bluuebunny/crossref_metadata_2025 huggingface dataset:
A Self-Sensing Method for Electromagnetic Actuators with Hysteresis Compensation
Authors: König Niklas , Carbon Yannik , Nienhaus Matthias , Grasso Emanuele
Published: October 2021

Self-sensing techniques are a commonly used approach for electromagnetic actuators since they allow the removal of position sensors. Thus, costs, space requirements, and system complexity of actuation systems can be reduced. A widely used parameter for self-sensing is the position-dependent incremental inductance. Nevertheless, this parameter is strongly affected by electromagnetic hysteresis, which reduces the performance of self-sensing. This work focuses on the design of a hysteresis-compensated self-sensing algorithm with low computational effort. In particular, the Integrator-Based Direct Inductance Measurement (IDIM) technique is used for the resource-efficient estimation of the incremental inductance. Since the incremental inductance exhibits a hysteresis with butterfly characteristics, it first needs to be transformed into a B-H curve-like hysteresis. Then, a modified Prandtl–Ishlinskii (MPI) approach is used for modeling this hysteretic behavior. By using a lumped magnetic circuit model, the hysteresis of the iron core can be separated from the air gap, thus allowing a hysteresis-compensated estimation of the position. Experimental studies performed on an industrial switching actuator show a significant decrease in the estimation error when the hysteresis model is considered. The chosen MPI model has a low model order and therefore allows a computationally lightweight implementation. Therefore, it is proven that the presented approach increases the accuracy of self-sensing on electromagnetic actuators with remarkable hysteresis while offering low computational effort which is an important aspect for the implementation of the technique in cost-critical applications.
ρ-MtreeRing: A Graphical User Interface for X-ray Microdensity Analysis
Authors: García-Hidalgo Miguel , García-Pedrero Ángel M. , Caetano-Sánchez Cristina , Gómez-España Marcos , Lillo-Saavedra Mario , Olano José Miguel
Published: October 2021

Wood microdensitometry provides an integrated measurement of inter and intra-annual changes in wood anatomy and lignification. Although it can be acquired through a wide array of techniques, X-ray-based techniques are still the standard. Conversion of a grayscale X-ray image to density and annual ring boundaries delimitation is performed through image analysis software. Proprietary software has dominated these applications, albeit Free Open Source Software (FOSS) has been developed recently. We present ρ-MtreeRing, a user-friendly FOSS that streamlines the entire microdensitometry analysis process through a graphical user interface based on Shiny R Software without any programming knowledge. We compared the results of this program with the most widely used commercial software (WinDendro), showing the validity of the results. ρ-MtreeRing can be personalized and developed by the microdensitometry research community.
Strategic Wildfire Response Decision Support and the Risk Management Assistance Program
Authors: Calkin David , O’Connor Christopher , Thompson Matthew , Stratton Richard
Published: October 2021

In 2016, the USDA Forest Service, the largest wildfire management organization in the world, initiated the risk management assistance (RMA) program to improve the quality of strategic decision-making on its largest and most complex wildfire events. RMA was designed to facilitate a more formal risk management process, including the use of the best available science and emerging research tools, evaluation of alternative strategies, consideration of the likelihood of achieving objectives, and analysis of tradeoffs across a diverse range of incident objectives. RMA engaged personnel from a range of disciplines within the wildfire management system to co-produce actionable science that met the needs of the highly complex incident decision-making environment while aiming to align with best practices in risk assessment, structured decision-making, and technology transfer. Over the four years that RMA has been in practice, the content, structure, and method of information delivery have evolved. Furthermore, the RMA program’s application domain has expanded from merely large incident support to incorporate pre-event assessment and training, post-fire review, organizational change, and system improvement. In this article, we describe the history of the RMA program to date, provide some details and references to the tools delivered, and provide several illustrative examples of RMA in action. We conclude with a discussion of past and ongoing program adaptations and of how this can inform ongoing change efforts and offer thoughts on future directions.
Storage Stability of Durum Wheat Pasta Enriched with Seaweeds Flours
Authors: Ribeiro Ana Ramalho , Botelho Goreti , Gaspar Ana , Costa Rui
Published: October 2021

The enrichment of semolina pasta with nutritionally rich ingredients has been targeted as a health strategy in recent years. In this work, the storage stability of seaweed-enriched pasta was assessed at different combinations of temperature and relative humidity. After six months of storage, pasta samples did not present variations in their sensory properties. The enrichment of durum wheat pasta with 1% of macroalgae Fucus vesiculosus and Ulva rigida flours, or flours of its extracts, was found to be adequate without influencing or modifying the sensory characteristics of pasta samples during the storage period. Water activity was shown to be the main criteria influencing the quality parameters of pasta during shelf life. A higher water activity during storage will lead to higher cooking losses and a lower firmness of cooked pasta, which will damage pasta quality over time.
Application of Whole Genome Sequencing to Understand Diversity and Presence of Genes Associated with Sanitizer Tolerance in Listeria monocytogenes from Produce Handling Sources
Authors: Bland Rebecca N. , Johnson Jared D. , Waite-Cusic Joy G. , Weisberg Alexandra J. , Riutta Elizabeth R. , Chang Jeff H. , Kovacevic Jovana
Published: October 2021

