bluuebunny/crossref_metadata_2025 huggingface dataset:
Early vs. Late Gestational Diabetes: Comparison between Two Groups Diagnosed by Abnormal Initial Fasting Plasma Glucose or Mid-Pregnancy Oral Glucose Tolerance Test
Authors: Zaccara Tatiana Assuncao , Paganoti Cristiane Freitas , Mikami Fernanda C. Ferreira , Francisco Rossana P. Vieira , Costa Rafaela Alkmin
Published: October 2022

Gestational diabetes mellitus (GDM) is one of the most common complications in pregnancy. It may be diagnosed using a fasting plasma glucose (FPG) early in pregnancy (eGDM) or a 75-g oral glucose tolerance test (OGTT) (late GDM). This retrospective cohort of women with GDM presents data from 1891 patients (1004 in the eGDM and 887 in the late GDM group). Student’s t-test, chi-squared or Fisher’s exact test and the Bonferroni test for post hoc analysis were used to compare the groups. Women with eGDM had higher pre-pregnancy BMI, more frequent family history of DM, more frequent history of previous GDM, and were more likely to have chronic hypertension. They were more likely to deliver by cesarean section and to present an abnormal puerperal OGTT. Even though they received earlier treatment and required insulin more frequently, there was no difference in neonatal outcomes. Diagnosing and treating GDM is necessary to reduce complications and adverse outcomes, but it is still a challenge. We believe that women with eGDM should be treated and closely monitored, even though this may increase healthcare-related costs.
Wildfire Smoke Exposure during Pregnancy: A Review of Potential Mechanisms of Placental Toxicity, Impact on Obstetric Outcomes, and Strategies to Reduce Exposure
Authors: Basilio Emilia , Chen Rebecca , Fernandez Anna Claire , Padula Amy M. , Robinson Joshua F. , Gaw Stephanie L.
Published: October 2022

Climate change is accelerating the intensity and frequency of wildfires globally. Understanding how wildfire smoke (WS) may lead to adverse pregnancy outcomes and alterations in placental function via biological mechanisms is critical to mitigate the harms of exposure. We aim to review the literature surrounding WS, placental biology, biological mechanisms underlying adverse pregnancy outcomes as well as interventions and strategies to avoid WS exposure in pregnancy. This review includes epidemiologic and experimental laboratory-based studies of WS, air pollution, particulate matter (PM), and other chemicals related to combustion in relation to obstetric outcomes and placental biology. We summarized the available clinical, animal, and placental studies with WS and other combustion products such as tobacco, diesel, and wood smoke. Additionally, we reviewed current recommendations for prevention of WS exposure. We found that there is limited data specific to WS; however, studies on air pollution and other combustion sources suggest a link to inflammation, oxidative stress, endocrine disruption, DNA damage, telomere shortening, epigenetic changes, as well as metabolic, vascular, and endothelial dysregulation in the maternal-fetal unit. These alterations in placental biology contribute to adverse obstetric outcomes that disproportionally affect the most vulnerable. Limiting time outdoors, wearing N95 respirator face masks and using high quality indoor air filters during wildfire events reduces exposure to related environmental exposures and may mitigate morbidities attributable to WS.
Marital Status, Living Arrangements and Mortality at Older Ages in Chile, 2004–2016
Authors: Sandoval Moisés H. , Alvear Portaccio Marcela E.
Published: October 2022

The risk of mortality in old age is associated with marital status and living arrangements. There is still little knowledge about this in Latin America. Our objectives are to examine the association between marital status, living arrangements and mortality of older adults (>60 years) in Chile, and to test whether this association varies when demographic, socioeconomic and health factors are included. We used data from the Social Protection Survey, and mortality data were linked to the Civil Registry. We estimate a series of Poisson regression models. Our results show a clear association between marriage and longevity, since even controlling for demographic, socioeconomic and health factors, we found that separated or divorced, widowed, and unmarried people showed higher relative mortality compared to married people (IRR1.24, IRR1.33, IRR1.35, respectively). Considering only living arrangements, the results show that living alone, alone with children, with children and other relatives or in other arrangements is associated with higher mortality (IRR1.22, IRR1.27, IRR1.35, IRR1.35, respectively) compared to those living with their partners and children. However, considering marital status and living arrangements together, we find that survival among older adults was strongly associated with marital status. Marital status continues to be a direct measure of living arrangements among older adults in Chile.
Effects of the Feldenkrais Method as a Physiotherapy Tool: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
Authors: Berland Rémi , Marques-Sule Elena , Marín-Mateo José , Moreno-Segura Noemi , López-Ridaura Ana , Sentandreu-Mañó Trinidad
Published: October 2022

