bluuebunny/crossref_metadata_2025 huggingface dataset:
Photograph Based Evaluation of Consumer Expectation on Healthiness, Fullness, and Acceptance of Sandwiches as Convenience Food
Authors: García-Segovia Purificación , Pagán-Moreno Mª Jesús , Tárrega Amparo , Martínez-Monzó Javier
Published: May 2021

Sandwiches are the most common “casual-food” consumed by all age groups in Spain. Due to the importance of visual appearance to promote unplanned or impulse buying, foodservice and hospitality companies focus on improving the visual impression of their food menus to create an expectation that satisfies both sensory and hedonic consumer experiences. To provide a list of attributes about the visual appearance of sandwiches, 25 students were recruited from a university and were invited to participate in two nominal group technique (NGT) sessions. To understand whether a sandwiches’ appearance can influence the expectation of consumers, 259 participants completed an online survey specially designed from the results of the NGT sessions. Data were analyzed using conjoint, internal preference mapping and cluster analysis; the interaction effect by gender was also studied. The conjoint results indicate that visual perception about the filling (vegetal or pork based) plays the most key role overall in consumer expectation. When consumers choose vegetables as the filling, the consumers’ perceived sandwiches as healthier, but the pork filling was perceived as more attractive and satiating. Interaction effect by gender was observed in filling when females perceived pork filling as less healthy than vegetable. By acceptance, consumers were segmented into three groups. The first cluster (n = 80) selected the pork filling. The smaller group (cluster 3, n = 36) prioritized the vegetal filling, and the most numerous cluster 2 (n = 140) liked sandwiches with multigrain bread. These results may help companies to build tailor-made marketing strategies to satisfy consumer segments.
The Effect of Electrospun Polycaprolactone Nonwovens Containing Chitosan and Propolis Extracts on Fresh Pork Packaged in Linear Low-Density Polyethylene Films
Authors: Vargas Romero Emeli , Lim Loong-Tak , Suárez Mahecha Héctor , Bohrer Benjamin M.
Published: May 2021

Fresh meat products are highly perishable and require optimal packaging conditions to maintain and potentially extend shelf-life. Recently, researchers have developed functional, active packaging systems that are capable of interacting with food products, package headspace, and/or the environment to enhance product shelf-life. Among these systems, antimicrobial/antioxidant active packaging has gained considerable interest for delaying/preventing microbial growth and deteriorative oxidation reactions. This study evaluated the effectiveness of active linear low-density polyethylene (LLDPE) films coated with a polycaprolactone/chitosan nonwoven (Film 1) or LLDPE films coated with a polycaprolactone/chitosan nonwoven fortified with Colombian propolis extract (Film 2). The active LLDPE films were evaluated for the preservation of fresh pork loin (longissimus dorsi) chops during refrigerated storage at 4 °C for up to 20 d. The meat samples were analyzed for pH, instrumental color, purge loss, thiobarbituric acid reactive substances (TBARS), and microbial stability (aerobic mesophilic and psychrophilic bacteria). The incorporation of the propolis-containing nonwoven layer provided antioxidant and antimicrobial properties to LLDPE film, as evidenced by improved color stability, no differences in lipid oxidation, and a delay of 4 d for the onset of bacteria growth of pork chops during the refrigerated storage period.
Elastic Rough Surface Contact and the Root Mean Square Slope of Measured Surfaces over Multiple Scales
Authors: Jackson Robert , Xu Yang , Saha Swarna , Schulze Kyle
Published: May 2021

This study investigates the predictions of the real contact area for perfectly elastic rough surfaces using a boundary element method (BEM). Sample surface measurements were used in the BEM to predict the real contact area as a function of load. The surfaces were normalized by the root-mean-square (RMS) slope to evaluate if contact area measurements would collapse onto one master curve. If so, this would confirm that the contact areas of manufactured, real measured surfaces are directly proportional to the root mean square slope and the applied load, which is predicted by fractal diffusion-based rough surface contact theory. The data predicts a complex response that deviates from this behavior. The variation in the RMS slope and the spectrum of the system related to the features in contact are further evaluated to illuminate why this property is seen in some types of surfaces and not others.
On a Five-Parameter Mittag-Leffler Function and the Corresponding Bivariate Fractional Operators
Authors: Özarslan Mehmet Ali , Fernandez Arran
Published: May 2021

Several extensions of the classical Mittag-Leffler function, including multi-parameter and multivariate versions, have been used to define fractional integral and derivative operators. In this paper, we consider a function of one variable with five parameters, a special case of the Fox–Wright function. It turns out that the most natural way to define a fractional integral based on this function requires considering it as a function of two variables. This gives rise to a model of bivariate fractional calculus, which is useful in understanding fractional differential equations involving mixed partial derivatives.
Nanoclay/Polymer-Based Hydrogels and Enzyme-Loaded Nanostructures for Wound Healing Applications
Authors: Villalba-Rodríguez Angel M. , Martínez-González Sara , Sosa-Hernández Juan Eduardo , Parra-Saldívar Roberto , Bilal Muhammad , Iqbal Hafiz M. N.
Published: May 2021

