bluuebunny/crossref_metadata_2025 huggingface dataset:
Echocardiography for the Assessment of Pulmonary Hypertension and Congenital Heart Disease in the Young
Authors: Meinel Katharina , Koestenberger Martin , Sallmon Hannes , Hansmann Georg , Pieles Guido E.
Published: December 2020

While invasive assessment of hemodynamics and testing of acute vasoreactivity in the catheterization laboratory is the gold standard for diagnosing pulmonary hypertension (PH) and pulmonary vascular disease (PVD) in children, transthoracic echocardiography (TTE) serves as the initial diagnostic tool. International guidelines suggest several key echocardiographic variables and indices for the screening studies when PH is suspected. However, due to the complex anatomy and special physiological considerations, these may not apply to patients with congenital heart disease (CHD). Misinterpretation of TTE variables can lead to delayed diagnosis and therapy, with fatal consequences, or–on the other hand-unnecessary invasive diagnostic procedures that have relevant risks, especially in the pediatric age group. We herein provide an overview of the echocardiographic workup of children and adolescents with PH with a special focus on children with CHD, such as ventricular/atrial septal defects, tetralogy of Fallot or univentricular physiology. In addition, we address the use of echocardiography as a tool to assess eligibility for exercise and sports, a major determinant of quality of life and outcome in patients with PH associated with CHD.
Blood-Based Detection of Colorectal Cancer Using Cancer-Specific DNA Methylation Markers
Authors: Cho Nam-Yun , Park Ji-Won , Wen Xianyu , Shin Yun-Joo , Kang Jun-Kyu , Song Sang-Hyun , Kim Hwang-Phill , Kim Tae-You , Bae Jeong Mo , Kang Gyeong Hoon
Published: December 2020

Cancer tissues have characteristic DNA methylation profiles compared with their corresponding normal tissues that can be utilized for cancer diagnosis with liquid biopsy. Using a genome-scale DNA methylation approach, we sought to identify a panel of DNA methylation markers specific for cell-free DNA (cfDNA) from patients with colorectal cancer (CRC). By comparing DNA methylomes between CRC and normal mucosal tissues or blood leukocytes, we identified eight cancer-specific methylated loci (ADGRB1, ANKRD13, FAM123A, GLI3, PCDHG, PPP1R16B, SLIT3, and TMEM90B) and developed a five-marker panel (FAM123A, GLI3, PPP1R16B, SLIT3, and TMEM90B) that detected CRC in liquid biopsies with a high sensitivity and specificity with a droplet digital MethyLight assay. In a set of cfDNA samples from CRC patients (n = 117) and healthy volunteers (n = 60), a panel of five markers on the platform of the droplet digital MethyLight assay detected stages I–III and stage IV CRCs with sensitivities of 45.9% and 95.7%, respectively, and a specificity of 95.0%. The number of detected markers was correlated with the cancer stage, perineural invasion, lymphatic emboli, and venous invasion. Our five-marker panel with the droplet digital MethyLight assay showed a high sensitivity and specificity for the detection of CRC with cfDNA samples from patients with metastatic CRC.
Serum Biomarkers of Inflammation and Turnover of Joint Cartilage Can Help Differentiate Psoriatic Arthritis (PsA) Patients from Osteoarthritis (OA) Patients
Authors: Waszczykowski Michał , Fabiś-Strobin Anna , Bednarski Igor , Lesiak Aleksandra , Narbutt Joanna , Fabiś Jarosław
Published: December 2020

The aim of this study was to find characteristic biomarkers in the serum of patients with osteoarthritis (OA) and psoriatic arthritis (PsA) responsible for inflammation and destruction of joint cartilage, which could differentiate these two diseases. The study included 67 people: 22 patients with knee OA, 22 patients with PsA, and 23 individuals who were the control group of healthy individuals (HC). The concentration of IL-18, IL-20, IL-6, MMP-1, MMP-3, COMP, PG-AG, and YKL-40 in serum were determined. Among the OA and PsA patients group, the radiological assessment and clinical assessment were also performed. The concentration of 7 out of 8 of examined biomarkers (except MMP-1) was statistically significantly higher in the serum of patients with OA and PsA than in the control group. Compering OA and PsA groups only, the serum PG-AG level in OA patients was statistically significantly higher than in PsA patients (p < 0.001). The results of univariate and multivariate logistic regression analysis comparing OA and PsA biomarker serum levels identified PG-AG and COMP as markers that are significantly different between patients with OA and PsA (odds ratio 0.995 and 1.003, respectively). The ROC curve constructed using the model with age showed PG-AG and COMP had an AUC of 0.907. The results of this study show that COMP and PG-AG may be sensitive markers differentiating patients with osteoarthiritis from psoriatic arthritis.
Towards a New Paradigm for Statistical Evidence in the Use of p-Value
Authors: Bhatti Muhammad , Kim Jae
Published: December 2020

As the guest editors of this Special Issue, we feel proud and grateful to write the editorial note of this issue, which consists of seven high-quality research papers [...]
Use of Augmented and Virtual Reality in Remote Higher Education: A Systematic Umbrella Review
Authors: Nesenbergs Krisjanis , Abolins Valters , Ormanis Juris , Mednis Artis
Published: December 2020

