amount of water or biological fluids, representing suitable candidates for wound dressing applications. They can provide a protective barrier and a moist environment, facilitating wound treatment. The present paper focuses on physical hydrogels obtained from poly(vinyl alcohol) (PVA) and pullulan (PULL) mixtures in different weight ratios by using the freezing/thawing method. Hybrid hydrogels of similar polymer compositions were prepared in the presence of 0.5% Laponite® RD. The influence of polysaccharide and clay addition on the properties of PVA hydrogels was investigated. Scanning electron microscopy showed evidence of the inner porous structure. The viscoelastic properties were investigated in different shear conditions and revealed the influence of the hydrogel composition on the network strength. The swelling behavior was followed in physiological saline solutions at 37 °C and pH = 7.4. For all samples, a quasi-Fickian diffusion mechanism was found. The delivery of neomycin sulfate was studied in similar conditions as for the swelling tests (0.15 M NaCl solutions; 37 °C; pH = 7.4) and different kinetic models were used to determine the release mechanism. The Peppas–Sahlin approach described very well the in vitro drug release mechanism from the polymeric hydrogels in the absence of clay. However, the hybrid polymer/clay hydrogels showed the best fit with the Korsmeyer–Peppas model. According to the present study, the porous membranes containing 40–60% PULL (in absence of clay) are suitable for the release of therapeutic agents at wound sites in physiological conditions.
Biosorption of Escherichia coli Using ZnO-Trimethyl Chitosan Nanocomposite Hydrogel Formed by the Green Synthesis Route
Authors: Bwatanglang Ibrahim Birma , Mohammad Faruq , Janet John Nahadi , Dahan Wasmia Mohammed , Al-Lohedan Hamad A. , Soleiman Ahmed A.
Published: July 2023

In this study, we tested the biosorption capacity of trimethyl chitosan (TMC)-ZnO nanocomposite (NC) for the adsorptive removal of Escherichia coli (E. coli) in aqueous suspension. For the formation of ZnO NPs, we followed the green synthesis route involving Terminalia mantaly (TM) aqueous leaf extract as a reducing agent, and the formed ZnO particles were surface-coated with TMC biopolymer. On testing of the physicochemical characteristics, the TM@ZnO/TMC (NC) hydrogel showed a random spherical morphology with an average size of 31.8 ± 2.6 nm and a crystal size of 28.0 ± 7.7 nm. The zeta potential of the composite was measured to be 23.5 mV with a BET surface area of 3.01 m2 g−1. The spectral profiles of TM@ZnO/TMC NC hydrogel on interaction with Escherichia coli (E. coli) revealed some conformational changes to the functional groups assigned to the stretching vibrations of N-H, C-O-C, C-O ring, and C=O bonds. The adsorption kinetics of TM@ZnO/TMC NC hydrogel revealed the pseudo-second-order as the best fit mechanism for the E. coli biosorption. The surface homogeneity and monolayer adsorption of the TM@ZnO/TMC NC hydrogel reflects majorly the entire adsorption mechanism, observed to display the highest correlation for Jovanovic, Redlich–Peterson, and Langmuir’s isotherm models. Further, with the use of TM@ZnO/TMC NC hydrogel, we measured the highest adsorption capacity of E. coli to be 4.90 × 10 mg g−1, where an in-depth mechanistic pathway was proposed by making use of the FTIR analysis.
Identification and Expression of Integrins during Testicular Fusion in Spodoptera litura
Authors: Chen Yaqing , Chen Yu , Jian Baozhu , Feng Qili , Liu Lin
Published: July 2023

Integrin members are cell adhesion receptors that bind to extracellular matrix (ECM) proteins to regulate cell–cell adhesion and cell-ECM adhesion. This process is essential for tissue development and organogenesis. The fusion of two testes is a physiological phenomenon that is required for sperm production and effective reproduction in many Lepidoptera. However, the molecular mechanism of testicular fusion is unclear. In Spodoptera litura, two separated testes fuse into a single testis during the larva-to-pupa transformation. We identified five α and five β integrin subunits that were closely associated with testicular fusion. Integrin α1 and α2 belong to the position-specific 1 (PS1) and PS2 groups, respectively. Integrin α3, αPS1/αPS2, and αPS3 were clustered into the PS3 group. Integrin β1 belonged to the insect β group, and β2, β3, and β5 were clustered in the βν group. Among these integrins, α1, α2, α3, αPS1/PS2, αPS3, β1, and β4 subunits were highly expressed when the testes fused. However, their expression levels were much lower before and after the fusion of the testis. The qRT-PCR and immunohistochemistry analyses indicated that integrin β1 mRNA and the protein were highly expressed in the peritoneal sheath of the testis, particularly when the testes fused. These results indicate that integrins might participate in S. litura testicular fusion.
NFTs and the Danger of Loss
Authors: Nogueira Andreia , Marques Célio Gonçalo , Manso António , Almeida Paula
Published: July 2023