Multi-polymeric nanocomposite hydrogels with multi-functional characteristics have been engineered with high interest around the globe. The ease in fine tunability with maintained compliance makes an array of nanocomposite biomaterials outstanding candidates for the biomedical sector of the modern world. In this context, the present work intends to tackle the necessity of alternatives for the treatment of diabetic foot ulcers through the formulation of nanoclay and/or polymer-based nanocomposite hydrogels. Laponite RD, a synthetic 2-D nanoclay that becomes inert when in a physiological environment, while mixed with water, becomes a clear gel with interesting shear-thinning properties. Adding Laponite RD to chitosan or gelatin allows for the modification of the mechanical properties of such materials. The setup explored in this research allows for a promising polymeric matrix that can potentially be loaded with active compounds for antibacterial support in foot ulcers, as well as enzymes for wound debridement.
Development of Polymer-Assisted Nanoparticles and Nanogels for Cancer Therapy: An Update
Authors: Neerooa Bibi Noorheen Haleema Mooneerah , Ooi Li-Ting , Shameli Kamyar , Dahlan Nuraina Anisa , Islam Jahid M. M. , Pushpamalar Janarthanan , Teow Sin-Yeang
Published: May 2021

With cancer remaining as one of the main causes of deaths worldwide, many studies are undergoing the effort to look for a novel and potent anticancer drug. Nanoparticles (NPs) are one of the rising fields in research for anticancer drug development. One of the key advantages of using NPs for cancer therapy is its high flexibility for modification, hence additional properties can be added to the NPs in order to improve its anticancer action. Polymer has attracted considerable attention to be used as a material to enhance the bioactivity of the NPs. Nanogels, which are NPs cross-linked with hydrophilic polymer network have also exhibited benefits in anticancer application. The characteristics of these nanomaterials include non-toxic, environment-friendly, and variable physiochemical properties. Some other unique properties of polymers are also attributed by diverse methods of polymer synthesis. This then contributes to the unique properties of the nanodrugs. This review article provides an in-depth update on the development of polymer-assisted NPs and nanogels for cancer therapy. Topics such as the synthesis, usage, and properties of the nanomaterials are discussed along with their mechanisms and functions in anticancer application. The advantages and limitations are also discussed in this article.
Sexual Violence and Trauma in Childhood: A Case Report Based on Strategic Counseling
Authors: Saladino Valeria , Eleuteri Stefano , Zamparelli Elisa , Petrilli Monica , Verrastro Valeria
Published: May 2021

Children and adolescents are too often victims of sexual abuse and harassment. According to the World Health Organization (WHO), approximately 150 million girls and 73 million children <18 have been victims of violence and sexual exploitation during their childhood. Data show that females are more likely to be a victim of abuse and violence than males (20% vs. 5–10%). Such abuses lead to long-term psychophysical and relational consequences and victims are often afraid of asking for support from both parents and professionals. This case report shows the story of a 17-year-old adolescent, Sara, involved by her mother in a strategic counseling process, to solve BDSM-type sexual addiction (slavery and discipline, domination and submission, sadism and masochism), self-aggressive behavior, and alcohol abuse issues. The strategic counseling process is structured in 15 sessions and was based on problem-solving techniques and corrective behavioral strategies. During the sessions, it emerged that Sara had been a victim of sexual violence at the age of 6 and that she had never talked about the rape with anyone. At the age of 12, she began to experience social anxiety and shame, feelings that led her to use alcohol and seek violent sexual partners and bondage relationships. During the counseling sessions, Sara elaborated on her trauma, becoming more aware of her resources and her desires, and she learned to manage the sense of guilt and shame associated with the violence suffered, through alternative strategies. At the end of the process, Sara normalized her relationship with sex and alcohol, regaining her identity.
Determinants and Prediction of Injury Severities in Multi-Vehicle-Involved Crashes
Authors: Song Xiuguang , Pi Rendong , Zhang Yu , Wu Jianqing , Dong Yuhuan , Zhang Han , Zhu Xinyuan
Published: May 2021

Multi-vehicle (MV) crashes, which can lead to great damages to society, have always been a serious issue for traffic safety. A further understanding of crash severity can help transportation engineers identify the critical reasons and find effective countermeasures to improve transportation safety. However, studies involving methods of machine learning to predict the possibility of injury-severity of MV crashes are rarely seen. Besides that, previous studies have rarely taken temporal stability into consideration in MV crashes. To bridge these knowledge gaps, two kinds of models: random parameters logit model (RPL), with heterogeneities in the means and variances, and Random Forest (RF) were employed in this research to identify the critical contributing factors and to predict the possibility of MV injury-severity. Three-year (2016–2018) MV data from Washington, United States, extracted from the Highway Safety Information System (HSIS), were applied for crash injury-severity analysis. In addition, a series of likelihood ratio tests were conducted for temporal stability between different years. Four indicators were employed to measure the prediction performance of the selected models, and four categories of crash-related characteristics were specifically investigated based on the RPL model. The results showed that the machine learning-based models performed better than the statistical models did when taking the overall accuracy as an evaluation indicator. However, the statistical models had a better prediction performance than the machine learning models had considering crash costs. Temporal instabilities were present between 2016 and 2017 MV data. The effect of significant factors was elaborated based on the RPL model with heterogeneities in the means and variances.
Infant Cognitive Development and Stimulating Parenting Practices in Rural China
Authors: Johnstone Hannah , Yang Yi , Xue Hao , Rozelle Scott
Published: May 2021

