bluuebunny/crossref_metadata_2025 huggingface dataset:
Identification and QTL Analysis of Flavonoids and Carotenoids in Tetraploid Roses Based on an Ultra-High-Density Genetic Map
Authors: Cheng Bixuan , Wan Huihua , Han Yu , Yu Chao , Luo Le , Pan Huitang , Zhang Qixiang
Published: June 2021

Roses are highly valuable within the flower industry. The metabolites of anthocyanins, flavonols, and carotenoids in rose petals are not only responsible for the various visible petal colors but also important bioactive compounds that are important for human health. In this study, we performed a QTL analysis on pigment contents to locate major loci that determine the flower color traits. An F1population of tetraploid roses segregating for flower color was used to construct an ultra-high-density genetic linkage map using whole-genome resequencing technology to detect genome-wide SNPs. Previously developed SSR and SNP markers were also utilized to increase the marker density. Thus, a total of 9,259 markers were mapped onto seven linkage groups (LGs). The final length of the integrated map was 1285.11 cM, with an average distance of 0.14 cM between adjacent markers. The contents of anthocyanins, flavonols and carotenoids of the population were assayed to enable QTL analysis. Across the 33 components, 46 QTLs were detected, explaining 11.85–47.72% of the phenotypic variation. The mapped QTLs were physically clustered and primarily distributed on four linkage groups, namely LG2, LG4, LG6, and LG7. These results improve the basis for flower color marker-assisted breeding of tetraploid roses and guide the development of rose products.
“Bumps in the Road”: A Pilot Study of a Therapeutic Technique for the Integration of Unresolved Family Loss and Trauma
Authors: Watts Gabriella J. , Lewis Andrew J. , Serfaty Irene G.
Published: June 2021

The ability to sustain a coherent narrative about experiences of trauma and loss is a prominent feature of secure-autonomous attachment states of mind as assessed in narrative tasks such as the Adult Attachment Interview. The current study examines the clinical application of the concepts of narrative coherence and discourse segregation within a therapeutic intervention for whole families.Bumps in the Roadis a family drawing task, which aims to facilitate the co-construction of family narratives about adversities such as trauma, loss and hardship. The technique aims to increase the family’s narrative coherence about such challenging events. The paper first presents a description of the task itself together with the discourse theories of defensive processing of adverse events. The study also presents pilot quantitative findings from 19 parents on the psychometric properties of a coding system of the families’ discourses in undertaking the task and the therapist’s techniques in administering the task. The predictive association of coding of the narratives were examined as predictors of change in internalising and externalising symptoms in the referred child, using the Child Behaviour Checklist. Findings showed that therapist competence in administration of the task did significantly predict the magnitude of treatment efficacy. The current study is the first presentation of this novel therapeutic task and sets a platform for further research on the use of narrative tasks and the formal coding of discourse in therapeutic work with children and families.
A Multi-Center Structural Equation Modeling Approach to Investigate Interpersonal Violence Screening for Public Health Promotion
Authors: Jiang Lan , Sutherland Melissa A. , Hutchinson M. Katherine , Si Bing
Published: June 2021

Background: Interpersonal violence is a significant public health issue. Routine health screening is a cost-effective strategy that may reduce harmful physical and mental consequences. However, existing research finds consistently low rates of violence screening offered by healthcare providers, e.g., nurses, nurse practitioners, physicians. There is a critical need for research that helps understand how providers' screening behaviors are impacted by individual-level and organizational-level factors to promote the uptake of routine screening for interpersonal violence. Two recent studies, i.e., The Health Care Providers study and Nurse Practitioners Violence Screening study, involved quantitative data collected to measure providers' screening behavior and multi-level factors impacting violence screening.

Methods: The current analysis includes a combination of multi-center data collected from The Health Care Providers and Nurse Practitioners Violence Screening studies, respectively. The total sample is 389 providers across the United States. The proposed research develops a system-level multi-center structural equation model framework to rigorously integrate data from the two studies and examine providers' screening behavior for interpersonal violence based upon Theory of Planned Behavior from a quantitative perspective.

Results & Conclusions: We successfully examine the efficacy of the Theory of Planned Behavior proposed by Ajzen to predict healthcare providers' screening behavior for interpersonal violence. Organizational factors, e.g., availability of policy for interpersonal violence screening, organizational priority given to violence screening relative to other priorities, and if providers within the health center are interested in improving care quality, were significantly associated with providers' screening behavior. The knowledge and insights generated from our study may facilitate the design and optimization of health professional training and practice environment, and lead to improved women's health and quality of care.
COVID-19 Pandemic—Frontline Experiences and Lessons Learned From a Tertiary Care Teaching Hospital at a Suburban Location of Southeastern India
Authors: Coumare V. Nirmal , Pawar Swati Jayant , Manoharan P. S. , Pajanivel R. , Shanmugam Lokesh , Kumar Hemanth , Boratne Abhijit V. , Subramanian Balanehru , Easow Joshy M. , Sivaprakash B. , Kalaivani R. , Renuka K. , Prabavathy S. , Angeline Kripa , Pillai Agieshkumar Balakrishna , Rao S. R.
Published: June 2021

