bluuebunny/crossref_metadata_2025 huggingface dataset:
Automation of Work Processes and Night Work
Authors: Kosem Urška , Markič Mirko , Gorenc Zoran Annmarie
Published: May 2021

Background: Automation of production processes is not just a simple replacement of a person in production, but it should lead to the success of an organization and contribute to the sustainable development of society and the natural environment. The aim of our study was to find out whether the level of automation of production processes affects the proportion of night work hours of production workers and whether employers are willing to automate production processes to achieve a lower number of night work hours. Methods: We used a quantitative approach to collect primary data through the survey method. The questionnaire was completed by 502 large and medium-sized manufacturing companies in Slovenia. Results: We found no statistically significant correlation between the level of automation of production processes and the percentage of night work hours of production workers. We also found that the reduction of the proportion of night work does not appear to be the main motivator for the introduction of automation of production processes. Conclusions: Based on the results, we rejected the assumption that automation of production processes has a direct impact on the proportion of night work. Moreover, our study will benefit all those who are concerned with the automation of production processes and night work.
COVID-19 Vaccine and Death: Causality Algorithm According to the WHO Eligibility Diagnosis
Authors: Pomara Cristoforo , Sessa Francesco , Ciaccio Marcello , Dieli Francesco , Esposito Massimiliano , Giammanco Giovanni Maurizio , Garozzo Sebastiano Fabio , Giarratano Antonino , Prati Daniele , Rappa Francesca , Salerno Monica , Tripodo Claudio , Mannucci Pier Mannuccio , Zamboni Paolo
Published: May 2021

The current challenge worldwide is the administration of anti-severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccines. Even if rarely, severe vascular adverse reactions temporally related to vaccine administration have induced diffidence in the population at large. In particular, researchers worldwide are focusing on the so-called “thrombosis and thrombocytopenia after COVID-19 vaccination”. This study aims to establish a practical workflow to define the relationship between adverse events following immunization (AEFI) and COVID-19 vaccination, following the basic framework of the World Health Organization (WHO). Post-mortem investigation plays a pivotal role to support this causality relationship when death occurs. To demonstrate the usefulness and feasibility of the proposed workflow, we applied it to two exemplificative cases of suspected AEFI following COVID-19 vaccination. Based on the proposed model, we took into consideration any possible causality relationship between COVID-19 vaccine administration and AEFI. This led us to conclude that vaccination with ChAdOx1 nCov-19 may cause the rare development of immune thrombocytopenia mediated by platelet-activating antibodies against platelet factor 4 (PF4), which clinically mimics heparin-induced autoimmune thrombocytopenia. We suggest the adoption of the proposed methodology in order to confirm or rule out a causal relationship between vaccination and the occurrence of AEFI.
Hepatocellular Carcinoma Drug-Eluting Bead Transarterial Chemoembolization (DEB-TACE): Outcome Analysis Using a Model Based On Pre-Treatment CT Texture Features
Authors: Tipaldi Marcello , Ronconi Edoardo , Lucertini Elena , Krokidis Miltiadis , Zerunian Marta , Polidori Tiziano , Begini Paola , Marignani Massimo , Mazzuca Federica , Caruso Damiano , Rossi Michele , Laghi Andrea
Published: May 2021

(1) Introduction and Aim: The aim of this study is to investigate the prognostic value, in terms of response and survival, of CT-based radiomics features for patients with HCC undergoing drug-eluting beads transarterial chemoembolization (DEB-TACE). (2) Materials and Methods: Pre-treatment CT examinations of 50 patients with HCC, treated with DEB-TACE were manually segmented to obtain the tumor volumetric region of interest, extracting radiomics features with TexRAD. Response to therapy evaluation was performed basing on post-procedural CT examination compared to pre-procedural CT, using modified RECIST criteria for HCC. The prognostic value of texture analysis was evaluated, investigating the correlation between radiomics features, response to therapy and overall survival. Three models based on texture and clinical variables and a combination of them were finally built; (3) Results: Entropy, skewness, MPP and kurtosis showed a significant correlation with complete response (CR) to TACE (all p < 0.001). A predictive model to identify patients with a high and low probability of CR was evaluated with an ROC curve, with an AUC of 0.733 (p < 0.001). The three models built for survival prediction yielded an HR of 2.19 (95% CI: 2.03–2.35) using texture features, of 1.7 (95% CI: 1.54–1.9) using clinical data and of 4.61 (95% CI: 4.24–5.01) combining both radiomics and clinical data (all p < 0.0001). (4) Conclusion: Texture analysis based on pre-treatment CT examination is associated with response to therapy and survival in patients with HCC undergoing DEB-TACE, especially if combined with clinical data.
Focal Pancreatic Lesions: Role of Contrast-Enhanced Ultrasonography
Authors: Bartolotta Tommaso Vincenzo , Randazzo Angelo , Bruno Eleonora , Alongi Pierpaolo , Taibbi Adele
Published: May 2021

