bluuebunny/crossref_metadata_2025 huggingface dataset:
Voltage Flip Efficiency Enhancement for Piezo Energy Harvesting
Authors: Frick Vincent , Wassouf Liana , Jamshidpour Ehsan
Published: October 2021

In this paper, we analyze the effect of an enhanced voltage flip technique on the power performance of a piezoelectric energy harvester. The enhanced voltage flip principle is based on a synchronized-switch-based architecture, and is referred to as FAR (Full Active Rectifier). It uses a tiny amount of the stored charge to boost the voltage flip. This work aims to demonstrate that, beside the enhanced flip efficiency, the FAR also contributes to improve the power efficiency of the harvester, especially under changing load constraint. Therefore, the paper proposes a thorough comparison between the FAR and its conventional counterpart, the Switch-only technique. The FAR is easy to implement and does not require any external inductor or capacitor. It only needs a reduced set of switches, an active diode and a simple control sequence, and can thus be implemented on a fully integrated circuit. The FAR can be used as a standalone voltage flip solution or in addition to further boost the flip efficiency in a state-of-the-art architecture such as SSHC for example. Tests were performed on a 0.35-µm process CMOS prototype IC. Experimental results revealed that the FAR extracts 19.1μW from an off-the-shelf piezoelectric transducer when the output voltage is regulated at 1 V with 1 V open-circuit voltage and delivers up to 20% more power than the conventional Switch-only technique under load constraint. It also shows over 11× power efficiency improvement compared to a conventional diode-based full bridge rectifier.
Artificial Jellyfish Search Algorithm-Based Selective Harmonic Elimination in a Cascaded H-Bridge Multilevel Inverter
Authors: Siddiqui Nimra Idris , Alam Afroz , Quayyoom Layeba , Sarwar Adil , Tariq Mohd , Vahedi Hani , Ahmad Shafiq , Mohamed Adamali Shah Noor
Published: October 2021

This paper used an artificial jellyfish search (AJFS) optimizer suitable for selective harmonic elimination-based modulation for multilevel inverter (MLI) voltage control application. The main objective was to remove the undesired lower-order harmonics in the output voltage waveform of an MLI. This algorithm was motivated by the behavior of jellyfish in the ocean. Jellyfish have the ability to find the global best position where a large quantity of nutritious food is available. The paper applied AJFS algorithm on five, seven, and nine levels of CHB-MLI. The optimum switching angle was calculated for the entire modulation range for the desired lower-order harmonics elimination. The problem formulated to achieve the objective was solved in a MATLAB environment. The total harmonic distortion (THD) values of five-, seven-, and nine-level inverters for various modulation indexes were computed using AJFS and compared with the powerful differential evolution (DE) algorithm. The comparison of THD results clearly demonstrated superior THD in the output of CHB-MLI of the AJFS algorithm over DE and GA algorithm for low and medium values of modulation index. The experimental results further validated the better performance of the AJFS algorithm.
A Behavior-Based Malware Spreading Model for Vehicle-to-Vehicle Communications in VANET Networks
Authors: Le Duc , Dang Khanh , Nguyen Quyen , Alhelaly Soha , Muthanna Ammar
Published: October 2021

Network attacking using malware has become very popular on the Internet and in many other networks, namely Vehicular Ad-hoc Network (VANET) networks. It is required to have the model describing the malware spreading based on factors, which directly affect this process to limit its influences. In this paper, we propose a mathematical model called SEIR-S (Susceptible–Exposed–Infectious–Recovered–Susceptible) based on the characteristics of the VANET network and the well-known disease-spreading model SIR (Susceptible–Infectious–Recovered). We take into account possible behaviors of malware and provide the corresponding states to vehicles: Susceptible (S), Exposed (E), Infectious (I), Recovered (R). We evaluate the basic reproduction number R0 of the model and perform a stability analysis of the proposed model. The results show that, when R0 < 1, the malware spreading will gradually decrease, and, when R0 > 1, that spreading cannot be extinguished. We also point out the condition that we can control the endemic in the VANET network. In addition, the correctness of the proposed model is verified using both numerical analysis and agent-based simulation on NetLogo.
Impacts of Ozone on Forest Plants and Ecosystems
Authors: Oksanen Elina
Published: October 2021

Globally, tropospheric ozone is one of the most important air pollutants and greenhouse gases, with adverse effects on forest trees and the function of ecosystems [...]
Nonlinear Wave Transformation in Coastal Zone: Free and Bound Waves
Authors: Kuznetsov Sergey , Saprykina Yana
Published: October 2021

