bluuebunny/crossref_metadata_2025 huggingface dataset:
Performance of a Rotating Detonation Rocket Engine with Various Convergent Nozzles and Chamber Lengths
Authors: Bennewitz John W. , Bigler Blaine R. , Ross Mathias C. , Danczyk Stephen A. , Hargus William A. , Smith Richard D.
Published: April 2021

A rotating detonation rocket engine (RDRE) with various convergent nozzles and chamber lengths is investigated. Three hundred hot-fire tests are performed using methane and oxygen ranging from equivalence ratio equaling 0.5–2.5 and total propellant flow up to 0.680 kg/s. For the full-length (76.2 mm) chamber study, three nozzles at contraction ratios ϵc = 1.23, 1.62 and 2.40 are tested. Detonation is exhibited for each geometry at equivalent conditions, with only fuel-rich operability slightly increased for the ϵc = 1.62 and 2.40 nozzles. Despite this, counter-propagation, i.e., opposing wave sets, becomes prevalent with increasing constriction. This is accompanied by higher number of waves, lower wave speed Uwv and higher unsteadiness. Therefore, the most constricted nozzle always has the lowest Uwv. In contrast, engine performance increases with constriction, where thrust and specific impulse linearly increase with ϵc for equivalent conditions, with a 27% maximum increase. Additionally, two half-length (38.1 mm) chambers are studied including a straight chamber and ϵc = 2.40 nozzle; these shortened geometries show equal performance to their longer equivalent. Furthermore, the existence of counter-propagation is minimized. Accompanying high-fidelity simulations and injection recovery analyses describe underlying injection physics driving chamber wave dynamics, suggesting the physical throat/injector interaction influences counter-propagation.
Experimental Procedures & First Results of an Innovative Solid Oxide Fuel Cell Test Rig: Parametric Analysis and Stability Test
Authors: Del Zotto Luca , Monforti Ferrario Andrea , Hatunoglu Arda , Dell’Era Alessandro , McPhail Stephen , Bocci Enrico
Published: April 2021

Solid Oxide Fuel Cells are a promising technology for Solid Oxide Fuel Cells (SOFC) are a promising technology For high-efficiency electrochemical conversion of a vast range of fuel gas mixtures, thigh operating temperature conditions (650–900 °C) represent a challenge both at system level and at laboratory testing level, in terms of material properties and performance dynamics. In this work a detailed procedural analysis is presented for an innovative all-ceramic compact SOFC test rig and first experimental testing results are reported in terms of polarization curves obtained under parametric variation of operating conditions (H2 content, air ratio λ and temperature) and short-term voltage stability test under load (140 h at 0.3 A/cm2). The electrochemical characterization results confirm the validity of the used all-ceramic cell holder, showing excellent cell performances in terms of polarization. H2 content has the most impact on SOFC performance, followed by temperature and finally air ratio, whose impact in the analyzed range is hardly seen. From the short-term stability test, the test bench setup reliability is demonstrated, showing no significant performance degradation after 140 continuous hours under load, which confirms the high quality and reproducibility of the results.
Design Framework for Achieving Guarantees with Learning-Based Observers
Authors: Németh Balázs , Hegedűs Tamás , Gáspár Péter
Published: April 2021

The paper proposes a novel framework for state observer design, in which learning-based observers are incorporated. The aim of the method is to provide a framework, which is able to guarantee the limitation of the observation error, even if the error of the learning-based observer under all scenarios cannot be verified. The framework is based on the robust H∞ design method, which is able to provide guarantees on the resulted observer. Moreover, the observer design process is extended with a controller design, which leads to a joint robust H∞ controller-observer design. In this paper the proposed method is applied on a vehicle control problem, such as lateral path following. In this problem the goal of the observer is to provide an accurate lateral velocity signal for the vehicle, which is used in the controlled system for the generation of front wheel steering angle. The effectiveness of the method is illustrated through simulation examples on high-fidelity vehicle dynamic simulator CarMaker.
A Review on State-of-the-Art Reviews in Wind-Turbine- and Wind-Farm-Related Topics
Authors: Sawant Manisha , Thakare Sameer , Rao A. Prabhakara , Feijóo-Lorenzo Andrés E. , Bokde Neeraj Dhanraj
Published: April 2021

For decades of wind energy technology developments, much research on the subject has been carried out, and this has given rise to many works encompassing different topics related to it. As a logical consequence of such a research and editorial activity, state-of-the-art review works have also been published, reporting about a wide variety of research proposals. Review works are particularly interesting documents for researchers because they try to gather different research works on the same topic present their achievements to researchers. They act, in a way, as a guidance for researchers to quickly access the most meaningful works. The proposal of this paper consists of going one step further, and to present a review of state-of-the-art review works on wind-energy-related issues. A classification into several main topics in the field of energy research has been done, and review works that can be classified in all these areas have been searched, analyzed, and commented on throughout the paper.
Transient Simulation of the Six-Inlet, Two-Stage Radial Turbine under Pulse-Flow Conditions
Authors: Kozak Dariusz , Mazuro Paweł
Published: April 2021

