bluuebunny/crossref_metadata_2025 huggingface dataset:
Medical Costs of Stroke Care Between Women With and Without Dysmenorrhea: A Population-Based Comparison
Authors: Lin Ya-Wen , Sung Fung-Chang , Lin Ming-Hung , Muo Chih-Hsin , Teng Yu-Kuei , Kao Chia-Hung , Tzeng Ya-Ling
Published: September 2021

Objective: This study investigated the medical care costs of stroke type between age-matched cohorts with and without dysmenorrhea using the National Health Insurance Research Database (NHIRD).

Methods: We collected all 66,048 women with dysmenorrhea and 66,048 women without dysmenorrhea whose age (15-44-year-old) and index year (from 1997 to 2013) were matched for comparison. We assessed the incidence and compared the risk of stroke and stroke subtype in two cohorts. The proportional distributions of stroke subtypes by age between the two cohorts were compared among the women with stroke, and their hospitalization rate was also estimated. In addition, medical cost, length of stay, and the medical cost within 30 days after stroke were compared between the two cohorts.

Results: The stroke risk in dysmenorrhea was greater than comparisons (HR = 1.26, 95% CI = 1.11–1.42). Proportionally, hemorrhagic stroke (HS) significantly decreased with age in both cohorts, whereas ischemic stroke (IS) significantly increased with age when both cohorts were combined. The dysmenorrhea cohort had a higher portion of transient cerebral ischemia (TIA) stroke than comparisons (31.3 vs. 24.2%, p = 0.01) and a lower risk of hospitalization for IS (OR = 0.48, 95% CI = 0.21–0.69). Among the four-stroke subtypes, the cost of care for TIA was the least (US$157 ± 254). The average cost for stroke care was not significantly different between women with and without dysmenorrhea.

Conclusion: The hospitalization rate and medical costs of TIA are lower than other types. All women should prevent and treat TIA as soon as possible to avoid recurrence or progression to major stroke events and reduce medical costs, regardless of whether they have dysmenorrhea.
Burden of Vitamin D, Vitamin B12 and Folic Acid Deficiencies in an Aging, Rural Indian Community
Authors: Sundarakumar Jonas S. , Shahul Hameed Shafeeq K. ,   SANSCOG Study Team, Ravindranath Vijayalakshmi
Published: September 2021

Introduction: The important role of micronutrient deficiencies in aging-related disorders including dementia is becoming increasingly evident. However, information on their burden in India is scarce, especially, among aging and rural communities.

Methods: Prevalence of vitamin D, B12 and folic acid deficiency was measured in an ongoing, aging cohort, from rural India–Srinivaspura Aging Neurosenescence and COGnition (SANSCOG) study cohort. Serum level estimation of vitamin D, B12 and folic acid, using chemiluminescence immunoassay, was performed on 1648 subjects (872 males, 776 females).

Results: Mean vitamin D, B12 and folic acid levels were 23.4 ± 10.6 ng/ml, 277.4 ± 194.4 pg/ml and 6 ± 3.5 ng/ml), respectively. Prevalence of low vitamin D (<30 ng/ml), vitamin D deficiency (<20 ng/ml), B12 deficiency (<200 pg/ml) and folic acid deficiency (<3 ng/ml) were 75.7, 39.1, 42.3, and 11.1%, respectively. Significantly more women had vitamin D deficiency, whereas more men had folic acid deficiency. Women belonging to the oldest age group (≥75 years) had the maximum burden of low vitamin D (94.3%) and folic acid deficiency (21.8%).

Discussion: Older, rural-dwelling Indians have high burden of vitamin D and B12 deficiencies, which is concerning given the potentially negative consequences on cognition, immunity and frailty in the aging population. Urgent public health strategies are needed to address this issue and prevent or mitigate adverse consequences.
A Qualitative Study Exploring Community Pharmacists' Experiences and Views About Weight Management Interventions and Services in Klang Valley, Malaysia
Authors: Verma Rohit Kumar , Chong Wei Wen , Taha Nur Akmar , Paraidathathu Thomas
Published: September 2021

Objective: To qualitatively explore the perspectives of community pharmacists in Malaysia on their roles in weight management, and the barriers and facilitators in the expansion of these roles.

Methods: A purposive sampling method was used to recruit community pharmacists in Klang Valley, Malaysia. Semi-structured individual interviews were conducted with community pharmacists, with an interview guide, from May 2018 to January 2019. The interviews were conducted in person (face-to-face). All interviews were audio-recorded with consent and transcribed verbatim. The interview transcripts were analyzed thematically, whereby emerging themes were coded and grouped into categories.

Results: Twenty-four community pharmacists were recruited, with years of experience in pharmacy practice ranging from 2 to 40 years. Participants described their perceptions on the different weight management interventions where they emphasized the importance of a comprehensive lifestyle intervention and viewed that it should be the first-line intervention. Participants regarded their weight management service as easily accessible or approachable since community pharmacies are often the first point of call for patients seeking advice for their conditions before consulting doctors. Barriers identified by community pharmacists were mainly organizational in nature, which included lack of private consultation rooms, lack of time, and lack of qualified staff. Participants also described the need for training in weight management.

