bluuebunny/crossref_metadata_2025 huggingface dataset:
Improvement in Psychodynamic Psychotherapy for Depression: A Qualitative Study of the Patients’ Perspective
Authors: Løvgren André , Røssberg Jan Ivar , Engebretsen Eivind , Ulberg Randi
Published: September 2020

The patient’s perspective on improvement in psychotherapy is crucial for tailoring the therapy he or she is receiving. The present study aimed at exploring the factors aiding and the patients’ experiences of improvement in time-limited psychodynamic psychotherapy for depression. Semi-structured, in-depth interviews were conducted with ten adult patients who received up to 28 sessions of manualized psychodynamic psychotherapy in the Norwegian study “Mechanisms of change in psychotherapy” (the MOP study). The post-therapy interviews addressed the participants’ experiences from therapy. The data were analyzed with thematic content analysis and hermeneutic interpretation. The analysis identified four helpful dimensions: “Therapist activities” comprised supporting and acknowledging, advising and offering tips for everyday life, questioning and pressuring. “Patient activities” included opening up, caring for oneself and showing agency. “Facilitators” for improvement were learning from therapy, learning to receive therapy and agreed goals. “Achievements” comprised new perspectives and understandings, increased self-awareness and mastery and changed thinking and feeling. Improvements from psychodynamic therapy seemed reliant on the degree to which the therapy could activate and be relevant to the patients’ everyday life. Tailoring therapy for patients with depression should link the focus on symptoms and ways of thinking and feeling with their life circumstances.
Disparities in Dental Service Utilization among Adults in Chinese Megacities: Do Health Insurance and City of Residence Matter?
Authors: Qu Xiaomin , Qi Xiang , Wu Bei
Published: September 2020

The aims of the study were to present the prevalence of dental service utilization among adults (age between 18 and 65) in Chinese megacities and to examine the associations of health insurance and city of residence with dental visits. This study was a cross-sectional analysis of the 2019 New Era and Living Conditions in Megacities Survey data with a sample of 4835 participants aged 18–65 from 10 different megacities in China. The data including gross domestic product (GDP) per capita of each megacity obtained from the National Bureau of Statistics of China as a city-level characteristic. After adjusting sampling weights, approximately 24.28% of the participants had at least one dental visit per year. Findings from multilevel mixed-effects linear models showed that participants residing in megacities with higher GDP per capita (β = 0.07, p < 0.001) who had Urban Employee Basic Medical Insurance (β = 0.25, p < 0.001) or Urban Resident Basic Medical Insurance (β = 0.19, p < 0.01) had more frequent dental visits after adjusting demographic characteristics, socioeconomic status, health status, health behavior and attitude, and oral health indicators. Margins post-estimation model results demonstrated disparities in the predicted probability of having never visited a dentist by types of health insurance and city of residence. In conclusion, the prevalence of dental visits in China was found to be low. This study highlights socioeconomic inequalities in dental service utilization. There is a great need to develop more dental care programs and services and expand health insurance to cover dental care in China.
Beyond Lipid Signaling: Pleiotropic Effects of Diacylglycerol Kinases in Cellular Signaling
Authors: Sim Jae Ang , Kim Jaehong , Yang Dongki
Published: September 2020

The diacylglycerol kinase family, which can attenuate diacylglycerol signaling and activate phosphatidic acid signaling, regulates various signaling transductions in the mammalian cells. Studies on the regulation of diacylglycerol and phosphatidic acid levels by various enzymes, the identification and characterization of various diacylglycerol and phosphatidic acid-regulated proteins, and the overlap of different diacylglycerol and phosphatidic acid metabolic and signaling processes have revealed the complex and non-redundant roles of diacylglycerol kinases in regulating multiple biochemical and biological networks. In this review article, we summarized recent progress in the complex and non-redundant roles of diacylglycerol kinases, which is expected to aid in restoring dysregulated biochemical and biological networks in various pathological conditions at the bed side.
The Macrophages-Microbiota Interplay in Colorectal Cancer (CRC)-Related Inflammation: Prognostic and Therapeutic Significance
Authors: Mola Silvia , Pandolfo Chiara , Sica Antonio , Porta Chiara
Published: September 2020

Tumor-associated macrophages (TAMs) are the main population of myeloid cells infiltrating solid tumors and the pivotal orchestrators of cancer-promoting inflammation. However, due to their exceptional plasticity, macrophages can be also key effector cells and powerful activators of adaptive anti-tumor immunity. This functional heterogeneity is emerging in human tumors, colorectal cancer (CRC) in particular, where the dynamic co-existence of different macrophage subtypes influences tumor development, outcome, and response to therapies. Intestinal macrophages are in close interaction with enteric microbiota, which contributes to carcinogenesis and affects treatment outcomes. This interplay may be particularly relevant in CRC, one of the most prevalent and lethal cancer types in the world. Therefore, both macrophages and intestinal microbiota are considered promising prognostic indicators and valuable targets for new therapeutic approaches. Here, we discuss the current understanding of the molecular circuits underlying the interplay between macrophages and microbiota in CRC development, progression, and response to both conventional therapies and immunotherapies.
Tricarboxylic Acid Cycle Metabolites as Mediators of DNA Methylation Reprogramming in Bovine Preimplantation Embryos
Authors: Ispada Jessica , da Fonseca Junior Aldcejam Martins , de Lima Camila Bruna , dos Santos Erika Cristina , Fontes Patricia Kubo , Nogueira Marcelo Fábio Gouveia , da Silva Vinicius Lourenço , Almeida Fernanda Nascimento , Leite Saul de Castro , Chitwood James Lee , Ross Pablo Juan , Milazzotto Marcella Pecora
Published: September 2020

