bluuebunny/crossref_metadata_2025 huggingface dataset:
Voluntary Sustainability Certification and State Regulations: Paths to Promote the Conservation of Ecosystem Services? Experiences in Indonesia
Authors: Ningsih Intan Kurniati , Ingram Verina , Savilaakso Sini
Published: May 2020

The Forest Stewardship Council initiated a Forest Certification for Ecosystem Services (ForCES) project from 2011 to 2017 to improve and promote sustainable forest management addressing a range of ecosystem services. Three sites in Indonesia were included in the pilot. Whilst the development of the certification standard was largely the result of a partnership between the certification standard organization, civil society and research organizations, implementation and monitoring of the impact of this sustainability standard will entail interactions with state regulations. This study examined how voluntary certification, other market-based approaches and state regulations concerning ecosystem services in Indonesia interplay, particularly in the agenda setting and negotiation stage. Using the conceptual lenses of transition theory and state and non-state market-based governance, interrelationships between ecosystem services certification and regulations were found to be complementary and antagonistic. The majority of interrelations were complementary and supporting. However, antagonism exists where regulations do not address multiple land uses and when there are contradictions in how state regulations define ecosystem services. There was limited state involvement in developing the ecosystem services certification standard, with no substitution between the voluntary standard and regulations occurring. To scale and transition this innovatory standard from a niche to a sociotechnical regime level, it is recommended that market-driven governance arrangements at farm, forest concession and landscape level are developed in collaboration with national and local governments. Collaboration can create synergies to incentivize the acceptance, adoption and effectiveness of non-state market driven instruments to positively enhance the conservation of ecosystem services.
Hardness of Densified Wood in Relation to Changed Chemical Composition
Authors: Mania Przemysław , Wróblewski Miłosz , Wójciak Adam , Roszyk Edward , Moliński Waldemar
Published: May 2020

The aim of this study was to evaluate some of the properties of densified poplar and birch wood earlier subjected to partial delignification of cell walls. The effects of delignification are presented as a comparison of the content of basic structural components in wood before and after chemical modification. In birch wood, the lignin content decreased by 20%, while that of cellulose decreased by 9.7% and that of hemicellulose decreased by 64.9%. In poplar, the lignin content decreased by 34.1%, that of cellulose decreaed by 13.5%, and that of hemicellulose decreased by 58.0%. The hardness of densified birch and poplar wood, after partial reduction of chemical components, was 147 and 111 MPa, respectively, and, compared with natural (non-densified) wood, was almost 4.5 times and 7 times higher, respectively. Poplar wood was more densified (without delignification 238% and after delignification 281%). In the case of birch wood, the density levels were 176% and 188%, respectively.
Identifying Forest Fire Driving Factors and Related Impacts in China Using Random Forest Algorithm
Authors: Ma Wenyuan , Feng Zhongke , Cheng Zhuxin , Chen Shilin , Wang Fengge
Published: May 2020

Reasonable forest fire management measures can effectively reduce the losses caused by forest fires and forest fire driving factors and their impacts are important aspects that should be considered in forest fire management. We used the random forest model and MODIS Global Fire Atlas dataset (2010~2016) to analyse the impacts of climate, topographic, vegetation and socioeconomic variables on forest fire occurrence in six geographical regions in China. The results show clear regional differences in the forest fire driving factors and their impacts in China. Climate variables are the forest fire driving factors in all regions of China, vegetation variable is the forest fire driving factor in all other regions except the Northwest region and topographic variables and socioeconomic variables are only the driving factors of forest fires in a few regions (Northwest and Southwest regions). The model predictive capability is good: the AUC values are between 0.830 and 0.975, and the prediction accuracy is between 70.0% and 91.4%. High fire hazard areas are concentrated in the Northeast region, Southwest region and East China region. This research will aid in providing a national-scale understanding of forest fire driving factors and fire hazard distribution in China and help policymakers to design fire management strategies to reduce potential fire hazards.
Effectiveness of Restoration Treatments for Reducing Fuels and Increasing Understory Diversity in Shrubby Mixed-Conifer Forests of the Southern Rocky Mountains, USA
Authors: Korb Julie E. , Stoddard Michael T. , Huffman David W.
Published: May 2020

Exclusion of natural surface fires in warm/dry mixed-conifer forests of the western U.S. has increased potential for stand-replacing crown fires and reduced resilience of these systems to other disturbances, such as drought and insect attack. Tree thinning and the application of prescribed fire are commonly used to restore more resilient ecological conditions, but currently, there is a lack of long-term data with which to evaluate restoration treatment effectiveness in forest types where resprouting shrubs dominate understory communities. At a mixed-conifer site in southwestern Colorado, we compared forest structure and understory vegetation responses to three restoration treatments (thin/burn, burn, and control) over 10 years in a completely randomized and replicated experiment. Forest density, canopy cover, and crown fuel loads were consistently lower, and crown base height was higher, in thin/burn than burn or controls, but the effects diminished over time. Ten years following treatment, >99% of all plant species within both treatments and the control were native in origin. There were no differences between treatments in understory richness, diversity, cover, or surface fuels, but graminoid cover more than doubled in all treatments over the 15-year monitoring period. Similarly, there was more than a 250% increase post-treatment in shrub density, with the greatest increases in the thin/burn treatment. In addition, we saw an increase in the average shrub height for both treatments and the control, with shrub stems >80 cm becoming the dominant size class in the thin/burn treatment. Conifer seedling density was significantly lower in thin/burn compared with burn and control treatments after 10 years. Taken together, these conditions create challenges for managers aiming to reestablish natural fire patterns and sustain mixed-conifer forests. To limit the dominance of resprouting shrubs and facilitate conifer regeneration after overstory thinning and prescribed fire, managers may need to consider new or more intensive approaches to forest restoration, particularly given current and projected climate change.
Shifts in Foliage Biomass and Its Vertical Distribution in Response to Operational Nitrogen Fertilization of Douglas-Fir in Western Oregon
Authors: Putney Jacob D. , Maguire Douglas A.
Published: May 2020