This research contributes to the discussion around the importance of the long-term preservation of non-fungible tokens (NFTs) and minted digital artworks. The paper is based on a review of the literature on blockchain in art and heritage management and conservation, with particular attention to references related to the production, marketing, maintenance, and distribution of NFT-based digital art. The aims of this paper involve anticipating potential problems in the oversight of NFTs and setting out good long-term management principles and practices as well as specific preservation strategies. Despite the fact that it also discusses issues over authorship, copyright, creative commons, and open access, the paper is particularly devoted to raising concerns about the high energy consumption associated with blockchain technology and its impact on climate change. It also highlights how the preservation of NFTs cannot be neglected, despite the belief that they last forever. Most studies dedicated to analysing the impact of blockchain technology on the cultural heritage sector ignore the most important issue: preserving not only the minted digital artworks themselves but also the respective blockchain networks. Overall, this paper seeks to foster a collective awareness of the need to reflect on blockchain-related art practices and their implications for the long-term protection of cultural property.
Wood Fiber from Norway Spruce—A Stand-Alone Growing Medium for Hydroponic Strawberry Production
Authors: Woznicki Tomasz , Jackson Brian E. , Sønsteby Anita , Kusnierek Krzysztof
Published: July 2023

There is an increased interest in the hydroponic production of strawberries in protected cultivation systems, and it is, therefore, urgent to develop new, more sustainable growing media alternatives. This study investigated the physical properties of wood fiber produced from Norway spruce (Picea abies (L.) H. Karst.) and peat:wood fiber substrate blends as well as the performance of the wood fiber in comparison to the industry standards, i.e., peat and coconut coir in the cultivation of hydroponic strawberry. Tray plants of the June-bearing strawberry (Fragaria × ananassa Duch.) cultivar ‘Malling Centenary’ were transplanted into five different growing media: a peat (80%) and perlite (20%) mixture, stand-alone (100%) coconut coir and three stand-alone (100%) Norway spruce wood fiber substrates (including coarse textured fibers with compact and loose packing density and compacted fine-textured fibers). Ripe strawberries were harvested and registered throughout the production season. The overall marketable yield was comparable across all the tested growing media; however, after 4 weeks of harvest, both coarse wood fiber and fine wood fiber showed better fruiting performance than the peat-perlite mixture. A trend for earlier berry maturation was observed for all wood fiber-based substrates. Plant parameters recorded after the end of production showed that plant height, number of leaves, and biomass production were higher in coarse wood fiber than in the peat-perlite mixture. Moreover, plants grown in wood fiber-based substrates had less unripe berries and flowers not harvested in comparison to both the peat and coir treatments.
Essential Oil Quality of Lavender Grown Outside Its Native Distribution Range: A Study from Serbia
Authors: Kiprovski Biljana , Zeremski Tijana , Varga Ana , Čabarkapa Ivana , Filipović Jelena , Lončar Biljana , Aćimović Milica
Published: July 2023