The Feldenkrais Method (FM) is based on the learning of alternative movement patterns, carried out in an active and conscious way, which may have therapeutic effects. The objective of this systematic review is to identify the populations and conditions for which the FM can be used in physiotherapy and to determine the intervention modalities. Research in PubMed, Cochrane and PEDro databases was performed. The PEDro scale was employed to assess the methodological quality. Meta-analyses (MA) were performed whenever populations and outcome measures were comparable in at least two studies. Sixteen studies were included. In elderly people, in three of the four selected trials, the FM group significantly improved gait, balance, mobility and quality of life. The MA showed significant differences between interventions in the Timed-Up-and-Go test [Cohen’s d = −1.14, 95% CI (−1.78, −0.49), p = 0.0006]. FM significantly improved pain, functional balance, and perceived exertion in three trials performed on subjects with cervical, dorsal, or shoulder pain. FM demonstrated improvements in pain, disability, quality of life and interoceptive awareness in the three trials performed in subjects with chronic low back pain. In multiple sclerosis, an improvement in functional capacity was observed in the two selected studies. The MA showed no significant differences between groups in the Function (p = 0.97) and Control (p = 0.82) dimensions of the Multiple Sclerosis Self-Efficacy Scale. In Parkinson’s disease, two studies showed significant effects on quality of life and functional tests. In conclusion, evidence shows that FM has therapeutic effects comparable to other physiotherapy techniques in patients with spine pain. In addition, improvements in mobility and balance were seen in the elderly and people with neurodegenerative diseases.
QFD-Based Research on Sustainable User Experience Optimization Design of Smart Home Products for the Elderly: A Case Study of Smart Refrigerators
Authors: Li Yongchuan , Ghazilla Raja Ariffin Raja , Abdul-Rashid Salwa Hanim
Published: October 2022

In the current situation of global aging, the current market shortage of age-appropriate smart home products and the recent epidemic have led to greater isolation of the elderly, seriously affecting their physical and mental health. In order to optimize the sustainable user experience of the elderly when using smart home products, this paper proposes a research method based on Quality Function Deployment (QFD) for the optimal design of user experience of smart home products for the elderly, taking the design of age-appropriate home smart refrigerators as an example. Firstly, based on the results of market research and user interviews, the requirements of smart refrigerators for the elderly are screened and integrated, and the Kano model is used to prioritize these needs, resulting in the identification of important features needed in smart refrigerators for the elderly. Secondly, based on QFD, user requirements are transformed into design requirements, and a quality house model is established to ascertain the degree of importance of each design requirement through user ratings so as to obtain the key requirements as the theoretical basis for the solution design. Finally, optional solutions are generated for concept evaluation based on PUGH concept selection, comparing the advantages and disadvantages of the solutions and recombining them into an evaluation to determine the best solution. The quantitative evaluation of the four solutions reveals that Solution A has the highest score of 117.358, followed by Solution D with 113.259, Solution B with 96.415, and Solution C with 85.511, which is the lowest. The scoring allows the best design solution to be selected and applied to product development. The results show that the introduction of the Kano model and PUGH concept selection into QFD can be effectively used as a research method for optimizing the user experience of smart refrigerators for the elderly, and a corresponding design strategy for sustainable user experience optimization is proposed. The method and strategy provide guidance for the innovative design of new smart home products.
A Bibliometric Analysis of High-Intensity Interval Training in Cardiac Rehabilitation
Authors: Liu Haitao , Liu Feiyue , Ji Haoyuan , Dai Zuanqin , Han Wenxiu
Published: October 2022

