bluuebunny/crossref_metadata_2025 huggingface dataset:
Sparsity Increases Uncertainty Estimation in Deep Ensemble
Authors: Dorjsembe Uyanga , Lee Ju Hong , Choi Bumghi , Song Jae Won
Published: April 2021

Deep neural networks have achieved almost human-level results in various tasks and have become popular in the broad artificial intelligence domains. Uncertainty estimation is an on-demand task caused by the black-box point estimation behavior of deep learning. The deep ensemble provides increased accuracy and estimated uncertainty; however, linearly increasing the size makes the deep ensemble unfeasible for memory-intensive tasks. To address this problem, we used model pruning and quantization with a deep ensemble and analyzed the effect in the context of uncertainty metrics. We empirically showed that the ensemble members’ disagreement increases with pruning, making models sparser by zeroing irrelevant parameters. Increased disagreement im-plies increased uncertainty, which helps in making more robust predictions. Accordingly, an energy-efficient compressed deep ensemble is appropriate for memory-intensive and uncertainty-aware tasks.
Preparation and Investigation of Pd and Bimetallic Pd-Sn Nanocrystals on γ-Al2O3
Authors: Bondarchuk Ivan , Cadete Santos Aires Francisco José , Mamontov Grigoriy , Kurzina Irina
Published: April 2021

One of the key factors for producing highly dispersed controlled nanoparticles is the method used for metal deposition. The decomposition of metal-organic precursors is a good method for deposition of metal nanoparticles with very small sizes and narrow size distributions on the surface of various supports. The preparation process of Pd and bimetallic Pd-Sn nanoparticles supported onto γ-Al2O3 is considered. The samples were prepared by diffusional co-impregnation of the γ-Al2O3 support by using organometallic Pd(acac)2 and Sn(acac)2Cl2 precursors. To achieve the formation of Pd and bimetallic Pd-Sn nanoparticles on the support surface, the synthesized samples were then subjected to thermal decomposition under Ar (to decompose the organometallic bound to the surface while keeping the formed nanoparticles small) followed by an oxidation in O2 (to eliminate the organic compounds remaining on the surface) and a reduction in H2 (to reduce the nanoparticles oxidized during the previous step). A combination of methods (ICP-OES, TPR-H2, XPS, TEM/EDX) was used to compare the physical-chemical properties of the synthesized Pd and bimetallic Pd-Sn nanoparticles supported on the γ-Al2O3. The three samples exhibit narrow size distribution with a majority on nanoparticles between 3 and 5 nm. Local EDX measurements clearly showed that the nanoparticles are bimetallic with the expected chemical composition and the measured global composition by ICP-OES. The surface composition and electronic properties of Pd and Sn on the γ-Al2O3 support were investigated by XPS, in particular the chemical state of palladium and tin after each step of thermal decomposition treatments (oxidation, reduction) by the XPS method has been carried out. The reducibility of the prepared bimetallic nanoparticles was measured by hydrogen temperature programmed reduction (TPR-H2). The temperature programmed reduction TPR-H2 experiments have confirmed the existence of strong surface interactions between Pd and Sn, as evidenced by hydrogen spillover of Pd to Sn (Pd-assisted reduction of oxygen precovered Sn). These results lead us to propose a mechanism for the formation of the bimetallic nanoparticles.
Efficiently Classifying Lung Sounds through Depthwise Separable CNN Models with Fused STFT and MFCC Features
Authors: Jung Shing-Yun , Liao Chia-Hung , Wu Yu-Sheng , Yuan Shyan-Ming , Sun Chuen-Tsai
Published: April 2021

Lung sounds remain vital in clinical diagnosis as they reveal associations with pulmonary pathologies. With COVID-19 spreading across the world, it has become more pressing for medical professionals to better leverage artificial intelligence for faster and more accurate lung auscultation. This research aims to propose a feature engineering process that extracts the dedicated features for the depthwise separable convolution neural network (DS-CNN) to classify lung sounds accurately and efficiently. We extracted a total of three features for the shrunk DS-CNN model: the short-time Fourier-transformed (STFT) feature, the Mel-frequency cepstrum coefficient (MFCC) feature, and the fused features of these two. We observed that while DS-CNN models trained on either the STFT or the MFCC feature achieved an accuracy of 82.27% and 73.02%, respectively, fusing both features led to a higher accuracy of 85.74%. In addition, our method achieved 16 times higher inference speed on an edge device and only 0.45% less accuracy than RespireNet. This finding indicates that the fusion of the STFT and MFCC features and DS-CNN would be a model design for lightweight edge devices to achieve accurate AI-aided detection of lung diseases.
Pediatric Abusive Head Trauma: A Systematic Review
Authors: Maiese Aniello , Iannaccone Francesca , Scatena Andrea , Del Fante Zoe , Oliva Antonio , Frati Paola , Fineschi Vittorio
Published: April 2021

