bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluation of the Ability of Nutri-Score to Discriminate the Nutritional Quality of Prepacked Foods Using a Sale-Weighting Approach
Authors: Hafner Edvina , Pravst Igor
Published: July 2021

The implementation of mandatory front-of-pack nutrition labelling is currently being discussed in the European Union (EU). The Nutri-Score (NS) was developed in France to empower consumers to make informed and healthier food choices. Based on strong evidence of its efficacy in supporting healthy choices, it has already been implemented for voluntary use in some EU member states, making it relevant to developing a harmonised EU scheme. This study aimed to evaluate the NS’s discriminating ability on products available in the food supply and compare it with Slovenian national nutritional recommendations based on an adapted WHO Europe (WHOE) profile. The innovative approach of the study is that we used sale-weighting to address the public health importance of available foods, with consideration of market share. We profiled 15,822 products available in the Slovenian food supply in 2017. The NS had a high ability to discriminate food products based on nutritional composition. Products that are generally encouraged in dietary recommendations (fruits, vegetables, cereals) had, in most cases, better NS grades than less favourable products (confectionery, snack foods, added fats), which is also in line with the national nutrition policy programme. The discriminating ability of the model was also shown within food (sub)categories (e.g., plain and flavoured yoghurt). Sale-weighting showed that offerings do not always reflect sales. Major differences between offerings and sales were observed for beverages, dairy, fruits/vegetables, and edible oils/emulsions. Additionally, sale-weighted distribution tended towards less favourable nutritional composition, particularly in categories with overall smaller offerings of products with favourable composition. The NS showed moderate agreement with the WHOE profile (κ = 0.57); differences were particularly observed in flavoured yoghurts, juices, cooking oils, and cheeses. Modelling the operation of the NS with representative real-life food samples provided insight valuable for developing and implementing harmonised mandatory front-of-pack nutrition labelling in Europe.
Microgreens: Functional Food with Antiproliferative Cancer Properties Influenced by Light
Authors: Truzzi Francesca , Whittaker Anne , Roncuzzi Chiara , Saltari Annalisa , Levesque Mitchell P. , Dinelli Giovanni
Published: July 2021

The anti-proliferative/pro-oxidant efficacy of green pea, soybean, radish, Red Rambo radish, and rocket microgreens, cultivated under either fluorescent lighting (predominant spectral peaks in green and orange) or combination light-emitting diode (LED, predominant spectral peak in blue) was investigated using Ewing sarcoma lines, RD-ES and A673, respectively. All aqueous microgreen extracts significantly reduced cell proliferation (cancer prevention effect) to varying extents in two-dimensional sarcoma cell cultures. The effect of the polyphenol fraction in the aqueous food matrix was unrelated to total polyphenol content, which differed between species and light treatment. Only Pisum sativum (LED-grown) extracts exercised anti-proliferative and pro-apoptotic effects in both three-dimensional RD-ES and A673 spheroids (early tumor progression prevention), without cytotoxic effects on healthy L929 fibroblasts. A similar anti-tumor effect of Red Rambo radish (LED and fluorescent-grown) was evident only in the RD-ES spheroids. Aside from the promising anti-tumor potential of the polyphenol fraction of green pea microgreens, the latter also displayed favorable growth quality parameters, along with radish, under both light treatments over the 10 day cultivation period.
Functionality and Palatability of Yogurt Produced Using Beetroot Pomace Flour Granulated with Lactic Acid Bacteria
Authors: Jovanović Marina , Zlatanović Snežana , Micić Darko , Bacić Dragan , Mitić-Ćulafić Dragana , Đuriš Mihal , Gorjanović Stanislava
Published: July 2021

Following the idea of sustainability in food production, a yogurt premix based on beetroot (Beta vulgaris) pomace flour (BPF) was developed. BPF was granulated with lactose solution containing lactic acid bacteria (LAB) by a fluidized bed. Particle size increased ~30%. A decrease in Carr Index from 21.5 to 14.98 and Hausner ratio from 1.27 to 1.18 confirmed improved flowability of granulated BPF, whereas a decrease in water activity implied better storability. Yogurts were produced weekly from neat starters and granulated BPF (3% w/w) that were stored for up to one month (4 °C). High viability of Streptococcus thermophilus was observed. Less pronounced syneresis, higher inhibition of colon cancer cell viability (13.0–24.5%), and anti-Escherichia activity were ascribed to BPF yogurts or their supernatants (i.e., extracted whey). Acceptable palatability for humans and dogs was demonstrated. A survey revealed positive consumers’ attitudes toward the granulated BPF as a premix for yogurts amended to humans and dogs. For the first time, BPF granulated with LAB was used as a premix for a fermented beverage. An initial step in the conceptualization of a novel DIY (do it yourself) formula for obtaining a fresh yogurt fortified with natural dietary fiber and antioxidants has been accomplished.
Low Oxygen Storage Improves Tomato Postharvest Cold Tolerance, Especially for Tomatoes Cultivated with Far-Red LED Light
Authors: Affandi Fahrizal Yusuf , Verschoor Jan A. , Paillart Maxence J. M. , Verdonk Julian C. , Woltering Ernst J. , Schouten Rob E.
Published: July 2021

