bluuebunny/crossref_metadata_2025 huggingface dataset:
Life Cycle Air Emissions and Social Human Health Impact Assessment of Liquified Natural Gas Maritime Transport
Authors: Aseel Saleh , Al-Yafei Hussein , Kucukvar Murat , Onat Nuri C.
Published: September 2021

Air pollution, which causes over seven million deaths per year, is the most significant and specifically related to health impacts. Nearly 90% of the urban population worldwide is exposed to pollution not meeting the World Health Organization guidelines for air quality. Many atmospheric carbon oxides, nitrogen oxides, and particulate matter emitting sources, such as inefficient energy and polluting transportation, directly impact health. Natural gas maritime transport from various parts of the world (carbon supplied to consuming areas) has become more critical. Natural gas liquefaction offers a cleaner and more efficient transportation option and also increases its storage capacity. It is expected that natural gas will reduce the human health impact compared with other traditional fuels consumed. This research establishes a life cycle assessment model of air emission and social human health impact related to LNG maritime transport to investigate the impact of each type of fuel used for the numerous maritime carriers. In order to build a model for air emissions and social human health impact assessments based on hypotheses on various unknown criteria, a calculation model is used. The results revealed Conventional-2 fuel type has the lowest human health impact for annual mode calculations, followed by Conventional-1, Q-Max, and finally Q-Flex. The analysis method for the per year demonstrated discrepancies in the relative human health impact due to the variation of the annual LNG demand by each destination and not only per the trip needs. The results show the importance of using a relatively cleaner fuel type such as Conventional-2 in reducing the health impact of LNG maritime transportation. Moreover, it shows differences in the air emissions as well as the human health impact based on the destination’s location and annual LNG demand.
Analytical, Experimental, and Numerical Investigation of Energy in Hydraulic Cylinder Dynamics of Agriculture Scale Excavators
Authors: Arai Ryo , Sakai Satoru , Tatsuoka Akihiro , Zhang Qin
Published: September 2021

This paper discusses energy behaviors in hydraulic cylinder dynamics, which are important for model-based control of agriculture scale excavators. First, we review hydraulic cylinder dynamics and update our physical parameter identification method to agriculture scale experimental excavators in order to construct a nominal numerical simulator. Second, we analyze the energy behaviors from the port-Hamiltonian point of view which provides many links to model-based control at laboratory scale at least. At agriculture scale, even though the nominal numerical simulator is much simpler than an experimental excavator, the analytical, experimental, and numerical energy behaviors are very close to each other. This implies that the port-Hamiltonian point of view will be applicable in agriculture scale against modeling errors.
A Brief History of the Kaplan Turbine Invention
Authors: Polák Martin
Published: September 2021

One of the most important milestones in the history of hydropower is the invention of the Kaplan turbine. It is a machine stemming from the Francis turbine, which Viktor Kaplan was originally trying to improve. However, it gradually developed into the creation of a completely new solution of an impeller with an axial flow rate and adjustable blades. The first patent relating to the new invention dates from 1913. Shortly afterwards, the Kaplan turbine became the most widely used type of device for the use of low heads and variable flow rates. That meant a significant expansion of the potential of economically usable hydropower. The article briefly introduces the history of turbine development. The overall picture is then completed by a few less-known historical documents.
An Energy Management System for the Control of Battery Storage in a Grid-Connected Microgrid Using Mixed Integer Linear Programming
Authors: Sigalo Marvin Barivure , Pillai Ajit C. , Das Saptarshi , Abusara Mohammad
Published: September 2021

This paper proposes an energy management system (EMS) for battery storage systems in grid-connected microgrids. The battery charging/discharging power is determined such that the overall energy consumption cost is minimized, considering the variation in grid tariff, renewable power generation and load demand. The system is modeled as an economic load dispatch optimization problem over a 24 h horizon and solved using mixed integer linear programming (MILP). This formulation, therefore, requires knowledge of the expected renewable energy power production and load demand over the next 24 h. To achieve this, a long short-term memory (LSTM) network is proposed. The receding horizon (RH) strategy is suggested to reduce the impact of prediction error and enable real-time implementation of the EMS that benefits from using actual generation and demand data on the day. At each hour, the LSTM predicts generation and load data for the next 24 h, the dispatch problem is then solved and the battery charging or discharging command for only the first hour is applied in real-time. Real data are then used to update the LSTM input, and the process is repeated. Simulation results show that the proposed real-time strategy outperforms the offline optimization strategy, reducing the operating cost by 3.3%.
Advanced Discretisation and Visualisation Methods for Performance Profiling of Wind Turbines
Authors: Dhont Michiel , Tsiporkova Elena , Boeva Veselka
Published: September 2021

