bluuebunny/crossref_metadata_2025 huggingface dataset:
Electrically Tunable Lenses: A Review
Authors: Chen Leihao , Ghilardi Michele , Busfield James J. C. , Carpi Federico
Published: June 2021

Optical lenses with electrically controllable focal length are of growing interest, in order to reduce the complexity, size, weight, response time and power consumption of conventional focusing/zooming systems, based on glass lenses displaced by motors. They might become especially relevant for diverse robotic and machine vision-based devices, including cameras not only for portable consumer electronics (e.g. smart phones) and advanced optical instrumentation (e.g. microscopes, endoscopes, etc.), but also for emerging applications like small/micro-payload drones and wearable virtual/augmented-reality systems. This paper reviews the most widely studied strategies to obtain such varifocal “smart lenses”, which can electrically be tuned, either directly or via electro-mechanical or electro-thermal coupling. Only technologies that ensure controllable focusing of multi-chromatic light, with spatial continuity (i.e. continuous tunability) in wavefronts and focal lengths, as required for visible-range imaging, are considered. Both encapsulated fluid-based lenses and fully elastomeric lenses are reviewed, ranging from proof-of-concept prototypes to commercially available products. They are classified according to the focus-changing principles of operation, and they are described and compared in terms of advantages and drawbacks. This systematic overview should help to stimulate further developments in the field.
Oral Health Policies to Tackle the Burden of Early Childhood Caries: A Review of 14 Countries/Regions
Authors: Chen Jieyi , Duangthip Duangporn , Gao Sherry Shiqian , Huang Fang , Anthonappa Robert , Oliveira Branca Heloisa , Turton Bathsheba , Durward Callum , El Tantawi Maha , Attia Dina , Heima Masahiro , Muthu Murugan Satta , Maharani Diah Ayu , Folayan Morenik Oluwatoyin , Phantumvanit Prathip , Sitthisettapong Thanya , Innes Nicola , Crystal Yasmi O. , Ramos-Gomez Francisco , Medina Aida Carolina , Lo Edward Chin Man , Chu Chun Hung
Published: June 2021

Aim:Early childhood caries (ECC) has significant public health implications but has received inadequate global attention. There is limited information regarding the success of oral health policies implemented to address the challenges of ECC. This review aimed to summarize such policies to tackle ECC from different countries/regions.

Method:Independent collaborators from 14 countries/regions (Australia, Brazil, Cambodia, China, Hong Kong, Egypt, India, Indonesia, Japan, Nigeria, Thailand, UK, USA, and Venezuela) collected the data. The ECC status, dental workforce, oral health policies on ECC prevention in different countries/regions were summarized by each country.

Results:The findings indicated that ECC prevalence varied in different countries/regions. The lowest prevalence of ECC among 5-year-old children was found in Nigeria (7%), and the highest was found in Indonesia (90%). The existing dental workforce and resources are limited in most countries. The smallest dentist to population ratio was reported by Nigeria at 1:48,400, whereas the highest ratio was in Brazil (1:600). Out of 14, three (21%) countries namely India, Venezuela and Cambodia had no national oral health policies addressing ECC and four (29%) countries (Cambodia, China, India, Venezuela) had no publicly funded dental care program for 0–5-year-old children. Water fluoridation is available in four countries/regions (Australia, Brazil, Hong Kong, USA).

Conclusion:ECC remains a global health challenge and dental workforce is limited. National/regional programs to tackle ECC are not yet prioritized in many countries/regions. Evidence to support demonstration projects is limited. Further research on the cost-effectiveness of interventions strategies is required for policymakers.
Evaluation of Feed Strategies and Changes of Stocking Rate to Decrease the Carbon Footprint in a Traditional Cow-Calf System: A Simulation Model
Authors: Toro-Mujica Paula
Published: June 2021

One of the main production challenges associated with climate change is the reduction of carbon emissions. Increasing the efficiency of resource utilization is one way to achieve this purpose. The modification of production systems through improved reproductive, genetic, feed, and grazing management practices has been proposed to increase technical–economic efficiency, even though the “environmental viability” of these modifications has not always been evaluated. The objective of this study was to evaluate the use of feeding and management strategies on the carbon footprint (CF) and economic variables in the traditional cow–calf system in southern Chile using a simulation model. The modifications evaluated corresponded to combinations of stocking rate, use of creep feeding practices with different supplementation levels, and the incorporation of feed additives to the supplement, using factorial experiments. Additionally, the scenarios were evaluated with and without carbon sequestration. The CF for the baseline scenarios was 12.5 ± 0.3 kg of CO2−eq/kg of live weight (LW) when carbon sequestration was considered and 13.0 ± 0.4 kg of CO2−eq/kg of LW in the opposite case. Changes in stocking rate, supplementation level, and consideration of carbon sequestration in pasture and soil had a significant effect on the CF in all simulated scenarios. The inclusion of additives in the supplement did not have a significant effect on production costs. With regard to reducing greenhouse gas (GHG) emissions, incorporating canola oil presented the best average results. The model developed made the selection of environmentally viable feed strategies or management adaptations possible.
Maintenance and Growth Requirements in Male Dorper × Santa Ines Lambs
Authors: Mendes Marcilio S. , Souza Jocely G. , Herbster Caio Julio L. , Brito Neto Antonio S. , Silva Luciano P. , Rodrigues João Paulo P. , Marcondes Marcos I. , Oliveira Ronaldo L. , Bezerra Leilson R. , Pereira Elzania S.
Published: June 2021

