bluuebunny/crossref_metadata_2025 huggingface dataset:
The impact of hearing loss on cognitive impairment: The mediating role of depressive symptoms and the moderating role of social relationships
Authors: Cao Xia , Liu Qian , Liu Jiali , Yang Bingfang , Zhou Jiansong
Published: April 2023

Background

Given the potentially negative effects of hearing loss on mental health and cognitive function, it is critical to gain a better understanding of the mechanisms underlying the link between hearing loss and cognitive impairment. This study aimed to investigate the moderating effects of social relationships, including their components in the role of depressive symptoms as a mediator between hearing loss and cognitive impairment.

Methods

Cross-sectional analyses were conducted with 8,094 Chinese older adults (aged ≥65 years) from the Chinese Longitudinal Healthy Longevity Survey in 2018. Simple mediation analysis and moderated mediation analysis were conducted to examine the roles of depressive symptoms and social relationships in the association between hearing loss and cognitive impairment.

Results

There is a significant correlation between hearing loss, depressive symptoms, social relationships, and cognitive function. Depressive symptoms partially mediated the association between hearing loss and cognitive function [standardized regression B-coefficient (B) = −0.114; 95% confidence interval (CI): (−0.158, −0.076)]. Social relationships moderated the effect of hearing loss on cognitive function through both path b (depressive symptoms - cognitive function) [B = 0.021; 95% CI: (0.008, 0.034)], and path c’ (hearing loss-cognitive function) [B = 0.597; 95% CI: (0.463, 0.730)]. Furthermore, social activities and social networks moderated both the direct and indirect effects of moderated mediation. However, there appeared to be no moderated effect of social support for both the direct and indirect paths.

Conclusion

Social relationships moderated both the direct and indirect effects of depressive symptoms on the association between hearing loss and cognitive impairment. These findings shed light on the mechanisms underlying the relationship between hearing loss and cognitive impairment in Chinese older adults. It might be worthwhile to recommend multidimensional health and social interventions aimed at improving mental health and social inclusion among older adults with hearing loss.
Systematic review of the development and effectiveness of digital health information interventions, compared with usual care, in supporting patient preparation for paediatric hospital care, and the impact on their health outcomes
Authors: Demblon Marie-Claire , Bicknell Colin , Aufegger Lisa
Published: April 2023

Background and aim

Elective surgery can be overwhelming for children, leading to pre-operative anxiety, which is associated with adverse clinical and behavioural outcomes. Evidence shows that paediatric preparation digital health interventions (DHIs) can contribute to reduced pre-operative anxiety and negative behavioural changes. However, this evidence does not consider their design and development in the context of behavioural science. This systematic review used the Theoretical Domains Framework (TDF) to evaluate the design and development of DHIs used to support children up to 14 years of age and their parents, prepare for hospital procedures, and determine any correlation to health outcomes. It also considered whether any behavioural frameworks and co-production were utilised in their design.

Methods

A search of the MEDLINE, EMBASE, PsycINFO, and HMIC databases was carried out, looking for original, empirical research using digital paediatric preparation technologies to reduce pre-operative anxiety and behavioural changes. Limitations for the period (2000–2022), English language, and age applied.

Results

Seventeen studies were included, sixteen randomised control trials and one before and after evaluation study. The results suggest that paediatric preparation DHIs that score highly against the TDF are (1) associated with improved health outcomes, (2) incorporate the use of co-production and behavioural science in their design, (3) are interactive, and (4) are used at home in advance of the planned procedure.

Conclusion

Paediatric preparation DHIs that are co-produced and designed in the context of behavioural science are associated with reduced pre-operative anxiety and improved health outcomes and may be more cost-effective than other interventions.

Systematic Review Registration

https://www.crd.york.ac.uk/prospero/, identifier: CRD42022274182.
Dematerialized participation challenges: Methods and practices for online focus groups
Authors: Poliandri Donatella , Perazzolo Monica , Pillera Giuseppe Carmelo , Giampietro Letizia
Published: April 2023

This study explores the limitations and benefits of different approaches to conducting online focus groups and illustrates an online focus group protocol used within the Value for Schools project in Italy. According to the project evaluation design, 13 online focus groups were organized, with the participation of 101 teachers and 37 school principals. The protocol setup, incorporation, and reorganization of the indications have been discussed in the literature, addressing the methodological and practical issues, such as the selection of participants and preliminary communication with them; the web conference platform (Zoom Business); timing, as well as access times and mode; the roles of the researchers involved (moderator, co-host technical assistant, co-host-observer, co-host-animator) and their integration spaces; technological support; and animation tools. The recording and transcription tools and subsequent analysis of the textual corpus are presented. Finally, the authors discuss the validation and reliability of online focus group protocols.
Dynamic stability during level walking and obstacle crossing in children aged 2–5 years estimated by marker-less motion capture
Authors: Yoshimoto Kohei , Mani Hiroki , Hirose Natsuki , Kurogi Takaki , Aiko Takumi , Shinya Masahiro
Published: April 2023

