bluuebunny/crossref_metadata_2025 huggingface dataset:
Suicide Prevention for International Students: A Scoping Review
Authors: McKay Samuel , Veresova Maria , Bailey Eleanor , Lamblin Michelle , Robinson Jo
Published: January 2023

International students are at risk of suicide and suicide prevention activities addressing their unique needs are required. However, no comprehensive review has been undertaken to identify effective suicide prevention approaches for international students. The current scoping review aimed to chart the extent, range, and nature of available evidence on the prevention strategies for international students. We systematically searched Medline, PsycInfo, ERIC, CINAHL, Proquest, and several gray literature databases to identify relevant peer-reviewed articles and gray literature. Eligible publications were those providing data or recommendations related to suicide prevention among international students; 15 peer-reviewed articles and 19 gray literature documents were included in the review. No studies of prevention programs or policies directly targeting suicidal ideation, suicide attempts, or suicide in international students were identified. A narrative synthesis of the suicide prevention recommendations for international students identified four categories: (1) cultural competency training on suicide and provision of culturally sensitive services; (2) improved and increased risk screening for suicide; (3) proactive intervention and engagement strategies; and (4) collaborative approaches to streamline service access and improve available support. These recommendations provide guidance on potential directions for international student suicide prevention. Research assessing the effectiveness of such recommendations will enable the development of novel evidence-based policies and interventions that reduce rates of suicide in international students.
The Effects and Differences of Social Support, Depression, and Vital Exhaustion during the COVID-19 Pandemic among International and Domestic University Students
Authors: Rekenyi Viktor , Garbóczy Szabolcs , Szemán-Nagy Anita , Al-Tammemi Ala’a B. , Sayed-Ahmad Mohamed , Kolozsvári László Robert
Published: January 2023

Background: Our study aimed to assess the differences between domestic and international students in terms of social support, vital exhaustion, and depression during the period of COVID-19 and to examine the relationships and potential effects of these factors on each other. Methods: The online cross-sectional survey was conducted via Google Forms® at three time intervals during the pandemic. Results: Here, 1320, 246, and 139 students completed our questionnaires in the different time intervals. The international students reported significantly lower values in terms of perceived social support. Concerning depression, the international female students reported higher values than the domestic female students. Significant correlations were found in both samples between vital exhaustion and depression, as well as between perceived social support and depression. Conclusion: In this study, the international students reported lower levels of perceived social support and higher levels of depression, particularly among females. The correlations between depression, social support, and vital exhaustion might highlight protective and risk factors. These findings emphasize the importance of addressing social support and mental health among university students, especially among international students who have a difficult time finding social support during times of stress, such as during the COVID-19 pandemic.
Interactive Allocation of Water Pollutant Initial Emission Rights in a Basin under Total Amount Control: A Leader-Follower Hierarchical Decision Model
Authors: Yu Qianwen , Sun Zehao , Shen Junyuan , Xu Xia , Chen Xiangnan
Published: January 2023

The initial emission rights allocation is the key measure to achieve the goal of total amount control and deepen the emission trading system. Although many studies have focused on the modeling of initial emission rights allocation, such as using game theory and multi-objective optimization methods, few studies have observed the hierarchical relationship of mutual interference and restriction between watershed management agency and local governments in each subarea during allocation. This relationship directly affects the rationality of the results of regional emission rights allocation. In this study, a leader-follower hierarchical decision model (LFHDM) for allocating initial emission rights in a basin is developed. Based on the bilevel programming approach, the model simulates the interactive decision-making process between the watershed management agency of the upper-level model (LFHDM-U) and the local government of the lower-level model (LFHDM-L) in the allocation under total amount control. A case study of China’s Yellow River Basin is conducted to demonstrate the feasibility and practicality of the model. Findings reveal that, compared with the single-level model, the developed LFHDM has higher satisfaction with the allocation scheme. Under different scenarios, the overall satisfaction of the configuration schemes of COD and NH3-N in each province and autonomous region remains above 0.9. In addition, the allocation volumes of COD and NH3-N in each province of the Yellow River Basin in planning year increase with the enhancement of allowable assimilative capacity of water bodies, but the interval gap of satisfaction with allocation schemes gradually narrows. It shows that when the allowable assimilation capacity of a water body is low, the decision-making of the allocation scheme needs to be more cautious. Moreover, for the Yellow River Basin, apart from Qinghai and Sichuan, the task of reducing water pollutants in other provinces in the next few years is very arduous. The average reduction of total COD and NH3-N in the basin is about 48% and 46%, respectively.
Beliefs and Norms Influencing Initiation and Sustenance of Exclusive Breastfeeding: Experiences of Mothers in Primary Health Care Facilities in Ermelo, South Africa
Authors: Modjadji Perpetua , Seabela Ethel Sekori , Ntuli Busisiwe , Madiba Sphiwe
Published: January 2023