The aim of this study was to estimate the energy and protein requirements for maintenance and growth of lambs. A total of 35 crossbreed Dorper × Santa Ines lambs [31 ± 1.28 kg of initial body weight (BW) and 4 months old] were distributed in a completely randomized design with three treatments groups (ad libitum, 30 and 60% of feed restriction). Five lambs were slaughtered at the beginning of the experimental trial as a reference group to estimate the initial empty BW (EBW) and body composition. When the animals of the ad libitum treatment reached a BW average of 47.2 kg, at day 84 of trial, all lambs were slaughtered. The feed restriction promoted reduction in body fat (P < 0.001) and energy concentration (P < 0.001), while protein showed a quadratic response (P = 0.05). The equations obtained for NEg and NPg requirements were 0.2984 × EBW0.75 × EBWG0.8069 and 248.617 × EBW−0.15546, respectively. The net energy (NEm) and protein (NPm) for maintenance were 71.00 kcal/kg EBW0.75/day and 1.76 g/kg EBW0.75/day, respectively. In conclusion, the NEg and NPg requirement for lambs with 30 kg of BW and 200 g of average daily gain (ADG) were 0.736 Mcal/day and 24.38 g/day, respectively. Our findings indicate that the NEm for crossbreed Dorper × Santa Ines lambs is similar to those recommended by the international committees; however, we support the hypothesis that the requirements for gain are lower.
Modeling and Fabrication of Soft Actuators Based on Fiber-Reinforced Elastomeric Enclosures
Authors: Chen Zhi , Zou Aicheng , Qin Zhantian , Han Xingguo , Li Tianming , Liu Shengkai
Published: June 2021

Unlike rigid actuators, soft actuators can easily adapt to complex environments. Understanding the relationship between the deformation of soft actuators and external factors such as pressure would enable rapid designs based on specific requirements, such as flexible, compliant endoscopes. An effective model is demonstrated that predicts the deformation of a soft actuator based on the virtual work principle and the geometrically exact Cosserat rod theory. The deformation process is analyzed for extension, bending, and twisting modules. A new manufacturing method is then introduced. Through any combination of modules, the soft actuator can have a greater workspace and more dexterity. The proposed model was verified for various fiber-reinforced elastomeric enclosures. There is good agreement between the model analysis and the experimental data, which indicates the effectiveness of the model.
Latest Advances in Sow Nutrition during Early Gestation
Authors: Langendijk Pieter
Published: June 2021

In the pig, the establishment and maintenance of luteal function in early gestation is crucial to endometrial function, embryo development, and survival. The level of feed intake has a positive effect on formation of luteal tissue and progesterone secretion by the ovaries in the pre-implantation period, which is important for endometrial remodeling and secretion. These effects are independent of luteinising hormone (LH) and probably driven by metabolic cues, such as insulin and insulin-like growth factor (IGF-1), and seem to support progesterone secretion and delivery to the endometrium, the latter which occurs directly, bypassing the systemic circulation. Even after implantation, a high feed intake seems to improve embryo survival and the maintenance of pregnancy. In this stage, luteal function is LH-dependent, although normal variations in energy intake may not result in pregnancy failure, but may contribute to nutrient supply to the embryos, since in this phase uterine capacity becomes limiting. Feed incidents, however, such as unintended fasting of animals or severe competition for feed, may result in embryo or even pregnancy loss, especially in periods of seasonal infertility. Specific nutrients such as arginine have a role in the vascularisation of the placenta and can improve the uterine capacity in the period after implantation.
Emergence of Hybrid Resistance and Virulence Plasmids Harboring New Delhi Metallo-β-Lactamase in Klebsiella pneumoniae in Russia
Authors: Starkova Polina , Lazareva Irina , Avdeeva Alisa , Sulian Ofeliia , Likholetova Darya , Ageevets Vladimir , Lebedeva Marina , Gostev Vladimir , Sopova Julia , Sidorenko Sergey
Published: June 2021

The emergence of carbapenem-resistant hypervirulent Klebsiella pneumoniae (CR-hvKp) is a new threat to healthcare. In this study, we analyzed nine CR-hvKp isolates of different sequence-types (ST) recovered from patients with nosocomial infections in two hospitals in Saint Petersburg. Whole-genome sequencing showed that eight of them harbored large mosaic plasmids carrying resistance to carbapenems and hypervirulence simultaneously, and four different types of hybrid plasmids were identified. BLAST analysis showed a high identity with two hybrid plasmids originating in the UK and Czech Republic. We demonstrated that hybrid plasmids emerged due to the acquisition of resistance genes by virulent plasmids. Moreover, one of the hybrid plasmids carried a novel New Delhi metallo-beta-lactamase (NDM) variant, differing from NDM-1 by one amino acid substitution (D130N), which did not provide significant evolutionary advantages compared to NDM-1. The discovery of structurally similar plasmids in geographically distant regions suggests that the actual distribution of hybrid plasmids carrying virulence and resistance genes is much wider than expected.
Test-Retest Reliability of Five Times Sit to Stand Test (FTSST) in Adults: A Systematic Review and Meta-Analysis
Authors: Muñoz-Bermejo Laura , Adsuar José Carmelo , Mendoza-Muñoz María , Barrios-Fernández Sabina , Garcia-Gordillo Miguel A. , Pérez-Gómez Jorge , Carlos-Vivas Jorge
Published: June 2021

