bluuebunny/crossref_metadata_2025 huggingface dataset:
Partial Cointegrated Vector Autoregressive Models with Structural Breaks in Deterministic Terms
Authors: Kurita Takamitsu , Nielsen Bent
Published: October 2019

This paper proposes a class of partial cointegrated models allowing for structural breaks in the deterministic terms. Moving-average representations of the models are given. It is then shown that, under the assumption of martingale difference innovations, the limit distributions of partial quasi-likelihood ratio tests for cointegrating rank have a close connection to those for standard full models. This connection facilitates a response surface analysis that is required to extract critical information about moments from large-scale simulation studies. An empirical illustration of the proposed methodology is also provided.
Impact of Element Pattern on the Performance of GNSS Power-Inversion Adaptive Arrays
Authors: Liu Jinyuan , Li Lixun , Lv Zhicheng , Chen Feiqiang , Ni Shaojie
Published: October 2019

Power-inversion (PI) adaptive arrays are widely used in Global Navigation Satellite System (GNSS) receivers for interference mitigation. The effects of element patterns on the performance of PI adaptive arrays are investigated in this paper. To this end, the performance of adaptive arrays is investigated by Monte Carlo simulations, using CST Microwave Studio (Dassault Systems, Vélizy-Villacoublay, France) to calculate the radiation patterns of circular microstrip elements which are used to compute the adaptive weight and the adaptive array gain. It is shown that the performance of PI adaptive arrays is mainly dependent on the gain pattern of the reference antenna element rather than the non-reference elements because the algorithm essentially pushes the elements into an unequal position. Furthermore, the results show that the impact of mutual coupling on the performance of the antenna array can be associated with the radiation patterns of the reference element, which is helpful in selecting the optimum reference element without increasing computational complexity, especially for small GNSS arrays.
A Compact Semi-Circular and Arc-Shaped Slot Antenna for Heterogeneous RF Front-Ends
Authors: Zebiri Chemseddine , Sayad Djamel , Elfergani Issa , Iqbal Amjad , Mshwat Widad F.A. , Kosha Jamal , Rodriguez Jonathan , Abd-Alhameed Raed
Published: October 2019

In this paper, a new miniaturized compact dual-band microstrip slot antenna is presented. To achieve the dual-band characteristics, two adjunct partial arc-shaped small slots are joined to two main circular slots embedded in the ground of the antenna structure. With a reduced size of 30 × 28.5 × 0.8 mm3, the proposed antenna presents a dual-band characteristic. The design is optimized using a High Frequency Structure Simulator (HFSS) followed by experimental verifications. An impedance bandwidth, for S11 ≤ 10 dB, that covers the 1.8 GHz and 2.4 GHz bands is accomplished, which makes the proposed antenna basically suitable for hand-held devices and medical applications. More applications such as digital communication system (DCS) 1.71–1.88 GHz, personal communication services (PCS) 1.85–1.99 GHz, Universal and mobile telecommunications system UMTS 1.92–2.17 GHz, Bluetooth 2.4–2.5 GHz, and Wi-Fi 2.4–2.454 GHz, Industrial Scientific and Medical radio frequency (RF) band ISM-2.4 GHz, Wireless Local Area Network (WLAN-2.4) are possible by simply changing one of the geometrical antenna dimensions. The antenna is characterized by stable radiation patterns as well.
Investigation on Temperature Dependency of Recessed-Channel Reconfigurable Field-Effect Transistor
Authors: Kim Jang Hyun , Kim Sangwan
Published: October 2019

Current-voltage (I-V) characteristics of a recessed-channel reconfigurable field-effect transistor (RC-RFET) is discussed, herein, depending on the variation of temperature (T) to understand the operation mechanisms, in depth. Assuming that RC-RFET can be simply modeled as a channel resistance (RCH) and a Schottky contact resistance (RSC) connected in series, the validity has been examined by a technology computer-aided design (TCAD) simulation with different Schottky barrier heights (SBHs) and carrier mobilities (μ). As a result, it was clearly determined that the drain current (ID) of RC-RFET is dominated by the bigger component, since RCH and RSC have an opposite correlation with T.
Dual-Input Isolated DC-DC Converter with Ultra-High Step-Up Ability Based on Sheppard Taylor Circuit
Authors: Shen Chih-Lung , Chen Li-Zhong , Chen Hong-Yu
Published: October 2019

A dual-input high step-up isolated converter (DHSIC) is proposed in this paper, which incorporates Sheppard Taylor circuit into power stage design so as to step up voltage gain. In addition, the main circuit adopts boosting capacitors and switched capacitors, based on which the converter voltage gain can further be improved significantly. Since the proposed converter possesses an inherently ultra-high step-up feature, it is capable of processing low input voltages. The DHSIC also has the important features of leakage energy recycling, switch voltage clamping, and continuous input-current obtaining. These characteristics advantage converter efficiency and benefit the DHSIC for high power applications. The structure of the proposed converter is concise. That is, it can lower cost and simplifies control approach. The operation principle and theoretical derivation of the proposed converter are discussed thoroughly in this paper. Simulations and hardware implementation are carried out to verify the correctness of theoretical analysis and to validate feasibility of the converter as well.
Regenerative Battery Charging Control Method for PMSM Drive without a DC/DC Converter
Authors: Ko Sung-Tae , Park Soon-Sun , Lee Jung-Hyo
Published: October 2019

