bluuebunny/crossref_metadata_2025 huggingface dataset:
NOD2 Genotypes Affect the Symptoms and Mortality in the Porcine Circovirus 2-Spreading Pig Population
Authors: Suzuki Kasumi , Shinkai Hiroki , Yoshioka Gou , Matsumoto Toshimi , Tanaka Junji , Hayashi Noboru , Kitazawa Haruki , Uenishi Hirohide
Published: September 2021

The nucleotide oligomerization domain (NOD)-like receptor 2 (NOD2) is an intracellular pattern recognition receptor that detects components of peptidoglycans from bacterial cell walls. NOD2 regulates bowel microorganisms, provides resistance against infections such as diarrhea, and reduces the risk of inflammatory bowel diseases in humans and mice. We previously demonstrated that a specific porcine NOD2 polymorphism (NOD2-2197A > C) augments the recognition of peptidoglycan components. In this study, the relationships between porcine NOD2-2197A/C genotypes affecting molecular functions and symptoms in a porcine circovirus 2b (PCV2b)-spreading Duroc pig population were investigated. The NOD2 allele (NOD2-2197A) with reduced recognition of the peptidoglycan components augmented the mortality of pigs at the growing stage in the PCV2b-spreading population. Comparison of NOD2 allele frequencies in the piglets before and after invasion of PCV2b indicated that the ratio of NOD2-2197A decreased in the population after the PCV2b epidemic. This data indicated that functional differences caused by NOD2-2197 polymorphisms have a marked impact on pig health and livestock productivity. We suggest that NOD2-2197CC is a PCV2 disease resistant polymorphism, which is useful for selective breeding by reducing mortality and increasing productivity.
Influence of DAT1 Promotor Methylation on Sports Performance
Authors: Grzywacz Anna , Chmielowiec Krzysztof , Boroń Agnieszka , Michałowska-Sawczyn Monika , Chmielowiec Jolanta , Trybek Grzegorz , Mroczek Bożena , Leźnicka Katarzyna , Cieszczyk Paweł , Masiak Jolanta
Published: September 2021

In the mammalian genome, DNA methylation is an epigenetic mechanism involving the transfer of a methyl group onto the C5 position of the cytosine to form 5-methylcytosine. DNA methylation regulates gene expression by recruiting proteins involved in gene repression or by inhibiting the binding of transcription factors (TFs) to DNA. As there are still many questions concerning the role of methylation in creating personality, we concentrated on searching for such associations. The research group was 100 sports male subjects (mean age = 22.88, SD = 6.35), whereas the control group included 239 healthy male volunteers matched for age (mean age = 21.69, SD = 3.39), both of European origin. The methods used in our research were as follows: DNA isolation, methylation-specific PCR, sequencing chromatophores, all conducted according to the manufacturer’s procedure. To evaluate personality traits, the NEO Five-Factor Personality Inventory (NEO-FFI) and STAI Inventory were used. We observed the existence of a statistically significant correlation for all the aspects of personality covered and CpG islands’ methylation. Nonetheless, we think that the tested group and the number of tested promotor islands in the DAT1 gene are still too small to make explicit conclusions, so it needs further profound analysis.
SNR-Based GNSS-R for Coastal Sea-Level Altimetry
Authors: Tabibi Sajad , Sauveur Renaldo , Guerrier Kelly , Metayer Gerard , Francis Olivier
Published: September 2021

Geodetic Global Navigation Satellite System reflectometry (GNSS-R) uses ground-based signals of opportunity to retrieve sea levels at an intermediate spatial scale. Geodetic GNSS-R is based on the simultaneous reception of Line-of-Sight (LoS) and its coherent GNSS sea surface reflection (non-LOS) signals. The scope of this paper is to present geodetic GNSS-R applied to sea level altimetry. Signal-to-Noise Ratio (SNR) measurements from a Commercial Off-The-Shelf (COTS) geodetic-quality GNSS station at the Haiti Coast Guard Base in Port-au-Prince is used to retrieve sea levels in the International Terrestrial Reference Frame 2014 (ITRF2014). The GNSS-R sea levels are compared with those of the OTT Radar Level Sensor (RLS) installed vertically below the GNSS antenna. The Root-Mean-Square Error (RMSE) between the geodetic GNSS-R sea levels and OTT RLS records is 3.43 cm, with a correlation of 0.96. In addition, the complex differences between the OTT RLS records and 15-min GNSS-R sea levels using Global Positioning System (GPS) and Globalnaya Navigazionnaya Sputnikovaya Sistema (or Global Navigation Satellite System; GLONASS) signals for all the eight major tidal constituents are in mm-level agreement. Therefore, geodetic GNSS-R can be used as a complementary approach to the conventional method for sea level studies in a stable terrestrial reference frame.
Influence of a Thin Horizontal Weak Layer on the Mechanical Behaviour of Shallow Foundations Resting on Sand
Authors: Ziccarelli Maurizio , Rosone Marco
Published: September 2021