Functional independence in adults is conditioned by lower limb muscle strength. Thus, it seems important to assess lower limb strength using reliable and easy to reproduce measurements. The purpose of this study was to conduct a systematic review and meta-analysis to collect studies that examined the test-retest reliability of the Five Times Sit to Stand Test (FTSST) in adults. The search was conducted in PubMed, Web of Science, and Scopus databases, including all studies published up to 28 December 2020. To be included, studies had to include relative reliability scores (ICC) and maximum torque or standard error of measurements (SEM) of FTSST. A total of 693 studies were initially identified, but only 8 met the eligibility criteria and were included in the meta-analysis, covering a total of 14 groups with 400 participants. Relative inter-rater reliability results (ICC = 0.937, p < 0.001, n = 400) revealed excellent reliability of FTSST to assess sitting and standing performance, lower limbs strength and balance control. Conclusion: The Five Times Sit to Stand Test is a highly reliable tool for assessing lower limbs strength, balance control, and mobility in both healthy adults and those with pathologies.
Diversity of Rainbow Trout Blood B Cells Revealed by Single Cell RNA Sequencing
Authors: Perdiguero Pedro , Morel Esther , Tafalla Carolina
Published: June 2021

Single-cell sequencing technologies capable of providing us with immune information from dozens to thousands of individual cells simultaneously have revolutionized the field of immunology these past years. However, to date, most of these novel technologies have not been broadly applied to non-model organisms such as teleost fish. In this study, we used the 10× Genomics single cell RNA sequencing technology and used it to analyze for the first time in teleost fish the transcriptional pattern of single B cells from peripheral blood. The analysis of the data obtained in rainbow trout revealed ten distinct cell clusters that seem to be associated with different subsets and/or maturation/differentiation stages of circulating B cells. The potential characteristics and functions of these different B cell subpopulations are discussed on the basis of their transcriptomic profile. The results obtained provide us with valuable information to understand the biology of teleost B cells and offer us a repertoire of potential markers that could be used in the future to differentiate trout B cell subsets.
Temporal Gradients Controlling Embryonic Cell Cycle
Authors: Liu Boyang , Zhao Han , Wu Keliang , Großhans Jörg
Published: June 2021

Cell proliferation in early embryos by rapid cell cycles and its abrupt pause after a stereotypic number of divisions present an attractive system to study the timing mechanism in general and its coordination with developmental progression. In animals with large eggs, such as Xenopus, zebrafish, or Drosophila, 11–13 very fast and synchronous cycles are followed by a pause or slowdown of the cell cycle. The stage when the cell cycle is remodeled falls together with changes in cell behavior and activation of the zygotic genome and is often referred to as mid-blastula transition. The number of fast embryonic cell cycles represents a clear and binary readout of timing. Several factors controlling the cell cycle undergo dynamics and gradual changes in activity or concentration and thus may serve as temporal gradients. Recent studies have revealed that the gradual loss of Cdc25 protein, gradual depletion of free deoxyribonucleotide metabolites, or gradual depletion of free histone proteins impinge on Cdk1 activity in a threshold-like manner. In this review, we will highlight with a focus on Drosophila studies our current understanding and recent findings on the generation and readout of these temporal gradients, as well as their position within the regulatory network of the embryonic cell cycle.
What Can N-glycomics and N-glycoproteomics of Cerebrospinal Fluid Tell Us about Alzheimer Disease?
Authors: Gaunitz Stefan , Tjernberg Lars O. , Schedin-Weiss Sophia
Published: June 2021

Proteomics—large-scale studies of proteins—has over the last decade gained an enormous interest for studies aimed at revealing proteins and pathways involved in disease. To fully understand biological and pathological processes it is crucial to also include post-translational modifications in the “omics”. To this end, glycomics (identification and quantification of glycans enzymatically or chemically released from proteins) and glycoproteomics (identification and quantification of peptides/proteins with the glycans still attached) is gaining interest. The study of protein glycosylation requires a workflow that involves an array of sample preparation and analysis steps that needs to be carefully considered. Herein, we briefly touch upon important steps such as sample preparation and preconcentration, glycan release, glycan derivatization and quantification and advances in mass spectrometry that today are the work-horse for glycomics and glycoproteomics studies. Several proteins related to Alzheimer disease pathogenesis have altered protein glycosylation, and recent glycomics studies have shown differences in cerebrospinal fluid as well as in brain tissue in Alzheimer disease as compared to controls. In this review, we discuss these techniques and how they have been used to shed light on Alzheimer disease and to find glycan biomarkers in cerebrospinal fluid.
Design of a Depth Control Mechanism for an Anguilliform Swimming Robot
Authors: Islam Ahmed , Taravella Brandon
Published: June 2021