We investigated the effects of low oxygen storage on chilling injury development, colour development, respiration and H2O2 levels of ‘Merlice’ tomatoes cultivated with and without far red (FR) LED lighting during 20 days of shelf-life. Mature green (MG) and red (R) tomatoes were stored at 2 °C in combination with 0.5, 2.5, 5 and 21 kPa O2 for 15 days (experiment 1). MG tomatoes cultivated under either white LED or white LED light with FR LED light were stored at 2 °C in combination with 1, 5 and 21 O2 kPa for 14 days (experiment 2). Chilled MG and R tomatoes from experiment 1 showed decay, firmness loss and higher weight loss during shelf-life which were reduced under low oxygen conditions. FR during cultivation improved chilling tolerance of MG tomatoes. Fastest colour development and lowest respiration rate during shelf-life were observed for MG fruit cultivated with FR lighting prior to storage at 1 kPa O2/0 kPa CO2. H2O2 levels during the shelf-life were not affected during cold storage. The improved cold tolerance of MG tomatoes cultivated with FR lighting is likely due to lower oxygen uptake that led to both higher lycopene synthesis and less softening.
An Untargeted Metabolomics Investigation of Milk from Dairy Cows with Clinical Mastitis by 1H-NMR
Authors: Zhu Chenglin , Tang Kaiwei , Lu Xuan , Tang Junni , Laghi Luca
Published: July 2021

Mastitis is one of the diseases with the highest incidence in dairy cows, causing huge economic losses to the dairy industry all over the world. The aim of the study was to characterize mastitic milk metabolome through untargeted nuclear magnetic resonance spectroscopy (1H-NMR). Taking advantage of the high reproducibility of 1H-NMR, we had the opportunity to provide quantitative information for all the metabolites identified. Fifty-four molecules were characterized, sorted mainly into the chemical groups, namely amino acids, peptides and analogues, carbohydrates and derivates, organic acids and derivates, nucleosides, nucleotides and analogues. Combined with serum metabolomic investigations, several pathways were addressed to explain the mechanisms of milk metabolome variation affected by clinical mastitis, such as tricarboxylic acid cycle (TCA cycle) and phenylalanine, tyrosine and tryptophan biosynthesis. These results provide a further understanding of milk metabolome altered by clinical mastitis, which can be used as a reference for the further milk metabolome investigations.
Combined Hurdle Technologies Using UVC Waterproof LED for Inactivating Foodborne Pathogens on Fresh-Cut Fruits
Authors: Kim Geun-Hyang , Lee Chae-Lim , Yoon Ki-Sun
Published: July 2021

This study investigated the combined bactericidal efficacy of slightly acidic electrolyzed water (SAEW), fumaric acid (FA), and ultravioletC waterproof light-emitting diodes (UVC W-LED) for the control of Staphylococcus aureus and Listeria monocytogenes in fresh-cut fruits. Cherry tomato, grape, apple, and pineapple were inoculated with S. aureus and L. monocytogenes and then washed with 30 ppm SAEW containing 0.5% FA in a container equipped with two UVC W-LEDs. Behaviors of S. aureus and L. monocytogenes and quality properties of fresh-cut fruits were monitored after storage at 10 °C and 15 °C for 7 days. The most effective reductions of S. aureus (1.65 log CFU/g) and L. monocytogenes (2.63 log CFU/g) were observed in the group with the combined treatment of SAEW + FA and UVC W-LED. At 10 °C and 15 °C, populations of both pathogens in the combined treatment group were lower than those in a control. Combined treatment showed no negative effect on moisture retention in the fruit. Moreover, visual changes were less significant than in the control. These results demonstrate that the combined treatment can improve the microbial safety and the quality of fruits. If it is properly used in the sanitizing step of the fresh produce industry, a positive effect can be expected.
A Nonlocal Fractional Peridynamic Diffusion Model
Authors: Wang Yuanyuan , Sun HongGuang , Fan Siyuan , Gu Yan , Yu Xiangnan
Published: July 2021

This paper proposes a nonlocal fractional peridynamic (FPD) model to characterize the nonlocality of physical processes or systems, based on analysis with the fractional derivative model (FDM) and the peridynamic (PD) model. The main idea is to use the fractional Euler–Lagrange formula to establish a peridynamic anomalous diffusion model, in which the classical exponential kernel function is replaced by using a power-law kernel function. Fractional Taylor series expansion was used to construct a fractional peridynamic differential operator method to complete the above model. To explore the properties of the FPD model, the FDM, the PD model and the FPD model are dissected via numerical analysis on a diffusion process in complex media. The FPD model provides a generalized model connecting a local model and a nonlocal model for physical systems. The fractional peridynamic differential operator (FPDDO) method provides a simple and efficient numerical method for solving fractional derivative equations.
“Why Not Nuevo Mexicano Studies?”: Interrogating Latinidades in the Intermountain West, 1528–2020
Authors: Muñoz Ed A.
Published: July 2021

