bluuebunny/crossref_metadata_2025 huggingface dataset:
Safety and Cost Implications of Same-Day Discharge Following Elective Percutaneous Closure of Patent Foramen Ovale and Atrial Septal Defects in Australia
Authors: Prashar Abhisheik , Shah Sanjana , Zhang Richard , Mitchell Kurt , Sader Mark
Published: November 2021

Background: Percutaneous closure of patent foramen ovale (PFO) and atrial septal defects (ASD) is being more commonly performed due to changes in international guidelines supporting its use. This study was performed to determine the clinical outcomes, safety and cost implications of same-day discharge (SDD) following such procedures and place this in an Australian context. Methods: This was a retrospective, observational study of patients undergoing elective percutaneous PFO or ASD closure at St. George Hospital, Australia between January 2011 and January 2020. Primary outcomes included 30-day major adverse cardiovascular endpoints (MACE) and readmission to hospital within 30 days. Results: Twenty-four patients were included in the primary analysis. Ten (41.7%) patients underwent elective ASD closure while 14 (58.3%) underwent PFO closure. Among the 24 patients who underwent elective percutaneous closure of structural heart disease, 23 patients (95.8%) were managed with SDD. There were no MACE outcomes at 30 days. No patients were re-admitted to hospital at 30 days following these procedures. When compared to overnight admission to hospital post-elective percutaneous structural heart condition closure, SDD yielded a cost saving of AUD 5999 per case. Conclusion: SDD following elective percutaneous closure of ASD and PFO was demonstrated to be a safe and effective strategy for managing patients. With more widespread use, it can lead to significant cost savings for hospitals without compromising patient care.
Diagnostics and Monitoring to Preserve a Hypogeum Site: The Case of the Mithraeum of Marino Laziale (Rome)
Authors: Luvidi Loredana , Prestileo Fernanda , De Paoli Michela , Riminesi Cristiano , Manganelli Del Fà Rachele , Magrini Donata , Fratini Fabio
Published: November 2021

Conservation of hypogea and their accessibility by the visitors is a hard question, due to the interaction of different factors such as the intrinsic characteristics of the hypogeal environments and the presence of public. A particular case is represented by the Mithraeum of Marino Laziale, located a few kilometers away from Rome and accidentally discovered in the 1960s. The uniqueness of the discovery was the presence of a well-preserved painting of the Mithraic scene (II century A.D.) probably due to the oblivion of the place of worship over the centuries as well as the isolation from the outdoor environment. Unfortunately, despite a recent complete restoration and recovery of the archaeological area, which ended in 2015, the area was never open to the visitors and only two years after completing the works it was no longer safe to use. Hence, the need for a new planning of interventions starting from the deep knowledge of this cultural heritage and from the analysis of past incorrect actions to arrive at the opening—without any risk for the archaeological findings and visitors—and management of this site, never exposed to the public. Therefore, since 2018 a diagnostic campaign and microclimate monitoring have been started. The data collected during the two years of investigations have been fundamental to assess the conservation state of the hypogeal environment and the potential risks for the preservation of the three paintings (the Mithraic scene and two dadophores). Long-term monitoring of indoor environmental conditions assumes the role of an essential tool for the planning of preventive conservation strategies but also for the control of the site after its opening to the visitors. Furthermore, the characterization of the microclimate is non-invasive, sufficiently economical and accurate. In this paper, the characterization of surfaces in the Mithraic gallery through optical microscopy, UV fluorescence/imaging techniques, FT-IR spectroscopy, XRD and the microclimatic parameters variation in the presence or absence of visitors are used to define the strategies for the opening and fruition of the Mithraeum. The strategies for the sustainable fruition of this unique archaeological site have been defined through a conservation protocol approved by the Italian Ministry of Cultural Heritage and necessary for the site managers and curators of the Municipality of Marino Laziale to finally support its opening.
Seed Micromorphology, In Vitro Germination, and Early-Stage Seedling Morphological Traits of Cattleya purpurata (Lindl. & Paxton) Van den Berg
Authors: Bazzicalupo Miriam , Calevo Jacopo , Adamo Martino , Giovannini Annalisa , Copetta Andrea , Cornara Laura
Published: November 2021

In the context of a symbiotic plant-fungus interaction study concerning Cattleya purpurata, we focused on some aspects of seed morphology and biology, and the early stages of seedling development. Seed morphology was characterized using light and scanning electron microscopy. In vitro seed germination capability was evaluated, comparing symbiotic and asymbiotic methods. The morphology of the seeds was overall comparable to that of other congeneric species, showing classical adaptations related to the aerodynamic properties and to the wettability of seeds, but calcium oxalate druses were identified inside the suspensor cells. Asymbiotic seed germination was successful in all tested media (17.1–46.5%) but was higher on 1/2 Murashige & Skoog. During symbiotic interaction with the fungal strain MUT4178 (Tulasnella calospora), germination rate was significantly lower than that obtained with the best three asymbiotic media, suggesting a low fungal compatibility. Seedling morphology was in line with other taxa from the same genus, showing typical characteristics of epiphytic species. Our observations, in particular, highlighted the presence of stomata with C-shaped guard cells in the leaves, rarely found in Cattleyas (where usually they are reniform), and confirm the presence of tilosomes in the roots. Idioblasts containing raphides were observed in both roots and leaves.
Drought and Darkness during Long-Term Simulated Shipping Delay Post-Shipping Flowering of Phalaenopsis Sogo Yukidian ‘V3’
Authors: Jeong Ju Hui , Oh Wook
Published: November 2021