This paper discusses the design and implementation of a depth control mechanism for an anguilliform swimming robot. Researchers analyzed three different methods of controlling the depth of the robot, including out-of-plane thrust direction, use of foil on the head and buoyancy control at the head and tail. It was determined that buoyancy control at the head and tail was the best method for controlling depth and pitch, given typical forward speeds of the robot. Details are given into the design of this mechanism, including a stress analysis on a critical part, as well as the impacts that these modifications have on the required torque of the drive servos.
New Online Resource on the 3Rs Principles of Animal Research for Wildlife Biologists, Ecologists, and Conservation Managers
Authors: Zemanova Miriam A.
Published: June 2021

The Earth’s biodiversity is in crisis. Without radical action to conserve habitats, the current rate of species extinction is predicted to accelerate even further. Efficient species conservation requires planning, management, and continuous biodiversity monitoring through wildlife research. Conservation biology was built on the utilitarian principle, where the well-being of species, populations, and ecosystems is given priority over the well-being of individual animals. However, this tenet has been increasingly under discussion and it has been argued that wildlife researchers need to safeguard the welfare of the individual animals traditionally subjected to invasive or lethal research procedures. The 3Rs principles of animal use (Replacement, Reduction, and Refinement) have become the cornerstone of ethical scientific conduct that could minimize the potential negative impact of research practices. One of the obvious strategies to implement the 3Rs in wildlife studies is to use non-invasive or non-lethal research methods. However, in contrast to toxicological or pharmacological research on laboratory animal models, up to now no 3Rs databases or online resources designed specifically for wildlife biologists, ecologists, and conservation managers have been available. To aid the implementation of the 3Rs principles into research on wildlife, I developed an online resource whose structure is outlined in this paper. The website contains a curated database of peer-reviewed articles that have implemented non-invasive or non-lethal research methods that could be used as a guideline for future studies.
Embbedded System-on-Chip 3D Localization and Mapping—eSoC-SLAM
Authors: Gerlein Eduardo A. , Díaz-Guevara Gabriel , Carrillo Henry , Parra Carlos , Gonzalez Enrique
Published: June 2021

This paper discusses a novel embedded system-on-chip 3D localization and mapping (eSoC-LAM) implementation, that followed a co-design approach with the primary aim of being deployed in a small system on a programmable chip (SoPC), the Intel’s (a.k.a Altera) Cyclone V 5CSEMA5F31C6N, available in the Terasic’s board DE1-SoC. This computer board incorporates an 800 MHz Dual-core ARM Cortex-A9 and a Cyclone V FPGA with 85k programmable logic elements and 4450 Kbits of embedded memory running at 50 MHz. We report experiments of the eSoC-LAM implementation using a Robosense’s 3D LiDAR RS-16 sensor in a Robotis’ TurtleBot2 differential robot, both controlled by a Terasic’s board DE1-SoC. This paper presents a comprehensive description of the designed architecture, design constraints, resource optimization, HPS-FPGA exchange of information, and co-design results. The eSoC-LAM implementation reached an average speed-up of 6.5× when compared with a version of the algorithm running in a the hard processor system of the Cyclone V device, and a performance of nearly 32 fps, while keeping high map accuracy.
On the Symbol Error Probability of STBC-NOMA with Timing Offsets and Imperfect Successive Interference Cancellation
Authors: Akhtar Muhammad Waseem , Hassan Syed Ali , Jung Haejoon
Published: June 2021

Due to the ability to handle a large number of users, low latency, and high data rates, NON-orthogonal multiple access (NOMA) is considered a promising access technology for next-generation communication systems. However, as the number of users increases, each user experiences a greater number of successive interference cancellations (SIC), causing the system’s performance to decline. With the increase in the number of users, the fraction of power allocated to each user becomes smaller. Cooperative communication in downlink NOMA is considered as a potential approach to enhance the reliability, capacity, and performance over wireless channels. Space-time block code (STBC)-aided cooperative NOMA (CNOMA) offers an opportunity to improve the weak users’ signal-to-interference-plus-noise (SINR) through strong user cooperation. In this paper, we study the symbol error probability (SEP) performance of the STBC-NOMA and derive the asymptotic expression for SEP when the network is impaired with imperfect SIC (ipSIC) and timing offsets. The simulation results show that the performance of STBC-NOMA was degraded significantly with an increase in the imperfection of SIC and timing errors and that traditional orthogonal access schemes, such as orthogonal frequency division multiple access (OFDMA) and time division multiple access (TDMA), should be used after a threshold SIC level.
Blockchain-Based Smart Propertization of Digital Content for Intellectual Rights Protection
Authors: Lee Nam-Yong , Yang Jinhong , Kim Chul-Soo
Published: June 2021

