bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparative Study of Several Machine Learning Algorithms for Classification of Unifloral Honeys
Authors: Mateo Fernando , Tarazona Andrea , Mateo Eva María
Published: July 2021

Unifloral honeys are highly demanded by honey consumers, especially in Europe. To ensure that a honey belongs to a very appreciated botanical class, the classical methodology is palynological analysis to identify and count pollen grains. Highly trained personnel are needed to perform this task, which complicates the characterization of honey botanical origins. Organoleptic assessment of honey by expert personnel helps to confirm such classification. In this study, the ability of different machine learning (ML) algorithms to correctly classify seven types of Spanish honeys of single botanical origins (rosemary, citrus, lavender, sunflower, eucalyptus, heather and forest honeydew) was investigated comparatively. The botanical origin of the samples was ascertained by pollen analysis complemented with organoleptic assessment. Physicochemical parameters such as electrical conductivity, pH, water content, carbohydrates and color of unifloral honeys were used to build the dataset. The following ML algorithms were tested: penalized discriminant analysis (PDA), shrinkage discriminant analysis (SDA), high-dimensional discriminant analysis (HDDA), nearest shrunken centroids (PAM), partial least squares (PLS), C5.0 tree, extremely randomized trees (ET), weighted k-nearest neighbors (KKNN), artificial neural networks (ANN), random forest (RF), support vector machine (SVM) with linear and radial kernels and extreme gradient boosting trees (XGBoost). The ML models were optimized by repeated 10-fold cross-validation primarily on the basis of log loss or accuracy metrics, and their performance was compared on a test set in order to select the best predicting model. Built models using PDA produced the best results in terms of overall accuracy on the test set. ANN, ET, RF and XGBoost models also provided good results, while SVM proved to be the worst.
Perception of the Health Threats Related to the Consumption of Wild Animal Meat—Is Eating Game Risky?
Authors: Niewiadomska Katarzyna , Kosicka-Gębska Małgorzata , Gębski Jerzy , Jeżewska-Zychowicz Marzena , Sułek Marianna
Published: July 2021

Consumer interest in game meat has increased in recent years. Consumers appreciate its nutritional value but still have many concerns. Based on data from a quantitative study conducted in the group of 450 purposively selected Polish respondents declaring to consume the game meat, consumers were segmented concerning the perception of health risks associated with its consumption. Three separate clusters were identified using hierarchical cluster analysis: Indifferent (42%), Fearful (30%), and Selective (28%). The clusters differed significantly in the perception of the role of game in their lives and taking actions to mitigate the health risks associated with its consumption. In addition, their socioeconomic profiles were significantly different. The Indifferent segment—significantly more often than the other segments—believes that game has a positive impact on health, and the way to counteract the health risks is to not eat raw meat. The Selective segment attaches great importance to the choice of consumption place as a warranty of access to safe meat. The Fearful segment is willing to pay more for good quality meat and search for information. The results proved that the game consumers are not a homogenous group. Recognizing the differences can indicate a path for the traders to efficiently meet the consumers’ expectations and needs.
Undeclared (Poly)phosphates Detection in Food of Animal Origin as a Potential Tool toward Fraud Prevention
Authors: Pavlovic Radmila , Di Cesare Federica , Longo Francesca , Abballe Franco , Panseri Sara , Bonanni Rossana Claudia , Baccelliere Rocco , Neri Bruno , Chiesa Luca Maria
Published: July 2021

(Poly)phosphates are approved as water-preserving and emulsifying agents that improve the appearance and consistency of many food products. The labelling of added (poly)phosphates is essential for protecting vulnerable population groups and to prevent unfair trade practices resulting in economic fraud. The problems with (poly)phosphates’ utilisation concerns both analytical and legislative issues, such as: (1) their straightforward detection; (2) excessive addition altering freshness perception and misleading consumers; (3) uncontrolled usage increasing foodstuff weight; (4) application in products where they are not permitted; and (5) no indication on the label. Bearing all these issues in mind, the main purpose of this study was the quantification and screening of the (poly)phosphates profile in meat, marine and dairy products (160 samples), of which 43 were without declared (poly)phosphate treatment. Analysis was completed by high-performance ion-exchange chromatography either with conductometric detection or coupled to Q-Exactive Orbitrap high-resolution mass spectrometry. Although the (poly)phosphates profiles varied greatly according to species and processing type, the following criteria for detection of illicit treatment were established: high orthophosphate level, quantified short-chain (poly)phosphate anions and the presence of long-chain forms. In conclusion, the instrumental platforms used in this study can be recommended to inspection bodies as reliable methods for the detection of food adulteration with (poly)phosphates.
The Effects of Conflicts and Self-Reported Insecurity on Maternal Healthcare Utilisation and Children Health Outcomes in the Democratic Republic of Congo (DRC)
Authors: Zhang Tingkai , Qi Xinran , He Qiwei , Hee Jiayi , Takesue Rie , Yan Yan , Tang Kun
Published: July 2021