Wind turbines are typically organised as a fleet in a wind park, subject to similar, but varying, environmental conditions. This makes it possible to assess and benchmark a turbine’s output performance by comparing it to the other assets in the fleet. However, such a comparison cannot be performed straightforwardly on time series production data since the performance of a wind turbine is affected by a diverse set of factors (e.g., weather conditions). All these factors also produce a continuous stream of data, which, if discretised in an appropriate fashion, might allow us to uncover relevant insights into the turbine’s operations and behaviour. In this paper, we exploit the outcome of two inherently different discretisation approaches by statistical and visual analytics. As the first discretisation method, a complex layered integration approach is used. The DNA-like outcome allows us to apply advanced visual analytics, facilitating insightful operating mode monitoring. The second discretisation approach is applying a novel circular binning approach, capitalising on the circular nature of the angular variables. The resulting bins are then used to construct circular power maps and extract prototypical profiles via non-negative matrix factorisation, enabling us to detect anomalies and perform production forecasts.
Improving the Performance of Controllers for Wind Turbines on Semi-Submersible Offshore Platforms: Fuzzy Supervisor Control
Authors: Zambrana Pablo , Fernandez-Quijano Javier , Fernandez-Lozano J. Jesus , Rubio Pedro M. Mayorga , Garcia-Cerezo Alfonso J.
Published: September 2021

The use of sea wind energy is restricted by the limited availability of suitable sites in shallow waters. To overcome this challenge, wind turbines located on offshore semi-submersible platforms appear as a valuable option, as they also allow the exploitation of other resources like wave energy or aquaculture. Nevertheless, the literature addressing this kind of design is scarce, and the interactions of the wind turbine and the platform movements increase the complexity of the control system with respect to the wind turbines with fixed foundations. Within this context, fuzzy control is a promising alternative to deal with these issues. However, while fuzzy controllers can be an alternative to substitute conventional PI control, the latter is a well-known, robust choice for operators. In this sense, fuzzy controllers can be designed to work in collaboration with PI controllers to ease their adoption. To this end, this paper addresses those gaps in the literature by presenting a methodology, its application to enhance controllers for large-scale wind turbines in semi-submersible offshore platforms and the results attained. The methodology is based on the implementation of an integrated simulation tool, together with the definition of three indexes that describe the performance of the control system in the overall platform behaviour regarding key aspects of its exploitation. Using it, an Anti-Wind-Up algorithm was designed to improve the behaviour of the conventional controller and is presented and evaluated along a fuzzy supervisor controller. In this kind of configuration, the fuzzy controller modifies the values of the PI controller. Finally, a comparison of the performance using the reference PI and the improved PI, in both cases together with a fuzzy supervisor controller modifying their values, is presented and discussed, contributing to extend the state of the art of controllers for large-scale wind turbines on offshore semi-submersible platforms.
Different Temporal Stability and Responses to Droughts between Needleleaf Forests and Broadleaf Forests in North China during 2001–2018
Authors: Li Xiran , Liu Muxing , Hajek Olivia L. , Yin Guodong
Published: September 2021

Droughts can affect the physiological activity of trees, damage tissues, and even trigger mortality, yet the response of different forest types to drought at the decadal time scale remains uncertain. In this study, we used two remote sensing-based vegetation products, the MODIS enhanced vegetation index (EVI) and MODIS gross primary productivity (GPP), to explore the temporal stability of deciduous needleleaf forests (DNFs) and deciduous broadleaf forests (DBFs) in droughts and their legacy effects in North China from 2001 to 2018. The results of both products showed that the temporal stability of DBFs was consistently much higher than that of DNFs, even though the DBFs experienced extreme droughts and the DNFs did not. The DBFs also exhibited similar patterns in their legacy effects from droughts, with these effects extending up to 4 years after the droughts. These results indicate that DBFs have been better acclimated to drought events in North China. Furthermore, the results suggest that the GPP was more sensitive to water variability than EVI. These findings will be helpful for forest modeling, management, and conservation.
Experimental Verification of a Highly Simplified, Preliminary Machinability Test for Wood-Based Boards in the Case of Drilling
Authors: Podziewski Piotr , Śmietańska Katarzyna , Górski Jarosław
Published: September 2021

In contrast to metalworking there are no standardized or (at least) generally accepted, relative machinability tests for innovative or less known wood-based panels. The most reliable testing procedures are based on the use of a specialized, accurate system for measuring cutting forces and on conducting all tests in conditions that are similar to real industrial conditions (machine tool, cutting parameters etc.). However, the need for a more simplified testing procedure has often been voiced—not all scientists specializing in wood-based materials development have a machine tool comparable to one that can be found in a real furniture factory and piezoelectric force sensors at their unlimited disposal. To meet this need, the highly simplified, preliminary machinability test for wood-based boards in the case of drilling was developed and tried. The results of experimental research suggest that the simplified way of testing of relative machinability of wood-based boards (i.e., testing based on the photoelectric measurement of the time needed to make a 10 mm deep hole under constant feed force) can be a useful substitute of standard machinability testing procedure (based on accurate cutting forces measurements carried out in the standard industrial conditions). When verifying the simplified testing procedure, samples from each of the three basic groups of wood-based materials of substantially different internal structures (fiberboard, particleboard, and veneer boards) were tested. The relationship between significantly reliable and highly simplified machinability indexes turned out to be at a satisfactory level (R2 = 0.97 for particleboards and R2 = 0.95 for fiberboards or boards made of veneer or solid wood). The use of a simplified procedure can be especially pragmatic in case of any preliminary testing of innovative wood-based boards during the material development work.
Nondestructive Detection of Weight Loss Rate, Surface Color, Vitamin C Content, and Firmness in Mini-Chinese Cabbage with Nanopackaging by Fourier Transform-Near Infrared Spectroscopy
Authors: Liu Qiang , Chen Shaoxia , Zhou Dandan , Ding Chao , Wang Jiahong , Zhou Hongsheng , Tu Kang , Pan Leiqing , Li Pengxia
Published: September 2021

