bluuebunny/crossref_metadata_2025 huggingface dataset:
Toxic Heavy Metals and Their Risk Assessment of Exposure in Selected Freshwater and Marine Fish in Thailand
Authors: Sirisangarunroj Prasit , Monboonpitak Nuntawat , Karnpanit Weeraya , Sridonpai Piyanut , Singhato Alongkote , Laitip Nunnapus , Ornthai Nattikarn , Yafa Charun , Judprasong Kunchit
Published: October 2023

This study identified the levels of arsenic, cadmium, mercury, and lead in 15 species of commonly consumed fish in Thailand (7 freshwater species, 8 marine species), as well as the risk of these toxic elements for consumers. Inductively coupled plasma mass spectrometry (ICP-MS-MS) was used to identify toxic elements, while an exposure assessment was conducted by applying consumption amounts from the national food consumption survey to the toxic element contents in the fish samples. The results showed that the fish contained arsenic ranging from less than the limit of detection (LOD) to 8.51 mg/kg fresh weight (FW), cadmium ranging from the LOD to 0.04 mg/kg FW, and mercury ranging from the limit of quantitation (LOQ) to 0.38 mg/kg FW. Lead was found in small amounts (<LOQ) when compared to the Codex and Thailand’s standards. Only grouper had a higher mercury content (0.55 mg/kg FW) than that of the Codex standard, but it was lower than the notification requirement of Thailand’s Ministry of Public Health. Based on the estimated daily intake scenario, the consumption of most fish species posed a low risk of concern in terms of cadmium and lead. A high risk of concern was found for arsenic exposure, with the exception of long, non-scaly fish (catfish and dory). Marine fish, with the exception of Indo-Pacific mackerel, also posed a high risk of mercury exposure, but only in the case of a high mercury content, high consumption, or both. For a high arsenic content with high consumption or both, children aged 0–5.9 years were at a high risk of concern. Food safety authorities should regularly monitor the levels of toxic element contamination in high-risk food products.
Elephant Black Garlic’s Beneficial Properties for Hippocampal Neuronal Network, Chemical Characterization and Biological Evaluation
Authors: Gavilán Javiera , Mardones Claudia , Oyarce Gabriela , Triviño Sergio , Espinoza-Rubilar Nicole , Ramírez-Molina Oscar , Pérez Claudia , Becerra José , Varas Patricio , Duran-Arcos Robinson , Muñoz-Montesino Carola , Moraga-Cid Gustavo , Yévenes Gonzalo E. , Fuentealba Jorge
Published: October 2023

Garlic has been used for decades as an important food and additionally for its beneficial properties in terms of nutrition and ancestral therapeutics. In this work, we compare the properties of fresh (WG) and aged (BG) extract obtained from elephant garlic, harvested on Chiloe Island, Chile. BG was prepared from WG with a 20-day aging process under controlled temperature and humidity conditions. We observed that in BG, compounds such as diallyl disulfide decrease, and compounds of interest such as 5-hydroxymethylfurfural (69%), diallyl sulfide (17%), 3H-1,2-Dithiole (22%) and 4-Methyl-1,2,3-trithiolane (16%) were shown to be increased. Using 2,2-diphenyl-1-picrylhydrazyl (DPPH, BG: 51 ± 5.7%, WG: 12 ± 2.6%) and 2,20-azino-bis-(3-ethylbenzothiazoline-6 sulfonate) diammonium salt (ABTS, BG: 69.4 ± 2.3%, WG: 21 ± 3.9%) assays, we observed that BG possesses significantly higher antioxidant activity than WG and increased cell viability in hippocampal slices (41 ± 9%). The effects of WG and BG were shown to improve the neuronal function through an increased in intracellular calcium transients (189 ± 4%). In parallel, BG induced an increase in synaptic vesicle protein 2 (SV-2; 75 ± 12%) and brain-derived neurotrophic factor (BDNF; 32 ± 12%) levels. Thus, our study provides the initial scientific bases to foster the use of BG from Chiloe Island as a functional food containing a mixture of bioactive compounds that may contribute to brain health and well-being.
Screening and Activity Analysis of α-Glucosidase Inhibitory Peptides Derived from Coix Seed Prolamins Using Bioinformatics and Molecular Docking
Authors: Li Zhiming , Zhang Shu , Meng Weihong , Zhang Jiayu , Zhang Dongjie
Published: October 2023

Hydrolysates of coix seed prolamins (CHPs) have an excellent hypoglycemic effect and can effectively inhibit α-glucosidase, which is the therapeutic target enzyme for type 2 diabetes mellitus. However, its hypoglycemic components and molecular mechanisms remain unclear, and its stability in food processing needs to be explored. In this study, four potential α-glucosidase inhibitory peptides (LFPSNPLA, FPCNPLV, HLPFNPQ, LLPFYPN) were identified and screened from CHPs using LC-MS/MS and virtual screening techniques. The results of molecular docking showed that the four peptides mainly inhibited α-glucosidase activity through hydrogen bonding and hydrophobic interactions, with Pro and Leu in the peptides playing important roles. In addition, CHPs can maintain good activity under high temperatures (40~100 °C) and weakly acidic or weakly alkaline conditions (pH 6.0~8.0). The addition of glucose (at 100 °C) and NaCl increased the inhibitory activity of α-glucosidase in CHPs. The addition of metal ions significantly decreased the inhibitory activity of α-glucosidase by CHPs, and their effects varied in magnitude with Cu2+ having the largest effect followed by Zn2+, Fe3+, K+, Mg2+, and Ca2+. These results further highlight the potential of CHPs as a foodborne hypoglycemic ingredient, providing a theoretical basis for the application of CHPs in the healthy food industry.
In Vivo Evaluation of the Potential of Thyme and Lemon Hydrolates as Processing Aids to Reduce Norovirus Concentration during Oyster Depuration
Authors: Battistini Roberta , Masotti Chiara , Bianchi Daniela Manila , Decastelli Lucia , Garcia-Vozmediano Aitor , Maurella Cristiana , Fauconnier Marie-Laure , Paparella Antonello , Serracca Laura
Published: October 2023

