bluuebunny/crossref_metadata_2025 huggingface dataset:
Achievement Goals, Fear of Failure and Self-Handicapping in Young Elite Athletes with and without Chronic Pain
Authors: Molenaar Bodile , Willems Charlotte , Verbunt Jeanine , Goossens Mariëlle
Published: July 2021

Background: Pain is a common problem in elite athletes. This exploratory study compares goal orientations towards sport, fear of failure, self-handicapping and pain catastrophizing between active young elite athletes with and without chronic pain (CP) complaints (longer than three months). It examines the associations between chronic pain, fear of failure, goal orientations, self-handicapping and pain catastrophizing in young elite athletes. We explore how far goal orientation can be explained by these factors. Methods: Young elite athletes completed an online questionnaire. Data analysis: Independent samples t-test, correlational analyses and multivariate regression analyses. Results: Participants were 132 young elite athletes (mean 16 years); data for 126 were analyzed. A total of 47% reported current pain, of which 60% had CP. Adolescents with CP showed significantly more pain intensity, fear of failure, self-handicapping and mastery–avoidance goals than those without. Pain intensity was significantly related to fear of failure, self-handicapping, pain catastrophizing and mastery–avoidance. Self-handicapping and fear of failure contributed significantly to mastery–avoidance variance. Performance–avoidance and –approach goals were explained by fear of failure. Conclusion: CP was common, with sufferers showing more fear of failure and self-handicapping strategies, and being motivated to avoid performing worse (mastery–avoidance). Self-handicapping and fear of failure influenced mastery–avoidance orientation, and fear of failure explained part of performance–avoidance and –approach orientations. Longitudinal studies should explore the role of these factors in the trajectory of CP in these athletes.
Determinants of Smallholder Livestock Farmers’ Household Resilience to Food Insecurity in South Africa
Authors: Myeki Vuyiseka A. , Bahta Yonas T.
Published: July 2021

This study identified factors affecting livestock farmers’ agricultural drought resilience to food insecurity in Northern Cape Province, South Africa. Data of 217 smallholder livestock farmers were used in a principal component analysis to estimate the agricultural drought resilience index. The structural equation approach was then applied to assess smallholder livestock farmers’ resilience to food insecurity. The study found that most smallholder livestock farmers (81%) were not resilient to agricultural drought. Assets (β = 0.150), social safety nets (β = 0.001), and adaptive capacity (β = 0.171) indicators positively impacted households’ resilience to food insecurity with 5% significance. Climate change indicators negatively impacted households’ resilience to food insecurity. Two variables were included under climate change, focusing on drought, namely drought occurrence (β = −0.118) and drought intensity (β = −0.021), which had a negative impact on household resilience to food insecurity with 10% significance. The study suggests that smallholder livestock farmers need assistance from the government and various stakeholders to minimize vulnerability and boost their resilience to food insecurity.
Signal Processing Algorithm Based on Discrete Wavelet Transform
Authors: Osadchiy Andrey , Kamenev Aleksandr , Saharov Vladimir , Chernyi Sergei
Published: July 2021

The use of digital technologies for processing and diagnosing electrocardiogram signals using wavelet-analysis can significantly improve the efficiency and quality of parameter estimations of the pacemaker configuration during implantation. It is also efficient in the process of correction of functional modes of cardiac pacemaker and diagnostics to eliminate postoperative complications, etc. A special processing of complex cardio signals at a qualitatively new level is an indispensable condition for the decisive improvement of the processing of current values of diagnosed parameters, widespread use of digital instruments for sound and informed decision-making on the provision of medical care and the treatment of people with diseases of the cardiovascular system. The article discusses the approximation method. Digital technologies are implemented using MATLAB computing environment.
Challenging Mimickers in the Diagnosis of Sarcoidosis: A Case Study
Authors: El Jammal Thomas , Jamilloux Yvan , Gerfaud-Valentin Mathieu , Richard-Colmant Gaëlle , Weber Emmanuelle , Bert Arthur , Androdias Géraldine , Sève Pascal
Published: July 2021

Sarcoidosis is a systemic granulomatous disease of unknown cause characterized by a wide variety of presentations. Its diagnosis is based on three major criteria: a clinical presentation compatible with sarcoidosis, the presence of non-necrotizing granulomatous inflammation in one or more tissue samples, and the exclusion of alternative causes of granulomatous disease. Many conditions may mimic a sarcoid-like granulomatous reaction. These conditions include infections, neoplasms, immunodeficiencies, and drug-induced diseases. Moreover, patients with sarcoidosis are at risk of developing opportunistic infections or lymphoma. Reliably confirming the diagnosis of sarcoidosis and better identifying new events are major clinical problems in daily practice. To address such issues, we present seven emblematic cases, seen in our department, over a ten-year period along with a literature review about case reports of conditions misdiagnosed as sarcoidosis.
Biomechanical Changes in Gait Patterns of Patients with Grade II Medial Gonarthritis
Authors: Skvortsov Dmitry , Kaurkin Sergey , Prizov Alexey , Altukhova Aljona , Troitskiy Alexander , Lazko Fedor
Published: July 2021