Exclusive breastfeeding (EBF) is not a norm in many communities in South Africa despite the World Health Organizations’ recommendations for EBF in the first six months of infant’s life. Thus, South Africa continues to observe suboptimal and poor practices of EBF. The purpose of the study was to explore the experiences of mothers who are HIV-positive and negative on EBF and examine the extent to which initiation and sustenance of EBF is influenced by cultural beliefs, societal norms, and family norms and practices in Mpumalanga Province. Three focus group discussions and twelve in-depth interviews were conducted among thirty mothers who were purposively selected during their visits to the facilities for childcare services. Interviews were audiotaped, transcribed verbatim, and transcripts were analysed through thematic analysis using NVivo version 10. Mothers were aged between 18 and 42 years, most were unemployed and were living in poor sociodemographic backgrounds in extended family households. We found evidence of factors that influence the decision to EBF and mix feed infants among mothers. Traditional and cultural beliefs and norms that exist within their communities informed decisions mothers took to EBF. These beliefs existed alongside mothers’ opinions on breastfeeding (BF) and HIV infection, as well as the fears of harming the baby through HIV infection, leading to early cessation of BF. Mothers were also advised by family members, friends, and even some healthcare workers to use traditional medicines while BF. The association of EBF with sagging breasts and weight loss as well as discomfort with public BF are personal beliefs that influenced initiation and early cessation of EBF. Breastfeeding messages ought to be context specific to improve the knowledge, understanding, acceptance and practice of EBF among HIV-positive and negative mothers. Culturally appropriate counselling messages that address the known cultural practices of the populations affected are essential to changing the beliefs and norms of the communities including extended families of EBF mothers.
Research on the Environmental Philosophy of China’s Environmental Crime Legislation from the Perspective of Ecological Civilization Construction
Authors: An Ran , Liu Peng
Published: January 2023

Modern environmental philosophy is a new type of philosophy for humans re-examining the relationship between man and nature and provides the value guidance for modern environmental law. China’s environmental crime legislation has gone through the exploration period, establishment period, and optimization period. The environmental philosophy behind this is worth discussing and determines the direction China will take environmental crime in the future and whether China’s environmental strategy can really be implemented. At present, the disputes about the environmental philosophy of environmental crime in China are mainly reflected in the contention between anthropocentrism, ecocentrism, and eco-anthropocentrism. There are radical risks of pure human centrism or pure ecological centrism, and these two theories struggle to serve as a value basis for environmental crime legislation. Although eco-anthropocentrism seems to be comprehensive, it is actually ambiguous, and it is still difficult to deal with the conflict between people and nature. In recent years, China has continuously emphasized the construction of ecological civilization construction and written this into the constitution. Therefore, in the environmental philosophy issues of environmental crimes in China, we should consider absorbing the advantages of anthropocentrism, ecocentrism, and eco-anthropocentrism, while taking the original Chinese ecological civilization philosophy as the value foundation.
A Systematic Review of the Efficacy of Microfocused Ultrasound for Facial Skin Tightening
Authors: Contini Mark , Hollander Marijke H. J. , Vissink Arjan , Schepers Rutger H. , Jansma Johan , Schortinghuis Jurjen
Published: January 2023

Objective: to systematically review the efficacy of microfocused ultrasound (MFU) for facial skin tightening. Methods: A systematic search was performed (Pubmed, Embase) to assess the efficacy of single MFU treatments for facial skin tightening. Eligible studies included randomised controlled trials, controlled trials, cohort studies and case series (n ≥ 10). Objective and subjective outcomes were assessed. Results: A total of 693 studies were identified of which 16 studies were eligible. All the studies involved female patients. MFU is capable of tightening the skin, as observed in studies measuring the results of brow lifts (0.47–1.7 mm) and submental lifts (measured as a 26–45 mm2 reduction in the submental area on lateral photographs). Data from the Global Aesthetic Improvement Scale (GAIS) were pooled, and the day 90 pooled subjective investigator reported scores (IGAIS) (n = 337) showed that 92% of the patients demonstrated an improvement in skin tightening and/or in wrinkle reduction which continued up to one year. Longer-term follow-up data are not available. The patient-reported pooled scores (SGAIS) (n = 81) showed that the skin improvements were mild and continued to increase from 42% (90 days) to 53% (360 days) post-treatment. The MFU treatment was moderately painful and caused transient erythema with or without oedema. Other adverse effects were rare (2%), including dysesthesia (numbness or hypersensitivity), bruising and stinging, mandibular burns, striations and contact dermatitis. Various device settings, treatment protocols and energies were applied. Excessive skin laxity and a BMI > 30 were posed as relative contraindications for MFU treatment because positive results declined with an increase in laxity and BMI. Conclusions: MFU treatment is effective in tightening female patients’ mildly to moderately lax facial skin. Future studies should focus on objective treatment outcomes, optimising treatment regimens and male patients.
Spatiotemporal Dynamics of Ecological Vulnerability and Its Influencing Factors in Shenyang City of China: Based on SRP Model
Authors: Gu Hanlong , Huan Chongyang , Yang Fengjiao
Published: January 2023