We investigated the relationship between simulated shipping (SS) without watering or light and post-shipping growth and flowering of Phalaenopsis Sogo Yukidian ‘V3’. Two experimental environments were created: a low-temperature chamber for simulated shipping and a growth chamber for simulated finishing at the destination. Plants from both the control and treatment groups were moved from the low-temperature chamber to the growth chamber after the end of the simulated shipping. Control plants received continuous light and regular irrigation; plants in the treatment group were placed in the low-temperature chamber under light (LSS) or dark (DSS) conditions for 10, 20, 30, 40, or 50 days, without irrigation. Once DSS duration exceeded 40 days, the leaf-yellowing rate increased rapidly. Chlorophyll content decreased from day 10 to 30 of DSS and slightly increased in LSS and DSS over 40 days. The photochemical reflectance index decreased with the SS duration. The maximum quantum yield PSII photochemistry (Fv/Fm) values sharply decreased after the end of SS; after 40 days, neither LSS nor DSS plants recovered to the normal range. In the same SS duration, the number of days to spiking was delayed in the DSS. In addition, the number of days to spiking was delayed, owing to the longer SS duration. LSS for 50 days induced early flowering, as in the control group, but lowered flower quality. The results demonstrate that drought stress from long-term shipping (>40 days) delayed flowering. In particular, DSS delayed flowering more than LSS due to the decrease in chlorophyll content and the reduction in carbohydrates through respiration.
Is Intracanal Cryotherapy Effective in Reducing Postoperative Endodontic Pain? An Updated Systematic Review and Meta-Analysis of Randomized Clinical Trials
Authors: Almohaimede Amal , Al-Madi Ebtissam
Published: November 2021

This research aimed to assess the potency of intracanal cold therapy in diminishing postoperative endodontic pain. PubMed, Scopus, the Cochrane Library, EMBASE, the Web of Science, grey literature, and endodontic journals were used to identify randomized controlled clinical trials evaluating postoperative pain after a final irrigation with a cold irrigant (as an experimental group) and a room temperature irrigant (as a control group). The risk of bias was rated according to the Cochrane Collaboration’s tool and the Grading Recommendation Assessment, Development, and Evaluation (GRADE) system was used to estimate the evidence quality. For the meta-analysis, a random effects model was utilized. The qualitative analysis contained 16 studies and the quantitative analysis contained 9 studies. The experimental groups showed a reduction in postoperative pain at 6 h (mean difference (MD) = −1.11; p = 0.0004; I2 = 72%; low quality evidence), 24 h (MD = −1.08; p = 0.003; I2 = 92%; low quality evidence), 48 h (MD = −0.38; p = 0.04; I2 = 81%; low quality evidence), and 72 h (MD = −0.69; p = 0.04; I2 = 90%; low quality evidence). A higher quality of evidence from more clinical trials is needed.
Usefulness of Digital Game-Based Learning in Nursing and Occupational Therapy Degrees: A Comparative Study at the University of Burgos
Authors: Sáiz-Manzanares María Consuelo , Martin Caroline Françoise , Alonso-Martínez Laura , Almeida Leandro S.
Published: November 2021

Teaching in higher education in the 21st century is moving towards e-Learning or b-Learning teaching models. This situation has increased due to the SARS CoV-2 health crisis. Therefore, teaching–learning models must be based on the use of active methodologies that facilitate students’ motivation to work in learning management systems (LMS). One of the most current resources is the digital game-based learning (DGBL) use, specifically in health sciences degrees (e.g., nursing). In this study, we worked with 225 third-year students of degrees in nursing (ND) and occupational therapy (OTD). The objectives were (1) to find out if there were significant differences between students who had worked with DGBL techniques vs. those who had not, and (2) to find out if there were significant differences depending on the type of degree (ND vs. OTD) regarding access to the LMS, learning outcomes and students’ satisfaction with teachers’ performance. A mixed-method research approach was applied. In the quantitative study, significant differences were found in the accesses to the LMS in favor of the groups that had worked with DGBL techniques. Significant differences were also found in ND students with respect to learning outcomes in the group that worked with DGBL. Regarding the results of the qualitative study, differences were found in the frequency of interaction and in the preference of DGBL activities depending on the type of degree. Further studies will investigate the possible causes of these differences.
Health Is Wealth: Study on Consumer Preferences and the Willingness to Pay for Ecological Agricultural Product Traceability Technology: Evidence from Jiangxi Province China
Authors: Chen Ximing , Shang Jie , Zada Muhammad , Zada Shagufta , Ji Xueqiang , Han Heesup , Ariza-Montes Antonio , Ramírez-Sobrino Jesús
Published: November 2021