Recent listeriosis outbreaks linked to fresh produce suggest the need to better understand and mitigate L. monocytogenes contamination in packing and processing environments. Using whole genome sequencing (WGS) and phenotype screening assays for sanitizer tolerance, we characterized 48 L. monocytogenes isolates previously recovered from environmental samples in five produce handling facilities. Within the studied population there were 10 sequence types (STs) and 16 cgMLST types (CTs). Pairwise single nucleotide polymorphisms (SNPs) ranged from 0 to 3047 SNPs within a CT, revealing closely and distantly related isolates indicative of both sporadic and continuous contamination events within the facility. Within Facility 1, we identified a closely related cluster (0–2 SNPs) of isolates belonging to clonal complex 37 (CC37; CT9492), with isolates recovered during sampling events 1-year apart and in various locations inside and outside the facility. The accessory genome of these CC37 isolates varied from 94 to 210 genes. Notable genetic elements and mutations amongst the isolates included the bcrABC cassette (2/48), associated with QAC tolerance; mutations in the actA gene on the Listeria pathogenicity island (LIPI) 1 (20/48); presence of LIPI-3 (21/48) and LIPI-4 (23/48). This work highlights the potential use of WGS in tracing the pathogen within a facility and understanding properties of L. monocytogenes in produce settings.
A Combination of Chromatography with Tandem Mass Spectrometry Systems (UPLC-MS/MS and GC-MS/MS), Modified QuEChERS Extraction and Mixed-Mode SPE Clean-Up Method for the Analysis of 656 Pesticide Residues in Rice
Authors: Tran-Lam Thanh-Thien , Bui Minh Quang , Nguyen Hoa Quynh , Dao Yen Hai , Le Giang Truong
Published: October 2021

The emerging ungovernable application of pesticides in rice farming has attracted public concerns as these hazardous chemicals leave long-lasting environmental impacts and cause severe health effects. Here, an optimized analytical method was proposed for the measurement of 656 pesticide residues in rice samples collected in Vietnam. We utilized chromatography with tandem mass spectrometry systems (UPLC-MS/MS and GC-MS/MS) combined with a modified quick, easy, cheap, effective, rugged, and safe (QuEChERS) extraction method and adopted a mixed-mode SPE clean-up method for the analysis. The results showed that a total of 341 and 315 compounds were determined by UPLC- and GC-MS/MS, respectively. Usage of 10 mL MeCN, 5 mL H2O and 1% glacial acetic acid as extraction solvent outperformed other mixtures in purifying the analytes from the sample matrix. Besides, pressure swing adsorption connected to a C18 cartridge with C18 placed on top exhibited remarkably more extracted compounds of high recovery which resulted in 299 and 318 compounds with recovery ranging from 70 to 120% in GC- and UPLC-MS/MS, respectively. Our optimized protocols also resulted in maximal limits of quantification of 10 μg Kg−1 in both MS methods with repeatability and reproducibility less than 20%. Application of validated method on 20 rice samples collected in Hanoi, Vietnam showed that 14 samples were contaminated with at least one pesticide, and insecticide was the most detected group. Overall, the compliance of all method validation parameters to SANTE/12682/2019 Guideline demonstrates that this protocol can be employed for the effective management of Vietnam’s rice in accordance with international requirements.
Functionalized Biscuits with Bioactive Ingredients Obtained by Citrus Lemon Pomace
Authors: Imeneo Valeria , Romeo Rosa , Gattuso Antonio , De Bruno Alessandra , Piscopo Amalia
Published: October 2021

In this study, functionalized biscuits were prepared through the enrichment of dough with lemon peel and natural antioxidants extracted from lemon pomace. Lemon pomace extract (LPE) was analyzed for total phenolic content before addition, and then a known concentration of 50 mg kg−1 was used for the formulation of enriched biscuits. Three different biscuit samples were compared to a control biscuit, without the addition of functional ingredients. The main physicochemical, microbiological, and sensory aspects of doughs and biscuits enriched with LPE were investigated. The enriched biscuits showed higher phenolic content and antioxidant activity than the control one and a longer induction period (IP), which means that the enriched products had a higher intrinsic resistance to lipid oxidation, thanks to the antioxidant effect exerted by the added fresh lemon peel and the LPE. Furthermore, from a sensorial point of view, they showed suitable acceptability, in terms of appearance, flavor, and aromatic attributes. Thus, results indicated that the incorporation of lemon processing by-products allowed the production of functional enriched biscuits with improved antioxidant properties.
Baking Quality Assessment of Twenty Whole Grain Oat Cultivar Samples
Authors: Sammalisto Saara , Laitinen Miikka , Sontag-Strohm Tuula
Published: October 2021