Deforming osteoarthritis (OA) of the knee is a progressive disease associated with pain and compromised function of the joint. Typical biomechanical modifications in the gait of subjects with medial knee OA are characterized by decreased gait speed and overload on the affected limb. The borderline stage for conservative versus surgical management is Grade II OA. The aim of this research was to study preoperatively the specific features of gait, knee, and hip function in patients with Grade II medial OA. We examined 26 patients with Grade II unilateral gonarthritis with varus deformity and 20 healthy adults. Biomechanical parameters of gait were recorded using an inertial sensor system. The gait cycle (GC) slightly increased both for the affected and for the intact limb. The hip joint movements showed significant symmetrical reduction in the first flexion amplitude, as well as a symmetrical delay in full hip extension at the end of the stance phase. In the knee, the first flexion amplitude was significantly reduced on the affected side compared to healthy control. The extension amplitude in the single support phase was significantly increased in both the affected and the intact lower limbs. The swing amplitude was significantly reduced on the affected side. On the affected side, the changes were more pronounced, both in incidence and in severity. The affected knee showed a syndrome of three reduced amplitudes. In patients, walking is characterized by several groups of symptoms: those of unloading of the affected limb, those of limiting the load on the affected joint and the musculoskeletal system as a whole, and those of gait harmonization. The symptoms of unloading the affected side and those of harmonization are the common symptoms of adaptation, typical for several pathological conditions with a relatively preserved function. The intensity of the observed symptoms can help assess changes in the subject’s functional condition over time and during the treatment.
Quantitative Analysis of the Time–Intensity Curve of Contrast-Enhanced Ultrasound of the Liver: Differentiation of Benign and Malignant Liver Lesions
Authors: Schwarz Sonja , Clevert Dirk-André , Ingrisch Michael , Geyer Thomas , Schwarze Vincent , Rübenthaler Johannes , Armbruster Marco
Published: July 2021

Background: To evaluate the diagnostic accuracy of quantitative perfusion parameters in contrast-enhanced ultrasound to differentiate malignant from benign liver lesions. Methods: In this retrospective study 134 patients with a total of 139 focal liver lesions were included who underwent contrast enhanced ultrasound (CEUS) between 2008 and 2018. All examinations were performed by a single radiologist with more than 15 years of experience using a second-generation blood pool contrast agent. The standard of reference was histopathology (n = 60), MRI or CT (n = 75) or long-term CEUS follow up (n = 4). For post processing regions of interests were drawn both inside of target lesions and the liver background. Time–intensity curves were fitted to the CEUS DICOM dataset and the rise time (RT) of contrast enhancement until peak enhancement, and a late-phase ratio (LPR) of signal intensities within the lesion and the background tissue, were calculated and compared between malignant and benign liver lesion using Student’s t-test. Quantitative parameters were evaluated with respect to their diagnostic accuracy using receiver operator characteristic curves. Both features were then combined in a logistic regression model and the cumulated accuracy was assessed. Results: RT of benign lesions (14.8 ± 13.8 s, p = 0.005), and in a subgroup analysis, particular hemangiomas (23.4 ± 16.2 s, p < 0.001) differed significantly to malignant lesions (9.3 ± 3.8 s). The LPR was significantly different between benign (1.59 ± 1.59, p < 0.001) and malignant lesions (0.38 ± 0.23). Logistic regression analysis with RT and LPR combined showed a high diagnostic accuracy of quantitative CEUS parameters with areas under the curve of 0.923 (benign vs. malignant) and 0.929 (hemangioma vs. malignant. Conclusions: Quantified CEUS parameters are helpful to differentiate malignant from benign liver lesions, in particular in case of atypical hemangiomas.
Universal Design for Learning: Is It Gaining Momentum in Irish Education?
Authors: Flood Margaret , Banks Joanne
Published: July 2021

Responding to student diversity has become a key policy priority in education systems around the world. In addition to international and national institutional policies, major changes are underway in instructional practices and pedagogy in many national contexts. Universal Design for Learning (UDL) has become a key pedagogical approach used in education systems which seek to promote inclusive and equitable education in response to student diversity. Despite Ireland’s policy commitment to inclusive education, UDL has been traditionally focused on the higher education sector with little discussion about the role UDL can play at primary and second-level education to achieve inclusion. Furthermore, there has been no research to date on the extent to which education policy reforms are introducing part, or all, of the aspects of the UDL framework. The purpose of this paper is to examine the extent to which UDL is gaining momentum in Irish primary and second-level education through an analysis of curriculum policy. This paper examines the development and evolution of UDL in Irish education policy over the past decade by exploring the use of UDL in national educational curriculum frameworks. The paper highlights how UDL is slowly and implicitly emerging in education policy at a national level but suggests further momentum could be gained from its inclusion in Initial Teacher Education (ITE) and professional development programmes. By exploring the development of UDL within existing policy contexts, the paper argues for a more explicit commitment to UDL as part of ongoing curriculum reform at the primary level, the review of Senior Cycle, and Ireland’s broader inclusive education agenda.
A New Approach for a Unified Architecture for Type IV DCT/DST with an Efficient Incorporation of Obfuscation Technique
Authors: Chiper Doru Florin , Cotorobai Laura-Teodora
Published: July 2021

