bluuebunny/crossref_metadata_2025 huggingface dataset:
Machine Learning Consensus Clustering of Morbidly Obese Kidney Transplant Recipients in the United States
Authors: Thongprayoon Charat , Mao Shennen A. , Jadlowiec Caroline C. , Mao Michael A. , Leeaphorn Napat , Kaewput Wisit , Vaitla Pradeep , Pattharanitima Pattharawin , Tangpanithandee Supawit , Krisanapan Pajaree , Qureshi Fawad , Nissaisorakarn Pitchaphon , Cooper Matthew , Cheungpasitporn Wisit
Published: June 2022

Background: This study aimed to better characterize morbidly obese kidney transplant recipients, their clinical characteristics, and outcomes by using an unsupervised machine learning approach. Methods: Consensus cluster analysis was applied to OPTN/UNOS data from 2010 to 2019 based on recipient, donor, and transplant characteristics in kidney transplant recipients with a pre-transplant BMI ≥ 40 kg/m2. Key cluster characteristics were identified using the standardized mean difference. Post-transplant outcomes, including death-censored graft failure, patient death, and acute allograft rejection, were compared among the clusters. Results: Consensus clustering analysis identified 3204 kidney transplant recipients with a BMI ≥ 40 kg/m2. In this cohort, five clinically distinct clusters were identified. Cluster 1 recipients were predominantly white and non-sensitized, had a short dialysis time or were preemptive, and were more likely to receive living donor kidney transplants. Cluster 2 recipients were older and diabetic. They were likely to have been on dialysis >3 years and receive a standard KDPI deceased donor kidney. Cluster 3 recipients were young, black, and had kidney disease secondary to hypertension or glomerular disease. Cluster 3 recipients had >3 years of dialysis and received non-ECD, young, deceased donor kidney transplants with a KDPI < 85%. Cluster 4 recipients were diabetic with variable dialysis duration who either received non-ECD standard KDPI kidneys or living donor kidney transplants. Cluster 5 recipients were young retransplants that were sensitized. One-year patient survival in clusters 1, 2, 3, 4, and 5 was 98.0%, 94.4%, 98.5%, 98.7%, and 97%, and one-year death-censored graft survival was 98.1%, 93.0%, 96.1%, 98.8%, and 93.0%, respectively. Cluster 2 had the worst one-year patient survival. Clusters 2 and 5 had the worst one-year death-censored graft survival. Conclusions: With the application of unsupervised machine learning, variable post-transplant outcomes are observed among morbidly obese kidney transplant recipients. Recipients with earlier access to transplant and living donation show superior outcomes. Unexpectedly, reduced graft survival in cluster 3 recipients perhaps underscores socioeconomic access to post-transplant support and minorities being disadvantaged in access to preemptive and living donor transplants. Despite obesity-related concerns, one-year patient and graft survival were favorable in all clusters, and obesity itself should be reconsidered as a hard barrier to kidney transplantation.
Biomarkers in Primary Focal Segmental Glomerulosclerosis in Optimal Diagnostic-Therapeutic Strategy
Authors: Musiała Aleksandra , Donizy Piotr , Augustyniak-Bartosik Hanna , Jakuszko Katarzyna , Banasik Mirosław , Kościelska-Kasprzak Katarzyna , Krajewska Magdalena , Kamińska Dorota
Published: June 2022

Focal segmental glomerulosclerosis (FSGS) involves podocyte injury. In patients with nephrotic syndrome, progression to end-stage renal disease often occurs over the course of 5 to 10 years. The diagnosis is based on a renal biopsy. It is presumed that primary FSGS is caused by an unknown plasma factor that might be responsible for the recurrence of FSGS after kidney transplantation. The nature of circulating permeability factors is not explained and particular biological molecules responsible for inducing FSGS are still unknown. Several substances have been proposed as potential circulating factors such as soluble urokinase-type plasminogen activator receptor (suPAR) and cardiolipin-like-cytokine 1 (CLC-1). Many studies have also attempted to establish which molecules are related to podocyte injury in the pathogenesis of FSGS such as plasminogen activator inhibitor type-1 (PAI-1), angiotensin II type 1 receptors (AT1R), dystroglycan(DG), microRNAs, metalloproteinases (MMPs), forkheadbox P3 (FOXP3), and poly-ADP-ribose polymerase-1 (PARP1). Some biomarkers have also been studied in the context of kidney tissue damage progression: transforming growth factor-beta (TGF-β), human neutrophil gelatinase-associated lipocalin (NGAL), malondialdehyde (MDA), and others. This paper describes molecules that could potentially be considered as circulating factors causing primary FSGS.
Expectations and Concerns about the Use of Telemedicine for Autism Spectrum Disorder: A Cross-Sectional Survey of Parents and Healthcare Professionals
Authors: Gabellone Alessandra , Marzulli Lucia , Matera Emilia , Petruzzelli Maria Giuseppina , Margari Anna , Giannico Orazio Valerio , Margari Lucia
Published: June 2022