In recent years, the automotive sector has been focused on emission reductions using hybrid and electric vehicles. This was mainly caused by political trends promoting “green energy”. However, that does not mean that internal combustion engines (ICEs) should be forgotten. The ICE has still the potential of recovering energy from exhaust gases. One of the promising ways to recover energy is turbocharging. Over the years engine manufacturers have designed very efficient turbocharger systems which have greatly increased the overall engine efficiency. This led to pollutant emission reductions. This paper presents the results of the three-dimensional (3-D) numerical simulations of the two-stage, six-inlet turbocharging system under the influence of unsteady, pulsed-flow conditions. The calculations were carried out for three turbine speeds. The most interesting results of this study were the separation of exhaust gases coming from the six-exhaust pipes and the performance of both stages under pulse-flow conditions. The two-stage turbocharging system was compared against the single-stage turbocharging system and the results showed that the newly designed two-stage turbine system properly separated the exhaust gases of the adjacent exhaust pipes.
Optimal Planning and Operation of a Residential Energy Community under Shared Electricity Incentives
Authors: Garavaso Pierpaolo , Bignucolo Fabio , Vivian Jacopo , Alessio Giulia , De Carli Michele
Published: April 2021

Energy communities (ECs) are becoming increasingly common entities in power distribution networks. To promote local consumption of renewable energy sources, governments are supporting members of ECs with strong incentives on shared electricity. This policy encourages investments in the residential sector for building retrofit interventions and technical equipment renovations. In this paper, a general EC is modeled as an energy hub, which is deemed as a multi-energy system where different energy carriers are converted or stored to meet the building energy needs. Following the standardized matrix modeling approach, this paper introduces a novel methodology that aims at jointly identifying both optimal investments (planning) and optimal management strategies (operation) to supply the EC’s energy demand in the most convenient way under the current economic framework and policies. Optimal planning and operating results of five refurbishment cases for a real multi-family building are found and discussed, both in terms of overall cost and environmental impact. Simulation results verify that investing in building thermal efficiency leads to progressive electrification of end uses. It is demonstrated that the combination of improvements on building envelope thermal performances, photovoltaic (PV) generation, and heat pump results to be the most convenient refurbishment investment, allowing a 28% overall cost reduction compared to the benchmark scenario. Furthermore, incentives on shared electricity prove to stimulate higher renewable energy source (RES) penetration, reaching a significant reduction of emissions due to decreased net energy import.
Energy Transition in Poland—Assessment of the Renewable Energy Sector
Authors: Pietrzak Michał , Igliński Bartłomiej , Kujawski Wojciech , Iwański Paweł
Published: April 2021

The topic of the article considers the functioning of the renewable energy (RE) sector in Poland. This is really important in the context of the energy transition of the national economy because it influences the creation of modern technologies and increases the competitiveness and innovation of the country. Poland is in a process of energy transition where the RE sector has been developing for two decades. The authors aimed to research the RE sector improvement possibilities in Poland, including the influence of this sector on chosen social and economic aspects. Because of this research’s aim a critical situation assessment of RE in Poland was conducted and a survey of a group of experts in this field was also involved. Legal, physical and mental determinants and their influence on RE sector were looked into. In the legal determinant context a necessity to simplify relevant legislation acts in Poland was found. Undoubtedly there is a need to improve several legal acts, including the Distance Act. In physical determinants it was found that solar, wind and biomass energy have the biggest chances for development. In the case of mental determinants the authors paid attention to the need of educating the public about using and obtaining energy. It is also important to make people aware how the RE sector influences the low emission economy positively. This will improve the creation of new jobs and reduce the emissions of harmful substances to the environment.
Life Cycle Assessment of Stationary Storage Systems within the Italian Electric Network
Authors: Carvalho Maria Leonor , Temporelli Andrea , Girardi Pierpaolo
Published: April 2021

The introduction of stationary storage systems into the Italian electric network is necessary to accommodate the increasing share of energy from non-programmable renewable sources and to reach progressive decarbonization targets. In this framework, a life cycle assessment is a suitable tool to assess environmental impacts during the entire life cycle of stationary storage systems, i.e., their sustainability. A Li-ion battery (lithium–iron–phosphate (LFP), nickel–manganese–cobalt (NMC) 532, and NMC 622) entire life cycle assessment (LCA) based on primary and literature data was performed. The LCA results showed that energy consumption (predominantly during cell production), battery design (particularly binder choice), inventory accuracy, and data quality are key aspects that can strongly affect results. Regarding the battery construction phase, LFP batteries showed better performance than the NMC ones, but when the end-of-life (EoL) stage was included, NMC cell performance became very close to those of LFPs. Sensitivity and uncertainty analyses, done using the Monte Carlo methodology, confirmed that the results (except for the freshwater eutrophication indicator) were characterized by a low dispersion and that the energy mix choice, during the different battery life phases, was able to greatly influence the overall impact. The use of primary and updated data related to battery cell production, like those used in the present paper, was necessary to obtain reliable results, and the application to a European production line is an item of novelty of this paper.
Investigation of Thermal-Flow Characteristics of Pipes with Helical Micro-Fins of Variable Height
Authors: Jasiński Piotr Bogusław , Kowalczyk Michał Jan , Romaniak Artur , Warwas Bartosz , Obidowski Damian , Gutkowski Artur
Published: April 2021