The aim of this study was to test the quality (physicochemical and sensory odor properties) and bioactivity (antimicrobial and antioxidant activities) of the essential oils (EO) obtained from the most frequently cultivated lavender and lavandin varieties in Serbia, whose cultivation areas were previously reserved for warmer climates, outside the agroecological region of Serbia. Seven EO from true lavenders (L. angustifolia Mill. and cultivars: ‘Hidcote blue’, ‘Munstead’, ‘Primorska’), Croatian indigenous lavandin cultivar (L. × intermedia ‘Budrovka’), lavandin ‘Grosso’ and one undetermined lavender sample (Lavandula sp.) showed compliance with standard requirements for lavender EO composition (contents of linalool 23.9–30.2% and 28.9–36.9%, and of linalyl acetate 22.2–32.2% and 6.9–20.7% in true lavender and lavandin samples, respectively). All EO were characterized as pleasant, with a floral aroma as a prominent odor. Samples exhibited high antimicrobial activities (3.5–14.2 µL mL−1 MIC and MBC values) against important Gram-positive (B. cereus and L. monocytogenes) and Gram-negative bacteria (E. coli) and yeasts (C. albicans), and high antioxidant capacity (IC50 values of 0.23–0.59 µg AAE mL−1 EO). This preliminary research on the quality of lavender EOs reveals the potential of this species for the future of medicinal and aromatic plant species production and further diversification of agriculture in the area.
Mineral and Metabolome Analyses Provide Insights into the Cork Spot Disorder on ‘Akizuki’ Pear Fruit
Authors: Yang Yingjie , Zhu Yanlin , Ji Piyu , Li Anqi , Qiu Zhiyun , Cheng Yuanyuan , Wang Ran , Ma Chunhui , Song Jiankun , Cui Zhenhua , Liu Jianlong , Nie Yitian , Zhou Xiaozhi , Li Dingli
Published: July 2023

Cork spot is a common physiological disorder in pear fruits, which has been found in some pear cultivars. Mineral nutrition imbalance in fruit is regarded as the principal influence factor for disorder incidence, with some ongoing confusion and controversy. In our research, we explored the cork spot characteristics in Japanese pear ‘Akizuki’ (Pyrus pyrifolia Nakai), adopted metabolome and mineral content analysis for healthy and disordered fruits, and made a correlation analysis of mineral and metabolites. Cork spots are mainly distributed on the outer flesh beneath the fruit peel. In cork spotted tissues, superoxide (SOD) and peroxidase (POD) activities, as well as malondialdehyde (MDA) content, increased. A total of 1024 known metabolites were identified from all the samples and more changes in metabolism were detected between normal and cork spotted flesh tissues. Correlation analysis displayed that Ca, especially the Mg/Ca in fruits, could be used to predict whether an orchard will develop cork spot disorder; Mg and B were associated with the appearance of symptoms, and the contents of Zn, Fe, and Mg, as well as Mg/B and Zn/B, might be strongly tied to the formation of cork spots in pears. This research provides insights into the occurrence of pear cork spot disorder and clarifies the role of minerals.
Difficulties in Addressing Diagnostic, Treatment and Support Needs in Individuals with Intellectual Disability and Persistent Challenging Behaviours: A Descriptive File Study of Referrals to an Expertise Centre
Authors: de Kuijper Gerda , Fokkema Tryntsje , Jansen Martine , Hoekstra Pieter J. , de Bildt Annelies
Published: July 2023

Service providers may experience difficulties in providing appropriate care to optimize the functioning of individuals with intellectual disability and challenging behaviour. External consultation to identify and address the unmet support needs underlying the behaviour may be beneficial. Applying the multidimensional American Association Intellectual and Developmental Disabilities (AAIDD) model may facilitate this approach. We aimed to describe the content and outcomes of consultation for individuals with intellectual disability and challenging behaviour referred to the Dutch Centre for Consultation and Expertise in relation to the AAIDD model. Interventions were based on the clients’ diagnostic, treatment, and support needs and were categorized according to the five dimensions of the AAIDD model. Outcomes of the consultations were assessed based on reports in the file and rated as ‘clear improvement’, ‘improvement’ or ‘no improvement or deterioration’. In two-thirds of the 104 studied files, consultees were satisfied with the improvement in functioning. Interventions targeted the difficulties of the service providers in supporting their clients and were most often applied within the Health and Context dimensions of the AAIDD model. We may conclude that consultation of an expert team may be valuable to support the care providers, and the use of the AAIDD model may be helpful to address the unmet needs to improve the functioning of individuals with challenging behaviour.
Facilitators for and Barriers to the Implementation of Performance Accountability Mechanisms for Quality Improvement in the Delivery of Maternal Health Services in a District Hospital in Pwani Region, Tanzania
Authors: August Francis , Nyamhanga Tumaini Mwita , Kakoko Deodatus Conatus Vitalis , Sirili Nathanael Shauri , Frumence Gasto Msoffee
Published: July 2023