Telemedicine has recently been used for diagnosis and interventions inpatients with autism spectrum disorder (ASD), traditionally performed in-person, but little attention has been paid to user expectations prior to its use. The aim of this study is to compare the expectations and concerns of 50 healthcare professionals and 45 parents of children with ASD regarding the use of telemedicine for diagnostic or treatment purposes. Parents have higher expectations for the use of telemedicine as an alternative (p = 0.0223) and supplement (p = 0.0061) to in-person diagnosis of ASD, as well as a supplement to traditional intervention (p ≤ 0.0001). In addition, while they also have greater hope for improvement in family routines (p = 0.0034) and parenting skills in child management (p = 0.0147), they express greater concern about the need for active parental involvement/supervision during telemedicine services (p = 0.015) and changes in the behaviour of the child with ASD during telemedicine services (p = 0.049). On the other hand, healthcare professionals are more concerned about barriers such as lack of devices (p = 0.000), unfamiliarity with the technology (p = 0.000), poor quality of internet connection (p = 0.006), and severity of ASD (p = 0.000). To achieve promising healthcare for ASD patients, the telemedicine service should try to meet the needs and preferences of both healthcare professionals and parents, as well as identify and, if possible, reduce perceived barriers.
The Affective Dimension of Pain Appears to Be Determinant within a Pain–Insomnia–Anxiety Pathological Loop in Fibromyalgia: A Case-Control Study
Authors: Mory Lliure-Naima , de Oliveira Fernandes Daniel , Mancini Christian , Mouthon Michael , Chabwine Joelle Nsimire
Published: June 2022

Background: Fibromyalgia (FM) is a chronic pain disease characterized by multiple symptoms whose interactions and implications in the disease pathology are still unclear. This study aimed at investigating how pain, sleep, and mood disorders influence each other in FM, while discriminating between the sensory and affective pain dimensions. Methods: Sixteen female FM patients were evaluated regarding their pain, while they underwent—along with 11 healthy sex- and age-adjusted controls—assessment of mood and sleep disorders. Analysis of variance and correlations were performed in order to assess group differences and investigate the interactions between pain, mood, and sleep descriptors. Results: FM patients reported the typical widespread pain, with similar sensory and affective inputs. Contrary to controls, they displayed moderate anxiety, depression, and insomnia. Affective pain (but neither the sensory pain nor pain intensity) was the only pain indicator that tendentially correlated with anxiety and insomnia, which were mutually associated. An affective pain–insomnia–anxiety loop was thus completed. High ongoing pain strengthened this vicious circle, to which it included depression and sensory pain. Conclusions: Discriminating between the sensory and affective pain components in FM patients disclosed a pathological loop, with a key role of affective pain; high ongoing pain acted as an amplifier of symptoms interaction. This unraveled the interplay between three of most cardinal FM symptoms; these results contribute to better understand FM determinants and pathology and could help in orienting therapeutic strategies.
One-Stage Coverage of Leg Region Defects with STSG Combined with VAC Dressing Improves Early Patient Mobilisation and Graft Take: A Comparative Study
Authors: Sapino Gianluca , Lanz Loise , Roesti Aurore , Guillier David , Deglise Sebastien , De Santis Giorgio , Raffoul Wassim , di Summa Pietro
Published: June 2022

Lower limb skin defects are very common and can result from a wide range of aetiologies. Split thickness skin graft (STSG) is a widely used method to address these problems. The role of postoperative dressing is primary as it permits one to apply a uniform pressure over the grafted area and promote adherence. Focusing on lower limb reconstruction, our clinical study compares the application of V.A.C. (Vacuum Assisted Closure) Therapy vs. conventional dressing in the immediate postoperative period following skin grafting. We included in the study all patients who received skin grafts on the leg region between January 2015 and December 2018, despite the aetiology of the defect. Only reconstructions with complete preoperative and postoperative follow-up data were included in the study. Patients were divided into two groups depending on if they received a traditional compressive dressing or a VAC dressing in the immediate postoperative period. We could retain 92 patients, 23 in the No VAC group and 69 in the VAC group. The patients included in the VAC group showed a statistically significant higher rate of graft take together with a lower immobilisation time (p < 0.05). Moreover, a lower rate of postoperative infection was recorded in the VAC group. This study represents the largest in the literature to report in detail surgical outcomes comparing the use of VAC therapy vs. conventional dressing after STSG in the postoperative management of lower limb reconstruction using skin grafts. VAC therapy was used to secure the grafts in the leg region, increasing the early graft take rate while at the same time improving patient mobilisation.
Impaired Relationship between Sense of Agency and Prediction Error Due to Post-Stroke Sensorimotor Deficits
Authors: Miyawaki Yu , Otani Takeshi , Morioka Shu
Published: June 2022

Sense of agency refers to the experience of controlling one’s actions. Studies on healthy people indicated that their self-other attribution can be realized based on prediction error which is an inconsistency between the internal prediction and sensory feedback of the movements. However, studies on patients with post-stroke sensorimotor deficits hypothesized that their self-other attribution can be based on different attribution strategies. This preliminary study examined this hypothesis by investigating whether post-stroke sensorimotor deficits can diminish the correlation between prediction errors and self-other judgments. Participants performed sinusoidal movements with visual feedback and judged if it represented their or another’s movements (i.e., self-other judgment). The results indicated that the patient who had worse upper limb sensorimotor deficits and lesser paretic upper limb activity compared with the other patient made more misattributions and showed a lower correlation between prediction errors and self-other judgments. This finding suggests that post-stroke sensorimotor deficits can impair the relationship between prediction error and self-other attribution, supporting the hypothesis that patients with such deficits can have altered strategies for the registration of agency.
Ga-68-PSMA-11 PET/CT in Patients with Biochemical Recurrence of Prostate Cancer after Primary Treatment with Curative Intent—Impact of Delayed Imaging
Authors: Kunikowska Jolanta , Pełka Kacper , Tayara Omar , Królicki Leszek
Published: June 2022