Several platform companies have been successful in competing with digital piracy by producing consumer-friendly services. Nowadays, however, the digital content service market has become more monopolized than ever, which forms barriers to the entry of new platform companies. The platform monopoly would cause considerable problems both to content providers and consumers as it limits the choice of consumers. To remove the platform monopoly in digital content markets, we propose a public blockchain-based digital content service method. The proposed method encrypts the digital content to a self-decryptable form, which we call Smart Propertized Digital Content (SPDC), and utilizes the decentralization and traceability of the public blockchain to provide a non-monopolistic ecosystem for the management and distribution of the SPDC license. The proposed method can be more beneficial both to content creators and users than the current winner-takes-all platform model. For instance, users can download SPDC once and play many times without requesting the decryption key, and SPDC owners can make SPDC licenses to be time-limited, device-limited, resellable, or terminated without resorting to help from other intermediaries. We conducted the threat analysis on the proposed method by examining possible attacks in various scenarios. Based on threat analysis, we conclude that the proposed method can provide a new type of digital content service ecosystem that can be operated in a completely decentralized way and neutrally beneficial to all participants.
Solid Biomass Energy Potential as a Development Opportunity for Rural Communities
Authors: Stolarski Mariusz Jerzy , Dudziec Paweł , Krzyżaniak Michał , Olba-Zięty Ewelina
Published: June 2021

Conventional energy sources often do not fully satisfy the needs of a modern economy, especially given the climate changes associated with them. These issues should be addressed by diversification of energy generation, including the development of renewable energy sources (RES). Solid biomass will play a major part in the process in Poland. The function of rural areas, along with a well-developed agricultural and forest economy sector, will be a key aspect in this as these areas are suitable for solid biomass acquisition in various ways. This study aimed to determine the solid biomass energy potential in the commune of Goworowo to illustrate the potential in the smallest administrative units of Poland. This research determined the environmental and natural conditions in the commune, which helped to identify the crucial usable solid biomass resources. The total energy potential of solid biomass resources in the commune of Goworowo amounted to 97,672 GJ y−1. The highest potential was accumulated in straw surplus (37,288 GJ y−1) and the lowest was in wood from roadside maintenance (113 GJ y−1). This study showed that rural areas could soon play a significant role in obtaining solid biomass, and individual communes could become spaces for the diversification of energy feedstock.
Stamp-Charged Coke-Making Technology—The Effect of Charge Density and the Addition of Semi-Soft Coals on the Structural, Textural and Quality Parameters of Coke
Authors: Rejdak Michał , Strugała Andrzej , Sobolewski Aleksander
Published: June 2021

Coke is an integral component of the blast furnace charge; therefore, it plays an important role in the integrated steelmaking process. Achieving the required coke quality parameters by producers requires the use of a high proportion of the highest quality coking coals (hard coking coals) in the coking blends, which significantly increases the unit production costs. Approximately 75% of these costs are constituted by the cost of the coal blend’s preparation. There is a deficit in the best quality coking coals on the world market and their supply are characterized by large fluctuations in quality parameters. Therefore, from the point of view of the economics of coke production, it is advantageous to produce high-quality coke from a coke blend with the highest possible content of cheaper coals. The paper presents the results of the influence of coal charge bulk density and semi-soft coking coal content in the coking blend on the textural and structural parameters of coke, which determine its quality. Research has shown that the application of increased density influences the parameters of the texture and structure of the coke, which shape its quality parameters. The use of stamp-charging technology contributes to the improvement of the coke quality or enables the production of coke of a predetermined quality from blends containing cheaper semi-soft coals.
Black-Box Modelling of Low-Switching-Frequency Power Inverters for EMC Analyses in Renewable Power Systems
Authors: Wan Lu , Beshir Abduselam Hamid , Wu Xinglong , Liu Xiaokang , Grassi Flavia , Spadacini Giordano , Pignari Sergio Amedeo , Zanoni Michele , Tenti Liliana , Chiumeo Riccardo
Published: June 2021

Electromagnetic interference (EMI) from renewable power systems to the grid attracts more attention especially in the low-frequency range, due to the low switching frequency of high-power inverters. It is significantly important to derive EMI models of power inverters as well as to develop strategies to suppress the related conducted emissions. In this work, black-box modelling is applied to a three-phase inverter system, by implementing an alternative procedure to identify the parameters describing the active part of the model. Besides, two limitations of black-box modelling are investigated. The first regards the need for the system to satisfy the linear and time-invariant (LTI) assumption. The influence of this assumption on prediction accuracy is analysed with reference to the zero, positive and negative sequence decomposition. It is showing that predictions for the positive/negative sequence are highly influenced by this assumption, unlike those for the zero sequence. The second limitation is related to the possible variation of the mains impedance which is not satisfactorily stabilized at a low frequency outside the operating frequency range of standard line impedance stabilization networks.
A Case of Crohn’s Disease with Cardiac Tamponade Caused by Tuberculous Pericarditis: Assessment of a Rare Phenomenon
Authors: Tominaga Keiichi , Tanaka Takanao , Kanazawa Mimari , Watanabe Shoko , Nemoto Rena , Abe Keiichiro , Kanamori Akira , Yamamiya Akira , Goda Kenichi , Kushima Yoshitomo , Chibana Kazuyuki , Masawa Taito , Fukuda Tomohiro , Hibi Toshifumi , Irisawa Atsushi
Published: June 2021