For Shenyang, the central city of Northeast China, its municipal-level Territorial Spatial Planning is of great significance to the whole of Northeast China. Territorial Spatial Planning is an essential carrier of China’s ecological civilization construction. The demarcation of “three districts and three lines” defines the scope of ecological protection areas, which is of guiding significance to the future development of ecological civilization construction. The regional ecological vulnerability assessment can provide reference for ecological pattern planning and the demarcation of ecological red lines in “three districts and three lines”. In order to explore the spatial distribution pattern of ecological vulnerability in Shenyang, predict the development trend of ecological vulnerability in the future and guide the construction of ecological civilization in Shenyang and provide certain basis for Shenyang’s Territorial Spatial Planning and the delineation of “three districts and three lines”. This paper based on the “sensitivity-resilience-pressure” model selected 13 indexes, to evaluate the ecological vulnerability of Shenyang from 2010 to 2020. Furthermore, the spatial distribution characteristics and influencing factors of ecological vulnerability in Shenyang are summarized using spatial autocorrelation analysis and geographic detector model, and the future development trend of ecological vulnerability in Shenyang in 2025 is predicted by using CA-Markov model. The results show that: (1) In 2010, 2015 and 2020, the total area of slightly vulnerable areas in Shenyang was large, and the ecological vulnerability showed a gradually vulnerable spatial change trend from south to north and from west to east. (2) The results of geographical detectors show that normalized difference vegetation index, economic density and nighttime light intensity are the main driving factors of ecological vulnerability in Shenyang. (3) The forecast result of CA-Markov model is reliable. In 2025, the ecological vulnerability of Shenyang will be mainly light and extreme vulnerability areas, and the areas of light and extreme vulnerability areas will increase in 2025. The research results can provide some reference for the delineation of “three districts and three lines” and ecological protection in Shenyang’s Territorial Spatial Planning, and have certain significance for promoting regional sustainable development and balancing ecological protection and economic development.
Mapping Evidence on the Epidemiology and Cost Associated with Maxillofacial Injury among Adults in Sub-Saharan Africa: A Scoping Review Protocol
Authors: Adeleke Adekunle I. , Hlongwa Mbuzeleni , Makhunga Sizwe , Ginindza Themba G.
Published: January 2023

(1) Background: Maxillofacial injury (MI) occurs universally, for it disregards preference for age, gender, and geographical region. The global incidence and prevalence of facial fractures rose by 39.45% and 54.39%, respectively, between the years 1990 to 2017. Projections indicate that the burden of injuries will persist in sub-Saharan Africa (SSA) in the next twenty years. This scoping review aims to map the literature on MI epidemiology and the economic burden on society in SSA. (2) Methods: The methodology presented by Arksey and O’Malley and extended by Levac and colleagues will be employed in the scoping review. The researcher will report the proposed review through the Preferred Reporting Items for Systematic Review, and Meta-Analysis extension for scoping reviews (PRISMA-ScR). The review will include studies encompassing MI in sub-Saharan African adults 18 years and above. (3) Results: This will be presented as a thematic analysis of the data extracted from the included studies, and the Nvivo version 12 will be employed. (4) Discussion: We anticipate searching for related literature on the prevalence, incidence, risk factors, mortality, and cost associated with MI in the adult population of SSA. The conclusion from the review will assist in ascertaining research gaps, informing policy, planning, authorizing upcoming research, and prioritizing funding for injury prevention and management.
Effect of Familial Longevity on Frailty and Sarcopenia: A Case–Control Study
Authors: Belenguer-Varea Angel , Avellana-Zaragoza Juan Antonio , Inglés Marta , Cunha-Pérez Cristina , Cuesta-Peredo David , Borrás Consuelo , Viña José , Tarazona-Santabalbina Francisco José
Published: January 2023

Familial longevity confers advantages in terms of health, functionality, and longevity. We sought to assess potential differences in frailty and sarcopenia in older adults according to a parental history of extraordinary longevity. A total of 176 community-dwelling subjects aged 65–80 years were recruited in this observational case–control study, pair-matched 1:1 for gender, age, and place of birth and residence: 88 centenarians’ offspring (case group) and 88 non-centenarians’ offspring (control group). The main variables were frailty and sarcopenia based on Fried’s phenotype and the European Working Group on Sarcopenia in Older People (EWGSOP) definitions, respectively. Sociodemographics, comorbidities, clinical and functional variables, the presence of geriatric syndromes, and laboratory parameters were also collected. Related sample tests were applied, and conditional logistic regression was performed. Cases had a higher percentage of robust patients (31.8% vs. 15.9%), lower percentages of frailty (9.1% vs. 21.6%) and pre-frailty (59.1% vs. 62.5%) (p = 0.001), and lower levels of IL-6 (p = 0.044) than controls. The robust adjusted OR for cases was 3.00 (95% CI = 1.06–8.47, p = 0.038). No significant differences in muscle mass were found. Familial longevity was also associated with less obesity, insomnia, pain, and polypharmacy and a higher education level and total and low-density lipoprotein cholesterol. The results suggest an inherited genetic component in the frailty phenotype, while the sarcopenia association with familial longevity remains challenging.
Study on the Influence Mechanism and Space Distribution Characteristics of Rail Transit Station Area Accessibility Based on MGWR
Authors: Li Daoyong , Zang Hengyi , Yu Demiao , He Qilin , Huang Xiaoran
Published: January 2023