In many cell types, epigenetic changes are partially regulated by the availability of metabolites involved in the activity of chromatin-modifying enzymes. Even so, the association between metabolism and the typical epigenetic reprogramming that occurs during preimplantation embryo development remains poorly understood. In this work, we explore the link between energy metabolism, more specifically the tricarboxylic acid cycle (TCA), and epigenetic regulation in bovine preimplantation embryos. Using a morphokinetics model of embryonic development (fast- and slow-developing embryos), we show that DNA methylation (5mC) and hydroxymethylation (5hmC) are dynamically regulated and altered by the speed of the first cleavages. More specifically, slow-developing embryos fail to perform the typical reprogramming that is necessary to ensure the generation of blastocysts with higher ability to establish specific cell lineages. Transcriptome analysis revealed that such differences were mainly associated with enzymes involved in the TCA cycle rather than specific writers/erasers of DNA methylation marks. This relationship was later confirmed by disturbing the embryonic metabolism through changes in α-ketoglutarate or succinate availability in culture media. This was sufficient to interfere with the DNA methylation dynamics despite the fact that blastocyst rates and total cell number were not quite affected. These results provide the first evidence of a relationship between epigenetic reprogramming and energy metabolism in bovine embryos. Likewise, levels of metabolites in culture media may be crucial for precise epigenetic reprogramming, with possible further consequences in the molecular control and differentiation of cells.
Alternative Options for Skin Cancer Therapy via Regulation of AKT and Related Signaling Pathways
Authors: Hwang Sun-Young , Chae Jung-Il , Kwak Ah-Won , Lee Mee-Hyun , Shim Jung-Hyun
Published: September 2020

Global environmental pollution has led to human exposure to ultraviolet (UV) radiation due to the damaged ozone layer, thereby increasing the incidence and death rate of skin cancer including both melanoma and non-melanoma. Overexpression and activation of V-akt murine thymoma viral oncogene homolog (AKT, also known as protein kinase B) and related signaling pathways are major factors contributing to many cancers including lung cancer, esophageal squamous cell carcinoma and skin cancer. Although BRAF inhibitors are used to treat melanoma, further options are needed due to treatment resistance and poor efficacy. Depletion of AKT expression and activation, and related signaling cascades by its inhibitors, decreases the growth of skin cancer and metastasis. Here we have focused the effects of AKT and related signaling (PI3K/AKT/mTOR) pathways by regulators derived from plants and suggest the need for efficient treatment in skin cancer therapy.
Elevated Pro-Inflammatory Cell-Free MicroRNA Levels in Cerebrospinal Fluid of Premature Infants after Intraventricular Hemorrhage
Authors: Fejes Zsolt , Erdei Judit , Pócsi Marianna , Takai Jun , Jeney Viktória , Nagy Andrea , Varga Alíz , Bácsi Attila , Bognár László , Novák László , Kappelmayer János , Nagy Béla
Published: September 2020

Intraventricular hemorrhage (IVH) represents a high risk of neonatal mortality and later neurodevelopmental impairment in prematurity. IVH is accompanied with inflammation, hemolysis, and extracellular hemoglobin (Hb) oxidation. However, microRNA (miRNA) expression in cerebrospinal fluid (CSF) of preterm infants with IVH has been unknown. Therefore, in the present study, candidate pro-inflammatory cell-free miRNAs were analyzed in CSF samples from 47 preterm infants with grade III or IV IVH vs. clinical controls (n = 14). miRNAs were quantified by RT-qPCR, normalized to “spike-in” cel-miR-39. Oxidized Hb and total heme levels were determined by spectrophotometry as well as IL-8, VCAM-1, ICAM-1, and E-selectin concentrations by ELISA. To reveal the origin of the investigated miRNAs, controlled hemolysis experiments were performed in vitro; in addition, human choroid plexus epithelial cell (HCPEpiC) cultures were treated with metHb, ferrylHb, heme, or TNF-α to replicate IVH-triggered cellular conditions. Levels of miR-223, miR-155, miR-181b, and miR-126 as well as Hb metabolites along with IL-8 were elevated in CSF after the onset of IVH vs. controls. Significant correlations were observed among the miRNAs, oxidized Hb forms, and the soluble adhesion molecules. During the post-IVH follow-up, attenuated expression of miRNAs and protein biomarkers in CSF was observed upon elimination of Hb metabolites. These miRNAs remained unaffected by a series of artificially induced hemolysis, which excluded red blood cells as their origin, while stimulation of HCPEpiCs with oxidized Hb fractions and heme resulted in increased extracellular miRNA levels in the cell culture supernatant. Overall, the hemorrhage-induced CSF miRNAs reflected inflammatory conditions as potential biomarkers in preterm IVH.
Combination of ACY-241 and JQ1 Synergistically Suppresses Metastasis of HNSCC via Regulation of MMP-2 and MMP-9
Authors: Cho Ha Young , Lee Sang Wu , Jeon Yu Hyun , Lee Dong Hoon , Kim Go Woon , Yoo Jung , Kim So Yeon , Kwon So Hee
Published: September 2020