The presence of prostate-specific membrane antigen (PSMA) on prostate cancer cells and its metastases allows its use in diagnostics using PET/CT. The aim of this study was to evaluate the usefulness of delayed phase images in the Ga-68-PSMA-11 PET/CT. Methods: 108 patients with prostate cancer (median age: 68.5 years, range: 49–83) were referred for Ga-68-PSMA-11 PET/CT due to biochemical relapse (PSA (prostate-specific antigen) (3.2 ± 5.4 ng/mL). Examinations were performed at 60 min, with an additional delayed phase of the pelvis region at 120–180 min. Results: The Ga-68-PSMA-11 PET/CT showed lesions in 86/108 (80%) patients; detection rate depending on the PSA level: 0.2 < PSA < 0.5 ng/mL vs. 0.5 ≤ PSA < 1.0 ng/mL vs. 1.0 ≤ PSA < 2.0 ng/mL vs. PSA ≥ 2.0 ng/mL was 56% (standard vs. delay: 56 vs. 56%) vs. 60% (52 vs. 60%) vs. 87% (83 vs. 87%) vs. 82% (77 vs. 82%) of patients, respectively. The delayed phase had an impact on the treatment in 14/86 patients (16%) (p < 0.05): 7 pts increased uptake was seen only after 60 min, which was interpreted as physiological or inflammatory accumulation; the delayed image showed increased accumulation in 7 patients only: 4 in regional lymph nodes, 1 in local recurrence, and 2 patients with local recurrence showed additional foci. Conclusions: Delayed phase of Ga-68-PSMA-11 PET/CT has an impact on treatment management in 16% of patients.
Challenges in the Diagnosis and Management of Non-Severe Hemophilia
Authors: Boeriu Estera , Arghirescu Teodora Smaranda , Serban Margit , Patrascu Jenel Marian , Boia Eugen , Jinca Cristian , Schramm Wolfgang , Traila Adina , Ursu Cristina Emilia
Published: June 2022

(1) Background: Mild and moderate hemophilia, synonymous with non-severe hemophilia (NSH), are of constant interest for the clinicians. Bleeding occurs usually after trauma, injury, surgery, or inhibitor development, sometimes leading to a shift of the clinical phenotype from mild to severe, even with life-threatening and unexpected outcomes. (2) Methods: We performed a retrospective observational study conducted on 112 persons with congenital coagulopathies, 26 of them with NSH, admitted to our clinic in the period 2000 to 2022. For the diagnosis, we used laboratory studies (complete blood cell count, coagulation assays, biochemistry, thromboelastography, genetic tests) and imaging investigations (X-ray, ultrasound, CT, MRI). We selected four cases confronted with pitfalls of diagnosis and evolution in order to illustrate the sometimes provocative field of NSH. (3) Results: Confronted with challenging cases with under-, missed or delayed diagnosis and severe consequences, we aimed at presenting four such selected cases with mild or moderate hemophilia, real pitfalls in our clinical activity. (4) Conclusions: In the field of NSH, if not timely recognized, tending sometimes to remain ignored by caregivers and patients themselves, we can be confronted with challenging diagnostic situations and life-threatening bleeds.
Implication of Lipids in Calcified Aortic Valve Pathogenesis: Why Did Statins Fail?
Authors: Nsaibia Mohamed J. , Devendran Anichavezhi , Goubaa Eshak , Bouitbir Jamal , Capoulade Romain , Bouchareb Rihab
Published: June 2022

Calcific Aortic Valve Disease (CAVD) is a fibrocalcific disease. Lipoproteins and oxidized phospholipids play a substantial role in CAVD; the level of Lp(a) has been shown to accelerate the progression of valve calcification. Indeed, oxidized phospholipids carried by Lp(a) into the aortic valve stimulate endothelial dysfunction and promote inflammation. Inflammation and growth factors actively promote the synthesis of the extracellular matrix (ECM) and trigger an osteogenic program. The accumulation of ECM proteins promotes lipid adhesion to valve tissue, which could initiate the osteogenic program in interstitial valve cells. Statin treatment has been shown to have the ability to diminish the death rate in subjects with atherosclerotic impediments by decreasing the serum LDL cholesterol levels. However, the use of HMG-CoA inhibitors (statins) as cholesterol-lowering therapy did not significantly reduce the progression or the severity of aortic valve calcification. However, new clinical trials targeting Lp(a) or PCSK9 are showing promising results in reducing the severity of aortic stenosis. In this review, we discuss the implication of lipids in aortic valve calcification and the current findings on the effect of lipid-lowering therapy in aortic stenosis.
Avoiding, Not Managing, Drug Withdrawal Syndrome in the Setting of COVID-19 Acute Respiratory Distress Syndrome. Comment on Ego et al. How to Manage Withdrawal of Sedation and Analgesia in Mechanically Ventilated COVID-19 Patients? J. Clin. Med. 2021, 10, 4917
Authors: Petitjeans Fabrice , de Kock Marc , Ghignone Marco , Quintin Luc
Published: June 2022