Conclusion: Community pharmacists in Malaysia believed that they can positively contribute to the area of weight management. They cited multiple roles that they could play in weight management interventions and services. The roles cited include provision of education and advice, including on lifestyle modifications, drug therapy, weight loss products and supplements, and monitoring and providing referrals to other healthcare professionals. However, barriers would need to be addressed, including through pharmacist training, to strengthen and improve community pharmacists' roles and contributions in weight management service.
Impact of an Educational Training Program on the Knowledge, Attitude, and Perceived Barriers of Community Pharmacists Towards Obesity and Overweight Management in Malaysia
Authors: Verma Rohit Kumar , Chong Wei Wen , Taha Nur Akmar , Paraidathathu Thomas
Published: September 2021

Objective: To evaluate the impact of an educational training program on the knowledge, attitude and perceived barriers of community pharmacists (CPs) towards obesity and overweight management.

Methods: This interventional study, which consisted of an educational training program, was conducted on a single cohort of Malaysian CPs. Thirty CPs attended the educational training program. The educational training program was delivered through didactic lectures, case studies and small group discussions, and consisted of various sessions covering different topics related to weight management. A validated questionnaire was used to assess the impact of the intervention on the CPs' knowledge, attitude, and perceived barriers.

Results: The overall mean knowledge score increased both immediately after (14.93 ± 1.62) and 30 days following the intervention (17.04 ± 2.51), and the increment was statistically significant 30 days following the intervention (p = 0.001) compared to both pre-intervention and immediate-post intervention stages. After the intervention, the participants had a more positive attitude towards the provision of weight management service (WMS) in community pharmacies. They had significantly stronger perceptions about the importance of their role to manage overweight and obesity and their professional competence to treat obese patients. In addition, the barrier of not having space in pharmacy to perform proper counselling for weight management and the barrier of not having training sessions in the area of obesity management were perceived to be significantly less important post-intervention.

Conclusion: This study showed the potential positive impact of an educational training program on CPs knowledge, attitudes and perceived barriers towards WMS.
Person-Centered Healthcare Practice in a Pandemic Context: An Exploration of People's Experience of Seeking Healthcare Support
Authors: Curnow Eleanor , Tyagi Vaibhav , Salisbury Lisa , Stuart Kim , Melville-Jóhannesson Barbara , Nicol Kath , McCormack Brendan , Dewing Jan , Magowan Ruth , Sagan Olivia , Bulley Cathy
Published: September 2021

Background: The recent COVID-19 pandemic increased pressure upon healthcare resources resulting in compromised health services. Enforced national lockdown led to people being unable to access essential services in addition to limiting contact with social support networks. The novel coronavirus, and subsequent condition known as long covid were not well-understood and clinicians were not supported by existing guidelines or pathways. Our study explored people's experiences of healthcare during this period with a person-centered “lens.”

Methods: Ninety-seven people participated in our online survey about their experiences of the pandemic, particularly while socially isolated and their experiences of healthcare. Following completion of the survey, 11 of these participants agreed to further semi-structured interviews to explore this further in their own words. Interview conversations were transcribed, checked; together with the responses to open questions in the survey. The data were then analyzed thematically by members of the research team. We conducted framework analysis from a post-positivist perspective, using the Person-centered Practice Framework to explore participants' experiences.

Results: There were few examples of people describing person-centered care. People experienced barriers to accessing support, and negative experiences of care that represented complexities enacting person-centered care at each level of the framework (processes, practice environment, prerequisites, and macro context). These barriers were influenced greatly by the pandemic, for example, with health professionals being harder to access. Some experiences related to the ways in which health professionals responded to the context, for example, positive examples included active listening, recognition of people's experiences, seeking to find out more, and engaging in collaborative problem-solving.

Discussion: People want to feel heard, supported to navigate healthcare systems, source trustworthy information, find appropriate services, and collaborate in learning and problem-solving with healthcare professionals. There have been enormous challenges to the provision of healthcare throughout the pandemic. Moving forward is crucial with emphasis on overcoming barriers to person-centered healthcare. This should focus on steps now and also in planning for the possibility of further rapid changes in the demand for and provision of healthcare.
Robots for Foreign Language Learning: Speaking Style Influences Student Performance
Authors: Fischer Kerstin , Niebuhr Oliver , Alm Maria
Published: September 2021