Overexpression of histone deacetylase 6 (HDAC6) and bromodomain-containing protein 4 (BRD4) is related to aggressiveness of head and neck squamous carcinoma (HNSCC). Based on studies that HDAC6 and BRD4 are potential therapeutic targets of HNSCC, we hypothesized that the combination treatment of BET inhibitor JQ1 and HDAC6-selective inhibitor ACY-241 could exhibit synergistic anticancer effects in human papillomavirus (HPV)-positive and HPV-negative HNSCC cells. In this study, HNSCC cell growth and viability were measured by CCK-8 assay, apoptosis was analyzed by flow cytometry, and metastasis was studied by wound healing and transwell assays. Furthermore, immunoblotting is conducted to investigate proteins that modulate apoptosis or metastasis. Here, we report that the combination of ACY-241 and JQ1 shows synergistic cell growth inhibition, viability reduction, and apoptosis induction in HNSCC cells through inactivation of AKT and NF-κB signaling. Importantly, we demonstrate that combined treatment of ACY-241 and JQ1 synergistically suppresses TNF-α-induced migration and invasion via dysregulating matrix metalloproteinase (MMP)-2, MMP-9, and MT1-MMP. Overall, the combination of ACY-241 and JQ1 significantly suppresses proliferation and metastasis in HPV-positive and HPV-negative HNSCC. Collectively, these findings suggest that the co-inhibition of BET and HDAC6 can be a new therapeutic strategy in HNSCC.
Leukoplakia and Immunology: New Chemoprevention Landscapes?
Authors: Grigolato Roberto , Bizzoca Maria Eleonora , Calabrese Luca , Leuci Stefania , Mignogna Michele Davide , Lo Muzio Lorenzo
Published: September 2020

Oral potentially malignant disorders (OPMDs) comprise a range of clinical-pathological alterations frequently characterized by an architectural and cytological derangements upon histological analysis. Among them, oral leukoplakia is the most common type of these disorders. This work aims to analyze the possible use of drugs such as immunochemopreventive agents for OPMDs. Chemoprevention is the use of synthetic or natural compounds for the reversal, suppression, or prevention of a premalignant lesion conversion to malignant form. Experimental and in vivo data offer us the promise of molecular prevention through immunomodulation; however, currently, there is no evidence for the efficacy of these drugs in the chemoprevention action. Alternative ways to deliver drugs, combined use of molecules with complementary antitumor activities, diet influence, and better definition of individual risk factors must also be considered to reduce toxicity, improve compliance to the protocol treatment and offer a better individualized prevention. In addition, we must carefully reconsider the mode of action of many traditional cancer chemoprevention agents on the immune system, such as enhancing immunosurveillance and reversing the immune evasion. Several studies emphasize the concept of green chemoprevention as an alternative approach to accent healthy lifestyle changes in order to decrease the incidence of HNSCC.
Role of Microglia in Modulating Adult Neurogenesis in Health and Neurodegeneration
Authors: Al-Onaizi Mohammed , Al-Khalifah Alaa , Qasem Dalal , ElAli Ayman
Published: September 2020

Microglia are the resident immune cells of the brain, constituting the powerhouse of brain innate immunity. They originate from hematopoietic precursors that infiltrate the developing brain during different stages of embryogenesis, acquiring a phenotype characterized by the presence of dense ramifications. Microglial cells play key roles in maintaining brain homeostasis and regulating brain immune responses. They continuously scan and sense the brain environment to detect any occurring changes. Upon detection of a signal related to physiological or pathological processes, the cells are activated and transform to an amoeboid-like phenotype, mounting adequate responses that range from phagocytosis to secretion of inflammatory and trophic factors. The overwhelming evidence suggests that microglia are crucially implicated in influencing neuronal proliferation and differentiation, as well as synaptic connections, and thereby cognitive and behavioral functions. Here, we review the role of microglia in adult neurogenesis under physiological conditions, and how this role is affected in neurodegenerative diseases.
Nasal Polyposis: Insights in Epithelial-Mesenchymal Transition and Differentiation of Polyp Mesenchymal Stem Cells
Authors: Chiarella Emanuela , Lombardo Nicola , Lobello Nadia , Aloisio Annamaria , Aragona Teodoro , Pelaia Corrado , Scicchitano Stefania , Bond Heather Mandy , Mesuraca Maria
Published: September 2020

Chronic rhinosinusitis is a common inflammatory disease of paranasal sinuses, which causes rhinorrhea, nasal congestion, and hyposmia. The genetic predisposition or the exposure to irritants can sustain the inflammatory response and the development of nasal polyposis. Nasal polyps are benign and teardrop-shaped growths that project in the nasal cavities, and originate from the ethmoid sinuses. This inflammatory process is associated with high expression of IL-4, IL-5 and IL-13 and IgE. Antibodies targeting these cytokines or receptors represent a therapeutic strategy in the treatment of nasal polyposis in combination with corticosteroids. The molecular pathogenesis of nasal polyps in chronic rhinosinusitis (CRS) patients is associated with remodeling transition, a process in which epithelial cells lose their typical phenotype, acquiring a mesenchymal-like aspect. TGFβ/SMAD, ERK, and Wnt/β-catenin pathways are altered during the nasal tissue remodeling. miRNA and inhibitor molecules targeting these signaling pathways are able to interfere with the process; which could lead to alternative therapies. Nasal polyps are an alternative source of mesenchymal stem cells, which can be isolated from surgical biopsies. A molecular understanding of the biology of PO-MSCs will contribute to the delineating inflammatory process underlying the development of nasal polyps.
Morphological and Spatial Diversity of the Discal Spot on the Hindwings of Nymphalid Butterflies: Revision of the Nymphalid Groundplan
Authors: Otaki Joji M.
Published: September 2020