As global quality of life has improved, the risk factors for cardiovascular diseases have gradually increased in prevalence. People have consequently sought to improve their health through physical exercise. High-intensity interval training (HIIT) is a cardiac rehabilitation (CR) tool that has been of great interest for several years. However, its feasibility and safety remain controversial. This study aimed to explore hot research topics and new directions regarding the role of HIIT in CR and to describe the dynamic development of the field. We used the Web of Science Core Collection database to develop visualizations using CiteSpace software (v.6.1.R2). The number of articles published, institutional collaboration networks, author partnerships, and keyword co-occurrence and clustering were used to analyze the impact of HIIT on CR. Our results showed that Norway, Canada, and the United States were the most prominent contributors to this field. Articles by Nigam, A and Juneau, M had the highest number of citations. The Norwegian University of Science and Technology had performed the most in-depth research in this area. The European Journal of Preventive Cardiology had published the most articles. The United States had the highest number of publishing journals. Relevant issues focused on coronary artery disease, exercise capacity, heart failure, cardiorespiratory fitness, and physical activity. HIIT in heart transplantation may be at the forefront of research in this field and future studies should focus on this topic. HIIT-based CR can therefore improve the exercise capacity and quality of life of cardiovascular patients and improve patient compliance in a safe manner.
Maternal Parenting and Preschoolers’ Psychosocial Adjustment: A Longitudinal Study
Authors: Cucinella Nicla , Canale Rossella , Cavarretta Maria Valentina , Ingoglia Sonia , Iannello Nicolò Maria , Inguglia Cristiano
Published: October 2022

Previous research reported that positive parenting and parenting stress might impact children’s psychosocial adjustment. The current longitudinal study aimed at evaluating the associations over time between mothers’ positive parenting, their parenting stress, and their preschoolers’ social–emotional competence and emotional–behavioral difficulties. Participants were 53 Italian mothers, aged between 24 and 47 years (M = 35.30, SD = 5.28) at T0, and their children (females = 51%), aged between 3 and 6 years (M = 4.48, SD = 0.84) at T0. Mothers completed self-report scales at 2 time points (with a 2-year lag). An autoregressive cross-lagged model was tested that had a good fit to the data, χ2(6) = 3.37 ns, CFI = 1.00, RMSEA = 0.00. The results showed that maternal positive parenting at T0 negatively predicted maternal parenting stress at T1; maternal parenting stress at T0 negatively predicted children’s social–emotional competence at T1. Moreover, at each time point, children’s social–emotional competence was associated positively with maternal positive parenting and negatively with maternal parenting stress; children’s emotional–behavioral difficulties were positively associated with maternal parenting stress. The results confirm that interactions with mothers are fundamental for children’s psychosocial adjustment. Implications for research and practice aimed at reducing parenting stress and fostering positive parenting are discussed.
The Effectiveness of Sensory Adaptive Dental Environments to Reduce Corresponding Negative Behaviours and Psychophysiology Responses in Children and Young People with Intellectual and Developmental Disabilities: A Protocol of a Systematic Review and Meta-Analysis
Authors: Reynolds Kaitlyn , Chandio Navira , Chimoriya Ritesh , Arora Amit
Published: October 2022

People with Intellectual and Developmental Disabilities (IDDs) are disproportionately vulnerable to poorer oral health due to their complex needs specifically sensory processing difficulties. This leads to increased maladaptive behaviours and psychophysiology responses of dental anxiety amplified by the overstimulating aspects of the dental environment. Although, there is a growing body of evidence to suggest that sensory adaptions are an effective strategy for individuals with IDDs in a wide range of settings, there is a lack of high-quality evidence detailing the effectiveness in a dental setting. The objective of this review is to assess the effectiveness of sensory adaptive dental environments (SADE) to reduce dental anxiety, corresponding negative behaviours and psychophysiology responses in children and young people with IDDs. The systematic review will include all Randomized Controlled Trials (RCTs) that investigate the effectiveness of SADE compared to control (no intervention), waitlist or usual care (regular dental environment) to reduce dental anxiety and the corresponding negative behaviours and psychophysiology responses in children and young people (upto the ages of 24 years) with IDDs. This review will be conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Databases including MEDLINE (Ovid), The Cochrane Library, Embase, Google Scholar, Web of Science and OT Seeker will be searched using appropriate keywords. Additionally, citation searching will be conducted. Screening based on titles and abstracts will be done after de-duplication, followed by full-text reading for selection based on the inclusion criteria. Data extracted from the included studies will be tabulated and assessed for risk of bias. If applicable, a meta-analysis of the pooled data will be conducted. The review is registered with PROSPERO (CRD42022322083).
Reproductive Desire in Women Living with HIV/AIDS with Serodiscordant Partners
Authors: Souza Marise Ramos de , Guimarães Rafael Alves , Amaral Waldemar Naves do , Cunha Vanessa Elias da , Moura Brenner Dolis Marretto de , Barbosa Maria Alves , Brunini Sandra Maria
Published: October 2022