The presence of minor details of the ground, including soil or rock masses, occurs more frequently than what is normally believed. Thin weak layers, shear bands, and slickensided surfaces can substantially affect the behaviour of foundations, as well as that of other geostructures. In fact, they can affect the failure mechanisms, the ultimate bearing capacity of footings, and the safety factor of the geotechnical system. In this research, numerically conducted through Finite Element Code Plaxis 2D, the influence of a horizontal thin weak layer on the mechanical behaviour of shallow footings was evaluated. The obtained results prove that the weak layer strongly influences both the failure mechanism and the ultimate bearing capacity if its depth is lower than two to four times the footing width. In fact, under these circumstances, the failure mechanisms are always mixtilinear in shape because the shear strains largely develop on the weak layer. However, the reduction in the ultimate bearing capacity is a function of the difference between the shear strength of the foundation soil and the layer. The presence of a thin weak layer decreases the ultimate bearing capacity up to 90%. In conclusion, this research suggests that particular attention must be paid during detailed ground investigations to find thin weak layers. Based on the obtained results, it is convenient to increase the soil volume investigation to a depth equal to four times the width of the foundation.
Factors Affecting the Initiation of a Shared Decision Making Program in Obstetric Practices
Authors: Bowen Deborah J. , Nguyen Ann M. , LeRouge Cynthia , LePoire Erin , Sheng Kwan-Gett Tao
Published: September 2021

As healthcare systems progress toward initiatives that increase patient engagement, stakeholder hopes are that shared decision making (SDM) will become routine practice. Yet, there is limited empirical evidence to guide such SDM program implementations, particularly in obstetric practices. The first stage of any project implementation is the “initiation stage”, in which project leaders define a project’s purpose and stakeholders and structures are put in place to support the new initiative. Our study’s objective was to identify factors affecting the initiation stage of an SDM program implementation project for TOLAC, trial of labor after Cesarean. We conducted a multiple-case study of an SDM program implementation in three obstetric settings in Washington State. The research design and analysis were guided by implementation science frameworks and project management literature. Data sources included interviews with key informants from the State, SDM tool vendors, and three project sites, as well as implementation documents. The study results provide insight into how the identified project implementation factors provide an essential foundation for informing project planning, execution, and reflection/evaluation. In this study, the State’s decision aid certification program pressured the project sites to shape the project purpose and engage stakeholders that would meet immediate project requirements (specifically, state requirements). The study reveals that external demands may not be in perfect alignment with the internal necessities required for an SDM program’s long-term viability and sustainability. Findings may be used by implementers and researchers to model and strategize the early stages of SDM program implementation projects, particularly in the obstetric setting.
Kohonen Neural Network Investigation of the Effects of the Visual, Proprioceptive and Vestibular Systems to Balance in Young Healthy Adult Subjects
Authors: Ojie Oseikhuemen Davis , Saatchi Reza
Published: September 2021

Kohonen neural network (KNN) was used to investigate the effects of the visual, proprioceptive and vestibular systems using the sway information in the mediolateral (ML) and anterior-posterior (AP) directions, obtained from an inertial measurement unit, placed at the lower backs of 23 healthy adult subjects (10 males, 13 females, mean (standard deviation) age: 24.5 (4.0) years, height: 173.6 (6.8) centimeter, weight: 72.7 (9.9) kg). The measurements were based on the modified Clinical Test of Sensory Interaction and Balance (mCTSIB). KNN clustered the subjects’ time-domain sway measures by processing their sway’s root mean square position, velocity, and acceleration. Clustering effectiveness was established using external performance indicators such as purity, precision-recall, and F-measure. Differences in these measures, from the clustering of each mCTSIB condition with its condition, were used to extract information about the balance-related sensory systems, where smaller values indicated reduced sway differences. The results for the parameters of purity, precision, recall, and F-measure were higher in the AP direction as compared to the ML direction by 7.12%, 11.64%, 7.12%, and 9.50% respectively, with their differences statistically significant (p < 0.05) thus suggesting the related sensory systems affect majorly the AP direction sway as compared to the ML direction sway. Sway differences in the ML direction were lowest in the presence of the visual system. It was concluded that the effect of the visual system on the balance can be examined mostly by the ML sway while the proprioceptive and vestibular systems can be examined mostly by the AP direction sway.
Early Spatiotemporal Patterns and Population Characteristics of the COVID-19 Pandemic in Southeast Asia
Authors: Zhu Mingjian , Kleepbua Jirapat , Guan Zhou , Chew Sien Ping , Tan Joanna Weihui , Shen Jian , Latthitham Natthjija , Hu Jianxiong , Law Jia Xian , Li Lanjuan
Published: September 2021

This observational study aims to investigate the early disease patterns of coronavirus disease 2019 (COVID-19) in Southeast Asia, consequently providing historical experience for further interventions. Data were extracted from official websites of the WHO and health authorities of relevant countries. A total of 1346 confirmed cases of COVID-19, with 217 recoveries and 18 deaths, were reported in Southeast Asia as of 16 March 2020. The basic reproductive number (R0) of COVID-19 in the region was estimated as 2.51 (95% CI:2.31 to 2.73), and there were significant geographical variations at the subregional level. Early transmission dynamics were examined with an exponential regression model: y = 0.30e0.13x (p < 0.01, R2 = 0.96), which could help predict short-term incidence. Country-level disease burden was positively correlated with Human Development Index (r = 0.86, p < 0.01). A potential early shift in spatial diffusion patterns and a spatiotemporal cluster occurring in Malaysia and Singapore were detected. Demographic analyses of 925 confirmed cases indicated a median age of 44 years and a sex ratio (male/female) of 1.25. Age may play a significant role in both susceptibilities and outcomes. The COVID-19 situation in Southeast Asia is challenging and unevenly geographically distributed. Hence, enhanced real-time surveillance and more efficient resource allocation are urgently needed.
Organizational Strategies for the Management of Intravenous Iron Therapy in Non-Hospitalized Settings: A Safe Opportunity to Implement Patient Blood Management in Italy
Authors: Bolcato Matteo , Beverina Ivo , Rodriguez Daniele , Aprile Anna , Trabucco Aurilio Marco
Published: September 2021