This paper illustrates regenerative battery charging control method of the permanent magnet synchronous motor (PMSM) drive without DC/DC converter. Conventional control methods for battery current and voltage control methods generally use a bidirectional DC/DC converter for regenerative control. The reason to use this DC/DC converter is the DC-Link current ripple of the inverter of is affected by switching of the inverter and the motor speed. This problem causes to use a low pass filter (LPF) for sensing the DC-link current, however, it occurs deteriorating the control performance. In this paper, battery current and voltage control methods using only the motor drive are illustrated. To control the DC-link current, power control is performed using the look-up table (LUT) data that are extracted from the experiment. In addition, an applicable method for the variable DC-link voltage of the proposed regenerative control method is illustrated.
Development of a Hardware Simulator for Reliable Design of Modular Multilevel Converters Based on Junction-Temperature of IGBT Modules
Authors: Jo Seung-Rae , Kim Seok-Min , Cho Sungjoon , Lee Kyo-Beum
Published: October 2019

This paper presents the development of a hardware simulator based on the junction-temperature of insulated-gate bipolar transistor (IGBT) modules in modular multilevel converters (MMCs). The MMC consists of various power-electronics components, and the IGBT is the main factor determining the lifetime of the MMC. The failure of IGBTs is mostly due to the junction-temperature swing; thus, the thermal profile of the IGBT should be established to predict the lifetime. The thermal behavior depends on the current flowing to the IGBT, and the load-current profile is related to the application. To establish the thermal profile of the IGBT, the proposed hardware simulator generates various shapes of output currents while the junction temperature is measured. Additionally, a controller design is presented for simulation of the arm current, which includes a direct current component as well as an alternative current component with a fundamental frequency. The validity and performance of the proposed hardware simulator and its control methods are analyzed according to various experimental results.
An Electric Taxi Charging Station Planning Scheme Based on an Improved Destination Choice Method
Authors: Shi Ruifeng , Liu Jiahua , Liao Zhenhong , Niu Li , Ibrahim Eke , Fu Fang
Published: October 2019

The environmental crisis has prompted the development of electric vehicles as a green and environmentally friendly mode of travel. Since a reasonable layout of electric vehicle (EV) charging stations is the prerequisite for developing the EV industry, obtaining an optimal and efficient EV charging station planning scheme is a key issue. Although the Chinese government has carried out a plan to build EV charging piles in residential and working places, it cannot properly fulfill the task of matching the charging needs for public transportation vehicles such as electric taxis (ETs). How to evaluate the performance of fast charging stations (FCSs) and how to help find the optimal ET charging station planning scheme are new challenges. In this paper, an improved destination selection model is proposed to simulate the ET operation system and to help find the optimal ET charging station size with statistical analysis based on the charging need prediction. A numerical case study shows that the proposed method can address ET charging behavior well and can help to statistically determine the size of each ET charging station, which should satisfy the constraints on the preset proportion of the ET charging service requests.
Chemical and Mineralogical Composition of Soot and Ash from the Combustion of Peat Briquettes in Household Boilers
Authors: Růžičková Jana , Kucbel Marek , Raclavská Helena , Švédová Barbora , Raclavský Konstantin , Šafář Michal , Kantor Pavel
Published: October 2019

Soot and ash as residues from the combustion of peat briquettes were analysed by chemical and mineralogical methods. The study aimed to characterize combustion in domestic boilers of two different emission classes. Ten samples of soot deposited in exhausting ways of boilers were obtained (five of each emission class). The analyses of organic substances in soot were performed using a combination of the methods for the determination of elemental and organic forms of carbon with analytical pyrolysis. Pyrolysis gas chromatography with mass spectrometric detection (Py-GC/MS) allowed the identification of organic compounds belonging to twenty different groups. The major and minor elements in peat briquettes, char and soot, were determined by X-ray fluorescence spectroscopy. The identification of grains and the chemical character of soot was performed using a scanning electron microscope with energy dispersive X-ray spectrometry. The mineral phases in ash were determined by X-ray diffraction. The behaviour of the inorganic elements in combustion products (ash and soot) was studied by means of an enrichment factor. The analytical results are used for characterizing the technological conditions of combustion. The soot deposits from the more advanced boilers with increased combustion temperature contain more organic compounds which indicate the highly carbonized cellulose (benzofurans and dibenzofurans). The increased combustion temperature is indicated by increased concentrations of heterocyclic and aliphatic nitrogen compounds, while the total concentrations of nitrogen in soot from boilers of both types are comparable.
Towards the Development of Syngas/Biomethane Electrolytic Production, Using Liquefied Biomass and Heterogeneous Catalyst
Authors: Gonçalves Ana , Puna Jaime Filipe , Guerra Luís , Campos Rodrigues José , Gomes João Fernando , Santos Maria Teresa , Alves Diogo
Published: October 2019