This paper aims at solving one challenging problem in designing VLSI chips, namely, the security of the hardware, by presenting a new design approach that incorporates the obfuscation technique in the VLSI implementation of some important DSP algorithms. The proposed method introduces a new approach in obtaining a unified VLSI architecture for computing type IV discrete cosine transform (DCT-IV) and type IV discrete sine transform (DST-IV), with an efficient integration of the obfuscation technique, while maintaining low overheads. The algorithms for these two transforms were restructured in such a way that their structures are fairly similar, and thus they can be implemented on the same VLSI chip and on the same hardware with very few modifications, with the latter being attributed to the pre-processing and post-processing stages. The design proposed uses the regular and modular structures, which are named quasi-correlation, and the architecture is inspired by the paradigm of the systolic array architecture. Thus, the introduced design benefits the security, for the hardware, and also the advantages introduced by the use of the regular and modular structures. A very efficient, unified VLSI architecture for type IV DCT/DST can be obtained, which allows the computation of the two algorithms on the same hardware, allowing an efficient incorporation of the obfuscation technique with very low overheads, and it can be very efficiently implemented, offering high-speed performances and low hardware complexity, with the latter being attributed to the efficient use of the hardware resources for the computation of these two algorithms.
Innovative IoT Solutions and Wearable Sensing Systems for Monitoring Human Biophysical Parameters: A Review
Authors: De Fazio Roberto , De Vittorio Massimo , Visconti Paolo
Published: July 2021

Digital and information technologies are heavily pervading several aspects of human activities, improving our life quality. Health systems are undergoing a real technological revolution, radically changing how medical services are provided, thanks to the wide employment of the Internet of Things (IoT) platforms supporting advanced monitoring services and intelligent inferring systems. This paper reports, at first, a comprehensive overview of innovative sensing systems for monitoring biophysical and psychophysical parameters, all suitable for integration with wearable or portable accessories. Wearable devices represent a headstone on which the IoT-based healthcare platforms are based, providing capillary and real-time monitoring of patient’s conditions. Besides, a survey of modern architectures and supported services by IoT platforms for health monitoring is presented, providing useful insights for developing future healthcare systems. All considered architectures employ wearable devices to gather patient parameters and share them with a cloud platform where they are processed to provide real-time feedback. The reported discussion highlights the structural differences between the discussed frameworks, from the point of view of network configuration, data management strategy, feedback modality, etc.
Deep Learning Techniques for the Classification of Colorectal Cancer Tissue
Authors: Tsai Min-Jen , Tao Yu-Han
Published: July 2021

It is very important to make an objective evaluation of colorectal cancer histological images. Current approaches are generally based on the use of different combinations of textual features and classifiers to assess the classification performance, or transfer learning to classify different organizational types. However, since histological images contain multiple tissue types and characteristics, classification is still challenging. In this study, we proposed the best classification methodology based on the selected optimizer and modified the parameters of CNN methods. Then, we used deep learning technology to distinguish between healthy and diseased large intestine tissues. Firstly, we trained a neural network and compared the network architecture optimizers. Secondly, we modified the parameters of the network layer to optimize the superior architecture. Finally, we compared our well-trained deep learning methods on two different histological image open datasets, which comprised 5000 H&E images of colorectal cancer. The other dataset was composed of nine organizational categories of 100,000 images with an external validation of 7180 images. The results showed that the accuracy of the recognition of histopathological images was significantly better than that of existing methods. Therefore, this method is expected to have great potential to assist physicians to make clinical diagnoses and reduce the number of disparate assessments based on the use of artificial intelligence to classify colorectal cancer tissue.
Threshold Effect of Economic Growth on Energy Intensity—Evidence from 21 Developed Countries
Authors: Zhou Jinjin , Ma Zenglin , Wei Taoyuan , Li Chang
Published: July 2021

Based on threshold regression models, this paper analyzes the effect of economic growth on energy intensity by using panel data from 21 developed countries from 1996 to 2015. Results show that a 1% increase in GDP per capita can lead to a 0.62–0.78% reduction in energy intensity, implying economic growth can significantly reduce energy intensity. The extent of the reduction in energy intensity varies depending on the economic development stages represented by key influencing factors including energy mix in consumption, urbanization, industrial structure, and technological progress. Specifically, the reduction in energy intensity due to economic growth can be enhanced with relatively more renewable energy consumption and more urban population until a threshold point, where the enhancement disappears. On the other hand, the extent of the energy intensity reduction due to economic growth can be weakened with relatively more tertiary industry activities and more research and development (R&D) investment in an economy until a threshold point, where the weakening cannot continue. However, compared to the early stages represented by the low ends of renewable energy consumption, urban population, tertiary industry activities, and R&D investment, the later stages represented by the high ends of these key factors after a threshold show the weakened effect of economic growth on the decline of energy intensity. Hence, when an economy is well-developed, policy makers are advised to put fewer expectations on the role of economic growth to reduce energy intensity, while pursuing relatively cleaner energy, greater urbanization, more tertiary industry activities, and advanced technologies.
Success Factors for the Implementation of Community Renewable Energy in Thailand
Authors: Luangchosiri Nilubon , Ogawa Takaya , Okumura Hideyuki , Ishihara Keiichi N.
Published: July 2021

