bluuebunny/crossref_metadata_2025 huggingface dataset:
A Cognitive—Behavioral Intervention for Postpartum Anxiety and Depression: Individual Phone vs. Group Format
Authors: Simhi Meital , Sarid Orly , Rowe Heather , Fisher Jane , Cwikel Julie
Published: December 2021

Cognitive–behavioral interventions can effectively treat symptoms of perinatal mood and anxiety disorders (PMADs). We assessed the acceptability and effectiveness of a workbook-based intervention (What Am I Worried About? (WAWA)) comprising of cognitive–behavioral and mindfulness techniques and weekly professional guidance to address symptoms of depression, anxiety, and stress among postpartum mothers. We compared the efficacy of group versus individual telephone consultation using a pre-and post-test single group, open trial, research design in replication pilot study. A convenience sample of community-residing postpartum women (n = 34) chose between group intervention (n = 24) or individual phone consultation with a mental health professional (n = 10). Outcome measures were anxiety (GAD-7), depression, anxiety, and stress (DASS21), and postpartum depression (PPD-EPDS). After four weeks intervention, significant reductions were observed in postpartum depression, anxiety, and stress scales. Cohen’s d statistics showed medium effect sizes (0.35–0.56). A small but significantly larger change in PPD-EPDS and DASS stress scores was reported among participants who opted for the phone intervention compared to those in the group intervention. Most participants felt that the intervention was highly beneficial and would recommend it to other postpartum women. In conclusion, the WAWA intervention showed efficacy for reducing postpartum anxiety, distress, and depressive symptoms among postpartum women, with a slightly greater reduction in PPD-EPDS and stress symptoms found among those who opted for individual phone consultation. Definitive evaluation of the intervention requires a larger sample and a RCT research design with two treatment arms: telephone and group intervention.
Chemosensitivity of Lung Metastatic High-Grade Synovial Sarcoma
Authors: Tetta Cecilia , Montrone Grazia , Longhi Alessandra , Rocca Michele , Londero Francesco , Parise Gianmarco , Parise Orlando , Maessen Jos G. , Miceli Marco , Gelsomino Sandro
Published: December 2021

Background: Synovial sarcoma is a relatively chemosensitive type of soft tissue sarcoma and it often metastasizes to the lung. We investigated the role of adjuvant chemotherapy in patients with high-grade synovial sarcoma at their first lung metastasectomy (LMTS). Methods: Forty-six HGSS patients had their first LMTS at our institute (Rizzoli Orthopedic Hospital, Bologna, Italy) between 2000 and 2020. We divided them into two groups: (1) those undergoing adjuvant chemotherapy (n = 24) and (2) those not receiving adjuvant chemotherapy (n = 22). The primary outcome was a median survival at 32.5 (IQR 18.0–82.7) median follow-up. The disease-free interval was calculated at time zero (DFI0, interval between the diagnosis of the primary tumor and the first CT-diagnosed lung metastasis) and at any further lung relapse (DFI1–3). T0 was defined as the time at first LMTS and T1–T3 referred to the time of further metastasectomy. Results: Freedom from SS-specific mortality at 60 months was significantly higher in patients without chemotherapy (50.0% (33.0–76.0%) vs. 20.8% (9.55%–45.4%), p = 0.01). Chemotherapy was associated with a higher risk of SS-specific mortality at multivariable Cox regression (HR 2.8, p = 0.02). Furthermore, DFI0 ≤ 6 months, female sex, age > 40 years, and primary tumor > 10 cm increased the risk of death by about four, six, >three, and >five times, respectively. Conclusions. Adjuvant chemotherapy did not show any advantage in terms of freedom from SS-specific mortality in HGSS patients. Further larger studies are necessary to confirm our findings.
Comparison of Intramedullary Magnetic Nail, Monolateral External Distractor, and Spatial External Fixator in Femur Lengthening in Adolescents with Congenital Diseases
Authors: Pietrzak Szymon , Grzelecki Dariusz , Parol Tomasz , Czubak Jarosław
Published: December 2021

The aim of this study is to evaluate the course of the treatment and clinical and functional outcomes of femur lengthening in adolescents with congenital disorders by the application of different surgical methods. This retrospective study comprised 35 patients (39 procedures). A total of 11 patients underwent femur lengthening with the use of the intramedullary magnetic nail (IMN) Precise 2 (NuVasive, San Diego, CA, USA), 7 patients (11 procedures) with the use of the monolateral external distractor Modular Rail System (MRS) (Smith and Nephew, Memphis, TN, USA), and 17 with the use of the computer-assisted external fixator Taylor Spatial Frame (TSF) (Smith and Nephew, Memphis, TN, USA). The inclusion criteria were as follows: (1) congenital femoral length deficiency without any axial deformities and (2), independently of the finally applied treatment, the technical possibility of use of each of the analyzed methods. The distraction index did not differ significantly between the groups (p = 0.89). The median lengthening index was the lowest in the IMN group (24.3 d/cm; IQR 21.8–33.1) and statistically different in comparison to the MRS (44.2 d/cm; IQR 42–50.9; p < 0.001) and the TSF groups (48.4 d/cm; IQR 38.6–63.5; p < 0.001). Similarly, the consolidation index in the IMN group (12.9 d/cm; IQR 10.7–21.3) was statistically lower than that in the MRS (32.9 d/cm; IQR 30.2–37.6; p < 0.001) and the TSF (36.9 d/cm; IQR 26.6–51.5; p < 0.001) groups. This study indicates that IMN is a more valuable method of treatment for femoral length discrepancy without axial deformity than MRS and TSF in complication rate and indexes of lengthening and consolidation.
Time Course of Acute Vertebral Fractures: A Prospective Multicenter Cohort Study
Authors: Inose Hiroyuki , Kato Tsuyoshi , Shirasawa Shinichi , Takahashi Shinji , Hoshino Masatoshi , Yamato Yu , Matsukura Yu , Hirai Takashi , Yoshii Toshitaka , Okawa Atsushi
Published: December 2021

