bluuebunny/crossref_metadata_2025 huggingface dataset:
Are Rural Primary Care Providers Able to Competently Manage Common Illnesses? A Cross-Sectional Study in Rural Sichuan, Western China
Authors: Fang Yian , Jiang Shaohua , Jiang Pei , Zhou Huan , Yang Min
Published: September 2022

Background: Strengthening primary care is a key focus of the latest healthcare reforms in China. However, many challenges, including the workforce competence, still exist. This study aimed to evaluate the common disease management competency of rural primary care providers in Sichuan Province, western China. Methods: A cross-sectional study was conducted in 9 township health centers and 86 village clinics in 3 counties. Diarrhea and respiratory infection were selected as the evaluation cases. General partitioners were assessed through their abilities to (1) take history; (2) make diagnoses; (3) propose treatment; and (4) deal with clinical cases. Results: In total, 362 healthcare workers were surveyed, and 130 general practitioners were enrolled into our study. On average, rural primary care providers could only answer 46.4% of questions absolutely correctly, with 29.7% partly correctly and 23.8% incorrectly. Conclusion: We suggest strengthening training to improve rural primary care providers’ competencies, especially their capacities of history taking. Policy action is also needed to address regional disparities.
Identification of Reliable Reference Genes for the Expression of Hydrangea macrophylla ‘Bailmer’ and ‘Duro’ Sepal Color
Authors: Zhang Gaitian , Yuan Suxia , Qi Hui , Chu Zhiyun , Liu Chun
Published: September 2022

Hydrangea spp. is renowned for its variety of color changes in its developmental stage and before and after aluminum treatment. We analyzed gene expression in hydrangeas sepals to study the causes of color change. The accuracy of quantitative RT-qPCR analysis depends on the reliability of reference genes. We selected reference genes for hydrangea of varying cultivars, at different developmental stages, and in aluminum treatment groups. We chose ‘Bailmer’ and ‘Duro’ as subject species. We selected eight candidate genes, all of which were ranked by geNorm, NormFinder, BestKeeper, and RefFinder. CCR, NHX1, and LODX were used to verify the exactitude of reference genes. According to the ranking result of RefFinder, the top-ranked reference genes in each group were different; the top four candidate reference genes in each group mostly included EF1-β, RPL34, GADPH, and RPL10. EF1-β and RPL34 ranked top in the ‘all materials’ group, and their expression trends, obtained from the analysis of CCR, NHX1, and LODX, were consistent. From the results, we gather that EF1-β and RPL34 can be used as reference genes to quantify target gene expression. In this study, we screened for reference genes in hydrangeas to provide a technical basis for hydrangea sepal formation and transformation for further experiments.
Seed Dormancy and Germination Characteristics of Vaccinium oldhamii Miq. (Ericaceae)
Authors: Lee Da Hyun , Park Chung Youl , Jung Young Ho , Kim Jun Hyeok , Park Sung Hyuk , Son Ho Jun , Na Chae Sun , Park Wan Geun
Published: September 2022

Vaccinium oldhamii Miq. is an edible berry; however, little is known about its seed dormancy-break and germination. Therefore, the aim of this study was to elucidate the seed-dormancy break and germination characteristics of V. oldhamii. The results showed that the length and width of the seeds of V. oldhamii were 2.4588 ± 0.0273 mm and 1.7028 ± 0.0248 mm, respectively, the filled percentage was 49.0 ± 3.0%, and the 1000-seed weight was 0.9453 g. Additionally, water imbibition test showed that the seed weight of V. oldhamii increased by more than 70% after 24 h, indicating the absence of physical dormancy. Embryo length measured at dispersal and just before germination did not differ significantly. There was no significant difference in E:S (Embryo:Seed) ratio in length at the time of seed dispersal (0.6780 ± 0.0258) and before germination (0.7370 ± 0.0469), indicating the absence of morphological dominance. Temperature treatments showed that the germination of the seed was 0, 6.0, 6.0, 20.0, and 0% under 15, 20, 25, 25/15, and 15/6 °C, respectively. However, treatment with 250 ppm of GA3 increased the germination of the seeds to 22.0, 36.0, 32.0, 40.0, and 1.0%, respectively. Additionally, treatment with 500 ppm of GA3 increased the germination to 34.6, 40.0, 40.0, 46.0 %, respectively. These results indicated that the seeds of V. oldhamii exhibited Nondeep physiological dormancy (Nondeep PD). Overall, the findings of this study showed that treatment with 500 ppm of GA3 at 25/15 °C can effectively break the dormancy of V. oldhamii seeds, which could facilitate further research on the species.
Analysis of Greenness Value and Photosynthetic Rate of Tomato Leaves Based on Spectral Technologies
Authors: Xu Jitong , Wang Fang , Zhang Zhe , Guo Yuhang , Liu Yufeng , Ning Xiaofeng
Published: September 2022