This study examines the prevalence of cognitive delay among infants and toddlers in rural China and its relationship with one of the potential sources of the observed delay: low levels of stimulating parenting practices (SPPs). Data were compiled from five distinct studies, resulting in a pooled sample of 4436 caregivers of 6–29-month-old infants. The sampling sites span five provinces in rural China. According to the data, on average, rates of delay are high—51 percent. The low rates of SPPs among our sample demonstrate that this may be one source of the high prevalence of delays. The results of the multivariate regression analysis reveal that reading books and singing songs are each significantly associated with an increase in infant cognitive score by 1.62 points (p = 0.003) and 2.00 points (p < 0.001), respectively. Telling stories to infants, however, is not significantly associated with infant cognitive scores. Our findings indicate that caregivers with different characteristics engage in various levels of stimulating practices and have infants with different rates of delay. Specifically, infants of better-educated mothers who have greater household assets are in families in which the caregivers provide more SPPs and have infants who score higher on the study’s cognitive abilities scales.
Personalized Type 2 Diabetes Management Using a Mobile Application Integrated with Electronic Medical Records: An Ongoing Randomized Controlled Trial
Authors: Lee Eun-Young , Yun Jae-Seung , Cha Seon-Ah , Lim Sun-Young , Lee Jin-Hee , Ahn Yu-Bae , Yoon Kun-Ho , Ko Seung-Hyun
Published: May 2021

Controlling type 2 diabetes (T2DM) requires a comprehensive approach including patient education, self-monitoring of blood glucose, individualized behavioral strategies, and frequent contact with healthcare professionals (HCPs). We aimed to compare the efficacy of a personalized lifestyle intervention based on a mobile phone application with regular care in participants with T2DM. This is an ongoing randomized controlled open-label parallel-group trial with a target accrual of 282 participants, of which 181 have been enrolled to date. Participants are randomly assigned to one of three groups: (1) regular care; (2) mobile diabetes management; or (3) mobile diabetes management with HCP feedback. The mobile application is enabled to integrate with both electronic medical records (EMR) and a web-based diabetes management system for HCPs. It can send customized messages based on participants’ responses to lifestyle questionnaires administered at the baseline. The intervention period is 26 weeks followed by observation for 26 weeks. We evaluate the intervention’s features in order to assess its clinical utility and efficacy and compare outcomes with regular care considering relevant clinical factors, such as age, baseline HbA1c, etc. We expect our study to provide new evidence in support of customized mobile application tools for the management of T2DM.
Barriers to Accessing Treatment Services: Child Victims of Youths with Problematic Sexual Behavior
Authors: Slemaker Alexandra , Mundey Peter , Taylor Erin K. , Beasley Lana O. , Silovsky Jane F.
Published: May 2021

Child sexual abuse (CSA) remains a significant public health problem. Although the deleterious effects on the child victims could be mitigated through evidence-based interventions, victims often fail to be identified and receive clinical assessment and therapy services, particularly when they have been victimized by another youth. Given that at least a third of CSA cases are committed by another youth, understanding the process of identifying and addressing the needs of CSA victims of youth is the focus of the present study. Factors impacting services for child victims of youths with problematic sexual behavior (PSB) were examined through qualitative interviews (N = 226) with mental health agency administrators, direct service providers, and community stakeholders from eight geographically diverse communities across the United States. Responses focused on macro and micro level barriers to the identification and service provision for child victims of PSB of youths. Implications for clinicians and policymakers are discussed, along with strategies to enhance access and provision of services to meet the needs of the child victims.
Association between Low House Cleaning Frequency, Cough and Risk of Miscarriage: A Case Control Study in China
Authors: Gao Fumei , Meng Xiangrui , Zhang Qiuxiang , Fu Min , Ren Yumeng , Hu Jianying , Shen Huan , Tang Kun
Published: May 2021

This study investigated the association between house cleaning frequency and the risk of miscarriage in a case control sample of Chinese population. We recruited 59 pregnant women with clinical pregnancy loss as cases and 122 women who chose to conduct induced abortion as controls. All participants were aged 20~40 years and completed a questionnaire of lifestyle exposure with a trained nurse. The effect of frequency of cleaning up on risk of miscarriage was estimated using multivariable logistic regressions, adjusting for potential confounders. In the present study, it was shown that house cleaning of less than twice per week was significantly associated with cough during day or night with odds ratio (OR) of 2.97 (95% CI: 1.36~6.75, p = 0.007), and cough during day or night was significantly associated with risk of miscarriage with OR of 2.69 (95% CI: 1.22~6.02, p = 0.014). Thus, house cleaning of less than twice per week was statistically significantly associated with miscarriage with OR of 3.05 (95% CI: 1.51~6.31, p = 0.002). We found that females who have their house cleaned less than twice per week are at elevated risk for miscarriage. Therefore, the home of pregnant woman should be cleaned at least twice per week in order to avoid miscarriage.
The Impact of Livelihood Assets on the Food Security of Farmers in Southern Iran during the COVID-19 Pandemic
Authors: Yazdanpanah Masoud , Tajeri Moghadam Maryam , Savari Moslem , Zobeidi Tahereh , Sieber Stefan , Löhr Katharina
Published: May 2021