Nitrogen (N) fertilization is a commonly applied silvicultural treatment in intensively managed coast Douglas-fir (Pseudotsuga menziesii (Mirb.) Franco var. menziesii) plantations. Field trials were established in a randomized complete block design by Stimson Lumber Company (Gaston, Oregon), to test the economic viability of N fertilization on their ownership and to better understand Douglas-fir growth responses. The 23 stands comprising the trials were Douglas-fir dominated, had a total age of 16–24 years, had been precommercially thinned, and had a density of 386–1021 trees ha−1. Fertilizer was applied aerially at a rate of 224 kg N ha−1 as urea during the 2009–2010 dormant season. In the dormant season of 2016–2017, seven growing seasons following application, 40 trees were felled and measured with the objective of assessing crown attributes and aboveground allometrics. Branch-level foliage mass equations were developed from 267 subsampled branches and were applied to the 40 felled sample trees on which the basal diameter and height of all live branches were measured, allowing estimation of both the total amount of foliage and its vertical distribution. A right-truncated Weibull distribution was fitted to data, with the truncation point specified as the base of live tree crown. The resulting tree-level parameter estimates were modeled as functions of tree-level variables. Stand-level factors not explicitly measured were captured through the use of linear and nonlinear mixed-effects models with random stand effects. Fertilization resulted in more total crown foliage mass in the middle crown-third and caused a downward shift in the vertical distribution of foliage, with implications for feedback responses in crown development and photosynthetic capacity. Defining the morphological responses of Douglas-fir crowns to nitrogen fertilization provides a framework for studying influences on stand dynamics and should ultimately facilitate improved site-specific predictions of stem-volume growth.
Coupled Flow and Heat or Mass Transfer
Authors: Papavassiliou Dimitrios V. , Razavi Sepideh , Nguyen Quoc
Published: May 2020

About three years ago we invited contributions for a Fluids Special Issue on “Flow and Heat or Mass Transfer for the Chemical Process Industry [...]
Measurement of Oral Moisture on Oral Dryness Patients
Authors: Mizuhashi Fumi , Koide Kaoru , Toya Shuji , Nashida Tomoko
Published: May 2020

Many elderly patients have oral dryness; thus, it is necessary to evaluate the oral moisture in a clinical setting. The aim of this study was to clarify the importance of controlling the measuring pressure of the oral moisture-checking device. The influence of the measuring pressure of the oral moisture-checking device was examined using agar under 10 measuring pressure conditions (Kruskal–Wallis test). Fifty-five oral dryness patients were examined the lingual moisture using the device with and without a tongue depressor. The tongue depressor was placed underneath the tongue to support it during the measurement. The mean value and the coefficient of variation of five measurements was evaluated (paired t-test or Wilcoxon signed-ranks test). The agar moisture values changed according to the measuring pressure (p < 0.05). The lingual moisture value with the tongue depressor was higher than that without the tongue depressor (p < 0.05). The coefficient of variation with the tongue depressor was smaller than that without the tongue depressor (p < 0.01). The results of this study indicated that the measuring pressure of oral moisture-checking device influenced the measurement value, and it is necessary to support the tongue for the measurement of lingual mucosal moisture in a uniform manner.
Quality of Life and Eligibility for Specific Financial Assistance for Medical Expenses: A Cross-Sectional Web-Based Survey among Patients with Inflammatory Bowel Disease in Japan
Authors: Thi Thanh Tran Huyen , Saito Shota , Noto Shinichi , Suzuki Kenji
Published: May 2020

Specific financial assistance for people with rare and intractable diseases is part of Japan’s public health system. This survey aimed to clarify the relationship between eligibility for this specific financial assistance and quality of life (QOL) among individuals with inflammatory bowel disease (IBD) in Japan. A nationwide, web-based survey was conducted in Japan among 300 people with IBD. Questionnaire items covered socioeconomic characteristics and QOL, assessed with the five-dimension, five-level EuroQol (EQ-5D-5L). The percentage of respondents who were ineligible for specific financial assistance was 11.0% among those with Crohn’s disease (CD) and 34.0% among those with ulcerative colitis (UC). For those with CD, the median EQ-5D-5L utility weight did not differ significantly between the non-assistance and assistance groups (p = 0.2222). For those with UC, the median EQ-5D-5L utility weight was significantly higher in the non-assistance group than in the assistance group (p = 0.0034). The present study demonstrated that the revision of the law on intractable and rare diseases has not had a negative influence on the QOL of patients with IBD in Japan. Based on our findings, further research on patient-reported outcomes among individuals with IBD may be necessary to inform health policy makers.
Screening of Heavy Metal-Immobilizing Bacteria and Its Effect on Reducing Cd2+ and Pb2+ Concentrations in Water Spinach (Ipomoea aquatic Forsk.)
Authors: Wang Tiejun , Wang Xiaoyu , Tian Wei , Yao Lunguang , Li Yadong , Chen Zhaojin , Han Hui
Published: May 2020