To date, it is still unclear how fresh osteoporotic vertebral fractures (OVFs) affect the patient’s quality of life and low back pain during a follow-up period of more than 1 year. In the previous trial, women with fresh OVF were randomized to rigid or soft brace for 12 weeks, then both groups were followed for the subsequent 48 weeks. In women completing this trial at our affiliated hospitals, we conducted a follow-up study to investigate the long-term course of an acute vertebral fracture in terms of pain and quality of life. When comparing visual analog scale scores for low back pain and European Quality of Life-5 Dimensions Questionnaire scores between consecutive time points, a significant difference was found between 0 and 12 weeks, but not between 12 and 48 weeks or between 48 weeks and final follow-up. A total 25% had residual low back pain at the final follow-up. A stepwise logistic regression analysis identified age and previous vertebral fracture as predictors of residual low back pain at the final follow-up. Therefore, the degree of low back pain and impairment of the quality of life improved by 12 weeks after injury and did not change thereafter until a mean follow-up of 5.3 years.
Effects of an Eccentric Training Protocol Using Gliding Discs on Balance and Lower Body Strength in Healthy Adults
Authors: Lopez-Barreiro Juan , Hernandez-Lucas Pablo , Garcia-Soidan Jose Luis , Romo-Perez Vicente
Published: December 2021

Impaired balance and lower body weakness are the main causes of falls, which are considered to be the major cause of fractures and head injuries in the elderly and are recognised as a serious health problem. The aim of this study is to observe the effect of eccentric training, introducing new technologies (gliding discs), on body composition, lower body strength, balance and quality of life. A quasi-experimental study was carried out with 56 healthy participants who were divided into an experimental group (n = 31) who underwent the protocol consisting of 12 training sessions and a control group (n = 25) who did not undergo the training. Before and after the intervention, all participants underwent a measurement of body composition, the SJ jump, balance with accelerometry and quality of life with the Short Form 12 Health Survey. In the experimental group, statistically significant improvements were found in the variables balance and lower body strength. The application of this training protocol improves lower body strength and the ability to control balance in the adult population.
Associations of Exercise Habits in Adolescence and Old Age with Risk of Osteoporosis in Older Adults: The Bunkyo Health Study
Authors: Otsuka Hikaru , Tabata Hiroki , Shi Huicong , Kaga Hideyoshi , Someya Yuki , Abulaiti Abudurezake , Naito Hitoshi , Umemura Futaba , Kakehi Saori , Ishijima Muneaki , Kawamori Ryuzo , Watada Hirotaka , Tamura Yoshifumi
Published: December 2021

We investigated effects of exercise habits (EHs) in adolescence and old age on osteoporosis prevalence and hip joint and lumbar spine bone mineral density (BMD). Body composition and BMD in 1596 people aged 65–84 years living in Bunkyo-ku, Tokyo, were measured using dual-energy X-ray absorptiometry. We divided participants into four groups by a combination of EHs in adolescence and old age: none in either period (None-None), only in adolescence (Active-None), only in old age (None-Active), and in both periods (Active-Active). Logistic regression models were employed to estimate multivariable-adjusted odds ratios (ORs) for osteoporosis determined by T-score (less than −2.5 SD) using the None-None reference group. In men, the combination of EHs in adolescence and old age was not associated with osteoporosis prevalence. However, the lumbar spine’s BMD was significantly higher in the Active-Active than the None-Active group (p = 0.043). In women, the Active-Active group had lower lumbar spine osteoporosis prevalence than the None-None group (OR 0.65; 95% CI, 0.42–1.00, p = 0.049). Furthermore, hip BMD was significantly higher in the Active-Active group than in the other three groups (p = 0.001). Older women with EHs in adolescence and old age had higher lumbar BMD and lower risk of osteoporosis.
Benchmarking PASADENA Consensus along the Learning Curve of Robotic Radical Cystectomy with Intracorporeal Neobladder: CUSUM Based Assessment
Authors: Lombardo Riccardo , Mastroianni Riccardo , Tuderti Gabriele , Ferriero Mariaconsiglia , Brassetti Aldo , Anceschi Umberto , Guaglianone Salvatore , De Nunzio Cosimo , Cicione Antonio , Tubaro Andrea , Gallucci Michele , Simone Giuseppe
Published: December 2021