The application of traceability technology is an important way to solve food safety problems. Different traceability technologies bring different effects to consumers. Existing studies have not explored consumers’ preferences in regards to product traceability technology applications, and they have not analyzed their willingness to pay. Therefore, this study focused on organic rice, an ecological agricultural product. The study was based on a survey from Jiangxi Province, China. It used a selective experiment method in order to analyze consumer preferences and the willingness to pay for ecological agricultural product traceability technology. The results show that consumer preferences are as follows: blockchain technology application attributes, traditional traceability-technology-application attributes, high credit-supervision attributes, and international-certification attributes. In terms of willingness to pay, consumers have the highest willingness to pay for the application of blockchain technology, which they are willing to pay CNY 21.902 more per kg for this attribute. At the same time, consumers are also willing to make additional payments for traditional traceability-technology-application attributes, high credit-supervision attributes, and international-certification attributes. Their willingness to pay is CNY 20.426, CNY 17.115 yuan, and CNY 11.049, respectively.
Quantification of the Ecological Value of Railroad Development Areas Using Logistic Regression Analysis
Authors: Kim Min-Kyeong , Park Duckshin , Kim Dong Yeob
Published: November 2021

According to the national railway network construction plan, Investment in railways has increased due to the need for environmentally friendly transportation, and the rail network is expanding throughout South Korea. Railway projects should be evaluated using strategic environmental impact assessments. In the “Guidelines for the Construction of Environment-friendly Railways”, seven priority headings that must be considered for railway projects are described. This guide notes that qualitative evaluation must be conducted during the survey process to reasonably predict impacts on the environment. However, quantitative evaluation with specific indicator values may also be necessary. In this study, independence analysis and logistic regression analysis were used to quantitatively evaluate railway environmental and ecological indicators. The results were used to develop a regression model reflecting seven indicators; biodiversity class, ecosystem type, vegetation conservation class, tree age class, ecological naturalness, presence of river ecosystems, and fragmented patch size. The fitness regression model showed 90.3% classification accuracy and the receiver operating curve (ROC) model fit was 88.6%. An environmental quality assessment map was prepared by classifying areas of environmental quality according to five grades. This is the first model for environmental and ecological evaluation of railway projects. Evaluation using the map showed that the railroad passes through areas with lower protection values compared to the results obtained using the national environmental evaluation map. Kappa analysis showed a low level of agreement between the two maps (kappa coefficient = 0.212). The results of this study can be applied to railway development project sites and may help to identify the best sites for the development of an environmentally friendly railway system.
Socio-Psychological Functions of Men and Women Triathlon Participation
Authors: Poczta Joanna , Almeida Nuno , Malchrowicz-Mośko Ewa
Published: November 2021

Motivations to run marathons have been recognised by many researchers, but few have paid attention to triathletes. Mass triathlon participation is a new trend, which manifests itself as a human need to invoke strong emotions and seek them in difficult sports, as well as to travel to participate in such events. Therefore, the main goal of this study was to recognise the motivations to participate in triathlons among men and women respondents, and to evaluate the differences between them. The empirical research among triathletes (n = 1141) recognised the motives for participation in mass triathlon sporting events in accordance with four types of orientation: social, experience, factual, and result. Most important conclusions resulting from the conducted research indicate that women significantly more often displayed the will to feel unity and integration, as well as the desire to gain recognition in the eyes of others, as compared to men. For men, the desire to feel equal was significantly more important than for women. Both men and women indicated the desire to maintain good physical condition and health, which turned out to be a significant factor. For men, Group B—specifying the experience orientation, was deemed the most important, while for women the most important group of motives was Group D—specifying the result orientation.
Influence of Imagery Training on Adjusting the Pressure of Fin Swimmers, Improving Sports Performance and Stabilizing Psychological Quality
Authors: Lin Hsiao-Hsien , Lin Tzu-Yun , Ling Ying , Lo Chih-Cheng
Published: November 2021

This study analyzed the effects of imagery training on athletes’ imagery ability, physical anxiety and athletic performance. This study employed a mixed research approach. Snowball sampling was used to select 55 fin swimmers with imagery training experience and formal competition participation. Basic statistics were obtained, and Pearson product-moment correlation coefficient (PPMCC) analysis was performed using IBM SPSS Statistics for Windows, Version 26.0, and the results were compared with the opinions of three experts and were tested using multivariate validation methods. The results revealed that although imagery training can help athletes improve their performance and significantly reduce their anxiety during the competition, athletes can still make mistakes due to internal and environmental factors and even have negative thoughts that lead to their reduced likelihood of competition participation. By strengthening strategic and technical imagery training, we can help our fin swimmers perform at a higher level, achieve their goals, and improve overall satisfaction with their competition process and performance.
In Vitro and In Vivo Models to Assess the Immune-Related Effects of Nanomaterials
Authors: Boraschi Diana , Li Dongjie , Li Yang , Italiani Paola
Published: November 2021

