bluuebunny/crossref_metadata_2025 huggingface dataset:
Assessment of the Genetic Diversity of a Local Pig Breed Using Pedigree and SNP Data
Authors: Krupa Emil , Moravčíková Nina , Krupová Zuzana , Žáková Eliška
Published: December 2021

Herein, the genetic diversity of the local Přeštice Black-Pied pig breed was assessed by the simultaneous analysis of the pedigree and single nucleotide polymorphism (SNP) data. The information about sire line, dam, date of birth, sex, breeding line, and herd for 1971 individuals was considered in the pedigree analysis. The SNP analysis (n = 181) was performed using the Illumina PorcineSNP60 BeadChip kit. The quality of pedigree and SNPs and the inbreeding coefficients (F) and effective population size (Ne) were evaluated. The correlations between inbreeding based on the runs of homozygosity (FROH) and pedigree (FPED) were also calculated. The average FPED for all animals was 3.44%, while the FROH varied from 10.81% for a minimum size of 1 Mbp to 3.98% for a minimum size of 16 Mbp. The average minor allele frequency was 0.28 ± 0.11. The observed and expected within breed heterozygosities were 0.38 ± 0.13 and 0.37 ± 0.12, respectively. The Ne, obtained using both the data sources, reached values around 50 animals. Moderate correlation coefficients (0.49–0.54) were observed between FPED and FROH. It is necessary to make decisions that stabilize the inbreeding rate in the long-term using optimal contribution selection based on the available SNP data.
Knowledge, Attitudes, and Practices towards Diabetic Retinopathy among Primary Care Physicians of Saudi Arabia: A Multicenter Cross-Sectional Study
Authors: Thirunavukkarasu Ashokkumar , Almulhim Abdulmohsen Khaled , Albalawi Faisal Ahmed , Alruwaili Ziyad Muharib , Almajed Ola Ali , Alruwaili Sultan Hamoud , Almugharriq Malek Mohammed , Alruwaili Abdulaziz Saud , Alkuwaykibi Malak Khalid
Published: December 2021

Primary care physicians play a vital role in preventing the progression of diabetic retinopathy (DR) from the initial stages to the late stages. This questionnaire-based analytical cross-sectional study was carried out to assess the knowledge, attitude, practices, and their correlation among 274 randomly selected primary care physicians in Saudi Arabia. Among the studied population, high knowledge, attitudes, and practice scores were observed in 21.5%, 15%, and 29.2% of the physicians, respectively. The mean knowledge score was significantly higher among the age group of less than 30 years (p = 0.031) and the female gender (p = 0.012). The attitude scores were significantly higher among the Saudi physicians (p = 0.027) and those with PHC work experience of less than five years (p < 0.001). Regarding the practices, a significant association was found among the age group of less than 30 years (p = 0.019) and Saudi physicians (p = 0.003). There was a significant positive correlation between knowledge (correlation coefficient (r) = 0.739, p < 0.001) and attitude (r = 0.479, p = 0.007) with the practice scores. It is recommended that targeted continuous medical education, workshops, and seminars are conducted on the prevention and care of DR among primary care physicians. Furthermore, an exploratory multicenter study that involves primary care physicians belonging to all ministries and private sectors is warranted.
Bedsores Management: Efficiency Simulation of a New Mattress Design
Authors: Alwasel Abdullatif , Alossimi Bandar , Alsadun Maha , Alhussaini Khalid
Published: December 2021

Bedsores, also known as pressure ulcers, are wounds caused by the applied external force (pressure) on body segments, thereby preventing blood supply from delivering the required elements to the skin tissue. Missing elements hinder the skin’s ability to maintain its health. It poses a significant threat to patients that have limited mobility. A new patented mattress design and alternative suggested designs aimed to reduce pressure are investigated in this paper for their performance in decreasing pressure. A simulation using Ansys finite element analysis (FEA) is carried out for comparison. Three-dimensional models are designed and tested in the simulation for a mattress and human anthropometric segments (Torso and Hip). All designs are carried out in solidworks. Results show that the original design can redistribute the pressure and decrease it up to 17% less than the normal mattress. The original design shows better ability to decrease the absolute amount of pressure on the body. However, increasing the surface area of the movable parts results in less pressure applied to the body parts. Thus, this work suggests changing the surface area of the cubes from 25 to 100 cm2.
Co-Design of an Evidenced Informed Service Model of Integrated Palliative Care for Persons Living with Severe Mental Illness: A Qualitative Exploratory Study
Authors: Tinkler Marianne , Reid Joanne , Brazil Kevin
Published: December 2021