This article analyzes the recommendations issued by the Emilia Romagna region in July 2020 on “Organizational strategies for the safe management of intravenous iron therapy in patients in non-hospitalized settings”. The objective of these recommendations is to set up safe intravenous iron administration sites outside the hospital environment across the national territory. The document facilitates the organization of methods for intravenous iron infusion that are safe for the patient and correct from a medico-legal perspective. In addition, it opens the way for the widespread use of iron infusion in the field, providing benefits to patient quality of life. This program prevents unnecessary transfusions, reduces costs, prevents overcrowding in hospitals in the event of a pandemic, and enables patient treatment in the field, thus, saving on the use of personnel.
Estimation of Human Mobility Patterns for Forecasting the Early Spread of Disease
Authors: Li Zhengyan , Li Huichun , Zhang Xue , Zhao Chengli
Published: September 2021

Human mobility data are indispensable in modeling large-scale epidemics, especially in predicting the spatial spread of diseases and in evaluating spatial heterogeneity intervention strategies. However, statistical data that can accurately describe large-scale population migration are often difficult to obtain. We propose an algorithm model based on the network science approach, which estimates the travel flow data in mainland China by transforming location big data and airline operation data into network structure information. In addition, we established a simplified deterministic SEIR (Susceptible-Exposed-Infectious-Recovered)-metapopulation model to verify the effectiveness of the estimated travel flow data in the study of predicting epidemic spread. The results show that individual travel distance in mainland China is mainly within 100 km. There is far more travel between prefectures within the same province than across provinces. The epidemic spatial spread model incorporating estimated travel data accurately predicts the spread of COVID-19 in mainland China. The results suggest that there are far more travelers than usual during the Spring Festival in mainland China, and the number of travelers from Wuhan mainly determines the number of confirmed cases of COVID-19 in each prefecture.
The Dental Aesthetic Index and Its Association with Dental Caries, Dental Plaque and Socio-Demographic Variables in Schoolchildren Aged 12 and 15 Years
Authors: Fernández-Riveiro Paula , Obregón-Rodríguez Nerea , Piñeiro-Lamas María , Rodríguez-Fernández Almudena , Smyth-Chamosa Ernesto , Suárez-Cunqueiro María Mercedes
Published: September 2021

The Dental Aesthetic Index (DAI) was determined in 12- and 15-year-old schoolchildren to ascertain the prevalence of malocclusion and to assess its association with dental caries experience, dental plaque accumulation, and socio-demographic variables. We performed a cross-sectional study with a stratified two-stage sampling design. An oral health survey and oral examination were conducted, and socio-demographic data were recorded. The sample comprised 1453 schoolchildren aged 12 (868) and 15 (585). These two samples were analyzed separately because statistically significant differences were found: the 12-year-old age group displayed a higher frequency of schoolchildren who attended state-run public schools (p = 0.004) and belonged to a lower social class (p = 0.001); the 15-year-old age group registered higher levels of caries (p = 0.001) and lower levels of dental plaque (p < 0.001). The malocclusion was 9.5% higher (p = 0.001), and the global mean DAI score was likewise higher among the 12-year-olds (p < 0.001). The multivariate regression analysis not only showed that caries and dental plaque were the variables that were the most strongly associated with malocclusion, but that caries (OR = 1.5) and dental plaque (OR > 2) were also risk factors for malocclusion in both groups. In conclusion, this study revealed a higher prevalence of malocclusion and dental plaque at age 12. A higher risk of caries and dental plaque was found to be related to the presence of malocclusion in both age groups.
Risk Management of COVID-19 in the Residential Educational Setting: Lessons Learned and Implications for Moving Forward
Authors: Cass Anna L. , Slining Meghan M. , Carson Connie , Cassidy Jason , Epright M. Carmela , Gilchrist Ann E. , Peterson Kenneth , Wheeler John F. , The Natalie S.
Published: September 2021

With limited COVID-19-guidelines for institutions of higher education (IHEs), colleges and universities began the 2020–2021 academic year with varying approaches. We present a comprehensive COVID-19 prevention and mitigation approach at a residential university during the 2020–2021 academic year, along with campus SARS-CoV-2 transmission during this time. Risk management of COVID-19 was facilitated through (1) a layered approach of primary, secondary, and tertiary prevention measures; (2) a robust committee structure leveraging institutional public health expertise; (3) partnerships with external health entities; and (4) an operations system providing both structure and flexibility to adapt to changes in disease activity, scientific evidence, and public health guidelines. These efforts collectively allowed the university to mitigate SARS-CoV-2 transmission on campus and complete the academic year offering in-person learning on a residential campus. We identified 36 cases of COVID-19 among the 2037 in-person learners during the fall semester, 125 cases in the inter-semester break, and 169 cases among 2095 in-person learners during the spring semester. SARS-CoV-2 infection during the academic year was associated with gender (p = 0.04), race/ethnicity (p = 0.01), and sorority/fraternity membership (p < 0.01). Infection was not associated with undergraduate vs. graduate student status, Division I athlete status, or housing type (all p > 0.05). A multi-faceted public health approach was critical for reducing the impact of COVID-19 while carrying out the university’s educational mission.
Influences of Flipped Teaching in Electronics Courses on Students’ Learning Effectiveness and Strategies
Authors: Lo Chih-Cheng , Hsieh Ming-Hsien , Lin Hsiao-Hsien , Hung Hsu-Hung
Published: September 2021