In this systematic umbrella review we aggregate the current knowledge of how virtual and augmented reality technologies are applicable to and impact remote learning in higher education; specifically, how they impact such learning outcomes as performance and engagement in all stages of higher education from course preparation to student evaluation and grading. This review was done as part of a state wide research effort of Latvia, to mitigate the impact of COVID-19 and specifically to provide a framework for a technological transformation of education in this context. In this work we search the Scopus and Web of Science databases for articles describing the use of virtual and/or augmented reality technologies in remote learning for higher education and their impact on learning outcomes. We identified 68 articles from which, after multiple screening and eligibility phases, nine review articles were left for extraction phase in which 30 structural elements with corresponding interventions and measured effects were extracted. Of these, 24 interventions had a measured effect on student performance (11 positive, seven negative, six no impact) and six interventions had a measured effect on student engagement (all six positive).
Study of Process-Focused Assessment Using an Algorithm for Facial Expression Recognition Based on a Deep Neural Network Model
Authors: Lee Ho-Jung , Lee Deokwoo
Published: December 2020

This study proposes an approach for process-focused assessment (PFA) utilizing the concept of deep neural networks with a sequence of facial images. Recently, process-based assessment has received significant attention compared to result-based assessment in the field of education. Continuously evaluating and quantifying student engagement, as well as understanding and interacting with teachers in study activities are considered important factors. However, to achieve PFA, from the technical and systematic perspectives, the real-time monitoring of the learning process of students is desired, which requires time consumption and extremely high attention to each student. This study proposes an approach to develop an efficient method for evaluating the process of learning and studying students in real time using facial images. We developed a method for PFA by learning facial expressions using a deep neural network model. The model learns and classifies facial expressions into three categories: easy, neutral, and difficult. Because the demand for online learning is increasing, PFA is required to achieve efficient, convenient, and confident assessment. This study chiefly considers a sequence of 2D image data of students solving some exam problems. The experimental results demonstrate that the proposed approach is feasible and can be applied to PFA in classrooms.
Rooftop Solar PV Penetration Impacts on Distribution Network and Further Growth Factors—A Comprehensive Review
Authors: Uzum Busra , Onen Ahmet , Hasanien Hany M. , Muyeen S. M.
Published: December 2020

In order to meet the electricity needs of domestic or commercial buildings, solar energy is more attractive than other renewable energy sources in terms of its simplicity of installation, less dependence on the field and its economy. It is possible to extract solar energy from photovoltaic (PV) including rooftop, ground-mounted, and building integrated PV systems. Interest in rooftop PV system applications has increased in recent years due to simple installation and not occupying an external area. However, the negative effects of increased PV penetration on the distribution system are troublesome. The power loss, reverse power flow (RPF), voltage fluctuations, voltage unbalance, are causing voltage quality problems in the power network. On the other hand, variations in system frequency, power factor, and harmonics are affecting the power quality. The excessive PV penetration also the root cause of voltage stability and has an adverse effect on protection system. The aim of this article is to extensively examines the impacts of rooftop PV on distribution network and evaluate possible solution methods in terms of the voltage quality, power quality, system protection and system stability. Moreover, it is to present a comparison of the advantages/disadvantages of the solution methods discussed, and an examination of the solution methods in which artificial intelligence, deep learning and machine learning based optimization and techniques are discussed with common methods.
A Flexible Fog Computing Design for Low-Power Consumption and Low Latency Applications
Authors: Losada Markos , Cortés Ainhoa , Irizar Andoni , Cejudo Javier , Pérez Alejandro
Published: December 2020

In this paper, we propose a flexible Fog Computing architecture in which the main features are that it allows us to select among two different communication links (WiFi and LoRa) on the fly and offers a low-power solution, thanks to the applied power management strategies at hardware and firmware level. The proposed Fog Computing architecture is formed by sensor nodes and an Internet of Things (IoT) gateway. In the case of LoRa, we have the choice of implementing the LoRaWAN and Application servers on the cloud or on the IoT gateway, avoiding, in this case, to send data to the Cloud. Additionally, we have presented an specific setup and methodology with the aim of measuring the sensor node’s power consumption and making sure there is a fair comparison between the different alternatives among the two selected wireless communication links by varying the duty cycle, the size of the payload, and the Spreading Factor (SF). This research work is in the scope of the STARPORTS Interconnecta Project, where we have deployed two sensor nodes in the offshore platform of PLOCAN, which communicate with the IoT gateway located in the PLOCAN premises. In this case, we have used LoRa communications due to the required large distance between the IoT gateway and the nodes in the offshore platform (in the range of kilometers). This deployment demonstrates that the proposed solution operates in a real environment and that it is a low-power and robust approach since it is sending data to the IoT gateway during more than one year and it continues working.
Flyback Converter for Solid-State Lighting Applications with Partial Energy Processing
Authors: Ponce-Silva Mario , Salazar-Pérez Daniel , Rodríguez-Benítez Oscar Miguel , Vela-Valdés Luis Gerardo , Claudio-Sánchez Abraham , De León-Aldaco Susana Estefany , Cortés-García Claudia , Saavedra-Benítez Yesica Imelda , Lozoya-Ponce Ricardo Eliu , Aquí-Tapia Juan Antonio
Published: December 2020