In the present study, dynamic stability during level walking and obstacle crossing in typically developing children aged 2–5 years (n = 13) and healthy young adults (n = 19) was investigated. The participants were asked to walk along unobstructed and obstructed walkways. The height of the obstacle was set at 10% of the leg length. Gait motion was captured by three RGB cameras. 2D body landmarks were estimated using OpenPose, a marker-less motion capture algorithm, and converted to 3D using direct linear transformation (DLT). Dynamic stability was evaluated using the margin of stability (MoS) in the forward and lateral directions. All the participants successfully crossed the obstacles. Younger children crossed the obstacle more carefully to avoid falls, as evidenced by obviously decreased gait speed just before the obstacle in 2-year-olds and the increased in maximum toe height with younger age. There was no significant difference in the MoS at the instant of heel contact between children and adults during level walking and obstacle crossing in the forward direction, although children increased the step length of the lead leg to a greater extent than the adults to ensure base of support (BoS)-center of mass (CoM) distance. In the lateral direction, children exhibited a greater MoS than adults during level walking [children: 9.5%, adults: 6.5%, median, W = 39.000, p < .001, rank-biserial correlation = −0.684]; however, some children exhibited a smaller MoS during obstacle crossing [lead leg: −5.9% to 3.6% (min–max) for 4 children, 4.7%–6.4% [95% confidence interval (CI)] for adults, p < 0.05; trail leg: 0.1%–4.4% (min–max) for 4 children, 4.7%–6.4% (95% CI) for adults, p < 0.05]]. These results indicate that in early childhood, locomotor adjustment needed to avoid contact with obstacles can be observed, whereas lateral dynamic stability is frangible.
Establishment and evaluation of a predictive model for length of hospital stay after total knee arthroplasty: A single-center retrospective study in China
Authors: Zhu Bo , Zhang Dejun , Sang Maocheng , Zhao Long , Wang Chaoqun , Xu Yunqiang
Published: April 2023

Background

Total knee arthroplasty (TKA) is the ultimate option for end-stage osteoarthritis, and the demand of this procedure are increasing every year. The length of hospital stay (LOS) greatly affects the overall cost of joint arthroplasty. The purpose of this study was to develop and validate a predictive model using perioperative data to estimate the risk of prolonged LOS in patients undergoing TKA.

Methods

Data for 694 patients after TKA collected retrospectively in our department were analyzed by logistic regression models. Multi-variable logistic regression modeling with forward stepwise elimination was used to determine reduced parameters and establish a prediction model. The discrimination efficacy, calibration efficacy, and clinical utility of the prediction model were evaluated.

Results

Eight independent predictors were identified: non-medical insurance payment, Charlson Comorbidity Index (CCI) ≥ 3, body mass index (BMI) > 25.2, surgery on Monday, age > 67.5, postoperative complications, blood transfusion, and operation time > 120.5 min had a higher probability of hospitalization for ≥6 days. The model had good discrimination [area under the curve (AUC), 0.802 95% CI, 0.754–0.850]] and good calibration (p = 0.929). A decision curve analysis proved that the nomogram was clinically effective.

Conclusion

This study identified risk factors for prolonged hospital stay in patients after TKA. It is important to recognize all the factors that affect hospital LOS to try to maximize the use of medical resources, optimize hospital LOS and ultimately optimize the care of our patients.
An Overview on the Challenges and Limitations Using Cloud Computing in Healthcare Corporations
Authors: Agapito Giuseppe , Cannataro Mario
Published: April 2023

Technological advances in high throughput platforms for biological systems enable the cost-efficient production of massive amounts of data, leading life science to the Big Data era. The availability of Big Data provides new opportunities and challenges for data analysis. Cloud Computing is ideal for digging with Big Data in omics sciences because it makes data analysis, sharing, access, and storage effective and able to scale when the amount of data increases. However, Cloud Computing presents several issues regarding the security and privacy of data that are particularly important when analyzing patients’ data, such as in personalized medicine. The objective of the present study is to highlight the challenges, security issues, and impediments that restrict the widespread adoption of Cloud Computing in healthcare corporations.
VP37 Protein Inhibitors for Mpox Treatment: Highlights on Recent Advances, Patent Literature, and Future Directions
Authors: Hudu Shuaibu , Alshrari Ahmed , Al Qtaitat Aiman , Imran Mohd
Published: April 2023

Monkeypox disease (Mpox) has threatened humankind worldwide since mid-2022. The Mpox virus (MpoxV) is an example of Orthopoxviruses (OPVs), which share similar genomic structures. A few treatments and vaccines are available for Mpox. OPV-specific VP37 protein (VP37P) is a target for developing drugs against Mpox and other OPV-induced infections such as smallpox. This review spotlights the existing and prospective VP37P inhibitors (VP37PIs) for Mpox. The non-patent literature was collected from PubMed, and the patent literature was gathered from free patent databases. Very little work has been carried out on developing VP37PIs. One VP37PI (tecovirimat) has already been approved in Europe to treat Mpox, while another drug, NIOCH-14, is under clinical trial. Developing tecovirimat/NIOCH-14-based combination therapies with clinically used drugs demonstrating activity against Mpox or other OPV infections (mitoxantrone, ofloxacin, enrofloxacin, novobiocin, cidofovir, brincidofovir, idoxuridine, trifluridine, vidarabine, fialuridine, adefovir, imatinib, and rifampicin), immunity boosters (vitamin C, zinc, thymoquinone, quercetin, ginseng, etc.), and vaccines may appear a promising strategy to fight against Mpox and other OPV infections. Drug repurposing is also a good approach for identifying clinically useful VP37PIs. The dearth in the discovery process of VP37PIs makes it an interesting area for further research. The development of the tecovirimat/NIOCH-14-based hybrid molecules with certain chemotherapeutic agents looks fruitful and can be explored to obtain new VP37PI. It would be interesting and challenging to develop an ideal VP37PI concerning its specificity, safety, and efficacy.
Preclinical Large Animal Porcine Models for Cardiac Regeneration and Its Clinical Translation: Role of hiPSC-Derived Cardiomyocytes
Authors: Sridharan Divya , Pracha Nooruddin , Rana Schaza Javed , Ahmed Salmman , Dewani Anam J. , Alvi Syed Baseeruddin , Mergaye Muhamad , Ahmed Uzair , Khan Mahmood
Published: April 2023