The results of numerical investigations of heat transfer and pressure drops in a channel with 30° helical micro-fins are presented. The main aim of the analysis is to examine the influence of the height of the micro-fins on the heat-flow characteristics of the channel. For the tested pipe with a diameter of 12 mm, the micro-fin height varies within the range of 0.05–0.40 mm (with 0.05 mm steps), which is equal to 0.4–3.3% of its diameter. The analysis was performed for a turbulent flow, within the range of Reynolds numbers 10,000–100,000. The working fluid is water with an average temperature of 298 K. For each tested geometry, the characteristics of the friction factor f(Re) and the Nusselt number Nu(Re) are shown in the graphs. The highest values of Nusselt numbers and friction factors were obtained for pipes with the micro-fins H = 0.30 mm and H = 0.35 mm. A large discrepancy is observed in the friction factors f(Re) calculated from the theoretical relationships (for the irregular relative roughness values shown in the Moody diagram) and those obtained from the simulations (for pipes with regular roughness formed by micro-fins). The PEC (Performance Evaluation Criteria) heat transfer efficiency analysis of the geometries under study is also presented, taking into account the criterion of the same pumping power. The highest PEC values, reaching 1.25, are obtained for micro-fins with a height of 0.30 mm and 0.35 mm and with Reynolds numbers above 40,000. In general, for all tested geometries and for large Reynolds numbers (above 20,000), the PEC coefficient reaches values greater than 1, while for lower Reynolds numbers (less than 20,000), its values are less than 1.
Rapid Process Natural Bamboo into Outdoor Bamboo-Fiber-Reinforced Composite with High Surface Photostability
Authors: Rao Fei , Ji Yaohui , Yang Yang , Zhang Yahui , Li Neng , Yu Wenji , Chen Yuhe
Published: April 2021

Surface photostability strongly influences the usefulness of bamboo and bamboo-based polymer composites in outdoor environments. In this study, accelerated aging tests were conducted to investigate how UV irradiation affects the color, surface appearance, and chemical characteristics of outdoor bamboo-fiber-reinforced composite (OBFRC) prepared from moso bamboo (Phyllostachys pubescens Mazel) by a three-step process involving phenol-formaldehyde (PF) resin impregnation. The surface color of natural bamboo (NB) changes rapidly during irradiation, but that of OBFRC remains relatively stable: densification mitigates the negative effects of UV irradiation. More generally, OBFRC exhibits enhanced surface photostability caused by structural and chemical modifications.
Assessment of Pellets from Three Forest Species: From Raw Material to End Use
Authors: Quiñones-Reveles Miguel Alfonso , Ruiz-García Víctor Manuel , Ramos-Vargas Sarai , Vargas-Larreta Benedicto , Masera-Cerutti Omar , Ngangyo-Heya Maginot , Carrillo-Parra Artemio
Published: April 2021

This study aimed to evaluate and compare the relationship between chemical properties, energy efficiency, and emissions of wood and pellets from madroño Arbutus xalapensis Kunth, tázcate Juniperus deppeana Steud, and encino colorado Quercus sideroxyla Humb. & Bonpl. in two gasifiers (top-lit-up-draft (T-LUD) and electricity generation wood camp stove (EGWCS)) in order to determine the reduction of footprint carbon. In accordance with conventional methodologies, we determined the extracts and chemical components (lignin, cellulose, holocellulose), and the immediate analyses were carried out (volatile materials, fixed carbon, ash content and microanalysis of said ash), as well as the evaluation of emission factors (total suspended particulate matter (PM2.5), CO, CO2, CH4, black carbon (BC), elemental carbon (EC), and organic carbon (OC)). The results were statistically analyzed to compare each variable among species and gasifiers. The raw material analyzed showed how the pH ranged from 5.01 to 5.57, and the ash content ranged between 0.39 and 0.53%. The content values of Cu, Zn, Fe, Mg, and Ca ranged from 0.08 to 0.22, 0.18 to 0.19, 0.38 to 0.84, 1.75 to 1.90, and 3.62 to 3.74 mg kg−1, respectively. The extractive ranges from cyclohexane were 2.48–4.79%, acetone 2.42–4.08%, methanol 3.17–7.99%, and hot water 2.12–4.83%. The range of lignin was 18.08–28.60%. The cellulose content ranged from 43.30 to 53.90%, and holocellulose from 53.50 to 64.02%. The volatile material range was 81.2–87.42%, while fixed carbon was 11.30–17.48%; the higher heating value (HHV) of raw material and pellets presented the ranges 17.68–20.21 and 19.72–21.81 MJ kg−1, respectively. Thermal efficiency showed statistically significant differences (p < 0.05) between pellets and gasifiers, with an average of 31% Tier 3 in ISO (International Organization for Standardization) for the T-LUD and 14% (ISO Tier 1) for EGWCS, with Arbutus xalapensis being the species with the highest energy yield. The use of improved combustion devices, as well as that of selected raw material species, can reduce the impact of global warming by up to 33% on a cooking task compared to the three-stone burner.
Recent Advances in Fluid Mechanics: Feature Papers
Authors: Massoudi Mehrdad
Published: April 2021