In this study, we evaluated the use of hydrolates, co-products of essential oil distillation, as processing aids to improve the depuration process of Pacific oysters (Crassostrea gigas) as a post-harvest method aimed at reducing the norovirus (NoV) viral load. Live oysters were kept in water to which hydrolates of Thymus serpyllum and Citrus limon at 1% were added for 24 h. The concentration of NoV was quantified using the ISO 15216-1 quantitative real-time RT-PCR method in the oyster digestive tissue both before and after the treatment. The results showed a significant reduction of 0.2 log in the NoV GII concentration after 24 h of treatment with 1% C. limon hydrolate. Conversely, treatment with T. serpyllum did not appear to reduce the concentration of NoV compared to the control. Additionally, a sensory analysis was conducted through a blind survey comparing untreated and treated oysters. No changes in the sensory and physical characteristics of the oysters were observed, except for a decrease in the marine flavour intensity, which was positively perceived by consumers. These results indicate that the addition of hydrolates of C. limon at 1% during depuration might represent a promising processing aid for enhancing both the safety and acceptability of live oysters.
Yellow Field Pea Protein (Pisum sativum L.): Extraction Technologies, Functionalities, and Applications
Authors: Asen Nancy D. , Aluko Rotimi E. , Martynenko Alex , Utioh Alphonsus , Bhowmik Pankaj
Published: October 2023

Yellow field peas (Pisum sativum L.) hold significant value for producers, researchers, and ingredient manufacturers due to their wealthy composition of protein, starch, and micronutrients. The protein quality in peas is influenced by both intrinsic factors like amino acid composition and spatial conformations and extrinsic factors including growth and processing conditions. The existing literature substantiates that the structural modulation and optimization of functional, organoleptic, and nutritional attributes of pea proteins can be obtained through a combination of chemical, physical, and enzymatic approaches, resulting in superior protein ingredients. This review underscores recent methodologies in pea protein extraction aimed at enhancing yield and functionality for diverse food systems and also delineates existing research gaps related to mitigating off-flavor issues in pea proteins. A comprehensive examination of conventional dry and wet methods is provided, in conjunction with environmentally friendly approaches like ultrafiltration and enzyme-assisted techniques. Additionally, the innovative application of hydrodynamic cavitation technology in protein extraction is explored, focusing on its prospective role in flavor amelioration. This overview offers a nuanced understanding of the advancements in pea protein extraction methods, catering to the interests of varied stakeholders in the field.
Development of an Efficient Variable Step-Size Gradient Method Utilizing Variable Fractional Derivatives
Authors: Ye Luotang , Chen Yanmao , Liu Qixian
Published: October 2023

The fractional gradient method has garnered significant attention from researchers. The common view regarding fractional-order gradient methods is that they have a faster convergence rate compared to classical gradient methods. However, through conducting theoretical convergence analysis, we have revealed that the maximum convergence rate of the fractional-order gradient method is the same as that of the classical gradient method. This discovery implies that the superiority of fractional gradients may not reside in achieving fast convergence rates compared to the classical gradient method. Building upon this discovery, a novel variable fractional-type gradient method is proposed with an emphasis on automatically adjusting the step size. Theoretical analysis confirms the convergence of the proposed method. Numerical experiments demonstrate that the proposed method can converge to the extremum point both rapidly and accurately. Additionally, the Armijo criterion is introduced to ensure that the proposed gradient methods, along with various existing gradient methods, can select the optimal step size at each iteration. The results indicate that, despite the proposed method and existing gradient methods having the same theoretical maximum convergence speed, the introduced variable step size mechanism in the proposed method consistently demonstrates superior convergence stability and performance when applied to practical problems.
Properties for a Certain Subclass of Analytic Functions Associated with the Salagean q-Differential Operator
Authors: Lashin Abdel Moneim Y. , Badghaish Abeer O. , Alshehri Fayzah A.
Published: October 2023

Using the Salagean q-differential operator, we investigate a novel subclass of analytic functions in the open unit disc, and we use the Hadamard product to provide some inclusion relations. Furthermore, the coefficient conditions, convolution properties, and applications of the q-fractional calculus operators are investigated for this class of functions. In addition, we extend the Miller and Mocanu inequality to the q-theory of analytic functions.
Formulation and In Vivo Evaluation of Biofilm Loaded with Silver Sulfadiazine for Burn Healing
Authors: Alshora Doaa , Ashri Lubna , Alfaraj Rihaf , Alhusaini Ahlam , Mohammad Raeesa , Alanaze Nawal , Ibrahim Mohamed , Badran Mohamed M. , Bekhit Mounir , Alsaif Shaikha , Alagili Modhi , Ali Rehab A. , Jreebi Adel
Published: October 2023