Community renewable energy (CRE) has recently been proposed as one of the effective policy tools to make a community sustainable and to strengthen this association. CRE is, however, not widespread yet in Thailand, and evidence-based research on CRE in the country is rather scarce. This paper aims to investigate the characteristics of CRE in Thailand to identify the key factors affecting its implementation. Data were collected through semi-structured interviews and document analysis for 26 active CRE projects in Thailand. Results show that the characteristics of CRE in Thailand are rooted in the geographical location of a community. A legal structure was created from a pre-existing group to implement a CRE project. The primary motivation for implementing CRE is sustainable development of a community. We examined essential factors separated into two groups—internal and external factors—in reference to CRE in developed nations. We highlight several issues concerning the further development of CRE in Thailand. First, a strong group leader and a formal structure are essential to drive and manage a project. Second, networks of CRE projects and long-term revolving funds are crucial external support to implement CRE.
Urban Forest Research in Malaysia: A Systematic Review
Authors: Sundara Rajoo Keeren , Karam Daljit Singh , Abdu Arifin , Rosli Zamri , James Gerusu Geoffery
Published: July 2021

Sustainable urban development is a major issue in developing countries, namely in environmental and social aspects. Urban forests have the potential to address these issues. Thus, it is not surprising that urban forest research is slowly gaining traction in these regions. However, there have been limited urban forest research reviews focusing on developing countries, especially tropical countries in the global south. Research reviews are vital in identifying the distribution of research themes, hence revealing research gaps and needs. Therefore, this review paper aims to provide a deep insight into the development of urban forest research in Malaysia in the past 20 years. The core purpose of this review is to analyze the distribution of research themes in Malaysia, thus identifying research gaps and needs in developing countries. A total of 43 articles were selected for this review, using the PRISMA framework. The distribution of research articles showed a continuous increase over time, especially for the past five years (2016 to 2021). The reviewed articles were categorized according to five emerging research themes in urban forestry. More than 41% of the reviewed articles fell under Theme 1 (the physicality of urban forests), with the majority being on biodiversity (n = 10). Theme 5 (the governance of urban forest) had the lowest research output (n = 3). Urban forestry research is slowly gaining prominence globally including the global south; however, there are obvious preferences in research focus, causing some research questions to be neglected. These research gaps are especially evident in four areas—soil science, ecophysiology, valuation (economics), and environmental justice. These research gaps should be addressed by the scientific community to ensure a thorough and complete research growth pertaining to urban forestry.
Effectiveness of Magnetized Flow on Nanofluid Containing Gyrotactic Micro-Organisms over an Inclined Stretching Sheet with Viscous Dissipation and Constant Heat Flux
Authors: Nabwey Hossam A. , El-Kabeir S.M.M. , Rashad A.M. , Abdou M.M.M.
Published: July 2021

The bioconvection phenomenon, through the utilization of nanomaterials, has recently encountered significant technical and manufacturing applications. Bioconvection has various applications in bio-micro-systems due to the improvement it brings in mixing and mass transformation, which are crucial problems in several micro-systems. The present investigation aims to explore the bioconvection phenomenon in magneto-nanofluid flow via free convection along an inclined stretching sheet with useful characteristics of viscous dissipation, constant heat flux, solutal, and motile micro-organisms boundary conditions. The flow analysis is addressed based on the Buongiorno model with the integration of Brownian motion and thermophoresis diffusion effects. The governing flow equations are changed into ordinary differential equations by means of appropriate transformation; they were solved numerically using the Runge–Kutta–Fehlberg integration scheme shooting technique. The influence of all the sundry parameters is discussed for local skin friction coefficient, local Nusselt number, local Sherwood number, and local density of the motile micro-organisms number.
Volatile Profile of Nuts, Key Odorants and Analytical Methods for Quantification
Authors: Valdés García Arantzazu , Sánchez Romero Raquel , Juan Polo Adriana , Prats Moya Soledad , Maestre Pérez Salvador E. , Beltrán Sanahuja Ana
Published: July 2021

The presence of nuts in diets has notably increased due to their composition, and the presence of antioxidants and their unsaturated fatty acid profile has led to a considerable increase in their consumption. The volatile profile of nuts is important from different points of view. It affects consumer’s selection, influences raw material selection for the production of composite foods, dictates variety selection in breeding programs, and, from a quality perspective, its changes can indicate food degradation or alteration. A review of the published bibliography concerning the determination of volatiles in nuts has been carried out. The information retrieved has been divided into four main sections. First, a discussion on the main volatiles present in nuts is performed; next, a revision of the methods used to determine the volatiles is presented; and, finally, two sections describing how harvesting conditions, healthy state and the thermal treatment of nuts modifies their volatile profile are added. Analysis of the published bibliography denoted the complexity of volatile determination and the different variables that can modify the compounds present in the volatile fraction of nuts.
The Use of Larval Sea Stars and Sea Urchins in the Discovery of Shared Mechanisms of Metazoan Whole-Body Regeneration
Authors: Wolff Andrew , Hinman Veronica
Published: July 2021

