bluuebunny/crossref_metadata_2025 huggingface dataset:
Longitudinal Evaluation of the Effect of Tricyclic Antidepressants and Neuroleptics on the Course of Huntington’s Disease—Data from a Real World Cohort
Authors: Achenbach Jannis , Saft Carsten , Faissner Simon
Published: March 2021

Background: Reducing the progress of neurodegeneration is a key goal in Huntington´s disease (HD). A previously performed systematic screening for medications with neuroprotective features identified tricyclic antidepressants and neuroleptics as neuroprotective and mitochondrioprotective agents. Here, we analyzed the characteristics of disease manifestation, progression and potential beneficial effects in HD patients treated with afore-mentioned medications compared to un- and otherwise treated motor-manifest patients in a large real-world cohort over two years. Methods: We analyzed cross-sectional data of the largest cohort worldwide of motor-manifest HD patients using the ENROLL-HD database, including demographic, moleculargenetic, clinical-motoric, cognitive and functional data. Longitudinal data of up to two years were obtained to analyze potential effects on disease progression between groups with different medications used. Data were analyzed using repeated ANOVA-analyses while controlling for the co-variates age and CAG-repeat length. Results: We identified n = 7397 motor-manifest HD patients using no or different medication (HD-ctrl) and subgroups treated with clomipramine (n = 56), clozapine (n = 66), chlorpromazine (n = 17), doxepine (n = 34) and desi-, imi- or trimipramine (n = 19). Demographic parameters, disease onset and CAP-score did not differ. Total motor scores (TMS) at baseline were higher in patients treated with clozapine (p < 0.001), chlorpromazine and clomipramine (p < 0.05) compared to HD-ctrl with higher sub scores for bradykinesia (all p < 0.01) and dystonia in clozapine treated patients (p < 0.001). Functional and cognitive capacities were worse in medication groups in comparison to HD-ctrl at baseline (p < 0.001). Repeated measures analysis of variance documented no differences regarding motoric, functional and cognitive disease progressions between groups. Conclusions: We identified group differences, potentially caused by side effects or potential selection bias in terms of bradykinetic motoric symptoms, more dystonia and lower functional and cognitive performance in some treatment groups at baseline, which were not entirely explained because of underlying fundamental characteristics. Disease progression regarding clinical, functional and cognitive outcomes over two years was not affected by any of the treatment groups compared to HD-ctrl. Our data do not support our hypothesis of a potential neuroprotective effect of these drugs on disease progression.
MAIT Cells: Partners or Enemies in Cancer Immunotherapy?
Authors: Cogswell Dasha T. , Gapin Laurent , Tobin Heather M. , McCarter Martin D. , Tobin Richard P.
Published: March 2021

A recent boom in mucosal-associated invariant T (MAIT) cell research has identified relationships between MAIT cell abundance, function, and clinical outcomes in various malignancies. As they express a variety of immune checkpoint receptors and ligands, and possess strong cytotoxic functions, MAIT cells are an attractive new subject in the field of tumor immunology. MAIT cells are a class of innate-like T cells that express a semi-invariant T cell antigen receptor (TCR) that recognizes microbially derived non-peptide antigens presented by the non-polymorphic MHC class-1 like molecule, MR1. In this review, we outline the current (and often contradictory) evidence exploring MAIT cell biology and how MAIT cells impact clinical outcomes in different human cancers, as well as what role they may have in cancer immunotherapy.
Predicting the Risk of Metastases by PSMA-PET/CT—Evaluation of 335 Men with Treatment-Naïve Prostate Carcinoma
Authors: Koerber Stefan A. , Boesch Johannes , Kratochwil Clemens , Schlampp Ingmar , Ristau Jonas , Winter Erik , Zschaebitz Stefanie , Hofer Luisa , Herfarth Klaus , Kopka Klaus , Holland-Letz Tim , Jaeger Dirk , Hohenfellner Markus , Haberkorn Uwe , Debus Juergen , Giesel Frederik L.
Published: March 2021

Men diagnosed with aggressive prostate cancer are at high risk of local relapse or systemic progression after definitive treatment. Treatment intensification is highly needed for that patient cohort; however, no relevant stratification tool has been implemented into the clinical work routine so far. Therefore, the aim of the current study was to analyze the role of initial PSMA-PET/CT as a prediction tool for metastases. In total, 335 men with biopsy-proven prostate carcinoma and PSMA-PET/CT for primary staging were enrolled in the present, retrospective study. The number and site of metastases were analyzed and correlated with the maximum standardized uptake value (SUVmax) of the intraprostatic, malignant lesion. Receiver operating characteristic (ROC) curves were used to determine sensitivity and specificity and a model was created using multiple logistic regression. PSMA-PET/CT detected 171 metastases with PSMA-uptake in 82 patients. A statistically significant higher SUVmax was found for men with metastatic disease than for the cohort without distant metastases (median 16.1 vs. 11.2; p < 0.001). The area under the curve (AUC) in regard to predicting the presence of any metastases was 0.65. Choosing a cut-off value of 11.9 for SUVmax, a sensitivity and specificity (factor 1:1) of 76.0% and 58.4% was obtained. The current study confirms, that initial PSMA-PET/CT is able to detect a relatively high number of treatment-naïve men with metastatic prostate carcinoma. Intraprostatic SUVmax seems to be a promising parameter for the prediction of distant disease and could be used for treatment stratification—aspects which should be verified within prospective trials.
Association of Polygenetic Risk Scores Related to Cell Differentiation and Inflammation with Thyroid Cancer Risk and Genetic Interaction with Dietary Intake
Authors: Song Sang Shin , Huang ShaoKai , Park Sunmin
Published: March 2021