This paper presents results on the research currently being carried out with the objective of developing new electrochemistry-based processes to produce renewable synthetic fuels from liquefied biomass. In the current research line, the gas mixtures obtained from the typical electrolysis are not separated into their components but rather are introduced into a reactor together with liquefied biomass, at atmospheric pressure and different temperatures, under acidified zeolite Y catalyst, to obtain synthesis gas. This gaseous mixture has several applications, like the production of synthetic 2nd generation biofuel (e. g., biomethane, biomethanol, bio-dimethyl ether, formic acid, etc.). The behaviour of operational parameters such as biomass content, temperature and the use of different amounts of acidified zeolite HY catalyst were investigated. In the performed tests, it was found that, in addition to the synthesis gas (hydrogen, oxygen, carbon monoxide and carbon dioxide), methane was also obtained. Therefore, this research is quite promising, and the most favourable results were obtained by carrying out the biomass test at 300 °C, together with 4% of acidified zeolite Y catalyst, which gives a methane volumetric concentration equal to 35%.
GIS-Based Urban Afforestation Spatial Patterns and a Strategy for PM2.5 Removal
Authors: Zhou Yejing , Liu Helin , Zhou Jingxuan , Xia Meng
Published: October 2019

Within the scope of ecological development planning in China, afforestation is highly valued. However, the scientific planning of afforestation still has inadequacies. There are few studies on the spatial distribution of urban forests targeted at air quality improvement. Here, we implemented a virtual experiment to evaluate whether different tree planting distribution plans with the same afforestation scale would have a significant effect on fine particulate matter (PM2.5) removal. As a case study of Wuhan, this paper identified the statistical regularity between PM2.5 concentration and adsorption of representative trees through field sampling and measurement, simulated the influence of different afforestation plans on PM2.5 concentration based on Geographic Information System (GIS), judged the significance of the difference of the plans, and proposed a greening distribution strategy. The results show that different forest layouts had no significant impact on PM2.5 in the administrative region, and the concentration reduction rate was only 1%–2%. Targeted planting of trees in heavily polluted areas in the city center would have achieved better air quality improvement, with a reduction rate of 3%–5%. In Wuhan construction areas, trees should be planted to increase the forest coverage rate to 30%. The edge of the urban metropolitan development zone needs to be strengthened with trees to form a forest belt 10 km–20 km wide, with a forest coverage rate of at least 60%. In general, the capability of trees to reduce PM2.5 concentration is weak. The fundamental way to improve air quality is to reduce emissions; planting trees is only an auxiliary measure. More ecological forest functions should be considered in city-wide afforestation distribution.
Social Innovation as a Prospect for the Forest Bioeconomy: Selected Examples from Europe
Authors: Ludvig Alice , Zivojinovic Ivana , Hujala Teppo
Published: October 2019

Very recently, social innovation has become a subject of investigation in forest research. Earlier on, social innovation turned into a term used in EU policy strategies for addressing social issues and the self-empowerment of local people, as well as for tackling economic, social, or environmental challenges. The question of how the forest bioeconomy might profit from social innovation remains. The article examined the forest bioeconomy from the perspective of social innovation features: How is social innovation reflected in the forest bioeconomy? The forest sector is identified as one principal supplier sectors in the updated European Bioeconomy Strategy. In the strategies’ general objectives of job creation and employment through the green economy, we detected some links to social innovation. In contrast, the EU Social Innovation Initiative includes social aspects via addressing collective action, integration of vulnerable social groups, and rural and urban economic development, without mentioning explicitly the forest sector. In order to make use of both EU policy documents, it is necessary to enquire on the overlaps. This research focused on the communalities in their policy goals as a reference framework for systematically identifying specific forest bioeconomy activities fitting into both realms. With example of these activities, we showed how the forest bioeconomy plays a unique role in addressing hitherto unmet needs with the development of new types of services. There is rich potential in the forest bioeconomy for private forest owners and producers with activities that range from social biomass plants to collectively organized charcoal (biochar) production in remote rural areas. Most of these are service innovations, while some combine services with product innovations. Our findings challenge positions that regard economic and social issues as strictly separated. As a result, they are identified as two combined complementary sources of income for Europe’s forest owners.
How Can Intra-Industry Trade of Forest Products be Promoted? An Empirical Analysis from China
Authors: Wang Feng-ting , Liu Si-tong , Cheng Bao-dong , Jiang Qin-er , Tian Yuan , Xiong Li-chun
Published: October 2019

Understanding the evolution of the intra-industry trade of forest products between China and its main partner countries is a prerequisite for improving the flow of trade. The intra-industry trade status and the main influencing factors of Chinese forest products trade were measured and identified via use of bilateral forest product trade data between China and its 24 partners from 2000 to 2014, and use of static, marginal, and structural intra-industry trade indices. The results show that, firstly, intra-industry trade of the major Chinese forest products is exhibiting a low-level growth trend and has considerable growth potential. The top five countries with relatively high intra-industry trade levels are Italy, Germany, the United States, Vietnam, and Japan, and the bottom five are New Zealand, Chile, Brazil, Russia, and Spain. Secondly, the intra-industry trade among China and 13 countries, represented by South Korea, is low quality and vertical-type trade; the intra-industry trade among China and seven countries, represented by Thailand, is high quality and a vertical type of trade. Finally, the empirical analysis shows that trade openness and geographical distance are the key factors of intra-industry trade of forest products. The per capita gross domestic product gap, urbanization, foreign direct investment, forest area, and import and export value of forest products also have certain impacts on intra-industry trade.
Tailoring Acoustic Performances of Resin Reinforced Biomass Fiber-Based Panel with Single and Multiple Tailed Cavity Inclusions for Interior Work
Authors: Setyowati Erni , Hardiman Gagoek , Purwanto Purwanto
Published: October 2019