Diverse butterfly wing color patterns are understood through the nymphalid groundplan, which mainly consists of central, border, and basal symmetry systems and a discal spot. However, the status of the discal spot remains unexplored. Here, the morphological and spatial diversity of the discal spot was studied in nymphalid hindwings. The discal spot is expressed as a small or narrow spot, a pair of parallel bands, a diamond or oval structure, a large dark spot, a few fragmented spots, or a white structure. In some cases, the discal spot is morphologically similar to and integrated with the central symmetry system (CSS). The discal spot is always located in a distal portion of the discal cell defined by the wing veins, which is sandwiched by the distal and proximal bands of the CSS (dBC and pBC) and is rarely occupied by border ocelli. The CSS occasionally has the central band (cBC), which differs from the discal spot. These results suggest that the discal spot is an independent and diverse miniature symmetry system nested within the CSS and that the locations of the discal spot and the CSS are determined by the wing veins at the early stage of wing development.
Predictors of Changes in Alcohol Craving Levels during a Virtual Reality Cue Exposure Treatment among Patients with Alcohol Use Disorder
Authors: Hernández-Serrano Olga , Ghiţă Alexandra , Figueras-Puigderrajols Natàlia , Fernández-Ruiz Jolanda , Monras Miquel , Ortega Lluïsa , Mondon Silvia , Teixidor Lidia , Gual Antoni , Ugas-Ballester Lidia , Fernández Maribel , Montserrat Roger , Porras-Garcia Bruno , Ferrer-Garcia Marta , Gutiérrez-Maldonado José
Published: September 2020

Background/Objective: Determining the predictive variables associated with levels of alcohol craving can ease the identification of patients who can benefit from treatments. This study aimed to describe changes (improvement or no change/deterioration) in alcohol craving levels and explore the predictors of these changes from admission to discharge in outpatients with alcohol use disorder (AUD) undergoing treatment-as-usual (TAU), or treatment-as-usual supplemented with virtual reality cue-exposure therapy (TAU + VR-CET). Method: A prospective cohort study was conducted amongst 42 outpatients with AUD (n = 15 TAU + VR-CET and n = 27 TAU) from a clinical setting. Changes in the levels of alcohol craving between admission and discharge were assessed with the Multidimensional Alcohol Craving Scale. Sociodemographic characteristics (age, gender, education, and socioeconomic and civil status), cognitive-affective behavioral patterns (AUD severity, abstinence duration, psychiatric comorbidity, state anxiety, attentional bias, and substance use), and type of treatment (TAU + VR-CET and only TAU) were also evaluated. Results: The TAU + VR-CET group showed greater changes of improvement in the levels of alcohol craving than the TAU group (χ2 = 10.996; p = 0.001). Intragroup changes in alcohol craving from pre to post-treatment were significant in the TAU + VR-CET group (χ2 = 13.818; p = 0.003) but not within the TAU group (χ2 = 2.349; p = 0.503). The odds of an improvement in any of the craving levels between pre- and post-test was 18.18 (1/0.055) times higher in the TAU + VR-CET group with respect to the TAU group. The use of illicit drugs in the month prior to the test increased the odds of having a positive change by 18.18 (1/0.055) with respect to not having consumed. Conclusions: Including VR-CET in TAU programs may provide benefits in the treatment of AUDs mainly among patients with intense alcohol craving and individuals having used illicit substances prior to treatment.
Hyperthyroidism Is Associated with the Development of Vasospastic Angina, but Not with Cardiovascular Outcomes
Authors: Kim Hyun-Jin , Jo Sang-Ho , Lee Min-Ho , Seo Won-Woo , Baek Sang Hong
Published: September 2020

Vasospastic angina (VA) is a functional disease caused by the alteration of vasomotor tone. We investigated the association of hyperthyroidism with the development and prognosis of VA. Study data were obtained from a prospective multicenter registry that included patients who had symptoms suggestive of VA. Coronary angiography and an ergonovine provocation test were performed, and patients were classified into a VA and a non-VA group. Among 1239 patients with suspected VA, 831 patients were classified in the VA group. Hyperthyroidism was more common in the VA group than in the non-VA group (10.0% vs. 3.7%, p < 0.001). After adjusting for confounding factors, hyperthyroidism was independently associated with a 3.27-fold increased risk of VA. Especially in women, hyperthyroidism was associated with a 4.38-fold higher risk of VA. All-cause death rates did not differ according to the presence or absence of hyperthyroidism. Hyperthyroidism is independently associated with the occurrence of VA especially in women but did not affect the total death in VA patients. Clinicians need to be aware of the role of thyroid function in patients with suspected VA.
Biosynthesis, Characterization, and Biological Activities of Procyanidin Capped Silver Nanoparticles
Authors: Badeggi Umar M. , Badmus Jelili A. , Botha Subelia S. , Ismail Enas , Marnewick Jeanine L. , Africa Charlene W. J. , Hussein Ahmed A.
Published: September 2020