The incidence of thyroid cancer continues to increase steadily, and this increasing incidence cannot be attributed solely to the overdiagnosis of microcarcinoma or technical advancements in detection methods and may also depend on environmental and genetic factors. However, the impacts and interactions of genetic and environmental factors remain controversial, and they may differ in Eastern and Western countries. The study’s purpose was to identify single nucleotide polymorphisms of genes related to cell differentiation and inflammation to influence thyroid cancer incidence and determine interactions with lifestyles in a large city hospital-based cohort. Genetic variants were selected by genome-wide association study with thyroid cancer participants (case; n = 495) and controls without cancers (n = 56,439). SNPs having gene–gene interactions were selected by generalized multifactor dimensionality reduction. Polygenic risk scores (PRSs) were generated by summing the number of selected SNP risk alleles. PRSs of the best model included 6 SNPs, that is, DIRC3_rs6759952, GAP43_rs13059137, NRG1_rs7834206, PROM1_rs72616195, LRP1B_rs1369535, and LOC100507065_rs11175834. Participants with a high-PRS had a higher thyroid cancer risk by 3.9-fold than those with a low-PRS. The following variables were related to an increased thyroid cancer risk; female (OR = 4.21), high white blood cell count (OR = 4.03), and high energy (OR = 7.00), low alcohol (OR = 4.11), and high seaweed (OR = 4.02) intakes. These variables also interacted with PRS to influence thyroid cancer risk. Meat/noodle diet patterns interacted with PRSs to increase thyroid cancer risk (p = 0.0023). In conclusion, women with a high-PRS associated with cell differentiation and inflammation were at an elevated thyroid cancer risk. Daily energy, seaweeds, and alcohol intake interacted with PRS for thyroid cancer risk. These results could be applied to personalized nutrition plans to reduce the risk of thyroid cancer.
Socioeconomic Inequalities and Ethnicity Are Associated with a Positive COVID-19 Test among Cancer Patients in the UK Biobank Cohort
Authors: Lee Shing Fung , Nikšić Maja , Rachet Bernard , Sanchez Maria-Jose , Luque-Fernandez Miguel Angel
Published: March 2021

We explored the role of socioeconomic inequalities in COVID-19 incidence among cancer patients during the first wave of the pandemic. We conducted a case-control study within the UK Biobank cohort linked to the COVID-19 tests results available from 16 March 2020 until 23 August 2020. The main exposure variable was socioeconomic status, assessed using the Townsend Deprivation Index. Among 18,917 participants with an incident malignancy in the UK Biobank cohort, 89 tested positive for COVID-19. The overall COVID-19 incidence was 4.7 cases per 1000 incident cancer patients (95%CI 3.8–5.8). Compared with the least deprived cancer patients, those living in the most deprived areas had an almost three times higher risk of testing positive (RR 2.6, 95%CI 1.1–5.8). Other independent risk factors were ethnic minority background, obesity, unemployment, smoking, and being diagnosed with a haematological cancer for less than five years. A consistent pattern of socioeconomic inequalities in COVID-19 among incident cancer patients in the UK highlights the need to prioritise the cancer patients living in the most deprived areas in vaccination planning. This socio-demographic profiling of vulnerable cancer patients at increased risk of infection can inform prevention strategies and policy improvements for the coming pandemic waves.
Deep-Learning-Based Detection of Cranio-Spinal Differences between Skeletal Classification Using Cephalometric Radiography
Authors: Jeong Seung Hyun , Yun Jong Pil , Yeom Han-Gyeol , Kim Hwi Kang , Kim Bong Chul
Published: March 2021

The aim of this study was to reveal cranio-spinal differences between skeletal classification using convolutional neural networks (CNNs). Transverse and longitudinal cephalometric images of 832 patients were used for training and testing of CNNs (365 males and 467 females). Labeling was performed such that the jawbone was sufficiently masked, while the parts other than the jawbone were minimally masked. DenseNet was used as the feature extractor. Five random sampling crossvalidations were performed for two datasets. The average and maximum accuracy of the five crossvalidations were 90.43% and 92.54% for test 1 (evaluation of the entire posterior–anterior (PA) and lateral cephalometric images) and 88.17% and 88.70% for test 2 (evaluation of the PA and lateral cephalometric images obscuring the mandible). In this study, we found that even when jawbones of class I (normal mandible), class II (retrognathism), and class III (prognathism) are masked, their identification is possible through deep learning applied only in the cranio-spinal area. This suggests that cranio-spinal differences between each class exist.
An Attack on Zawadzki’s Quantum Authentication Scheme
Authors: González-Guillén Carlos E. , González Vasco María Isabel , Johnson Floyd , Pérez del Pozo Ángel L.
Published: March 2021