The potential influence of the COVID-19 pandemic has changed the status of school education and further accelerated the revolution of regular teaching method. This study compared the learning effectiveness and learning strategies of vocational high school students in flipped teaching and traditional teaching modes. By adopting flipped teaching on an electronics course throughout the entire academic year, this study aimed to explore the effect of learning strategies of the students under flipped teaching. The subjects of this study were 85 sophomore students majoring in Electrical Engineering. This study randomly selected one class as the control group (n = 43), and adopted the regular teaching method while another class was selected as the experimental group (n = 42), and employed the flipped teaching method. This study used the “Learning strategy scale of students in vocational high schools” as the instrument. The students’ scores of the Testing Center for Technological and Vocational Education Test were used to evaluate their learning effectiveness. The results of this study indicate that students under the flipped teaching model made remarkable progress in the electronics course and the learning outcomes remained significant after a long period of time. Moreover, they made notable changes in their learning strategies, including “learning motivation”, “reading and exams”, “self-testing”, and “problem solving strategies”.
Matrix of Architectural Solutions for the Conflict between Transport Infrastructures, Landscape and Urban Habitat along the Mediterranean Coastline: The Case of the Maresme Region in Barcelona, Spain
Authors: Martínez Anna , Martín Xavier , Gordon Jordi
Published: September 2021

Maresme is a littoral region of Barcelona (Spain) in which the railway and an important road run along the coastline with a high landscape impact. Over time, several facilities connected to these transport infrastructures have appeared, such as industries, malls, marinas or train stations. These activities profit from the easy connection but create a barrier between the inhabitants and the sea. This research follows three aspects identified in a large variety of locations along the Mediterranean coast: longitudinal mobility, transversal accessibility and landscape discontinuities. The first territorial analysis defines a series of urban problematics classified by category. Then, the most representative case studies are developed by means of urban and architectural projects. The comparative analysis of these proposals provides a catalogue of design strategies which can be combined as criteria for solving multiple conflicts detected in the region. The result of this project is a methodology based on a matrix of general guidelines to ease the solving of local conflicts in a homogeneous way for the whole territory. The final aim is to re-establish order and continuity in the Mediterranean littoral skyline, fostering sustainable mobility and recovering public space for inhabitants.
Learning and Expertise in Mineral Exploration Decision-Making: An Ecological Dynamics Perspective
Authors: Davies Rhys Samuel , Davies Marianne Julia , Groves David , Davids Keith , Brymer Eric , Trench Allan , Sykes John Paul , Dentith Michael
Published: September 2021

The declining discovery rate of world-class ore deposits represents a significant obstacle to future global metal supply. To counter this trend, there is a requirement for mineral exploration to be conducted in increasingly challenging, uncertain, and remote environments. Faced with such increases in task and environmental complexity, an important concern in exploratory activities are the behavioural challenges of information perception, interpretation and decision-making by geoscientists tasked with discovering the next generation of deposits. Here, we outline the Dynamics model, as a diagnostic tool for situational analysis and a guiding framework for designing working and training environments to maximise exploration performance. The Dynamics model is based on an Ecological Dynamics framework, combining Newell’s Constraints model, Self Determination Theory, and including feedback loops to define an autopoietic system. By implication of the Dynamics model, several areas are highlighted as being important for improving the quality of exploration. These include: (a) provision of needs-supportive working environments that promote appropriate degrees of effort, autonomy, creativity and technical risk-taking; (b) an understanding of the wider motivational context, particularly the influence of tradition, culture and other ‘forms of life’ that constrain behaviour; (c) relevant goal-setting in the design of corporate strategies to direct exploration activities; and (d) development of practical, representative scenario-based training interventions, providing effective learning environments, with digital media and technologies presenting decision-outcome feedback, to assist in the development of expertise in mineral exploration targeting.
Validation of TMMS-24 in Three Spanish-Speaking Countries: Argentina, Ecuador, and Spain
Authors: Górriz Ana Belén , Etchezahar Edgardo , Pinilla-Rodríguez Diego E. , Giménez-Espert María del Carmen , Soto-Rubio Ana
Published: September 2021