The immunological safety of drugs, nanomaterials and contaminants is a central point in the regulatory evaluation and safety monitoring of working and public places and of the environment. In fact, anomalies in immune responses may cause diseases and hamper the physical and functional integrity of living organisms, from plants to human beings. In the case of nanomaterials, many experimental models are used for assessing their immunosafety, some of which have been adopted by regulatory bodies. All of them, however, suffer from shortcomings and approximations, and may be inaccurate in representing real-life responses, thereby leading to incomplete, incorrect or even misleading predictions. Here, we review the advantages and disadvantages of current nanoimmunosafety models, comparing in vivo vs. in vitro models and examining the use of animal vs. human cells, primary vs. transformed cells, complex multicellular and 3D models, organoids and organs-on-chip, in view of implementing a reliable and personalized nanoimmunosafety testing. The general conclusion is that the choice of testing models is key for obtaining reliable predictive information, and therefore special attention should be devoted to selecting the most relevant and realistic suite of models in order to generate relevant information that can allow for safer-by-design nanotechnological developments.
In Vivo Imaging-Based Techniques for Early Diagnosis of Oral Potentially Malignant Disorders—Systematic Review and Meta-Analysis
Authors: Mazur Marta , Ndokaj Artnora , Venugopal Divyambika Catakapatri , Roberto Michela , Albu Cristina , Jedliński Maciej , Tomao Silverio , Vozza Iole , Trybek Grzegorz , Ottolenghi Livia , Guerra Fabrizio
Published: November 2021

Objectives: Oral potentially malignant disorders (OPMDs) are lesions that may undergo malignant transformation to oral cancer. The early diagnosis and surveillance of OPMDs reduce the morbidity and mortality of patients. Diagnostic techniques based on medical images analysis have been developed to diagnose clinical conditions. This systematic review and meta-analysis aimed to evaluate the efficacy of imaging-based techniques compared to the gold standard of histopathology to assess their ability to correctly identify the presence of OPMDs. Design: Literature searches of free text and MeSH terms were performed using MedLine (PubMed), Scopus, Google Scholar, and the Cochrane Library (from 2000 to 30 June 2020). The keywords used in the search strategy were: (“oral screening devices” or “autofluorescence” or “chemiluminescence” or “optical imaging” or “imaging technique”) and (“oral dysplasia” or “oral malignant lesions” or “oral precancerosis”). Results: The search strategy identified 1282 potential articles. After analyzing the results and applying the eligibility criteria, the remaining 43 papers were included in the qualitative synthesis, and 34 of these were included in the meta-analysis. Conclusions: None of the analyzed techniques based on assessing oral images can replace the biopsy. Further studies are needed to explore the role of techniques-based imaging analysis to identify an early noninvasive screening method.
Maternal Perinatal Characteristics in Patients with Severe Preeclampsia: A Case-Control Nested Cohort Study
Authors: Aracil Moreno Irene , Rodríguez-Benitez Patrocinio , Ruiz-Minaya Maria , Bernal Claverol Mireia , Ortega Abad Virginia , Hernández Martin Concepción , Pintado Recarte Pilar , Yllana Fátima , Oliver-Barrecheguren Cristina , Álvarez-Mon Melchor , Ortega Miguel A. , De Leon-Luis Juan A.
Published: November 2021

Preeclampsia is one of the most worrisome complications during pregnancy, affecting approximately 1 out of 20 women worldwide. Preeclampsia is mainly characterized by a sustained hypertension, proteinuria, also involving a significant organ dysfunction. Moreover, 25% of the cases could be classified as severe preeclampsia (SP), a serious condition that could be life-threatening for both the mother and fetus. Although there are many studies focusing on preeclampsia, less efforts have been made in SP, frequently limited to some specific situations. Thus, the present study aims to conduct a comparative analysis of risk factors, maternal characteristics, obstetric and neonatal outcomes and maternal complications in patients with severe preeclampsia versus patients without severe preeclampsia. Hence, 235 cases and 470 controls were evaluated and followed in our study. We described a set of variables related to the development of severe preeclampsia, including maternal age > 35 years (69.8%), gestational (26.8%) or chronic arterial hypertension (18.3%), obesity (22.6%), use of assisted reproduction techniques (12.3%), prior history of preeclampsia (10.2%) and chronic kidney disease (7.7%) All patients had severe hypertension (>160 mmHg) and some of them presented with additional complications, such as acute renal failure (51 cases), HELLP syndrome (22 cases), eclampsia (9 cases) and acute cerebrovascular accidents (3 cases). No case of maternal death was recorded, although the SP group had a higher cesarean section rate than the control group (60% vs. 20.9%) (p < 0.001), and there was a notably higher perinatal morbidity and mortality in these patients, who had a prematurity rate of 58.3% (p < 0.001) and 14 perinatal deaths, compared to 1 in the control group. Overall, our study recognized a series of factors related to the development of SP and related complications, which may be of great aid for improving the clinical management of this condition.
The Acceptability of Physical Activity to Older Adults Living in Lower Socioeconomic Status Areas: A Multi-Perspective Study
Authors: Devereux-Fitzgerald Angela , Powell Rachael , French David P.
Published: November 2021

