bluuebunny/crossref_metadata_2025 huggingface dataset:
Postural Assessment Scale for Stroke Patients in Acute, Subacute and Chronic Stage: A Construct Validity Study
Authors: Estrada-Barranco Cecilia , Cano-de-la-Cuerda Roberto , Abuín-Porras Vanesa , Molina-Rueda Francisco
Published: February 2021

(1) Background: Observational scales are the most common methodology used to assess postural control and balance in people with stroke. The aim of this paper was to analyse the construct validity of the Postural Assessment Scale for Stroke Patients (PASS) scale in post-stroke patients in the acute, subacute, and chronic stroke phases. (2) Methods: Sixty-one post-stroke participants were enrolled. To analyze the construct validity of the PASS, the following scales were used: the Functional Ambulatory Category (FAC), the Wisconsin Gait Scale (WGS), the Barthel Index (BI) and the Functional Independence Measure (FIM). (3) Results: The construct validity of the PASS scale in patients with stroke at acute phase was moderate with the FAC (r = −0.791), WGS (r = −0.646) and FIM (r = −0.678) and excellent with the BI (r = 0.801). At subacute stage, the construct validity of the PASS scale was excellent with the FAC (r = 0.897), WGS (r = −0.847), FIM (r = −0.810) and BI (r = −0.888). At 6 and 12 months, the construct validity of the PASS with the FAC, WGS, FIM and BI was also excellent. (4) Conclusions: The PASS scale is a valid instrument to assess balance in post-stroke individuals especially, in the subacute and chronic phases (at 6 and 12 months).
Local Laboratory Testing of Germline BRCA Mutations vs. Myriad: A Single-Institution Experience in Korea
Authors: Hong Joohyun , Lee Jiyun , Kwon Minsuk , Kim Ji-Yeon , Kim Jong-Won , Ahn Jin Seok , Im Young-Hyuck , Park Yeon Hee
Published: February 2021

Genetic diagnosis for human epidermal growth factor receptor 2-negative metastatic breast cancer patients with the germline BRCA (gBRCA) mutation has been emphasized since the development of polyadenosine diphosphate-ribose polymerase inhibitors. Myriad Genetics, Inc.’s (Salt Lake City, UT, USA) companion diagnostics service is almost exclusively used for genetic testing. The aim of this study was to compare the results of germline BRCA mutation tests returned by a local laboratory and those performed by Myriad. Between April 2014 and February 2018, 31 patients with gBRCA 1/2 mutation test results from both Samsung Medical Center (Seoul, Korea) and Myriad were enrolled. “Discordant: Opposite classification” was observed for only one among 27 (3.7%). This discrepancy was due to the detection of a deleterious large genomic rearrangement of BRCA 1 by Myriad. Samsung Medical Center performed multiple ligation-dependent probe amplifications (MLPA) to detect large genomic rearrangements only in high-risk patients. This one case was not suspected as high risk and MLPA was not performed. The concordant rate was 74.1% for all 27 patients. “Discordant: Laboratory’s uncertain classification” was found in 22.2% of the sample (six patients). All discrepancies were generated during interpretation of BRCA 2 gene sequencing. Further studies and standardization of genetic testing for BRCA 1/2 genes are required.
Comparison of Lung Ultrasound versus Chest X-ray for Detection of Pulmonary Infiltrates in COVID-19
Authors: Mateos González María , García de Casasola Sánchez Gonzalo , Muñoz Francisco Javier Teigell , Proud Kevin , Lourdo Davide , Sander Julia-Verena , Jaimes Gabriel E. Ortiz , Mader Michael , Canora Lebrato Jesús , Restrepo Marcos I. , Soni Nilam J.
Published: February 2021

Point-of-care lung ultrasound (LUS) is an attractive alternative to chest X-ray (CXR), but its diagnostic accuracy compared to CXR has not been well studied in coronavirus disease 2019 (COVID-19) patients. We conducted a prospective observational study to assess the correlation between LUS and CXR findings in COVID-19 patients. Ninety-six patients with a clinical diagnosis of COVID-19 underwent an LUS exam and CXR upon presentation. Physicians blinded to the CXR findings performed all LUS exams. Detection of pulmonary infiltrates by CXR versus LUS was compared between patients categorized as suspected or confirmed COVID-19 based on reverse transcriptase-polymerase chain reaction. Sensitivities and correlation by Kappa statistic were calculated between LUS and CXR. LUS detected pulmonary infiltrates more often than CXR in both suspected and confirmed COVID-19 subjects. The most common LUS abnormalities were discrete B-lines, confluent B-lines, and small subpleural consolidations. Most important, LUS detected unilateral or bilateral pulmonary infiltrates in 55% of subjects with a normal CXR. Substantial agreement was demonstrated between LUS and CXR for normal, unilateral or bilateral findings (Κ = 0.48 (95% CI 0.34 to 0.63)). In patients with suspected or confirmed COVID-19, LUS detected pulmonary infiltrates more often than CXR, including more than half of the patients with a normal CXR.
Optimization of a 3D-Printed Permanent Magnet Coupling Using Genetic Algorithm and Taguchi Method
Authors: Andriushchenko Ekaterina , Kallaste Ants , Belahcen Anouar , Vaimann Toomas , Rassõlkin Anton , Heidari Hamidreza , Tiismus Hans
Published: February 2021