Much previous research suggests that teachers’ individual characteristics may affect students’ performance; however, which factors are particularly helpful is as yet unclear and methodologically very difficult to assess. In this paper, we study the effects of robots’ speaking styles when instructing students on a task. 40 participants saw a brief video in which a robot presented its instructions either in a charismatic or a not so charismatic speaking style. Participants’ task was then to produce foreign language sentences on the basis of visualizations of the prosodic properties of these sentences. A subsequent analysis of participants’ productions shows that language learners’ performance was significantly better when the robot had delivered its instructions in a charismatic voice. The results suggest not only that a charismatic speaking style may be crucial for teachers in general and hence one of the factors causing the interpersonal variation between teachers, but also that students can benefit from instructions by robots delivered in a charismatic speaking style.
A Review of Possible EEG Markers of Abstraction, Attentiveness, and Memorisation in Cyber-Physical Systems for Special Education
Authors: Dimitrova Maya , Wagatsuma Hiroaki , Krastev Aleksandar , Vrochidou Eleni , Nunez-Gonzalez J. David
Published: September 2021

Cyber-physical systems (CPSs) for special education rely on effective mental and brain processing during the lesson, performed with the assistance of humanoid robots. The improved diagnostic ability of the CPS is a prerogative of the system for efficient technological support of the pedagogical process. The article focuses on the available knowledge of possible EEG markers of abstraction, attentiveness, and memorisation (in some cases combined with eye tracking) related to predicting effective mental and brain processing during the lesson. The role of processing abstraction is emphasised as the learning mechanism, which is given priority over the other mechanisms by the cognitive system. The main markers in focus are P1, N170, Novelty P3, RewP, N400, and P600. The description of the effects is accompanied by the analysis of some implications for the design of novel educational scenarios in inclusive classes.
Automatic Detection of Gaze and Body Orientation in Elementary School Classrooms
Authors: Araya Roberto , Sossa-Rivera Jorge
Published: September 2021

Detecting the direction of the gaze and orientation of the body of both teacher and students is essential to estimate who is paying attention to whom. It also provides vital clues for understanding their unconscious, non-verbal behavior. These are called “honest signals” since they are unconscious subtle patterns in our interaction with other people that help reveal the focus of our attention. Inside the classroom, they provide important clues about teaching practices and students' responses to different conscious and unconscious teaching strategies. Scanning this non-verbal behavior in the classroom can provide important feedback to the teacher in order for them to improve their teaching practices. This type of analysis usually requires sophisticated eye-tracking equipment, motion sensors, or multiple cameras. However, for this to be a useful tool in the teacher's daily practice, an alternative must be found using only a smartphone. A smartphone is the only instrument that a teacher always has at their disposal and is nowadays considered truly ubiquitous. Our study looks at data from a group of first-grade classrooms. We show how video recordings on a teacher's smartphone can be used in order to estimate the direction of the teacher and students’ gaze, as well as their body orientation. Using the output from the OpenPose software, we run Machine Learning (ML) algorithms to train an estimator to recognize the direction of the students’ gaze and body orientation. We found that the level of accuracy achieved is comparable to that of human observers watching frames from the videos. The mean square errors (RMSE) of the predicted pitch and yaw angles for head and body directions are on average 11% lower than the RMSE between human annotators. However, our solution is much faster, avoids the tedium of doing it manually, and makes it possible to design solutions that give the teacher feedback as soon as they finish the class.
Atomization Control to Improve Soft Actuation Through Vaporization
Authors: Lee Han-Joo , Guerra-Bravo Esteban , Baltazar Arturo , Loh Kenneth J.
Published: September 2021

Soft actuation through droplet evaporation has significantly improved the actuation speed of methods that utilize liquid vaporization. Instead of boiling bulk liquid, this method implements atomization to disperse small droplets into a heater. Due to the large surface area of the droplets, the liquid evaporates much faster even at small temperature changes. However, further analysis is required to maximize the performance of this complex multi-physics method. This study was conducted to provide further insight into the atomizer and how it affects actuation. Numerical simulations were used to inspect the vibration modes and determine how frequency and voltage affect the atomization process. These results were used to experimentally control the atomizer, and the droplet growth on the heater surface was analyzed to study the evaporation process. A cuboid structure was inflated with the actuator to demonstrate its performance. The results show that simply maximizing the atomization rate creates large droplets on the surface of the heater, which slows down the vaporization process. Thus, an optimal atomization rate should be determined for ideal performance.
Non-communicable Diseases and Oral Health: An Overview
Authors: Wolf Thomas Gerhard , Cagetti Maria Grazia , Fisher Julian-Marcus , Seeberger Gerhard Konrad , Campus Guglielmo
Published: September 2021