Tomatoes, a major vegetable crop, are not only delicious but can also prevent cancer and lower blood pressure. However, they are easily infected with diseases during the growth process, so it is of great significance to find a technology for nondestructive testing of the tomato growth state. In this study, partial least squares regression (PLSR) was used to establish a prediction model of the tomato leaf greenness value and photosynthetic rate based on laser-induced fluorescence spectroscopy and a hyperspectral imaging system. The results showed that the best preprocessing method for the fluorescence spectral model was SD+SNV, and the best methods for the hyperspectral model were FD+SNV and FD+MSC. The results for the prediction of the photosynthetic rate based on the fluorescence spectral and hyperspectral models were as follows: the coefficient of determination (R2) values were 0.9982 and 0.9739, respectively, and the root-mean-square error of prediction (RMSEP) values were 0.2781 and 0.3374, respectively. When measuring greenness, the R2 values were 0.9816 and 0.9595, and the RMSEP values were 0.1696 and 0.4032, respectively. The experimental results showed that the model based on the fluorescence spectrum had higher accuracy and lower deviation in the detection and prediction of the tomato growth state; these results provide a specific method and reference for subsequent research.
COVID-19 in Older Individuals Requiring Hospitalization
Authors: Ioannou Petros , Spentzouri Despoina , Konidaki Myrto , Papapanagiotou Michalis , Tzalis Sotiris , Akoumianakis Ioannis , Filippatos Theodosios D. , Panagiotakis Symeon , Kofteridis Diamantis P.
Published: September 2022

Older individuals have an increased risk for severe coronavirus disease 2019 (COVID-19) and a higher risk for complications and death. The aim of this study was to investigate the clinical characteristics of older patients admitted with COVID-19 and describe their outcomes. This was a retrospective cohort study of patients older than 65 years admitted to the COVID-19 Department of the University Hospital of Heraklion. Data recorded and evaluated included age, gender, Infectious Diseases Society of America (IDSA) severity score, Charlson comorbidity index (CCI), high-flow nasal oxygen (HFNO) use, admission to the Intensive Care Unit (ICU), laboratory exams, treatment administered, and outcome. In total, 224 patients were evaluated in the present study. The median age was 75 years and 105 (46.9%) were female. In 50 patients (22.7%), HFNO was used and 23 (10.3%) were admitted to the ICU. Mortality was 13.4% (30 patients). Patients that died had higher age, were more likely to be male, had an IDSA severity score of 3, had prior HFNO use, had been admitted to the ICU, and were also more likely to have a higher white blood cell (WBC) count, CRP, ferritin, procalcitonin, d-dimers, and troponin. A multivariate logistic regression analysis identified age and the need for HFNO use to be independently positively associated with mortality. To conclude, COVID-19 carries significant mortality in hospitalized older patients, which increases with age, while the need for HFNO also increased the likelihood of worse outcomes. Clinicians caring for patients with COVID-19 should bear in mind these two factors. Future studies could elaborate on the effect of new variants on the dynamics of mortality in older patients.
Psychological Responses of Hungarian Students during the First Wave of the COVID-19 Pandemic
Authors: Morvay-Sey Kata , Trpkovici Melinda , Ács Pongrác , Paár Dávid , Pálvölgyi Ágnes
Published: September 2022

(1) Background: Changes in daily life and academic training has led to uncertainty in the higher education student population during COVID-19. The goal of the study was to examine the impacts of the pandemic on Hungarian students. (2) Methods: A cross-sectional study was conducted by using self-report questionnaires collected in Google Forms. Eight-hundred-and-twenty-seven students (25.29 ± 8.09) took part anonymously. The respondents rate their overall physical and mental health on a 5-point Likert scale and validated scales were used: Well Being Index (WHO-5); Mindfulness Attention and Awareness Scale (MAAS); and Perceived Stress Scale (PSS-14). Statistical analyses were performed with IBM SPSS 24.0, results were considered at a significance level p ≤ 0.05. (3) Results: Positive correlation was found between MAAS and WHO-5 (r = 0.363, p < 0.001) negative correlation between MAAS and PSS-14 (r = −0.448, p < 0.001), and negative correlation between WHO-5 and PSS-14 (r = −0.671, p < 0.001). Females had higher PSS-14 mean score (32.51 ± 10.16) than males (27.71 ± 10.19; p < 0.001; Z = −5703), males (60.92 ± 12.10) had higher MAAS level than females (57.31 ± 12.51; p < 0.001; Z = −3589). No difference was found in gender regarding WHO-5 mean scores. Athletes (7.03 ± 3.27) differ significantly from non-athletes (6.00 ± 3.04) in WHO-5 (p < 0.001; Z = −4.349) and MAAS level (p = 0.012; Z = −2.498), but showed no difference in PSS-14 (p = 0.101; Z = −1.641). Students rated mental (3.01 ± 0.99) worse than physical health (3.49 ± 0.98; p < 0.001, r = 0.426) and the narrowing of social relationships worse (3.83 ± 1.26) than physical (p < 0.001, r = −0.212) and mental health (p < 0.001, r = −0.408). Females had worse mental health (2.96 ± 9.94) than males (3.20 ± 0.99; p = 0.003; Z = −2.924) and rated the narrowing of social relationships worse (3.90 ± 1.23) than males (3.59 ± 1.35; p = 0.006; Z = −2.730). (4) Conclusions: The pandemic has negatively impacted students, and it may have long-term consequences on their mental and physical health and education.
An Insight into the Sorption Behavior of 2,3,7,8-Tetrachlorodibenzothiophene on the Sediments and Paddy Soil from Chaohu Lake Basin
Authors: Nian Kainan , Xiong Wenli , Tao Yalu , Zhu Ziqing , Pan Xiaoxue , Zhang Kang , Zhang Xuesheng
Published: September 2022