Myocardial Infarction (MI) occurs due to a blockage in the coronary artery resulting in ischemia and necrosis of cardiomyocytes in the left ventricular heart muscle. The dying cardiac tissue is replaced with fibrous scar tissue, causing a decrease in myocardial contractility and thus affecting the functional capacity of the myocardium. Treatments, such as stent placements, cardiac bypasses, or transplants are beneficial but with many limitations, and may decrease the overall life expectancy due to related complications. In recent years, with the advent of human induced pluripotent stem cells (hiPSCs), newer avenues using cell-based approaches for the treatment of MI have emerged as a potential for cardiac regeneration. While hiPSCs and their derived differentiated cells are promising candidates, their translatability for clinical applications has been hindered due to poor preclinical reproducibility. Various preclinical animal models for MI, ranging from mice to non-human primates, have been adopted in cardiovascular research to mimic MI in humans. Therefore, a comprehensive literature review was essential to elucidate the factors affecting the reproducibility and translatability of large animal models. In this review article, we have discussed different animal models available for studying stem-cell transplantation in cardiovascular applications, mainly focusing on the highly translatable porcine MI model.
Lung Inflammation Induced by Inactivated SARS-CoV-2 in C57BL/6 Female Mice Is Controlled by Intranasal Instillation of Vitamin D
Authors: Fernandes de Souza William Danilo , Zorzella-Pezavento Sofia Fernanda Gonçalves , Ayupe Marina Caçador , Salgado Caio Loureiro , Oliveira Bernardo de Castro , Moreira Francielly , da Silva Guilherme William , Muraro Stefanie Primon , de Souza Gabriela Fabiano , Proença-Módena José Luiz , Araujo Junior Joao Pessoa , Fonseca Denise Morais da , Sartori Alexandrina
Published: April 2023

The COVID-19 pandemic was triggered by the coronavirus SARS-CoV-2, whose peak occurred in the years 2020 and 2021. The main target of this virus is the lung, and the infection is associated with an accentuated inflammatory process involving mainly the innate arm of the immune system. Here, we described the induction of a pulmonary inflammatory process triggered by the intranasal (IN) instillation of UV-inactivated SARS-CoV-2 in C57BL/6 female mice, and then the evaluation of the ability of vitamin D (VitD) to control this process. The assays used to estimate the severity of lung involvement included the total and differential number of cells in the bronchoalveolar lavage fluid (BALF), histopathological analysis, quantification of T cell subsets, and inflammatory mediators by RT-PCR, cytokine quantification in lung homogenates, and flow cytometric analysis of cells recovered from lung parenchyma. The IN instillation of inactivated SARS-CoV-2 triggered a pulmonary inflammatory process, consisting of various cell types and mediators, resembling the typical inflammation found in transgenic mice infected with SARS-CoV-2. This inflammatory process was significantly decreased by the IN delivery of VitD, but not by its IP administration, suggesting that this hormone could have a therapeutic potential in COVID-19 if locally applied. To our knowledge, the local delivery of VitD to downmodulate lung inflammation in COVID-19 is an original proposition.
Diversity of Food Insecurity Coping Strategies among Livestock Farmers in Northern Cape Province of South Africa
Authors: Bahta Yonas T. , Musara Joseph P.
Published: April 2023

Small-scale livestock farmers in the drylands of South Africa are highly exposed to agricultural drought-related food insecurity. Research has used descriptive analyses and missed the need to index the diversity of coping strategies used for managing agricultural drought-induced food insecurity. This study was conducted to bridge this gap using a two-step procedure. Initially, the study identified the farmers’ coping strategies and food security status. A coping strategy diversity index was computed using the Shannon–Weiner method and its relationship with the food security status was determined. Secondly, the determinants of the coping strategy diversity index were explored using an ordered logit regression model after testing for the proportional odds assumption. A mixed methods approach was utilized and a standardized questionnaire was administered to 217 smallholder livestock farmers in the Northern Cape province of South Africa. The household food insecurity mean score (8.429 ± 7.105) from the household food insecurity scale (HFIAS) was significantly related to a higher diversity of coping strategies. Similar results were reported for the household food insecurity access prevalence (HFIAP) status. The different forms of support (e.g., cash, food, training and assets) had a significant (p < 0.05) and positive effect on the coping strategy diversity index among the households. Education, access to credit and insurance facilities and the frequency of droughts significantly (p < 0.05) influenced the diversity of coping strategies under drought conditions. The utilization of cash reserves and investment stocks also significantly (p < 0.05) influenced the extent of coping strategy diversity. The study recommended strengthening the functional and technical capacity pillars of dealing with agricultural drought through strategic partnerships between the government and livestock value chain players. This collaboration should target affordable credit lines tailor-made for farmers to cope with agricultural drought. If well-coordinated, these interventions should reduce food insecurity prevalence, especially during drought conditions among vulnerable smallholder livestock farmers. Lessons from this study could also inform future research on the effectiveness of the current agricultural drought coping strategies while expanding the diversity clusters over space and time.
Blade Twist Effects on Aerodynamic Performance and Noise Reduction in a Multirotor Propeller
Authors: Sun Jianwei , Yonezawa Koichi , Tanabe Yasutada , Sugawara Hideaki , Liu Hao
Published: April 2023

