bluuebunny/crossref_metadata_2025 huggingface dataset:
Proposed Management System and Response Estimation Algorithm for Motorway Incidents
Authors: Kontogiannis Sotirios , Asiminidis Christodoulos
Published: May 2021

Motorway’s personnel tasks management and incidents monitoring, and response are critical processes that contribute to the motorway’s orderly and smooth operation. Existing management practices utilize SCADA technologies that control motorway actuator systems as well as various means of personnel communications mobile technologies. Nevertheless, contemporary motorways lack a unified incident response solution that tracks resources, sends notification alerts when necessary, and automates incident resolution. This paper presents a new holistic and unified management and response system called Resources Management System (RMS). This system was originally implemented as a generic motorways resources management system for the EGNATIA ODOS motorway that uses it in Greece. The implemented RMS provides real-time resources tracking, personnel utilization algorithms, and data mining capabilities towards incident confrontation. It operates as an incidents’ collection and resources central communication interface. It is also capable of incident response and completion time categorization; real-time tunnel exits sensory monitoring, staff mobilization, and tracking system. Furthermore, the RMS includes machine learning methodologies and smart agents (bots) for solving the problem of estimating and evaluating the response and completion time of incidents based on previous successful incidents’ confrontations.
Interval Optimization to Schedule a Multi-Energy System with Data-Driven PV Uncertainty Representation
Authors: Kaffash Mahtab , Ceusters Glenn , Deconinck Geert
Published: May 2021

Recently, multi-energy systems (MESs), whereby different energy carriers are coupled together, have become popular. For a more efficient use of MESs, the optimal operation of these systems needs to be considered. This paper focuses on the day-ahead optimal schedule of an MES, including a combined heat and electricity (CHP) unit, a gas boiler, a PV system, and energy storage devices. Starting from a day-ahead PV point forecast, a non-parametric probabilistic forecast method is proposed to build the predicted interval and represent the uncertainty of PV generation. Afterwards, the MES is modeled as mixed-integer linear programming (MILP), and the scheduling problem is solved by interval optimization. To demonstrate the effectiveness of the proposed method, a case study is performed on a real industrial MES. The simulation results show that, by using only historical PV measurement data, the point forecaster reaches a normalized root-mean square error (NRMSE) of 14.24%, and the calibration of probabilistic forecast is improved by 10% compared to building distributions around point forecast. Moreover, the results of interval optimization show that the uncertainty of the PV system not only has an influence on the electrical part of the MES, but also causes a shift in the behavior of the thermal system.
Multi-Objective Optimization of Steel Off-Gas in Cogeneration Using the ε-Constraint Method: A Combined Coke Oven and Converter Gas Case Study
Authors: García Sergio García , Montequín Vicente Rodríguez , Piloñeta Marina Díaz , Lougedo Susana Torno
Published: May 2021

Increasingly demanding environmental regulations are forcing companies to reduce their impacts caused by their activity while defending the economic viability of their manufacturing processes, especially energy and carbon-intensive ones. Therefore, these challenges must be addressed by posing optimization problems that involve several objectives simultaneously, corresponding to different conditions, and often conflicting between. In this study, the residual gases of an integral steel factory were evaluated and modeled with the goal of developing an optimization problem considering two opposing objectives: CO2 emissions and profit. The problem was first approached in a mono-objective manner, optimizing profit through Mixed Integer Linear Programming (MILP), and then was extended to a bi-objective problem solved by means of the ε-constraint method, to find the Pareto front relating profit and CO2 emissions. The results show that multiobjective optimization is a very valuable resource for plant managers’ decision-making processes. The model makes it possible to identify inflection points from which the level of emissions would increase disproportionately. It gives priority to the consumption of less polluting fuels. The model also makes it possible to make the most of temporary buffers such as the gas holders, adapting to the hourly price of the electricity market. By applying this method, CO2 emissions decrease by more than 3%, and profit amounts up to 14.8% compared to a regular case under normal operating conditions. The sensitivity analysis of the CO2 price and CO2 constraints is also performed.
Biogas from Anaerobic Digestion as an Energy Vector: Current Upgrading Development
Authors: Iglesias Raquel , Muñoz Raúl , Polanco María , Díaz Israel , Susmozas Ana , Moreno Antonio D. , Guirado María , Carreras Nely , Ballesteros Mercedes
Published: May 2021

The present work reviews the role of biogas as advanced biofuel in the renewable energy system, summarizing the main raw materials used for biogas production and the most common technologies for biogas upgrading and delving into emerging biological methanation processes. In addition, it provides a description of current European legislative framework and the potential biomethane business models as well as the main biogas production issues to be addressed to fully deploy these upgrading technologies. Biomethane could be competitive due to negative or zero waste feedstock prices, and competitive to fossil fuels in the transport sector and power generation if upgrading technologies become cheaper and environmentally sustainable.
Minimum Set of Rotor Parameters for Synchronous Reluctance Machine and Improved Optimization Convergence via Forced Rotor Barrier Feasibility
Authors: Ban Branko , Stipetic Stjepan , Jercic Tino
Published: May 2021