In recent decades, the genetic algorithm (GA) has been extensively used in the design optimization of electromagnetic devices. Despite the great merits possessed by the GA, its processing procedure is highly time-consuming. On the contrary, the widely applied Taguchi optimization method is faster with comparable effectiveness in certain optimization problems. This study explores the abilities of both methods within the optimization of a permanent magnet coupling, where the optimization objectives are the minimization of coupling volume and maximization of transmitted torque. The optimal geometry of the coupling and the obtained characteristics achieved by both methods are nearly identical. The magnetic torque density is enhanced by more than 20%, while the volume is reduced by 17%. Yet, the Taguchi method is found to be more time-efficient and effective within the considered optimization problem. Thanks to the additive manufacturing techniques, the initial design and the sophisticated geometry of the Taguchi optimal designs are precisely fabricated. The performances of the coupling designs are validated using an experimental setup.
Open Information Architecture for Seamless Integration of Renewable Energy Sources
Authors: Veichtlbauer Armin , Langthaler Oliver , Andrén Filip Pröstl , Kasberger Christian , Strasser Thomas I.
Published: February 2021

Electric power systems are currently confronted with a fundamental paradigm change related to its planning and operation, mainly caused by the massive integration of renewables. To allow higher penetration of them within existing grid infrastructures, the “smart grid” makes more efficient use of existing resources by integrating appropriate information technologies. Utilising the benefits of such smart grids, it is necessary to develop new automation architectures and control strategies, as well as corresponding information and communication solutions. This makes it possible to effectively use and manage a large amount of dispersed generators and to utilise their “smart” capabilities. The scalability and openness of automation systems currently used by energy utilities have to be improved significantly for handling a high amount of distributed generators. This will be needed to meet the challenges of missing common and open interfaces, as well as the large number of different protocols. In the work at hand, these shortcomings have been tackled by a conceptual solution for open and interoperable information exchange and engineering of automation applications. The approach is characterised by remote controllable services, a generic communication concept, and a formal application modelling method for distributed energy resource components. Additionally, the specification of an access management scheme for distributed energy resources, taking into account different user roles in the smart grid, allowed for a fine-grained distinction of access rights for use cases and actors. As a concrete result of this work, a generic and open communication underlay for smart grid components was developed, providing a flexible and adaptable infrastructure and supporting future smart grid requirements and roll-out. A proof-of-concept validation of the remote controllable service concept based on this infrastructure has been conducted in appropriate laboratory environments to confirm the main benefits of this approach.
Colorization of Logo Sketch Based on Conditional Generative Adversarial Networks
Authors: Tian Nannan , Liu Yuan , Wu Bo , Li Xiaofeng
Published: February 2021

Logo design is a complex process for designers and color plays a very important role in logo design. The automatic colorization of logo sketch is of great value and full of challenges. In this paper, we propose a new logo design method based on Conditional Generative Adversarial Networks, which can output multiple colorful logos only by providing one logo sketch. We improve the traditional U-Net structure, adding channel attention and spatial attention in the process of skip-connection. In addition, the generator consists of parallel attention-based U-Net blocks, which can output multiple logo images. During the model optimization process, a style loss function is proposed to improve the color diversity of the logos. We evaluate our method on the self-built edges2logos dataset and the public edges2shoes dataset. Experimental results show that our method can generate more colorful and realistic logo images based on simple sketches. Compared to the classic networks, the logos generated by our network are also superior in visual effects.
Modeling and Performance Evaluation of Multi-Class Queuing System with QoS and Priority Constraints
Authors: Alotaibi Fahad Mazaed , Ullah Israr , Ahmad Shakeel
Published: February 2021

Many service providers often categorize their users into multi-classes, depending on their service requirements. Each class has strict quality of service (QoS) demands (e.g., minimum required service rate or transfer time) that must be ensured throughout its service. In some cases, priorities are also assigned in a multi-class user’s environment to ensure that the important class user shall be serviced first. In this paper, we have developed a novel Markov chain based analytical model to investigate and evaluate a multi-class queuing system with a strict QoS requirement and priority constraints. Experimental analysis is conducted for two users classes, i.e., class-1 (may be free/student users) and class-2 (may be paid/research users). Each class requests have strict QoS requirements in terms of the minimum required rate (MRR) that must be ensured throughout its lifetime once the request is admitted into the system. Secondly, class-2 requests have preemption priority over class-1, i.e., if there is no room for newly arriving class-2 requests, then one or more active flows of class-1 can be ejected in order to accommodate high-class requests. Model results are validated through simulation results and performance measures of our interest include blocking probability (BP) of individual classes and the overall system, effect of higher-class jobs on lower-class jobs, and link capacity utilization. The proposed model can be instrumental in developing advanced connection admission control (CAC), efficient resource dimensioning, and capacity planning of the queuing system.
Analysis of ATO System Operation Scenarios Based on UPPAAL and the Operational Design Domain
Authors: Meng Zicong , Tang Tao , Wei Guodong , Yuan Lei
Published: February 2021