Non-communicable diseases (NCDs) such as cardiovascular and metabolic diseases, diabetes, cancer and diseases of the oral cavity such as caries or periodontitis represent a global and highly relevant problem due to demographic and epidemiological changes. NCDs are not only responsible for millions of deaths worldwide, but they cause relevant costs for national economies arise for the health care of societies. Assuming that oral health and general health are directly linked, emerging interactions between systemic and oral diseases are increasingly being researched. Common important risk factors have implications for economic, social, and moral determinants of health. Interdisciplinarity trained oral health professionals are needed to address the excessively high rates of inequities in oral health. The main reason that oral diseases are still a global health problem is related to mainly individual subjective high-risk approaches, which resulting in high costs and low effectiveness. A paradigm shift for a public health approach is needed at population level that integrates different health professionals who deal with NCDs. Oral care, like physical activity, is one of the most important lifestyle-related determinants of health. Widespread recognition of this kind of approach is critical to both reducing the impact of oral and non-oral NCDs. A multi-sectoral, comprehensive and integrated strategy is therefore necessary. The focus should be on social, environmental and population strategies, but should also support individual strategies.
Explaining the Black-White Disparity in Preterm Birth: A Consensus Statement From a Multi-Disciplinary Scientific Work Group Convened by the March of Dimes
Authors: Braveman Paula , Dominguez Tyan Parker , Burke Wylie , Dolan Siobhan M. , Stevenson David K. , Jackson Fleda Mask , Collins James W. , Driscoll Deborah A. , Haley Terinney , Acker Julia , Shaw Gary M. , McCabe Edward R. B. , Hay William W. , Thornburg Kent , Acevedo-Garcia Dolores , Cordero José F. , Wise Paul H. , Legaz Gina , Rashied-Henry Kweli , Frost Jordana , Verbiest Sarah , Waddell Lisa
Published: September 2021

In 2017–2019, the March of Dimes convened a workgroup with biomedical, clinical, and epidemiologic expertise to review knowledge of the causes of the persistent Black-White disparity in preterm birth (PTB). Multiple databases were searched to identify hypothesized causes examined in peer-reviewed literature, 33 hypothesized causes were reviewed for whether they plausibly affect PTB and either occur more/less frequently and/or have a larger/smaller effect size among Black women vs. White women. While definitive proof is lacking for most potential causes, most are biologically plausible. No single downstream or midstream factor explains the disparity or its social patterning, however, many likely play limited roles, e.g., while genetic factors likely contribute to PTB, they explain at most a small fraction of the disparity. Research links most hypothesized midstream causes, including socioeconomic factors and stress, with the disparity through their influence on the hypothesized downstream factors. Socioeconomic factors alone cannot explain the disparity's social patterning. Chronic stress could affect PTB through neuroendocrine and immune mechanisms leading to inflammation and immune dysfunction, stress could alter a woman's microbiota, immune response to infection, chronic disease risks, and behaviors, and trigger epigenetic changes influencing PTB risk. As an upstream factor, racism in multiple forms has repeatedly been linked with the plausible midstream/downstream factors, including socioeconomic disadvantage, stress, and toxic exposures. Racism is the only factor identified that directly or indirectly could explain the racial disparities in the plausible midstream/downstream causes and the observed social patterning. Historical and contemporary systemic racism can explain the racial disparities in socioeconomic opportunities that differentially expose African Americans to lifelong financial stress and associated health-harming conditions. Segregation places Black women in stressful surroundings and exposes them to environmental hazards. Race-based discriminatory treatment is a pervasive stressor for Black women of all socioeconomic levels, considering both incidents and the constant vigilance needed to prepare oneself for potential incidents. Racism is a highly plausible, major upstream contributor to the Black-White disparity in PTB through multiple pathways and biological mechanisms. While much is unknown, existing knowledge and core values (equity, justice) support addressing racism in efforts to eliminate the racial disparity in PTB.
Renewing Universities in Our Climate Emergency: Stewarding System Change and Transformation
Authors: Fazey Ioan , Hughes Claire , Schäpke Niko A. , Leicester Graham , Eyre Lee , Goldstein Bruce Evan , Hodgson Anthony , Mason-Jones Amanda J. , Moser Susanne C. , Sharpe Bill , Reed Mark S.
Published: September 2021

This paper outlines climate emergencies facing universities and, by drawing on research on system transition, provides insights about how change to overcome the challenges might be stewarded. Climate change brings three interconnected and urgent emergencies for universities: (1) Manifest emergencies such as risks to operations and business models; (2) Conceptual emergencies that arise because assumptions, ideologies, systems, and structures cannot match the scale of the manifest challenges; and (3) Existential emergencies where current identities and sense of purpose are incapable of supporting the changes needed to overcome the conceptual challenges. To be viable leaders in the world, universities will need to renew their commitments to serving the public good, be dedicated to an unwavering challenge-orientation, create post-disciplinary structures, and be the change one seeks to see in the world. Importantly, universities will need to overcome the emergencies on the inside if they are to help society address the scale of the challenges on the outside, to which both universities and human capacity are seriously cognitively and emotionally ill-prepared. Fortunately, new insights from research on system transition provide helpful advice on how to steward transformational change. This work highlights that successful transformation requires strong adherence to transformational intent and, in the case of universities, working with all three emergencies simultaneously. Successful transformation will also require harnessing opportunities to disrupt the status quo; supporting an interplay of different forms of management and orientations to the future; developing appropriate infrastructure to support transformation; and rapidly accelerating the development of capacities for transformational change. By actively developing capacities for transformation on the inside universities will then be in a much better position to help and lead others beyond the halls of the academy.
Integrating Behavioral Theories in Agent-Based Models for Agricultural Drought Risk Assessments
Authors: Schrieks Teun , Botzen W. J. Wouter , Wens Marthe , Haer Toon , Aerts Jeroen C. J. H.
Published: September 2021