Infected burned skin is a life-threatening condition, which may lead to sepsis. The aims of this work are to formulate a biofilm composed of silver sulfadiazine (SSD), chitosan (CS), and sodium alginate (SA), and to evaluate its wound-healing effectiveness. A full factorial design was used to formulate different matrix formulations. The prepared biofilm was tested for physicochemical, and in vitro release. The optimized formulation is composed of 0.833% of CS and 0.75% of SA. The release of SSD almost reached 100% after 6 h. The mechanical properties of the optimized formula were reasonable. The antibacterial activity for the optimized biofilm was significantly higher than that of blank biofilm, which is composed of CS and SA, p = 1.53922 × 10−12. Moreover, the in vivo study showed a 75% reduction in wound width when using the formulated SSD biofilm compared to standard marketed cream (57%) and the untreated group (0%).
Evaluation of the Effect of Honey-Containing Chitosan/Hyaluronic Acid Hydrogels on Wound Healing
Authors: Şalva Emine , Akdağ Ahmet Enes , Alan Saadet , Arısoy Sema , Akbuğa Fatma Jülide
Published: October 2023

The 3D polymeric network structure of hydrogels imitates the extracellular matrix, thereby facilitating cell growth and differentiation. In the current study, chitosan/hyaluronic acid/honey coacervate hydrogels were produced without any chemicals or crosslinking agents and investigated for their wound-healing abilities. Chitosan/hyaluronic acid/honey hydrogels were characterized by FTIR, SEM, and rheology analysis. Moreover, their water content, water uptake capacities, and porosity were investigated. In FT-IR spectra, it was discovered that the characteristic band placement of chitosan with hyaluronic acid changed upon interacting with honey. The porosity of the honey-containing hydrogels (12%) decreased compared to those without honey (17%). Additionally, the water-uptake capacity of honey-containing hydrogels slightly decreased. Also, it was observed that hydrogels’ viscosity increased with the increased hyaluronic acid amount and decreased with the amount of honey. The adhesion and proliferation of fibroblast cells on the surface of hydrogel formulations were highest in honey-containing hydrogels (144%). In in vivo studies, wound healing was accelerated by honey addition. It has been demonstrated for the first time that honey-loaded chitosan-hyaluronic acid hydrogels, prepared without the use of toxic covalent crosslinkers, have potential for use in wound healing applications.
Production and In Situ Modification of Bacterial Cellulose Gels in Raisin Side-Stream Extracts Using Nanostructures Carrying Thyme Oil: Their Physicochemical/Textural Characterization and Use as Antimicrobial Cheese Packaging
Authors: Adamopoulou Vasiliki , Salvanou Anastasia , Bekatorou Argyro , Petsi Theano , Dima Agapi , Giannakas Aris E. , Kanellaki Maria
Published: October 2023

We report the production of BC gels by Komagataeibacter sucrofermentans in synthetic (Hestrin and Schramm; HS) and natural media (raisin finishing side-stream extracts; RFSE), and their in situ modification by natural zeolite (Zt) and activated carbon (AC) nanostructures (NSs) carrying thyme oil (Th). The NS content for optimum BC yield was 0.64 g/L for both Zt-Th (2.56 and 1.47 g BC/L in HS and RFSE, respectively), and AC-Th (1.78 and 0.96 g BC/L in HS and RFSE, respectively). FTIR spectra confirmed the presence of NS and Th in the modified BCs, which, compared to the control, had reduced specific surface area (from 5.7 to 0.2–0.8 m2/g), average pore diameter (from 264 to 165–203 Å), cumulative pore volume (from 0.084 to 0.003–0.01 cm3/g), crystallinity index (CI) (from 72 to 60–70%), and crystallite size (from 78 to 72–76%). These values (except CI and CS), slightly increased after the use of the BC films as antimicrobial coatings on white cheese for 2 months at 4 °C. Tensile properties analysis showed that the addition of NSs resulted in a decrease of elasticity, tensile strength, and elongation at break values. The best results regarding an antimicrobial effect as cheese coating were obtained in the case of the RFSE/AC-Th BC.
Preparation and Performance of Resin-Gel–Rubber Expandable Lost Circulation Material Blend
Authors: Zhu Jinzhi , Lou Erbiao , Zhang Shaojun , Lu Haiying , Wang Ziwu
Published: October 2023

Aiming at the complex strata, lost circulation often occurs. and lost circulation control becomes a difficult issue. A drilling fluid loss accident delays the drilling progress and even causes major economic losses. If we take a self-made sodium polyacrylate grafting and modify a starch water absorbent resin, using an amphiphilic compatibilizer as raw material through mechanical blending and chemical compatibilization, we can synthesize a resin–rubber blend swelling lost circulation material. This material presents a good resistance to anti-high-temperature performance, but the quality declines while the temperature is higher than 363 °C, and with the increasing temperature, the water-swelling expansion ratio becomes higher. The range of the water-swelling expansion ratio is 8 to 25 times and the water swelling rate becomes larger along with the reduced diameter of the lost circulation materials and decreases with the increasing salinity. The resin-rubber blend swelling lost circulation material after water swelling has excellent toughness and high elastic deformation capacity, thus, forming a 7 Mpa to 2 mm fracture via expansion, extrusion, deformation, and filling, which presents a good performance for fracture plugging and realizes the purpose of lost circulation control.
Nexus Advances Using Marine Biopolymeric Gel Material as a Photocatalyst for the Oxidation of Agricultural Wastewater Containing Insecticides
Authors: Hassan Ehssan Ahmed , Tony Maha A.
Published: October 2023