(1) Aim: Robot assisted radical cystectomy (RARC) with intacorporeal neobladder (iN) is a challenging procedure. There is a paucity of reports on RARC-iN, the extracorporeal approach being the most used. The aim of our study was to assess the learning curve of RARC-iN and to test its performance in benchmarking Pasadena consensus outcomes. (2) Material and methods: The single-institution learning curve of RARC-iN was retrospectively evaluated. Demographic, clinical and pathologic data of all patients were recorded. Indications to radical cystectomy included muscle invasive bladder cancer (pT ≥ 2) or recurrent high grade non muscle invasive bladder cancer. The cumulative sum (CUSUM) technique, one of the methods developed to monitor the performance and quality of the industrial sector, was adopted by the medical field in the 1970s to analyze learning curves for surgical procedures. The learning curve was evaluated using the following criteria: 1. operative time (OT) <5 h; 2. 24-h Hemoglobin (Hb) drop <2 g/dl; 3. severe complications (according to the Clavien classification system) <30%; 4. positive surgical margins <5%; and 5. complete lymph-node dissection defined as more than 16 nodes. Benchmarking of all five items on quintile analysis was tested, and a failure rate <20% for any outcome was set as threshold. (3) Results: the first 100 consecutive RARC-iN patients were included in the analysis. At CUSUM analysis, RARC required 20 cases to achieve a plateau in terms of operative time (defined as more than 3 consecutive procedures below 300 min). Hemoglobin drop, PSM and number of removed lymph-nodes did not change significantly along the learning curve. Overall, 41% of the patients presented at least one complication. Low-grade and high-grade complication rates were 30% and 17%, respectively. When assessing the benchmarks of all five Pasadena consensus outcomes on quintile analysis, a plateau was achieved after the first 60 cases. (4) Conclusions: RARC-iN is a challenging procedure. The potential impact of the learning curve on significant outcomes, such as high grade complications and positive surgical margins, has played a detrimental effect on its widespread adoption. According to this study, in tertiary referral centers, 60 procedures are sufficient to benchmark all outcomes defined in Pasadena RARC consensus.
Extracorporeal Shock Wave Therapy Combined with Complex Decongestive Therapy in Patients with Breast Cancer-Related Lymphedema: A Systemic Review and Meta-Analysis
Authors: Tsai Yu Lin , I Ting Jie , Chuang Ya Chi , Cheng Yuan Yang , Lee Yu Chun
Published: December 2021

Breast cancer-related lymphedema (BCRL) is one of the most significant complications seen after surgery. Several studies demonstrated that extracorporeal shock wave therapy (ESWT), in addition to conventional complex decongestive therapy (CDT), had a positive effect on BCRL in various aspects. The systematic review and meta-analysis aim to explore the effectiveness of ESWT with or without CDT on BRCL patients. We searched PubMed, Embase, PEDro, Cochrane Library Databases, and Google Scholar for eligible articles and used PRISMA2020 for paper selection. Included studies were assessed by the PEDro score, Modified Jadad scale, STROBE assessment, and GRADE framework for the risk of bias evaluation. The primary outcomes were the volume of lymphedema and arm circumference. Secondary outcome measures were skin thickness, shoulder joint range of motion (ROM), and an impact on quality-of-life questionnaire. Studies were meta-analyzed with the mean difference (MD). Eight studies were included in the systemic review and four in the meta-analysis. In summary, we found that adjunctive ESWT may significantly improve the volume of lymphedema (MD = −76.44; 95% CI: −93.21, −59.68; p < 0.00001), skin thickness (MD = −1.65; 95% CI: −3.27, −0.02; p = 0.05), and shoulder ROM (MD = 7.03; 95% CI: 4.42, 9.64; p < 0.00001). The evidence level was very low upon GRADE appraisal. ESWT combined with CDT could significantly improve the volume of lymphedema, skin thickness, and shoulder ROM in patients with BCRL. There is not enough evidence to support the use of ESWT as a replacement for CDT. This study was registered with PROSPERO: CRD42021277110.
Comparison of Acute Withdrawal and Slow Taper of Antiseizure Medications during Video Electroencephalographic Monitoring: Efficacy for Shortening of Hospital Stay
Authors: Motoki Ayako , Akamatsu Naoki , Fumuro Tomoyuki , Miyoshi Ayako , Tanaka Hideaki , Hagiwara Koichi , Ohara Shinji , Kamada Takashi , Shigeto Hiroshi , Murai Hiroyuki
Published: December 2021

Antiepileptic medications (ASMs) are withdrawn at the epilepsy monitoring unit to facilitate seizure recordings. The effect of rapid tapering of ASMs on the length of hospital stay has not been well documented. We compared the mean length of hospital stay between patients who underwent acute ASM withdrawal and slow dose tapering during long-term video electroencephalography (EEG) monitoring. We retrospectively investigated 57 consecutive patients admitted to the epilepsy monitoring unit regarding the mean length of hospital stay in the acute ASM withdrawal group (n = 30) and slow-taper group (n = 27). In the acute-withdrawal group, all ASMs were discontinued once the patients were admitted. In the slow-taper group, the doses of ASMs were gradually reduced by 15–30% daily. We also evaluated the safety of the acute-withdrawal and slow-taper protocols. The mean lengths of hospital stay were 3.8 ± 1.92 and 5.2 ± 0.69 days in the acute-withdrawal and slow-taper groups, respectively (p < 0.005). No severe adverse events, including status epilepticus, were observed. Acute ASM withdrawal has the advantage of significantly reducing the length of hospital stay over slow tapering, without any severe adverse effects.
Distal Radial Artery Access for Coronary and Peripheral Procedures: A Multicenter Experience
Authors: Achim Alexandru , Kákonyi Kornél , Jambrik Zoltán , Nagy Ferenc , Tóth Julia , Sasi Viktor , Hausinger Péter , Nemes Attila , Varga Albert , Bertrand Olivier F. , Ruzsa Zoltán
Published: December 2021