The introduction of contrast-enhanced ultrasonography (CEUS) has led to a significant improvement in the diagnostic accuracy of ultrasound in the characterization of a pancreatic mass. CEUS, by using a blood pool contrast agent, can provide dynamic information concerning macro- and micro-circulation of focal lesions and of normal parenchyma, without the use of ionizing radiation. On the basis of personal experience and literature data, the purpose of this article is to describe and discuss CEUS imaging findings of the main solid and cystic pancreatic lesions with varying prevalence.
A Review of Unoccupied Aerial Vehicle Use in Wetland Applications: Emerging Opportunities in Approach, Technology, and Data
Authors: Dronova Iryna , Kislik Chippie , Dinh Zack , Kelly Maggi
Published: May 2021

Recent developments in technology and data processing for Unoccupied Aerial Vehicles (UAVs) have revolutionized the scope of ecosystem monitoring, providing novel pathways to fill the critical gap between limited-scope field surveys and limited-customization satellite and piloted aerial platforms. These advances are especially ground-breaking for supporting management, restoration, and conservation of landscapes with limited field access and vulnerable ecological systems, particularly wetlands. This study presents a scoping review of the current status and emerging opportunities in wetland UAV applications, with particular emphasis on ecosystem management goals and remaining research, technology, and data needs to even better support these goals in the future. Using 122 case studies from 29 countries, we discuss which wetland monitoring and management objectives are most served by this rapidly developing technology, and what workflows were employed to analyze these data. This review showcases many ways in which UAVs may help reduce or replace logistically demanding field surveys and can help improve the efficiency of UAV-based workflows to support longer-term monitoring in the face of wetland environmental challenges and management constraints. We also highlight several emerging trends in applications, technology, and data and offer insights into future needs.
Teaching Critical Vocabulary to Filipino Heritage Language Learners
Authors: Parba Jayson
Published: May 2021

Engaging in critical dialogues in language classrooms that draw on critical pedagogical perspectives can be challenging for learners because of gaps in communicative resources in their L1 and L2. Since critically oriented classrooms involve discussing social issues, students are expected to deploy “literate talk” to engage in critiquing society and a wide range of texts. Although recent studies have explored teachers’ and students’ engagement with critical materials and critical dialogues, research that explores language development in critical language teaching remains a concern for language teachers. In this paper, I share my experience of fostering language development, specifically the overt teaching of critical vocabulary to students of (Tagalog-based) Filipino language at a university in Hawai’i. Through a discussion of racist stereotypes targeting Filipinos and the impacts of these discourses on students’ lived experiences, the notion of “critical vocabulary” emerges as an important tool for students to articulate the presence of and to dismantle oppressive structures of power, including everyday discourses supporting the status quo. This paper defines critical vocabulary and advances its theoretical and practical contribution to critical language teaching. It also includes students’ perspectives of their language development and ends with pedagogical implications for heritage/world language teachers around the world.
Efficient Electrocatalytic Approach to Spiro[Furo[3,2-b]pyran-2,5′-pyrimidine] Scaffold as Inhibitor of Aldose Reductase
Authors: Elinson Michail N. , Vereshchagin Anatoly N. , Ryzhkova Yuliya E. , Ryzhkov Fedor V. , Fakhrutdinov Artem N. , Egorov Mikhail P.
Published: May 2021

A continuously growing interest in convenient and ‘green’ reaction techniques encourages organic chemists to elaborate on new synthetic methodologies. Nowadays, organic electrochemistry is a new useful method with important synthetic and ecological advantages. The employment of an electrocatalytic methodology in cascade reactions is very promising because it provides the combination of the synthetic virtues of the cascade strategy with the ecological benefits and convenience of electrocatalytic procedures. In this research, a new type of the electrocatalytic cascade transformation was found: the electrochemical cyclization of 1,3-dimethyl-5-[[3-hydroxy-6-(hydroxymethyl)-4-oxo-4H-pyran-2-yl](aryl)methyl]pyrimidine-2,4,6(1H,3H,5H)-triones was carried out in alcohols in an undivided cell in the presence of sodium halides with the selective formation of spiro[furo[3,2-b]pyran-2,5′-pyrimidines] in 59-95% yields. This new electrocatalytic process is a selective, facile, and efficient way to create spiro[furo[3,2-b]pyran-2,5′-pyrimidines], which are pharmacologically active heterocyclic systems with different biomedical applications. Spiro[furo[3,2-b]pyran-2,5′-pyrimidines] were found to occupy the binding pocket of aldose reductase and inhibit it. The values of the binding energy and Lead Finder’s Virtual Screening scoring function showed that the formation of protein–ligand complexes was favorable. The synthesized compounds are promising for the inhibition of aldose reductase. This makes them interesting for study in the treatment of diabetes or similar diseases.
Control of Optoelectronic Scanning and Tracking Seeker by Means the LQR Modified Method with the Input Signal Estimated Using of the Extended Kalman Filter
Authors: Gapiński Daniel , Koruba Zbigniew
Published: May 2021