The impact of COVID-19 on farmers’ livelihoods and food security is a key concern in rural communities. This study investigates the impacts of the livelihood assets on the food security of rural households during the COVID-19 pandemic and determines those factors related to food security. The population of this study includes rural households in Dashtestan county, Bushehr province, in southern Iran. Based on the Krejcie and Morgan sampling table, 293 households were selected using the convenience sampling method. To measure food security, the American standard index and ordinal regression are used to analyze the factors. The results of the food security situation show highly precarious and food insecure situations among the studied rural households. The regression analysis shows that the most important assets affecting the food security of rural households under COVID-19 are financial, psychological, physical, and human assets, respectively. The results can help rural development planners and policymakers to improve both livelihoods and food security in rural communities, not just during the COVID-19 pandemic, but also in its aftermath.
Risk-Taking Behavior and the Consumption of Alcohol Mixed with Energy Drink among Australian, Dutch and UK Students
Authors: Johnson Sean J. , Benson Sarah , Scholey Andrew , Alford Chris , Verster Joris C.
Published: May 2021

The relationship between risk-taking behavior, alcohol consumption and negative alcohol-related consequences is well known. The current analyses were conducted to investigate whether alcohol mixed with energy drink (AMED) is related to risk-taking behavior and if there is a relationship between the amount of energy drink mixed with alcohol consumed, risk-taking behavior and negative alcohol-related consequences. Data from N = 1276 AMED consuming students from the Netherlands, UK and Australia who completed the same survey were evaluated. The analysis revealed that, compared to AMED occasions, on alcohol only (AO) occasions significantly more alcohol was consumed and significantly more negative alcohol-related consequences were reported. On both AO and AMED occasions, there was a strong and positive relationship between amount of alcohol consumed, level of risk-taking behavior and number of reported negative alcohol-related consequences. In contrast, the level of risk-taking behavior was not clearly related to energy drink consumption. Across risk-taking levels, differences in the amount of energy drink consumed on AMED occasions did not exceed one 250 mL serving of energy drink. When correcting for the amount of alcohol consumed, there were no statistically significant differences in the number of energy drinks consumed on AMED occasions between the risk-taking groups. In conclusion, alcohol consumption is clearly related to risk-taking behavior and experiencing negative alcohol-related consequences. In contrast, energy drink intake was not related to level of risk-taking behavior and only weakly related to the number of experienced negative alcohol-related consequences.
COVID-19—Related Assault on Asians: Economic Hardship in the United States and India Predicts Diminished Support for Victim Compensation and Assailant Punishment
Authors: Johnson James , Sattler David N. , Otton Kylie
Published: May 2021

Background: There has been an alarming increase in discrimination and violence towards Asians during the coronavirus (COVID-19) pandemic amid reports that the virus was first detected in China. In an incident involving a COVID-19-related physical assault, this study examined whether economic hardship experienced by participants during the pandemic and the race of the victim (Chinese, White) would influence support to compensate a victim and punish the assailant. The study also explored whether the perception that the victim experienced emotional and physical suffering due to the assault would mediate the relationships. Method: Participants in India and the United States reported on their own economic hardship due to the pandemic. They then read about an incident in which an innocent person suffered a COVID-19-related physical and verbal attack, and indicated if they would support punishing the assailant and financially compensating the victim. Results: When the victim was Chinese, participants experiencing a high degree of COVID-19 economic hardship were less likely to support financially compensating the victim or punishing the assailant compared to when the victim was White. Furthermore, when the victim was Chinese, the negative associations between economic hardship and financially compensating the victim and punishing the assailant were mediated by reduced recognition that the victim suffered emotional trauma and pain as a result of the attack. Conclusions: COVID-19-driven economic hardship experienced by participants predicted an array of reactions that reflected reduced recognition of the civil and human rights of a victim of a COVID-19-related assault. These findings have significant implications for mental health, public health, and the justice system, and underscore the pressing need for prompt action to mitigate economic hardship and to address racism and discrimination.
Assessment of the Dynamics of Temperature Changes in the Knee Joint Area in Response to Selected Cooling Agents in Thermographic Tests
Authors: Radecka Aleksandra , Pluta Waldemar , Lubkowska Anna
Published: May 2021

Although local cryotherapy (LC) is performed with various cooling agents (CAg) such as ice, water, and gasses, in clinical practice, it is mostly performed with cooling gasses. Presently, LC with cooling gasses is very popular but the inference about the thermal (stimulus) effect on the tissues is mainly based on research carried out using ice packs. The proposed objective of the study was to evaluate the dynamics of temperature changes in the knee joint area in response to a 3-min exposure to liquid nitrogen vapors (LNVs), cold air (CA) and ice bag (IB). The study group included 23 healthy volunteers with an average age of 26.67 ± 4.56. The exposed (ROIE) and contralateral (ROINE) areas of the knee joint after exposure to CAg were observed. Immediately after 3 min of LC, the ROIE temperature dropped by 10.11 ± 0.91 °C after LNV, 7.59 ± 0.14 °C after IB and 6.76 ± 1.3 °C after CA. Significant tissue cooling was maintained up to 15 min after LNV (p < 0.01), 10 min after IB (p < 0.05) and 5 min after CA (p < 0.05). LC causes significant temperature changes both in ROIE and ROINE. The greatest cooling potential was demonstrated for LNV and the lowest for CA.
Post-COVID-19 Syndrome and the Potential Benefits of Exercise
Authors: Jimeno-Almazán Amaya , Pallarés Jesús G. , Buendía-Romero Ángel , Martínez-Cava Alejandro , Franco-López Francisco , Sánchez-Alcaraz Martínez Bernardino J. , Bernal-Morel Enrique , Courel-Ibáñez Javier
Published: May 2021

