bluuebunny/crossref_metadata_2025 huggingface dataset:
Salivary Hormones and Quality of Life in Female Postmenopausal Burning Mouth Patients—A Pilot Case-Control Study
Authors: Lončar-Brzak Božana , Vidranski Valentina , Andabak-Rogulj Ana , Vidović-Juras Danica , Todorić-Laidlaw Ivana , Gabrić Dragana , Škrinjar Ivana
Published: October 2020

The objective of our study was to investigate salivary levels of estradiol, progesterone and dehydroepiandrosterone (DHEA), and quality of life, in female postmenopausal women with burning mouth syndrome. The study included new patients diagnosed with burning mouth syndrome and excluded local and systemic causes. Unstimulated saliva samples were taken in the morning from 9 AM and 11 AM and immediately frozen for hormone analysis. The patients filled out a self-perceived quality of life questionnaire Oral Health Impact Profile-14 and determined the intensity of mucosal symptoms according to the visual-analog scale grading 0 to 10. A total of 40 patients were included. The study group had significantly lower levels of salivary estradiol. No difference was observed in levels of progesterone and DHEA between the groups. The levels of salivary hormones did not exhibit a significant correlation according to the Spearman correlation test with a self-perceived quality of life questionnaire (OHIP-14) in the study group or in the control group. Further research on a larger number of patients is needed to verify these results. This information might help to enable more precise and efficient treatment.
Comment on Tsallis, C. Black Hole Entropy: A Closer Look. Entropy 2020, 22, 17
Authors: Pessoa Pedro , Arderucio Costa Bruno
Published: October 2020

In a recent paper (Entropy 2020, 22(1), 17), Tsallis states that entropy—as in Shannon or Kullback–Leiber’s definitions—is inadequate to interpret black hole entropy and suggests that a new non-additive functional should take the role of entropy. Here we counterargue by explaining the important distinction between the properties of extensivity and additivity; the latter is fundamental for entropy, while the former is a property of particular thermodynamical systems that is not expected for black holes. We also point out other debatable statements in his analysis of black hole entropy.
Digital Escape Room, Using Genial.Ly and A Breakout to Learn Algebra at Secondary Education Level in Spain
Authors: Jiménez Cristina , Arís Nuria , Magreñán Ruiz Ángel , Orcos Lara
Published: October 2020

One of the main objectives in mathematics education is to motivate students due to the fact that their interest in this area is often very low. The use of different technologies, as well as gamification in the classroom, can help us to meet this goal. In this case, it is presented the use of two techniques, which are a digital escape room, using Genial.ly and a breakout, for learning algebra in the third course of secondary education. To carry out the experience, a comparison of the course 2018/2019 and the course 2019/2020 is made. Students of both courses completed an exam of algebraic fractions and then an equations exam; the exams were done in the course 2019/2020 taken after having used the techniques. The results show that there are low significant differences between both courses in the algebraic fractions exam qualifications, but those of the equations exam were significant, with a difference of almost two points, which led us to conclude that the use of this techniques improved the qualifications of students. Finally, the perception that students had of the experience was very positive, as shown by the data obtained and allowed them to improve their knowledge as well as their motivation and teamwork.
Random Number Generator with Long-Range Dependence and Multifractal Behavior Based on Memristor
Authors: Téllez María , Mejía Johan , López Hans , Hernández Cesar
Published: October 2020

Random number generators are used in areas such as encryption and system modeling, where some of these exhibit fractal behaviors. For this reason, it is interesting to make use of the memristor characteristics for the random number generation. Accordingly, the objective of this article is to evaluate the performance of a chaotic memristive system as a random number generator with fractal behavior and long-range dependence. To achieve the above, modeling memristor and its corresponding chaotic systems is performed, from which a random number generator is constructed. Subsequently, the Hurst parameter for the detection of long-range dependence is estimated and a fractal analysis of the synthesized data is performed. Finally, a comparison between the model proposed in the research and the β-MWM algorithm is made. The results obtained show that the data synthesized from the proposed generator have a variable Hurst parameter and both monofractal and multifractal behavior. The main contribution of this research is the proposal of a new model for the synthesis of traces with long-range dependence and fractal behavior based on the non-linearity of the memristor.
Design of a Ka-Band U-Shaped Bandpass Filter with 20-GHz Bandwidth in 0.13-μm BiCMOS Technology
Authors: Men Kai , Liu Hang , Yeo Kiat Seng
Published: October 2020

In this work, the design of a novel Ka-band miniaturized bandpass filter with broad bandwidth is demonstrated by using inversely coupled U-shaped transmission lines. In the proposed filter, two transmission zeros can be generated within a cascaded U-shaped structure and it can also be proven that, by inversely coupling two stacked U-shaped transmission lines, the notch frequency at the upper stopband can be shifted to a lower frequency, which results in a smaller chip size. The key parameters affecting the performance of the proposed filter are investigated in detail with the effective lumped-element circuit illustrated. Fabricated in a 0.13-μm SiGe BiCMOS process, the proposed filter achieves an insertion loss of 3.6 dB at a frequency of 28.75 GHz and the measured bandwidth is from 20.75 GHz to 41 GHz. The return loss is better than −10 dB from 20.5 GHz to 39 GHz. The lower transmission zero is located at 11.75 GHz with a suppression of 54 dB while the upper transmission zero is around 67 GHz with an attenuation of 34.6 dB. The measurement agrees very well with the simulation results and the overall chip size of the proposed filter is 176 × 269 μm2.
Blockchain Based Smart Contracts for Internet of Medical Things in e-Healthcare
Authors: Sharma Ashutosh , Sarishma  , Tomar Ravi , Chilamkurti Naveen , Kim Byung-Gyu
Published: October 2020