Emotional intelligence (EI) is a fundamental skill related to different aspects of human life, such as psychological well-being or mood states. The present study has a triple objective: first, to explore the psychometric properties of the TMMS-24 in three Spanish-speaking countries (Argentina, Ecuador, and Spain); second, to examine the relation of EI with mood and avoidance of responsibility; and finally, to analyse the influence of sex, age and national differences on EI. The relevance of this study is given by the need for tools to assess EI in different cultures. A sample of 1048 adults (Mage = 21.11 years, SD = 5.84; 52.3% male) was selected by convenience sampling. The psychometric properties of the TMMS-24 were adequate, and the Spanish sample showed lower levels of EI than the Argentinian and Ecuadorian ones. EI was associated with mood and the avoidance of responsibility, with higher levels in women in all cases. Regarding the national and sex-specific differences, the Spanish sample showed significant differences in attention and repair, with men exhibiting higher scores in attention and women having higher scores in repair. In the Argentinean sample, no significant differences were found, and in the Ecuadorian one, women presented higher scores in attention than men. The TMMS-24 can be considered a useful, practical tool to assess EI in adults in different cultures and with different languages.
Oxidative Stress and Inflammation, MicroRNA, and Hemoglobin Variations after Administration of Oxygen at Different Pressures and Concentrations: A Randomized Trial
Authors: Bosco Gerardo , Paganini Matteo , Giacon Tommaso Antonio , Oppio Alberto , Vezzoli Alessandra , Dellanoce Cinzia , Moro Tatiana , Paoli Antonio , Zanotti Federica , Zavan Barbara , Balestra Costantino , Mrakic-Sposta Simona
Published: September 2021

Exercise generates reactive oxygen species (ROS), creating a redox imbalance towards oxidation when inadequately intense. Normobaric and hyperbaric oxygen (HBO) breathed while not exercising induces antioxidant enzymes expression, but literature is still poor. Twenty-two athletes were assigned to five groups: controls; 30%, or 50% O2; 100% O2 (HBO) at 1.5 or 2.5 atmosphere absolute (ATA). Twenty treatments were administered on non-training days. Biological samples were collected at T0 (baseline), T1 (end of treatments), and T2 (1 month after) to assess ROS, antioxidant capacity (TAC), lipid peroxidation, redox (amino-thiols) and inflammatory (IL-6, 10, TNF-α) status, renal function (i.e., neopterin), miRNA, and hemoglobin. At T1, O2 mixtures and HBO induced an increase of ROS, lipid peroxidation and decreased TAC, counterbalanced at T2. Furthermore, 50% O2 and HBO treatments determined a reduced state in T2. Neopterin concentration increased at T1 breathing 50% O2 and HBO at 2.5 ATA. The results suggest that 50% O2 treatment determined a reduced state in T2; HBO at 1.5 and 2.5 ATA similarly induced protective mechanisms against ROS, despite the latter could expose the body to higher ROS levels and neopterin concentrations. HBO resulted in increased Hb levels and contributed to immunomodulation by regulating interleukin and miRNA expression.
The Road from Pathological Narcissism to Suicidality in Adolescence: An Empirical Study
Authors: Williams Riccardo , Casini Maria Pia , Moselli Marta , Frattini Camilla , Ronningstam Elsa
Published: September 2021

Background: Clinical and empirical research evidenced a complex link between pathological narcissism and the suicidal process in adulthood. Given the relevance of suicidality and the peculiar narcissistic vicissitudes of adolescence, the proposed research investigated the relationship between pathological narcissism analyzed from the multi-dimensional perspective of the Diagnostic Interview for Narcissism (DIN) and suicidal ideation conducted in a sample of Italian Adolescents. Methods: One hundred and three Italian male and female adolescents between 12 and 18 were administered the DIN, SCIDII, CSSRS, and Kiddie-SADS with six months follow-up. Results: The correlation, t-test, multiple regression analyses evidenced the association of narcissistic affective states and mood with both suicidal ideation and lethality of conduct. The increase in the dimension of grandiosity is associated with the passage to potentially highly lethal suicidal gestures. Conclusions: Suicidal ideation and conduct seem to serve the function of restoring a sense of control and self-esteem in narcissistic individuals experiencing a state of affective dysregulation. Narcissistic pathological functioning seems to play an important role in the adolescent suicidal process, quite like adulthood. Assessing an adolescent’s narcissistic functioning may provide useful clinical information in understanding and managing the suicidal risk in this phase of life.
The Mediating Role of Resilience in the Relationship between Perceived Stress and Mental Health
Authors: Lara-Cabrera Mariela Loreto , Betancort Moisés , Muñoz-Rubilar C. Amparo , Rodríguez Novo Natalia , De las Cuevas Carlos
Published: September 2021

The COVID-19 pandemic has created great uncertainty around the world, and due to the pandemic, nurses have been exposed to an increase in highly stressful clinical situations. This study examines the relationships between perceived stress and emotional disorders among nurses who have provided direct patient care during the COVID-19 pandemic and explores the mediating role of resilience in these relationships. In an online cross-sectional design, we asked Spanish nurses (N = 214) to complete self-reported scales, and we performed correlation and mediation analyses between perceived stress (Perceived Stress Scale, PSS-4), resilience (Wagnild Resilience Scale, RS-14), wellbeing (World Health Organization Wellbeing Index, five items, WHO-5), anxiety (PHQ-2) and depression (GAD-2). The nurses self-reported moderate levels of perceived stress, considerable psychological distress and high resilience. We found resilience to be significantly negatively correlated with the reported levels of perceived stress, anxiety and depression (p < 0.001). The mediating analysis revealed that resilience played a protective role in the direct relationships of stress with depression, anxiety, and psychological distress. To conclude, our findings supported the hypothesis that resilience mediated the relationship between stress and mental health.
Prognosis of Hypothermic Patients Undergoing ECLS Rewarming—Do Alterations in Biochemical Parameters Matter?
Authors: Hymczak Hubert , Podsiadło Paweł , Kosiński Sylweriusz , Pasquier Mathieu , Mendrala Konrad , Hudziak Damian , Gocoł Radosław , Plicner Dariusz , Darocha Tomasz
Published: September 2021