Although rare earth materials are the critical component in high torque density permanent magnet machines, their use has historically been a commercial risk. The alternatives that have been in the recent industry focus are synchronous reluctance machines (SyRM). They have lower torque density but also relatively low material cost and higher overload capability. Multi-layer IPM and SyRM machines have significant geometric complexity, resulting in a high number of parameters. Considering that modern machine design requires the use of optimization algorithms with computational load proportional to the number of parameters, the whole design process can take several days. This paper presents novel SyRM parameterization with reduced number of parameters. Furthermore, the paper introduces the novel forced feasibility concept, applied on rotor barrier parameters, resulting in improved optimization convergence with overall optimization time reduced by 12.3%. Proposed approaches were demonstrated using optimization procedure based on the existing differential evolution algorithm (DE) framework.
How to Predict Energy Consumption in BRICS Countries?
Authors: Khan Atif Maqbool , Osińska Magdalena
Published: May 2021

Brazil, Russia, China, India, and the Republic of South Africa (BRICS) represent developing economies facing different energy and economic development challenges. The current study aims to predict energy consumption in BRICS at aggregate and disaggregate levels using the annual time series data set from 1992 to 2019 and to compare results obtained from a set of models. The time-series data are from the British Petroleum (BP-2019) Statistical Review of World Energy. The forecasting methodology bases on a novel Fractional-order Grey Model (FGM) with different order parameters. This study contributes to the literature by comparing the forecasting accuracy and the predictive ability of the FGM1,1 with traditional ones, like standard GM1,1 and ARIMA1,1,1 models. Moreover, it illustrates the view of BRICS’s nexus of energy consumption at aggregate and disaggregates levels using the latest available data set, which will provide a reliable and broader perspective. The Diebold-Mariano test results confirmed the equal predictive ability of FGM1,1 for a specific range of order parameters and the ARIMA1,1,1 model and the usefulness of both approaches for energy consumption efficient forecasting.
Hybrid Floating Solar Plant Designs: A Review
Authors: Solomin Evgeny , Sirotkin Evgeny , Cuce Erdem , Selvanathan Shanmuga Priya , Kumarasamy Sudhakar
Published: May 2021

The world’s demand for electricity will double by 2050. Despite its high potential as an eco-friendly technology for generating electricity, solar energy only covers a small percentage of the global demand. One of the challenges is associated with the sustainable use of land resources. Floating PV (FPV) plants on water bodies such as a dam, reservoir, canal, etc. are being increasingly developed worldwide as an alternative choice. In this background, the purpose of this research is to provide an outline of the hybrid floating solar system, which can be used to generate renewable energy. The hybrid technologies discussed include: FPV + hydro systems, FPV + pumped hydro, FPV + wave energy converter, FPV + solar tree, FPV + tracking, FPV + conventional power, FPV + hydrogen. The review also summarizes the key benefits and constraints of floating solar PV (FPV) in hybrid operation. Among the various hybrid FPV technologies, with solar input and hydro energy were among the most promising methods that could be potentially used for efficient power generation. The valuable concepts presented in this work provide a better understanding and may ignite sustainable hybrid floating installations for socio-economic growth with less environmental impact.
OptiMEMS: An Adaptive Lightweight Optimal Microgrid Energy Management System Based on the Novel Virtual Distributed Energy Resources in Real-Life Demonstration
Authors: Bintoudi Angelina D. , Zyglakis Lampros , Tsolakis Apostolos C. , Gkaidatzis Paschalis A. , Tryferidis Athanasios , Ioannidis Dimosthenis , Tzovaras Dimitrios
Published: May 2021

As microgrids have gained increasing attention over the last decade, more and more applications have emerged, ranging from islanded remote infrastructures to active building blocks of smart grids. To optimally manage the various microgrid assets towards maximum profit, while taking into account reliability and stability, it is essential to properly schedule the overall operation. To that end, this paper presents an optimal scheduling framework for microgrids both for day-ahead and real-time operation. In terms of real-time, this framework evaluates the real-time operation and, based on deviations, it re-optimises the schedule dynamically in order to continuously provide the best possible solution in terms of economic benefit and energy management. To assess the solution, the designed framework has been deployed to a real-life microgrid establishment consisting of residential loads, a PV array and a storage unit. Results demonstrate not only the benefits of the day-ahead optimal scheduling, but also the importance of dynamic re-optimisation when deviations occur between forecasted and real-time values. Given the intermittency of PV generation as well as the stochastic nature of consumption, real-time adaptation leads to significantly improved results.
New Deterministic Mathematical Model for Estimating the Useful Energy Output of a Medium-Sized Solar Domestic Hot Water System
Authors: Zukowski Miroslaw , Jezierski Walery
Published: May 2021

