bluuebunny/crossref_metadata_2025 huggingface dataset:
The Assessment of Nipple Areola Complex Sensation with Semmes-Weinstein Monofilaments—Normative Values and Its Covariates
Authors: Kasielska-Trojan Anna , Szulia Agata , Zawadzki Tomasz , Antoszewski Bogusław
Published: November 2021

Objective: To establish normative data for nipple-areola complex (NAC) sensibility examined with Semmes-Weinstein monofilament test (SWMT) and two-point discrimination (TPD) in women with varying breast sizes, including women with gigantomastia. We also aimed to identify clinical variables influencing NAC sensation. Methods: A total of 320 breasts in 160 Caucasian women (mean age 33.6 years, SD 11 years) were examined (including 50 hypertrophic breasts). NACs sensation was examined using Semmes-Weinstein monofilaments (SWM) and the Weber Two-Point Discrimination Test. Results: The nipple appeared to be the most sensitive part of NAC. In normal-sized breasts, sensation thresholds (SWM) correlated with: age, BMI, history of births, breast size and ptosis (for all locations), breastfeeding history (for nipple and upper areola) and areola diameter (for all locations apart from the nipple). Regression analysis showed that age, cup size and suprasternal notch-to-nipple distance are risk factors for diminished NAC sensation. Sensation thresholds in all NAC locations of hypertrophic breasts were significantly higher compared to normal-sized breasts, while TPD tests did not differ between the groups. Conclusions: We provided normative values of NAC sensation (tactile threshold and TPD) for different NAC areas. Our investigation indicated that SWM are useful diagnostic tools when the following factors are considered while examining NAC sensation: location (nipple vs. areola), age, breast size, suprasternal notch-to-nipple distance, history of births and breastfeeding. Hypertrophic breasts presented significantly higher sensation thresholds for all NAC locations. The report may serve as a reference data for further investigations regarding NAC sensation after different breast surgeries.
Urban Intelligence for Planetary Health
Authors: Lai Yuan
Published: November 2021

The health of human-being and our planet are incessantly interlinked, and such links often exist in the context of cities. This article articulates urban intelligence as an essential capacity for cities to be more adaptive and responsive to face the risks in the context of climate change and global pandemics. Urban intelligence includes data intelligence, design intelligence, and crowd intelligence, which collectively contribute to planetary health with better understandings in cities’ complex physical-environmental-technical-social dynamics. In the long run, urban intelligence supports cities by enabling a better conceptual understanding of human-earth conflicts, transdisciplinary research in the science of the cities, and governmental collaborations at the local and global scale.
Preferences for Infrastructure and Determinants of Decision to Live in a Makeshift House in Informal Settlements
Authors: Ezebilo Eugene Ejike , Savadogo Patrice
Published: November 2021

The upgrade paradigm has been a widely accepted solution to informal settlements. However, implementing an effective upgrade program has been challenging for governments of most developing countries. This paper reports a study which examined informal settlement residents’ preferences for infrastructure provided by an upgrade project and factors influencing their decision to live in a makeshift house. It also examined how an informal settlement upgrade project can be implemented in an effective manner. The data originated from interviews with 231 residents of informal settlements in Port Moresby and was analyzed using mixed methods approach which includes descriptive statistics, qualitative content analysis and binary logistic regression model. The results show that all the residents would support the upgrade project and would pay for service charges associated with infrastructure and services provided by the project. Piped borne water and health care facility were the most preferred. In order for the upgrade project to be successful, residents should be fully involved in planning and implementing the project. Results from the logistic model revealed that decision to live in a makeshift house is influenced by factors such as house and land ownership, frequency of crime in the area, household size, occupation, access to toilet and number of years lived in informal settlement. There is a need to develop an effective mechanism for restricting the emergence of new informal settlements. The findings contribute to urban development planning by providing guidelines for upgrading informal settlements in an effective and efficient manner. The findings will be useful for policy makers, planners and urban development managers in the informal settlement upgrade process.
The Impact of the COVID-19 Pandemic on Cross-Border Mergers and Acquisitions’ Determinants: New Empirical Evidence from Quasi-Poisson and Negative Binomial Regression Models
Authors: Lee Han-Sol , Degtereva Ekaterina A. , Zobov Alexander M.
Published: November 2021

The cross-border movement of capital has suffered due to the COVID-19 pandemic since December 2019. Nevertheless, it is unrealistic for multinational companies to withdraw giant global value chains (GVCs) overnight because of the pandemic. Instead, active discussions and achievements of deals in cross-border mergers and acquisitions (M&As) are expected in the post-COVID-19 era among various other market entry modes, considering the growing demand in high technologies in societies. This paper analyzes particular determinants of cross-border mergers and acquisitions (M&As) during the pandemic year (2020) based on cross-sectional datasets by employing quasi-Poisson and negative binomial regression models. According to the empirical evidence, COVID-19 indices do not hamper M&A deals in general. This indicates that managerial capabilities of the coronavirus, not the outbreak itself, determined locational decisions of M&A deals during the pandemic. In this vein, it is expected that the vaccination rate will become a key factor of locational decision for M&A deals in the near future. Furthermore, countries that have been outstanding in coping with COVID-19 and thus serve as a good example for other nations may seize more opportunities to take a leap forward. In addition, as hypothesized, the results present positive and significant associations with M&A deals and the SDG index, confirming the resource-based theory of internationalization. In particular, the achievement of SDGs seems to exercise much influence in developing countries for M&A bidders during the pandemic year. This indicates that the pandemic demands a new zeitgeist that pursues growth while resolving existing but disregarded environmental issues and cherishes humanitarian values, for all countries, non-exceptionally, standing at the start line of the post-COVID-19 era.
Reduced Perceived Trustworthiness during Face Mask Wearing
Authors: Gabrieli Giulio , Esposito Gianluca
Published: November 2021