The accessibility of rail transit station areas is an important factor affecting the efficiency of rail transit. Taking the Beijing rail transit station area as our research object, this paper took a 15 min walking distance as the index of station area accessibility, and investigated the status quo and influencing factors of the unbalanced distribution of rail transit station area accessibility in Beijing. In this paper, the data of Beijing rail transit stations were obtained from the Amap open platform, and the accessibility of the station area was calculated using the path planning service provided by the Amap API. The Getis–Ord Gi* method was used to analyze the overall distribution characteristics of the accessibility of the Beijing rail transit station area, then the high accessibility area and the low accessibility area were determined. To explore the factors influencing domain accessibility, multi-source data were obtained, a total of 11 indicators were constructed, and the random forest model was used to identify feature importance. Using the eight selected influencing factors, the OLS regression model, GWR model, and MGWR model were used to study the spatial heterogeneity of influencing factors. By comparison, it was concluded that the MGWR model can not only effectively analyze the spatial heterogeneity of rail transit station accessibility, which can automatically mediate the bandwidth of different influencing factors, and then reflect the spatial changes of the influencing factors of rail transit station accessibility more truly. The results show that (1) the accessibility of the Beijing rail transit station area shows obvious spatial agglomeration characteristics in space. The accessibility of the station area in the fourth ring is higher than that outside of the fourth ring road, and the accessibility near the south and north fifth ring road is higher than that of the east fifth ring road and the west fifth ring road. (2) The basic influencing factors of rail transit station accessibility include road density and functional mixing degree.
Evaluating Therapeutic Healthcare Environmental Criteria: Architectural Designers’ Perspectives
Authors: Cho Minjung
Published: January 2023

This study presents architectural designers’ perception of the importance of healthcare environmental criteria in the implementation of user-centered, therapeutic hospital design. Architectural designers with over three years of professional experience (N = 182) in South Korea were surveyed using an empirical questionnaire. The extensive interviews of 15 hospital design experts followed to interpret the survey results and discuss the barriers and suggestions for the successful delivery of therapeutic healthcare design practice. Among the 27 variables selected from the preliminary literature review, factor analyses revealed seven important therapeutic environmental criteria (i.e., management, interior design, spatial quality, service, nature and rest, ambient indoor comfort, and social program and space; χ2 = 1783.088, df = 300, p < 0.001). Analyses of variance revealed the level of importance among these criteria related to respondents’ personal and professional characteristics. Significant differences were found for the variables from the management, interior design, and spatial quality factors in relation to the respondents sex and age. For the successful delivery of therapeutic healthcare design, the design experts highlighted the implementation of evidence-based design practice that integrates local and international knowledge from various hospital users and multi-disciplinary specialists participating in the healthcare design process.
Influence of Coal Mining on Historical Buildings: Case Study in Shanxi
Authors: Sun Yingfeng , Zhu Shuaipeng , Peng Zhiqian , Yang Chunran , Zhou Biao , Wang Xiaoliang , Zhao Yixin
Published: January 2023

Numerous historical buildings exist in Shanxi Province, a major coal producing area in China, so there exist many overlapping areas between ancient wooden buildings and coal mining. Coal mining in overlapping areas will lead to surface subsidence, which will have an impact on historical buildings. Based on the distribution of historical buildings and the distribution and mining of coal resources in Shanxi Province, this paper concludes that the overlapping areas of coal mining and ancient wooden buildings in Shanxi Province are mainly concentrated in Changzhi City, and the Lu’an mining area in Changzhi City is selected as the research object. In addition, using the gray correlation analysis method, the surface subsidence coefficient, which characterizes the intensity of mining subsidence, is used as the reference sequence. Seven factors selected from the geological conditions and mining conditions of the Lu’an mining area are used as the comparison sequence to calculate the gray correlation between each influencing factor and the surface subsidence coefficient, and to obtain that geological factors such as the nature of the overlying rock layer, bedrock thickness and dip angle of the coal seam, and mining factors such as mining height, average mining depth and working face size largely determine the surface subsidence coefficient. The surface subsidence in the overlap area could largely be influenced by geological factors such as the nature of the overlying rock layer, bedrock thickness and coal seam inclination, and mining factors such as mining height, average mining depth and working face size. Finally, we investigate the possible effects of surface subsidence on ancient wooden buildings in the overlapping area with the surface subsidence and formation mechanism and propose technical measures to reduce the effects of surface subsidence due to coal mining on historical buildings in the overlapping area.
Benefits in Cardiac Function from a Remote Exercise Program in Children with Obesity
Authors: Mannarino Savina , Santacesaria Sara , Raso Irene , Garbin Massimo , Pipolo Andreana , Ghiglia Silvia , Tarallo Gabriele , De Silvestri Annalisa , Vandoni Matteo , Lucini Daniela , Carnevale Pellino Vittoria , Bernardelli Giuseppina , Gatti Alessandro , Rossi Virginia , Calcaterra Valeria , Zuccotti Gianvincenzo
Published: January 2023

