bluuebunny/crossref_metadata_2025 huggingface dataset:
Determinants of Ship Management Revenues: The Case of Cyprus
Authors: Michail Nektarios , Melas Konstantinos , Louca Kyriaki
Published: July 2023

We explore, for the first time in the literature, how the revenues of ship management companies respond to macroeconomic exogenous shocks. Using data for ship-management companies in Cyprus, we find evidence that a demand shock has the largest impact on revenues, exhibiting an almost one-for-one relationship. If the demand shock is permanent, we observe a ceteris paribus permanent effect on revenues. Similarly, this occurs irrespective of the final effect that demand has on the relevant freight rate, proxied via the Baltic dry and tanker (dirty and clean) indices. The BDI and the BDTI indices have a smaller effect on revenues, standing at approximately 0.05% for every 1% shock, while the clean tanker index does not have an effect, most likely due to their fleet composition. In accordance with the literature, we find that a shock in the price of Brent oil increases revenues. Our results bear importance not only for ship management companies per se, but also for countries that are ship management hubs.
Distributed Cooperative Automatic Modulation Classification Using DWA-ADMM in Wireless Communication Networks
Authors: Zhang Qin , Guan Yutong , Li  Hai , Song Zhengyu
Published: July 2023

Automatic modulation classification (AMC) is an important component in non-cooperative wireless communication networks to identify the modulation schemes of the received signals. In this paper, considering the multipath effect in practical propagation environments, a distributed cooperative AMC (Co-AMC) network based on machine learning is proposed to identify the modulation scheme in non-cooperative wireless communication networks. Specifically, feature vectors are first obtained by applying a cyclic spectrum to facilitate the feature extraction of the received signal. Then, a classifier based on the K-nearest neighbor (KNN) method is designed to obtain the local decision for modulation classification at each distributed node. Meanwhile, the reliability of the local decision is estimated by applying two loss functions to assess the quality of the local decision. Finally, the unified classification result is obtained to fuse the local decisions according to their reliabilities by applying a designed decision fusion algorithm based on the distributed weighted average alternating direction method of multipliers (DWA-ADMM). The simulation results demonstrate that the proposed Co-AMC network achieves superior classification accuracy compared to existing AMC methods across a range of modulation schemes and SNRs. More importantly, the proposed Co-AMC exhibits great flexibility and practicability since it is adaptive to wireless networks with various scales and topologies.
Potential Energy Recovery and Direct Reuse System of Hydraulic Hybrid Excavators Based on the Digital Pump
Authors: Yue Daling , Gao Hongfei , Liu Zengguang , Wei Liejiang , Liu Yinshui , Zuo Xiukun
Published: July 2023

The potential energy recovery of hydraulic excavators is very significant for improving energy efficiency and reducing pollutant emissions. However, the more common solutions for potential energy recovery require more energy conversion processes before these potential energies can be reused, which adds to the complexity and high cost of the system. To tackle the above challenges, we proposed a novel energy recovery system for hydraulic hybrid excavators based on the digital pump with an energy recovery function. The new system could operate in three different modes: pump, energy recovery, and direct reuse. Based on the descriptions of the working principle of the digital pump and the whole energy recovery system, the mathematical models of the digital pump, the excavator arm cylinder, and the accumulator were established and the AMESim simulation model (combining mechanics, hydraulics, and electrics) was developed. The dynamic characteristics of the energy recovery system were studied under no-load and full-load conditions. The simulation results showed that this scheme could achieve 86% energy recovery when the boom was lowered and reused the recovered energy directly when raised, which could decrease the system input energy by 78.1%. This paper can provide an optimized solution for construction machinery or off-road vehicles and presents a reference for the research on digital hydraulics.
A Non-Equilibrium Thermodynamic Approach for Analysis of Power Conversion Efficiency in the Wind Energy System
Authors: Shchur Ihor , Lis Marek , Biletskyi Yurii
Published: July 2023

This article proposes an approach and develops an appropriate method of applying linear non-equilibrium thermodynamics to analyze energy processes, in particular using the example of the wind energy conversion system (WECS) with a directly connected vertical axis wind turbine (VAWT) and vector-controlled permanent magnet synchronous generator (PMSG). The main steps of the proposed approach are the description of the component subsystems as universal linear or linearized energy converters (ECs), which are characterized by several dimensionless parameters, the main one of which is the degree of coupling between their input and output. According to their value, as well as justified efficiency criteria, the optimal operating points of each ECs can be easily found. Such an approach makes it possible to abstract from physical laws of a different nature and equally assess the work of each of the subsystems. The next step is a connection of the received ECs. As shown in the paper, for the most common cascade connection of ECs, there are the best conditions for their connection, under which the newly formed equivalent EC can have maximum efficiency. This opens up an opportunity to analyze the influence of already real parameters of cascaded interconnected subsystems on the quality of their connection and justify specific solutions that would not have been seen without this approach. For example, in this study, from all parameters of the PMSG, only the selection of the optimal rated inductance of the armature winding made it possible to improve the quality of the connection of the PMSG with a specific VAWT and approximate the efficiency of the entire WECS to the maximum possible, especially in medium and high winds.
Performance Assessment of Two Different Phase Change Materials for Thermal Energy Storage in Building Envelopes
Authors: Vanaga Ruta , Narbuts Jānis , Freimanis Ritvars , Zundāns Zigmārs , Blumberga Andra
Published: July 2023