Whole grain oat has become an increasingly popular baking ingredient. Still, oat baking poses many industrial challenges because the baking quality criteria have not been set for whole grain oat flours, and cultivar variation remains unknown. We aimed to assess the baking quality variation of twenty whole grain oat cultivar samples, and to identify the factors that caused the variation. It was hypothesised that by optimising the water absorption of the dough (i.e., dough yield) by test baking method, the best baking potential could be achieved for all oat cultivar samples. The baking trials were conducted as whole oat baking, without wheat or gluten additions. In most of the samples, good baking quality was obtained by dough yield optimisation. The highest specific volumes (1.9–1.93 mL/g) and best crumb properties were achieved in the samples with the highest optimal dough yields, 205. However, baking quality varied, as all samples could not be baked with good quality at high dough yields. Additionally, small median particle size and high fat content of the oat flours were related to good baking properties of whole grain oat at optimised dough yield (p < 0.05). These findings can benefit the development and the optimisation of industrial oat baking processes.
Storage Proteins Are Driving Pediatric Hazelnut Allergy in a Lipid Transfer Protein-Rich Area
Authors: Valbuena Teresa , Reche Marta , Marco Guadalupe , Toboso Inmaculada , Ringauf Anna , Thuissard-Vasallo Israel J. , Lozano-Ojalvo Daniel , Martínez-Blanco Mónica , Molina Elena
Published: October 2021

Oral food challenge (OFC) remains the gold standard for the diagnosis of food allergies. However, this test is not without risks, given that severe allergic reactions can be triggered while it is conducted. The purpose of this study is to identify potential demographic variables, clinical characteristics of the patients and biomarkers that may be associated with severe reactions during the hazelnut oral challenge test. The sample included 22 children allergic to hazelnut who underwent a tree nut skin prick test (SPT), specific IgE (sIgE) to hazelnut, component-resolved diagnosis (CRD) with different hazelnut allergens (Cor a 1, Cor a 8, Cor a 9, Cor a 11, Cor a 14), and a single-blind placebo-controlled challenge with hazelnut. A statistically significant relationship was found between the severity of the reaction and the highest values of sIgE to hazelnut, Cor a 11 and Cor a 14, cumulative symptom-triggering dose and sunflower seed sensitization. The use of the CRD is a useful tool to identify patients at higher risk of developing a severe reaction. In this pediatric population sample from Spain, storage proteins were confirmed to be most involved in hazelnut allergy and the development of severe reactions.
Structural Protein Analysis of Driver Gene Mutations in Conjunctival Melanoma
Authors: Djulbegovic Mak B. , Uversky Vladimir N. , Harbour J. William , Galor Anat , Karp Carol L.
Published: October 2021

In recent years, there has been tremendous enthusiasm with respect to detailing the genetic basis of many neoplasms, including conjunctival melanoma (CM). We aim to analyze five proteins associated with CM, namely BRAF, NRAS, c-KIT, NF1, and PTEN. We evaluated each protein for its intrinsically disordered protein regions (IDPRs) and its protein-protein interactions (PPI) with the Predictor of Natural Disordered Protein Regions (PONDR®) and the Search Tool for the Retrieval of Interacting Genes (STRING®). Our PONDR® analysis found high levels of IDPRs in all five proteins with mutations linked to CM. The highest levels of IDPRs were in BRAF (45.95%), followed by PTEN (31.76%), NF1 (22.19%), c-KIT (21.82%), and NRAS (14.81%). Our STRING analysis found that each of these five proteins had more predicted interactions then expected (p-value < 1.0 × 10−16). Our analysis demonstrates that the mutations linked to CM likely affected IDPRs and possibly altered their highly complex PPIs. Quantifying IDPRs in BRAF, NRAS, c-KIT, NF1, and PTEN and understanding these protein regions are important processes as IDPRs can be possible drug targets for novel targeted therapies for treating CM.
Effect of Composition on Engineering Behavior of Clay Tills
Authors: Paranthaman Rajeevkaran , Azam Shahid
Published: October 2021

Glacial geology, marine environment, and arid climate govern the composition of clay tills. The main purpose of this work is to develop a clear understanding of the engineering behavior of compacted clay till under soil suction and applied stress. The results indicate moderate water adsorption due to the presence of clay minerals (26% corrensite, 10% illite, and 8% kaolinite) with Ca2+ as the dominant cation and a flocculated fabric in a slightly basic (pH = 7.5) pore water. The water retention curve comprised four transition points that are associated with capillary water drainage from large pores (air entry value of 2 kPa and residual suction value of 20 kPa) and small pores (air entry value of 700 kPa and residual suction value of 5 × 104 kPa). Beyond the last value, vapor flow is dominant and removes the adsorbed water by evaporation. The ratio of soil volume change to water volume change best described the s-shaped shrinkage path that also comprised four stages, namely: from most large pores with low volume change; from remaining large and most small pores along with almost equal volume change; from some small pores with low volume change; and from the rest of the small pores with no volume change. Likewise, the s-shaped swelling potential curve comprised three stages and correlated well with bimodal hydraulic conductivity curve, that is, slow initial swelling (unsaturated hydraulic conductivity around 10−14 m/s) due to expansion of peripheral clay in lumps; high primary swelling (unsaturated hydraulic conductivity of up to 10−11 m/s) due to thickened double layer of most colloids; and slow secondary swelling (albeit unsaturated hydraulic conductivity around 10−10 m/s) due to expansion of remaining particles. Soil compression (compression index of 0.164) was due to a gradual reduction in number of large pores, whereas rebound (swelling index of 0.047) was due to water adsorption on clay with part of the deformations recovered. Finally, the consolidation rate was related to saturated hydraulic conductivity, which varied by three orders of magnitude.
Rearward-Facing Infant Child Restraint Systems with Support Legs in Frontal and Frontal-Oblique Impacts
Authors: Patton Declan A. , Belwadi Aditya N. , Maheshwari Jalaj , Arbogast Kristy B.
Published: October 2021