Microbial immobilization is considered as a novel and environmentally friendly technology that uses microbes to reduce heavy metals accumulation in plants. To explore microbial resources which are useful in these applications, three water spinach rhizosphere soils polluted by different levels of heavy metals (heavy pollution (CQ), medium pollution (JZ), and relative clean (NF)) were collected. The community composition of heavy metal-immobilizing bacteria in rhizosphere soils and its effects on reducing the Cd2+ and Pb2+ concentrations in water spinach were evaluated. Four hundred strains were isolated from the CQ (belonging to 3 phyla and 14 genera), JZ (belonging to 4 phyla and 25 genera) and NF (belonged to 6 phyla and 34 genera) samples, respectively. In the CQ sample, 137 strains showed a strong ability to immobilize Cd2+ and Pb2+, giving Cd2+ and Pb2+ removal rates of greater than 80% in solution; Brevundimonas, Serratia, and Pseudoarthrobacter were the main genera. In total, 62 strains showed a strong ability to immobilize Cd2+ and Pb2+ in the JZ sample and Bacillus and Serratia were the main genera. A total of 22 strains showed a strong ability to immobilize Cd2+ and Pb2+ in the NF sample, and Bacillus was the main genus. Compared to the control, Enterobacter bugandensis CQ-7, Bacillus thuringensis CQ-33, and Klebsiella michiganensis CQ-169 significantly increased the dry weight (17.16–148%) of water spinach and reduced the contents of Cd2+ (59.78–72.41%) and Pb2+ (43.36–74.21%) in water spinach. Moreover, the soluble protein and Vc contents in the shoots of water spinach were also significantly increased (72.1–193%) in the presence of strains CQ-7, CQ-33 and CQ-169 compared to the control. In addition, the contents of Cd and Pb in the shoots of water spinach meet the standard for limit of Cd2+ and Pb2+ in vegetables in the presence of strains CQ-7, CQ-33 and CQ-169. Thus, the results provide strains as resources and a theoretical basis for the remediation of Cd- and Pb-contaminated farmlands for the safe production of vegetables.
Combating the COVID-19 Epidemic: Experiences from Vietnam
Authors: Ha Bui Thi Thu , Ngoc Quang La , Mirzoev Tolib , Tai Nguyen Trong , Thai Pham Quang , Dinh Phung Cong
Published: May 2020

The COVID-19 pandemic is spreading fast globally. Vietnam’s strict containment measures have significantly reduced the spread of the epidemic in the country. This was achieved through the use of emergency control measures in the epidemic areas and integration of resources from multiple sectors including health, mass media, transportation, education, public affairs, and defense. This paper reviews and shares specific measures for successful prevention and control of COVID-19 in Vietnam, which could provide useful learning for other countries.
Chronic Health Conditions in Aging Individuals with Intellectual Disabilities
Authors: García-Domínguez Laura , Navas Patricia , Verdugo Miguel Ángel , Arias Víctor B.
Published: May 2020

Life expectancy of people with intellectual disability (ID) has increased in recent decades. However, there is little evidence of whether these extra years of life are spent in good health. The aim of this study, conducted in Spain, is to obtain information about the prevalence of chronic health conditions in people with ID over the age of 44 and compare it with that of their peers without disability. Twenty health conditions were analyzed in 1040 people with ID and 12,172 people without ID through a study of their prevalence. The findings show that chronic constipation, urinary incontinence, thyroid disorders and obesity are the most prevalent chronic diseases among individuals with ID. In addition, this population group suffers these health conditions more frequently than older adults without ID. Detection and early intervention in these health conditions will improve adequate access to social health services and subsequent treatment of aging adults with ID.
Fluoroquinolone Metalloantibiotics: A Promising Approach against Methicillin-Resistant Staphylococcus aureus
Authors: Ferreira Mariana , Bessa Lucinda J. , Sousa Carla F. , Eaton Peter , Bongiorno Dafne , Stefani Stefania , Campanile Floriana , Gameiro Paula
Published: May 2020

Fluoroquinolones (FQs) are antibiotics commonly used in clinical practice, although nowadays they are becoming ineffective due to the emergence of several mechanisms of resistance in most bacteria. The complexation of FQs with divalent metal ions and phenanthroline (phen) is a possible approach to circumvent antimicrobial resistance, since it forms very stable complexes known as metalloantibiotics. This work is aimed at determining the antimicrobial activity of metalloantibiotics of Cu(II)FQphen against a panel of multidrug-resistant (MDR) clinical isolates and to clarify their mechanism of action. Minimum inhibitory concentrations (MICs) were determined against MDR isolates of Escherichia coli, Pseudomonas aeruginosa and methicillin-resistant Staphylococcus aureus (MRSA). Metalloantibiotics showed improved antimicrobial activity against several clinical isolates, especially MRSA. Synergistic activity was evaluated in combination with ciprofloxacin and ampicillin by the disk diffusion and checkerboard methods. Synergistic and additive effects were shown against MRSA isolates. The mechanism of action was studied though enzymatic assays and atomic force microscopy (AFM) experiments. The results indicate a similar mechanism of action for FQs and metalloantibiotics. In summary, metalloantibiotics seem to be an effective alternative to pure FQs against MRSA. The results obtained in this work open the way to the screening of metalloantibiotics against other Gram-positive bacteria.
Effects of 25-Min Nap Opportunity during Ramadan Observance on the 5-m Shuttle Run Performance and the Perception of Fatigue in Physically Active Men
Authors: Hsouna Hsen , Boukhris Omar , Trabelsi Khaled , Abdessalem Raouf , Ammar Achraf , Irandoust Khadijah , Taheri Morteza , Souissi Nizar , Shephard Roy Jesse , Garbarino Sergio , Bragazzi Nicola Luigi , Chtourou Hamdi
Published: May 2020