The management of sedation in the setting of COVID-19 (“COVID”) by Ego et al. [...]
Novel Drugs in a Pipeline for Progressive Multiple Sclerosis
Authors: Sapko Klaudia , Jamroz-Wiśniewska Anna , Rejdak Konrad
Published: June 2022

Multiple sclerosis (MS) is a widely known inflammatory, demyelinating disease of the central nervous system. The pathogenesis of progressive multiple sclerosis (PMS) is a complex, multi-level process that causes therapeutic difficulties. Along with variables such as age and duration of the disease, pathogenetic mechanisms change from inflammatory to neurodegenerative processes. Therefore, the efficacy of available anti-inflammatory drugs approved for the treatment of PMS, such as ocrelizumab or siponimod, is limited in time. In search of innovative solutions, several research studies have been conducted to evaluate the effectiveness of drugs with neuroprotective or remyelinating effects in PMS, including biotin, ibudilast, simvastatin, alpha-lipoic acid, clemastine, amiloride, fluoxetine, riluzole, masitinib, opicinumab, and lamotrigine. The current review includes those compounds, which have entered the clinical phase of assessment, and the authors discuss future prospects for successful PMS treatment.
Effectiveness of ERAS (Enhanced Recovery after Surgery) Protocol via Peripheral Nerve Block for Total Knee Arthroplasty
Authors: Lee Hyun Hee , Kwon Hyuck Min , Lee Woo-Suk , Yang Ick Hwan , Choi Yong Seon , Park Kwan Kyu
Published: June 2022

Peripheral nerve block (PNB) for patients with total knee arthroplasty (TKA) is one of the recommended interventions in ERAS protocols. However, most existing studies involved unilateral TKA (UTKA). As such, this study aimed to evaluate the effectiveness of PNB in terms of immediate postoperative analgesia, length of hospital stays (LOS), and early functional outcomes in both UTKA and simultaneous bilateral TKAs (BTKAs). We reviewed 236 patients who underwent primary TKA with PNB, with 138 and 98 being UTKA and BTKAs, respectively; those in the PNB group underwent femoral nerve and adductor canal block. The matched control and PNB groups—who received intravenous/epidural patient-controlled analgesia (IVPCA/PCEA) alone or IVPCA in addition to PNB after surgery, respectively—were compared. The VAS scores at rest until 48 h after surgery were significantly lower in PNB groups compared to those in the IVPCA groups. At 0– 6 h of activity, VAS scores of the UTKA with PNB group were also lower than the IVPCA group. Compared to PCEA groups, VAS scores at 0–6 h of activity were higher in both the UTKA and BTKAs with PNB groups. However, at 24–48 h at rest, the scores of those in the UTKA with PNB group were lower than those in the PCEA group. The control and experimental UTKA and BTKAs groups had similar LOS and functional outcomes at 90 days postoperatively. In primary TKA, PNB has great analgesic effects for immediate postoperative pain control, and represents a similar analgesic effect to epidural PCA.
Zirconium Containing Periodic Mesoporous Organosilica: The Effect of Zr on CO2 Sorption at Ambient Conditions
Authors: Gunathilake Chamila A. , Dassanayake Rohan S. , Fernando Chacrawarthige A. N. , Jaroniec Mietek
Published: June 2022

Two series of zirconium-incorporated-periodic-mesoporous-organosilica (Zr–PMO) materials were successfully prepared, via a co-condensation strategy, in the presence of Pluronic P123 triblock copolymer. The first series of Zr–PMO was prepared using tris[3-(trimethoxysilyl)propyl]isocyanurate (ICS), tetraethylorthosilicate (TEOS), and zirconyl chloride octahydrate(ZrCO), denoted as Zr-I-PMO, where I refers to ICS. The second series was synthesized using bis(triethoxysilyl)benzene (BTEE), TEOS, and ZrCO as precursors, named as Zr-B-PMO, where B refers to BTEE. Zr–PMO samples exhibit type (IV) adsorption isotherms, with a distinct H2-hysteresis loop and well-developed structural parameters, such as pore volume, pore width, high surface area, and narrow pore-size distribution. Structural properties were studied by varying the Zr:Si ratio, adding TEOS at different time intervals, and changing the amount of block copolymer-Pluronic P123 used as well as the calcination temperature. Surface characteristics were tailored by precisely controlling the Zr:Si ratio, upon varying the amount of TEOS present in the mesostructures. The addition of TEOS at different synthesis stages, notably, enhanced the pore size and surface area of the resulting Zr-I-PMO samples more than the Zr-B-PMO samples. Changing the amount of block copolymer, also, played a significant role in altering the textural and morphological properties of the Zr-I-PMO and Zr-B-PMO samples. Optimizing the amount of Pluronic P123 added is crucial for tailoring the surface properties of Zr–PMOs. The prepared Zr–PMO samples were examined for use in CO2 sorption, at ambient temperature and pressure (25 °C, 1.2 bar pressure). Zr–PMO samples displayed a maximum CO2 uptake of 2.08 mmol/g, at 25 °C and 1.2 bar pressure. However, analogous zirconium samples, without any bridging groups, exhibited a significantly lower CO2 uptake, of 0.72 mmol/g, under the same conditions. The presence of isocyanurate- and benzene-bridging groups in Zr-I-PMO and Zr-B-PMO samples enhances the CO2 sorption. Interestingly, results illustrate that Zr–PMO materials show potential in capturing CO2, at ambient conditions.
Physical Simulation of Laser Surface Treatment to Study Softening Effect on Age-Hardened Aluminium Alloys
Authors: Palmieri Maria Emanuela , Tricarico Luigi
Published: June 2022