Previous studies of support legs in rearward-facing infant CRS models have focused on frontal impacts and have found that the presence of a support leg is associated with a reduction in head injury metrics. However, real-world crashes often involve an oblique principal direction of force. The current study used sled tests to evaluate the effectiveness of support legs in rearward-facing infant CRS models for frontal and frontal-oblique impacts with and without a simulated front row seatback. Frontal and frontal-oblique impact sled tests were conducted using the simulated Consumer Reports test method with and without the blocker plate, which was developed to represent a front row seatback. The Q1.5 anthropomorphic test device (ATD) was seated in rearward-facing infant CRS models, which were tested with and without support legs. The presence of a support leg was associated with significant reductions of head injury metrics below injury tolerance limits for all tests, which supports the findings of previous studies. The presence of a support leg was also associated with significant reductions of peak neck tensile force. The presence of the blocker plate resulted in greater head injury metrics compared to tests without the blocker plate, but the result was non-significant. However, the fidelity of the interaction between the CRS and blocker plate as an adequate representation of the interaction that would occur in a real vehicle is not well understood. The findings from the current study continue to support the benefit of support legs in managing the energy of impact for a child in a rearward-facing CRS.
Prioritization of the Target Population for Coronavirus Disease 2019 (COVID-19) Vaccination Program in Thailand
Authors: Suphanchaimat Rapeepong , Tuangratananon Titiporn , Rajatanavin Nattadhanai , Phaiyarom Mathudara , Jaruwanno Warisara , Uansri Sonvanee
Published: October 2021

Thailand was hit by the second wave of Coronavirus Disease 2019 (COVID-19) in a densely migrant-populated province (Samut Sakhon). COVID-19 vaccines were known to be effective; however, the supply was limited. Therefore, this study aimed to predict the effectiveness of Thailand’s COVID-19 vaccination strategy. We obtained most of the data from the Ministry of Public Health. Deterministic system dynamics and compartmental models were utilized. The reproduction number (R) between Thais and migrants was estimated at 1.25 and 2.5, respectively. Vaccine effectiveness (VE) to prevent infection was assumed at 50%. In Samut Sakhon, there were 500,000 resident Thais and 360,000 resident migrants. The contribution of migrants to the province’s gross domestic product was estimated at 20%. Different policy scenarios were analyzed. The migrant-centric vaccination policy scenario received the lowest incremental cost per one case or one death averted compared with the other scenarios. The Thai-centric policy scenario yielded an incremental cost of 27,191 Baht per one life saved, while the migrant-centric policy scenario produced a comparable incremental cost of 3782 Baht. Sensitivity analysis also demonstrated that the migrant-centric scenario presented the most cost-effective outcome even when VE diminished to 20%. A migrant-centric policy yielded the smallest volume of cumulative infections and deaths and was the most cost-effective scenario, independent of R and VE values. Further studies should address political feasibility and social acceptability of migrant vaccine prioritization.
Deep Ensemble Learning Approaches in Healthcare to Enhance the Prediction and Diagnosing Performance: The Workflows, Deployments, and Surveys on the Statistical, Image-Based, and Sequential Datasets
Authors: Nguyen Duc-Khanh , Lan Chung-Hsien , Chan Chien-Lung
Published: October 2021

With the development of information and technology, especially with the boom in big data, healthcare support systems are becoming much better. Patient data can be collected, retrieved, and stored in real time. These data are valuable and meaningful for monitoring, diagnosing, and further applications in data analysis and decision-making. Essentially, the data can be divided into three types, namely, statistical, image-based, and sequential data. Each type has a different method of retrieval, processing, and deployment. Additionally, the application of machine learning (ML) and deep learning (DL) in healthcare support systems is growing more rapidly than ever. Numerous high-performance architectures are proposed to optimize decision-making. As reliability and stability are the most important factors in the healthcare support system, enhancing the predicted performance and maintaining the stability of the model are always the top priority. The main idea of our study comes from ensemble techniques. Numerous studies and data science competitions show that by combining several weak models into one, ensemble models can attain outstanding performance and reliability. We propose three deep ensemble learning (DEL) approaches, each with stable and reliable performance, that are workable on the above-mentioned data types. These are deep-stacked generalization ensemble learning, gradient deep learning boosting, and deep aggregation learning. The experiment results show that our proposed approaches achieve more vigorous and reliable performance than traditional ML and DL techniques on statistical, image-based, and sequential benchmark datasets. In particular, on the Heart Disease UCI dataset, representing the statistical type, the gradient deep learning boosting approach dominates the others with accuracy, recall, F1-score, Matthews correlation coefficient, and area under the curve values of 0.87, 0.81, 0.83, 0.73, and 0.91, respectively. On the X-ray dataset, representing the image-based type, the deep aggregation learning approach shows the highest performance with values of 0.91, 0.97, 0.93, 0.80, and 0.94, respectively. On the Depresjon dataset, representing the sequence type, the deep-stacked generalization ensemble learning approach outperforms the others with values of 0.91, 0.84, 0.86, 0.8, and 0.94, respectively. Overall, we conclude that applying DL models using our proposed approaches is a promising method for the healthcare support system to enhance prediction and diagnosis performance. Furthermore, our study reveals that these approaches are flexible and easy to apply to achieve optimal performance.
The Practice of Vigorous Physical Activity Is Related to a Higher Educational Level and Income in Older Women
Authors: Zapata-Lamana Rafael , Poblete-Valderrama Felipe , Cigarroa Igor , Parra-Rizo María Antonia
Published: October 2021