Background: While ECLS is a highly invasive procedure, the identification of patients with a potentially good prognosis is of high importance. The aim of this study was to analyse changes in the acid-base balance parameters and lactate kinetics during the early stages of ECLS rewarming to determine predictors of clinical outcome. Methods: This single-centre retrospective study was conducted at the Severe Hypothermia Treatment Centre at John Paul II Hospital in Krakow, Poland. Patients ≥18 years old who had a core temperature (Tc) < 30 °C and were rewarmed with ECLS between December 2013 and August 2018 were included. Acid-base balance parameters were measured at ECLS implantation, at Tc 30 °C, and at 2 and 4 h after Tc 30 °C. The alteration in blood lactate kinetics was calculated as the percent change in serum lactate concentration relative to the baseline. Results: We included 50 patients, of which 36 (72%) were in cardiac arrest. The mean age was 56 ± 15 years old, and the mean Tc was 24.5 ± 12.6 °C. Twenty-one patients (42%) died. Lactate concentrations in the survivors group were significantly lower than in the non-survivors at all time points. In the survivors group, the mean lactate concentration decreased −2.42 ± 4.49 mmol/L from time of ECLS implantation until 4 h after reaching Tc 30 °C, while in the non-survivors’ group (p = 0.024), it increased 1.44 ± 6.41 mmol/L. Conclusions: Our results indicate that high lactate concentration is associated with a poor prognosis for hypothermic patients undergoing ECLS rewarming. A decreased value of lactate kinetics at 4 h after reaching 30 °C is also associated with a poor prognosis.
A Study of Environmentally Friendly Menstrual Absorbents in the Context of Social Change for Adolescent Girls in Low- and Middle-Income Countries
Authors: Foster Jasmin , Montgomery Paul
Published: September 2021

Girls in low- and middle-income countries struggle to maintain good menstrual hygiene in part due to a lack of affordable sanitary products. The unaffordability of reliable sanitary products can lead to school absenteeism and is a barrier to education attainment and gender equality for girls in low-income contexts. Further, the lack of adequate disposal facilities can lead to social embarrassment and environmental pollution. Low-cost biodegradable absorbents (cotton terry cloth, linen, hemp cloth and bamboo wadding) were investigated in gelatine solution in terms of their absorption for use in menstrual hygiene. Bamboo wadding exhibits the highest absorption index (7.86), greater than cotton terry cloth (0.84), hemp cloth (1.4), linen (1.57) and a commercial sanitary pad (4.38). Though the absorption index of bamboo wadding is promising, especially in light of the vast availability of bamboo in tropical low- and middle-income countries, challenges lie in overcoming complex extraction processes from bamboo plants, which is discussed. This simple research of a physical material from a technical aspect, if further investigated with a social science and policy lens, could increase school attendance, improve the education levels attained by girls and be a key step towards gender equality in low- and middle-income countries.
The Association between Diabetes Mellitus and Keratoplasty in Poland in the Years 2013–2017
Authors: Kozioł Milena , Nowak Michał Szymon , Udziela Monika , Szaflik Jacek Paweł
Published: September 2021

Background: The aim of this study is to assess the incidence and characteristic of corneal grafts and its association with diabetes mellitus in Poland in the years 2013–2017. Methods: The retrospective survey of the National Database of Hospitalizations was performed to identify all the corneal transplantations in Poland between January 2013 and December 2017. The comorbid diseases, in particular diabetes mellitus, were verified in the patients’ medical history. The logistic regression was applied to demonstrate the factors related to urgent surgeries. Results: In total, 5069 corneal grafts in 4710 patients were reported in the years 2013–2017. The number of CTs gradually increased by 37% from 914 (2.37 surgeries per one hundred thousand population) in the year 2013 to 1250 (3.25 surgeries per one hundred thousand population) in 2017, the final year of the study. CT incidence was the highest in subjects aged 70 years or older: 13.18 per one hundred thousand population in the year 2017. On average, about 22.43% of procedures were performed in patients with DM. The chance of urgent surgery was mostly correlated with full thickness CT and patients’ age. Conclusions: Despite the relatively low value of CT in Poland, there was an increasing number of CTs in the analyzed period.
Hypothesizing Nutrigenomic-Based Precision Anti-Obesity Treatment and Prophylaxis: Should We Be Targeting Sarcopenia Induced Brain Dysfunction?
Authors: Blum Kenneth , Gold Mark S. , Llanos-Gomez Luis , Jalali Rehan , Thanos Panayotis K. , Bowirrat Abdalla , Downs William B. , Bagchi Debasis , Braverman Eric R. , Baron David , Roy Alphonso Kenison , Badgaiyan Rajendra D.
Published: September 2021