In this study, procyanidin dimers and Leucosidea sericea total extract (LSTE) were employed in the synthesis of silver nanoparticles (AgNPs) and characterized by ultraviolet-visible (UV-Visible) spectroscopy, high-resolution transmission electron microscopy (HRTEM), selected area electron diffraction (SAED), X-ray diffraction (XRD), and dynamic light scattering (DLS) techniques. AgNPs of about 2–7 nm were obtained. DLS and stability evaluations confirmed that the AgNPs/procyanidins conjugates were stable. The formed nanoparticles exhibited good inhibitory activities against the two enzymes studied. The IC50 values against the amylase enzyme were 14.92 ± 1.0, 13.24 ± 0.2, and 19.13 ± 0.8 µg/mL for AgNPs coordinated with LSTE, F1, and F2, respectively. The corresponding values for the glucosidase enzyme were 21.48 ± 0.9, 18.76 ± 1.0, and 8.75 ± 0.7 µg/mL. The antioxidant activities were comparable to those of the intact fractions. The AgNPs also demonstrated bacterial inhibitory activities against six bacterial species. While the minimum inhibitory concentrations (MIC) of F1-AgNPs against Pseudomonas aeruginosa and Staphylococcus aureus were 31.25 and 15.63 µg/mL respectively, those of LSTE-AgNPs and F2-AgNPs against these organisms were both 62.50 µg/mL. The F1-AgNPs demonstrated a better bactericidal effect and may be useful in food packaging. This research also showed the involvement of the procyanidins as reducing and capping agents in the formation of stable AgNPs with potential biological applications.
Frequency Downshifting in Wave Spectra in Coastal Zone and Its Influence on Mudbank Formation
Authors: Saprykina Yana , Shtremel Margarita , Volvaiker Samiksha , Kuznetsov Sergey
Published: September 2020

The evolution of wind waves in coastal zones leads to changes in the shape of the wave spectrum. Along the coast of Kerala, due to the presence of mudbanks during the southwest monsoon, we could observe downshifting of the peak frequency in the wave spectral data. The present study aims at proving the mechanism of frequency downshifting and possible influence of the downshifting process on mudbank formation. The results of SWASH (Simulating WAves till SHore) modeling and bispectral analysis shows that frequency downshifting occurs due to the difference nonlinear triad interactions of the main frequency peak of the wave spectrum with frequencies of the infragravity range independent of the viscosity of the medium. The increase in wave dissipation accelerates frequency downshifting additionally, decreasing the wave energy in the main peak frequency. It is shown that frequency downshifting can be one of the possible wave mechanisms of mudbank formation due to essentially different wave attenuation coefficients at the beginning and end of this process. For muddy cohesive sediments, it will lead to formation with an erosive profile at first and then an accumulative profile, i.e., mudbank formation.
Sensitivity of Flood Hazard and Damage to Modelling Approaches
Authors: Lyddon Charlotte E. , Brown Jennifer M. , Leonardi Nicoletta , Plater Andrew J.
Published: September 2020

Combination of uncertainties in water level and wave height predictions for extreme storms can result in unacceptable levels of error, rendering flood hazard assessment frameworks less useful. A 2D inundation model, LISFLOOD-FP, was used to quantify sensitivity of flooding to uncertainty in coastal hazard conditions and method used to force the coastal boundary of the model. It is shown that flood inundation is more sensitive to small changes in coastal hazard conditions due to the setup of the regional model, than the approach used to apply these conditions as boundary forcing. Once the threshold for flooding is exceeded, a few centimetres increase in combined water level and wave height increases both the inundation and consequent damage costs. Improved quantification of uncertainty in inundation assessments can aid long-term coastal flood hazard mitigation and adaptation strategies, to increase confidence in knowledge of how coastlines will respond to future changes in sea-level.
A Closer Look at the “Right” Format for Clinical Decision Support: Methods for Evaluating a Storyboard BestPractice Advisory
Authors: Douthit Brian J. , Musser R. Clayton , Lytle Kay S. , Richesson Rachel L.
Published: September 2020

(1) Background: The five rights of clinical decision support (CDS) are a well-known framework for planning the nuances of CDS, but recent advancements have given us more options to modify the format of the alert. One-size-fits-all assessments fail to capture the nuance of different BestPractice Advisory (BPA) formats. To demonstrate a tailored evaluation methodology, we assessed a BPA after implementation of Storyboard for changes in alert fatigue, behavior influence, and task completion; (2) Methods: Data from 19 weeks before and after implementation were used to evaluate differences in each domain. Individual clinics were evaluated for task completion and compared for changes pre- and post-redesign; (3) Results: The change in format was correlated with an increase in alert fatigue, a decrease in erroneous free text answers, and worsened task completion at a system level. At a local level, however, 14% of clinics had improved task completion; (4) Conclusions: While the change in BPA format was correlated with decreased performance, the changes may have been driven primarily by the COVID-19 pandemic. The framework and metrics proposed can be used in future studies to assess the impact of new CDS formats. Although the changes in this study seemed undesirable in aggregate, some positive changes were observed at the level of individual clinics. Personalized implementations of CDS tools based on local need should be considered.
Formal Finance Usage and Innovative SMEs: Evidence from ASEAN Countries
Authors: Arif Muhammad , Hasan Mudassar , Shafique Joyo Ahmed , Gan Christopher , Abidin Sazali
Published: September 2020