The key challenges to any health care setup during emergency situations, such as that of the COVID-19 pandemic would be to rapidly address hospital preparedness and response tailored to the local population, societal influences, political factors within the existing infrastructure, and workforce. Second, to adopt and moderate policies, standard operating procedures (SOPs) and guidelines issued by national and international agencies, such as WHO, CDC, and the Indian Council for Medical Research (ICMR) were tailor-made to the local conditions of the hospital and community. In this publication, we have discussed the challenges and experiences in preparation and responses to the ongoing COVID-19 pandemic at a tertiary teaching hospital situated at a suburban locale in a small union territory. Puducherry is located in the South Eastern Coromandel Coast of India. The core processes, such as hospital preparedness, adoption, and amendments to SOPs based on dynamic changes in guidelines released by the central and local government, training given to health care workers, setting up the in-house diagnostic facility, surge capacity, management of supplies during the lockdown, infection prevention, and control and patient care are discussed. We have also reinforced our experiences in translating COVID-related opportunities for research and innovation in the form of awards and research proposals for the faculty and students of our institute. The lessons learned in terms of strength and limitations on the ground level of public health during this process is worth sharing as it would provide guidance in preparing the health care setups for pre- and post-pandemic.
Urban Greening for New Capital Cities. A Meta Review
Authors: de Vries Walter Timo
Published: June 2021

In light of the discussions on relocating the capital city of Indonesia to a new location in Kalimantan, and create a new green capital city (referred to as IKN), the purpose of this meta-review paper is learn from experiences from other relocations of capital cities and creations of green cities in the world. Specific emphasis is hereby given to urban greening and gentrification. This article applies a meta-analytical approach by connecting the basic tenets of the 8R framework of responsible land management to assess the pros and cons of a selected set of capital city relocations and green cities. From the comparison, it is possible to generate general recommendations for Indonesia's new green capital city. The comparison reveals that each of the selected cases falls short in one or more aspects of the 8R framework. In all cases, constructing green capitals requires a mixed and integrated land use planning, a transparent regulatory framework toward land use control, extensive consultation with both local, national and international stakeholders, and participation with local residents. Only under these conditions, one can ensure ownership, respect and trust in the decision. The quandaries highlight the complexity of capital city relocation and green city creation. The originality lies in the specific land management framework perspective and discursive analysis of documented discourses on constructing new capital and green cities. This provides new options for devising and extending regulatory guidelines and for assigning responsibilities for such new mega-endeavors. Given the conceptual and discursive character of the paper, a limitation of the approach may be that there are no specific empirical data collected, yet several recommendations for further research include expanding the boundary work between the land management, the spatial planning and governance domains.
Loop Quantum Black Hole Extensions Within the Improved Dynamics
Authors: Gambini Rodolfo , Olmedo Javier , Pullin Jorge
Published: June 2021

We continue our investigation of an improved quantization scheme for spherically symmetric loop quantum gravity. We find that in the region where the black hole singularity appears in the classical theory, the quantum theory contains semi-classical states that approximate general relativity coupled to an effective anisotropic fluid. The singularity is eliminated and the space-time can be continued into a white hole space-time. This is similar to previously considered scenarios based on a loop quantum gravity quantization.
Sustainability Comes to Life. Nature-Based Adventure Tourism in Norway
Authors: Rosenberg Axel , Lynch Pip M. , Radmann Aage
Published: June 2021

This paper investigates how tourists and guides perform sustainability during adventure tourism trips in natural environments. The paper draws on empirical data from an ethnographic study of five different multi-day trips in Norway, each of which used skiing, hiking, or biking as the mode of travel. In our analysis, we focus on how the different actors understood, operationalized and practiced elements of sustainability in their everyday lives while on the trips. The paper applies a micro-sociological perspective to the nature-based adventure tourism scene where the interplay between tourists, guides, adventure activities and nature is understood as multiple dialectic performances co-produced by the different actors. Goffman's dramaturgical metaphors, and concepts of frames, appearance, and manner saturate recent research on tourism and nature guiding. This paper builds on the “performance turn” as a theoretical point of departure for understanding sustainability in nature-based adventure tourism experiences. In participant observations and post-trip interviews with Norwegian and international tourists and their guides, we found that sustainability performances were not a major aspect of the trips. We did find some performances of mainly “light” sustainability and, among them, elements of ambivalence and ambiguity. Our data indicate that some guides tread a fine line between enhancing and deepening tourists' experiences of nature and sustainability or negatively impacting the perceived enjoyment imperative of the trip. International tourists expressed deeper sustainability overall. We reflect on the relative explanatory strengths of Goffman's “frames” and interaction order, and Persson's “framing,” for understanding the interplay between guide and tourist sustainability performances and conclude with pointers for teasing out the complexities we identify.
Assessing the Risks of Vessel Icing and Aviation Hazards during Downslope Windstorms in the Russian Arctic
Authors: Shestakova Anna A.
Published: June 2021