The main contribution of this paper is to show a new AC/DC converter based on the rearrangement of the flyback converter. The proposed circuit only manages part of the energy and the rest is delivered directly from the source to the load. Therefore, with the new topology, the efficiency is increased, and the stress of the components is reduced. The rearrangement consist of the secondary of the flyback is placed in parallel with the load, and this arrangement is connected in series with the primary side and the rectified voltage source. The re-arranged flyback is only a reductive topology and with no magnetic isolation. It was studied as a power supply for LEDs. A low frequency averaged analysis (LFAA) was used to determine the behavior of the proposed circuit and an equivalent circuit much easier to analyze was obtained. To validate the theoretical analysis, a design methodology was developed for the re-arranged flyback converter. The designed circuit was implemented in a 10 W prototype. Experimental results showed that the converter has a THDi = 21.7% and a PF = 0.9686.
Equivalent Circuit Modeling of a Dual-Gate Graphene FET
Authors: Hasan Saima , Kouzani Abbas Z. , Mahmud M A Parvez
Published: December 2020

This paper presents a simple and comprehensive model of a dual-gate graphene field effect transistor (FET). The quantum capacitance and surface potential dependence on the top-gate-to-source voltage were studied for monolayer and bilayer graphene channel by using equivalent circuit modeling. Additionally, the closed-form analytical equations for the drain current and drain-to-source voltage dependence on the drain current were investigated. The distribution of drain current with voltages in three regions (triode, unipolar saturation, and ambipolar) was plotted. The modeling results exhibited better output characteristics, transfer function, and transconductance behavior for GFET compared to FETs. The transconductance estimation as a function of gate voltage for different drain-to-source voltages depicted a proportional relationship; however, with the increase of gate voltage this value tended to decline. In the case of transit frequency response, a decrease in channel length resulted in an increase in transit frequency. The threshold voltage dependence on back-gate-source voltage for different dielectrics demonstrated an inverse relationship between the two. The analytical expressions and their implementation through graphical representation for a bilayer graphene channel will be extended to a multilayer channel in the future to improve the device performance.
Signal Detection Based on Power-Spectrum Sub-Band Energy Ratio
Authors: Li Han , Hu Yanzhu , Wang Song
Published: December 2020

The power-spectrum sub-band energy ratio (PSER) has been applied in a variety of fields, but reports on its statistical properties and application in signal detection have been limited. Therefore, the statistical characteristics of the PSER were investigated and a signal detection method based on the PSER was created in this paper. By analyzing the probability and independence of power spectrum bins, as well as the relationship between F and beta distributions, we developed a probability distribution for the PSER. Our results showed that in a case of pure noise, the PSER follows beta distribution. In addition, the probability density function exhibited no relationship with the noise variance—only with the number of bins in the power spectrum. When Gaussian white noise was mixed with the signal, the resulting PSER followed a doubly non-central beta distribution. In this case, the probability density and cumulative distribution functions were represented by infinite double series. Under the constant false alarm strategy, we established a signal detector based on the PSER and derived the false alarm probability and detection probability of the PSER. The main advantage of this detector is that it did not need to estimate noise variance. Compared with time-domain energy detection and local spectral energy detection, we found that the PSER had better robustness under noise uncertainty. Finally, the results in the simulation and real signal showed that this detection method was valid.
Spectral Analysis of Stationary Signals Based on Two Simplified Arrangements of Chirp Transform Spectrometer
Authors: Zhao Quan , Tong Ling , Gao Bo
Published: December 2020

The classical two-channel push-pull chirp transform spectrometer (CTS) has been widely applied in satellite-borne remote sensing systems for earth observation and deep space exploration. In this paper, we present two simplified structures with single M(l)-C(s) CTS arrangements for the spectral analysis of stationary signals. A simplified CTS system with a single M(l)-C(s) arrangement and a time delay line was firstly developed. Another simplified structure of CTS with a M(l)-C(s) arrangement and a frequency conversion channel was also developed for spectral analysis of stationary signals. Simulation and experiment results demonstrate that the two simplified arrangements can both realize spectrum measurement for the stationary signals and obtain the same frequency resolution, amplitude accuracy and system sensitivity as that of the classical two-channel push–pull CTS system. Compared to the classical CTS structure, the two simplified arrangements require fewer devices, save power consumption and have reduced mass. The matching problem between the two channels can be avoided in the two simplified arrangements. The simplified CTS arrangements may have potential application in the spectrum measurement of stationary signals in the field of aviation and spaceflight.
Influence of L. thermotolerans and S. cerevisiae Commercial Yeast Sequential Inoculation on Aroma Composition of Red Wines (Cv Trnjak, Babic, Blatina and Frankovka)
Authors: Korenika Ana-Marija Jagatić , Tomaz Ivana , Preiner Darko , Lavrić Marina , Šimić Branimir , Jeromel Ana
Published: December 2020