Few studies have shown evidence about the factors that can determine physical practice in women over 60 years of age due to educational, economic, social, or health inequalities. Its knowledge could help to understand the determinants that encourage the practice of physical activity and the improvement of health in women over 60. Therefore, the aim of this research was to evaluate the level of studies, income, and the usefulness of social and health services in physically active older women according to the level of activity they practice. The IPAQ (International Physical Activity Questionnaire) and CUBRECAVI (subjective health scale) scales have been applied to a sample of 257 women between 61 and 93 years old (M = 69.44, SD = 4.61). The results have shown that those with vigorous physical activity are related to higher levels of education (p < 0.001) and income (p = 0.004). Furthermore, being dissatisfied with social and health services is associated with low levels of physical activity (p = 0.005). Older women who perform physical activity regularly are associated with high levels in some of the socio-environmental aspects of quality of life. High physical activity is related to a higher educational level and income. Socio-environmental factors generate social inequalities and modulate the lifestyles of older women.
“My 9 to 5 Job Is Birth Work”: A Case Study of Two Compensation Approaches for Community Doula Care
Authors: Gomez Anu Manchikanti , Arteaga Stephanie , Arcara Jennet , Cuentos Alli , Armstead Marna , Mehra Renee , Logan Rachel G. , Jackson Andrea V. , Marshall Cassondra J.
Published: October 2021

With the increased policy emphasis on promoting doula care to advance birth equity in the United States, there is a vital need to identify sustainable and equitable approaches for compensation of community doulas, who serve clients experiencing the greatest barriers to optimal pregnancy-related outcomes. This case study explores two different approaches for compensating doulas (contractor versus hourly employment with benefits) utilized by SisterWeb San Francisco Community Doula Network in San Francisco, California. We conducted qualitative interviews with SisterWeb doulas in 2020 and 2021 and organizational leaders in 2020. Overall, leaders and doulas reported that the contractor approach, in which doulas were paid a flat fee per client, did not adequately compensate doulas, who regularly attend trainings and provide additional support for their clients (e.g., referrals to promote housing and food security). Additionally, this approach did not provide doulas with healthcare benefits, which was especially concerning during the COVID-19 pandemic. As hourly, benefited employees, doulas experienced a greater sense of financial security and wellbeing from receiving consistent pay, compensation for all time worked, and benefits such as health insurance and sick leave, allowing some to dedicate themselves to birth work. Our study suggests that efforts to promote community doula care must integrate structural solutions to provide appropriate compensation and benefits to doulas, simultaneously advancing birth equity and equitable labor conditions for community doulas.
Concentrations of Salivary Cortisol in Victims of Intimate Partner Violence According to the CIRCORT Database
Authors: Mata-Gil Sarai , Sánchez-Cabaco Antonio , Del Moral-Martínez Jerónimo , Seisdedos-Benito Antonio , Lundberg Ulf
Published: October 2021

This work analyzes the different levels of salivary cortisol in women from the southwest of Spain that were victims of intimate partner violence (IPV) with respect to a control group, assessing for the first time the different concentrations obtained in relation to a worldwide reference standard provided by the CIRCORT meta-global cortisol database. The clinical sample (N = 24) and the control group (N = 25) had an average of 39.12 years (SD = 12.31) and 39.52 years (SD = 11.74), respectively. Cortisol awakening response (CAR) was determined by defining the area under the curve (AUCi). There were no differences between the CAR data of the two populations F (1, 141) = 1.690, p = 0.196, but there was a highly significant difference in the three sampling days, where the clinical sample exceeded the cortisol levels of the CIRCORT database in the evening as compared to the control group (p = 0.004, p = 0.001 and p = 0.000). Salivary cortisol concentration samples taken in the evening were significantly higher than those standardized in the CIRCORT database, from the women victims of IPV as compared to the control group, showing its usefulness as an effective supportive tool for problems such as those triggered by IPV.
A Simulation Analysis of Maternal Pelvic Floor Muscle
Authors: Xuan Rongrong , Yang Mingshuwen , Gao Yajie , Ren Shuaijun , Li Jialin , Yang Zhenglun , Song Yang , Huang Xu-Hao , Teo Ee-Chon , Zhu Jue , Gu Yaodong
Published: October 2021