Tanzania experiences a burden of maternal mortality and morbidity. Despite the efforts to institute accountability mechanisms, little is known about quality improvement in the delivery of maternal health services. This study aimed at exploring barriers and facilitators to enforcing performance accountability mechanisms for quality improvement in maternal health services. A case study design was used to conduct semi-structured interviews with thirteen key informants. Data were analyzed using thematic analyses. The findings were linked to two main performance accountability mechanisms: maternal and perinatal death reviews (MPDRs) and monitoring and evaluation (M&E). Prioritization of the maternal health agenda by the government and the presence of maternal death review committees were the main facilitators for MPDRs, while negligence, inadequate follow-up, poor record-keeping, and delays were the main barriers facing MPDRs. M&E was facilitated by the availability of health management information systems, day-to-day ward rounds, online ordering of medicines, and the use of biometrics. Non-use of data for decision-making, supervision being performed on an ad hoc basis, and inadequate health workforce were the main barriers to M&E. The findings underscore that barriers to the performance accountability mechanisms are systemic and account for limited effectiveness in the improvement of quality of care.
Voices from a Multidisciplinary Healthcare Center: Understanding Barriers in Gender-Affirming Care—A Qualitative Exploration
Authors: Ross Maeghan B. , Jahouh Hiba , Mullender Margriet G. , Kreukels Baudewijntje P. C. , van de Grift Tim C.
Published: July 2023

When seeking gender-affirming care, trans* and gender-diverse individuals often describe experiencing barriers. However, a deeper understanding of what constitutes such barriers is generally lacking. The present research sought to better understand the barriers trans* and gender-diverse individuals experienced, and their effects, when seeking gender-affirming care in the Netherlands. Qualitative interviews were conducted with trans* and gender-diverse individuals who sought care at a Dutch multidisciplinary medical center. Twenty-one participants were included, of which 12 identified as (trans) male, six identified as (trans) female, one as trans*, and one as gender-nonconforming (GNC)/non-binary. The interviews were mostly conducted at the homes of the participants and lasted between 55 min and 156 min (mean = 85 min). Following data collection and transcription, the interviews were analyzed using axial coding and thematic analysis. A total of 1361 codes were extracted, which could be classified into four themes describing barriers: lack of continuity: organizational and institutional factors (ncodes = 546), patient–staff dynamics (ncodes = 480), inadequate information and support (ncodes = 210), and lack of autonomy in decision making (ncodes = 125). Within our study, trans* and gender-diverse individuals described encountering multiple and diverse barriers when seeking gender-affirming care in the Netherlands. Future studies are needed to evaluate whether individualized care, the decentralization of care, and the use of decision aids can improve the experienced barriers of trans* and gender-diverse individuals seeking gender-affirming care within the Dutch healthcare system.
Geospatial Associations between Female Breast Cancer Mortality Rates and Environmental Socioeconomic Indicators for North Carolina
Authors: Burwell Alanna , Kimbro Sean , Mulrooney Timothy
Published: July 2023

In North Carolina, over 6000 women will be diagnosed with breast cancer yearly, and over 1000 will die. It is well known that environmental conditions contribute greatly to health outcomes, and many of these factors include a geographic component. Using death data records from 2003–2019 extracted from North Carolina Vital Statistics Dataverse, a spatial database was developed to map and analyze female breast cancer mortality rates at the ZIP code scale in North Carolina. Thirty-nine hot spots and thirty cold spots of age-adjusted death rates were identified using the Getis–Ord analysis. Two-tailed t-tests were run between each cohort for environmental socioeconomic-related factors associated with breast cancer progression and mortality. The median age and household income of individuals who resided in ZIP codes with the highest breast cancer mortality were significantly lower than those who lived in ZIP codes with lower breast cancer mortality. The poverty rate, percentage of SNAP benefits, and the percentage of minorities were all significantly higher (p < 0.05, p < 0.001, and p < 0.001) in ZIP codes with high breast cancer rates. High-quality (ZIP code) granular cancer data were developed for which detailed analysis can be performed for future studies.
Potential Mechanisms of Action and Outcomes of Equine-Assisted Services for Veterans with a History of Trauma: A Narrative Review of the Literature
Authors: Marchand William R.
Published: July 2023