The coronavirus disease (COVID-19), caused by severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) infection, is leading to unknown and unusual health conditions that are challenging to manage. Post-COVID-19 syndrome is one of those challenges, having become increasingly common as the pandemic evolves. The latest estimates suggest that 10 to 20% of the SARS-CoV-2 patients who undergo an acute symptomatic phase are experiencing effects of the disease beyond 12 weeks after diagnosis. Although research is beginning to examine this new condition, there are still serious concerns about the diagnostic identification, which limits the best therapeutic approach. Exercise programs and physical activity levels are well-known modulators of the clinical manifestations and prognosis in many chronic diseases. This narrative review summarizes the up-to-date evidence on post-COVID-19 syndrome to contribute to a better knowledge of the disease and explains how regular exercise may improve many of these symptoms and could reduce the long-term effects of COVID-19.
Evaluation of the Prognosis of COVID-19 Patients According to the Presence of Underlying Diseases and Drug Treatment
Authors: Kim Ejin , Kim Yong Chul , Park Jae Yoon , Jung Jiyun , Lee Jung Pyo , Kim Ho
Published: May 2021

Certain underlying diseases such as diabetic mellitus and hypertension are a risk factor for the severity and mortality of coronavirus disease (COVID-19) patients. Furthermore, both angiotensin converting enzyme inhibitors (ACEi) and angiotensin II receptor blockers (ARBs) are controversial at role in the process of COVID-19 cases. The aim of the study was to investigate whether underlying diseases and taking ACEi/ARBs, affect the duration of hospitalization and mortality in patients with confirmed COVID-19. Medical usage claims data for the past three years until 15 May 2020, from the “CORONA-19 International Cooperation Research” project was used. We analyzed the medical insurance claims data for all 7590 coronavirus (COVID-19) patients confirmed by RT-PCR tests nationwide up to 15 May 2020. Among the comorbidities, a history of hypertension (hazard ratio [HR], 1.51; 95% confidence interval [CI], 1.056–2.158) and diabetes (HR, 1.867; 95% CI, 1.408–2.475) were associated significantly with mortality. Furthermore, heart failure (HR, 1.391; 95% CI, 1.027–1.884), chronic obstructive pulmonary disease (HR, 1.615; 95% CI, 1.185–2.202), chronic kidney disease (HR, 1.451; 95% CI, 1.018–2.069), mental disorder (HR, 1.61; 95% CI, 1.106–2.343), end stage renal disease (HR, 5.353; 95% CI, 2.185–13.12) were also associated significantly with mortality. The underlying disease has increased the risk of mortality in patients with COVID-19. Diabetes, hypertension, cancer, chronic kidney disease, heart failure, and mental disorders increased mortality. Controversial whether taking ACEi/ARBs would benefit COVID-19 patients, in our study, patients taking ACEi/ARBs had a higher risk of mortality.
Psychometric Analysis of the Czech Version of the Toronto Empathy Questionnaire
Authors: Novak Lukas , Malinakova Klara , Mikoska Petr , van Dijk Jitse P. , Dechterenko Filip , Ptacek Radek , Tavel Peter
Published: May 2021

Empathy is a concept associated with various positive outcomes. However, to measure such a multifaceted concept, valid and reliable tools are needed. Negatively worded items (NWIs) are suspected to decrease some psychometric parameters of assessment instruments, which complicates the research of empathy. Therefore, the aim of this study was to assess the factor structure and validity of the TEQ on the Czech population, including the influence of the NWIs. Data were collected from three surveys. In total, 2239 Czech participants were included in our study. Along with socio-demographic information, we measured empathy, neuroticism, spirituality, self-esteem, compassion and social desirability. NWI in general yielded low communalities, factor loadings and decreased internal consistency. Therefore, in the next steps, we tested the model consisting of their positively reformulated versions. A higher empathy was found in females, married and religious individuals. We further found positive associations between empathy, compassion and spirituality. After the sample was split in half, exploratory factor analysis of the model with reformulated items was followed by confirmatory factor analysis (CFA), which supported a unidimensional solution with good internal consistency: Cronbach’s α = 0.85 and McDonald’s ω = 0.85. The CFA indicated an acceptable fit χ2 (14) = 83.630; p < 0.001; CFI = 0.997; TLI = 0.995; RMSEA = 0.070; SRMR = 0.037. The Czech version of the TEQ is a valid and reliable tool for the assessment of empathy. The use of NWIs in Czech or in a similar language environment seems to be questionable and their rewording may represent a more reliable approach.
Challenges in Diagnosing Intermediate Maple Syrup Urine Disease by Newborn Screening and Functional Validation of Genomic Results Imperative for Reproductive Family Planning
Authors: Sajeev Mona , Chin Sharon , Ho Gladys , Bennetts Bruce , Sankaran Bindu Parayil , Gutierrez Bea , Devanapalli Beena , Tolun Adviye Ayper , Wiley Veronica , Fletcher Janice , Fuller Maria , Balasubramaniam Shanti
Published: May 2021