With the gradual maturity of the automatic train operation (ATO) system in subways, its application scope has also expanded to the high-speed railway field. Considering that the ATO system is still in the early stages of operation, it will take time to fully mature, and definite specifications of the requirements for system operation have not yet been formed. This paper presents the operational design domain (ODD) of the high-speed railway ATO system and proposes a scenario analysis method based on the operational design domain to obtain the input conditions of the system requirements. The article models and verifies the scenario of the linkage control of the door and platform door based on the UPPAAL tools and extracts the input and expected output of the system requirements of the vehicle ATO system. Combined with the input conditions of the system requirements, the system requirements of the vehicle ATO in this scenario are finally obtained, which provides a reference for future functional specification generation and test case generation.
Micro- and Nanotechnology of Wide-Bandgap Semiconductors
Authors: Piotrowska Anna B. , Kamińska Eliana , Wojtasiak Wojciech
Published: February 2021

Gallium Nitride and Related Wide-Bandgap Semiconductors (WBS) have constantly received a great amount of attention in recent years [...]
Research on Evaluation Index of Automotive Antenna Testing
Authors: Qu Meijun , Sun Siyang , Jing Huanhuan , Pei Long
Published: February 2021

Mounted locations and the ground plane structure have remarkable influences on the performance of roof-mounted automotive antennas. To distinguish this influence in radiation, figure of merits (FoMs), including total radiated power (TRP), near-horizontal part radiated power (NHPRP), and cumulative distribution function (CDF), are studied in this paper. It is proved that TRPs are almost the same with different mounting configurations. Because the radiation toward the horizon is a critical performance metric for automotive antennas, NHPRP is analyzed within certain degrees near the horizon. Even though a bigger deviation has been observed in NHPRP, the discrimination between different mounted scenarios is still not enough. Different from TPR and NHPRP, which are efficiency-based FoMs, CDF combines the gain values and the pattern shape together, achieving a comprehensive and intuitive insight into the antenna performance. It is more predictive and distinguishable in terms of the radiation pattern than NHPRP and TRP. Therefore, CDF can be utilized as a good supplement to existing metrics and can better distinguish the radiation performance of different antenna mounting configurations.
Design of a “Clean-Label” Gluten-Free Bread to Meet Consumers Demand
Authors: Montemurro Marco , Pontonio Erica , Rizzello Carlo Giuseppe
Published: February 2021

The market of gluten-free (GF) products has been steadily increasing in last few years. Due to the technological importance of gluten, the GF food production is still a challenge for the industry. Indeed, large quantities of fat, sugars, structuring agents, and flavor enhancers are added to GF formulations to make textural and sensorial characteristics comparable to conventional products, leading to nutritional and caloric intake imbalances. The formulation of the novel “clean-label” GF bread included a commonly used mixture of maize and rice flour (ratio 1:1) fortified with selected protein-rich flours. Naturally hydrocolloids-containing flours (psyllium, flaxseed, chia) were included in the bread formulation as structuring agents. A type-II sourdough was obtained by using a selected Weissella cibaria P9 and a GF sucrose-containing flour as substrate for fermentation to promote the exo-polysaccharides synthesis by the starter lactic acid bacterium. A two-step protocol for bread-making was set-up: first, the GF sourdough was fermented (24 h at 30 °C); then, it was mixed with the other ingredients (30% of the final dough) and leavened with baker’s yeast before baking. Overall, the novel GF bread was characterized by good textural properties, high protein content (8.9% of dry matter) and in vitro protein digestibility (76.9%), low sugar (1.0% of dry matter) and fat (3.1% of dry matter) content, and an in vitro predicted glycemic index of 85.
Physicochemical Changes of Deep-Fat-Fried Chicken Drumsticks Treated with Quercetin-in-Edible Coating during Storage Time
Authors: Adrah Kelvin , Ananey-Obiri Daniel , Tahergorabi Reza
Published: February 2021

In this study, 10% of chicken protein isolate (CPI) and quercetin (1 mg/mL) were used to develop an edible coating to improve the oxidative stability of deep-fat-fried chicken drumsticks during refrigerated storage (4 °C) for 10 days. Chicken samples with edible coating formulated with only 10% CPI served as the control. Although the thiobarbituric acid reactive substances (TBARS) values of the treated samples were lower than the control samples, no significant differences were observed. Quercetin-treated samples were generally harder than control samples. The pH was reduced by quercetin incorporation (p < 0.05). L* and b* values increased, while there was no significant variation in a* values during storage (p > 0.05).
Angiotensin-I Converting Enzyme Inhibition and Antioxidant Activity of Papain-Hydrolyzed Camel Whey Protein and Its Hepato-Renal Protective Effects in Thioacetamide-Induced Toxicity
Authors: Osman Ali , El-Hadary Abdalla , Korish Aida A. , AlNafea Haifa M. , Alhakbany Manan A. , Awad Awad A. , Abdel-Hamid Mahmoud
Published: February 2021