A nondestructive optical method is described for the quality assessment of mini-Chinese cabbage with nanopackaging during its storage, using Fourier transform-near infrared (FT-NIR) spectroscopy. The sample quality attributes measured included weight loss rate, surface color index, vitamin C content, and firmness. The level of freshness of the mini-Chinese cabbage during storage was divided into three categories. Partial least squares regression (PLSR) and the least squares support vector machine were applied to spectral datasets in order to develop prediction models for each quality attribute. For a comparative analysis of performance, the five preprocessing methods applied were standard normal variable (SNV), first derivative (lst), second derivative (2nd), multiplicative scattering correction (MSC), and auto scale. The SNV-PLSR model exhibited the best prediction performance for weight loss rate (Rp2 = 0.96, RMSEP = 1.432%). The 1st-PLSR model showed the best prediction performance for L* value (Rp2 = 0.89, RMSEP = 3.25 mg/100 g), but also the lowest accuracy for firmness (Rp2 = 0.60, RMSEP = 2.453). The best classification model was able to predict freshness levels with 88.8% accuracy in mini-Chinese cabbage by supported vector classification (SVC). This study illustrates that the spectral profile obtained by FT-NIR spectroscopy could potentially be implemented for integral assessments of the internal and external quality attributes of mini-Chinese cabbage with nanopacking during storage.
Rootstock Affects the Fruit Quality of ‘Early Bigi’ Sweet Cherries
Authors: Martins Valter , Silva Vânia , Pereira Sandra , Afonso Sílvia , Oliveira Ivo , Santos Marlene , Ribeiro Carlos , Vilela Alice , Bacelar Eunice , Silva Ana Paula , Gonçalves Berta
Published: September 2021

The cherry rootstock influences the performance of the scion cultivar. It has an effect on cherry fruit quality, tree growth, yield and yield efficiency and floral and foliar nutrition. In this work, the influence of Saint Lucie 64 and Maxma 60 rootstocks on the fruit quality traits of cv. Early Bigi was evaluated. For this, several parameters, namely fruit weight (FW) and size (FS), soluble solids content (SSC), pH, titratable acidity (TA), flesh firmness (FF), epidermis rupture force (ERF), color and sensory profile, were assessed. Results showed that the fruits from trees on Saint Lucie 64 presented higher FF and ERF values and, consequently, better texture. On the other hand, fruits from trees on Maxma 60 showed sweeter cherries (higher SSC). Moreover, these trees presented the darkest cherries (lower values of L*, a*, b*, C* and hue°) and the highest SSC. Therefore, although the trees on Saint Lucie 64 produced firmer cherries, it was those with the Maxma 60 rootstock that produced sweeter and darker fruits. In conclusion, both scion–rootstock combinations proved to be good options for the region of Resende.
Stable Up-Down Quark Matter Nuggets, Quark Star Crusts, and a New Family of White Dwarfs
Authors: Wang Lang , Hu Jian , Xia Cheng-Jun , Xu Jian-Feng , Peng Guang-Xiong , Xu Ren-Xin
Published: September 2021

The possible existence of stable up-down quark matter (udQM) was recently proposed, and it was shown that the properties of udQM stars are consistent with various pulsar observations. In this work we investigate the stability of udQM nuggets and found at certain size those objects are more stable than others if a large symmetry energy and a small surface tension were adopted. In such cases, a crust made of udQM nuggets exists in quark stars. A new family of white dwarfs comprised entirely of udQM nuggets and electrons were also obtained, where the maximum mass approaches to the Chandrasekhar limit.
Association Analysis of Genetic Variants of Sodium Taurocholate Co-Transporting Polypeptide NTCP Gene (SLC10A1) and HBV Infection Status in a Cohort of Egyptian Patients
Authors: Raziky Maissa El Said El , Zayed Naglaa Ali , Ibrahim Yasmin Saad , Elrashdy Fatma , Shahin Rasha Mohamad Hosny , Hassany Mohamed , Serafy Magdy El , Doss Wahid , Uversky Vladimir N. , Yosry Ayman , Eldeen Hadeel Gamal
Published: September 2021