Background: Globally, close to one billion people are living with a mental health disorder, and it is one of the most neglected areas in Public Health. People with severe mental illness have greater mortality risk than the general population, experience health care inequalities throughout life and represent a vulnerable, under-served and under-treated population, who have been overlooked in health inequality research to date. There is currently a dearth of evidence in relation to understanding the palliative care needs of people with severe mental illness and how future care delivery can be designed to both recognise and respond to those needs. This study aims to co-design an evidenced informed service model of integrated palliative care for persons living with a severe mental illness. Methods: This qualitative sequential study underpinned by interpretivism will have six phases. An expert reference group will be established in Phase 1, to inform all stages of this study. Phase 2 will include a systematic literature review to synthesise current evidence in relation to palliative care service provision for people with severe mental illness. In Phase 3, qualitative interviews will be undertaken with both, patients who have a severe mental illness and in receipt of palliative care (n = 13), and bereaved caregivers of people who have died 6–18 months previously with a diagnosis of severe mental illness (n = 13), across two recruitment sties in the United Kingdom. Focus groups (n = 4) with both mental health and palliative care multidisciplinary staff will be undertaken across the two recruitment sites in Phase 4. Phase 5 will involve the co-design of a service model of integrated palliative care for persons living with severe mental illness. Phase 6 will develop practice recommendations for this client cohort. Discussion: Palliative care needs to be available at all levels of care systems; it is estimated that, globally, only 14% of patients who need palliative care receive it. Reducing inequalities experienced by people with severe mental illness is embedded in the National Health Service Long Term Plan. Internationally, the gap between those with a mental illness needing care and those with access to care remains considerable. Future policy and practice will benefit from a better understanding of the needs of this client cohort and the development of a co-designed integrated care pathway to facilitate timely access to palliative care for people with a severe mental illness.
A Machine Learning Approach to Predicting Diabetes Complications
Authors: Jian Yazan , Pasquier Michel , Sagahyroon Assim , Aloul Fadi
Published: December 2021

Diabetes mellitus (DM) is a chronic disease that is considered to be life-threatening. It can affect any part of the body over time, resulting in serious complications such as nephropathy, neuropathy, and retinopathy. In this work, several supervised classification algorithms were applied for building different models to predict and classify eight diabetes complications. The complications include metabolic syndrome, dyslipidemia, neuropathy, nephropathy, diabetic foot, hypertension, obesity, and retinopathy. For this study, a dataset collected by the Rashid Center for Diabetes and Research (RCDR) located in Ajman, UAE, was utilized. The dataset consists of 884 records with 79 features. Some essential preprocessing steps were applied to handle the missing values and unbalanced data problems. Furthermore, feature selection was performed to select the top five and ten features for each complication. The final number of records used to train and build the binary classifiers for each complication was as follows: 428—metabolic syndrome, 836—dyslipidemia, 223—neuropathy, 233—nephropathy, 240—diabetic foot, 586—hypertension, 498—obesity, 228—retinopathy. Repeated stratified k-fold cross-validation (with k = 10 and a total of 10 repetitions) was employed for a better estimation of the performance. Accuracy and F1-score were used to evaluate the models’ performance reaching a maximum of 97.8% and 97.7% for accuracy and F1-scores, respectively. Moreover, by comparing the performance achieved using different attributes’ sets, it was found that by using a selected number of features, we can still build adequate classifiers.
Cost-Effectiveness and Safety of Same-Day Discharge after Elective Percutaneous Coronary Intervention
Authors: Prashar Abhisheik , Mitchell Kurt , Hopkins Andrew , Sader Mark , Prasan Ananth M.
Published: December 2021

Objectives: We sought to investigate the rates of same-day discharge (SDD) post elective percutaneous coronary intervention (PCI) at our institution and review its safety by examining clinical outcomes. We also performed an economic analysis evaluating our hospital’s cost data for SDD following PCI. Methods: Patients undergoing elective PCI at St George Hospital, Australia, from January 2017 to December 2019 were evaluated. Primary outcomes included 7-day major adverse cardiovascular endpoints (MACEs) and readmission to hospital within 30 days. Results: Among 502 patients who underwent elective PCI, 421 patients (83.8%) were managed with SDD. There was one case of acute stent thrombosis and one case of coronary wire-induced perforation requiring a pericardial drain that occurred following elective PCI with SDD (0.54%). Unplanned cardiac re-hospitalisation at 30 days following elective PCI was 5.2%. SDD after elective PCI was associated with a healthcare cost saving of AUD 4817 per case. Conclusion: SDD following elective PCI was demonstrated to be a safe and effective strategy that was also associated with significant cost savings. SDD following elective PCI warrants more widespread use as it lowers healthcare costs, has equivalent patient outcomes and improves patient satisfaction.
Brown Marmorated Stink Bug (Halyomorpha halys Stål.) Attack Induces a Metabolic Response in Strawberry (Fragaria × ananassa Duch.) Fruit
Authors: Weber Nika Cvelbar , Razinger Jaka , Jakopič Jerneja , Schmitzer Valentina , Hudina Metka , Slatnar Ana , Veberič Robert , Štampar Franci , Zamljen Tilen
Published: December 2021