Improving assessments of droughts risk for smallholder farmers requires a better understanding of the interaction between individual adaptation decisions and drought risk. Agent-based modeling is increasingly used to capture the interaction between individual decision-making and the environment. In this paper, we provide a review of drought risk agent-based models with a focus on behavioral rules. This review leads to the conclusion that human decision rules in existing drought risk agent-based models are often based onad hocassumptions without a solid theoretical and empirical foundation. Subsequently, we review behavioral economic and psychological theories to provide a clear overview of theories that can improve the theoretical foundation of smallholder farmer behavior and we review empirical parameterization, calibration, and validation methods of those theories. Based on these reviews, we provide a conceptual framework that can give guidance for the integration of behavioral theories in agent-based models. We conclude with an agenda to guide future research in this field.
Nutrient Analysis in Arctic Waters Using a Portable Sensing Platform
Authors: McCaul Margaret , Magni Paolo , Jordan Sean F , McNamara Eoghan , Satta Andrea , Diamond Dermot , Ribotti Alberto
Published: September 2021

A portable sensing platform for the detection of nutrients (PO43−, NO2−, NO3−) in natural waters has been realized through the use of rapid prototyping techniques, colorimetric chemistries, electronics, and LED-based optical detection. The sensing platform is modular in design incorporating interchangeable optical detection units, with a component cost per unit of ca. €300, and small form factor (20 cm × 6 cm x 3.5 cm). Laboratory testing and validation of the platform was performed prior to deployment at the CNR Dirigibile Italia Arctic Research Station, Ny-Aselund (79°N, 12°E). Results obtained showed excellent linear response, with a limit of detection of 0.05 μM (NO2−, NO3−), and 0.03 μM (PO43−). On the June 22, 2016 a field campaign took place within Kongsfjorden, Ny-Aselund (78.5–79°N, 11.6–12.6°E), during which 55 water samples were acquired using 10 L Niskin bottles on board the MS Teisten research vessel. 23 hydrological casts were also performed using a Seabird 19plus V2 SeaCAT Profiler CTD probe with turbidity and dissolved oxygen sensors. Water samples were subsequently analyzed for PO43−, NO2−, NO3− at the CNR Dirigibile Italia Arctic Research Station Laboratory using the adaptive sensing platform. Nutrient concentrations were compared to hydrological data to assess the processes that influence the nutrient concentrations within the Fjord. This research highlights the potential use of the adaptive sensing platform in remote locations as a stand-alone platform and/or for the validation of deployable environmental sensor networks.
Ways of Being Together During the COVID-19 Pandemic: Support Bubbles and the Legal Construction of Relationships
Authors: Trotter Sarah
Published: September 2021

This article focuses on the concept of the support bubble. The concept was introduced in New Zealand in March 2020 in the context of the COVID-19 pandemic to denote a network of people with whom a person could have physical contact, and was later taken up in various forms elsewhere, particularly in the UK. The article focuses on the meaning that was attached to the concept and to the ways of being together that it encapsulated and stipulated. Where support bubbles were formalised as a matter of law, as in New Zealand and the UK, a particular form of relating was legally constructed and real relationships were affected through law. The article addresses the meaning and implications of the concept of the support bubble in this light. First, it considers the concept of the support bubble as a new legal form, which drew in, and built on, a range of relationships and then recast them in terms of a new legal form. Second, it analyses the central question posed by the concept as one of the meaning of being together in a support bubble, not only for those navigating and living with the concept in practice, but also as mediated in and through law. Third, it outlines how the concept of the support bubble represented a distinct legal development. It enabled those who were eligible to define for themselves, albeit within a specified framework, the meaning and nature of a relationship of support of this kind. It also supplied a space in which some kinds of relationships that had not necessarily attracted much previous legal attention—like friendships and dating relationships—came to find a degree of legal reflection and recognition.
Twin High-Resolution, High-Speed Imagers for the Gemini Telescopes: Instrument Description and Science Verification Results
Authors: Scott Nicholas J. , Howell Steve B. , Gnilka Crystal L. , Stephens Andrew W. , Salinas Ricardo , Matson Rachel A. , Furlan Elise , Horch Elliott P. , Everett Mark E. , Ciardi David R. , Mills Dave , Quigley Emmett A.
Published: September 2021