Downslope windstorms are known sources of hazardous weather, such as severe gusty winds, rapid temperature changes, ship icing, strong turbulence and others, posing a great danger to people and infrastructure. This paper investigates the risks of ship icing and aviation hazards (rapid changes in the angle of attack and gust load factor) during downslope windstorms in five regions in the Russian Arctic based on observational data, reanalysis, and mesoscale numerical modeling. The highest frequency of ship icing was found during downslope windstorms downstream from Svalbard and Novaya Zemlya. Icing is rare during Tiksi and Wrangel Island downslope windstorms due to almost permanent sea ice cover during the cold season, while icing is absent during very warm Pevek downslope windstorm even in the ice-free conditions. Conditions for heavy icing are rather frequent (up to 5% of cases in winter) during Novaya Zemlya downslope windstorms and less frequent (up to 0.5% in spring) during Svalbard windstorm. The presence of downslope windstorms in those regions causes an increase in the maximum icing rate by about 2 times. Strong aviation turbulence hazardous for light aircraft is typical for all considered regions with downslope windstorms; it is observed mainly at an altitude of 1 to 4 km above the surface. Hazardous turbulence for jet aircraft like Boeing 737 on its cruising flight levels was found on Svalbard and in Tiksi region in 10–15% of cases during strong downslope windstorms.
Anemia and the Risk of Cognitive Impairment: An Updated Systematic Review and Meta-Analysis
Authors: Kung Woon-Man , Yuan Sheng-Po , Lin Muh-Shi , Wu Chieh-Chen , Islam Md. Mohaimenul , Atique Suleman , Touray Musa , Huang Chu-Ya , Wang Yao-Chin
Published: June 2021

Background: Cognitive impairment is one of the most common, burdensome, and costly disorders in the elderly worldwide. The magnitude of the association between anemia and overall cognitive impairment (OCI) has not been established. Objective: We aimed to update and expand previous evidence of the association between anemia and the risk of OCI. Methods: We conducted an updated systematic review and meta-analysis. We searched electronic databases, including EMBASE, PubMed, and Web of Science for published observational studies and clinical trials between 1 January 1990 and 1 June 2020. We excluded articles that were in the form of a review, letter to editors, short reports, and studies with less than 50 participants. The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines were followed. We estimated summary risk ratios (RRs) with random effects. Results: A total of 20 studies, involving 6558 OCI patients were included. Anemia was significantly associated with an increased risk of OCI (adjusted RR (aRR) 1.39 (95% CI, 1.25–1.55; p < 0.001)). In subgroup analysis, anemia was also associated with an increased risk of all-cause dementia (adjusted RR (aRR), 1.39 (95% CI, 1.23–1.56; p < 0.001)), Alzheimer’s disease [aRR, 1.59 (95% CI, 1.18–2.13; p = 0.002)], and mild cognitive impairment (aRR, 1.36 (95% CI, 1.04–1.78; p = 0.02)). Conclusion: This updated meta-analysis shows that patients with anemia appear to have a nearly 1.39-fold risk of developing OCI than those without anemia. The magnitude of this risk underscores the importance of improving anemia patients’ health outcomes, particularly in elderly patients.
Undifferentiated Embryonal Sarcoma of the Liver in Children Versus Adults: A National Cancer Database Analysis
Authors: Ziogas Ioannis A. , Zamora Irving J. , Lovvorn III Harold N. , Bailey Christina E. , Alexopoulos Sophoclis P.
Published: June 2021

This study evaluates the clinicopathological characteristics and outcomes of children vs. adults with undifferentiated embryonal sarcoma of the liver (UESL). A retrospective analysis of 82 children (<18 years) and 41 adults (≥18 years) with UESL registered in the National Cancer Database between 2004–2015 was conducted. No between-group differences were observed regarding tumor size, metastasis, surgical treatment, margin status, and radiation. Children received chemotherapy more often than adults (92.7% vs. 65.9%; p < 0.001). Children demonstrated superior overall survival vs. adults (log-rank, p < 0.001) with 5-year rates of 84.4% vs. 48.2%, respectively. In multivariable Cox regression for all patients, adults demonstrated an increased risk of mortality compared to children (p < 0.001), while metastasis was associated with an increased (p = 0.02) and surgical treatment with a decreased (p = 0.001) risk of mortality. In multivariable Cox regression for surgically-treated patients, adulthood (p = 0.004) and margin-positive resection (p = 0.03) were independently associated with an increased risk of mortality. Multimodal treatment including complete surgical resection and chemotherapy results in long-term survival in most children with UESL. However, adults with UESL have poorer long-term survival that may reflect differences in disease biology and an opportunity to further refine currently available treatment schemas.
Classification of Non-Small Cell Lung Cancer’s Tumor Immune Micro-Environment and Strategies to Augment Its Response to Immune Checkpoint Blockade
Authors: Chi Alexander , He Xia , Hou Lin , Nguyen Nam P. , Zhu Guangying , Cameron Robert B. , Lee Jay M.
Published: June 2021