The polyphagous brown marmorated stink bug (Halyomorpha halys Stål.) is an important pest in many countries. Recently it was noticed that it can feed on and cause damage to strawberries (Fragaria × ananassa Duch.). The metabolic response of strawberries to brown marmorated stink bug attacks was studied. Brown marmorated stink bugs attacked strawberry fruit which had 18% lower total sugar content compared to that of the control treatment. However, organic acid content had no significant difference among the three treatments, with the exception of shikimic acid, which had the highest content in the attacked fruit. Thirty-one phenolic compounds were identified. Results showed a strong effect on secondary metabolites due to H. halys attacks. Halyomorpha halys treatment had 27% higher total analyzed phenolic content compared to the indirect Halyomorpha halys treatment. The brown marmorated stink bug significantly increased total ellagic acid derivatives (33.1% to 37% higher), hydroxycinnamic acids (22.3% higher) and anthocyanins’ (39% higher) contents. Fruit attacked by Halyomorpha halys also had higher catechin and epicatechin content than that of the control treatments. This pest had a significant influence on the plant’s secondary metabolism, and this improved our understanding of how a strawberry plant reacts to the attacks of this very important pest. H. halys-infested fruit are not suitable for commercial production, due to the production of off-flavors.
Influence of Saltwater Submergence on Geohydraulic Properties of Sand: A Laboratory Investigation
Authors: Basack Sudip , Goswami Ghritartha , Sonowal Sumanpran , Karakouzian Moses
Published: December 2021

Saline water intrusion into freshwater aquifers is a major geohydraulic problem relevant to coastal environment. Apart from contaminating the fresh groundwater resources, the saltwater intrusion alters the geotechnical properties of the aquifer materials, affecting the coastal water resource planning and management. The present study focuses on an in-depth laboratory investigation of the influence of saltwater submergence on the geohydraulic properties of sand. The fine sand sample was submerged under saline water of specified concentrations for specific periods, and the alteration in their engineering properties has been studied. It is observed that the specific gravity, dry density, and permeability of fine sand is significantly affected by the period of submergence and saline concentration. The specific gravity of sand particles was observed to increase almost linearly with period of submergence and saline concentration. While the sand dry density decreased fairly linearly with the period of submergence, the same is not being affected significantly by saline concentration. The permeability of sand increased nonlinearly with both period of submergence and saline concentration; for a submergence period of 14 days and saline concentration of 30,000 ppm, the permeability increased to a maximum value.
Neck Circumference Predicts Mortality in Hospitalized COVID-19 Patients
Authors: Di Bella Stefano , Zerbato Verena , Sanson Gianfranco , Roman-Pognuz Erik , De Cristofaro Paolo , Palermo Andrea , Valentini Michael , Gobbo Ylenia , Jaracz Anna Wladyslawa , Bozic Hrzica Elizabeta , Bresani-Salvi Cristiane Campello , Galindo Alexandre Bezerra , Crovella Sergio , Luzzati Roberto
Published: December 2021

We aimed to determine whether neck circumference predicts mortality among hospitalized COVID-19 patients with respiratory failure. We performed a prospective multicenter (Italy and Brasil) study carried out from March to December 2020 on 440 hospitalized COVID-19 patients with respiratory failure. Baseline neck circumference was measured. The study outcome was 30- and 60-days mortality. Female and male participants were classified as “large neck” when exceeding fourth-quartile. Patients had a median age of 65 years (IQR 54–76), 68% were male. One-quarter of patients presented with grade-1 or higher obesity. The median neck circumference was 40 cm (IQR 38–43): 38 cm (IQR 36–40) for female and 41 cm (IQR 39–44) for male subjects. “Large neck” patients had a significantly higher prevalence of hypertension (63 vs. 48%), diabetes (33 vs. 19%), obesity (26 vs. 14%), and elevated C-reactive protein (CRP) (98 vs. 88%). The cumulative mortality rate was 13.1% (n = 52) and 15.9% (n = 63) at 30 and 60 days, respectively. After adjusting for age, BMI, relevant comorbidities, and high C-reactive protein to albumin ratio, “large neck” patients showed a significantly increased risk of death at 30- (adjusted HR 2.50; 95% CI 1.18–5.29; p = 0.017) and 60-days (adjusted HR 2.26; 95% CI 1.14–4.46; p = 0.019). Neck circumference is easy to collect and provides additional prognostic information to BMI. Among hospitalized COVID-19 patients with respiratory failure, those with large neck phenotype had a more than double risk of death at 30 and 60 days.
Occupational Risk of Low-Level Blast Exposure and TBI-Related Medical Diagnoses: A Population-Based Epidemiological Investigation (2005–2015)
Authors: Belding Jennifer N. , Englert Robyn , Bonkowski James , Thomsen Cynthia J.
Published: December 2021

Because traumatic brain injury (TBI)—most often caused by exposure to high-level blast (HLB)—is a leading cause of medical evacuations of deployed U.S. service members in recent conflicts, researchers seek to identify risk factors for TBI. Previous research using self-reported data has identified low-level blast (LLB) as one such risk factor and suggests an association with susceptibility to and symptoms associated with TBI. This article presents a population-based study of all branches of military service that examines the association between occupational risk for LLB and both clinically diagnosed TBIs—from concussions to severe and penetrating TBIs—and conditions commonly comorbid with concussion. Using archival medical and career records from >2 million service members between 2005–2015, this work demonstrates that occupational risk of LLB is associated with any TBI, mild TBI, moderate TBI, cognitive problems, communication problems, hearing problems, headaches, any behavioral health condition, anxiety, drug abuse/dependence, alcohol abuse/dependence, delirium/dementia, posttraumatic stress disorder, post-concussive syndrome, tinnitus, fatigue, and migraines. Understanding the full scope of the effects of LLB on service members will help ensure the health and readiness of service members and may influence both military policy and clinical practice guidelines for blast-induced injuries.
Working with Young People at Risk of Suicidal Behaviour and Self-Harm: A Qualitative Study of Australian General Practitioners’ Perspectives
Authors: Bellairs-Walsh India , Byrne Sadhbh J. , Bendall Sarah , Perry Yael , Krysinska Karolina , Lin Ashleigh , Michail Maria , Lamblin Michelle , Li Tina Yutong , Hetrick Sarah , Robinson Jo
Published: December 2021