Even though Saccharomyces cerevisiae starter cultures are still largely used nowadays, the non-Saccharomyces contribution is re-evaluated, showing positive enological characteristics. Among them, Lachancea thermotolerans is one of the key yeast species that are desired for their contribution to wine sensory characteristics. The main goal of this work was to explore the impact of L. thermotolerans commercial yeast strain used in sequential inoculation with S. cerevisiae commercial yeast on the main enological parameters and volatile aroma profile of Trnjak, Babić, Blatina, and Frankovka red wines and compare it with wines produced by the use of S. cerevisiae commercial yeast strain. In all sequential fermented wines, lactic acid concentrations were significantly higher, ranging from 0.20 mg/L in Trnjak up to 0.92 mg/L in Frankovka wines, while reducing alcohol levels from 0.1% v/v in Trnjak up to 0.9% v/v in Frankovka wines. Among volatile compounds, a significant increase of ethyl lactate and isobutyl acetate, geraniol, and geranyl acetate was detected in all wines made by use of L. thermotolerans. In Babić wines, the strongest influence of sequential fermentation was connected with higher total terpenes and total ester concentrations, while Trnjak sequentially fermented wines stood up with higher total aldehyde, volatile phenol, and total lactone concentrations. Control wines, regardless of variety, stood up with higher concentrations of total higher alcohols, especially isoamyl alcohol. The present work contributed to a better understanding of the fermentation possibilities of selected non-Saccharomyces strains in the overall red wine quality modeling.
Adding Value to Bycatch Fish Species Captured in the Portuguese Coast—Development of New Food Products
Authors: Silva Frederica , Duarte Ana M. , Mendes Susana , Borges Patrícia , Magalhães Elisabete , Pinto Filipa R. , Barroso Sónia , Neves Ana , Sequeira Vera , Vieira Ana Rita , Magalhães Maria Filomena , Rebelo Rui , Assis Carlos , Gordo Leonel Serrano , Gil Maria Manuel
Published: December 2020

We live in a world of limited biological resources and ecosystems, which are essential to feed people. Consequently, diversifying target species and considering full exploitation are essential for fishery sustainability. The present study focuses on the valorization of three low commercial value fish species (blue jack mackerel, Trachurus picturatus; black seabream, Spondyliosoma cantharus; and piper gurnard, Trigla lyra) and of two unexploited species (comber, Serranus cabrilla and boarfish, Capros aper) through the development of marine-based food products with added value. A preliminary inquiry with 155 consumers from Região de Lisboa e Vale do Tejo (Center of Portugal) was conducted to assess fish consumption, the applicability of fish product innovation, and the importance of valorizing discarded fish. Five products (black seabream ceviche, smoked blue jack mackerel pâté, dehydrated piper gurnard, fried boarfish, and comber pastries) were developed and investigated for their sensory characteristics and consumer liking by hedonic tests to 90 consumers. The most important descriptors were identified for each product (texture, flavor, color, and appearance). Comber pastries had the highest purchase intention (88%), followed by black seabream ceviche (85%) and blue jack mackerel pâté (76%). Sensory evaluations showed a clear tendency of consumers to accept reformulated products, with the introduction of the low-value and unexploited species under study.
Aspergillus oryzae Fermented Rice Bran: A Byproduct with Enhanced Bioactive Compounds and Antioxidant Potential
Authors: Punia Sneh , Sandhu Kawaljit Singh , Grasso Simona , Purewal Sukhvinder Singh , Kaur Maninder , Siroha Anil Kumar , Kumar Krishan , Kumar Vikas , Kumar Manoj
Published: December 2020

Rice bran (RB) is a byproduct of the rice industry (milling). For the fermentation process and to add value to it, RB was sprayed with fungal spores (Aspergillus oryzae MTCC 3107). The impact of fermentation duration on antioxidant properties was studied. Total phenolic content (TPC) determined using the Folin–Ciocalteu method, increased during fermentation until the 4th day. The antioxidant activity analyzed using the 2,2 Diphenyl–1′ picrylhydrazyl (DPPH) assay, total antioxidant activity (TAC), 2,2′-azinobis 3-ethylbenzothiazoline-6-sulfonic acid (ABTS+) assay, reducing power assay (RPA) and hydroxyl free radical scavenging activity (HFRSA) for fermented rice bran (FRB) were determined and compared to unfermented rice bran (URB). TAC, DPPH, ABTS+ and RPA of FRB increased till 4th day of fermentation, and then decreased. The specific bioactive constituents in extracts (Ethanol 50%) from FRB and URB were identified using high performance liquid chromatography (HPLC). HPLC confirmed a significant (p < 0.05) increase in gallic acid and ascorbic acid. On the 4th day of fermentation, the concentrations of gallic acid and ascorbic acid were 23.3 and 12.7 µg/g, respectively. The outcome of present investigation confirms that antioxidant potential and TPC of rice bran may be augmented using SSF.
Discrete Choice Analysis of Consumer Preferences for Meathybrids—Findings from Germany and Belgium
Authors: Profeta Adriano , Baune Marie-Christin , Smetana Sergiy , Broucke Keshia , Van Royen Geert , Weiss Jochen , Heinz Volker , Terjung Nino
Published: December 2020