The nonlinear transformation of waves in the coastal zone over the sloping bottom is considered on the base of field, laboratory, and numerical experiments by methods of spectral and wavelet analyses. The nonlinearity leads to substantial changes of wave shape during its propagation to the shore. Since these changes occur rapidly, the wave movement is non-periodical in space, and the application of linear theory concepts of wavenumber or wavelength results in some paradoxical phenomena. When analyzing the spatial evolution of waves in the frequency domain, the effect of periodic energy exchange and changes in the phase shift between the first and second wave harmonics are observed. When considering the wavenumber domain, the free and bound waves of both the first and second harmonics with constant in space amplitudes appear, and all spatial fluctuations of the wave parameters are caused by interference of these four harmonics. Practically important consequences such as the wave energy spatial fluctuations and of anomalous dispersion of the second harmonic are shown and discussed.
Chemical Profile and Evaluation of the Antioxidant and Anti-Acetylcholinesterase Activities of Annona squamosa L. (Annonaceae) Extracts
Authors: Leite Débora Odília Duarte , Camilo Cicera Janaine , Nonato Carla de Fatima Alves , Carvalho Natália Kelly Gomes de , Salazar Gerson Javier Torres , de Morais Selene Maia , Costa José Galberto Martins da
Published: October 2021

This study presents the chemical profile of extracts from the pulp and seed of Annona squamosa L., as well as the evaluation of their antioxidant and acetylcholinesterase inhibition activities. In the chemical prospection, qualitative assays were performed, and the contents of total phenols, flavonoids, vitamin C, and carotenoids were quantified. For the compounds identification, analyses of the extracts were performed by liquid chromatography coupled to mass spectrometry. Antioxidant evaluation was performed using the DPPH, ABTS, Fe3+ reduction, 2-DR protection, and β-carotene protection methods. The assay for inhibition of acetylcholinesterase activity was determined using the method described by Ellman. The secondary metabolites identified were anthocyanidins, flavones, flavonols, and alkaloids. Phenol analysis showed a higher quantitative value of total phenols and flavonoids for the seed extract, and the vitamin C content was higher in the pulp extract. There was no significant difference in relation to the carotenoids quantification. The best results obtained for antioxidant activity, for both seed and pulp extracts, were with the ABTS method with IC50 of 0.14 ± 0.02 and 0.38 ± 0.02 mg/mL, respectively. Compared to A. squamosa seed extract, the pulp extract demonstrates higher AChE inhibitory activity with IC50 of 18.82 ± 0.17 µg/mL. A. squamosa is a nutritious food source. The continuity of the studies is fundamental to relate the consumption of this food and its effects on neurodegenerative diseases.
Evaluation of Sensory Quality for Taiwanese Specialty Teas with Cold Infusion Using CATA and Temporal CATA by Taiwanese Consumers
Authors: Liu Shih-Lun , Jaw Yih-Mon , Wang Li-Fei , Chuang George Chao-Chi , Zhuang Zhen-Yu , Chen Yuh-Shuen , Liou Bo-Kang
Published: October 2021

The market size of varied carbonated teas and bottled ready-to-drink tea products in Taiwan has surpassed that of traditional Taiwan tea with hot infusion. The consumption behavior of Taiwanese consumers for new and varied types of cold infusion tea products has also differed from that of traditional hot infusion ones. More kinds of Taiwan tea with different fermentation levels are gradually being used as raw materials for various cold infusion tea products. Therefore, to study consumers’ responses towards cold-brewed tea has become more important for the market of tea in Taiwan. This study recruited Taiwanese consumers to taste seven Taiwanese specialty tea infusions with various degrees of fermentation, and their opinions were gathered by questionnaires composed of check-all-that-apply (CATA), and temporal check-all-that-apply (TCATA) questions and hedonic scales. We found that both CATA and TCATA data agreed that the sensory features of unfermented and lightly semi-fermented tea infusions could be plainly distinguished from the ones of heavily semi-fermented and fully fermented teas based on correspondence analyses. Through CATA and TCATA, the sensory characteristics of the cold-brewed tea of various fermentation degrees could be clearly identified. The first-hand information of cold tea beverages analyzed through this study could be useful for the development of the market in Taiwan. The proper level of bitterness, astringency, fresh tea leaf flavor, and late sweetness were the essential qualities of cold infusions brewed from lightly fermented teas, which could be the best raw materials for production of cold tea beverages to satisfy as many consumers as possible.
Temporal Transcriptome Analysis Reveals Dynamic Expression Profiles of Gametes and Embryonic Development in Japanese Flounder (Paralichthys olivaceus)
Authors: Hao Xiancai , Wang Qian , Hou Jilun , Liu Kaiqiang , Feng Bo , Shao Changwei
Published: October 2021

The maternal-to-zygotic transition (MZT) is a crucial event in embryo development. While the features of the MZT across species are shared, the stage of this transition is different among species. We characterized MZT in a flatfish species, Japanese flounder (Paralichthys olivaceus). In this study, we analyzed the 551.57 GB transcriptome data of two types of gametes (sperms and eggs) and 10 embryo developmental stages in Japanese flounder. We identified 2512 maternal factor-related genes and found that most of those maternal factor-related genes expression decreased at the low blastula (LB) stage and remained silent in the subsequent embryonic development period. Meanwhile, we verified that the zygotic genome transcription might occur at the 128-cell stage and large-scale transcription began at the LB stage, which indicates the LB stage is the major wave zygotic genome activation (ZGA) occurs. In addition, we indicated that the Wnt signaling pathway, playing a diverse role in embryonic development, was involved in the ZGA and the axis formation. The results reported the list of the maternal genes in Japanese flounder and defined the stage of MZT, contributing to the understanding of the details of MZT during Japanese flounder embryonic development.
Angiotensin–Converting Enzyme (ACE) 1 Gene Polymorphism and Phenotypic Expression of COVID-19 Symptoms
Authors: Yamamoto Naoki , Nishida Nao , Yamamoto Rain , Gojobori Takashi , Shimotohno Kunitada , Mizokami Masashi , Ariumi Yasuo
Published: October 2021