Immune checkpoint blockade (ICB) with checkpoint inhibitors has led to significant and durable response in a subset of patients with advanced stage EGFR and ALK wild-type non-small cell lung cancer (NSCLC). This has been consistently shown to be correlated with the unique characteristics of each patient’s tumor immune micro-environment (TIME), including the composition and distribution of the tumor immune cell infiltrate; the expression of various checkpoints by tumor and immune cells, such as PD-L1; and the presence of various cytokines and chemokines. In this review, the classification of various types of TIME that are present in NSCLC and their correlation with response to ICB in NSCLC are discussed. This is conducted with a focus on the characteristics and identifiable biomarkers of different TIME subtypes that may also be used to predict NSCLC’s clinical response to ICB. Finally, treatment strategies to augment response to ICB in NSCLC with unresponsive types of TIME are explored.
Regulation of RAD51 at the Transcriptional and Functional Levels: What Prospects for Cancer Therapy?
Authors: Orhan Esin , Velazquez Carolina , Tabet Imene , Sardet Claude , Theillet Charles
Published: June 2021

The RAD51 recombinase is a critical effector of Homologous Recombination (HR), which is an essential DNA repair mechanism for double-strand breaks. The RAD51 protein is recruited onto the DNA break by BRCA2 and forms homopolymeric filaments that invade the homologous chromatid and use it as a template for repair. RAD51 filaments are detectable by immunofluorescence as distinct foci in the cell nucleus, and their presence is a read out of HR proficiency. RAD51 is an essential gene, protecting cells from genetic instability. Its expression is low and tightly regulated in normal cells and, contrastingly, elevated in a large fraction of cancers, where its level of expression and activity have been linked with sensitivity to genotoxic treatment. In particular, BRCA-deficient tumors show reduced or obliterated RAD51 foci formation and increased sensitivity to platinum salt or PARP inhibitors. However, resistance to treatment sets in rapidly and is frequently based on a complete or partial restoration of RAD51 foci formation. Consequently, RAD51 could be a highly valuable therapeutic target. Here, we review the multiple levels of regulation that impact the transcription of the RAD51 gene, as well as the post-translational modifications that determine its expression level, recruitment on DNA damage sites and the efficient formation of homofilaments. Some of these regulation levels may be targeted and their impact on cancer cell survival discussed.
Patients with Primary Central Nervous System Lymphoma Not Eligible for Clinical Trials: Prognostic Factors, Treatment and Outcome
Authors: Seidel Sabine , Margold Michelle , Kowalski Thomas , Baraniskin Alexander , Schroers Roland , Korfel Agnieszka , Thiel Eckhard , Weller Michael , Martus Peter , Schlegel Uwe
Published: June 2021

Patients with primary central nervous system lymphoma (PCNSL) not fulfilling inclusion criteria for clinical trials represent an underreported population. Thirty-four consecutive PCNSL patients seen at our center between 2005 and 2019 with exclusion criteria for therapeutic trials were analyzed (non-study patients) and compared with patients from the G-PCNSL-SG-1 (German PCNSL Study Group 1) study (study patients), the largest prospective multicenter trial on PCNSL, comprising 551 patients. Median follow up was 68 months (range 1–141) in non-study patients and 51 months (1–105) in study patients. Twenty-seven/34 (79.4%) non-study patients received high dose methotrexate (HDMTX), while seven/34 (20.6%) with a glomerular filtration rate (GFR) < 50 mL/min did not. Median overall survival (OS) was six months (95% confidence interval [CI] 0–21 months) in those 34 non-study patients. The 27 non-study patients treated with HDMTX were compared with 526/551 G-PCNSL-SG-1 study patients who had received HDMTX as well. Median OS was 20 months (95% CI 0–45)/21 months (95% CI 18–25) in 27 non-study/526 study patients (p = 0.766). Favorable prognostic factors in non-study patients were young age, application of HDMTX and early response on magnet resonance imaging (MRI). If HDMTX-based chemotherapy can be applied, long-term disease control is possible even in patients not qualifying for clinical trials. Initial response on early MRI might be useful for decision on treatment continuation.
Early Progression in Non-Small Cell Lung Cancer (NSCLC) with High PD-L1 Treated with Pembrolizumab in First-Line Setting: A Prognostic Scoring System Based on Clinical Features
Authors: Passaro Antonio , Novello Silvia , Giannarelli Diana , Bria Emilio , Galetta Domenico , Gelibter Alain , Reale Maria Lucia , Carnio Simona , Vita Emanuele , Stefani Alessio , Pizzutilo Pamela , Stati Valeria , Attili Ilaria , de Marinis Filippo
Published: June 2021