Identification schemes are interactive cryptographic protocols typically involving two parties, a prover, who wants to provide evidence of their identity and a verifier, who checks the provided evidence and decides whether or not it comes from the intended prover. Given the growing interest in quantum computation, it is indeed desirable to have explicit designs for achieving user identification through quantum resources. In this paper, we comment on a recent proposal for quantum identity authentication from Zawadzki. We discuss the applicability of the theoretical impossibility results from Lo, Colbeck and Buhrman et al. and formally prove that the protocol must necessarily be insecure. Moreover, to better illustrate our insecurity claim, we present an attack on Zawadzki’s protocol and show that by using a simple strategy an adversary may indeed obtain relevant information on the shared identification secret. Specifically, through the use of the principal of conclusive exclusion on quantum measurements, our attack geometrically reduces the key space resulting in the claimed logarithmic security being reduced effectively by a factor of two after only three verification attempts.
Dynamics of Ultracold Bosons in Artificial Gauge Fields—Angular Momentum, Fragmentation, and the Variance of Entropy
Authors: Lode Axel U. J. , Dutta Sunayana , Lévêque Camille
Published: March 2021

We consider the dynamics of two-dimensional interacting ultracold bosons triggered by suddenly switching on an artificial gauge field. The system is initialized in the ground state of a harmonic trapping potential. As a function of the strength of the applied artificial gauge field, we analyze the emergent dynamics by monitoring the angular momentum, the fragmentation as well as the entropy and variance of the entropy of absorption or single-shot images. We solve the underlying time-dependent many-boson Schrödinger equation using the multiconfigurational time-dependent Hartree method for indistinguishable particles (MCTDH-X). We find that the artificial gauge field implants angular momentum in the system. Fragmentation—multiple macroscopic eigenvalues of the reduced one-body density matrix—emerges in sync with the dynamics of angular momentum: the bosons in the many-body state develop non-trivial correlations. Fragmentation and angular momentum are experimentally difficult to assess; here, we demonstrate that they can be probed by statistically analyzing the variance of the image entropy of single-shot images that are the standard projective measurement of the state of ultracold atomic systems.
Robust Partial Feedback Linearized Controller Design for Standalone Hybrid PV-BES System
Authors: Mahmud Md Rasel , Pota Hemanshu
Published: March 2021

This paper presents a mixed-sensitivity-based robust H∞ loop-shaping partial feedback linearized control scheme to enhance the transient stability of a battery energy storage-associated standalone solar photovoltaic system. The proposed control scheme has been provided independent operating points for a generalized nonlinear dynamical model of DC microgrids connected standalone hybrid solar photovoltaic and battery energy storage system. A parametric uncertainty model is developed for the generalized dynamical model, and the noise disengaging merit of the proposed control technique has been investigated. The designed controller’s performance has been demonstrated under four different scenarios, and it is compared with the conventional PI controller for partial feedback linearized control law.
Examining Statistical Methods in Forecasting Financial Energy of Households in Poland and Taiwan
Authors: Korol Tomasz
Published: March 2021

This paper examines the usefulness of statistical methods in forecasting the financial energy of households. The study’s objective is to create the innovative ratios that combine both financial and demographic information of households and implement them in the forecasting models. To conduct this objective, six forecasting models are developed using three different methods—discriminant analysis, logit analysis, and decision trees separately for households in Poland and Taiwan. Such a research approach will answer the question whether the implementation of constructed ratios can increase effectiveness of the forecasting model and its’ versatility between different economic regions. The research relies on four samples of households—two learning samples and two testing samples (one for each country) consisting of 2400 households from both countries. This study is one of the first attempts in the literature globally to develop forecasting models based on ratios constructed with a combination of two different types of variables—one financial with one demographic variable. Findings confirm the high usability of the proposed innovative approach for forecasting the financial energy of households by taking into account a wide spectrum of diagnostic variables representing the financial strength of consumers.
A Low Power AC/DC Interface for Wind-Powered Sensor Nodes
Authors: Haidar Mohammad , Chible Hussein , Boragno Corrado , Caviglia Daniele D.
Published: March 2021

Sensor nodes have been assigned a lot of tasks in a connected environment that is growing rapidly. The power supply remains a challenge that is not answered convincingly. Energy harvesting is an emerging solution that is being studied to integrate in low power applications such as internet of things (IoT) and wireless sensor networks (WSN). In this work an interface circuit for a novel fluttering wind energy harvester is presented. The system consists of a switching converter controlled by a low power microcontroller. Optimization techniques on the hardware and software level have been implemented, and a prototype is developed for testing. Experiments have been done with generated input signals resulting in up to 67% efficiency for a constant voltage input. Other experiments were conducted in a wind tunnel that showed a transient output that is compatible with the target applications.
Radio Frequency Based Wireless Charging for Unsupervised Clustered WSN: System Implementation and Experimental Evaluation
Authors: Khalifeh Ala’ , Saadeh Mai , Darabkh Khalid A. , Nagaradjane Prabagarane
Published: March 2021