Two new imaging instruments, ‘Alopeke and Zorro, were designed, built, and commissioned at the Gemini-North and Gemini-South telescopes in 2018 and 2019, respectively. Here we describe them and present the results from over a year of operation. The two identical instruments are based on the legacy of the DSSI (Differential Speckle Survey Instrument) instrument, successfully used for years at the WIYN and the Gemini telescopes in Hawaii and Chile. ‘Alopeke and Zorro are dual-channel imagers having both speckle (6.7″) and “wide-field” (∼1 arcminute) field-of-view options. They were built to primarily perform speckle interferometry providing diffraction-limited imagery at optical wavebands, yielding pixel scale uncertainties of ±0.21 mas, position angle uncertainties of ±0.7◦, and photometric uncertainties of Δm ± 0.02–0.04 magnitudes (for the blue and red channels, respectively) when run through the standard data reduction pipeline. One of their main scientific roles is the validation and characterization of exoplanets and their host stars as discovered by transit surveys such as the NASA Kepler, K2, and TESS missions. The limiting magnitude for speckle observations at Gemini can be quite faint (r ∼18 in good observing conditions) but typically the observed targets are brighter. The instruments can also function as conventional CCD imagers providing a 1 arc-minute field of view and allowing simultaneous two-color, high-speed time-series operation. These resident visitor instruments are remotely operable and are available for use by the community via the peer-reviewed proposal process.
Understanding Reduced Gravity Effects on Early Plant Development Before Attempting Life-Support Farming in the Moon and Mars
Authors: Medina F. Javier , Manzano Aránzazu , Villacampa Alicia , Ciska Malgorzata , Herranz Raúl
Published: September 2021

Plants are a necessary component of any system of bioregenerative life-support for human space exploration. For this purpose, plants must be capable of surviving and adapting to gravity levels different from the Earth gravity, namely microgravity, as it exists on board of spacecrafts orbiting the Earth, and partial-g,as it exists on the surface of the Moon or Mars. Gravity is a fundamental environmental factor for driving plant growth and development through gravitropism. Exposure to real or simulated microgravity produces a stress response in plants, which show cellular alterations and gene expression reprogramming. Partial-gstudies have been performed in the ISS using centrifuges and in ground based facilities, by implementing adaptations in them. Seedlings and cell cultures were used in these studies. The Mars gravity level is capable of stimulating the gravitropic response of the roots and preserving the auxin polar transport. Furthermore, whereas Moon gravity produces alterations comparable, or even stronger than microgravity, the intensity of the alterations found at Mars gravity was milder. An adaptive response has been found in these experiments, showing upregulation of WRKY transcription factors involved in acclimation. This knowledge must be improved by incorporating plants to the coming projects of Moon exploration.
Utilizing Heart Rate Variability for Coaching Athletes During and After Viral Infection: A Case Report in an Elite Endurance Athlete
Authors: Hottenrott Laura , Gronwald Thomas , Hottenrott Kuno , Wiewelhove Thimo , Ferrauti Alexander
Published: September 2021

Background: Viral diseases have different individual progressions and can lead to considerable risks/long-term consequences. Therefore, it is not suitable to give general recommendations on a time off from training for athletes. This case report aims to investigate the relevance of detecting heart rate (HR) and HR variability (HRV) during an orthostatic test (OT) to monitor the progression and recovery process during and after a viral disease in an elite endurance athlete.

Methods: A 30-year-old elite marathon runner contracted a viral infection (upper respiratory tract infection) 4 weeks after a marathon race. RR intervals in HR time series in supine and standing positions were monitored daily in the morning. Analyzed parameters included HR, the time-domain HRV parameter root mean square of successive difference (RMSSD), peak HR (HRpeak) in a standing position, and the time to HR peak (tHRpeak).

Results: During the 6-day viral infection period, HR increased significantly by an average of 11 bpm in the supine position and by 22 bpm in the standing position. In addition, the RMSSD decreased from 20.8 to 4.2 ms, the HRpeak decreased by 13 bpm, and the tHRpeak increased by 18 s in the standing position significantly. There were no significant changes in the pre-viral infection RMSSD values in the supine position. The viral infection led to a significant change in HR and HRV parameters. The cardiac autonomic system reacted more sensitively in the standing position compared to the supine position after a viral infection in the present case study.

Conclusion: These data have provided supportive rationale as to why the OT with a change from supine to standing body position and the detection of different indicators based on HR and a vagal driven time-domain HRV parameter (RMSSD) is likely to be useful to detect viral diseases early on when implemented in daily routine. Given the case study nature of the findings, future research has to be conducted to investigate whether the use of the OT might be able to offer an innovative, non-invasive, and time-efficient possibility to detect and evaluate the health status of (elite endurance) athletes.
Does Becoming Fit Mean Feeling (f)it? A Comparison of Physiological and Experiential Fitness Data From the iReAct Study
Authors: Gropper Hannes , Mattioni Maturana Felipe , Nieß Andreas M. , Thiel Ansgar
Published: September 2021