A 28-year-old woman was hospitalized for cardiac tamponade caused by tuberculous pericarditis. She was taking ustekinumab (UST) for Crohn’s disease. UST is not considered to significantly increase the risk of developing serious infections, including tuberculosis. However, there is still a risk of Mycobacterium tuberculosis reactivation. Therefore, for patients on concurrent UST and antituberculosis medication, a close collaboration among specialists in infectious diseases, cardiology, and gastroenterology is necessary.
Biosimilar Insulins and Their Impact on Prices and Utilization of Insulins in Bulgaria
Authors: Tachkov Konstantin , Mitkova Zornitsa , Milushewa Petya , Petrova Guenka
Published: June 2021

The aim was to explore the availability of biosimilar insulins on the national market in Bulgaria and their impact on prices and utilization. This was a retrospective, quantitative, longitudinal study during the period 2014–2020. Authorized-for-sale, biosimilar insulins at the European level were compared with those on the national market. Prices and utilization were compared in value, number of defined daily dose (DDD), and DDD/1000 inh/day. Almost all types of insulins possessed biosimilars, and even more than one on the European market, but only two were found to be available and reimbursed on the national market. The total number of reimbursed INNs was 11, and for seven of them, changes in reference price per DDD were found. The highest price decrease was observed for insulin (price per DDD decline from 2.77 to 2.22 Bulgarian Leva (BGN)). The total expenditure for insulin increased from 68 to approximately 72.8 mil BGN (34 to approximately 37 mil Euro). The utilization in DDD/1000/inh/day decreased from 16.12 to 15.31. Only two biosimilar insulins were found to be available on the national market, with a slow decrease in prices and stable utilization. Other regulatory and financial measures are probably necessary to foster the insulins’ competition at the biosimilar level.
Participatory Action Research on the Impact of Community Gardening in the Context of the COVID-19 Pandemic: Investigating the Seeding Plan in Shanghai, China
Authors: Kou Huaiyun , Zhang Sichu , Li Wenjia , Liu Yuelai
Published: June 2021

This study aims to examine the impacts of community gardening on the daily life of residents and the management organisation of pandemic prevention in the context of the COVID-19 pandemic, a major public health scourge in 2020. The research team applied a participatory action research approach to work with residents to design and implement the Seeding Plan, a contactless community gardening program. The authors carried out a study to compare the everyday conditions reflecting residents’ mental health of the three subject groups during the pandemic: the participants of the Seeding Plan (Group A), the non-participants living in the same communities that had implemented the Seeding Plan (Group B), and the non-participants in other communities (Group C). According to the results, group A showed the best mental health among the three; Group B, positively influenced by seeding activities, was better than Group C. The interview results also confirmed that the community connections established through gardening activities have a significant impact on maintaining a positive social mentality under extraordinary circumstances. From this, the study concluded that gardening activities can improve people’s mental health, effectively resist negative impacts, and it is a convenient tool with spreading influence on the entire community, so as to support the collective response to public health emergencies in a bottom-up direction by the community.
Is There Utility in Specifying Professional Efficacy as an Outcome of Burnout in the Employee Health Impairment Process
Authors: de Beer Leon T.
Published: June 2021

The aim of this study was to investigate the utility of specifying professional efficacy as an outcome of burnout in the employee health impairment process of the job demands–resources model. The sample comprised a general, but purposive, sample of employees (n = 660). Specifically, participants needed to be at least 18 years of age and be employed in the formal sector. Structural equation modeling methods were applied to analyze the data with a mean- and variance-adjusted weighted least squares estimation. The results showed that the research model was a good fit to the data. Furthermore, the results showed that burnout had a statistically significant negative structural path to professional efficacy, but that professional efficacy in turn did not statistically significantly explain variance in either psychological distress or turnover intention beyond burnout. There were also no meaningful indirect effects, from emotional load to either psychological distress or turnover intention, of professional efficacy. All in all, the results showed that there was no practical utility in specifying professional efficacy as an outcome of burnout in the employee health impairment process of the job demands–resources model, except if professional efficacy is being investigated as an outcome for its own sake.
Analyzing Spatial Patterns of Health Vulnerability to Drought in the Brazilian Semiarid Region
Authors: Menezes Júlia Alves , Madureira Ana Paula , Santos Rhavena Barbosa dos , Duval Isabela de Brito , Regoto Pedro , Margonari Carina , Barata Martha Macêdo de Lima , Confalonieri Ulisses
Published: June 2021