Pelvic floor disorder (PFD) is a common disease affecting the quality of life of middle-aged and elderly women. Pelvic floor muscle (PFM) damage is related to delivery mode, fetal size, and parity. Spontaneous vaginal delivery causes especially great damage to PFM. The purpose of this study was to summarize the characteristics of PFM action during the second stage of labor by collecting female pelvic MRI (magnetic resonance imaging) data and, further, to try to investigate the potential pathogenetic mechanism of PFD. A three-dimensional model was established to study the influence factors and characteristics of PFM strength. In the second stage of labor, the mechanical responses, possible damage, and the key parts of postpartum lesions of PFM due to the different fetal biparietal diameter (BPD) sizes were analyzed by finite element simulations. The research results showed that the peak stress and strain of PFM appeared at one-half of the delivery period and at the attachment point of the pubococcygeus to the skeleton. In addition, during the simulation process, the pubococcygeus was stretched by about 1.2 times and the levator ani muscle was stretched by more than two-fold. There was also greater stress and strain in the middle area of the levator ani muscle and pubococcygeus. According to the statistics, either being too young or in old maternal age will increase the probability of postpartum PFM injury. During delivery, the entire PFM underwent the huge deformation, in which the levator ani muscle and the pubococcygeus were seriously stretched and the attachment point between the pubococcygeus and the skeleton were the places with the highest probability of postpartum lesions.
Children with Secondary Care Episodes for Otitis Media Have Poor Literacy and Numeracy Outcomes: A Data Linkage Study
Authors: Bell Megan F. , Lima Fernando , Lehmann Deborah , Glauert Rebecca , Moore Hannah C. , Brennan-Jones Christopher G.
Published: October 2021

We examined the association between otitis media (OM) and educational attainment in a retrospective population cohort of Western Australian children who participated in the grade 3 National Assessment Program—Literacy and Numeracy in 2012 (N = 19,262). Literacy and numeracy scores were linked to administrative hospital and emergency department data to identify secondary care episodes for OM. Results of multivariate multilevel models showed that children with OM episodes had increased odds of poor performance on literacy and numeracy tests, compared to children without OM episodes (46–79% increase in odds for Aboriginal children; 20–31% increase in odds for non-Aboriginal children). There were no significant effects found for age at the first episode, nor for OM episode frequency (all ps > 0.05). Regardless of the timing or frequency of episodes, children with OM episodes are at risk of poor literacy and numeracy attainment. Aboriginal children with OM appeared to be particularly at risk of poor literacy and numeracy achievement. Intervention to reduce the prevalence of otitis media in young children, and early treatment of OM, are important for limiting the negative effects on academic outcomes.
The Relationship between Mental Health, Educational Burnout and Strategies for Coping with Stress among Students: A Cross-Sectional Study of Poland
Authors: Długosz Piotr , Liszka Damian
Published: October 2021

This study sought to investigate the risk factors of poor psychosomatic health among students during the quarantine of the first wave of the COVID-19 pandemic. A survey was conducted on-line, on a sample of 1978 respondents in Poland. The study was carried out towards the end of the summer 2020 semester. The questionnaire used in the study was designed so that it allows for the observation of the main risk factors which have an impact on the students’ mental health. Variance analysis and hierarchical regression analysis were used to determine the predictors of mental health problems. The results indicate that average and high levels of psychosomatic disorders were observed among 61% of respondents. The hierarchical regression analysis showed that an increase in the level of educational burnout, a decreased life satisfaction, and use of negative strategies of coping with stress, were accompanied by a deteriorated mental condition of students. Moreover, it was observed that female respondents scored higher on the scale of disorders in comparison to males.
GERD—A Burning Problem after Sleeve Gastrectomy?
Authors: Znamirowski Przemysław , Bryk Piotr , Lewitowicz Piotr , Kozieł Dorota , Głuszek Stanisław
Published: October 2021

Background: Surgical treatment is the most effective method of treatment for obesity; and laparoscopic sleeve gastrectomy (LSG) is the most frequently performed bariatric surgery. Objective: The aim of the study was evaluation of the frequency of occurrence and the degree of progression of changes characteristic of GERD in patients who had undergone LSG in clinical; endoscopic; and microscopic images in the obtained bioptats; and an attempt to correlate the results obtained with the effectiveness of bariatric treatment. Materials and Method: The anonymized clinical data concerning 214 patients who had undergone LSG were collected from the database. Invitations for check-up examinations were distributed, to which 37 patients responded. Two patients were excluded from the study. In 35 patients after LSG check-up clinical examination, bariatric endoscopy (BE) and bariatric microscopy (BM) were performed on bioptats collected from the site of the gastro-esophageal junction; and 3 specimens collected at 2 cm intervals from the Z-line. The study was performed according to the standard protocol. Results: In the analyzed group, clinical symptoms of GERD occurred in 12 patients (34.5%), including 10 females and 2 males. The symptom reported by all patients was retrosternal pain/burning (heartburn). In BE, foci of ectopic mucosa in the epicardial part of the esophagus were found in 16 patients (14 F and 2 M). No correlation was observed between the analyzed parameters and the occurrence of the above-mentioned changes. In BM, only in three patients were the changes described as normal esophageal mucosa; while in another three, as foci of intestinal metaplasia, Barrett’s esophagus. In this group no foci of dysplasia were found. In eight patients, the changes were described as inflammatory. In ten patients from this group, microscopic changes occurred without clinical symptoms of the disease. Conclusions: GERD is an important clinical problem in patients after LSG; therefore; the problem of occurrence or exacerbation of symptoms of the disease should be discussed with the patient during qualification for bariatric surgery. The bariatric effectiveness of LSG does not correlate with the occurrence of the symptoms of GERD after the procedure. However; the lack of clinical symptoms of the disease does not mean the lack of its occurrence. Therefore; the endoscopic check-up after LSG should be routinely performed. During the qualification for LSG screening, histopathologic examinations of the esophagus may be useful for the assessment of the microscopic symptoms of GERD in oligosymptomatic patients; and exclusion of rare pathologies of the esophagus (e.g., eosinophilic esophagitis), which may complicate post-operative course.
Generalized Anxiety among Swiss Health Professions and Non-Health Professions Students: An Open Cohort Study over 14 Months in the COVID-19 Pandemic
Authors: Volken Thomas , Zysset Annina , Amendola Simone , von Wyl Agnes , Dratva Julia ,   on behalf of the HES-C Research Group
Published: October 2021

