bluuebunny/crossref_metadata_2025 huggingface dataset:
Optimal Duration of Neoadjuvant Taxane and Carboplatin Combined With Anti-HER2 Targeted Therapy for HER2-Positive Breast Cancer
Authors: Xie Yifan , Wu Siyu , Zhang Ying , Li Jianwei , Mo Miao , Shao Zhimin , Liu Guangyu
Published: June 2021

Background

Taxane, carboplatin and trastuzumab (TCH) is an effective neoadjuvant regimen for human epidermal growth factor receptor 2 (HER2)-positive breast cancer with high pathologic complete response (pCR) rate. The KATHERINE trial changes the outlook for high-risk HER2-positive breast cancer, which suggests that escalation treatment for patients with residual disease after neoadjuvant anti-HER2 therapy may improve survival. The major objective of this study was to investigate the fewest cycles of neoadjuvant TCH therapy needed to screen out non-pCR patients.

Methods

This retrospective study included patients with HER2-positive breast cancer who received either four or six cycles of TCH preoperatively at Fudan University Shanghai Cancer Center between 2008 and 2019. The pCR status was evaluated, and relevant factors associated with pCR were identified using univariate and multivariable analyses. The pathological results of core needle biopsy (CNB) in the breast tumor after two cycles of neoadjuvant chemotherapy were also collected. Kaplan-Meier curve was used to estimate the event-free survival (EFS).

Results

Of 758 eligible patients, 303 were included and analyzed in the four-cycle group and 455 in the six-cycle group. There was no significant difference between the two groups in terms of the pCR rate (46.5% [95% CI 40.9% - 52.2%] in the four-cycle group and 49.9% [95% CI 45.3% - 54.5%] in the six-cycle group, p = 0.365) or the four-year EFS (90.8% in four-cycle group and 93.8% in six-cycle group; p = 0.264). Multivariable analysis indicated that a negative hormone receptor status and the weekly paclitaxel were independent factors for predicting pCR. After adjusting for factors in the multivariable analysis, there was still no significant difference between four and six cycles of neoadjuvant TCH (OR = 1.252, 95% CI 0.904 - 1.733, p = 0.176). Furthermore, 17.9% patients with invasive carcinoma on CNB after two cycles of TCH ultimately achieved pCR in the breast after the completion of neoadjuvant treatment.

Conclusion

Four cycles of taxane/carboplatin-based neoadjuvant anti-HER2 therapy may be applied as an optimal treatment duration for screening high-risk HER2-positive breast cancer patients for escalation treatment. Further prospective study is warranted.
Anti-Fibrotic Effects of Low Toxic Microcystin-RR on Bleomycin-Induced Pulmonary Fibrosis: A Comparison with Microcystin-LR
Authors: Wang Jie , Ren Yan , Zheng Xiufen , Kang Jiaqi , Huang Zhenqian , Xu Lizhi , Wang Yaping
Published: June 2021

Idiopathic pulmonary fibrosis (IPF) is a chronic progressive interstitial pulmonary disease characterized with radiographically evident pulmonary infiltrates and extracellular matrix deposition with limited treatment options. We previously described that microcystin-LR (MC-LR) reduces transforming growth factor (TGF)-β1/Smad signaling and ameliorates pulmonary fibrosis in bleomycin (BLM)-induced rat models. In the present study, we further demonstrate that microcystin-RR (MC-RR), an MC congener with lower toxicity than MC-LR, exerted an anti-fibrotic effect on BLM-induced pulmonary fibrosis rodent models and compared it with MC-LR. Our data show that MC-RR treatment attenuated BLM-associated pulmonary inflammation and collagen deposition in both therapeutic and preventive models. MC-RR reduced the expression of fibrotic markers, including vimentin, α-smooth muscle actin, collagen 1α1, and fibronectin, in rat pulmonary tissues. Furthermore, the core features of BLM-induced pulmonary fibrotic lesions were better alleviated by MC-RR than by MC-LR. MC-RR treatment substantially decreased the number of pulmonary M2 macrophages. In vitro, MC-RR attenuated the epithelial-mesenchymal transition and fibroblast-myofibroblast transition triggered by M2 macrophages. Therefore, we highlight MC-RR as a promising molecule for developing therapeutic and prophylactic strategies against IPF, a refractory lung disease.
High Prevalence of Multimorbidity and Polypharmacy in Elderly Patients With Chronic Pain Receiving Home Care are Associated With Multiple Medication-Related Problems
Authors: Schneider Juliana , Algharably Engi Abd Elhady , Budnick Andrea , Wenzel Arlett , Dräger Dagmar , Kreutz Reinhold
Published: June 2021

Aim: To measure the extent of polypharmacy, multimorbidity and potential medication-related problems in elderly patients with chronic pain receiving home care.

Methods: Data of 355 patients aged ≥65 years affected by chronic pain in home care who were enrolled in the ACHE study in Berlin, Germany, were analyzed. History of chronic diseases, diagnoses, medications including self-medication were collected for all patients. Multimorbidity was defined as the presence of ≥2 chronic conditions and levels were classified by the Charlson-Comorbidity-Index. Polypharmacy was defined as the concomitant intake of ≥5 medications. Potentially clinically relevant drug interactions were identified and evaluated; underuse of potentially useful medications as well as overprescription were also assessed.