Equine-assisted services (EASs) are being increasingly used as complementary interventions for military veterans who have experienced trauma. However, there is limited evidence of benefit for this population and almost no literature describing the desired potential outcomes and possible mechanisms of action. The aim of this article is to address these gaps by reviewing the extant literature of animal-assisted interventions in general, and equine-assisted services in particular, with the goal of providing guidance for future investigations in the field. Currently, the field is in the early stage of scientific development, but published results are promising. Interventions that enhance treatment compliance and/or outcomes could benefit this population. Preliminary results, reviewed herein, indicate that EAS interventions might benefit the military veteran population by enhancing treatment engagement and therapeutic alliance, as well as by contributing to symptom reduction and resulting in various transdiagnostic benefits. It is recommended that future studies include exploration of potential beneficial outcomes discussed herein, as well as investigate suggested mechanisms of action.
Treatment Harms in Paediatric Primary Care
Authors: Reith David M. , Leitch Sharon , Eggleton Kyle , Wallis Katharine , Lillis Steven , Williamson Martyn , Cunningham Wayne
Published: July 2023

The aim of this study was to describe the epidemiology in children of harms detectable from general practice records, and to identify risk factors. The SHARP study examined 9076 patient records from 44 general practices in New Zealand, with an enrolled population of 210,559 patients. “Harm” was defined as disease, injury, disability, suffering, and death, arising from the health system. The age group studied was ≤20 years of age. There were 193 harms to 141 children and adolescents during the 3-year study period. Harms were reported in one (3.5%) patient aged <2 years, 80 (6.6%) aged 2 to <12 years, 36 (4.9%) aged 12 to <18 years, and 24 (7.5%) aged 18 to ≤20 years. The annualised rates of harm were 36/1000 child and adolescent population for all harms, 20/1000 for medication-related harm (MRH), 2/1000 for severe MRH, and 0.4/1000 for hospitalisation. For MRH, the drug groups most frequently involved were anti-infectives (51.9%), genitourinary (15.4%), dermatologicals (12.5%), and the nervous system (9.6%). Treatment-related harm in children was less common than in a corresponding adult population. MRH was the most common type of harm and was related to the most common treatments used. The risk of harm increased with the number of consultations.
Place-Centered Bus Accessibility Time Series Classification with Floating Car Data: An Actual Isochrone and Dynamic Time Warping Distance-Based k-Medoids Method
Authors: Wang Chen , Zhao Si-jia , Ren Zong-qiang , Long Qi
Published: July 2023

Classifying a time series is a fundamental task in temporal analysis. This provides valuable insights into the temporal characteristics of data. Although it has been applied to traffic flow and individual-centered accessibility analysis, it has yet to be applied to place-centered accessibility research. In this study, we have proposed an actual isochrone and dynamic time-wrapping distance-based k-medoids method and tested its applicability to a bus accessibility analysis. Using bus floating car data, our method calculated the actual isochrone area as an accessibility measurement and constructs an accessibility time series for each hexagonal geographical unit within the area of interest. We then calculated the dynamic time warp distance between the accessibility time series of pairwise geographical units and used these distances for k-medoid clustering. The optimized class number k was selected by considering the elbow method, silhouette score, and human examination. Our case study in Hefei, China demonstrates the feasibility of our method for accessibility time series classification. We also discovered that the resulting classes follow clear spatial patterns, indicating that different time series classes may be correlated with their spatial location. To our knowledge, this is the first time that such a classification method has been applied to place-centered accessibility time series analysis. Our data-driven method can inform place-centered accessibility in an era in which large quantities of spatiotemporal data like floating car data are available.
Experimental Analysis of the Three Dimensional Flow in a Wells Turbine Rotor
Authors: Licheri Fabio , Ghisu Tiziano , Cambuli Francesco , Puddu Pierpaolo
Published: July 2023