The automotive industry is interested in manufacturing components with tailored mechanical properties. To this end, advanced heating treatments can be exploited to obtain the so-called Tailored Heat-Treated Blanks (THTB). However, mechanical properties are strongly affected by the process parameters of heating treatments, which require a preliminary design. Physical simulation can be a decisive tool in this phase to obtain useful information at the laboratory scale, even when heat treatments such as those carried out with laser technologies impose high heating and cooling rates on the material. This work uses physical simulation to investigate the changes in strength and ductility caused by laser heat treatment (LHT) on aluminum alloys hardened by aging; the methodology was implemented on the EN AW 6082 T6 alloy. First, a finite-element (FE) transient thermal model was developed to simulate LHT by varying the process parameters (laser power/peak temperature and treatment speed). Second, the resulting thermal cycles were physically simulated by means of the Gleeble 3180 system. Third, the strength and the ductility of physically simulated specimens were evaluated through micro-hardness and tensile tests; to study aging effects, investigations were performed both (i) right after Gleeble tests (samples in the supersaturated solid state, i.e., as-physically simulated (APS) state) and (ii) after one week from Gleeble tests (aged specimens—T4 state). The obtained results show that there are peak temperatures that guarantee maximum softening levels for each investigated state (T4 and APS). The optimal peak temperature ranges are in agreement with the data in the literature, demonstrating that the proposed methodology is suitable for the study of softening phenomena on aging-hardened aluminum alloys.
Comparative Study of Δ9-Tetrahydrocannabinol and Cannabidiol on Melanogenesis in Human Epidermal Melanocytes from Different Pigmentation Phototypes: A Pilot Study
Authors: Goenka Shilpi
Published: June 2022

Δ9-tetrahydrocannabinol (THC) is one of the primary ingredients of cannabis plants and is responsible for the psychoactive properties of cannabis. While cannabidiol (CBD), the non-psychoactive compound from cannabis, has been shown to stimulate human epidermal melanogenesis, the effects of THC have not been addressed in human epidermal melanocytes. Moreover, to date, no study has tested the effects of these compounds on melanocytes differing in pigmentation, representative of different skin phototypes, which would be significant as different ethnicities are known to differentially metabolize these xenobiotics. Herein, the effects of THC were studied and compared alongside CBD in human epidermal melanocytes derived from lightly-pigmented (HEMn-LP; Caucasian) and darkly-pigmented (HEMn-DP; African-American) cells over a chronic exposure of 6 d. Results demonstrated that both compounds displayed cytotoxicity at 4 µM but stimulated melanin synthesis and tyrosinase activity in a similar manner in LP and DP cells at nontoxic concentrations of 1–2 µM. However, THC and CBD showed a differential effect on dendricity in both cells; THC and CBD reversibly increased dendricity in LP cells while there was no significant change in DP cells. THC and CBD induced higher levels of reactive oxygen species (ROS) in LP cells while there was no change in the ROS levels in DP cells. In summary, although THC was relatively less cytotoxic as compared to CBD to both LP and DP cells, it exhibited a similar capacity as CBD to stimulate melanin synthesis and export in LP cells which was accompanied by a significant oxidative stress. DP cells were relatively resistant to the effects of both THC and CBD which might implicate the protective effects conferred by melanin in dark-skinned individuals.
Using Consumer-Wearable Activity Trackers for Risk Prediction of Life-Threatening Heart Arrhythmia in Patients with an Implantable Cardioverter-Defibrillator: An Exploratory Observational Study
Authors: Frodi Diana My , Manea Vlad , Diederichsen Søren Zöga , Svendsen Jesper Hastrup , Wac Katarzyna , Andersen Tariq Osman
Published: June 2022

Ventricular arrhythmia (VA) is a leading cause of sudden death and health deterioration. Recent advances in predictive analytics and wearable technology for behavior assessment show promise but require further investigation. Yet, previous studies have only assessed other health outcomes and monitored patients for short durations (7–14 days). This study explores how behaviors reported by a consumer wearable can assist VA risk prediction. An exploratory observational study was conducted with participants who had an implantable cardioverter-defibrillator (ICD) and wore a Fitbit Alta HR consumer wearable. Fitbit reported behavioral markers for physical activity (light, fair, vigorous), sleep, and heart rate. A case-crossover analysis using conditional logistic regression assessed the effects of time-adjusted behaviors over 1–8 weeks on VA incidence. Twenty-seven patients (25 males, median age 59 years) were included. Among the participants, ICDs recorded 262 VA events during 8093 days monitored by Fitbit (median follow-up period 960 days). Longer light to fair activity durations and a higher heart rate increased the odds of a VA event (p < 0.001). In contrast, lengthier fair to vigorous activity and sleep durations decreased the odds of a VA event (p < 0.001). Future studies using consumer wearables in a larger population should prioritize these outcomes to further assess VA risk.
Pharmacogenomic Profile of Amazonian Amerindians
Authors: Rodrigues Juliana Carla Gomes , Fernandes Marianne Rodrigues , Ribeiro-dos-Santos André Maurício , de Araújo Gilderlanio Santana , de Souza Sandro José , Guerreiro João Farias , Ribeiro-dos-Santos Ândrea , de Assumpção Paulo Pimentel , Santos Ney Pereira Carneiro dos , Santos Sidney
Published: June 2022