The concept of Blockchain has penetrated a wide range of scientific areas, and its use is considered to rise exponentially in the near future. Executing short scripts of predefined code called smart contracts on Blockchain can eliminate the need of intermediaries and can also raise the multitude of execution of contracts. In this paper, we discuss the concept of Blockchain along with smart contracts and discuss their applicability in the Internet of Medical Things (IoMT) in the e-healthcare domain. The paper analyses the dimensions that decentralization and the use of smart contracts will take the IoMT in e-healthcare, proposes a novel architecture, and also outlines the advantages, challenges, and future trends related to the integration of all three. The proposed architecture shows its effectiveness with average packet delivery ratio, average latency, and average energy efficiency performance parameters when compared with traditional approaches.
Circuit Modeling and Statistical Analysis of Differential-to-Common-Mode Noise Conversion Due to Filter Unbalancing in Three-Phase Motor Drive Systems
Authors: Bellan Diego
Published: October 2020

This work deals with circuit modeling of noise mode conversion due to system asymmetry in a three-phase motor drive system. In fact, it is well-known that in case of system asymmetry (e.g., slightly asymmetrical LC filter parameters), differential-mode noise can convert into common-mode noise, resulting in increased level of conducted electromagnetic interference. This phenomenon has been observed with measurements and reported in previous works, but a clear and rigorous analytical description is still a challenging point. The main novelty proposed in the paper is a rigorous analytical description of differential-to-common-mode noise conversion based on the Clarke transformation and the eigenvalue analysis. In particular, the magnitude and the frequency location of the differential-mode resonances injected into the common-mode circuit are derived in closed form. Moreover, since system asymmetry is usually uncontrolled (e.g., component tolerance and parasitic elements), a statistical analysis is also presented by treating the parameters of the LC filter as random variables. Thus, a second contribution proposed in the paper is the analytical derivation in closed form of the probability density function, the mean value, and the standard deviation of the random frequency location of the resonance peaks injected into the common-mode circuit. The importance of the analytical results derived in the paper is two-fold. First, a deep theoretical understanding of the phenomenon in terms of circuit theory concepts is achieved. Second, the impact of differential-to-common-mode noise conversion is described in quantitative terms. Thus, the obtained analytical results can be used to predict or explain the noise conversion impact on the frequency-domain measurements of common-mode currents. Theoretical derivations are validated through a time-domain Simulink implementation of a three-phase motor drive system, and a frequency-domain analysis through the discrete Fourier transform.
The Influence of the Process of Sugar Beet Storage on Its Biochemical Methane Potential
Authors: Mioduszewska Natalia , Pilarska Agnieszka A. , Pilarski Krzysztof , Adamski Mariusz
Published: October 2020

The manner of storage of sugar beets largely influences their physical and chemical properties, which may subsequently determine their biochemical methane potential. In this study, samples of fresh sugar beets as well as beets stored in two ways—in airtight conditions and in an open-air container—were tested. In both cases, measurements were taken on specific dates, i.e., after 4, 8, 16 and 32 weeks of storage. A decrease in pH was observed in all samples, with the lowest decrease occurring in hermetically stored samples. The lowest pH value of 3.71 was obtained for sugar beets stored in an open-air container after 32 weeks of storage. During storage, a gradual decrease in total solids was also recorded along with accompanying losses of organic matter, more significant in the case of storage in an open-air container. In subsequent storage periods, the biogas/methane production efficiency differed slightly for both methods. The highest volume of biogas was obtained for fresh sugar beets—148.23 mL·g−1 fresh matter (FM)—and subsequently in the 8th and 16th weeks of storage: 139.35 mL·g−1 FM (H—airtight conditions) and 144.14 mL·g−1 FM (O—open-air container), and 147.58 H mL·g−1 FM (H) and 148.22 mL·g−1 FM (O), respectively. The storage period affected the time of anaerobic decomposition of the organic matter—fresh sugar beets took the longest to ferment (26 days), while the material stored for 32 weeks took the shortest to ferment. In the experiment, the content of selected organic compounds in individual samples, i.e., sugar, methanol, ethanol, lactic acid and acetic acid, was also analysed. Within these results, significant differences were found between the samples stored using the two different methods. A high content of sugar, methanol, ethanol and other chemical compounds in the “O” materials showed the hydrolysis and acidogenesis processes taking place in an open-air container, with the participation of catalytic microorganisms.
The Utilization of Plum Stones for Pellet Production and Investigation of Post-Combustion Flue Gas Emissions
Authors: Dołżyńska Magdalena , Obidziński Sławomir , Piekut Jolanta , Yildiz Güray
Published: October 2020