General Practitioners (GPs) play a crucial role in the identification and support of young people at risk of suicidal behaviour and self-harm; however, no studies have explored GPs’ perspectives, approaches, challenges, and resource needs when working with this cohort in an Australian setting. This was a qualitative study where fifteen GPs (Mage = 45.25 years) from multiple clinics in Western Australia took part in semi-structured interviews, and data were analysed thematically. Seven main themes were identified: (1) working with young people has its unique challenges; (2) screening and assessment tools can help to manage uncertainty and discomfort; (3) going beyond tools–the dialogue and relationship are most important; (4) there are limits to what we can offer in the time available; (5) the service access and referral pathways lack clarity and coordination; (6) the provision of mental health support should not fall on GPs alone; and (7) more comprehensive training in suicide and self-harm is needed. The findings highlight a number of opportunities to enhance care and better assist GPs working with young people who present with suicidal behaviour and self-harm, including considerations for conducting assessments, targeted resources such as training, and system and service improvements.
The Sagittal Integral Morphotype in Male and Female Rowers
Authors: Alvero-Cruz Jose Ramón , Santonja-Medina Fernando , Sanz-Mengibar Jose Manuel , Sainz de Baranda Pilar
Published: December 2021

The goal of this study was to describe the integrated spinal assessment of the sagittal morphotype in rowers to determine whether the intense practice of rowing causes a modification of the sagittal curvatures of the spine, its relationship with the rowing technique, and training background. The second goal was to analyse how the dorsal and lumbar curves behave in the three phases of the rowing gesture, and to determine which phases can be detrimental to the correct development of the spine during growth. We analysed the spine curvatures in the sagittal plane of 29 females and 82 males, which were measured with an inclinometer in standing, slump sitting, maximal trunk flexion and during rowing performance. The average value of thoracic kyphosis in the rowers was 30° (mean, 30 + 8.27°). Thoracic hyperkyphosis was found in only two rowers (1.8%). Lumbar lordosis was within normal range in 84.1% of the males (mean, 27 + 9.57°) and 75.9% of female rowers (mean, 33°). Functional thoracic hyperkyphosis was observed in 57.4% of the males and 17.1% of the females. Functional lumbar hyperkyphosis was observed in 28 of the 69 males (40.5%) and five of 22 females (17.2%). Rowing seems to provide adequate spine alignment in the sagittal plane on standing. The integrated spinal assessment of the sagittal morphotype showed that half or our rowers presented with functional thoracic hyperkyphosis, and 43.2% presented with functional lumbar hyperkyphosis. Spine behaviour during the rowing technique shows that the thoracic kyphosis (98.2%) and lumbar spine (91%) perform within normative ranges and could explain the adequate positioning of the spine in the sagittal plane on standing. Years of rowing training tend to reduce thoracic kyphosis in males.
Causes and Treatment of Hypoxia during Total Hip Arthroplasty in Elderly Patients: A Case Report
Authors: Ji Jae Young , Chung Jin Hun , Kim Nan Seol , Seo Yong Han , Jung Ho Soon , Chun Hea Rim , Gong Hyung Yoon , Kim Woo Jong , Ahn Jae Min , Park Yu Jun
Published: December 2021

Intraoperative hypoxia occurs in approximately 6.8% of surgeries and requires appropriate management to avoid poor outcomes, such as increased mortality or extended hospitalization. Hypoxia can be caused by a variety of factors, including laryngospasm, inhalational anesthetics, and surgery for abdominal pathology or hip fractures. In particular, elderly patients are more vulnerable to hypoxia due to their existing lung diseases or respiratory muscle weakness. This study presents the cases of two elderly patients who developed hypoxia during total hip arthroplasty under general anesthesia. Positive end expiratory pressure, the recruitment maneuver, and increased fraction of inspired oxygen improved hypoxia only temporarily, and patients’ oxygen saturation level again dropped to 79–80%. We suspected that hypoxia was caused by atelectasis and, therefore, resumed spontaneous respiration. Thereafter, both the patients showed an improvement in hypoxia. Intraoperative hypoxia that is suspected to be caused by atelectasis can be improved by securing sufficient lung volume for respiration through increased muscle tone with spontaneous respiration.
Physiological and Psychological Effects of Visual Stimulation with Green Plant Types
Authors: Jeong Ji-Eun , Park Sin-Ae
Published: December 2021