To curb the diffusion of the novel coronavirus (SARS-CoV-2), governments worldwide have introduced different policies, including lockdowns, social distancing, and mandatory mask wearing. Face mask wearing, especially, has an impact on the formation of first impressions, given that when meeting someone for the first time, individuals rely on the only available piece of information, the newly met person’s aesthetic appearance, in order to make initial estimations of other traits, such as competence, intelligence, or trustworthiness. However, face mask wearing affects the aesthetic appearance of an individual, creating uncertainty which, in turn, has been reported to reduce others’ perceived trustworthiness. In this paper, the influence of face mask wearing on strangers’ perceived trustworthiness and aesthetic appearance is assessed to verify the impact of this policy on impression formation. Participants (N = 71) have been instructed to assess the trustworthiness and the aesthetic appearance of a selection of 96 images depicting individuals of different ages (children, adults, and older adults), gender (men and women), and ethnicity (Asians or Caucasians). Participants were randomly divided into two groups: an experimental group and a control group. Participants in the experimental group (N = 38) rated faces of individuals wearing a face mask, while participants in the control group rated the same faces but in the absence of a face mask. Images were presented in random order. For each face, participants were asked to rate the aesthetic appearance and perceived trustworthiness of the stranger on two different 100-point Likert scales. Results demonstrate that (i) the correlation between perceived trustworthiness and aesthetic appearance is not affected by the presence of a face mask, and (ii) age, but not ethnicity and gender, influences the magnitude of differences in perceived trustworthiness levels during mask wearing.
Detection of Mental Stress through EEG Signal in Virtual Reality Environment
Authors: Kamińska Dorota , Smółka Krzysztof , Zwoliński Grzegorz
Published: November 2021

This paper investigates the use of an electroencephalogram (EEG) signal to classify a subject’s stress level while using virtual reality (VR). For this purpose, we designed an acquisition protocol based on alternating relaxing and stressful scenes in the form of a VR interactive simulation, accompanied by an EEG headset to monitor the subject’s psycho-physical condition. Relaxation scenes were developed based on scenarios created for psychotherapy treatment utilizing bilateral stimulation, while the Stroop test worked as a stressor. The experiment was conducted on a group of 28 healthy adult volunteers (office workers), participating in a VR session. Subjects’ EEG signal was continuously monitored using the EMOTIV EPOC Flex wireless EEG head cap system. After the session, volunteers were asked to re-fill questionnaires regarding the current stress level and mood. Then, we classified the stress level using a convolutional neural network (CNN) and compared the classification performance with conventional machine learning algorithms. The best results were obtained considering all brain waves (96.42%) with a multilayer perceptron (MLP) and Support Vector Machine (SVM) classifiers.
Conversion Method of Thermionic Emission Current to Voltage for High-Voltage Sources of Electrons
Authors: Kuś Dariusz , Kurnicki Adam , Sikora Jarosław , Mroczka Janusz
Published: November 2021

The stability of the electron thermionic emission current is one of the most important requirements for electron sources used, inter alia, in evaporators, production of rare gas excimers, and electron beam objects for high energy physics. In emission current control systems, a negative feedback signal, directly proportional to the emission current is transferred from the high-voltage anode circuit to the low-voltage cathode circuit. This technique, especially for high-voltage sources of electrons, requires the use of galvanic isolation. Alternatively, a method of converting the emission current to voltage in the cathode power supply circuit was proposed. It uses a linear cathode current intensity distribution and multiplicative-additive processing of two voltage signals, directly proportional to the values of cathode current intensity. The simulation results show that a relatively high conversion accuracy can be obtained for low values of the electron work function of the cathode material. The results of experimental tests of the dynamic parameters of the electron source and the steady-state Ie-V characteristic of the converter are presented. The implementation of the proposed Ie-V conversion method facilitates the design of the emission current controller, especially for high-voltage sources of electrons, because a negative feedback loop between the anode and cathode circuits is not required, all controller sub-components are at a common electrostatic potential.
Air and Metal Vias Combined Metamaterial-Based Lens for Radiation Performance Enhancement of Short-Pulse Tapered Slot Antenna
Authors: Yin Yifan , Zhang Qiuyi , Li Shunli
Published: November 2021