Papain hydrolysis of camel whey protein (CWP) produced CWP hydrolysate (CWPH). Fractionation of CWPH by the size exclusion chromatography (SEC) generated fractions (i.e., SEC-F1 and SEC-F2). The angiotensin converting enzyme inhibitory activity (ACE-IA) and free radical scavenging actions were assessed for CWP, CWPH, SEC-F1, and SEC-F2. The SEC-F2 exerted the highest ACE-IA and scavenging activities, followed by CWPH. The protective effects of CWPH on thioacetamide (TAA)-induced toxicity were investigated in rats. The liver enzymes, protein profile, lipid profile, antioxidant enzyme activities, renal functions, and liver histopathological changes were assessed. Animals with TAA toxicity showed impaired hepatorenal functions, hyperlipidemia, and decreased antioxidant capacity. Treatment by CWPH counteracted the TAA-induced oxidative tissue damage as well as preserved the renal and liver functions, the antioxidative enzyme activities, and the lipid profile, compared to the untreated animals. The current findings demonstrate that the ACE-IA and antioxidative effects of CWPH and its SEC-F2 fraction are worth noting. In addition, the CWPH antioxidative properties counteracted the toxic hepatorenal dysfunctions. It is concluded that the hydrolysis of CWP generates a wide range of bioactive peptides with potent antihypertensive, antioxidant, and hepatorenal protective properties. This opens up new prospects for the therapeutic utilization of CWPH and its fractions in the treatment of oxidative stress-associated health problems, e.g., hypertension and hepatorenal failure.
Effect of Organic and Conventional Production Methods on Fruit Yield and Nutritional Quality Parameters in Three Traditional Cretan Grape Varieties: Results from a Farm Survey
Authors: Hasanaliyeva Gultakin , Chatzidimitrou Eleni , Wang Juan , Baranski Marcin , Volakakis Nikolaos , Pakos Panagiotis , Seal Chris , Rosa Eduardo A. S. , Markellou Emilia , Iversen Per Ole , Vigar Vanessa , Willson Adam , Barkla Bronwyn , Leifert Carlo , Rempelos Leonidas
Published: February 2021

The antioxidants found in grapes and wine have been linked to health benefits in humans, but may be affected by agronomic parameters, grape type/variety, and processing. Here, we report results of a farm survey which investigated the effects of production system (organic vs. conventional) and grape variety on fruit yield, total antioxidant activity/capacity (TAA, assessed by the Trolox Equivalent Antioxidant Capacity (TEAC) and 2,2-diphenyl-1-picrylhydrazyl (DPPH) radical scavenging assays), and total concentrations of total phenolics (TPC) and anthocyanins (TAC) in grapes of one red (Kotsifali) and two white (Villana and/or Vidiano) traditional Cretan grape varieties. Analysis of variance (ANOVA) results showed that grape variety choice had a more substantial effect on TPC, TAA, and TAC than primary production protocols, and significant interactions were identified between production system and grape variety choice for TAATEAC. Specifically, TAATEAC was significantly (57%) higher in organic than conventional Vidiano grapes, while there was no significant effect of production system on TAATEAC in Kotsifali and Villana grapes. As expected from previous studies, the TAC was substantially higher in red Kotsifali grapes. Redundancy analysis (RDA) identified grape variety as the only strong explanatory variable/driver for yield, TPC, TAA, and TAC of table grapes, and positive associations were detected between the variety Vidiano and both TPC and TAATEAC. All other explanatory variables included in the RDA (including supplementary irrigation, orchard orientation, production system, soil type, vineyard age, plant density, and fertiliser inputs) explained only a small proportion of the additional variation.
Comprehensive Genome-Wide Exploration of C2H2 Zinc Finger Family in Grapevine (Vitis vinifera L.): Insights into the Roles in the Pollen Development Regulation
Authors: Arrey-Salas Oscar , Caris-Maldonado José Carlos , Hernández-Rojas Bairon , Gonzalez Enrique
Published: February 2021

Some C2H2 zinc-finger proteins (ZFP) transcription factors are involved in the development of pollen in plants. In grapevine (Vitis vinifera L.), it has been suggested that abnormalities in pollen development lead to the phenomenon called parthenocarpy that occurs in some varieties of this cultivar. At present, a network involving several transcription factors types has been revealed and key roles have been assigned to members of the C2H2 zinc-finger proteins (ZFP) family in model plants. However, particularities of the regulatory mechanisms controlling pollen formation in grapevine remain unknown. In order to gain insight into the participation of ZFPs in grapevine gametophyte development, we performed a genome-wide identification and characterization of genes encoding ZFP (VviZFP family). A total of 98 genes were identified and renamed based on the gene distribution into grapevine genome. The analysis performed indicate significant changes throughout VviZFP genes evolution explained by high heterogeneity in sequence, length, number of ZF and presence of another conserved domains. Moreover, segmental duplication participated in the gene family expansion in grapevine. The VviZFPs were classified based on domain and phylogenetic analysis into three sets and different groups. Heat-map demonstrated differential and tissue-specific expression patterns of these genes and k-means clustering allowed to identify a group of putative orthologs to some ZFPs related to pollen development. In transgenic plants carrying the promVviZFP13::GUS and promVviZFP68::GUS constructs, GUS signals were detectable in the anther and mature pollen grains. Expression profiling of selected VviZFP genes showed differential expression pattern during flower development and provides a basis for deepening in the understanding of VviZFPs role on grapevine reproductive development.
Fracture Kinematics and Holocene Stress Field at the Krafla Rift, Northern Iceland
Authors: Corti Noemi , Bonali Fabio L. , Pasquaré Mariotto Federico , Tibaldi Alessandro , Russo Elena , Hjartardóttir Ásta Rut , Einarsson Páll , Rigoni Valentina , Bressan Sofia
Published: February 2021