Agri-food waste is generated at various food cycle stages and is considered to be a valuable feedstock in energy systems and chemical syntheses. This research identifies the potential and suitability of a representative agri-food waste sample (i.e., plum stones) as a solid fuel. Ground plum stones containing 10, 15, and 20 wt.% of rye bran were subjected to pelletization. The pelletizer was operated at 170, 220, and 270 rpm, and its power demand for the mixture containing 20 wt.% of rye bran was 1.81, 1.89, and 2.21 kW, respectively. Such pellets had the highest quality in terms of their density (814.6 kg·m−3), kinetic durability (87.8%), lower heating value (20.04 MJ·kg−1), and elemental composition (C: 54.1 wt.%; H: 6.4 wt.%; N: 0.73 wt.%; S: 0.103 wt.%; Cl: 0.002 wt.%; O: 38.2 wt.%). Whole plum stones and pellets were subjected to combustion in a 25 kW retort grate boiler in order to determine the changes in the concentrations of NO, SO2, CO, CO2, HCl, and O2 in the post-combustion flue gas. Collected results indicate that plum stone–rye bran pellets can serve as effective substitutes for wood pellets in prosumer installations, meeting the Ecodesign Directive requirements for CO and NO.
Prediction of Slag Characteristics Based on Artificial Neural Network for Molten Gasification of Hazardous Wastes
Authors: Lin Xiongchao , Xi Wenshuai , Dai Jinze , Wang Caihong , Wang Yonggang
Published: October 2020

Molten gasification is considered as a promising technology for the processing and safe disposal of hazardous wastes. During this process, the organic components are completely converted while the hazardous materials are safely embedded in slag via the fusion-solidification-vitrification transformation. Ideally, the slag should be glassy with low viscosity to ensure the effective immobilization and steady discharge of hazardous materials. However, it is very difficult to predict the characteristics of slag using existing empirical equations or conventional mathematical methods, due to the complex non-linear relationship among the phase transformation, vitrification transition and chemical composition of slag. Equipped with a strong nonlinear mapping ability, an artificial neural network may be able to predict the properties of slags if a large amount of data is available for training. In this work, over 10,000 experimental data points were used to train and develop a slag classification model (glassy vs. non-glassy) based on a neural network. The optimal structure of the neural network was figured out and validated. The results suggest that the classification accuracy for the independent test samples reached 93.3%. Using 1 and 0 as model inputs to represent mildly reducing and inert atmospheres, a double hidden layer structure in the neural network enabled the accurate classification of slags under various atmospheres. Furthermore, the neural network for the prediction of glassy slag viscosity was optimized; it featured a double hidden layer structure. Under a mildly reducing atmosphere, the absolute error from the independent test data was generally within 4 Pa·s. By adding a gas atmosphere into the input of the neural network using a simple normalization method, a multi-atmosphere slag viscosity prediction model was developed. Said model is much more accurate than its counterpart that does not consider the effect of the atmosphere. In summary, the artificial neural network proved to be an effective approach to predicting the slag properties under different atmospheres. The data-driven models developed in this work are expected to facilitate the commercial deployment of molten gasification technology.
The Numerical Simulation Study of the Oil–Water Seepage Behavior Dependent on the Polymer Concentration in Polymer Flooding
Authors: Wang Qiong , Liu Xiuwei , Meng Lixin , Jiang Ruizhong , Fan Haijun
Published: October 2020

It is well acknowledged that due to the polymer component, the oil–water relative permeability curve in polymer flooding is different from the curve in waterflooding. As the viscoelastic properties and the trapping number are presented for modifying the oil–water relative permeability curve, the integration of these two factors for the convenience of simulation processes has become a key issue. In this paper, an interpolation factor Ω that depends on the normalized polymer concentration is firstly proposed for simplification. Then, the numerical calculations in the self-developed simulator are performed to discuss the effects of the interpolation factor on the well performances and the applications in field history matching. The results indicate that compared with the results of the commercial simulator, the simulation with the interpolation factor Ω could more accurately describe the effect of the injected polymer solution in controlling water production, and more efficiently simplify the combination of factors on relative permeability curves in polymer flooding. Additionally, for polymer flooding history matching, the interpolation factor Ω is set as an adjustment parameter based on core flooding results to dynamically consider the change of the relative permeability curves, and has been successfully applied in the water cut matching of the two wells in Y oilfield. This investigation provides an efficient method to evaluate the seepage behavior variation of polymer flooding.
Feedstock Security Analysis for Wood Pellet Production in Thailand
Authors: Saosee Piyarath , Sajjakulnukit Boonrod , Gheewala Shabbir H.
Published: October 2020

Thailand is one of the upcoming wood pellet exporters in the Southeast Asia region. Wood pellet production has been gradually increasing in Thailand; however, the recent trend is more rapid. Therefore, the objective of this study is to analyze the feedstock security for wood pellet production in Thailand. The important issue of feedstock security analysis relates to availability and diversity of feedstock (Shannon index) to meet the increased demand for the wood pellets in the future. The results present that the feedstock supply (from waste wood and fast-growing tree wood) in Thailand is 5.32 million tonnes of wood pellets per year. However, increasing 25% of wood pellet export and 50% of wood pellet domestic use causes a deficit in fast-growing tree wood because para-rubber waste wood is not distributed uniformly in all regions of the country. The present diversity of feedstock supply is quite low (Shannon index 0.17). Increasing the fast-growing tree plantation area in the wastelands could help increase diversity. Recommendations on policy from this study focus on encouragement for the increase in domestic use of wood pellets, cultivation of fast-growing trees in wasteland and optimized logistics management.
Ten Years of Provenance Trials and Application of Multivariate Random Forests Predicted the Most Preferable Seed Source for Silviculture of Abies sachalinensis in Hokkaido, Japan
Authors: Tsuyama Ikutaro , Ishizuka Wataru , Kitamura Keiko , Taneda Haruhiko , Goto Susumu
Published: October 2020