Considering the frequent detection of polychlorinated dibenzothiophenes (PCDTs) in various environmental matrices and the potential ecological health risks, the environmental behavior of such compounds needs to be elucidated further. In this work, the sorption behavior of 2,3,7,8-tetrachlorodibenzothiophene (2,3,7,8-TCDT) onto three sediments and paddy soil from Chaohu Lake were investigated via batch equilibration experiments. From the perspective of sorption kinetics and isotherms, the sorption characteristics and mechanism of 2,3,7,8-TCDT on the above four carriers were compared, and the relationship between their structural characteristics and soil sorption capacity was discussed. Results suggested that rapid sorption played the primary role during the sorption process of 2,3,7,8-TCDT and the corresponding sorption isotherms were well fitted using the Freundlich logarithmic model. Moreover, the effects of pH and dissolved organic matter (DOM) on the sorption of 2,3,7,8-TCDT were investigated. The maximum sorption capacity of 2,3,7,8-TCDT on sediment was under acidic pH condition (pH = 4.0). Meanwhile, DOM at a low level promoted the sorption capacity of sediment toward 2,3,7,8-TCDT, while the high concentration of DOM inhibited this effect. In addition, the values of logKoc were obtained using high-performance liquid chromatography (HPLC) and did not show any significant correlation with organic carbon (OC) contents, thereby indicating that the partition effect was the dominating influencing factor for the sorption of 2,3,7,8-TCDT both on sediments and soil. This work provides useful data to understand the sorption behavior of 2,3,7,8-TCDT on sediments and soil and assess its potential environmental risk.
Does Human Capital Matter for China’s Green Growth?—Examination Based on Econometric Model and Machine Learning Methods
Authors: Liu Xiaoxue , Cao Fuzhen , Fan Shuangshuang
Published: September 2022

To tackle the increasingly severe environmental challenges, including climate change, we should pay more attention to green growth (GG), a path to realize sustainability. Human capital (HC) has been considered a crucial driving factor for developing countries to move towards GG, but the impact and mechanisms for emerging economies to achieve GG need to be further discussed. To bridge this gap, this paper investigates the relation between HC and GG in theory and demonstration perspective. It constructs a systematic theoretical framework for their relationship. Then, it uses a data envelopment analysis (DEA) model based on the non-radial direction distance function (NDDF) to measure the GG performance of China’s 281 prefecture level cities from 2011 to 2019. Ultimately, it empirically tests the hypothesis by using econometric model and LightGBM machine learning (ML) algorithm. The empirical results indicate that: (1) There is a U-shaped relationship between China’s HC and GG. Green innovation and industrial upgrading are transmission channels in the process of HC affecting GG. (2) Given other factors affecting GG, HC and economic growth contribute equally to GG (17%), second only to city size (21%). (3) China’s HC’s impact on GG is regionally imbalanced and has city size heterogeneity.
Association between Lifetime Classic Psychedelic Use and Sick Leave in a Population-Based Sample
Authors: Mellner Christin , Dahlen Micael , Simonsson Otto
Published: September 2022

Objectives: Absenteeism from work due to illness, and related costs, has increased steadily during the past decades. In recent years, there has been a reemergence of research on the therapeutic effects of classic psychedelics showing associations with both physical and mental health. However, the association between classic psychedelics and sick leave remains unknown. The aim of this study is to investigate the association between lifetime classic psychedelic use and sick leave in the past 30 days among adults in the United States (N = 407,717), using data from the National Survey on Drug Use and Health (2005–2019), weighted to be representative of the US adult population. Methods: The primary analysis was conducted using multiple linear regression, controlling for sociodemographic characteristics, risky behavior, and use of other substances. Results: There was a significant and negative association between lifetime classic psychedelic use and sick leave in the past 30 days (B = −0.09, p < 0.01) when adjusting for all control variables. Conclusion: These findings suggest that classic psychedelics could potentially lead to reduced sick leave and associated costs in the general population, but more research is needed to investigate potential causal pathways of classic psychedelics on sick leave and evaluate possible mechanisms.
A Nutritionally Complete Oral Nutritional Supplement Powder Improved Nutritional Outcomes in Free-Living Adults at Risk of Malnutrition: A Randomized Controlled Trial
Authors: Yeung Suey S. Y. , Lee Jenny S. W. , Kwok Timothy
Published: September 2022

Background: This randomized controlled trial investigated the effectiveness of an oral nutritional supplement (ONS) on nutrition-related outcomes over 12 weeks in Chinese adults with or at risk of malnutrition. Methods: 88 Chinese adults ≥18 years living independently in Hong Kong with Mini Nutritional Assessment-Short Form (MNA-SF) score ≤11 were randomly assigned to (1) 2 servings/day of nutritionally complete ONS powder made with water (Fresubin® Powder (Fresubin Kabi Deutschland GmbH, Bad Homburg, Germany), 600 kcal, 22.4 g protein) for 12 weeks (intervention group) or (2) no treatment (control group). The primary outcome was increase in body weight (BW) over 12 weeks. Secondary outcomes included improvement in body mass index (BMI), mid-arm circumference (MAC), calf circumference, MNA-SF score, quality of life, self-rated health, frailty, and diet quality. Results: The intervention group showed a significantly higher mean increase in BW compared with the control group (1.381 kg, intervention vs control, p < 0.001). The intervention group also showed significantly higher mean increases in BMI, MAC, calf circumference, intake of energy, protein, vitamin D, and calcium compared with the control group. No group differences in the changes of other outcomes were observed. Conclusions: For Chinese free-living adults at risk of malnutrition, daily consumption of a nutritionally complete ONS powder improved nutritional outcomes compared with the control group.
Factors Affecting Fatigue among Nurses during the COVID-19 Pandemic
Authors: Lee Haeyoung , Choi Seunghye
Published: September 2022