Results: More than half of the patients (55.4%) had moderate to severe comorbidity levels. The median number of prescribed drugs was 9 (range 0–25) and polypharmacy was detected in 89.5% of the patients. Almost half of them (49.3%) were affected by excessive polypharmacy (≥10 prescribed drugs). Polypharmacy and excessive polypharmacy occurred at all levels of comorbidity. We detected 184 potentially relevant drug interactions in 120/353 (34.0%) patients and rated 57 (31.0%) of them as severe. Underprescription of oral anticoagulants was detected in 32.3% of patients with atrial fibrillation whereas potential overprescription of loop diuretics was observed in 15.5% of patients.

Conclusion: Multimorbidity and polypharmacy are highly prevalent in elderly outpatients with chronic pain receiving home care. Medication-related problems that could impair safety of drug treatment in this population are resulting from potentially relevant drug interactions, overprescribing as well as underuse.
The Potential of Traditional Knowledge to Develop Effective Medicines for the Treatment of Leishmaniasis
Authors: Passero Luiz Felipe D. , Brunelli Erika dos Santos , Sauini Thamara , Amorim Pavani Thais Fernanda , Jesus Jéssica Adriana , Rodrigues Eliana
Published: June 2021

Leishmaniasis is a neglected tropical disease that affects people living in tropical and subtropical areas of the world. There are few therapeutic options for treating this infectious disease, and available drugs induce severe side effects in patients. Different communities have limited access to hospital facilities, as well as classical treatment of leishmaniasis; therefore, they use local natural products as alternative medicines to treat this infectious disease. The present work performed a bibliographic survey worldwide to record plants used by traditional communities to treat leishmaniasis, as well as the uses and peculiarities associated with each plant, which can guide future studies regarding the characterization of new drugs to treat leishmaniasis. A bibliographic survey performed in the PubMed and Scopus databases retrieved 294 articles related to traditional knowledge, medicinal plants and leishmaniasis; however, only 20 were selected based on the traditional use of plants to treat leishmaniasis. Considering such studies, 378 quotes referring to 292 plants (216 species and 76 genera) that have been used to treat leishmaniasis were recorded, which could be grouped into 89 different families. A broad discussion has been presented regarding the most frequent families, including Fabaceae (27 quotes), Araceae (23), Solanaceae and Asteraceae (22 each). Among the available data in the 378 quotes, it was observed that the parts of the plants most frequently used in local medicine were leaves (42.3% of recipes), applied topically (74.6%) and fresh poultices (17.2%). The contribution of Latin America to studies enrolling ethnopharmacological indications to treat leishmaniasis was evident. Of the 292 plants registered, 79 were tested against Leishmania sp. Future studies on leishmanicidal activity could be guided by the 292 plants presented in this study, mainly the five species Carica papaya L. (Caricaceae), Cedrela odorata L. (Meliaceae), Copaifera paupera (Herzog) Dwyer (Fabaceae), Musa × paradisiaca L. (Musaceae), and Nicotiana tabacum L. (Solanaceae), since they are the most frequently cited in articles and by traditional communities.
Localized Oxygen Exchange Platform for Intravital Video Microscopy Investigations of Microvascular Oxygen Regulation
Authors: Sové Richard J. , Milkovich Stephanie , Nikolov Hristo N. , Holdsworth David W. , Ellis Christopher G. , Fraser Graham M.
Published: June 2021

Intravital microscopy has proven to be a powerful tool for studying microvascular physiology. In this study, we propose a gas exchange system compatible with intravital microscopy that can be used to impose gas perturbations to small localized regions in skeletal muscles or other tissues that can be imaged using conventional inverted microscopes. We demonstrated the effectiveness of this system by locally manipulating oxygen concentrations in rat extensor digitorum longus muscle and measuring the resulting vascular responses. A computational model of oxygen transport was used to partially validate the localization of oxygen changes in the tissue, and oxygen saturation of red blood cells flowing through capillaries were measured as a surrogate for local tissue oxygenation. Overall, we have demonstrated that this approach can be used to study dynamic and spatial responses to local oxygen challenges to the microenvironment of skeletal muscle.
The Pretreatment of Lignocelluloses With Green Solvent as Biorefinery Preprocess: A Minor Review
Authors: Yin Xiaoyan , Wei Linshan , Pan Xueyuan , Liu Chao , Jiang Jianchun , Wang Kui
Published: June 2021

Converting agriculture and forestry lignocellulosic residues into high value-added liquid fuels (ethanol, butanol, etc.), chemicals (levulinic acid, furfural, etc.), and materials (aerogel, bioresin, etc.) via a bio-refinery process is an important way to utilize biomass energy resources. However, because of the dense and complex supermolecular structure of lignocelluloses, it is difficult for enzymes and chemical reagents to efficiently depolymerize lignocelluloses. Strikingly, the compact structure of lignocelluloses could be effectively decomposed with a proper pretreatment technology, followed by efficient separation of cellulose, hemicellulose and lignin, which improves the conversion and utilization efficiency of lignocelluloses. Based on a review of traditional pretreatment methods, this study focuses on the discussion of pretreatment process with recyclable and non-toxic/low-toxic green solvents, such as polar aprotic solvents, ionic liquids, and deep eutectic solvents, and provides an outlook of the industrial application prospects of solvent pretreatment.
Identification of Glutathione S-Transferase Genes in Hami Melon (Cucumis melo var. saccharinus) and Their Expression Analysis Under Cold Stress
Authors: Song Wen , Zhou Fake , Shan Chunhui , Zhang Qin , Ning Ming , Liu Xiumin , Zhao Xinxin , Cai Wenchao , Yang Xinquan , Hao Guangfei , Tang Fengxian
Published: June 2021