Research highlights: Using 10-year tree height data obtained after planting from the range-wide provenance trials of Abies sachalinensis, we constructed multivariate random forests (MRF), a machine learning algorithm, with climatic variables. The constructed MRF enabled prediction of the optimum seed source to achieve good performance in terms of height growth at every planting site on a fine scale. Background and objectives: Because forest tree species are adapted to the local environment, local seeds are empirically considered as the best sources for planting. However, in some cases, local seed sources show lower performance in height growth than that showed by non-local seed sources. Tree improvement programs aim to identify seed sources for obtaining high-quality timber products by performing provenance trials. Materials and methods: Range-wide provenance trials for one of the most important silvicultural species, Abies sachalinensis, were established in 1980 at nine transplanting experimental sites. We constructed an MRF to estimate the responses of tree height at 10 years after planting at eight climatic variables at 1 km × 1 km resolution. The model was applied for prediction of tree height throughout Hokkaido Island. Results: Our model showed that four environmental variables were major factors affecting height growth—winter solar radiation, warmth index, maximum snow depth, and spring solar radiation. A tree height prediction map revealed that local seeds showed the best performance except in the southernmost region and several parts of northern regions. Moreover, the map of optimum seed provenance suggested that deployment of distant seed sources can outperform local sources in the southernmost and northern regions. Conclusions: We predicted that local seeds showed optimum growth, whereas non-local seeds had the potential to outperform local seeds in some regions. Several deployment options were proposed to improve tree growth.
Baseline of Carbon Stocks in Pinus radiata and Eucalyptus spp. Plantations of Chile
Authors: Olmedo Guillermo F. , Guevara Mario , Gilabert Horacio , Montes Cristián R. , Arellano Eduardo C. , Barría-Knopf Beatriz , Gárate Francisco , Mena-Quijada Pablo , Acuña Eduardo , Bown Horacio E. , Ryan Michael G.
Published: October 2020

Forest plantations have a large potential for carbon sequestration, playing an important role in the global carbon cycle. However, despite the large amount of research carried out worldwide, the absolute contribution of forest plantations is still incomplete for some parts of the world. To help bridge this gap, we calculated the amount of C stock in three fast growing forest species in Chile. Carbon pools in above-ground and below-ground biomass, forest floor, and soil were considered for this analysis. Across the plantation forests of Chile, carbon accumulated in the above-ground biomass was 181–212 Mg · ha−1 for Pinus radiata, 147–180 Mg · ha−1 for Eucalyptus nitens, and 95–117 Mg · ha−1 for Eucalyptus globulus (age 20–24 years for P. radiata and 10–14 years for Eucalyptus). Total C stocks were for 343 Mg · ha−1 for P. radiata, 352 Mg · ha−1 for E. nitens, and 254 Mg · ha−1 for E. globulus, also at the end of a typical rotation. The carbon pool in the forest floor was found to be significantly lower (less than 4% of the total) when compared to the other pools and showed large spatial variability. Our results agree with other studies showing that 30–50% of the total C stock is stored in the soil. The baseline data will be valuable for modelling C storage changes under different management regimes (changes in species, rotation length and stocking) and for different future climates. Given the contribution of soils to total carbon stocks, special attention should be paid to forest management activities that affect the soil organic carbon pool.
Modification of Apple Pomace by Extrusion Processing: Studies on the Composition, Polymer Structures, and Functional Properties
Authors: Schmid Vera , Trabert Antje , Schäfer Judith , Bunzel Mirko , Karbstein Heike P. , Emin M. Azad
Published: October 2020

By-products of fruit and vegetable processing are an inexpensive and sustainable source of dietary fiber, potentially offering valuable functional properties such as water binding and thickening. Due to these favorable properties, they can be utilized to reformulate widely-consumed foods, e.g., bakery products or beverages. In this study, apple pomace was used as a model system to study whether extrusion technology affects food by-product functionality and thus has the potential to broaden the application of by-products in foods. The effect of the process parameters and the extent of thermo-mechanical treatment on the structural and functional properties of apple pomace were analyzed after extrusion trials using various screw speeds, water contents, and barrel temperatures. Compared to the raw material, apple pomace extruded at Tbarrel = 100 °C, n = 700 min−1 and mH2O = 17% showed an increased water solubility up to 33%. The water absorption increased from 5 to 19 Pa·s and the paste viscosity from 5 to 339 Pa·s by extrusion processing. Analyses of dietary fiber contents and fiber polysaccharide structures revealed that thermo-mechanical stress (n = 700 min−1, mH2O = 22%) increased the content of soluble dietary fiber from 12.5 to 16.7 g/100 g dry matter, and that the harshest conditions even enabled the formation of low-molecular-weight dietary fiber. Arabinans (as neutral rhamnogalacturonan I side chains) appeared to be most sensitive to thermo-mechanical stress, whereas xylans (i.e., a group of minor polysaccharides) were an example of a more stable fiber polysaccharide. Also, the degree of methylation of the pectic polysaccharides was strongly reduced from 50% to 15% when thermo-mechanical stress was applied. Imaging and pore size analysis showed that extrusion processing could disrupt the rigid cell wall macromolecular structure.
Effect of Carrier Agents on the Physicochemical and Technofunctional Properties and Antioxidant Capacity of Freeze-Dried Pomegranate Juice (Punica granatum) Powder
Authors: Adetoro Adegoke Olusesan , Opara Umezuruike Linus , Fawole Olaniyi Amos
Published: October 2020