This study identified clinical nurses’ fatigue and related factors during the COVID-19 pandemic. This was a cross-sectional study. Data were collected from South Korean hospitals on 234 nurses’ general characteristics, fatigue, depression, occupational stress, insomnia, and perceived daytime sleepiness using a structured questionnaire. The prevalence of fatigue was 62.0%, depression 52.1%, insomnia 20.7%, and daytime sleepiness 36.1%. Insomnia, sleepiness, depression, and occupational stress were significantly associated with fatigue. Ward nurses who cared for COVID-19 patients within the past month had significantly higher occupational stress related to organizational climate than those who had not provided care, and ICU nurses who cared for COVID-19 patients had significantly higher job insecurity-related occupational stress. Nurses have a high prevalence of fatigue and depression during the pandemic. Thus, insomnia, sleepiness, depression, and occupational stress must be reduced to lower nurses’ fatigue. Caring for COVID-19 patients was not significantly associated with fatigue, but there were significant differences in occupational stress between nurses who provided such care and those who did not. Work environment-specific strategies are needed to reduce nurses’ occupational stress during the pandemic.
Kinky Sex and Deliberate Partner Negotiations: Case Studies of Canadian Transgender Men Who Have Sex with Men, Their HIV Risks, Safer Sex Practices, and Prevention Needs
Authors: Liboro Renato M. , Fehr Charles , Da Silva George
Published: September 2022

Growing research in the last two decades has begun to investigate the HIV risks and sexual health practices of transgender men, especially as a subpopulation of men who have sex with men (MSM) that likely shares certain HIV risks and sexual health practices with cisgender MSM, the sociodemographic group that continues to be at highest risk for HIV in many developed countries since the start of the epidemic. As part of our Community-Based Participatory Research project and larger strengths-based qualitative study that was dedicated to examine multiple factors that promote resilience to HIV utilizing the perspectives and lived experiences of middle-aged and older MSM, the case studies we present in this article feature the distinct insights and experiences of three HIV-negative transgender MSM from Downtown Toronto, Ontario, Canada, who participated in our one-on-one interviews. The three case studies provide not only an enlightening snapshot of some of the specific contexts, HIV risks, safer sex practices, and HIV prevention needs of transgender MSM, but also a unique opportunity to critically reflect on the potential implications of the insights and experiences that were shared by our participants, particularly for adapting and developing current and future HIV services and programs to maximally benefit transgender MSM.
Oral Lesions Associated with COVID-19 and the Participation of the Buccal Cavity as a Key Player for Establishment of Immunity against SARS-CoV-2
Authors: Gutierrez-Camacho Jose Roberto , Avila-Carrasco Lorena , Martinez-Vazquez Maria Calixta , Garza-Veloz Idalia , Zorrilla-Alfaro Sidere Monserrath , Gutierrez-Camacho Veronica , Martinez-Fierro Margarita L.
Published: September 2022

Background: Some oral lesions have been described in patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2); the possibility has been raised that the buccal lesions observed in patients with the coronavirus disease 2019 (COVID-19) are due to this virus and the patient’s systemic condition. The aim of this review was to integrate the knowledge related to the oral lesions associated with COVID-19 and the participation of the buccal cavity in the establishment of immunity against SARS-CoV-2. Methods: A literature search on the manifestations of buccal lesions from the beginning of the pandemic until October 2021 was carried out by using the PubMed database. A total of 157 scientific articles were selected from the library, which included case reports and reports of lesions appearing in patients with COVID-19. Results: Oral lesions included erosions, ulcers, vesicles, pustules, plaques, depapillated tongue, and pigmentations, among others. The oral cavity is a conducive environment for the interaction of SARS-CoV-2 with the mucosal immune system and target cells; direct effects of the virus in this cavity worsen the antiviral inflammatory response of underlying oral disorders, immunodeficiencies, and autoimmunity primarily. Conclusions: The oral cavity is an accessible and privileged environment for the interaction of SARS-CoV-2 with the mucosal immune system and target cells; the direct effects of the virus in this cavity worsen the antiviral inflammatory response of underlying oral disorders, in particular those related to immunodeficiencies and autoimmunity.
Is Education Beneficial to Environmentally Friendly Behaviors? Evidence from CEOs
Authors: Wang Changrong , Gou Lufeng , Li Xuemei
Published: September 2022