Abusive head trauma (AHT) represents a commonly misdiagnosed condition. In fact, there is no pathognomonic sign that allows the diagnosis in children. Therefore, it is such an important medico-legal challenge to evaluate reliable diagnostic tools. The aim of this review is to evaluate the current scientific evidence to assess what the best practice is in order to diagnose AHT. We have focused particularly on evaluating the importance of circumstantial evidence, clinical history, the use of postmortem radiological examinations (such as CT and MRI), and the performance of the autopsy. After autopsy, histological examination of the eye and brain play an important role, with attention paid to correlation with symptoms found in vivo.
Role of Ranolazine in the Prevention and Treatment of Atrial Fibrillation in Patients with Left Ventricular Systolic Dysfunction: A Meta-Analysis of Randomized Clinical Trials
Authors: Leelapatana Pattranee , Thongprayoon Charat , Prasitlumkum Narut , Vallabhajosyula Saraschandra , Cheungpasitporn Wisit , Chokesuwattanaskul Ronpichai
Published: April 2021

Background: Ranolazine has the potential to prevent atrial fibrillation (AF) and plays a role in rhythm control strategy for atrial fibrillation in various clinical settings. However, data on the use of ranolazine in patients with left ventricular (LV) systolic dysfunction are limited. The aims of this meta-analysis of randomized clinical trials are to investigate the efficacy and safety of ranolazine in AF patients with LV systolic dysfunction. PubMed and the Cochrane Database of Systematic Reviews were searched until July 2020. The efficacy outcomes included the incidence of new-onset AF, the rate of sinus rhythm restoration, and the time until sinus rhythm restoration. Safety endpoints were at death, and any adverse events were reported in the enrolled studies. We initially identified 204 studies and finally retrieved 5 RCTs. Three studies were analyzed in the meta-analysis. Among AF patients with LV systolic dysfunction, our meta-analysis showed that the combination of ranolazine to amiodarone significantly increased the sinus rhythm restoration rate compared to amiodarone alone (risk ratio (RR) 2.87, 95% confidence interval (CI) 2.48–3.32). Moreover, the time to sinus rhythm restoration was 2.46 h shorter in the ranolazine added to amiodarone group (95% CI: 2.27–2.64). No significant adverse events and proarrhythmias in the ranolazine group were identified. In conclusion, in AF patients with LV systolic dysfunction, ranolazine as an add-on therapy to amiodarone potentiates and accelerates the conversion of AF to sinus rhythm. Moreover, ranolazine shows good safety profiles. Further studies to investigate the effectiveness of ranolazine in the prevention of new-onset AF among patients with LV systolic dysfunction are needed.
Assessing the Potential of Remotely-Sensed Drone Spectroscopy to Determine Live Coral Cover on Heron Reef
Authors: Cornet Valerie J. , Joyce Karen E.
Published: April 2021

Coral reefs, as biologically diverse ecosystems, hold significant ecological and economic value. With increased threats imposed on them, it is increasingly important to monitor reef health by developing accessible methods to quantify coral cover. Discriminating between substrate types has previously been achieved with in situ spectroscopy but has not been tested using drones. In this study, we test the ability of using point-based drone spectroscopy to determine substrate cover through spectral unmixing on a portion of Heron Reef, Australia. A spectral mixture analysis was conducted to separate the components contributing to spectral signatures obtained across the reef. The pure spectra used to unmix measured data include live coral, algae, sand, and rock, obtained from a public spectral library. These were able to account for over 82% of the spectral mixing captured in each spectroscopy measurement, highlighting the benefits of using a public database. The unmixing results were then compared to a categorical classification on an overlapping mosaicked drone image but yielded inconclusive results due to challenges in co-registration. This study uniquely showcases the potential of using commercial-grade drones and point spectroscopy in mapping complex environments. This can pave the way for future research, by increasing access to repeatable, effective, and affordable technology.
Research on Dynamic Evolution Model and Method of Communication Network Based on Real War Game
Authors: Lu Tongliang , Chen Kai , Zhang Yan , Deng Qiling
Published: April 2021

Based on the data in real combat games, the combat System-of-Systems is usually composed of a large number of armed equipment platforms (or systems) and a reasonable communication network to connect mutually independent weapons and equipment platforms to achieve tasks such as information collection, sharing, and collaborative processing. However, the generation algorithm of the combat system in the existing research is too simple and not suitable for reality. To overcome this problem, this paper proposes a communication network generation algorithm by adopting the joint distribution strategy of power law distribution and Poisson distribution to model the communication network. The simulation method is used to study the operation under continuous attack on communication nodes. The comprehensive experimental results of the dynamic evolution of the combat network in the battle scene verify the rationality and effectiveness of the communication network construction.
Improving Emission Uniformity of InGaN/GaN-Based Vertical LEDs by Using Reflective ITO/Ag n-Contact
Authors: Yum Woong-Sun , Koo Ji-Hyun , Lee Dae-Hee , Kim Young-Hoon , Jeong Young-Kyu , Jung Se-Yeon , Lee Sang-Youl , Jeong Hwan-Hee , Seong Tae-Yeon
Published: April 2021