As a group of multifunctional enzymes, glutathione S-transferases (GSTs) participate in oxidative stress resistance and cellular detoxification. Here, we identified 39 CmGST genes with typical binding sites from the Hami melon genome, and they can be classified into seven subfamilies. Their molecular information, chromosomal locations, phylogenetic relationships, synteny relationships, gene structures, protein–protein interactions, structure of 3-D models, and expression levels under cold stress were analyzed. Expression analysis indicates that cold-tolerant Jia Shi-310 (JS) had higher GST enzyme activities and expression levels of 28 stress-related genes under cold stress. Some CmGSTs belonging to Tau, Phi, and DHAR classes play significant roles under cold stress, and they could be regarded as candidate genes for further studies. The present study systematically investigated the characterization of the Hami melon GST gene family, extending our understanding of Hami melon GST mediated stress-response mechanisms in this worldwide fruit.
COVID-19 Lockdown: Key Factors in Citizens’ Stress
Authors: Rodríguez Susana , Valle Antonio , Piñeiro Isabel , González-Suárez Rocío , Díaz Fátima M. , Vieites Tania
Published: June 2021

Background: Confinement due to COVID-19 can have a short‐ and long-term impact on mental health (increased levels of stress and anxiety and emotional upheaval) and on people’s quality of life. Knowing what factors are behind the stress can benefit the development of strategies and resources for future situations of a similar nature. The purpose of this study is to examine the incidence of a series of sociodemographic factors, confinement conditions, and work situation on the stress reported by confined citizens.

Method: The sample is made up of 2008 citizens (19.9% men), the Perceived Stress Scale of 14 items (PSS-14) was used to assess the stress level of the population, as well as a sociodemographic questionnaire and different questions aimed at obtain information about the characteristics of the confinement and the employment situation. Data were collected using exponential snowball-type non-probability sampling.

Results: The results suggest that sociodemographic factors such as age, gender, and income level could be good predictors of confinement stress. Post-confinement work expectancy along with pre-confinement working conditions can be key to protecting the well-being of confined populations.

Limitations: This is a transversal study that forces us to be cautious with causal interpretations. The questionnaire was administered online, which means it excluded a good proportion of the population.

Conclusion: The perception of stress being higher in women than men, with the lowest stress in older people and those with higher reported incomes. Stress levels increase as populations spend more weeks in confinement and the pre-confinement work situation seems key to protecting the well-being of the population. A lower stress is observed among stable couples without children confined in residential or suburban areas. Low income or economic instability is associated with a higher rate of stress and anxiety. The results can contribute to prioritizing actions and aid by contributing to the formation of teams and the design of tools for work in the current pandemic situation.
Prevalence of Major Depressive Disorder Among Adults in China: A Systematic Review and Meta-Analysis
Authors: Zhao Yan-Jie , Jin Yu , Rao Wen-Wang , Zhang Qing-E , Zhang Ling , Jackson Todd , Su Zhao-Hui , Xiang Mi , Yuan Zhen , Xiang Yu-Tao
Published: June 2021

Background: Prevalence estimates of major depressive disorder (MDD) among adults in China have varied widely between studies. In this systematic review and meta-analysis, the overall prevalence of MDD in the Chinese population was estimated from published epidemiological studies and potential moderators that account for variability in estimates were assessed.

Methods: A systematic literature search was conducted in PubMed, EMBASE, Web of Science, PsycINFO, China National Knowledge Internet (CNKI), and WanFang databases to identify relevant studies. Data analyses were conducted using the Comprehensive Meta-Analysis Version 2.0.

Results: Forty studies comprising 1,024,087 subjects were included. The pooled point, 12-month, and lifetime prevalence rates of MDD in China were 1.1% (95% CI: 0.9–1.4%), 1.6% (95% CI: 1.0–2.5%), and 1.8% (95% CI: 1.5–2.2%), respectively. Subgroup and meta-regression analyses revealed gender, marital status, survey year, being published in English language, use of the Diagnostic and Statistical Manual of Mental Disorders (DSM) diagnostic systems and age as significant moderators of MDD prevalence.

Conclusion: The overall prevalence of MDD in the Chinese population appears to be lower than that of most countries, but the rates have been increasing over time and are elevated in particular demographic subgroups. Due to the negative consequences of MDD, effective preventive measures, early identification, and timely treatments are still important and should be offered to those in need.
Lower Ventromedial Prefrontal Cortex Glutamate Levels in Patients With Obsessive–Compulsive Disorder
Authors: Batistuzzo Marcelo C. , Sottili Bruna A. , Shavitt Roseli G. , Lopes Antonio C. , Cappi Carolina , de Mathis Maria Alice , Pastorello Bruno , Diniz Juliana B. , Silva Renata M. F. , Miguel Euripedes C. , Hoexter Marcelo Q. , Otaduy Maria C.
Published: June 2021