Corporate environmental investment decisions play a crucial role in the protection of the public environment. As the decision-maker and executor, the environmental consciousness and social responsibility of the chief executive officer (CEO) has a long-term impact on the company’s environmental protection strategy, and the CEO’s level of education is a significant factor influencing the CEO’s environmental protection decisions. In this paper, we investigate the extent to which CEO education influences environmental protection investment decisions. A CEO education index is constructed as a proxy for CEO education based on the CEO’s educational background, using a panel sample of Chinese listed firms from 2010 to 2019 and providing robust evidence supporting the notioin that firms with highly educated CEOs are likely to engage in environmental protection spending activities. However, the positive relationship between CEO education and corporate environmental protection investment is reduced when the CEO also holds the position of chairman. The heterogeneity analysis shows that the positive relationship between CEO education and corporate environmental investment behavior is stronger in non-manufacturing and highly monopolistic market competitive industries. Our study contributes to the sustainability literature by providing a new impetus for corporate environmental activities from the perspective of CEO education and sheds light on the impact of the internal and external factors of firms on the investment in environmental protection. It may also help decision makers to decide whether to hire highly educated CEOs and use a dual structure of CEOs in markets with different levels of competition.
Maintaining Factors of Anorexia Nervosa Addressed from a Psychotherapeutic Group for Parents: Supplementary Report of a Patient’s Therapeutic Success
Authors: García-Anaya María , Caballero-Romo Alejandro , González-Macías Laura
Published: September 2022

(1) Background: Anorexia nervosa is an eating disorder (ED) where up to 30% of individuals remain unresponsive to treatments, whether they partially respond, or do respond and later relapse. It has been broadly reported how presenting maladaptive family functioning and communication style contributes to treatment drop-out, poor treatment compliance, and poor long-term outcomes. We studied the mother and father of a patient with AN, binge-purge subtype (according to DSM-IV TR) who achieved remission after her parents but not her attended an intervention through a psychotherapy group for parents (PGP). (2) Methods: We previously reported this patient’s case report, and now, through an Interpretative Phenomenological Analysis (IPA) approach, we aimed to explore the understanding and meanings ascribed by the mother and father to their experience at the PGP and to their daughter’s clinical and functional improvement. (3) Results: We identified two main stages along the process: one related to the presence of maintaining factors of their daughter’s disorder, and the other related to the emergence of a reflective function and to the implementation of behavioral, emotional and cognitive changes. (4) Conclusions: The interview revealed both parents’ experience at the PGP promoted a change process, where they were able to modify their previous style of communication and functioning, and to identify them as a contributors to maintain their daughter’s disorder. Reflective function (RF) emerged in the mother and father throughout the psychotherapeutic process. Both parents also revealed some elements that were intergenerationally transmitted, that affected three generations and contributed to maintaining the ED. We observed the multilevel open-group structure of the PGP, enhancing the mother’s and father’s change process.
Exploring Oral Microbiome in Healthy Infants and Children: A Systematic Review
Authors: D’Agostino Silvia , Ferrara Elisabetta , Valentini Giulia , Stoica Sorana Andreea , Dolci Marco
Published: September 2022

Recent advances in the development of next-generation sequencing (NGS) technologies, such as the 16S rRNA gene sequencing, have enabled significant progress in characterizing the architecture of the oral microbiome. Understanding the taxonomic and functional components of the oral microbiome, especially during early childhood development, is becoming critical for identifying the interactions and adaptations of bacterial communities to dynamic conditions that may lead to the dysfunction of the host environment, thereby contributing to the onset and/or progression of a wide range of pathological conditions. We aimed to provide a comprehensive overview of the most recent evidence from studies of the oral microbiome of infants and young children, focusing on the development of oral microbiome in the window of birth to 18 years, focusing on infants. A systematic literature search was conducted in PubMed, Scopus, WOS, and the WHO clinical trial website for relevant articles published between 2006 to 2022 to identify studies that examined genome-wide transcriptome of the oral microbiome in birth, early childhood, and adolescence performed via 16s rRNA sequence analysis. In addition, the references of selected articles were screened for other relevant studies. This systematic review was performed in accordance PRISMA guidelines. Data extraction and quality assessment were independently conducted by two authors, and a third author resolved discrepancies. Overall, 34 studies were included in this systematic review. Due to a considerable heterogeneity in study population, design, and outcome measures, a formal meta-analysis was not carried out. The current evidence indicates that a core microbiome is present in newborns, and it is stable in species number. Disparity about delivery mode influence are found. Further investigations are needed.
Research on Ecological Landscape Design and Healing Effect Based on 3D Roaming Technology
Authors: Lin Zhengsong , Wang Yuting , Song Yang , Huang Tao , Gan Feng , Ye Xinyue
Published: September 2022

Impacted by the COVID-19 epidemic, the human sub-health in national high-tech zones (hereinafter referred to as high-tech zones) has become more prominent. It is critical for the mental sub-health group in the high-tech zone to relieve the anxiety and tension caused by the pressure of life and work. This paper uses SketchUp virtual engine (Unity 2019) software, and 3D roaming technology to carry out the ecological landscape transformation design of the Baotzixi ecological corridor in the East Lake High-tech Zone, to construct a 3D roaming landscape scene and measure its therapeutic effect by inviting subjects to participate in an interactive experience experiment on the ErgoLAB platform. The results illustrate that: (1) the thermogram trend shows that the more attractive the 3D roaming landscape scene is, the stronger the subjects’ interest is; (2) the participants have a positive emotional arousal state in the immersive experience of the 3D roaming landscape scene after the modification design; and (3) the mean skin conductance (SC) fluctuation variance of the subjects is 5.819%, indicating that the healing effect is significant in the state of positive emotional arousal. The research results show that there is a connection between the subjects and the 3D roaming landscape scene after the transformation design of “high interest, emotional arousal and significant healing”.
The Use of Evidence-Informed Deliberative Processes for Health Benefit Package Design in Kazakhstan
Authors: Oortwijn Wija , Surgey Gavin , Novakovic Tanja , Baltussen Rob , Kosherbayeva Lyazzat
Published: September 2022