Background: Single nucleotide polymorphisms (SNPs) in the SLC10A1 gene, coding for a functional receptor of hepatitis B virus (HBV), sodium taurocholate co-transporting polypeptide (NTCP), may influence the susceptibility, outcome, and disease course of HBV infection in some populations. Aim: to determine the prevalence of SNPs of the NTCP gene, rs2296651 and rs943277, and their relationship with chronic HBV infection in a group of Egyptian patients. Methods: One hundred and thirty seven patients with HBV and 65 healthy controls were enrolled, and the patients were divided into two groups; group I chronic HBV infection (68 patients with normal ALT and minimal or no liver necroinflammation or fibrosis) and group II chronic hepatitis B (69 patients with elevated ALT and moderate or severe liver necroinflammation). They were subjected to full history taking, clinical examination, laboratory investigations, abdominal ultrasound, and liver stiffness measurement using both Echosens® Fibroscan and acoustic radiation force impulse (ARFI). A real time PCR TaqMan 5′ allelic discrimination assay was applied to detect the SNPs in the NTCP gene, rs2296651 and rs943277. Results: On studying the rs2296651 variant, all controls and patients had genotype GG without any significant association with HBV infection or disease progression. However, the rs943277 variant in all controls and 98% of patients had genotype GA, except for two chronic HBV infection patients who had genotype AA, but no significant difference between patients and controls was found. The non-invasive methods for liver fibrosis assessment ARFI, AST/platelet’s ratio (APRI), and fibrosis-4 score (FIB-4) could predict the stages of fibrosis in agreement with Fibroscan with AUCOR 0.8, 0.79, and 0.76, respectively. Conclusion: These findings may suggest that there is no relation between these SNPs of the NTCP gene and the susceptibility or chronicity of HBV infection in the Egyptian population. We also suggest that the use of the non-invasive methods for liver fibrosis assessment, ARFI, FIB-4, and APRI, may decrease the need for liver biopsies in the prediction of significant hepatic fibrosis in chronic HBV patients.
YB-1 Oncoprotein Controls PI3K/Akt Pathway by Reducing Pten Protein Level
Authors: Delicato Antonella , Montuori Eleonora , Angrisano Tiziana , Pollice Alessandra , Calabrò Viola
Published: September 2021

YB-1 is a multifunctional protein overexpressed in many types of cancer. It is a crucial oncoprotein that regulates cancer cell progression and proliferation. Ubiquitously expressed in human cells, YB-1 protein functions are strictly dependent on its subcellular localization. In the cytoplasm, where YB-1 is primarily localized, it regulates mRNA translation and stability. However, in response to stress stimuli and activation of PI3K and RSK signaling, YB-1 moves to the nucleus acting as a prosurvival factor. YB-1 is reported to regulate many cellular signaling pathways in different types of malignancies. Furthermore, several observations also suggest that YB-1 is a sensor of oxidative stress and DNA damage. Here we show that YB-1 reduces PTEN intracellular levels thus leading to PI3K/Akt pathway activation. Remarkably, PTEN reduction mediated by YB-1 overexpression can be observed in human immortalized keratinocytes and HEK293T cells and cannot be reversed by proteasome inhibition. Real-time PCR data indicate that YB-1 silencing up-regulates the PTEN mRNA level. Collectively, these observations indicate that YB-1 negatively controls PTEN at the transcript level and its overexpression could confer survival and proliferative advantage to PTEN proficient cancer cells.
When Much Is Too Much—Compared to Light Exercisers, Heavy Exercisers Report More Mental Health Issues and Stress, but Less Sleep Complaints
Authors: Golshani Sanobar , Najafpour Ali , Hashemian Seyed Sepehr , Goudarzi Nasser , Shahmari Fatemeh , Golshani Sanam , Babaei Masthaneh , Firoozabadi Kimia , Dürsteler Kenneth M. , Brühl Annette Beatrix , Shakeri Jalal , Brand Serge , Sadeghi-Bahmani Dena
Published: September 2021

Background: Physical inactivity has become a global somatic and mental health issue. To counterbalance, promoting regular physical activity appears plausible, above all among adults, where physical inactivity is particularly high. However, some, but sparse, research also indicates that excessive exercising might be associated with unfavorable mental health dimensions. Here, we tested the hypothesis that excessive exercising was associated with more mental health issues. To this end, we assessed mental health issues, stress, mental toughness, and sleep disturbances among heavy and light adult exercisers. Methods: A total of 200 adults (mean age: 35 years; 62% females) took part in the study. Of those, 100 were heavy exercisers (18–22 h/week), and 100 were light exercisers (1–6 h/week). Participants completed questionnaires covering sociodemographic information, mental health issues, perceived stress, mental toughness, and sleep disturbances. Results: Compared with light exercisers, heavy exercisers reported higher mental health issues, more stress, but also higher mental toughness scores and less sleep disturbances. Higher age, lower mental toughness scores, heavy exerciser-status, and more sleep disturbances predicted higher mental health complaints. Conclusions: Compared with light exercising, heavy exercising might be associated with more mental health issues. As such, it appears that the association between exercise frequency, intensity, and duration and psychological well-being might be related to an optimum point, but not to a maximum point. In a similar vein, heavily exercising athletes, their coaches, parents, and representatives of sports associations should get sensitized to possible adverse psychological effects of excessive physical activity patterns.
Will Policy Uncertainty Deteriorate Haze Pollution? A Spatial Spillover Perspective
Authors: Qi Xiulin , Wang Xin , Jin Xiao , Wang Zhenyu M. , Zhang Beibei , Wen Chuanhao
Published: September 2021