To meet the 2050 EU decarbonization goals, there is a need for new and innovative ideas to increase energy efficiency, which includes reducing the energy consumption of buildings and increasing the use of on-site renewable energy sources. One possible solution for achieving efficient thermal energy transition in the building sector is to assign new functionalities to the building envelope. The building envelope can function as a thermal energy storage system, which can help compensate for irregularities in solar energy availability. This can be accomplished by utilizing phase change materials as the energy storage medium in the building envelope. In this paper, two phase change materials with different melting temperatures of 21 °C and 28 °C are compared for their application in a dynamic solar building envelope. Both experimental and numerical studies were conducted within the scope of this study. The laboratory testing involved simulating the conditions of the four seasons through steady-state and dynamic experiments. The performance of the phase change materials was evaluated using a small-scale PASLINK test stand that imitates indoor and outdoor conditions. A numerical model of a small-scale building envelope was created using data from laboratory tests. The purpose of this model was to investigate how the tested phase change materials perform under different climate conditions. The experimental findings show that RT21HC is better at storing thermal energy in the PCM and releasing it into the indoor area than RT28HC. On the other hand, the numerical simulation results demonstrate that RT28HC has an advantage in terms of thermal storage capacity in climates found in Southern Europe, as it prevents overheating of the room.
Accurate Remaining Available Energy Estimation of LiFePO4 Battery in Dynamic Frequency Regulation for EVs with Thermal-Electric-Hysteresis Model
Authors: Zhang Zhihang , Lu Languang , Li Yalun , Wang Hewu , Ouyang Minggao
Published: July 2023

Renewable energy power generation systems such as photovoltaic and wind power have characteristics of intermittency and volatility, which can cause disturbances to the grid frequency. The battery system of electric vehicles (EVs) is a mobile energy storage system that can participate in bidirectional interaction with the power grid and support the frequency stability of the grid. Lithium iron phosphate (LiFePO4) battery systems, with their advantages of high safety and long cycle life, are widely used in EVs and participate in frequency regulation (FR) services. Accurate assessment of the state of charge (SOC) and remaining available energy (RAE) status in LiFePO4 batteries is crucial in formulating control strategies for battery systems. However, establishing an accurate voltage model for LiFePO4 batteries is challenging due to the hysteresis of open circuit voltage and internal temperature changes, making it difficult to accurately assess their SOC and RAE. To accurately evaluate the SOC and RAE of LiFePO4 batteries in dynamic FR working conditions, a thermal-electric-hysteresis coupled voltage model is built. Based on this model, closed-loop optimal SOC estimation is achieved using the extended Kalman filter algorithm to correct the initial value of SOC calculated by ampere-hour integration. Further, RAE is accurately estimated using a method based on future voltage prediction. The research results demonstrate that the thermal-electric-hysteresis coupling model exhibits high accuracy in simulating terminal voltage under a 48 h dynamic FR working condition, with a root mean square error (RMSE) of only 18.7 mV. The proposed state estimation strategy can accurately assess the state of LiFePO4 batteries in dynamic FR working conditions, with an RMSE of 1.73% for SOC estimation and 2.13% for RAE estimation. This research has the potential to be applied in battery management systems to achieve an accurate assessment of battery state and provide support for the efficient and reliable operation of battery systems.
The Energy Potential of Waste from Banana Production: A Case Study of the Mediterranean Region
Authors: Atilgan Atilgan , Krakowiak-Bal Anna , Ertop Hasan , Saltuk Burak , Malinowski Mateusz
Published: July 2023

Recently, with the development of technology, the number of studies on the need for energy and the possibilities of covering this need in a sustainable way has been increasing. The management of agricultural biomass and waste is cited as one of the challenges as well as a solution. Mersin and Antalya sites, where banana production is intensively practiced in Turkey, were selected as the study region. The potential amounts of energy values obtained from the waste generated during banana cultivation in the field area of study were calculated. The energy potential was calculated on the basis of the conversion of biogas that can be obtained from the waste. The values obtained were analyzed and compared with the levels of electricity used to determine the economic gains that can be achieved for Mersin and Antalya regions. The data on bananas used in study were obtained from the Turkish Statistical Institute (for the years 2016–2020). It is calculated that 2884.43 MWh of electricity can be generated in Mersin and 2218.26 MWh in Antalya per 5 years from the waste generated during banana production. The values of the number of houses whose needs can be met with the calculated five-year potential electricity amount are 1237 in Mersin and 952 in Antalya. It can be considered that reusing the potential energy that can be obtained from banana waste, examined as material for energy, used in agricultural production will result in a positive impetus to agricultural activities. Energy obtained from banana waste can cover a very small amount of the electrical energy needs of agricultural production, ranging from 0.19% to 0.34%. However, it is concluded that the potential amount of energy to be obtained by recycling not only banana waste but also other agricultural and food waste will be even higher.
Perspectives on the Applications of Radiative Cooling in Buildings and Electric Cars
Authors: Mousavi N. S. Susan , Azzopardi Brian
Published: July 2023