An experimental investigation of the local flow field in a Wells turbine has been conducted, in order to produce a detailed analysis of the aerodynamic characteristics of the rotor and support the search for optimized solutions. The measurements were conducted with a hot-wire anemometer (HWA) probe, reconstructing the local three-dimensional flow field both upstream and downstream of a small-scale Wells turbine. The multi-rotation technique has been applied to measure the three velocity components of the flow field for a fixed operating condition. The results of the investigation show the local flow structures along a blade pitch, highlighting the location and radial extension of the vortices which interact with the clean flow, thus degrading the turbine’s overall performance. Some peculiarities of this turbine have also been shown, and need to be considered in order to propose modified solutions to improve its performance.
Virtual Restaurants: Customer Experience Keeps Their Businesses Alive
Authors: Klouvidaki Maria I. , Antonopoulos Nikos , Styliaras Georgios D. , Kanavos Andreas
Published: July 2023

Due to COVID-19 restrictions, many restaurants were forced to discontinue in-person service, either by locking down or finding alternative methods of operation. Despite the fact that, in the United States of America, digital restaurants have already been established for many years, in Greece, this phenomenon became popular during the pandemic. These delivery-only companies operate exclusively online, allowing customers to place orders from restaurants without a physical location. This has revolutionized the process of ordering food, as customers can browse digital menus, view images, and utilize other options provided by digital food technology. As a result, customers have had new experiences with food thanks to digital eateries during the pandemic. This research study is quantitative and utilized a questionnaire distributed to 1097 participating consumers over the internet. The sample was selected using straightforward random sampling, where each member of the population had an equal and unique chance of participating in the survey. The data were collected over a period of 2 months.
Review of Recent Progress on the Effects of High Temperatures on the Mechanical Behavior of Masonry Prisms
Authors: Nalon Gustavo Henrique , Ribeiro José Carlos Lopes , Pedroti Leonardo Gonçalves , Silva Roberto Marcio da , Araújo Eduardo Nery Duarte de , Santos Rodrigo Felipe , Lima Gustavo Emilio Soares de
Published: July 2023

The structural performance of civil engineering infrastructures exposed to elevated temperatures has been investigated in many recent works. Some of these studies evaluated the residual mechanical behavior of masonry prisms subjected to high temperatures, as these specimens are simplified models (2–5 units in height) that can be easily produced and tested, in terms of operational and economic factors. However, there is no previous literature review on the mechanical properties of fire-damaged masonry prisms. Therefore, this paper presents an investigation of the current state-of-the-art on this topic. It provides a careful review of recent knowledge on the failure mechanisms, residual compressive strength, modulus of elasticity, and stress–strain behavior of masonry prisms made with different types of units, mortars, and/or grout after exposure to different types of thermal treatments. Based on the revised information, future research directions on the scientific field of masonry infrastructures are reported.
Long-Term Effects of Postoperative Atrial Fibrillation following Mitral Valve Surgery
Authors: Alghosoon Haneen , Arafat Amr A. , Albabtain Monirah A. , Alsubaie Faisal F. , Alangari Abdulaziz S.
Published: July 2023

Background: New-onset postoperative atrial fibrillation (PoAF) is one of the most frequent yet serious complications following cardiac surgery. Long-term consequences have not been thoroughly investigated, and studies have included different cardiac operations. The objectives were to report the incidence and short- and long-term outcomes in patients with PoAF after mitral valve surgery. Methods: This is a retrospective cohort study of 1401 patients who underwent mitral valve surgery from 2009 to 2020. Patients were grouped according to the occurrence of PoAF (n = 236) and the nonoccurrence of PoAF (n = 1165). Long-term outcomes included mortality, heart failure rehospitalization, stroke, and mitral valve reinterventions. Results: The overall incidence of PoAF was 16.8%. PoAF was associated with higher rates of operative mortality (8.9% vs. 3.3%, p < 0.001), stroke (6.9% vs. 1.5%, p < 0.001), and dialysis (13.6% vs. 3.5%, p < 0.001). ICU and hospital stays were significantly longer in patients with PoAF (p < 0.001 for both). PoAF was significantly associated with an increased risk of mortality [HR: 1.613 (95% CI: 1.048–2.483); p = 0.03], heart failure rehospitalization [HR: 2.156 (95% CI: 1.276–3.642); p = 0.004], and stroke [HR: 2.722 (95% CI: 1.321–5.607); p = 0.007]. However, PoAF was not associated with increased mitral valve reinterventions [HR: 0.938 (95% CI: 0.422–2.087); p = 0.875]. Conclusions: Atrial fibrillation after mitral valve surgery is a common complication, with an increased risk of operative mortality. PoAF was associated with lower long-term survival, increased heart failure rehospitalization, and stroke risk. Future studies are needed to evaluate strategies that can be implemented to improve the outcomes of these patients.
Long-Term Prognosis of Patients with Polypoidal Choroidal Vasculopathy Treated with Photodynamic Therapy
Authors: Sakaeda Yukinori , Kato Aki , Kuwayama Soichiro , Hirahara Shuichiro , Suzuki Norihiro , Ogura Yuichiro , Nakazawa Yoko , Yasukawa Tsutomu
Published: July 2023