The attention of the research community is focused not only on waste elimination, but also on waste valorization. The natural marine biopolymer gel substance chitosan, which can be derived from the waste substances of marine life, is a polymer-matrix-based nanocomposite. Chitosan attracts special attention due to its potential applications, especially in wastewater treatment. In this regard, magnetite-incorporated chitosan powders of nanometer scale were synthesized by a simple co-precipitation method to attain the dual functions of chitosan gel and magnetite. The synthesized magnetite-incorporated chitosan nanopowders were verified using X-ray diffraction (XRD), Fourier-transform infrared (FTIR) spectroscopy, a vibrating-sample magnetometer (VSM), a scanning electron microscope (SEM), and transmission electron microscopy (TEM) images, which showed that the synthesized magnetite-incorporated chitosan was nanosized. The superior application of such a material to offset the deterioration of the environment caused by insecticides is attained through a photocatalytic reaction. The experimental results verified the function of magnetite-incorporated chitosan, since it increased the composite-specific surface area, resulting in high methomyl molecule oxidation. Methomyl oxidation reached almost complete insecticide removal (99%) within only one hour of irradiance time. The optimal operational conditions were investigated, and the maximal removal rate occurred when the aqueous solution was at an acidic pH of 3.0. The reaction was affected by differing hydrogen peroxide and catalyst doses, and the optimized reagent was recorded at the levels of 40 and 400 mg/L of catalyst and hydrogen peroxide, respectively. Also, catalyst reusability was attained, confirming its sustainability, since it could be used for successive cycles. From the current investigation, it is proposed that magnetite–chitosan nanoparticles could serve as a promising photocatalyst for the elimination of insecticides from wastewater in a green manner.
Contemporary Challenges in Destination Planning: A Geographical Typology Approach
Authors: Sarantakou Efthymia
Published: October 2023

This paper aims to outline a framework for reviewing the issues faced by tourism destination planning in the 21st century. This paper documents the use of tourism destination typologies as a framework for policy analysis and as a basis for decision making. The main research hypothesis of this study is that typologies based on, or primarily focused on, geographical dimensions have historically been the appropriate framework for strategic planning. This study proposes the use of a basic geographical typology, according to which destinations are categorized into urban, island, coastal, and mountainous. This paper refers to the evolution, key features, and challenges faced by each type of destination. Through a review of international best practices, this study maps out the fundamental objectives, developmental patterns, and strategies for each geographical type of destination, offering valuable insights for future research. Emphasis is given to contemporary trends in tourism planning in the first few decades of the 21st century.
Impact of State Stroke Systems of Care Laws on Stroke Outcomes
Authors: Fulmer Erika B. , Keener Mast Dana , Godoy Garraza Lucas , Gilchrist Siobhan , Rasool Aysha , Xu Ye , Brown Amanda , Omeaku Nina , Ye Zhiqiu , Donald Bruce , Shantharam Sharada , Coleman King Sallyann , Popoola Adebola , Cincotta Kristen
Published: October 2023

Since 2003, 38 US states and Washington, DC have adopted legislation and/or regulations to strengthen stroke systems of care (SSOCs). This study estimated the impact of SSOC laws on stroke outcomes. We used a coded legal dataset of 50 states and DC SSOC laws (years 2003–2018), national stroke accreditation information (years 1997–2018), data from the Healthcare Cost and Utilization Project (years 2012–2018), and National Vital Statistics System (years 1979–2019). We applied a natural experimental design paired with longitudinal modeling to estimate the impact of having one or more SSOC policies in effect on outcomes. On average, states with one or more SSOC policies in effect achieved better access to primary stroke centers (PSCs) than expected without SSOC policies (ranging from 2.7 to 8.0 percentage points (PP) higher), lower inpatient hospital costs (USD 610–1724 less per hospital stay), lower age-adjusted stroke mortality (1.0–1.6 fewer annual deaths per 100,000), a higher proportion of stroke patients with brain imaging results within 45 min of emergency department arrival (3.6–5.0 PP higher), and, in some states, lower in-hospital stroke mortality (5 fewer deaths per 1000). Findings were mixed for some outcomes and there was limited evidence of model fit for others. No effect was observed in racial and/or rural disparities in stroke mortality.
Effects of Post Traumatic Growth on Successful Aging in Breast Cancer Survivors in South Korea: The Mediating Effect of Resilience and Intolerance of Uncertainty
Authors: Yi Su Jeong , Kim Ku Sang , Lee Seunghee , Lee Hyunjung
Published: October 2023