A post-wall-structured tapered slot antenna (PWTSA) loaded with an embedded metamaterial-based lens (metalens) is proposed and investigated for short-pulse applications. The proposed embedded metalens consists of not only a metallic delay lens, but also an airy acceleration region surrounding the lens, which is different from the conventional metalenses used in various tapered slot antennas and can exhibit a small equivalent permittivity. Therefore, the embedded metalens has a large usable range of permittivity and does not increase the size of the original prototype PWTSA. The post-wall structure and metalens of the proposed antenna can help it achieve a comprehensive and balanced performance, including a high fidelity, low cross-polarization, stable main-lobe direction and gain enhancement. The simulated and measured results show that without any increase in antenna size, the proposed antenna enhances the realized gain by 6.4 dB over the frequency range from 9 to 26 GHz and achieves a stable radiation with the offset of the main-lobe direction being confined to 2° up to 24.9 GHz. Furthermore, the cross-polarization levels are less than −20 dB and the fidelity is kept high for the short-pulse radiation with the frequency spectrum up to 30 GHz.
Two-Stage Recognition and beyond for Compound Facial Emotion Recognition
Authors: Kamińska Dorota , Aktas Kadir , Rizhinashvili Davit , Kuklyanov Danila , Sham Abdallah Hussein , Escalera Sergio , Nasrollahi Kamal , Moeslund Thomas B. , Anbarjafari Gholamreza
Published: November 2021

Facial emotion recognition is an inherently complex problem due to individual diversity in facial features and racial and cultural differences. Moreover, facial expressions typically reflect the mixture of people’s emotional statuses, which can be expressed using compound emotions. Compound facial emotion recognition makes the problem even more difficult because the discrimination between dominant and complementary emotions is usually weak. We have created a database that includes 31,250 facial images with different emotions of 115 subjects whose gender distribution is almost uniform to address compound emotion recognition. In addition, we have organized a competition based on the proposed dataset, held at FG workshop 2020. This paper analyzes the winner’s approach—a two-stage recognition method (1st stage, coarse recognition; 2nd stage, fine recognition), which enhances the classification of symmetrical emotion labels.
Smart Charging of Electric Vehicles Considering SOC-Dependent Maximum Charging Powers
Authors: Schaden Benjamin , Jatschka Thomas , Limmer Steffen , Raidl Günther Robert
Published: November 2021

The aim of this work is to schedule the charging of electric vehicles (EVs) at a single charging station such that the temporal availability of each EV as well as the maximum available power at the station are considered. The total costs for charging the vehicles should be minimized w.r.t. time-dependent electricity costs. A particular challenge investigated in this work is that the maximum power at which a vehicle can be charged is dependent on the current state of charge (SOC) of the vehicle. Such a consideration is particularly relevant in the case of fast charging. Considering this aspect for a discretized time horizon is not trivial, as the maximum charging power of an EV may also change in between time steps. To deal with this issue, we instead consider the energy by which an EV can be charged within a time step. For this purpose, we show how to derive the maximum charging energy in an exact as well as an approximate way. Moreover, we propose two methods for solving the scheduling problem. The first is a cutting plane method utilizing a convex hull of the, in general, nonconcave SOC–power curves. The second method is based on a piecewise linearization of the SOC–energy curve and is effectively solved by branch-and-cut. The proposed approaches are evaluated on benchmark instances, which are partly based on real-world data. To deal with EVs arriving at different times as well as charging costs changing over time, a model-based predictive control strategy is usually applied in such cases. Hence, we also experimentally evaluate the performance of our approaches for such a strategy. The results show that optimally solving problems with general piecewise linear maximum power functions requires high computation times. However, problems with concave, piecewise linear maximum charging power functions can efficiently be dealt with by means of linear programming. Approximating an EV’s maximum charging power with a concave function may result in practically infeasible solutions, due to vehicles potentially not reaching their specified target SOC. However, our results show that this error is negligible in practice.
Chemical Characterization of Waterlogged Charred Wood: The Case of a Medieval Shipwreck
Authors: Mitsi Eirini , Boyatzis Stamatis , Pournou Anastasia
Published: November 2021

In 2008, a medieval wooden shipwreck was discovered at the port of Rhodes, Greece. The shipwreck was party burned, presenting a challenge for conservators, as uncharred, semi-charred and charred waterlogged wood were often encountered on the same piece of timber. In seeking the most appropriate conservation method for this unusual material, its chemical characterization was considered necessary. This study examined the chemistry of the three dominant wood conditions found in the wreck. Fourier transform infrared spectroscopy and X-ray diffraction analysis were implemented in comparison to reference samples. Energy dispersive analysis was also used for assessing the inorganic composition of each condition. Moreover, for charred and semi-charred wood, proximate analysis was undertaken. Results obtained regarding the organic moieties of the waterlogged archaeological material, demonstrated that charred samples were chemically comparable to charcoals, semi-charred material showed similarity to thermally modified wood, whereas uncharred waterlogged wood was proven to have an analogous chemistry to biodeteriorated wood. Elemental analysis results also diversified among the three shipwreck’s conditions. Sulfur, iron, and oxygen decreased in charred areas, whereas carbon increased. Proximate analysis showed that ash and fixed carbon content increased with charring, whereas volatile mater decreased. This work proved major chemical differences among shipwreck timbers’ conditions owing to different degree of charring. These are anticipated to influence not only conservation methods’ efficacy, but also the post-treatment behavior of the material. Further investigation is needed for correlating the chemistry of the archaeological material to its physical properties in order to contribute to practical aspects of conservation.
Opportunities to Develop Lifelong Learning Tendencies in Practice-Based Teacher Education: Getting Ready for Education 4.0
Authors: Matsumoto-Royo Kiomi , Ramírez-Montoya Maria Soledad , Conget Paulette
Published: November 2021