Given the role of pharmacogenomics in the large variability observed in drug efficacy/safety, an assessment about the pharmacogenomic profile of patients prior to drug prescription or dose adjustment is paramount to improve adherence to treatment and prevent adverse drug reaction events. A population commonly underrepresented in pharmacogenomic studies is the Native American populations, which have a unique genetic profile due to a long process of geographic isolation and other genetic and evolutionary processes. Here, we describe the pharmacogenetic variability of Native American populations regarding 160 pharmacogenes involved in absorption, distribution, metabolism, and excretion processes and biological pathways of different therapies. Data were obtained through complete exome sequencing of individuals from 12 different Amerindian groups of the Brazilian Amazon. The study reports a total of 3311 variants; of this, 167 are exclusive to Amerindian populations, and 1183 are located in coding regions. Among these new variants, we found non-synonymous coding variants in the DPYD and the IFNL4 genes and variants with high allelic frequencies in intronic regions of the MTHFR, TYMS, GSTT1, and CYP2D6 genes. Additionally, 332 variants with either high or moderate (disruptive or non-disruptive impact in protein effectiveness, respectively) significance were found with a minimum of 1% frequency in the Amazonian Amerindian population. The data reported here serve as scientific basis for future design of specific treatment protocols for Amazonian Amerindian populations as well as for populations admixed with them, such as the Northern Brazilian population.
New Ways of Working through Emerging Technologies: A Meta-Synthesis of the Adoption of Blockchain in the Accountancy Domain
Authors: Agrifoglio Rocco , de Gennaro Davide
Published: June 2022

In an attempt to deepen how the way of working is changing due to the digital transformation, this research aims at understanding the process by which individuals adopt blockchain technology in accountancy. We conducted a meta-synthesis of the qualitative literature on the topic of blockchain technology adoption in the context of accountancy. Drawing from 10 systematically selected qualitative studies, we analyzed the process of blockchain technology adoption in accountancy, with particular reference to the impacts on accounting professionals, in terms of individual attitudes and behaviors, as well as organizations. Our findings contribute to the existing literature in at least two ways. First, our research explores the topic of blockchain adoption in the accountancy domain and stresses the relevance of the use of that emerging technology by accounting professionals and organizations, as well as the main problems that could limit its adoption and use. Second, we provide an overview of the process of blockchain technology adoption with specific reference to the questions of “why” and “how” blockchain is (or is not) adopted by accounting professionals and organizations, in an effort to shed light on a critical issue that has yet to be explored in accountancy.
Walking Accessibility to the Bus Stop: Does It Affect Residential Rents? The Case of Jinan, China
Authors: Liu Qingchun , Zhao Peixiong , Xiao Yan , Zhou Xin , Yang Jun
Published: June 2022

It is a crucial question to understand the relationship between public transit and residential rents for the proposal of a sustainable transportation system and efficient allocation of lands during the policy marking process. Little has been discovered in the current literature regarding the impact of the bus system on residential rents. This study investigated walking accessibility to the bus stop based on the average daily on-ridership data of bus stops and street networks in Jinan, China, and analysed the impact on the spatial differentiation of residential rents using the spatial autocorrelation analysis and the geographically weighted regression (GWR) method. Our results suggested that residential rent levels in Jinan had evident spatial dependence and spatial differentiation characteristics, which was signified by a significant high rent, and a high accessibility distribution pattern surrounding both city and sub-city centres. GWR results further showed that walking accessibility to the bus stop could significantly improve residential rents. On the spatial scale, a 1% increase in walking accessibility could result in a premium of up to 0.427% and a 2.984% decline in rental prices. Lastly, we found that walking accessibility to the bus stop significantly affected housing rents incrementally with increasing distance between residences and the city centre. Moreover, walking accessibility to the bus stop showed a marginal ‘first increase and then decrease’ effect on residential rents as the distance to the bus stop increased. The premium effect was the most significant among residences within 500–900 m of a bus stop.
Nature-Based Solutions to Hydro-Climatic Risks: Barriers and Triggers for Their Implementation in Seville (Spain)
Authors: Lara Ángela , Moral Leandro del
Published: June 2022

Nature-based solutions (NbS) are currently a priority of international institutions (UN and EU) to improve urban resilience to hydro-climatic risks. However, responsible institutions, such as river basin authorities and local governments, while still prioritizing gray infrastructure, often present resistance to these strategies. This paper analyzes this issue in the case of Seville (Spain). We identify historical and recent institutional practices related to the development of gray infrastructure and the experience of citizens’ movements that demand the implementation of green infrastructure and the naturalization of urban space. Based on the theoretical framework of the sustainability transition, the article contributes to the identification of the factors that hinder or trigger the processes of change, drawing from the results of a case with a long tradition in hydro-climatic disaster management. The research has included an in-depth review of risk planning in the city of Seville, semi-structured interviews with 24 social and institutional actors, and participant observation of both urban planning processes and the practices of citizen movements. Our results show that the generation of shared visions clashes, first with conflicting perceptions of the city’s strengths and weaknesses regarding risks; second, with contradictions between institutional discourses and practices, and finally, with the operational limitations of public participation processes.
Relativizing State Space: Deciphering China’s New Dynamics of Urban Transformation Engineered through the Creation of National New Areas
Authors: Chao Heng
Published: June 2022