High levels of meat consumption are increasingly being criticised for ethical, environmental and social reasons. Plant-based meat substitutes have been identified as healthy sources of protein that, in comparison to meat, offer a number of social, environmental and health benefits and may play a role in reducing meat consumption. However, there has been a lack of research on the role they can play in the policy agenda and how specific meat substitute attributes can influence consumers to partially replace meat in their diets. This paper is focused on consumers’ preferences for so-called meathybrid or plant-meathybrid products. In meathybrids, only a fraction of the meat product (e.g., 20% to 50%) is replaced with plant-based proteins. Research demonstrates that in many countries, consumers are highly attached to meat and consider it as an essential and integral element of their daily diet. For these consumers that are not interested in vegan or vegetarian alternatives as meat substitutes, meathybrids could be a low-threshold option for a more sustainable food consumption behaviour. In this paper, the results of an online survey with 500 German and 501 Belgian consumers are presented. The results show that more than fifty percent of consumers substitute meat at least occasionally. Thus, about half of the respondents reveal an eligible consumption behaviour with respect to sustainability and healthiness, at least sometimes. The applied discrete choice experiment demonstrated that the analysed meat products are the most preferred by consumers. Nonetheless, the tested meathybrid variants with different shares of plant-based proteins took the second position followed by the vegetarian-based alternatives. Therefore, meathybrids could facilitate the diet transition of meat-eaters in the direction toward a more healthy and sustainable consumption. The analysed consumer segment is more open-minded to the meathybrid concept in comparison to the vegetarian substitutes.
GIS Analysis and Spatial Networking Patterns in Upland Ancient Warfare: The Roman Conquest of Dacia
Authors: Oltean Ioana A. , Fonte João
Published: December 2020

Generally seen as natural peripheries, upland landscapes present particular challenges both in terms of living, and of recording past human activity within. LiDAR (light detection and ranging) technology has now brought considerable improvement in our ability to record and map surviving archaeological features, but not necessarily increased our appreciation of local agency. Though the iconic landscape around the Iron Age Dacian capital of Sarmizegetusa Regia (Romania) and its Roman conquest have long caught the attention of specialists and the wider public, both previous research and more recent results from an airborne LiDAR survey leave considerable gaps in our understanding of networking potential across this challenging landscape. Based on LiDAR and satellite-generated high- and mid-resolution topographic data, our paper employs an innovative combination of GIS (geographic information system) spatial analysis tools to examine the spatial relationships between Roman military bases, Dacian targets, and the wider landscape as an integral part of a wider interdisciplinary archaeological research. This helped us formulate and test spatial and historical hypotheses, according to which all known and potential Roman military bases in the study area functioned as part of a system where each contributed individual advantages in securing their domination across the landscape. Our research highlighted the advantages and challenges for Comărnicelu as one of the key Roman logistical nodes, and for the attackers at Şesului and Muncelu working in tandem to besiege and subdue Sarmizegetusa Regia. Our study raises doubts with respect of the fall and destruction of the hillfort at Vârfu lui Hulpe as a result of a Roman siege, making space for alternative political narratives. Ultimately, our findings help build a better understanding of this iconic world heritage landscape and its Roman conquest.
On Becoming a Non-Jewish Holocaust Writer: Yann Martel’s Beatrice and Virgil
Authors: Brenner Rachel F.
Published: December 2020

To appraise Martel’s non-Jewish perspective of Holocaust thematic, it is important to assess it in the context of the Jewish relations with the Holocaust. Even though the Jewish claim to the uniqueness of the Holocaust has been disputed since the end of the war especially in Eastern Europe, the Jewish response determined to a large extent the reception of the disaster on the global scene. On a family level, the children of survivors have identified themselves as the legitimate heirs of the unknowable experience of their parents. On a collective level, the decree of Jewish annihilation constructed a Jewish identity that imposed an obligation to keep the Holocaust memory in the consciousness of the world. Martel proposes to supersede the history of the Holocaust with a story which would downplay the Jewish filiation with the Holocaust, elicit an affiliative response to the event of the non-Jewish writer and consequently integrate it into the memory of humanity at large. However, the Holocaust theme of Beatrice and Virgil refuses to assimilate within the general memory of humanity; rather, the consciousness of the event, which pervades the post-Holocaust world, insists on its constant presence. The omnipresence of the Holocaust blurs the distinctions between the filiative (Jewish) and affiliative (non-Jewish) attitudes toward the Jewish tragedy, gripping the writer in its transcendent horror. Disregarding his ethnic or religious origins, the Holocaust takes over the writer’s personal life and determines his story.
Empirical Analysis of Factors Influencing Healthcare Efficiency among Emerging Countries
Authors: Zhou Lulin , Ampon-Wireko Sabina , Dauda Lamini , Xu Xinglong , Antwi Maxwell Opuni , Larnyo Ebenezer
Published: December 2020

Numerous factors, including inefficient utilization of healthcare resources have been attributed to the poor health outcome. The study aims to compare the efficiency of health expenses and its determining factors in the emerging economies based on their income levels. Data for the study is extracted from the World Bank’s World Development Indicators for 21 countries covering the period of 2000 to 2018. Analysis of the research involves two stages. Stage one computes the efficiency scores, whereas second stage examines factors affecting health efficiency by employing the Tobit regression and Simar-Wilson regression test to confirm the results. The Tobit result shows that research and development (R&D) and physicians enhanced health efficiency at the main panel, lower-middle-income, upper-middle-income, and high-income countries. Corruption remained negative with education showing mixed results. The interaction between research and development and physicians increases health efficiency in all the panels. Health research must be a policy focus if efficiency is to be achieved by the emerging economies.
Survey of Frontline Police Officers’ Responses and Requirements in Psychiatric Emergency Situations
Authors: Lee Kyung Ja , Lee Kyunghee , Lee Yeong Mi , Choi Hyun Seok
Published: December 2020