Objective: To estimate the prevalence and factors associated with reproductive desire in a sample of women living with HIV/AIDS (WLHA) with serodiscordant partners. Study design: Between September 2015 and August 2016, a cross-sectional study was conducted among 110 WLHA from HIV/AIDS treatment services and non-governmental organizations. An interview was conducted using a structured questionnaire to collect sociodemographic data, reproductive desire, and potential predictor variables. Poisson regression was used to analyze the factors associated with reproductive desire in the sample. Results: The prevalence of reproductive desire was 32.7% (95% Confidence Interval: % CI: 24.7–42.0%). In regression analysis, we observed an association between reproductive desire and the following variables: age < 30 years; relationship time < 2 years; reproductive desire for the partner; and absence of children. Conclusions: The prevalence of reproductive desire in the investigated sample was relatively high. Young age and reproductive desire for the partner were the main associated factors.
Epidemiological Patterns of Cannabis- and Substance- Related Congenital Uronephrological Anomalies in Europe: Geospatiotemporal and Causal Inferential Study
Authors: Reece Albert , Hulse Gary
Published: October 2022

Introduction. Recent reports linking prenatal and community cannabis exposure to elevated uronephrological congenital anomaly (UCA) rates (UCAR’s) raise the question of its European epidemiology given recent increases in community cannabinoid penetration there. Methods. UCAR data from Eurocat. Drug use data from European Monitoring Centre for Drugs and Drug Addiction. Income from World bank. Results. UCAR increased across Spain, Netherlands, Poland and France. UCAR’s and cannabis resin THC increased simultaneously in France, Spain, Netherlands and Bulgaria. At bivariate analysis all UCA’s were related to cannabis herb and resin THC concentrations. All UCAR’s were bivariately related to cannabis metrics ordered by median minimum E-value (mEV) as hypospadias > multicystic renal disease > bilateral renal agenesis > UCA’s > hydronephrosis > posterior urethral valve > bladder exstrophy/epispadias. At inverse probability weighted multivariable analysis terms including cannabis were significant for the following series of anomalies: UCA’s, multicystic renal disease, bilateral renal agenesis, hydronephrosis, congenital posterior urethral valves from P = 1.91 × 10−5, 2.61 × 10−8, 4.60 × 10−15, 4.60 × 10−15 and 2.66 × 10−10. At geospatial analysis the same series of UCA’s were significantly related to cannabis from P = 7.84 × 10−15, 7.72 × 10−5, 0.0023, 6.95 × 10−5, and 8.82 × 10−5. 45/51 (88.2%) of E-value estimates and 31/51 (60.8%) of mEV’s >9. Conclusion. Analysis confirms a close relationship between cannabis metrics and all seven UCA’s and fulfill formal criteria for quantitative causal inference. Given the exponential cannabinoid genotoxicity dose–response relationship results provide a powerful stimulus to constrain community cannabinoid exposure including protection of the food chain to preserve the genome and epigenome of coming generations.
The Assessment of Disability in Italy: The Laborious Procedure and Sharing of Objectives
Authors: Consolazio Giuseppe
Published: October 2022

The assessment of disability in Italy requires the support of a system entirely dedicated to forensic evaluative medicine, which, for years, has been associated with the National Social Security Institute (INPS). Its medical offices are daily engaged in evaluating applications submitted by citizens. Their examination takes place in two different ways in the various Italian regions: assessments carried out by the Local Health Authority (ASL) and controlled by the INPS; evaluations carried out entirely by the INPS only. The main problem observed, and not yet resolved, is the excess time taken to respond to a citizen’s request, especially in areas where the procedure retains the biphasic ASL–INPS modality. This phenomenon is exemplified by the presentation of cases of the INPS medical office of Iglesias (South Sardinia, Italy), which include a series of disability applications examined in the year 2021 from January to September. The most favourable feedback is a tested and shared path in the determination of judgments.
Safeguarding Children Subjected to Violence in the Family: Child-Centered Risk Assessments
Authors: Eriksson Maria , Broberg Anders G. , Hultmann Ole , Chawinga Emma , Axberg Ulf
Published: October 2022