While there has been an explosion of scholarly interest in the historical and contemporary social, economic, and political status of U.S. Latinx individuals and communities, the majority focuses on traditional Southwestern U.S., Northeastern U.S., and South Florida rural/urban enclaves. Recent “New Destinations” research, however, documents the turn of the 21st century Latinx experiences in non-traditional white/black, and rural/urban Latinx regional enclaves. This socio-historical essay adds to and challenges emerging literature with a nearly five-century old delineation of Latinidad in the Intermountain West, a region often overlooked in the construction of Latina/o identity. Selected interviews from the Spanish-Speaking Peoples in Utah Oral History and Wyoming’s La Cultura Hispanic Heritage Oral History projects shed light on Latinidad and the adoption of Latinx labels in the region during the latter third of the 20th century centering historical context, material conditions, sociodemographic characteristics, and institutional processes in this decision. Findings point to important implications for the future of Latinidad in light of the region’s Latinx renaissance at the turn of the 21st century. The region’s increased Latino proportional presence, ethnic group diversity, and socioeconomic variability poses challenges to the region’s long-established Hispano/Nuevo Mexicano Latinidad.
Isolation of High Molecular Weight DNA from the Model Beetle Tribolium for Nanopore Sequencing
Authors: Volarić Marin , Veseljak Damira , Mravinac Brankica , Meštrović Nevenka , Despot-Slade Evelin
Published: July 2021

The long-read Nanopore sequencing has been recently applied for assembly of complex genomes and analysis of linear genome organization. The most critical factor for successful long-read sequencing is extraction of high molecular weight (HMW) DNA of sufficient purity and quantity. The challenges associated with input DNA quality are further amplified when working with extremely small insects with hard exoskeletons. Here, we optimized the isolation of HMW DNA from the model beetle Tribolium and tested for use in Nanopore sequencing. We succeeded in overcoming all the difficulties in HMW handling and library preparation that were encountered when using published protocols and commercial kits. Isolation of nuclei and subsequent purification of DNA on an anion-exchange chromatography column resulted in genomic HMW DNA that was efficiently relaxed, of optimal quality and in sufficient quantity for Nanopore MinION sequencing. DNA shearing increased average N50 read values up to 26 kb and allowed us to use a single flow cell in multiple library loads for a total output of more than 13 Gb. Although our focus was on T. castaneum and closely related species, we expect that this protocol, with appropriate modifications, could be extended to other insects, particularly beetles.
DNA Methylation Alterations in Blood Cells of Toddlers with Down Syndrome
Authors: Naumova Oxana Yu. , Lipschutz Rebecca , Rychkov Sergey Yu. , Zhukova Olga V. , Grigorenko Elena L.
Published: July 2021

Recent research has provided evidence on genome-wide alterations in DNA methylation patterns due to trisomy 21, which have been detected in various tissues of individuals with Down syndrome (DS) across different developmental stages. Here, we report new data on the systematic genome-wide DNA methylation perturbations in blood cells of individuals with DS from a previously understudied age group—young children. We show that the study findings are highly consistent with those from the prior literature. In addition, utilizing relevant published data from two other developmental stages, neonatal and adult, we track a quasi-longitudinal trend in the DS-associated DNA methylation patterns as a systematic epigenomic destabilization with age.
Novel STAG1 Frameshift Mutation in a Patient Affected by a Syndromic Form of Neurodevelopmental Disorder
Authors: Di Muro Ester , Palumbo Pietro , Benvenuto Mario , Accadia Maria , Di Giacomo Marilena Carmela , Manieri Sergio , Abate Rosaria , Tagliente Maria , Castellana Stefano , Mazza Tommaso , Carella Massimo , Palumbo Orazio
Published: July 2021

The cohesin complex is a large evolutionary conserved functional unit which plays an essential role in DNA repair and replication, chromosome segregation and gene expression. It consists of four core proteins, SMC1A, SMC3, RAD21, and STAG1/2, and by proteins regulating the interaction between the complex and the chromosomes. Mutations in the genes coding for these proteins have been demonstrated to cause multisystem developmental disorders known as “cohesinopathies”. The most frequent and well recognized among these distinctive clinical conditions are the Cornelia de Lange syndrome (CdLS, OMIM 122470) and Roberts syndrome (OMIM 268300). STAG1 belongs to the STAG subunit of the core cohesin complex, along with five other subunits. Pathogenic variants in STAG1 gene have recently been reported to cause an emerging syndromic form of neurodevelopmental disorder that is to date poorly characterized. Here, we describe a 5 year old female patient with neurodevelopmental delay, mild intellectual disability, dysmorphic features and congenital anomalies, in which next generation sequencing analysis allowed us to identify a novel pathogenic variation c.2769_2770del p.(Ile924Serfs*8) in STAG1 gene, which result to be de novo. The variant has never been reported before in medical literature and is absent in public databases. Thus, it is useful to expand the molecular spectrum of clinically relevant alterations of STAG1 and their phenotypic consequences.
Laboratory Investigation of Geobag Revetment Performance in Rivers
Authors: Khajenoori Leila , Wright Grant , Crapper Martin
Published: July 2021