Education 4.0 prepares new generations to develop the skills required to perform in a technological, dynamic, and unpredictable world. The main barrier to implementing Education 4.0 in schools is that teachers have not been trained for it. Given the advances and new resources of the technological field, teacher preparation will be insufficient if it focuses on technological skills but does not incorporate the necessary dispositions for lifelong learning. Universities have the ethical imperative to update teacher education so teachers can become lifelong learners. The objective of this study was to understand whether practice-based curricula offer opportunities to promote lifelong learning tendencies. We used a sequential explanatory method. Quantitative and qualitative instruments were applied to pre-service teachers (survey: n = 231, semi-structured interviews: n = 8), and causal and descriptive approaches were supported by a structural equation model and constant comparative method, respectively. Data triangulation confirmed and added depth to the relationship found. Practice opportunities provided by teacher educators in learning activities and assessment tasks promote curiosity, motivation, perseverance, and self-learning regulation, when they are (i) systematic; (ii) relevant to the classroom work; (iii) presented with clear instructions and effective rubrics; (iv) accompanied with feedback focused on the task, soliciting reflection, and performed by peers and teacher educators in a trustworthy environment. This research may be of value to universities looking to renew their Education 4.0 programs because it shows that practice-based curricula not only transform pre-service teachers into teaching experts but also into lifelong learners.
Evaluation of Marrubium vulgare Growing Wild in Tunisia for Its Potential as a Dietary Supplement
Authors: Rezgui Marwa , Basma Mabrouk , Neng Nuno , Nogueira José Manuel , Bettaieb Ben-Kaab Leila , Machado Araújo Maria Eduarda
Published: November 2021

Marrubium vulgare L., known as horehound, is a widespread and widely known plant that is used in beer breweries and also as a traditional remedy in Tunisia. In this study, methanolic extracts of plants harvested from five different locations were investigated for their antioxidant activities using three assays (ferric reducing power, radical scavenging activity, and β-carotene-linoleic acid bleaching assay) as well as the total phenolic content. The mineral composition of the plant was also investigated concerning the following elements: Fe, Mg, Ca, Cu, Zn, Mn, K, and three heavy metals, Ni, Pb, and Cd. Marrubiin, the major bioactive diterpenoid lactone, was quantified by NMR in the samples. The essential oils were obtained by hydrodistillation, and their radical scavenging activity was investigated. The toxicity of essential oils was evaluated against Artemia salina (the brine shrimp larva). The essential oil showed a weak radical scavenging activity and low toxicity. Data obtained from the five different locations showed that the antioxidant activity, as well as the total phenolic and marrubiin content, were strongly affected by the harvest sites. The metal content in the samples showed differences with the harvest location, but there was always a great abundance of calcium, magnesium, and potassium.
Mach Fronts in Random Media with Fractal and Hurst Effects
Authors: Ran Junren , Ostoja-Starzewski Martin , Povstenko Yuriy
Published: November 2021

An investigation of transient second sound phenomena due to moving heat sources on planar random media is conducted. The spatial material randomness of the relaxation time is modeled by Cauchy or Dagum random fields allowing for decoupling of fractal and Hurst effects. The Maxwell–Cattaneo model is solved by a second-order central differencing. The resulting stochastic fluctuations of Mach wedges are examined and compared to unperturbed Mach wedges resulting from the heat source traveling in a homogeneous domain. All the examined cases are illustrated by simulation movies linked to this paper.
Heat and Mass Transfer Impact on Differential Type Nanofluid with Carbon Nanotubes: A Study of Fractional Order System
Authors: Javed Fatima , Riaz Muhammad Bilal , Iftikhar Nazish , Awrejcewicz Jan , Akgül Ali
Published: November 2021

This paper is an analysis of flow of MHD CNTs of second grade nano-fluid under the influence of first order chemical reaction, suction, thermal generation and magnetic field. The fluid is flowing through a porous medium. For the study of heat and mass transfer, we applied the newly introduced differential operators to model such flow. The equations for heat, mass and momentum are established in the terms of Caputo (C), Caputo–Fabrizio (CF) and Atangana–Baleanu in Caputo sense (ABC) fractional derivatives. This shows the novelty of this work. The equations for heat, mass and momentum are established in the terms of Caputo (C), Caputo–Fabrizio (CF) and Atangana–Baleanu in Caputo sense (ABC) fractional derivatives. The solutions are evaluated by employing Laplace transform and inversion algorithm. The flow in momentum profile due to variability in the values of parameters are graphically illustrated among C, CF and ABC models. It is concluded that fluid velocity showed decreasing behavior for χ, P, ℏ2, Mo, Pr, ℵ and Sc while it showed increasing behavior for Gr, Gm, κ and Ao. Moreover, ABC fractional operator presents larger memory effect than C and CF fractional operators.
The eMERLIN and EVN View of FR 0 Radio Galaxies
Authors: Baldi Ranieri D. , Giovannini Gabriele , Capetti Alessandro
Published: November 2021