Background The Democratic Republic of Congo (DRC) has experienced political unrest, civil insecurity, and military disputes, resulting in extreme poverty and a severely impaired health care system. To reduce the morbidity and mortality in women and children by strengthening healthcare, this study aimed at exploring the relationship between self-reported insecurity of mothers and maternal health-seeking behaviours and diseases in children in the DRC. Method Data collected from 8144 mothers and 14,403 children from the Multiple Indicators Cluster Survey (MICS) conducted by the National Institute of Statistics in 2017–2018, in collaboration with the United Nations Children’s Fund (UNICEF), was used. The severity of the conflict in different provinces was measured using the Uppsala Conflict Data Program (UCDP) reports. Multivariate logistic regression and stratified analysis were utilized to explore the association between conflicts with maternal health-seeking behaviours and diseases among children. Results High self-reported insecurity was positively associated with skilled antenatal care (OR1.93, 95%CI 1.50–2.49), skilled attendants at delivery (OR1.42, 95%CI 1.08–1.87), and early initiation of breastfeeding (OR1.32, 95%CI 1.04–1.68). These associations were more significant in regions with more armed conflict. It was also found that children of mothers with high self-reported insecurity were more likely to suffer from diarrhoea (OR1.47, 95%CI: 1.14–1.88), fever (OR1.23, 95%CI 1.01–1.50), cough (OR1.45, 95%CI 1.19–1.77), and dyspnea (OR2.04, 95%CI 1.52–2.73), than children of mothers with low self-reported insecurity. Conclusions Conflicts increases mothers’ insecurities and negatively affects children’s development. However, high conflict regions have to increase governmental and international assistance to promote the availability and access to maternal and child health services.
Analysis of Social Effects on Employment Promotion Policies for College Graduates Based on Data Mining for Online Use Review in China during the COVID-19 Pandemic
Authors: Chen Tinggui , Rong Jingtao , Peng Lijuan , Yang Jianjun , Cong Guodong , Fang Jing
Published: July 2021

As an important part of human resources, college graduates are the most vigorous, energetic, and creative group in society. The employment of college graduates is not only related to the vital interests of graduates themselves and the general public, but also related to the sustainable and healthy development of higher education and the country’s prosperity through science and education. However, the outbreak of COVID-19 at the end of 2019 has left China’s domestic labor and employment market in severe condition, which has a significant impact on the employment of college graduates. Based on the situation, the Chinese government has formulated a series of employment promotion policies for college graduates in accordance with local conditions to solve the current difficulties in employment of college graduates during the COVID-19Pandemic. Do these policies meet the expectations of the people? Is the policy implementation process reasonable? All these issues need to be tested and clarified urgently. This paper takes the employment promotion policy of college graduates under the COVID-19 as the research object, uses the PMC index model to screen the policy texts, obtains two perfect policy texts, and uses the Weibo comments to construct the evaluation model of policy measures support degree to analyze the social effects of employment promotion policies for college graduates. The results show that the public’s support degree with the employment promotion policies for college graduates under COVID-19 needs to be improved. Among them, the public has a neutral attitude towards position measures and transference measures but is obviously dissatisfied with subsidy measures and channel measures. Finally, suggestions for improving policy are given to make the employment policy in line with public opinion and effectively relieve the job hunting pressure of college graduates.
The Ecuadorian Version of the Burnout Assessment Tool (BAT): Adaptation and Validation
Authors: Vinueza-Solórzano Andrea M. , Portalanza-Chavarría Cecilia Alexandra , de Freitas Clarissa P. P. , Schaufeli Wilmar B. , De Witte Hans , Hutz Claudio S. , Souza Vazquez Ana Claudia
Published: July 2021

This study aimed to adapt and show evidence of validity for the Ecuadorian version of the Burnout Assessment Tool (BAT) considering only its “core” dimensions. The adaptation process included its translation and back translation. For content validation, expert reviews and focus groups were carried out. A confirmatory factor analysis was used to identify the psychometric properties and dimensionality of the scale. The reliability of the scale was assessed through the alpha, omega and composite reliability indices. To carry out the study, the questionnaire was applied to a sample of workers with a high level of education in Ecuador. In total, 2237 respondents were considered in the analysis. The results showed that the hierarchical model for BAT-23 and its short version, the BAT-12 scale, is the most adequate structure for analysis of the construct in the Ecuadorian context. The reliability of the general factor of burnout and its dimensions, evaluated by composite reliability, omega and Cronbach’s alpha, showed satisfactory indices. The findings obtained provide support for the reliability and validity of the Burnout Assessment Tool for the Ecuadorian context.
The Moderating Role of Emotion Regulation in the Recall of Negative Autobiographical Memories
Authors: Colombo Desirée , Serino Silvia , Suso-Ribera Carlos , Fernández-Álvarez Javier , Cipresso Pietro , García-Palacios Azucena , Riva Giuseppe , Botella Cristina
Published: July 2021