We investigated the effect of Ti/Al and ITO/Ag n-type contacts on the emission uniformity and light output of different chip-size vertical-geometry light-emitting diodes (VLEDs) for vehicle headlamp application. The forward voltage of the Ti/Al-based reference VLEDs decreased from 3.38 to 3.20 V at 1500 mA with increasing chip size from (1280 × 1000 µm2) to (1700 × 1700 µm2), whereas that of the ITO/Ag-based samples changed from 3.37 to 3.15 V. Regardless of chip size, the ITO/Ag-based samples revealed higher light output power than the reference samples. For example, the ITO/Ag-based samples (chip size of 1700 × 1700 µm2) exhibited 3.4% higher light output power at 1500 mA than the reference samples. The ITO/Ag samples underwent less degradation in the Wall-plug efficiency (WPE) than the reference sample. For instance, the ITO/Ag-based samples (1700 × 1700 µm2) gave 4.8% higher WPE at 1500 mA than the reference samples. The ITO/Ag-based samples illustrated more uniform emission than the Ti/Al-based sample. Both the reference and ITO/Ag-based samples underwent no degradation when operated at 1500 mA for 1000 h.
Assessing the Effectiveness of the Energy Storage Rule-Based Control in Reducing the Power Flow Uncertainties Caused by Distributed Photovoltaic Systems
Authors: Pasetti Marco
Published: April 2021

Battery energy storage systems (BESSs) are increasingly adopted to mitigate the negative effects caused by the intermittent generation of photovoltaic (PV) systems. The majority of commercial BESSs implement the self-consumption, rule-based approach, which aims at storing the excess of PV production, and then reusing it when the power demand of the loads exceeds the PV power generation. Even though this approach proved to be a valid solution to increase the self-consumption of distributed generators, its ability to reduce the power flow uncertainties caused by PV systems is still debatable. To fill this gap, this study aims at answering this question by proposing a dedicated set of key performance indicators (KPIs). These KPIs are used to evaluate the performance of a 13.8 kWp/25.2 kWh Lithium-Ion BESS coupled with a 64 kWp PV system. The results of the study revealed that the impact of the storage system had almost negligible effects on the uncertainty of the net power flows, while showing better results in terms of the reduction of the absolute power ramps, particularly during the BESS charge stages. These results represent an interesting point of discussion by suggesting that different storage control approaches should be investigated.
The Effects of Ultra-Low Viscosity Engine Oil on Mechanical Efficiency and Fuel Economy
Authors: Zhang Yanyan , Ma Ziyuan , Feng Yan , Diao Ziyu , Liu Zhentao
Published: April 2021

The development of a sustainable powertrain requires improved thermal efficiency. Reducing frictional power losses through the use of ultra-low viscosity oil is one of the most effective and economical ways. To assess the potential for efficiency enhancement in a new generation of future engines using low-viscosity oils, a technical analysis was conducted based on numerical simulation and theoretical analysis. This study proposes a numerical method coupling the whole multi-dynamics model and lubrication model under mixed lubrication regimes. Then, load distribution was calculated numerically and verified experimentally. Finally, this paper compares the bearing load and frictional energy loss of the main bearings when using The Society of Automotive Engineers (SAE) 15W40 and SAE 0W20 oil. The results indicate that the application of ultralow-viscosity lubricant can reduce the hydraulic friction loss up to 24%, but the asperity friction loss would increase due to the reduction in load capacity. As a result, the design of a new generation of high efficiency internal combustion engines requires careful calculation and design to balance the trade-off relations between hydraulic friction and asperity friction.
Experimental Validation of the Thermal Processes Modeling in a Solar Still
Authors: Radomska Ewelina , Mika Lukasz , Sztekler Karol , Kalawa Wojciech
Published: April 2021

Passive solar distillation is cheap and energy-efficient technology but its main disadvantage is low productivity. Thus, there are many attempts to improve solar stills’ productivity, and one of them is changing the mass of the water. This paper presents the results of validation of the thermal processes modeling in a solar still (SS). In order to validate the model, the experimental studies were conducted in a laboratory to ensure uniform climatic conditions. The studies were carried out for 10 kg, 15 kg, and 20 kg of water under three different solar irradiance conditions. The results show that 10 kg and 20 kg of water ensure the highest and the lowest daily productivity, respectively, independently of solar irradiance. When the water mass is 10 kg, the solar still’s productivity is 800 mL/m2/day, 3732 mL/m2/day, and 9392 mL/m2/day for low, medium, and high solar irradiance, respectively. Additionally, it is found that reducing the water mass from 20 kg to 10 kg can improve solar still’s productivity by a maximum value of 21.6%, which is obtained for low solar irradiance. The proposed mathematical model allows predicting the performance of the SS. The results of the theoretical calculations are in good agreement with the results of the experiments. The minimum and maximum deviation between the actual and theoretical productivity of the SS is 1.1% and 8.3%, respectively.
Identification of Efficient Sampling Techniques for Probabilistic Voltage Stability Analysis of Renewable-Rich Power Systems
Authors: Alzubaidi Mohammed , Hasan Kazi N. , Meegahapola Lasantha , Rahman Mir Toufikur
Published: April 2021