Background: The United States Centers for Disease Control and Prevention (CDC) estimates a total obesity rate of 30% for 12 states and a 20% obesity rate nationwide. The obesity epidemic continues to increase in spite of preventative measures undertaken worldwide. Pharmacological treatments promise to reduce total fat mass. However, medications may have significant side effects and can be potentially fatal. Data Retrieval: This brief review, based on a PUBMED search of the key terms “Obesity” and” Sarcopenia,” will present evidence to corroborate the existence of Reward Deficiency Syndrome (RDS) in obesity and the involvement of catecholaminergic pathways in substance seeking behavior, particularly as it relates to carbohydrates cravings. Expert Opinion: The genetic basis and future genetic testing of children for risk of aberrant generalized craving behavior are considered a prevention method. Here we present evidence supporting the use of precursor amino acid therapy and modulation of enkephalinase, MOA, and COMT inhibition in key brain regions. Such treatments manifest in improved levels of dopamine/norepinephrine, GABA, serotonin, and enkephalins. We also present evidence substantiating insulin sensitivity enhancement via Chromium salts, which affect dopamine neuronal synthesis regulation. We believe our unique combination of natural ingredients will influence many pathways leading to the promotion of well-being and normal healthy metabolic functioning. Sarcopenia has been shown to reduce angiogenesis and possible cerebral blood flow. Exercise seems to provide a significant benefit to overcome this obesity-promoting loss of muscle density. Conclusion: Utilization of proposed nutrigenomic formulae based on coupling genetic obesity risk testing promotes generalized anti-craving of carbohydrates and can inhibit carbohydrate bingeing, inducing significant healthy fat loss and relapse prevention.
Assessing the Impacts of Hierarchical Healthcare System on the Accessibility and Spatial Equality of Healthcare Services in Shenzhen, China
Authors: Tao Zhuolin , Han Wenchao
Published: September 2021

The hierarchical healthcare system is widely considered to be a desirable mode of the delivery of healthcare services. It is expected that the establishment of a hierarchical healthcare system can help provide better and more equal healthcare accessibility. However, limited evidence has been provided on the impacts of a hierarchical healthcare system on healthcare accessibility. This study develops an improved Hierarchical two-step floating catchment area (2SFCA) method, which incorporates variable catchment area sizes, distance friction effects and utilization efficiency for facilities at different levels. Leveraging the Hierarchical 2SFCA method, various scenarios are set up to assess the accessibility impacts of a hierarchical healthcare system. The methods are applied in a case study of Shenzhen. The results reveal significant disparity and inequality in healthcare accessibility and also differences between various facility levels in Shenzhen. The overall healthcare accessibility and its equality can be significantly improved by fully utilizing existing facilities. It is also demonstrated that allocating additional supply to lower-level facilities can generate larger accessibility gains. Furthermore, allocating new supply to primary facilities would mitigate the inequality in healthcare accessibility, whereas inequality tends to be aggravated with new supply allocated to tertiary facilities. These impacts cannot be captured by traditional accessibility measures. This study demonstrates the pivotal role of primary facilities in the hierarchical healthcare system. It can contribute to the literature by providing transferable methods and procedures for measuring hierarchical healthcare accessibility and assessing accessibility impacts of a hierarchical healthcare system in developing countries.
Indoor Traveling Salesman Problem (ITSP) Path Planning
Authors: Yan Jinjin , Zlatanova Sisi , Lee Jinwoo (Brian) , Liu Qingxiang
Published: September 2021

With the growing complexity of indoor living environments, people have an increasing demand for indoor navigation. Currently, navigation path options in indoor are monotonous as existing navigation systems commonly offer single-source shortest-distance or fastest paths. Such path options might be not always attractive. For instance, pedestrians in a shopping mall may be interested in a path that navigates through multiple places starting from and ending at the same location. Here, we name it as the indoor traveling salesman problem (ITSP) path. As its name implies, this path type is similar to the classical outdoor traveling salesman problem (TSP), namely, the shortest path that visits a number of places exactly once and returns to the original departure place. This paper presents a general solution to the ITSP path based on Dijkstra and branch and bound (B&B) algorithm. We demonstrate and validate the method by applying it to path planning in a large shopping mall with six floors, in which the QR (Quick Response) codes are assumed to be utilized as the indoor positioning approach. The results show that the presented solution can successfully compute the ITSP paths and their potentials to apply to other indoor navigation applications at museums or hospitals.
Improving Room-Level Location for Indoor Trajectory Tracking with Low IPS Accuracy
Authors: Kim Taehoon , Kim Kyoung-Sook , Li Ki-Joune
Published: September 2021