According to the authors of this paper, the mathematical point of view allows us to see what sometimes cannot be seen from the designer’s point of view. The aim of this study was to estimate the influence of the most important parameters (volume of heat storage tanks, daily consumption of domestic hot water, optical efficiency, heat loss coefficient, and total area of a solar collector) on the thermal power output of solar domestic hot water (SDHW) system in European climatic conditions. Three deterministic mathematical models of these relationships for Madrid, Budapest, and Helsinki were created. The database for the development of these models was carried out using computer simulations made in the TRNSYS software environment. The SDHW system located at the Bialystok University of Technology (Poland) was the source of the measurement results used to validate the simulation model. The mathematical optimization procedure showed that the maximum annual useful energy output that can be obtained from 1 m2 of gross collector area is 1303 kWh in the case of Madrid, 918.5 kWh for Budapest, and 768 kWh for Helsinki weather conditions.
The Patterns of Energy Innovation Convergence across European Countries
Authors: Kijek Tomasz , Kijek Arkadiusz , Bolibok Piotr , Matras-Bolibok Anna
Published: May 2021

Energy innovation is critical for addressing climate change and the ecological transitions of both developed and emerging economies. The present paper aims at the identification and assessment of patterns in energy innovation convergence across a sample of 27 European countries over the period 2000–2018. The research is based on data covering a broad category of patents related to climate change mitigation technologies in the energy sector, including combustion inventions with mitigation potential (e.g., using biomass), extracted from the Organisation for Economic Co-operation and Development (OECD) Statistical Database. Using a nonlinear time-varying factor model, the paper demonstrates that energy innovation efforts in the examined sample follow a pattern of club convergence. The findings allow the identification of three convergence clubs characterised by distinct disparities in energy patent intensity, as measured by the number of patent applications per 10 million inhabitants. Moreover, the results of an ordered logit model demonstrate that the emergence of the identified convergence clubs might be attributable to initial differences in per capita environmental research and development (R&D) expenditure, human resources in science and technology (HRST), and environmental policy stringency. The findings have important policy implications as they suggest the need for more tailored policies based on smart development and specialization frameworks designed to boost the energy innovation performance of the laggard countries, more fully exploiting the potential of their less technologically advanced sectors, such as agriculture.
The Development of Decarbonisation Strategies: A Three-Step Methodology for the Suitable Analysis of Current EVCS Locations Applied to Istanbul, Turkey
Authors: Kaya Ömer , Alemdar Kadir Diler , Campisi Tiziana , Tortum Ahmet , Çodur Merve Kayaci
Published: May 2021

One of the solutions to reduce environmental emissions is related to the deployment of electric vehicles (EVs) with sustainable energy. In order to be able to increase the number of electric vehicles in circulation, it is important to implement optimal planning and design of the infrastructure, with particular reference to areas equipped with charging stations. The suitable analysis of the location of current electric vehicle charging stations (EVCSs) is the central theme of this document. The research focused on the actual location of the charging stations of five major EVCS companies in the province by selecting Istanbul as the study area. The study was conducted through a three-step approach and specifically (i) the application of the analytical hierarchy process (AHP) method for creating the weights of the 6 main and 18 secondary criteria that influence the location of EVCSs; (ii) a geospatial analysis using GIS considering each criterion and developing the suitability map for the locations of EVCSs, and (iii) application of the technique for order preference by similarity to ideal solution (TOPSIS) to evaluate the location performance of current EVCSs. The results show that the ratio between the most suitable and unsuitable areas for the location of EVCSs in Istanbul and the study area is about 5% and 4%, respectively. The results achieved means of improving sustainable urban planning and laying the basis for an assessment of other areas where EVCSs could be placed.
Application and Suitability of Polymeric Materials as Insulators in Electrical Equipment
Authors: Haque SK Manirul , Ardila-Rey Jorge Alfredo , Umar Yunusa , Mas’ud Abdullahi Abubakar , Muhammad-Sukki Firdaus , Jume Binta Hadi , Rahman Habibur , Bani Nurul Aini
Published: May 2021

In this paper, the applications of thermoplastic, thermoset polymers, and a brief description of the functions of each subsystem are reviewed. The synthetic route and characteristics of polymeric materials are presented. The mechanical properties of polymers such as impact behavior, tensile test, bending test, and thermal properties like mold stress-relief distortion, generic thermal indices, relative thermal capability, and relative thermal index are mentioned. Furthermore, this paper covers the electrical behavior of polymers, mainly their dielectric strength. Different techniques for evaluating polymers’ suitability applied for electrical insulation are covered, such as partial discharge and high current arc resistance to ignition. The polymeric materials and processes used for manufacturing cables at different voltage ranges are described, and their applications to high voltage DC systems (HVDC) are discussed. The evolution and limitations of polymeric materials for electrical application and their advantages and future trends are mentioned. However, to reduce the high cost of filler networks and improve their technical properties, new techniques need to be developed. To overcome limitations associated with the accuracy of the techniques used for quantifying residual stresses in polymers, new techniques such as indentation are used with higher force at the stressed location.
Somatic Cell Count in Goat Milk: An Indirect Quality Indicator
Authors: Podhorecká Klára , Borková Markéta , Šulc Miloslav , Seydlová Růžena , Dragounová Hedvika , Švejcarová Martina , Peroutková Jitka , Elich Ondřej
Published: May 2021