Haze has been a severe problem in China for some time, jeopardizing air quality, public health and sustainable growth. This paper examines the direct effect and spatial spillover effect of policy uncertainty on haze pollution with a spatial panel model, using prefecture-level data from 2004 to 2016. This study shows that: (1) policy uncertainty has increased the level of local haze pollution and has a significant spatial spillover effect on surrounding areas; (2) although local policy uncertainty has increased the haze pollution in geographically adjacent cities, it only affects the cities within the province with similar economic distances; and (3) the policy at the central level can effectively alleviate the impact of policy uncertainty at the local level on haze pollution, especially in relation to the spatial spillover effect, but still has limitations in eliminating the direct effect, which is due to the ineradicable nature of policy uncertainty.
Effectiveness of a Mindfulness and Self-Compassion Standard Training Program versus an Abbreviated Training Program on Stress in Tutors and Resident Intern Specialists of Family and Community Medicine and Nursing in Spain
Authors: Verdes-Montenegro-Atalaya Juan Carlos , Pérula-de Torres Luis Ángel , Lietor-Villajos Norberto , Bartolomé-Moreno Cruz , Moreno-Martos Herminia , Rodríguez Luis Alberto , Grande-Grande Teresa , Pardo-Hernández Rocío , León-del-Barco Benito , Santamaría-Peláez Mirian , Mínguez Luis A. , González-Santos Josefa , Soto-Cámara Raúl , González-Bernal Jerónimo J. ,   on behalf of the MINDUUDD Collaborative Study Group
Published: September 2021

Stress is one of the most common problems among healthcare professionals, as they are exposed to potentially stressful and emotionally challenging situations in the workplace. Mindfulness-based stress reduction (MBSR) training programs have been shown to decrease stress. The objective of this study was to compare the effectiveness of an abbreviated 4-weeks MBSR training program in relation to a standard 8-weeks one on the stress levels. A controlled and randomized clinical trial was designed, in which 112 tutors and resident intern specialists in Family and Community Medicine and Nursing of six Spanish National Health System teaching units (TUs) participated. Participants included in the experimental groups (EGs) received a MBRS training program (standard or abbreviated), while control group (CG) participants did not receive any intervention. The stress levels were assessed by the Perceived Stress Questionnaire (PSQ) in three different moments during the study: before, immediately after, and 3 months after the intervention. Adjusted covariance analysis (ANCOVA), using pretest scores as the covariate, showed a significant reduction in stress (F(2,91) = 5.165; p = 0.008; η2 = 0.102) in the post-test visit, attributable to the implementation of the standard training program, but without the maintenance of its effects over time. No significant impact of the abbreviated training program on stress levels was observed in the intergroup comparison. A standard 8-weeks MBSR training program aimed at tutors and resident intern specialists in Family and Community Medicine and Nursing produces significant improvements in stress levels compared with the abbreviated intervention and no intervention. New studies about abbreviated training programs are needed to provide effective treatments which improve well-being of these professionals.
Characteristics of Presentations to the Emergency Department Following Attempted Suicide with Drugs
Authors: Kummer Mirjam , Müller Thomas , Exadaktylos Aristomenis K. , Krähenbühl Stephan , Liakoni Evangelia
Published: September 2021

A relatively high proportion of attempted suicides employ self-poisoning with medication. Data from emergency department presentations can help to identify possible risk drug classes and provide a basis for preventive measures. This retrospective analysis included cases presenting at the emergency department of the University Hospital of Bern, Switzerland, from May 2012 to August 2016, after attempted suicide with drugs. We excluded attempted suicides with only alcohol or other non-medical substances. During the study period, there were 488 cases (466 patients) of attempted suicide with medical substances. The median patient age was 33 years (range 16–93) and 354 (73%) cases were female. The most commonly involved substances/drug classes were benzo-diazepines (n = 167, 34%), neuroleptics (n = 114, 23%) and paracetamol (n = 111, 23%). A total of 231 (47%) cases employed only a single substance. Common symptoms included somnolence (n = 245, 50%), tachycardia (n = 119, 24%) and nausea/vomiting (n = 76, 16%). In most cases, the poisoning was of minor severity (n = 231, 47%) and the patients were admitted to a psychiatric hospital (n = 264, 54%). Important preventive measures may include careful monitoring for suicidal behaviour when prescribing psychotropic drugs, in addition to restrictions in pack size. Efforts should also be made to enhance the awareness of health professionals qualified to prescribe or supply paracetamol.
Pain, Sleep, and Health-Related Quality of Life after Multidisciplinary Intervention for Chronic Pain
Authors: Skúladóttir Hafdís , Sveinsdottir Herdis , Holden Janean E. , Gunnarsdóttir Thóra Jenný , Halldorsdottir Sigridur , Björnsdottir Amalia
Published: September 2021

Multidisciplinary pain-management programs have the potential to decrease pain intensity, improve health-related quality of life (HRQOL), and increase sleep quality. In this longitudinal prospective cohort study, the aim was to investigate the long-term effects of multidisciplinary pain rehabilitation interventions in Iceland. More precisely, we (a) explored and described how individuals with chronic pain evaluated their pain severity, sleep, and HRQOL at pre-treatment and at one-year follow-up and (b) examined what predicted the participants’ one-year follow-up HRQOL. Seventy-nine patients aged 20–68 years, most of whom were women (85%), responded. The participants scored their pain lower at one-year follow-up (p < 0.001). According to their response, most of them had disrupted sleep, mainly because of pain. One year after the treatment, more participants slept through the night (p = 0.004), and their HRQOL increased. Higher pre-treatment mental component summary (MCS) scores and having pursued higher education predicted higher MCS scores at one-year follow-up, and higher pre-treatment physical component summary (PCS) scores predicted higher PCS scores at one-year follow-up. Sleep problems, being a woman, and having children younger than 18 years of age predicted lower MCS scores at one-year follow-up. These findings are suggestive that patients should be examined with respect to their mental status, and it could be beneficial if they received some professional support after completing the intervention.
Twelve Smartphone Applications for Health Management of Older Adults during the COVID-19 Pandemic
Authors: Ha Seong Kyu , Lee Hey Sig , Park Hae Yean
Published: September 2021