This Special Issue is a collection of top-quality papers from some of the Editorial Board Members of Fluids, Guest Editors, and leading researchers discussing new knowledge or new cutting-edge developments on all aspects of fluid mechanics [...]
Transcriptome Analysis Revealed Ameliorative Effects of Bacillus Based Probiotic on Immunity, Gut Barrier System, and Metabolism of Chicken under an Experimentally Induced Eimeria tenella Infection
Authors: Memon Fareed Uddin , Yang Yunqiao , Leghari Imdad Hussain , Lv Feifei , Soliman Ahmed M. , Zhang Weiyu , Si Hongbin
Published: April 2021

In this study, we performed transcriptome analysis in the cecum tissues of negative control untreated non-challenged (NC), positive control untreated challenged (PC), and Bacillus subtilis (B. subtilis) fed challenged chickens (BS + ET) in order to examine the underlying potential therapeutic mechanisms of Bacillus based probiotic feeding under an experimental Eimeria tenella (E. tenella) infection. Our results for clinical parameters showed that birds in probiotic diet decreased the bloody diarrhea scores, oocyst shedding, and lesion scores compared to positive control birds. RNA-sequencing (RNA-seq) analysis revealed that in total, 2509 up-regulated and 2465 down-regulated differentially expressed genes (DEGs) were detected in the PC group versus NC group comparison. In the comparison of BS + ET group versus PC group, a total of 784 up-regulated and 493 down-regulated DEGs were found. Among them, several DEGs encoding proteins involved in immunity, gut barrier integrity, homeostasis, and metabolism were up-regulated by the treatment of probiotic. Functional analysis of DEGs also revealed that some gene ontology (GO) terms related with immunity, metabolism and cellular development were significantly affected by the exposure of probiotic. Kyoto encyclopedia of genes and genomes (KEGG) pathway analysis showed that the DEGs in the cecum of B. subtilis-fed challenged group were mainly participated in the pathways related with immunity and gut barrier integrity, included mitogen-activated protein kinase (MAPK) signaling pathway, toll-like receptor (TLR) signaling pathway, extracellular matrix (ECM)–receptor interaction, tight junction, and so on. Taken together, these results suggest that Bacillus based probiotic modulate the immunity, maintain gut homeostasis as well as barrier system and improve chicken metabolism during E. tenella infection.
Autosomal Recessive Retinitis Pigmentosa Associated with Three Novel REEP6 Variants in Chinese Population
Authors: Zhang Lujia , Li Ya , Qin Litao , Wu Yu , Lei Bo
Published: April 2021

Retinitis pigmentosa 77 is caused by mutations of REEP6 (MIM: 609346), which encodes a protein for the development of photoreceptors. Our study was to identify disease-causing variants in three Chinese families using targeted next-generation sequencing (NGS). Multiple lines of computational predictions combined with in vitro cellular experiments were applied to evaluate the pathogenicity of the newly found variants. Three novel variants in REEP6, including one missense variant, c.268G>C, one frameshift variant, c.468delC, and one splicing variant, c.598+1G>C, were found, while c.268G>C was detected in all probands. The three variants were classified as likely pathogenic by the American College of Medical Genetics and Genomics (ACMG). REEP6 variant proteins c.268G>C and c.468delC in cultured cells destabilized the REEP6 protein and induced intracellular inclusions. Our data suggested that REEP6 c.268G>C may be a recurrent causative variant in Chinese autosomal recessive retinitis pigmentosa patients.
The Jew Uncut: Circumcising Holocaust Representation in Europa Europa
Authors: Wolfson Jeffrey E.
Published: April 2021

Film adaptations invariably yield insights into their written source material, at least to the extent that they elect to translate or omit what may be deemed the literature’s essential components. This is certainly the case for director Agnieszka Holland’s 1990 film, Europa Europa, which adapts Solomon Perel’s account of surviving the Shoah. By drawing on discourse in Holocaust studies and adaptation studies, and by examining the film adaptation’s points of alignment with what Perel records in his memoir, I argue that Europa Europa resists the dominant trend of de-Judaizing the Shoah in artistic representation. Europa Europa privileges explicitly Jewish content and an unmistakably Jewish point of view by focusing on the theme of circumcision. In doing so, the film succeeds in highlighting how the Shoah was, at its core, a campaign to annihilate not just the Jewish people, but also the longstanding principle of the Jewish covenant with the Eternal, as embodied by circumcision. Through its cutting and reshaping of the memoir’s details, Holland’s film seeks to establish a covenant with the viewer to bear witness to the Jewish spirit of the survivor’s testimony. The film presents a model for representing the Holocaust in art, a model that masterfully defies the de-Judaization of society that the Nazis envisioned and tried to make real.
Core Competencies for Health Workers to Deal with Climate and Environmental Change
Authors: Jagals Paul , Ebi Kristie
Published: April 2021