A high somatic cell count (SCC) impacts dairy quality to a large extent. The goal of this work was to investigate differences in goat milk composition and technological parameters according to SCC cut-off (600, 700, 800, and 1000.103/mL). Thirty-four individual milk samples of White Shorthair goats in a similar stage of lactation were investigated. The first differences in milk quality appeared already at SCC cut-off of 600.103/mL (5.58 LSCS-linear somatic cell score), yet the most striking differences were found for SCC over 1000.103/mL (6.32 LSCS), which was expressed by lowering heat stability (126 vs. 217 s, p = 0.034), increasing protein (3.41 vs. 3.04%, p = 0.009), casein (2.80 vs. 2.44%, p = 0.034) and chloride (164 vs. 147 mg/100 mL, p = 0.004) levels, as well as non-fat dry matter (8.79 vs. 8.45%, p = 0.045). It has been shown that low levels of Staphylococcus spp. bacteria (120–1600 CFU/mL) in the mammary gland correlated with decreased lactose content (4.60 vs. 4.47 g/100 g, p = 0.022). Since our results indicate that even low SCC values may significantly affect the technological properties of goat milk, SCC should therefore be routinely screened and reported to dairy manufacturers to assure the consumer of high end-product quality.
Phototherapy and Tailored Brushing Method. Personalized Oral Care in Patients with Facial and Dental Trauma. A Report of a Case
Authors: Nardi Gianna Maria , Guerra Fabrizio , Ndokaj Artnora , Corridore Denise , Straker Marsha Alicia , Sportelli Pasquale , Di Giorgio Roberto , Grassi Felice Roberto , Grassi Roberta , Ottolenghi Livia
Published: May 2021

(1) Background: Traumatic dental injuries are frequent in children and young adults. The facial structures involved in dental trauma may include soft tissues of the face and mouth, bone and dental structures. Dental trauma often results in augmented dental anxiety. Phototherapy can improve stress and pain control thereby improving compliance in young patients with the necessary dental treatments, after dental trauma has occurred. (2) Methods: Phototherapy was performed to enable soft tissue healing. The Tailored Brushing Method (TBM), a personalized approach for at-home oral hygiene procedures, was also utilized, with the aim of improving biofilm control in traumatized patients. (3) Results: The approach hereafter presented made it possible to obtain subjective control of anxiety and pain documented on a visual analog scale (VAS) due to the innovative use of photo-biomodulation. In addition, for the first time, the TBM was adapted to the needs of a patient with facial trauma and illustrated. (4) Conclusions: Phototherapy and TBM were found to be effective in the combined treatment of soft tissue wounds and in the oral care of the traumatized patient.
Religiosity and Attitudes towards Health, Disease, Death and the Use of Stimulants among Jehovah’s Witnesses
Authors: Jakubowska Klaudia , Chruściel Paweł , Jurek Krzysztof , Machul Michał , Kościołek Aneta , Dobrowolska Beata
Published: May 2021

Religiosity is considered as one of the many factors shaping an individual’s health consciousness. The aim of the study is an analysis of the correlation between the religiosity of Jehovah’s Witnesses and their attitudes towards health and disease. A cross-sectional study was performed on the convenience sample of 171 Jehovah’s Witnesses from eastern Poland with the use of two research tools: the author’s questionnaire, focusing on attitudes towards health, disease, death and the use of stimulants, and the Duke University Religion Index (DUREL). The research involved 99 females (57.9%) and 72 males (42.1%), with an average age of 37.25 (SD = 12.59) years. On average, they have been a Jehovah’s Witness for 29.21 (SD = 13.22) years and are characterised by a high ratio of organisational religious activity (ORA) (M = 5.60; SD = 0.62) and intrinsic religiosity (IR) (M = 4.81; SD = 0.37). Those who had never smoked before becoming one of Jehovah’s Witnesses had a higher IR (Z = −2.822; p = 0.005), similarly to those respondents who smoked cigarettes before they became Jehovah’s Witnesses (Z = −2.977; p = 0.003) and those who did not abuse alcohol before they became Jehovah’s Witnesses (Z= −1.974; p = 0.048). Jehovah’s Witnesses are a group characterised by a high degree of consistency when it comes to religiosity, attitudes regarding health and disease and health behaviours. This means that they follow the teachings of their religion with regard to health issues. Knowledge about the association between religiosity and health behaviours is important to provide effective health education, health promotion and development of health prevention policy, specifically when dealing with more religious groups of clients.
Factors Related to Nurses’ Burnout during the First Wave of Coronavirus Disease-19 in a University Hospital in Italy
Authors: Bellanti Francesco , Lo Buglio Aurelio , Capuano Erika , Dobrakowski Michał , Kasperczyk Aleksandra , Kasperczyk Sławomir , Ventriglio Antonio , Vendemiale Gianluigi
Published: May 2021