The ability to regenerate is scattered among the metazoan tree of life. Further still, regenerative capacity varies widely within these specific organisms. Numerous organisms, all with different regenerative capabilities, have been studied at length and key similarities and disparities in how regeneration occurs have been identified. In order to get a better grasp on understanding regeneration as a whole, we must search for new models that are capable of extensive regeneration, as well as those that have been under sampled in the literature. As invertebrate deuterostomes, echinoderms fit both of these requirements. Multiple members regenerate various tissue types at all life stages, including examples of whole-body regeneration. Interrogations in two highly studied echinoderms, the sea urchin and the sea star, have provided knowledge of tissue and whole-body regeneration at various life stages. Work has begun to examine regeneration in echinoderm larvae, a potential new system for understanding regenerative mechanisms in a basal deuterostome. Here, we review the ways these two animals’ larvae have been utilized as a model of regeneration.
Genetic and Transcriptomic Analysis Reveal the Molecular Basis of Photoperiod-Regulated Flowering in Xishuangbanna Cucumber (Cucumis sativus L. var. xishuangbannesis Qi et Yuan)
Authors: Tian Zhen , Jahn Molly , Qin Xiaodong , Obel Hesbon Ochieng , Yang Fan , Li Ji , Chen Jinfeng
Published: July 2021

Xishuangbanna (XIS) cucumber (Cucumis sativus L. var. xishuangbannesis Qi et Yuan), is a botanical variety of cucumber cultivars native to southwest China that possesses excellent agronomic traits for cucumber improvement. However, breeding utilization of XIS cucumber is limited due to the current poor understanding of its photoperiod-sensitive flowering characteristics. In this study, genetic and transcriptomic analysis were conducted to reveal the molecular basis of photoperiod-regulated flowering in XIS cucumber. A major-effect QTL locus DFF1.1 was identified that controls the days to first flowering (DFF) of XIS cucumbers with a span of 1.38 Mb. Whole-genome re-sequencing data of 9 cucumber varieties with different flowering characteristics in response to photoperiod suggested that CsaNFYA1 was the candidate gene of DFF1.1, which harbored a single non-synonymous mutation in its fifth exon. Transcriptomic analysis revealed the positive roles of auxin and ethylene in accelerating flowering under short-day (SD) light-dark cycles when compared with equal-day/night treatment. Carbohydrate storage and high expression levels of related genes were important reasons explaining early flowering of XIS cucumber under SD conditions. By combining with the RNA-Seq data, the co-expression network suggested that CsaNFYA1 integrated multiple types of genes to regulate the flowering of XIS cucumber. Our findings explain the internal regulatory mechanisms of a photoperiodic flowering pathway. These findings may guide the use of photoperiod shifts to promote flowering of photoperiod-sensitive crops.
Geomorphological Approach to Cliff Instability in Volcanic Slopes: A Case Study from the Gulf of Naples (Southern Italy)
Authors: Di Crescenzo Giuseppe , Santangelo Nicoletta , Santo Antonio , Valente Ettore
Published: July 2021

This paper deals with the problem of cliff stability and proposes a geomorphological zonation of a cliff using a sector of the Posillipo promontory (named the Coroglio-Trentaremi sea cliff, Italy), in the Campi Flegrei coastal area, as a case study. A detailed geological and geomorphological analysis was carried out, by combining field work with analysis of detailed scale topographic maps, orthophoto, and stratigraphical data from deep boreholes. Field and borehole data, together with structural data collected in seven different stations along the cliff, allowed us to derive six geological cross-sections and to reconstruct the complex stratigraphical and structural setting of the cliff. Geomorphological analysis focused on the detection of the main geomorphological factors predisposing to cliff instability. We selected the most significant factors and divided them into two groups: factors influencing landslide intensity and factors influencing cliff instability. Then, by means of a heuristic approach, we constructed a matrix that was used to derive a map showing the geomorphological zonation of the sea cliff. This map may enable to development of a reliable scenario of cliff instability and consequent retreat, which may be useful either to plan intervention works in the most critical areas or to organize prevention plans aimed at risk mitigation.
Unmet Needs and Quality of Life of Cancer Patients and Their Families: Actor–Partner Interdependence Modeling
Authors: Jang Yubeen , Jeong Younhee
Published: July 2021