In the Northern Volcanic Zone of Iceland, the geometry, kinematics and offset amount of the structures that form the active Krafla Rift were studied. This rift is composed of a central volcano and a swarm of extension fractures, normal faults and eruptive fissures, which were mapped and analysed through remote sensing and field techniques. In three areas, across the northern, central and southern part of the rift, detailed measurements were collected by extensive field surveys along the post-Late Glacial Maximum (LGM) extension fractures and normal faults, to reconstruct their strike, opening direction and dilation amount. The geometry and the distribution of all the studied structures suggest a northward propagation of the rift, and an interaction with the Húsavík–Flatey Fault. Although the opening direction at the extension fractures is mostly normal to the general N–S rift orientation (average value N99.5° E), a systematic occurrence of subordinate transcurrent components of motion is noticed. From the measured throw at each normal fault, the heave was calculated, and it was summed together with the net dilation measured at the extension fractures; this has allowed us to assess the stretch ratio of the rift, obtaining a value of 1.003 in the central sector, and 1.001 and 1.002 in the northern and southern part, respectively.
Assessment of Occupational Health and Job Satisfaction in Workers with Intellectual Disability: A Job Demands–Resources Perspective
Authors: Flores Noelia , Moret-Tatay Carmen , Gutiérrez-Bermejo Belén , Vázquez Andrea , Jenaro Cristina
Published: February 2021

In the contexts where people with intellectual disability work, there are factors that determine their job satisfaction. The objective of this study was to test the adequacy of the central assumptions of the Job Demands–Resources (JD-R) theory in workers with intellectual disability employed in different work alternatives. Data from 362 workers in sheltered workshops and 192 workers in supported employment were utilized. The model was contrasted using a structural equation model and a multi-group analysis. The results supported the suitability of the model and confirmed that job demands and job resources evoke two relatively independent processes such as health impairment and motivational process. The multi-group analysis confirmed the invariance of the model between the two work alternatives. Thus, the JD-R model offers a useful framework to explain the job satisfaction of workers with intellectual disability. Implications for the improvement of personal and job results are discussed.
Immediate Effects of a Telerehabilitation Program Based on Aerobic Exercise in Women with Fibromyalgia
Authors: Hernando-Garijo Ignacio , Ceballos-Laita Luis , Mingo-Gómez María Teresa , Medrano-de-la-Fuente Ricardo , Estébanez-de-Miguel Elena , Martínez-Pérez María Natividad , Jiménez-del-Barrio Sandra
Published: February 2021

Background: We analyzed the immediate effects of a Telerehabilitation Program (TP) based on aerobic exercise in women with fibromyalgia (FM) syndrome during the lockdown declared in Spain due to the COVID-19 pandemic. Methods: A single-blind randomized controlled trial was designed. Thirty-four women with FM were randomized into two groups: TP group and Control group. The intervention lasted 15 weeks, with 2 sessions per week. The TP based on aerobic exercise was guided by video and the intensity of each session was monitored using the Borg scale. Pain intensity (Visual Analogue Scale), mechanical pain sensitivity (algometer), number of tender points, FM impact (Revised Fibromyalgia Impact Questionnaire), pain catastrophizing (Pain Catastrophizing Scale), physiological distress (Hospital Anxiety and Depression Scale), upper (Arm Curl Test) and lower-limb physical function (6-min Walk Test) were measured at baseline and after the intervention. Results: The TP group improved pain intensity (p = 0.022), mechanical pain sensitivity (p < 0.05), and psychological distress (p = 0.005), compared to the Control group. The Control group showed no statistically significant changes in any variable (p > 0.05). Conclusions: A TP based on aerobic exercise achieved improvements on pain intensity, mechanical pain sensitivity, and psychological distress compared to a Control group during the lockdown declared in Spain due to COVID-19 pandemic.
Serum KL-6 Could Represent a Reliable Indicator of Unfavourable Outcome in Patients with COVID-19 Pneumonia
Authors: Scotto Riccardo , Pinchera Biagio , Perna Francesco , Atripaldi Lidia , Giaccone Agnese , Sequino Davide , Zappulo Emanuela , Sardanelli Alessia , Schiano Moriello Nicola , Stanziola Anna , Bocchino Marialuisa , Gentile Ivan , Sanduzzi Alessandro
Published: February 2021

KL-6 is a sialoglycoprotein antigen which proved elevated in the serum of patients with different interstitial lung diseases, especially in those with a poorer outcome. Given that interstitial pneumonia is the most common presentation of SARS-CoV2 infection, we evaluated the prognostic role of KL-6 in patients with COVID-19 pneumonia. Patients with COVID-19 pneumonia were prospectively enrolled. Blood samples were collected at the time of enrolment (TOE) and on day 7 (T1). Serum KL-6 concentrations were measured by chemiluminescence enzyme immunoassay using a KL-6 antibody kit (LUMIPULSE G1200, Fujirebio) and the cut-off value was set at >1000 U/mL. Fifteen out of 34 enrolled patients (44.1%) died. Patients with unfavourable outcome showed significantly lower P/F ratio and higher IL-6 values and plasmatic concentrations of KL-6 at TOE compared with those who survived (median KL-6: 1188 U/mL vs. 260 U/mL, p < 0.001). KL-6 > 1000 U/mL resulted independently associated with death (aOR: 11.29, p < 0.05) with a positive predictive value of 83.3%. Our results suggest that KL-6 is a reliable indicator of pulmonary function and unfavourable outcome in patients with COVID-19 pneumonia. A KL-6 value > 1000 U/mL resulted independently associated with death and showed good accuracy in predicting a poorer outcome. KL-6 may thus represent a quick, inexpensive, and sensitive parameter to stratify the risk of severe respiratory failure and death.
Efficacy of Artificial-Intelligence-Driven Differential-Diagnosis List on the Diagnostic Accuracy of Physicians: An Open-Label Randomized Controlled Study
Authors: Harada Yukinori , Katsukura Shinichi , Kawamura Ren , Shimizu Taro
Published: February 2021