The paper presents the concept of controlling the designed optoelectronic scanning and tracking seeker. The above device is intended for the so-called passive guidance of short-range anti-aircraft missiles to various types of air maneuvering targets. In the presented control method, the modified linear-quadratic regulator (LQR) and the estimation of input signals using the extended Kalman filter (EKF) were used. The LQR regulation utilizes linearization of the mathematical model of the above-mentioned seeker by means of the so-called Jacobians. What is more, in order to improve the stability of the seeker control, vector selection of signals received by the optoelectronic system was used, which also utilized EKF. The results of the research are presented in a graphical form. Numerical simulations were carried out on the basis of the author’s own program developed in the programming language C++.
Correction: Gaspari et al. A Simplified Algorithm to Predict Indoor Microclimate in Case of Courtyard Covering. A Case Study for the Courtyard of Palazzo Poggi in Bologna. Eng 2020, 1, 222–239
Authors: Gaspari Jacopo , Fabbri Kristian , Vodola Vincenzo , Ferretti Giorgia , Indio Lorenzo
Published: May 2021

The authors wish to make the following corrections to this paper [...]
Control of Heterobasidion in Norway Spruce Stands: The Impact of Stump Cover on Efficacy of Urea and Phlebiopsis gigantea and Implications for Forest Management
Authors: Zaluma Astra , Sherwood Patrick , Bruna Lauma , Skola Uvis , Gaitnieks Talis , Rönnberg Jonas
Published: May 2021

This study investigated the efficacy of Rotstop®, a native Latvian Phlebiopsis gigantea strain and 35% urea solution in combination with a stump cover treatment to control against natural spore infection by Heterobasidion spp. upon precommercial thinning of Norway spruce in three stands growing on former agricultural lands. The major findings were that (i) infection rates of Heterobasidion spp. on stumps treated with the native P. gigantea strain, Rotstop® or urea are similar when stumps are uncovered, and (ii) stump cover promotes stump colonization by the Latvian P. gigantea strain and Rotstop®, leading to a significantly smaller relative area colonized by Heterobasidion spp., as well greater efficiency against Heterobasidion in comparison with urea. Covering of stumps appears beneficial for controlling Heterobasidion stump colonization and may be valuable to forest owners if used in small-scale operations, but it is impractical in automatized thinnings, where managers should consider using regular Rotstop® without covering the stumps.
Potential Valorization of Hazelnut Shells through Extraction, Purification and Structural Characterization of Prebiotic Compounds: A Critical Review
Authors: Fuso Andrea , Risso Davide , Rosso Ginevra , Rosso Franco , Manini Federica , Manera Ileana , Caligiani Augusta
Published: May 2021

Hazelnuts are one of the most widely consumed nuts, but their production creates large quantities of by-products, especially shells, that could be upcycled into much more valuable products. Recent studies have shown that hazelnut shell hemicellulose is particularly rich in compounds that are potential precursors of xylooligosaccharides and arabino-xylooligosaccharides ((A)XOS), previously defined as emerging prebiotics very beneficial for human health. The production of these compounds on an industrial scale-up could have big consequences on the functional foods market. However, to produce (A)XOS from a lignocellulosic biomass, such as hazelnut shell, is not easy. Many methods for the extraction and the purification of these prebiotics have been developed, but they all have different efficiencies and consequences, including on the chemical structure of the obtained (A)XOS. The latter, in turn, is strongly correlated to the nutritional effects they have on health, which is why the optimization of the structural characterization process is also necessary. Therefore, this review aims to summarize the progress made by research in this field, so as to contribute to the exploitation of hazelnut waste streams through a circular economy approach, increasing the value of this biomass through the production of new functional ingredients.
Fat Tail in the Phytoplankton Movement Patterns and Swimming Behavior: New Insights into the Prey-Predator Interactions
Authors: Xiao Xi , Xu Caicai , Yu Yan , He Junyu , Li Ming , Cattani Carlo
Published: May 2021

Phytoplankton movement patterns and swimming behavior are important and basic topics in aquatic biology. Heavy tail distribution exists in diverse taxa and shows theoretical advantages in environments. The fat tails in the movement patterns and swimming behavior of phytoplankton in response to the food supply were studied. The log-normal distribution was used for fitting the probability density values of the movement data of Oxyrrhis marina. Results showed that obvious fat tails exist in the movement patterns of O. marina without and with positive stimulations of food supply. The algal cells tended to show a more chaotic and disorderly movement, with shorter and neat steps after adding the food source. At the same time, the randomness of turning rate, path curvature and swimming speed increased in O. marina cells with food supply. Generally, the responses of phytoplankton movement were stronger when supplied with direct prey cells rather than the cell-free filtrate. The scale-free random movements are considered to benefit the adaption of the entire phytoplankton population to varied environmental conditions. Inferentially, the movement pattern of O. marina should also have the characteristics of long-range dependence, local self-similarity and a system of fractional order.
Analytic Solution of the Langevin Differential Equations Dominated by a Multibrot Fractal Set
Authors: Ibrahim Rabha W. , Baleanu Dumitru
Published: May 2021