Safety of healthcare workers in hospitals is a major concern during the COVID-19 pandemic. Being exposed for several working hours per day to infected patients, nurses dealing with COVID-19 face several issues that lead to physical/psychological breakdown. This study focused on burnout and its associated factors in nurses working in an Italian University Hospital during the first wave of COVID-19 pandemic. We designed a web-based cross-sectional study addressed to nurses working at the University Hospital in Foggia, Italy. The online questionnaire was organized in sections aimed at collecting demographic and occupational variables, including the Maslach Burnout Inventory (MBI) and the Oldenburg Burnout Inventory (OBI). Two hundred and ninety-three nurses agreed to participate. According to MBI, we reported moderate/high emotional exhaustion in 76.5%, depersonalization in 50.2%, and personal gratification in 54.6% of participants. COVID-19-related burnout measured by OBI resulted medium/high in 89.1% of participants. Among demographic and occupational factors, a multivariate regression analysis identified emotional support, consideration of leaving job, and workload as predictive of burnout in nurses. In conclusion, this study suggests that the improvement of employer and family support to nurses, as well as reduction of workload and job-related stress, would contribute to reducing burnout in nurses during COVID-19 pandemics.
Delay-Adjusted Age-Specific COVID-19 Case Fatality Rates in a High Testing Setting: South Korea, February 2020 to February 2021
Authors: Shim Eunha
Published: May 2021

In South Korea, a country with a high coronavirus disease 19 (COVID-19) testing rate, a total of 87,324 COVID-19 cases, including 1562 deaths, have been recorded as of 23 February 2021. This study assessed the delay-adjusted COVID-19 case fatality risk (CFR), including data from the second and third waves. A statistical method was applied to the data from 20 February 2021 through 23 February 2021 to minimize bias in the crude CFR, accounting for the survival interval as the lag time between disease onset and death. The resulting overall delay-adjusted CFR was 1.97% (95% credible interval: 1.94–2.00%). The delay-adjusted CFR was highest among adults aged ≥80 years and 70–79 years (22.88% and 7.09%, respectively). The cumulative incidence rate was highest among individuals aged ≥80 years and 60–69 years. The cumulative mortality rate was highest among individuals aged ≥80 years and 70–79 years (47 and 12 per million, respectively). In South Korea, older adults are being disproportionately affected by COVID-19 with a high death rate, although the incidence rate among younger individuals is relatively high. Interventions to prevent COVID-19 should target older adults to minimize the number of deaths.
“UHAND”—A National Cancer Institute Funded Partnership to Advance Cancer Health Equity through Scholar Training
Authors: Haq Arooba A. , Reitzel Lorraine R. , Chen Tzuan A. , Chang Shine , Escoto Kamisha H. , Solari Williams Kayce D. , Roberson Crystal , Koshy Litty , McNeill Lorna H.
Published: May 2021

Black and Hispanic adults are disproportionately affected by cancer incidence and mortality, and experience disparities in cancer relative to their White counterparts in the US. These groups, including women, are underrepresented among scientists in the fields of cancer, cancer disparities, and cancer care. The “UHAND” Program is a partnership between institutions (University of Houston and The University of Texas MD Anderson Cancer Center) aiming to build the capacity of underrepresented and racial/ethnic minority student “scholars” to conduct research on eliminating cancer inequities by reducing social and physical risk factors among at-risk groups. Here, we examine the outcomes of the UHAND Program’s first scholar cohort (n = 1 postdoctoral fellow, n = 3 doctoral scholars, n = 6 undergraduate scholars). Data collection included baseline, mid-program, and exit surveys; program records; and monthly scholar achievement queries. From baseline to exit, scholars significantly increased their research self-efficacy (p = 0.0293). Scholars largely met goals for academic products, achieving a combined total of 65 peer-reviewed presentations and nine empirical publications. Eight scholars completed the 2-year program; one undergraduate scholar received her degree early and the postdoctoral fellow accepted a tenure-track position at another university following one year of training. Scholars highly rated UHAND’s programming and their mentors’ competencies in training scholars for research careers. Additionally, we discuss lessons learned that may inform future training programs.
Establishment and Social Impacts of the Red Imported Fire Ant, Solenopsis invicta, (Hymenoptera: Formicidae) in Taiwan
Authors: Liu Yu-Sheng , Huang Sin-An , Lin I-Lin , Lin Chung-Chi , Lai Hung-Kuan , Yang Chun-Hsiang , Huang Rong-Nan
Published: May 2021

The first report of the red imported fire ant (RIFA), Solenopsis invicta Buren, in Taiwan was in the city of Taoyuan in 2003. The government has made great efforts to bring RIFA-infested areas under control. RIFA has gradually spread outward since its discovery, but it is still confined in northern Taiwan, in part due to the control efforts. RIFA is well established in densely populated environments (i.e., urban areas), causing damage to public utilities and significantly affects the inhabitants of Taiwan. Out of 10,127 human encounters with RIFA reported by the Plant Pest Information Management System in the Bureau of Animal and Plant Health Inspection and Quarantine, Council of Agriculture, Executive Yuan, 3819 (37.71%) persons were stung, with 834 (21.8%) persons exhibiting wheal-and-flare reaction (swelling and redness of the skin). Among the victims, 288 (7.5%) sought medical care, and about 21 (0.6%) developed severe cellulitis and urticaria. Unexpectedly, 2.8% (106) of the victims exhibited anaphylactic shock, which was higher than previously reported cases (1%). The high anaphylactic shock percentage was probably because most victims were elderly farmers or because Asian people have higher sensitivity to the RIFA sting. RIFA is well adapted to the environmental conditions in Taiwan, which makes it extremely difficult (if not impossible) to eradicate. The management of RIFA in the future should focus on lowering the speed of spread to mitigate possible dangers to the inhabitants. Six major challenges of RIFA management in Taiwan are also discussed.
Ultrasound-Guided Popliteal Nerve Block with Short-Acting Lidocaine in the Surgical Treatment of Ingrown Toenails
Authors: Kim Beom Suk , Kim Kyungho , Day Jonathan , Seilern Und Aspang Jesse , Kim Jaeyoung
Published: May 2021

