bluuebunny/crossref_metadata_2025 huggingface dataset:
Age-Dependent Presentation and Clinical Course of 1465 Patients Aged 0 to Less than 18 Years with Ovarian or Testicular Germ Cell Tumors; Data of the MAKEI 96 Protocol Revisited in the Light of Prenatal Germ Cell Biology
Authors: Calaminus Gabriele , Schneider Dominik T. , von Schweinitz Dietrich , Jürgens Heribert , Infed Nacera , Schönberger Stefan , Olson Thomas A. , Albers Peter , Vokuhl Christian , Stein Raimund , Looijenga Leendert , Sehouli Jalid , Metzelder Martin , Claviez Alexander , Dworzak Michael , Eggert Angelika , Fröhlich Birgit , Gerber Nicolas U. , Kratz Christian P. , Faber Jörg , Klingebiel Thomas , Harms Dieter , Göbel Ulrich
Published: March 2020

Objective: To evaluate prognostic factors in pediatric patients with gonadal germ cell tumors (GCT). Methods: Patients <18 years with ovarian and testicular GCT (respectively OGCT and TGCT) were prospectively registered according to the guidelines of MAKEI 96. After resection of the primary tumor, patients staged ≥II received risk-stratified cisplatin-based combination chemotherapy. Patients were analyzed in respect to age (six age groups divided into 3-year intervals), histology, stage, and therapy. The primary end point was overall survival. Results: Between January 1996 and March 2016, the following patients were registered: 1047 OGCT, of those, 630 had ovarian teratoma (OTER) and 417 had malignant OGCT (MOGCT); and 418 TGCT, of those, 106 had testicular teratoma (TTER) and 312 had malignant TGCT (MTGCT). Only in MTGCT, older age correlated with a higher proportion of advanced tumors. All 736 teratomas and 240/415 stage I malignant gonadal GCT underwent surgery and close observation alone. In case of watchful waiting, the progression rate of OGCT was higher than that of TGCT. However, death from disease was reported in 8/417 (1.9%) MOGCT and 8/312 (2.6%) MTGCT irrespective of adjuvant chemotherapy and repeated surgery. Conclusions: The different pathogenesis and histogenesis of gonadal GCT reflects sex- and age-specific patterns that define clinically relevant risk groups. Therefore, gender and age should be considered in further research on the biology and clinical practice of pediatric gonadal GCT.
Globular Adiponectin Inhibits Breast Cancer Cell Growth through Modulation of Inflammasome Activation: Critical Role of Sestrin2 and AMPK Signaling
Authors: Pham Duc-Vinh , Raut Pawan Kumar , Pandit Mahesh , Chang Jae-Hoon , Katila Nikita , Choi Dong-Young , Jeong Jee-Heon , Park Pil-Hoon
Published: March 2020

Adiponectin, an adipokine predominantly derived from adipose tissue, exhibits potent antitumor properties in breast cancer cells. However, its mechanisms of action remain elusive. Inflammasomes—intracellular multimeric protein complexes—modulate cancer cell growth in a complicated manner, as well as playing a role in the innate immune system. Herein, we examined the potential role of inflammasomes in the antitumor activity of adiponectin and found that globular adiponectin (gAcrp) significantly suppressed inflammasomes activation in breast cancer cells both in vitro and in vivo conditions, as determined by decreased expression of inflammasomes components, including NOD-like receptor pyrin domain-containing protein 3 (NLRP3) and the apoptosis-associated speck-like protein containing a CARD (ASC), and inhibition of interleukin-1β and caspase-1 activation. Treatment with pharmacological inhibitors of inflammasomes caused decrease in cell viability, apoptosis induction, and G0/G1 cell cycle arrest, suggesting that inflammasomes activation is implicated in the growth of breast cancer cells. In addition, treatment with gAcrp generated essentially similar results to those of inflammasomes inhibitors, further indicating that suppression of breast cancer cell growth by gAcrp is mediated via modulation of inflammasomes. Mechanistically, gAcrp suppressed inflammasomes activation through sestrin2 (SESN2) induction, liver kinase B1 (LKB-1)-dependent AMP-activated protein kinase (AMPK) phosphorylation, and alleviation of endoplasmic reticulum (ER) stress. Taken together, these results demonstrate that gAcrp inhibits growth of breast cancer cells by suppressing inflammasomes activation, at least in part, via SESN2 induction and AMPK activation-dependent mechanisms.
Nanosphere Loaded With Curcumin Inhibits the Gastrointestinal Cell Death Signaling Pathway Induced by the Foodborne Pathogen Vibrio vulnificus
Authors: Kim Ji-Yun , Lee Young-Min , Kim Do-Wan , Min Taesun , Lee Sei-Jung
Published: March 2020