Introduction: Distal radial access (dRA) has recently gained global popularity as an alternative access route for vascular procedures. Among the benefits of dRA are the low risk of entry site bleeding complications, the low rate of radial artery occlusion, and improved patient and operator comfort. The aim of this large multicenter registry was to demonstrate the feasibility and safety of dRA in a wide variety of routine procedures in the catheterization laboratory, ranging from coronary angiography and percutaneous coronary intervention to peripheral procedures. Methods: The study comprised 1240 patients who underwent coronary angiography, PCI or noncoronary procedures through dRA in two Hungarian centers from January 2019 to April 2021. Baseline patient characteristics, number and duration of arterial punctures, procedural success rate, crossover rate, postoperative compression time, complications, hospitalization duration, and different learning curves were analyzed. Results: The average patient age was 66.4 years, with 66.8% of patients being male. The majority of patients (74.04%) underwent a coronary procedure, whereas 25.96% were involved in noncoronary interventions. dRA was successfully punctured in 97% of all patients, in all cases with ultrasound guidance. Access site crossover was performed in 2.58% of the patients, mainly via the contralateral dRA. After experiencing 150 cases, the dRA success rate plateaued at >96%. Our dedicated dRA step-by step protocol resulted in high open radial artery (RA) rates: distal and proximal RA pulses were palpable in 99.68% of all patients at hospital discharge. The rate of minor vascular complications was low (1.5%). A threshold of 50 cases was sufficient for already skilled radial operators to establish a reliable procedural method of dRA access. Conclusion: The implementation of distal radial artery access in the everyday routine of a catheterization laboratory for coronary and noncoronary interventions is feasible and safe with an acceptable learning curve.
Analyzing the Fitting of Novel Preformed Osteosynthesis Plates for the Reduction and Fixation of Mandibular Fractures
Authors: Fuessinger Marc Anton , Gass Mathieu , Woelm Caroline , Cornelius Carl-Peter , Zimmerer Ruediger M. , Poxleitner Philipp , Schlager Stefan , Metzger Marc Christian
Published: December 2021

Purpose: The known preformed osteosynthesis plates for the midface are helpful tools for a precise and fast fixation of repositioned fractures. The purpose of the current study is to analyze the precision of newly developed prototypes of preformed osteosynthesis plates for the mandible. Methods: Four newly designed preformed osteosynthesis plates, generated by a statistical shape model based on 115 CT scans, were virtually analyzed. The used plates were designed for symphyseal, parasymphyseal, angle, and condyle fractures. Each type of plate has three different sizes. For analysis, the shortest distance between the plate and the bone surface was measured, and the sum of the plate-to-bone distances over the whole surface was calculated. Results: A distance between plate and bone of less than 1.5 mm was defined as sufficient fitting. The plate for symphyseal fractures showed good fitting in 90% of the cases for size M, and in 84% for size L. For parasymphyseal fractures, size S fits in 80%, size M in 68%, and size L in 65% of the cases. Angle fractures with their specific plate show good fitting for size S in 53%, size M in 60%, and size L in 47%. The preformed plate for the condyle part fits for size S in 75%, for size M in 85%, and for size L in 74% of the cases. Conclusion: The newly developed mandible plates show sufficient clinical fitting to ensure adequate fracture reduction and fixation.
The Utility of Metabolic Parameters on Baseline F-18 FDG PET/CT in Predicting Treatment Response and Survival in Paediatric and Adolescent Hodgkin Lymphoma
Authors: Reed Janet Denise , Masenge Andries , Buchner Ane , Omar Fareed , Reynders David , Vorster Mariza , Van de Wiele Christophe , Sathekge Mike
Published: December 2021

Lymphoma is the third most common paediatric cancer. Early detection of high-risk patients is necessary to anticipate those who require intensive therapy and follow-up. Current literature shows that residual tumor avidity on PET (Positron Emission Tomography) following chemotherapy corresponds with decreased survival. However, the value of metabolic parameters has not been adequately investigated. In this retrospective study, we aimed to evaluate the prognostic value of metabolic and other parameters in paediatric and adolescent Hodgkin lymphoma. We recorded tMTV (total Metabolic Tumor Volume), TLG (Total Lesion Glycolysis), and SUVmax (maximum Standard Uptake Value) on baseline PET, as well the presence of bone marrow or visceral involvement. HIV (human immunodeficiency virus) status and baseline biochemistry from clinical records were noted. All patients received stage-specific standard of care therapy. Response assessment on end-of-treatment PET was evaluated according to the Deauville criteria. We found that bone marrow involvement (p = 0.028), effusion (p < 0.001), and treatment response (p < 0.001) on baseline PET, as well as HIV status (p = 0.036) and baseline haemoglobin (p = 0.039), were significantly related to progression-free survival (PFS), whereas only effusion (p = 0.017) and treatment response (p = 0.050) were predictive of overall survival (OS). Only baseline tMTV predicted treatment response (p = 0.017). This confirms the value of F-18 FDG PET/CT (Fluoro-deoxy-glucose Positron Emission Tomography/Computed Tomography) in prognostication in paediatric and adolescent Hodgkin lymphoma; however, further studies are required to define the significance of metabolic parameters.
Does COVID-19 Clinical Status Associate with Outcome Severity? An Unsupervised Machine Learning Approach for Knowledge Extraction
Authors: Karlafti Eleni , Anagnostis Athanasios , Kotzakioulafi Evangelia , Vittoraki Michaela Chrysanthi , Eufraimidou Ariadni , Kasarjyan Kristine , Eufraimidou Katerina , Dimitriadou Georgia , Kakanis Chrisovalantis , Anthopoulos Michail , Kaiafa Georgia , Savopoulos Christos , Didangelos Triantafyllos
Published: December 2021