The renin–angiotensin–aldosterone system (RAAS) appears to play an important role in SARS-CoV-2 infection. Polymorphisms within the genes that control this enzymatic system are candidates for elucidating the pathogenesis of COVID-19, since COVID-19 is not only a pulmonary disease but also affects many organs and systems throughout the body in multiple ways. Most striking is the fact that ACE2, one of the major components of the RAAS, is a prerequisite for SARS-COV-2 infection. Recently, we and other groups reported an association between a polymorphism of the ACE1 gene (a homolog of ACE2) and the phenotypic expression of COVID-19, particularly in its severity. The ethnic difference in ACE1 insertion (I)/deletion (D) polymorphism seems to explain the apparent difference in mortality between the West and East Asia. The purpose of this review was to further evaluate the evidence linking ACE1 polymorphisms to COVID-19. We searched the Medline database (2019–2021) for reference citations of relevant articles and selected studies on the clinical outcome of COVID-19 related to ACE1 I/D polymorphism. Although the numbers of patients are not large enough yet, most available evidence supports the notion that the DD genotype adversely influences COVID-19 symptoms. Surprisingly, small studies conducted in several countries yielded opposite results, suggesting that the ACE1 II genotype is a risk factor. This contradictory result may be the case in certain geographic areas, especially in subgroups of patients. It may also be due to interactions with other genes or to yet unexplained biochemical mechanisms. According to our hypothesis, such candidates are genes that are functionally involved in the pathophysiology of COVID-19, can act in concert with the ACE1 DD genotype, and that show differences in their frequency between the West and East Asia. For this, we conducted research focusing on Alu-related genes. The current study on the ACE1 genotype will provide potentially new clues to the pathogenesis, treatment, and diagnosis of SARS-CoV-2 infections.
The Influence of Nordic Walking on Spinal Posture, Physical Function, and Back Pain in Community-Dwelling Older Adults: A Pilot Study
Authors: Huang Yi-Hung , Fang I-Yao , Kuo Yi-Liang
Published: October 2021

Nordic walking is an increasingly popular form of exercise among the elderly. Using poles is thought to facilitate a more upright posture; however, previous studies primarily investigated the effects of Nordic walking on respiratory function and physical fitness. The aims of this study were to investigate the influence of Nordic walking on spinal posture, physical functions, and back pain in community-dwelling older adults. Thirty-one community-dwelling older adults aged ≥ 60 years participated in a twice weekly Nordic walking training program for 12 weeks. The outcome measures, including spinal posture, physical functions, back pain, and the strength and endurance of back extensor muscles were assessed before and after a 12-week program. After training, spinal posture, back pain, and the strength and endurance of back extensor muscles did not show any statistically significant changes. Among the seven clinical tests of physical function, only the 30 s arm curl test, the 30 s chair stand test, and the single leg stance test showed significant improvements. Nordic walking has limited influence on age-related hyperkyphosis and back pain, but may be effective for physical function. The results of this study can provide useful information for people involved in the prevention and treatment of physical dysfunction in community-dwelling older adults.
Sex Difference in the Socioeconomic Burden of Osteoporosis among South Koreans
Authors: Lee Eun-Whan , Nam Jin Young
Published: October 2021

Background: The prevalence of osteoporosis is increasing with the aging of the population and the socioeconomic burden. The purpose of this study was to determine the socioeconomic burden of osteoporosis in Korea. Methods: The prevalence of osteoporosis was analyzed using 2017 National Patients Sample and Korea National Health and Nutrition Examination Survey data. Direct costs were divided into healthcare and non-healthcare costs, and indirect costs were calculated by assessing the cost of loss of productivity for labor loss due to disease. Results: The prevalence of osteoporosis diagnosis was 1.91% in total, which was 13 times higher in women than in men (3.57% vs. 0.26%). The socioeconomic cost of osteoporosis was 299.1 million USD based on main diagnosis, and the cost was 13 times higher in women than in men (277.6 vs. 21.5 million USD). The total cost based on main and secondary diagnosis was 981.8 million USD. Similarly, the cost was seven times higher in women than in men (862.4 vs. 119.4 million USD). Conclusions: Osteoporosis increases the socioeconomic burden of disease, and it is significantly higher in women than in men. The policy support for the implementation of prevention and management programs would be necessary to reduce the burden of osteoporosis.
Feelings of Entrapment during the COVID-19 Pandemic Based on ACE Star Model: A Concept Analysis
Authors: Lee Hyun-Jung , Park Bom-Mi
Published: October 2021