We evaluated the long-term prognosis of the eyes of patients with polypoidal choroidal vasculopathy (PCV) treated with photodynamic therapy (PDT). In total, 60 eyes of 57 patients diagnosed with PCV and treated with PDT were reviewed retrospectively in real-world settings. The best-corrected visual acuity (BCVA), central retinal thickness (CRT), anatomical findings (vision-threatening findings), and treatment history were assessed. In total, 38 eyes underwent PDT as the initial treatment (initial PDT group) and 22 eyes underwent PDT as a rescue treatment (rescue PDT group). In the initial PDT group, 11 eyes (29%) did not require additional therapy throughout the observation period and maintained good BCVA. A total of 27 eyes (71%) underwent additional treatments and the mean BCVA was only stabilized for 2 years; thereafter, decreased vision occurred even with additional treatments. In the rescue PDT group, 22 eyes (95%) required additional treatment. Hard exudate, serous pigment epithelial detachment, and the total vision-threatening score were related to worse BCVA. Initial PDT may be effective in about 30% of cases with preservation of good vision and no need for additional treatment. However, patients with received rescue PDT needed additional treatment in most cases and the vision decreased in many cases.
Fenestrated Physician-Modified Endografts for Preservation of Main and Accessory Renal Arteries in Juxtarenal Aortic Aneurysms
Authors: Chan Hon-Lai , Papazoglou Dimitrios D. , Jungi Silvan , Weiss Salome , Becker Daniel , Kotelis Drosos , Makaloski Vladimir
Published: July 2023

Background: There is a paucity of reporting outcomes of complex aortic aneurysm treatment such as juxtarenal abdominal aortic aneurysms, where additional techniques to preserve renal artery perfusion are required. Methods: Retrospective analysis of consecutive patients who underwent emergent and elective aortic repair with fenestrated PMEGs between March 2019 and January 2023. Endpoints were technical success, reinterventions, secondary reinterventions and target vessel patency. Results: Forty-seven target vessels in 37 patients (23 male, median age 75 years) were targeted, of which 44 were renal arteries (RAs) with a mean diameter of 5.4 ± 1.0 mm. Thirteen were accessory RAs and six had a diameter ≤ 4 mm. Technical success rate was 87% overall; 97% for main and 62% for accessory RAs respectively. Target vessel patency and freedom from secondary reintervention was 100% and 97% at 30 days and 96% and 91% at one year, respectively. There was no 30-day mortality. Conclusion: Fenestrated physician-modified endografts are safe and effective for the treatment of patients with juxtarenal abdominal aortic aneurysms when incorporating main renal arteries. Limited technical success may be expected when targeting accessory renal arteries, especially when small in diameter. Long-term follow-up is needed to confirm durability of PMEGs for renal artery preservation.
Flexural Characteristics of Functionally Layered Fiber-Reinforced Cementitious Composite with Polyvinyl Alcohol Fibers
Authors: Zhang Hang , Kanakubo Toshiyuki
Published: July 2023

The main purpose of this study is to investigate the flexural characteristics of a functionally layered fiber-reinforced cementitious composite (FL-FRCC) with polyvinyl alcohol fibers and to verify the adaptability of the proposed tri-linear stress-strain model based on the bridging law for large fiber orientation intensity, which shows the fiber orientation distribution as almost 2-D. The average maximum bending moment of FL-FRCC specimens is almost twice that of homogeneous (Hmg-FRCC) specimens, which indicates that the FL-FRCC specimens lead to larger bending capacity. The proposed wide-range stress-strain model based on the bridging law was verified and showed good adaptability with the experimental results through a comparison with the conducted section analysis.