The aim of this research is to observe the acoustic performance of absorber-based biomass fiber-reinforced polyester resins that were experimentally associated with the design of tailed cavity resonator inclusion, i.e., the cavities are partly in the form of a narrow slit. The model of electro-acoustic resonators and several treatments were developed and became the bases for understanding the changes of acoustic reactance in the new structure. Variations in the inclusion cavity and the addition of a narrow slit were tested experimentally using an impedance tube technique based on ASTM E1050-98 and ASTM E2611-09. The improvements of acoustic performance were conducted by single and multiple cavity tailed inclusions with the addition of a Dacron fibrous layer and back cavity. The experimental results showed that a sample of 15 mm single tailed cavity kenaf fiber had higher sound absorption and wider broadband frequencies than did the hemp fiber, with a peak on 0.31–0.32 between 1.00–2.00 kHz. Meanwhile on multiple tailed cavities, the 30 mm hemp fiber had higher and wider broadband frequencies than did the kenaf, with peaks on 0.45–0.63 at frequencies between 1.75–2.10 kHz. It can be concluded that the tailed cavity inclusions could improve performance. Compared to the coco-husk with resonators in previous studies, the tailed cavity was a little bit lower, but the tailed cavities hemps and kenafs samples showed good sound absorption performance with lower band frequencies capabilities.
The Use of Candida pyralidae and Pichia kluyveri to Control Spoilage Microorganisms of Raw Fruits Used for Beverage Production
Authors: Mewa-Ngongang Maxwell , du Plessis Heinrich W. , Ntwampe Seteno Karabo Obed , Chidi Boredi Silas , Hutchinson Ucrecia Faith , Mekuto Lukhanyo , Jolly Neil Paul
Published: October 2019

Undesired fermentation of fruit-derived beverages by fungal, yeast and bacterial spoilage organisms are among the major contributors of product losses in the food industry. As an alternative to chemical preservatives, the use of Candida pyralidae and Pichia kluyveri was assessed for antimicrobial activity against several yeasts (Dekkera bruxellensis, Dekkera anomala, Zygosaccharomyces bailii) and fungi (Botrytis cinerea, Colletotrichum acutatum and Rhizopus stolonifer) associated with spoilage of fruit and fruit-derived beverages. The antagonistic properties of C. pyralidae and P. kluyveri were evaluated on cheap solidified medium (grape pomace extract) as well as on fruits (grapes and apples). Volatile organic compounds (VOCs) from C. pyralidae and P. kluyveri deemed to have antimicrobial activity were identified by gas chromatography-mass spectrometry (GC-MS). A cell suspension of C. pyralidae and P. kluyveri showed growth inhibition activity against all spoilage microorganisms studied. Direct contact and extracellular VOCs were two of the mechanisms of inhibition. Twenty-five VOCs belonging to the categories of alcohols, organic acids and esters were identified as potential sources for the biocontrol activity observed in this study. This study reports, for the first time, the ability of C. pyralidae to inhibit fungal growth and also for P. kluyveri to show growth inhibition activity against spoilage organisms (n = 6) in a single study.
Extra Virgin Olive Oil Quality as Affected by Yeast Species Occurring in the Extraction Process
Authors: Guerrini Simona , Mari Eleonora , Barbato Damiano , Granchi Lisa
Published: October 2019

In extra virgin olive oil (EVOO) extraction process, the occurrence of yeasts that could affect the quality of olive oil was demonstrated. Therefore, in this work, at first, the yeasts occurring during different extractive processes carried out in a Tuscany oil mill, at the beginning, in the middle, and the end of the harvesting in the same crop season, were quantified. Then, possible effects on quality of EVOO caused by the predominant yeast species, possessing specific enzymatic activities, were evaluated. Yeast concentrations were higher in extraction processes at the end of the harvesting. Twelve yeast species showing different isolation frequencies during olive oil extractive process and according to the harvesting date were identified by molecular methods. The yeast species dominating olive oil samples from decanter displayed enzymatic activities, potentially affecting EVOO quality according to zymogram analysis. HS-SPME-GC-MS analysis of the volatile compounds in commercial EVOO, inoculated with three yeast species (Nakazawaea molendini-olei, Nakazawaea wickerhamii, Yamadazyma terventina), pointed out significant differences depending on the strain inoculated. In conclusion, during the olive oil extractive processes, some yeast species colonize the extraction plant and may influence the chemical and sensory characteristics of EVOO depending on the cell concentrations and their enzymatic capabilities.
SWEET Transporters for the Nourishment of Embryonic Tissues during Maize Germination
Authors: López-Coria Montserrat , Sánchez-Sánchez Tomás , Martínez-Marcelo Víctor Hugo , Aguilera-Alvarado G. Paulina , Flores-Barrera Mireya , King-Díaz Beatriz , Sánchez-Nieto Sobeida
Published: October 2019