Since the beginning of the COVID-19 pandemic, 195 million people have been infected and 4.2 million have died from the disease or its side effects. Physicians, healthcare scientists and medical staff continuously try to deal with overloaded hospital admissions, while in parallel, they try to identify meaningful correlations between the severity of infected patients with their symptoms, comorbidities and biomarkers. Artificial intelligence (AI) and machine learning (ML) have been used recently in many areas related to COVID-19 healthcare. The main goal is to manage effectively the wide variety of issues related to COVID-19 and its consequences. The existing applications of ML to COVID-19 healthcare are based on supervised classifications which require a labeled training dataset, serving as reference point for learning, as well as predefined classes. However, the existing knowledge about COVID-19 and its consequences is still not solid and the points of common agreement among different scientific communities are still unclear. Therefore, this study aimed to follow an unsupervised clustering approach, where prior knowledge is not required (tabula rasa). More specifically, 268 hospitalized patients at the First Propaedeutic Department of Internal Medicine of AHEPA University Hospital of Thessaloniki were assessed in terms of 40 clinical variables (numerical and categorical), leading to a high-dimensionality dataset. Dimensionality reduction was performed by applying a principal component analysis (PCA) on the numerical part of the dataset and a multiple correspondence analysis (MCA) on the categorical part of the dataset. Then, the Bayesian information criterion (BIC) was applied to Gaussian mixture models (GMM) in order to identify the optimal number of clusters under which the best grouping of patients occurs. The proposed methodology identified four clusters of patients with similar clinical characteristics. The analysis revealed a cluster of asymptomatic patients that resulted in death at a rate of 23.8%. This striking result forces us to reconsider the relationship between the severity of COVID-19 clinical symptoms and the patient’s mortality.
Risk of Dementia in Patients Who Underwent Surgery under Neuraxial Anesthesia: A Nationwide Cohort Study
Authors: Kwon Young-Suk , Lee Jae-Jun , Lee Sang-Hwa , Kim Chulho , Yu Hyunjae , Sohn Jong-Hee , Kim Dong-Kyu
Published: December 2021

The incidence of dementia in patients with surgery under neuraxial anesthesia and the possibility of surgery under neuraxial anesthesia as a risk factor for dementia were investigated. We performed a retrospective matched cohort study with nationwide, representative cohort sample data of the Korean National Health Insurance Service in South Korea between 1 January 2003, and 31 December 2004. The participants were divided into control (n = 4488) and neuraxial groups (n = 1122) using propensity score matching. After 9 years of follow-up, the corresponding incidences of dementia were 11.5 and 14.8 cases per 1000 person-years. The risk of dementia in the surgery under neuraxial group was 1.44-fold higher (95% confidence interval [95%CI], 1.17–1.76) than that in the control group. In the subgroup analysis of dementia, the risk of Alzheimer’s disease in those who underwent surgery under neuraxial anesthesia was 1.48-fold higher (95%CI, 1.17–1.87) than that in those who did not undergo surgery under anesthesia. Our findings suggest that patients who underwent surgery under neuraxial anesthesia had a higher risk of dementia and Alzheimer’s disease than those who did not undergo surgery under neuraxial anesthesia.
Who Started, Stopped, and Continued Participating in Outdoor Recreation during the COVID-19 Pandemic in the United States? Results from a National Panel Study
Authors: Taff B. Derrick , Rice William L. , Lawhon Ben , Newman Peter
Published: December 2021

The COVID-19 pandemic has been proposed as a catalyst for many U.S. residents to re-engage in outdoor recreation or engage in outdoor recreation for the first time. This manuscript describes the results of a representative U.S. national panel study aimed at better understanding the socio-demographic profile (gender, ethnicity, community type, income, and age) of those participants new to outdoor recreation since the start of the COVID-19 pandemic. In doing so, we address how these new outdoor recreationists differ from (1) those who frequently participated in outdoor recreation prior to the pandemic and continue to participate in outdoor recreation, (2) those who did not frequently participate in outdoor recreation prior to the pandemic and remain un-engaged, and (3) those who frequently participated in outdoor recreation prior to the pandemic but stopped their frequent participation following the onset of the pandemic. Results from this U.S. national study suggest that 35.8% of respondents indicated that they did not participate regularly in outdoor recreation prior to the pandemic or during the pandemic, 30.4% indicated that they did participate regularly in outdoor recreation prior to the pandemic and continued to do so regularly during the pandemic, and 13.5% indicated that they did participate regularly in outdoor recreation prior to the pandemic, but did not continue to do so during the pandemic. More than 20% of the sample indicated that they were new outdoor recreationists. The majority of respondents in all categories, including those that were new to outdoor recreation amidst the pandemic, identified as being white, however these new outdoor recreationists were also the least ethnically diverse. The previously but no longer outdoor recreationist respondents were significantly more ethnically diverse than the other three groups, and they tended to live in more urbanized settings. Discussion of these results includes implications for outdoor recreation managers, and researchers who seek to better understand who the COVID-19 pandemic has influenced with regard to outdoor recreation participation. Implications regarding social justice, access and equity to public places that facilitate outdoor recreation, and health-related policies are discussed.
A Geospatial Approach to Measure Social Benefits in Urban Land Use Optimization Problem
Authors: Rahman Md. Mostafizur , Szabó György
Published: December 2021