This study was designed to assess the physiological and psychological benefits of visually looking at foliage plants in adults. This study involved 30 adults in their 20s (11 males, 19 females), and using a crossover design, participants looked at four different types of visual stimuli, namely, real plants, artificial plants, a photograph of plants, and no plants for 5 min. Brain waves were measured while viewing each type of plant, and a subjective evaluation of emotions was performed after each visual stimulus. Semantic differential methods (SDM) and Profile of Mood States (POMS) were used for the subjective evaluation. During the real plant visual stimulation, relative theta (RT) power spectrum was increased in the bilateral occipital lobes, while relative high beta (RHB) power spectrum was reduced in the left occipital lobe, indicating a reduction in stress, anxiety, and tension. The subjective survey results revealed that when looking at real plants, the participants exhibited significantly higher “comfort,” “natural,” and “relaxed” scores as well as an increase in positive mood conditions. In conclusion, among the four types of plants, visual stimulation with real plants induces physiological relaxation in adults and has a positive psychological effect.
Factors Influencing Self-Care Behavior and Treatment Adherence in Hemodialysis Patients
Authors: Kim Hana , Cho Mi-Kyoung
Published: December 2021

Low self-care and treatment adherence are found among hemodialysis patients. We aimed to identify the factors influencing self-care behavior and treatment adherence and examine the mediating effect of treatment adherence on self-care behavior. A questionnaire was administered through a social media community from 11 July to 13 August 2021. The data collected from 100 participants were analyzed using the independent t-test, one-way analysis of variance, Pearson’s correlation, multiple linear regression analysis, and hierarchical multiple regression analysis. The mean self-care behavior and treatment adherence scores were 3.52 ± 0.57 and 4.01 ± 0.48, respectively. The mean age and hemodialysis duration were 51.70 ± 9.40 and 7.57 ± 7.21 years, respectively. The common primary cause of end-stage renal disease was glomerulonephritis (n = 39, 39%). Self-care behavior varied with education, frequency of self-care behavior education, and social support and was positively correlated with treatment adherence and social support. Treatment adherence was positively correlated with social support. Treatment adherence, social support, and health status were influenced self-care behavior (54.5%. Self-care behavior and frequency of self-care behavior education influenced treatment adherence (61.3%). Treatment adherence partially mediated the relationship between social support and self-care behavior. Intervention strategies that increase both social support and treatment adherence can promote self-care behavior.
Wii or Kinect? A Pilot Study of the Exergame Effects on Older Adults’ Physical Fitness and Psychological Perception
Authors: Li Jinhui , Li Long , Huo Peng , Ma Cheng , Wang Linlin , Theng Yin Leng
Published: December 2021

Exergames are now often implemented among older adults for health purposes. This study aimed to investigate whether playing Kinect and Wii exergames has effects on older adults’ physical fitness and psychological perceptions towards exergames. A total of 23 older participants aged above 60 years were recruited and randomly assigned into two groups, in which they played either Kinect or Wii Bowling exergames for three sessions in one week. Physiological and psychological measures were collected including heart rate, blood pressure, shoulder flexibility, as well as perceived benefits and intentions for future use. Findings indicated that exergames are equivalent to light-intensity exercises, and hence pose no or minimal risk to older adults. Older adults had a positive attitude towards exergames and have a strong willingness to engage in exergaming on a regular basis. Although no significant platform difference was identified, observation and qualitative findings suggested that Wii might provide a more intense physical activity than Kinect, while Kinect might obtain a higher perception among older adults than Wii. The study has several practical implications for both health professionals and exergame designers targeting the ageing population.
Relationships between Plantar Pressure Distribution and Rearfoot Alignment in the Taiwanese College Athletes with Plantar Fasciopathy during Static Standing and Walking
Authors: Chow Tong-Hsien , Chen Yih-Shyuan , Hsu Chin-Chia
Published: December 2021

Background: Plantar fasciopathy (PF) is usually related to changes in foot arch, foot shape and rearfoot posture. However, little research has been implemented by using large-scale datasets, and even less has been conducted centering on plantar pressure distributions (PPDs) of different genders of PF athletes. This study aimed to investigate the relationships among the arch index (AI), the PPDs and the rearfoot postural alignment in hundreds of college athletes with PF during static standing and walking. Methods: Cross-sectional study of 100 male and 102 female athletes with PF was undertaken. The PF athletes’ pain assessment and self-reported health status were examined for evaluating their musculoskeletal painful areas. Results: The PF athletes’ PPDs mainly concentrated on inner feet in static standing, and transferred to lateral forefeet during the midstance phase of walking. The males’ PPDs from the static standing to the midstance phase of walking mainly transferred to anterolateral feet. The females’ PPDs mainly transferred to posterolateral feet. The PF athletes’ static rearfoot alignment matched the valgus posture pattern. The medial band of plantar fascia and calcaneus were the common musculoskeletal pain areas. Conclusions: Characteristics of higher plantar loads beneath medial feet associated with rearfoot valgus in bipedal static stance could be the traceable features for PF-related foot diagrams. Higher plantar loads mainly exerted on the lateral forefoot during the midstance phase of walking, and specifically concentrated on outer feet during the transition from static to dynamic state. Pain profiles seem to echo PPDs, which could function as the traceable beginning for the possible link among pronated low-arched feet, PF, metatarsalgia, calcanitis and Achilles tendinitis.
Waste Electrical and Electronic Fund Policy: Current Status and Evaluation of Implementation in China
Authors: Yang Xiao-Shan , Zheng Xiao-Xue , Zhang Tian-Yu , Du Ying , Long Fengru
Published: December 2021