To date, little is known about the long-term trajectory of generalized anxiety disorder (GAD) symptoms in health professions (HP) students over the course of the pandemic. Like health professionals in general, HP students may have a significantly greater susceptibility to GAD symptoms due to their involvement in the health care system and the associated specific stressors and risks during the COVID-19 pandemic. The HEalth in Students during the Corona pandemic study (HES-C) provided the opportunity to investigate the long-term course of GAD symptoms with eight measurement points over 14 months in 9380 HP and non-HP students in Switzerland between March 2020 and June 2021. We employed logistic regression models with clustered sandwich standard errors to estimate unadjusted and adjusted prevalence of GAD symptoms. In the full model, we adjusted for age, gender, nationality, social status, social support, self-efficacy, and COVID-19 symptoms in the past 4 weeks. At baseline, the estimated adjusted GAD symptom prevalence was 17.6% (95% CI = 14.4–20.7) in HP students and 24.4% (95% CI = 22.3–26.5) in their peers. With the peak of the second SARS-CoV-2 infection wave in October/November 2020, GAD symptom prevalence substantially increased and then remained stable over time, despite changes in the epidemiological situation and its associated containment measures. At the last follow-up in June 2021, GAD symptom prevalence in HP and non-HP students was 22.9% (95% CI = 16.3–29.5) and 36.9% (95% CI = 32.9–40.9), respectively. Absolute differences in GAD symptom prevalence between student groups over all eight measurement points ranged from 6.2% to 14.9% (all p < 0.05). Non-HP students are identified as a specifically vulnerable group. Accordingly, target group-specific public health campaigns and interventions should be developed with the aim to strengthen their resources, reducing GAD symptoms, and preventing chronification.
Korean Domestic Tourists’ Decision-Making Process under Threat of COVID-19
Authors: Wang JunHui , Choe Yunseon , Song HakJun
Published: October 2021

The purpose of this study is to build a theoretical framework to explain Korean domestic tourists’ decision-making process under COVID-19 by applying an extended model of goal-directed behavior. The role of positive expectation of COVID-19, the effect of mass media, and perception of government policy were considered as new variables in the process of tourism decision-making. The results of this present study show that positive and negative anticipated emotion, positive expectation, and the frequency of past behavior positively influence the desire for travel domestically within the next three months, while the effect of mass media negatively affected the desire for travel domestically within the next three months. Two anticipated emotions and positive expectations were positive antecedents of the desire for travel domestically within this year. The anticipated emotions and the effect of mass media affected the desire to travel domestically next year. The results of this tourist’s decision-making research will offer government, the tourism sector, and policy decision-makers better insights for establishing tourism policy responses and create safe destinations to help an adequate recovery and development of the tourism industry.
The Usability of an Online Tool to Promote the Use of Evidence-Based Smoking Cessation Interventions
Authors: Zijlstra Daniëlle N. , Bolman Catherine A. W. , Muris Jean W. M. , de Vries Hein
Published: October 2021

To increase usage of evidence-based smoking cessation interventions (EBSCIs) among smokers, an online decision aid (DA) was developed. The aims of this study were (1) to conduct a usability evaluation; (2) to conduct a program evaluation and evaluate decisional conflict after using the DA and (3) to determine the possible change in the intention to use EBSCIs before and directly after reviewing the DA. A cross-sectional study was carried out in September 2020 by recruiting smokers via the Internet (n = 497). Chi-squared tests and t-tests were conducted to test the differences between smokers who differed in the perceived usability of the DA on the program evaluation and in decisional conflict. The possible changes in intention to use EBSCIs during a cessation attempt before and after reviewing the DA were tested using t-tests, McNemar’s test and χ2 analysis. The participants evaluated the usability of the DA as moderate (MU; n = 393, 79.1%) or good (GU; n = 104, 20.9%). GU smokers rated higher on all the elements of the program evaluation and experienced less decisional conflict, but also displayed a higher intention to quit. After reviewing the DA, the participants on average had a significantly higher intention to use more EBSCIs, in particular in the form of eHealth. Recommendations to make the DA more usable could include tailoring, using video-based information and including value clarification methods. Furthermore, a hybrid variant in which smokers can use the DA independently and with the guidance of a primary care professional could aid both groups in choosing a fitting EBSCI option.
Using COVID-19 Symbols in Anti-Smoking Fear Appeal Advertisements for Encouraging Smoking Cessation among Israeli Smokers
Authors: Gavish Iris , Gavish Yossi
Published: October 2021