Background: Pembrolizumab is approved in monotherapy for the first-line (1L) of advanced or metastatic NSCLC patients with high PD-L1 (≥50%). Despite a proportion of patients achieve long-term survival, about one-third of patients experience detrimental survival outcomes, including early death, hyperprogression, and fast progression. The impact of clinical factors on early progression (EP) development has not been widely explored. Methods: We designed a retrospective, multicenter study involving five Italian centers, in patients with metastatic NSCLC with PD-L1 ≥ 50%, treated with Pembrolizumab in a 1L setting. EP was defined as a progressive disease within three months from pembrolizumab initiation. Baseline clinical factors of patients with and without EP were collected and analyzed. Logistic regression was performed to identify clinical factors associated with EP and an EP prognostic score was developed based on the logistic model. Results: Overall, 321 out of 336 NSCLC patients treated with 1L pembrolizumab provided all the data for the analysis. EP occurred in 137 (42.7%) patients; the median PFS was 3.8 months (95% CI: 2.9–4.7), and median OS was not reached in the entire study population. Sex, Eastern Cooperative Oncology Group (ECOG) performance status (PS), steroids, metastatic sites ≥2, and the presence of liver/pleural metastasis were confirmed as independent factors for EP by multivariate analysis. By combining these factors, we developed an EP prognostic score ranging from 0–13, with three-risk group stratification: 0–2 (good prognosis), 3–6 (intermediate prognosis), and 7–13 (poor prognosis). The area under the curve (AUC) of the model was 0.76 (95% CI: 0.70–0.81). Conclusions: We identified six clinical factors independently associated with EP. We developed a prognostic score model for EP-risk to potentially improve clinical practice and patient selection for 1L pembrolizumab in NSCLC with high PD-L1, in the real-world clinical setting.
Ecological Characteristics and Changes to the Forest in the Rear Garden at Changdeokgung, a World Cultural Heritage Site
Authors: Park Seok-Cheol , Han Bong-Ho , Kwak Jeong-In , Kim Jong-Yup
Published: June 2021

The forest at the Changdeokgung Rear Garden is under ecological threat from factors such as soil acidification due to the growing influence of nearby metropolitan Seoul. It is difficult to maintain biodiversity in forests without first setting a clear direction for ecosystem management. Conservation and management should be based on the history and natural ecological succession of the Rear Garden forest. This study classified the ecology of the Rear Garden at Changdeokgung, a world cultural heritage site, based on soil characteristics, actual vegetation, and plant community structure and identified ecological changes over time (1986–2018) through the analysis of past survey data. The soil pH in the forest of the Changdeokgung’s Rear Garden has decreased over time, and the organic matter content has also decreased. Changdeokgung’s Rear Garden was first created and managed as a Pinus densiflora forest, and subsequently as a Quercus aliena forest. It includes a series of Quercus spp., predominantly Q. serrate. The plant community in the forest is unstable due to the absence of deciduous broad-leaved trees in the understory layer in most of the regions of the garden. Therefore, vegetation management is required in areas with high densities of Acer pseudosieboldianum, Acer palmatum, and Sorbus alnifolia to ensure stability of the ecosystem.
How a Paleogenomic Approach Can Provide Details on Bioarchaeological Reconstruction: A Case Study from the Globular Amphorae Culture
Authors: Vai Stefania , Diroma Maria Angela , Cannariato Costanza , Budnik Alicja , Lari Martina , Caramelli David , Pilli Elena
Published: June 2021

Ancient human remains have the potential to explain a great deal about the prehistory of humankind. Due to recent technological and bioinformatics advances, their study, at the palaeogenomic level, can provide important information about population dynamics, culture changes, and the lifestyles of our ancestors. In this study, mitochondrial and nuclear genome data obtained from human bone remains associated with the Neolithic Globular Amphorae culture, which were recovered in the Megalithic barrow of Kierzkowo (Poland), were reanalysed to gain insight into the social organisation and use of the archaeological site and to provide information at the individual level. We were able to successfully estimate the minimum number of individuals, sex, kin relationships, and phenotypic traits of the buried individuals, despite the low level of preservation of the bone samples and the intricate taphonomic conditions. In addition, the evaluation of damage patterns allowed us to highlight the presence of “intruders”—that is, of more recent skeletal remains that did not belong to the original burial. Due to its characteristics, the study of the Kierzkowo barrow represented a challenge for the reconstruction of the biological profile of the human community who exploited it and an excellent example of the contribution that ancient genomic analysis can provide to archaeological reconstruction.
Family Physician Perceptions of Climate Change, Migration, Health, and Healthcare in Sub-Saharan Africa: An Exploratory Study
Authors: Scheerens Charlotte , Bekaert Els , Ray Sunanda , Essuman Akye , Mash Bob , Decat Peter , De Sutter An , Van Damme Patrick , Vanhove Wouter , Lietaer Samuel , De Maeseneer Jan , Madzimbamuto Farai , Ruyssen Ilse
Published: June 2021

Although family physicians (FPs) are community-oriented primary care generalists and should be the entry point for the population’s interaction with the health system, they are underrepresented in research on the climate change, migration, and health(care) nexus (hereafter referred to as the nexus). Similarly, FPs can provide valuable insights into building capacity through integrating health-determining sectors for climate-resilient and migration-inclusive health systems, especially in Sub-Saharan Africa (SSA). Here, we explore FPs’ perceptions on the nexus in SSA and on intersectoral capacity building. Three focus groups conducted during the 2019 WONCA-Africa conference in Uganda were transcribed verbatim and analyzed using an inductive thematic approach. Participants’ perceived interactions related to (1) migration and climate change, (2) migration for better health and healthcare, (3) health impacts of climate change and the role of healthcare, and (4) health impacts of migration and the role of healthcare were studied. We coined these complex and reinforcing interactions as continuous feedback loops intertwined with socio-economic, institutional, and demographic context. Participants identified five intersectoral capacity-building opportunities on micro, meso, macro, and supra (international) levels: multi-dimensional and multi-layered governance structures; improving FP training and primary healthcare working conditions; health advocacy in primary healthcare; collaboration between the health sector and civil society; and more responsibilities for high-income countries. This exploratory study presents a unique and novel perspective on the nexus in SSA which contributes to interdisciplinary research agendas and FP policy responses on national, regional, and global levels.
Sensitivity Analysis of Emission Models of Parcel Lockers vs. Home Delivery Based on HBEFA
Authors: Schnieder Maren , Hinde Chris , West Andrew
Published: June 2021