Regular exercise fosters fitness-enhancing benefits. We assume that exercise interventions become successful and sustainable if physiological benefits of exercise are also subjectively perceivable. The goal of this study was to examine how young inactive adults physiologically respond to an exercise intervention and how those responses are subjectively experienced. Furthermore, we aimed to assess whether the sequence of two distinct endurance-based exercise modes has an impact on physiological and subjectively experienced physical fitness. Thirty-one young inactive adults were assessed for this substudy of the larger iReAct study. Participants were randomly assigned to a high-intensity interval training (HIIT) or a moderate-intensity continuous training (MICT) group for 6 weeks and subsequently switched groups for a second training period. Physiological fitness data was collected at baseline, follow-up I, and follow-up II using a graded cardiopulmonary exercise test. Subjectively reconstructed (i.e., retrospective constructions) experiences relating to physical fitness were assessed at follow-up II using a biographical mapping method. A repeated-measures one-way ANOVA on each training group was performed to see whether physiological and subjectively experienced fitness differed across training periods. The rate of change between all variables was calculated for the first and the second training period in order to compare the agreement between physiological and subjective fitness improvements. Participants increased their fitness across the intervention period both physiologically and subjectively. However, the rate of change depended on the sequence of the two training modes. While VO2max increased significantly in both training periods in the MICT-HIIT sequence, a significant increase in VO2max in the HIIT-MICT sequence was only observed in the HIIT period. Participants similarly perceived those increases subjectively in their exercise-related physical fitness, although they experienced a significant decrease in the second period of the HIIT-MICT sequence. For subjectively perceived physical fitness relating to everyday activities, significant increases were only observed for the first period of the MICT-HIIT sequence. Young inactive adults can improve both their physiological and their subjectively perceived fitness through regular exercise. However, exercise modes and their sequence can make a substantial difference regarding measured and perceived physical fitness. Additionally, despite a favorable tendency toward HIIT over MICT, inter- and intra-individual variability, particularly in the subjective experiences of fitness, reiterates the necessity of individualized approaches to exercise.
Selected Aspects and Determinants of the Slovak Agro-Food Companies' Innovativeness
Authors: Moravčíková Danka , Tkáč Filip , Mušinská Kristína
Published: September 2021

Sustainability and innovation are key elements of the economic growth and productivity in the contemporary era. The willingness, ability, and capacity to innovate is a strategic tool for the Slovak agro-food companies that want to maintain and/or to improve their market. The aim of this paper is to discuss the selected aspects and determinants of innovative performance of the Slovak agro-food companies and point out key areas and types in innovations, problems influencing their implementation, and assessing their success. The issue of innovation and the “new” role of the agro-food sector have become crucial in the context of transition of the Slovak economy toward more sustainable approaches. Therefore they have become important topics of both scientific research and policy agendas. Using a case study method, a questionnaire survey among 99 agro-food companies in Slovakia was carried out to obtain empirical data about the way how they manage, implement and evaluate the innovations. The study outlined the selected aspects and key determinants which affect the motivation of agro-food companies to innovate as well as selected factors influencing the processes of implementation and management of innovation. The research findings also point out that substantial changes will be required in regulation and support of innovations in the agro-food sector in Slovakia. The study could contribute to help the agro-food companies' managers to improve the innovation activities and competitiveness of their companies, and it would be also helpful for public administration in the development of policies and instruments supporting innovations in the agro-food sector.
The RAI-6 Questionnaire: A New Screening Questionnaire to Monitor Complications of Radioiodine Treatment
Authors: Buchholzer Samanta , Thakachy Subha Sethu , Tchérémissinoff Livia , Boselie Franciscus , Triponez Frédéric , Faure Frédéric , Lopez Jean-Michel , Borner Urs , Kleinjung Tobias , Seebach Jörg D. , Dulguerov Pavel , Marchal Francis
Published: September 2021

Objective: The aim of this study is to develop a simple and efficient screening questionnaire to be able to routinely monitor potential radioiodine therapy-induced complications.

Materials and Methods: A new radioiodine 6 (RAI-6) questionnaire containing six questions adressing salivary, ocular, and nasal symptoms as well as quality of life was developed. Validation of the RAI-6 questionnaire was assessed with a group of fifty-four patients diagnosed with differentiated thyroid carcinoma treated post-operatively with radioiodine therapy, and in a group of fifty healthy volunteers. The patient's group was subdivided into subgroups according to the radioiodine dose received: 23 patients received less or 30 mCi, 28 patients received 100 mCi, and three patients received between 200 and 300 mCi. We asked the patients to complete the RAI-6 questionnaire in a retrospective manner, regarding their situation before radioiodine therapy and regarding their actual symptoms after radioiodine therapy. The time needed to complete the RAI-6 was also assessed both in patients and in healthy volunteers.

Results: The mean post radioiodine treatment RAI-6 score were significantly higher than the mean pre radioiodine RAI-6 scores (p < 0.001) and the scores of healthy participants (p < 0.001). The mean total RAI-6 scores increased significantly with increasing radioiodine dose. A total mean RAI-6 score of each question was also analysed and revealed that ocular and nasal discomfort as well as quality of life were the items which affected the patients most after radioiodine treatment. The mean time to fill the RAI-6 questionnaire was 2 min for patients and 49 s for healthy volunteers.