Different conflicting objectives are used in urban land use optimization problems. The maximization of social benefit is one of the important objectives in urban land use optimization problems. Many researchers have used different methods to measure social benefits in land use optimization. Studies show that there is no established method to measure social benefit in the urban land use allocation game. Against this background, this study aims to (a) identify the appropriate indicators as a measure of social benefit, and (b) propose a composite index to measure social benefit in urban land use optimization problems. Based on the literature review and expert opinion, this study identifies four indicators as a measure of social benefit. These are spatial compactness, land use compatibility, land use mix, and evenness of population distribution. Using the weighted sum approach, this study proposes a composite social benefit index (SBI) to measure social benefit in urban land use allocation/optimization problems and planning. The study suggests that spatial compactness is the most influential indicator to the SBI, but the most critical indicator is compatibility, whose 11.60% value reduction from 0.5 alters the decision of choice. Finally, the proposed method was applied in Rajshahi city in Bangladesh. The result suggests the potential of using SBI in the land use allocation problem. It is expected that the proposed social benefit index (SBI) will help the land use optimization and planning and will be helpful for decision makers.
Conserving Working Rangelands: A Social–Ecological Case Study from Northeastern Colorado
Authors: Bruno Jasmine E. , Leisz Stephen J. , Bobula Jake S. , Fernández-Giménez María E.
Published: December 2021

Land changes in rangeland systems cascade through interconnected social and ecological spheres, affecting both humans and the environment. This study applied a multi-method approach to examine the causes and consequences of change in two rangeland communities in northeastern (NE) Colorado. First, this study used a Random Forest supervised classifier to analyze 36 years of land-cover data and create a land-cover/use change classification model. Second, the research team analyzed transcripts of interviews with 32 ranchers, examining how ranchers’ adaptive strategies influence land-cover change trends. Lastly, the analysis integrated the quantitative and qualitative data, constructing a social–ecological rangeland change conceptual model. This study found that the cultivated area decreased in both study sites from 1984–2019, with 16.0% and 18.7% of each site transitioning out of the cultivated area. Moreover, 10.3% and 18.4% of each site, respectively, transitioned to herbaceous/grassland cover from 1984–2019. The qualitative analysis identified the role of conservation policies, such as open space programs, on land change. Also, despite the relatively small area that transitioned to developed cover—1.83% and 0.183% of each site—participants emphasized that the associated demographic and cultural shifts drive land-use change. This study highlights that while rangelands are undergoing social–ecological change, land-use decisions and land conservation programs can help mitigate the global trend of declining rangeland and grassland cover.
The Influence of Subjective and Objective Characteristics of Urban Human Settlements on Residents’ Life Satisfaction in China
Authors: Li Xueming , Liu He
Published: December 2021

Under the guidance of people-oriented development concepts, improving residents’ life satisfaction has gradually become the goal of urban governance. Based on Chinese household tracking survey data and national socio-economic statistics, this study used the entropy method, multi-layer linear regression model and geographically weighted regression model and discusses the spatial heterogeneity of the impact of objective environmental characteristics and subjective perceived characteristics of urban residential environments on residents’ life satisfaction. It is of great importance to study the mechanisms through which subjective and objective characteristics of urban human settlements influence living satisfaction among residents. It is also important to discuss how to improve living satisfaction levels through the urban human settlements and to realize high-quality urban development. The research results show that in 2018, the overall level of life satisfaction among Chinese urban residents was relatively high. However, it is still necessary to continue to optimize the urban human settlements to improve residents’ life satisfaction. The objective characteristics of the urban human settlements, such as natural environmental comfort and environmental health, have a significant positive impact on residents’ life satisfaction. Residents’ subjective perceptions of government integrity, environmental protection, wealth gap, social security, medical conditions and medical level, as well as residents’ individual gender, age and health status also have a significant impact on residents’ life satisfaction. The direction and intensity of effects of different elements of the urban human settlements and residents’ personal attributes on urban residents’ life satisfaction have different characteristics in different regions.
Efficient Generation of P53 Biallelic Mutations in Diannan Miniature Pigs Using RNA-Guided Base Editing
Authors: Li Honghui , Cheng Wenmin , Chen Bowei , Pu Shaoxia , Fan Ninglin , Zhang Xiaolin , Jiao Deling , Shi Dejia , Guo Jianxiong , Li Zhuo , Qing Yubo , Jia Baoyu , Zhao Hong-Ye , Wei Hong-Jiang
Published: December 2021