This study aimed to identify post-traumatic growth and successful aging and the mediating effects of resilience and intolerance of uncertainty in breast cancer survivors. This study employed a descriptive survey approach. Data were collected from 143 breast cancer survivors between 27 January and 10 December 2021, at a cancer center in Gyeongsangnam-do, South Korea. SPSS/WIN 25.0 and PROCESS Macro version 3.5 were used for data analysis. Descriptive statistics were analyzed with SPSS. PROCESS was used to conduct a mediation analysis and the significance of the mediating effect was evaluated using 95% confidence intervals. Successful aging was significantly associated with post-traumatic growth, resilience, and the intolerance of uncertainty. The impact of post-traumatic growth on successful aging was mediated by resilience in breast cancer survivors. Resilience should be considered when developing nursing interventions to enhance post-traumatic growth and promote successful aging in breast cancer survivors.
Multicomponent Training Improves the Quality of Life of Older Adults at Risk of Frailty
Authors: Moradell Ana , Navarrete-Villanueva David , Fernández-García Ángel Iván , Gusi Narcis , Pérez-Gómez Jorge , González-Gross Marcela , Ara Ignacio , Casajús José Antonio , Gómez-Cabello Alba , Vicente-Rodríguez Germán
Published: October 2023

Achieving a high quality of life in older adults can be difficult if they have limited physical function. The aims of this study were to evaluate the relationship between baseline values and variations in body composition, fitness, and nutritional status on health-related quality of life (HRQoL) and to describe the effects of a 6-month multicomponent training (MCT) programme and a 4-month detraining period on HRQoL. A total of 106 participants with limited physical function were included in this study (age: 80.8 ± 5.9 years; 74 females) and were divided into two groups: control (CON) and intervention (TRAIN). HRQoL was measured using the EQ-5D-3L questionnaire and a visual analogue scale (EQ-VAS). Information on body composition, physical fitness, Mediterranean diet adherence, and nutritional status were obtained. Healthier baseline values for body composition, fitness and nutritional status were associated with better HRQoL (explaining 23.7–55.4%). The TRAIN group showed increased HRQoL during this 6-month MCT, showing group-by-time interaction (p < 0.05) and a deleterious effect of detraining. Changes in weight, arm strength, and aerobic capacity contributed to explaining 36% of the HRQoL changes obtained with MCT (all p < 0.05). This MCT improved HRQoL in older adults with limited physical function. However, HRQoL returned to baseline values after detraining. This study highlights the importance of performing ongoing programs in this population.
A Study of the Relationship between Men Who Have Sex with Men Stigma and Depression: A Moderated Mediation Model
Authors: Zhou Tianyi , Chen Qiao , Zhong Xiaoni
Published: October 2023

(1) Background: Men who have sex with men (MSM) have a high prevalence of depression due to stigma. However, whether resilience and social support play a moderating role in the effects of stigma on depression remains to be tested. This study constructed a moderated mediation model to explore the mediating role of perceived stigma in the relationship between enacted stigma and depression and whether this relationship is moderated by social support. (2) Methods: MSM were recruited during November–December 2022 using a non-probability sampling method, and a total of 1091 participants were included. Enacted stigma, perceived stigma, resilience, social support, and depressive symptoms were measured. Mediation and moderated mediation models were used to analyze the relationships between these variables. (3) Results: Moderated mediation analyses show that enacted stigma indirectly affects depression through perceived stigma (β = 0.315, 95% confidence interval = 0.221 to 0.421). Social support had a positive moderating effect between enacted stigma and depressive symptoms (β = 0.194, p < 0.001) and a negative moderating effect between perceived stigma and depressive symptoms (β = −0.188, p < 0.001). (4) Resilience and perceived stigma mediated the relationship between enacted stigma and depression, and the relationship between enacted stigma, perceived stigma, and depression was moderated by social support. Reducing stigma while increasing social support has the potential to alleviate depressive symptoms among Chinese MSM.
The Effect of the Knowledge, Skills, and Attitudes from Nurse Training Using In Situ Simulation in an Intensive Care Unit
Authors: Lien Ru-Yu , Cheng Chun-Gu , Hung Shih-Hsin , Wang Chien-Ying , Lin Hui-Chen , Lu Shu-Fen , Chin Shu-I , Kuo Yi-Wen , Liu Chia-Wen , Yung Ming-Chi , Cheng Chun-An
Published: October 2023

Background: In situ simulation is the practice of using simulated scenarios to improve skill implementation, train critical thinking and problem-solving abilities, and enhance self-efficacy. This study aimed to enhance nursing knowledge, skills, and attitudes toward clinical work by applying in situ simulation training to improve the healthcare of critically ill patients. Methods: This study was conducted from a medical center in northern Taiwan and included 86 trainees who received intensive care training courses from 1 June 2017 to 31 May 2019. The self-report knowledge assessment, empathetic self-efficacy scale, skill assessment, and attitudes of instructors before and after training were collected. The statistical analysis used the Wilcoxon test for knowledge and attitudes, and chi-square tests were used for skills to evaluate the learning effect. Results: The results showed a statistically significant improvement in knowledge, skills, attitudes, and empathy in nursing care. Conclusions: In situ simulation learning can be an accepted method for nursing skills in the intensive care unit. Through this study, we understood that the in situ simulation method was beneficial to nurses’ care and care thinking processes. It is worth developing and evaluating integrated simulation education to enhance learning, change behavior, and promote holistic care in the nursing field.
Incidence of Acute Upper Gastrointestinal Bleeding and Related Risk Factors among Elderly Patients Undergoing Surgery for Major Limb Fractures: An Analytical Cohort Study
Authors: Chen Guan-Yu , Wu Wen-Tien , Lee Ru-Ping , Chen Ing-Ho , Yu Tzai-Chiu , Wang Jen-Hung , Yeh Kuang-Ting
Published: October 2023