Wireless Charging (WC) is a promising technology that has recently attracted the research community and several companies. WC has a myriad of advantages and diverse applications especially in the emerging Internet of Things (IoT) and Wireless Sensor Networks (WSNs), where energy harvesting and conservation are very crucial to prolonging network lifetime. Several companies have launched WC products and solutions and made them available to the end-users. This paper provides experimental and practical insights about this technology utilizing off-the-shelf (commercially available) products provided by Powercast Inc.; a pioneering company that has made their wireless charging kits and solutions available to the research and academic communities. In addition, a theoretical study of this technology is presented, where a close match between the theoretical and practical results is demonstrated. This will in turn assist the learners and technology adopters to better understand the technology and adopt it in various application scenarios. Furthermore, the paper presents the potential of using WC in unsupervised clustered WSN, where the Cluster Head (CH) node is proposed to be a mobile Unmanned Ground Vehicle (UGV) equipped with a wireless charging station. The UGV position is chosen to be in the centroid of the cluster in order to ensure that wireless charging takes place in the context of the cluster nodes efficiently.
Time-Dependent Heat Transfer Calculations with Trefftz and Picard Methods for Flow Boiling in a Mini-Channel Heat Sink
Authors: Piasecka Magdalena , Hożejowska Sylwia , Maciejewska Beata , Pawińska Anna
Published: March 2021

The intensification of heat transfer using two-phase boiling flow in mini-channels is widely used to dissipate the high heat fluxes in miniaturized electronic devices. However, the process itself is not fully recognized and still requires experimental studies and developing computation methods appropriate for them. The main aim of this work was the mathematical modeling of time-dependent heat transfer process in FC-72 flow boiling in a mini-channel heat sink with five parallel mini-channels of 1 mm depth. Channels have an asymmetrically heated wall while its outer temperature was measured by infrared thermography. The opposite wall of the mini-channels was transparent, helping to record flow patterns due to a high-speed digital camera. The objective of the numerical calculations was to determine the heat transfer coefficient on the wall-fluid contact surface from the Robin boundary condition. The problem was solved using methods based on the Trefftz-type functions. Three mathematical methods were applied in calculations: the FEM with Trefftz type basis functions, the Classical Trefftz Method, and the Hybrid Picard-Trefftz Method. The results were compared with the values of the heat transfer coefficient obtained from theoretical correlations from the literature.
Valorization of Sicanaodorifera (Vell.) Naudin Epicarp as a Source of Bioactive Compounds: Chemical Characterization and Evaluation of Its Bioactive Properties
Authors: Albuquerque Bianca R. , Dias Maria Inês , Pereira Carla , Petrović Jovana , Soković Marina , Calhelha Ricardo C. , Oliveira M. Beatriz P. P. , Ferreira Isabel C. F. R. , Barros Lillian
Published: March 2021

Fruit bio-residues can be interesting for the recovery of bioactive molecules, such as phenolic compounds, tocopherols, vitamins, among others. These compounds can be targeted at the food industry and used for the development of functional foods or as food additives. In some cases, fruit epicarps are converted into by-products with non-commercial value, and generally, these fruit parts have a higher content in bioactive compounds than the fruit pulp. From this perspective, S. odorifera, a Brazilian fruit, has an inedible epicarp that could be explored to obtain biological compounds. Therefore, the aims of this study were to evaluate the chemical composition and the antioxidant, anti-proliferative, anti-inflammatory, and antimicrobial bioactivities of this by-product. S. odorifera epicarp showed a total of four organic acids, four phenolic compounds, highlighting the high concentration of anthocyanins (24 ± 1 mg/g dry weight (dw)) and high content of tocopherols (366 ± 2 mg/100 g dw). The hydroethanolic extract showed considerable antioxidant activity (EC50 values of 48.2 ± 0.5 and 27 ± 1 µg/mL for TBARS and OxHLIA assays, respectively), as also antibacterial and antifungal activities (minimal inhibitory concentrations (MICs) ≤ 2.2 mg/mL). The results obtained in this study suggest that Sicana odorifera epicarp represents a reliable option for the development of novel natural-based colorants with functional/bioactive proprieties.
Genome-Wide Identification of Genes Involved in Acid Stress Resistance of Salmonella Derby
Authors: Gu Dan , Xue Han , Yuan Xiaohui , Yu Jinyan , Xu Xiaomeng , Huang Yu , Li Mingzhu , Zhai Xianyue , Pan Zhiming , Zhang Yunzeng , Jiao Xinan
Published: March 2021

Resistance to and survival under acidic conditions are critical for Salmonella to infect the host. As one of the most prevalent serotypes identified in pigs and humans, how S. Derby overcomes acid stress remains unclear. Here, we de novo sequenced the genome of a representative S. Derby strain 14T from our S. Derby strain stock and identified its acid resistance-associated genes using Tn-seq analysis. A total of 35 genes, including those belonging to two-component systems (TCS) (cpxAR), the CRISPR-Cas system (casCE), and other systems, were identified as essential for 14T to survive under acid stress. The results demonstrated that the growth curve and survival ability of ΔcpxA and ΔcpxR were decreased under acid stress, and the adhesion and invasion abilities to the mouse colon cancer epithelial cells (MC38) of ΔcpxR were also decreased compared with the wild type strain, suggesting that the TCS CpxAR plays an essential role in the acid resistance and virulence of S. Derby. Also, CasC and CasE were found to be responsible for acid resistance in S. Derby. Our results indicate that acid stress induces multiple genes’ expression to mediate the acid resistance of S. Derby and enhance its pathogenesis during an infection.
Problematic Internet Use in Adolescents from Divorced Families: The Role of Family Factors and Adolescents’ Self-Esteem
Authors: van Dijk Rianne , van der Valk Inge E. , Vossen Helen G. M. , Branje Susan , Deković Maja
Published: March 2021