We aimed to investigate the effects of a 25-min nap opportunity on physical performance during the 5-m shuttle run test (5mSRT), feelings (i.e., evaluated by the feeling scale), attention (i.e., evaluated by the digit cancellation test) and the perception of fatigue (i.e., recorded by the rating of perceived exertion (RPE)) during Ramadan observance. Twelve physically active men (age: 21.1 ± 3.2 yrs, height: 1.76 ± 0.05 m, body-mass: 71.2 ± 9.3 kg) voluntarily participated in five test sessions: 15 days before Ramadan (BR), the first 10 days of Ramadan (FR), the last 10 days of Ramadan (ER), 10 days after Ramadan (10AR) and 20 days after Ramadan (20AR). During each test session, participants performed the digit cancellation test, a 5-min standard warm-up, the 5mSRT (6 × 30-s with 35-s intervals-between) and the rating of perceived exertion (RPE) after no-nap (N0) and 25-min nap opportunity (N25) conditions. Participants also completed the Pittsburgh Sleep Quality Index (PSQI) during each period. The total distance covered during the 5mSRT did not differ significantly before, during or after Ramadan, but was significantly greater after N25 compared to N0 at 10AR (687.5 ± 23.0 m vs. 725.6 ± 41.1 m; p = 0.018) and 20AR (698.3 ± 19.8 m vs. 742.6 ± 58.3 m; p = 0.003). The attention scores were higher after N25 in comparison with N0 at 10AR (p = 0.04) and 20AR (p = 0.02). RPE scores were not significantly different between N25 and N0 conditions. Feelings scores were higher after N25 compared to N0 during both FR (p = 0.007) and 20AR (p = 0.04). A significant deterioration of sleep quality was recorded during Ramadan (i.e., PSQI scores were significantly higher during and after compared to BR (p < 0.0005)). A 25-min nap opportunity was beneficial for physical and cognitive performance after Ramadan observance; however, any effect is insufficient to show significant beneficial impacts during Ramadan.
Unplanned Readmission within 28 Days of Hospital Discharge in a Longitudinal Population-Based Cohort of Older Australian Women
Authors: Shebeshi Dinberu S. , Dolja-Gore Xenia , Byles Julie
Published: May 2020

This study aimed to estimate the incidence of 28-day unplanned readmission among older women, and associated factors. Data were used from the 1921–1926 birth cohort of the Australian Longitudinal Study on Women’s Health. Linkage of self-reported survey data with the Admitted Patient Data Collection allowed the identification of hospital admissions for each woman and the corresponding baseline characteristics. The Cox proportional-hazards model was used to identify factors associated with time to unplanned readmission, using SAS software V 9.4. (SAS Institute, Cary, NC, USA). Of 2056 women with index unplanned admission, 363 (17.5%) were readmitted within 28 days of discharge, and of these 229 (11.14%) had unplanned readmission. Among women with unplanned readmission, 24% were for the same condition as for the index hospitalisation. Cardiovascular diseases were the main diagnoses for the index admission and readmission. Unplanned readmission risk was higher if not partnered (hazard ratio (HR) = 1.43, 95% confidence interval (CI): 1.05–1.95), of non-English speaking background (HR = 1.62%, 95% CI: 1.07–2.47), more than three days length of stay on index admission (HR = 1.41%, 95% CI: 1.04–1.90) and one or two of the assessed chronic diseases (HR = 1.68, 95% CI: 1.19–2.36). At least one in ten women had unplanned readmission at some time between ages 75–95 years. Women who are not partnered, not of English-speaking background, with longer hospital stay and those with multi-morbidity, may need further efforts during their stay and on discharge to mitigate unplanned readmission.
Research on Color Space Perceptions and Restorative Effects of Blue Space Based on Color Psychology: Examination of the Yijie District of Dujiangyan City as an Example
Authors: Wan Jiangjun , Zhou Yawen , Li Yuxin , Su Yi , Cao Ying , Zhang Lingqing , Ying Liu , Deng Wei
Published: May 2020