Background: Digital nerve block (DB) is a commonly utilized anesthetic procedure in ingrown toenail surgery. However, severe procedure-related pain has been reported. Although the popliteal sciatic nerve block (PB) is widely accepted in foot and ankle surgery, its use in ingrown toenail surgery has not been reported. Therefore, this study aimed to investigate the safety and effectiveness of PB in the surgical treatment of ingrown toenails. Methods: One-hundred-ten patients surgically treated for an ingrown toenail were enrolled. Sixty-six patients underwent DB, and 44 underwent PB. PB was performed under ultrasound-guidance via a 22-gauge needle with 15 mL of 1% lidocaine in the popliteal region. The visual analogue scale was used to assess pain at two-time points: pain with skin penetration and pain with the solution injection. Time to sensory block, duration of sensory block, need for additional injections, and adverse events were recorded. Results: PB group demonstrated significantly lower procedure-related pain than the DB group. Time to sensory block was significantly longer in the PB group (20.8 ± 4.6 versus 6.5 ± 1.6 minutes). The sensory block duration was significantly longer in the PB group (187.9 ± 22.0 versus 106.5 ± 19.1 minutes). Additional injections were required in 16 (24.2%) DB cases, while no additional injections were required in PB cases. Four adverse events occurred in the DB group and two in the PB group. Conclusion: PB was a less painful anesthetic procedure associated with a longer sensory block duration and fewer repeat injections compared with DB. The result of this study implicates that PB can be an alternative anesthetic option in the surgical treatment of ingrown toenails.
Comparing the Quality of Primary Care between Public and Private Providers in Urban China: A Standardized Patient Study
Authors: Su Min , Zhou Zhongliang , Si Yafei , Sylvia Sean , Chen Gang , Su Yanfang , Rozelle Scott , Wei Xiaolin
Published: May 2021

Previous studies have been limited by not directly comparing the quality of public and private CHCs using a standardized patient method (SP). This study aims to evaluate and compare the quality of the primary care provided by public and private CHCs using a standardized patient method in urban China. We recruited 12 standardized patients from the local community presenting fixed cases (unstable angina and asthma), including 492 interactions between physicians and standardized patients across 63 CHCs in Xi’an, China. We measured the quality of primary care on seven criteria: (1) adherence to checklists, (2) correct diagnosis, (3) correct treatment, (4) number of unnecessary exams and drugs, (5) diagnosis time, (6) expense of visit, (7) patient-centered communication. Significant quality differences were observed between public CHCs and private CHCs. Private CHC physicians performed 4.73 percentage points lower of recommended questions and exams in the checklist. Compared with private CHCs, public CHC providers were more likely to give a higher proportion of correct diagnosis and correct treatment. Private CHCs provided 1.42 fewer items of unnecessary exams and provided 0.32 more items of unnecessary drugs. Private CHC physicians received a 9.31 lower score in patient-centered communication. There is significant quality inequality in different primary care models. Public CHC physicians might provide a higher quality of service. Creating a comprehensive, flexible, and integrated health care system should be considered an effective approach towards optimizing the management of CHC models.
Does Trypsin Oral Spray (Viruprotect®/ColdZyme®) Protect against COVID-19 and Common Colds or Induce Mutation? Caveats in Medical Device Regulations in the European Union
Authors: Huijghebaert Suzy , Vanham Guido , Van Winckel Myriam , Allegaert Karel
Published: May 2021

Background: nasal or oral sprays are often marketed as medical devices (MDs) in the European Union to prevent common cold (CC), with ColdZyme®/Viruprotect® (trypsin/glycerol) mouth spray claiming to prevent colds and the COVID-19 virus from infecting host cells and to shorten/reduce CC symptoms as an example. We analyzed the published (pre)-clinical evidence. Methods: preclinical: comparison of in vitro tests with validated host cell models to determine viral infectivity. Clinical: efficacy, proportion of users protected against virus (compared with non-users) and safety associated with trypsin/glycerol. Results: preclinical data showed that exogenous trypsin enhances SARS-CoV-2 infectivity and syncytia formation in host models, while culture passages in trypsin presence induce spike protein mutants. The manufacturer claims >98% SARS-CoV-2 deactivation, although clinically irrelevant as based on a tryptic viral digest, inserting trypsin inactivation before host cells exposure. Efficacy and safety were not adequately addressed in clinical studies or leaflets (no COVID-19 data). Protection was obtained among 9–39% of users, comparable to or lower than placebo-treated or non-users. Several potential safety risks (tissue digestion, bronchoconstriction) were identified. Conclusions: the current European MD regulations may result in insufficient exploration of (pre)clinical proof of action. Exogenous trypsin exposure even raises concerns (higher SARS-CoV-2 infectivity, mutations), whereas its clinical protective performance against respiratory viruses as published remains poor and substandard.
The Effect of Social Isolation on Physical Activity during the COVID-19 Pandemic in France
Authors: Porrovecchio Alessandro , Olivares Pedro R. , Masson Philippe , Pezé Thierry , Lombi Linda
Published: May 2021