We present the results from high-resolution observations carried out with the eMERLIN UK-array and the European VLBI network (EVN) for a sample of 15 FR 0s, i.e., compact core-dominated radio sources associated with nearby early-type galaxies (ETGs), which represent the bulk of the local radio galaxy population. The 5 GHz eMERLIN observations available for five objects exhibit sub-mJy core components and reveal pc-scale twin jets for four out of five FR 0s once the eMERLIN and JVLA archival visibilities data are combined. The 1.66 GHz EVN observations available for 10 FR 0s display one- and two-sided jetted morphologies and compact cores. The pc-scale core emission contributes, on average, to about one tenth of the total extended radio emission, although we noted an increasing core contribution for flat-/inverted-spectrum sources. We found an unprecedented linear correlation between the pc-scale core luminosity (∼1021.3–1023.6 W Hz−1) and [O III] line luminosity, generally considered as proxy of the accretion power, for a large sample of LINER-type radio-loud low-luminosity active nuclei, all hosted in massive ETGs, which include FR 0s and FR Is. This result represents further evidence of a common jet–disc coupling in FR 0s and FR Is, despite then differing in kpc-scale radio structure. For our objects and for other FR 0 samples reported in the literature, we estimated the jet brightness sidedness ratios, which typically range between one and three. This parameter roughly gauges the jet bulk Lorentz factor Γ, which turns out to range from 1 to 2.5 for most of the sample. This corroborates the scenario that FR 0s are characterized by mildly relativistic jets, possibly as a result of lower-spinning black holes (BHs) than the highly spinning BHs of relativistic-jetted radio galaxies, FR Is.
Genetic and Phenotypic Landscape of PRPH2-Associated Retinal Dystrophy in Japan
Authors: Oishi Akio , Fujinami Kaoru , Mawatari Go , Naoi Nobuhisa , Ikeda Yasuhiro , Ueno Shinji , Kuniyoshi Kazuki , Hayashi Takaaki , Kondo Hiroyuki , Mizota Atsushi , Shinoda Kei , Kusuhara Sentaro , Nakamura Makoto , Iwata Takeshi , Tsujikawa Akitaka , Tsunoda Kazushige
Published: November 2021

Peripherin-2 (PRPH2) is one of the causative genes of inherited retinal dystrophy. While the gene is relatively common in Caucasians, reports from Asian ethnicities are limited. In the present study, we report 40 Japanese patients from 30 families with PRPH2-associated retinal dystrophy. We identified 17 distinct pathogenic or likely pathogenic variants using next-generation sequencing. Variants p.R142W and p.V200E were relatively common in the cohort. The age of onset was generally in the 40’s; however, some patients had earlier onset (age: 5 years). Visual acuity of the patients ranged from hand motion to 1.5 (Snellen equivalent 20/13). The patients showed variable phenotypes such as retinitis pigmentosa, cone-rod dystrophy, and macular dystrophy. Additionally, intrafamilial phenotypic variability was observed. Choroidal neovascularization was observed in three eyes of two patients with retinitis pigmentosa. The results demonstrate the genotypic and phenotypic variations of the disease in the Asian cohort.
Landscape Mapping, Ichnological and Benthic Foraminifera Trends in a Deep-Water Gateway, Discovery Gap, NE Atlantic
Authors: Dorokhova Evgenia V. , Rodríguez-Tovar Francisco J. , Dorokhov Dmitry V. , Kuleshova Liubov A. , Mena Anxo , Glazkova Tatiana , Krechik Viktor A.
Published: November 2021

Multidisciplinary studies have allowed us to describe the abiotic landscapes and, thus, reveal the ichnological and benthic foraminifera trends in a deep-water gateway. Mesoscale landscape mapping is presented based on the bathymetric position index, substrate types and near-bottom water temperature. Four sediment cores, retrieved from the entrance, centre and exit of the gap, were subject to computed tomography, ichnological and benthic foraminifera studies. A high diversity of abiotic landscapes in the relatively small area of Discovery Gap is detected and its landscape is characterized by 23 landscape types. The most heterogeneous abiotic factor is a topography that is associated with sediment patchiness and substrate variability. The ichnological and tomographical studies of the sediment cores demonstrate lateral and temporal differences in the macrobenthic tracemaker behaviour. The ichnofossils assemblage of the sediment core can be assigned to the Zoophycos ichnofacies with a higher presence of Zoophycos in the entrance site of the gap and during glacial intervals. Higher benthic foraminifera diversity and species richness during the Holocene are also registered in the southern part of the gap compared to the northern part. The spatial and temporal differences in macro-benthos behavior and benthic foraminifera distribution in the deep-water gateway are proposed to relate to the topographical variations of the Antarctic Bottom Water and its influence on the hydrodynamic regime, nutrient transport, etc.
Effect of Practice Environment on Nurse Reported Quality and Patient Safety: The Mediation Role of Person-Centeredness
Authors: Jarrar Mu’taman , Al-Bsheish Mohammad , Aldhmadi Badr K. , Albaker Waleed , Meri Ahmed , Dauwed Mohammed , Minai Mohd Sobri
Published: November 2021