Curcumin, a hydrophobic polyphenol of turmeric, has a variety of biological functions as a herbal supplement, but its poor gastric absorption rate is one of the major factors limiting its oral bioavailability. In the present study, we have investigated the functional role of a nanosphere loaded with curcumin (CN) during host cell death elicited by the Gram-negative bacterium V. vulnificus in human gastrointestinal epithelial HT-29 cells and an ileal-ligated mouse model. The recombinant protein (r) VvhA produced by V. vulnificus significantly reduced the viability of HT-29 cells. The cytotoxic effect of rVvhA was restored upon a treatment with CN (100 ng/mL), which had shown 1000-fold higher anti-apoptotic efficacy than curcumin. CN inhibited the phosphorylation of c-Src and PKC mediated by intracellular ROS responsible for the distinctive activation of the MAPKs in rVvhA-treated HT-29 cells. Interestingly, CN significantly restored the expression of Bax, Bcl-2, and cleaved caspase-3 as regulated by the phosphorylation of NF-κB. In mouse models of V. vulnificus infection, treatment with CN had a blocking effect that elevated the levels of TUNEL-positive DNA fragmentation and apoptosis-related proteins. These results indicate that CN is a functional agent that manipulates the V. vulnificus VvhA signaling pathway responsible for gastrointestinal cell death.
Centimetric-Sized Chromium (III) Oxide Object Synthesized by Means of the Carbon Template Replication
Authors: GIBOT Pierre
Published: March 2020

A simple, efficient synthesis approach for designing large ceramic pieces, herein termed chromium (III) oxide (Cr2O3) material, is provided. The process can be called the replica technique, or replication. The elaboration of a material with a unique morphology is a result of a ceramic salt coating that has been previously dissolved in ethylene glycol as the solvent; this process is performed on a carbon material surface that is selected as a template. Here, the carbon template was carbon fiber. After a heat treatment to convert the ceramic precursor to the corresponding ceramic oxide followed by the removal of the template, hollow ceramic oxide wires were obtained. The resulting material was characterized by X-ray diffraction, Raman and Fourier transform infrared spectroscopies, and scanning electron microscopy. The material exhibited a multiscale architecture, assembling nanosized nodules to form micron-sized tubes that assemble themselves into a centimetric structure. Objects with such tailored architectures can be used in a large variety of applications in fields as diverse as pyrotechnics, adsorption, and catalysis.
Closed-Form Expressions for Contact Angle Hysteresis: Capillary Bridges between Parallel Platens
Authors: Bowen James , Cheneler David
Published: March 2020

A closed form expression capable of predicting the evolution of the shape of liquid capillary bridges and the resultant force between parallel platens is derived. Such a scenario occurs within many micro-mechanical structures and devices, for example, in micro-squeeze flow rheometers used to ascertain the rheological properties of pico- to nano-litre volumes of complex fluids, which is an important task for the analysis of biological liquids and during the combinatorial polymer synthesis of healthcare and personal products. These liquid bridges exhibit capillary forces that can perturb the desired rheological forces, and perhaps more significantly, determine the geometry of the experiment. The liquid bridge has a curved profile characterised by a contact angle at the three-phase interface, as compared to the simple cylindrical geometry assumed during the rheological analysis. During rheometry, the geometry of the bridge will change in a complex nonlinear fashion, an issue compounded by the contact angle undergoing hysteresis. Owing to the small volumes involved, ascertaining the bridge geometry visually during experiment is very difficult. Similarly, the governing equations for the bridge geometry are highly nonlinear, precluding an exact analytical solution, hence requiring a substantial numerical solution. Here, an expression for the bridge geometry and capillary forces based on the toroidal approximation has been developed that allows the solution to be determined several orders of magnitude faster using simpler techniques than numerical or experimental methods. This expression has been applied to squeeze-flow rheometry to show how the theory proposed here is consistent with the assumptions used within rheometry. The validity of the theory has been shown through comparison with the exact numerical solution of the governing equations. The numerical solution for the shape of liquid bridges between parallel platens is provided here for the first time and is based on existing work of liquid bridges between spheres.
A Note on Complexities by Means of Quantum Compound Systems
Authors: Watanabe Noboru
Published: March 2020

It has been shown that joint probability distributions of quantum systems generally do not exist, and the key to solving this concern is the compound state invented by Ohya. The Ohya compound state constructed by the Schatten decomposition (i.e., one-dimensional orthogonal projection) of the input state shows the correlation between the states of the input and output systems. In 1983, Ohya formulated the quantum mutual entropy by applying this compound state. Since this mutual entropy satisfies the fundamental inequality, one may say that it represents the amount of information correctly transmitted from the input system through the channel to the output system, and it may play an important role in discussing the efficiency of information transfer in quantum systems. Since the Ohya compound state is separable state, it is important that we must look more carefully into the entangled compound state. This paper is intended as an investigation of the construction of the entangled compound state, and the hybrid entangled compound state is introduced. The purpose of this paper is to consider the validity of the compound states constructing the quantum mutual entropy type complexity. It seems reasonable to suppose that the quantum mutual entropy type complexity defined by using the entangled compound state is not useful to discuss the efficiency of information transmission from the initial system to the final system.
Quantum Hair on Colliding Black Holes
Authors: Crowell Lawrence , Corda Christian
Published: March 2020