Background: Recent studies using magnetic resonance spectroscopy (1H-MRS) indicate that patients with obsessive–compulsive disorder (OCD) present abnormal levels of glutamate (Glu) and gamma aminobutyric acid (GABA) in the frontal and striatal regions of the brain. These abnormalities could be related to the hyperactivation observed in cortico-striatal circuits of patients with OCD. However, most of the previous 1H-MRS studies were not capable of differentiating the signal from metabolites that overlap in the spectrum, such as Glu and glutamine (Gln), and referred to the detected signal as the composite measure—Glx (sum of Glu and Gln). In this study, we used a two-dimensional JPRESS 1H-MRS sequence that allows the discrimination of overlapping metabolites by observing the differences in J-coupling, leading to higher accuracy in the quantification of all metabolites. Our objective was to identify possible alterations in the neurometabolism of OCD, focusing on Glu and GABA, which are key neurotransmitters in the brain that could provide insights into the underlying neurochemistry of a putative excitatory/inhibitory imbalance. Secondary analysis was performed including metabolites such as Gln, creatine (Cr), N-acetylaspartate, glutathione, choline, lactate, and myo-inositol.

Methods: Fifty-nine patients with OCD and 42 healthy controls (HCs) underwent 3T 1H-MRS in the ventromedial prefrontal cortex (vmPFC, 30 × 25 × 25 mm3). Metabolites were quantified using ProFit (version 2.0) and Cr as a reference. Furthermore, Glu/GABA and Glu/Gln ratios were calculated. Generalized linear models (GLMs) were conducted using each metabolite as a dependent variable and age, sex, and gray matter fraction (fGM) as confounding factors. GLM analysis was also used to test for associations between clinical symptoms and neurometabolites.

Results: The GLM analysis indicated lower levels of Glu/Cr in patients with OCD (z = 2.540; p = 0.011). No other comparisons reached significant differences between groups for all the metabolites studied. No associations between metabolites and clinical symptoms were detected.

Conclusions: The decreased Glu/Cr concentrations in the vmPFC of patients with OCD indicate a neurochemical imbalance in the excitatory neurotransmission that could be associated with the neurobiology of the disease and may be relevant for the pathophysiology of OCD.
Mental Health in Persons With Chronic Myeloid Leukemia During the SARS-CoV-2 Pandemic: The Need for Increased Access to Health Care Services
Authors: Bao Mei , Yang Sen , Gale Robert Peter , Zhang Yanli , Liu Xiaoli , Zhu Huanling , Liang Rong , Liu Bingcheng , Zhou Li , Li Zongru , Dou Xuelin , Shi Dayu , Wang Tao , Meng Li , Li Weiming , Jiang Qian
Published: June 2021

Mental health problems in the general population have been reported during the SARS-CoV-2 pandemic; however, there were rare data in persons with chronic myeloid leukemia (CML). Therefore, we performed a cross-sectional study on mental health evaluated using the 9-item Patient Health Questionnaire (PHQ-9; depression), the 7-item Generalized Anxiety Disorder (GAD-7; anxiety), and the 22-item Impact of Event Scale—Revised (IES-R; distress), including subscales of avoidance, intrusion, and hyper-arousal in persons with CML, non-cancer persons, and immediate family members of persons with cancer as controls (≥16 years) by an online survey. Data from 3,197 persons with CML and 7,256 controls were collected. In multivariate analyses, CML was significantly associated with moderate to severe depression (OR = 1.6; 95% Confidence Interval [CI], 1.4, 1.9; p < 0.001), anxiety (OR = 1.4 [1.1, 1.7]; p = 0.001), distress (OR = 1.3 [1.1, 1.5]; p < 0.001), and hyper-arousal (OR = 1.5 [1.3, 1.6]; p < 0.001). Moreover, delay in regular monitoring was significantly associated with depression (OR 1.3 [1.0, 1.7]; p = 0.024), anxiety (OR = 1.3 [1.0, 1.8]; p = 0.044), avoidance (OR = 1.2 [1.0, 1.4]; p = 0.017), and intrusion (OR = 1.2 [1.0, 1.4]; p = 0.057); tyrosine kinase-inhibitor dose reduction or discontinuation, depression (OR = 1.9 [1.3, 2.8]; p = 0.001), distress (OR = 2.0 [1.4, 2.8]; p < 0.001), avoidance (OR = 1.6 [1.2, 2.1]; p = 0.004), intrusion (OR = 1.6 [1.1, 2.1]; p = 0.006), and hyper-arousal (OR = 1.3 [1.0, 1.8]; p = 0.088). We concluded that persons with CML during the SARS-CoV-2 pandemic have worse mental health including depression, anxiety, and distress symptoms. Decreasing or stopping monitoring or dose resulted in adverse mental health consequences.
Factors Influencing Development and Implementation of Patients' Access to Electronic Health Records—A Comparative Study of Sweden and the Netherlands
Authors: Cijvat Charlotte D. , Cornet Ronald , Hägglund Maria
Published: June 2021

Background: Patient-accessible electronic health records (PAEHRs) and associated national policies have increasingly been set up over the past two decades. Still little is known about the most effective strategy for developing and implementing PAEHRs. There are many stakeholders to take into account, and previous research focuses on the viewpoints of patients and healthcare professionals. Many known barriers and challenges could be solved by involving end-users in the development and implementation process. This study therefore compares barriers and facilitators for PAEHR development and implementation, both general and specific for patient involvement, that were present in Sweden and the Netherlands.

Methods: There were a total of 14 semi-structured interviews with 16 key informants from both countries, on which content analysis was performed. The Consolidated Framework for Implementation Research was used to guide both the construction of the interview guides and the content analysis.