An increasing number of studies have demonstrated that blue space can promote the recovery of the human body, as does green space. However, the influence of blue space on the color space has been studied much less. Based on research on color psychology and healthy cities, the current study takes Yijie District of Dujiangyan City as the research object. Logistic regression models and the semantic differential method was used to explore residents’ perceptions of color space and their restorative ratings of blue space. This study describes the characteristics of the people visiting blue space, investigates whether the benefits brought about by blue space are related to the color space, and studies whether the surrounding colors in the blue space have a positive effect in promoting residents’ perceptions of pleasure. Based on residents’ choices of environmental pictures containing various colors, a color tendency map was constructed. The results revealed strong correlations between residents’ perceived pleasure and color space color collocation. Socio-demographic factors were found to affect the frequency of visiting blue space. Reasonable color planning is necessary for human health. Based on the study findings, relevant planning suggestions are proposed as a reference basis for waterfront space color planning.
What Are the Peer Interaction Strengths and Difficulties in Children with Developmental Language Disorder? A Systematic Review
Authors: Lloyd-Esenkaya Vanessa , Russell Ailsa J. , Clair Michelle C. St
Published: May 2020

The current review gathers together research investigating peer interaction skills in children with Developmental Language Disorder (DLD) to give an overview of the strengths and challenges experienced by these children when interacting with other children. A systematic review was conducted to summarise the literature on peer interaction strengths and difficulties in children with DLD. No restrictions on time-period were made and the selection criteria accounted for many of the diagnostic labels previously used to refer to DLD. Studies included in this review involve English-speaking children of UK primary school age (4–11 years). A systematic search of databases identified 28 papers that met the inclusion criteria. Children with DLD are found to experience many challenges when interacting with peers. Difficulties have been found in studies exploring discourse characteristics such as turn-taking and in behaviours during play, such as access behaviours. Heterogeneity was however notable and peer interaction strengths are found in terms of the children’s abilities to make friends, use verbal and non-verbal behaviour to make joint decisions with peers, and abilities to engage with peers in social pretend play. While it is encouraging to find research exploring many different areas of peer interaction competence in children with DLD, the research is highly disparate and there are many research findings awaiting replication. The current evidence base is unable to comprehensively define the characteristics of peer interactions of children with DLD.
Intention to Pay for HPV Vaccination among Women of Childbearing Age in Vietnam
Authors: Le Xuan Thi Thanh , Nguyen Phuong Thi Ngoc , Do Toan Thi Thanh , Nguyen Thang Huu , Le Huong Thi , Nguyen Cuong Tat , Ha Giang Hai , Hoang Chi Linh , Tran Bach Xuan , Latkin Carl A. , Ho Roger C.M. , Ho Cyrus S.H.
Published: May 2020

The intention to pay for human papillomavirus (HPV) vaccination among women of childbearing age in Vietnam, where cervical cancer remains a significant public health concern, has been mostly lacking. To examine this issue, we conducted a cross-sectional study of 807 pregnant women in an urban and a rural district (Dong Da and Ba Vi) of Hanoi, Vietnam. The vast percentage of our respondents expressed a firm intention to vaccinate, especially women in rural areas (over 90.0%). However, on being informed of the current price of the HPV vaccine, their intention to vaccinate dropped to about one-fifth of overall respondents, i.e., only 4.4% of women in rural areas. It was also observed that the initial intention to get the HPV vaccination among women in the rural district was about ten times higher than that of women living in the metropolitan district. Those participants who had greater knowledge of cervical cancer and HPV vaccinations also had a significantly higher intention to vaccinate. Our findings underscore the need to develop a well-designed vaccination program in Vietnam and other countries in a similar situation to increase the adoption of HPV vaccination.
Implication of Vaginal and Cesarean Section Delivery Method in Black–White Differentials in Infant Mortality in the United States: Linked Birth/Infant Death Records, 2007–2016
Authors: Holmes Jr. Laurens , O’Neill Leah , Elmi Hikma , Chinacherem Chinaka , Comeaux Camillia , Pelaez Lavisha , Dabney Kirk W. , Akinola Olumuyiwa , Enwere Michael
Published: May 2020

Racial/ethnic disparities in infant mortality (IM) continue to persist in the United States, with Black/African Americans (AA) being disproportionally affected with a three-fold increase in mortality compared to Whites. Epidemiological data have identified maternal characteristics in IM risk such as preeclampsia, eclampsia, maternal education, smoking, maternal weight, maternal socioeconomic status (SES), and family structure. Understanding the social gradient in health including implicit bias, as inherent in the method of labor and delivery and the racial heterogeneity, may facilitate intervention mapping in narrowing the Black–White IM risk differences. We aimed to assess the temporal/racial trends and the methods of delivery, mainly vaginal vs. cesarean section (C-section) as an exposure function of IM. The United States linked birth/infant death records (2007–2016) were used with a cross-sectional ecological design. The analysis involved chi squared statistic, incidence rate estimation by binomial regression model, and period percent change. Of the 40,445,070 births between 2007 and 2016, cumulative mortality incidence was 249,135 (1.16 per 1000). The IM rate was highest among Black/AA (11.41 per 1000), intermediate among Whites (5.19 per 1000), and lowest among Asian /Pacific Islanders (4.24 per 1000). The cumulative incidence rate difference, comparing vaginal to cesarean procedure was 1.73 per 1000 infants, implying excess IM with C-section. Compared to C-section, there was a 31% decreased risk of IM among mothers with vaginal delivery, rate ratio (RR) = 0.69, 95% confidence interval (CI): 0.64–0.74. Racial disparities were observed in the method of delivery associated with IM. Black/AA mothers with vaginal delivery had a 6% decreased risk of IM compared to C-section, RR = 0.94, 95% CI: 0.92–0.95, while Whites with vaginal delivery had a 38% decrease risk of IM relative to C-section, RR= 0.68, 95% CI: 0.67–0.69, p < 0.001. Infant mortality varied by race, with Black/AA disproportionally affected, which is explained in part by labor and delivery procedures, suggestive of reliable and equitable intrapartum assessment of Black/AA mothers during labor, as well as implicit bias marginalization in the healthcare system.
Environmental Impact of High Concentration Nitrate Migration in Soil System Using HYDRUS Simulation
Authors: Zhang Yuanyuan , Lee Duujong , Ding Jing , Lu Jianfeng
Published: May 2020