This study aimed to analyze the concept of the “feelings of entrapment” during the COVID-19 (coronavirus disease 2019) pandemic using a systematic review. We included literature based on content and outcomes related to feelings of entrapment, such as antecedents, attributes, and consequences. The exclusion criteria were studies that did not have inappropriate subject, content, conceptual definition, and degree thesis was excluded. Walker and Avant’s process of concept analysis was used in this systematic literature review. The attributes of the concept of feelings of entrapment during the COVID-19 pandemic were found to be feelings of: (1) being out of control, (2) no escape, (3) being trapped, (4) being robbed, and (5) hopelessness. The causes for these were identified as (1) the COVID-19 pandemic, (2) lockdown system, (3) restricted situation, (4) uncertain future, (5) economic hardship, and (6) poor coping abilities. Consequences of the concept were: (1) increased suicide, (2) decreased mental health, and (3) decreased well-being. In situations such as COVID-19, it is important need to know what feelings of entrapment’s antecedents and attributes are to prevent suicide and enhance mental health and well-being. Based on the results of this study, counseling services, policies, and systems for relieving feelings of entrapment in the COVID-19 situation are recommended.
A Machine-Learning Method of Predicting Vital Capacity Plateau Value for Ventilatory Pump Failure Based on Data Mining
Authors: Chang Wenbing , Ji Xinpeng , Wang Liping , Liu Houxiang , Zhang Yue , Chen Bang , Zhou Shenghan
Published: October 2021

Ventilatory pump failure is a common cause of death for patients with neuromuscular diseases. The vital capacity plateau value (VCPLAT) is an important indicator to judge the status of ventilatory pump failure for patients with congenital myopathy, Duchenne muscular dystrophy and spinal muscular atrophy. Due to the complex relationship between VCPLAT and the patient’s own condition, it is difficult to predict the VCPLAT for pediatric disease from a medical perspective. We established a VCPLAT prediction model based on data mining and machine learning. We first performed the correlation analysis and recursive feature elimination with cross-validation (RFECV) to provide high-quality feature combinations. Based on this, the Light Gradient Boosting Machine (LightGBM) algorithm was to establish a prediction model with powerful performance. Finally, we verified the validity and superiority of the proposed method via comparison with other prediction models in similar works. After 10-fold cross-validation, the proposed prediction method had the best performance and its explained variance score (EVS), mean absolute error (MAE), mean squared error (MSE), root mean square error (RMSE), median absolute error (MedAE) and R2 were 0.949, 0.028, 0.002, 0.045, 0.015 and 0.948, respectively. It also performed well on test datasets. Therefore, it can accurately and effectively predict the VCPLAT, thereby determining the severity of the condition to provide auxiliary decision-making for doctors in clinical diagnosis and treatment.
Knee Pathology before and after SARS-CoV-2 Pandemic: An Analysis of 1139 Patients
Authors: Giorgino Riccardo , Maggioni Davide Maria , Viganò Marco , Verdoni Fabio , Pandini Elisa , Balbino Cristiana , Manta Nicola , D’Anchise Roberto , Mangiavini Laura
Published: October 2021

Background: The SARS-CoV-2 pandemic drastically changed daily life activities and medical practice, leading to a reorganization of healthcare activities. People spent two months in home-isolation, changing their daily habits and undertaking a more sedentary lifestyle. Change in lifestyle is related to important consequences in knee pathologies. The aim of this study was to evaluate the outpatient activity for knee pathologies before and after lockdown in terms of incidence, severity, diagnosis, and treatment. Methods: Medical records of patients with knee pathology in outpatient follow-up at IRCCS Istituto Ortopedico Galeazzi in Milan (Italy) were analyzed in the time frame 4 May–4 September 2020 and compared with patients examined between 4 May and 4 September 2019. Results: A significant increase of knee diagnoses associated to patellofemoral disorders in 2020 was found (p = 0.004). In addition, physiotherapy was significantly more prescribed in 2020 than in 2019 (p = 0.012). Conclusions: The SARS-CoV-2 pandemic lockdown did not drastically change knee pathology, but it may have had an impact on it, highlighting a summary worsening of patellofemoral disorders associated with other knee diagnoses. Further studies are required to validate this result.
Incidence and Risk Factors for Notifiable Typhoid and Paratyphoid in Taiwan during the Period 2011–2020
Authors: Lin Fu-Huang , Chen Bao-Chung , Chou Yu-Ching , Hsieh Chi-Jeng , Yu Chia-Peng
Published: October 2021