Outcomes: The main barriers present in both countries are resistance from healthcare professionals and technical barriers regarding electronic health record systems and vendors. Facilitators varied across the two contexts, where the national infrastructure and program management were highlighted as facilitators in Sweden and stakeholder engagement (including patients and healthcare professionals) was described as a facilitator in both contexts. Strong leadership was also described as a critical success factor, especially when faced with healthcare professional resistance.

Conclusion: Most of the major barriers and facilitators from both countries are covered in existing literature. This study, however, identified factors that can be seen as more practical and that would not have arisen from interviews with patients or physicians. Recommendations for policymakers include keeping the mentioned barriers in mind from the start of development and paving the way for facilitators, mainly strict policies, learning from peer implementers, and patient involvement, when possible. Implementers should focus on strong decision-making and project management and on preparing the healthcare organization for the PAEHR.
Prospects of Immunology Education and Research in Developing Countries
Authors: Kwarteng Alexander , Sylverken Augustina , Antwi-Berko Daniel , Ahuno Samuel Terkper , Asiedu Samuel Opoku
Published: June 2021

The burden of infectious disease in developing countries is substantially higher than in developed nations. Reasons include poor health care infrastructure and deficiencies in public understanding of infectious disease mechanisms and disease prevention. While immunology education and research have an enviable role in understanding host-pathogen interactions, training programs in immunology remain fully integrated into the curricula of higher institutions, and by extension, to high schools of developing nations. Therefore, we discussed the need to make major investments in immunology research and research training into all natural sciences teaching curricula, particularly in developing countries.
Identification of Demographic Variables Influencing Dementia Literacy and Risk Perception Through a Global Survey
Authors: Horst Becky R. , Furlano Joyla A. , Wong Michelle Y. S. , Ford Sabrina D. , Han Brenna B. , Nagamatsu Lindsay S.
Published: June 2021

Dementia literacy is important for risk mitigation and preventative strategies before disease onset. The aim of our study was to investigate dementia literacy and how demographic characteristics influence these perceptions in order to provide evidence for how dementia-centered public health initiatives should structure their focus. We conducted a globally administered online survey, through Amazon Mechanical Turk (mTurk). Survey items evaluated: (1) personal perception on the preventability of dementia, and (2) risk awareness of lifestyle factors. Differences in risk scoring between the 598 respondents were compared using Kruskal-Wallis testing factored by demographic categorizations. Most of the sample demonstrated understanding that lifestyle factors contribute some risk toward dementia, though these risk scores were generally low. Differences in risk scoring varied by demographic characteristics. Women, older adults, those with non-post-secondary attainment, below average income, and White background tended to report lower risk scores. Public health education and initiatives for dementia prevention should focus on lifestyle risk factors, in addition to considering the barriers related to the demographic factors identified that may prevent populations from accessing programs and information.
Therapy Dogs in Educational Settings: Guidelines and Recommendations for Implementation
Authors: Grové Christine , Henderson Linda , Lee Felicia , Wardlaw Phoebe
Published: June 2021

Therapy dogs in educational settings have gained increase traction in recent years. Despite its potential benefits and popularity, there remain concerns of perceived risks such as sanitation, allergies, and safety issues, as well as a lack of guidelines, regulations and support resources available to school staff. Research is further lacking into the implementation process of therapy dog programs in educational settings. To construct a set of recommendations for school staff to achieve successful implementation of a therapy dog program, the present study investigated the perceived facilitative and impeding factors when implementing a therapy dog program. A total of 13 school staff and 2 coordinators from therapy dog organisations took part in an open-ended online survey and/or a semi-structured interview over the phone, with the aim of gathering their perspectives of implementing a therapy dog program in schools. The thematic analysis of the data indicated facilitative factors such as program flexibility, whole-school support, the need for communication and training for all staff, as well as dog welfare. Successful implementation of therapy dogs in an education setting appear to revolve around (1) flexibility of the dog therapy program to target school's needs, (2) qualities of program instigator, (3) whole-school support, (4) communication, training and education, (5) considerations for dog's welfare. Key barriers identified included a high workload, lack of guidelines on processes, lack of support from the school community, as well as the need for better understanding of the role of a therapy dog. The results highlighted the importance of a whole-school effort when implementing a therapy dog program, as well as the need for guidelines for assessing school readiness, key factors for consideration, and strategies to overcome challenges associated with program implementation.
Cross-Sectoral Zoonotic Disease Surveillance in Western Kenya: Identifying Drivers and Barriers Within a Resource Constrained Setting
Authors: Thomas Lian Francesca , Rushton Jonathan , Bukachi Salome A. , Falzon Laura C. , Howland Olivia , Fèvre Eric M.
Published: June 2021

Background: Collaboration between the human and animal health sectors, including the sharing of disease surveillance data, has the potential to improve public health outcomes through the rapid detection of zoonotic disease events prior to widespread transmission in humans. Kenya has been at the forefront of embracing a collaborative approach in Africa with the inception of the Zoonotic Disease Unit in 2011. Joint outbreak responses have been coordinated at the national level, yet little is currently documented on cross-sectoral collaboration at the sub-national level.

Methods: Key informant interviews were conducted with 28 disease surveillance officers from the human and animal health sectors in three counties in western Kenya. An inductive process of thematic analysis was used to identify themes relating to barriers and drivers for cross-sectoral collaboration.