Family functioning is salient in explaining adolescents’ problematic internet use (PIU), and precisely this family functioning is under pressure after parental divorce. Moreover, growing up with divorced parents is identified as a risk factor for PIU. Therefore, examining which factors are associated with adolescents’ PIU after divorce is particularly important. Based on self-report data from N = 244 adolescents of divorced families (49.6% boys, M = 13.42), structural equation modeling (SEM) was used to examine the associations of PIU with interparental conflict, triangulation, maternal and paternal warmth, and adolescents’ self-esteem. Potential buffering effects of self-esteem were tested, as well as gender differences in associations. The results showed that more triangulation and less maternal warmth were related to higher levels of PIU, but these effects disappeared after adding self-esteem to the models. Adolescent self-esteem did not significantly buffer the effects of the different family factors on PIU, nor were there any significant gender differences in association. Hence, especially adolescents’ self-esteem seems to be a key aspect for PIU in adolescents from divorced families.
Insulin Resistance in Association with Thyroid Function, Psychoemotional State, and Cardiovascular Risk Factors
Authors: Kazukauskiene Nijole , Podlipskyte Aurelija , Varoneckas Giedrius , Mickuviene Narseta
Published: March 2021

Background: Individuals with insulin resistance (IR) have a high risk of diabetes or metabolic syndrome, and they are more likely to have depression. Furthermore, IR by itself is a major cardiovascular risk factor in healthy persons. Thus, we aimed to investigate IR in association with thyroid function, psychoemotional state, and cardiovascular risk factors among 45–84-year-old citizens of Palanga. Methods: A randomized epidemiological study was performed with 850 subjects. All participants were evaluated for sociodemographic, clinical, and cardiovascular risk factors and biochemical analysis. IR was evaluated by the homeostasis model assessment of IR (HOMA-IR). Results: All study participants were stratified into groups without IR (HOMA-IR ≤ 2.7) and with IR (HOMA-IR > 2.7). The analysis of parameters between the two study groups showed some statistically significant relationships between IR and cardiovascular risk factors. The predictable accuracy was presented using receiver performance characteristic curves for HOMA-IR scores in women and men separately. If the HOMA-IR score is higher than 3.45, individuals are significantly more likely to have type 2 diabetes mellitus (T2DM). Conclusions: An increase of fasting glucose and more frequent incidence of metabolic syndrome, diabetes, and cardiovascular diseases in subjects with IR are associated with the prevalence of cardiovascular risk factors. There was no significant association between thyroid function and HOMA-IR. HOMA-IR cut-offs could predict the presence of T2DM.
The Lived Experiences of Community Health Workers Serving in a Large-Scale Water, Sanitation, and Hygiene Intervention Trial in Rural Bangladesh
Authors: Rahman Mahbubur , Jahir Tania , Yeasmin Farzana , Begum Farzana , Mobashara Mosammot , Hossain Khobair , Khan Rizwana , Hossain Rezwana , Nizame Fosiul Alam , Jain Anika , Leontsini Elli , Unicomb Leanne , Luby Stephen P. , Winch Peter J.
Published: March 2021

Community health workers (CHWs) are key to implementing community-based health interventions and quality can be enhanced by better understanding their lived experiences. The WASH Benefits, Bangladesh trial engaged 540 female CHWs to promote varying health intervention packages. We report on factors influencing their lived experiences during the trial, to aid future recruitment, training and retention of CHWs. Nine focus groups and 18 in-depth interviews were conducted with CHWs. Focus groups and interviews were transcribed and thematic content analysis performed to summarize the results. All CHWs described experiencing positive working conditions and many benefits both socially and financially; these contributed to their retention and job satisfaction. Their honorarium was commonly applied towards their children’s education and invested for income generation. CHWs gained self-confidence as women, to move unaccompanied in the community and speak in public. They earned respect from the community and their family members who helped them manage their family obligations during work and were viewed as a resource for advice on health and social issues. Many participated in family decision-making from which they were previously excluded. Health programs should foster a positive experience among their CHWs to aid the recruitment, retention and development of this important human resource.
Contextualizing Evidence for Action on Diabetes in Low-Resource Settings—Project CEAD Part-II, Strengthening the Health System: A Mixed-Methods Study Protocol
Authors: Bernal-Soriano Mari Carmen , Barrera-Guarderas Francisco , Alonso-Jaquete Alfonso , Chilet-Rosell Elisa , Benazizi Ikram , Caicedo-Montaño Cintia , Márquez-Figueroa Mónica , Puig-García Marta , Lumbreras Blanca , Hernández-Aguado Ildefonso , Torres-Castillo Ana Lucía , Parker Lucy Anne
Published: March 2021