Kazakhstan strives to obtain Universal Health Coverage (UHC) by using health technology assessment (HTA) for determining their health benefit package. This paper reports on employing evidence-informed deliberative processes (EDPs), a practical and stepwise approach to enhance legitimate health benefit package design in Kazakhstan. Methods: The Ministry of Health of Kazakhstan approved the operationalization and application of EDPs during March 2019 and December 2020. We used a combination of desk research, conducting HTA, online surveys as well as a face-to-face workshop in Nur-Sultan, Kazakhstan, and two online workshops to prioritize 25 selected health technologies. During the latter, we tested two alternative approaches to prioritization: quantitative multicriteria decision analysis (MCDA) and the use of decision rules. Results: For each of the HTA reports, evidence summaries were developed according to the decision criteria (safety, social priority disease, severity of disease, effectiveness, cost-effectiveness, level of evidence, financial risk protection and budget impact). When appraising the evidence, the advisory committee preferred using quantitative MCDA, and only when this would result in any controversy could decision rules be applied. Conclusions: Despite several challenges, including a partial disruption because of the COVID-19 pandemic, implementation of the process will likely play a key role in determining an evidence-informed and transparent health benefit package.
Determining Trends and Factors Associated with Self-Reported Physical Activity among Adolescents in Rural North Carolina
Authors: Kazemzadeh Sina , Opper Chloe E. , Fang Xiangming , Lazorick Suzanne
Published: September 2022

It is important to better understand factors associated with physical activity (PA) levels in adolescents in rural areas. Cross-sectional data were used to obtain self-reported PA levels among adolescents in a school-based intervention in fall 2018. Demographic data, environmental variables, and cardiovascular fitness (PACER score) were also measured. Analyses included a two-sample t-test, ANOVA, a Chi-square test, and a linear regression model. Participants included 3799 7th graders. Male (p < 0.0001), white (p < 0.0001), and healthy weight (p < 0.0001) participants reported more days of PA. The correlation between school physical education (PE) and PACER was modest (r = 0.27, p < 0.0001). Multiple linear regression model showed significant effects of school PE (p = 0.0011), gender (p < 0.0001), race (p < 0.0001), and weight category (p < 0.0001) on self-reported PA. The percentage of students reporting 60 min of PA for 5 (p < 0.0001) or 7 (p = 0.0307) days per week tended to be higher with increased days per week of school PE. Policy changes that increase PA and PE in middle schools may present opportunities to improve PA levels in adolescents, with emphasis on being inclusive and mindful of minority and female youth.
Psychometric Properties of the Spanish Versions of EQ-5D-Y-3L and EQ-5D-Y-5L in Children with Cancer: A Comparative Study
Authors: Perez-Sousa Miguel A. , Olivares Pedro R. , Gusi Narcis
Published: September 2022

(1) Background: The recent published version with five levels of response of EQ-5D-Y needs to be studied in children with chronic illness. For this, the aim of the present study was to assess and compare the psychometric properties of EQ-5D-Y-3L and EQ-5D-Y-5L in terms of feasibility, ceiling effect, redistribution properties, informativity and inconsistence responses in children with cancer. (2) Methods: A core set of self-report tools, including the Spanish version of EQ-5D-Y-3L and EQ-5D-Y-5L, were administered to children drawn from the population with cancer. EQ-5D-Y-3L and EQ-5D-Y-5L were evaluated in terms of feasibility, ceiling effects, redistribution properties and differences in absolute and relative informativity. (3) Results: A total of 73 children (9.7 ± 2.3 years old) from the population with cancer participated in the study. No missing data in the new EQ-5D-Y-5L were visualized, so the feasibility was acceptable. EQ-5D-Y-5L showed a low ceiling effect in all dimensions with relative changes from EQ-5D-Y-3L to EQ-5D-Y-5L of between 15.3% and 42.4% for the dimensions and 44.6% for the overall system. Compared to EQ-5D-Y-3L, EQ-5D-Y-5L provided a better distribution of the severity of the problem in the five levels of response. The absolute informativity (Shannon’s index) did not show statistically significant differences between EQ-5D-Y-3L and EQ-5D-Y-5L in all dimensions and the overall system. (4) Conclusions: EQ-5D-Y-5L is feasible, presenting a low ceiling effect and high discriminative power.
The Impact of Rail Transit on Accessibility and Spatial Equity of Public Transit: A Case Study of Guangzhou, China
Authors: Chen Huiling , Yang Wenyue , Li Tao
Published: September 2022

The urban rail transit network provides the possibility for people to shift from car to public transit for travel. This paper clarified the relationships among public transit, accessibility, and equity and studied the impact of rail transit on public transit accessibility that incorporates the measure of travel time and transit fare and the impacts’ spatial equity. The results show that rail transit contributes to the similar distribution between high rate of changes of time-based accessibility communities and fare-based accessibility communities, which are located nearby the rail transit lines. The degree of inequity in travel time is higher than the degree in transit fare in two scenarios. Due to the well-connected bus transit in the city center, absolute changes in travel time are slight, while relative changes are high. The rail transit has promoted the improvement of public transit equity in some areas. The difference between the time-based accessibility of Conghua District, northern and southern Baiyun District, Huadu District, Nansha District and southern Panyu District, and other communities is getting smaller, which is conducive to the improvement of spatial equity. The results provide theoretical support for the development of an integrated multimodal public transit system.
Mechanisms Analysis for Fatal Accident Types Caused by Multiple Processes in the Workplace: Based on Accident Case in South Korea
Authors: Won Jeong-Hun , Jeong Hyeon-Ji , Kim WonSeok , Kim Seungjun , Kang Sung-Yong , Hwang Jong Moon
Published: September 2022