Results: The study identified four interlinking themes related to drivers and barriers for cross-sectoral collaboration. To drive collaboration at the sub-national level there needs to be a clear identification of “common objectives,” as currently exemplified by the response to suspected rabies and anthrax cases and routine meat hygiene activities. The action of collaboration, be it integrated responses to outbreaks or communication and data sharing, require “operational structures” to facilitate them, including the formalisation of reporting lines, supporting legislation and the physical infrastructure, from lab equipment to mobile phones, to facilitate the activities. These structures in turn require “appropriate resources” to support them, which will be allocated based on the “political will” of those who control the resources.

Conclusions: Ongoing collaborations between human and animal disease surveillance officers at the sub-national level were identified, driven by common objectives such as routine meat hygiene and response to suspected rabies and anthrax cases. In these areas a suitable operational structure is present, including a supportive legislative framework and clearly designated roles for officers within both sectors. There was support from disease surveillance officers to increase their collaboration, communication and data sharing across sectors, yet this is currently hindered by the lack of these formal operational structures and poor allocation of resources to disease surveillance. It was acknowledged that improving this resource allocation will require political will at the sub-national, national and international levels.
Damage Identification of Long-Span Bridges Using the Hybrid of Convolutional Neural Network and Long Short-Term Memory Network
Authors: Fu Lei , Tang Qizhi , Gao Peng , Xin Jingzhou , Zhou Jianting
Published: June 2021

The shallow features extracted by the traditional artificial intelligence algorithm-based damage identification methods pose low sensitivity and ignore the timing characteristics of vibration signals. Thus, this study uses the high-dimensional feature extraction advantages of convolutional neural networks (CNNs) and the time series modeling capability of long short-term memory networks (LSTM) to identify damage to long-span bridges. Firstly, the features extracted by CNN and LSTM are fused as the input of the fully connected layer to train the CNN-LSTM model. After that, the trained CNN-LSTM model is employed for damage identification. Finally, a numerical example of a large-span suspension bridge was carried out to investigate the effectiveness of the proposed method. Furthermore, the performance of CNN-LSTM and CNN under different noise levels was compared to test the feasibility of application in practical engineering. The results demonstrate the following: (1) the combination of CNN and LSTM is satisfactory with 94% of the damage localization accuracy and only 8.0% of the average relative identification error (ARIE) of damage severity identification; (2) in comparison to the CNN, the CNN-LSTM results in superior identification accuracy; the damage localization accuracy is improved by 8.13%, while the decrement of ARIE of damage severity identification is 5.20%; and (3) the proposed method is capable of resisting the influence of environmental noise and acquires an acceptable recognition effect for multi-location damage; in a database with a lower signal-to-noise ratio of 3.33, the damage localization accuracy of the CNN-LSTM model is 67.06%, and the ARIE of the damage severity identification is 31%. This work provides an innovative idea for damage identification of long-span bridges and is conducive to promote follow-up studies regarding structural condition evaluation.
Approximately Optimal Control of Nonlinear Dynamic Stochastic Problems with Learning: The OPTCON Algorithm
Authors: Blueschke Dmitri , Blueschke-Nikolaeva Viktoria , Neck Reinhard
Published: June 2021

OPTCON is an algorithm for the optimal control of nonlinear stochastic systems which is particularly applicable to economic models. It delivers approximate numerical solutions to optimum control (dynamic optimization) problems with a quadratic objective function for nonlinear economic models with additive and multiplicative (parameter) uncertainties. The algorithm was first programmed in C# and then in MATLAB. It allows for deterministic and stochastic control, the latter with open loop (OPTCON1), passive learning (open-loop feedback, OPTCON2), and active learning (closed-loop, dual, or adaptive control, OPTCON3) information patterns. The mathematical aspects of the algorithm with open-loop feedback and closed-loop information patterns are presented in more detail in this paper.
On-Site Pilot Testing of Hospital Wastewater Ozonation to Reduce Pharmaceutical Residues and Antibiotic-Resistant Bacteria
Authors: Svebrant Sofia , Spörndly Robert , Lindberg Richard H. , Olsen Sköldstam Therese , Larsson Jim , Öhagen Patrik , Söderström Lindström Hanna , Järhult Josef D.
Published: June 2021

Hospital sewage constitutes an important point source for antibiotics and antibiotic-resistant bacteria due to the high antibiotic use. Antibiotic resistance can develop and cause problems in sewage systems within hospitals and municipal wastewater treatment plants, thus, interventions to treat hospital sewage on-site are important. Ozonation has proven effective in treating relatively clean wastewater, but the effect on untreated wastewater is unclear. Therefore, we piloted implementation of ozonation to treat wastewater in a tertiary hospital in Uppsala, Sweden. We measured active pharmaceutical ingredients (APIs) using liquid chromatography-mass spectrometry and antibiotic-resistant Enterobacteriaceae using selective culturing pre- and post-ozonation. Comparing low (1 m3/h) and high (2 m3/h) flow, we obtained a ‘dose-dependent’ effect of API reduction (significant reduction of 12/29 APIs using low and 2/29 APIs using high flow, and a mean reduction of antibiotics of 41% using low vs. 6% using high flow, 25% vs. 6% for all APIs). There was no significant difference in the amount of antibiotic-resistant Enterobacteiaceae pre- and post-ozonation. Our results demonstrate that ozonation of untreated wastewater can reduce API content. However, due to the moderate API decrease and numerous practical challenges in the on-site setting, this specific ozonation system is not suitable to implement at full scale in our hospital.
Oral Abscess Caused by Chryseobacterium indologenes in Ball Python (Python regius); A Case Report
Authors: Tamai Iradj Ashrafi , Pakbin Babak , Kafi Zahra Ziafati , Brück Wolfram Manuel
Published: June 2021