Background: The efficacy of artificial intelligence (AI)-driven automated medical-history-taking systems with AI-driven differential-diagnosis lists on physicians’ diagnostic accuracy was shown. However, considering the negative effects of AI-driven differential-diagnosis lists such as omission (physicians reject a correct diagnosis suggested by AI) and commission (physicians accept an incorrect diagnosis suggested by AI) errors, the efficacy of AI-driven automated medical-history-taking systems without AI-driven differential-diagnosis lists on physicians’ diagnostic accuracy should be evaluated. Objective: The present study was conducted to evaluate the efficacy of AI-driven automated medical-history-taking systems with or without AI-driven differential-diagnosis lists on physicians’ diagnostic accuracy. Methods: This randomized controlled study was conducted in January 2021 and included 22 physicians working at a university hospital. Participants were required to read 16 clinical vignettes in which the AI-driven medical history of real patients generated up to three differential diagnoses per case. Participants were divided into two groups: with and without an AI-driven differential-diagnosis list. Results: There was no significant difference in diagnostic accuracy between the two groups (57.4% vs. 56.3%, respectively; p = 0.91). Vignettes that included a correct diagnosis in the AI-generated list showed the greatest positive effect on physicians’ diagnostic accuracy (adjusted odds ratio 7.68; 95% CI 4.68–12.58; p < 0.001). In the group with AI-driven differential-diagnosis lists, 15.9% of diagnoses were omission errors and 14.8% were commission errors. Conclusions: Physicians’ diagnostic accuracy using AI-driven automated medical history did not differ between the groups with and without AI-driven differential-diagnosis lists.
Work Methods for Nursing Care Delivery
Authors: Parreira Pedro , Santos-Costa Paulo , Neri Manoel , Marques António , Queirós Paulo , Salgueiro-Oliveira Anabela
Published: February 2021

This article analyzes the work methods based on care design, identification of needs, care organization, planning, delivery, evaluation, continuity, safety, and complexity of care, and discharge preparation. It describes the diagnosis of the situation, goal setting, strategy selection, implementation, and outcome evaluation that contribute to adopting a given work conception and/or method for nursing care delivery. Later, the concepts underlying the several methods—management theories and theoretical nursing concepts—are presented, with reference to relevant authors. The process of analysis and selection of the method is explained, highlighting the importance of diagnosis of the situation, goal setting, strategy selection, implementation, and outcome evaluation. The importance of various elements is highlighted, such as structural aspects, nature of care, target population, resources, and philosophy of the institution, which may condition the adoption of a method. The importance of care conceptualization is also underlined. The work methods are presented with a description of the key characteristics, advantages, and disadvantages of the task-oriented method (functional nursing) and patient-centered methods: individual, team nursing, and primary nursing. A critical and comparative analysis of the methods is then performed, alluding to the combination of person-centered methods.
A Qualitative Study of Impacts of the COVID-19 Pandemic on Lives in Adults with Attention Deficit Hyperactive Disorder in Japan
Authors: Ando Mizuho , Takeda Toshinobu , Kumagai Keiko
Published: February 2021

(1) Background: COVID-19 may deteriorate some aspects among individuals with attention deficit hyperactivity disorder (ADHD). Although some positive aspects were reported during the pandemic, it remains unclear how COVID-19 qualitatively influences their living context; (2) Methods: this study employed interviews with four participants with ADHD during the declaration of emergency issued in Japan. The study was a part of ongoing coaching as a psychosocial intervention for ADHD, which was initiated long before the pandemic. The data were the answers to the question: “how are things going with participants during this pandemic?”. In a qualitative analysis, the researchers coded the data to identify different themes and sub-themes; (3) Results and Discussion: the qualitative data analysis yielded five themes: (1) Terrible feeling caused by frustration, stress, and anger; (2) Closeness due to the internal difficulties and conflict; (3) Deteriorating ADHD symptoms and executive function related matters; (4) Condition is the same as usual; and (5) Positive aspects associated with the self-lockdown. As a whole, these results show that the COVID-19 pandemic could be a factor in inducing psychological distress in the participants who adjust relatively better at work/school but did not do well at home before the pandemic; (4) Conclusions: this study indicates the need for special support for individuals with ADHD, especially those who originally had difficulties at home.
Family Physicians’ Standpoint and Mental Health Assessment in the Light of COVID-19 Pandemic—A Nationwide Survey Study
Authors: Vilovic Tina , Bozic Josko , Vilovic Marino , Rusic Doris , Zuzic Furlan Sanja , Rada Marko , Tomicic Marion
Published: February 2021