(1) Background: Upper gastrointestinal bleeding (UGIB), a major postoperative complication after surgical fixation of major limb fractures, can be fatal but is often neglected. This study determined the incidence rates of and related risk factors for perioperative UGIB among older patients with major upper limb fractures but without a history of peptic ulcer disease (PUD). (2) Methods: We collected the data of patients aged more than 65 years who underwent surgery for major limb fracture between 1 January 2001 and 31 December 2017, from Taiwan’s National Health Insurance Research Database and excluded those with a history of UGIB and PUD before the date of surgery. The primary outcome was the incidence of UGIB requiring panendoscopy during hospitalization. A multiple logistic regression model was used to identify the independent predictors of UGIB, with adjustment for confounding factors. The final model included variables that were either statistically significant in univariate analyses or deemed clinically important. (3) Results: The incidence of UGIB was 2.8% among patients with major limb fractures. Male sex, older age, major lower limb fracture, and a history of chronic renal disease were significant risk factors for the increased incidence of perioperative UGIB. (4) Conclusions: Patients with major limb fractures who underwent surgery exhibited a higher rate of stress ulceration with UGIB, even when they had no history of PUD. Perioperative preventive protocols (e.g., protocols for the administration of proton-pump inhibitors) may be necessary for patients with these major risk factors.
Performance of ChatGPT on Registered Nurse License Exam in Taiwan: A Descriptive Study
Authors: Huang Huiman
Published: October 2023

(1) Background: AI (artificial intelligence) chatbots have been widely applied. ChatGPT could enhance individual learning capabilities and clinical reasoning skills and facilitate students’ understanding of complex concepts in healthcare education. There is currently less emphasis on its application in nursing education. The application of ChatGPT in nursing education needs to be verified. (2) Methods: A descriptive study was used to analyze the scores of ChatGPT on the registered nurse license exam (RNLE) in 2022~2023, and to explore the response and explanations of ChatGPT. The process of data measurement encompassed input sourcing, encoding methods, and statistical analysis. (3) Results: ChatGPT promptly responded within seconds. The average score of four exams was around 51.6 to 63.75 by ChatGPT, and it passed the RNLE in 2022 1st and 2023 2nd. However, ChatGPT may generate misleading or inaccurate explanations, or it could lead to hallucination; confusion or misunderstanding about complicated scenarios; and languages bias. (4) Conclusions: ChatGPT may have the potential to assist with nursing education because of its advantages. It is recommended to integrate ChatGPT into different nursing courses, to assess its limitations and effectiveness through a variety of tools and methods.
What Sexual Problems Does a Sample of LGB+ People Report Having, and How Do They Define Sexual Pleasure: A Qualitative Study to Inform Clinical Practice
Authors: Manão Andreia A. , Martins Edna , Pascoal Patrícia M.
Published: October 2023

Introduction: Sexual pleasure is a human right and a central aspect of human sexuality that contributes significantly to people’s overall well-being, making it an essential element to consider in clinical settings. This study aims to expand the understanding of sexual pleasure by examining how LGB+ people (lesbian, gay, bisexual, and other minority sexual orientations)-who perceived having a sexual problem-define solitary and partnered sexual pleasure. Methods: A cross-sectional exploratory qualitative study was conducted online. The current study included 85 people who self-identified as LGB+ and reported experiencing a sexual problem. Data analysis was performed using summative content analysis. Results: The results for solitary sexual pleasure comprised the creation of 5 categories (Enhancing the relationship with oneself, Specification of solitary pleasure, Negative experience, Unrestrained experience and A goal). For partnered sexual pleasure, 9 categories were created (The perks of being with another, Openness to experience, A result of sexual techniques, Psychophysiological experience, Misconceptions about sexual pleasure, Absence of intrapersonal constraints, Undesirable feelings, Explicit consent, and Absence of interpersonal constraints). Discussion: Despite reporting sexual problems, most participants reported having experienced sexual pleasure, and were able to define it. This study provided a deeper understanding of the perspectives on and experiences of sexuality among LGB+ people who experience sexual problems. Our findings highlight that current diagnostic criteria (e.g., DSM-5) do not seem to align with the problems reported by this sample population (the problems presented are beyond their sexual function). This reinforces the importance of viewing sexual problems from a perspective that goes beyond the categorial psychopathology model. Our study’s findings may offer valuable insights for the evaluation and treatment of sexual problems, where sexual pleasure is considered a crucial aspect of sexual well-being.
The Impact of the COVID-19 Pandemic on Depressive Disorder with Postpartum Onset: A Cross-Sectional Study
Authors: Ciolac Livia , Craina Marius Lucian , Enatescu Virgil Radu , Tudor Anca , Bernad Elena Silvia , Nitu Razvan , Hogea Lavinia , Boscu Lioara , Bernad Brenda-Cristiana , Timircan Madalina Otilia , Ciolac Valeria , Nediglea Cristian-Octavian , Maghiari Anca Laura
Published: October 2023