This paper presents a comparative analysis of six sampling techniques to identify an efficient and accurate sampling technique to be applied to probabilistic voltage stability assessment in large-scale power systems. In this study, six different sampling techniques are investigated and compared to each other in terms of their accuracy and efficiency, including Monte Carlo (MC), three versions of Quasi-Monte Carlo (QMC), i.e., Sobol, Halton, and Latin Hypercube, Markov Chain MC (MCMC), and importance sampling (IS) technique, to evaluate their suitability for application with probabilistic voltage stability analysis in large-scale uncertain power systems. The coefficient of determination (R2) and root mean square error (RMSE) are calculated to measure the accuracy and the efficiency of the sampling techniques compared to each other. All the six sampling techniques provide more than 99% accuracy by producing a large number of wind speed random samples (8760 samples). In terms of efficiency, on the other hand, the three versions of QMC are the most efficient sampling techniques, providing more than 96% accuracy with only a small number of generated samples (150 samples) compared to other techniques.
Pervasive Intelligent Models to Predict the Outcome of COVID-19 Patients
Authors: Ferreira Ana Teresa , Fernandes Carlos , Vieira José , Portela Filipe
Published: April 2021

Nowadays, there is an increasing need to understand the behavior of COVID-19. After the Directorate-General of Health of Portugal made available the infected patient’s data, it became possible to analyze it and gather some conclusions, obtaining a better understanding of the matter. In this context, the project developed—ioCOVID19—Intelligent Decision Support Platform aims to identify patterns and develop intelligent models to predict and support clinical decisions. This article explores which typologies are associated with different outcomes to help clinicians fight the virus with a decision support system. So, to achieve this purpose, classification algorithms were used, and one target was studied—Patients outcome, that is, to predict if the patient will die or recover. Regarding the obtained results, the model that stood out is composed of scenario s4 (composed of all comorbidities, symptoms, and age), the decision tree algorithm, and the oversampling sampling method. The obtained results by the studied metrics were (in order of importance): Sensitivity of 95.20%, Accuracy of 90.67%, and Specificity of 86.08%. The models were deployed as a service, and they are part of a clinical decision support system that is available for authorized users anywhere and anytime.
The Potential Role of Probiotics in Protection against Influenza a Virus Infection in Mice
Authors: Lu Wenwei , Fang Zhifeng , Liu Xinyang , Li Lingzhi , Zhang Pinghu , Zhao Jianxin , Zhang Hao , Chen Wei
Published: April 2021

Influenza A virus induces severe respiratory tract infection and results in a serious global health problem. Influenza infection disturbs the cross-talk connection between lung and gut. Probiotic treatment can inhibit influenza virus infection; however, the mechanism remains to be explored. The mice received Lactobacillus mucosae 1025, Bifidobacterium breve CCFM1026, and their mixture MIX for 19 days. Effects of probiotics on clinical symptoms, immune responses, and gut microbial alteration were evaluated. L. mucosae 1025 and MIX significantly reduced the loss of body weight, pathological symptoms, and viral loading. B. breve CCFM1026 significantly reduced the proportion of neutrophils and increased lymphocytes, the expressions of TLR7, MyD88, TRAF6, and TNF-α to restore the immune disorders. MIX increased the antiviral protein MxA expression, the relative abundances of Lactobacillus, Mucispirillum, Adlercreutzia, Bifidobacterium, and further regulated SCFA metabolism resulting in an enhancement of butyrate. The correlation analysis revealed that the butyrate was positively related to MxA expression (p < 0.001) but was negatively related to viral loading (p < 0.05). The results implied the possible antiviral mechanisms that MIX decreased viral loading and increased the antiviral protein MxA expression, which was closely associated with the increased butyrate production resulting from gut microbial alteration.
PACE Labels on Healthy and Unhealthy Snack Products in a Laboratory Shopping Setting: Perception, Visual Attention, and Product Choice
Authors: Mehlhose Clara , Schmitt Daniel , Risius Antje
Published: April 2021

Informative food labels are one way to increase nutritional awareness in society and can essentially help individuals maintain balanced dietary practices. Nonetheless, making food labels ‘informative’, in the sense of applicability, is not always easy. Physical activity calorie equivalent (PACE) food labeling is one approach to achieve this goal. Yet, it is neither understood how consumers perceive PACE labels, nor how effective they are in regards to healthy food choices. Moreover, it is of interest to assess the perception of real products in close-to-realistic environments. Therefore, this study examined a simulated purchase situation and consumers’ visual attention on PACE labels—on 20 different real snack products with varying health values. In a laboratory-shopping environment, the gaze behaviors of 91 consumers were examined with a head-mounted eye-tracker. In regards to perception, it was elucidated that every participant noticed at least one PACE label. On average 1.39 PACE label fixations on different products were counted with a mean fixation duration of 0.55 s and a mean time to first fixation of 22.46 s. On average, 22.9% of the participants viewed the PACE labels at least once, but the intensity and duration varied greatly between the different products; ’healthier products’ attracted more visual attention than ‘unhealthier products’. In regards to health choice, it became obvious that the choices observed were rather healthy and PACE labels attracted attention. This may have been especially true for participants with little involvement in physical activity and health behavior, which may have been the main target group. Hence, catchy, communicable PACE labels, as well as balanced product offerings may facilitate more healthy food choices. The real-world laboratory setting offered valuable insights, which should be followed-up on.
Ancient and Modern Cereals as Ingredients of the Gluten-Free Diet: Are They Safe Enough for Celiac Consumers?
Authors: Colombo Francesca , Di Lorenzo Chiara , Biella Simone , Bani Corinne , Restani Patrizia
Published: April 2021