The physicochemical and technofunctional properties and antioxidant capacity of freeze-dried “Wonderful” pomegranate juice powder (PJP), produced with different carrier agents, were investigated. Powders were produced using maltodextrin, gum Arabic, and waxy starch as carrier agents and characterised by scanning electron microscopy (SEM) and particle size distribution. Results showed that PJP produced with maltodextrin had the highest yield (46.6%), followed by gum arabic (40.6%), while waxy starch had the least yield (35.4%). Powders produced with maltodextrin (96.5%) and gum arabic (96.1%) were highly soluble, which indicates better reconstitution properties. Waxy starch-added PJP had the lowest hygroscopicity (4.7%), which offers good stability during storage and a lower degree of caking compared to maltodextrin (10.2%) and gum arabic (12.6%) powders. Powders obtained from maltodextrin and gum arabic exhibited larger particle diameters ranging between 12 to 120 µm while the lowest particle diameter range was with powders formed from waxy starch (8–40 µm). Freeze-dried pomegranate powder produced with maltodextrin retained more redness (a*) by approximately 44%, compared to gum arabic. Similarly, PJP with maltodextrin and gum arabic had higher total soluble solids (10.3 and 10.4 °Brix), respectively. Total anthocyanin content was 54% more in PJP with maltodextrin than waxy starch PJP. Similarly, the powder produced with maltodextrin had higher radical scavenging activity (33.19 mM TE/g dry matter; DM) compared to gum arabic (28.45 mM TE/g DM) and waxy starch (26.96 mM TE/g DM). Overall, maltodextrin reflected the most suitable carrier agent to produce PJP.
Biogeochemistry of Household Dust Samples Collected from Private Homes of a Portuguese Industrial City
Authors: Marinho-Reis Amélia P. , Costa Cristiana , Rocha Fernando , Cave Mark , Wragg Joanna , Valente Teresa , Sequeira-Braga Amália , Noack Yves
Published: October 2020

The main objectives of the present study were to (i) investigate the effects of mineralogy and solid-phase distribution on element bioaccessibility and (ii) perform a risk assessment to calculate the risks to human health via the ingestion pathway. Multiple discriminant analysis showed that the dust chemistry discriminates between indoor and outdoor samples. The solid-phase distribution of the elements in indoor dust indicated that a large proportion of zinc, nickel, lead, copper, and cobalt is associated with an aluminum oxy-hydroxides component, formed by the weathering of aluminum silicates. This component, which seems to influence the mobility of many trace elements, was identified for a group of indoor dust samples that probably had a considerable contribution from outdoor dust. An iron oxide component consisted of the highest percentage of chromium, arsenic, antimony, and tin, indicating low mobility for these elements. The bioaccessible fraction in the stomach phase from the unified BARGE method was generally high in zinc, cadmium, and lead and low in nickel, cobalt, copper, chromium, and antimony. Unlike other potentially toxic elements, copper and nickel associated with aluminum oxy-hydroxides and calcium carbonates were not extracted by the stomach solutions. These trace elements possibly form stable complexes with gastric fluid constituents such as pepsin and amino acid. Lead had a hazard quotient >1, which indicates the risk of non-carcinogenic health effects, especially for children.
The Characteristics of Adjacent Anatomy of Mandibular Third Molar Germs: A CBCT Pilot Study in Patients with Osteogenesis Imperfecta
Authors: D’Angeli Giacomo , Messineo Daniela , Riminucci Mara , Corsi Alessandro , Celli Mauro , Vozza Iole , Sfasciotti Gian Luca
Published: October 2020

(1) Objectives: The aim of our study was to investigate the anatomical features of lower third molar and its adjacent anatomical connections in type I Osteogenesis Imperfecta (OI) patients through cone beam computed tomography (cbct). (2) Methods: The study was conducted among 25 patients, 13 patients with type I OI and 12 control patients (individuals with no disorders and no treatment); average age was 15.44 ± 2.06, 23 third molar germs for each group. The germs have been compared to the parameters using the Mann-Whitney test. A chi-square test was also used to investigate the correlation between the status case/control and tooth development stage. (3) Results: Mann-Whitney test showed significant differences between cases and controls: diameter of the tooth germ in toto (U = 93.5; p < 0.001), tooth development stage, (U = 145; p < 0.01), roots length (U = 44.5; p < 0.01), cementoenamel junction diameter (U = 157.5; p < 0.05), size of the pulp chamber (U = 95.5; p < 0.05). Type I OI is not associated with the relationship between the germ of mandibular third molar and alveolar canal on axial plane (χ2 = 4.095; p = 0.129), and parasagittal (χ2 = 4.800; p = 0.091). The association between type I OI and relationship with the germ of mandibular third molar and alveolar canal on the coronal plane has been significant (χ2 = 9.778; p < 0.05) as the perforation of the lingual cortical bone in the region of mandibular third molar tooth germ (χ2 = 11.189; p < 0.01). (4) Conclusions: The results confirm the cbct accuracy in the evaluation of bone density in type I OI patients giving also the opportunity to study the tridimensional anatomy of germs and the adjacent anatomical structures in order to avoid any perioperative complications.
A Qualitative Study Investigating the Barriers to the Implementation of the ‘Sepsis Six Care Bundle’ in Maternity Wards
Authors: Abutheraa Nouf , Mullen Alexander B. , Grant June , Akram Gazala
Published: October 2020