Unmet needs and quality of life (QOL) are important nursing issues for both patients and their families. However, studies into their direct association, considering the dyadic relationship between them, have not been done. We investigated the associations using the actor–partner interdependence modeling for dyadic data. Data were collected from 115 patient–family dyads at a tertiary teaching hospital. The study variables were assessed using the questionnaires and clinical data. To analyze patient–family dyad data, the actor–partner interdependence modeling and structural equation modeling were used. The cancer patients and their families experienced diverse and high levels of unmet needs that affected their quality of life, both physically and mentally. The cancer patients’ unmet needs decreased their physical and mental quality of life, while those of their families had a negative impact on their own physical and mental quality of life. However, the cancer patients’ unmet needs did not have partner effects on their families’ quality of life, and vice versa. Therefore, unmet needs played important roles in their QOL taking into dyadic relationships in the model. The results suggest that nursing intervention programs to meet the needs of both patients and their families are required to improve their quality of life.
On Redefining the Body Image Satisfaction Questionnaire: A Preliminary Test of Multidimensionality
Authors: Rodrigues Filipe , Monteiro Diogo , Flores Pedro , Forte Pedro
Published: July 2021

The aim of the present study was to examine the Body Image Satisfaction Questionnaire (BISQ) as a multidimensional instrument, designed to measure individuals’ body image satisfaction. A sample of 790 Portuguese healthy adults (female = 399; male = 391) aged 18 and 49 years old (M = 28.61, SD = 7.97) completed the BISQ. Exploratory factor analysis of the BISQ provided initial psychometric validity for a five-factor model assessing five dimensions of body image, namely, face, upper torso, lower torso, lower body, and overall body appearance. Confirmatory factor analysis supported this five-correlated model, in which a bifactor model provided the best fit to the data, defining a body image satisfaction factor and five specific factors. The BISQ clearly distinguished between various dimensions of body image satisfaction and showed satisfactory psychometric quality through factor analyses. This measure may have a broad application for research and practice, as a tool for capturing individual body image satisfaction.
Work-Related Satisfaction among Clinicians Working at Inpatient Treatment Facilities for Substance Use Disorder: The Role of Recovery Orientation
Authors: Johannessen Dagny , Nordfjærn Trond , Geirdal Amy
Published: July 2021

Several psychosocial factors have been suggested as facilitators of change among inpatients treated for substance use disorder (SUD). Research suggests that staff members are also influenced by the practice in which they are involved, and by contextual psychosocial factors at their treatment facilities. This cross-sectional questionnaire survey study was conducted to investigate the role of recovery-orientated interventions in describing work-related satisfaction among clinicians at inpatient SUD treatment facilities. The respondents (n = 407) rated items indicating work-related satisfaction and the degree of recovery orientation at their treatment facilities. The main findings of two block regression analyses indicated that clinicians’ work-related satisfaction was positively influenced by inpatients’ opportunities to pursue their goals and choices, and negatively influenced by inpatient involvement. The change in clinicians’ work-related satisfaction could not be described by the degree of individually tailored and varied interventions at the treatment facility. Clinicians should be supported and involved in the process of implementing measures to increase inpatient involvement in the treatment programmes, and treatment measures that enable inpatients to pursue their goals and choices should be enhanced. The findings of this and previous studies indicate that a recovery-oriented framework promotes clinicians’ work-related satisfaction and has an enabling influence on both inpatients and clinicians.
Comparison of Efficacy among Three Radiofrequency Ablation Techniques for Treating Knee Osteoarthritis: A Systematic Review and Meta-Analysis
Authors: Chou Shih-Hsiang , Shen Po-Chih , Lu Cheng-Chang , Liu Zi-Miao , Tien Yin-Chun , Huang Peng-Ju , Chou Cheng-Ming , Shih Chia-Lung
Published: July 2021

Radiofrequency ablation (RFA) was first introduced for treating knee osteoarthritis (OA) in 2010 and has emerged as a minimally invasive treatment option. Three RFA techniques have been adopted for treating knee OA, including conventional, pulsed, and cooled RFA. However, the efficacy among different RFA techniques in the treatment of knee OA is still unclear. Three electronic databases were systematically searched for relevant articles, including PubMed, Embase, and Cochrane Library. A meta-analysis of articles that investigated the use of RFA techniques in the treatment of knee OA was conducted to pool the effect size in pain before and after treatment. A total of 20 eligible articles (including 605 patients) were included for our meta-analysis. After treatment, the patients had significant improvements in pain for all three RFA techniques when compared with the baseline level for the 1, 3-, and 6-month follow-ups (p < 0.00001). However, there were no significant differences in the efficacy among the three RFA techniques for all follow-up visits (p > 0.05). The three RFA techniques demonstrated a significant improvement in pain for up to 6 months after treatment. Comparing the efficacy of the three RFA techniques in the treatment of knee OA, our results showed that no significant differences in pain relief among the three RFA techniques were observed at the 1-, 3-, 6, and 12-month follow-up visits.
The Ecological Footprint of COVID-19 mRNA Vaccines: Estimating Greenhouse Gas Emissions in Germany
Authors: Kurzweil Peter , Müller Alfred , Wahler Steffen
Published: July 2021