Chryseobacterium indologenes is an opportunistic pathogen isolated from human infections and, rarely, from some aquatic animals. A 3-year-old male ball python (Python regius) was admitted to the veterinary clinic by a pet owner because of acute respiratory and swallowing failure. During physical examinations, oral secretions and abscesses were observed in the mouth cavity and throat of the animal. After microbiological analysis including isolation, identification, and 16s rRNA sequencing, C. indologenes was detected as the main cause of the oral abscess in this case. Phylogenetic relatedness analysis showed a close relationship between this isolate and other strains isolated from human infections. Antimicrobial susceptibility testing revealed that the isolate was multi-drug resistant. However, it was very sensitive to minocycline, ceftazidime, and tetracycline. The patient was treated by antibiotic therapy and completely recovered after two weeks. To the best of our knowledge, this is the first incidence of C. indologenes in an oral abscess in a ball python. As a result we would consider this organism as an opportunistic animal pathogen with zoonotic potentiality.
Synergistic Activity of New Diclofenac and Essential Oils Combinations against Different Candida spp.
Authors: Rosato Antonio , Altini Elisabetta , Sblano Sabina , Salvagno Lara , Maggi Filippo , de Michele Giuliana , Carocci Alessia , Clodoveo Maria Lisa , Corbo Filomena , Fracchiolla Giuseppe
Published: June 2021

According to recent studies, Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) have shown a good antimicrobial and antifungal activity. Their association with essential oils (EOs) could be useful for the treatment of infections caused by Candida spp. The aim of this studyis to evaluate the synergistic antifungal activity of new combinations between Diclofenac Sodium Salt (DSS), a widely used NSAID, with EOs of Mentha × piperita, Pelargonium graveolens and Melaleuca alternifolia. The in-vitro antifungal activity was determined on different Candida strains. The determination of the chemical composition of EOs was carried out by gaschromatography-massspectrometry (GC-MS). Susceptibility testing of planktonic cells was performed by using the broth microdilution assay and checkerboard methods. Minimum Inhibitory Concentrations (MIC) of DSS was in a range from 1.02 to 2.05 μg/mL reaching a MIC value of 0.05 μg/mL when combined with Pelargonium graveolens (FICI = 0.23–0.35) or Menthapiperita (FICI = 0.22–0.30) EOs. These preliminary results show thatthe combination of the EOs with DSS improves the antifungal activity on all the tested Candida strains.
Cognitive and Neuroimaging Correlates of the Insomnia Severity Index in Obstructive Sleep Apnea: A Pilot-Study
Authors: Ramos Alberto R. , Alperin Noam , Lee Sang , Gonzalez Kevin A. , Tarraf Wassim , Hernandez-Cardenache Rene
Published: June 2021

We aim to determine the sleep correlates of age-related brain loss in a sample of middle-aged to older males with obstructive sleep apnea (OSA). We recruited consecutive treatment naïve male patients with moderate to severe OSA from January to November of 2019. We excluded participants if they had dementia, stroke or heart disease. We collected demographic variables and vascular risk factors. We also obtained the insomnia severity index, the Epworth sleepiness scale and the Pittsburgh sleep quality index. We also obtained computerized neurocognitive testing with the go-no-go response inhibition test, Stroop interference test, catch game test, staged information processing speed test, verbal memory test and non-verbal memory test. We derived age and education adjusted domain-specific Z-scores for global cognition, memory, attention, processing speed and executive function. We used brain MRI T1-weighted images to derive total hippocampal and gray matter volumes. Partial correlations evaluated associations between variables from sleep questionnaires (e.g., insomnia severity index score), and polysomnographic variables (the apnea-hypopnea index, average oxygen levels during sleep) with cognitive domains and brain volumes. We examined 16 participants with an age range of 40–76 years, 73% Hispanic/Latino. The mean apnea-hypopnea index was 48.9 ± 25.5 and average oxygen saturation during sleep was 91.4% ± 6.9%. Hypertension was seen in 66% and diabetes mellitus in 27%. We found that the insomnia severity index score and average oxygen levels during sleep had the strongest correlations with brain volumes and cognition. These preliminary findings may aid in developing future strategies to improve age-related brain loss in patients with OSA.
The Structure and Mechanical Properties of Hemp Fibers-Reinforced Poly(ε-Caprolactone) Composites Modified by Electron Beam Irradiation
Authors: Malinowski Rafał , Raszkowska-Kaczor Aneta , Moraczewski Krzysztof , Głuszewski Wojciech , Krasinskyi Volodymyr , Wedderburn Lauren
Published: June 2021