This study aims to explore the potential mediation role of person-centeredness between the effects of the work environment and nurse reported quality and patient safety. A quantitative cross-sectional survey collected data from 1055 nurses, working in medical and surgical units, in twelve Malaysian private hospitals. The data collection used structured questionnaires. The Hayes macro explored the mediation effect of person-centeredness between the associations of work environment dimensions and care outcomes, controlling nurses’ demographics and practice characteristics. A total of 652 nurses responded completely to the survey (61.8% response rate). About 47.7% of nurses worked 7-h shifts, and 37.0% were assigned more than 15 patients. Higher workload was associated with unfavorable outcomes. Nurses working in 12-h shifts reported a lower work environment rating (3.46 ± 0.41, p < 0.01) and person-centered care (3.55 ± 0.35, p < 0.01). Nurses assigned to more than 15 patients were less likely to report a favorable practice environment (3.53 ± 0.41, p < 0.05), perceived lower person-centered care (3.61 ± 0.36, p < 0.01), and rated lower patient safety (3.54 ± 0.62, p < 0.05). Person-centeredness mediates the effect of nurse work environment dimensions on quality and patient safety. Medical and surgical nurses, working in a healthy environment, had a high level of person-centeredness, which, in turn, positively affected the reported outcomes. The function of person-centeredness was to complement the effects of the nurse work environment on care outcomes. Improving the nurse work environment (task-oriented) with a high level of person-centeredness (patient-oriented) was a mechanism through which future initiatives could improve nursing care and prevent patient harm.
Perception of Medical Professionalism among Medical Residents in Spain
Authors: García-Estañ Joaquín , Cabrera-Maqueda Jose María , González-Lozano Eduardo , Fernández-Pardo Jacinto , Atucha Noemí M.
Published: November 2021

Background: Medical professionalism, defined as commitment to the primacy of patient welfare, is the basis for doctor–patient–society relationships, but previous research with medical students has shown that professionalism and social commitment to medicine may be waning. To determine if this trend also appears in recently qualified practicing doctors, we surveyed 90 newly graduated doctors currently working as medical residents in two university hospitals in Murcia, Spain. A previously validated questionnaire that studies the perception of six categories (responsibility, altruism, service, excellence, honesty and integrity, and respect) defining medical professionalism was used. Results: A good perception of professionalism was found among medical residents, with more than 70% positive responses in all these six categories. There is an increasing trend in the number of negative responses as the residency goes on. Altruism was the category with the greatest percentage of negative answers (22.3%) and Respect was the category with the lowest percentage (12.9%). Conclusions: The results show a good professionalism perception in medical residents, but also a slight decline in positive answers that began during medical school. A significant trend was found when including both students and residents. Although there were some differences between students and residents, these were not statistically significant. Educational interventions are needed both at the level of medical school and postgraduate medical residency.
Erratum: Barsasella et al. Sleep Quality among Breast and Prostate Cancer Patients: A Comparison between Subjective and Objective Measurements. Healthcare 2021, 9, 785
Authors: Barsasella Diana , Syed-Abdul Shabbir , Malwade Shwetambara , Kuo Terry B. J. , Chien Ming-Jen , Núñez-Benjumea Francisco J. , Lai Gi-Ming , Kao Ruey-Ho , Shih Hung-Jen , Wen Yu-Ching , Li Yu-Chuan (Jack) , Carrascosa Iván Palomares , Bai Kuan-Jen , Broekhuizen Youri C. B. , Jaspers Monique W. M.
Published: November 2021

The authors wish to make the following erratum to this paper [...]
“Together We Stand”: A Pilot Study Exploring the Feasibility, Acceptability, and Preliminary Effects of a Family-Based Psychoeducational Intervention for Patients on Hemodialysis and Their Family Caregivers
Authors: Sousa Helena , Ribeiro Oscar , Paúl Constança , Costa Elísio , Frontini Roberta , Miranda Vasco , Oliveira Jaime , Ribeiro Fernando , Figueiredo Daniela
Published: November 2021

This pilot study aimed to assess the feasibility, acceptability, and preliminary effects of a family-based psychoeducational intervention for patients undergoing hemodialysis (HD) and their family members. This was a single-group (six dyads), six-week, pre–post pilot study, delivered in a multifamily group format. Feasibility was based on screening, eligibility, content, retention, completion, and intervention adherence rates. Acceptability was assessed at post-intervention through a focus group interview. Self-reported anxiety and depression and patients’ inter-dialytic weight gain (IDWG) were also measured. The screening (93.5%), retention (85.7%), and completion (100%) rates were satisfactory, whereas eligibility (22.8%), consent (18.4%), and intervention adherence (range: 16.7–50%) rates were the most critical. Findings showed that participants appreciated the intervention and perceived several educational and emotional benefits. The results from the Wilcoxon Signed-Rank Test showed that a significant decrease in anxiety symptoms (p = 0.025, r = 0.646) was found, which was followed by medium to large within-group effect sizes for changes in depression symptoms (p = 0.261, r = 0.325) and patients’ IDWG (p = 0.248, r = 0.472), respectively. Overall, the results indicated that this family-based psychoeducational intervention is likely to be feasible, acceptable, and effective for patients undergoing HD and their family caregivers; nonetheless, further considerations are needed on how to make the intervention more practical and easily implemented in routine dialysis care before proceeding to large-scale trials.
Workplace Health Promotion and COVID-19 Support Measures in Outpatient Care Services in Germany: A Quantitative Study
Authors: Neumann Felix Alexander , Rohwer Elisabeth , Mojtahedzadeh Natascha , Makarova Nataliya , Nienhaus Albert , Harth Volker , Augustin Matthias , Mache Stefanie , Zyriax Birgit-Christiane
Published: November 2021