Background: In 2014, the Sepsis Six Care Bundle (SSCB) was introduced into a Scottish health region to improve patient outcomes. Poor compliance was demonstrated with the SSCB across different specialities. This study explored determinants of non-compliance with the SSCB in maternity wards. Methods: In-depth interviews were conducted with midwives in a single Scottish health region. Convenience sampling was used to recruit interviewees. The interviews were digitally recorded, transcribed verbatim, entered into NVivo software, and analysed using thematic analysis. Results: Thirteen face-to-face interviews were completed and lasted an average of 33 min. Three main barriers were identified to SSCB implementation; the difficulty of diagnosing sepsis, the suitability of the SSCB in a maternity setting as part of the pre-conditions phase, and the lack of staff training as part of the pre-implementation phase. Conclusion: The findings emphasize the importance of adapting improvement initiatives with sufficient preparation of staff in the rationale use to the context of care bundles.
Learning Assessment from a Lecture about Fundamentals on Basic Life Support among Undergraduate Students of Health Sciences
Authors: Tavares Luis Fernando Barbosa , Raimundo Rodrigo Daminello , Leone Claudio , Castanha Cyntia Souza Carvalho , Gonçalves de Oliveira Adriana , Daboin Blanca Elena Guerrero , Mendes Joseane Elza Tonussi , Abreu Luiz Carlos de
Published: October 2020

Introduction: Cardiac arrest is one of the leading public health problems worldwide and in Brazil. A victim of cardiorespiratory arrest needs prompt basic life support (BLS) to increase survival. Objective: To evaluate the performance of a synthesis lecture on BLS given to university students in Health Sciences. Methods: A total of 422 undergraduate students in Nursing, Physiotherapy, and Medicine participated in this study. Data were collected by applying a pre-test through a BLS questionnaire based on the American Heart Association guidelines. Results: Students obtained a minimum grade of 40% of the pre-test questions. The score increased to 75% in the post-test; the students with the best performance in the pre-test maintained a higher total number of correct answers in the post-test. There was also better performance in those with previous training in BLS. The students from the first year of medical school were the ones who benefited the most from the lecture. Conclusion: Regardless of the grade course, the Health Science students showed a significant improvement in their level of knowledge after attending the synthesis lecture, indicating its adequacy to promote initial learning about BLS.
Feasibility Trial of an eHealth Intervention for Health-Related Quality of Life: Implications for Managing Patients with Chronic Pain During the COVID-19 Pandemic
Authors: Licciardone John C. , Pandya Vishruti
Published: October 2020

Purpose: This study was conducted to determine the feasibility of providing an eHealth intervention for health-related quality of life (HRQOL) to facilitate patient self-management. Methods: A randomized controlled trial was conducted from 2019–2020 within the Pain Registry for Epidemiological, Clinical, and Interventional Studies and Innovation. Eligible patients included those with chronic low back pain and a SPADE (sleep disturbance, pain interference with activities, anxiety, depression, and low energy/fatigue) cluster score ≥ 55 based on the relevant scales from the Patient-Reported Outcomes Measurement Information System instrument with 29 items (PROMIS-29). Patients were randomized to the eHealth treatment group, which received a tailored HRQOL report and interpretation guide, or to a wait-list control group. The primary outcome was change in the SPADE cluster score, including its five component scales, over 3 months. Secondary outcomes were changes in low back pain intensity and back-related disability. Treatment effects were measured using the standardized mean difference (SMD) in change scores between groups. The eHealth intervention was also assessed by a survey of the experimental treatment group 1 month following randomization. Results: A total of 102 patients were randomized, including 52 in the eHealth treatment group and 50 in the wait-list control group, and 100 (98%) completed the trial. A majority of patients agreed that the HRQOL report was easy to understand (86%), provided new information (79%), and took actions to read or learn more about self-management approaches to improve their HRQOL (77%). Although the eHealth intervention met the criteria for a small treatment effect in improving the overall SPADE cluster score (SMD = 0.24; p= 0.23) and anxiety (SMD = 0.24; p = 0.23), and for a small-to-medium treatment effect in improving depression (SMD = 0.37; p = 0.06) and back-related disability (SMD = 0.36; p = 0.07), none of these results achieved statistical significance because of limited sample size. Conclusion: Given the feasibility of rapid online deployment, low cost, and low risk of adverse events, this eHealth intervention for HRQOL may be useful for patients with chronic pain during the COVID-19 pandemic.
The Agriculture–Nutrition–Income Nexus in Tonga: Is Postharvest Loss Undermining Horticulture Market Efficiency in Tonga?
Authors: Underhill Steven , Patolo Soane , Zhou Yuchan , Burkhart Sarah
Published: October 2020