This paper presents a novel integrated study of the aerodynamic performance and acoustic signature of multirotor propellers with a specific focus on the blade twist angle effect. Experimental measurements and computational fluid dynamic (CFD) simulations were utilized to examine and compare the aerodynamic performance and noise reduction between twisted and untwisted blades. A 2D phase-locked particle image velocimetry (PIV) was employed to visualize flow structures at specific blade locations in terms of tip vortices and trailing edge vortices. Good consistency between the simulations and measurements was observed in aerodynamic and acoustic performance. It is verified that the propellers with twisted blades enable a maximum increase of 9.3% in the figure of merit compared to untwisted blades while achieving the same thrust production and are further capable to reduce overall sound pressure level by a maximum of 4.3 dB. CFD results reveal that the twisted propeller remarkedly reduces far-field loading noise by suppressing trailing-edge vortices, hence mitigating kinetic energy fluctuation at the blade tip, while having minimal impact on thickness noise. This study points to the crucial role of blade twists in altering the aeroacoustic characteristics, indicating that optimal designs could lead to significant improvements in both aerodynamic and acoustic performance.
Systematic Classification of Curvature and Feature Descriptor of 3D Shape and Its Application to “Complexity” Quantification Methods
Authors: Matsuyama Kazuma , Shimizu Takahiro , Kato Takeo
Published: April 2023

Generative design is a system that automates part of the design process, but it cannot evaluate psychological issues related to shapes, such as “beauty” and “liking”. Designers therefore evaluate and choose the generated shapes based on their experience. Among the design features, “complexity” is considered to influence “aesthetic preference”. Although feature descriptors calculated from curvature can be used to quantify “complexity”, the selection guidelines for curvature and feature descriptors have not been adequately discussed. Therefore, this study aimed to conduct a systematic classification of curvature and a feature descriptor of 3D shapes and to apply the results to the “complexity” quantification. First, we surveyed the literature on curvature and feature descriptors and conducted a systematic classification. To quantify “complexity”, we used five curvatures (Gaussian curvature, mean curvature, Casorati curvature, shape index, and curvature index) and a feature descriptor (entropy of occurrence probability) obtained from the classification and compared them with the sensory evaluation values of “complexity”. The results showed that the determination coefficient between the quantified and sensory evaluation values of “complexity” was highest when the mean curvature was used. In addition, the Casorati curvature tended to show the highest signal-to-noise ratio (i.e., a high determination coefficient irrespective of the parameters set in the entropy calculation). These results will foster the development of generative design of 3D shapes using psychological evaluation.
Estimation Model of Agrivoltaic Systems Maximizing for Both Photovoltaic Electricity Generation and Agricultural Production
Authors: Yajima Daisuke , Toyoda Teruya , Kirimura Masaaki , Araki Kenji , Ota Yasuyuki , Nishioka Kensuke
Published: April 2023

Climate change and increasing food demand are global issues that require immediate attention. The agrivoltaic system, which involves installing solar panels above farmland, can simultaneously solve climate and food issues. However, current systems tend to reduce agricultural production and delay the harvest period due to shading by the solar panels. A delayed harvest period impacts the income of farmers who wish to sell produce at specific times. Incorporating a model that calculates the amount of electricity generated by solar irradiation, this study establishes a model to estimate the correct start date of cultivation for solar panel covered crops to ensure the correct harvest date and determines the expected income of farmers by calculating agricultural production and power generation. Using taro cultivation in Miyazaki Prefecture as a case study, the model estimated that the start date of cultivation should be brought forward by 23 days to ensure the ideal harvest period and agricultural production. This would prevent an opportunity loss of USD 16,000 per year for a farm area of 10,000 m2. Furthermore, an additional income of USD 142,000 per year can be expected by adjusting shading rates for the cultivation and non-cultivation periods.
The Underground Coal Gasification Process in Laboratory Conditions: An Experimental Study
Authors: Laciak Marek , Durdán Milan , Kačur Ján , Flegner Patrik
Published: April 2023