The risk of the geographic transmission of emerging infectious diseases through air travel varies greatly. In this study, we collected data on cases of food-borne diseases between the years 2011 and 2020 in Taiwan to access the epidemiological features, differences, and trends in domestic and imported cases of typhoid and paratyphoid in terms of patient sex, age, month of confirmation, and area of residence. In this study, we made use of the open data website provided by Taiwan’s Centers for Disease Control (TCDC) to extract the reported numbers of cases of typhoid and paratyphoid between January and December from 2011 to 2020 for comparison. Univariate analysis was performed using the Chi-square test for categorical variables. Fisher’s exact test was performed if an expected frequency was less than 5. A total of 226 typhoid cases and 61 paratyphoid cases were analyzed from the database. The incidences of typhoid and paratyphoid per million of the population were 0.42–2.11 and 0–0.39, respectively. There was a significant difference in the incidence of the diseases between the age groups (p = 0.019), with a gradual increase in the 20–40 years group. A distinct seasonal (between fall and spring) variation was also observed (p = 0.012). There were 34 cases of children with typhoid in the period 2011–2015 and 12 cases of children with typhoid in the period 2016–2020. During these periods, there were two cases of paratyphoid. This study indicated that the risk of children suffering from typhoid has been significantly reduced in the last five years. Furthermore, we found that more women have acquired typhoid and paratyphoid than men, and that living in the Taipei metropolitan area and the northern area was a potential risk factor. Furthermore, the number of imported cases of typhoid (n = 3) and paratyphoid (n = 0) reported during the COVID-19 pandemic was lower than that reported for the same disease from 2011 to 2020. More typhoid and paratyphoid cases were imported from Indonesia, India, Myanmar, and Cambodia. This study represents the first report on confirmed cases of acquired typhoid and paratyphoid from surveillance data from Taiwan’s CDC for the period 2011–2020. This study also demonstrates that the cases of typhoid and paratyphoid decreased in Taiwan during the COVID pandemic. Big data were used in this study, which may inform future surveillance and research efforts in Taiwan.
Service Evaluation of the English Refugee Health Information System: Considerations and Recommendations for Effective Resettlement
Authors: Dunn Thomas James , Browne Annabel , Haworth Steven , Wurie Fatima , Campos-Matos Ines
Published: October 2021

Since 2015, the UK has resettled over 25,000 refugees. To support resettlement and integration, refugees undergo a pre-arrival medical health assessment (MHA), which is used for healthcare planning by local government in England. This study aimed to understand the utility and effectiveness of the MHA and flow of data to support resettlement planning. Seven local government representatives were interviewed regarding their experiences and perceptions of the refugee health information system (HIS) and the MHA for resettlement in England. Data was analyzed using thematic analysis. The three themes indicated that the HIS was perceived to be effective, however, issues on governance, timeliness of information and access were identified. Findings showed that for the MHA to be more useful for planning, assessments for mental health issues and child special educational needs (SEN) are needed. Findings also indicated resettlement promoted joint working and acceptability of refugee resettlement. In areas where data sharing and governance processes are well defined, the HIS is effective and the MHA supports resettlement. National agencies should put structures in place to support timely health information flow.
Awareness, Experience, and Knowledge of Farming Households in Rural Bangladesh Regarding Mold Contamination of Food Crops: A Cross-Sectional Study
Authors: Kyei Nicholas N. A. , Waid Jillian L. , Ali Nurshad , Gabrysch Sabine
Published: October 2021

Aside from specific environmental conditions, poor agricultural practices contribute to mold and thus the mycotoxin contamination of crops. This study investigated Bangladeshi farming households’ (i) awareness of and experience with mold contamination of food crops; (ii) knowledge and awareness of the timing, causes, and consequences of mold and mycotoxin contamination; and (iii) knowledge of the recommended agricultural practices for controlling and preventing mold contamination of food crops. A survey was conducted with 1280 households in rural areas of Habiganj district, Bangladesh. Basic descriptive statistics were calculated, and mixed-effects linear regression analyses were performed to examine associations between household characteristics and overall knowledge scores. The awareness of mold contamination of food crops was very high (99%; 95% CI: 98–100%) and a shared experience among households (85%; 95% CI: 80–88%). Yet, the majority (80%; 95% CI: 76–84%) demonstrated a low level of knowledge of the timing, causes, and preventive practices regarding mold contamination of crops. Knowledge scores were similar over demographic groups and better for households with more arable land. The findings suggest a generally insufficient knowledge of the conditions that favor mold contamination and the measures for preventing mold contamination of food crops. These findings underline the need for tailored interventions to promote good agricultural practices and reduce mold contamination of food crops.
Gestational Bell’s Palsy Is Associated with Higher Blood Pressure during Late Pregnancy and Lower Birth Weight: A Retrospective Case-Control Study
Authors: Leelawai Sumonthip , Suwanrath Chitkasaem , Pruphetkaew Nannapat , Chongphattararot Pensri , Sathirapanya Pornchai
Published: October 2021

The associations between gestational Bell’s palsy (GBP) and late obstetric complications (LOCs), i.e., preeclampsia (PE), eclampsia (EC), gestational hypertension (GHT), and gestational diabetes mellitus (GDM) remain unclear. This study aimed to evaluate these associations and the neonatal health of the newborns born from pregnant women with and without GBP. A retrospective 1:5 case-control study matching exact maternal age and gravidity between pregnant women with and without GBP in Songklanagarind Hospital from 2006 to 2016 was conducted. The associations between GBP and PE, EC, GHT, and GDM, as well as comparison of the newborns’ health indices were analyzed by bivariate analysis (p < 0.05). Eight GBP cases out of 8,756 pregnant women were recruited. Six GBP cases were first or second gravid. GBP occurred during the third trimester in five cases. Except for higher median systolic blood pressure (125 (114.2, 127.5) vs. (110 (107.0, 116.0), p = 0.045) and diastolic blood pressures (77 (73.0, 80.8) vs. 70 (65.0, 73.2), p = 0.021) in the GBP cases, associations between GBP and all LOCs could not be concluded due to the lack of power. However, a significantly lower mean birth weight in the newborns of GBP mothers was found (2672.2 (744.0) vs. 3154.8 (464.7), p = 0.016) with statistically significant power. Except for the higher blood pressures and lower birth weights of the newborns of GBP mothers, an association between GBP and LOCs remains inconclusive.
Effects of a Personal Health Record in Maternity Care: A Stepped-Wedge Trial
Authors: Groenen Carola J. M. , Kremer Jan A. M. , IntHout Joanna , Meinders Marjan J. , van Duijnhoven Noortje T. L. , Vandenbussche Frank P. H. A.
Published: October 2021