This paper provides evidence on the likelihood of formal finance usage among innovative small and medium enterprises (SMEs) operating in ASEAN countries. To this end, the SMEs are classified into four categories, namely non-innovators and product, process, and product-and-process innovator SMEs. Subsequently, a propensity score weighting (PSW) analysis is performed to adjust for diversity existing across innovative SMEs. The resulting propensity scores are further used to perform the causal effect analysis based on the average treatment effect (ATE) approach, which measures the likelihood of formal finance usage among different types of innovative SMEs. Our ATE results reveal that SMEs simultaneously engaged in product and process innovation show a higher likelihood of using formal finance than non-innovators. However, formal finance usage of SMEs perusing only product/service or process innovation is not any different from non-innovators. Furthermore, our pairwise analysis shows that product and process innovators also exhibit a higher likelihood of formal finance usage than product/service or process innovators. Besides, younger and medium-size product and process innovating SMEs are more likely to use formal finance. These results are robust for different subsamples and firm- and country-level controls.
The Association between Periodontitis and Human Colorectal Cancer: Genetic and Pathogenic Linkage
Authors: Di Spirito Federica , Toti Paolo , Pilone Vincenzo , Carinci Francesco , Lauritano Dorina , Sbordone Ludovico
Published: September 2020

Periodontitis has been associated with an increased risk of and mortality associated with human colorectal cancer (CRC). Current evidence attributes such an association to the direct and indirect effects of virulence factors belonging to periodontal pathogens, to inflammatory mediators and to genetic factors. The aims of the study were to assess the existence of a genetic linkage between periodontitis and human CRC, to identify genes considered predominant in such a linkage, thus named leader genes, and to determine pathogenic mechanisms related to the products of leader genes. Genes linking periodontitis and CRC were identified and classified in order of predominance, through an experimental investigation, performed via computer simulation, employing the leader gene approach. Pathogenic mechanisms relating to leader genes were determined through cross-search databases. Of the 83 genes linking periodontitis and CRC, 12 were classified as leader genes and were pathogenically implicated in cell cycle regulation and in the immune-inflammatory response. The current results, obtained via computer simulation and requiring further validation, support the existence of a genetic linkage between periodontitis and CRC. Cell cycle dysregulation and the alteration of the immuno-inflammatory response constitute the pathogenic mechanisms related to the products of leader genes.
The Impact of a Nanocellulose-Based Wound Dressing in the Management of Thermal Injuries in Children: Results of a Retrospective Evaluation
Authors: Cattelaens Julia , Turco Laura , Berclaz Luc M. , Huelsse Birgit , Hitzl Wolfgang , Vollkommer Tobias , Bodenschatz Karl J.
Published: September 2020

The aim of this retrospective study is to evaluate for the first time the impact of a nanocellulose-based wound dressing in the treatment of pediatric patients with both partial- and deep-thickness burns. Usability and effectiveness were defined based on parameters such as frequency of dressing changes under narcosis, duration of hospital stay, onset of complications, need for additional treatments, and follow up scar formation assessment. Fifty-six children who sustained burns in the year 2018 and were treated with a nanocellulose-based wound dressing were included in the trial. The mean stay in hospital was 6.7 days. Patients underwent dressing changes under narcosis 2.4 times on average, and none had wound-associated infection. In all, 82% of the patients were treated only with nanocellulose-based wound dressings, and reepithelialization occurred after ten days. The majority of patients had scars with normal pigmentation (98%), vascularization (91%), height (92%), and pliability (92%). In conclusion, using a nanocellulose-based wound dressing for the treatment of both superficial, partial-thickness and deep, full-thickness burns has several advantages. Compared with the results published in literature on other wound dressings, it requires a moderate number of dressing changes under narcosis and results in short hospital stays. Additionally, it has a low associated infection rate and promotes wound healing.
A Critical Appraisal of the Definition of Sarcopenia in Patients with Non-Alcoholic Fatty Liver Disease: Pitfall of Adjusted Muscle Mass by Body Weight
Authors: Park Huiyul , Jun Dae Won , Park Hoon-ki , Park Kye-Yeung , Kim Minki , Hwang Hwan-Sik
Published: September 2020

Traditionally, sarcopenia has defined as amount of absolute muscle mass adjusted by height in the elderly people. However, relative muscle mass adjusted by weight has been used extensively in most non-alcoholic fatty liver disease (NAFLD) studies. Here, we attempted to investigate the pitfall of adjusted muscle mass by weight to evaluate association between sarcopenia and NAFLD. Adult subjects (n = 1343) who underwent a health check-up were finally included for analysis. The weight-adjusted skeletal muscle mass index (wSMI) and height-adjusted SMI (hSMI) calculated by dividing the total appendicular skeletal muscle (ASM) by weight or the square of height, respectively. Prevalence of sarcopenia defined by wSMI in the NAFLD group was significantly higher than in the control group (1.3% vs. 8.8%, p < 0.001). However, there was no difference in the prevalence of sarcopenia defined by hSMI between the control and NAFLD groups (2.0% vs. 0.8%, p = 0.055). Since body weight was the most potent independent risk factor for NAFLD in multivariable logistic regression analysis, abnormal rates (<−1 SD) of almost all parameters increased in the NAFLD population, after weight adjustment. However, abnormal rates of non-metabolic parameter did not increase in NAFLD, after height adjustment. Only metabolic parameters showed relationship with NAFLD, after height adjustment. As NAFLD is highly associated with body weight, careful attention should be given in the case of studying the relationship of NAFLD with sarcopenia adjusted by body weight.
Tuning the Optical Band Gap of Semiconductor Nanocomposites—A Case Study with ZnS/Carbon
Authors: Voigt Dominik , Sarpong Larry , Bredol Michael
Published: September 2020