The underground coal gasification (UCG) process represents a modern and effective coal mining technology that enables coal energy extraction through thermic decomposition. The coal is transformed into syngas by oxidizers (e.g., air, technical oxygen, or water steam) and is injected into a georeactor. The produced syngas is exhausted on the surface, where it is transformed into the desired form of energy. This paper presents an experimental study of two experiments performed in ex-situ reactors. The paper describes the equipment for the UCG process, the physical models of the coal seam, and the analysis of coal. The obtained results from the experiments are presented as the behavior of the temperatures in the coal during the experiment, the syngas composition, and its calorific value. The material balance and effective gasification time of the UCG process were also identified for the individual experiments. The aim was to evaluate the impact of the coal seam model on the gasification process efficiency. Calculating the material balance during the gasification appears to be an effective tool for assessing leaks in the reactor while measuring the flow and concentration of the oxidizers and produced gas. The material balance data are make it possible to propose methods for controlling the input oxidizers. To increase the efficiency of the gasification in an ex-situ reactor, it is necessary to ensure the impermeable or poorly permeable surrounding layers of the coal seam.
Thermoacoustic Combustion Stability Analysis of a Bluff Body-Stabilized Burner Fueled by Methane–Air and Hydrogen–Air Mixtures
Authors: Ceglie Vito , Stefanizzi Michele , Capurso Tommaso , Fornarelli Francesco , Camporeale Sergio M.
Published: April 2023

Hydrogen can play a key role in the gradual transition towards a full decarbonization of the combustion sector, e.g., in power generation. Despite the advantages related to the use of this carbon-free fuel, there are still several challenging technical issues that must be addressed such as the thermoacoustic instability triggered by hydrogen. Given that burners are usually designed to work with methane or other fossil fuels, it is important to investigate their thermoacoustic behavior when fueled by hydrogen. In this framework, the present work aims to propose a methodology which combines Computational Fluid Dynamics CFD (3D Reynolds-Averaged Navier-Stokes (RANS)) and Finite Element Method (FEM) approaches in order to investigate the fluid dynamic and the thermoacoustic behavior introduced by hydrogen in a burner (a lab-scale bluff body stabilized burner) designed to work with methane. The case of CH4-air mixture was used for the validation against experimental results and benchmark CFD data available in the literature. Numerical results obtained from CFD simulations, namely thermofluidodynamic properties and flame characteristics (i.e., time delay and heat release rate) are used to evaluate the effects of the fuel change on the Flame Response Function to the acoustic perturbation by means of a FEM approach. As results, in the H2-air mixture case, the time delay decreases and heat release rate increases with respect to the CH4-air mixture. A study on the Rayleigh index was carried out in order to analyze the influence of H2-air mixture on thermoacoustic instability of the burner. Finally, an analysis of both frequency and growth rate (GR) on the first four modes was carried out by comparing the two mixtures. In the H2-air case the modes are prone to become more unstable with respect to the same modes of the case fueled by CH4-air, due to the change in flame topology and variation of the heat release rate and time delay fields.
Online Lifetime Prediction for Lithium-Ion Batteries with Cycle-by-Cycle Updates, Variance Reduction, and Model Ensembling
Authors: Strange Calum , Ibraheem Rasheed , dos Reis Gonçalo
Published: April 2023

Lithium-ion batteries have found applications in many parts of our daily lives. Predicting their remaining useful life (RUL) is thus essential for management and prognostics. Most approaches look at early life prediction of RUL in the context of designing charging profiles or optimising cell design. While critical, said approaches are not directly applicable to the regular testing of cells used in applications. This article focuses on a class of models called ‘one-cycle’ models which are suitable for this task and characterized by versatility (in terms of online prediction frameworks and model combinations), prediction from limited input, and cells’ history independence. Our contribution is fourfold. First, we show the wider deployability of the so-called one-cycle model for a different type of battery data, thus confirming its wider scope of use. Second, reflecting on how prediction models can be leveraged within battery management cloud solutions, we propose a universal Exponential-smoothing (e-forgetting) mechanism that leverages cycle-to-cycle prediction updates to reduce prediction variance. Third, we use this new model as a second-life assessment tool by proposing a knee region classifier. Last, using model ensembling, we build a “model of models”. We show that it outperforms each underpinning model (from in-cycle variability, cycle-to-cycle variability, and empirical models). This ‘ensembling’ strategy allows coupling explainable and black-box methods, thus giving the user extra control over the final model.
Optimum Conditions for Enhanced Biohydrogen Production from a Mixture of Food Waste and Sewage Sludge with Alkali Pretreatment
Authors: Nam Joo-Youn
Published: April 2023

Given the increasing demand for hydrogen, owing to its environmentally friendly nature, it is important to explore efficient methods for hydrogen production. This study investigates dark-fermentative hydrogen production by the co-digestion of food waste and sewage sludge. Both wastes were subjected to alkali pretreatment (at pH 13) to enhance biodegradability. Batch tests were conducted to enhance hydrogen production from food waste and sewage sludge under various volatile solid (VS) concentrations of 1.5–5% and food waste to sewage sludge mixing ratios of 0:100–100:0. We found that alkali pretreatment was effective in increasing hydrogen yields. The maximum specific hydrogen production rate of 163.8 mL H2/g volatile suspended solid/h was obtained at a VS concentration of 5.0% and food waste composition of 62.5%. Additionally, VS concentration of 2.8% and food waste composition of 100% yielded a maximum hydrogen production potential of 152.1 mL H2/g VS. Our findings indicate that food waste and sewage sludge with alkali pretreatment are potential substrates to produce biohydrogen.
Process Improvement of Biogas Production from Sewage Sludge Applying Iron Oxides-Based Additives
Authors: Dauknys Regimantas , Mažeikienė Aušra
Published: April 2023