We present an analytic solvability of a class of Langevin differential equations (LDEs) in the asset of geometric function theory. The analytic solutions of the LDEs are presented by utilizing a special kind of fractal function in a complex domain, linked with the subordination theory. The fractal functions are suggested for the multi-parametric coefficients type motorboat fractal set. We obtain different formulas of fractal analytic solutions of LDEs. Moreover, we determine the maximum value of the fractal coefficients to obtain the optimal solution. Through the subordination inequality, we determined the upper boundary determination of a class of fractal functions holding multibrot function ϑ(z)=1+3κz+z3.
Identification of a Splice Variant (c.5074+3A>C) of BRCA1 by RNA Sequencing and TOPO Cloning
Authors: Hong Jinyoung , Kim Ji Hyun , Ahn Se Hee , Gu Hyunjung , Chang Suhwan , Lee Woochang , Kim Dae-Yeon , Chun Sail , Min Won-Ki
Published: May 2021

Grading the pathogenicity of BRCA1/2 variants has great clinical importance in patient treatment as well as in the prevention and screening of hereditary breast and ovarian cancer (HBOC). For accurate evaluation, confirming the splicing effect of a possible splice site variant is crucial. We report a significant splicing variant (c.5074+3A>C) in BRCA1 in a patient with recurrent ovarian cancer. Next-generation sequencing (NGS) of BRCA1/2 from patient’s peripheral blood identified the variant, which was strongly suspected of being a splicing mutation based on in silico predictions. Direct RNA analysis yielded multiple transcripts, and TOPO cloning of the complementary DNA (cDNA) and Sanger sequencing revealed an aberrant transcript with an insertion of the first 153 bp of intron 17, and another transcript with the 153 bp insertion along with an exon 18 deletion. A premature termination codon was presumed to be formed by the 153 bp partial intron retention common to the two transcripts. Therefore, BRCA1 c.5074+3A>C was classified as a likely pathogenic variant. Our findings show that active use of functional studies of variants suspected of altered splicing are of great help in classifying them.
Breast Milk and COVID-19: From Conventional Data to “Omics” Technologies to Investigate Changes Occurring in SARS-CoV-2 Positive Mothers
Authors: Bardanzellu Flaminia , Puddu Melania , Fanos Vassilios
Published: May 2021

In this context of COVID-19 pandemic, great interest has been aroused by the potential maternal transmission of SARS-CoV-2 by transplacental route, during delivery, and, subsequently, through breastfeeding. Some open questions still remain, especially regarding the possibility of finding viable SARS-CoV-2 in breast milk (BM), although this is not considered a worrying route of transmission. However, in BM, it was pointed out the presence of antibodies against SARS-CoV-2 and other bioactive components that could protect the infant from infection. The aim of our narrative review is to report and discuss the available literature on the detection of anti-SARS-CoV-2 antibodies in BM of COVID-19 positive mothers, and we discussed the unique existing study investigating BM of SARS-CoV-2 positive mothers through metabolomics, and the evidence regarding microbiomics BM variation in COVID-19. Moreover, we tried to correlate metabolomics and microbiomics findings in BM of positive mothers with potential effects on breastfed infants metabolism and health. To our knowledge, this is the first review summarizing the current knowledge on SARS-CoV-2 effects on BM, resuming both “conventional data” (antibodies) and “omics technologies” (metabolomics and microbiomics).
Impacts of Dual-Income Household Rate on Suicide Mortalities in Japan
Authors: Nakamoto Misaki , Nakagawa Takatoshi , Murata Masahiko , Okada Motohiro
Published: May 2021

To explore impact of enhancing social advancement of females in Japan, this study determined the effects of the dual-income household rate on suicide mortalities disaggregated by attributes of gender, age, and motives between 2009 and 2017 in Japan. This study analysed impact of dual-income household rate, other household-related factors (savings, liabilities and yearly incomes per household, minors and elderly rate per household), and social/employment factors (complete unemployment rate, employment rate, temporary male and female employment rates and certification rate of long-term care insurance) on suicide mortalities disaggregated by attributes of gender, age, and motives using hierarchical linear-regression model. Dual-income household rate was significantly/negatively related to suicide mortality of the working-age female population, but significantly/positively related to that of the elderly female population. Suicide mortalities of the working-age male population and the elderly male population were significantly/positively related to dual-income household rate. Male suicide mortalities caused by family-, health-, economy- and employment-related motives were significantly/positively related to dual-income household rate; however, the dual-income household rate was significantly/positively related to female suicide mortalities caused by family-, health-, economy- and school-related motives, but significantly/negatively related to suicide mortalities caused by romance-related motives. Dual-income households suppress social-isolation and develop economical/psychological independence of females, leading to reduced suicide mortality in working-age females. However, elderly and school-age populations, who are supported by the working-age female, suffer from isolation. Working-age males also suffer from inability to adapt from the traditional concept of work–life and work–family balances to the novel work–family balance concept adapted to dual-income households. These results suggest occurrence of new social/family problems in the 21st century due to vulnerability of traditional Japanese culture and life–working–family balance concepts as well as novel sociofamilial disturbances induced by declining birth rate and ageing population in Japan.
Options in Pregnancy to Increase ActiveLy Sitting (OPALS) Feasibility Study
Authors: Fazzi Caterina , Denison Fiona C. , Saunders David H. , Norman Jane E. , Reynolds Rebecca M.
Published: May 2021