Geobag (sand-filled geotextile bags) revetments have recently emerged as long-term riverbank protection measures in developing countries; however, their performance is still not well understood. The hydraulic stability of geobag revetments used for riverbank protection has been studied within an extensive laboratory programme to improve our understanding of the complete failure processes of geobag revetments. A 1:10 scale distorted physical model was tested in a laboratory flume, comparing a range of different construction methods and revetment side slopes, subjected to different flow loading. The results indicate that whilst failure mechanisms are highly dependent on water depth and revetment slope, the construction method had no noticeable impact. It was thus concluded that the dominating factor is the friction between individual geobags, which itself is dependent on bag longitudinal overlap rather than a specific construction method.
Evaluation of Machine Learning Algorithms for Object-Based Mapping of Landslide Zones Using UAV Data
Authors: Karantanellis Efstratios , Marinos Vassilis , Vassilakis Emmanuel , Hölbling Daniel
Published: July 2021

Landslides are a critical geological phenomenon with devastating and catastrophic consequences. With the recent advancements in the geoinformation domain, landslide documentation and inventorization can be achieved with automated workflows using aerial platforms such as unmanned aerial vehicles (UAVs). As a result, ultra-high-resolution datasets are available for analysis at low operational costs. In this study, different segmentation and classification approaches were utilized for object-based landslide mapping. An integrated object-based image analysis (OBIA) workflow is presented incorporating orthophotomosaics and digital surface models (DSMs) with expert-based and machine learning (ML) algorithms. For segmentation, trial and error tests and the Estimation of Scale Parameter 2 (ESP 2) tool were implemented for the evaluation of different scale parameters. For classification, machine learning algorithms (K- Nearest Neighbor, Decision Tree, and Random Forest) were assessed with the inclusion of spectral, spatial, and contextual characteristics. For the ML classification of landslide zones, 60% of the reference segments have been used for training and 40% for validation of the models. The quality metrics of Precision, Recall, and F1 were implemented to evaluate the models’ performance under the different segmentation configurations. Results highlight higher performances for landslide mapping when DSM information was integrated. Hence, the configuration of spectral and DSM layers with the RF classifier resulted in the highest classification agreement with an F1 value of 0.85.
Are Strength Indicators and Skin Temperature Affected by the Type of Warm-Up in Paralympic Powerlifting Athletes?
Authors: de Aquino Resende Marcelo , Aidar Felipe J. , Vasconcelos Resende Roberta Barreto , Reis Gracielle Costa , de Oliveira Barros Layanne , de Matos Dihogo Gama , Marçal Anderson Carlos , de Almeida-Neto Paulo Francisco , Díaz-de-Durana Alfonso López , Merino-Fernández María , Vilaça-Alves José , de Araújo Tinoco Cabral Breno Guilherme , Neves Eduardo Borba , Reis Victor Machado , Clemente Filipe Manuel , Garrido Nuno Domingos
Published: July 2021

(1) Background: the present study aimed to evaluate the effect of different types of warm-ups on the strength and skin temperature of Paralympic powerlifting athletes. (2) Methods: the participants were 15 male Paralympic powerlifting athletes. The effects of three different types of warm-up (without warm-up (WW), traditional warm-up (TW), or stretching warm-up (SW)) were analyzed on static and dynamic strength tests as well as in the skin temperature, which was monitored by thermal imaging. (3) Results: no differences in the dynamic and static indicators of the force were shown in relation to the different types of warm-ups. No significant differences were found in relation to peak torque (p = 0.055, F = 4.560, η2p = 0.246 medium effect), and one-repetition maximum (p = 0.139, F = 3.191, η2p = 0.186, medium effect) between the different types of warm-ups. In the thermographic analysis, there was a significant difference only in the pectoral muscle clavicular portion between the TW (33.04 ± 0.71 °C) and the WW (32.51 ± 0.74 °C) (p = 0.038). The TW method also presented slightly higher values than the SW and WW in the pectoral muscles sternal portion and the deltoid anterior portion, but with p-value > 0.05. (4) Conclusions: the types of warm-ups studied do not seem to interfere with the performance of Paralympic Powerlifting athletes. However, the thermal images showed that traditional warm-up best meets the objectives expected for this preparation phase.
Traditional versus Microsphere Embolization for Hepatocellular Carcinoma: An Effectiveness Evaluation Using Data Mining
Authors: Chang Pi-Yi , Cheng Chen-Yang , Hon Jau-Shin , Kuo Cheng-Ding , Yen Chieh-Ling , Chai Jyh-Wen
Published: July 2021