Older adults in lower socioeconomic status (SES) areas are the least active of all adult groups but are often absent from physical activity research. The present study aimed to elicit perspectives on acceptability of physical activity from older adults and physical activity providers in lower SES areas. Semi-structured interviews were conducted with 19 older adults and eight physical activity trainers/providers in lower SES areas. An inductive, multi-perspective Thematic Analysis was conducted. Eight themes were identified that covered one or both groups’ perceptions of what was important in ensuring acceptability of activity provision. Older adults perceived a lack of value that was reinforced by lack of resources and unequal provision. Acceptability was hindered by centralisation of facilities and lack of understanding of needs by facility management. Facilitating social interaction within physical activities appeared key, thereby meeting multiple needs with fewer resources. In conclusion, to increase acceptability of physical activity for older adults in low SES areas, providers should address the lack of perceived value felt by many older adults. Equitable provision of physical activities addressing multiple needs may allow older adults with limited resources to be physically active without sacrificing other needs. Facilitating creation of social bonds may foster maintenance of physical activities.
The Patient Centered Assessment Method (PCAM) for Action-Based Biopsychosocial Evaluation of Patient Needs: Validation and Perceived Value of the Dutch Translation
Authors: Smeets Rowan G. M. , Hertroijs Dorijn F. L. , Kroese Mariëlle E. A. L. , Hameleers Niels , Ruwaard Dirk , Elissen Arianne M. J.
Published: November 2021

The Patient Centered Assessment Method (PCAM) is an action-based tool that supports professionals to engage in a biopsychosocial assessment with patients and measure their needs. It is a promising tool for person-centered care. As the Netherlands lacks such a tool, a Dutch version was developed. Furthermore, we aimed to contribute to the relatively limited insights into the psychometric properties and value of the tool when used as part of a needs assessment in primary care. Confirmatory factor analysis was used to study construct validity and Cronbach’s alpha was computed to assess reliability. Furthermore, we interviewed 15 primary care professionals who used the PCAM. It was confirmed that each PCAM domain measures a separate construct, informed by the biopsychosocial model. The tool showed adequate reliability (Cronbach’s alpha = 0.83). Despite face validity concerns, the tool was mainly valued for measurement of patient needs and to facilitate action planning. Criticism of the PCAM pertained to a limited focus on the patient perspective, which is one of the crucial aspects of person-centered care. These rich, mixed-method insights can help to improve the value of the PCAM, as one of the few multifunctional tools to support professionals in holistic assessments.
Baseline Drug Treatments as Indicators of Increased Risk of COVID-19 Mortality in Spain and Italy
Authors: Bliek-Bueno Kevin , Mucherino Sara , Poblador-Plou Beatriz , González-Rubio Francisca , Aza-Pascual-Salcedo Mercedes , Orlando Valentina , Clerencia-Sierra Mercedes , Ioakeim-Skoufa Ignatios , Coscioni Enrico , Carmona-Pírez Jonás , Perrella Alessandro , Trama Ugo , Prados-Torres Alexandra , Menditto Enrica , Gimeno-Miguel Antonio
Published: November 2021

This study aims to identify baseline medications that, as a proxy for the diseases they are dispensed for, are associated with increased risk of mortality in COVID-19 patients from two regions in Spain and Italy using real-world data. We conducted a cross-country, retrospective, observational study including 8570 individuals from both regions with confirmed SARS-CoV-2 infection between 4 March and 17 April 2020, and followed them for a minimum of 30 days to allow sufficient time for the studied event, in this case death, to occur. Baseline demographic variables and all drugs dispensed in community pharmacies three months prior to infection were extracted from the PRECOVID Study cohort (Aragon, Spain) and the Campania Region Database (Campania, Italy) and analyzed using logistic regression models. Results show that the presence at baseline of potassium-sparing agents, antipsychotics, vasodilators, high-ceiling diuretics, antithrombotic agents, vitamin B12, folic acid, and antiepileptics were systematically associated with mortality in COVID-19 patients from both countries. Treatments for chronic cardiovascular and metabolic diseases, systemic inflammation, and processes with increased risk of thrombosis as proxies for the conditions they are intended for can serve as timely indicators of an increased likelihood of mortality after the infection, and the assessment of pharmacological profiles can be an additional approach to the identification of at-risk individuals in clinical practice.
Short-Term Acute Exposure to Wildfire Smoke and Lung Function among Royal Canadian Mounted Police (RCMP) Officers
Authors: Moitra Subhabrata , Tabrizi Ali , Fathy Dina , Kamravaei Samineh , Miandashti Noushin , Henderson Linda , Khadour Fadi , Naseem Muhammad , Murgia Nicola , Melenka Lyle , Lacy Paige
Published: November 2021