Iron additives are effective in the anaerobic sewage sludge digestion process, but the composition and dosage of these additives are not precisely defined. This research investigates the effects of three iron oxides-based additives on the destruction of volatile solids, the production and quality of biogas, as well as the quality of the supernatant. Additive No 1 contained >41.5% of FeO and >41.5% of Fe2O3, additive No 2 contained ≥86% of Fe3O4, and additive No 3 contained ≥98% of Fe3O4. The best results were obtained by applying an iron oxides-based additive with a higher content of divalent iron oxide. The increase in efficiency of the VSs destruction was not significant and on average 2.2%. The increase in biogas production was on average 20% while the average increase in the content of methane in the biogas was 6.3%. Applying the additive, the reduction in the concentration of ammonium nitrogen in the supernatant was up to 28%, as well as a reduction in the concentration of phosphate phosphorus in the supernatant by up to 3.1 times could be expected compared to the case when the additive was not applied. The dose of additive No 1 was between 7.5 g/kg of dry solids and 15 g/kg of dry solids in the lab-scale test. The dose was specified in the full-scale test, and the recommended dose of the additive was 10 g/kg of dry solids to improve biogas production.
Effects of Visual Communication Design Accessibility (VCDA) Guidelines for Low Vision on Public and Open Government Health Data
Authors: Lim Jongho , Kim Woojin , Kim Ilkon , Lee Eunjoo
Published: April 2023

Since 2019, the Korean government’s investments in making data more accessible to the public have grown by 337%. However, open government data, which should be accessible to everyone, are not entirely accessible to people with low vision, who represent an information-vulnerable class. Emergencies, such as the COVID-19 pandemic, decrease face-to-face encounters and inevitably increase untact encounters. Thus, the information gap experienced by low-vision people, who are underprivileged in terms of information, will be further widened, and they may consequently face various disadvantages. This study proposed visual communication design accessibility (VCDA) guidelines for people with low vision. Introduced screens enhanced by accessibility guidelines were presented to 16 people with low vision and 16 people with normal vision and the speed of visual information recognition was analyzed. No statistically significant difference (p > 0.05) was found due to the small sample size; however, this study’s results approached significance with improved visual recognition speed for people with low vision after adopting VCDA. As a result of the intervention, the visual information recognition speed of both normal and low-vision people improved. Thus, our results can help improve information recognition speed among people with normal and low vision.
Variability of Micro- and Macro-Elements in Anaerobic Co-Digestion of Municipal Sewage Sludge and Food Industrial By-Products
Authors: Szaja Aleksandra , Montusiewicz Agnieszka , Lebiocka Magdalena
Published: April 2023

The main aim of this study was to evaluate the effect of the addition of selected industrial food wastes on the fate of micro- and macro-elements within an anaerobic digestion process (AD), as well as define the relationship between their content and AD efficiency. Orange peels, (OP), orange pulp (PL) and brewery spent grain (BSG) were used as co-substrates, while municipal sewage sludge (SS) was applied as the main component. The introduction of co-substrates resulted in improvements in feedstock composition in terms of macro-elements, with a simultaneous decrease in the content of HMs (heavy metals). Such beneficial effects led to enhanced methane production, and improved process performance at the highest doses of PL and BSG. In turn, reduced biogas and methane production was found in the three-component digestion mixtures in the presence of OP and BSG; therein, the highest accumulation of most HMs within the process was also revealed. Considering the agricultural application of all digestates, exceedances for Cu, Zn and Hg were recorded, thereby excluding their further use for that purpose.
The Role of Title 1 Secondary School Athletic Trainers in the Primary and Patient-Centered Care of Low Socioeconomic Adolescents
Authors: Harris Nicolette A. , Odai Michelle L.
Published: April 2023

Athletic trainers (ATs) provide regular encounters with a healthcare provider for many Title 1 student–athletes with healthcare access and quality barriers. Thus, they are uniquely positioned to serve as a student–athletes’ first point of contact for general medical concerns. This study aimed to describe ATs’ experiences providing primary care for Title 1 student–athletes. This qualitative design employing an interpretative phenomenological analysis (IPA) approach used in-depth, virtual focus groups to examine the experiences of ATs practicing at Title 1 secondary schools. The findings reveal that ATs were called upon to evaluate, treat, and, when necessary, refer student–athletes with general medical conditions. However, Title 1 ATs encountered numerous complex social determinants of health (SDoH) preventing efficient and effective referral to specialty healthcare providers. Thus, ATs ultimately felt their most important roles in the primary care of low socioeconomic adolescents were as caregivers who mitigated avoidable healthcare barriers in addition to coordinators of integrated care that assisted student–athletes and their families with navigating the healthcare system. Title I ATs need to be aware of the SDoH affecting their student–athletes and the ability of those SDoH to affect health outcomes as well as overall student–athlete health and well-being.
The Effects of a 12-Week-Long Sand Exercise Training Program on Neuromechanical and Functional Parameters in Type II Diabetic Patients with Neuropathy
Authors: Prókai Judit , Murlasits Zsolt , Bánhidi Miklós , Csóka László , Gréci Viktória , Atlasz Tamás , Váczi Márk
Published: April 2023