In maize seed germination, the endosperm and the scutellum nourish the embryo axis. Here, we examined the mRNA relative amount of the SWEET protein family, which could be involved in sugar transport during germination since high [14-C]-glucose and mainly [14-C]-sucrose diffusional uptake were found in embryo tissues. We identified high levels of transcripts for SWEETs in the three phases of the germination process: ZmSWEET4c, ZmSWEET6b, ZmSWEET11, ZmSWEET13a, ZmSWEET13b, ZmSWEET14b and ZmSWEET15a, except at 0 h of imbibition where the abundance of each ZmSWEET was low. Despite the major sucrose (Suc) biosynthesis capacity of the scutellum and the high level of transcripts of the Suc symporter SUT1, Suc was not found to be accumulated; furthermore, in the embryo axis, Suc did not decrease but hexoses increased, suggesting an efficient Suc efflux from the scutellum to nourish the embryo axis. The influx of Glc into the scutellum could be mediated by SWEET4c to take up the large amount of transported sugars due to the late hydrolysis of starch. In addition, sugars regulated the mRNA amount of SWEETs at the embryo axis. These results suggest an important role for SWEETs in transporting Suc and hexoses between the scutellum and the embryo axis, and differences in SWEET transcripts between both tissues might occur because of the different sugar requirements and metabolism.
Geochemical Signatures of Paleoclimate Changes in the Sediment Cores from the Gloria and Snorri Drifts (Northwest Atlantic) over the Holocene-Mid Pleistocene
Authors: Demina Liudmila L. , Novichkova Ekaterina A. , Lisitzin Alexander P. , Kozina Nina V.
Published: October 2019

A multiproxy study of the sediment cores taken from the Snorri Drift, formed under the influence of the Iceland–Scotland bottom contour current, and from the Gloria Drift, located southward Greenland at the boundary of Irminger and Labrador Seas, was performed. This area undergoes a variable mixing of polar waters with the warm North Atlantic current, whose intensity and direction seemed to change dramatically with the alteration of warming and cooling periods during the six marine isotope stages MIS 1-6. The relative age of this core does not exceed 190,000 cal yr BP; the average sedimentation rate was 1.94 and 2.45 cm/kyr in the Gloria and Snorri Drifts core respectively. In both the cores, the sediment records showed the downcore co-variation of ice-rafted debris (IRD); and terrigenous elements, such as Si, Al, Ti, Cr, and Zr, were revealed; their values were clearly higher in the glacial periods (MIS 2, 4, and 6) compared to interglacials (MIS 1, 3, and 5). The downcore rhythmic distributions of these elements, as well as Al/Si, Ti/Al, Fe/Al ratios exhibit an opposite trend with that of δ18O values, biogenic components (CaCO3, BioSiO2), and Si/Fe and Mn/Fe ratios.
Contamination by Antibiotic-Resistant Bacteria in Selected Environments in Thailand
Authors: Thamlikitkul Visanu , Tiengrim Surapee , Thamthaweechok Narisara , Buranapakdee Preeyanuch , Chiemchaisri Wilai
Published: October 2019

This study determined the presence of important antibiotic-resistant bacteria in selected environments in Thailand, including wastewater samples from 60 hospitals; washed fluid, leachate, flies, cockroaches, and rats collected from five open markets; washed fluid from garbage trucks; and stabilized leachate from a landfill facility. At least one type of antibiotic-resistant bacteria was isolated from all samples of influent fluid before treatment in hospitals, from wastewater treatment tank content in hospitals, and from 15% of effluent fluid samples after treatment with chlorine prior to draining it into a public water source. Antibiotic-resistant bacteria were recovered from 80% of washed market fluid samples, 60% of market leachate samples, all fly samples, 80% of cockroach samples, and all samples of intestinal content of rats collected from the open markets. Antibiotic-resistant bacteria were recovered from all samples from the landfill. Extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli and/or Klebsiella pneumoniae were the most common antibiotic-resistant bacteria recovered from all types of samples, followed by carbapenem-resistant E. coli and/or K. pneumoniae. Colistin-resistant Enterobacteriaceae, carbapenem-resistant Psuedomonas aeruginosa, carbapenem-resistant Acinetobacter baumannii, colistin-resistant Enterobacteriaceae, vancomycin-resistant Enterococci, and methicillin-resistant S. aureus were less common. These findings suggest extensive contamination by antibiotic-resistant bacteria in hospital and community environment in Thailand.
Patient Input in Regional Healthcare Planning—A Meaningful Contribution
Authors: Sturm Heidrun , Colombo Miriam , Hebeiss Teresa , Joos Stefanie , Koch Roland
Published: October 2019