Black hole (BH) collisions produce gravitational radiation which is generally thought, in a quantum limit, to be gravitons. The stretched horizon of a black hole contains quantum information, or a form of quantum hair, which is a coalescence of black holes participating in the generation of gravitons. This may be facilitated with a Bohr-like approach to black hole (BH) quantum physics with quasi-normal mode (QNM) approach to BH quantum mechanics. Quantum gravity and quantum hair on event horizons is excited to higher energy in BH coalescence. The near horizon condition for two BHs right before collision is a deformed A d S spacetime. These excited states of BH quantum hair then relax with the production of gravitons. This is then argued to define RT entropy given by quantum hair on the horizons. These qubits of information from a BH coalescence should then appear in gravitational wave (GW) data.
Nanostructured Carbon Material Effect on the Synthesis of Carbon-Supported Molybdenum Carbide Catalysts for Guaiacol Hydrodeoxygenation
Authors: Ochoa Elba , Torres Daniel , Pinilla José Luis , Suelves Isabel
Published: March 2020

The impact of using different nanostructured carbon materials (carbon nanofibers, carbon nanotubes, graphene oxide and activated carbon) as a support for Mo2C-based catalysts on the hydrodeoxygenation (HDO) of guaiacol was studied. To optimise the catalyst preparation by carbothermal hydrogen reduction (CHR), a thermogravimetric study was conducted to select the optimum CHR temperature for each carbon material, considering both the crystal size of the resulting β-Mo2C particles and the extent of the support gasification. Subsequently, catalysts were prepared in a fixed bed reactor at the optimum temperature. Catalyst characterization evidenced the differences in the catalyst morphology as compared to those prepared in the thermogravimetric study. The HDO results demonstrated that the carbon nanofiber-based catalyst was the one with the best catalytic performance. This behaviour was attributed to the high thermal stability of this support, which prevented its gasification and promoted a good evolution of the crystal size of Mo species. This catalyst exhibited well-dispersed β-Mo2C nanoparticles of ca. 11 nm. On the contrary, the other supports suffered from severe gasification (60–70% wt. loss), which resulted in poorer HDO efficiency catalysts regardless of the β-Mo2C crystal size. This exhibited the importance of the carbon support stability in Mo2C-based catalysts prepared by CHR.
Comparative Performance Metric Assessment of A Military Turbojet Engine Utilizing Hydrogen And Kerosene Fuels Through Advanced Exergy Analysis Method
Authors: Yuksel Burak , Balli Ozgur , Gunerhan Huseyin , Hepbasli Arif
Published: March 2020

This study dealt with evaluating the (J85-GE-5H) military turbojet engine (TJE) in terms of exergetic and advanced exergetic analyses at Military (MIL) and Afterburner (AB) process modes by utilizing kerosene (JP-8) and hydrogen (H2) fuels. First, exergy and advanced exergy analyses of the engine were performed using JP-8 fuel as per actual engine operating conditions. These analyses of the turbojet engine using hydrogen fuel were also examined parametrically. The performance evaluation of the engine was lastly executed by comparing the obtained results for both fuels. Based on the parametric studies undertaken, the entire engine’s exergetic efficiency with JP-8 was reckoned 30.85% at the MIL process mode while it was calculated as 16.98% at the AB process mode. With the usage of H2, the efficiencies of the engine decreased to 28.62% and 15.33% for the above mentioned two modes, respectively. As the supreme exergy destructions occurred in the combustion chamber (CC) and afterburner exhaust duct (ABED) segments, the new technological developments should be considered to design more efficient engines. As a result, the engine worked less efficiently with hydrogen fuel due to the enhancement in exergy destructions. Conversely, the greenhouse gas (GHG) emission parameters lessened with the utilization of H2 fuel.
A Review of Topology Optimisation for Fluid-Based Problems
Authors: Alexandersen Joe , Andreasen Casper Schousboe
Published: March 2020

This review paper provides an overview of the literature for topology optimisation of fluid-based problems, starting with the seminal works on the subject and ending with a snapshot of the state of the art of this rapidly developing field. “Fluid-based problems” are defined as problems where at least one governing equation for fluid flow is solved and the fluid–solid interface is optimised. In addition to fluid flow, any number of additional physics can be solved, such as species transport, heat transfer and mechanics. The review covers 186 papers from 2003 up to and including January 2020, which are sorted into five main groups: pure fluid flow; species transport; conjugate heat transfer; fluid–structure interaction; microstructure and porous media. Each paper is very briefly introduced in chronological order of publication. A quantititive analysis is presented with statistics covering the development of the field and presenting the distribution over subgroups. Recommendations for focus areas of future research are made based on the extensive literature review, the quantitative analysis, as well as the authors’ personal experience and opinions. Since the vast majority of papers treat steady-state laminar pure fluid flow, with no recent major advancements, it is recommended that future research focuses on more complex problems, e.g., transient and turbulent flow.
Modernist Women Writers and Whimsy: Marianne Moore and Dorothy Parker
Authors: May Will
Published: March 2020

This article assesses the work of Dorothy Parker (1893–1967) and Marianne Moore (1887–1972) in relation to the aesthetic category of whimsy. It considers how whimsy has been used as a term of dismissal for American women poets, outlines ways both writers’ receptions have been informed by this context, and explores questions of cost, worth, and value raised by their work. It situates whimsy in relation to Sianne Ngai’s account of diminutive modes in Our Aesthetic Categories (2015) and suggests why American women’s modernist poetry can be a useful context for exploring the aesthetic and cultural associations of whimsy.
Progressive Invasion of Aedes albopictus in Northern Spain in The Period 2013–2018 and A Possible Association with The Increase in Insect Bites
Authors: Goiri Fátima , González Mikel Alexander , Goikolea Joseba , Oribe Madalen , de Castro Visitación , Delacour Sarah , Lucientes Javier , Ortega-Araiztegi Ione , Barandika Jesús Felix , García-Pérez Ana Luisa
Published: March 2020