The increasing incidence of extreme wildfire is becoming a concern for public health. Although long-term exposure to wildfire smoke is associated with respiratory illnesses, reports on the association between short-term occupational exposure to wildfire smoke and lung function remain scarce. In this cross-sectional study, we analyzed data from 218 Royal Canadian Mounted Police officers (mean age: 38 ± 9 years) deployed at the Fort McMurray wildfires in 2016. Individual exposure to air pollutants was calculated by integrating the duration of exposure with the air quality parameters obtained from the nearest air quality monitoring station during the phase of deployment. Lung function was measured using spirometry and body plethysmography. Association between exposure and lung function was examined using principal component linear regression analysis, adjusting for potential confounders. In our findings, the participants were predominantly male (71%). Mean forced expiratory volume in 1 s (FEV1), and residual volume (RV) were 76.5 ± 5.9 and 80.1 ± 19.5 (% predicted). A marginal association was observed between air pollution and higher RV [β: 1.55; 95% CI: −0.28 to 3.37 per interquartile change of air pollution index], but not with other lung function indices. The association between air pollution index and RV was significantly higher in participants who were screened within the first three months of deployment (2.80; 0.91 to 4.70) than those screened later (−0.28; −2.58 to 2.03), indicating a stronger effect of air pollution on peripheral airways. Acute short-term exposure to wildfire-associated air pollutants may impose subtle but clinically important deleterious respiratory effects, particularly in the peripheral airways.
Orthodontic Status and Orthodontic Treatment Need of 12- and 15-Year-Old Greek Adolescents: A National Pathfinder Survey
Authors: Mylonopoulou Ioulia-Maria , Sifakakis Iosif , Berdouses Elias , Kavvadia Katerina , Arapostathis Konstantinos , Oulis Constantine J.
Published: November 2021

The purpose of this research was to assess the orthodontic status and orthodontic treatment needs of 12- and 15-year-old schoolchildren in Greece, in relation to sociodemographic factors and parental education level. A total of 1102 12-year-old children and 1131 15-year-old adolescents across Greece were assessed using the Modified Dental Health component (DHC) of the Index of Orthodontic Treatment Need (IOTN). An amount of 38.7% of 12-year-olds and 33.7% of 15-year-olds were in definite need of orthodontic treatment. The most common etiologic factors were tooth eruption and position anomalies. A higher rate of orthodontic treatment need was recorded among subjects with lower parental education level. Class I malocclusion was found in 50.9%, Class II in 38.4% and Class III in 10.8% of the total sample. A higher incidence of dental trauma was found in the 12-year-olds presenting with a Class II molar relationship and >3 mm overjet. The need for orthodontic treatment in Greece was higher, in comparison to other European countries, with one out of two children presenting a severe overjet associated with a high incidence of dental trauma. One out of three adolescents were still judged as having a need for orthodontic treatment by the age of 15.
School-Related Stressors and the Intensity of Perceived Stress Experienced by Adolescents in Poland
Authors: Kaczmarek Maria , Trambacz-Oleszak Sylwia
Published: November 2021

Higher stress reactivity during adolescence is a vulnerability marker of exposure to various environmental stressors. This study aimed to investigate the association between a high level of perceived stress experienced by adolescents and stressful stimuli induced from school environment, peer, and parental relationships. The data used were from a cross-sectional, observational study conducted in a stratified sample of 1846 adolescents (13–18 years) in the Wielkopolska province, Poland. Data were collected through self-administered questionnaires and anthropometric measurements. Perceived stress was assessed using the Perceived Stress Scale (PSS-10). The association of a high level of perceived stress with school-induced exposures was determined using multivariate logistic regression after adjusting for gender, age, height and weight status and interpersonal relationships (STATISTICA 13.1). It was found that girls were over three times more likely than boys to experience a high level of perceived stress. Moreover, girls appeared to be more vulnerable than boys to school-related stressors and weight status, while boys to stressors that can arise from interpersonal relationships. School environment was the only predictor factor of high perceived stress level with a large effect size in both boys (OR = 4.45; 95% CI: 3.11–6.36) and girls (OR = 6.22; 95% CI: 4.18–7.59). Given the findings of the present study, preventive programs are critical to mitigate the effect of stress from school on adolescents’ health and well-being.
Waterscapes for Promoting Mental Health in the General Population
Authors: Zhang Xindi , Zhang Yixin , Zhai Jun , Wu Yongfa , Mao Anyuan
Published: November 2021

The WHO estimates that, with the development of urbanization, 25% of the population is suffering from psychological and mental distress. Preliminary evidence has suggested that aquatic environments and riparian areas, i.e., waterscapes, can benefit psychological and mental wellbeing. The aim of this study was to identify the processes of waterscape psychological and mental health promotion through aliterature review. We propose a design framework of waterscapes for achieving psychological and mental health in the general population that often visits waterscapes, which has the function of therapeutic landscapes through values of accessibility, versatility, habitats, and biodiversity. According to theories, waterscapes can improve psychological and mental health to divert negative emotions through mitigation (e.g., reduced urban heat island), instoration (e.g., physical activity and state of nature connectedness), and restoration (e.g., reduced anxiety/attentional fatigue). By accessing water (e.g., streams, rivers, lakes, wetlands, and the coast) and riparian areas, people can get in close contact with nature and spend more time in activities (e.g., walking, exploring, talking, and relaxing). Waterscapes with healing effects can enhance psychological resilience to promote people’s psychological and mental health. Future research should focus on ensuring an adequate supply of waterscapes and promoting the efficiency of waterscape ecosystem services on mental health. Moreover, fora deep understanding of the complexity of nature–human health associations, it is necessary to explore more consistent evidence for therapeutic waterscapes considering the characteristics and functional mechanisms of waterscape quality, in terms of freshness, luminescence, rippling or fluidity, and cultural value, to benefit public health and biodiversity conservation.
Pediatric Dentists’ Service Provisions in South-East Europe during the First Wave of COVID-19 Epidemic: Lessons Learned about Preventive Measures and Personal Protective Equipment Use
Authors: Vuković Ana , Mandić-Rajčević Stefan , Sava-Rosianu Ruxandra , D Betancourt Marcela , Xhajanka Edit , Hysenaj Neada , Bajric Elmedin , Zukanović Amila , Philippides Vrassidas , Zosimas Marios , Nikolaos Maroufidis , Vlahović Zoran , Denkovski Marijan , Peric Tamara , Markovic Dejan , Campus Guglielmo
Published: November 2021