The linear photochemical response of materials depends on two critical parameters: the size of the optical band gap determines the onset of optical excitation, whereas the absolute energetic positions of the band edges define the reductive or oxidative character of photo-generated electrons and holes. Tuning these characteristics is necessary for many potential applications and can be achieved through changes in the bulk composition or particle size, adjustment of the surface chemistry or the application of electrostatic fields. In this contribution the influence of surface chemistry and fields is investigated systematically with the help of standard DFT calculations for a typical case, namely composites prepared from ZnS quantum dots and functionalized carbon nanotubes. After comparing results with existing qualitative and quantitative experimental data, it is shown conclusively, that the details of the surface chemistry (especially defects) in combination with electrostatic fields have the largest influence. In conclusion, the development of novel or improved photoresponsive materials therefore will have to integrate a careful analysis of the interplay between surface chemistry, surface charges and interaction with the material environment or substrate.
Deep Neural Network for Predicting Diabetic Retinopathy from Risk Factors
Authors: Alfian Ganjar , Syafrudin Muhammad , Fitriyani Norma Latif , Anshari Muhammad , Stasa Pavel , Svub Jiri , Rhee Jongtae
Published: September 2020

Extracting information from individual risk factors provides an effective way to identify diabetes risk and associated complications, such as retinopathy, at an early stage. Deep learning and machine learning algorithms are being utilized to extract information from individual risk factors to improve early-stage diagnosis. This study proposes a deep neural network (DNN) combined with recursive feature elimination (RFE) to provide early prediction of diabetic retinopathy (DR) based on individual risk factors. The proposed model uses RFE to remove irrelevant features and DNN to classify the diseases. A publicly available dataset was utilized to predict DR during initial stages, for the proposed and several current best-practice models. The proposed model achieved 82.033% prediction accuracy, which was a significantly better performance than the current models. Thus, important risk factors for retinopathy can be successfully extracted using RFE. In addition, to evaluate the proposed prediction model robustness and generalization, we compared it with other machine learning models and datasets (nephropathy and hypertension–diabetes). The proposed prediction model will help improve early-stage retinopathy diagnosis based on individual risk factors.
Level Sets of Weak-Morse Functions for Triangular Mesh Slicing
Authors: Mejia-Parra Daniel , Ruiz-Salguero Oscar , Cadavid Carlos , Moreno Aitor , Posada Jorge
Published: September 2020

In the context of CAD CAM CAE (Computer-Aided Design, Manufacturing and Engineering) and Additive Manufacturing, the computation of level sets of closed 2-manifold triangular meshes (mesh slicing) is relevant for the generation of 3D printing patterns. Current slicing methods rely on the assumption that the function used to compute the level sets satisfies strong Morse conditions, rendering incorrect results when such a function is not a Morse one. To overcome this limitation, this manuscript presents an algorithm for the computation of mesh level sets under the presence of non-Morse degeneracies. To accomplish this, our method defines weak-Morse conditions, and presents a characterization of the possible types of degeneracies. This classification relies on the position of vertices, edges and faces in the neighborhood outside of the slicing plane. Finally, our algorithm produces oriented 1-manifold contours. Each contour orientation defines whether it belongs to a hole or to an external border. This definition is central for Additive Manufacturing purposes. We set up tests encompassing all known non-Morse degeneracies. Our algorithm successfully processes every generated case. Ongoing work addresses (a) a theoretical proof of completeness for our algorithm, (b) implementation of interval trees to improve the algorithm efficiency and, (c) integration into an Additive Manufacturing framework for industry applications.
Composition and Antibacterial Activity of the Essential Oil from Pimenta dioica (L.) Merr. from Guatemala
Authors: Mérida-Reyes Max Samuel , Muñoz-Wug Manuel Alejandro , Oliva-Hernández Bessie Evelyn , Gaitán-Fernández Isabel Cristina , Simas Daniel Luiz Reis , Ribeiro da Silva Antonio Jorge , Pérez-Sabino Juan Francisco
Published: September 2020

Background:Pimenta dioica is a native tree of Central America, Southern Mexico, and the Caribbean used in traditional medicine. It grows in wet forests in the Guatemalan departments of Petén and Izabal. Since the plant is not being economically exploited in Guatemala, this study was aimed at determining the composition of the essential oil of P. dioica leaves and fruits and the antibacterial activity of the leaves in order to evaluate its possible use in health products. The essential oils of fruits and leaves are used as rubefacient, anti-inflammatory, carminative, antioxidant, and antiflatulent in different countries. Methods: Fruits and leaves of P. dioica from Izabal Department were collected in April 2014 and extracted by hydrodistillation method. The oils were analyzed by gas chromatography coupled with mass spectrometry (GC/MS). Results: Yields of 1.02 ± 0.11% for dried leaves and 1.51 ± 0.26% for fruits were obtained. Eugenol was the main component (65.9–71.4%). The leaf oil showed growth inhibition against two Gram-positive and two Gram-negative bacteria. Conclusions: The authors consider that the tree’s leaves can be evaluated as a source of ingredients for antiseptic products, and that it is important to evaluate other types of properties such as anti-inflammatory activity.
Effect of Pretreatment on Hydraulic Performance of the Integrated Membrane Process for Concentrating Nutrient in Biogas Digestate from Swine Manure
Authors: Zhan Yuanhang , Yin Fubin , Yue Caide , Zhu Jun , Zhu Zhiping , Zou Mengyuan , Dong Hongmin
Published: September 2020