Studies have proven the effectiveness of different weight-bearing exercise interventions for diabetic patients with neuropathy; however, several adverse effects were reported using solid surfaces. Thus, in the present study, we investigated the effects of a novel sand exercise training intervention on biomechanical and functional parameters in seven diabetic patients (age = 62.7 ± 9.7 years) with neuropathy. Patients underwent a 12-week sand exercise training program, using strengthening, stretching, balance, and gait exercises. They were tested for ankle plantar- and dorsiflexion peak torque, active range of motion (ROM), timed up and go (TUG), and bilateral static balance. EMG activity of tibialis anterior (TA), gastrocnemius medialis (GM), and lateralis (GL) muscles were measured during unilateral isometric contraction in plantar- and dorsiflexion. In the intervention period, plantarflexion peak torque improved significantly (p = 0.033), while dorsiflexion torque remained unchanged. Plantar- and dorsiflexion ROM increased (p = 0.032) and (p = 0.021), respectively. EMG activity of GM (p = 0.005) and GL (p = 0.002) measured during dorsiflexion and postural sway in the balance test, as well as time to complete the TUG test, decreased significantly (p = 0.021) and (p = 0.002), respectively. No adverse effect was reported during the intervention period. We concluded that sand exercise training can be a safe and effective method to improve plantarflexion strength, ankle flexibility, and balance, which is reflected in better gait function in patients with diabetic peripheral neuropathy (DPN).
Accelerometer-Measured Physical Behavior and Cardiorespiratory Fitness as Indicators of Work Ability
Authors: Husu Pauliina , Tokola Kari , Vähä-Ypyä Henri , Sievänen Harri , Vasankari Tommi
Published: April 2023

Work ability (WA) reflects an individual’s resources, work demands, and related environment. Self-reports have shown that higher physical activity (PA) is associated with better WA. This study investigated associations of accelerometer-measured (24/7) physical behavior and cardiorespiratory fitness (CRF) with WA. In the FinFit2017-population-based study, the physical behavior of 20–69-year-old working Finns was measured in terms of PA, standing, and sedentariness using validated MAD-APE algorithms based on raw triaxial accelerometer data. During waking hours, the accelerometer was hip-worn, while during the time in bed (TIB), it was worn on the non-dominant wrist. CRF was measured with a 6 min walk test. WA was assessed by four questions excerpted from the Work Ability Index (WAI), called the short WAI (sWAI). Participants (n = 1668, mean age 46.6, SD = 10.9, 57% women) scored on average 23.3 on the sWAI (range 6–27), with a higher value indicating a better WA. More minutes in standing (p = 0.001) and in moderate (p = 0.004) and vigorous PA (p < 0.001) as well as a higher step number (p < 0.001) and better CRF (p < 0.001) were associated with a higher sWAI value. More time spent lying down (p < 0.001) and in high-movement (p < 0.001) and total TIB (p = 0.001) was associated with a lower sWAI. Detailed analysis of 24/7 physical behavior can be utilized in identifying individual-related indicators of WA.
Does Sport Participation Protect Adolescents from Alcohol Consumption? A Scoping Review
Authors: Walczak Bartłomiej , Walczak Anna , Tricas-Sauras Sandra , Kołodziejczyk Jakub
Published: April 2023

(1) Background: Participation in youth sports is believed to protect against alcohol consumption. Although this concept has been questioned for over 40 years, the review of methodologically reliable evidence data is scarce. This review summarizes the state of knowledge on the association between practicing sports and alcohol consumption among adolescents (10–19 years old) and its moderators. (2) Methods: The review covers only random-sample-based and population research. A systematic search was conducted on Scopus, PubMed, and WoS, for articles published between 2000 and 2021. From the 1944 identified records, 139 advanced to the full-text review, and 32 to the final data extraction and quality review. (3) Results: About two-thirds of the studies, including all the longitudinal ones, showed a positive association between sport participation and alcohol consumption. The most common mediators were gender (males were at higher risk), discipline (odds for team sports were higher, but professionalization could reduce it), and race, which intersected with gender, putting white males at the highest risk. (4) Conclusions: Further longitudinal research based on random samples using standardized indicators, including psychological and social variables, may provide more consistent outcomes and allow for the identification of mediating mechanisms.
Feasibility and Acceptability of a Mindfulness-Based Smartphone App among Pregnant Women with Obesity
Authors: Ward Kerrie , Herekar Anjali , Wang Peiyi , Lindsay Karen L.
Published: April 2023