When facing a negative event, people implement different strategies to regulate ongoing emotions. Although the previous literature has suggested that the emotional intensity of a negative episode is associated with the characteristics of the subsequent autobiographical memory, it is still unknown whether emotion regulation (ER) moderates this relationship. In the present study, we provided undergraduate students with a smartphone-based diary to report a negative episode immediately after its occurrence and rate the momentary use of two ER strategies: cognitive reappraisal and rumination. To explore autobiographical memory, two “surprise” recall tasks were performed one week and one month after the event. According to the results, cognitive reappraisal was linked with better memory performances, and a tendency to retrospectively underestimate the negativity of highly intense events was observed only in participants adopting high rates of this strategy. Conversely, intense rumination was found to be associated with less detailed memories of emotionally intense events, as well as with higher emotional involvement with negative episodes over time, regardless of their intensity. Together, our results support the maladaptive role of rumination and the adaptive influence of cognitive reappraisal on autobiographical memory.
Impact of Mass Workplace COVID-19 Rapid Testing on Health and Healthcare Resource Savings
Authors: López Seguí Francesc , Navarrete Duran Jose Maria , Tuldrà Albert , Sarquella Maria , Revollo Boris , Llibre Josep Maria , Ara del Rey Jordi , Estrada Cuxart Oriol , Paredes Deirós Roger , Hernández Guillamet Guillem , Clotet Sala Bonaventura , Vidal Alaball Josep , Such Faro Patricia
Published: July 2021

Background: The epidemiological situation generated by COVID-19 has cast into sharp relief the delicate balance between public health priorities and the economy, with businesses obliged to toe the line between employee health and continued production. In an effort to detect as many cases as possible, isolate contacts, cut transmission chains, and limit the spread of the virus in the workplace, mass testing strategies have been implemented in both public health and industrial contexts to minimize the risk of disruption in activity. Objective: To evaluate the economic impact of the mass workplace testing strategy as carried out by a large automotive company in Catalonia in terms of health and healthcare resource savings. Methodology: Analysis of health costs and impacts based on the estimation of the mortality and morbidity avoided because of screening, and the resulting savings in healthcare costs. Results: The economic impact of the mass workplace testing strategies (using both PCR and RAT tests) was approximately €10.44 per test performed or €5575.49 per positive detected; 38% of this figure corresponds to savings derived from better use of health resources (hospital beds, ICU beds, and follow-up of infected cases), while the remaining 62% corresponds to improved health rates due to the avoided morbidity and mortality. In scenarios with higher positivity rates and a greater impact of the infection on health and the use of health resources, these results could be up to ten times higher (€130.24 per test performed or €69,565.59 per positive detected). Conclusion: In the context of COVID-19, preventive actions carried out by the private sector to safeguard industrial production also have concomitant public benefits in the form of savings in healthcare costs. Thus, governmental bodies need to recognize the value of implementing such strategies in private settings and facilitate them through, for example, subsidies.
Overview of Canada’s Answer to the COVID-19 Pandemic’s First Wave (January–April 2020)
Authors: Urrutia Deborah , Manetti Elisa , Williamson Megan , Lequy Emeline
Published: July 2021

Canada is a federal state of almost 38 million inhabitants distributed over ten provinces and three territories, each with their own power regarding health. This case study describes the health infrastructures’ situation before the COVID-19 outbreak and their adaptations to face the expected cases, the available epidemiologic data for the beginning of the first wave (January–April 2020), and the public health and economic measures taken to control the pandemic both at the federal level and breaking down by province and territory. Canadian health infrastructures offered on average 12.9 intensive care units beds per 100,000 (occupancy rate ~90% before the outbreak), unevenly distributed across provinces and territories. Canada implemented public health measures, such as social distancing, when hospitalization and death rates due to the pandemic were still lower than in other countries; each province and territory adapted and implemented specific measures. Cumulated cases and deaths substantially increased from mid-March 2020, reaching 65 cases and 2 deaths per 100,000 on April 12, with strong differences across provinces and territories. Canada has been affected by the COVID-19 pandemic’s first wave with a generally slower dynamic than in the USA or in the European Union at the same period. This suggests that implementation of public health measures when health indicators were still low may have been efficient in Canada; yet the long-term care sector faced many challenges in some provinces, which drove a large part of the pandemic indicators.
Effect of Physical Guidance on Learning a Tracking Task in Children with Cerebral Palsy
Authors: Nobari Hadi , Azimzadeh Elham , Hassanlouei Hamidollah , Badicu Georgian , Pérez-Gómez Jorge , Ardigò Luca
Published: July 2021

The purpose of this study was to investigate the effect of physical guidance (PG) frequency on learning a tracking task in children with hemiplegic spastic cerebral palsy (CP). For this purpose, 25 children, aged 7–15 years with CP affecting the left side of the body, who were classified in levels II–III of Manual Abilities Classification System (MACS) and levels III–IV of Gross Motor Function Classification System (GMFCS), were recruited from 10 clinical centers. A pre-test including two blocks of 12 trials of the tracking task without any PG was performed by all participants, after that they were assigned into five homogenous groups (with 100%, 75%, 50%, 25%, and 0% of PG) through blocked randomization according to their age. All participants involved in an intervention consisted of eight sessions (four blocks of 12 trials in each session) practicing a tracking task. The 0% PG group received no PG, the 25% PG group received PG for three trials, the 50% PG group received PG for six trials, the 75% PG group received PG for nine trials, and the 100% PG group received PG for all twelve trials. PG consisted of placing the experimenter’s hand around the child’s less-involved hand guiding to stay on the track and complete the task. Learning was inferred by acquisition and delayed retention tests. The results showed that the higher frequency of PG led to more accurate performance during practice phase. However, the group that received 75% PG had significantly better performance compared to the other groups in the retention phase. It is concluded that optimum level of PG, about 75% of trials, can be helpful for learning a tracking task in children with spastic hemiplegic CP, supporting the challenge point framework.
Occupational Therapy in Mental Health via Telehealth during the COVID-19 Pandemic
Authors: Sánchez-Guarnido Antonio José , Domínguez-Macías Esther , Garrido-Cervera José Antonio , González-Casares Roberto , Marí-Boned Silvia , Represa-Martínez Águeda , Herruzo Carlos
Published: July 2021