Background: For hepatocellular carcinoma (“HCC”), the current standard of treatment is hepatic artery embolization, generally through trans-catheter arterial chemoembolization (“TACE”). There are two types: traditional (“conventional” or “cTACE”) and microsphere (“DC bead TACE”). Unfortunately, the literature comparing the relative effectiveness of cTACE versus DC bead TACE is inconclusive, partially due to the complexity of HCC and its response to treatment. Data mining is an excellent method to extract meaning from complex data sets. Purpose: Through the application of data mining techniques, to compare the relative effectiveness of cTACE and DC bead TACE using a large patient database and to use said comparison to establish usable guidelines for developing treatment plans for HCC patients. Materials and Methods: The data of 372 HCC patients who underwent TACE in Taichung Veterans General Hospital were analyzed. The chi-square test was used to compare the difference in the effectiveness of the two therapies was compared. Logistic regression was used to calculate the odds ratios. Furthermore, using the C4.5 decision tree, the two therapies were classified into applicable fields. Chi-square test, the t-test, and logistic regression were used to verify the classification results. Results: In Barcelona Clinic Stages A and B cancers, cTACE was found to be 22.7% more effective than DC bead TACE. By using the decision tree C4.5 as a classifier, the effectiveness of either treatment for small tumors was 8.475 times than that for large tumors. DC bead TACE was 3.39 times more successful in treating patients with a single tumor than with multiple tumors. For patients with a single tumor, the chi-square test showed that 100–300 μm microspheres were significantly more effective than 300–500 μm. While these findings provide a reference for the selection of an appropriate TACE approach, we noted that overall accuracy was somewhat low, possibly due to the limited population. Conclusions: We found that data mining could be applied to develop clear guidelines for physician and researcher use in the case of complex pathologies such as HCC. However, some of our results contradicted those elsewhere in the literature, possibly due to a relatively small sample size. Significantly larger data sets with appropriate levels of granularity could produce more accurate results.
Excitation and Contraction of the Failing Human Heart In Situ and Effects of Cardiac Resynchronization Therapy: Application of Electrocardiographic Imaging and Speckle Tracking Echo-Cardiography
Authors: Andrews Christopher M. , Singh Gautam K. , Rudy Yoram
Published: July 2021

Despite the success of cardiac resynchronization therapy (CRT) for treating heart failure (HF), the rate of nonresponders remains 30%. Improvements to CRT require understanding of reverse remodeling and the relationship between electrical and mechanical measures of synchrony. The objective was to utilize electrocardiographic imaging (ECGI, a method for noninvasive cardiac electrophysiology mapping) and speckle tracking echocardiography (STE) to study the physiology of HF and reverse remodeling induced by CRT. We imaged 30 patients (63% male, mean age 63.7 years) longitudinally using ECGI and STE. We quantified CRT-induced remodeling of electromechanical parameters and evaluated a novel index, the electromechanical delay (EMD, the delay from activation to peak contraction). We also measured dyssynchrony using ECGI and STE and compared their effectiveness for predicting response to CRT. EMD values were elevated in HF patients compared to controls. However, the EMD values were dependent on the activation sequence (CRT-paced vs. un-paced), indicating that the EMD is not intrinsic to the local tissue, but is influenced by factors such as opposing wall contractions. After 6 months of CRT, patients had increased contraction in native rhythm compared to baseline pre-CRT (baseline: −8.55%, 6 months: −10.14%, p = 0.008). They also had prolonged repolarization at the location of the LV pacing lead. The pre-CRT delay between mean lateral LV and RV electrical activation time was the best predictor of beneficial reduction in LV end systolic volume by CRT (Spearman’s Rho: −0.722, p < 0.001); it outperformed mechanical indices and 12-lead ECG criteria. HF patients have abnormal EMD. The EMD depends upon the activation sequence and is not predictive of response to CRT. ECGI-measured LV activation delay is an effective index for CRT patient selection. CRT causes persistent improvements in contractile function.
Lines of Settlement: Lost Landscapes within Maps for Future Morphologies
Authors: Sanders Paul , Lozanovska Mirjana , Van Galen Lana
Published: July 2021

The value of archival documents quite often extends beyond their original purpose, as evidence contained within these artefacts, whether written or drawn, can provide veracity for new lines of heritage inquiry. Many settlements in the ‘new world’ were set out by land surveyors whose drawings charted the accurate placement and alignment of new streets and block perimeters laid upon drawings of the extant topographical landscape features. The paper discusses three settlement maps of Melbourne, Australia, through the lens of Michel de Certeau’s idea that maps are an instrument of power are not just about recording; maps are actually about appropriating and producing regimes of place. In the Australian context, the settlement drawings, prepared under the direction of the colonial administration, inadvertently depicts Country that had been under the custodial care of the First Nations peoples for millennia, and through the intentions of the settlement maps about to be irrevocably disturbed, altered or destroyed. We raise the prospect that urban and landscape design can reflect on the ‘lost landscapes’ of cultural significance, and discuss new ways of interpreting representation through an approach of design reconciliation.
Roles of Knowledge and Attitude in the Willingness of Nursing Students to Care for Older Adults in Hong Kong
Authors: Cheng Winnie Lai-Sheung
Published: July 2021