Maternal obesity is associated with an increased risk for prenatal depressive symptoms. Mindfulness-based interventions (MBIs) have been shown to reduce the risk of prenatal depression. This pilot study assesses the feasibility and acceptability of a smartphone-based MBI among pregnant women with obesity, and its potential for improving maternal mental and behavioral health outcomes. Five second-trimester pregnant women with a prepregnancy body mass index > 30 kg/m2 participated in a 30-day audio-guided mindfulness practice using the Headspace app. All participants engaged in the pregnancy module, while three concurrently engaged in the mindful eating module. Daily engagement with the app was tracked and a post-trial survey assessed maternal acceptability. Validated pre- and post-trial questionnaires explored changes in perceived stress, anxiety, depression, and eating habits. All participants completed the study with varying levels of adherence to the prescribed daily practice; the average number of days of engagement was 23/30 (77%) for the pregnancy module and 20/30 (67%) for the mindful eating module. All subjects reported some degree of perceived benefit, and none reported negative experiences. Trends were observed for improvements in maternal mental wellbeing and eating behaviors. This pilot study shows that a smartphone-based MBI is feasible, acceptable, and perceived to provide benefit among pregnant women with obesity.
Emergency Air Transport of Patients with Acute Chest Pain in the Adriatic Islands of Croatia: A Four-Year Analysis
Authors: Zanic Antonija , Kovacic Vedran , Jukic Ivana
Published: April 2023

Background: An efficient first-aid system usually supports ground services with a helicopter emergency medical service (HEMS). An HEMS is important for patients with acute chest pain on remote islands. The current study sought to identify the characteristics of HEMS in acute chest pain cases on the Croatian Adriatic islands over a four-year period. Methods: We conducted a four-year observational study to investigate HEMS from Adriatic islands. The study population consisted of all patients with acute coronary syndrome or pulmonary embolisms who were urgently transferred by HEMS to the University Hospital in Split 1 June 2018–1 June 2022. Results: During the observation period, 222 adult patients (67 females, or 30.2%) were urgently transferred. The mean age was 71.81 ± 13.42 years. The most common diagnosis was ST-elevated myocardial infarction (113, 50.9%). Most of the HEMS cases were from Hvar (91, 41.0%). The mean call-to-flight time was 19.10 ± 10.94 min, and the total time from call to hospital was 68.50 ± 22.29 min. The total time from call to hospital was significantly correlated with call-to-flight time (r = 0.761, P < 0.001). Of the 222 participants, 5 (2.25%) were transported for more than 120 min, and 35 (15.8%) were transported for more than 90 min. Conclusion: This study provided a detailed insight into HEMS in the area of the Croatian Adriatic islands. The average time from the call to the helicopter taking off was 19.10 min. An increase in dispatching time has a significant impact on the prolongation of the total time for the hospital admission. Shortening the response time is critical to reducing hospital arrival time.
Tuberculosis in Prisons: Importance of Considering the Clustering in the Analysis of Cross-Sectional Studies
Authors: Marín Diana , Keynan Yoav , Bangdiwala Shrikant I. , López Lucelly , Rueda Zulma Vanessa
Published: April 2023

The level of clustering and the adjustment by cluster-robust standard errors have yet to be widely considered and reported in cross-sectional studies of tuberculosis (TB) in prisons. In two cross-sectional studies of people deprived of liberty (PDL) in Medellin, we evaluated the impact of adjustment versus failure to adjust by clustering on prevalence ratio (PR) and 95% confidence interval (CI). We used log-binomial regression, Poisson regression, generalized estimating equations (GEE), and mixed-effects regression models. We used cluster-robust standard errors and bias-corrected standard errors. The odds ratio (OR) was 20% higher than the PR when the TB prevalence was >10% in at least one of the exposure factors. When there are three levels of clusters (city, prison, and courtyard), the cluster that had the strongest effect was the courtyard, and the 95% CI estimated with GEE and mixed-effect models were narrower than those estimated with Poisson and binomial models. Exposure factors lost their significance when we used bias-corrected standard errors due to the smaller number of clusters. Tuberculosis transmission dynamics in prisons dictate a strong cluster effect that needs to be considered and adjusted for. The omission of cluster structure and bias-corrected by the small number of clusters can lead to wrong inferences.
Transcriptome-Assisted SNP Marker Discovery for Phytophthora infestans Resistance in Solanum lycopersicum L.
Authors: Deb Saptarathi , Della Lucia Maria Cristina , Ravi Samathmika , Bertoldo Giovanni , Stevanato Piergiorgio
Published: April 2023

Late blight, caused by oomycetes Phytophthora infestans is one of the most challenging fungal diseases to manage in tomato plants (Solanum lycopersicum L.). Toward managing the disease, conventional breeding has successfully introgressed genetic loci conferring disease resistance from various wild relatives of tomato into commercial varieties. The cataloging of disease-associated SNP markers and a deeper understanding of disease-resistance mechanisms are needed to keep up with the demand for commercial varieties resistant against emerging pathogen strains. To this end, we performed transcriptome sequencing to evaluate the gene expression dynamics of tomato varieties, resistant and susceptible to Phytophthora infection. Further integrating the transcriptome dataset with large-scale public genomic data of varieties with known disease phenotypes, a panel of single nucleotide polymorphism (SNP) markers correlated with disease resistance was identified. These SNPs were then validated on 31 lines with contrasting phenotypes for late blight. The identified SNPs are located on genes coding for a putative cysteine-rich transmembrane module (CYSTM), Solyc09g098310, and a nucleotide-binding site–leucine-rich repeat protein, Solyc09g098100, close to the well-studied Ph-3 resistance locus known to have a role in plant immunity against fungal infections. The panel of SNPs generated by this study using transcriptome sequencing showing correlation with disease resistance across a broad set of plant material can be used as markers for molecular screening in tomato breeding.