The COVID-19 pandemic has brought about changes in mental health occupational therapy. Research into these changes and the associated risks of relapse is insufficient. To explore the changes that have taken place in forms of occupational intervention (face-to-face and online) during the pandemic, and to analyze their association with subsequent relapses, a multicenter retrospective cohort study was carried out of 270 patients with mental disorder diagnoses under follow-up in day hospitals during 2020. Our results show that the frequency of face-to-face occupational therapy interventions decreased during lockdown and subsequently recovered. Interventions via telehealth increased during lockdown and have since been continued to a greater extent than before lockdown. Patients who received occupational intervention via telehealth relapsed less in the following six months (10.7% vs. 26.3%; χ2 = 10.372; p = 0.001), especially those who received intervention via videoconferencing (4.2% vs. 22%; χ2 = 5.718; p = 0.017). In conclusion, lockdown subsequent to the COVID-19 outbreak led to a reduction in face-to-face occupational therapy interventions, putting people with prior mental disorders at risk, while the implementation of telehealth tools helped reduce relapses.
Pediatric Vulvar Lichen Sclerosus—A Review of the Literature
Authors: Orszulak Dominika , Dulska Agnieszka , Niziński Kacper , Skowronek Kaja , Bodziony Jakub , Stojko Rafał , Drosdzol-Cop Agnieszka
Published: July 2021

Vulvar lichen sclerosus (VLS) is a chronic inflammatory condition affecting the anogenital region, which may present in a prepubertal or adolescent patient. The most popular theories are its autoimmune and genetic conditioning, although theories concerning hormonal and infectious etiology have also been raised. The most common presenting symptoms of VLS is vulva pruritus, discomfort, dysuria and constipation. In physical examination, a classic “Figure 8” pattern is described, involving the labia minora, clitoral hood, and perianal region. The lesions initially are white, flat-topped papules, thin plaques, or commonly atrophic patches. Purpura is a hallmark feature of VLS. The treatment includes topical anti-inflammatory agents and long-term follow-up, as there is a high risk of recurrence and an increased risk of vulvar cancer in adult women with a history of lichen sclerosus. This article reviews vulvar lichen sclerosus in children and provides evidence-based medicine principles for treatment in the pediatric population. A systematic search of the literature shows recurrence of VLS in children. Maintenance regimens deserve further consideration.
A Generalized Structural Equation Model Approach to Long Working Hours and Near-Misses among Healthcare Professionals in Japan
Authors: Anzai Tatsuhiko , Yamauchi Takashi , Ozawa Masaki , Takahashi Kunihiko
Published: July 2021

(1) Background: Near-miss incidents are the foundation of major injuries. They are warning signs that loss is imminent. Long working hours are a risk factor for near-misses along with sleep problems, job-related stress, and depressive symptoms. This study aimed to evaluate the indirect effects of long working hours via mediating variables on near-miss occurrences among Japanese healthcare professionals. (2) Methods: 1490 Japanese healthcare professionals’ reports from a web-based survey of workers in October 2018 were analyzed to evaluate total, direct, and indirect effects of long working hours on near-misses. We applied a generalized structural equation model with three mediating variables: sleep problems, job-related stress, and depressive symptoms. (3) Results: The total effect and direct effect of the categories of working hours longer than 41 h per week (h/w) for occurrence of near-misses were not significantly higher than that of 35–40 h/w. However, for indirect effects on occurrence of near-misses that first passed through job-related stress, there were higher reports for each category compared to 35–40 h/w, with odds ratios (OR) and 95% confidence intervals (95% CI) of OR = 1.12, 95% CI (1.07, 1.21) for 41–50 h/w; 1.25, (1.14, 1.41) for 51–60 h/w; and 1.31, (1.18, 1.51) for ≥ 61 h/w. (4) Conclusion: The results suggest that reducing working hours might improve job-related stress, which could reduce near-misses and prevent injuries.
Global Performance Index for Integrated Management System: GPI-IMS
Authors: Silvestri Alessandro , Falcone Domenico , Di Bona Gianpaolo , Forcina Antonio , Gemmiti Marco
Published: July 2021

Background: The present work starts from a literature review of the evolution of Integrated Management Systems (IMSs), considering different points of view and standards: quality, environmental, occupational health and safety, sustainability and social issues. Even if the benefits are possible, there is not a common approach and a clear link between the integration of management systems and business performance, in particular considering safety performance. Methods: The present study analyzes the application of Risk Assessment in order to realize the integration of management systems. The main objective is to provide a tool for an integrated evaluation of all company performances, starting from the definition of some Key Performance Indicators—KPIs—proposed for a particular case study, even if their choice is not the core of the paper. The assessment team members on the basis of their knowledge, experience and useful literature, could choose the right KPIs for the specific application, able to take a picture of the current state and to suggest a possible recommended action of improving. The proposed Risk Assessment approach is an integration of modern management techniques: Integrated Management System and Improving Cycle DMAIC. Results: The new method, called the Global Performance Index for Integrated Management System—GPI-IMS, has been applied to a real case study in the logistic field in order to evaluate its goodness and possible generalization. Conclusions: The proposed method allows to define the requirements that any company must have to perform the best. The role of the assessment team is very important to evaluate the global performance of the company and to suggest the corrective actions to be adopted.
Factors Affecting the Manufacturing Industry Transformation and Upgrading: A Case Study of Guangdong–Hong Kong–Macao Greater Bay Area
Authors: Yang Fan , Sun Yanming , Zhang Yuan , Wang Tao
Published: July 2021