Introduction: Having in mind the importance of providing continuous pediatric dental services during the COVID-19 pandemic and the fact that children have similar viral loads to adults, the potential to spread the virus to others, and with variable clinical presentation of COVID-19 infection, this study aimed to analyze the impact of COVID-19 outbreak on pediatric dentistry service provision, risks, and preventive measures before and during dental treatment. Method: Structured and closed epidemiological cross-sectional survey involved seven Southeastern European countries. The questionnaire was developed using the modified Delphi method, pretested, and tested in North Italy during April 2020. The sample consisted of licensed dental professionals reached via national dental chambers and social media using the best strategies according to the national setting. Results: A total of 3227 dentists participated in the survey, and we included 643 specialists in this study—among them, 164 were pediatric dentists. Most pediatric dentists worked in the public sector (61.0%) and provided emergency (64.6%) and routine dental treatment (18.3%) during the outbreak. One-third of pediatric dentists were COVID-19 tested, statistically significantly more than other specialties, and 3.0% tested COVID-19 positive. In addition, significantly more pediatric dentists (13.4%) reported the presence of at least one symptom related to COVID-19 compared to other specialists (6.1%). None of the pediatric dentists reported PPE shortage. However, 26.2% of all specialists stated that they lacked clear step by step professional guidance in a national language. Similarly, in both groups, around 10% of specialists attended education on coronavirus. Conclusions: Considering that most pediatric dentists provided dental treatment during lockdown in their countries in public health centers and that they will continue to work during pandemic, our results suggest that pediatric dentists might be at higher risk of COVID-19 infection. Further research should focus on finding better ways to promote and adapt preventive, protective measures and PPE in the pediatric dental setting to be behaviorally acceptable. Moreover, additional efforts should be invested in dental education regarding COVID-19 in the mother tongue.
The Relationship between Physical Activity, Self-Regulation and Cognitive School Readiness in Preschool Children
Authors: Bai Pulan , Johnson Sarah , Trost Stewart G. , Lester Leanne , Nathan Andrea , Christian Hayley
Published: November 2021

(1) Background: Limited research exists on the pathways through which physical activity influences cognitive development in the early years. This study examined the direct and indirect relationships between physical activity, self-regulation, and cognitive school readiness in preschool children. (2) Method: Participants (n = 56) aged 3–5 years were recruited from the PLAYCE study, Perth, Western Australia. Physical activity was measured using 7-day accelerometry. Self-regulation was measured using the Head Toes Knees and Shoulders task and cognitive school readiness was assessed using the Bracken School Readiness Assessment. Baron and Kenny’s method was used for mediation analysis. (3) Results: After adjustment for socio-demographic factors, total physical activity was positively and significantly associated with cognitive school readiness (B = 0.16, SE = 0.07, p ≤ 0.05). Moderate-vigorous physical activity (MVPA) was positively and significantly associated with self-regulation (B = 0.3, SE = 0.13, p ≤ 0.05) and cognitive school readiness score (B = 0.20, SE = 0.09, p ≤ 0.05). Self-regulation was found to be a partial mediator of the relationship between MVPA and cognitive school readiness. (4) Conclusion: These findings highlight the direct and indirect association between preschool children’s physical activity, self-regulation, and cognitive school readiness. Further research is needed to determine the causal relationships between young children’s physical activity and cognitive development, over time.
eHealth Literacy: From Theory to Clinical Application for Digital Health Improvement. Results from the ACCESS Training Experience
Authors: Bevilacqua Roberta , Strano Stefano , Di Rosa Mirko , Giammarchi Cinzia , Cerna Katerina Katka , Mueller Claudia , Maranesi Elvira
Published: November 2021