Cooling energy consumption is a major contributor to various sectors in hot climates with a significant number of warm days throughout the year. Buildings account for 40% of total energy consumption, with approximately ∼30–40% of that used for cooling in geographical areas such as Iran. Energy demand for cooling is an important factor in the overall energy efficiency of electric mobility. Electric vehicles (EVs) consume ∼30–50% of energy for the air conditioning (AC) system. Therefore, the efficient management of the cooling demand is essential in implementing energy-saving strategies. Passive radiative cooling is capable of providing subambient cooling without consuming any energy. This article reviews potential applications of passive radiative cooling in reducing cooling energy for buildings. It also provides a rough estimate of the amount of energy saved when applying a radiative cool roof to a model building. It is shown that by using radiative cool materials on roofs, the share of electricity usage for cooling can be reduced to 10%, leading to a reduction in cooling load by 90%. Additionally, the potential use of radiative cool coats of various types for different EV components, such as shell/body, windows, and fabrics, is introduced. Although the prospects of the design and engineering of radiative cooling products appear promising for both buildings and EVs, further investigations are necessary to evaluate scalability, durability, and performance based on factors such as geography and meteorology.
Fusion Approaches to Individual Tree Species Classification Using Multisource Remote Sensing Data
Authors: Li Qian , Hu Baoxin , Shang Jiali , Li Hui
Published: July 2023

With the wide availability of remotely sensed data from various sensors, fusion-based tree species classification approaches have emerged as a prominent and ongoing research topic. However, most recent studies primarily focused on combining multisource data at the feature level, while few systematically examined their positive or negative contributions to tree species classification. This study aimed to investigate fusion approaches at the feature and decision levels deployed with support vector machine and random forest algorithms to classify five dominant tree species: Norway maple, honey locust, Austrian pine, white spruce, and blue spruce in individual crowns. Spectral, textural, and structural features derived from multispectral imagery (MSI), a very high-resolution panchromatic image (PAN), and LiDAR data were systematically exploited to assess their contributions to accurate classifications. Among the various classification schemes that were explored, both feature- and decision-level fusion approaches demonstrated significant improvements in tree species classification compared with the utilization of MSI (0.7), PAN (0.74), or LiDAR (0.8) in isolation. Notably, the decision-level fusion approach achieved the highest overall accuracies (0.86 for SVM and 0.84 for RF) and kappa coefficients (0.82 for SVM and 0.79 for RF). The misclassification analysis of fusion approaches highlighted the potential and flexibility of decision-level fusion in tree species classification.
Intermediates Production in Methane Oxidation Coupled with Denitrification: Current Status, Challenges, and Future Opportunities
Authors: Zheng Xiao-Chuan , Li Hong-Shan , Wang Zi-Han , Sun Zhong-Fang , Zhao Lei
Published: July 2023

Climate warming is a hot environmental issue of global concern. As one of the major methane sinks, the process of methane oxidation coupled with denitrification (MOD) reduces the environmental impact brought by the greenhouse effect and water eutrophication. In addition, as an energy substance, methane can also improve its economic value by transforming into other liquid chemicals. Previous studies on the mechanism of the process have mainly focused on the extracellular electron transfer between species. However, in recent years, the production of intermediates influenced by different factors, and the existence of a large number of acid-producing bacteria and methanogens under anaerobic conditions, has led some researchers to pursue research into a new mechanism of the process. Moreover, the discovery of CO2 as a potential electron acceptor in products is certainly exciting, being a big opportunity under the ‘carbon neutral’ policy. This review looks back at the development of the MOD process and describes its functional microorganism and mechanism in detail when summarizing the types of microorganisms and intermediates at different oxygen levels, and introduces some traditional and novel biotechnologies, such as metagenomics, meta-transcriptomics, and meta-proteomics, etc., to help explore the novel mechanism of the process of MOD mediated by intermediates.
Antioxidant Potential of Spray- and Freeze-Dried Extract from Oregano Processing Wastes, Using an Optimized Ultrasound-Assisted Method
Authors: Vareltzis Patroklos , Stergiou Aggelos , Kalinderi Kallirhoe , Chamilaki Maria
Published: July 2023