Background: There are well-known methodological and analytical challenges in planning regional healthcare services (HCS). Increasingly, the need for data-derived planning, including user-perspectives, is discussed. This study aims to better understand the possible contribution of citizen experience in the assessment of regional HCS needs in two regions of Germany. Methods: We conducted a written survey in two regions of differing size—a community (3653 inhabitants) and a county (165,211 inhabitants). Multinomial logistic regression was used to assess the impact of sociodemographic and regional factors on the assessment of HCS provided by general practitioners (GPs) and specialists. Results: Except for age and financial resources available for one’s own health, populations did not differ significantly between the regions. However, citizens’ perception of HCS (measured by satisfaction with 1 = very good to 5 = very poor) differed clearly between different services (e.g., specialists: 3.8–4.3 and pharmacies: 1.7–2.5) as well as between regions (GPs: 1.7–3.1; therapists: 2.9–4). In the multivariate model, region (next to income and age) was a consistent predictor of the perception of GP- and specialist-provided care. Discussion: Citizens’ perceptions of HCS correspond to regional provider density (the greater the density, the better the perception) and add insights into citizens’ needs. Therefore, they can provide valuable information on regional HCS strengths and weaknesses and are a valid resource to support decision makers in shaping regional care structures.
Why Do Patients Move from Online Health Platforms to Hospitals? The Perspectives of Fairness Theory and Brand Extension Theory
Authors: Le Wei , Chang Po-Ya , Chang Yu-Wei , Chen Jiahe
Published: October 2019

Online healthcare services are growing rapidly. Patients can receive health support through communication with online health professionals. However, previous research on eHealth has focused on patients’ online behavioral intentions. The purpose of this study is to investigate the effect of online patient–doctor communication on offline behavioral intentions and to propose a conceptual model for eHealth. We integrate fairness theory and band extension theory to develop a research model. This is further tested by structural equation modeling (SEM), with 279 valid sets of data from patients on the online health platform. Using partial least squares analysis (PLS), the results show that perceived fairness is an important factor affecting online satisfaction and the willingness to ask online doctors, which in turn has a positive impact on the willingness to go to offline doctors. These findings shed light on the research model for eHealth and offer suggestions for improving patients’ online satisfaction, as well as both online and offline behavioral intentions.
Co-producing Progression Criteria for Feasibility Studies: A Partnership between Patient Contributors, Clinicians and Researchers
Authors: Young Hannah , Goodliffe Samantha , Madhani Meeta , Phelps Kay , Regen Emma , Locke Anthony , Burton James , Singh Sally , Smith Alice , Conroy Simon
Published: October 2019

There is a lack of guidance for developing progression criteria (PC) within feasibility studies. We describe a process for co-producing PC for an ongoing feasibility study. Patient contributors, clinicians and researchers participated in discussions facilitated using the modified Nominal Group Technique (NGT). Stage one involved individual discussion groups used to develop and rank PC for aspects of the trial key to feasibility. A second stage involving representatives from each of the individual groups then discussed and ranked these PC. The highest ranking PC became the criteria used. At each stage all members were provided with a brief education session to aid understanding and decision-making. Fifty members (15 (29%) patients, 13 (25%) researchers and 24 (46%) clinicians) were involved in eight initial groups, and eight (two (25%) patients, five (62%) clinicians, one (13%) researcher) in one final group. PC relating to eligibility, recruitment, intervention and outcome acceptability and loss to follow-up were co-produced. Groups highlighted numerous means of adapting intervention and trial procedures should ‘change’ criteria be met. Modified NGT enabled the equal inclusion of patients, clinician and researcher in the co-production of PC. The structure and processes provided a transparent mechanism for setting PC that could be replicated in other feasibility studies.
Spatial-Temporal Coupling Analysis of the Coordination between Urbanization and Water Ecosystem in the Yangtze River Economic Belt
Authors: Han Han , Li Huimin , Zhang Kaize
Published: October 2019

As a primary pioneering region in China’s ongoing urbanization process, the Yangtze River Economic Belt’s (YREB’s) urbanization process is itself continually accelerating, causing increasing pressure on the area’s water ecosystem. It is necessary to examine the coordination relationship between the urbanization system and the water ecosystem in the YREB for realizing sustainable urban development. To this purpose, we use two comprehensive index systems, along with an improved coupling coordination degree (CCD) model. This method is used to analyze the coordination between urbanization and the water ecosystem across spatial gradients and temporal scales in the YREB, from 2008 to 2017. The factors acting as obstacles were diagnosed by utilizing the obstacle degree model. The results show that: (1) the coordination state of each region gradually improved during the 2008–2017 period. In terms of spatial distribution, the coordination state between two systems gradually increased from east to west. Moreover, the spatial differences across the 11 analyzed regions gradually narrowed with the passage of time. (2) The coordination between the two systems, from 2008 to 2017, evolved from a state of serious imbalance to a state of good coordination. The two systems passed from an initial period of imbalance or antagonism, coupled with rapid growth (2008–2011), through a period of basic coordination with steady growth (2011–2014), and finally toward a period of good coordination with slow growth (2014–2017). (3) Spatial urbanization and pressures on subsystems are the key factors acting as obstacles in the urbanization system and water ecosystem, respectively. Facing the process of rapid urbanization in China, the coupling analysis of the coordination between urbanization and the water ecosystem can help the government to formulate a reasonable new-type urban development strategy. This strategy will play an important role in China’s sustainable urban development and water environmental protection. The findings of this study provide important support for urban planning in the future.
Clinical Physicians’ Attitudes towards Evidence-Based Medicine (EBM) and Their Evidence-Based Practice (EBP) in Wuhan, China
Authors: Hong Jianan , Chen Jing
Published: October 2019