To improve both the active involvement of pregnant women in their maternal health and multidisciplinary collaboration between maternal care professionals, we introduced a personal health record (PHR) in routine maternity care. We studied the effects of this intervention on the percentage of uncomplicated births, women’s perspectives on quality of care, and the collaboration between health care professionals. We performed a stepped-wedge cluster randomized controlled trial with four clusters and 13 maternity health centers (community-based midwife practices and hospitals) in one collaborative area. In total, 7350 pregnant women and 220 health care professionals participated. Uncomplicated births accounted for 51.8% (95% CI 50.1–53.9%) of total births in the control group and 55.0% (CI 53.5–56.5%) of total births in the intervention group (p = 0.289). Estimated means revealed that the differences detected in the stepped-wedge study were due to time and not the intervention. Women’s perspectives on quality of care and collaboration between health care professionals revealed no relevant differences between the control and intervention groups. The introduction of the PHR resulted in no significant effect on the chosen measures of quality of maternal care. The suggested positive effect in the raw data was a local trend which was less visible in the national database, and thus might be related to subtle changes toward an improved collaborative culture in the study region.
Prevalence of Psychological Distress and Associated Factors in Nursing Students during the COVID-19 Pandemic: A Cross-Sectional Study
Authors: Tanji Fumiya , Kodama Yuki
Published: October 2021

Little is known about psychological distress and its associated factors during the COVID-19 pandemic among nursing students, especially during the initial spread. The present study aimed to investigate the prevalence of psychological distress among Japanese nursing students after the first semester of 2020 with shifted classes and practice online. Furthermore, we examined whether factors such as health issues and resilience were associated with psychological distress. The data were obtained from a cross-sectional, self-administered questionnaire survey at a Japanese nursing college from September to November 2020 (n = 289). We collected data such as sociodemographic variables, medical history, insomnia, and resilience (Bidimensional Resilience Scale). Psychological distress was measured using the K6 scale (scores ≥ 5). The prevalence of psychological distress was 58.5%. The multivariate Poisson regression analysis found a negative association between innate resilience factors, and positive associations between medical history, insomnia, and psychological distress. The present study showed that more than half of the study participants experienced high levels of psychological distress. Our results suggest the importance of monitoring mental health among nursing students, focusing not only on health issues, but also personality components such as innate resilience during the prolonged COVID-19 pandemic.
Adult Stature Estimation from Radiographic Metatarsal Length in a Contemporary Korean Population
Authors: Park Suyeon , Yi Young , Tsengel Battur , Kim Jahyung , Chun Dong-Il , Won Sung-Hun , Min Tae-Hong , Park Jeong-Hyun , Lee Mijeong , Cho Jaeho
Published: October 2021

The ability to estimate stature can be important in the identification of skeletal remains. This study aims to develop a Korean-specific equation predicting stature using radiographic measurements in the contemporary Korean population. 200 healthy Korean adults, including 102 males and 98 females, were randomly selected (age, range 20–86 years). The first and second metatarsals of the foot were measured by a standing X-ray using a digital medical image viewer. The result showed a statistically significant correlation between metatarsal length and stature in Korean populations (male, R = 0.46, p < 0.001; female, R = 0.454, p < 0.001). Values of correlation coefficients (R) of the equations were 0.431 to 0.477. Compared to equations derived from other races, the Korean-specific equation showed significantly lower error values for estimating the actual height of Koreans through cross-validation. In conclusion, this study is the first to propose a Korean-specific regression formula for estimating stature using metatarsal length and a verified formula for precise application to the Korean population. However, given the relatively low correlation coefficient, the stature estimation formula derived from this study can be utilized when other bones that allow more accurate stature estimation are not available.
Teamworking in Healthcare during the COVID-19 Pandemic: A Mixed-Method Study
Authors: Anjara Sabrina , Fox Robert , Rogers Lisa , De Brún Aoife , McAuliffe Eilish
Published: October 2021