Police officers in South Korea can be summoned to incidents involving individuals with mental health problems. Therefore, for officers to communicate effectively in such situations, education is necessary. Accordingly, this study obtained frontline police officers’ perceptions of such educational programs and their suggestions regarding supplementary field manuals. Data were collected from 471 frontline police officers from 8 July until 9 August 2020. Data analysis incorporated frequency analysis, cross tabulation, text mining, and meaning network analysis. Participation in educational programs related to people with mental health problems depended on officers’ field experience with such persons (χ2 = 7.432, p = 0.006). Among officers who received educational programs, most expressed satisfaction with the programs (χ2 = 72.243, p < 0.001) and believed that these facilitated problem-solving (χ2 = 7.574, p = 0.023), improved understanding of people with mental health problems (χ2 = 10.220, p = 0.006), enabled better communication with such individuals (χ2 = 21.588, p < 0.001), and improved confidence in clarity of verbal expression in conversations with them (χ2 = 6.634, p = 0.036). An on-site response manual for communicating with people with mental health problems would represent an effective educational intervention to improve police judgment and responses.
Linking Disaster Risk Reduction and Healthcare in Locations with Limited Accessibility: Challenges and Opportunities of Participatory Research
Authors: Kelman Ilan , Harris Myles
Published: December 2020

Disaster risk reduction and healthcare support each other, including the mitigation of further harm after illness or injury. These connections are particularly relevant in locations which have permanent or temporary limited accessibility. In these circumstances, people are required to be self-sufficient in providing emergency and long-term healthcare with limited resources. Planning and preparing to mitigate further harm after illness or injury from disasters (disaster risk reduction) must include people living and working in locations with limited accessibility, meaning that participatory research can be used. The challenges and opportunities of enacting participatory research in such contexts have not been thoroughly examined. The research question of this paper is therefore, “What challenges and opportunities occur when participatory research links disaster risk reduction and healthcare to mitigate illness and injury in locations with limited accessibility?” To answer this research question, the method used is a qualitative evidence synthesis, combined with an overview paper approach. Two principal themes of challenges and opportunities are examined: defining the data and collecting the data. The themes are explored in theory and then through contextual examples. The conclusion is that an overarching challenge is divergent goals of research and actions that, when recognized, lead to opportunities for improved connections between disaster risk reduction and healthcare.
Association between Cardiac Autonomic Control and Postural Control in Patients with Parkinson’s Disease
Authors: Espinoza-Valdés Yoan , Córdova-Arellano Rocio , Espinoza-Espinoza Maiter , Méndez-Alfaro Diego , Bustamante-Aguirre Juan Pablo , Maureira-Pareja Hernán Antonio , Zamunér Antonio Roberto
Published: December 2020

Parkinson’s disease (PD) is a neurodegenerative disorder that affects postural and cardiac autonomic control. However, since it is unknown whether these changes are associated, the objective of this study was to determine whether such a relationship exists. Twenty-three patients with PD participated. The RR intervals were recorded in different positions and heart rate variability (HRV) was analyzed. Postural sway was analyzed based on the center of pressure. No significant differences on HRV indices were induced by postural change. A correlation was found between these indices and postural control, high frequency (HF), and anterior-posterior (AP) root mean square (RMS-AP) (r = 0.422, p = 0.045), low frequency (LF)/HF, and AP mean velocity (r = 0.478, p = 0.021). A correlation was found between HRV induced by postural change and postural control, Δ LF/HF and RMS-AP (r = 0.448, p = 0.032), Δ LF/HF and ellipse area (r = 0.505, p = 0.014), Δ LF/HF and AP mean velocity (r = −0.531; p = 0.009), and Δ LF and AP mean velocity (r = −0.424, p = 0.044). There is an association between the autonomic and postural systems, such that PD patients with blunted cardiac autonomic function in both the supine and orthostatic positions have worse postural control.
Global Burden of Headache Disorders in Children and Adolescents 2007–2017
Authors: Leonardi Matilde , Grazzi Licia , D’Amico Domenico , Martelletti Paolo , Guastafierro Erika , Toppo Claudia , Raggi Alberto
Published: December 2020

Headache disorders are prevalent and disabling conditions impacting on people of all ages, including children and adolescents with substantial impact on their school activities and leisure time. Our study aims to report specific information on headaches in children and adolescents based on the Global Burden of Disease (GBD) study, that provides estimates for incidence, prevalence, fatal and non-fatal outcomes. We relied on 2007 and 2017 GBD estimates for prevalence and Years Lived with Disability (YLDs) at the global level and in WHO regions. The results show that, migraine and tension-type headache (TTH) together account for 37.5% of all-cause prevalence and for 7% of all-cause YLDs. Over the past decade, prevalence rates showed a mild increase of TTH in all ages and of migraine alone for adolescents. The YLDs increased among females of all ages with some regional differences that might be connected to the unequal availability of effective acute and prophylactic treatments across world regions. GBD data support the need to promote public health policies and strategies including diagnosis, pharmacological and non-pharmacological treatments that are expected to help reduce the disability and burden associated to migraine and TTH among children and adolescents.
Daylight and School Performance in European Schoolchildren
Authors: Baloch Ramen , Nichole Maesano Cara , Christoffersen Jens , Mandin Corinne , Csobod Eva , de Oliveira Fernandes Eduardo , Annesi-Maesano Isabella ,   on behalf of the SINPHONIE Consortium
Published: December 2020