(1) Background: Aedes albopictus has rapidly expanded throughout Europe, becoming a public health concern in the Mediterranean Basin. (2) Methods: Following the detection of Ae. albopictus in the southwestern French region of Aquitaine in 2012, an entomological surveillance programme was implemented in the Basque Country (Northern Spain) in 2013. (3) Results: Ae. albopictus eggs were first detected in 2014 in a transited parking area in the northeastern sampling point, 22 km away from the nearest French site with recorded presence of tiger mosquito. At this site, eggs were found throughout the study (2014–2018). Other western and southern municipalities became positive in 2017 and 2018. Ae. albopictus adults were first captured in 2018 by aspiration of the vegetation in an area where eggs had been detected since 2015, suggesting a progressive establishment of a self-sustained population. Incidence of insect bites in humans was roughly constant over the study period except for a significant increase in 2018 in the Health County where eggs had been detected since 2014. Densities of Ae. albopictus eggs in positive areas remained at similar levels over the years. (4) Conclusion: Multiple approaches and standardized methods are necessary to successfully control this vector.
Prediction of Epidemic Spread of the 2019 Novel Coronavirus Driven by Spring Festival Transportation in China: A Population-Based Study
Authors: Fan Changyu , Liu Linping , Guo Wei , Yang Anuo , Ye Chenchen , Jilili Maitixirepu , Ren Meina , Xu Peng , Long Hexing , Wang Yufan
Published: March 2020

After the 2019 novel coronavirus (2019-nCoV) outbreak, we estimated the distribution and scale of more than 5 million migrants residing in Wuhan after they returned to their hometown communities in Hubei Province or other provinces at the end of 2019 by using the data from the 2013–2018 China Migrants Dynamic Survey (CMDS). We found that the distribution of Wuhan’s migrants is centred in Hubei Province (approximately 75%) at a provincial level, gradually decreasing in the surrounding provinces in layers, with obvious spatial characteristics of circle layers and echelons. The scale of Wuhan’s migrants, whose origins in Hubei Province give rise to a gradient reduction from east to west within the province, and account for 66% of Wuhan’s total migrants, are from the surrounding prefectural-level cities of Wuhan. The distribution comprises 94 districts and counties in Hubei Province, and the cumulative percentage of the top 30 districts and counties exceeds 80%. Wuhan’s migrants have a large proportion of middle-aged and high-risk individuals. Their social characteristics include nuclear family migration (84%), migration with families of 3–4 members (71%), a rural household registration (85%), and working or doing business (84%) as the main reason for migration. Using a quasi-experimental analysis framework, we found that the size of Wuhan’s migrants was highly correlated with the daily number of confirmed cases. Furthermore, we compared the epidemic situation in different regions and found that the number of confirmed cases in some provinces and cities in Hubei Province may be underestimated, while the epidemic situation in some regions has increased rapidly. The results are conducive to monitoring the epidemic prevention and control in various regions.
The Relationship between Health Literacy, Quality of Life, and Subjective Health: Results of a Cross-Sectional Study in a Rural Region in Germany
Authors: Ehmann Anna T. , Groene Oliver , Rieger Monika A. , Siegel Achim
Published: March 2020

Low health literacy is associated with poorer health and quality of life. An open question is whether a regional integrated healthcare system whose management strives to enable and empower its members with regard to health issues can contribute to a higher level of health literacy in the population. Against this background, in a cross-sectional study we surveyed a random selection of members of an integrated healthcare system in southwestern Germany (n = 180). The standardized questionnaire included, inter alia, questions on health literacy and subjective health. In this sample we wanted to (1) determine the proportion of respondents with sufficient health literacy and (2) investigate whether the association between health literacy and quality of life and subjective health status—as found in other studies—can be replicated. In our sample a health literacy score could be calculated in 126 subjects (70%). A sufficient level of health literacy was detected in 62% of respondents. Confirming the findings of a meta-analysis based on international studies, we found moderate correlations between health literacy and quality of life (r = 0.41) and health literacy and subjective health status (r = 0.40); these correlations hardly decreased when we controlled for various sociodemographic characteristics. As the proportion of respondents with sufficient health literacy was higher in our sample than in comparable studies conducted in Germany, we may hypothesize that an integrated healthcare system like the one we surveyed could have contributed to increased health literacy in the population. Thus, it could be worthwhile to investigate this research question with a more rigorous study design and a larger sample.
Metabolic Functional Community Diversity of Associated Bacteria during the Degradation of Phytoplankton from a Drinking Water Reservoir
Authors: Chen Sheng-Nan , Shang Pan-Lu , Kang Peng-Liang , Du Man-Man
Published: March 2020