Maple syrup urine disease is caused by a deficiency of branched-chain alpha-ketoacid dehydrogenase, responsible for degradation of leucine, isoleucine, and valine. Biallelic pathogenic variants in BCKDHA, BCKDHB, or DBT genes result in enzyme deficiency. We report the case of a female infant who presented with mild gross motor delay at 4 months, and seizures with hypoglycaemia at 5 months. Newborn screening returned total leucine/isoleucine at the 99.5th centile of the population; however, as second-tier testing reported minimal alloisoleucine, the results were considered inconsistent with MSUD. Plasma amino acid and urine organic acid analyses at 5 months were, however, consistent with a diagnosis of MSUD. A brain MRI showed bilateral symmetrical T2 hyperintense signal abnormalities involving white matter, globus pallidus, thalamus, brainstem, and dentate nuclei with restricted diffusion. A repeat MRI 10 months post-dietary-intervention showed the resolution of these changes and progression in myelination. Her clinical phenotype, including protein tolerance, correlated with intermediate MSUD. Molecular analysis of all three genes identified two variants of uncertain significance, c.434-15_434-4del and c.365A>G (p. Tyr122Cys) in the DBT gene. The rate of leucine decarboxylation in fibroblasts was reduced, but not to the extent observed in classical MSUD patients, supporting an intermediate form of MSUD. Previously reported mRNA splicing studies supported a deleterious effect of the c.434-15_434-4del variant. This functional evidence and confirmation that the variants were in trans, permitted their reclassification as pathogenic and likely pathogenic, respectively, facilitating subsequent prenatal testing. This report highlights the challenges in identifying intermediate MSUD by newborn screening, reinforcing the importance of functional studies to confirm variant pathogenicity in this era of molecular diagnostics.
A Systematic Review of Design Workshops for Health Information Technologies
Authors: Ozkaynak Mustafa , Sircar Christina M. , Frye Olivia , Valdez Rupa S.
Published: May 2021

Background: Design workshops offer effective methods in eliciting end-user participation from design inception to completion. Workshops unite stakeholders in the utilization of participatory methods, coalescing in the best possible creative solutions. Objective: This systematic review aimed to identify design approaches whilst providing guidance to health information technology designers/researchers in devising and organizing workshops. Methods: A systematic literature search was conducted in five medical/library databases identifying 568 articles. The initial duplication removal resulted in 562 articles. A criteria-based screening of the title field, abstracts, and pre-full-texts reviews resulted in 72 records for full-text review. The final review resulted in 10 article exclusions. Results: 62 publications were included in the review. These studies focused on consumer facing and clinical health information technologies. The studied technologies involved both clinician and patients and encompassed an array of health conditions. Diverse workshop activities and deliverables were reported. Only seven publications reported workshop evaluation data. Discussion: This systematic review focused on workshops as a design and research activity in the health informatics domain. Our review revealed three themes: (1) There are a variety of ways of conducting design workshops; (2) Workshops are effective design and research approaches; (3) Various levels of workshop details were reported.
Monitoring Exotic Beetles with Inexpensive Attractants: A Case Study
Authors: Ruzzier Enrico , Galli Andrea , Bani Luciano
Published: May 2021

Detecting and monitoring exotic and invasive Coleoptera is a complex activity to implement, and citizen science projects can provide significant contributions to such plans. Bottle traps are successfully used in wildlife surveys and can also be adapted for monitoring alien species; however, a sustainable, large scale trapping plan must take into account the collateral catches of native species and thus minimize its impact on local fauna. In the present paper, we tested the use of bottles baited with standard food products that can be purchased in every supermarket and immediately used (apple cider vinegar, red wine, and 80% ethyl alcohol) in capturing exotic and invasive beetles in the area surrounding Malpensa Airport (Italy). In particular, we reduced the exposition type of the traps in each sampling round to three days in order to minimize native species collecting. We found a significant effect of the environmental covariates (trap placement, temperature, humidity, and forest type) in affecting the efficiency in catching target beetles. Nearly all invasive Nitidulidae and Scarabaeidae known to be present in the area were captured in the traps, with apple cider vinegar usually being the most effective attractant, especially for the invasive Popillia japonica.
Sympathetic Activation and Arrhythmogenesis after Myocardial Infarction: Where Do We Stand?
Authors: Zekios Konstantinos C. , Mouchtouri Eleni-Taxiarchia , Lekkas Panagiotis , Nikas Dimitrios N. , Kolettis Theofilos M.
Published: May 2021

Myocardial infarction often leads to progressive structural and electrophysiologic remodeling of the left ventricle. Despite the widespread use of β-adrenergic blockade and implantable defibrillators, morbidity and mortality from chronic-phase ventricular tachyarrhythmias remains high, calling for further investigation on the underlying pathophysiology. Histological and functional studies have demonstrated extensive alterations of sympathetic nerve endings at the peri-infarct area and flow-innervation mismatches that create a highly arrhythmogenic milieu. Such accumulated evidence, along with the previously well-documented autonomic dysfunction as an important contributing factor, has stirred intense research interest for pharmacologic and non-pharmacologic neuromodulation in post-infarction heart failure. In this regard, aldosterone inhibitors, sacubitril/valsartan and sodium-glucose cotransporter type 2 inhibitors have shown antiarrhythmic effects. Non-pharmacologic modalities, currently tested in pre-clinical and clinical trials, include transcutaneous vagal stimulation, stellate ganglion modulation and renal sympathetic denervation. In this review, we provide insights on the pathophysiology of ventricular arrhythmogenesis post-myocardial infarction, focusing on sympathetic activation.
Serum Periostin as a Potential Biomarker in Pediatric Patients with Primary Hypertension
Authors: Szyszka Michał , Skrzypczyk Piotr , Stelmaszczyk-Emmel Anna , Pańczyk-Tomaszewska Małgorzata
Published: May 2021