Working conditions in the care sector, especially under the increased strain during COVID-19, make it difficult for outpatient caregivers to adhere to health-promoting behaviours. Research on workplace health promotion (WHP) and COVID-19 support measures in outpatient care services is limited. The aim of this pilot study was to characterise the current situation of WHP and COVID-19 support measures in outpatient care services and to explore how to offer WHP support measures targeted for a specific group. A web-based cross-sectional survey was conducted with outpatient caregivers (N = 171) in northern Germany. The results showed that 60.2% of the study participants were offered WHP support measures, with significantly higher work engagement when WHP support measures were available (Z = 4279.50, p < 0.01) and that 77.2% received specific support from their employer during the COVID-19 pandemic. Although spending a break in a break room was significantly associated with longer breaks as compared with being in a car (Z = 39.10, padj. = 0.01), a break room was neither available in all outpatient care services, nor did it appear to be feasible. Overall, WHP in outpatient care services is insufficiently covered. In order to be able to offer WHP support measures that are targeted to outpatient caregivers, cooperation among local care services, feasibility, and digital measures should be examined.
Do Organizational Health Climates and Leader Health Mindsets Enhance Employees’ Work Engagement and Job Crafting Amid the Pandemic?
Authors: Shin Yuhyung , Hur Won-Moo
Published: November 2021

Although the COVID-19 pandemic has resulted in many health- and stress-related symptoms among employees, surprisingly few studies have assessed the effect of a health-promoting organizational climate or leadership on employee work outcomes. To fill this gap, our research proposed and tested a moderated mediation model involving perceived organizational health climate (POHC), leader health mindset (LHM), work engagement, and job crafting. Our propositions were tested using two-wave data collected from 301 South Korean employees. As predicted, POHC was positively related to employees’ job crafting, and this relationship was mediated by work engagement. Moreover, the positive relationship between POHC and work engagement and the indirect effect of POHC on job crafting through work engagement were more pronounced when LHM was high than when it was low. These findings support the job demands–resources model and social exchange theory and have implications for helping employees maintain their work attitudes and behavior in times of crisis.
Elements of the Design and Implementation of Interventions to Prevent Violence against Women and Girls Associated with Success: Reflections from the What Works to Prevent Violence against Women and Girls? Global Programme
Authors: Jewkes Rachel , Willan Samantha , Heise Lori , Washington Laura , Shai Nwabisa , Kerr-Wilson Alice , Gibbs Andrew , Stern Erin , Christofides Nicola
Published: November 2021

Intimate partner violence (IPV) has a large and sustained impact on women’s mental health, and so effective prevention is critical. A review of 96 rigorous evaluations of interventions for their impact on violence against women and girls (mostly IPV) found that several intervention approaches were effective. However, not every evaluation of a ‘successful approach’ showed success in reducing IPV. In order to understand what else impacts success, we analysed practitioners’ accounts and documentation of the design and implementation of seventeen interventions evaluated as part of What Works to Prevent Violence against Women and Girls (VAWG). Six features were identified as characteristics of all successful interventions: a rigorously planned intervention with a robust theory of change (ToC), attuned to the local context; addressing multiple drivers of VAWG; support for survivors; working with women and men; implementing at optimal intensity and having sufficient, well-selected, trained and supported staff and volunteers. Four features were necessary for success when relevant for the intervention approach: gender and social empowerment group activities and promoting positive interpersonal relations; participatory learning methods, emphasising empowerment, critical reflection and communication skills; carefully designed user-friendly manuals systematically followed; and when working with children, having an age-appropriate design with time for learning and an engaging pedagogy. This analysis provides the IPV prevention field with critical information for enhancing the impact of group- and community-based interventions in IPV prevention and through this strengthening women’s mental health.
COVID-19 Pandemic—Knowledge, Attitudes, Behaviours, and Actions among Faculty of Health Sciences Students
Authors: Stefanowicz-Bielska Anna , Słomion Magdalena , Stefanowicz Joanna
Published: November 2021