In the drinking water reservoir ecosystem, phytoplankton and bacteria play important roles in shaping freshwater health and function. In this work, the associated bacterial community functional diversity during degradation of phytoplankton was determined using the substrate utilization profiling (BIOLOG) technique, meanwhile, the composition and concentration of phytoplankton were examined using a microscope. The results indicated that Euglena decreased 58.33% from 0 to 38 d, while the smallest degradation of Bacillariophyta was 20.19%. Average well color development (AWCD590nm) increased during the static periods from 0 to 38 d; however, the AWCD590nm of 18 and 38 d had no significant difference (p < 0.05). The Simpson’s index (D) was in accordance with Shannon’s diversity (H) and species richness(S); it was measured to be18 > 38 > 5 > 0 d. There were significant differences in the pattern and level of carbon sources used by the phytoplankton-associated bacteria. In addition, the principle component analyses (PCA) suggested that the first principle component (PC1) and the second principle component (PC2) explained 46.76% and 21.49% of the total variation for bacterial community, respectively. Redundancy analysis (RDA) revealed that cell abundance of phytoplankton was negatively correlated with the AWCD590nm, amino acids and other functional indexes. Therefore, the data suggest that there are differences in the phytoplankton-associated bacterial community functional diversity during different static stages of water samples collected from the drinking water reservoir.
Differences in Training Adaptations of Endurance Performance during Combined Strength and Endurance Training in a 6-Month Crisis Management Operation
Authors: Pihlainen Kai , Häkkinen Keijo , Santtila Matti , Raitanen Jani , Kyröläinen Heikki
Published: March 2020

Decreases in aerobic fitness during military operations have been observed in several studies. Thus, differences in training adaptations during a 6-month crisis-management operation were compared by using the change in endurance performance as the outcome measure. Sixty-six male soldiers volunteered for the study, consisting of pre–post assessments of blood biomarkers, body composition, physical performance, and the military simulation test (MST) performance. Physical training volume was self-reported. After the follow-up, the data were divided based on individual changes in endurance performance. Endurance performance was improved in the high-responder group (HiR, n = 25) and maintained or decreased in the low-responder group (LoR n = 24). During the operation, the LoR group decreased while the HiR group increased their endurance training frequency from the pre-deployment level (Δ 28 ± 57% vs. −40 ± 62%, p = 0.004). Fat mass decreased (−7.6 ± 11.7% vs. 14.2 ± 20.4%, p < 0.001), and 1-min push-up (27.7 ± 21.9% vs. 11.7 ± 26.1%, p = 0.004) and MST performance improved (−13.6 ± 6.8% vs. −7.5 ± 6.5%, p = 0.006) more in the HiR group. No differences were observed in the changes of other physical performance test results or analyzed biomarkers. In conclusion, soldiers who were initially leaner and fitter in terms of lower body strength and power were more likely to decrease their aerobic fitness during the operation.
Adolescents’ Reactions to Adverts for Fast-Food and Confectionery Brands That are High in Fat, Salt, and/or Sugar (HFSS), and Possible Implications for Future Research and Regulation: Findings from a Cross-Sectional Survey of 11–19 Year Olds in the United Kingdom
Authors: Critchlow Nathan , Newberry Le Vay Jessica , MacKintosh Anne , Hooper Lucie , Thomas Christopher , Vohra Jyotsna
Published: March 2020

The influence that marketing for foods high in fat, salt, and/or sugar (HFSS) has on adolescents extends beyond a dose-response relationship between exposure and consumption. It is also important to explore how marketing shapes or reinforces product/brand attitudes, and whether this varies by demography and Body Mass Index (BMI). To examine this, a cross-sectional survey was conducted with 11–19 year olds in the United Kingdom (n = 3348). Participants watched 30 s video adverts for a fast-food and confectionery brand. For each advert, participants reported reactions on eight measures (e.g., 1 = Makes [product] seem unpopular choice–5 = Makes [product] seem popular choice), which were binary coded based on whether a positive reaction was reported (Yes/No). At least half of adolescents had positive reactions to both adverts for 5/8 measures. Positive reactions had associations with age, gender and, to a lesser extent, BMI. For example, 11–15 year olds were more likely than 16–19 year olds to report appeal to their age group for the fast-food (OR = 1.33, 95% CI: 1.13–1.58) and confectionery advert (OR = 1.79, 95% CI: 1.52–2.12). If these reactions are typical of other HFSS products, future research and regulatory change should examine whether additional controls on the content of HFSS marketing, for example mandated health or nutritional information and revised definitions of youth appeal, offer additional protection to young people.
Difficulties in Getting to Sleep and their Association with Emotional and Behavioural Problems in Adolescents: Does the Sleeping Duration Influence this Association?
Authors: Kosticova Michaela , Husarova Daniela , Dankulincova Zuzana
Published: March 2020

Sleep problems are common in adolescence with a negative impact on the mental health and functioning of adolescents. However, the roles of different sleep problems in relation to emotional and behavioural problems (EBPs), classified according to the 10th version of the International Classification of Diseases as emotional, conduct, hyperactivity and social functioning disorders, are not clear. The first aim of the study was to investigate the association between difficulties in getting to sleep and EBPs in adolescents. The second aim was to explore the role of sleep duration in this association. We used data from the Health Behaviour in School-aged Children (HBSC) study conducted in 2018 in Slovakia. Presented are results for specific age groups of 13-year-old (N = 1909) and 15-year-old (N = 1293) adolescents. Subjective measures of sleep variables were used. Binary logistic regression models adjusted for age and gender were used to assess associations between difficulties in getting to sleep, sleep duration and EBPs measured using the Strengths and Difficulties Questionnaire. Modification of the association between difficulties in getting to sleep and EBPs by sleep duration was also explored. We found that difficulties in getting to sleep at least once a week as well as insufficient sleep (less than 8 h) increased the probability of EBPs. Interactions of sleep duration with difficulties in getting to sleep on EBPs were found to be non-significant. The results suggest that caregivers and clinicians should screen and intervene for both sleep quality and quantity problems in adolescents as they might indicate and promote EBPs.
Analytical Method Development and Chemometric Approach for Evidencing Presence of Plasticizer Residues in Nectar Honey Samples
Authors: Notardonato Ivan , Passarella Sergio , Ianiri Giuseppe , Di Fiore Cristina , Russo Mario Vincenzo , Avino Pasquale
Published: March 2020