Objective: Numerous studies have proved the importance of Evidence-Based Medicine (EBM) in daily clinical practice, however, clinicians’ attitudes play an important role in determining its implementation. The objective of this study was to investigate Chinese clinical physicians’ perception of and attitude towards EBM and their Evidence-Based Practice (EBP) as well as the barriers towards EBP. Methods: Using a cross-sectional design, self-response questionnaires were distributed to clinical physicians (internal medicine and surgery departments) across three tertiary hospitals in Wuhan, China. Results: In total, 131 out of 195 (67.2%) physicians completed and returned the questionnaire. A total of 64.9% of the physicians either knew moderately or a lot about EBM. The mean score of physicians’ attitude toward EBM was 2.35 ± 0.35, and that of their EBP skill/ competency was 1.51 ± 0.56 (on 0–3 Likert scale). In total, 76.0% of physicians often or sometimes applied EBM in routine daily practice. The largest barrier preventing implementation was the varying individual differences in diseases (61.0%), followed by a lack of investment from the hospital/department (39.8%), and a lack of patient cooperation (37.4%). Chinese physicians in tertiary hospitals possessed expressed positive attitudes towards EBM; however, they only retained a moderate level of clinical evidence competency. Both an individual factor (personal interest) and organizational factors (workload, hospital requirement) had an effect on physicians’ attitudes and their EBP skills. Management and organizational efforts, in addition to time dedicated for EBP projects could help reduce barriers that prevent EBP.
Short-Term Effects of Ambient Air Pollution on ST-Elevation Myocardial Infarction Events: Are There Potentially Susceptible Groups?
Authors: Pan Hsiu-Yung , Cheung Shun-Man , Chen Fu-Cheng , Wu Kuan-Han , Cheng Shih-Yu , Chuang Po-Chun , Cheng Fu-Jen
Published: October 2019

Background: Air pollution exposure is associated with greater risk for cardiovascular events. This study aims to examine the effects of increased exposure to short-term air pollutants on ST-segment elevation myocardial infarction (STEMI) and determine the susceptible groups. Methods: Data on particulate matter PM2.5 and PM10 and other air pollutants, measured at each of the 11 air-quality monitoring stations in Kaohsiung City, were collected between 2011 and 2016. The medical records of non-trauma adult (>17 years) patients who had visited the emergency department (ED) with a typical electrocardiogram change of STEMI were extracted. A time-stratified and case-crossover study design was used to examine the relationship between air pollutants and daily ED visits for STEMI. Results: An interquartile range increment in PM2.5 on lag 0 was associated with an increment of 25.5% (95% confidence interval, 2.6%–53.4%) in the risk of STEMI ED visits. Men and persons with ≥3 risk factors (male sex, age, hypertension, diabetes, current smoker, dyslipidemia, history of myocardial infarction, and high body mass index) for myocardial infarction (MI) were more sensitive to the hazardous effects of PM2.5 (interaction: p = 0.039 and p = 0.018, respectively). The associations between PM10, NO2, and O3 and STEMI did not achieve statistical significance. Conclusion: PM2.5 may play an important role in STEMI events on the day of exposure in Kaohsiung. Men and persons with ≥3 risk factors of MI are more susceptible to the adverse effects of PM2.5 on STEMI.
Genetic Characterization of Antimicrobial-Resistant Escherichia coli Isolated from a Mixed-Use Watershed in Northeast Georgia, USA
Authors: Cho Sohyun , Nguyen Hoang Anh Thi , McDonald Jacob M. , Woodley Tiffanie A. , Hiott Lari M. , Barrett John B. , Jackson Charlene R. , Frye Jonathan G.
Published: October 2019

In order to determine the role of surface water in the development and spread of antibiotic-resistant (AR) bacteria, water samples were collected quarterly from 2015 to 2016 from a mixed-use watershed in Georgia. In our previous study, 496 Escherichia coli were isolated from surface water, out of which, 34 isolates were resistant to antimicrobials. For the current study, these 34 AR E. coli were characterized using pulsed-field gel electrophoresis, AR gene detection, plasmid replicon typing, class I integron detection, and multi-locus sequence typing. Genes were identified as conferring resistance to azithromycin (mph(A)); β-lactams (blaCMY, blaCTX, blaTEM); chloramphenicol (floR); streptomycin (strA, strB); sulfisoxazole (sul1, sul2); tetracycline (tetA, tetB, tetC); and trimethoprim/sulfamethoxazole (dhfr5, dhfr12). Five ciprofloxacin- and/or nalidixic-resistant isolates contained point mutations in gyrA and/or parC. Most of the isolates (n = 28) carried plasmids and three were positive for class I integrons. Twenty-nine sequence types (ST) were detected, including three epidemic urinary-tract-infection-associated ST131 isolates. One of the ST131 E. coli isolates exhibited an extended-spectrum β-lactamase (ESBL) phenotype and carried blaCTX-M-15 and blaTEM-1. To our knowledge, this is the first study on the emergence of an ESBL-producing E. coli ST131 from environmental water in the USA, which poses a potential risk to human health through the recreational, agricultural, or municipal use of this natural resource. This study identified E. coli with AR mechanisms to commonly used antimicrobials and carrying mobile genetic elements, which could transfer AR genes to other bacteria in the aquatic environment.
Predictor Factors of Perceived Health in Family Caregivers of People Diagnosed with Mild or Moderate Alzheimer’s Disease
Authors: Ruiz-Fernández María Dolores , Hernández-Padilla José Manuel , Ortiz-Amo Rocío , Fernández-Sola Cayetano , Fernández-Medina Isabel María , Granero-Molina José
Published: October 2019