Origanum vulgare is recognized worldwide for its numerous applications, in the food industry and beyond. However, the extraction of its essential oils generates a significant amount of waste. The aim of this research was to achieve the valorization of solid waste from oregano hydro-distillation, by (i) optimizing the ultrasound extraction of antioxidants, (ii) evaluating the effect of spray and freeze drying on the extract’s physicochemical properties, and (iii) characterizing the obtained powder by its antioxidant capacity. A central composite design of experiments was used to optimize the sample/solvent ratio, ethanol/water ratio, and extraction time. The extract was analyzed for its antioxidant potential by determining the percentage of DPPH inhibition, FRAP, and total phenolic content (TPC). The GAB model best fit the data for the moisture sorption isotherm of the resulting powder. The antioxidant activity of the powders was tested in a ground-beef food system. The TPC was maximized at times longer than 58 min, a sample/solvent ratio between 0.058 and 0.078, and a ratio of ethanol/water around 1. Neither drying method significantly affected the antioxidant properties of the extract, even though the resulting powders from each showed a different morphology (determined using SEM). Encapsulation with maltodextrin protected the spray-dried extract during a 6-month storage period. Powders from both drying methods equally retarded lipid oxidation, and were comparable to the synthetic antioxidant BHT. It is concluded that oregano processing waste is a potent source of antioxidants, and that its dried extract, via an ultrasound-assisted process, can potentially be used as a natural alternative to synthetic antioxidants.
The Role of Nutraceuticals and Functional Foods in Skin Cancer: Mechanisms and Therapeutic Potential
Authors: Peterle Lucia , Sanfilippo Serena , Borgia Francesco , Li Pomi Federica , Vadalà Rossella , Costa Rosaria , Cicero Nicola , Gangemi Sebastiano
Published: July 2023

Skin cancer is a prevalent type of cancer worldwide and has a high growth rate compared to other diseases. Although modern targeted therapies have improved the management of cutaneous neoplasms, there is an urgent requirement for a safer, more affordable, and effective chemoprevention and treatment strategy for skin cancer. Nutraceuticals, which are natural substances derived from food, have emerged as a potential alternative or adjunctive treatment option. In this review, we explore the current evidence on the use of omega-3 fatty acids and polyphenols (curcumin, epigallocatechin gallate, apigenin, resveratrol, and genistein) for the treatment of melanoma and non-melanoma skin cancer (NMSC), as well as in their prevention. We discuss the mechanisms of action of the aforementioned nutraceuticals and their probable therapeutic benefits in skin cancer. Omega-3 fatty acids, curcumin, epigallocatechin gallate, apigenin, resveratrol, and genistein have several properties, among which are anti-inflammatory and anti-tumor, which can help to prevent and treat skin cancer. However, their effectiveness is limited due to poor bioavailability. Nanoparticles and other delivery systems can improve their absorption and targeting. More research is needed to evaluate their safety and effectiveness as a natural approach to skin cancer prevention and treatment. These compounds should not replace conventional cancer treatments, but may be used as complementary therapy under the guidance of a healthcare professional.
Effect of Hopper Loading on the Formation of Alkyl Alcohols in Olive Fruits and Its Relationship with Sensory Quality Losses of Virgin Olive Oil
Authors: Boudebouz Abdelaziz , Romero Agustí , Hermoso Juan-F. , Boqué Ricard , Mestres Montserrat
Published: July 2023

The storage of olives in large hoppers is a widespread practice in oil mills, but these large volumes and their unloading can cause a physical deterioration of the olives that will affect the quality of the oil obtained. This research deals with the effect of hopper charge on the formation of alkyl alcohols in olive fruits and its relationship with the sensory quality losses of ‘Arbequina’ virgin olive oil. The contents of ethanol, methanol, and acetaldehyde were measured in olive samples loaded and stored for a short time in a large hopper and analyzed at three different hopper-discharging times, which are related to three different positions inside the hopper. The corresponding oil from each sampling was obtained by using ABENCOR and was evaluated by a trained tasting panel. Results showed that the ethanol content in olives increased during their storage in the hopper, while methanol and acetaldehyde contents did not show significant differences. Regarding their position in the hopper, fruits located at the bottom or on the lateral sides showed a greater deterioration. The sensory analyses showed an inverse relationship between the positive attributes of olive oils and their content of alcohols.
Effect of Peanut Protein Treated with Alkaline Protease and Flavorzyme on BALB/c Mice
Authors: Shu Erlian , Wang Shuo , Niu Bing , Chen Qin
Published: July 2023

This article aims to analyze the effects of enzyme treatment concentration, temperature, and time on peanut protein so as to obtain an optimal enzymatic hydrolysis condition for flavorzyme (Fla) and alkaline protease (Alk). The results were as follows: enzymatic hydrolysis temperature 60 °C and 55 °C, enzyme concentration 10% and 4%, enzymatic hydrolysis time 80 min and 60 min, and double enzyme hydrolysis ratio 2% Fla + 5% Alk, respectively. The BALB/c mice were sensitized with gavage of peanut protein before and after enzyme treatment to evaluate the effects of different enzyme treatments on peanut allergenicity. Compared with the mice sensitized with raw peanuts, the weight growth rate of the mice sensitized with enzyme treatment peanut increased but not as much as the control, the degranulation degree of mast cell and basophils decreased, the inflammatory infiltration and congestion in jejunum and lung tissue decreased, the expression of proinflammatory factors and thymic stromal lymphopoietin (TSLP) gene decreased, and the secretion of specific antibodies (IgE, and IgG) decreased, and the binding ability of peanut protein with peanut-specific IgE antibodies decreased as well. The results above indicate that the allergenicity of peanut protein decreases after enzyme treatment and the dual enzyme (Fla + Alk) treatment can be much more efficient.
Quality Evaluation of Fresh Pasta Fortified with Sourdough Containing Wheat Germ and Wholemeal Semolina
Authors: Catzeddu Pasquale , Fois Simonetta , Tolu Valentina , Sanna Manuela , Braca Angela , Vitangeli Ilaria , Anedda Roberto , Roggio Tonina
Published: July 2023