Background. A negative association between obesity and pregnancy outcomes has been described, as well as between time sedentary and pregnancy outcomes. Most interventions based on physical activity involving obese pregnant women have failed in improving pregnancy outcomes. Exchanging time spent in sedentary activities with time spent in light-intensity activities, performed in a home-based setting, might help morbidly obese pregnant women. We aimed to assess the feasibility of an exercise intervention. Methods. An exercise intervention for morbidly obese pregnant women was designed involving morbidly obese pregnant women. Pregnant women with BMI ≥ 40 kg/m² with 20 or less weeks of gestation were invited to take part in the OPALS Feasibility Study. A home-based approach was employed. Participants were asked to perform the intervention for at least 12 weeks, and to register their performance in an activity diary. After the intervention, participants were asked to return the activity diary and answer a feasibility questionnaire. Results. In the intervention, 28 participants took part. Six women completed the intervention for 12 weeks or more. All declared they intended to keep on doing the intervention. All women reported that the exercises made them feel better. Conclusion. Empowering, and involving morbidly obese pregnant women in taking care of themselves and giving them realistic tasks to do on their own and around their environment helps to increase commitment, as does avoiding the effect of their own weight whilst exercising. A 20% of compliance was observed in this study, which might be explained by the difficulties that pregnancy and excess weight mean. Thus, for future studies, we suggest adding a supervision plan to increase that number.
Comparison of Muscle Strength, Aerobic Capacity and Body Composition between Healthy Adolescents and Those Living with HIV: A Systematic Review and Meta-Analysis
Authors: da Silva Cunha de Medeiros Rafaela Catherine , dos Santos Isis Kelly , de Oliveira Anna Luiza Vasconcelos , de Goes Carlos Jean Damasceno , de Medeiros Jason Azevedo , da Silva Tatiane Andreza Lima , de Souza Araujo Juliany , de Alcântara Varela Phelipe Wilde , Cobucci Ricardo Ney , de Araújo Tinoco Cabral Breno Guilherme , Dantas Paulo Moreira Silva
Published: May 2021

Background: The adverse effects of antiretroviral therapy associated with complications generated by human immunodeficiency virus (HIV) promote impairments in physical fitness in adolescents. Objective: To analyze the aerobic capacity, muscle strength, and body composition of adolescents living with HIV compared with a healthy population of the same age. Methods: Searches were performed in the MEDLINE, Embase, Web of Science, Scopus and SportDiscus databases until September 2019 and updated in April 2020. Eligibility Criteria: adolescents of both sexes in the age group from 10 to 19 years; living with HIV; cross-sectional, case–control, cohort studies; comparing with a healthy population. Mean differences and 95% Confidence intervals (CIs) were calculated using RevMan (software for systematic reviews). Results: Five articles were included, involving 197 adolescents living with HIV (16 to 18 years) and 185 without infection (13 to 18 years), with the sample in each study ranging from 15 to 65 adolescents. Aerobic capacity and muscle strength were reduced in adolescents with HIV, and body mass index was also significantly lower in this group. Conclusion: Adolescents living with HIV have impaired cardiorespiratory fitness, muscle strength, and body composition when compared to their uninfected peers. However, this systematic review provides limited evidence on the differences between the physical fitness outcomes of adolescents living with HIV compared to healthy adolescents.
Short Dental Implants (≤8.5 mm) versus Standard Dental Implants (≥10 mm): A One-Year Post-Loading Prospective Observational Study
Authors: Pardo-Zamora Guillermo , Ortiz-Ruíz Antonio José , Camacho-Alonso Fabio , Martínez-Marco José Francisco , Molina-González Juan Manuel , Piqué-Clusella Núria , Vicente-Hernández Ascensión
Published: May 2021

Background: Recent data have shown that short dental implants can be the preferred treatment in most of cases of posterior atrophic alveolar ridges, offering higher survival and lower complication rates than long implants. The survival rates, stability, and marginal bone level changes were compared between short implants (7 and 8.5 mm) and standard-length implants (≥10 mm). Methods: Prospective observational study in which adult patients requiring ≥1 osseointegrated implants to replace missing teeth were recruited consecutively. A clinical examination was performed on the day the definitive prosthesis was placed and after 6 and 12 months. Implant stability quotient (ISQ), marginal bone level (MBL) changes, and the correlation between these parameters and the characteristics of the implants were evaluated. Results: A total of 99 implants were inserted (47 short, 52 standard) in 74 patients. The 12-month survival rate was 100%. ISQ values showed a similar pattern for both types of implants. No correlation was found between ISQ changes after one year and MBL values, nor between the latter and the characteristics of the implants. Conclusions: With clinical treatment criteria, shorter implants (7 and 8.5 mm in length) can be just as useful as standard-length implants in atrophic alveolar ridges, demonstrating similar rates of survival, stability, and crestal bone loss.
An Agile Digital Platform to Support Population Health—A Case Study of a Digital Platform to Support Patients with Delirium Using IoT, NLP, and AI
Authors: Tanniru Mohan R. , Agarwal Nimit , Sokan Amanda , Hariri Salim
Published: May 2021