The current study aims to reveal whether using COVID-19 as the threatening message in anti-smoking ads will influence smokers differently than other threat appeals. All ads that were chosen for this study were created by the Israel Cancer Association/the Israeli Ministry of Health. Since the coronavirus has proven to have far-reaching effects on the human respiratory system, it is directly connected to smoking. The present study included semi-structured in-depth interviews with experts, a pre-test (n = 106) and an online questionnaire including 721 participants (adults aged 18–30 versus 55+). The findings indicated that when using the COVID-19 symbol as the threatening message in an anti-smoking ad for the older participants, smoking cessation intentions were higher than when using a cigarette simulating a ‘gunpoint’ threat (p < 0.08). Additionally, when using the COVID-19 symbol, there was a positive relation between participants’ age and smoking cessation intentions. The average smoking cessation intention for the participants from the older age group (M = 3.05, SD = 1.07) was higher than the average for the participants from the young age group (M = 2.80, SD = 1.13). Finally, when using impotence (for men) and pregnancy risks (for women) as the threatening message in the ads for young respondents, smoking cessation intentions were higher than when using COVID-19 (p < 0.05). The results may help decision-makers and public health officials in choosing the marketing communication suited for conveying messages aimed to encourage people to reduce/quit smoking.
Systemic Sclerosis: Elevated Levels of Leukotrienes in Saliva and Plasma Are Associated with Vascular Manifestations and Nailfold Capillaroscopic Abnormalities
Authors: Mandujano Angélica , Méndez-Ramírez Ignacio , Silveira-Torre Luis Humberto
Published: October 2021

The role of leukotrienes (LTs) in the pathogenesis of systemic sclerosis (SSc) needs clarification. We analyzed the association of salivary (sa) and plasma (p) levels (pg/mL) of cysteinyl-leukotrienes (CysLT) and LTB4 with SSc vascular manifestations and nailfold capillaroscopy (NFC) in a cross-sectional study. Patients and healthy controls were evaluated for vascular manifestations and NFC. LTs were compared between groups as follows: SSc with or SSc without vascular features and controls, and by NFC parameters. Twenty SSc patients and 16 volunteers were recruited; Raynaud’s phenomenon (RP) history (SSc: saCysLT 99.4 ± 21.8 vs. controls: 23.05 ± 23.7, p = 0.01), RP at examination (SSc: saCysLT 129.3 ± 24.6 vs. controls: 23.05 ± 22.46, p = 0.01; pCysLT SSc: 87.5 ± 11.2 vs. controls: 32.37 ± 10.75, p = 0.002), capillary loss (saCysLT 138.6 ± 26.7 vs. 23.05 ± 21.6, p = 0.0007; saLTB4 3380.9 ± 426.6 vs. 1216.33 ± 346.1, p = 0.0005), “late” scleroderma pattern vs. controls (saCysLT 205.6 ± 32 vs. 23 ± 19.6, p = 0.0002; saLTB4 4564.9 ± 503.6 vs. 1216.3 ± 308.3; p < 0.0001) were all significant. Late patterns had higher levels (saCysLT, p = 0.002; LTB4 p = 0.0006) compared to active and early patterns (LTB4, p = 0.0006), and giant capillaries (p = 0.01) showed higher levels of LTs. Levels of pCysLT were higher in patients with RP at examination vs. patients without RP; saCysLT and LTB4 were higher in SSc group with vs. without capillary loss. LTs could be involved in the pathophysiology of vascular abnormalities. Further research is required to determine if blocking LTs could be a therapeutic target for SSc vascular manifestations.
Multifactorial Programs for Healthy Older Adults to Reduce Falls and Improve Physical Performance: Systematic Review
Authors: Loureiro Vânia , Gomes Margarida , Loureiro Nuno , Aibar-Almazán Agustín , Hita-Contreras Fidel
Published: October 2021

The aim of this systematic review of randomized controlled trials (RCTs) was to investigate the effects of multifactorial programs on the rate of falls and physical performance in ≥60 years old adults. A systematic literature search was conducted in four databases (PubMed, Scopus, Web of Science and Cochrane Library). A total of 518 articles were identified in the initial search, and six RCTs were finally included. Articles written in English, Portuguese and Spanish and published from January 2009 to May 2020 were included in this study. The methodological quality of the included studies was evaluated by the PEDro scale. A total of 518 studies were identified in the initial search, six RCTs were finally included, and three reached a level 1 of evidence. The findings of this systematic review of RCTs suggest that a physical exercise program, especially exercise group activities, combined with health education or with fall risk home assessment, were the most effective multifactorial program in reducing the rate of falls, although the results were not conclusive in all the studies included. Significant beneficial effects were observed in physical performance, particularly when assessed as gait, mobility and balance, regardless of the components of multifactorial program or exercise. This inconsistency in the results, particularly regarding the rate of falls, together with the variability among the multifactorial programs, suggest that any conclusion must be drawn with caution.