Global concerns about the environmental effects (e.g., pollution, land use, noise) of last-mile deliveries are increasing. Parcel lockers are seen as an option to reduce these external effects of last-mile deliveries. The contributions of this paper are threefold: firstly, the research studies simulating the emissions caused by parcel delivery to lockers are summarized. Secondly, a demand model for parcel deliveries in New York City (NYC) is created for 365 days and delivery trips to lockers and homes are optimized for 20 “real-world” scenarios. Thirdly, using the emission factors included in the HandBook Emission Factors for Road Transport (HBEFA) database, the maximum percentage of customers who could pick up a parcel by car from parcel lockers that would result in fewer total emissions (driving customers + walking customers) than if home deliveries were adopted is calculated for various pollutants and scenario assumptions (i.e., street types, temperature, parking duration, level of service and vehicle drivetrain). This paper highlights how small changes in the calibration can significantly change the results and therefore using average values for emission factors or only considering one pollutant like most studies may not be appropriate.
Social Inequality and Solidarity in Times of COVID-19
Authors: Stok F. Marijn , Bal Michèlle , Yerkes Mara A. , de Wit John B. F.
Published: June 2021

The enormous public health burdens of the COVID-19 pandemic are not distributed equally. Inequalities are noticeable along socio-economic and socio-cultural fault lines. These social determinants of health affect both the prevalence and severity of COVID-19 infections as well as the magnitude of negative impacts of the measures taken to slow the spread of the virus. This perspective paper summarizes key inequalities in who is affected by SARS-CoV-2 infection and in who is affected by COVID-19 prevention measures, based on evidence presented in state-of-the-art literature, and discusses the scope of challenges that these inequalities pose to solidarity and social justice. Key challenges for solidarity are highlighted across three areas: challenges to intergenerational solidarity, to global solidarity, and to intergroup solidarity.
Exploring a Fuzzy Rule Inferred ConvLSTM for Discovering and Adjusting the Optimal Posture of Patients with a Smart Medical Bed
Authors: Costello Francis Joseph , Kim Min Gyeong , Kim Cheong , Lee Kun Chang
Published: June 2021

Several countries nowadays are facing a tough social challenge caused by the aging population. This public health issue continues to impose strain on clinical healthcare, such as the need to prevent terminal patients’ pressure ulcers. Provocative approaches to resolve this issue include health information technology (HIT). In this regard, this paper explores one technological solution based on a smart medical bed (SMB). By integrating a convolutional neural network (CNN) and long-short term memory (LSTM) model, we found this model enhanced performance compared to prior solutions. Further, we provide a fuzzy inferred solution that can control our proposed proprietary automated SMB layout to optimize patients’ posture and mitigate pressure ulcers. Therefore, our proposed SMB can allow autonomous care to be given, helping prevent medical complications when lying down for a long time. Our proposed SMB also helps reduce the burden on primary caregivers in fighting against staff shortages due to public health issues such as the increasing aging population.
Safe Sexual Behavior Intentions among College Students: The Construction of an Extended Theory of Planned Behavior
Authors: Lin Chien-Liang , Ye Yuan , Lin Peng , Lai Xiao-Ling , Jin Yuan-Qing , Wang Xin , Su Yu-Sheng
Published: June 2021

Sexual health education is an essential part of quality-oriented education for college students. It aims to help these students to acquire knowledge of sexual physiology, sexual psychology, and sexual social norms that is consistent with the maturity of the students. Along with college students’attitudes toward sex, their perceptions regarding sexual behavior have also undergone profound changes. The importance of safe sexual behavior, sexual taboos, and sexual autonomy are gaining increasing attention as Chinese society is becoming more open. For college students who have just reached adulthood and have full autonomy of themselves, however, are they really going to have sexual behavior without careful consideration? Or is it something they have planned to do in the first place? To answer the above questions, this study was conducted to understand the relationship between college students’ attitudes toward sex, subjective norms, and behavioral control of their sexual behavior intentions by applying the Theory of Planned Behavior. In this study, 460 valid questionnaires were collected from Chinese college students and analyzed with partial least squares structural equation modeling (PLS-SEM). This study analyzes the relationship of multiple factors, including those influencing college students’ sexual behavior intentions. Meanwhile, it also compares the differences in factors affecting sexual behavior intentions between college students with or without sexual experience and those of different genders. Based on the results of the study, it was found that, first, subjective norms and perceived behavioral control of college students had a significant effect on safe sexual behavior intentions, while attitudes did not have a significant effect on safe sexual behavior intentions. Second, the gender and sexual experience of college students had a significant effect on safe sexual behavior intentions. Third, non-sexually experienced college students were more likely to be influenced by external factors. Relevant future research suggestions will be proposed based on the results of this study. Finally, this study helps to provide substantive suggestions for enhancing safe sexual behavior among college students in the context of universal higher education, as well as strengthening the self-protection of college students and providing practical advice for the development of sex education in China.
Impact of the COVID-19 Pandemic on Healthcare-Seeking Behaviors among Frequent Emergency Department Users: A Cohort Study
Authors: Chou Yi-Chang , Yen Yung-Feng , Chu Dachen , Hu Hsiao-Yun
Published: June 2021