Pasta is a staple food in the Mediterranean diet, primarily manufactured with two essential ingredients, semolina and water; nowadays, it is often supplemented with functional ingredients. In this work, a sourdough obtained with wheat germ and wholemeal semolina was used, in order to improve sensorial and nutritional properties of fresh pasta, to prevent lipids oxidation, and to improve the shelf life. Three different formulations were prepared, a first one using semolina, a second one with raw wheat germ, wholemeal semolina, and semolina, and the last one with semolina and sourdough. The study highlighted the improved nutritional properties of pasta with sourdough (reduced phytic acid content, higher antioxidant activity and phenolic content). Proteins, ashes, dietary fibers, lipids, and tocols (vitamin E) increased in pasta with wheat germ and wholemeal semolina, and with sourdough. The amount of tocols decreased in pasta samples after cooking, except for the β–tocopherol in sourdough pasta, the amount of which remained high, surprisingly. Lipase and lipoxygenase enzymes likely decreased as an effect of the pasteurization process. The NMR analysis showed that lipid oxidation was higher in semolina pasta than in pasta with wheat germ, most likely due to the protective effect of antioxidants deriving from wheat germ.
Preparation and Characterization of a Biodegradable Film Using Irradiated Chitosan Incorporated with Lysozyme and Carrageenan and Its Application in Crayfish Preservation
Authors: Qiu Liang , Luo Qinghua , Bai Chan , Xiong Guangquan , Jin Shiwei , Li Hailan , Liao Tao
Published: July 2023

In this study, a composite film was prepared using irradiated chitosan, lysozyme, and carrageenan for crayfish preservation. First, the chitosan was degraded by gamma rays, with the best antimicrobial properties being found at 100 KGy. By using the response surface method, the components of the composite film were irradiated chitosan (CS) at 0.016 g/mL, lysozyme (LM) at 0.0015 g/mL, and carrageenan (CA) at 0.002 g/mL. When compared to the natural chitosan film, the Fourier-transform infrared spectroscopy (FTIR) and X-ray diffraction (XRD) results demonstrated that the chemical properties of the composite film did not change with the addition of LM and CA, while the physical and antibacterial properties increased, including tensile strength (16.87 → 20.28 N), hydrophobicity (67.9 → 86.3°), and oxygen permeability (31.66 → 24.31 m3∙um/m2∙day∙kPa). Moreover, the antibacterial activity of the films increased with the addition of LM and CA, especially for Shewanella putrefaciens: the zone of inhibition (mm) of CS, CS/LM, and CS/LM/CA was 9.97 ± 0.29, 14.32 ± 0.31, and 14.78 ± 0.21, respectively. Finally, the CS/LM/CA film could preserve crayfish for 10 days at 4 °C, whereas the polyethylene (PE) film could only preserve them for 6 days. Moreover, the composite film was excellent at inhibiting oxidative deterioration (TBARS value: 2.12 mg/kg, day10) and keeping the texture of crayfish muscle. Overall, our results suggested that the CS/LM/CA composite film produced can be applied as a biodegradable film in aquatic product packaging.
Genetic Polymorphism and Population Genetic Structure Analysis of 21 Autosomal STR Loci for a Han-Chinese Population from Luzhou of Southwest China
Authors: Song Binghui , Fu Jiewen , Qian Jie , Yang Lisha , Cheng Jingliang , Fu Junjiang
Published: July 2023

The Han nationality is an ancient and populous people, and different places in China may have their distinct group relationships. Luzhou area, as a crossroads of several provinces in Southwest China, lacks autosomal short tandem repeat (STR) research and population genetics research. In this study, 21 autosomal STR loci were evaluated in 1959 Han-Chinese individuals from Luzhou area. There was no substantial linkage disequilibrium (LD) among the 21 autosomal STR markers, and all markers were in Hardy–Weinberg equilibrium (HWE). The total discrimination power (TDP) and cumulative probability of exclusion (CPE) of the 21 autosomal STR loci were calculated to be 1–9.8505 × 10−16 and 1–1.9406 × 10−9, respectively. There were 333 alleles for 21 STRs with allelic frequencies ranging from 0.00026 to 0.51302, and the number of alleles ranged from 7 in locus TPOX to 29 in locus Penta E. According to the results of population comparison and population differentiation, historical influences, geographical distribution, cultural integration, and economic development may have an impact on the Luzhou Han population and other Chinese populations. These 21 STR loci were found to enrich autosomal STR information in forensic databases and provide highly informative polymorphisms for our forensic practice in China, including personal identification and parentage testing.
Impact of a Digital Tool on Pharmacy Students’ Ability to Perform Medication Reviews: A Randomized Controlled Trial
Authors: Dabidian Armin , Obarcanin Emina , Ali Sherazi Bushra , Schlottau Sabina , Schwender Holger , Laeer Stephanie
Published: July 2023