Diabetes is a major public health problem, increasingly affecting low- and middle-income countries. The project CEAD (Contextualizing Evidence for Action in Diabetes in low-resource settings) aims to evaluate the implementation of comprehensive diabetes care in two low-resource settings in Ecuador and to stimulate context-led health systems innovations to improve diabetes care and reduce inequity. The mixed-methods approach includes a 24-month retrospective study to assess the current level of implementation of comprehensive diabetes care and participants will be followed up prospectively for two years to assess changes in healthcare and clinical outcomes from the outset of the research. We will include individuals diagnosed with type-2 diabetes aged over 18 years, who are accessing diabetes care in health facilities in the study districts. Varied stakeholders (patients and family members, community members, healthcare workers and decision-makers) will interpret the underlying causes of the observed weaknesses and propose solutions to strengthen diabetes-related healthcare in focus group discussions (FG). A second set of FG will analyze perceived improvements in healthcare based on prospective cohort findings and consider the success/failure of any context-led innovations occurring throughout the research. Our study will demonstrate how evidence can be contextualized to stimulate local innovations and overcome weaknesses of diabetes-related healthcare in low resource settings.
Arterial Stiffness and Hemodynamics in Young Women: The Effects of Oral Contraceptive Intake and Physical Habits
Authors: Enea Carina , Laffetas Pernelle , Pichon Aurélien , Delpech Nathalie
Published: March 2021

Oral contraceptive (OC) intake seems to be associated with increased central hemodynamics and arterial stiffness. Conversely, physical activity (PA) is known to induce benefits on vascular structure and function, suggesting that the negative effects of the OC pill could be counterbalanced by regular PA. The aim of this cross-sectional study was to determine (1) whether OC intake in young women is associated with higher values of hemodynamic parameters and arterial stiffness and (2) whether these negative effects could be counterbalanced by regular physical activity. Forty-nine young healthy women (21.9 years ± 2.1) were recruited and divided into 4 groups, depending on their hormonal status (OC users: OC+ or non-OC users: OC−) and their physical habits (active/inactive). Assessments of central hemodynamics (central blood pressure, Aix75) and pulse wave velocity (PWV) were performed using applanation tonometry. cBP was higher in OC+ vs. OC−, while PWV was similar between these two groups. No interaction between physical activity and hormonal status was observed for any of these variables. Nevertheless, PWV was lower in young active women compared with age-matched inactive women, suggesting that the positive effect of regular physical exercise on the cardiovascular system is already visible in the first years of women’s adulthood, whatever the hormonal status.
Instrument Development and Validation to Assess Care Barriers for Patients in Saudi Arabia with Oral Clefts
Authors: Khogeer Layla , Helal Narmin , Basri Osama , Madani Sara , Basri Abeer , El-Houseiny Azza A.
Published: March 2021

The study objective was to construct and validate a tool to assess, measure, and evaluate the barriers and obstacles that patients with orofacial clefts (OFCs), and their families, face during treatment. The Effective Accessibility and Accommodation subscale, based on the translated Primary Care Assessment Survey and Primary Care Assessment Tool scales, was used as a reference for the questionnaire. A total of 165 parents from three main cleft referral centers in Saudi Arabia were interviewed. Questionnaire content validity was conducted by calculation of a content validity index for each item (I-CVI) as well as for the total scale (S-CVI). Reliability was tested using Cronbach’s alpha. Factor analysis and principal components analysis were performed to determine the factor structure of the instrument. The final questionnaire had nine items. Rating results showed both I-CVI and S-CVI scores of 1 and Cronbach’s alpha was 0.86. There were three factors (geographic accessibility, appointment availability and accessibility, and scheduling-related barriers) with eigenvalues above 1.00, which collectively accounted for 73% of the variance. In conclusion, this tool is valid and reliable to evaluate accessibility and barriers to care of patients with OFCs in Saudi Arabia.
Perceived Suicide Stigma and Associated Factors in Chinese College Students: Translation and Validation of the Stigma of Suicide Attempt Scale and the Stigma of Suicide and Suicide Survivors Scale
Authors: Wu Yang , Chen Zhenzhen , Batterham Philip J. , Han Jin
Published: March 2021

This study aims to translate and validate two perceived suicide stigma scales, including the Stigma of Suicide Attempt Scale (STOSA) and the Stigma of Suicide and Suicide Survivor Scale (STOSASS) into Chinese language, examining the factor structure, and assessing the correlation between suicide stigma and a series of variables. After translating and back translating the STOSA and STOSASS, an online survey was administrated to 412 college students in China. These two scales were tested for their dimensionality in a series of confirmatory factor analyses. A series of regression analyses were conducted to examine the factors that are associated with perceived and public suicide stigma, including demographics, psychological distress, suicidality, suicide exposure, and perceived entitativity of suicide ideators, decedents, and survivors. The results showed that the two translated scales, STOSA and STOSASS, were reliable (Cronbach’s α = 0.79~0.83) and valid in Chinese contexts and it can be treated as unidimensional scales. Suicidality, exposure to suicide, and perceived entitativity of suicide-related persons were significantly associated with higher endorsement of public suicide stigma (SOSS Stigma, p < 0.03), but not perceived stigma (STOSA, STOSASS). Higher levels of psychological distress were associated with both higher perceived and public suicide stigma (p < 0.05).
Experiences and Perceptions of Trans and Gender Non-Binary People Regarding Their Psychosocial Support Needs: A Systematic Review of the Qualitative Research Evidence
Authors: McCann Edward , Donohue Gráinne , Brown Michael
Published: March 2021