The base editing 3 (BE3) system, a single-base gene editing technology developed using CRISPR/Cas9n, has a broad range of applications for human disease model construction and gene therapy, as it is highly efficient, accurate, and non-destructive. P53 mutations are present in more than 50% of human malignancies. Due to the similarities between humans and pigs at the molecular level, pig models carrying P53 mutations can be used to research the mechanism of tumorigenesis and improve tumor diagnosis and treatment. According to pathogenic mutations of the human P53 gene at W146* and Q100*, sgRNAs were designed to target exon 4 and exon 5 of the porcine P53 gene. The target editing efficiencies of the two sgRNAs were 61.9% and 50.0%, respectively. The editing efficiency of the BE3 system was highest (about 60%) when C (or G) was at the 5th base. Puromycin screening revealed that 75.0% (21/28) and 68.7% (22/32) of cell colonies contained a P53 mutation at sgRNA-Exon5 and sgRNA-Exon4, respectively. The reconstructed embryos from sgRNA-Exon5-5# were transferred into six recipient gilts, all of which aborted. The reconstructed embryos from sgRNA-Exon4-7# were transferred into 6 recipient gilts, 3 of which became pregnant, resulting in 14 live and 3 dead piglets. Sequencing analyses of the target site confirmed 1 P53 monoallelic mutation and 16 biallelic mutations. The qPCR analysis showed that the P53 mRNA expression level was significantly decreased in different tissues of the P53 mutant piglets (p < 0.05). Additionally, confocal microscopy and western blot analysis revealed an absence of P53 expression in the P53 mutant fibroblasts, livers, and lung tissues. In conclusion, a porcine cancer model with a P53 point mutation can be obtained via the BE3 system and somatic cell nuclear transfer (SCNT).
House Dust Mite Precision Allergy Molecular Diagnosis (PAMD@) in the Th2-prone Atopic Dermatitis Endotype
Authors: González-Pérez Ruperto , Poza-Guedes Paloma , Pineda Fernando , Castillo Miriam , Sánchez-Machín Inmaculada
Published: December 2021

Atopic dermatitis (AD) endotyping might be important for developing personalized diagnostic and therapeutic strategies to the different phenotypes. The current study investigated the IgE molecular profile to Dermatophagoides pteronyssinus (D. pteronyssinus) in a subset of patients afflicted with varying severity stages of atopic dermatitis in a subtropical region subjected to a high perennial house dust mite (HDM) exposure. We selected patients showing a clinically relevant sensitization to HDM with mild-to-moderate and severe AD according to their basal Severity Scoring Atopic Dermatitis (SCORAD) index. Skin prick test (SPT) with standardized mite extracts, as well as a Precision Allergy Molecular Diagnosis (PAMD@) panel including nine different D. pteronyssinus allergens and the related protein allergenic characterization, were assessed in all serum samples. A total of 80 European American AD patients with the marked T2 endotype confirmed their eligibility for the study. Major allergens (Der p 23, Der p 2, and Der p 1) were present in more than 86% of all subjects, with mid-tier allergens (Der p 5, Der p 7, and Der p 21) reaching up to 65%. A serodominant role for Der p 11 could not be quantitatively confirmed in the present cohort. The proposed component resolved diagnosis (CRD) panel appeared to be sufficient to obtain a precise D. pteronyssinus molecular diagnosis in AD patients subjected to a climate-dependent high-mite allergen exposure. The raised seroprevalence of IgE response to Der p 23 confirmed this constituent as a major D. pteronyssinus allergen in severe stages of atopic dermatitis. A clinically driven molecular approach appears to be essential to frame a more precise diagnosis and therapy of this heterogeneous allergic condition.
Activation of the Hippo Pathway in Rana sylvatica: Yapping Stops in Response to Anoxia
Authors: Gupta Aakriti , Storey Kenneth B.
Published: December 2021

Wood frogs (Rana sylvatica) display well-developed anoxia tolerance as one component of their capacity to endure prolonged whole-body freezing during the winter months. Under anoxic conditions, multiple cellular responses are triggered to efficiently cope with stress by suppressing gene transcription and promoting activation of mechanisms that support cell survival. Activation of the Hippo signaling pathway initiates a cascade of protein kinase reactions that end with phosphorylation of YAP protein. Multiple pathway components of the Hippo pathway were analyzed via immunoblotting, qPCR or DNA-binding ELISAs to assess the effects of 24 h anoxia and 4 h aerobic recovery, compared with controls, on liver and heart metabolism of wood frogs. Immunoblot results showed significant increases in the relative levels of multiple proteins of the Hippo pathway representing an overall activation of the pathway in both organs under anoxia stress. Upregulation of transcript levels further confirmed this. A decrease in YAP and TEAD protein levels in the nuclear fraction also indicated reduced translocation of these proteins. Decreased DNA-binding activity of TEAD at the promoter region also suggested repression of gene transcription of its downstream targets such as SOX2 and OCT4. Furthermore, changes in the protein levels of two downstream targets of TEAD, OCT4 and SOX2, established regulated transcriptional activity and could possibly be associated with the activation of the Hippo pathway. Increased levels of TAZ in anoxic hearts also suggested its involvement in the repair mechanism for damage caused to cardiac muscles during anoxia. In summary, this study provides the first insights into the role of the Hippo pathway in maintaining cellular homeostasis in response to anoxia in amphibians.
Inhibition of HDACs Suppresses Cell Proliferation and Cell Migration of Gastric Cancer by Regulating E2F5 Targeting BCL2
Authors: Ali Arshad , Ali Ayaz , Khan Shaker , Ibrahim Muhammad , Alshehri Mohammed Ali , Thirupathi Anand
Published: December 2021