Aims and objectives: Lighting constitutes a critical issue in school design because of its importance as a strong enabler of performance, which is crucial for child development. However, data on light impacts on school performance are scarce. The main objective of this study was to assess the relationship between daylighting conditions in classrooms and mathematical and logical test scores. Methods: The population-based SINPHONIE (Schools Indoor Pollution and Heath: Observatory Network in Europe) study provides information on relationships between lighting conditions and school performance for 2670 elementary schoolchildren, aged 8–13 years from 155 classrooms in 53 schools across 12 European countries. These data were acquired through direct physical assessments and questionnaires completed by teachers, schoolchildren, and their parents, allowing for estimations of multiple objective daylight indicators, as well as subjective parameters such as the perception of lighting. Schoolchildren performed an attention/concentration exam that included simple mathematical exercises in addition to a logical ciphering test. The corresponding performance scores were compared against multiple daylighting parameters. Results: A positive relationship was found between performance scores and type of window shading, latitude, percentage of window facing south, and window glazing, with the highest impact due to the window-to-floor area ratio. Conclusion: Data collected in the SINPHONIE study across 12 European countries indicate that daylighting parameters are relevant to schoolchildren’s performance. As SINPHONIE was not designed specifically with lighting in mind, dedicated studies covering a wide range of classroom configurations would be enlightening.
Nutritional Status of Children 24–60 Months Attending Early Child Development Centres in a Semi-Rural Community in South Africa
Authors: Makanjana Onwaba , Naicker Ashika
Published: December 2020

Despite the numerous efforts to improve the nutritional status of children, a high prevalence of malnutrition still exists in South Africa. This study aimed to determine the nutritional status of children attending Early Child Development centres in South Africa. In this baseline study, we randomly selected two Early Child Development centres comprising 116 children aged 24–60 months, separated into two cohorts, of 24–47 months and 48–60 months. Dietary intake was measured through the 24 hDR and analysed using Food Finder software. The food frequency questionnaire was used to calculate the food variety and food group diversity scores. Anthropometric measurements were taken and the WHO Anthro software was used to convert it to nutritional data indices. Blood samples were collected through dried blood spot cards in order to determine serum retinol and haemoglobin levels and they were assessed using WHO indicators. The findings showed that participants between 24 and 47 months had a high mean energy intake (4906.2 kJ and 4997.9 kJ for girls and boys, respectively). For the 48–60 months age group, energy intake was lower than the EER (5936.4 kJ and 5621.2 kJ; p = 0.038). There was low fruit and vegetable consumption (24–47 months; 63.8 g and 69.5 g (p = 0.037), 48–60 months; 68.3 g and 74.4 g (p = 0.038) and the top five foods consumed were carbohydrate rich foods for girls and boys, respectively. Stunting was noted in 7% and 20% (48–60 months) (p = 0.012) and overweight in 8% and 17% (24–47 months) and 17% and 13% (48–60 months) (p = 0.041) in girls and boys, respectively. Low serum retinol levels (<0.070 µmol/L) were found in 9.1% of boys (24–47 months), and 8% and 7.4% of girls and boys (48–60 months), respectively. Low haemoglobin levels (<11.0 g/dL) were found in 50.0% and 30.4% (24–47 months) and 8.6% and 39.3% (48–60 months) of girls and boys, respectively. Malnutrition, despite many national and provincial initiatives, still exists in Early Childhood Development centres in South Africa, calling for the application of contextualized nutrition interventions to suit resource-poor settings.
Knowledge Discovery Web Service for Spatial Data Infrastructures
Authors: Omidipoor Morteza , Toomanian Ara , Neysani Samany Najmeh , Mansourian Ali
Published: December 2020

The size, volume, variety, and velocity of geospatial data collected by geo-sensors, people, and organizations are increasing rapidly. Spatial Data Infrastructures (SDIs) are ongoing to facilitate the sharing of stored data in a distributed and homogeneous environment. Extracting high-level information and knowledge from such datasets to support decision making undoubtedly requires a relatively sophisticated methodology to achieve the desired results. A variety of spatial data mining techniques have been developed to extract knowledge from spatial data, which work well on centralized systems. However, applying them to distributed data in SDI to extract knowledge has remained a challenge. This paper proposes a creative solution, based on distributed computing and geospatial web service technologies for knowledge extraction in an SDI environment. The proposed approach is called Knowledge Discovery Web Service (KDWS), which can be used as a layer on top of SDIs to provide spatial data users and decision makers with the possibility of extracting knowledge from massive heterogeneous spatial data in SDIs. By proposing and testing a system architecture for KDWS, this study contributes to perform spatial data mining techniques as a service-oriented framework on top of SDIs for knowledge discovery. We implemented and tested spatial clustering, classification, and association rule mining in an interoperable environment. In addition to interface implementation, a prototype web-based system was designed for extracting knowledge from real geodemographic data in the city of Tehran. The proposed solution allows a dynamic, easier, and much faster procedure to extract knowledge from spatial data.
CaSR-Mediated hBMSCs Activity Modulation: Additional Coupling Mechanism in Bone Remodeling Compartment
Authors: Cho Hyunji , Lee Jisoo , Jang Seoyoung , Lee Jungsun , Oh Tong In , Son Youngsook , Lee EunAh
Published: December 2020