With the development of indoor positioning methods, such as Wi-Fi positioning, geomagnetic sensor positioning, Ultra-Wideband positioning, and pedestrian dead reckoning, the area of location-based services (LBS) is expanding from outdoor to indoor spaces. LBS refers to the geographic location information of moving objects to provide the desired services. Most Wi-Fi-based indoor positioning methods provide two-dimensional (2D) or three-dimensional (3D) coordinates in 1–5 m of accuracy on average approximately. However, many applications of indoor LBS are targeted to specific spaces such as rooms, corridors, stairs, etc. Thus, they require determining a service space from a coordinate in indoor spaces. In this paper, we propose a map matching method to assign an indoor position to a unit space a subdivision of an indoor space, called USMM (Unit Space Map Matching). Map matching is a commonly used localization improvement method that utilizes spatial constraints. We consider the topological information between unit spaces and moving objects’ probabilistic properties, compared to existing room-level mappings based on sensor signals, especially received signal strength-based fingerprinting. The proposed method has the advantage of calculating the probability even if there is only one input trajectory. Last, we analyze the accuracy and performance of the proposed USMM methods by extensive experiments in real and synthetic environments. The experimental results show that our methods bring a significant improvement when the accuracy level of indoor positioning is low. In experiments, the room-level location accuracy improves by almost 30% and 23% with real and synthetic data, respectively. We conclude that USMM methods are helpful to correct valid room-level locations from given positioning locations.
Oxytocin and Fear Memory Extinction: Possible Implications for the Therapy of Fear Disorders?
Authors: Baldi Elisabetta , Costa Alessia , Rani Barbara , Passani Maria Beatrice , Blandina Patrizio , Romano Adele , Provensi Gustavo
Published: September 2021

Several psychiatric conditions such as phobias, generalized anxiety, and post-traumatic stress disorder (PTSD) are characterized by pathological fear and anxiety. The main therapeutic approach used in the management of these disorders is exposure-based therapy, which is conceptually based upon fear extinction with the formation of a new safe memory association, allowing the reduction in behavioral conditioned fear responses. Nevertheless, this approach is only partially resolutive, since many patients have difficulty following the demanding and long process, and relapses are frequently observed over time. One strategy to improve the efficacy of the cognitive therapy is the combination with pharmacological agents. Therefore, the identification of compounds able to strengthen the formation and persistence of the inhibitory associations is a key goal. Recently, growing interest has been aroused by the neuropeptide oxytocin (OXT), which has been shown to have anxiolytic effects. Furthermore, OXT receptors and binding sites have been found in the critical brain structures involved in fear extinction. In this review, the recent literature addressing the complex effects of OXT on fear extinction at preclinical and clinical levels is discussed. These studies suggest that the OXT roles in fear behavior are due to its local effects in several brain regions, most notably, distinct amygdaloid regions.
Increased Autotaxin Levels in Severe COVID-19, Correlating with IL-6 Levels, Endothelial Dysfunction Biomarkers, and Impaired Functions of Dendritic Cells
Authors: Nikitopoulou Ioanna , Fanidis Dionysios , Ntatsoulis Konstantinos , Moulos Panagiotis , Mpekoulis George , Evangelidou Maria , Vassiliou Alice G. , Dimakopoulou Vasiliki , Jahaj Edison , Tsipilis Stamatios , Orfanos Stylianos E. , Dimopoulou Ioanna , Angelakis Emmanouil , Akinosoglou Karolina , Vassilaki Niki , Tzouvelekis Argyrios , Kotanidou Anastasia , Aidinis Vassilis
Published: September 2021

Autotaxin (ATX; ENPP2) is a secreted lysophospholipase D catalyzing the extracellular production of lysophosphatidic acid (LPA), a pleiotropic signaling phospholipid. Genetic and pharmacologic studies have previously established a pathologic role for ATX and LPA signaling in pulmonary injury, inflammation, and fibrosis. Here, increased ENPP2 mRNA levels were detected in immune cells from nasopharyngeal swab samples of COVID-19 patients, and increased ATX serum levels were found in severe COVID-19 patients. ATX serum levels correlated with the corresponding increased serum levels of IL-6 and endothelial damage biomarkers, suggesting an interplay of the ATX/LPA axis with hyperinflammation and the associated vascular dysfunction in COVID-19. Accordingly, dexamethasone (Dex) treatment of mechanically ventilated patients reduced ATX levels, as shown in two independent cohorts, indicating that the therapeutic benefits of Dex include the suppression of ATX. Moreover, large scale analysis of multiple single cell RNA sequencing datasets revealed the expression landscape of ENPP2 in COVID-19 and further suggested a role for ATX in the homeostasis of dendritic cells, which exhibit both numerical and functional deficits in COVID-19. Therefore, ATX has likely a multifunctional role in COVID-19 pathogenesis, suggesting that its pharmacological targeting might represent an additional therapeutic option, both during and after hospitalization.
Enhanced Thermostability of D-Psicose 3-Epimerase from Clostridium bolteae through Rational Design and Engineering of New Disulfide Bridges
Authors: Zhao Jingyi , Chen Jing , Wang Huiyi , Guo Yan , Li Kai , Liu Jidong
Published: September 2021

D-psicose 3-epimerase (DPEase) catalyzes the isomerization of D-fructose to D-psicose (aka D-allulose, a low-calorie sweetener), but its industrial application has been restricted by the poor thermostability of the naturally available enzymes. Computational rational design of disulfide bridges was used to select potential sites in the protein structure of DPEase from Clostridium bolteae to engineer new disulfide bridges. Three mutants were engineered successfully with new disulfide bridges in different locations, increasing their optimum catalytic temperature from 55 to 65 °C, greatly improving their thermal stability and extending their half-lives (t1/2) at 55 °C from 0.37 h to 4–4.5 h, thereby greatly enhancing their potential for industrial application. Molecular dynamics simulation and spatial configuration analysis revealed that introduction of a disulfide bridge modified the protein hydrogen–bond network, rigidified both the local and overall structures of the mutants and decreased the entropy of unfolded protein, thereby enhancing the thermostability of DPEase.