Experimental studies suggest that periostin is involved in tissue repair and remodeling. The study aimed to evaluate serum periostin concentration as potential biomarker in pediatric patients with primary hypertension (PH). We measured serum periostin, blood pressure, arterial damage, biochemical, and clinical data in 50 children with PH and 20 age-matched healthy controls. In univariate analysis, children with PH had significantly lower serum periostin compared to healthy peers (35.42 ± 10.43 vs. 42.16 ± 12.82 [ng/mL], p = 0.038). In the entire group of 70 children serum periostin concentration correlated negatively with peripheral, central, and ambulatory blood pressure, as well as with aortic pulse wave velocity (aPWV). In multivariate analysis, periostin level significantly correlated with age (β = −0.614, [95% confidence interval (CI), −0.831–−0.398]), uric acid (β = 0.328, [95%CI, 0.124–0.533]), body mass index (BMI) Z-score (β = −0.293, [95%CI, −0.492–−0.095]), high-density lipoprotein (HDL)-cholesterol (β = 0.235, [95%CI, 0.054–0.416]), and triglycerides (β = −0.198, [95%CI, −0.394–−0.002]). Neither the presence of hypertension nor blood pressure and aPWV influenced periostin level. To conclude, the role of serum periostin as a biomarker of elevated blood pressure and arterial damage in pediatric patients with primary hypertension is yet to be unmasked. Age, body mass index, uric acid, and lipid concentrations are key factors influencing periostin level in pediatric patients.
Holter-Derived Autonomic Function, Arrhythmias and Carbohydrate Metabolism in Patients with Class III Obesity Treated with Laparoscopic Sleeve Gastrectomy
Authors: Bienias Piotr , Rymarczyk Zuzanna , Domienik-Karłowicz Justyna , Lisik Wojciech , Sobieraj Piotr , Pruszczyk Piotr , Ciurzyński Michał
Published: May 2021

The effects of weight loss following bariatric surgery on autonomic balance, arrhythmias and insulin resistance are still of interest. We prospectively investigated 50 patients with BMI > 40 kg/m2, aged 36.5 (18–56) years who underwent laparoscopic sleeve gastrectomy. Among other examinations, all subjects had 24-h Holter monitoring with heart rate variability (HRV) and heart rate turbulence (HRT) evaluation. After a median of 15 months, BMI decreased from 43.9 to 29.7 kg/m2, the incidence of hypertension decreased from 54 to 32% (p = 0.04) and any carbohydrate disorders decreased from 24 to 6% (p = 0.02). Fasting insulin concentration and insulin resistance index improved significantly (p < 0.001). Improvements in HRV parameters related to the sympathetic autonomic division were also observed (p < 0.001), while HRT evaluation was not conclusive. The enhancement of autonomic tone indices was correlated with reduction of BMI (SDNN-I r = 0.281 p = 0.04; SDNN r = 0.267 p = 0.05), but not with reduction of waist circumference, and it was also associated with decrease of mean heart rate (OR 0.02, 95%CI 0.0–0.1, p < 0.001). The incidence of arrhythmias was low and similar before and after follow-up. In conclusion, improvement of homeostasis of carbohydrate metabolism and autonomic function is observed in relatively young patients after weight loss due to laparoscopic sleeve gastrectomy.
Evaluation of the Impact of Virtual Reality-Enhanced Cardiac Rehabilitation on Depressive and Anxiety Symptoms in Patients with Coronary Artery Disease: A Randomised Controlled Trial
Authors: Jóźwik Sandra , Cieślik Błażej , Gajda Robert , Szczepańska-Gieracha Joanna
Published: May 2021

The aim of this study was to assess the efficacy of virtual reality (VR)-enhanced cardiac rehabilitation (CR) in reducing the intensity of depression and anxiety symptoms in patients undergoing phase II of CR in ambulatory conditions. One hundred participants (mean age 65.7 years) were divided randomly into two groups. Both groups took part in eight sessions of standard CR (three times per week). The experimental group was additionally supported by eight sessions of VR therapy using the VR TierOne device and the control group by eight sessions of Schultz Autogenic Training. The Hospital Anxiety and Depression Scale (HADS) was used as the primary outcome measure. The Perception of Stress Questionnaire was used as the secondary outcome measure. The data from 77 participants were subject to analysis. Post-intervention, in the experimental group, the overall HADS score was statistically significantly reduced by 13.5%, HADS-Depression by 20.8%, and the general stress level by 12.8% (p < 0.05). In the control group, the scores of the HADS, HADS-Anxiety and the general stress level were statistically significantly higher, by 4.8%, 6.5%, and 4.9%, respectively. VR-enhanced CR for individuals with cardiovascular disease reduced the level of anxiety and depression symptoms compared to standard CR.
Aconitine Neurotoxicity According to Administration Methods
Authors: Chung Ji Yeon , Lee Seung Jae , Lee Hyuck Jin , Bong Jeong Bin , Lee Chan-Hyuk , Shin Byoung-Soo , Kang Hyun Goo
Published: May 2021