People who identify as trans and gender non-binary experience many challenges in their lives and more interest is being paid to their overall health and wellbeing. However, little is known about their experiences and perceptions regarding their distinct psychosocial needs. The aim of this systematic review is to critically evaluate and synthesize the existing research evidence relating to the unique psychological and social experiences of trans people and identify aspects that may help or hinder access to appropriate psychosocial interventions and supports. The PRISMA procedure was utilized. A search of relevant databases from January 2010 to January 2021 was undertaken. Studies were identified that involved trans people, and addressed issues related to their psychosocial needs. The search yielded 954 papers in total. Following the application of rigorous inclusion and exclusion criteria a total of 18 papers were considered suitable for the systematic review. Quality was assessed using the MMAT instrument. Following analysis, four themes were identified: (i) stigma, discrimination and marginalization (ii) trans affirmative experiences (iii) formal and informal supports, and (iv) healthcare access. The policy, education and practice development implications are highlighted and discussed. Future research opportunities have been identified that will add significantly to the body of evidence that may further the development of appropriate health interventions and supports to this population.
A Clinical Bridge between Family Caregivers and Older Adults: The Contribution of Patients’ Frailty and Optimism on Caregiver Burden
Authors: Sardella Alberto , Lenzo Vittorio , Alibrandi Angela , Catalano Antonino , Corica Francesco , Quattropani Maria C. , Basile Giorgio
Published: March 2021

The association between caregiver burden and the physical frailty of older adults has been the object of previous studies. The contribution of patients’ dispositional optimism on caregiver burden is a poorly investigated topic. The present study aimed at investigating whether older adults’ multidimensional frailty and optimism might contribute to the burden of their family caregivers. The Caregiver Burden Inventory was used to measure the care-related burden of caregivers. The multidimensional frailty status of each patient was evaluated by calculating a frailty index, and the revised Life Orientation Test was used to evaluate patients’ dispositional optimism. The study involved eighty family caregivers (mean age 64.28 ± 8.6) and eighty older patients (mean age 80.45 ± 7.13). Our results showed that higher frailty status and lower levels of optimism among patients were significantly associated with higher levels of overall burden and higher burden related to the restriction of personal time among caregivers. Patients’ frailty was additionally associated with caregivers’ greater feelings of failure, physical stress, role conflicts, and embarrassment. Understanding the close connection between patient-related factors and the burden of caregivers appears to be an actual challenge with significant clinical, social, and public health implications.
The Impact of Water Sanitation and Hygiene (WASH) Improvements on Hand Hygiene at Two Liberian Hospitals during the Recovery Phase of an Ebola Epidemic
Authors: Kanagasabai Udhayashankar , Enriquez Kayla , Gelting Richard , Malpiedi Paul , Zayzay Celina , Kendor James , Fahnbulleh Shirley , Cooper Catherine , Gibson Williamatta , Brown Rose , Nador Nadoris , Williams Desmond E. , Chiriboga David , Niescierenko Michelle
Published: March 2021

Fourteen years of civil war left Liberia with crumbling infrastructure and one of the weakest health systems in the world. The 2014–2015 Ebola virus disease (EVD) outbreak exposed the vulnerabilities of the Liberian health system. Findings from the EVD outbreak highlighted the lack of infection prevention and control (IPC) practices, exacerbated by a lack of essential services such as water, sanitation, and hygiene (WASH) in healthcare facilities. The objective of this intervention was to improve IPC practice through comprehensive WASH renovations conducted at two hospitals in Liberia, prioritized by the Ministry of Health (MOH). The completion of renovations was tracked along with the impact of improvements on hand hygiene (HH) practice audits of healthcare workers pre- and post-intervention. An occurrence of overall HH practice was defined as the healthcare worker practicing compliant HH before and after the care for a single patient encounter. Liberia Government Hospital Bomi (LGH Bomi) and St. Timothy Government Hospital (St. Timothy) achieved World Health Organization (WHO) minimum global standards for environmental health in healthcare facilities as well as Liberian national standards. Healthcare worker (HCW) overall hand hygiene compliance improved from 36% (2016) to 89% (2018) at LGH Bomi hospital and from 86% (2016) to 88% (2018) at St. Timothy hospital. Improved WASH services and IPC practices in resource-limited healthcare settings are possible if significant holistic WASH infrastructure investments are made in these settings.
Effect of 4 Weeks of Cervical Deep Muscle Flexion Exercise on Headache and Sleep Disorder in Patients with Tension Headache and Forward Head Posture
Authors: Choi Wonho
Published: March 2021