The widespread impact of COVID-19 on healthcare has demanded new ways of working across many organisation types and many forms of healthcare delivery while at the same time endeavouring to place minimal, or no, additional burden on already strained healthcare teams. This is a cross-sectional mixed-method study which captured the experiences of teamwork during the COVID-19 pandemic contributing to successful collaboration. We hypothesised that work engagement and psychological safety separately contribute to collective leadership and organisational citizenship behaviours. Participants were healthcare staff on active duty during the COVID-19 pandemic in Ireland (n = 152) who responded to our social media (Twitter) invitation to participate in this study. Survey and free-text responses were collected through an online platform. Structural equation modelling examined the relationships between work engagement and psychological safety, and collective leadership and OCBs. Open text responses relating to experiences of teamworking during the pandemic were analysed for latent themes. From the survey data, the structural model demonstrated excellent statistical fit indicating that psychological safety, but not work engagement, was predictive of collective leadership and OCBs. From the qualitative data, two key themes were generated: (1) Contrasting experiences of working in a team during the pandemic; and (2) The pandemic response: a tipping point for burnout. This study offers a valuable starting point to explore the factors driving change and the shift to more collective ways of working observed in response to COVID-19. Future studies should use longitudinal data to capture the temporal relationship of these variables which could be moderated by prolonged pressure to healthcare staff during the pandemic.
Development and Validation of the Psychotherapeutic Effectiveness Attribution Questionnaire (PEAQ-12) in a Spanish Population
Authors: Romero-Moreno Antonio , Paramio Alberto , Cruces-Montes Serafín J. , Zayas Antonio , Gómez-Carmona Diego , Merchán-Clavellino Ana
Published: October 2021

In recent decades, the study of psychotherapy effectiveness has been one of the pillars of clinical research because of its implication for therapeutic cure. However, although many studies have focused their interest on the patient’s perception, there are no instruments oriented to the study of psychotherapists’ attributions of effectiveness: to what factors psychotherapists attribute responsibility for the cure of the therapies they provide. The present study aimed to develop and validate an instrument for assessing the attribution of the effectiveness of psychotherapy in a population of 69 psychotherapists of different theoretical orientations. After an initial process of inter-judge content validation, 12 items were selected for validation in the targeted population, adequately fulfilling the quality requirements in the validity–reliability tests, and grouped into four factors after principal component analysis. These factors were as follows: (1) therapeutic alliance enhancers; (2) psychotherapist emotional characteristics; (3) therapy-specific variables; and (4) facilitators of patient engagement with therapy. This four-factor structure also showed a good fit for the fit indices checked in confirmatory factor analysis. In summary, we can conclude that the Psychotherapeutic Effectiveness Attribution Questionnaire (PEAQ-12) developed in our research can be helpful if tested on a larger number of individuals. The results can be replicated in other populations of psychotherapists.
The Impact of COVID-19 Vaccination on Anxiety Levels of Turkish Dental Professionals and Their Attitude in Clinical Care: A Cross-Sectional Study
Authors: Karayürek Fatih , Çebi Ahmet Taylan , Gülses Aydın , Ayna Mustafa
Published: October 2021

Background: The current study aimed to assess the anxiety and fear levels and the attitude towards clinical care, such as the use of personal protective equipment and number of patients examined, before and after COVID-19 vaccination among Turkish dental professionals. Methods: A questionnaire including socio-demographical characteristics and clinical data regarding the number of patients, the use of personal protective equipment, vaccine confidence interval, positive or negative COVID-19 diagnosis, and fear and anxiety levels were examined. Results: A total of 475 dentists (196 men and 279 women) participated. Overall, the vaccination had a positive effect on the decrease of fear and anxiety levels of dental professionals. It was observed that the number of interventional procedures significantly increased after vaccination. Besides that, the amount of personal protective equipment used in patients, especially after the vaccination, has decreased. Conclusion: Despite the positive effects of vaccination on the anxiety levels of dental professionals, protective measurements should further be the main concern, regardless of the vaccination status of both the dental professional and the patient.
Association between Anxiety, Depressive Symptoms, and Quality of Life in Patients Undergoing Diagnostic Flexible Video Bronchoscopy
Authors: Brajer-Luftmann Beata , Mardas Marcin , Stelmach-Mardas Marta , Lojko Dorota , Batura-Gabryel Halina , Piorunek Tomasz
Published: October 2021

Bronchoscopy is one of the basic invasive procedures in pulmonology accompanied by patients’ anxiety. This study aimed to find an association between predictors of state anxiety/depression and patient’s quality of life (QOL) with pulmonary symptoms undergoing diagnostic flexible video bronchoscopy (FVB). A total of 125 adult patients before FVB were included in a prospective observational study. The quality of life (QOL) was assessed by WHOQOL-BREF questionnaire, the depression possibility by the Beck’s Depression Inventory-II (BDI-II), and the anxiety level by Spielberger’s State-Trait Anxiety Inventory (STAI-S; STAI-T). Results show that the older patients and patients with more comorbidities showed a significantly higher anxiety level. The previous FVB under deep sedation significantly reduced state anxiety. A significantly positive association was found between the STAI score and total BDI-II score. More severe symptoms of anxiety were especially related to lower QOL (physical health, psychological and environmental domains) in patients. Statistically higher trait anxiety in lower social QOL domain scores was observed. Our findings show that high state and trait anxiety were associated with higher depression scores and lower quality of life in the elderly. It seems that the elderly and patients at risk of depression development require more attention in the clinical setting to minimize the anxiety accompanying the bronchoscopy.
Towards Managing Visual Pollution: A 3D Isovist and Voxel Approach to Advertisement Billboard Visual Impact Assessment
Authors: Chmielewski Szymon
Published: October 2021

