Search

The use of electronic patient-reported outcomes has increased recently, and smartphones offer distinct advantages over other devices. However, previous systematic reviews have not investigated the reliability of the Center for Epidemiologic Studies Depression Scale (CES-D), Generalized Anxiety Disorder-7 (GAD-7), and Kessler Screening Scale for Psychological Distress (K6) when used with smartphones, and this has not been fully explored. This study aimed to evaluate the equivalence of the paper and smartphone versions of the CES-D, GAD-7, and K6, which were compared following a randomized crossover design method in 100 adults in Gunma, Japan. Participants responded to the paper and smartphone versions at 1-week intervals. The equivalence of paper and smartphone versions was evaluated using the intraclass correlation coefficient (ICC agreement ). The mean participant age was 19.86 years (SD = 1.08, 23% male). The ICC agreements for the paper and smartphone versions of the CES-D, GAD-7, and K6 were 0.76 (95% confidence interval [CI] 0.66-0.83), 0.68 (95% CI 0.59-0.77), and 0.83 (95% CI 0.75-0.88), respectively. Thus, the CES-D and K6 scales are appropriate for use in a smartphone version, which could be applied to clinical and research settings in which the paper or smartphone versions could be used as needed.

Bisphenol A (BPA) is used as a color developer in a thermal paper that after a heating process reacts with a leuco dye and changes it to a colored form. Receipts from cash registers are considered as the main source of consumer exposure to bisphenols together with polycarbonates and epoxy resins. Levels of BPA and its possible alternatives were determined in thermal paper samples collected between May 2018 and May 2019 in 22 European and 17 non-European countries on all inhabited continents (220 samples in total, 133 of which were from Europe and 87 from other countries). These measurements were intended to check the level of BPA presence in receipts originating from different countries, especially from Europe in the light of changing regulations restricting its use. The effect of thermal printing on developer content was also analyzed, but no major changes in concentrations of bisphenols were observed during the process. Thus, printed receipts could be used for the determination of bisphenol content. Analysis of receipts from 39 countries has shown that BPA is still the most common compound used around the world with 69% samples containing this color developer. Among other tested bisphenols, BPS was used as a color developer in 20% samples, but it was noted that all samples collected from Japan and the United States of America were found to contain only BPS. Other bisphenols (F, AF, E, and B) considered as possible alternatives for BPA were detected only at trace levels or not detected at all, which showed that they were not used as color developers. The relatively large use of BPS as a BPA substitute is worrying because this compound not only has similar endocrine properties but is also poorly biodegradable. Besides, its relatively high polarity facilitates spreading in the environment., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2020 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Clinical reasoning competency is essential for an appropriate clinical dental treatment. Among the tools for the assessment of clinical reasoning competency, computer-based testing (CBT) is considered more useful than paper-based testing (PBT), because teachers can control the timing of information given to the examinees. Such timings could possibly affect the thinking process of examinees. However, few studies reported differences of reasoning between the two testing modes. In the present study, we developed an assessment of clinical reasoning and applied it using CBT and PBT to compare the examinees' performance. The participants comprised 60 students in the fifth-year class in 2012 of the School of Dentistry, Faculty of Dentistry, Tokyo Medical and Dental University. The tests comprised 25 problems, each with four questions, totaling 100 questions. The contents of the questions were the same in CBT and PBT. The students were assigned to CBT (Group C, n = 30) and PBT (Group P, n = 30) groups, with an almost equal gender ratio in the groups. The difference between scores was analyzed with a univariate analysis of variance. No significant intergroup differences were found regarding the test duration, total score, and average score of each question. The number of problems with perfect marks was higher in Group P than in Group C (P < 0.05), probably because Group P students could access the information of the previous question (s) within a problem. Thus, the differences of the examinees' performance between the two testing modes were small.

A risk assessment study of seven phthalates in paper diapers for newborn babies produced in Japan was performed. The diapers were purchased and the contents of the seven phthalates were determined and estimated amounts of exposure were calculated based on the eluted rate into artificial medium of urine or sweat, average weight of infants, and frequency of use. Di-2-ethylhexyl phthalate and di-n-butyl phthalate were detected in the topsheets and determined to be 0.6 μg/g and 0.2 μg/g, respectively. The daily estimated exposure volume was calculated to be in the range of 1.86 × 10(-10)-2.98 × 10(-6) mg/kg/day as follows: content of seven phthalates in the topsheet (0.1-1 μg/g) × eluted rate of phthalates into artificial sweat (0.0006-2.4%) × weight of the topsheet of a diaper (1.5 g) × the number of diapers used per day (12 sheets) × skin absorption rate (0.005-0.1)/average body weight (2.9 kg). For hazard assessment, we used 0.2-300 mg/kg/day for the seven phthalates based on the data available at international agencies. The margin of exposure to the seven phthalates was 6.71 × 10(4)-1.99 × 10(11), indicating that the risk of exposure to phthalates from the diapers produced in Japan was negligible., (Copyright © 2015 Elsevier Inc. All rights reserved.)