Nitrate is a promising heat transfer fluid in solar thermal power and nuclear power systems, but its leakage can cause serious environmental problems. The present paper investigates the deep and prolonged migration of high concentrations of nitrate into the soil system, and the associated diffusion range is studied to estimate and reduce the environmental pollution caused by nitrate leaks. The vertical nitrate contaminated range is mainly impacted by annual precipitation, soil properties and groundwater depth, while the horizontal contaminated range is mainly affected by the initial leakage area. During the process, the vertical contaminated range first continuously enlarges, and then decreases after a long time. The nitrate contaminant can exist and affect the environment for as long as 115–625 years, and the nitrate contamination time can be even longer in dry regions. Since nitrate diffuses more quickly in unsaturated regions rather than in saturated regions, the migration region and contaminated range both decrease as the groundwater depth is increased.
A Diarrhoeagenic Enteropathogenic Escherichia coli (EPEC) Infection Outbreak That Occurred among Elementary School Children in Gyeongsangbuk-Do Province of South Korea Was Associated with Consumption of Water-Contaminated Food Items
Authors: Lim Min-A , Kim Ji-Yeong , Acharya Dilaram , Bajgain Bishnu Bahadur , Park Ji-Hyuk , Yoo Seok-Ju , Lee Kwan
Published: May 2020

(1) Background: In response to the notification made by an elementary school authority that reported a number of elementary school children being absent in three schools as a result of gastroenteritis symptoms on 4 July 2018, in Gyeongsangbuk-Do Province, South Korea, an epidemic investigation was carried out to determine the extent, cause, and source of the outbreak in order to prevent secondary cases and make recommendations to prevent future recurrences. (2) Methods: In this epidemiologic study, a total of 106 human subjects (school children, staff members, and cooks) who had consumed the possibly contaminated foodstuffs were enrolled retrospectively. Human specimens from clinically defined cases, food and drinks, supply and storage of them, and environmental and sanitary conditions were also assessed by observation, laboratory tests, and survey questionnaires—where and whatever applicable. The attack rate and positive rate for human specimens were first presented followed by the calculation of the relative risk ratio (RR) with 95% CI (confidence intervals) in order to identify the exposure and outcome relationships. (3) Results: The attack rate was 12.26% (13/106) for those who had ingested the food items at the three schools and the positive rate of enteropathogenic Escherichia coli (EPEC) was 15.38% (2/13). The relative risk (RR) of developing food poisoning of those who consumed the cucumber chili with ssamjang and seasoned cucumber and chives were 4.55 (95% CI 1.05–19.54) and 9.20 (95% CI 1.24–68.22), respectively. In addition, within the human specimens as well as the water and environmental samples different strains of diarrhoeagenic enteropathogenic Escherichia coli (EPEC) were detected. (4) Conclusions: Provision of safe and wholesome water access to all elementary schools by concerned authorities, especially during the likely seasons of water source contamination, as well as health education promotion about foodborne outbreaks to all school stakeholders is therefore recommended.
Oral Cancer: A Historical Review
Authors: Inchingolo Francesco , Santacroce Luigi , Ballini Andrea , Topi Skender , Dipalma Gianna , Haxhirexha Kastriot , Bottalico Lucrezia , Charitos Ioannis Alexandros
Published: May 2020

Aim: This historical medical literature review aims at understanding the evolution of the medical existence of oral cancer over times, particularly better comprehending if the apparent lower prevalence of this type of cancer in antiquity is a real value due to the absence of modern environmental and lifestyle factors or it is linked to a misinterpretation of ancient foreign terms found in ancient medical texts regarding oral neoplasms. Methods: The databases MedLne, PubMed, Web of Science, Elsevier’s EMBASE.com, Cochrane Review, National Library of Greece (Stavros Niarchos Foundation, Athens) and the Library of the School of Health Sciences of the National and Kapodistrian University of Athens (Greece) were extensively searched for relevant studies published during the past century on the history of oral cancer and its treatment from antiquity to modern times, in addition to the WHO website to analyse the latest epidemiological data. In addition, we included historical books on the topic of interest and original sources. Results: Historical references reveal that the cradle of the oral oncology was in ancient Egypt, the Asian continent and Greece and cancer management was confined to an approximate surgical practice, in order to remove abnormal masses and avoid bleeding with cauterization. In the Medieval Age, little progress occurred in medicine in general, oral cancers management included. It is only from the Renaissance to modern times that knowledge about its pathophysiological mechanisms and histopathology and its surgical and pharmacological treatment approaches became increasingly deep all over the world, evolving to the actual integrated treatment. Despite the abundant literature exploring oncology in past civilizations, the real prevalence of oral cancer in antiquity is much less known; but a literature analysis cannot exclude a consistent prevalence of this cancer in past populations, probably with a likely lower incidence than today, because many descriptions of its aggressiveness were found in ancient medical texts, but it is still difficult to be sure that each single description of oral masses could be associated to cancer, particularly for what concerns the period before the Middle Ages. Conclusions: Modern oncologists and oral surgeons must learn a lot from their historic counterparts in order to avoid past unsuccessful efforts to treatment oral malignancies. Several descriptions of oral cancers in the antiquity that we found let us think that this disease might be linked to mechanisms not strictly dependent on environmental risk factors, and this might guide future research on oral cavity treatments towards strategical cellular and molecular techniques.
Bilateral Asymmetries Assessment in Elite and Sub-Elite Male Futsal Players
Authors: López-Fernández Jorge , García-Unanue Jorge , Sánchez-Sánchez Javier , Colino Enrique , Hernando Enrique , Gallardo Leonor
Published: May 2020