The Kingdom of Tonga has one of the highest rates of diet-related non-communicable diseases (NCDs) in the world. Initiatives to promote pro-health dietary behaviour are possibly being compromised by poor or inconsistent consumer accessibility to affordable and safe fresh fruits and vegetables, referred to as the agriculture–nutrition–income nexus. While donors increasingly focus on nutrition-sensitive agriculture across the Pacific, there is little contemporary information concerning Tonga’s domestic horticultural distribution and market system, particularly in regards to food loss. This study surveyed 292 municipal and road-side vendors on Tongatapu and ‘Utu Vava’u Islands, with the aim of mapping and analyzing horticultural markets and farm supply, transport logistics, and quantifying postharvest practice and market loss. Tonga’s domestic horticultural market structure consists of a central municipal market and on Tongatapu Island, a supplementary network of urban and rural based road-side vendors. There is limited inter-island trade, with most farms located within 25 km of the central municipal market. Mean postharvest horticultural loss was very low, at 1.4% to 5.3%, with road-side vendors more vulnerable to loss. This level of loss was thought to reflect short intra-island transport distance, the type of crops being traded, and rapid market throughput, rather than a level of value chain efficiency. Vendors regulated market supply volume and price discounting and were the principal strategies to mitigate postharvest loss. While low levels of postharvest loss, short transport logistics, and fast market throughput are consistent with a relatively efficient horticulture market system, vendor practice may be impeding fresh fruit and vegetable accessibility.
Impact of Different Growing Substrates on Growth, Yield and Cannabinoid Content of Two Cannabis sativa L. Genotypes in a Pot Culture
Authors: Burgel Lisa , Hartung Jens , Graeff-Hönninger Simone
Published: October 2020

The impacts of different growing substrate compositions, consisting of peat (PM), peat substituted with 30% green fibre (G30) and coco coir fibre (CC) growth media, were investigated in regard to the plant height, biomass and floral yield, biomass nitrogen (N) content, root growth, and cannabidiol content (CBD/A) of two phytocannabinoid-rich cannabis genotypes in an indoor pot cultivation system. Genotypes and substrate treatment combinations were randomly allocated to 36 plants according to a Latin square design. The results showed a higher total plant height for PM (39.96 cm), followed by G30 (35.28 cm), and the lowest in CC (31.54 cm). The N content of leaves indicated the highest values for plants grown in G30 (52.24 g kg DW−1), followed by PM (46.75 g kg DW−1) and a significantly lower content for CC (37.00 g kg DW−1). Root length density (RLD) increased by 40% (PM) and 50% (G30), compared to CC treatments, with no significant differences in root dry weight. Both genotypes, Kanada (KAN) and 0.2x, reacted in a genotype-specific manner. KAN indicated a reduced floral yield of plants grown in G30 (4.94 g plant−1) and CC (3.84 g plant−1) compared to PM (8.56 g plant−1). 0.2x indicated stable high floral yields of 9.19 g plant−1 (G30) to 7.90 g plant−1 (CC). Leaf DW increased in PM (5.78 g plant−1) and G30 (5.66 g plant−1) compared to CC (3.30 g plant−1), while CBD/A content remained constant. Due to a higher biomass yield, the CBD/A yield of flowers (549.66 mg plant−1) and leaves (224.16 mg plant−1) revealed 0.2x as an interesting genotype for indoor pot cultivation in a peat-based substrate substituted with 30% green fibres. Overall, the demand for organic green fibres to partly replace fractionated peat showed a genotype-specific option for a homogeneous plant development, with comparable high biomass yields and stable cannabinoid contents compared to a peat containing standard substrate.
Mind the Gap: Perceived Partner Responsiveness as a Bridge between General and Partner-Specific Attachment Security
Authors: Rice TeKisha M. , Kumashiro Madoka , Arriaga Ximena B.
Published: October 2020

A core idea of attachment theory is that security develops when attachment figures are responsive to a person’s connection needs. Individuals may be more or less secure in different relationships. We hypothesized that individuals who perceive a current relationship partner as being responsive to their needs will feel more secure in that specific relationship, and that the benefits of perceived partner responsiveness would be more pronounced for individuals who generally feel insecure. The current study included 472 individuals (236 couples) in romantic relationships. Consistent with our predictions, individuals who perceived more responsiveness from their partner displayed lower partner-specific attachment anxiety and partner-specific avoidance, especially when they were generally insecure. These findings are discussed in terms of the conditions that promote secure attachment bonds.
Digital Healthy Diet Literacy and Self-Perceived Eating Behavior Change during COVID-19 Pandemic among Undergraduate Nursing and Medical Students: A Rapid Online Survey
Authors: Duong Tuyen Van , Pham Khue M. , Do Binh N. , Kim Giang B. , Dam Hoa T. B. , Le Vinh-Tuyen T. , Nguyen Thao T. P. , Nguyen Hiep T. , Nguyen Trung T. , Le Thuy T. , Do Hien T. T. , Yang Shwu-Huey
Published: October 2020