For an organization to be customer centric and service oriented requires that it use each encounter with a customer to create value, leverage advanced technologies to design digital services to fulfill the value, and assess perceived value-in-use to continue to revise the value as customer expectations evolve. The adaptation of value cycles to address the rapid changes in customer expectations requires agile digital platforms with dynamic software ecosystems interacting with multiple actors. For public health agencies focused on population health, these agile digital platforms should provide tailored care to address the distinct needs of select population groups. Using prior research on aging and dynamic software ecosystems, this paper develops a template for the design of an agile digital platform to support value cycle activities among clinical and non-clinical actors, including population groups. It illustrates the design of an agile digital platform to support clients that suffer from delirium, using digital services that leverage Internet of Things, natural language processing, and AI that uses real-time data for learning and care adaption. We conclude the paper with directions for future research.
Malaria Temporal Variation and Modelling Using Time-Series in Sussundenga District, Mozambique
Authors: Ferrão João L. , Earland Dominique , Novela Anísio , Mendes Roberto , Tungadza Alberto , Searle Kelly M.
Published: May 2021

Malaria is one of the leading causes of morbidity and mortality in Mozambique, which has the fifth highest prevalence in the world. Sussundenga District in Manica Province has documented high P. falciparum incidence at the local rural health center (RHC). This study’s objective was to analyze the P. falciparum temporal variation and model its pattern in Sussundenga District, Mozambique. Data from weekly epidemiological bulletins (BES) was collected from 2015 to 2019 and a time-series analysis was applied. For temporal modeling, a Box-Jenkins method was used with an autoregressive integrated moving average (ARIMA). Over the study period, 372,498 cases of P. falciparum were recorded in Sussundenga. There were weekly and yearly variations in incidence overall (p < 0.001). Children under five years had decreased malaria tendency, while patients over five years had an increased tendency. The ARIMA (2,2,1) (1,1,1) 52 model presented the least Root Mean Square being the most appropriate for forecasting. The goodness of fit was 68.15% for malaria patients less than five years old and 73.2% for malaria patients over five years old. The findings indicate that cases are decreasing among individuals less than five years and are increasing slightly in those older than five years. The P. falciparum case occurrence has a weekly temporal pattern peaking during the wet season. Based on the spatial and temporal distribution using ARIMA modelling, more efficient strategies that target this seasonality can be implemented to reduce the overall malaria burden in both Sussundenga District and regionally.
Advocacy, Hesitancy, and Equity: Exploring U.S. Race-Related Discussions of the COVID-19 Vaccine on Twitter
Authors: Criss Shaniece , Nguyen Thu T. , Norton Samantha , Virani Imaya , Titherington Eli , Tillmanns Emma Lou , Kinnane Courtney , Maiolo Gabrielle , Kirby Anne B. , Gee Gilbert C.
Published: May 2021

Background: Our study aimed to describe themes of tweets related to COVID-19 vaccines, race, and ethnicity to explore the context of the intersection of these topics on Twitter. Methods: We utilized Twitter’s Streaming Application Programming Interface (API) to collect a random 1% sample of publicly available tweets from October 2020 to January 2021. The study team conducted a qualitative content analysis from the full data set of 1110 tweets. Results: The tweets revealed vaccine support through vaccine affirmation, advocacy through reproach, a need for a vaccine, COVID-19 and racism, vaccine development and efficacy, racist vaccine humor, and news updates. Vaccine opposition was demonstrated through direct opposition, vaccine hesitancy, and adverse reactions. Conspiracy and misinformation included scientific misinformation, political misinformation, beliefs about immunity and protective behaviors, and race extermination conspiracy. Equity and access focused on overcoming history of medical racism, pointing out health disparities, and facilitators to vaccine access. Representation touted pride in development and role models, and politics discussed the role of politics in vaccines and international politics. Conclusion: Our analysis demonstrates that Twitter can provide nuances about multiple viewpoints on the vaccine related to race and ethnicity and can be beneficial in contributing to insights for public health messaging.
Short-Term Soil Flushing with Tannic Acid and Its Effect on Metal Mobilization and Selected Properties of Calcareous Soil
Authors: Gusiatin Zygmunt Mariusz , Kaal Joeri , Wasilewska Agnieszka , Kumpiene Jurate , Radziemska Maja
Published: May 2021