Skills, knowledge, and awareness of digital and technological tools are essential to improve the state of well-being and health of older adults and also to mitigate the condition of social isolation in the aging process. For this reason, it is necessary to implement a social learning of electronic/digital tools for health of older people to support the achievement of eHealth and digital competences. The paper reports the results of an Italian innovative eHealth training for the European project ACCESS. The training has been based on blended didactical and interactive educational techniques, aimed at collecting as many points of view as possible from older adults. A total of 58 older adults were recruited to attend a four-week training program, which included five modules. The results showed a statistical significant difference between the eHealth Literacy Scale (eHEALS) mean value before and after the course. A significant negative correlation was found between eHEALS and positive/total Survey of Technology Use (SOTU), suggesting an inverse relationship between positive/total SOTU and eHEALS. There is a strong positive and statistically significant relationship between satisfaction with the training and eHEALS. The results indicate that the intervention increased the digital competences of participants connected to health.
Health Inequities in LGBT People and Nursing Interventions to Reduce Them: A Systematic Review
Authors: Medina-Martínez Jorge , Saus-Ortega Carlos , Sánchez-Lorente María Montserrat , Sosa-Palanca Eva María , García-Martínez Pedro , Mármol-López María Isabel
Published: November 2021

Background: Lesbian, gay, bisexual, and transgender (LGBT) people present poorer mental and physical health results compared to the heterosexual and cisgender population. There are barriers in the healthcare system that increase these health inequities. Objective: To synthesise the available evidence on how nurses can intervene in reducing health inequities in LGBT people, identifying their specific health needs and describing their experiences and perceptions of the barriers they face in the healthcare system. Methods: Systematic review. Between March and April 2021, a bibliographic search was carried out in the Cuiden, LILACS, PubMed, Dialnet, SciELO, Trip Database, and Web of Science databases and metasearch engines. Inclusion criteria: Articles published in the last 5 years that address the specific health needs of LGBT people, their experiences and perceptions, or interventions in this group in which nurses may engage. Results: A total of 16 articles were selected. Health disparities were detected in the LGBT community, which exhibited higher rates of mental health problems, substance abuse, risky sexual behaviours, self-harm, and suicide. These inequalities were related to minority stress, and each of them differently impacted individual populations within the broader LGBT community depending on their sexual orientations and gender identities. The impact of these factors was, in turn, modified by the intersections of race/ethnicity, geographic region, and socioeconomic factors. LGBT people described discriminatory experiences by health professionals, as well as their distrust and fear in this setting. Nurses can carry out interventions such as inclusive education about sex and sexual and gender diversity and bullying and suicide prevention programmes, and can provide gender-affirming and family-centred care. Conclusions: LGBT people experience health inequities and discrimination in the healthcare system. Nurses can implement diverse interventions to reduce these problems and, moreover, these health professionals are obliged to acquire cultural competence regarding LGBT health.
Traditional Communities and Mental Maps: Dialogues between Local Knowledge and Cartography from the Socioenvironmental Atlas of Lençóis Maranhenses, Brazil
Authors: Souza Filho Benedito , Pérez Machado Reinaldo Paul , Murasugi Kumiko , Vieira Souza Ulisses Denache
Published: November 2021

The Lençóis Maranhenses region, located in the state of Maranhão in northeastern Brazil, constitutes an area that includes a national park and presents extreme physical, geographic and climatic contrasts in addition to economic diversity and emerging tourism. Scattered throughout this portion of the Brazilian territory are local inhabitants whose traditional lifestyles are characterized by agricultural, extractive, fishing and animal husbandry activities. These local residents use guidance systems and mental maps developed through their long history, interaction with nature, and knowledge of the environment in which they live and work. Based on sketches prepared by residents and by Health Agents serving the communities, and with the support of cartographic-based materials produced by the team of the Socioenvironmental Atlas of Lençóis Maranhenses (ASALM, Portuguese abbreviation for Socioenvironmental Atlas of Lençóis Maranhenses), we present a set of digital and interactive cartographic materials that reproduce the movements, uses and practices of the families of these communities as well as the environmental dynamics of this vast region. Such cartography can serve as an instrument of planning, understanding and action, both to safeguard the rights of the local residents and for the handling and management of natural resources. Based on the dialogue between local knowledge and cartography, we present the methods, processes and results of our research project.
A Data-Based Bi-Objective Approach to Explore the Accessibility of Multimodal Public Transport Networks
Authors: Yu Wentao , Sun Huijun , Feng Tao , Wu Jianjun , Lv Ying , Xin Guangyu
Published: November 2021

One of the top concerns for travelers when choosing public transportation is whether they can reach their destination in limited time and monetary cost on the basis of ensured reliability. However, the existing literature shows no studies on how to evaluate bi-objective multimodal accessibility under travel time uncertainty. In order to fill this research gap, this paper creates a multimodal super network based on smart card data in which the transfers among taxi, bus, and subway modes are developed and applied. Next, we propose a two-stage opportunity accessibility model to calculate bi-objective multimodal accessibility under travel time uncertainty. Then we propose a multimodal reliability path finding model and a reliability boundary convergence algorithm to solve this problem. Finally, we conduct a large-scale real-world case study. It is found that the impedance heterogeneity between different modes is significant, and multimodal travel has better accessibility than a unimodal one. Although multimodal accessibility decreases as the reliability increases, the advantage of multimodal over unimodal accessibility increases with reliability, and it can be improved up to 14.61% by multimodal transfers. This model can effectively guide traffic management departments to improve traffic accessibility in terms of time and cost and advise commuters to choose living places.