Assessing risk, planning for safety and security, and aiding recovery for children subjected to violence in a family setting is a complex process. The aim of the article is to synthesize the current research literature about risks for children subjected to violence in the family and outline an empirical base for a holistic and practically usable model of risk assessments placing the individual child at the center. Such assessments need to recognize four different areas of risk: (1) child safety, i.e., known risk factors for severe and dangerous violence aimed at both adults and children and how they play out in the individual case; (2) the child’s response in situations with violence; (3) the child’s perspective, especially fear and feelings of powerlessness in situations with violence; (4) developmental risks, e.g., instability in the child’s situation and care arrangements, lack of a carer/parent as a “secure base” and “safe haven”, the child developing difficulties due to the violence (e.g., PTSD), problems in parents’ caring capacities in relation to a child with experiences of, and reactions to, violence, and lack of opportunities for the child to make sense of, and create meaning in relation to, experiences of violence. In addition to the four areas of risk, the article emphasizes the importance of assessing the need for immediate intervention and safety planning in the current situation as regards safety, the child’s responses, the child’s perspectives, and long-term developmental risks.
Measurement Properties of the Duke Activity Status Index in Arab Patients with Cardiovascular Disease
Authors: Albarrati Ali , Abdulghani Abeer H. , Aldhahi Monira I. , Nazer Rakan
Published: October 2022

The aim of the study was to examine the measurement properties of the Arabic version of the Duke Activity Status Index (DASI) in patients with cardiovascular disease (CVD). A sample of 100 Arab patients with CVD completed the Arabic version of the DASI and underwent an exercise stress test (EST) on the first visit, and the metabolic equivalent (MET) was obtained from each outcome measure. On the second visit, patients with CVD completed the Arabic version of the DASI along with the global rating of change scale (GRC). Reliability, including the internal consistency, test–retest reliability, and construct validity, were examined. Patients with CVD (86 males), mean (SD) age 54.98 (10.2) years, completed the study. The Cronbach’s alpha was 0.87, and the intraclass correlation coefficient (ICC2,1) was 0.93. The estimated MET and peak VO2 obtained from the DASI were correlated with the estimated MET and peak VO2 obtained from the EST (r = 0.58, r = 0.56, all p-values < 0.001). The Arabic version of the DASI is a simple, quick, reliable, and valid measure of functional capacity in Arabic-speaking patients with CVD. The DASI may serve as a screening tool for functional capacity in patients with CVD in clinical settings.
An Examination of Child Pedestrian Rule Compliance at Crosswalks around Parks in Montreal, Canada
Authors: Cloutier Marie-Soleil , Rafiei Mojgan , Desrosiers-Gaudette Lambert , AliYas Zeinab
Published: October 2022

This study aims to examine child pedestrian safety around parks by considering four rule-compliance measures: temporal, spatial, velocity and visual search compliance. In this regard, street crossing observations of 731 children were recorded at 17 crosswalks around four parks in Montreal, Canada. Information on child behaviors, road features, and pedestrian–vehicle interactions were gathered in three separate forms. Chi-square tests were used to highlight the individual, situational, behavioral and road environmental characteristics that are associated with pedestrian rule compliance. About half of our sampled children started crossing at the same time as the adults who accompanied them, but more rule violations were observed when the adult initiated the crossing. The child’s gender did not have a significant impact on rule compliance. Several variables were positively associated with rule compliance: stopping at the curb before crossing, close parental supervision, and pedestrian countdown signals. Pedestrian–car interaction had a mixed impact on rule compliance. Overall, rule compliance among children was high for each of our indicators, but about two-thirds failed to comply with all four indicators. A few measures, such as longer crossing signals and pedestrian countdown displays at traffic lights, may help to increase rule compliance and, ultimately, provide safer access to parks.
Associations between Maternal Polychlorinated Dibenzo-p-dioxin and Dibenzofuran Serum Concentrations and Pulse Pressure in Early Pregnancy: A Cross-Sectional Study
Authors: Liu Xiaofang , Cao Wencheng , Liu Xiao , Zhou Yan , Wen Sheng
Published: October 2022