Over the years, anthropogenic sources have increasingly affected food quality. One of the most sensitive and nutritional matrices affected by chemical contamination is honey, due to the use of acaricides. Recently, the attention has moved to the presence of phthalates (PAEs) and bisphenol A (BP-A), molecules present in plastic materials used both in the production phase and in the conservation of honey. In this study, an analytical method for the simultaneous determination of PAEs (dimethyl phthalate DMP, diethyl phthalate DEP, diisobutyl phthalate DiBP, dibutyl phthalate DBP, bis(2-ethylhexyl) phthalate DEHP, and di-n-octyl-phthalate DnOP) and BP-A was developed. The extraction technique is the ultrasound-vortex-assisted dispersive liquid–liquid microextraction (UVA-DLLME), using 150 µL of toluene as an extraction solvent, followed by the gas chromatography coupled with ion trap mass spectrometry analysis (GC–IT/MS). The developed method is sensitive, reliable, and reproducible: it shows high correlation coefficients (R > 0.999); limits of detection (LODs) less than 11 ng·g−1; limits of quantification (LOQs) less than 16 ng·g−1; repeatability below 3.6%, except BP-A (11.6%); and accuracy below 4.8%, except BP-A (17.6%). The method was applied to 47 nectar honey samples for evidencing similarities among them. The chemometric approach based on Hierarchical Cluster Analysis and Principal Component Analysis evidenced some similitudes about sample origin as well as marked differences between PAE and BP-A sources.
Diagnostic Accuracy of Videofluoroscopy for Symptomatic Cervical Spine Injury Following Whiplash Trauma
Authors: Freeman Michael D. , Katz Evan A. , Rosa Scott L. , Gatterman Bryan G. , Strömmer Ellen M. F. , Leith Wendy M.
Published: March 2020

Background: Intervertebral instability is a relatively common finding among patients with chronic neck pain after whiplash trauma. Videofluoroscopy (VF) of the cervical spine is a potentially sensitive diagnostic tool for evaluating instability, as it offers the ability to examine relative intervertebral movement over time, and across the entire continuum of voluntary movement of the patient. At the present time, there are no studies of the diagnostic accuracy of VF for discriminating between injured and uninjured populations. Methods: Symptomatic (injured) study subjects were recruited from consecutive patients with chronic (>6 weeks) post-whiplash pain presenting to medical and chiropractic offices equipped with VF facilities. Asymptomatic (uninjured) volunteers were recruited from family and friends of patients. An ethical review and oversight were provided by the Spinal Injury Foundation, Broomfield, CO. Three statistical models were utilized to assess the sensitivity, specificity, positive and negative predictive values (PPV and NPV) of positive VF findings to correctly discriminate between injured and uninjured subjects. Results: A total of 196 subjects (119 injured, 77 uninjured) were included in the study. All three statistical models demonstrated high levels of sensitivity and specificity (i.e., receiver operating characteristic (ROC) values of 0.71 to 0.95), however, the model with the greatest practical clinical utility was based on the number of abnormal VF findings. For 2+ abnormal VF findings, the ROC was 0.88 (93% sensitivity, 79% specificity) and the PPV and NPV were both 88%. The highest PPV (1.0) was observed with 4+ abnormal findings. Conclusions: Videofluoroscopic examination of the cervical spine provides a high degree of diagnostic accuracy for the identification of vertebral instability in patients with chronic pain stemming from whiplash trauma.
Urban–Rural Differences in Long-Term Care Service Status and Needs Among Home-Based Elderly People in China
Authors: Zhang Liangwen , Zeng Yanbing , Wang Lixia , Fang Ya
Published: March 2020