With the accelerated iteration of global electronic and electrical product updates, the demand for electronic and electrical products presents a new trend in which the life cycle of electronic and electrical products is shortened. Waste electrical and electronic equipment (WEEE) products pose a great threat to the global ecological environment, and solving this problem is urgent. Therefore, governments around the world have formulated funding policies for WEEE products, which has led to continuous improvements in such policies. Along these lines, we adopt the circular economy concept, extended producer responsibility theory and life cycle assessment method to comparatively analyse and compare the different fund operation modes in China, Germany, Japan and The Netherlands. In addition, based on the data related to fund policy implementation, we point out the problems in the development of the WEEE industry in China. The analysis results show that although China is the largest WEEE market, it is still in the initial stage and lags behind Western countries in efficiency and cost management. Then, taking as an example ‘Go Green’, an O2O classified recycling platform launched in 2005, this paper performs an extended analysis of the “Internet +” recycling model, which was proposed as a WEEE fund operation solution in China. Finally, we discuss the economic impact of this study on the future implementation and valuation of WEEE fund policy.
Effects of Copenhagen Adduction Exercise on the Architectural Characteristics of Adductors in U-17 Male Soccer Players: A Randomized Controlled Trial
Authors: Alonso-Calvete Alejandra , Lorenzo-Martínez Miguel , Padrón-Cabo Alexis , Rey Ezequiel
Published: December 2021

Groin injuries are one of the most prevalent in male soccer players, especially due to the hip adductor muscles’ weakness which is considered as a risk factor in these injuries. The Copenhagen adduction (CA) exercise has been demonstrated to increase the strength of adductor muscles, but its effects on the architectural characteristics of adductor muscles have not been studied yet. This study aimed to analyze the effects of the CA exercise on the muscle thickness of the adductors. Twelve male U-17 soccer players were randomized into two groups: the control group with no intervention and the experimental group with an intervention based on an eight-week training with CA exercise. The muscle thickness of adductors was measured before and after the intervention using ultrasound imaging. A significant increase in muscle thickness was found in both control (p = 0.002) and experimental group (p < 0.001), but the experimental group did not show additional effects in comparison with the control group. In conclusion, an 8-week CA exercise intervention does not increase the muscle thickness of adductors in U-17 soccer players more than their regular training.
Parents’ Experiences of Weighted Blankets’ Impact on Children with Attention-Deficit/Hyperactivity Disorder (ADHD) and Sleep Problems—A Qualitative Study
Authors: Larsson Ingrid , Aili Katarina , Nygren Jens M. , Jarbin Håkan , Svedberg Petra
Published: December 2021

Sleep disturbances are common among children with attention-deficit/hyperactivity disorder (ADHD). While pharmacological treatment has increased dramatically, parents often prefer non-pharmacological interventions. Research on experiences of weighted blankets and their effect in sleep improvement is scarce. The aim of this study was to explore parents’ experiences of weighted blankets for children with ADHD and sleep problems, and the impact on their children’s sleep. The explorative design was based on qualitative content analysis. Interviews were conducted with a purposeful sample of 24 parents of children with ADHD and sleep problems, after completing a sleep intervention with weighted blankets for 16 weeks. Parents reported that children sleeping with weighted blankets: (1) achieved satisfactory sleep, including improved sleep onset latency, sleep continuity, and sleep routines; (2) achieved overall well-being, including improved relaxation and reduced anxiety; and (3) mastered everyday life, including improved balance in life, family function, and participation in school and leisure activities. This study brings forward novel aspects of the effects of improved sleep among children with ADHD. The findings contribute to the understanding of potential positive effects of an intervention with weighted blankets critical for clinical practice to improve sleep, well-being, and everyday life of children with ADHD and their families.
Parental Role Changes in Romanian Transnational Families: Consequences of Migration
Authors: Matei Aniela , Bobârnat Elen-Silvana
Published: December 2021

Even if there are consistent studies on the issue of transnational families, research is still needed to address the parental role changes in these families. The aim of this article was to identify the main changes in the parental roles of Romanian transnational families as a result of the parents’ labor migration. We used interviewing as the research method and directed content analysis to analyze the data. Purposive sampling was conducted in order to identify the interviewees. The results captured important role changes regarding the income provider role of the parent, but especially the role of emotional support provider that the parent should take on for the children. These findings highlight the need to develop specific measures to address the possible negative effects that affect these transnational families.
Exclusive and Dual Cigarette and Hookah Smoking Is Associated with Adverse Perinatal Outcomes among Pregnant Women in Cairo, Egypt
Authors: El-Shahawy Omar , Labib Kareem , Stevens Elizabeth , Kahn Linda G. , Anwar Wagida , Oncken Cheryl , Loney Tom , Sherman Scott E. , Mead-Morse Erin L.
Published: December 2021