This study investigated smartphone applications that may be helpful in managing the health of the elderly during COVID-19. The application searched the seven areas of health management, newly classified in OTPF 4th edition with keywords in the Google Play Store. As a result, two applications meeting the selection criteria were selected for each area. The selected applications are social and emotional health promotion and maintenance: Wysa & MindDoc, symptom and condition management: Ada & Diseases Dictionary, communication with the health care system: Telehealth & Blood Pressure Diary, medication management: Medisafe & MyTherapy, physical activity: FitOn & Samsung Health, nutrition management: Lifesum & Health and Nutrition Guide. Through the analyzed applications, twelve applications with the potential to improve the health management and quality of life in older adults during social distancing or self-isolation due to COVID-19 were identified.
Hospital Childbirth: Perspectives of Women and Professionals for a Positive Experience—A Qualitative Study
Authors: Pereda-Goikoetxea Beatriz , Huitzi-Egilegor Joseba Xabier , Zubeldia-Etxeberria Josune , Uranga-Iturrioz Maria Jose , Elorza-Puyadena Maria Isabel
Published: September 2021

The perception and interpretation of childbirth are changing as values change. This requires women and professionals to adapt to new circumstances. The objective of this study was to analyze the perspectives of women and professionals on hospital birth and to identify improvement areas in order to achieve a positive perinatal experience. A qualitative prospective study with a phenomenological approach was conducted using semi-structured interviews with women, two and eight months after childbirth, participant observation, and professional focus groups. The analysis of the transcribed texts involved a thematic inductive approach. Four improvement areas emerged from the analysis: (a) strengthening communication and the therapeutic relationship; (b) unifying criteria between hospitals and primary care centers to provide coordinated and coherent information; (c) involvement of the partner in the whole process of pregnancy-childbirth-puerperium; (d) improvement of the spaces used in prenatal care and births. The need for a continuity of care from the beginning of pregnancy to the postpartum period is emphasized, which requires an improvement in information, participation, and the promotion of shared decision-making. To this end, coordinated interdisciplinary work, involvement of the partner and the improvement of the spaces used in prenatal care and births are essential.
The Relationship between Online and Offline Information-Seeking Behaviors for Healthy Nutrition
Authors: Fehér András , Véha Miklós , Boros Henrietta Mónika , Kovács Bence , Kontor Enikő , Szakály Zoltán
Published: September 2021

In addition to preserving their health, young people can also play a role in providing information to wider society. Nutrition habits that have developed over the years at college have an impact on the foundation of a lifelong lifestyle. Our aim was to identify university students’ online and offline information-seeking attitudes related to healthy nutrition and create a new theoretical concept. Participants were university students (n = 612), and the self-administered, paper-based questionnaires were sent out to nine Hungarian universities. Both descriptive and multivariate statistical procedures were used in the analysis. Online and offline information sources were categorized. In relation to university students’ information-seeking competence, the component of electronic health literacy was determined. In analyzing attitudes, the components of acceptance of, incentive for, and rejection of or ambivalence towards healthy nutrition were identified. The information-seeking categories related to the stages of university students’ conscious transition to healthy nutrition were also identified. University students’ competences related to electronic health literacy are essentially favorable. This target group accepts healthy nutrition and tries to recommend it to others, too. However, a rejecting or ambivalent attitude could also be identified. Online and offline sources of information accompany university students’ transition of the relevant stages of changes. The theoretical concept that we developed can contribute to bridging gaps in the interrelatedness of diverse information sources and healthy nutrition.
Civil Servants and Non-Western Migrants’ Perceptions on Pathways to Health Care in Serbia—A Grounded Theory, Multi-Perspective Study
Authors: Buch Mejsner Sofie , Kristiansen Maria , Eklund Karlsson Leena
Published: September 2021

(1) Background: Informal patient payments continue to persist in the Serbian health care system, exposing vulnerable groups to private spending on health care. Migrants may in particular be subject to such payments, as they often experience barriers in access to health care. Little is known about migrants paying informally to access health care in Serbia. The study aims to explore pathways of accessing health care, including the role of informal patient payments, from the perspectives of civil servants and non-western migrants in Serbia. (2) Methods: Respondents (n = 8 civil servants and n = 6 migrants) were recruited in Belgrade in 2018, where semi-structured interviews were conducted. The interviews were analysed applying the grounded theory methodological steps. (3) Results: Data reveal different pathways to navigate the Serbian health care system, and ultimately whether paying informally occurs. Migrants appear less prone to paying informally and receive the same or better-quality health care. Locals experience the need to pay informal patient payments, quasi-formal payments and to bring medicine, materials or equipment when in health facilities. (4) Conclusions: Paying informally or using private care in Serbia appear to have become common. Despite a comprehensive health insurance coverage, high levels of out-of-pocket payments show barriers in accessing health care. It is highly important to not confuse the cultural beliefs with forced spending on health care and such private spending should be reduced to not push people into poverty.
Association of Pesticides and Kidney Function among Adults in the US Population 2001–2010
Authors: Wan En-Tzu , Darssan Darsy , Karatela Shamshad , Reid Simon A. , Osborne Nicholas John
Published: September 2021