The objective of this cross-sectional study is to analyze the changes in physical activity (PA) practice of a sample of 2099 French adults, mostly females, who answered an online questionnaire during the first COVID-19 lockdown (March–May 2020). A descriptive analysis of participants was performed using relative frequencies. Chi-squared tests were performed to compare the responses of selected variables. Multinomial logistic regressions were performed to compare the variations of PA with all the variables identified. The age of participants ranged from 18 to 88. Among people who practiced PAs before the first lockdown, the probability to keep practicing PAs is higher among those with a lower level of education, among housewives and retirees and among those who lived in cities of 10,000–19,999 inhabitants. For those who did not practice PAs before the social distancing, the probability of starting to practice is greater in those with a lower level of education and for those who suffered from a chronic disease. Our results place the emphasis on the complexity and multifactoriality of the changes that emerged during the first lockdown. The “education” factor emerges, as a significant determinant of PA that should certainly be explored further.
Rise of Clinical Studies in the Field of Machine Learning: A Review of Data Registered in ClinicalTrials.gov
Authors: Zippel Claus , Bohnet-Joschko Sabine
Published: May 2021

Although advances in machine-learning healthcare applications promise great potential for innovative medical care, few data are available on the translational status of these new technologies. We aimed to provide a comprehensive characterization of the development and status quo of clinical studies in the field of machine learning. For this purpose, we performed a registry-based analysis of machine-learning-related studies that were published and first available in the ClinicalTrials.gov database until 2020, using the database’s study classification. In total, n = 358 eligible studies could be included in the analysis. Of these, 82% were initiated by academic institutions/university (hospitals) and 18% by industry sponsors. A total of 96% were national and 4% international. About half of the studies (47%) had at least one recruiting location in a country in North America, followed by Europe (37%) and Asia (15%). Most of the studies reported were initiated in the medical field of imaging (12%), followed by cardiology, psychiatry, anesthesia/intensive care medicine (all 11%) and neurology (10%). Although the majority of the clinical studies were still initiated in an academic research context, the first industry-financed projects on machine-learning-based algorithms are becoming visible. The number of clinical studies with machine-learning-related applications and the variety of medical challenges addressed serve to indicate their increasing importance in future clinical care. Finally, they also set a time frame for the adjustment of medical device-related regulation and governance.
Unified Protocol for the Transdiagnostic Treatment of Emotional Disorders in Medical Conditions: A Systematic Review
Authors: Osma Jorge , Martínez-García Laura , Quilez-Orden Alba , Peris-Baquero Óscar
Published: May 2021

Emotional disorders are those that most commonly present comorbidly with medical conditions. The Unified Protocol for the Transdiagnostic Treatment of Emotional Disorders (UP), a cognitive-behavioral emotion-based intervention, has proven efficacy and versatility. The aim of this systematic review is to know the current (research studies) and future research interest (study protocols) in using the UP for the transdiagnostic treatment of emotional symptoms or disorders (EDs) in people with a medical condition. Using the PRISMA guidelines, a literature search was conducted in Web of Science, PubMed, Medline, and Dialnet. The nine research studies included in this review indicated that the UP is effective in treating emotional symptomatology in a population with a medical condition (effect sizes ranging from d = −3.34 to d = 2.16). The three included study protocols suggest interest in the future UP application to different medical conditions, and also in distinct application formats. Our review results are encouraging, and conducting more controlled studies is advised to recommend the UP to treat and/or prevent EDs in medical conditions, especially in children and youths.
Physical Activity Counseling among Adults in Primary Health Care Centers in Brazil
Authors: Santos Letícia Pechnicki dos , Silva Alice Tatiane da , Rech Cassiano Ricardo , Fermino Rogério César
Published: May 2021