This study aimed to develop the accident mechanism of fatal accidents taking place in multiple processes at the workplace. Multiple processes were defined as the existence of multiple work types and work processes in the same workspace. Recently, various processes are frequently conducted simultaneously in one workplace with the participation of several companies, and more workers are increasingly experiencing industrial accidents while working in multiple processes. To prevent accidents in the multiple processes caused by the sameness of work period and space, the accident process was investigated by analyzing the investigation reports on serious industrial accidents in South Korea, and then the accident mechanism model was developed. By utilizing the developed model, the major safety measures to be taken by the contractor for each of the 8 types of accidents caused by the multiple processes were drawn. The roles and responsibilities of the contractor to be implemented in order to prevent accident occurrence in multiple processes were proposed through the accident mechanism of each type of fatal accident. It is expected that the accidents taking place in the multiple processes can be prevented with the drawn results.
Spatial Differences of Ecological Well-Being Performance in the Poyang Lake Area at the Local Level
Authors: Wang Shengyun , Duan Liancheng , Zhu Qin , Zhang Yaxin
Published: September 2022

Maintaining low ecological consumption and high well-being while making economic progress and thus achieving sustainable development is a significant issue facing the world today. Ecological well-being performance (EWP) is one indicator that tracks this progress. Although EWP has been typically assessed at the national, provincial and urban levels, investigations into EWP units in the Great Lakes region are lacking. This study applied the two-stage super-efficiency slack-based measure (Super-NSBM) model and DEA window analysis to evaluate the EWP and sub-stage efficiency in the Poyang Lake (largest freshwater lake in China) area and analyzed its spatial differences at the local level. Redundancy analysis was conducted to explore the EWP improvement paths of different counties in the Poyang Lake region and Dagum’s Gini coefficient was applied to clarify the policy priorities of coordinated regional development. Results showed that the EWP of the Poyang Lake area presents an improving trend from 2007 to 2019, although the overall level is still low. The Poyang Lake area mainly faces the incongruity of ecological and economic development, which is the main reason for the low overall level of EWP. Excessive resource input and severe environmental pollution are common in most counties, but the focus of measures to improve EWP differs from county to county. The expansion of spatial differences in eco-economic efficiency leads to the spatial differences of EWP in the Poyang Lake area being still apparent at the local level. Reducing inter-basin disparities while alerting the widening of intra-basin differences is the policy focus for the future coordinated development of the Poyang Lake area.
A Study on the Perceptions of Korean Older Adult Patients and Caregivers about Polypharmacy and Deprescribing
Authors: Lee Han-Gyul , Kwon Seungwon , Jang Bo-Hyoung , Jeon Jin Pyeong , Lee Ye-Seul , Jung Woo-Sang , Moon Sang-Kwan , Cho Ki-Ho
Published: September 2022

Polypharmacy is continuously increasing among older adults. The resultant potentially inappropriate medications (PIMs) can be harmful to patient health. Deprescribing refers to stopping or reducing PIMs. In this study, the current status of polypharmacy and willingness of older adults to deprescribe were investigated among patients and caregivers who are not associated with one another. The survey used the Korean translated version of the revised Patients’ Attitude Towards Deprescribing (rPATD) Scale. Data were collected through an online survey of 500 participants (250 patients and caregivers each) in this study. The following results were found for patients and caregivers, respectively: 74.8% and 63.6% felt their number of medications was high, 64.4% and 55.6% desired to reduce their medications, 70.4% and 60.8% were concerned about medication discontinuation, 63.2% and 61.2% had a good understanding of their medications, 77.6% and 76.4% were willing to be well informed, and 79.6% and 72% wanted to reduce the number of medications if medically feasible. Patients and caregivers commonly agreed to the burden of the number of medications they were taking, and were willing to reduce the number of medications if the doctor said it was possible. Doctors should consider this information during the deprescribing process, and promote deprescription while involving patients and caregivers in the decision-making process.
Conflict at Work Impairs Physiological Recovery during Sleep: A Daily Diary Study
Authors: Kerman Katja , Prem Roman , Kubicek Bettina , Meyer Edo , Tement Sara , Korunka Christian
Published: September 2022

Sleep plays an essential role in maintaining employees’ health and well-being. However, stressors, such as conflict at work, may interfere with employees’ sleep. Drawing on previous literature on the relationship between conflict at work and sleep outcomes, we proposed a negative relationship between daily conflict at work and physiological changes during early sleep, particularly nocturnal heart rate variability (HRV). Furthermore, building on the perseverative cognition hypothesis, we proposed that daily work-related rumination mediates the relationship between conflict at work and nocturnal HRV. Ninety-three healthcare employees participated in a daily diary study for five workdays, resulting in 419 observations. Multilevel analysis revealed a significant relationship between daily conflict at work and nocturnal HRV, specifically high-frequency (HF) power. Daily conflict at work was found to predict rumination; however, rumination did not significantly predict nocturnal HRV. Our results suggest that daily conflict at work increases rumination during the off-job time and may directly alter nocturnal HRV, specifically parasympathetic function in early sleep.
Psychometric Properties of the Functional Impairment Checklist (FIC) as a Disease-Specific Patient-Reported Outcome Measure (PROM) in Previously Hospitalized COVID-19 Survivors with Long-COVID
Authors: Fernández-de-las-Peñas César , Palacios-Ceña Maria , Rodríguez-Jiménez Jorge , de-la-Llave-Rincón Ana I. , Fuensalida-Novo Stella , Cigarán-Méndez Margarita , Florencio Lidiane L. , Ambite-Quesada Silvia , Ortega-Santiago Ricardo , Pardo-Hernández Alberto , Hernández-Barrera Valentín , Palacios-Ceña Domingo , Gil-de-Miguel Ángel
Published: September 2022