Rapid, detrimental climate change and environmental degradation pose real threats to the health, environment, social, economic and technological wellbeing of society (HESET). It has become even more imperative that the health workforce (public health and medical healthcare as well as auxiliary and support workers) be ‘climate-environment’ competent to fulfil their role in managing the environmental public health risks and impacts as climate and environment inevitably continue to change. We developed a broad six-domain competency framework consisting of (1) climate and environment sciences, (2) drivers of climate change (3) evidence, projections and assessments (4) iterative risk management (5) mitigation, adaptation and health co-benefits and (6) collective strategies—harnessing international/regional/local agreements and frameworks. The framework can be used by health/medical trainers to design cross-sectoral sub-competencies and learning content for training health workers to function at local, regional and global levels. Reaching, maintaining and improving the different levels of competency, the health workforce will be increasingly invaluable partners in intra- as well as inter-sectoral responses to climate and environmental risks and impacts.
Factors Related to Lacking Knowledge on the Recommended Daily Salt Intake among Medical Professionals in Mongolia: A Cross-Sectional Study
Authors: Hikita Naoko , Batsaikhan Enkhtungalag , Sasaki Satoshi , Haruna Megumi , Yura Ariunaa , Oidovsuren Otgontogoo
Published: April 2021

In Mongolia, the recommendations are to restrict salt intake to less than 5 g/day to reduce the risk of cardiovascular disease. We aimed to reveal factors associated with not knowing the recommended daily salt intake among medical professionals in Mongolia. Of the recruited 538 medical professionals working at public health facilities in Darkhan-Uul Province, the data from 338 (62.8%), obtained using self-administered questionnaires, were analyzed. Among these, 175 (51.8%) did not know the recommended daily salt intake. Compared with medical doctors, midwives and nurses had higher odds of not knowing the recommendations (adjusted odds ratio (AOR): 4.20, 95% confidence interval (CI): 1.40–12.59; AOR: 2.10, 95% CI: 1.15–3.76, respectively). Compared to participants who consumed more than four cups/day of salted suutei tsai (Mongolian milk tea), those who consumed approximately two cups/week had lower odds of not knowing the recommendations (AOR: 0.21, 95% CI: 0.07–0.63). With most participants lacking accurate knowledge on this topic, and considering that people who are aware of the recommendations are more likely to take action to reduce dietary salt intake, it is imperative to urgently address this knowledge deficit because medical professionals have a responsibility to educate the community by disseminating accurate health information.
Producers of Engineered Nanomaterials—What Motivates Company and Worker Participation in Biomonitoring Programs?
Authors: Crézé Camille , François Marjorie , Hopf Nancy B. , Dorribo Victor , Sauvain Jean-Jacques , Bergamaschi Enrico , Garzaro Giacomo , Domat Maida , Friesl Judith , Penssler Eva , Progiou Athena , Guseva Canu Irina
Published: April 2021

Production and handling of engineered nanomaterials (ENMs) can yield worker exposure to these materials with the potential for unforeseen negative health effects. Biomonitoring enables regular exposure and health assessment and an effective risk management. We aimed to identify factors influencing biomonitoring acceptance according to hierarchical positions of ENM producers. Managers and workers were invited to complete an online questionnaire. Forty-three companies producing or handling ENMs such as titanium dioxide (61%) and multi-walled carbon nanotubes (44%) participated. The majority of managers (72%) and all workers responded positively to participating in biomonitoring studies. The main reasons for refusing participation included concerns about data confidentiality and sufficient knowledge about ENM health and safety. Acquisitions of individual study results, improvement of workers’ safety, and help to the development of ENM-specific health and safety practice were among the most valuable reasons for positively considering participation. All workers indicated feeling comfortable with biomonitoring procedures of exhaled air sampling—about half were similarly comfortable with exhaled breath condensate, urine, and buccal cell sampling. The majority of both workers and managers stated that participation in a biomonitoring program should take place during working hours. Although our survey only had limited participation, our results are useful in designing appropriate biomonitoring programs for workers exposed to ENMs.
The Efficacy of Primavera, a Prevention Programme on Alcohol and Tobacco Use among 10–12-Year-Old Schoolchildren: A Randomized Controlled Cluster Study
Authors: Diaz Gomez Cristina , Morel Alain , Sedano Isabelle , Aubin Henri-Jean
Published: April 2021

Alcohol and tobacco use is a major health problem and one of the first causes of the burden of disease and mortality. School-based alcohol and tobacco use prevention programmes that have demonstrated efficacy are most often based on psychosocial skill development, individuals’ experiential learning strategies, and community resources. Furthermore, early and prolonged interventions have been recommended. Primavera is a pluri-annual, generic, multimodal, experiential-oriented prevention program. It runs over a three-year period from the last year of primary school to the second year of secondary school. This randomized controlled cluster study aimed at assessing the effects of the Primavera programme compared to a control prevention intervention among schoolchildren from 10 to 12 years in eight secondary schools in a particular French geographical area. The primary outcomes were lifetime tobacco use and past-month alcohol use. Data were collected at baseline and over three follow-up time points. In all, 287 and 266 questionnaires, respectively, were collected at baseline from the Primavera group and from the control group. Attrition was 45% and 41%, respectively. The SARS-COV2 pandemic crisis made it impossible for questionnaires to be collected during the final year. After adjustment, children from the Primavera group were less likely to report current alcohol use at the end of the first year (odds ratio = 0.39, 95% CI: 0.18–0.78) and past-month alcohol use at the end of the second year (odds ratio = 0.07, 95% CI: 0.01–0.66) compared to those from the control group. The results for psychosocial skills and alcohol and tobacco use denormalization were contrasted. Primavera is shown to be effective in reducing alcohol use among schoolchildren.
Physician-Related Variability in the Outcomes of an Invasive Treatment for Neck and Back Pain: A Multi-Level Analysis of Data Gathered in Routine Clinical Practice
Authors: Royuela Ana , Kovacs Francisco M. , Seco-Calvo Jesús , Fernández-Félix Borja M. , Abraira Víctor , Zamora Javier
Published: April 2021