Compared to the medical, economic and social implications of COVID-19 vaccinations, little attention has been paid to the ecological balance to date. This study is an attempt to estimate the environmental impact of two mRNA vaccines in terms of CO2 equivalents with respect to their different freezing strategies and supply chain organization. Although it is impossible to accurately calculate the actual environmental impact of the new biochemical synthesis technology, it becomes apparent that transport accounts for up to 99% of the total carbon footprint. The emissions for air freight, road transportation and last-mile delivery are nearly as 19 times the emissions generated from ultra-deep freeze technologies, the production of dry ice, glass and medical polymers for packaging. The carbon footprint of a single mRNA vaccine dose injected into a patient is about 0.01 to 0.2 kg CO2 equivalents, depending on the cooling technology and the logistic routes to the vaccination sites in Germany.
A Descriptive Study of Specialist and Non-Specialist Teachers’ Preparation towards Educational Inclusion
Authors: Rojo-Ramos Jorge , Manzano-Redondo Fernando , Barrios-Fernandez Sabina , Garcia-Gordillo Miguel A. , Adsuar Jose Carmelo
Published: July 2021

Attention to educational diversity in educational centers has become an important topic, so it is necessary to address challenges to offer an individualized educational response. Thus, specialist teachers must adopt a leading role in order that education systems move towards inclusion. The objective of this study is to measure Spanish primary school teachers’ perceptions about their preparation for inclusive education, considering possible differences between specialist teachers (therapeutic pedagogy and hearing and speech) and non-specialist teachers. The sample was made up of 284 teachers who work in the primary education stage in public Spanish schools, who responded to the Questionnaire for the Evaluation of Teacher Preparation for Inclusion (CEFI-R). Significant differences were found according to the specialism of the participants. It can be concluded that teachers consider their initial preparation in this subject insufficient but show positive conception towards educational inclusion.
Environmental Air Pollutants Inhaled during Pregnancy Are Associated with Altered Cord Blood Immune Cell Profiles
Authors: Martins Costa Gomes Gabriela , Karmaus Wilfried , Murphy Vanessa E. , Gibson Peter G. , Percival Elizabeth , Hansbro Philip M. , Starkey Malcolm R. , Mattes Joerg , Collison Adam M.
Published: July 2021

Air pollution exposure during pregnancy may be a risk factor for altered immune maturation in the offspring. We investigated the association between ambient air pollutants during pregnancy and cell populations in cord blood from babies born to mothers with asthma enrolled in the Breathing for Life Trial. For each patient (n = 91), daily mean ambient air pollutant levels were extracted during their entire pregnancy for sulfur dioxide (SO2), nitric oxide, nitrogen dioxide, carbon monoxide, ozone, particulate matter <10 μm (PM10) or <2.5 μm (PM2.5), humidity, and temperature. Ninety-one cord blood samples were collected, stained, and assessed using fluorescence-activated cell sorting (FACS). Principal Component (PC) analyses of both air pollutants and cell types with linear regression were employed to define associations. Considering risk factors and correlations between PCs, only one PC from air pollutants and two from cell types were statistically significant. PCs from air pollutants were characterized by higher PM2.5 and lower SO2 levels. PCs from cell types were characterized by high numbers of CD8 T cells, low numbers of CD4 T cells, and by high numbers of plasmacytoid dendritic cells (pDC) and low numbers of myeloid DCs (mDCs). PM2.5 levels during pregnancy were significantly associated with high numbers of pDCs (p = 0.006), and SO2 with high numbers of CD8 T cells (p = 0.002) and low numbers of CD4 T cells (p = 0.011) and mDCs (p = 4.43 × 10−6) in cord blood. These data suggest that ambient SO2 and PM2.5 exposure are associated with shifts in cord blood cell types that are known to play significant roles in inflammatory respiratory disease in childhood.
Give Older Persons a Voice in the Society—By Using Information Compiled during Preventive Home Visits on a Societal Level
Authors: Nivestam Anna , Haak Maria , Westergren Albert , Petersson Pia
Published: July 2021

Preventive home visits (PHVs) are offered to older persons with the purpose of promoting health and preventing risks on an individual level. However, aspects of health need to be considered on a societal level as well. This study aims to get a deeper understanding of perceptions of the usability of the information compiled during the PHVs to promote health, among older persons, on a societal level. Three online focus groups were conducted with heads of unit of PHVs, heads of department, and politicians responsible for health and welfare in seven municipalities in Sweden (n = 12). The findings were visualised in the core category Enable an inclusive society and the interrelated categories Monitoring determinants of health and Enabling exchange of information. The information from the PHVs could be used to monitor determinants of health by identifying assets, challenges, shifts, trends, and future needs in the society. Moreover, exchange of information from the PHVs could occur within and outside the health and welfare organisation. However, the potential use was affected by hindrances illustrated in the category Obstacles to interpreting and communicating the information. To conclude, using the information from the PHVs could possibly contribute to an inclusive society, where persons not usually represented in decision making are given a voice.
Assessing the Knowledge of Analgesic Drugs Utilization during Pregnancy among Women in Saudi Arabia: A Cross-Sectional Study
Authors: AlSaeed Maryam Jamal , Elmaghraby Dalia Ahmed
Published: July 2021