Celiac disease is an autoimmune disorder that occurs in genetically predisposed individuals after consuming prolamins from some cereals. Although the products available for celiac subjects have increased significantly in quality and quantity over the last few decades, research still focuses on identifying new ingredients to improve the nutritional, sensorial and functional qualities of gluten-free products. In terms of toxicity for people with celiac disease, there is a wide variability between ancient and modern grains. The most contradictory results are related to the role of oats in the gluten-free diet. In order to clarify the role of minor cereals (such as oat) and ancient grains in the diets of celiac patients, this review discusses recent in vitro and in vivo studies performed on those cereals for which the toxicity for celiac subjects is still controversial. According to in vivo studies, selected oat varieties could be tolerated by celiac patients. On the other hands, although some wheat-ancient grains (Triticum monococcum, Triticum aestivum ssp. spelta and Kamut®) showed a reduced in vitro toxicity, to date, these grains are still considered toxic for celiac patients. Contradictory results underline the importance of studying the safety of “unusual” cereals in more detail.
Simultaneous Characterization of Relaxation, Creep, Dissipation, and Hysteresis by Fractional-Order Constitutive Models
Authors: Duan Jun-Sheng , Hu Di-Chen , Chen Yang-Quan
Published: April 2021

We considered relaxation, creep, dissipation, and hysteresis resulting from a six-parameter fractional constitutive model and its particular cases. The storage modulus, loss modulus, and loss factor, as well as their characteristics based on the thermodynamic requirements, were investigated. It was proved that for the fractional Maxwell model, the storage modulus increases monotonically, while the loss modulus has symmetrical peaks for its curve against the logarithmic scale log(ω), and for the fractional Zener model, the storage modulus monotonically increases while the loss modulus and the loss factor have symmetrical peaks for their curves against the logarithmic scale log(ω). The peak values and corresponding stationary points were analytically given. The relaxation modulus and the creep compliance for the six-parameter fractional constitutive model were given in terms of the Mittag–Leffler functions. Finally, the stress–strain hysteresis loops were simulated by making use of the derived creep compliance for the fractional Zener model. These results show that the fractional constitutive models could characterize the relaxation, creep, dissipation, and hysteresis phenomena of viscoelastic bodies, and fractional orders α and β could be used to model real-world physical properties well.
Unraveling the Balance between Genes, Microbes, Lifestyle and the Environment to Improve Healthy Reproduction
Authors: D’Argenio Valeria , Dittfeld Lara , Lazzeri Paolo , Tomaiuolo Rossella , Tasciotti Ennio
Published: April 2021

Humans’ health is the result of a complex and balanced interplay between genetic factors, environmental stimuli, lifestyle habits, and the microbiota composition. The knowledge about their single contributions, as well as the complex network linking each to the others, is pivotal to understand the mechanisms underlying the onset of many diseases and can provide key information for their prevention, diagnosis and therapy. This applies also to reproduction. Reproduction, involving almost 10% of our genetic code, is one of the most critical human’s functions and is a key element to assess the well-being of a population. The last decades revealed a progressive decline of reproductive outcomes worldwide. As a consequence, there is a growing interest in unveiling the role of the different factors involved in human reproduction and great efforts have been carried out to improve its outcomes. As for many other diseases, it is now clear that the interplay between the underlying genetics, our commensal microbiome, the lifestyle habits and the environment we live in can either exacerbate the outcome or mitigate the adverse effects. Here, we aim to analyze how each of these factors contribute to reproduction highlighting their individual contribution and providing supporting evidence of how to modify their impact and overall contribution to a healthy reproductive status.
Influence of Social and Demographic Factors on the Montreal Cognitive Assessment (MoCA) Test in Rural Population of North-Eastern Greece
Authors: Tsiakiri Anna , Vadikolias Konstantinos , Tripsianis Grigorios , Vlotinou Pinelopi , Serdari Aspasia , Terzoudi Aikaterini , Heliopoulos Ioannis
Published: April 2021

The current study aims to investigate the influence of socio-demographic factors on the Montreal Cognitive Assessment (MoCA) test results in a Greek-speaking population consisting of a sample of healthy older adults, individuals with mild cognitive impairment (MCI), and dementia patients in rural areas. In addition, the current research focuses on determining optimal cut-off scores for the clinical diagnoses of MCI and dementia. The data originated from 283 participants in an ongoing registry of the Neurology Department of Alexandroupolis University Hospital, recruited in different rural districts of north-eastern Greece, across a broad range of educational and occupational categories. Total and sub-domain scores for the MoCA varied significantly, according to sex, age, and education, among the three study groups. The optimal cut-off points of 25/26 for the MoCA total score was determined to classify healthy subjects from individuals with MCI, 24 to discriminate healthy participants from demented, and 21/22 to discriminate subjects with MCI from dementia. Overall, the clinical use of the MoCA test can be supported by demographically adjusted standard scores in a Greek-speaking rural population. These findings serve to improve the diagnostic accuracy and utility of the MoCA test.
Psychometric Properties of the Self-Healing Assessment Scale for Community-Dwelling Older Adults
Authors: Wu Yi-Chen , Hsu Hua-I , Tung Heng-Hsin , Pan Shi-Jun , Lin Shu-Wei
Published: April 2021