This study aims to analyze the development trend of the manufacturing industry transformation and upgrading in the Guangdong–Hong Kong–Macao Greater Bay Area (2008–2018). On the basis of synergetics, the order parameter method of factor analysis is used to study these factors. The results show that: (1) There are five slow variable factors, such as intelligent manufacturing industry, technological innovation, scale agglomeration, market demand, and fixed asset investment, which are important power sources of the transformation and upgrading of the manufacturing industry in Greater Bay Area. The development of these factors is relatively mature, and they cooperate with each other. (2) Similar to a fast variable of manufacturing development ecology, green development is an important coordinating factor in removing bottlenecks. Finally, suggestions for the development of the transformation and upgrading of the manufacturing industry are put forward.
Monitoring Patients Reported Outcomes after Valve Replacement Using Wearable Devices: Insights on Feasibility and Capability Study: Feasibility Results
Authors: Ocagli Honoria , Lorenzoni Giulia , Lanera Corrado , Schiavo Alessandro , D’Angelo Livio , Liberti Alessandro Di , Besola Laura , Cibin Giorgia , Martinato Matteo , Azzolina Danila , D’Onofrio Augusto , Tarantini Giuseppe , Gerosa Gino , Cabianca Ester , Gregori Dario
Published: July 2021

Wearable devices (WDs) can objectively assess patient-reported outcomes (PROMs) in clinical trials. In this study, the feasibility and acceptability of using commercial WDs in elderly patients undergoing transcatheter aortic valve replacement (TAVR) or surgical aortic valve replacement (SAVR) will be explored. This is a prospective observational study. Participants were trained to use a WD and a smartphone to collect data on their physical activity, rest heart rate and number of hours of sleep. Validated questionnaires were also used to evaluate these outcomes. A technology acceptance questionnaire was used at the end of the follow up. In our participants an overall good compliance in wearing the device (75.1% vs. 79.8%, SAVR vs. TAVR) was assessed. Half of the patients were willing to continue using the device. Perceived ease of use is one of the domains that scored higher in the technology acceptance questionnaire. In this study we observed that the use of a WD is accepted in our frail population for an extended period. Even though commercial WDs are not tailored for clinical research, they can produce useful information on patient behavior, especially when coordinated with intervention tailored to the single patient.
Prevalence of High Resilience in Old Age and Association with Perceived Threat of COVID-19—Results from a Representative Survey
Authors: Weitzel Elena Caroline , Löbner Margrit , Röhr Susanne , Pabst Alexander , Reininghaus Ulrich , Riedel-Heller Steffi G.
Published: July 2021

Little is known about resilience in old age and its manifestation during the COVID-19 pandemic. This study aims to estimate the prevalence of high resilience in the German old age population. We further examine the socio-demographic correlates and whether high resilience reflects on older adults’ perception of the threat posed by COVID-19. The data were derived from a representative telephone survey of n = 1005 older adults (≥65 years) during the first COVID-19 lockdown. Assessments included socio-demographic variables, the perceived threat of COVID-19, and high resilience (Brief Resilience Scale; cutoff: ≥4.31). The association between high resilience and threat from COVID-19 was analyzed using ordinal logistic regression. The study sample had a mean age (SD) of 75.5 (7.1) years, and n = 566 (56.3%) were female. The estimated prevalence of high resilience was 18.7% (95% CI = [16.3; 21.2]). High resilience was more prevalent in the younger age group and participants with higher education levels. High resilience was significantly associated with a lower perception of threat from COVID-19. The results of the representative survey in the German old age population showed that one out of five adults aged 65 years and older had high resilience. Older adults with high resilience tended to feel less threatened by COVID-19. Further research on resilience in old age is needed to support vulnerable groups in the context of care.
Influence of Cognitive Orientation and Attentional Focus on Pain Perception
Authors: Diotaiuti Pierluigi , Corrado Stefano , Mancone Stefania , Falese Lavinia , Rodio Angelo , Siqueira Thaìs Cristina , Andrade Alexandro
Published: July 2021