The aim of the study was to assess the level of knowledge about COVID-19 disease and preventive behaviour of undergraduate students of nursing, midwifery, and emergency medicine. Material and Methods: An electronic survey was conducted among students of nursing, midwifery, and emergency medicine during the COVID-19 pandemic, from 8 April 2021 to 6 June 2021 in the Pomeranian Voivodeship. Results: A total of 37 men and 238 women participated in the study. A moderate level of knowledge was found in 88% and high in 11% of students Midwifery students had a higher level than nursing students (p = 0.002) and students of emergency medicine (p = 0.003). The female gender is much more afraid of SARS-CoV-2 virus infection (p = 0.021). The most common preventive measure was to avoid people who coughed or had a cold (93%). Only 84% of students were vaccinated. Students who had a high level of knowledge more often avoided people who coughed or had a cold (p = 0.03) and gave up on meeting with friends (p = 0.02). Conclusions: Constant education of students on the principles of dealing with the risk of infection with SARS-CoV-2 is necessary. It is important to continually motivate students to adhere to the principles of prevention. In the face of the existing epidemiological threat, there is a need to change the curricula for the fields of health sciences by adding the subject infectious diseases—clinic and nursing, with special attention to practical aspects.
Surgical Treatment of “Large Uterine Masses” in Pregnancy: A Single-Center Experience
Authors: Cavaliere Anna Franca , Vidiri Annalisa , Gueli Alletti Salvatore , Fagotti Anna , La Milia Maria Concetta , Perossini Silvia , Restaino Stefano , Vizzielli Giuseppe , Lanzone Antonio , Scambia Giovanni
Published: November 2021

Uterine myomas or uterine fibroids are the most common benign uterine masses affecting women. The management of large myoma during pregnancy is challenging, and surgical treatment is a possible option. We report nine cases of pregnant women affected by uterine masses larger than 10 cm, who underwent surgical treatment during the second trimester of pregnancy. In all cases, the masses were preconceptionally unknown and diagnosed during the first trimester. In eight cases, no maternal and fetal complications arose during or after surgical treatment and delivery occurred at full term of pregnancy. In one case, spontaneous abortion was recorded. In all cases, histologic diagnosis demonstrated the benign nature. Women affected by large uterine masses diagnosed for the first time in pregnancy could be taken into consideration for surgical treatment in a referral center during the second trimester.
Radioactivity, Metals Pollution and Mineralogy Assessment of a Beach Stretch from the Ionian Coast of Calabria (Southern Italy)
Authors: Caridi Francesco , Paladini Giuseppe , Venuti Valentina , Crupi Vincenza , Procopio Salvatore , Belvedere Alberto , D’Agostino Maurizio , Faggio Giuliana , Grillo Rossella , Marguccio Santina , Messina Giacomo , Majolino Domenico
Published: November 2021

In the present article, a case study is reported regarding an investigation carried out in order to assess radioactivity concentration, heavy metals pollution and mineralogy of a beach stretch extending from Soverato to Squillace municipalities of the Ionian coast of Calabria, South of Italy, a popular tourist destination, especially in summer. The analysis of radionuclides contents was performed by using a High Purity Germanium (HPGe) gamma-ray detector, in order to quantify the average specific activity of 226Ra, 232Th and 40K natural radionuclides and 137Cs anthropogenic radioisotope. The absorbed dose rate and the annual effective dose equivalent radiological hazard indices were also estimated. Furthermore, X-ray Fluorescence (XRF) spectrometry measurements were carried out for the quantitative elemental analysis of the sand, in order to investigate any possible chemical pollution by heavy metals. For this aim, different indices such as Enrichment Factor (EF), Geoaccumulation Index (Igeo), Contamination Factor (CF) and Pollution Load Index (PLI) were applied to estimate the level of toxicity imposed on the ecosystem by the detected heavy metals. Finally, in order to identify the crystalline mineral components of the investigated sand samples, X-ray Diffraction (XRD) and Micro-Raman Scattering (MRS) measurements were carried out.
Indoor Air Quality Prior to and Following School Building Renovation in a Mid-Atlantic School District
Authors: Zaeh Sandra E. , Koehler Kirsten , Eakin Michelle N. , Wohn Christopher , Diibor Ike , Eckmann Thomas , Wu Tianshi David , Clemons-Erby Dorothy , Gummerson Christine E. , Green Timothy , Wood Megan , Majd Ehsan , Stein Marc L. , Rule Ana , Davis Meghan F. , McCormack Meredith C.
Published: November 2021

Children spend the majority of their time indoors, and a substantial portion of this time in the school environment. Air pollution has been shown to adversely impact lung development and has effects that extend beyond respiratory health. The goal of this study was to evaluate the indoor environment in public schools in the context of an ongoing urban renovation program to investigate the impact of school building renovation and replacement on indoor air quality. Indoor air quality (CO2, PM2.5, CO, and temperature) was assessed for two weeks during fall, winter, and spring seasons in 29 urban public schools between December 2015 and March 2020. Seven schools had pre- and post-renovation data available. Linear mixed models were used to examine changes in air quality outcomes by renovation status in the seven schools with pre- and post-renovation data. Prior to renovation, indoor CO measurements were within World Health Organization (WHO) guidelines, and indoor PM2.5 measurements rarely exceeded them. Within the seven schools with pre- and post-renovation data, over 30% of indoor CO2 measurements and over 50% of indoor temperatures exceeded recommended guidelines from the American Society of Heating, Refrigerating, and Air Conditioning Engineers. Following renovation, 10% of indoor CO2 measurements and 28% of indoor temperatures fell outside of the recommended ranges. Linear mixed models showed significant improvement in CO2, indoor PM2.5, and CO following school renovation. Even among schools that generally met recommendations on key guidelines, school renovation improved the indoor air quality. Our findings suggest that school renovation may benefit communities of children, particularly those in low-income areas with aging school infrastructure, through improvements in the indoor environment.