(1) Background: Gastric cancer (GC) is the most common high death-rate cancer type worldwide, with an enhanced prevalence and increased rate of mortality. Although significant evidence on surgery strategy has been generated for the treatment of GC, conclusions are still uncertain regarding profound metastatic or persevering gastric cancer. Therefore, it is essential to develop novel and effective biomarkers or therapeutic targets for the diagnosis of GC. Histone deacetylations (HDACs) are important epigenetic regulators that control the aberrant transcription of critical genes that are mainly involved in cell proliferation, cell migration, regulation of the cell cycle, and different signal pathways. (2) Methods: Expression analysis of HDACs family members and E2F5 in gastric cancer cell lines was determined by RT-PCR and Western blotting. The cell proliferation was determined through an MTT assay. Cell migration was determined using a wound-healing assay. Flow cytometry experiments were used to determine cell-cycle analysis. The statistical software OriginPro 2015 (OriginLab, Northampton, MA, USA) was used to analyze data. A p value of < 0.05 was regarded as significant. (3) Results: The present study shows that E2F5 expression is upregulated in GC cancer cell lines compared to normal cell lines, and is positively associated with the level of HDACs and BCL2. HDACi and knocking down of E2F5 as tumor suppressors inhibited cell proliferation, migration invasion, and blocked the cell cycle in gastric cancer cells by suppressing BCL2. The results conclude that the anticancer mechanism of HDACi was determined by regulating E2F5 via targeting BCL2. (4) Conclusions: Our results suggest that the HDAC–E2F5–BCL2 signaling axis might be a novel potential biomarker in gastric cancer.
Biodiversity and Community Analysis of Plant-Parasitic and Free-Living Nematodes Associated with Maize and Other Rotational Crops from Punjab, Pakistan
Authors: Sikandar Aatika , Khanum Tabassum Ara , Wang Yuanyuan
Published: December 2021

Maize (Zea mays L.) is one of Pakistan’s essential staple food crops. Plant-parasitic nematodes (PPNs) are a significant restraint in maize production. However, free-living nematodes (FLNs) provide crucial ecological functions such as suppressing pests and nutrient mineralization. This study aimed to assess the community analysis of plant-parasitic and free-living nematodes associated with maize and other rotational crops (those cultivated in sequence with the maize in the same field) from Punjab, Pakistan. The occurrence percentage was observed per 500 g soil for each nematode genus. The present study revealed that 24 species of plant-parasitic and free-living nematodes were identified from maize crops and other rotational crops from 16 localities through Punjab, Pakistan. Nematode communities were analyzed by absolute frequency, relative frequency, relative density, and prominence value, while cluster analysis was based on the presence or absence of nematode in different localities. The overall proportion of plant-parasitic nematodes was 35%, while free-living soil nematodes recovered 65%, out of 210 samples of maize and other rotational crops. Several major genera of plant-parasitic nematodes were reported during the present study viz., Ditylenchus, Filenchus, Helicotylenchus, Hemicriconemoides, Heterodera, Hoplolaimus, Malenchus, Pratylenchus, Psilenchus, Rotylenchulus, Seinura, Telotylenchus, Tylenchorhynchus, and Xiphinema Community relationship revealed the overall dominance of Heterodera zeae, with the highest incidence (55.71%) followed by Tylenchorhynchus elegans (33.33%) and Helicotylenchus certus (24.76%). The results provide valuable information on the community structure of nematodes in maize and other rotational crops of maize in Punjab, Pakistan. Moreover, this data can be used as a preventive measure before PPN incidence results in greater losses on maize.
Modulation of Epithelial Mesenchymal Transition after AGTR-1 Gene Edition by Crispr/Cas9 and Losartan Treatment in Mammary Tumor Cell Line: A Comparative Study between Human and Canine Species
Authors: Moschetta-Pinheiro Marina Gobbe , Colombo Jucimara , Godoy Bianca Lara Venâncio de , Balan Julia Ferreira , Nascimento Bianca Carlos , Zuccari Debora Aparecida Pires de Campos
Published: December 2021

Breast cancer is the most prevalent tumor type among women and female dogs. Tumor malignancy is characterized by the epithelial-to-mesenchymal transition (EMT) which leads to the metastasis formation. The inhibition of angiotensin II type I receptor (AGTR1) by an antagonist such as losartan can suppress angiogenesis, consequently contributing to the metastasis control. The aim of this study was to analyze the capacity of losartan and AGTR-1 gene edition to modulate the EMT process in triple negative/metastatic mammary tumor cells, compared to existing treatment protocols such as carboplatin. The cell lines CF41.Mg and MDA-MB-468, were cultured and treated with carboplatin, losartan, or submitted to AGTR-1 gene edition by CRISPR/Cas9. EMT markers and PARP-1 protein and gene expression were evaluated by immunofluorescence or immunocytochemistry and qRT-PCR, respectively. Cell migration capacity was also evaluated. For CF41.Mg and MDA-MB-468 cell lines, there was an increase in E-cadherin and a decrease in N-cadherin and PARP-1 protein and gene expression after treatment with carboplatin, losartan, both in combination and after AGTR-1 gene edition. There was a decrease in VEGF and PARP-1 protein and gene expression after AGTR-1 gene edition. Moreover, in both lines, reduction in invasion rate was observed after all treatments. Our data suggest that losartan and the gene edition of AGTR-1 by CRISPR/Cas9 were able to block the DNA repair and control the EMT process, such as carboplatin. The results in the canine species are unprecedented, as there are no data in the literature that demonstrate the action of losartan in this tumor type.