Physical activity (PA) counseling by health professionals has promising results in behavior change. However, few studies have evaluated its prevalence in Primary Health Care in Latin American countries. This study aimed to describe the prevalence and analyze the associated factors of PA counseling in adults in Primary Health Care in Brazil. This is a cross-sectional study with a representative sample of 779 adults (70% women). Counseling was identified among those who reported having received PA counseling during a health professional consultation in the last 12 months. Sociodemographic factors, health conditions, and leisure-time PA were analyzed with Poisson regression. The prevalence of counseling was 43% (95% Confidence Interval [CI]: 39.5–46.4%), higher in people aged ≥40 years (Prevalence Ratio [PR]: 1.44; 95% CI: 1.19–1.75], who are married (PR: 1.27; 95% CI: 1.07–1.59), obese (PR: 1.53; 95% CI: 1.23–1.90), take prescription medication (PR: 1.83; 95% CI: 1.47–2.27), and walk for leisure (PR: 1.28; 95% CI: 1.06–1.54). People with more education were less likely to receive PA counseling (PR: 0.82; 95% CI: 0.68–0.99). In conclusion, 4 out of 10 users reported receiving PA counseling and this was associated with sociodemographic factors, health conditions, and walking for leisure. These results can guide PA promotion in Primary Health Care.
Promoting the Psychological Well-Being of Healthcare Providers Facing the Burden of Adverse Events: A Systematic Review of Second Victim Support Resources
Authors: Busch Isolde Martina , Moretti Francesca , Campagna Irene , Benoni Roberto , Tardivo Stefano , Wu Albert W. , Rimondini Michela
Published: May 2021

Given the negative impact of adverse events on the wellbeing of healthcare providers, easy access to psychological support is crucial. We aimed to describe the types of support resources available in healthcare organizations, their benefits for second victims, peer supporters’ experiences, and implementation challenges. We also explored how these resources incorporate aspects of Safety I and Safety II. We searched six databases up to 19 December 2019 and additional literature, including weekly search alerts until 21 January 2021. Two reviewers independently performed all methodological steps (search, selection, quality assessment, data extraction, formal narrative synthesis). The 16 included studies described 12 second victim support resources, implemented between 2006 and 2017. Preliminary data indicated beneficial effects not only for the affected staff but also for the peer responders who considered their role to be challenging but gratifying. Challenges during program implementation included persistent blame culture, limited awareness of program availability, and lack of financial resources. Common goals of the support programs (e.g., fostering coping strategies, promoting individual resilience) are consistent with Safety II and may promote system resilience. Investing in second victim support structures should be a top priority for healthcare institutions adopting a systemic approach to safety and striving for just culture.
The Effect of Weekly Training Load across a Competitive Microcycle on Contextual Variables in Professional Soccer
Authors: Chena Marcos , Morcillo José Alfonso , Rodríguez-Hernández María Luisa , Zapardiel Juan Carlos , Owen Adam , Lozano Demetrio
Published: May 2021

Analysis of the key performance variables in soccer is one of the most continuous and attractive research topics. Using global positioning devices (GPS), the primary aim of this study was to highlight the physiological response of a professional soccer team across competitive microcycles in-season according to the most influential contextual performance variables. Determining the training load (TL), a work ratio was established between all recorded data within the training sessions and the competitive profile (CP). Each microcycle was classified in accordance with the contextual variables: opponent level (high, medium, low), match location (home and away) and score (win, draw, lose). Results revealed that the team were significantly more successful (games won) in competitive games against high-level opponents and when played at home. Cumulative microcycle/weekly training load (WTL) was significantly lower when the team won. In addition to the opponent level and the match location, WTL could condition the athlete’s performance in the competition. Competitive performance responses are the main source of information for the planning of training programs. The results of this study could be used as a reference to structure TL and WTL according to contextual variables in the competition. This study, which is the first of its kind, revealed that WTL effects the performance of the players in the competition.
Editorial of Special Issue “Sirtuins in Health and Disease”
Authors: Sedej Simon , Bugger Heiko
Published: May 2021

The discovery and characterization of sirtuins as NAD+-dependent deacylases have transformed our understanding of post-translational protein regulation [...]
Acceleration of TAA-Induced Liver Fibrosis by Stress Exposure Is Associated with Upregulation of Nerve Growth Factor and Glycopattern Deviations
Authors: Atorrasagasti Catalina , Piccioni Flavia , Borowski Sophia , Tirado-González Irene , Freitag Nancy , Cantero María José , Bayo Juan , Mazzolini Guillermo , Alaniz Laura D. , Blois Sandra M. , Garcia Mariana G.
Published: May 2021

Liver fibrosis results from many chronic injuries and may often progress to cirrhosis and hepatocellular carcinoma (HCC). In fact, up to 90% of HCC arise in a cirrhotic liver. Conversely, stress is implicated in liver damage, worsening disease outcome. Hence, stress could play a role in disrupting liver homeostasis, a concept that has not been fully explored. Here, in a murine model of TAA-induced liver fibrosis we identified nerve growth factor (NGF) to be a crucial regulator of the stress-induced fibrogenesis signaling pathway as it activates its receptor p75 neurotrophin receptor (p75NTR), increasing liver damage. Additionally, blocking the NGF decreased liver fibrosis whereas treatment with recombinant NGF accelerated the fibrotic process to a similar extent than stress challenge. We further show that the fibrogenesis induced by stress is characterized by specific changes in the hepatoglycocode (increased β1,6GlcNAc-branched complex N-glycans and decreased core 1 O-glycans expression) which are also observed in patients with advanced fibrosis compared to patients with a low level of fibrosis. Our study facilitates an understanding of stress-induced liver injury and identify NGF signaling pathway in early stages of the disease, which contributes to the established fibrogenesis.