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus is associated with a plethora of long-lasting symptoms (long-COVID). The presence of long-COVID symptoms causes decreased functionality. This study described the psychometric properties of the Functional Impairment Checklist (FIC), a disease-specific patient-reported outcome measure (PROM) used for evaluating the functional consequences of SARS in previously hospitalized COVID-19 survivors with long-COVID symptoms. The LONG-COVID-EXP-CM is a multicenter cohort study including patients hospitalized with COVID-19 during the first wave of the pandemic in five hospitals in Madrid. A total of 1969 (age: 61 ± 16 years, 46.4% women) COVID-19 survivors with long-COVID completed the FIC at a long-term follow-up after hospitalization (mean: 8.4 ± 1.5 months). Internal consistency (Cronbach alpha value), reliability (item-internal consistency, item-discriminant validity), construct validity (exploratory factor analysis), floor effect and ceiling effect were calculated. The mean time for fulfilling the FIC was 62 ± 11 s. The Cronbach’s alpha values reflecting the internal consistency reliability were 0.864 for FIC-symptoms and 0.845 for FIC-disability. The correlation coefficient between the FIC-symptoms and FIC-disability scale was good (r: 0.676). The ceiling effect ranged from 2.29% to 9.02%, whereas the floor effect ranged from 38.56% to 80.19%. The exploratory factor analysis showed factor loadings from 0.514 to 0.866, supporting good construct validity. Women exhibited greater limitations in all physical symptoms and disability-related domains of the FIC compared with men (all, p < 0.001). Further, younger patients (those aged <45 years) self-reported lower physical symptoms and disability-related domains than older patients. In conclusion, this study indicates that the FIC has good psychometric properties to be used as a specific-disease PROM to measure function and disability in COVID-19 survivors with long-COVID.
Competencies of Nurse Managers as Predictors of Staff Nurses’ Job Satisfaction and Turnover Intention
Authors: Choi Pin-Pin , Lee Wai-Man , Wong Suet-Shan , Tiu Mei-Ha
Published: September 2022

Nurse managers have played an integral role in stabilizing the nursing work environment and workforce in the face of the COVID-19 pandemic, yet the competencies required for such a feat are largely unknown. This study was conducted during the pandemic to identify the specific domains of nurse manager competencies that associate with nurse outcomes. A cross-sectional survey was conducted on a convenience sample of 698 staff nurses to measure the perceived competence of their nurse managers and their job satisfaction and turnover intention levels. The overall perceived nurse manager competency level in our sample was 3.15 out of 5 (SD = 0.859). The findings indicated that 34.3% of nurses were dissatisfied with their current jobs, and 36.3% of nurses were considering leaving their current workplace. Regression analyses identified “Team Communication and Collaboration” (β = 0.289; p = 0.002), “Staff Advocacy and Development” (β = 0.229; p = 0.019), and “Quality Monitoring and Pursuance” (β = 0.213; p = 0.031) as significant predictors of staff nurses’ job satisfaction and “Staff Advocacy and Development” (β = −0.347; p < 0.000) and “Team Communication and Collaboration” (β = −0.243; p = 0.012) as significant predictors of nurses’ turnover intention. The findings of the study have implications for the future recruitment, training, and performance evaluation of nurse managers.
Parental Assessment of Benefits and of Dangers Determines Children’s Permission to Play Outdoors
Authors: Jidovtseff Boris , Pirard Florence , Martin Anne , McCrorie Paul , Vidal Andora , Pools Elodie
Published: September 2022

During the early years, children’s outdoor play is dependent on parental supervision. Parents’ perceptions are likely to influence what the child is permitted to do. To better understand the involved mechanisms in parents’ decision making in such contexts, an online photo-based questionnaire was administered. The tool investigates, in different situations, parents and their children’s experience, parents’ perceptions, and permission to play. A total of 417 parents of children aged from 1.5 and 6.0 completed the questionnaire. Results showed that parents, overall, have a positive attitude towards outdoor play. Main concerns were about risk of injury but in most cases, perceived benefits outweigh perceived dangers. “Sawing wood” was the only situation with a negative benefits/dangers balance. A linear regression analysis revealed that permission to play outdoors is based on parental assessment of benefits and dangers. Perceived benefits appeared to have more influence on parental decision than perceived dangers, while perceived competence had only a small influence. The results also showed that parents’ childhood experience of outdoor play was an important determinant for adults’ perceptions, perhaps demonstrating intergenerational concerns, as outdoor play is in decline. To overcome a negative intergenerational effect on children’s outdoor play, interventions and communication should focus on associated benefits.