Neuro-reflexotherapy (NRT) is a proven effective, invasive treatment for neck and back pain. To assess physician-related variability in results, data from post-implementation surveillance of 9023 patients treated within the Spanish National Health Service by 12 physicians were analyzed. Separate multi-level logistic regression models were developed for spinal pain (SP), referred pain (RP), and disability. The models included all patient-related variables predicting response to NRT and physician-related variables. The Intraclass Correlation Coefficient (ICC) and the Median Odds Ratio (MOR) were calculated. Adjusted MOR (95% CI) was 1.70 (1.47; 2.09) for SP, 1.60 (1.38; 1.99) for RP, and 1.65 (1.42; 2.03) for disability. Adjusted ICC (95%CI) values were 0.08 (0.05; 0.15) for SP, 0.07 (0.03; 0.14) for RP, and 0.08 (0.04; 0.14) for disability. In the sensitivity analysis, in which the 6920 patients treated during the physicians’ training period were excluded, adjusted MOR was 1.38 (1.17; 1.98) for SP, 1.37 (1.12; 2.31) for RP, and 1.25 (1.09; 1.79) for disability, while ICCs were 0.03 (0.01; 0.14) for SP, 0.03 (0.00; 0.19) for RP, and 0.02 (0.00; 0.10) for disability. In conclusion, the variability in results obtained by different NRT-certified specialists is reasonable. This suggests that current training standards are appropriate.
A Web Survey to Evaluate the Thermal Stress Associated with Personal Protective Equipment among Healthcare Workers during the COVID-19 Pandemic in Italy
Authors: Messeri Alessandro , Bonafede Michela , Pietrafesa Emma , Pinto Iole , de’Donato Francesca , Crisci Alfonso , Lee Jason , Marinaccio Alessandro , Levi Miriam , Morabito Marco ,   on behalf of the WORKLIMATE Collaborative Group
Published: April 2021

The pandemic has been afflicting the planet for over a year and from the occupational point of view, healthcare workers have recorded a substantial increase in working hours. The use of personal protective equipment (PPE), necessary to keep safe from COVID-19 increases the chances of overheating, especially during the summer seasons which, due to climate change, are becoming increasingly warm and prolonged. A web survey was carried out in Italy within the WORKLIMATE project during the summer and early autumn 2020. Analysis of variance (ANOVA) was used to evaluate differences between groups. 191 questionnaires were collected (hospital doctor 38.2%, nurses 33.5%, other healthcare professionals 28.3%). The impact of PPE on the thermal stress perception declared by the interviewees was very high on the body areas directly covered by these devices (78% of workers). Workers who used masks for more than 4 h per day perceived PPE as more uncomfortable (p < 0.001) compared to the others and reported a greater productivity loss (p < 0.001). Furthermore, the study highlighted a high perception of thermal stress among healthcare workers that worn COVID-19-PPE and this enhances the need for appropriate heat health warning systems and response measures addressed to the occupational sector.
The Influence of Body Image, Insight, and Mental Health Confidence on Medication Adherence in Young Adult Women with Mental Disorders
Authors: Lee Eunmi , Jang Mi Heui
Published: April 2021

The aim of this descriptive study was to investigate the impact of body image, insight, and mental health confidence on medication adherence among young adult women with mental disorders. Data collection occurred from August to September 2018. The study participants were 147 young adult women aged 19 to 45 with mental disorders who were psychiatry outpatients either getting treatment in general hospitals located in Seoul and Gyeonggi Province or receiving rehabilitation therapy through local mental health welfare centers in Korea, and agreed to participate in the study. The measurement tools used were the Body Image Scale; the Scale to Assess Unawareness of Mental Disorder, Korean short-form version; the Korean version of the Mental Health Confidence Scale; and the Korean version of the Medication Compliance Scale. The collected data were analyzed using descriptive statistics, t-test, analysis of variance, Pearson correlation analysis, and multiple regression analysis in SPSS/WIN 25.0 (IBM Corp., Armonk, NY, USA). Medication adherence among the study participants differed by age (F = 2.95, p = 0.042), religion (t = −2.06, p = 0.042), level of trust in psychiatrists (F = 5.40, p = 0.006), treatment duration (F = 4.48, p = 0.005), and noncompliance to medication regimens due to weight gain (t = −2.61, p = 0.010). Multiple regression analysis demonstrated that body image (β = −0.32, p < 0.001), insight (β = −0.24, p = 0.002), and mental health confidence (β = 0.24, p = 0.004) had a significant impact on the medication adherence of the participants. Body image, in particular, had the greatest influence on the medication adherence of the participants. This study found that body image, insight, and mental health confidence were important in improving medication adherence among young adult women with mental disorders. Practical, patient-centered, and individualized approaches that can improve medication adherence by seeking to understand negative perceptions regarding body image should be considered.
Psychometric Properties of the Proxy-Reported Life-Space Assessment in Institutionalized Settings (LSA-IS-Proxy) for Older Persons with and without Cognitive Impairment
Authors: Hauer Klaus , Ullrich Phoebe , Heldmann Patrick , Bauknecht Laura , Hummel Saskia , Abel Bastian , Bauer Juergen M. , Lamb Sarah E. , Werner Christian
Published: April 2021