During the coronavirus disease 2019 (COVID-19) outbreak, family physicians (FPs) are the backbone of the healthcare system with considerable impact on the general population, and their well-being is of great importance. The aim of this investigation was to assess FPs mental health, as well as knowledge, attitudes and practices (KAPs) regarding the pandemic, and opinions on non-communicable disease (NCD) health care provided to patients. A cross-sectional study was carried out with a sample of 613 FPs. Anxiety and depression levels were estimated with the Hospital Anxiety and Depression Scale, subjective perceived stress with the Perceived Stress Scale, while trauma-related symptoms were assessed using the Impact on Event Scale-COVID19. KAPs toward the pandemic and opinions regarding NCD patients were evaluated with questionnaires accordingly. Results have shown that age (β = −0.02, p = 0.013) and personal risk of COVID‑19 (β = 1.05, p < 0.001) were significant independent correlates of the knowledge score. A total of 87.7% FPs expressed moderate/high perceived stress, 45.2% moderate/severe trauma-related symptoms, 60.4% borderline/abnormal anxiety levels, and 52.4% borderline/abnormal depression levels. Knowledge score was an independent predictor of perceived stress (β = −0.33, p = 0.023) and anxiety (β = −0.31, p = 0.006) levels. Limited accessibility to healthcare services and decreased number of newly-diagnosed NCD cases were mostly agreed on. The pandemic puts a considerable strain on FPs mental health, as well as on public health measures, due to the decreased overall quality of NCD patient health care. Educational programs may bridge the gaps between FPs’ knowledge. Thus lowering anxiety and improving patient care.
Analgesic Opioid Misuse and Opioid Use Disorder among Patients with Chronic Non-Cancer Pain and Prescribed Opioids in a Pain Centre in France
Authors: Guillou-Landreat Morgane , Quinio Bertrand , Le Reste Jean Yves , Le Goff Delphine , Fonsecca Jérôme , Grall-Bronnec Marie , Dany Antoine
Published: February 2021

(1) Background: Chronic non-cancer pain (CNCP) remains a public health challenge around the world. Opioids (PO) have been increasingly used in the treatment of CNCP in the last 20 years. This study aimed to assess the prevalence of opioid misuse and prescribed-opioid use disorder (p-OUD) among patients with CNCP in a pain centre in France, and to analyse risk factors for moderate or severe p-OUD. (2) Method: A cross-sectional study was conducted, including patients consulting for pain management in the pain centre of Brest University Hospital. A self-questionnaire was administered (sociodemographic data, medical data, PO misuse, and p-OUD according the Diagnostic and Statistical Manual of Mental Disorders 5 (DSM 5) criteria). Descriptive, univariate, and multivariate analyses were conducted, together with a principal component analysis, in order to identify factors associated with p-OUD. (3) Results: In total, 115 patients were included, the majority of whom were women, with a mean age of 52 years old [18–82]; 64.3% (n = 74) had a current prescription for opioid analgesics (weak or strong). In this group, 56.7% (n = 42) had no or only mild p-OUD and 43.3% (n = 32) had current moderate or severe p-OUD. Patients with moderate or severe p-OUD were more likely to have a current antidepressant prescription, to have had psychotherapy, to currently use strong opioids and oxycodone, and to report taking more frequent doses than prescribed and feeling dependent. (4) Conclusions: We showed that the prevalence of current moderate/severe p-OUD concerned 43.3% of the patients with a CNCP seeking treatment in a pain centre. According to these results, several measures are relevant in managing p-OUD among patients with CNCP.
COVID-19 Lockdown and Mental Health in a Sample Population in Spain: The Role of Self-Compassion
Authors: Gutiérrez-Hernández María Elena , Fanjul Luisa Fernanda , Díaz-Megolla Alicia , Reyes-Hurtado Pablo , Herrera-Rodríguez Jonay Francisco , Enjuto-Castellanos María del Pilar , Peñate Wenceslao
Published: February 2021

Previous data support that mental health is affected during pandemic and lockdown situations. Yet, little is known about the positive factors that protect mental health during a lockdown. This study analyzed mental health status—particularly emotional problems—and the role of several sociodemographic and clinical variables; it also explored whether there is a positive relationship between self-compassion and better mental health status. A cross-sectional study was carried out in Spain with the participation of 917 fluent Spanish-speaking residents in a survey conducted approximately midway through the COVID-19 lockdown. The survey tested for anxiety, depression, and stress using the Depression Anxiety Stress Scale-21 (DASS-21), the Self-Compassion Scale (SCS) to measure self-compassion values, and the Perceived Vulnerability to Disease Questionnaire (PVDQ) to assess the degree of risk perceived by participants. Around 30% of the individuals surveyed (recruited by snowball sampling) showed clinically significant levels of anxiety, depression, and stress. The variables most frequently associated with anxiety, depression, and stress were low levels of self-compassion, age, gender, previous physical symptoms, a previous mental disorder, being a student, and perceived vulnerability to disease. We discuss the hypothetical protective role against anxiety, depression, and stress of certain skills such as self-compassion and the possibility that increasing self-compassion may be used to promote better mental health in similar situations.
Advancing the Population Needs-Based Health Workforce Planning Methodology: A Simulation Tool for Country Application
Authors: Asamani James , Christmals Christmal , Reitsma Gerda
Published: February 2021