In 2020, Taiwan’s healthcare system faced a notable burden imposed by the coronavirus disease (COVID-19) pandemic. Emergency department (ED) is a high-risk area for severe acute respiratory syndrome coronavirus 2 transmission. The effect of COVID-19 on the utilization of ED services among frequent ED users remains unknown. This cohort study determined the impact of the COVID-19 pandemic on healthcare-seeking behaviors among frequent ED users at Taipei City Hospital, Taiwan. We included ED users aged ≥ 18 years admitted to Taipei City Hospital during February 2019–January 2020 (before the pandemic) and February 2020–January 2021 (during the pandemic). Frequent ED users were patients with four or more ED visits per year. Stepwise logistic regression was performed to identify predictors of frequent ED use during the COVID-19 pandemic. Frequent ED users had shorter hospital stays in the ED during the pandemic. After adjusting for sociodemographic factors and other covariates, patients with a triage status of level 4–5, pneumonia diagnosis, giddiness, or dyspnea were more likely frequent ED visitors during the COVID-19 pandemic. To reduce the risk of acquiring COVID-19, it is important to utilize territorial healthcare or telehealth to avoid inappropriate ED visits for patients with a low level of risk or chronic disease.
Mental Health of Refugees and Migrants during the COVID-19 Pandemic: The Role of Experienced Discrimination and Daily Stressors
Authors: Spiritus-Beerden Eva , Verelst An , Devlieger Ines , Langer Primdahl Nina , Botelho Guedes Fábio , Chiarenza Antonio , De Maesschalck Stephanie , Durbeej Natalie , Garrido Rocío , Gaspar de Matos Margarida , Ioannidi Elisabeth , Murphy Rebecca , Oulahal Rachid , Osman Fatumo , Padilla Beatriz , Paloma Virginia , Shehadeh Amer , Sturm Gesine , van den Muijsenbergh Maria , Vasilikou Katerina , Watters Charles , Willems Sara , Skovdal Morten , Derluyn Ilse
Published: June 2021

The COVID-19 pandemic is a defining global health crisis of our time. While the impact of COVID-19, including its mental health impact, is increasingly being documented, there remain important gaps regarding the specific consequences of the pandemic on particular population groups, including refugees and migrants. This study aims to uncover the impact of the COVID-19 pandemic on the mental health of refugees and migrants worldwide, disentangling the possible role of social and daily stressors, i.e., experiences of discrimination and daily living conditions. Descriptive analysis and structural equation modeling were used to analyze the responses of N = 20,742 refugees and migrants on the self-reporting global ApartTogether survey. Survey findings indicated that the mental health of refugees and migrants during the COVID-19 pandemic was significantly impacted, particularly for certain subgroups, (i.e., insecure housing situation and residence status, older respondents, and females) who reported experiencing higher levels of increased discrimination and increases in daily life stressors. There is a need to recognize the detrimental mental health impact of the COVID-19 pandemic on particular refugee and migrant groups and to develop interventions that target their unique needs.
Changes in Unemployment Affect Sickness Absence and Disability Retirement Rates: A Municipality-Level Panel Study
Authors: Blomgren Jenni , Laaksonen Mikko , Perhoniemi Riku
Published: June 2021

To enhance understanding of the interplay between unemployment and sickness absence and disability retirement, the aim of this study was to examine how changes in area-level unemployment rates are associated with changes in sickness absence and disability retirement rates in a longitudinal setting. Municipality-level time-series data were collected on unemployment, sickness absence, disability retirement and covariates from databases for Finnish municipalities for years 2003–2017 (n = 4425 municipality–year observations). Fixed effects panel regression models were used to analyse how changes in unemployment rates predict changes in sickness absence and disability retirement rates when comparing consecutive years. The results showed that when examining yearly cross-sections, a higher level of unemployment in the municipality was associated with higher sickness absence and disability retirement rates. However, longitudinal assessment of consecutive years with panel regression models showed that a one percentage point increase in the municipality-level unemployment rate was associated with a decrease both in the sickness absence rate (−1.3%, p < 0.001) and in the disability retirement rate (−2.1%, p = 0.011), adjusted for simultaneous changes in demographic and socio-economic covariates, morbidity and economic situation of the municipality. The results indicate that unemployment and disability benefits partly act as substitutes for each other. Unemployment and disability rates should be assessed together to reach a more complete understanding of the level of non-employment overall and in different areas.
The Role of Organizational Culture and Climate for Well-Being among Police Custody Personnel: A Multilevel Examination
Authors: Werner-de-Sondberg Christopher Robert Mark , Karanika-Murray Maria , Baguley Thomas , Blagden Nicholas
Published: June 2021