This study aimed to investigate morphological, functional, and neuromuscular asymmetries on futsal players’ lower limbs at different competitive levels. Sixteen male elite futsal players from the Spanish National Futsal League and thirteen male sub-elite futsal players from the third division participated in this study. Morphological asymmetry was assessed through bioelectrical impedance (fat-mass (g and %) and lean-mass (g)). Functional asymmetry was assessed by means of a 20-s static unipedal balance test. Finally, neuromuscular asymmetry was assessed using tensiomiography tests on both the rectus femoris (RF) and biceps femoris (BF) of each participant. The three tests conducted did not reveal significant bilateral asymmetries in elite players. On the other hand, sub-elite players showed significant bilateral asymmetry in fat-mass percentage between dominant and non-dominant limbs (+6%; CI95%: 1 to 11; ES: 0.88; p = 0.019). They also showed higher bilateral asymmetry in the delay time of the RF (+13%; CI95%: 7 to 21; ES: 1.3; p < 0.05). However, the static unipedal balance test (p > 0.05) did not evidence asymmetries regardless of the level of the participants. Elite futsal players do not develop bilateral asymmetries in lower limbs in the studied parameters. On the contrary, sub-elite players are likely to develop morphological and neuromuscular asymmetries between their dominant leg and non-dominant leg.
Outcome Expectations for Exercise and Decisional Balance Questionnaires Predict Adherence and Efficacy of Exercise Programs in Dialysis Patients
Authors: Bogataj Špela , Pajek Maja , Buturović Ponikvar Jadranka , Pajek Jernej
Published: May 2020

The purpose of this study was to define if Outcomes Expectations for Exercise (OEE) and Decisional Balance (DB) scales predict adherence to guided exercise programs and associate with the improvement in physical performance in the dialysis population. Participants (n = 40; age 63.6 ± 12.5 years) completed OEE and DB questionnaires before randomization to the experimental group (n = 20) and control group (n = 20) of a two-phased exercise program—the experimental group received eight weeks of supervised functional exercise and exercise counseling (1st phase) before commencing eight weeks of home-based exercise on non-dialysis days (2nd phase). Both groups performed intradialytic cycling on dialysis days during both study phases. Patients with above-median OEE and DB scores (>3.15 and >1.3, respectively) expressed significantly better adherence to intradialytic cycling (89% vs. 76%, 89% vs. 77%, respectively, p < 0.05). Experimental group patients with an above-median OEE (but not DB) score had significantly better adherence to supervised and home-based functional exercise (93% vs. 81% and 85% vs. 60%, respectively, p < 0.05). Baseline DB score predicted the final result in the hand-grip test and 6-min walk test. Low OEE and, to a lesser degree, low DB questionnaire scores associate with inferior adherence to dialysis bundled and home-based exercise programs and may help define patient subsets in need of intensified motivational input by exercise caregivers.
Using an Accelerometer-Based Step Counter in Post-Stroke Patients: Validation of a Low-Cost Tool
Authors: Negrini Francesco , Gasperini Giulio , Guanziroli Eleonora , Vitale Jacopo Antonino , Banfi Giuseppe , Molteni Franco
Published: May 2020

Monitoring the real-life mobility of stroke patients could be extremely useful for clinicians. Step counters are a widely accessible, portable, and cheap technology that can be used to monitor patients in different environments. The aim of this study was to validate a low-cost commercial tri-axial accelerometer-based step counter for stroke patients and to determine the best positioning of the step counter (wrists, ankles, and waist). Ten healthy subjects and 43 post-stroke patients were enrolled and performed four validated clinical tests (10 m, 50 m, and 6 min walking tests and timed up and go tests) while wearing five step counters in different positions while a trained operator counted the number of steps executed in each test manually. Data from step counters and those collected manually were compared using the intraclass coefficient correlation and mean average percentage error. The Bland–Altman plot was also used to describe agreement between the two quantitative measurements (step counter vs. manual counting). During walking tests in healthy subjects, the best reliability was found for lower limbs and waist placement (intraclass coefficient correlations (ICCs) from 0.46 to 0.99), and weak reliability was observed for upper limb placement in every test (ICCs from 0.06 to 0.38). On the contrary, in post-stroke patients, moderate reliability was found only for the lower limbs in the 6 min walking test (healthy ankle ICC: 0.69; pathological ankle ICC: 0.70). Furthermore, the Bland–Altman plot highlighted large average discrepancies between methods for the pathological group. However, while the step counter was not able to reliably determine steps for slow patients, when applied to the healthy ankle of patients who walked faster than 0.8 m/s, it counted steps with excellent precision, similar to that seen in the healthy subjects (ICCs from 0.36 to 0.99). These findings show that a low-cost accelerometer-based step counter could be useful for measuring mobility in select high-performance patients and could be used in clinical and real-world settings.
Preparedness of Frontline Doctors in Jordan Healthcare Facilities to COVID-19 Outbreak
Authors: Suleiman Aiman , Bsisu Isam , Guzu Hasan , Santarisi Abeer , Alsatari Murad , Abbad Ala’ , Jaber Ahmad , Harb Taima’a , Abuhejleh Ahmad , Nadi Nisreen , Aloweidi Abdelkarim , Almustafa Mahmoud
Published: May 2020