Health determinants might play an important role in shaping the impacts related to long-term disasters such as droughts. Understanding their distribution in populated dry regions may help to map vulnerabilities and set coping strategies for current and future threats to human health. The aim of the study was to identify the most vulnerable municipalities of the Brazilian semiarid region when it comes to the relationship between drought, health, and their determinants using a multidimensional index. From a place-based framework, epidemiological, socio-economic, rural, and health infrastructure data were obtained for 1135 municipalities in the Brazilian semiarid region. An exploratory factor analysis was used to reduce 32 variables to four independent factors and compute a Health Vulnerability Index. The health vulnerability was modulated by social determinants, rural characteristics, and access to water in this semiarid region. There was a clear distinction between municipalities with the highest human welfare and economic development and those municipalities with the worst living conditions and health status. Spatial patterns showed a cluster of the most vulnerable municipalities in the western, eastern, and northeastern portions of the semiarid region. The spatial visualization of the associated vulnerabilities supports decision making on health promotion policies that should focus on reducing social inequality. In addition, policymakers are presented with a simple tool to identify populations or areas with the worst socioeconomic and health conditions, which can facilitate the targeting of actions and resources on a more equitable basis. Further, the results contribute to the understanding of social determinants that may be related to medium- and long-term health outcomes in the region.
Clinical Outcomes of Meniscus Repair with or without Multiple Intra-Articular Injections of Platelet Rich Plasma after Surgery
Authors: Yang Cheng-Pang , Hung Kung-Tseng , Weng Chun-Jui , Chen Alvin Chao-Yu , Hsu Kuo-Yao , Chan Yi-Sheng
Published: June 2021

Preservation of the meniscal volume is crucial in meniscus repair. The goal of this study was to evaluate the clinical outcome of repeated intra-articular platelet-rich plasma (PRP) injections after arthroscopic repair of a traumatic meniscal tear. We retrospectively reviewed 61 primary meniscal repairs in 61 patients (PRP group: 30; non-PRP: 31) from 2017 to 2018. Patients in the PRP group received repeated intra-articular PRP injections in week 2,4,6 after the primary meniscus repair. Subsequent meniscal repair treatment or meniscectomy, knee arthroplasty, and IKDC changes of less than 11.5 points were defined as healing failures. After following up for at least 24 months, the IKDC score was 75.1 ± 13.6, and the Lysholm score was 80.6 ± 14.9 in the PRP group and 72.6 ± 15.8 (IKDC) and 77.7 ± 17.2 (Lysholm) in the non-PRP group. Healing rates of the PRP and the non-PRP groups were 93.3% (Kaplan-Meier 91.6%) and 87.1% (Kaplan-Meier 84.7%), respectively (log rank test p = 0.874). Our study is the first to use multiple intra-articular PRP injections to facilitate meniscal healing after meniscal repair. Though selection bias may be present in this study, the PRP group had similar functional outcome and healing rate compared to non-PRP group.
Extracellular Vesicles: An Important Biomarker in Recurrent Pregnancy Loss?
Authors: Rajaratnam Nina , Ditlevsen Nadja E. , Sloth Jenni K. , Bæk Rikke , Jørgensen Malene M. , Christiansen Ole B.
Published: June 2021

Recurrent pregnancy loss (RPL) has an estimated incidence of 1–3% of all couples. The etiology is considered to be multifactorial. Extracellular vesicles (EVs) take part in numerous different physiological processes and their contents show the originating cell and pathophysiological states in different diseases. In pregnancy disorders, changes can be seen in the composition, bioactivity and concentration of placental and non-placental EVs. RPL patients have an increased risk of pregnancy complications. The aim of this prospective study was to examine whether measuring different specific EV markers in plasma before and during pregnancy could be used as predictors of pregnancy loss (PL) in women with RPL. Thirty-one RPL patients were included in this study; 25 had a live birth (LB group) and six had a new PL (PL group). Five blood samples were obtained, one before achieved pregnancy and the others in gestational week 6, 8, 10 and 16. Moreover, some of the patients received intravenous immunoglobulin (IVIG) infusions as part of treatment, and it was also examined whether this treatment influenced the EV levels. Seventeen EV markers specific for the immune system, coagulation, placenta and hypoxia were analyzed in the samples with EV Array, a method able to capture small EVs by using an antibody panel targeting membrane proteins. Comparing the LB and PL groups, one EV marker, CD9, showed a significant increase from before pregnancy to gestational week 6 in the PL group. The changes in the other 16 markers were nonsignificant. One case of late-onset PL showed steeply increasing levels, with sudden decrease after gestational week 10 in nine of 17 markers. Moreover, there was an overall increase of all 17 markers after IVIG treatment in the LB group, which was significant in 15 of the markers. Whether increases in EVs positive for CD9 characterize RPL patients who subsequently miscarry should be investigated in future larger studies.
Double-Needle Yamane Technique Using Flanged Haptics in Ocular Trauma—A Retrospective Survey of Visual Outcomes and Safety
Authors: Nowomiejska Katarzyna , Haszcz Dariusz , Onyszkiewicz Maksymilian , Choragiewicz Tomasz , Czarnek-Chudzik Aleksandra , Szpringer-Wabicz Agata , Baltaziak Katarzyna , Brzozowska Agnieszka , Toro Mario Damiano , Rejdak Robert
Published: June 2021