Chronic kidney disease of unknown cause is prevalent in a range of communities; however, its etiology remains unclear. We examined the association between pesticide exposures and the risk of kidney function loss using four waves of the National Health and Nutrition Examination Survey (NHANES) to identify a pathological pathway. We pooled data from four cross-sectional waves of NHANES, with 41,847 participants in total. Exposure to malathion increased the risk of low kidney function (aOR = 1.26, 95% CI = 1.01–1.56) in the adjusted model. Increased risk of low kidney function was not found among those exposed to 2,4-D (aOR = 0.88, 95% CI = 0.72–1.09), 3,5,6-trichloropyridinol (aOR = 0.96, 95% CI = 0.83–1.12), and 3-PBA (aOR = 1.03, 95% CI = 0.94–1.13). Our findings provide evidence of altered kidney function in people exposed to malathion, highlighting the potential of organophosphate pesticides’ role in renal injury.
The Effect of High-Density Built Environments on Elderly Individuals’ Physical Health: A Cross-Sectional Study in Guangzhou, China
Authors: Zhang Rongrong , Liu Song , Li Ming , He Xiong , Zhou Chunshan
Published: September 2021

The built environment refers to the objective material environment built by humans in cities for living and production activities. Existing studies have proven that the built environment plays a significant role in human health, but little attention is paid to the elderly in this regard. At the same time, existing studies are mainly concentrated in Western developed countries, and there are few empirical studies in developing countries such as China. Based on POI (point of interest) data and 882 questionnaires collected from 20 neighborhoods in Guangzhou, we employ multilevel linear regression modeling, mediating effect modeling, to explore the path and mechanism of the impact of the built environment on elderly individuals’ physical health, especially the mediating effects of physical and social interaction activity. The results show that the number of POIs, the distance to the nearest park and square, and the number of parks and squares are significantly positively correlated with the physical health of the elderly, while the number of bus and subway stations and the distance to the nearest station are significantly negatively correlated. Secondly, physical activity and social networks play a separate role in mediating the effect of the built environment on elderly individuals’ physical health. The results enrich the research on the built environment and elderly individuals’ health in the context of high-density cities in China and provide some reference basis for actively promoting spatial intervention and cultivating a healthy aging society.
Prediction of Cardiorespiratory Fitness in Czech Adults: Normative Values and Association with Cardiometabolic Health
Authors: Maranhao Neto Geraldo A. , Pavlovska Iuliia , Polcrova Anna , Mechanick Jeffrey I. , Infante-Garcia Maria M. , Hernandez Jose Pantaleón , Araujo Miguel A. , Nieto-Martinez Ramfis , Gonzalez-Rivas Juan P.
Published: September 2021

Cardiorespiratory fitness (CRF) is a strong independent predictor of morbidity and mortality. However, there is no recent information about the impact of CRF on cardiometabolic risk specifically in Central and Eastern Europe, which are characterized by different biological and social determinants of health. In this cross-sectional study normative CRF values were proposed and the association between CRF and cardiometabolic outcomes was evaluated in an adult Czechian population. In 2054 participants (54.6% females), median age 48 (IQR 19 years), the CRF was predicted from a non-exercise equation. Multivariable-adjusted logistic regressions were carried out to determine the associations. Higher CRF quartiles were associated with lower prevalence of hypertension, type 2 diabetes (T2D) and dyslipidemia. Comparing subjects within the lowest CRF, we see that those within the highest CRF had decreased chances of hypertension (odds ratio (OR) = 0.36; 95% CI: 0.22–0.60); T2D (OR = 0.16; 0.05–0.47), low HDL-c (OR = 0.32; 0.17–0.60), high low-density lipoprotein (OR = 0.33; 0.21–0.53), high triglycerides (OR = 0.13; 0.07–0.81), and high cholesterol (OR = 0.44; 0.29–0.69). There was an inverse association between CRF and cardiometabolic outcomes, supporting the adoption of a non-exercise method to estimate CRF of the Czech population. Therefore, more accurate cardiometabolic studies can be performed incorporating the valuable CRF metric.
Analysis of Roadkill on the Korean Expressways from 2004 to 2019
Authors: Kim Minkyung , Park Hyomin , Lee Sangdon
Published: September 2021