The number of COVID-19 (Coronavirus Disease of 2019) cases in Jordan is rising rapidly. A serious threat to the healthcare system appears on the horizon. Our study aims to evaluate preparedness of Jordanian frontline doctors to the worsening scenario. It has a questionnaire-based cross-sectional structure. The questionnaire was designed to evaluate preparedness according to knowledge about virus transmission and protective measures, adherence to protection guidelines, and psychological impacts affecting doctors. Institutional factors affecting doctors’ readiness like adopting approach protocols and making protection equipment available were investigated; 308 doctors from different healthcare facilities participated (response rate: 53.9%). Approximately 25% of doctors (n = 77) previously took care of COVID-19 patients, and 173 (56.2%) have institutional COVID-19 approach protocols. Only 57 doctors (18.5%) reported all PPE (Personal Protective Equipment) available. The self-reported score of preparedness to deal with COVID-19 patients was 4.9 ± 2.4. Doctors having institutional protocols for dealing with COVID-19 cases and those with sustained availability of PPE reported higher scores of preparedness (5.5 ± 2.3 and 6.2 ± 2.1 with p < 0.001, respectively). Correlations with knowledge score, adherence to PPE score, and psychological impacts were investigated. The study revealed multiple challenges and insufficiencies that can affect frontline doctors’ preparedness. Policy makers are urged to take these findings into consideration and to act promptly.
Morphological Characterization of Indoor Airborne Particles in Seven Primary Schools
Authors: Pallarés Susana , Gómez Eva Trinidad , Martínez África , Miguel Jordán Manuel
Published: May 2020

This paper focuses on a study of fine (less than 2.5 µm) airborne particles collected inside seven primary schools located on a coastal Mediterranean area which has a significant industrial hub for the processing of clays and other minerals as raw materials. Of the seven schools, three are located in an urban area 20 km away from the main industrial hub, three are in a town located next to the industrial estate, and one is in a rural location, 30 km from the industrial area. The objective of this study is to identify the main types of particles found in the three examined environments. The particle matter identified in the fine particle samples is grouped into three main groups: mineral compounds, particles from combustion processes and phases emitted in high-temperature industrial processes. The mineral particles, which can come from natural or anthropogenic emissions, have been classified depending on their morphology as isometric allotriomorphs or subidiomorphs, with a tabular habit; acicular forms; or pure crystalline forms. Compounds from combustion processes have two types of morphologies: spheroid and dendritic soot particles. Additionally, in smaller quantities, spherical particles associated with high-temperature industrial processes, such as the emissions of ceramic tile-firing and frit-melting processes, are identified. A summary table is shown, which lists the characteristics, as well as the most significant origin of the main particles identified in the fine (<2.5 μm) airborne particles collected inside primary schools located in three different environments (urban, industrial and rural). A visual scale has been established based on the number of particles observed in the samples of the atmospheric particulate fraction between the sizes of 2.5 and 10 µm collected inside the schools. The ratios Ca/Si, S/Si, S/Ca and (Si+Ca)/S have been established. Results obtained may be useful in epidemiological studies in the ceramic cluster area in order to estimate children’s exposure to different indoor primary school microenvironments. Effective policies and mitigation measurements for the protection of children’s health should be carried out in this highly industrialized area.
Personal and Social Responsibility Programme Effects, Prosocial Behaviours, and Physical Activity Levels in Adolescents and Their Families
Authors: García-García Juana , Manzano-Sánchez David , Belando-Pedreño Noelia , Valero-Valenzuela Alfonso
Published: May 2020

The aim of this study was to analyse a personal and social responsibility programme in students and their family’s perceptions relative to responsibility, prosocial behaviours, empathy, violence perception and physical activity levels. A sample consisting of 57 physical education students between 11 and 14 years old (mean (M) = 11.93; standard deviation (SD) = 0.73) that included 32 of their parents (M = 49.31; SD = 6.39) was distributed into experimental and control groups. The main results indicate that there were initial significant differences in favour of the control group for personal and social responsibility compared to the experimental group and they disappeared at the end of the treatment. There was an increase in antisocial behaviours for the control group at the end of the treatment. The experimental group also enhanced the values in violence perception for both students and families as compared to the control group. These results seem contradictory, which may be due in part to a short-time intervention programme and a low number of participants in the sample. More studies will clarify the improvements this kind of programme can bring to the variables studied.