Caring for a person diagnosed with Alzheimer’s disease has a negative impact on family caregivers’ psychological health. This study examined the factors related to ‘perceived health’ and ‘presence of new-onset mental health problems’ in family caregivers of people diagnosed with mild and moderate Alzheimer’s disease. A cross-sectional observational study carried out in Almeria’s Healthcare District (Spain). A total of 255 family caregivers (42.4% cared for people with mild Alzheimer’s disease and 57.6% cared for people with moderate Alzheimer’s disease) participated in the study from January to December 2015. Mainly, caregivers were women (81.5% in the mild Alzheimer’s disease group and 88.4% in the moderate Alzheimer’s disease group), and their average age was 56.54 years (standard deviation (SD) = 13.13) and 54.47 years (SD = 11.71), respectively. Around 47% of the caregivers had been caring for the person with Alzheimer’s between two and five years. The Goldberg General Health Questionnaire was used to measure perceived health and the presence of new-onset mental health problems. An exploratory descriptive analysis and a multivariate logistic regression analysis were conducted. For caregivers of people with mild Alzheimer’s disease, ‘perceived health’ was related to ‘perceived social support’ (r = −0.21; p = 0.028), ‘person’s level of dependency’ (r = −0.24, p = 0.05), ‘severity of the person’s neuropsychiatric symptoms’ (r = 0.22; p = 0.05), and ‘caregiver’s emotional distress in response to the person’s neuropsychiatric symptoms’ (r = 0.22; p = 0.05). For caregivers of people with moderate Alzheimer’s disease, ‘perceived health’ was related to ‘perceived social support’ (r = −0.31; p ˂ 0.01), ‘presence of neuropsychiatric symptoms’ (r = 0.27, p = 0.01), ‘severity of the person’s neuropsychiatric symptoms’ (r = 0.32, p = 0.01) and ‘caregiver’s emotional distress in response to the person’s neuropsychiatric symptoms’ (r = 0.029; p = 0.01). The presence of new-onset mental health problems was detected in 46.3% (n = 50) of caregivers of people with mild Alzheimer’s and 61.9% (n = 91) of caregivers of people with moderate Alzheimer’s. When people are diagnosed with mild Alzheimer’s disease, intervention programs for caregivers should aim to regulate emotions and promote positive coping strategies. When people are diagnosed with moderate Alzheimer’s disease, intervention programs for caregivers must allow them to adapt to caregiving demands that arise with the progression of Alzheimer’s disease.
Aging and Oral Care: An Observational Study of Characteristics and Prevalence of Oral Diseases in an Italian Cohort
Authors: Lauritano Dorina , Moreo Giulia , Carinci Francesco , Borgia Raffaele , Lucchese Alberta , Contaldo Maria , Della Vella Fedora , Bernardelli Patrizia , Moreo Guido , Petruzzi Massimo
Published: October 2019

Background: Poor oral health is a common condition in patients suffering from dementia. Several aspects of this systemic pathology contribute to causing oral problems: cognitive impairment, behavior disorders, communication and, motor skills deterioration, low levels of cooperation and medical-nursing staff incompetency in the dental field. Objectives: The objectives of this study were to evaluate the prevalence and the characteristics of oral pathology in a demented elderly population, as well as to check the association between the different degree of dementia and the oral health condition of each patient. Materials and Methods: In this observational study (with cross-sectional design) two groups of elderly patients suffering from dementia, living in two different residential care institutions were recruited. The diagnosis of dementia of each included patient was performed using the Clinical Dementia Rating Scale. In order to evaluate the oral health condition of the included subjects, each patient underwent a physical examination of the oral cavity, during which different clinical parameters were analyzed (number of remaining teeth, oral mucosa, periodontal tissues, bone crests). To each parameter, a score was assigned. Spearman’s Rho test was used. Results: Regarding the prevalence of oral pathology in elderly suffering from dementia, it emerged that 20.58% of the included patients had mucosal lesions and/or new mucosal formations (in most cases undiagnosed and therefore untreated). The prevalence of periodontal disease was equal to 82.35% and a marked clinically detectable reabsorption of bone crests was found in almost all patients (88.23%). 24.13% of patients, who underwent the oral examination, had totally edentulous maxillae and/or with retained roots, without prosthetic rehabilitations. The correlation index r showed the presence of a linear correlation (inverse relationship) between the degree of dementia and the state of health of the oral cavity of each patient. Conclusions: Several factors contribute to poor oral health in the elderly suffering from dementia: cognitive functions deterioration, behavioral disorders and inadequate medical-staff nursing training on oral hygiene. This study also demonstrated that the lower the dementia degree is, the lower tends to be the oral health status. In order to guarantee a complete assistance to these patients, residential care institutions should include in their healthcare program specific dental protocols.