Due to the ageing population, nursing students will be more likely to work with older adults after graduation. It is important to assess whether Hong Kong nursing students are well prepared to care for older adults. A convenience sample of 139 nursing students was surveyed using questionnaires: Palmore’s Facts on Ageing Quiz (FAQ), Kogan’s Attitudes Toward Old People scale (KAOP), and the Willingness to Care for Older People (WCOP) scale to assess the knowledge of and attitudes toward older adult care, and willingness to care for older adults, respectively. The overall score in the FAQ was medium-low (mean = 15.1, SD = 2.8). The KAOP score was medium-high (mean = 121.6, SD = 12.0). The willingness score was slightly high (mean = 5.2, SD = 1.1). Positive attitudes and knowledge about ageing are the predictors of nursing students’ willingness to take care of older adults. The findings provide evidence to nurse educators and clinical mentors that (a) courses providing knowledge about ageing are valuable, and (b) elements that cultivate positive attitudes towards older adult care should be included in curricula. Nursing curricula that provide knowledge and experience about older adult care play a pivotal role in creating a workforce of nurses ready and willing to care for the ever growing number of ageing adults.
Different Risk Factors for Erosive Tooth Wear in Rural and Urban Nepal: A National Study
Authors: Karki Saujanya , Alaraudanjoki Viivi , Päkkilä Jari , Laitala Marja-Liisa , Anttonen Vuokko
Published: July 2021

Background: Erosive tooth wear (ETW) is of growing concern, but data on ETW among Nepalese children are scarce. The main aim of the study was to investigate the prevalence and severity of ETW among Nepalese schoolchildren. We also aimed to analyse the risk indicators for ETW according to location (rural/urban) and the role of obesity in the risk for ETW. Methods: This national study was conducted among 5–15-year-old Nepalese schoolchildren from different regions. Altogether, 1137 out of 1151 schoolchildren participated in both a clinical examination and a survey. ETW was recorded using the Basic Erosive Wear Examination. Results: The prevalence of ETW was 65%. One-fifth of the examined subjects were in need of preventive or restorative treatment. Living in an urban area and studying in a private school were protective factors for ETW, whereas consuming fruits frequently and using charcoal for tooth cleaning increased the odds for ETW. Central obesity was the strongest risk indicator for ETW among urban residents. Conclusions: ETW of low severity is common among Nepalese children and adolescents. Socio-demographic factors influence the prevalence of ETW in Nepal and there seems to be different factors that play a role in the ETW process according to location of residence.
Assessing Medication Adherence Barriers to Short-Term Oral Antibiotic Treatment in Primary Care—Development and Validation of a Self-Report Questionnaire (BIOTICA)
Authors: Haag Melanie , Hersberger Kurt E. , Arnet Isabelle
Published: July 2021

Background: Pharmacists are increasingly involved in strategies to fight antimicrobial resistance by ensuring optimised antibiotic (AB) use, including adherence support. Successful adherence interventions should be tailored to patients’ barriers and validated instruments are needed. This study aimed to identify adherence barriers to AB treatment, develop a self-report questionnaire, and validate it in outpatients. Method: Adherence barriers were identified through a systematic literature search and focus group discussion. Unmodifiable and irrelevant barriers were excluded from further processing. A validation study assessed the questionnaire’s internal reliability and construct validity by comparing the questionnaire’s score with electronically monitored adherence data. Results: A 15-item questionnaire was created. Overall, 68 patients were included in the construct validation analysis (60.3% female). The mean consecutive taking adherence was 88% and the most frequently reported barriers were “worries about side-effects” (37%) and “having swallowing difficulties” (19%). Three items were excluded from the questionnaire, which was supported by an increase of Cronbach’s alpha (0.69 to 0.70). The 12-item version’s score correlated significantly with medication adherence rate (r = −0.34, p < 0.01). Conclusion: The self-report questionnaire is a reliable and valid tool to pre-emptively assess adherence barriers in outpatients prescribed ABs. In the future, appropriate adherence interventions can be matched to barriers and tested in a pilot intervention study.
Attitudes of Polish Medical and Health Sciences Students towards Persons with Physical Disabilities Using the MAS-PL Scale
Authors: Radlińska Iwona , Kożybska Marta , Karakiewicz Beata
Published: July 2021

Discovering the role of negative attitudes in the social functioning of people with disabilities, tools were developed to measure these attitudes, of which the Multidimensional Attitude Scale of People with Disabilities (MAS) is a good one. It is particularly important to study the attitudes of people who are professionally involved in meeting the needs of people with disabilities. The aim of this study was to determine the attitudes towards people with physical disabilities among medical and health sciences students regarding gender, year of study, field of study, and place of residence. The study was conducted among 625 students in Poland with the use of the MAS-PL scale. The results obtained indicate that women display more positive attitudes towards people with disabilities than men in the cognition and behavioural domains. In the emotional domain, these attitudes were more negative than in the other domains and almost identical for both genders. The year of study, field of study, and place of residence did not differentiate students in terms of their MAS score. Since the sociodemographic variables studied do not determine a positive attitude, educational interventions to increase contact with people with disabilities should be undertaken in future research, and this factor should be investigated as an element of attitude modulation.
Urban-Rural Inequality of Opportunity in Health Care: Evidence from China
Authors: Ma Chao , Song Ze , Zong Qingqing
Published: July 2021