Background. Recently, a growing interest has emerged in the role of attention and hypervigilance in the experience of pain. Shifting attention away from pain seems likely to reduce the perception of pain itself. Objectives. The present study has been designed to test the following overall hypotheses: (1) disposition to catastrophize, self-efficacy perceived in pain resistance (task self-efficacy), previous experiences concerning the tolerance of physical pain, and degree of impulsiveness are significant predictors of the decision to abandon a painful test such as the cold pressor test (CPT); (2) the manipulation of the attentive focus (internal or external) can influence the level of perceived pain. Methods. Effects of the manipulation of attentional focus (internal and external) on pain perception and response of trial abandonment were evaluated in a sample of university students (n = 246) subjected to the cold pressor test. Results. A significant effect (p < 0.05) was found through a test–retest comparison on the final level of perceived pain among subjects who had received instruction to externalize the focus of their attention (mixed factorial analysis of variance), but no significance was observed with respect to the decision to abandon the experiment. A general explanatory model of the abandonment behavior demonstrating overall good fit measurements was tested too. Conclusion. The abandonment of tests has been shown to be predicted mainly by catastrophic attitude. Attentive impulsiveness showed a further positive effect on catastrophic attitude. Perceived self-efficacy in the tolerance of pain limited learned helplessness, which in turn positively influenced catastrophizing.
Is Mesothelioma Unrelated to the Lung Asbestos Burden? Comment on Visonà et al. Inorganic Fiber Lung Burden in Subjects with Occupational and/or Anthropogenic Environmental Asbestos Exposure in Broni (Pavia, Northern Italy): An SEM-EDS Study on Autoptic Samples. Int. J. Environ. Res. Public Health 2021, 18, 2053
Authors: Mirabelli Dario , Angelini Alessia , Barbieri Pietro Gino , Calisti Roberto , Capacci Fabio , Girardi Paolo , Silvestri Stefano , Somigliana Anna Benedetta
Published: July 2021

We read with interest the report by Visonà and coworkers on the lung asbestos fiber burden in an autopsy series of decedents from mesothelioma (MM: 59 cases) and individuals who “suffered from asbestosis and died of its complications” (13 cases) [...]
Shame and STIs: An Exploration of Emerging Adult Students’ Felt Shame and Stigma towards Getting Tested for and Disclosing Sexually Transmitted Infections
Authors: Scheinfeld Emily
Published: July 2021

Emerging adulthood is identified as a time of identity exploration, during which emerging adults (EAs) may engage in sexual exploration and risky behaviors, potentially resulting in the contraction of a sexually transmitted infection (STI). Many EAs, do not disclose their status to partners or those who can provide social support, like parents. Nor do they often get tested. This may be due to the changing status of stigma surrounding STIs. This study examines traditional measures of the stigma/shame of STI diagnoses, treatment, and testing, and their relevance alongside both increased opportunities for casual sex and not only heightened education surrounding STIs, but also heightened prevalence of STIs in the U.S. Results show EAs perceived that if their community found out they got tested, they would likely be treated differently. They also felt they would be uncomfortable disclosing an STI to parents as well as to sexual partners. However, disclosing to a monogamous partner yielded less felt shame and stigma by EAs. Lastly, stigma/shame was associated with STI communication, as well as with overall perception of STI knowledge, and getting tested. Further explanation of the results and possible implications of this study are discussed.
Reply to Mirabelli et al. Is Mesothelioma Unrelated to the Lung Asbestos Burden? Comment on “Visonà et al. Inorganic Fiber Lung Burden in Subjects with Occupational and/or Anthropogenic Environmental Asbestos Exposure in Broni (Pavia, Northern Italy): An SEM-EDS Study on Autoptic Samples. Int. J. Environ. Res. Public Health 2021, 18, 2053”
Authors: Visonà Silvia Damiana , Capella Silvana , Bodini Sofia , Borrelli Paola , Villani Simona , Crespi Eleonora , Frontini Andrea , Colosio Claudio , Vigliaturo Ruggero , Belluso Elena
Published: July 2021

We appreciate very much the interest of Mirabelli et al. [...]
Proteus mirabilis Urease: Unsuspected Non-Enzymatic Properties Relevant to Pathogenicity
Authors: Grahl Matheus V. C. , Uberti Augusto F. , Broll Valquiria , Bacaicoa-Caruso Paula , Meirelles Evelin F. , Carlini Celia R.
Published: July 2021

Infection by Proteus mirabilis causes urinary stones and catheter incrustation due to ammonia formed by urease (PMU), one of its virulence factors. Non-enzymatic properties, such as pro-inflammatory and neurotoxic activities, were previously reported for distinct ureases, including that of the gastric pathogen Helicobacter pylori. Here, PMU was assayed on isolated cells to evaluate its non-enzymatic properties. Purified PMU (nanomolar range) was tested in human (platelets, HEK293 and SH-SY5Y) cells, and in murine microglia (BV-2). PMU promoted platelet aggregation. It did not affect cellular viability and no ammonia was detected in the cultures’ supernatants. PMU-treated HEK293 cells acquired a pro-inflammatory phenotype, producing reactive oxygen species (ROS) and cytokines IL-1β and TNF-α. SH-SY5Y cells stimulated with PMU showed high levels of intracellular Ca2+ and ROS production, but unlike BV-2 cells, SH-SY5Y did not synthesize TNF-α and IL-1β. Texas Red-labeled PMU was found in the cytoplasm and in the nucleus of all cell types. Bioinformatic analysis revealed two bipartite nuclear localization sequences in PMU. We have shown that PMU, besides urinary stone formation, can potentially contribute in other ways to pathogenesis. Our data suggest that PMU triggers pro-inflammatory effects and may affect cells beyond the renal system, indicating a possible role in extra-urinary diseases.
Inherited Retinal Diseases Due to RPE65 Variants: From Genetic Diagnostic Management to Therapy
Authors: Aoun Manar , Passerini Ilaria , Chiurazzi Pietro , Karali Marianthi , De Rienzo Irene , Sartor Giovanna , Murro Vittoria , Filimonova Natalia , Seri Marco , Banfi Sandro
Published: July 2021