The need for the development of new biodegradable materials and modification of the properties the current ones possess has essentially increased in recent years. The aim of this study was the comparison of changes occurring in poly(ε-caprolactone) (PCL) due to its modification by high-energy electron beam derived from a linear electron accelerator, as well as the addition of natural fibers in the form of cut hemp fibers. Changes to the fibers structure in the obtained composites and the geometrical surface structure of sample fractures with the use of scanning electron microscopy were investigated. Moreover, the mechanical properties were examined, including tensile strength, elongation at break, flexural modulus and impact strength of the modified PCL. It was found that PCL, modified with hemp fibers and/or electron radiation, exhibited enhanced flexural modulus but the elongation at break and impact strength decreased. Depending on the electron radiation dose and the hemp fibers content, tensile strength decreased or increased. It was also found that hemp fibers caused greater changes to the mechanical properties of PCL than electron radiation. The prepared composites exhibited uniform distribution of the dispersed phase in the polymer matrix and adequate adhesion at the interface between the two components.
Effect of Characteristics of Ground Motion on Seismically Induced Sliding Surface of Slopes
Authors: Khalid Muhammad Irslan , Lee Yonggook , Lee Yonghee , Kim Hak-Sung , Park Duhee
Published: June 2021

The seismic performance of slopes is typically evaluated with a pseudo-static method using equivalent horizontal load or with Newmark sliding block analysis. In both procedures, the definition of the potential sliding surface is a required input. The sliding surface has been reported to be marginally influenced by the input ground motion and, therefore, is most often assumed from a pseudo-static procedure. In this study, extensive series of two-dimensional dynamic nonlinear finite element analyses are performed to evaluate the sensitivity of the sliding surface on the slope geometry, soil strength parameters, and input ground motion characteristics. It is demonstrated that the sliding surface may vary with the intensity and frequency characteristics of the input motion. Slopes with inclination angle equal or less than 35° are shown to be marginally influenced by motion intensity if the mean period (Tm) < 0.3 s. However, slopes inclined at 45° are revealed to be more sensitive to the motion intensity and Tm. For motions with Tm > 0.3 s, the sliding surface is demonstrated to widen with an increase in the intensity of the input ground motions. The degree of widening increases proportionally with an increase in Tm. It is, therefore, recommended to derive sliding surfaces from a dynamic analysis for steep slopes.
A Review of Machine Learning and Deep Learning Techniques for Anomaly Detection in IoT Data
Authors: Al-amri Redhwan , Murugesan Raja Kumar , Man Mustafa , Abdulateef Alaa Fareed , Al-Sharafi Mohammed A. , Alkahtani Ammar Ahmed
Published: June 2021

Anomaly detection has gained considerable attention in the past couple of years. Emerging technologies, such as the Internet of Things (IoT), are known to be among the most critical sources of data streams that produce massive amounts of data continuously from numerous applications. Examining these collected data to detect suspicious events can reduce functional threats and avoid unseen issues that cause downtime in the applications. Due to the dynamic nature of the data stream characteristics, many unresolved problems persist. In the existing literature, methods have been designed and developed to evaluate certain anomalous behaviors in IoT data stream sources. However, there is a lack of comprehensive studies that discuss all the aspects of IoT data processing. Thus, this paper attempts to fill this gap by providing a complete image of various state-of-the-art techniques on the major problems and core challenges in IoT data. The nature of data, anomaly types, learning mode, window model, datasets, and evaluation criteria are also presented. Research challenges related to data evolving, feature-evolving, windowing, ensemble approaches, nature of input data, data complexity and noise, parameters selection, data visualizations, heterogeneity of data, accuracy, and large-scale and high-dimensional data are investigated. Finally, the challenges that require substantial research efforts and future directions are summarized.
A Distributed Biogas Production Model and Its Use in the Livestock Sector. Case Study: Castile and León
Authors: Reparaz Carlos , Sánchez-Martín Laura , de Godos Ignacio , Mora Pedro , Llamas Bernardo
Published: June 2021

The population increase and the food demand increase the fight against climate change. Porcine production in Europe continues to increase, and Spain is the leading country in pig production. Manure management has a significant environmental impact that requires anaerobic digestion technologies for its mitigation. This technology helps produce biogas, a fuel that will reduce CO2 emissions. This study defines a distributed biogas generation model, determining the expected incomes from the development of this technology in small manure generation facilities (digestible organic waste). The development of this technology will contribute to reduce the demand for fossil energy and increase revenues by 22.7% regarding the expected revenues from the use of biogas for electricity generation.
A Data-Driven Robust Scheduling Method Integrating Particle Swarm Optimization Algorithm with Kernel-Based Estimation
Authors: Zheng Peng , Zhang Peng , Wang Ming , Zhang Jie
Published: June 2021

The assembly job shop scheduling problem (AJSSP) widely exists in the production process of many complex products. Robust scheduling methods aim to optimize the given criteria for improving the robustness of the schedule by organizing the assembly processes under uncertainty. In this work, the uncertainty of process setup time and processing time is considered, and a framework for the robust scheduling of AJSSP using data-driven methodologies is proposed. The framework consists of obtaining the distribution information of uncertain parameters based on historical data and using a particle swarm optimization (PSO) algorithm to optimize the production schedule. Firstly, the kernel density estimation method is used to estimate the probability density function of uncertain parameters. To control the robustness of the schedule, the concept of confidence level is introduced when determining the range of uncertain parameters. Secondly, an interval scheduling method constructed using interval theory and a customized discrete PSO algorithm are used to optimize the AJSSP with assembly constraints. Several computational experiments are introduced to illustrate the proposed method, and these were proven effective in improving the performance and robustness of the schedule.