Although the conceptual underpinnings of needs-based health workforce planning have developed over the last two decades, lingering gaps in empirical models and lack of open access tools have partly constrained its uptake in health workforce planning processes in countries. This paper presents an advanced empirical framework for the need-based approach to health workforce planning with an open-access simulation tool in Microsoft® Excel to facilitate real-life health workforce planning in countries. Two fundamental mathematical models are used to quantify the supply of, and need for, health professionals, respectively. The supply-side model is based on a stock-and-flow process, and the need-side model extents a previously published analytical frameworks using the population health needs-based approach. We integrate the supply and need analyses by comparing them to establish the gaps in both absolute and relative terms, and then explore their cost implications for health workforce policy and strategy. To illustrate its use, the model was used to simulate a real-life example using midwives and obstetricians/gynaecologists in the context of maternal and new-born care in Ghana. Sensitivity analysis showed that if a constant level of health was assumed (as in previous works), the need for health professionals could have been underestimated in the long-term. Towards universal health coverage, the findings reveal a need to adopt the need-based approach for HWF planning and to adjust HWF supply in line with population health needs.
A Scoping Review of Selected Studies on Predictor Variables Associated with the Malaria Status among Children under Five Years in Sub-Saharan Africa
Authors: Obasohan Phillips Edomwonyi , Walters Stephen J. , Jacques Richard , Khatab Khaled
Published: February 2021

Background/Purpose: In recent times, Sub-Saharan Africa (SSA) had been rated by the World Health Organization (WHO) as the most malaria-endemic region in the world. Evidence synthesis of the factors associated with malaria among children aged under-five in SSA is urgently needed. This would help to inform decisions that policymakers and executors in the region need to make for the effective distribution of scarce palliative resources to curb the spread of the illness. This scoping review is aimed at identifying studies that have used multivariate classical regression analysis to determine the predictors associated with malaria among children under five years old in SSA. Methods/Design: The search terms followed population, intervention, comparator, outcome, timing, setting (PICOTS), and were used in searching through the following databases: PubMed, MEDLINE, Web of Science, Cumulative Index of Nursing and Allied Health Literature (CINAHL), Scopus, and Measure DHS. The databases were searched for published articles from January 1990 to December 2020. Results: Among the 1154 studies identified, only thirteen (13) studies met the study’s inclusion criteria. Narrative syntheses were performed on the selected papers to synchronize the various predictors identified. Factors ranging from child-related (age, birth order and use of a bed net), parental/household-related (maternal age and education status, household wealth index) and community-related variables (community wealth status, free bed net distribution) were some of the identified significant predictors. Conclusions: It is timely to have a synthesis of predictors that influence the malaria status of children under-five in SSA. The outcome of the review will increase the knowledge of the epidemiology of morbidity that will form the basis for designing efficient and cost-effective distribution of palliatives and control of malaria in SSA.
Rapid Degradation of Carbon Tetrachloride by Microscale Ag/Fe Bimetallic Particles
Authors: Zhu Xueqiang , Zhou Lai , Li Yuncong , Han Baoping , Feng Qiyan
Published: February 2021

Cost-effective zero valent iron (ZVI)-based bimetallic particles are a novel and promising technology for contaminant removal. The objective of this study was to evaluate the effectiveness of CCl4 removal from aqueous solution using microscale Ag/Fe bimetallic particles which were prepared by depositing Ag on millimeter-scale sponge ZVI particles. Kinetics of CCl4 degradation, the effect of Ag loading, the Ag/Fe dosage, initial solution pH, and humic acid on degradation efficiency were investigated. Ag deposited on ZVI promoted the CCl4 degradation efficiency and rate. The CCl4 degradation resulted from the indirect catalytic reduction of absorbed atomic hydrogen and the direct reduction on the ZVI surface. The CCl4 degradation by Ag/Fe particles was divided into slow reaction stage and accelerated reaction stage, and both stages were in accordance with the pseudo-first-order reaction kinetics. The degradation rate of CCl4 in the accelerated reaction stage was 2.29–5.57-fold faster than that in the slow reaction stage. The maximum degradation efficiency was obtained for 0.2 wt.% Ag loading. The degradation efficiency increased with increasing Ag/Fe dosage. The optimal pH for CCl4 degradation by Ag/Fe was about 6. The presence of humic acid had an adverse effect on CCl4 removal.
Housing and Community Environments vs. Independent Mobility: Roles in Promoting Children’s Independent Travel and Unsupervised Outdoor Play
Authors: Qiu Lingyi , Zhu Xuemei
Published: February 2021

Children’s independent mobility (CIM) has declined dramatically in recent decades despite its benefits in facilitating childhood development, promoting physical activity, and combating the obesity epidemic. This US-based study examines the impacts of housing and neighborhood environments on two modes of CIM—home-based independent travel to non-school destinations and unsupervised outdoor play—while considering personal and social factors. A bilingual parent/guardian survey was distributed to public elementary schools in Austin, Texas, asking about children’s travel and play, housing and neighborhood environments, and personal and social factors. A Google Street View audit was conducted to capture additional housing-related information. Logistic regressions were used to predict CIM. For second to fifth graders (N = 525), less than two-thirds of the parents would allow children’s independent travel to non-school destinations (62%) and unsupervised outdoor play (57.9%), with the majority limited to a short distance (five-minute walk) and a few destinations (e.g., friend’s/relative’s home). Stranger danger was a negative predictor and the presence of friend’s/relative’s home was a positive predictor for both modes of CIM. Quality of neighborhood environment was another positive correlate for independent travel to non-school destinations. Significant personal and social factors were also identified. Study findings demonstrated the impacts of physical environments on CIM and the potential of using relevant interventions to promote children’s health and development.