Near the bone remodeling compartments (BRC), extracellular calcium concentration (Ca2+o) is locally elevated and bone marrow stromal cells (BMSCs) close to the BRC can be exposed to high calcium concentration. The calcium-sensing receptor (CaSR) is known to play a key role in maintaining extracellular calcium homeostasis by sensing fluctuations in the levels of extracellular calcium (Ca2+o). When human BMSCs (hBMSCs) were exposed to various calcium concentrations (1.8, 3, 5, 10, 30 mM), moderate-high extracellular calcium concentrations (3–5 mM) stimulated proliferation, while a high calcium concentration (30 mM) inhibited the proliferation. Exposure to various calcium concentrations did not induce significant differences in the apoptotic cell fraction. Evaluation of multi-lineage differentiation potential showed no significant difference among various calcium concentration groups, except for the high calcium concentration (30 mM) treated group, which resulted in increased calcification after in vitro osteogenic differentiation. Treatment of NPS2143, a CaSR inhibitor, abolished the stimulatory effect on hBMSCs proliferation and migration indicating that CaSR is involved. These results suggest that the calcium concentration gradient near the BRC may play an important role in bone remodeling by acting as an osteoblast–osteoclast coupling mechanism through CaSR.
Melatonin Prevents Early but Not Delayed Ventricular Fibrillation in the Experimental Porcine Model of Acute Ischemia
Authors: Tsvetkova Alena S. , Bernikova Olesya G. , Mikhaleva Natalya J. , Khramova Darya S. , Ovechkin Alexey O. , Demidova Marina M. , Platonov Pyotr G. , Azarov Jan E.
Published: December 2020

Antiarrhythmic effects of melatonin have been demonstrated ex vivo and in rodent models, but its action in a clinically relevant large mammalian model remains largely unknown. Objectives of the present study were to evaluate electrophysiological and antiarrhythmic effects of melatonin in a porcine model of acute myocardial infarction. Myocardial ischemia was induced by 40-min coronary occlusion in 25 anesthetized pigs. After ischemia onset, 12 animals received melatonin (4 mg/kg). 48 intramyocardial electrograms were recorded from left ventricular wall and interventricular septum (IVS). In each lead, activation time (AT) and repolarization time (RT) were determined. During ischemia, ATs and dispersion of repolarization (DOR = RTmax − RTmin) increased reaching maximal values by 3–5 and 20–25 min, respectively. Ventricular fibrillation (VF) incidence demonstrated no relations to redox state markers and was associated with increased DOR and delayed ATs (specifically, in an IVS base, an area adjacent to the ischemic zone) (p = 0.031). Melatonin prevented AT increase in the IVS base, (p < 0.001) precluding development of early VF (1–5 min, p = 0.016). VF occurrence in the delayed phase (17–40 min) where DOR was maximal was not modified by melatonin. Thus, melatonin-related enhancement of activation prevented development of early VF in the myocardial infarction model.
Perinatal Gram-Positive Bacteria Exposure Elicits Distinct Cytokine Responses In Vitro
Authors: Reuschel Edith , Toelge Martina , Haeusler Sebastian , Deml Ludwig , Seelbach-Goebel Birgit , Solano Maria Emilia
Published: December 2020

During pregnancy, infections caused by the gram-positive bacteria Enterococcus faecalis (E. faecalis), Streptococcus agalacticae (S. agalacticae), and Staphylococcus aureus (S. aureus) are major reasons for preterm labor, neonatal prematurity, meningitis, or sepsis. Here, we propose cytokine responses to bacterial infections by the immature perinatal immune system as central players in the pathogenesis of preterm birth and neonatal sepsis. We aimed to close the gap in knowledge about such cytokine responses by stimulating freshly isolated umbilical blood mononuclear cells (UBMC) with lysates of E. faecalis, S. agalacticae, and S. aureus collected from pregnant women in preterm labor. Bacterial lysates and, principally, S. aureus and S. agalacticae distinctly triggered most of the eleven inflammatory, anti-inflammatory, TH1/TH2 cytokines, and chemokines quantified in UBMC culture media. Chemokines depicted the most robust induction. Among them, MIP-1β was further enhanced in UBMC from female compered to male newborn infants. Due to its stability and high levels, we investigated the diagnostic value of IL-8. IL-8 was critically upregulated in cord blood of preterm neonates suffering from infections compared to gestational age-matched controls. Our results provide novel clues about perinatal immunity, underscoring a potential value of IL-8 for the timely detection of infections and suggesting that MIP-1β constitutes an early determinant of sex-specific immunity, which may contribute, e.g., to male’s vulnerability to preterm birth.