Cadmium, Cu, Ni, Pb, and Zn removal via soil flushing with tannic acid (TA) as a plant biosurfactant was studied. The soil was treated for 30 h in a column reactor at a constant TA concentration and pH (3%, pH 4) and at variable TA flow rates (0.5 mL/min or 1 mL/min). In the soil leachates, pH, electrical conductivity (EC), total dissolved organic carbon, and metal concentrations were monitored. Before and after flushing, soil pH, EC, organic matter content, and cation exchange capacity (CEC) were determined. To analyze the organic matter composition, pyrolysis as well as thermally assisted hydrolysis and methylation coupled with gas chromatography-mass spectrometry were used. Metal fractionation in unflushed and flushed soil was analyzed using a modified sequential extraction method. The data on cumulative metal removal were analyzed using OriginPro 8.0 software (OriginLab Corporation, Northampton, MA, USA) and were fitted to 4-parameter logistic sigmoidal model. It was found that flushing time had a stronger influence on metal removal than flow rate. The overall efficiency of metal removal (expressed as the ratio between flushed metal concentration and total metal concentration in soil) at the higher flow rate decreased in this order: Cd (86%) > Ni (44%) > Cu (29%) ≈ Zn (26%) > Pb (15%). Metals were removed from the exchangeable fraction and redistributed into the reducible fraction. After flushing, the soil had a lower pH, EC, and CEC; a higher organic matter content; the composition of the organic matter had changed (incorporation of TA structures). Our results prove that soil flushing with TA is a promising approach to decrease metal concentration in soil and to facilitate carbon sequestration in soil.
“It’s Like Juggling, Constantly Trying to Keep All Balls in the Air”: A Qualitative Study of the Support Needs of Working Caregivers Taking Care of Older Adults
Authors: Vos Eline E. , de Bruin Simone R. , van der Beek Allard J. , Proper Karin I.
Published: May 2021

Many informal caregivers of older adults combine their caregiving tasks with a paid job. Adequate support is important to enable them to combine paid work with caregiving, while maintaining their health and wellbeing. To date, however, knowledge about working caregivers’ support needs is fragmented. This study, therefore, aimed to obtain more insight into the support needs of working caregivers of older adults. We conducted six online semi-structured focus group interviews with in total 25 working caregivers of older adults living at home. Data were complemented with information from seven working caregivers participating in the study’s advisory board. Data were analyzed using inductive and deductive thematic analysis. Six themes related to working caregivers’ needs were identified: (1) Recognition of caregivers, including the challenges they face; (2) Attention for caregivers’ health, wellbeing and ability to cope; (3) Opportunities to share care responsibilities; (4) Help with finding and arranging care and support; (5) Understanding and support from the work environment; (6) Technological support tailored to the needs and capacities of caregivers and older adults. To address these needs, working caregivers suggested several options in multiple domains of life (i.e., work, home and social life, care environment, personal health and wellbeing). To successfully support them, a multi-faceted effort, involving actors from multiple settings, is needed.
Influence of Ideational Praxis on the Development of Play and Adaptive Behavior of Children with Autism Spectrum Disorder: A Comparative Analysis
Authors: Serrada-Tejeda Sergio , Santos-del-Riego Sergio , May-Benson Teresa A. , Pérez-de-Heredia-Torres Marta
Published: May 2021

Background: Traditionally, assessment of praxis skills in children with ASD has focused on the evaluation of aspects related to the planning and execution of actions. This study aimed to evaluate the ideational abilities of children with ASD and analyze possible relationships with the development of play and adaptive behaviors. Methods: 40 children between 4 to 6 years (TD = 20; ASD = 20) were evaluated with the Test of Ideational Praxis, the Revised Knox Preschool Play Scale, and the Adaptive Behavior Assessment System II. Results: Statistically significant relationships were obtained between ideational praxis and play skills development (r = 0.649; p = 0.01), adaptive leisure behavior (r = 0.338; p = 0.04) and social adaptive behavior (r = 0.319; p = 0.04). Results of multiple linear regression models found a linear relationship between ideational praxis and play development (p = 0.005) and adaptive leisure skills (p = 0.004), but not with social interaction skills (p > 0.05). Conclusions: Objective evaluation with a specific ideational praxis assessment facilitates understanding of the ideational abilities and widens understanding of praxis skills and their impact on play and adaptive behaviors in children with ASD.
Healthcare Utilization in Different Stages among Patients with Dementia: A Nationwide Population-Based Study
Authors: Chen Yu-Han , Lai Yi-Chen , Wu Yu-Cih , Sasaki Jun , Tsai Kang-Ting , Ho Chung-Han
Published: May 2021

To evaluate the trend of healthcare utilization among patients with dementia (PwD) in different post-diagnosis periods, Taiwan’s nationwide population database was used in this study. PwD were identified on the basis of dementia diagnoses during 2002–2011. We further subdivided the cases into 10 groups from the index year to the 10th year after diagnosis. The frequency of emergency department visits and hospitalizations, the length of stay, outpatient and department visits, and the number of medications used were retrieved. The Joinpoint regression approach was used to estimate the annual percent change (APC) of healthcare utilization. The overall trend of healthcare utilization increased with the progression of dementia, with a significant APC during the first to second year after diagnosis (p < 0.01), except that the frequency of outpatient visits showed a decreasing trend with a significant APC from the first to fifth year. All sex- and age-stratified analyses revealed that male gender and old age contributed to greater use of healthcare services but did not change the overall trend. This study provides a better understanding of medical resource utilization across the full spectrum of dementia, which can allow policymakers, physicians, and caregivers to devise better care plans for PwD.
Implementation of COVID-19 Infection Control Measures by German Dentists: A Qualitative Study to Identify Enablers and Barriers
Authors: Müller Anne , Melzow Florentina Sophie , Göstemeyer Gerd , Paris Sebastian , Schwendicke Falk
Published: May 2021