(1) Background: Life-space mobility assessments for institutionalized settings are scarce and there is a lack of comprehensive validation and focus on persons with cognitive impairment (CI). This study aims to evaluate the psychometric properties of the Life-Space Assessment for Institutionalized Settings by proxy informants (LSA-IS-proxy) for institutionalized, older persons, with and without CI. (2) Methods: Concurrent validity against the self-reported version of the LSA-IS, construct validity with established construct variables, test-retest reliability, sensitivity to change during early multidisciplinary geriatric rehabilitation treatment, and feasibility (completion rate, floor/ceiling effects) of the LSA-IS-proxy, were assessed in 94 hospitalized geriatric patients (83.3 ± 6.1 years), with and without CI. (3) Results: The LSA-IS-proxy total score showed good-to-excellent agreement with the self-reported LSA-IS (Intraclass Correlations Coefficient, ICC3,1 = 0.77), predominantly expected small-to-high correlations with construct variables (r = 0.21–0.59), good test–retest reliability (ICC3,1 = 0.74), significant sensitivity to change over the treatment period (18.5 ± 7.9 days; p < 0.001, standardized response mean = 0.44), and excellent completion rates (100%) with no floor/ceiling effects. These results were predominantly confirmed for the sub-scores of the LSA-IS-proxy and were comparable between the sub-groups with different cognitive status. (4) Conclusions: The LSA-IS-proxy has proven to be feasible, valid, reliable, and sensitive to change in hospitalized, geriatric patients with and without CI.
Characteristics and Causes of Particularly Major Road Traffic Accidents Involving Commercial Vehicles in China
Authors: Yan Mingwei , Chen Wentao , Wang Jianhao , Zhang Mengmeng , Zhao Liang
Published: April 2021

Major accidents occurred frequently in the road transportation industry, and the resulting harm to drivers, property loss, and traffic interruption are very serious. This study investigated 11 particularly major accidents involving commercial vehicles in China, and performed analysis on accident characteristics regarding the time, location, types of vehicles, and accident causation at different levels based on the 24Model. Large buses and dangerous goods vehicles were involved in 10 accidents and they all occurred on a freeway. The months from May to August, especially during the time periods of 2:00–4:00 and 14:00–16:00 every day, were the most prone to accidents. The driver’s speeding and fatigued driving, and vehicle failure were the direct causes of most of the accidents. The defects in organizational safety management involved 12 system elements, such as safety accountability, education and training, etc. Procedures are of no use if they were not followed, and there was often no effective process to assess the implementation of procedures in many organizations. The weaknesses in organizational safety culture were the source of accidents, which was mainly manifested in members’ inadequate cognition of key elements in the aspects of safety importance, safety commitment, safety management system, etc. Understanding the characteristics and root causes of accidents can help to prevent the recurrence of similar mistakes and strengthen preventative measures in road transportation enterprises.
Influence of Major Public Health Emergencies on Family Relationship and Humanistic Geographical Characteristics of China
Authors: Guo Xiaojia , Li Jingzhong , Gao Yexin , Su Fang , Xue Bing
Published: April 2021

Harmonious and stable family relations are undoubtedly an important component of victory in terms of epidemic prevention. Take the COVID-2019 (2019 new crown pneumonia epidemic) as the major public events background; 24,188 national samples were obtained based on a network survey. We selected gender, education level, occupation type, family scale, neighborhood relationship and psychological state as independent variables, and adopted multiple logistic models to assess the impact of major public events on family relationships and the characteristics of humanistic–regional attributes. The findings are as follows: (1) During the epidemic period, major public health emergencies effectively promoted the national residents’ family relationships. (2) The family relationships of national residents presented a high level in central China and a low level in the border areas of China, which is consistent with the spread of COVID-2019 in January and February. (3) Family relationship level averages between 2.201~2.507 among different groups when divided by occupation, age and education. The family relationship has improved, but the change is not drastic and the gap between various groups is not significant, so there is essentially no difference. (4) The impact of major public health emergencies on all families is nearly sudden and instant, so that family relationship changes are often also abrupt. (5) Educational level, family size and gender have a positive effect on the change in family relations, but this effect is weakened as family education level increases; while the anxiety of the interviewees and the neighborhood had a negative effect on the change in family relationship, this indicates that the better the neighborhood relations are, the more harmonious a family relationship is. The above research can provide an important scientific support and decision-making basis for the government to carry out community prevention work, respond to major public health emergencies and construct a family support social policy system in the future.
Importance of Immediate Electronic-Based Feedback to Enhance Feedback for First-Time CPR Trainees
Authors: Misztal-Okońska Patrycja , Goniewicz Krzysztof , Goniewicz Mariusz , Ranse Jamie , Hertelendy Attila J. , Gray Lesley , Carlström Eric , Løwe Sørensen Jarle , Khorram-Manesh Amir
Published: April 2021