We evaluated the toxic effects of aconitine on the human nervous system and its associated factors, and the general clinical characteristics of patients who visited the emergency room due to aconitine intoxication between 2008 and 2017. We also analyzed the differences related to aconitine processing and administration methods (oral pill, boiled in water, and alcohol-soaked), and the clinical characteristics of consciousness deterioration and neurological symptoms. Of the 41 patients who visited the hospital due to aconitine intoxication, 23 (56.1%) were female, and most were older. Aconitine was mainly used for pain control (28 patients, 68.3%) and taken as oral pills (19 patients, 46%). The patients showed a single symptom or a combination of symptoms; neurological symptoms were the most common (21 patients). All patients who took aconitine after processing with alcohol showed neurological symptoms and a higher prevalence of consciousness deterioration. Neurological symptoms occurred most frequently in patients with aconitine intoxication. Although aconitine intoxication presents with various symptoms, its prognosis may vary with the processing method and prevalence of consciousness deterioration during the early stages. Therefore, the administration method and accompanying symptoms should be comprehensively investigated in patients who have taken aconitine to facilitate prompt and effective treatment and better prognoses.
Evaluation of Anti-Activated Factor X Activity and Activated Partial Thromboplastin Time Relations and Their Association with Bleeding and Thrombosis during Veno-Arterial ECMO Support: A Retrospective Study
Authors: Moussa Mouhamed Djahoum , Soquet Jérôme , Lamer Antoine , Labreuche Julien , Gantois Guillaume , Dupont Annabelle , Abou-Arab Osama , Rousse Natacha , Liu Vincent , Brandt Caroline , Foulon Valentin , Leroy Guillaume , Schurtz Guillaume , Jeanpierre Emmanuel , Duhamel Alain , Susen Sophie , Vincentelli André , Robin Emmanuel
Published: May 2021

Background: We aimed to investigate the relationship between anti-activated Factor X (anti-FXa) and activated Partial Thromboplastin Time (aPTT), and its modulation by other haemostasis co-variables during veno-arterial extracorporeal membrane oxygenation (VA-ECMO) support. We further investigated their association with serious bleeding and thrombotic complications. Methods: This retrospective single-center study included 265 adults supported by VA-ECMO for refractory cardiogenic shock from January 2015 to June 2019. The concordance of anti-FXa and aPTT and their correlations were assessed in 1699 paired samples. Their independent associations with serious bleeding or thrombotic complications were also analysed in multivariate analysis. Results: The concordance rate of aPTT with anti-FXa values was 50.7%, with 39.3% subtherapeutic aPTT values. However, anti-FXa and aPTT remained associated (β = 0.43 (95% CI 0.4–0.45) 10−2 IU/mL, p < 0.001), with a significant modulation by several biological co-variables. There was no association between anti-FXa nor aPTT values with serious bleeding or with thrombotic complications. Conclusion: During VA-ECMO, although anti-FXa and aPTT were significantly associated, their values were highly discordant with marked sub-therapeutic aPTT values. These results should favour the use of anti-FXa. The effect of biological co-variables and the failure of anti-FXa and aPTT to predict bleeding and thrombotic complications underline the complexity of VA-ECMO-related coagulopathy.
Optimal Timing for Primary Early Endoscopic Dacryocystorhinostomy in Acute Dacryocystitis
Authors: Sung Jae Yun , Kim Ju Mi , Hwang Jae Yul , Kim Kyoung Nam , Kim Jaeyoung , Lee Sung Bok
Published: May 2021

Purpose: To evaluate the surgical outcomes of primary early endoscopic dacryocystorhinostomy (EnDCR) in acute dacryocystitis (AD) and to determine the optimal timing for surgery. Methods: A retrospective review of medical records was performed on consecutive patients who underwent primary early EnDCR (within 1 week) for AD between May 2010 and June 2020 (AD group) and an age- and gender-matched control group of NLDO patients who underwent EnDCR (non-AD group). The primary outcome measures were the surgical outcomes at the final follow-up examination. The secondary outcome measure was the clinical course of AD patients. Subgroup analysis was performed to determine the optimal timing of surgery by comparing the outcomes of very early EnDCR (within 3 days) and those of early EnDCR (between 4 and 7 days). Results: Forty-one patients were included in the AD group and 82 patients in the non-AD group. The anatomical and functional success rates were 87.8% and 82.9% in the AD group, and 91.5% and 84.1% in the non-AD group, which were not significantly different between the two groups (p = 0.532 and p = 0.863). In the AD group, the mean times for pain relief and resolution of swelling after surgery were 2.4 and 6.5 days after surgery, respectively. In the subgroup analysis according to the timing of surgery, the time for symptom resolution after diagnosis, the length of hospital stays, and the duration of antibiotic treatments were significantly shorter after very early EnDCR (all ps < 0.05), whereas the surgical outcomes were not different between the two groups (p = 1.000). Conclusions: Primary early EnDCR is a safe and effective procedure for the treatment of AD. In particular, very early EnDCR performed within 3 days leads to faster recovery and shortens the course of antibiotic treatment.