Inherited retinal diseases (IRDs) are a heterogeneous group of conditions that include retinitis pigmentosa (RP) and Leber congenital amaurosis (LCA) and early-onset severe retinal dystrophy (EO[S]RD), which differ in severity and age of onset. IRDs are caused by mutations in >250 genes. Variants in the RPE65 gene account for 0.6–6% of RP and 3–16% of LCA/EORD cases. Voretigene neparvovec is a gene therapy approved for the treatment of patients with an autosomal recessive retinal dystrophy due to confirmed biallelic RPE65 variants (RPE65-IRDs). Therefore, the accurate molecular diagnosis of RPE65-IRDs is crucial to identify ‘actionable’ genotypes—i.e., genotypes that may benefit from the treatment—and is an integral part of patient management. To date, hundreds of RPE65 variants have been identified, some of which are classified as pathogenic or likely pathogenic, while the significance of others is yet to be established. In this review, we provide an overview of the genetic diagnostic workup needed to select patients that could be eligible for voretigene neparvovec treatment. Careful clinical characterization of patients by multidisciplinary teams of experts, combined with the availability of next-generation sequencing approaches, can accelerate patients’ access to available therapeutic options.
Molecular Hydrogen as a Novel Protective Agent against Pre-Symptomatic Diseases
Authors: Yamamoto Haru , Ichikawa Yusuke , Hirano Shin-ichi , Sato Bunpei , Takefuji Yoshiyasu , Satoh Fumitake
Published: July 2021

Mibyou, or pre-symptomatic diseases, refers to state of health in which a disease is slowly developing within the body yet the symptoms are not apparent. Common examples of mibyou in modern medicine include inflammatory diseases that are caused by chronic inflammation. It is known that chronic inflammation is triggered by the uncontrolled release of proinflammatory cytokines by neutrophils and macrophages in the innate immune system. In a recent study, it was shown that molecular hydrogen (H2) has the ability to treat chronic inflammation by eliminating hydroxyl radicals (·OH), a mitochondrial reactive oxygen species (ROS). In doing so, H2 suppresses oxidative stress, which is implicated in several mechanisms at the root of chronic inflammation, including the activation of NLRP3 inflammasomes. This review explains these mechanisms by which H2 can suppress chronic inflammation and studies its applications as a protective agent against different inflammatory diseases in their pre-symptomatic state. While mibyou cannot be detected nor treated by modern medicine, H2 is able to suppress the pathogenesis of pre-symptomatic diseases, and thus exhibits prospects as a novel protective agent.
The Influence of Food Waste Rearing Substrates on Black Soldier Fly Larvae Protein Composition: A Systematic Review
Authors: Hopkins Indee , Newman Lisa P. , Gill Harsharn , Danaher Jessica
Published: July 2021

The Black Soldier Fly (BSF) offers the potential to address two global challenges; the environmental detriments of food waste and the rising demand for protein. Food waste digested by BSF larvae can be converted into biomass, which may then be utilized for the development of value-added products including new food sources for human and animal consumption. A systematic literature search was conducted to identify studies investigating the influence of food waste rearing substrates on BSF larvae protein composition. Of 1712 articles identified, 23 articles were selected for inclusion. Based on the results of this review, BSF larvae reared on ‘Fish waste Sardinella aurita’ for two days reported the highest total protein content at 78.8% and BSF larvae reared on various formulations of ‘Fruit and vegetable’ reported the lowest protein content at 12.9%. This review is the first to examine the influence of food waste on the protein composition of BSF larvae. Major differences in larval rearing conditions and methods utilized to perform nutritional analyses, potentially influenced the reported protein composition of the BSF larvae. While this review has highlighted the role BSF larvae in food waste management and alternative protein development, their application in nutrition is still in its infancy.
Transcatheter Closure of PFO and ASD: Multimodality Imaging for Patient Selection and Perioperative Guidance
Authors: Egidy Assenza Gabriele , Spinardi Luca , Mariucci Elisabetta , Balducci Anna , Ragni Luca , Ciuca Cristina , Formigari Roberto , Angeli Emanuela , Vornetti Gianfranco , Gargiulo Gaetano Domenico , Donti Andrea
Published: July 2021

Transcatheter closure of patent foramen ovale (PFO) and secundum type atrial septal defect (ASD) are common transcatheter procedures. Although they share many technical details, these procedures are targeting two different clinical indications. PFO closure is usually considered to prevent recurrent embolic stroke/systemic arterial embolization, ASD closure is indicated in patients with large left-to-right shunt, right ventricular volume overload, and normal pulmonary vascular resistance. Multimodality imaging plays a key role for patient selection, periprocedural monitoring, and follow-up surveillance. In addition to routine cardiovascular examinations, advanced neuroimaging studies, transcranial-Doppler, and interventional transesophageal echocardiography/intracardiac echocardiography are now increasingly used to deliver safely and effectively such procedures. Long-standing collaboration between interventional cardiologist, neuroradiologist, and cardiac imager is essential and it requires a standardized approach to image acquisition and interpretation. Periprocedural monitoring should be performed by experienced operators with deep understanding of technical details of transcatheter intervention. This review summarizes the specific role of different imaging modalities for PFO and ASD transcatheter closure, describing important pre-procedural and intra-procedural details and providing examples of procedural pitfall and complications.
Tumor Necrosis with Adjunction of Preoperative Monocyte-to-Lymphocyte Ratio as a New Risk Stratification Marker Can Independently Predict Poor Outcomes in Upper Tract Urothelial Carcinoma
Authors: Lin Kun-Che , Jan Hau-Chern , Hu Che-Yuan , Ou Yin-Chien , Kao Yao-Lin , Yang Wen-Horng , Ou Chien-Hui
Published: July 2021