(1) Background: We aim to measure the urban-rural inequality of opportunity in healthcare in China based on the theory of Equality of Opportunity (EOp). (2) Methods: Following the compensation principle, we establish a decomposition strategy for the fairness gap, which we use for the measurement of the inequality of opportunity in urban-rural healthcare utilization. We then use China Health and Nutrition Survey (CHNS) data from 1997 to 2006 to calculate the fairness gap. (3) Results: Empirical analysis using CHNS data shows that the ratio of the fairness gap to the directly observed average urban-rural difference in healthcare was 1.167 for 1997–2000 and 1.744 for 2004–2006. The average urban-rural difference observed directly from original statistical data may have underestimated the degree of this essential inequity. (4) Conclusions: Our findings suggest that upgrading urban-rural reimbursement ratios may not be sufficient in eliminating the inequality of opportunity in healthcare utilization between urban and rural residents. Within the context of an urban-rural dualistic social structure and widening of the urban-rural income gap, a shift to a pro-disadvantaged policy will be a more effective approach in promoting equality of opportunity in healthcare.
International Investment and Indigenous Peoples’ Environment: A Survey of ISDS Cases from 2000 to 2020
Authors: Wang Chao , Ning Jing , Zhang Xiaohan
Published: July 2021

Indigenous peoples’ environments can be easily disrupted by foreign investments, and disputes have occasionally occurred over the past few years. The objective of this research article is to examine if current international investment law, especially its investor-state dispute settlement (ISDS) mechanism, could provide necessary protection to Indigenous rights. We searched all publicly available ISDS cases from 2000 to 2020, and selected 10 typical ones for comprehensive case study by using various research methods such as doctrinal legal research and comparative analysis. Our research revealed that Indigenous peoples’ participation in the ISDS proceedings is legally restrained, time-consuming, and rarely favorably decided by the arbitral tribunals. Responsibility for such undesirable outcomes rests with all stakeholders involved in the process, while the consequences of post-arbitration tend to be “triple losing”. These findings highlight the quest for a more sustainable international investment regime that promotes Indigenous peoples’ wellbeing and environment protection. We argue that future reform could be promoted not only over ISDS procedural matters, but also by upgrading substantive rules in international investment agreements (IIAs), emphasizing free, prior, and informed consent (FPIC), and strengthening foreign investors’ corporate social responsibilities (CSR).
Temporomandibular Myofascial Pain Syndrome—Aetiology and Biopsychosocial Modulation. A Narrative Review
Authors: Golanska Paulina , Saczuk Klara , Domarecka Monika , Kuć Joanna , Lukomska-Szymanska Monika
Published: July 2021

This review elaborates on the aetiology, diagnosis, and treatment of temporomandibular (TMD) myofascial pain syndrome (MPS) regulated by psychosocial factors. MPS impairs functioning in society due to the accompanying pain. Directed and self-directed biopsychosocial profile modulation may be beneficial in the treatment of MPS. Moreover, nutrition is also a considerable part of musculoskeletal system health. A fruit and vegetable diet contributes to a reduction in chronic pain intensity because of its anti-inflammatory influence. Cannabidiol (CBD) oils may also be used in the treatment as they reduce stress and anxiety. A promising alternative treatment may be craniosacral therapy which uses gentle fascia palpation techniques to decrease sympathetic arousal by regulating body rhythms and release fascial restrictions between the cranium and sacrum. MPS is affected by the combined action of the limbic, autonomic, endocrine, somatic, nociceptive, and immune systems. Therefore, the treatment of MPS should be deliberated holistically as it is a complex disorder.
The Effect of Route Choice in Children’s Exposure to Ultrafine Particles Whilst Walking to School
Authors: Rafiepourgatabi Mehrdad , Woodward Alistair , Salmond Jennifer A. , Dirks Kim Natasha
Published: July 2021

Children walking to school are at a high risk of exposure to air pollution compared with other modes because of the time they spend in close proximity to traffic during their commute. The aim of this study is to investigate the effect of a walker’s route choice on their exposure to ultrafine particles (UFP) on the walk to school. During morning commutes over a period of three weeks, exposure to UFP was measured along three routes: two routes were alongside both sides of a busy arterial road with significantly higher levels of traffic on one side compared to the other, and the third route passed through quiet streets (the background route). The results indicate that the mean exposure for the pedestrian walking along the background route was half the exposure experienced on the other two routes. Walkers on the trafficked side were exposed to elevated concentrations (>100,000 pt/cc) 2.5 times longer than the low-trafficked side. However, the duration of the elevated exposure for the background route was close to zero. Public health officials and urban planners may use the results of this study to promote healthier walking routes to schools, especially those planned as part of organized commutes.
The Effect of Meteorological, Pollution, and Geographic Exposures on Death by Suicide: A Scoping Review
Authors: Cornelius Sarah L. , Berry Tara , Goodrich Amanda J. , Shiner Brian , Riblet Natalie B.
Published: July 2021