Background: Long-term care (LTC) needs for the elderly have become increasingly crucial policy concerns in rapidly aging Asia, especially in China, the most populous nation. However, very few studies have examined the cohort differences in terms of their existing and expected utilization of LTC services, above all urban–rural differences. This study aims to evaluate the differences of LTC current status and needs between urban–rural areas and age groups, and to identify influencing factors causing the different LTC needs. Methods: The data come from the Chinese Longitudinal Health Longevity Survey in 2014. A total of 7192 home-based elderly aged ≥65 years by multistage sampling were enrolled. The Andersen Model was applied to categorize the influential factors into three components including predisposing, enabling and needs. Multivariate logistic regression analysis was used to analyze the influential factors of the three levels of LTC needs. Results: A total of 6909 valid sample sizes were included in this study. The overall LTC needs of the elderly showed a rapidly increasing trend among which older people had the highest needs for bathing (27.29%) and toileting (15.8%). It was also demonstrated the aged cohort between urban and rural exerted an impact on all aspects of LTC status and needs to varying degrees (p < 0.05). Compared with urban areas, the LTC needs for the elderly in rural areas was more vigorous, but the supply was seriously inadequate. The elderly who were older, living in rural areas, unmarried, non-farming, with low income, in poor health and having less autonomy had higher anticipated needs for LTC services (OR > 1, p < 0.01). Compared with the young-old in rural areas, the young-old in urban areas were prone to live alone (OR = 1.61, p < 0.01). The elderly who were older, living in rural areas, farming, with low income, lonely and depressed had higher anticipated needs for community-based services (1 < OR < 1.69, p < 0.05). Conclusions: The aged cohort in urban–rural distinction were facing an increasing need for immediate care due to the inadequate support being provided, especially among rural elderly. The oldest elderly in rural areas had higher LTC needs, and different levels of needs were affected by age, economic level, family support, health status and other related effects. This study provides evidence-based recommendation for further improving the construction and development of the LTC system in China.
An Evaluation of Staff Engagement with Infectious Healthcare Waste Management Policies: A Case Study of Tunisia
Authors: Maaroufi Kaouther , Tudor Terry , Vaccari Mentore , Siala Afef , Mahmoudi Ezzeddine
Published: March 2020

This study evaluated the engagement of staff regarding infectious healthcare waste management, in two case-study universities in Tunisia. Using a questionnaire survey, it was found that the most significant reported factors that influenced engagement were the availability of technical sheets and posters, training and education programs, and the age range of the staff. While there was some accordance with the Tunisian Decree application n° 2008–2745 of July 28th, 2008, as well as international guidelines and best practice (e.g. the use of color coded bins, waste management teams, and infection control measures), there were also limitations in the provision of training. This limitation in training and, to a lesser extent, awareness impacted on the beliefs about infectious healthcare waste management of staff and their practices. Recommendations for addressing these issues are suggested.
Psychophysical Health Factors and Its Correlations in Elderly Wheelchair Users Who Live in Nursing Homes
Authors: Wołoszyn Natalia , Grzegorczyk Joanna , Wiśniowska-Szurlej Agnieszka , Kilian Justyna , Kwolek Andrzej
Published: March 2020

Background: The aging is a multi-faceted process comprising both—the physical and mental alterations. Thus, the aim of the study was to evaluate the variables affecting the psychophysical state of the elderly people using wheelchairs and living in nursing homes (NH). Methods: 165 older wheelchair users were included in the study after meeting the inclusion criteria and expressing written consent. The assessment involved cognitive functioning, depression, body balance and flexibility, lung capacity and upper limbs dexterity, strenght and endurance. The results showed negative correlation between depression and balance, upper limb dexterity and endurance and shoulder flexion. A positive correlation between cognitive functioning and balance, upper limb dexterity, strenght and endurance, lung capacity and joint mobility was determined. Also, the study proved positive correlation between daily functioning and functional fitness, muscle strength and endurance, body flexibility, joint mobility. The regression analysis showed that better scores in balance test and joint mobility implied with higher scores in cognitive functioning. The most important determinants of functional fitness were balance, hand grip strenght and joint mobility. Conclusion: The future study should be focused on developing interventions aimed at senior wheelchair users living in NHs to prevent the deterioration of their mental and physical fitness.
Standing Meetings Are Feasible and Effective in Reducing Sitting Time among Office Workers—Walking Meetings Are Not: Mixed-Methods Results on the Feasibility and Effectiveness of Active Meetings Based on Data from the “Take a Stand!” Study
Authors: Danquah Ida H , Tolstrup Janne S
Published: March 2020

Active meetings (standing or walking) have the potential to reduce sitting time among office workers. The aim of the present study was to explore the feasibility and effectiveness of standing and walking meetings. The “Take a Stand!” study was a cluster-randomized trial, consisting of multiple components including the possibility of active meetings. Analyses were based on the 173 participants in the intervention group. Feasibility was evaluated by questionnaire and interview data from participants, ambassadors and leaders. Effectiveness was assessed as the change in objectively measured sitting time from baseline to 3 months follow-up. Regular standing meetings were implemented at all offices and were generally popular, as they were perceived as more effective and focused. In contrast, only a few walking meetings were completed, and these were generally associated with several barriers and perceived as ineffective. Participants who participated in standing meetings on a regular basis had 59 min less sitting per 8 h workday (95%CI −101;−17) compared to participants who did not participate in standing meetings at all. Walking meeting participation was not significantly associated with changes in sitting time, likely due to the low number of employees who used this option. This explorative study concludes that standing meetings in office workplaces were feasible and well-liked by the employees, and having frequent standing meetings was associated with reduced sitting time. In contrast, walking meetings were unfeasible and less liked, and thus had no effect on sitting time.
Timed Up-and-Go Dual-Task Testing in the Assessment of Cognitive Function: A Mixed Methods Observational Study for Development of the UDDGait Protocol
Authors: Cedervall Ylva , Stenberg Anna M. , Åhman Hanna B. , Giedraitis Vilmantas , Tinmark Fredrik , Berglund Lars , Halvorsen Kjartan , Ingelsson Martin , Rosendahl Erik , Åberg Anna Cristina
Published: March 2020