Physical activity (PA) is a crucial factor in preventing and treating obesity and related complications. In this one-arm pre–post longitudinal prospective study, we evaluated the effects of a 12-week online supervised training program on cardiac morphology, function and blood pressure (BP) in children with obesity. The training program consisted of three sessions per week, each lasting 60 min. Advanced echocardiographic imaging (tissue Doppler and longitudinal strain analysis) was used to detect subclinical changes in heart function. Categorical variables were described as counts and percentages; quantitative variables as the mean and standard deviation (SD) as they were normally distributed (Shapiro–Wilks test). Pre–post comparisons were made with a paired t-test. A total of 27/38 (71%) enrolled patients (18M/9F, 11 ± 2 years) completed the training protocol and were considered in the analysis. At baseline, no hypertensive patient was noted; all echocardiographic variables were within the normal range. After training, we observed a significant reduction in BP parameters, including systolic BP values and Z-score, diastolic BP values, centiles and Z-score, and mean arterial pressure (all p < 0.05). Significant variations in echocardiographic interventricular septum (IVSd) thickness (p = 0.011), IVSd Z-score (p = 0.001), left ventricular (LV) end-diastolic diameter (p = 0.045), LV posterior wall thickness Z-score (p = 0.017), and LV global longitudinal strain (p = 0.016) were detected. No differences in LV diastolic function and right ventricular strain were noted. PA plays a decisive role in improving BP control and has benefits on left ventricle systolic function, representing a strategic approach to limit CV risk. Online exercise could be an excellent method of training in children with obesity.
Effect of Midwife-Provided Orientation of Birth Companions on Maternal Anxiety and Coping during Labor: A Stepped Wedge Cluster Randomized Control Trial in Eastern Uganda
Authors: Wanyenze Eva Wodeya , Nalwadda Gorrette K. , Byamugisha Josaphat K. , Muwanguzi Patience A. , Tumwesigye Nazarius Mbona
Published: January 2023

The study aimed to assess the effect of midwife-provided orientation of birth companions on maternal anxiety and coping during labor. A stepped wedge cluster randomized trial design was conducted among 475 participants (control n = 240), intervention n = 235) from four clusters. Midwives in the intervention period provided an orientation session for the birth companions on supportive labor techniques. Coping was assessed throughout labor and anxiety scores were measured after birth. Independent t-test and Chi-Square tests were used to assess the differences by study period. Anxiety scores were reduced among women in the intervention period (p = 0.001). The proportion of women able to cope during early active labor was higher during the intervention period (p = 0.031). Women in the intervention period had 80% higher odds of coping (p = 0.032) compared to those in the control period. Notable differences in anxiety and coping with labor were observed among first-time mothers, younger women, and when siblings provided support. Midwife-provided orientation of birth companions on labor support lowers maternal anxiety and improves coping during labor. Findings could inform the planning and development of policies for the implementation of the presence of birth companions in similar low-resource settings.
Using Co-Design to Explore New Trends in Future Kitchen Designs: An Exploratory Workshop Study of College Students in China
Authors: Xu Zhidiankui , Wu Yu , Bao Yixi , Li Jiawei , Zhou Zhengzhong
Published: January 2023

The current COVID-19 pandemic is exacerbating the challenges facing human society. The public is increasingly concerned about the health and well-being of individuals, families, and communities. To enhance human health and well-being, user expectations for the future need to be understood. The kitchen, a central area of a home, is closely related to healthy living. In this study, a series of seven exploratory workshops were held at a Chinese university using co-design to understand the expectations and thinking of Chinese college students about the future of kitchen design in terms of health and well-being. A methodological innovation was introduced in co-design workshops, where participants were asked to imagine, discuss, and sketch concepts together to stimulate creative design. A six-dimensional tentative model of future kitchen expectations, including 34 sub-themes, was constructed based on the data analysis to explore the expected characteristics of kitchens. These dimensions include intelligent technologies and interaction experiences, health and well-being, inclusivity and extensibility, ecosystem circulation and sustainability, emotional and meaningful experience, and spatial planning and aesthetic experience. The resulting model provides valuable insights into the expectations of future users, providing direction and systematic strategies for future kitchens along the six-dimensional characteristics. Future kitchens, if the younger generation is to adopt them, need to positively affect users’ lives and meet their health and well-being standards.
Creation and Validation of a Portuguese Version of the UCLA Scleroderma Clinical Trial Consortium Gastrointestinal Tract Instrument
Authors: Ferreira Pedro L. , Genrinho Inês , Santiago Tânia , Carones Adriana , Mazeda Carolina , Barcelos Anabela , Beirão Tiago , Costa Flávio , Santos Inês , Couto Maura , Rato Maria , Terroso Georgina , Monteiro Paulo
Published: January 2023