Abandonment of the taken-for-granted attitude of territoriality in the studies of state space has been followed by diverse concerns and competing interpretations with different focuses notably on state–market relations, spatiality of social life, and relativization of scale. Inspired by Lefebvre’s spatial triad, applied textual analysis, and in-depth interview, this study critically evaluates the Chinese practices of setting up National New Areas to reshape the trajectory of urban and regional development using the Liangjiang National New Area (LNNA). Our research foregrounds the relativizing dimensions of state space in which the creation of the LNNA was conceived, perceived, and lived by key stakeholders holding different positions and vested interests. The LNNA is the spatial manifestation of the special vision and mission of China’s national developmental agenda and the adjustment of power relations within an authoritarian Party-state. However, it is a controversial project which requires negotiation, contestation, and reconciliation among grassroots people. This study shows that even in China, there existed pervasive negotiation and resistance from diverse stakeholders from the bottom up. Our research suggests an alternative perspective that goes beyond the popular dichotomy of state–market or society–space relations in the studies of state space and takes seriously the dialectical relations among the forces at work in the (re)production of state space.
Impact of COVID-19 Lock-Downs on Nature Connection in Southern and Eastern Africa
Authors: Lee Ju-hyoung , Mkandawire Madalitso , Niyigena Patrick , Xotyeni Abonisiwe , Itamba Edwin , Siame Sylvester
Published: June 2022

The response of African countries immediately after the COVID-19 pandemic declaration was rapid and appropriate, with low infections and mortality rates until June 2020. Severe lock-down measures were effective in Africa; however, the reduction in the amount of natural experience influences the quality of life in modern society. This study is conducted as an international comparative study in five African countries on changes in the perception of health recovery and outdoor activities in urban forests during the COVID-19 pandemic. An online survey was conducted with 430 respondents to investigate the relationships between COVID-19 stress, indoor activity, appreciation of greenspaces, perception of health recovery, and use of greenspaces. A structural equation model was used for analysis. The visit frequency and staying time in urban forests after lock-down dramatically decreased, raising concerns about nature-deficit disorder across the target countries after the end of the pandemic. This study confirmed urban dwellers’ desire for natural experiences and health recovery during the pandemic and predicts an explosive increase in urban forest utilization after the pandemic has ended.
Innovative Local Development Initiatives in the Eastern Alps: Forest Therapy, Land Consolidation Associations and Mountaineering Villages
Authors: Bassi Ivana , Carzedda Matteo , Iseppi Luca
Published: June 2022

Since the 19th century, Italy’s mountain regions have suffered from depopulation and land abandonment. How can we counter this phenomenon? Here, we present three cases of innovative and participatory approaches implemented in the Eastern Alps of Friuli Venezia Giulia. Forest therapy is a new approach to medical therapy based on the beneficial effects on the human health of frequenting forests. It also has the potential to provide space for local economic initiatives, e.g., hospitality services. Land consolidation associations were created in France to collectively restore the productivity of fragmented and abandoned farmland. They can evolve into long-term planning for the conservation of landed wealth and the valorization of territories. Finally, Mountaineering villages have the potential to develop a more sustainable form of tourism by fostering a sense of responsibility for the natural and cultural heritage of the European Alps, in accordance with the Alpine Convention. These initiatives share the involvement of local actors in the definition of local development strategies, the capability of enhancing endogenous resources and increasing the environmental value of places, the importance of offering qualified and organized services, and the ability to support the local socioeconomic system. The adoption of innovative and participatory approaches such as these has the potential to revert depopulation and economic depression trends in mountain areas.
Curonian Spit Coastal Dunes Landscape: Climate Driven Change Calls for the Management Optimization
Authors: Šimanauskienė Rasa , Linkevičienė Rita , Povilanskas Ramūnas , Satkūnas Jonas , Veteikis Darijus , Baubinienė Aldona , Taminskas Julius
Published: June 2022

On the Curonian Spit, the leading conservation issue is an opposition between the two contrasting nature-management principles—anthropocentricity and biocentricity. Land managers still waver between the two options, and the worst-case scenario materializes as a rapid proliferation of vegetation to the accumulative sandplain (palve). It results in the decline of sand drift to the mobile dunes. This article aims to examine how climate change affects the coastal dune landscape and to identify current dune protection and management priorities. The analysis of hydroclimatic changes; succession patterns in forest, herbaceous, and open-sand ecosystems; and phenological-based evaluation (NDVI from MODIS, 2000–2020), influencing possible management directions, were carried out in this study. The results show the significant hydro-climatic changes (air temperature, precipitation, and sea level) occurring over the last thirty years. They influence the prevailing overgrowth trends in recent decades, especially in herbaceous ecosystems. Therefore, if the EU’s priority habitat—open-sand ecosystems—is to be preserved, the main policy recommendation is to apply adequate management tools such as grazing, and to pay more attention to the aesthetic ecosystem services of the mobile dunes parallel to biodiversity conservation.
The Competitiveness of Regional Urban System in Hubei Province of China
Authors: Ye Xiaoxiao , Fan Yong , Miao Jing , He Zongyi
Published: June 2022