Pulse pressure (PP) is the difference between systolic blood pressure (SBP) and diastolic blood pressure (DBP), and an independent predictor of cardiovascular risk. Previous research suggests, with different conclusions, that exposure to polychlorinated dibenzo-p-dioxins and dibenzofurans (PCDD/Fs) could affect blood pressure (BP). We conducted a cross-sectional study to determine the association of dioxin exposure with PP in early pregnancy. A total of 305 pregnant women in early pregnancy in Yingcheng, China, recruited from May 2018 to February 2021, were included in this study. We measured 17 congeners of PCDD/Fs in maternal serum via high-resolution gas chromatography tandem high-resolution mass spectrometry. A generalized linear regression model was used to analyze the influencing factors of dioxin exposure and their relationships with PP. The levels of total PCDD/Fs (∑PCDD/Fs) ranged from 163.52 pg/g lipid to 1,513,949.52 pg/g lipid, with a mean of 10,474.22 pg/g lipid. The mean toxicity equivalent (TEQ) of total PCDD/Fs (∑TEQ-PCDD/Fs) was 42.03 pg/g lipid. The ratio of tetrachlorinated to octa-chlorinated congeners in maternal serum was enriched with an increasing number of chlorines. Pregnant women with college and above education had higher concentrations of ∑PCDD/Fs than those with education levels of junior high school and below (β = 0.34, 95% CI: 0.01, 0.67). The adjusted model for ∑TEQ-PCDD/Fs was significantly and negatively associated with PP (β = −1.79, 95% CI: −2.91, −0.68). High levels of dioxins were found in this area, and exposure to dioxins may affect the PP of women in early pregnancy, with health risks.
Characterizing Carbon Emissions and the Associations with Socio-Economic Development in Chinese Cities
Authors: Shen Zijie , Xin Liguo
Published: October 2022

Reducing carbon emissions in cities is crucial for addressing climate change, while the city-level emissions of different compositions and their relationships with socio-economic features remain largely unknown in China. Here, we explored the city-level emission pattern from the industrial, transportation, and household sectors and the emission intensity, as well as their associations with socio-economic features in China, using the up-to-date (2020) CO2 emissions based on 0.1° grid (10 × 10 km) emission data. The results show that: (1) CO2 emissions from the industrial sector were considerably dominant (78%), followed by indirect (10%), transportation (8%), and household (2%) emissions on the national scale; (2) combining total emissions with emission intensity, high emission–high intensity cities, which are the most noteworthy regions, were concentrated in the North, while low emission–low intensity types mainly occurred in the South-West; (3) cities with a higher GDP tend to emit more CO2, while higher-income cities tend to emit less CO2, especially from the household sector. Cities with a developed economy, as indicated by GDP and income, would have low emissions per GDP, representing a high emission efficiency. Reducing the proportion of the secondary sector of the economy could significantly decrease CO2 emissions, especially for industrial cities. Therefore, the carbon reduction policy in China should focus on the industrial cities in the North with high emission–high intensity performance. Increasing the income and proportion of the tertiary industry and encouraging compact cities can effectively reduce the total emissions during the economic development and urbanization process.
A Mobile Application-Based Relational Agent as a Health Professional for COVID-19 Patients: Design, Approach, and Implications
Authors: Chaudhry Beenish Moalla , Islam Ashraful
Published: October 2022

Relational Agents’ (RAs) ability to maintain socio-emotional relationships with users can be an asset to COVID-19 patients. The goal of this research was to identify principles for designing an RA that can act as a health professional for a COVID-19 patient. We first identified tasks that such an RA can provide by interviewing 33 individuals, who had recovered from COVID-19. The transcribed interviews were analyzed using qualitative thematic analysis. Based on the findings, four sets of hypothetical conversations were handcrafted to illustrate how the proposed RA will execute the identified tasks. These conversations were then evaluated by 43 healthcare professionals in a qualitative study. Thematic analysis was again used to identify characteristics that would be suitable for the proposed RA. The results suggest that the RA must: model clinical protocols; incorporate evidence-based interventions; inform, educate, and remind patients; build trusting relationships, and support their socio-emotional needs. The findings have implications for designing RAs for other healthcare contexts beyond the pandemic.
A Case Series of SARS-CoV-2 Reinfection in Elite Athletes
Authors: Fülöp Gábor Áron , Lakatos Bálint , Ruppert Mihály , Kovács Attila , Juhász Vencel , Dér Gábor , Tállay András , Vágó Hajnalka , Kiss Boldizsár , Merkely Béla , Zima Endre
Published: October 2022