(1) Background: The UCLA GIT 2.0 questionnaire has been recognized as a feasible and reliable instrument to assess gastrointestinal (GI) symptoms in systemic sclerosis (SSc) patients and their impact on quality of life. The aim of this study was to create and validate UCLA GIT 2.0 for Portuguese patients with SSc. (2) Methods: A multi-center study was conducted enrolling SSc patients. UCLA GIT 2.0 was validated in Portuguese using reliability (internal consistency, item –total correlation, and reproducibility) and validity (content, construct, and criterion) tests. Criterion tests included EQ-5D and SF-36v2. Social–demographic and clinical data were collected. (3) Results: 102 SSc patients were included, 82.4% of them female, and with a mean sample age of 57.0 ± 12.5 years old. The limited form of SSc was present in 62% of the patients and 56.9% had fewer than five years of disease duration. Almost 60% presented with SSc-GI involvement with a negative impact on quality of life. The means for SF-36v2 were 39.3 ± 10.3 in the physical component summary and 47.5 ± 12.1 in the mental component summary. Total GI score, reported as mild in 57.8% of the patients, was highly reliable (ICC = 0.912) and the Cronbach’s alpha was 0.954. There was a high correlation between the total GI score and EQ-5D-5L and SF-36v2 scores. (4) Conclusion: The Portuguese version of UCLA GIT 2.0 showed good psychometric properties and can be used in research and clinical practice.
Comparing Virtual and Center-Based Cardiac Rehabilitation on Changes in Frailty
Authors: MacEachern Evan , Giacomantonio Nicholas , Theou Olga , Quach Jack , Firth Wanda , Abel-Adegbite Ifedayo , Kehler Dustin Scott
Published: January 2023

Many patients with cardiovascular disease (CVD) are frail. Center-based cardiac rehabilitation (CR) can improve frailty; however, whether virtual CR provides similar frailty improvements has not been examined. To answer this question, we (1) compared the effect of virtual and accelerated center-based CR on frailty and (2) determined if admission frailty affected frailty change and CVD biomarkers. The virtual and accelerated center-based CR programs provided exercise and education on nutrition, medication, exercise safety, and CVD. Frailty was measured with a 65-item frailty index. The primary outcome, frailty change, was analyzed with a two-way mixed ANOVA. Simple slopes analysis determined whether admission frailty affected frailty and CVD biomarker change by CR model type. Our results showed that admission frailty was higher in center-based versus virtual participants. However, we observed no main effect of CR model on frailty change. Results also revealed that participants who were frailer at CR admission observed greater frailty improvements and reductions in triglyceride and cholesterol levels when completing virtual versus accelerated center-based CR. Even though both program models did not change frailty, higher admission frailty was associated with greater frailty reductions and change to some CVD biomarkers in virtual CR.
Effects of Mindfulness-Based Cognitive Therapy on Major Depressive Disorder with Multiple Episodes: A Systematic Review and Meta-Analysis
Authors: Tseng Hui-Wen , Chou Fan-Hao , Chen Ching-Hsiu , Chang Yu-Ping
Published: January 2023

This study synthesizes the effect of mindfulness-based cognitive therapy (MBCT) on depression and suicidal ideation among patients with major depressive disorder (MDD). During treatment, patients with MDD may experience repeated episodes, negative counseling, and suicidal ideation, which can lead to further depression and ultimately affect quality of life. Recent studies have shown that MBCT can improve the level of depression and suicidal ideation in patients with MDD. A systematic review and meta-analysis of randomized controlled trials was conducted. The literature search for articles up to December 2021 was performed in the following electronic databases: Airiti Library, PsycINFO, CINAHL, Cochrane Library, PubMed/MEDLINE, ProQuest, and the Index of the Taiwan Periodical Literature System. Records were independently evaluated by two reviewers. Disagreements were resolved through consensus. The quality of study was evaluated using the Modified Jadad Scale score. A meta-analysis was performed using Review Manager Version 5.3.5 software with a random-effects model. Thirteen studies (1159 participants) investigating MBCT for patients with MDD were included. The MBCT sessions lasted 1.5–2.5 h and were delivered by therapists five times per week for 8 weeks. The meta-effects of MBCT among patients with MDD showed significant improvement in depression and suicidal ideation. Future research should evaluate the long-term effects of MBCT. MBCT is relatively convenient and effective for preventing and alleviating depression and suicidal ideation. Further research can provide detailed suggestions for effective MBCT implementation.
Effects of Face-to-Face and eHealth Blended Interventions on Physical Activity, Diet, and Weight-Related Outcomes among Adults: A Systematic Review and Meta-Analysis
Authors: Yang Min , Duan Yanping , Liang Wei , Peiris D. L. I. H. K. , Baker Julien Steven
Published: January 2023