Sudden cardiac arrest is one of the leading causes of death globally. The recommended clinical management in out-of-hospital cardiac arrest cases is the immediate initiation of high-quality cardiopulmonary resuscitation (CPR). Training mannequins should be combined with technology that provides students with detailed immediate feedback on the quality of CPR performance. This study aimed to verify the impacts of the type of feedback (basic or detailed) the responders receive from the device while learning CPR and how it influences the quality of their performance and the motivation to improve their skills. The study was conducted at the Medical University of Lublin among 694 multi-professional health students during first aid classes on basic life support (BLS). The students first practiced on an adult mannequin with a basic control panel; afterward, the same mannequin was connected to a laptop, ensuring a detailed record of the performed activities through a projector. Next, the participants expressed their subjective opinion on how the feedback provided during the classes, basic vs. detailed, motivated them to improve the quality of their CPR performance. Additionally, during the classes, the instructor conducted an extended observation of students’ work and behavior. In the students’ opinion, the CPR training with detailed feedback devices provided motivation for learning and improving CPR proficiency than that with a basic control panel. Furthermore, the comments given from devices seemed to be more acceptable to the students, who did not see any bias in the device’s evaluation compared to that of the instructor. Detailed device feedback motivates student health practitioners to learn and improve the overall quality of CPR. The use of mannequins that provide detailed feedback during BLS courses can improve survival in out-of-hospital cardiac arrest.
Comparison of Depressive Symptoms and Its Influencing Factors among the Elderly in Urban and Rural Areas: Evidence from the China Health and Retirement Longitudinal Study (CHARLS)
Authors: Liu Haixia , Fan Xiaojing , Luo Huanyuan , Zhou Zhongliang , Shen Chi , Hu Naibao , Zhai Xiangming
Published: April 2021

Depression amongst the elderly population is a worldwide public health problem, especially in China. Affected by the urban–rural dual structure, depressive symptoms of the elderly in urban and rural areas are significantly different. In order to compare depressive symptoms and its influencing factors among the elderly in urban and rural areas, we used the data from the fourth wave of the China Health and Retirement Longitudinal Study (CHARLS). A total of 7690 participants at age 60 or older were included in this study. The results showed that there was a significant difference in the prevalence estimate of depression between urban and rural elderly (χ2 = 10.9.76, p < 0.001). The prevalence of depression among rural elderly was significantly higher than that of urban elderly (OR-unadjusted = 1.88, 95% CI: 1.67 to 2.12). After adjusting for gender, age, marital status, education level, minorities, religious belief, self-reported health, duration of sleep, life satisfaction, chronic disease, social activities and having income or not, the prevalence of depression in rural elderly is 1.52 times (OR = 1.52, 95% CI: 1.32 to 1.76) than that of urban elderly. Gender, education level, self-reported health, duration of sleep, chronic diseases were associated with depression in both urban and rural areas. In addition, social activities were connected with depression in urban areas, while minorities, marital status and having income or not were influencing factors of depression among the rural elderly. The interaction analysis showed that the interaction between marital status, social activities and urban and rural sources was statistically significant (divorced: coefficient was 1.567, p < 0.05; social activities: coefficient was 0.340, p < 0.05), while gender, education level, minorities, self-reported health, duration of sleep, life satisfaction, chronic disease, social activities having income or not and urban and rural sources have no interaction (p > 0.05). Thus, it is necessary to propose targeted and precise intervention strategies to prevent depression after accurately identifying the factors’ effects.
Hemi- and Homozygous Loss-of-Function Mutations in DSG2 (Desmoglein-2) Cause Recessive Arrhythmogenic Cardiomyopathy with an Early Onset
Authors: Brodehl Andreas , Meshkov Alexey , Myasnikov Roman , Kiseleva Anna , Kulikova Olga , Klauke Bärbel , Sotnikova Evgeniia , Stanasiuk Caroline , Divashuk Mikhail , Pohl Greta Marie , Kudryavtseva Maria , Klingel Karin , Gerull Brenda , Zharikova Anastasia , Gummert Jan , Koretskiy Sergey , Schubert Stephan , Mershina Elena , Gärtner Anna , Pilus Polina , Laser Kai Thorsten , Sinitsyn Valentin , Boytsov Sergey , Drapkina Oxana , Milting Hendrik
Published: April 2021

About 50% of patients with arrhythmogenic cardiomyopathy (ACM) carry a pathogenic or likely pathogenic mutation in the desmosomal genes. However, there is a significant number of patients without positive familial anamnesis. Therefore, the molecular reasons for ACM in these patients are frequently unknown and a genetic contribution might be underestimated. Here, we used a next-generation sequencing (NGS) approach and in addition single nucleotide polymor-phism (SNP) arrays for the genetic analysis of two independent index patients without familial medical history. Of note, this genetic strategy revealed a homozygous splice site mutation (DSG2–c.378+1G>T) in the first patient and a nonsense mutation (DSG2–p.L772X) in combination with a large deletion in DSG2 in the second one. In conclusion, a recessive inheritance pattern is likely for both cases, which might contribute to the hidden medical history in both families. This is the first report about these novel loss-of-function mutations in DSG2 that have not been previously identi-fied. Therefore, we suggest performing deep genetic analyses using NGS in combination with SNP arrays also for ACM index patients without obvious familial medical history. In the future, this finding might has relevance for the genetic counseling of similar cases.