Assessing healthy diet literacy and eating behaviors is critical for identifying appropriate public health responses to the COVID-19 pandemic. We examined the psychometric properties of digital healthy diet literacy (DDL) and its association with eating behavior changes during the COVID-19 pandemic among nursing and medical students. We conducted a cross-sectional study from 7 April to 31 May 2020 at 10 public universities in Vietnam, in which 7616 undergraduate students aged 19–27 completed an online survey to assess socio-demographics, clinical parameters, health literacy (HL), DDL, and health-related behaviors. Four items of the DDL scale loaded on one component explained 71.32%, 67.12%, and 72.47% of the scale variances for the overall sample, nursing, and medical students, respectively. The DDL scale was found to have satisfactory item-scale convergent validity and criterion validity, high internal consistency reliability, and no floor or ceiling effect. Of all, 42.8% of students reported healthier eating behavior during the pandemic. A 10-index score increment of DDL was associated with 18%, 23%, and 17% increased likelihood of healthier eating behavior during the pandemic for the overall sample (OR, 1.18; 95%CI, 1.13, 1.24; p < 0.001), nursing students (OR, 1.23; 95%CI, 1.10, 1.35; p < 0.001), and medical students (OR, 1.17; 95%CI, 1.11, 1.24; p < 0.001), respectively. The DDL scale is a valid and reliable tool for the quick assessment of digital healthy diet literacy. Students with higher DDL scores had a higher likelihood of healthier eating behavior during the pandemic.
The Development of a Knowledge Test on Transgender Patients’ Care
Authors: Hernández-Agosto Jonathan , Melin Kyle , Rosa-Vega Jurynelliz , Carlo-Frontera Edgar , Rodríguez-Ochoa Andrés , Santiago-Quiñones Darlene
Published: October 2020

The objective of this study was to develop an assessment instrument to measure the effects of a continuing education intervention on 3 domains in pharmacists’ knowledge needed to provide pharmaceutical care for transgender patients: (1) foundations of gender-affirming care, (2) health disparities and the specific needs of transgender patients, and (3) hormone treatments for transgender patients. Multiple-choice questions were developed, and an initial item bank of 47 items was drafted. Item bank revision was conducted by content matter experts, while feedback from 8 practicing pharmacists was provided for face validity and further insights. A preliminary test, containing 42 items was administered to 64 pharmacists before and after a three-hour continuing education intervention. Cronbach’s alpha coefficient yielded a value of 0.65 as a pre-test and 0.77 as a post-test. Items were less difficult to answer by participants after taking the three-hour continuing education, showing better discrimination among high and low performers in the instrument administration as post-test, as well as better correlation when comparing participants’ performance in the overall score against item-level performance. Psychometric evidence supports further instrument examination, which can improve this tool to measure gains in pharmacists’ knowledge related to the care of transgender patients.
The Prevalence of Cognitive Impairment on Admission to Nursing Home among Residents with and without Stroke: A Cross–Sectional Survey of Nursing Homes in Ireland
Authors: Donnelly Nora-Ann , Sexton Eithne , Merriman Niamh A. , Bennett Kathleen E. , Williams David J , Horgan Frances , Gillespie Paddy , Hickey Anne , Wren Maev-Ann
Published: October 2020

Post–stroke cognitive impairment (PSCI) is a common consequence of stroke. Epidemiological evidence indicates that, with an ageing population, stroke and PSCI are likely to increase in the coming decades. This may have considerable implications for the demand for nursing home placement. As prevalence estimates of both cognitive impairment and dementia on admission to nursing home among residents with and without stroke have not yet been compared, they were estimated and compared in this study. We performed a cross–sectional survey to establish the admission characteristics of 643 residents in 13 randomly selected nursing homes in Ireland. The survey collected data on resident’s stroke and cognitive status at the time of nursing home admission. The survey found, among nursing home residents that experienced stroke prior to admission, prevalence estimates for cognitive impairment (83.8%; 95% CI = 76.9–90.6%) and dementia (66.7%; 95% CI = 57.9–75.4%) were significantly higher compared to residents that had not experienced stroke prior to admission (cognitive impairment: 56.6%; 95% CI = 52.4–60.8%; X2 (1) = 28.64; p < 0.001; dementia: 49.8%; 95% CI = 45.6–54.1%; X2 (1) = 10.47; p < 0.01). Since the prevalence of PSCI is likely to increase in the coming decades, the findings highlight an urgent need for health service planning for this increased demand for nursing home care to meet the care needs of these stroke survivors.
What Is Rural Adversity, How Does It Affect Wellbeing and What Are the Implications for Action?
Authors: Lawrence-Bourne Joanne , Dalton Hazel , Perkins David , Farmer Jane , Luscombe Georgina , Oelke Nelly , Bagheri Nasser
Published: October 2020

A growing body of literature recognises the profound impact of adversity on mental health outcomes for people living in rural and remote areas. With the cumulative effects of persistent drought, record-breaking bushfires, limited access to quality health services, the COVID-19 pandemic and ongoing economic and social challenges, there is much to understand about the impact of adversity on mental health and wellbeing in rural populations. In this conceptual paper, we aim to review and adapt our existing understanding of rural adversity. We undertook a wide-ranging review of the literature, sought insights from multiple disciplines and critically developed our findings with an expert disciplinary group from across Australia. We propose that rural adversity be understood using a rural ecosystem lens to develop greater clarity around the dimensions and experiences of adversity, and to help identify the opportunities for interventions. We put forward a dynamic conceptual model of the impact of rural adversity on mental health and wellbeing, and close with a discussion of the implications for policy and practice. Whilst this paper has been written from an Australian perspective, it has implications for rural communities internationally.