An increasing number of studies are blending face-to-face interventions and electronic health (eHealth) interventions to jointly promote physical activity (PA) and diet among people. However, a comprehensive summary of these studies is lacking. This study aimed to synthesize the characteristics of blended interventions and meta-analyze the effectiveness of blended interventions in promoting PA, diet, and weight-related outcomes among adults. Following the PRISMA guidelines, PubMed, SPORTDiscus, PsycINFO, Embase, and Web of Science were systematically searched to identify eligible articles according to a series of inclusion criteria. The search was limited to English language literature and publication dates between January 2002 and July 2022. Effect sizes were calculated as standardized mean difference (SMD) for three intervention outcomes (physical activity, healthy diet, and weight-related). Random effect models were used to calculate the effect sizes. A sensitivity analysis and publication bias tests were conducted. Of the 1561 identified studies, 17 were eligible for the systematic review. Studies varied in participants, intervention characteristics, and outcome measures. A total of 14 studies were included in the meta-analyses. There was evidence of no significant publication bias. The meta-analyses indicated that the blended intervention could lead to a significant increase in walking steps (p < 0.001), total PA level (p = 0.01), and diet quality (p = 0.044), a significant decrease in energy intake (p = 0.004), weight (p < 0.001), BMI (p < 0.001), and waist circumferences (p = 0.008), but had no influence on more moderate-to-vigorous physical activity (MVPA) or fruit and vegetable intake among adults, compared with a control group. The study findings showed that blended interventions achieve preliminary success in promoting PA, diet, and weight-related outcomes among adults. Future studies could improve the blended intervention design to achieve better intervention effectiveness.
Proposing a New Conceptual Syndemic Framework for COVID-19 Vaccine Hesitancy: A Narrative Review
Authors: AlShurman Bara’ Abdallah , Butt Zahid Ahmad
Published: January 2023

Background: Discussions regarding syndemics have dominated research in recent years. Vaccine hesitancy has also been propelled to the forefront. In this narrative review, we aim to frame a novel syndemic framework to understand the interaction between vaccine hesitancy, COVID-19, and negative health outcomes. Methods: A non-systematic electronic search was conducted in PubMed and Google Scholar. Search criteria were limited to articles published between November 2019 and June 2022. Articles related to the COVID-19 syndemic and vaccine hesitancy were included. Results: Our review revealed that the adherence to COVID-19 regulations—although they were effective in preventing COVID-19 transmission, cases, and deaths—created a dynamically unstable ‘vicious cycle’ between undesirable health, economic, and social outcomes. The “accumulation” of complex stressors decreased individuals’ cognitive flexibility and hindered them from making decisions and getting vaccinated. Furthermore, it increased individuals’ risk of acquiring COVID-19, losing their employment, increasing poverty, and decreasing healthcare utilization. We illustrated how the amalgamation of sociodemographic and contextual factors associated with COVID-19 might impact people’s vaccine decisions, making them more hesitant toward COVID-19 vaccination. Failing to receive vaccinations increases the chances of COVID-19 transmission, hospitalization, and other negative health outcomes. Conclusions: Understanding the interaction between these factors is essential to provide policymakers with inspiration to set appropriate interventions for promoting COVID-19 vaccination acceptance to decrease the overall burden of pandemics.
Circulating Peptidome Is Strongly Altered in COVID-19 Patients
Authors: Baldanzi Gianluca , Purghè Beatrice , Ragnoli Beatrice , Sainaghi Pier Paolo , Rolla Roberta , Chiocchetti Annalisa , Manfredi Marcello , Malerba Mario
Published: January 2023

Whilst the impact of coronavirus disease 2019 (COVID-19) on the host proteome, metabolome, and lipidome has been largely investigated in different bio-fluids, to date, the circulating peptidome remains unexplored. Thus, the present study aimed to apply an untargeted peptidomic approach to provide insight into alterations of circulating peptides in the development and severity of SARS-CoV-2 infection. The circulating peptidome from COVID-19 severe and mildly symptomatic patients and negative controls was characterized using LC-MS/MS analysis for identification and quantification purposes. Database search and statistical analysis allowed a complete characterization of the plasma peptidome and the detection of the most significant modulated peptides that were impacted by the infection. Our results highlighted not only that peptide abundance inversely correlates with disease severity, but also the involvement of biomolecules belonging to inflammatory, immune-response, and coagulation proteins/processes. Moreover, our data suggested a possible involvement of changes in protein degradation patterns. In the present research, for the first time, the untargeted peptidomic approach enabled the identification of circulating peptides potentially playing a crucial role in the progression of COVID-19.
Pancreatic Cancer in Celiac Disease Patients—A Systematic Review and Meta-Analysis
Authors: Gromny Iga , Neubauer Katarzyna
Published: January 2023