The purpose of this study was to investigate the effect of flexion exercise of the deep cervical muscles on headache and sleep disorders in patients with tension headaches and forward head posture. A total of 32 patients with tension headaches and forward head posture were randomly assigned to two groups: an experimental group (n = 16) and a control group (n = 16). The experimental group performed cervical deep muscle flexion exercises for 4 weeks, whereas the control group performed stretching exercises for the same period. The Henry Ford Hospital Headache Disability Inventory (HDI) was used for headache assessment, and the Korean version of the Pittsburgh Sleep Quality Index (PSQI-K) was used for sleep disorder assessment. The experimental group showed a significant reduction in both HDI and PSQI-K score after 4 weeks of intervention (p < 0.001), while no significant difference was found in the control group (p > 0.05). On comparing the experimental and control groups, we found a significant difference in changes in the HDI and PSQI-K between the groups (p < 0.05). The results indicate that flexion exercise of the deep cervical muscles in patients with tension headache and forward head posture will improve the quality of life and activities of daily life by mitigating headaches and sleep disorders.
Understanding the Environment for Health-Promoting Schools Policies in Nova Scotia: A Comprehensive Scan at the Provincial and Regional School Level
Authors: Graham-DeMello Anna , Yusuf Joshua , Kay-Arora Margaret , Hancock Friesen Camille L. , Kirk Sara F. L.
Published: March 2021

The World Health Organization has identified the school community as a key setting for health promotion efforts, laying out its priorities in the Health-Promoting Schools (HPS) framework. This framework offers a comprehensive approach that has been adopted in countries around the globe, with defining characteristics focused around the school curriculum and environment. Nova Scotia (NS) adopted the HPS framework at a provincial level in 2005, but it has been variably implemented. We aimed to identify, categorize, and broadly describe the environment for HPS policies in NS. Four iterative steps were employed: (1) a scan of government and regional school websites to identify publicly available policies; (2) consultations with provincial departments with respect to policy relevance and scope; (3) cross-comparison of policies by two reviewers; (4) compilation of policies into an online database. Seventy policies at the provincial level and 509 policies across eight public school regions were identified. Policies focusing on a ‘safe school environment’ were most common; those addressing mental health and well-being, physical activity, nutrition and healthy eating, and substance use were among those least commonly identified. This scan provides a comprehensive overview of HPS-relevant policies in NS, along with relative proportions and growth over time. Our findings suggest areas of policy action and inaction that may help or hinder the implementation of HPS principles and values.
Stock Market Liberalization and Corporate Green Innovation: Evidence from China
Authors: Zhang Yuming , Zhang Juanjuan , Cheng Zhang
Published: March 2021

Corporate green innovation is an effective way to achieve energy conservation and emission reduction. Enterprises’ willingness to pursue green innovation is increasingly affected by external factors. By using a quasi-natural experiment of China’s Stock Connect program, we investigate the impact of stock market liberalization on corporate green innovation. We find that stock market liberalization increases enterprises’ green innovation, especially for state-owned enterprises. We also find that stock market liberalization plays a stronger role in promoting the green invention patents of enterprises whose managers have overseas experience and enterprises in areas with a higher degree of openness. Our mechanism analysis suggests that stock market liberalization attracts the attention of securities analysts and increases managers’ focus on environmental protection, thereby promoting corporate green innovation. Our findings show that stock market liberalization plays an important role in the governance of firms’ non-financial behavior, which has important theoretical and practical implications.
Analysing the Impacts of Financial Support for Regional Suicide Prevention Programmes on Suicide Mortality Caused by Major Suicide Motives in Japan Using Statistical Government Data
Authors: Nakano Tomosuke , Hasegawa Toshiki , Okada Motohiro
Published: March 2021

To improve and plan regional suicide prevention programmes that utilise more cost-effective governmental financial support compared with previous programmes, the present study determined the effects of the amount of financial support provided for regional suicide prevention programmes, such as the Emergency Fund to Enhance Community-Based Suicide Countermeasures (EFECBSC), on the trends of suicide mortalities caused by six major suicide motives between 2009 and 2018, using forward multiple regression analysis. The ranking order of motives for male suicide was health, economy, family, employment, romance and school (in that order), whereas the ranking order for females was health, family, economy, romance, employment and school. Male suicide mortality caused by economy-related motives was significantly/inversely related to prefectural intervention programmes, whereas mortality caused by health-related motives was also significantly/inversely related to prefectural intervention programmes, but significantly/positively related to prefectural personal consultation support programmes. Contrary to males, female suicide mortality caused by health-related motives was significantly/inversely related to the municipal development programmes of leaders/listeners, whereas mortality caused by family- and school-related motives was significantly/positively related to prefectural and municipal telephone consultation support programmes, respectively. Contrary to our expectations, school-aged female suicide mortality caused by school-related motives was significantly/positively related to prefectural personal consultation support, enlightenment and municipal telephone consultation support programmes. These results indicate that Japanese regional suicide prevention programmes probably affect the suppression of male suicide mortality. However, these programmes are possibly ineffective, or at least partially, have an adverse effect, in regard to the suicide mortalities of female and school-aged populations. Therefore, we should work to improve regional suicide prevention programmes, making them more cost-effective and targeted towards female and school-aged populations in the future.