Self-healing, an intrinsic healing capacity, helps individuals’ bodies and minds to regain wholeness and is significant in the pursuit of one’s own healthy ageing and independence. This study was intended to develop and preliminarily test the reliability and validity of the self-healing assessment scale (SHAS) for community-dwelling older adults, and was conducted in three phases. Phase 1: The definitions of self-healing were synthesized from our knowledge of the literature regarding the ontology of self-healing and panels of 25 experts. The initial version of the 12-item questionnaire was developed by the in-depth interviews of focus groups and panels, and the content was validated by six experts. Phase 2: A cross-sectional survey, including a total of 500 community-dwelling older adults with a mean age of 71.76, was then conducted for the preliminary reliability and validity test. The content validity indices were satisfied. Twelve items were retained, and three factors were identified, namely, physical and mental state, socioeconomic and environmental status, and independent lifestyle, which explained 65.8% of the variance under explorative approval. Phase 3: the standardized factor above 60 obtained by confirmatory factorial analysis indicated good convergent validity. The relationship between self-healing and health-related quality of life was confirmed via concurrent validity testing. The SHAS can facilitate the evaluation of factors associated with community-dwelling older adults’ self-healing capacity. Programs tailored to enhance self-healing capacity should be designed, implemented, and inspected regarding their effectiveness in older adults.
Predicting Hospital Overall Quality Star Ratings in the USA
Authors: Kurian Nisha , Maid Jyotsna , Mitra Sharoni , Rhyne Lance , Korvink Michael , Gunn Laura H.
Published: April 2021

The U.S. Centers for Medicare and Medicaid Services (CMS) assigns quality star ratings to hospitals upon assessing their performance across 57 measures. Ratings can be used by healthcare consumers for hospital selection and hospitals for quality improvement. We provide a simpler, more intuitive modeling approach, aligned with recent criticism by stakeholders. An ordered logistic regression approach is proposed to assess associations between performance measures and ratings across eligible (n = 4519) U.S. hospitals. Covariate selection reduces the double counting of information from highly correlated measures. Multiple imputation allows for inference of star ratings when information on all measures is not available. Twenty performance measures were found to contain all the relevant information to formulate star rating predictions upon accounting for performance measure correlation. Hospitals can focus their efforts on a subset of model-identified measures, while healthcare consumers can predict quality star ratings for hospitals ineligible under CMS criteria.
An Overview of Aquifer Physiognomies and the δ18O and δ2H Distribution in the South African Groundwaters
Authors: Abiye Tamiru A. , Demlie Molla B. , Mengistu Haile
Published: April 2021

A comprehensive assessment of the stable isotope distribution in the groundwater systems of South Africa was conducted in relation to the diversity in the aquifer lithology and corresponding hydraulic characteristics. The stable isotopes of oxygen (18O) and hydrogen (2H) in groundwater show distinct spatial variation owing to the recharge source and possibly mixing effect in the aquifers with the existing water, where aquifers are characterized by diverse hydraulic conductivity and transmissivity values. When the shallow aquifer that receives direct recharge from rainfall shows a similar isotopic signature, it implies less mixing effect, while in the case of deep groundwater interaction between recharging water and the resident water intensifies, which could change the isotope signature. As aquifer depth increases the effect of mixing tends to be minimal. In most cases, the isotopic composition of recharging water shows depletion in the interior areas and western arid zones which is attributed to the depleted isotopic composition of the moisture source. The variations in the stable isotope composition of groundwater in the region are primarily controlled by the isotope composition of the rainfall, which shows variable isotope composition as it was observed from the local meteoric water lines, in addition to the evaporation, recharge and mixing effects.
Acrylamide in Bakery Products: A Review on Health Risks, Legal Regulations and Strategies to Reduce Its Formation
Authors: Sarion Cristina , Codină Georgiana Gabriela , Dabija Adriana
Published: April 2021

Acrylamide is a contaminant as defined in Council Regulation (EEC) No 315/93 and as such, it is considered a chemical hazard in the food chain. The toxicity of acrylamide has been acknowledged since 2002, among its toxicological effects on humans being neurotoxicity, genotoxicity, carcinogenicity, and reproductive toxicity. Acrylamide has been classified as carcinogenic in the 2A group, with human exposure leading to progressive degeneration of the peripheral and central nervous systems characterized by cognitive and motor abnormalities. Bakery products (bread, crispbread, cakes, batter, breakfast cereals, biscuits, pies, etc.) are some of the major sources of dietary acrylamide. The review focuses on the levels of acrylamide in foods products, in particular bakery ones, and the risk that resulting dietary intake of acrylamide has on human health. The evolving legislative situation regarding the acrylamide content from foodstuffs, especially bakery ones, in the European Union is discussed underlining different measures that food producers must take in order to comply with the current regulations regarding the acrylamide levels in their products. Different approaches to reduce the acrylamide level in bakery products such as the use of asparginase, calcium salts, antioxidants, acids and their salts, etc., are described in detail.
Effects of Reallocating Time Spent Engaging in Sedentary Behavior and Physical Activity on Mortality in Older Adults: ELSIA Study
Authors: Galvão Lucas Lima , Silva Rizia Rocha , Ribeiro Renato Mendonça , Tribess Sheilla , Santos Douglas de Assis Teles , Virtuoso Júnior Jair Sindra
Published: April 2021