Urban competitiveness is an indispensable topic for urban management. The purpose of this work was to study the status quo of urban system competitiveness in any region and explore the internal factors that affect urban competitiveness. In this study, 30 indicators were selected from six dimensions: population, economic strength, infrastructure, technology and culture, open exchange, and quality of life, and a two-level evaluation index system was constructed. The entropy weight method was used to calculate the weight, and 12 prefecture-level cities in Hubei Province were taken as the evaluation object. This study found that in Hubei province, (1) science, technology, and culture are the first driving forces of urban competitiveness; (2) the impact of the quality of life on urban competitiveness is deepening and obvious, especially the impact of residents’ consumption; and (3) Wuhan, the provincial capital city, is far ahead in terms of its competition and its position is unshakable, followed by Yichang and Xiangyang. Overall, the competitiveness gap between cities in the region is gradually narrowing.
Cropland Exposed to Drought Is Overestimated without Considering the CO2 Effect in the Arid Climatic Region of China
Authors: Jiang Shan , Zhou Jian , Wang Guojie , Lin Qigen , Chen Ziyan , Wang Yanjun , Su Buda
Published: June 2022

Drought seriously restricts people’s lives and social–economic development. An accurate understanding of the evolution of drought characteristics and future changes in cultivated land exposure can reduce the risk of drought. There is evidence that increased CO2 concentrations alter the physiological properties of vegetation and, thus, affect drought evolution. In this study, both changes and differences in drought (i.e., characteristics and cropland exposure) with and without the CO2 effect over the arid region of China are investigated, using seven CMIP6 outputs and land-use under seven shared-socioeconomic-pathway (SSP)-based scenarios. The results show that: (1) drier conditions will be more severe in 2015–2100 under SSP5-8.5, especially if the CO2 effect is neglected. Moreover, the CO2 effect will increase with increasing emission concentrations; (2) drought intensity will be greater than in the baseline period (1995–2014, approximately −1.45) but weaker than that without the CO2 effect under all scenarios; (3) drought frequency will decrease, and will generally decline faster if the CO2 effect is not considered; (4) drought duration will increase and the difference between the presence and absence of the CO2 effect will always be smallest under SSP1-1.9 and largest under SSP5-8.5; (5) drought acreage will also increase, and neglecting the CO2 effect is always higher than that considering CO2. The difference between the two algorithms will increase with time; and (6) cropland exposure to drought will increase, and can even reach 669,000 km2 and 524,000 km2 considering and ignoring the CO2 effect, respectively. Our findings suggest that ignoring CO2 in drought evaluations will result in significant overestimations of drought projections.
Green Public Areas and Urban Open Spaces Management: New GreenCAL Tool Algorithms and Circular Economy Implications
Authors: Cappucci Sergio , Nappi Serena , Cappelli Andrea
Published: June 2022

Urban Open Spaces (UOS) are green infrastructures that provide social and ecosystem services. Green public areas contribute to mitigation and adaptation strategies for addressing climate changes, but their maintenance has a significant cost. Frequent grass cutting operations must be carried out during growing periods to ensure the safe livability of UOS to citizens. In the present paper, a geo database was developed to map green public areas of the city of Latina (Lazio Region, Central Italy) by using a multisource dataset according to the European INSPIRE Directive. The GreenCAL Tool was implemented. Two algorithms to determine UOS extension and the necessary budget for grass cutting operations are used, considering the contribution of different mowing (i.e., mulcher, lawnmower, or brush cutter) and UOS extension itself (~160 ha). The implemented processing chain allowed us to simulate forestation of abandoned areas and potential CO2 sequestration values. Two different scenarios of maintenance programs were also implemented to reduce more than 60% of operational cost according to: (1) different use of UOS; (2) their position within the urban area; (3) guidelines of Italian working group on public green management; and (4) management of vegetal residues. The management of the latter, derived by mowing, contribute to more than 23% of the budget allocated to maintain UOS. Besides the long-term environmental and health perspective, the short-term impact of the present applied research is relevant for a geomatic approach, green public procurements, as well as land use and climate interactions. The alternative management of UOS discussed in the present paper can also reduce organic waste production if the mowing within the UOS is managed as a resource for agriculture rather than urban waste.
Populism and the Threat to International Law
Authors: Humble Kristian
Published: June 2022

The rise of populism represents a threat to constitutionalism, democracy, and the rule of law. Populist governments are a threat to the international legal order and to the authority of international legal agreements. This article will, therefore, look at the serious threat to international law that is presented by populism. This fundamental threat to international institutions, multilateralism, and the funding received by NGOs Non-Governmental Organisations (NGOs) is based on the promotion by populist governments that the edicts of international law are merely a matter of coordination and interventionism. Populists and populist governments traditionally promote this ideal through their policies, which are anti-pluralist and are focused on a limited set of agenda-setting goals that are in opposition to the fundamental international goal-setting of protecting human rights, along with the collective agreements between nations for the enhancement of the international community. This article will ascertain the very real threat that is posed by the continued rise of populism and, in particular, a populist government.