Digital Medication Review Tools (DMRTs) are increasingly important in pharmacy practice. To ensure that young pharmacists are sufficiently competent to perform medication reviews after graduation, the introduction of DMRTs teaching in academic education is necessary. The aim of our study was to demonstrate the effect of DMRTs use on pharmacy students’ performance when conducting a medication review (MR) in a randomized controlled pre-post design. Forty-one pharmacy students were asked to complete a MR within 60 min, followed by a 10-min consultation with (intervention group) and without a DMRT (control group). The MR performance was subdivided into four categories: communication skills, subjective and objective patient data, assessment, and plan. Performance was assessed using objective structured clinical examinations (OSCEs) and analytical checklists. With the use of DMRTs, the overall performance was improved by 17.0% compared to the control group (p < 0.01). Improvement through DMRTs was seen in the subcategories “Assessment” and “Plan”. Furthermore, pharmacy students liked using DMRTs and felt more confident overall. Our study results demonstrate that DMRTs improve the performance of MRs, hence DMRTs should become an integral part of pharmacy curriculum. Consequently, digitally enabled pharmacists using DMRTs will be better prepared for their professional careers in pharmacy practice.
Impact of COVID-19 on Quality of Life in Long-Term Advanced Rectal Cancer Survivors
Authors: Blasko Daniel , Schweizer Claudia , Fitz Tim , Schröter Christoph , Sörgel Christopher , Kallies Annett , Fietkau Rainer , Distel Luitpold Valentin
Published: July 2023

Colorectal cancer remains one of the most commonly diagnosed cancers. Advanced rectal cancer patients receive neoadjuvant radiochemotherapy as well as surgery and suffer from reduced health-related quality of life due to various side effects. We were interested in the role of the COVID-19 pandemic and how it affected those patients’ quality of life. A total of 489 advanced rectal cancer patients from the University Hospital Erlangen in Germany were surveyed between May 2010 and March 2022 and asked to fill out the EORTC QLQ-C30 and QLQ-CR38 questionnaires over eight different time points: at the beginning, during and after radiochemotherapy, right before surgery, and in yearly intervals after surgery for up to four years. Answers were converted to scores to compare the COVID-19 period to the time before March 2020, focusing on the follow-ups, the developments over time—including by sex and age—and the influence of the TNM cT-stage. Overall, a trend of impaired functional and symptom scores was found across all surveys with few significances (body image −10.6 percentage points (pp) after one year; defecation problems +13.5 pp, insomnia +10.2 pp and weight loss +9.8 pp after three years; defecation problems +11.3 pp after four years). cT4-stage patients lost significantly more weight than their cT1-3-stage counterparts (+10.7 to 13.7 pp). Further studies should be conducted to find possible causes and develop countermeasures for future major infectious diseases.
Pre-Hospital Emergency Medical Services Utilization Amid COVID-19 in 2020: Descriptive Study Based on Routinely Collected Dispatch Data in Bavaria, Germany
Authors: Hegenberg Kathrin , Althammer Alexander , Gehring Christian , Prueckner Stephan , Trentzsch Heiko
Published: July 2023

Background and Importance: The COVID-19 pandemic affected the utilization of health care services and posed organizational challenges. While many previous studies focused on the misuse of pre-hospital EMS for low-urgency health problems, the pandemic has put more emphasis on the avoidance of medically necessary calls. Objective: To compare the utilization of pre-hospital emergency medical services before and after specific pandemic periods. Design, setting and participants: This was a retrospective, descriptive analysis of routine data from 26 dispatch centers in Bavaria, Germany. Outcomes measure and analysis: We investigated the number of emergencies per 100,000 population, as well as the relative change in the emergency rates and transport rates in 2020, compared to the two previous years. Boxplots showed the distributions across the Bavarian districts per calendar week. The mean rates and standard deviations as well as the relative changes were presented for the specific periods. A paired samples t-test was used to compare the rates. Main results: Compared to the average of the two previous years, the emergency rates in 2020 were lower in 35 out of 52 calendar weeks. The strongest reductions were observed during the first wave, where the average emergency rate declined by 12.9% (SD 6.8, p < 0.001). There was no statistically significant difference in the overall emergency rate during the summer holidays. Lower transport rates were observed throughout the year, especially during the first wave. Conclusions: Utilization of pre-hospital emergency medical services decreased in 2020, especially during the periods with strict measures. This could be due to the lower morbidity from the behavioral changes during the pandemic, but also to the avoidance of medical services for both less urgent and severe conditions. While a reduction in unnecessary care would be beneficial, patients must be encouraged to seek necessary urgent care, even during a pandemic.
Improving Knowledge of Audit and Feedback among Health Care Professionals in Sicily
Authors: Ielo Augusto , Cola Maria Cristina De , Corallo Francesco , D’Aleo Giangaetano , Mento Agata , Cardile Davide , Cappadona Irene , Pagano Maria , Bramanti Placido , Ciurleo Rosella
Published: July 2023