This study assessed the prevalence of prenatal smoking, factors associated with prenatal smoking, and its association with birth outcomes in a sample of pregnant women in Egypt. Pregnant women were recruited during their last trimester from antenatal clinics in Cairo from June 2015 to May 2016. Participants completed an interviewer-administered survey that assessed tobacco use and attitudes, and exhaled carbon monoxide (CO) was measured. Gestational age at delivery and offspring birth weight were collected via a postnatal phone interview. Two hundred pregnant women ages 16–37 years participated. More than a quarter (29.0%) of women reported smoking (cigarettes, hookah, or both) during their current pregnancy, and hookah was more popular than cigarettes. Most women who smoked prior to their current pregnancy either maintained their current smoking habits (46.6%) or switched from dual to hookah-only smoking (46.6%). Current smokers during pregnancy had a higher mean (±SD) exhaled CO level (2.97 ± 1.45 vs. 0.25 ± 0.60 ppm, p < 0.001) and had babies with a lower mean birth weight (2583 ± 300 vs. 2991 ± 478 g, p < 0.001) than non-smokers. Smokers during pregnancy had greater odds of premature birth and/or low birth weight babies compared to non-smokers. Dual cigarette-hookah smokers had the highest risk. Additional focused programs are required to prevent women of childbearing age from initiating tobacco use and empower women to stop tobacco use during the preconception and gestational periods.
The Psychological Impact of COVID-19 on Front Line Nurses: A Synthesis of Qualitative Evidence
Authors: Huerta-González Sara , Selva-Medrano Dolores , López-Espuela Fidel , Caro-Alonso Pedro Ángel , Novo Andre , Rodríguez-Martín Beatriz
Published: December 2021

Caring for people with COVID-19 on the front line has psychological impacts for healthcare professionals. Despite the important psychological impacts of the pandemic on nurses, the qualitative evidence on this topic has not been synthesized. Our objective: To analyze and synthesize qualitative studies that investigate the perceptions of nurses about the psychological impacts of treating hospitalized people with COVID-19 on the front line. A systematic review of qualitative studies published in English or Spanish up to March 2021 was carried out in the following databases: The Cochrane Library, Medline (Pubmed), PsycINFO, Web of Science (WOS), Scopus, and CINHAL. The PRISMA statement and the Cochrane recommendations for qualitative evidence synthesis were followed. Results: The main psychological impacts of caring for people with COVID-19 perceived by nurses working on the front line were fear, anxiety, stress, social isolation, depressive symptoms, uncertainty, and frustration. The fear of infecting family members or being infected was the main repercussion perceived by the nurses. Other negative impacts that this review added and that nurses suffer as the COVID-19 pandemic progress were anger, obsessive thoughts, compulsivity, introversion, apprehension, impotence, alteration of space-time perception, somatization, and feeling of betrayal. Resilience was a coping tool used by nurses. Conclusions: Front line care for people with COVID-19 causes fear, anxiety, stress, social isolation, depressive symptoms, uncertainty, frustration, anger, obsessive thoughts, compulsivity, introversion, apprehension, impotence, alteration of space-time perception, somatization, and feeling of betrayal in nurses. It is necessary to provide front line nurses with the necessary support to reduce the psychological impact derived from caring for people with COVID-19, improve training programs for future pandemics, and analyze the long-term impacts.
REM Sleep: An Unknown Indicator of Sleep Quality
Authors: Barbato Giuseppe
Published: December 2021

Standard polysomnographic analysis of sleep has not provided evidence of an objective measure of sleep quality; however, factors such as sleep duration and sleep efficiency are those more consistently associated with the subjective perception of sleep quality. Sleep reduction as currently occurs in our 24/7 society has had a profound impact on sleep quality; the habitual sleep period should fit within what is a limited nighttime window and may not be sufficient to satisfy the whole sleep process; moreover, the use of artificial light during the evening and early night hours can delay and disturb the circadian rhythms, especially affecting REM sleep. The correct phase relationship of the sleep period with the circadian pacemaker is an important factor to guarantee adequate restorative sleep duration and sleep continuity, thus providing the necessary background for a good night’s sleep. Due to the fact that REM sleep is controlled by the circadian clock, it can provide a window-like mechanism that defines the termination of the sleep period when there is still the necessity to complete the sleep process (not only wake-related homeostasis) and to meet the circadian end of sleep timing. An adequate amount of REM sleep appears necessary to guarantee sleep continuity, while periodically activating the brain and preparing it for the return to consciousness.
Impact of Different Operational Definitions of Sarcopenia on Prevalence in a Population-Based Sample: The Salus in Apulia Study
Authors: Lampignano Luisa , Bortone Ilaria , Castellana Fabio , Donghia Rossella , Guerra Vito , Zupo Roberta , De Pergola Giovanni , Di Masi Marta , Giannelli Gianluigi , Lozupone Madia , Panza Francesco , Boeing Heiner , Sardone Rodolfo
Published: December 2021