Suicide is a significant public health concern worldwide and in the United States. Despite the far-reaching impact of suicide, risk factors are still not well understood and efforts to accurately assess risk have fallen short. Current research has highlighted how potentially modifiable environmental exposures (i.e., meteorological, pollution, and geographic exposures) can affect suicide risk. A scoping review was conducted to evaluate the strength of the historical and current literature on the environment’s effect on suicide and suicide risk. Three databases (i.e., Medline, Embase, and PsychInfo) were reviewed to identify relevant studies and two authors independently reviewed studies considering pre-determined inclusion criteria. A total of 46 meteorological studies were included as well as 23 pollution studies and 12 geographic studies. Descriptive statistics, including counts, percentages, review of studies’ sample size (minimum, maximum, median, and interquartile range), were calculated using Excel and SAS 9.4. Overall, strong evidence supports that exposure to sunlight, temperature, air pollution, pesticides, and high altitude increases suicide risk, although effect sizes range from very small to small.
Safety Performance of Healthcare Professionals: Validation and Use of the Adapted Workplace Health and Safety Instrument
Authors: Heier Lina , Gambashidze Nikoloz , Hammerschmidt Judith , Riouchi Donia , Weigl Matthias , Neal Andrew , Icks Andrea , Brossart Peter , Geiser Franziska , Ernstmann Nicole
Published: July 2021

Improving patient safety and reducing occupational accidents are two of the main challenges in healthcare. Instruments to measure safety performance and occupational safety are rare. This study aimed to prepare and validate a German version of the adapted workplace health and safety instrument to assess the safety performance of healthcare professionals. Overall, 168 healthcare professionals participated in this explorative cross-sectional study. The instrument consists of 16 items related to safety performance in four dimensions. We calculated mean values and standard deviations for each individual item and those of the four dimensions of the instrument. We evaluated internal consistency and construct validity, explored the dimensionality of the instrument through exploratory factor analysis, and tested how our data fit with the original model with confirmatory factor analysis. Among the participants, 73.8% were nurses and nurses in training, with the majority of the sample being female (71.9%) and younger than 30 (52.5%). Cronbach’s alpha for all four dimensions was >0.7. All items were loaded on factors according to the original theoretical model. Confirmatory factor analysis showed good model fit (normed χ²/df = 1.43 (≤2.5), root mean square error of approximation = 0.06 (≤0.07), goodness of fit index = 0.90 (>0.90), comparative fit index = 0.95 (≥0.90), and Tucker–Lewis index = 0.93 (>0.90). The German version of the instrument demonstrated acceptable properties and was a good fit to the original theoretical model, allowing measurement of healthcare professionals’ safety knowledge, motivation, compliance, and participation.
Psychometric Testing of the Spanish Modified Version of the Mini-Suffering State Examination
Authors: Gutiérrez-Sánchez Daniel , Gómez-García Rafael , López-Medina Isabel María , Cuesta-Vargas Antonio I.
Published: July 2021

Background: The mini-suffering state examination is a valid and reliable measure that have been used to assess suffering in patients with advanced cancer. The aim of this study was to carry out a psychometric analysis of the Spanish version of the mini-suffering state examination. Method: A validation study was conducted. Seventy-two informal caregivers of deceased patients in palliative care were included in this study. A psychometric testing of content validity, internal consistency, and convergent validity with the Spanish version of the quality of dying and death questionnaire was performed. Results: The original instrument was modified to be used by informal caregivers. The content validity was acceptable (0.96), and the internal consistency was moderate (α = 0.67). Convergent validity was demonstrated (r = −0.64). Conclusion: The Spanish modified version of the MSSE showed satisfactory measurement properties. The Spanish modified version of MSSE can be useful to facilitate screening, monitor progress, and guide treatment decisions in end-of-life cancer patients.
Self-Reported Depressive Symptoms and Suicidality in Adolescents with Attention-Deficit/Hyperactivity Disorder: Roles of Bullying Involvement, Frustration Intolerance, and Hostility
Authors: Liu Tai-Ling , Hsiao Ray C. , Chou Wen-Jiun , Yen Cheng-Fang
Published: July 2021

This study examined the relationships of cyberbullying and traditional bullying victimization and perpetration, perceived family function, frustration discomfort, and hostility with self-reported depressive symptoms and suicidality in adolescents diagnosed as having attention-deficit/hyperactivity disorder (ADHD). Both the self-reported severity of depressive symptoms on the Center for Epidemiological Studies Depression Scale and the occurrence of suicidal ideation or a suicide attempt on the suicidality module of the Kiddie Schedule for Affective Disorders and Schizophrenia were assessed in 195 adolescents with ADHD. The adolescents completed the Cyberbullying Experiences Questionnaire, Chinese version of the School Bullying Experience Questionnaire, Frustration–Discomfort Scale, Buss–Durkee Hostility Inventory, and Family APGAR Index. Caregivers completed the ADHD problems component of the Child Behavior Checklist for Ages 6–18. Multiple regression analyses were used to examine the correlates for each of self-reported depressive symptoms and suicidality. The results showed that after the effects of gender, age, ADHD symptoms, and family function were controlled, greater frustration discomfort and bullying perpetration significantly predicted self-reported depressive symptoms. Being cyberbullying victims and displaying hostility significantly predicted the risk of suicidality. Various types of bullying involvement, frustration intolerance, and hostility significantly predicted self-reported depressive symptoms and suicidality in adolescents with ADHD. By monitoring and intervening in these factors, we can reduce the risk of depression-related problems and suicidality in adolescents with ADHD.