Background: The objective of the study is to investigate the effects of reallocating time spent engaging in sedentary behavior (SB) and physical activity on the risk of mortality. Methods: In all, 332 older adult low-income and low-education populations participated in the study. At the end of the study, 273 of the participants were alive and 59 had died. Time spent undertaking moderate to vigorous physical activity (MVPA) and SB was assessed using the international physical activity questionnaire. The Cox proportional hazards regression model was used. Results: The replacement of time spent engaging in SB with MVPA reduced the risk of mortality from all causes in the older adults, resulting in reductions in mortality risk of between 10% and 46%. Conclusion: A reduction in the risk of mortality in older adults was observed when time spent in SB was replaced with the same amount of time in MVPA for all times tested.
The Significance of Demographic Variables on Psychosocial Health from the Early Stage and Nine Months after the COVID-19 Pandemic Outbreak. A Cross-National Study
Authors: Geirdal Amy K. Østertun , Price Daicia , Schoultz Mariyana , Thygesen Hilde , Ruffolo Mary , Leung Janni , Bonsaksen Tore
Published: April 2021

This cross-national study explored stability and change in mental health, quality of life, well-being and loneliness during the early stage and nine months after the implementation of COVID-19 pandemic social distancing measures and periodic lockdowns as adjusted by demographic variables. In the USA, the UK, Australia and Norway, 7284 individuals responded to the invitation to take part in two cross-sectional web-based surveys (April and November 2020), including questions about sociodemographic variables and psychosocial outcomes. Independent t-tests and generalized linear models (GLM) and estimated marginal means were used to analyze differences between subgroups and countries, multiple linear regression analyses were conducted on the psychosocial outcome measures by demographic variables and time in each country and mean responses presented by time after adjusting for all demographic variables in the model. Age, gender, civil status, education, employment, place of work and living area were all significant factors for psychosocial health across the countries. Differences in mental health, quality of life, well-being and loneliness were found between the countries in both April and November 2020, while time did not contribute to reducing the toll in any of the four countries over the nine-month period.
Long Covid-19: Proposed Primary Care Clinical Guidelines for Diagnosis and Disease Management
Authors: Sisó-Almirall Antoni , Brito-Zerón Pilar , Conangla Ferrín Laura , Kostov Belchin , Moragas Moreno Anna , Mestres Jordi , Sellarès Jaume , Galindo Gisela , Morera Ramon , Basora Josep , Trilla Antoni , Ramos-Casals Manuel ,   on behalf of the CAMFiC long COVID-19 Study Group
Published: April 2021

Long COVID-19 may be defined as patients who, four weeks after the diagnosis of SARS-Cov-2 infection, continue to have signs and symptoms not explainable by other causes. The estimated frequency is around 10% and signs and symptoms may last for months. The main long-term manifestations observed in other coronaviruses (Severe Acute Respiratory Syndrome (SARS), Middle East respiratory syndrome (MERS)) are very similar to and have clear clinical parallels with SARS-CoV-2: mainly respiratory, musculoskeletal, and neuropsychiatric. The growing number of patients worldwide will have an impact on health systems. Therefore, the main objective of these clinical practice guidelines is to identify patients with signs and symptoms of long COVID-19 in primary care through a protocolized diagnostic process that studies possible etiologies and establishes an accurate differential diagnosis. The guidelines have been developed pragmatically by compiling the few studies published so far on long COVID-19, editorials and expert opinions, press releases, and the authors’ clinical experience. Patients with long COVID-19 should be managed using structured primary care visits based on the time from diagnosis of SARS-CoV-2 infection. Based on the current limited evidence, disease management of long COVID-19 signs and symptoms will require a holistic, longitudinal follow up in primary care, multidisciplinary rehabilitation services, and the empowerment of affected patient groups.
Humanness Is Not Always Positive: Automatic Associations between Incivilities and Human Symbols
Authors: Rodríguez-Gómez Laura , Delgado Naira , Betancor Verónica , Chen-Xia Xing Jie , Rodríguez-Pérez Armando
Published: April 2021

Uncivil behavior involves an attack on social norms related to the protection of public property and respect for community life. However, at the same time, the low-frequency and relatively low-intensity damage caused by most of these behaviors could lead to incivilities being considered a typically human action. The purpose of this set of studies is to examine the automatic associations that people establish between humanness and both civic and uncivil behaviors. Across three studies, uncivil behaviors were more strongly associated with human pictures than animal pictures (study 1) and with human-related words than animal-related words (study 2). We replicated study 2 with uncivil behaviors that do not prime graphically human beings (study 3). Overall, our results showed that uncivil behaviors and civic behaviors were clearly associated with human concepts. Our findings have direct implications for the conceptualization of humanness and its denial.
Common and Unique Barriers to the Exchange of Administrative Healthcare Data in Environmental Public Health Tracking Program
Authors: Shin Mikyong , Hawley Charles , Strosnider Heather
Published: April 2021