Background: In 2010, the European Working Group on Sarcopenia in Older People (EWGSOP1) issued its first operational definition to diagnose sarcopenia. This was updated in 2019 with a revised sequence of muscle mass and muscle strength (EWGSOP2). The aim of the study was to investigate the impact of these different operational definitions on sarcopenia prevalence in a representative population-based sample. Methods: For each algorithm, the prevalence of sarcopenia-related categories was calculated and related to sociodemographic and lifestyle variables, anthropometric parameters, and laboratory biomarkers. The present analysis used data from the Salus in Apulia Study (Italy, 740 subjects, mean age 75.5 ± 5.9 years, 54% women). Results: The application of the EWGSOP1 adapted algorithm resulted in 85% [95% confidence intervals (CI): 82–88%] non-sarcopenic subjects, 10% (95% CI: 8–12%) pre-sarcopenic subjects, and 5% (95% CI: 3–7%) sarcopenic/severe sarcopenic subjects. The sarcopenia-related categories were inversely related to weight and body mass index (BMI), particularly in overweight/obese subjects, and these categories showed favorable metabolic biomarkers. The EWGSOP2 algorithm yielded 73% (95% CI: 69–76%) non-sarcopenic subjects, 24% (95% CI: 21–27%) probably sarcopenic subjects, and 4% (95% CI: 2–5%) sarcopenic subjects. Conclusions: The present study identified BMI as a potential confounder of the prevalence estimates of sarcopenia-related categories in population-based settings with different EWGSOP operational definitions.
HBM4EU Occupational Biomonitoring Study on e-Waste—Study Protocol
Authors: Scheepers Paul T. J. , Duca Radu Corneliu , Galea Karen S. , Godderis Lode , Hardy Emilie , Knudsen Lisbeth E. , Leese Elizabeth , Louro Henriqueta , Mahiout Selma , Ndaw Sophie , Poels Katrien , Porras Simo P. , Silva Maria J. , Tavares Ana Maria , Verdonck Jelle , Viegas Susana , Santonen Tiina ,   HBM4EU e-Waste Study Team
Published: December 2021

Workers involved in the processing of electronic waste (e-waste) are potentially exposed to toxic chemicals. If exposure occurs, this may result in uptake and potential adverse health effects. Thus, exposure surveillance is an important requirement for health risk management and prevention of occupational disease. Human biomonitoring by measurement of specific biomarkers in body fluids is considered as an effective method of exposure surveillance. The aim of this study is to investigate the internal exposure of workers processing e-waste using a human biomonitoring approach, which will stimulate improved work practices and contribute to raising awareness of potential hazards. This exploratory study in occupational exposures in e-waste processing is part of the European Human Biomonitoring Initiative (HBM4EU). Here we present a study protocol using a cross sectional survey design to study worker’s exposures and compare these to the exposure of subjects preferably employed in the same company but with no known exposure to industrial recycling of e-waste. The present study protocol will be applied in six to eight European countries to ensure standardised data collection. The target population size is 300 exposed and 150 controls. Biomarkers of exposure for the following chemicals will be used: chromium, cadmium and lead in blood and urine; brominated flame retardants and polychlorobiphenyls in blood; mercury, organophosphate flame retardants and phthalates in urine, and chromium, cadmium, lead and mercury in hair. In addition, the following effect biomarkers will be studied: micronuclei, epigenetic, oxidative stress, inflammatory markers and telomere length in blood and metabolomics in urine. Occupational hygiene sampling methods (airborne and settled dust, silicon wristbands and handwipes) and contextual information will be collected to facilitate the interpretation of the biomarker results and discuss exposure mitigating interventions to further reduce exposures if needed. This study protocol can be adapted to future European-wide occupational studies.
Oral Health-Related Quality of Life in Adolescents as Measured with the Child-OIDP Questionnaire: A Systematic Review
Authors: Alvarez-Azaustre María Paloma , Greco Rossana , Llena Carmen
Published: December 2021

Oral health-related quality of life (OHRQoL) refers to impacts of oral health on physical, psychological, functional and social aspects of individuals. Among specific measurement instruments to assess OHRQoL in adolescents, the C-OIDP (Child Oral Impact on Daily Performances) questionnaire has demonstrated validity, reliability and suitable psychometric properties. Our aim was to identify cross-sectional studies using the C-OIDP questionnaire to perform a qualitative synthesis and assessment of their methodology and results. A literature electronic search was carried out on the PubMed-Medline, Scopus, Web of Science (WoS), EMBASE, LILACS and SciELO databases, followed by a study selection process and quality assessment. OHRQoL perceived by adolescents is related to age, sex and sociodemographic factors. Eating is the most frequently affected dimension and toothache is the first cause of impact, showing a generally mild intensity and severity of impact. The impact on oral quality of life is greater in younger adolescents. Several factors such as previous caries experience, the DMFT (Decayed, Missed, Filled, Tooth) index, caries in primary teeth, canker sores, bleeding gums and malocclusion have been associated with a lower level of OHRQoL. More longitudinal studies are needed to clarify divergent results and complete our knowledge of oral impacts on quality of life.
Precarious Job Makes Me Withdraw? The Role of Job Insecurity and Negative Affect
Authors: Zheng Shanting , Ding Tangli , Chen Hao , Wu Yunhong , Cai Wenjing
Published: December 2021

An expanding “gig” economy has changed the nature of employment; thus, researchers have recently focused on exploring the role of job precariousness in the workplace. However, little research attention has been given to understanding why, how and when job precariousness leads to employees’ negative behavioral outcomes in the service-oriented industry. In the current study, we examined job insecurity as a mediator and employees’ negative affect as a moderator in the relationship between job precariousness and employees’ withdrawal behavior. Using a sample of 472 employees working in Chinese hotels, we found that job precariousness is positively related to employees’ withdrawal behavior by increasing their job insecurity. Moreover, this mediating relationship is conditional on the moderator variable of employees’ negative affect for the path from job insecurity to withdrawal behavior. The importance of these findings for understanding the undesirable behavior outcomes of job precariousness is discussed.