Visual pollution (VP) is a visual landscape quality issue, and its most consistently recognized symptom is an excess of out of home advertising billboards (OOHb). However, the VP related research concerns landscape aesthetic and advertisement cultural context, leaving the impact of outdoor billboard infrastructure on landscape openness unanswered to date. This research aims to assess the visual impact of outdoor billboard infrastructure on landscape openness, precisely the visual volume—a key geometrical quality of a landscape. The method uses 3D isovists and voxels to calculate the visible and obstructed subsets of visible volume. Using two case studies (Lublin City, Poland) and 26 measurement points, it was found that OOHb decreased landscape openness by at least 4% of visible volume; however, the severe impact may concern up to 35% of visual volume. GIS scientists develop the proposed method for policy-makers, and urban planners end users. It is also the very first example of compiling 3D isovists and voxels in ArcGIS Pro software in an easy-to-replicate framework. The research results, accompanied by statistically significant proofs, explain the visual landscape’s fragility and contribute to understanding the VP phenomenon.
Spatial Distribution and Mechanism of Urban Occupation Mixture in Guangzhou: An Optimized GeoDetector-Based Index to Compare Individual and Interactive Effects
Authors: Deng Xingdong , Liu Yang , Gao Feng , Liao Shunyi , Zhou Fan , Cai Guanfang
Published: October 2021

Numerous studies have been devoted to uncovering the characteristics of resident density and urban mobility with multisource geospatial big data. However, little attention has been paid to the internal diversity of residents such as their occupations, which is a crucial aspect of urban vibrancy. This study aims to investigate the variation between individual and interactive influences of built environment factors on occupation mixture index (OMI) with a novel GeoDetector-based indicator. This study first integrated application (App) use and mobility patterns from cellphone data to portray residents’ occupations and evaluate the OMI in Guangzhou. Then, the mechanism of OMI distribution was analyzed with the GeoDetector model. Next, an optimized GeoDetector-based index, interactive effect variation ratio (IEVR) was proposed to quantify the variation between individual and interactive effects of factors. The results showed that land use mixture was the dominating factor, and that land use mixture, building density, floor area ratio, road density affected the OMI distribution directly. Some interesting findings were uncovered by IEVR. The influences of cultural inclusiveness and metro accessibility were less important in factor detector result, while they were found to be the most influential in an indirect way interacting with other built environment factors. The results suggested that both “hardware facilities” (land use mixture, accessibility) and “soft facilities” (cultural inclusiveness) should be considered in planning a harmonious urban employment space and sustainable city.
Machine Learning Reveals a Significant Shift in Water Regime Types Due to Projected Climate Change
Authors: Ayzel Georgy
Published: October 2021

A water regime type is a cumulative representation of seasonal runoff variability in a textual, qualitative, or quantitative form developed for a particular period. The assessment of the respective water regime type changes is of high importance for local communities and water management authorities, increasing their awareness and opening strategies for adaptation. In the presented study, we trained a machine learning model—the Random Forest classifier—to predict water regime types in northwest Russia based on monthly climatological hydrographs derived for a historical period (1979–1991). Evaluation results show the high efficiency of the trained model with an accuracy of 91.6%. Then, the Random Forest model was used to predict water regime types based on runoff projections for the end of the 21st century (2087–2099) forced by four different General Circulation Models (GCM) and three Representative Concentration Pathway scenarios (RCP). Results indicate that climate is expected to modify water regime types remarkably. There are two primary directions of projected changes. First, we detect the tendency towards less stable summer and winter flows. The second direction is towards a shift in spring flood characteristics. While spring flooding is expected to remain the dominant phase of the water regime, the flood peak is expected to shift towards earlier occurrence and lower magnitude. We identified that the projected changes in water regime types are more pronounced in more aggressive RCP scenarios.
Translational Applications of Linear and Circular Long Noncoding RNAs in Endometriosis
Authors: Wang Xiyin , Parodi Luca , Hawkins Shannon M.
Published: October 2021

Endometriosis is a chronic gynecologic disease that negatively affects the quality of life of many women. Unfortunately, endometriosis does not have a cure. The current medical treatments involve hormonal manipulation with unwanted side effects and high recurrence rates after stopping the medication. Sadly, a definitive diagnosis for endometriosis requires invasive surgical procedures, with the risk of complications, additional surgeries in the future, and a high rate of recurrence. Both improved therapies and noninvasive diagnostic tests are needed. The unique molecular features of endometriosis have been studied at the coding gene level. While the molecular components of endometriosis at the small RNA level have been studied extensively, other noncoding RNAs, such as long intergenic noncoding RNAs and the more recently discovered subset of long noncoding RNAs called circular RNAs, have been studied more limitedly. This review describes the molecular formation of long noncoding and the unique circumstances of the formation of circular long noncoding RNAs, their expression and function in endometriosis, and promising preclinical studies. Continued translational research on long noncoding RNAs, including the more stable circular long noncoding RNAs, may lead to improved therapeutic and diagnostic opportunities.