Background: Pain is a common compensation mechanism in pregnant women that they may face during gestation due to physiological changes. Paracetamol and non-steroidal anti-inflammatory drugs are the most administered analgesic drugs worldwide. Therefore, safety and efficacy are important measures for the use of analgesics during pregnancy. Objective: Assess the knowledge of analgesic drug utilization among Saudi pregnant women. Method: We conducted a self-administered survey with an electronic questionnaire via Google Drive among a sample of 406 Saudi women. Results: About half of the respondents took analgesics during the first trimester, and 52.5% of women have used analgesics at least once without any medical advice during their gestation. Most participants agreed that paracetamol is the safest and effective analgesic drug during pregnancy, yet 61.8% of women are not aware that analgesics could be detrimental to the fetus if inappropriately administered in the third trimester. Conclusion: Participants have a good perception of the safest and most effective analgesic drug during pregnancy, but they have poor knowledge about analgesics’ side effects.
Psychological Distress among Students in Higher Education: One Year after the Beginning of the COVID-19 Pandemic
Authors: Schmits Emilie , Dekeyser Sarah , Klein Olivier , Luminet Olivier , Yzerbyt Vincent , Glowacz Fabienne
Published: July 2021

The COVID-19 pandemic has affected the psychological well-being of students. Several stressors (such as socioeconomic and education-related contexts) could influence mental health, as well as individual and relational dimensions. This study proposes to evaluate the predictive effect of these factors on anxiety and depressive symptoms among students in higher education one year after the beginning of the pandemic. A sample of 23,307 students (Mage = 20.89; SD = 1.96; 69.08% of women) was assessed through an online self-report questionnaire including adapted and validated measures. The main rates were as follows: 50.6% of students presented anxiety symptoms; 55.1% reported depressive symptoms; 20.8% manifested suicidal ideations; 42.4% saw their financial situation deteriorate; 39.1% felt they were dropping out of school. One year after the beginning of the pandemic, students in higher education are anxious and depressed, especially those who identify as women (for both anxiety and depression) and as a non-binary gender (only for anxiety), experience a deterioration in their financial situation, are dropping out of school, or manifest hostility (for both anxiety and depression). The degree of study affects the symptoms’ severity (Bachelor 2 and 3 for anxiety and Master for depression). Contact with family and friends (for both anxiety and depression) as well as regular physical activity (only for depression) should provide some protection against psychological distress. Policy-makers must make a long-term investment in the well-being and positive mental health of the student community.
Antiretroviral Therapy (ART) Adherence and Prenatal Alcohol Use among Women Who Are Pregnant with HIV in South Africa
Authors: Washio Yukiko , Browne Felicia A. , Ndirangu Jacqueline , Kline Tracy L. , Wechsberg Wendee M.
Published: July 2021

This brief report emphasizes the need to focus on women with HIV who are pregnant who use alcohol or other drugs. A recently completed implementation science study tested a gender-focused behavioral intervention, the Women’s Health CoOp (WHC), to improve antiretroviral therapy (ART) adherence and reduce alcohol use among women with HIV. The study identified 33 participants who had a positive pregnancy test result at the baseline assessment, of whom five participants remained pregnant during the 6-month duration of the study. Of the 33 pregnant participants at the baseline assessment, 55% reported past-month alcohol use, with 27% reporting a history of physical abuse and 12% reporting a history of sexual abuse. The five women who remained pregnant at 6 months showed improved ART adherence and reduced prenatal alcohol use. The gender-focused WHC intervention shows promise as a cost-effective, sustainable, behavioral intervention to address these intersecting syndemic issues. Future research should focus on identifying the needs of women with HIV who are pregnant who use alcohol or other drugs and developing tailored evidence-based behavioral interventions such as the WHC for preventing FASD in addition to improving ART adherence in this key population of women and reducing the economic burden on society.
Facebook Reviews as a Supplemental Tool for Hospital Patient Satisfaction and Its Relationship with Hospital Accreditation in Malaysia
Authors: A. Rahim Afiq Izzudin , Ibrahim Mohd Ismail , Musa Kamarul Imran , Chua Sook-Ling
Published: July 2021

Patient satisfaction is one indicator used to assess the impact of accreditation on patient care. However, traditional patient satisfaction surveys have a few disadvantages, and some researchers have suggested that social media be used in their place. Social media usage is gaining popularity in healthcare organizations, but there is still a paucity of data to support it. The purpose of this study was to determine the association between online reviews and hospital patient satisfaction and the relationship between online reviews and hospital accreditation. We used a cross-sectional design with data acquired from the official Facebook pages of 48 Malaysian public hospitals, 25 of which are accredited. We collected all patient comments from Facebook reviews of those hospitals between 2018 and 2019. Spearman’s correlation and logistic regression were used to evaluate the data. There was a significant and moderate correlation between hospital patient satisfaction and online reviews. Patient satisfaction was closely connected to urban location, tertiary hospital, and previous Facebook ratings. However, hospital accreditation was not found to be significantly associated with online reports of patient satisfaction. This groundbreaking study demonstrates how Facebook reviews can assist hospital administrators in monitoring their institutions’ quality of care in real time.