United Kingdom Police custody is one of the most challenging of work environments, liable to excessive demands and reduced well-being. Being difficult to access, it is also a much-neglected area of research that has focused on one or two roles, rather than the full range available, and on individual-level research, rather than a more comprehensive multilevel understanding of how organizational culture and climate can simultaneously influence a range of well-being outcomes. The present longitudinal study explored all types of roles, in both the public and private sectors, across seven English police forces and 26 custody sites (N = 333, response rate 46.57%, with repeated returns = 370). The Integrated Multilevel Model of Organizational Culture and Climate (IMMOCC) was applied to examine the organizational-level influences on individual well-being. Results indicated that (1) custody sergeants were most vulnerable to low well-being, followed by publicly contracted detention officers; (2) shared leadership (a source of team cohesion) was linked to four of six well-being outcomes; (3) two sub-components of culture reflected tensions never acknowledged before, especially in respect of role; and (4) reverse relationships existed between well-being outcomes and the dimensions of culture and climate. The findings inform practical recommendations, including resilience training and the need to raise the status of police custody, while also highlighting concerns about private sector scrutiny that may be relevant to other professions.
Developing Super-Hydrophobic and Abrasion-Resistant Wool Fabrics Using Low-Pressure Hexafluoroethane Plasma Treatment
Authors: Parveen Shama , Rana Sohel , Goswami Parikshit
Published: June 2021

The growing interest in wool fibres as an eco-friendly and sustainable material for diverse industrial applications requires an enhancement of their functional performance. To address this, wool fabrics were treated in the present research with low-pressure hexafluoroethane (C2F6) plasma to impart superhydrophobicity and improve their abrasion resistance. Unscoured and scoured wool fabrics were treated with C2F6 while varying plasma power (80 W and 150 W), gas flow rate (12 sccm and 50 sccm) and treatment time (6 min and 20 min), and the effect of plasma parameters on the abrasion resistance, water contact angle and dyeing behaviour of the wool fabrics was studied. Martindale abrasion testing showed that the surface abrasion of the wool fabrics increased with the number of abrasion cycles, and the samples treated with 150 W, 20 min, 12 sccm showed superior abrasion resistance. The scoured wool fabrics showed a contact angle of ~124°, which was stable for only 4 min 40 s, whereas the plasma-treated samples showed a stable contact angle of over 150°, exhibiting a stable superhydrophobic behaviour. The C2F6 plasma treatment also significantly reduced the exhaustion of an acid dye by wool fabrics. The EDX study confirmed the deposition of fluorine-containing elements on the wool fabrics significantly altering their properties.
Development of Resistance Spot Welding Processes of Metal–Plastic Composites
Authors: Kustroń Paweł , Korzeniowski Marcin , Piwowarczyk Tomasz , Sokołowski Paweł
Published: June 2021

Metal–plastic composites (MPCs) are gaining importance mainly due to high strength to weight ratio. They consist of three layers, two outer metallic cover sheets, and a plastic core. The presence of that inner plastic layer makes them rather unsuitable for joining by means of any conventional welding processes, which significantly reduces the application range of MPC. In this work, three various resistance spot welding (RSW)-based concepts were developed to overcome that limitation and join Litecor to DP600 steel. In all cases, a dedicated initial stage was implemented to RSW, which was aimed at removing the non-conductive polymer layer from the welding zone and creating the proper electrical contact for the resistance welding. These were, namely: (i) shunt current-assisted RSW; (ii) induction heating-assisted RSW; and (iii) ultrasonic-assisted RSW. The development of each concept was supported by finite element modeling, which was focused on setting the proper process parameters for polymer layer removal. Finally, the macro- and microstructure of exemplary RSW joints are shown and the most common spot weld features as well as the further development possibilities are discussed.
Seismic Performance of Steel Fiber Reinforced High–Strength Concrete Beam–Column Joints
Authors: Shi Ke , Zhang Mengyue , Zhang Tao , Li Pengfei , Zhu Junpeng , Li Li
Published: June 2021

In high–strength concrete, the reinforcement concentration will cause some problems in the beam–column joints (BCJs) due to a large amount of transverse reinforcement. Hence, the main object of this paper is to prevent the reinforcement concentration and reduce the amount of transverse reinforcement in the BCJs through the ideal usage of steel fibers and reinforced high–strength concrete. Pseudo–static tests on seven specimens were carried out to investigate and evaluate the seismic performance of beam–column joints in steel fiber reinforced high–strength concrete (SFRHC). Test variables were steel fiber volume ratio, concrete strength, the stirrup ratio in the core area, and an axial compression ratio of the column end. During the test, the hysteresis curves and failure mode were recorded. The seismic indicators, such as energy dissipation, ductility, strength, and stiffness degradation, were determined. The experimental results indicated that the failure modes of SFRHC beam–column joints mainly included the core area failure and the beam end bending failure. With the increase in stirrup ratio, volume ratio of steel fiber, and axial compression ratio in the core area, both the ductility and energy consumption of beam–column joints increased, while the opposite was true for concrete strength.