Audit and Feedback (A & F) is considered one of the most significant tools for implementing continuous Quality Improvement (QI) in the healthcare field. The audit process is a structured inspection of professional practice against known standards or targets. The results of this inspection are subsequently feedback from professionals in order to implement an improvement process. The Italian Ministry of Health has recently funded the network project EASY-NET, with the main objective of evaluating the effectiveness of A&F strategies to improve healthcare practice and equity in various clinical and organizational settings in seven Italian regions. The Sicily region is represented within the EASY-NET project by the IRCCS Centro Neurolesi Bonino-Pulejo of Messina as the Work Package 7 (WP7). One of the objectives of the WP7 is to assess mechanisms and tools to enhance the effectiveness of A&F strategies. The purpose of this study is to investigate the influence that training interventions can have on improving knowledge of A&F strategies among healthcare professionals. The study employed a quasi-experimental design with a pretest-posttest evaluation strategy. The participants’ initial knowledge of A&F strategies was evaluated through a baseline survey. Subsequently, the participants attended an online training workshop led by A&F experts, and a follow-up survey consisting of the same set of questions was conducted at the end of the process. Results showed statistically significant positive changes in the level of knowledge of A&F among participants following the training intervention. Furthermore, dividing the participants into two subgroups based on their professional background revealed significant differences in the level of knowledge of A&F methodologies between the observed categories of healthcare professionals. In conclusion, the study revealed that training interventions can be facilitators to implementing effective A&F programs.
Lettuce in Monoculture or in Intercropping with Tomato Changes the Antioxidant Enzyme Activities, Nutrients and Growth of Lettuce
Authors: Cunha-Chiamolera Tatiana P. L. , Cecílio Filho Arthur Bernardes , Santos Durvalina M. M. , Chiamolera Fernando M. , Guevara-González Ramón G. , Nicola Silvana , Urrestarazu Miguel
Published: July 2023

Intercropping systems are a widely used agricultural practice by smallholder farmers to enhance food security and to use natural resources more efficiently. The objective of this study was to evaluate two lettuce cvs under an intercropping system. Enzymatic growth, yield and economic benefit were evaluated. The experiment was carried out from August to February in Jaboticabal (Brazil) using tomato plants as a main crop and Lucy Brown and Vanda cvs of lettuce as secondary crops. The catalase, superoxide dismutase and peroxidase activity of lettuce plants was analyzed. Mineral nutrient content, growth, yield parameters and commercial economic benefit were measured. Significant differences in stress and activity enzymatic indicators were found versus cultivars of lettuce. The loss of abiotic factors such as radiation or its effect on enzymatic stress indicators was greater than its effect on yield. Yield loss in the intercropping systems was different for each cultivar system, with cv Lucy Brown showing greater yield loss than cv Vanda. Economic benefit was only found for the Vanda lettuce cv. Although the benefits of intercropping have been demonstrated as very appropriate cultural management, the choice of cultivars involved might be the determining factor for the agronomic success of the system.
A Comparison Study of the Western Ontario Rotator Cuff Index, and the Constant–Murley Score with Objective Assessment of External Rotator Muscle Strength and Pain in Patients after Arthroscopic Rotator Cuff Repair
Authors: Bejer Agnieszka , Płocki Jędrzej , Probachta Mirosław , Kotela Ireneusz , Kotela Andrzej
Published: July 2023

Although rotator cuff injures are often associated with a limited range of motion and muscle weakness, being able to conduct pain-free and efficient performances of the activities as part of daily living seems to be more important for patients. The aim of this study was to investigate the correlation between two questionnaires—the disease-specific, subjective questionnaire termed the Western Ontario Rotator Cuff Index (WORC), and the shoulder-specific, subjective-objective questionnaire Constant–Murley score (CMS), with the objective assessment of external rotator muscle strength, and the subjective assessment of pain according to the visual analog scale (VAS) in patients after arthroscopic rotator cuff repair. The study was carried out among 47 patients twice—6 and 12 months after surgery, respectively. All patients completed the WORC, the CMS, and the VAS. Isokinetic evaluation of the external rotators was performed using the Biodex 4 ProSystem. The correlations of all assessed muscle strength parameters with both the CMS and the WORC were found to be statistically significant, being mostly average during the 1st examination and mostly strong during the 2nd examination. There was a significant improvement in all assessed tools as a result of the undertaken rehabilitation. There were weak correlations present between changes in the WORC and changes in the external rotator muscle strength, with correlations between WORC-Sport and EXT900-AVERAGE-POWER and PEAK-TORQUE also being found statistically significant. Correlations of changes in the CMS scale with changes in the external rotator muscle strength were weak and statistically insignificant. It seems that the WORC questionnaire can be recommended more for the population after rotator cuff repair, which allows for a reliable assessment of patients’ ability to function and its changes in various areas of life, and at the same time does not require a direct assessment by a clinician or researcher.
Monkeypox-Related Stigma and Vaccine Challenges as a Barrier to HIV Pre-Exposure Prophylaxis among Black Sexual Minority Men
Authors: Turpin Rodman E. , Mandell CJ , Camp Aaron D. , Davidson Mhonde Rochelle R. , Dyer Typhanye V. , Mayer Kenneth H. , Liu Hongjie , Coates Thomas , Boekeloo Bradley O.
Published: July 2023