New methods to screen for and identify early-stage dementia disorders are highly sought after. The purpose of this pilot study is to develop a study protocol for a dual-task test aimed at aiding the early detection of dementia disorders. We used the Timed Up-and-Go (TUG) test, which is a mobility task involving starting in a sitting position, standing up, walking three meters to cross a line on the floor, turning around, walking back and sitting down again. We combined TUG with the verbal task of naming different animals. Pilot study participants were 43 individuals with and without established dementia diagnoses who attended a clinic for memory assessment. Video-recorded test performances were systematically analysed. Deviant test performances concerning the interplay between test administration and participants’ responses to the assessment instructions were revealed and led to refinements being made to the final study protocol. Exploration of the dual-task test outcome measures in a sub-sample of 22 persons, ten with and twelve without dementia, indicated that step-length and number of named animals after the turning point of the dual-task test might constitute appropriate measures for examining this kind of sample. We concluded that the refined study protocol is feasible for testing individuals undergoing initial memory assessments and healthy controls. Follow-up studies with larger samples are being carried out and will bring new knowledge to this area of research. It may also provide an opportunity for further studies exploring possibilities for broad clinical implementation.
Provincial Dietary Intake Study (PDIS): Energy and Macronutrient Intakes of Children in a Representative/Random Sample of 1–<10-Year-Old Children in Two Economically Active and Urbanized Provinces in South Africa
Authors: Steyn Nelia P. , Nel Johanna H. , Malczyk Sonia , Drummond Linda , Senekal Marjanne
Published: March 2020

The double burden of malnutrition is still prevalent in South Africa, hence the importance of a dietary survey to identify risks of under- and over-nutrition. A multistage stratified cluster random sampling design was applied in two economically active provinces, Gauteng (GTG) (N = 733) and Western Cape (WC) (N = 593). Field workers completed questionnaires, and a 24 h recall with children taking part aged 1–<10-years (N = 1326). Important findings were that 71% and 74%, respectively, of 3–<6-year-olds and 6–<10-year-olds had an energy intake below the estimated energy requirement (EER), while 66% 1–<3-year-olds had intakes above the EER. The percentage of children with a total fat intake below recommended levels decreased as age increased ((51%, 40% and 5%) respectively, for the three age groups). Similarly, the percentage of those who had a total fat intake above the recommendation increased with increasing age (4%, 11% and 26%, respectively, for the three age groups). Saturated fat intake above 10%E was highest in the youngest and oldest children (33% and 32%, respectively). The percentage of children with a free sugars intake above 10%E was 47%, 48% and 52% respectively, and 98–99% had a fibre intake that was less than recommended. Overall, the diet was not healthy, with the main food items being very refined, and the diet being high in salty snacks and sugary items, and low in fruit, vegetables and legumes.
Health Literacy as Communicative Action—A Qualitative Study among Persons at Risk in the Context of Predictive and Preventive Medicine
Authors: Harzheim Laura , Lorke Mariya , Woopen Christiane , Jünger Saskia
Published: March 2020

Predictive and preventive medicine play an increasingly important role in public debates on health, providing cutting-edge technologies with the potential to measure and predict individual risks of getting ill. This leads to an ever-expanding definitional space between being “healthy” and being “ill”, challenging the individual’s everyday life, attitudes and perceptions towards the self and the process of health-related decision-making. “How do the condition of ‘being at risk’ and individual health literacy interrelate?” is the leading question of the current contribution. Drawing on empirical qualitative data, collected by means of narrative interviews with persons at risk in four clinical fields, a bottom-up ethnographic and health sciences perspective on health literacy (with an emphasis on critical health literacy) is employed. The findings will be embedded within theoretical approaches dealing with power relations and communication in healthcare encounters, particularly Habermas’ theory of communicative action. The core outcome of our study is a concept for an overarching model of health literacy in the context of health-related risk prediction across indications, based on empirical insights gained through interpretative analysis of the four clinical domains.
Exploring Associated Factors of Subjective Health Literacy in School-Aged Children
Authors: Fretian Alexandra , Bollweg Torsten Michael , Okan Orkan , Pinheiro Paulo , Bauer Ullrich
Published: March 2020

Low health literacy is considered to lead to worse health-related outcomes and behaviors and has therefore been recognized as a social determinant of health. While health literacy and its potential determinants have been studied in adults, little research has been conducted with children. This study aims to address this research gap by investigating factors associated with children’s subjective health literacy. Cross-sectional data was collected from fourth graders at German schools with a self-report questionnaire. Sociodemographic characteristics, health-related attitudes, and motivation were analyzed. We used hierarchical multivariate linear regression to explain variance in the dependent variable “subjective health literacy”. A total of n = 907 fourth graders were surveyed. Regarding health literacy, eight out of ten participants (82.2%) reported that it was “rather easy” or “very easy” to deal with health-related information. Family affluence, but not language spoken at home, was significantly related to subjective health literacy, after controlling for confounding. Moreover, parental health orientation, self-efficacy, and motivation are factors significantly associated with health literacy. Based on the results of this study, it is hypothesized that a general motivation to learn new things about health, as well as an environment promoting health-positive behavior, might foster children’s health literacy.