Conclusion: The RAI-6 represents a new questionnaire which is easy and quick to complete. This simple screening tool can be recommended for general clinical practise and further epidemiological research.
Management and Follow-Up Practices of Women With Recurrent Stress Urinary Incontinence Following Transobturator Mid-urethral Synthetic Sling Procedure: A 6-Year Retrospective Monocentric University-Based Study
Authors: Huang Yi , Chen Zhengsen , Shen Baixin , Shao Yunpeng , Gao Jie , Zhou Yiduo , Margit Fisch , Wei Zhongqing , Ding Liucheng
Published: September 2021

Purpose: The purpose of this study is to evaluate the efficacy of management and follow-up practices in repeat retropubic mid-urethral synthetic sling (MUS) procedure after transobturator tape/tension-free vaginal tape-obturator (TOT/TVT-O) failure, and to clarify the possible etiology of recurrent stress urinary incontinence.

Methods: The charts of all women patients who underwent tension-free vaginal tape (TVT) slings after previous failed transobturator MUS procedures between February 2012 and November 2018 at a single center were reviewed retrospectively. The transperineal ultrasound was performed to assess the pre-operative or post-operative urethral mobility and location of the slings. Furthermore, some essential evaluations were also made, mainly including medical history, physical examination, 1 h pad test, and urodynamic study. Finally, primary outcomes were evaluated according to the above items at 3, 6, and 12 months after the second operation, respectively.

Results: Thirty-five patients were included in the primary transobturator MUS sling procedure. At the 6 months follow-up, 32 (91.42%) patients were socially continent and negative in 1 h pad test. The transperineal ultrasound measurement results revealed that the bladder neck descent (BND) values were significantly decreased after the repeat sling operation, and better urinary continence function was observed according to the post-operative urodynamic study. Multifactorial etiologies resulted in recurrent stress urinary incontinence (SUI), including poor surgical technique, inadequate sling tension when treating ISD, and inappropriate sling position. Then the detail of the surgical procedure varied with the results of pre-operative evaluations, affecting the validity of the second sling.

Conclusion: Recurrent SUI has resulted from multi factors, pre-operative urodynamic study and transperineal ultrasound might be valuable tools to guide repeat sling operation and predict post-operative outcomes. A repeat TVT procedure may be regarded as a remedial measure for a failed transobturator MUS operation.
Feral Swine Commercial Slaughter and Condemnation at Federally Inspected Slaughter Establishments in the United States 2017–2019
Authors: Akkina Judy , Burkom Howard , Estberg Leah , Carpenter Lydia , Hennessey Morgan , Meidenbauer Karen
Published: September 2021

Feral swine populations in the United States (US) are capable of carrying diseases that threaten the health of the domestic swine industry. Performing routine, near-real time monitoring for an unusual rise in feral swine slaughter condemnation will increase situational awareness and early detection of potential animal health issues, trends, and emerging diseases. In preparation to add feral swine to APHIS weekly monitoring, a descriptive analysis of feral swine slaughter and condemnations was conducted to understand the extent of commercial feral swine slaughter in the US at federally inspected slaughter establishments and to determine which condemnation reasons should be included. There were 17 establishments that slaughtered 242,198 feral swine across seven states from 2017 to 2019. For all 17 establishments combined, feral swine accounted for 63% of slaughtered animals. A total of 23 types of condemnation reasons were noted: Abscess/Pyemia, Arthritis, Contamination, Deads, Emaciation, General Miscellaneous, Icterus, Injuries, Metritis, Miscellaneous Degenerative & Dropsical Condition, Miscellaneous Inflammatory Diseases, Miscellaneous Parasitic Conditions, Moribund, Nephritis/Pyelitis, Non-ambulatory, Pericarditis, Pneumonia, Residue, Sarcoma, Septicemia, Sexual Odor, Toxemia, and Uremia. Exploratory analysis was conducted to determine which condemnation reasons should be included for weekly monitoring. For most condemn reasons, weeks of unusually high condemnations were noted. For example, a period of high pneumonia condemnations occurred from December 2, 2018 through February 3, 2019 with a spike on January 6, 2019 and a spike in dead swine occurred on November 3, 2019. The seasonal impacts on limited quality food resources, seasonal variation in the pathogen(s) causing pneumonia, and harsher weather are suspected to have an impact on the higher condemnation rates of pneumonia and dead swine during the winter months. Based on condemnation frequencies and the likelihood of enabling situational awareness and early detection of feral swine health emerging diseases, the following were selected for weekly monitoring: abscess/pyemia, contamination/peritonitis, deads, emaciation, injuries, miscellaneous parasitic conditions, moribund, pneumonia and septicemia. Detection of notable increases in condemnation reasons strongly suggestive of foreign animal or emerging diseases should contribute valuable evidence toward the overall disease discovery process when the anomalies are both confirmed with follow up investigation and combined with other types of surveillance.