Objectives: The actual frequency and the risk factors of SARS-CoV-2 reinfection is still a matter of intense scientific discussion. In this case series, we report three elite athletes who underwent COVID-19 reinfection with a short time frame. Case presentations: As a part of contact tracing, three speed skaters (22-, 24-, and 29-year-old males) were found to be SARS-CoV-2 positive by polymerase chain reaction (PCR) tests. Later on, only one of the athletes experienced mild symptoms, such as fatigue, loss of smell and taste and subfebrility, while the other two athletes were asymptomatic. Following the quarantine period, detailed return-to-play examinations, including laboratory testing, ECG, 24-h Holter monitoring, transthoracic echocardiography and cardiac magnetic resonance imaging, revealed no apparent abnormality; therefore, the athletes restarted training. After a median of 74 days, all three athletes presented with typical symptoms of COVID-19, such as fever, marked fatigue and headache. SARS-CoV-2 PCR tests were performed again, showing recurrent positivity. Repeated return-to-play assessments were initiated, finding no relevant abnormality. Athletes were also tested for SARS-CoV-2 anti-nucleoprotein antibody titers, showing only modest increases following the second infection. Conclusions: We report a small cluster of elite athletes who underwent a PCR-proven SARS-CoV-2 reinfection. According to these findings, athletes may be considered as a high-risk group in terms of recurrent COVID-19.
Glycemic and Insulinemic Responses of Healthy Humans to a Nutrition Bar with or without Added Fibersym® RW, a Cross-Linked Phosphorylated RS4-Type Resistant Wheat Starch
Authors: Steele Trevor J. , Steele Catherine C. , Maningat Clodualdo C. , Seib Paul A. , Haub Mark D. , Rosenkranz Sara K.
Published: October 2022

The current study compared postprandial glycemic and insulinemic responses to four nutrition bars containing two different doses of resistant starch type-4. Normoglycemic adults (n = 17) completed six treatments, consuming either 50 g or 30 g digestible carbohydrate as: dextrose beverages (DEX), control puffed wheat bars (PWB), or RS4 test bars (RS4). Glucose (mg/dL) and insulin (µIU/mL) were measured at baseline and 10, 20, 30, 60, 90, and 120 min. There was a main effect of dose and treatment on glucose incremental area under the curve (iAUC, ps < 0.001), such that RS4 (50 g: 941, 95% confidence interval (CI): 501, 1519; 30 g: 481, 95% CI: 186, 914) was lower than PWB (50 g: 1746, 95% CI: 1109, 2528; 30 g: 693, 95% CI: 331, 1188) and DEX (50 g: 1940, 95% CI: 1249, 2783; 30 g:1432, 95% CI: 883, 2114). There was a main effect of dose and treatment on insulin iAUC (ps < 0.001), such that RS4 (50 g: 1993, 95% CI: 1347, 2764; 30 g: 943, 95% CI: 519, 1493) was lower than PWB (50 g: 3501, 95% CI: 2625, 4502; 30 g: 1789, 95% CI: 1193, 256) and DEX (50 g: 3143, 95% CI: 2317, 4095; 30 g: 2184, 95% CI: 1519, 2970). Results demonstrate significantly lower glycemic and insulinemic responses following consumption of nutrition bars containing RS4, regardless of dose, when compared with puffed wheat bars and dextrose.
Inland Waterways and Population Health and Wellbeing: A Cross-Sectional Study of Waterway Users in the UK
Authors: Afentou Nafsika , Moore Patrick , Hull Katrina , Shepherd Jenny , Elliott Stephanie , Frew Emma
Published: October 2022