Background: COVID-19 has led to a global health crisis that is defining for our times and one of the greatest challenges to emerge since World War II. The potential impact of the pandemic on mental health should not be overlooked, especially among vulnerable populations such as women who gave birth during the COVID-19 pandemic. Materials and Methods: The study is a cross-sectional survey conducted from 1 March 2020 to 1 March 2023, during the period of the SARS-CoV-2 (COVID-19) pandemic, based on a retrospective evaluation of 860 postpartum women. The screening tool used to assess symptoms of postpartum depression was the Edinburgh Postnatal Depression Rating Scale (EPDS) questionnaire. The questionnaire was completed both in the Obstetrics and Gynaecology Clinical Sections I and II of the “Pius Brînzeu” County Emergency Hospital in Timisoara, Romania, and online using Google Forms. Results: The highest severity of postpartum depression symptoms was observed during the COVID-19 pandemic. The results of the study conducted during the period of the SARS-CoV-2 pandemic (COVID-19) showed that the prevalence of major postpartum depressive disorder (EPDS ≥ 13) was 54.2% (466 patients), while 15.6% (134) had minor depressive disorder (10 < EPDS ≤ 12) in the first year after delivery. Comparing these results with those obtained in research conducted before the onset of the pandemic period showed an alarming increase in the prevalence of postpartum depression. The risk factors associated with postpartum depression included the type of delivery, level of education, socio-economic conditions, health status, age, background, and personal obstetric history (number of abortions on demand, parity). Conclusions: The effects of the pandemic on mental health are of particular concern for women in the first year after childbirth. Observing these challenges and developing effective measures to prepare our health system early can be of great help for similar situations in the future. This will help and facilitate effective mental health screening for postpartum women, promoting maternal and child health.
A Korean Nationwide Cross-Sectional Study Investigating Risk Factors, Prevalence, and Characteristics of Sarcopenia in Men in Early Old Age
Authors: Hwang Jongseok , Park Soonjee
Published: October 2023

The present study investigated the risk factors, prevalence, and characteristics of sarcopenia among men aged 50–64 years. A total of 2868 participants were enrolled in this study. Of these, 328 individuals were classified into a sarcopenia group; the remaining 2540 were assigned to a control group. This study examined several variables, including skeletal muscle mass index, age, height, weight, body mass index, waist circumference, systolic and diastolic blood pressure, fasting glucose, triglyceride and total cholesterol levels, alcohol consumption, and tobacco use. It employed a stratified, clustered, and multistage probability sampling design. Complex sampling was used for the data analysis. The prevalence of sarcopenia was 10.25% (95% CI: 8.98–11.69). All anthropometric measures, including height, weight, BMI, and waist circumference, were significantly different between the two groups (p < 0.05). In terms of blood pressure, only systolic blood pressure (SBP) was significant (p < 0.05), and fasting glucose and triglyceride levels were risk factors for sarcopenia (p < 0.05). Tobacco use differed significantly between the two groups (p < 0.05). This study reported the specific prevalence of sarcopenia and identified its risk factors among men in early old age.
Preschool Emotional Problems in the Post-Pandemic Era between Parental Risk and Protective Factors
Authors: Prino Laura Elvira , Arace Angelica , Zonca Paola , Agostini Protima , Scarzello Donatella
Published: October 2023

The psychosocial adaptation of children born or experiencing their early years during the COVID-19 pandemic remains uncertain. In order to implement prevention strategies, it is, therefore, a priority to deeply analyze children’s mental health in this post-pandemic phase and to identify family risk and protective factors. Indeed, recent studies reveal that children’s emotional distress increased with the COVID-19 pandemic, especially in situations of high parental stress. The study investigates associations between some parental characteristics (coping strategies, parental burnout, resilience, perception of social support, and promotion of children’s social-emotional competence) and children’s emotional symptoms, considering gender differences. A total of 358 parents of children aged 2 to 6 years participated in this study. Regression analyses show that parental burnout is a predictor of emotional symptoms; moreover, for females, higher levels of emotional symptoms are associated with parental maladaptive coping strategies, whereas for males, the parent’s ability to promote children’s emotional competence is a protective factor. Results emphasize the importance of supporting parental well-being as a critical factor in shielding children from the repercussions of adverse situations.
Development of Machine Learning Model for VO2max Estimation Using a Patch-Type Single-Lead ECG Monitoring Device in Lung Resection Candidates
Authors: Lee Hyun , Yu Woosik , Choi Jong , Lee Young-sin , Park Ji , Jung Yun , Sheen Seung , Jung Junho , Haam Seokjin , Kim Sang , Park Ji
Published: October 2023

A cardiopulmonary exercise test (CPET) is essential for lung resection. However, performing a CPET can be challenging. This study aimed to develop a machine learning model to estimate maximal oxygen consumption (VO2max) using data collected through a patch-type single-lead electrocardiogram (ECG) monitoring device in candidates for lung resection. This prospective, single-center study included 42 patients who underwent a CPET at a tertiary teaching hospital from October 2021 to July 2022. During the CPET, a single-lead ECG monitoring device was applied to all patients, and the results obtained from the machine-learning algorithm using the information extracted from the ECG patch were compared with the CPET results. According to the Bland–Altman plot of measured and estimated VO2max, the VO2max values obtained from the machine learning model and the FRIEND equation showed lower differences from the reference value (bias: −0.33 mL·kg−1·min−1, bias: 0.30 mL·kg−1·min−1, respectively). In subgroup analysis, the developed model demonstrated greater consistency when applied to different maximal stage levels and sexes. In conclusion, our model provides a closer estimation of VO2max values measured using a CPET than existing equations. This model may be a promising tool for estimating VO2max and assessing cardiopulmonary reserve in lung resection candidates when a CPET is not feasible.
How Does the Agro-Ecological Conditions Grown Kiwifruit (Actinidia deliciosa) Affect the Fruit Quality Traits and Bioactive Compounds during Shelf Life?
Authors: Korkmaz Murat , Ozturk Burhan , Uzun Serkan
Published: October 2023