Background: The U.S. monkeypox (mpox) outbreak of 2022 was a unique emergent public health crisis disproportionately affecting Black sexual minority men (BSMM). Similar to other stigmas, mpox-related stigma may have adverse effects on BSMM, including deterring HIV prevention such as PrEP. Methods: Our study investigated the experiences and perceptions of BSMM related to mpox, including mpox-associated stigma, and PrEP engagement among BSMM. We conducted qualitative interviews of 24 BSMM attending HIV prevention-related events in the greater D.C. Metropolitan area. In-depth interviews were conducted via phone, and responses to questions specific to the mpox outbreak were analyzed using thematic analysis. Results: We identified three key themes from the analysis: Mpox-related stigma, Mpox vaccine availability concerns, and Mpox vaccine hesitancy. Participants also described relationships between each of these three themes and PrEP use. Mpox stigma was particularly relevant as it is related to sexual stigma and is a deterrent to PrEP use. A sense of health system neglect of BSMM, especially related to low mpox vaccine availability, was also described. Conclusions: We identified mpox stigma and challenges related to mpox vaccination as key themes among BSMM, with implications for PrEP use. Future research exploring medical mistrust among BSMM, particularly related to HIV prevention, is recommended.
A Qualitative Analysis of the Experiences of Young Patients and Caregivers Confronting Pediatric and Adolescent Oncology Diagnosis
Authors: Testoni Ines , Nicoletti Anna Elena , Moscato Matilde , De Vincenzo Ciro
Published: July 2023

Epidemiological studies show that new cases of young oncology patients are increasing by 400,000 every year. Psychological literature has shown that receiving an oncological diagnosis can cause significant psychological stress and discomfort. However, the experiences of young patients and their caregivers as they confront this challenge are not yet fully understood. This paper adopts a qualitative methodological approach to explore how young patients with an oncological diagnosis and their parents make sense of the experiential challenges they face. Thus, the research realized 18 semi-structured interviews, 11 of which were with pediatric and adolescent oncology patients, and 7 of which were with 6 mothers and 1 father. The qualitative thematic analysis revealed that the oncological diagnosis triggers different emotions taking the scene in the attempt to cope with the threats of meaning that the diagnosis poses. However, such intense experience promotes transformative feelings in parents and young patients, leading to important personal growth. Lastly, this article discusses the need to improve palliative psychological care competences in pediatric oncology. By providing comprehensive psychological care to young oncology patients and their families, healthcare providers can mitigate the psychological stress and pain associated with the diagnosis and treatment of cancer.
Framing Effects of Cognitive Behavioural Therapy for Depression on Perceptions of Believability, Acceptability, and Credibility
Authors: Salimuddin Saba , Beshai Shadi , Iskric Adam , Watson Lisa
Published: July 2023

While CBT is an effective treatment for depression, uptake can be low. This is largely due to attitudinal barriers. Accordingly, the goals of the current investigation were to (a) tailor and develop persuasive psychoeducational materials to match dominant cultural beliefs about the causes of depression and (b) examine the effectiveness of tailored CBT descriptions in improving CBT perceptions. We examined the believability of CBT mechanisms by invoking commonly endorsed etiological models of depression and investigated whether tailoring CBT descriptions to match etiological beliefs about depression influences perceptions of CBT. Participants were recruited using TurkPrime. In Study 1, participants (n = 425) read a CBT description that was generic or framed to match an etiological model of depression (biological, stress/environmental, or relationship/interpersonal). The participants indicated believability of each model as adopted by CBT. In study 2, the participants (n = 449) selected what they believed was the most important cause of depression. Subsequently, the participants were randomised to receive either a CBT description tailored to their endorsed model or a generic CBT description, and they provided ratings for CBT’s acceptability, credibility, and expectancy. In Study 1, the believability of biological CBT mechanisms was low across conditions, but participants reported greater believability when receiving a biological description than when receiving other mechanistic descriptions. Participants who received the stress- and relationship-focused descriptions did not rate the respective models as more believable than those who received a generic description. In study 2, there were no differences in the perceptions of acceptability, credibility and expectancy between participants who received a tailored description and those who received a generic description. Our findings suggest that CBT is believed to be a psychologically appropriate treatment; however, the believability of biological mechanisms is improved by presenting a biology-focused description.