Objectives: This study aimed at investigating the prognostic impact of tumor necrosis and preoperative monocyte-to-lymphocyte ratio (MLR) in patients treated with radical nephroureterectomy (RNU) for upper tract urothelial carcinoma (UTUC). Methods: A total of 521 patients with UTUC treated with RNU from January 2008 to June 2019 at our institution were enrolled. Histological tumor necrosis was defined as the presence of microscopic coagulative necrosis. The optimal value of MLR was determined as 0.4 by receiver operating characteristic (ROC) analysis based on cancer-specific mortality. The Kaplan–Meier method with log-rank test and Cox proportional hazards regression models were performed to evaluate the impact of tumor necrosis and MLR on overall (OS), cancer-specific (CSS), and recurrence-free survival (RFS). Furthermore, ROC analysis was used to estimate the predictive ability of potential prognostic factors for oncological outcomes. Results: Tumor necrosis was present in 106 patients (20%), which was significantly associated with tumor location, high pathological tumor stage, lymph node metastasis, high tumor grade, lymphovascular invasion, tumor size, and increased monocyte counts. On multivariate analysis, the combination of tumor necrosis and preoperative MLR was an independent prognosticator of OS, CSS, and RFS (all p < 0.05). Moreover, ROC analyses revealed the predictive accuracy of a combination of tumor necrosis and preoperative MLR for OS, CSS, and RFS with the area under the ROC curve of 0.745, 0.810, and 0.782, respectively (all p < 0.001). Conclusions: The combination of tumor necrosis and preoperative MLR can be used as an independent prognosticator in patients with UTUC after RNU. The identification of this combination could help physicians to recognize high-risk patients with unfavorable outcomes and devise more appropriate postoperative treatment plans.
Validation and Inter-rater Reliability of the Modified Videofluoroscopic Dysphagia Scale (mVDS) in Dysphagic Patients with Multiple Etiologies
Authors: Chang Min Cheol , Lee Changbae , Park Donghwi
Published: July 2021

Background: the Videofluoroscopic Dysphagia Scale (VDS) is used to interpret and predict the long-term prognosis of patients with dysphagia. However, the inter-rater agreement of the VDS was shown to be lower in a previous study. To overcome the mentioned limitation of the VDS, a modified version (mVDS) was created and applied clinically. We aimed to validate its usefulness in determining the appropriate feeding method and predicting the prognosis of dysphagia. Methods: the videofluroscopic swallowing study (VFSS) data of 50 patients with dysphagia were collected retrospectively. The VFSS data were evaluated using the mVDS, and the inter-rater reliability was calculated. We also evaluated the association between the mVDS and type of feeding method selected, and between the mVDS and presence of aspiration pneumonia in patients with dysphagia. Results: among the different parameters of mVDS, “aspiration” showed the highest reliability (k = 0.767), followed by “mastication” and “lip closure” (k = 0.648 and k = 0.634, respectively). Conversely, “triggering pharyngeal swallow” and “pyriformis residue” demonstrated the lowest reliabilities (k = 0.312 and k = 0.324, respectively). The intraclass correlation coefficient (ICC), which is used as a measure of the reliability of the total mVDS score, was 0.876. In all patients with dysphagia, the mVDS score correlated significantly with the type of feeding method selected (p < 0.05), and the presence of aspiration pneumonia (p < 0.05). Conclusion: the ICC of the total mVDS score was 0.876. Therefore, the mVDS could be a useful tool for quantifying the severity of dysphagia. It could be helpful in the analysis of the VFSS findings among patients with dysphagia in clinical settings and research.
Application of K-Means Clustering Algorithm to Commercial Parameters of Pleurotus spp. Cultivated on Representative Agricultural Wastes from Province of Guayas
Authors: Guevara-Viejó Fabricio , Valenzuela-Cobos Juan Diego , Vicente-Galindo Purificación , Galindo-Villardón Purificación
Published: July 2021

Data of the commercial parameters of Pleurotus ostreatus and Pleurotus djamor were analyzed using the data mining technique: K-means clustering algorithm. The parameters evaluated were: biological efficiency, crop yield ratio, productivity rate, nutritional composition, antioxidant and antimicrobial activities in the production of fruit bodies of 50 strains of Pleurotus ostreatus and 50 strains of Pleurotus djamor, cultivated on the most representative agricultural wastes from the province of Guayas: 80% sugarcane bagasse and 20% wheat straw (M1), and 60% wheat straw and 40% sugarcane bagasse (M2). The database of the parameters obtained in experimental procedures was grouped into three clusters, providing a visualization of the strains with a higher relation to each parameter (vector) measured.