To evaluate visual outcomes and safety of the double-needle technique using flanged haptics (Yamane technique) in patients with aphakia caused by ocular trauma at a trauma referral center. Retrospective: Consecutive interventional case series of 30 patients who underwent the Yamane technique due to posttraumatic aphakia. The double-needle technique using flanged haptics was combined with anterior vitrectomy (group A) in 14 patients, and with pars plana vitrectomy (PPV) (group B) due to retinal detachment, nucleus dislocation into the vitreous cavity, or intraocular lens (IOL) displacement in 16 patients. No intraoperative complications were noted. There was significant improvement in the visual acuity in both groups at the second postoperative visit. However, the visual acuity was significantly worse in the group treated with the Yamane technique combined with PPV. Silicone oil tamponade in PPV group was associated with worse visual acuity, whereas post lensectomy status was associated with poor visual function result in the anterior vitrectomy group. There was one case of slight IOL decentration and one retinal detachment during the postoperative follow-up period in the group with PPV. In this case series, the Yamane technique applied in traumatized eyes was found to be an efficacious and safe procedure. Combining the Yamane technique with PPV due to posterior segment ocular trauma was associated with worse functional results in the follow-up at three months. Further studies with longer follow-up evaluations are required to verify long-term complications.
Neutrophil-to-Lymphocyte Ratio and Early Variation of NLR to Predict In-Hospital Mortality and Severity in ED Patients with SARS-CoV-2 Infection
Authors: Abensur Vuillaume Laure , Le Borgne Pierrick , Alamé Karine , Lefebvre François , Bérard Lise , Delmas Nicolas , Cipolat Lauriane , Gennai Stéphane , Bilbault Pascal , Lavoignet Charles-Eric ,   on behalf of the CREMS Network (Clinical Research in Emergency Medicine and Sepsis)
Published: June 2021

(1) Introduction: The neutrophil-to lymphocyte ratio is valued as a predictive marker in several inflammatory diseases. For example, an increasing NLR is a risk factor of mortality in sepsis. It also appears to be helpful in other settings such as cancer. The aim of our work was to study the prognostic value of NLR for disease severity and mortality in patients infected with SARS-CoV-2 upon their admission to the Emergency Department (ED) and its early variation (ΔNLR) in the first 24 h of management (H-24). (2) Methods: Between 1 March and 30 April 2020, we conducted a multicenter and retrospective cohort study of patients with moderate or severe coronavirus disease 19 (COVID-19), who were all hospitalized after presenting to the ED. (3) Results: A total of 1035 patients were included in our study. Factors associated with infection severity were C-reactive protein level (OR: 1.007, CI 95%: [1.005–1.010], p < 0.001), NLR at H-24 (OR: 1.117, CI 95%: [1.060–1.176], p < 0.001), and ΔNLR (OR: 1.877, CI 95%: [1.160–3.036], p: 0.01). The best threshold of ΔNLR to predict the severity of infection was 0.222 (sensitivity 56.1%, specificity 68.3%). In multivariate analysis, the only biochemical factor significantly associated with mortality was again ΔNLR (OR: 2.142, CI 95%: ([1.132–4.056], p: 0.019). The best threshold of ΔNLR to predict mortality was 0.411 (sensitivity 53.3%; specificity 67.3%). (4) Conclusion: The NLR and its early variation (ΔNLR) could help physicians predict both severity and mortality associated with SARS-CoV-2 infection, hence contributing to optimized patient management (accurate triage and treatment).
CLAP: A Cross-Layer Analytic Platform for the Correlation of Cyber and Physical Security Events Affecting Water Critical Infrastructures
Authors: Gonzalez-Granadillo Gustavo , Diaz Rodrigo , Caubet Juan , Garcia-Milà Ignasi
Published: June 2021

Water CIs are exposed to a wide number of IT challenges that go from the cooperation and alignment between physical and cyber security teams to the proliferation of new vulnerabilities and complex cyber-attacks with potential disastrous consequences. Although novel and powerful solutions are proposed in the literature, most of them lack appropriate mechanisms to detect cyber and physical attacks in real time. We propose a Cross-Layer Analytic Platform (denoted as CLAP) developed for the correlation of Cyber and Physical security events affecting water CIs. CLAP aims to improve the detection of complex attack scenarios in real time based on the correlation of cyber and physical security events. The platform assigns appropriate severity values to each correlated alarm that will guide security analysts in the decision-making process of prioritizing mitigation actions. A series of passive and active attack scenarios against the target infrastructure are presented at the end of the paper to show the mechanisms used for the detection and correlation of cyber–physical security events. Results show promising benefits in the improvement of response accuracy, false rates reduction and real-time detection of complex attacks based on cross-correlation rules.
Power Two-Wheelers as an Element of Sustainable Urban Mobility in Europe
Authors: Dorocki Sławomir , Wantuch-Matla Dorota
Published: June 2021

Nowadays in Europe, there is a noticeable increase in the popularity of power two-wheelers (PTW). This is largely due to the increase in urban transport problems. The aim of the study was to present the changes in urban mobility in terms of the use of power two-wheelers. In relation to this process, the activities of local authorities and organisations related to PTW traffic were also presented to adapt the city infrastructure to the traffic of two-track vehicles in selected European countries. The study used numerical data analysis methods and data from an online survey of motorcyclists in Poland as well as an online search of planning materials from the authorities of selected European cities. Based on the results obtained, communication by PTW vehicles can be considered one of the possibilities for developing alternative transport in cities. Their advantage is both high mobility and economic value. PTW vehicles are also a part of an exhaust reduction policy. The best solutions to promote this mode of transport are the reduction of parking fees and the availability of public service lanes. Supporting PTW communication is included in communication policies and brings especially positive spatial results in cities such as Barcelona, London or Vienna.