CDC’s National Environmental Public Health Tracking Program (Tracking Program) receives administrative data annually from 25–30 states to track potential environmental exposures and to make data available for public access. In 2019, the CDC Tracking Program conducted a cross-sectional survey among principal investigators or program managers of the 26 funded programs to improve access to timely, accurate, and local data. All 26 funding recipients reported having access to hospital inpatient data, and most states (69.2%) regularly update data user agreements to receive the data. Among the respondents, 15 receive record-level data with protected health information (PHI) and seven receive record-level data without PHI. Regarding geospatial resolution, approximately 50.0% of recipients have access to the street address or census tract information, 34.6% have access to ZIP code, and 11.5% have other sub-county geographies (e.g., town). Only three states receive administrative data for their residents from all border states. The survey results will help the Tracking Program to identify knowledge gaps and perceived barriers to the use and accessibility of administrative data for the CDC Tracking Program. The information collected will inform the development of resources that can provide solutions for more efficient and timely data exchange.
Heat Acclimation Following Heat Acclimatization Elicits Additional Physiological Improvements in Male Endurance Athletes
Authors: Benjamin Courteney L. , Sekiguchi Yasuki , Struder Jeb F. , Szymanski Michael R. , Manning Ciara N. , Grundstein Andrew J. , Lee Elaine C. , Huggins Robert A. , Armstrong Lawrence E. , Casa Douglas J.
Published: April 2021

The purpose of this study was to assess the effectiveness of heat acclimatization (HAz) followed by heat acclimation (HA) on physiological adaptations. 25 male endurance athletes (age 36 ± 12 y, height 178.8 ± 6.39 cm, body mass 73.03 ± 8.97 kg, and VO2peak 57.5 ± 7.0 mL·kg−1·min−1) completed HAz and HA. HAz was 3 months of self-directed summer training. In the laboratory, a 5-day HA prescribed exercise to target a hyperthermic zone (HZHA) of Trec between 38.50 and 39.75 °C for 60 min. Exercise trials were 60 min of running (59% ± 2% VO2peak) in an environmental chamber (wet bulb globe temperature 29.53 ± 0.63 °C) and administered at: baseline, post-HAz, and post-HAz+HA. Measured variables included internal body temperature (Trec), heart rate (HR), and sweat rate (SR). Repeated measure ANOVAs and post hoc comparisons were used to assess statistically significant (p < 0.05) differences. Trec was lower post-HAz+HA (38.03 ± 0.39 °C) than post-HAz (38.25 ± 0.42 °C, p = 0.009) and baseline (38.29 ± 0.37 °C, p = 0.005). There were no differences between baseline and post-HAz (p = 0.479) in Trec. HR was lower post-HAz (143 ± 12 bpm, p = 0.002) and post-HAz+HA (134 ± 11 bpm, p < 0.001) than baseline (138 ± 14 bpm). HR was lower post-HAz+HA than post-HAz (p = 0.013). SR was higher post-HAz+HA (1.93 ± 0.47 L·h−1) than post-HAz (1.76 ± 0.43 L·h−1, p = 0.027). Combination HAz and HA increased physiological outcomes above HAz. This method can be used to improve performance and safety in addition to HAz alone.
Mini-Implant-Retained Overdentures for the Rehabilitation of Completely Edentulous Maxillae: A Systematic Review and Meta-Analysis
Authors: Vi Serena , Pham Damon , Du Yu Yian Marina , Arora Himanshu , Tadakamadla Santosh Kumar
Published: April 2021

Purpose: Mini-dental implants (MDIs) have been used to support and retain overdentures, providing patients with a less invasive placement procedure. Although lucrative, the use of MDIs to retain a maxillary overdenture is still not an established treatment modality. This systematic review aims to answer the question: Do mini-implant-retained maxillary overdentures provide a satisfactory treatment outcome for complete edentulism? Methods: A systematic search for relevant articles was conducted to include articles published until April 2021 in the following electronic databases: CINAHL, Cochrane, EMBASE, PubMed, and Web of Science. All empirical studies evaluating the biological, survival, or patient-reported outcomes after placing mini-implant-retained overdentures in maxilla were considered for inclusion. The risk of bias was assessed by utilizing the Joanna Briggs Institute critical appraisal checklist. Study screening and data extraction were conducted by three reviewers independently. Results: The electronic search retrieved 1276 titles after omitting duplicates. Twenty articles were considered for full-text review, of which six studies were included in this systematic review. The included studies evaluated a total of 173 participants with a mean age of 66.3 years. The overall mini-implant survival rate was 77.1% (95% CI: 64.7–89.5%) with a mean follow-up time of 1.79 years (range: 6 months to 3 years). Implant survival differed significantly when comparing complete and partial palatal coverage overdentures. Those with complete palatal coverage exhibited less bone loss overall compared to partial coverage overdentures. Participants of all studies reported an increase in the quality of life and in satisfaction after rehabilitation treatment with MDIs. Conclusions: The survival rate of mini-implants retaining an overdenture in the maxilla was observed to be lower than the values reported for traditional implants in the literature. Improvements were observed in all aspects in terms of patient satisfaction, quality of life, oromyofunction, and articulation after the treatment.