Expressways in Korea are high-speed traffic roads connecting important cities. Road infrastructure continues to expand to accommodate the increase in traffic volume associated with the growth of industry and tourism. Here, data on 36,863 roadkill events that occurred on expressway routes managed by the Korea Expressway Corporation between 2004 and 2019 were analyzed. Characterizing patterns of roadkill is important for prioritizing roadkill mitigation measures. We identified consistently increasing or decreasing trends using Mann–Kendall statistics and Sen’s slope. Roadkill was most common in Gangwon Province and was concentrated between May and June and between October and December. Water deer (Hydropotes inermis) was the most common road-killed species. The trend analysis revealed a statistically significant decline in Gangwon Province and a statistically significant increase in the Capital Area and Chungnam Province. There was a significant increase in wild boar (Sus scrofa) roadkill in the first and fourth quarters. Mitigation measures are needed for regions and species showing increasing trends, including water deer in the first to third quarters, periods for which no decline in water deer roadkill was noted.
Global Challenges vs. the Need for Regional Performance Models under the Present Pandemic Crisis
Authors: Ionescu Romeo-Victor , Zlati Monica Laura , Antohi Valentin Marian
Published: September 2021

The present study uses the analysis of the EU’s regional performance structure based on clusters to test the versatility of the regional administrative capacity in relation to three disruptive global phenomena: the economic crisis, the coronavirus epidemic and the phenomenon of refugee migration to Europe. We defined a regional performance model based on maintaining sustainability indicators in the 240 EU regions. The objectives of the study are aimed primarily at a structured assessment of regional administrative capacity in the initial version, based on statistical indicators, and in the current version, after the outbreak of the pandemic, based on quantifying the impact of the disturbing factors. Secondly, the objectives of the study are to evaluate the reaction of the administrative units according to their ability to respond to the economic problems in the region, in the sense of improving the performance of the regional economies. The methods used in this paper will be empirical (the study of the specialized literature), analytical and will contain econometric modelling and statistical processing of the data. The results of the study will allow the identification of the necessary traits to train a leader in regional performance, traits that will be useful to European decision makers in adjusting the EU regional policy. Moreover, the need to redefine the EU in terms of performance will be substantiated once again. The study is current and is based on the latest Eurostat information, pertinent tables and diagrams.
Associations between Oral Hypofunction Tests, Age, and Sex
Authors: Hatanaka Yukiko , Furuya Junichi , Sato Yuji , Uchida Yoshiki , Shichita Toshiharu , Kitagawa Noboru , Osawa Tokiko
Published: September 2021

Oral function declines in older individuals due to disease and age-related changes, making them vulnerable to oral and physical frailty. Therefore, it is important to manage the decline in oral function in older outpatients. Oral hypofunction is diagnosed by seven tests related to oral function, oral hygiene, oral moisture, occlusal force, oral diadochokinesis, tongue pressure, masticatory function, and swallowing function. However, sex or age were not factored into the current reference values of these tests. We included subjects attending the dental hospital clinic for maintenance, and recorded and analyzed oral hypofunction and the factors associated with its diagnosis. Of the 134 outpatients (53 males and 81 females, mean age 75.2 ± 11.2 years), 63% were diagnosed with oral hypofunction. Oral hypofunction prevalence increased significantly with age, and significant variations were observed in all tests. Furthermore, oral hygiene and swallowing function were not associated with oral hypofunction diagnosis. All examined factors decreased with increasing age, even after adjusting sex, except for oral hygiene and moisture. Occlusal force and masticatory function were higher in men after adjusting age. This study suggested that older outpatients were likely to be diagnosed with oral hypofunction, and that the test reference value and their selection for oral hypofunction should be reconsidered.
Insufficient Physical Activity and Sedentary Behaviors among Medical Students during the COVID-19 Lockdown: Findings from a Cross-Sectional Study in Pakistan
Authors: Ullah Irfan , Islam Md. Saiful , Ali Sajjad , Jamil Hashaam , Tahir Muhammad Junaid , Arsh Aatik , Shah Jaffer , Islam Sheikh Mohammed Shariful
Published: September 2021

Background: The unprecedented COVID-19 pandemic has resulted in social distancing and isolation which leads to insufficient physical activity and thereby increases sedentary behaviors. Hence, this study aimed to assess the prevalence of insufficient physical activity and sedentary behaviors among medical students during the COVID-19 lockdown in Pakistan, and to determine their associated factors. Methods: A cross-sectional online survey was carried out among 407 medical students from the Punjab and Sindh provinces between May and June 2020. To collect data, an e-questionnaire was sent to obtain informed consent along with questions concerning socio-demographics as well as an International Physical Activity Questionnaires–Short Form (IPAQ–SF). Results: As per the IPAQ, almost five in ten participants were physically inactive (48.2%), and 45.2% reported sedentary behaviors. Participants with insufficient physical activity were more likely to report sedentary behaviors than their counterparts (AOR = 2.53; 95% CI = 1.66–3.85, p < 0.001). The odds of insufficient physical activity were higher among the participants who did not strictly follow the COVID-19 preventive measures (AOR = 2.51; 95% CI = 1.35–4.69, p = 0.004); similarly, there were increased odds of sedentary behaviors observed among participants within a normal weight range compared to those who were underweight (AOR = 2.69; 95% CI = 1.76–4.11, p < 0.001). Conclusions: Insufficient physical activity and sedentary behavior are prevalent among medical students in Pakistan during the COVID-19 pandemic. These findings indicate the importance of establishing tailored policies and programs to encourage young adults to engage in physical activity.