The kiwifruit (Actinidia deliciosa cv. ‘Hayward’), which shows climacteric characteristics, continues to ripen after harvest. In this process, quality losses occur in fruits, and this causes economic losses. The post-harvest storage conditions are essential in preventing these losses. The main purpose of this study was to assess the effect of agro-ecological conditions on quality traits and bioactive compounds of the kiwifruit throughout the shelf life. In this study, kiwifruit grown in 5 different locations (Ordu, Giresun, Rize, Samsun, and Yalova) constituted the plant material of the study. The fruits treated with modified atmosphere packaging (MAP) were stored at 0 ± 0.5 °C and 90 ± 5% relative humidity (RH) for 150 days in cold storage. For shelf life measurements, fruits were kept at 20 ± 1 °C and 65 ± 5% RH for 5 d. Quality analysis was performed at monthly intervals (at harvest, 30th, 60th, 90th, 120th, and 150th d). In this study, the lowest respiration rate at the end of the shelf life was measured in kiwifruit grown in Yalova. Flesh firmness was higher in kiwifruit grown in Rize, Ordu, and Giresun than Samsun. In all periods, Yalova’s L* value in flesh was higher than that of Ordu. The opposite situation was observed for the hue angle. The soluble solids content (SSC) values measured in Samsun and Yalova were higher than in Ordu and Rize. In the last four measurements, higher vitamin C was detected in Yalova than in Ordu, Rize and Giresun. In all periods, the highest total phenolics and antioxidant activity (in DPPH assay) were obtained in kiwifruit grown in Yalova. On the contrary, the highest flavonoids were measured in kiwifruit grown in Ordu. As a result, it was revealed that agro-ecological conditions may affect the quality traits and bioactive compounds of kiwifruit.
Bond Issuance as Reputational Signal: Debunking the Negative Perception of Additional Liability
Authors: Sheng Dachen , Montgomery Heather A.
Published: October 2023

This paper examines the determinants of bond issuance in the Chinese market and the influence of capital structure—in particular direct debt finance—on firm performance and the cost of debt. The results reveal that institutional factors in the Chinese market, in particular the involvement of the financial authority permission process during bond issuance, enhance the credibility of firms that are able to successfully issue bonds. Empirical analysis of Chinese listed manufacturing firms over the period from 2010 to 2021 demonstrates that firms with higher outstanding levels of bonds perform better and face lower costs of both bond and nonbond direct finance. We interpret this as bond issuance approval serving as a signal to markets of an implicit government guarantee on firms that are approved to issue bonds. The agency problem is analyzed using propensity-score matching and Logit analysis, revealing a trade-off between the principal–agent conflict and conflicts of interest among different shareholders when power is very concentrated through CEO duality: the CEO simultaneously serves as the chairman of the board. In large firms, as measured by total assets, the cost-reducing effect of the principal–agent problem being mitigated by CEO duality outweighs the agency costs arising from conflicts of interest between large and small shareholders, leading to an increased likelihood of successful bond issuance. However, in large firms, as measured by market capitalization, where share ownership is likely more diversified, this effect diminishes. In conclusion, this paper posits that policymakers ought to investigate strategies for granting preferential treatment to high-growth, small to mid-sized enterprises, enabling them to secure funding through direct debt financing.
Observed Equity and Driving Factors of Automated External Defibrillators: A Case Study Using WeChat Applet Data
Authors: Liao Shunyi , Gao Feng , Feng Lei , Wu Jiemin , Wang Zexia , Chen Wangyang
Published: October 2023

Out-of-hospital cardiac arrest (OHCA) causes a high mortality rate each year, which is a threat to human well-being and health. An automated external defibrillator (AED) is an effective device for heart attack-related diseases and is a panacea to save OHCA. Most relevant literature focuses on the spatial distribution, accessibility, and configuration optimization of AED devices, which all belong to the characteristics of the spatial distribution of AED devices. Still, there is a lack of discussion on related potential influencing factors. In addition, analysis of AED facilities involving multiple city comparisons is less considered. In this study, data on AED facilities in two major cities in China were obtained through the WeChat applet. Then, the AED equity at the city and block scales and its socioeconomic factors were analyzed using the Gini coefficient, Lorenz curve, and optimal parameters-based geo-graphical detector (OPGD) model. Results show that the number of AEDs in Shenzhen was about eight-times that of in Guangzhou. The distribution of AEDs in Shenzhen was more equitable with a global Gini of 0.347, higher than that in Guangzhou with a global Gini of 0.504. As for the determinants of AED equity, residential density was the most significant determinant in both Guangzhou and Shenzhen from the perspective of individual effects on AED equity. Differently, due to the aging population in Guangzhou, the proportion of the elderly in blocks was influential to local AED equity. The local economic development level was crucial to local AED equity in Shenzhen. The results of the interaction detector model illustrate that relatively equitable AED distributions were found in the high-density residential areas with a balance of employment and housing, high-aging residential areas, and high-mobility residential areas in Guangzhou. The area with a high level of local economic development, dense population, and large mobility was the area with a relatively equitable distribution of AEDs in Shenzhen. The results of this paper are conducive to understanding the equity of AEDs and its socio-economic determinants, providing scientific reference for the optimization and management of AEDs.