Objectives: COVID-19 infection control measures have been recommended for dental practices worldwide. This qualitative study explored barriers and enablers for the implementation of these measures in German dental practices. Methods: Semi-structured phone interviews were conducted in November/December 2020 (purposive/snowball sampling). The Theoretical Domains Framework (TDF) and the Capabilities, Opportunities and Motivations influencing Behaviors model (COM-B) were used to guide interviews. Mayring’s content analysis was employed to analyze interviews. Results: All dentists (28–71 years, 4/8 female/male) had implemented infection control measures. Measures most frequently not adopted were FFP2 masks, face shields (impractical), the rotation of teams (insufficient staffing) and the avoidance of aerosol-generating treatments. Dentists with personal COVID-19 experience or those seeing themselves as a role model were more eager to adopt measures. We identified 34 enablers and 20 barriers. Major barriers were the lack of knowledge, guidelines and recommendations as well as limited availability and high costs of equipment. Pressure by staff and patients to ensure infection control was an enabler. Conclusions: Dentists are motivated to implement infection control measures, but lacking opportunities limited the adoption of certain measures. Policy makers and equipment manufacturers should address these points to increase the implementation of infection control measures against COVID-19 and potential future pandemics.
The Experience of Clinical Nurses after Korea’s Enactment of Workplace Anti-Bullying Legislation: A Phenomenological Study
Authors: Kim Hee-Sun , Sim In-Ok
Published: May 2021

Workplace bullying is a global issue that has emerged over the past decades and is widespread all around the world. In Korea, there is a high prevalence of bullying in nursing. In 2019, Korea enacted its workplace anti-bullying legislation. This study explores the changes experienced by nurses after the enactment of the legislation and identifies problems and improvements. Qualitative research was conducted using the phenomenological analysis method proposed by Van Kaam. Twelve nurses with experience in working before and after the enactment of the legislation were selected as study participants. They worked in various departments in five general hospitals across Korea. Purposive sampling was used to recruit participants. Data were collected using one-on-one interviews. These data were analyzed by extracting significant statements and classifying them into categories, themes, and subthemes. The analysis yielded 14 subthemes, five themes, and three categories. The three categories were “positive effect of the law”, “need for awareness of the law reform”, and “impracticalities of the law that caused chaos”. There is a difference between the theory of the law and how things happen in practice in actual nursing situations. Nurses have been educated about the new law, but better education with input from nurses themselves is needed. This study lays the groundwork for a quantitative study of the issue.
Matrix-Based Formulation of Heterogeneous Individual-Based Models of Infectious Diseases: Using SARS Epidemic as a Case Study
Authors: Duan Wei
Published: May 2021

Heterogeneities of individual attributes and behaviors play an important role in the complex process of epidemic spreading. Compared to differential equation-based system dynamical models of infectious disease transmission, individual-based epidemic models exhibit the advantage of providing a more detailed description of realities to capture heterogeneities across a population. However, the higher granularity and resolution of individual-based epidemic models comes with the cost of increased computational complexities, which result in difficulty in formulating individual-based epidemic models with mathematics. Furthermore, it requires great effort to understand and reproduce existing individual-based epidemic models presented by previous researchers. We proposed a mathematical formulation of heterogeneous individual-based epidemic models using matrices. Matrices and vectors were applied to represent individual attributes and behaviors. We derived analytical results from the matrix-based formulations of individual epidemic models, and then designed algorithms to force the computation of matrix-based individual epidemic models. Finally, we used a SARS epidemic control as a case study to verify the matrix-based formulation of heterogeneous individual-based epidemic models.
Is the Travel Bubble under COVID-19 a Feasible Idea or Not?
Authors: Yu Jo-Hung , Lin Hsiao-Hsien , Lo Yu-Chih , Tseng Kuan-Chieh , Hsu Chin-Hsien
Published: May 2021

The present study aimed to understand Taiwanese people’s willingness to participate in the travel bubble policy. A mixed research method was used to collect 560 questionnaires, and SPSS 22.0 software was used for the statistical validation and Pearson’s performance correlation analysis. Expert opinions were collected and the results were validated using multivariate analysis. Findings: People were aware of the seriousness of the virus and the preventive measures but were not afraid of the threat of infection. They looked forward to traveling to heighten their enthusiasm, relieve stress, and soothe their emotions. However, the infection and death rates have been high, there have been various routes of infection, and it has been difficult to identify the symptoms. The complex backgrounds of people coming in and out of airports, hotels and restaurants may create pressure on the participants of events. In addition, the flawed policies and high prices resulted in a loss of confidence in the policies and a wait-and-see attitude toward tourism activities. Thus, travel decisions (0.634), physical and mental health assessment (0.716), and environmental risk (−0.130) were significantly (p < 0.05) related to travel intentions, and different issues were affected to different degrees, while health beliefs had no significant effect (p > 0.05).