Nanofiltration (NF) or reverse osmosis (RO) process has been widely applied for concentrating nutrient in biogas digestate. However, efficient pretreatment is key to the sustainable operation of NF or RO. In this study, the combination of NF and RO for concentrating biogas digestate was compared using different pretreatments of hollow fiber ultrafiltration membrane (HFUFM) and ceramic membrane (CUFM). Pilot-scale batch tests were conducted (500 L). CUFM showed a higher membrane flux than HFUFM (100 ~ 180 L·(m2·h)−1 vs. 17 ~ 35 L·(m2·h)−1), but they showed little impact on the NF + RO process. Membrane fluxes of NF and RO were 20 ~ 48 L·(m2·h)−1 and 16 ~ 40 L·(m2·h)−1, respectively. In the RO permeates, the removal rates of total suspended solids (TSS), total solids (TS), chemical oxygen demand (COD), total nitrogen (TN), NH4+-N, and Cl− were above 91%. In the concentrates, TN and total potassium (TK) were concentrated by 1.60 and 2.00 folds in the NF stage, and by 2.10 and 2.30 folds in the RO stage. Further attention should be paid to the antibiotics risks in the concentrates before they are utilized as plant fertilizers.
Electrospun Hybrid Perfluorosulfonic Acid/Sulfonated Silica Composite Membranes
Authors: Santos Leslie , Powers Devon , Wycisk Ryszard , Pintauro Peter
Published: September 2020

Electrospinning was employed to fabricate composite membranes containing perfluorosulfonic acid (PFSA) ionomer, poly(vinylidene fluoride) (PVDF) reinforcement and a sulfonated silica network, where the latter was incorporated either in the PFSA matrix or in the PVDF fibers. The best membrane, in terms of proton conductivity, was made by incorporating the sulfonated silica network in PFSA fibers (Type-A) while the lowest conductivity membrane was obtained when sulfonated silica was incorporated into the reinforcing PVDF fibers (Type-B). A Type-A membrane containing 65 wt.% PFSA with an embedded sulfonated silica network (at 15 wt.%) and with 20 wt.% PVDF reinforcing fibers proved superior to the pristine PFSA membrane in terms of both the proton conductivity in the 30–90% RH at 80 °C (a 25–35% increase) and lateral swelling (a 68% reduction). In addition, it was demonstrated that a Type-A membrane was superior to that of a neat 660 EW perfluoroimide acid (PFIA, from 3M Co.) films with respect to swelling and mechanical strength, while having a similar proton conductivity vs. relative humidity profile. This study demonstrates that an electrospun nanofiber composite membrane with a sulfonated silica network added to moderately low EW PFSA fibers is a viable alternative to an ultra-low EW fluorinated ionomer PEM, in terms of properties relevant to fuel cell applications.
Effect of Periodic Overloads on Short Fatigue Crack Behavior in CuNi2Si Alloy under Rotating Bending Load
Authors: Qin Yahang , Yang Bing , Feng Bo , Li Yifan , Xiao Shoune , Yang Guangwu , Zhu Tao
Published: September 2020

In this study, the short fatigue crack behavior in a precipitation-strengthened CuNi2Si alloy was investigated using a replica technique under rotating bending loads with periodic overloads, an overload ratio of 1.5, and the stress ratio of both was R = −1. The results show that all the fatigue cracks originated from the surface of the specimen and displayed a trend of slow initiation and then rapid propagation. The introduction of overloads significantly reduced the fatigue crack initiation time and the fatigue life of the sample. The average life of the overloaded samples was only 31% that of the constant load samples. For overload specimens, multiple cracks grew at the same time and merged at different stages, causing the crack length to increase instantaneously after they merged, thereby considerably reducing the fatigue life. Fractographical analysis and observation of the surface-etched sample replica film showed that cracks in samples with and without overload both propagated along the grain boundaries.
Chasing the Major Sphingolipids on Earth: Automated Annotation of Plant Glycosyl Inositol Phospho Ceramides by Glycolipidomics
Authors: Panzenboeck Lisa , Troppmair Nina , Schlachter Sara , Koellensperger Gunda , Hartler Jürgen , Rampler Evelyn
Published: September 2020

Glycosyl inositol phospho ceramides (GIPCs) are the major sphingolipids on earth, as they account for a considerable fraction of the total lipids in plants and fungi, which in turn represent a large portion of the biomass on earth. Despite their obvious importance, GIPC analysis remains challenging due to the lack of commercial standards and automated annotation software. In this work, we introduce a novel GIPC glycolipidomics workflow based on reversed-phase ultra-high pressure liquid chromatography coupled to high-resolution mass spectrometry. For the first time, automated GIPC assignment was performed using the open-source software Lipid Data Analyzer (LDA), based on platform-independent decision rules. Four different plant samples (salad, spinach, raspberry, and strawberry) were analyzed and the results revealed 64 GIPCs based on accurate mass, characteristic MS2 fragments and matching retention times. Relative quantification using lactosyl ceramide for internal standardization revealed GIPC t18:1/h24:0 as the most abundant species in all plants. Depending on the plant sample, GIPCs contained mainly amine, N-acetylamine or hydroxyl residues. Most GIPCs revealed a Hex-HexA-IPC core and contained a ceramide part with a trihydroxylated t18:0 or a t18:1 long chain base and hydroxylated fatty acid chains ranging from 16 to 26 carbon atoms in length (h16:0–h26:0). Interestingly, four GIPCs containing t18:2 were observed in the raspberry sample, which was not reported so far. The presented workflow supports the characterization of different plant samples by automatic GIPC assignment, potentially leading to the identification of new GIPCs. For the first time, automated high-throughput profiling of these complex glycolipids is possible by liquid chromatography-high-resolution tandem mass spectrometry and subsequent automated glycolipid annotation based on decision rules.