Background: Celiac disease (CD) is an autoimmune enteropathy affecting approximately 1% of the population and is associated with an increased risk of enteropathy-associated T-cell lymphoma and small bowel adenocarcinoma, whereas the association between CD and other malignancies is unclear. Since pancreatic cancer (PC) remains one of the most lethal neoplasms and its incidence is increasing despite numerous ongoing research on diagnostic biomarkers and novel therapies, we aimed to investigate whether CD has an impact on the risk of PC. Material and Methods: We performed a systematic review of the literature published from January 2000 to March 2022 in two databases: Web of Science and Scopus and a meta-analysis of eligible studies. Results: Our search identified eight publications included in the systematic review. A total of five studies involving 47,941 patients, including 6399 CD patients with malignancies and 1231 PC cases were included in the meta-analysis and 221 cases of PC in CD patients with other cancers were recognized. The pooled OR for PC was 1.46 (95% CI 1.26–1.7) with significant heterogeneity (89.1%; p < 0.05), suggesting that CD patients with malignancies were at higher risk for PC. Conclusions: The association between CD and PC is uncertain. However, the results of the current meta-analysis may indicate an increased risk of PC in the group of patients with CD and other cancers. Further multicenter studies are warranted.
The Effect of Human Settlement Pedestrian Environment on Gait of Older People: An Umbrella Review
Authors: Xuan Changzheng , Zhang Bo , Jia Xiaohu
Published: January 2023

Older people are limited by the pedestrian environment in human settlements and are prone to travel difficulties, falls, and stumbles. Furthermore, we still lack systematic knowledge of the pedestrian environment affecting the gait of older people. The purpose of this review is to synthesize current evidence of effective human settlement pedestrian environments interfering with gait in older people. The systematic effects of the human settlement pedestrian environment on gait in older people are discussed. Databases such as Web of Science, Medline (via PubMed), Scopus, and Embase were searched for relevant studies up to June 2022. The literature was screened to extract relevant evidence from the included literature, assess the quality of the evidence, and analyze the systematic effects of the pedestrian environment on gait in older people. From the 4297 studies identified in the initial search, 11 systematic reviews or meta-analysis studies were screened, from which 18 environmental factors and 60 gait changes were extracted. After removing duplicate elements and merging synonymous features, a total of 53 relationships between environmental factors and gait change in older people were extracted: the main human settlement pedestrian environmental factors affecting gait change in older people in existing studies were indoor and outdoor stairs/steps, uneven and irregular ground, obstacles, walking path turns, vibration interventions, mechanical perturbation during gait, and auditory sound cues. Under the influence of these factors, older people may experience changes in the degree of cautiousness and conservatism of gait and stability, and their body posture performance and control, and muscle activation may also be affected. Factors such as ground texture or material, mechanical perturbations during gait, and vibration interventions stimulate older people’s understanding and perception of their environment, but there is controversy over the results of specific gait parameters. The results support that human settlements’ pedestrian environment affects the gait changes of older people in a positive or negative way. This review may likely contribute evidence-based information to aid communication among practitioners in public health, healthcare, and environmental construction. The above findings are expected to provide useful preference for associated interdisciplinary researchers to understand the interactions among pedestrian environments, human behavior, and physiological characteristics.
Environmental Dissemination of SARS-CoV-2 in a University Hospital during the COVID-19 5th Wave Delta Variant Peak in Castile-León, Spain
Authors: Gomes da Silva Priscilla , Gonçalves José , Torres Franco Andrés , Rodriguez Elisa , Diaz Israel , Orduña Domingo Antonio , Garcinuño Pérez Sonsoles , March Roselló Gabriel Alberto , Dueñas Gutiérrez Carlos Jesús , São José Nascimento Maria , Sousa Sofia I.V. , Garcia Encina Pedro , Mesquita João R.
Published: January 2023

The dominant SARS-CoV-2 Delta variant (B.1.617.2) became the main circulating variant among countries by mid 2021. Attention was raised to the increased risk of airborne transmission, leading to nosocomial outbreaks even among vaccinated individuals. Considering the increased number of COVID-19 hospital admissions fueled by the spread of the variant, with Spain showing the highest COVID-19 rates in mainland Europe by July 2021, the aim of this study was to assess SARS-CoV-2 environmental contamination in different areas of a University Hospital in the region of Castile-León, Spain, during the peak of the 5th wave of COVID-19 in the country (July 2021). Air samples were collected from sixteen different areas of the Hospital using a Coriolis® μ air sampler. Surface samples were collected in these same areas using sterile flocked plastic swabs. RNA extraction followed by a one-step RT-qPCR were performed for detection of SARS-CoV-2 RNA. Of the 21 air samples, only one was positive for SARS-CoV-2 RNA, from the emergency waiting room. Of the 40 surface samples, 2 were positive for SARS-CoV-2 RNA, both from the microbiology laboratory. These results may be relevant for risk assessment of nosocomial infection within healthcare facilities, thus helping prevent and minimize healthcare staff’s exposure to SARS-CoV-2, reinforcing the importance of always wearing appropriate and well-fit masks at all times and proper PPE when in contact with infected patients.