Natural environments, such as inland waterways (IWs), have been identified as a potential means to increase physical activity and promote health and wellbeing. However, further information on predictors of IW usage and their relationship with health and wellbeing outcomes is needed. Data were taken from the cross-sectional UK Waterways Engagement Monitor survey of waterway users (n = 21,537) in 2019/2020. Health outcome measures were life satisfaction, physical activity, and mental wellbeing. Visit frequency was an additional outcome measure. Both bivariate and multivariable associations between outcome measures and features of IWs were explored. The travel-cost method was used to estimate users’ demand, expressed by travel costs to waterways. Multivariable models showed positive associations of frequent visits and use for recreational/leisure purposes with life satisfaction and physical activity. Rural visits were associated with higher life satisfaction than urban ones. Lower visit satisfaction negatively impacted life satisfaction and mental wellbeing. Visit frequency was influenced by individual characteristics and purpose of visit, including visits for exercise. Waterway visits were inversely associated with travel costs (IRR = 0.99, p-value ≤ 0.001), and there was greater demand elasticity for short distances (≤5 miles). Socioeconomic-related inequalities were present. Future policies could enhance frequent use of waterways and alleviate accessibility-related inequalities to improve population health outcomes.
Role of Perception, Health Beliefs, and Health Knowledge in Intentions to Receive Health Checkups among Young Adults in Korea
Authors: Cho Mi-Kyoung , Cho Yoon-Hee
Published: October 2022

Regular health checkups allow early treatment when problems occur and prevent disease progression, but the rate of health checkups among young adults is low. This study aimed to investigate the factors affecting the intentions to receive health checkups among young adults in their 20s in Korea. The study design was a descriptive cross-sectional study and examined their intentions to receive health checkups, their health beliefs (perceived sensitivity, perceived severity, perceived benefit, perceived barrier, cue to action, self-efficacy), their attitude toward health checkups, and their knowledge of health checkups. The participants were 252 adults in their 20s in South Korea who were eligible for national health checkups. The intentions to receive check-ups model identified five variables, including sex, perceived sensitivity, cue to action, self-efficacy, and attitudes toward health checkups, were as significant influencing factors for the intentions to receive health checkups with 51.0% explanatory power (F = 53.18, p < 0.001). Different approaches must be adopted according to past experiences with health checkups when attempting to improve the intentions to receive health checkups in young adults.
Recruiting and Engaging Women of Reproductive Age with Obesity: Insights from A Mixed-Methods Study within A Trial
Authors: Killeen Sarah Louise , Byrne David F. , Geraghty Aisling A. , Yelverton Cara A. , van Sinderen Douwe , Cotter Paul D. , Murphy Eileen F. , O’Reilly Sharleen L. , McAuliffe Fionnuala M.
Published: October 2022

Engaging women with obesity in health-related studies during preconception is challenging. Limited data exists relating to their participation. The aim of this study is to explore the experiences and opinions of women participating in a weight-related, preconception trial. This is an explanatory sequential (quan-QUAL) mixed-methods Study Within A Trial, embedded in the GetGutsy randomized controlled trial (ISRCTN11295995). Screened participants completed an online survey of eight questions (single or multiple choice and Likert scale) on recruitment, motivations and opinions on study activities. Participants with abdominal obesity (waist circumference ≥ 80 cm) were invited to a subsequent semi-structured, online focus group (n = 2, 9 participants) that was transcribed and analyzed using inductive thematic analysis, with a pragmatic epistemological approach. The survey (n = 102) showed the main research participation motivations were supporting health research (n = 38, 37.3%) and wanting health screening (n = 30, 29.4%). Most participants were recruited via email (n = 35, 34.7%) or social media (n = 15, 14.7%). In the FGs, participants valued flexibility, convenience and. research methods that aligned with their lifestyles. Participants had an expanded view of health that considered emotional well-being and balance alongside more traditional medical assessments. Clinical trialists should consider well-being, addressing the interconnectedness of health and incorporate a variety of research activities to engage women of reproductive age with obesity.
Public Discourse Surrounding Suicide during the COVID-19 Pandemic: An Unsupervised Machine Learning Analysis of Twitter Posts over a One-Year Period
Authors: Lim Shu Rong , Ng Qin Xiang , Xin Xiaohui , Lim Yu Liang , Boon Evelyn Swee Kim , Liew Tau Ming
Published: October 2022

Many studies have forewarned the profound emotional and psychosocial impact of the protracted COVID-19 pandemic. This study thus aimed to examine how individuals relate to suicide amid the COVID-19 pandemic from a global perspective via the public Twitter discourse around suicide and COVID-19. Original Twitter tweets from 1 February 2020 to 10 February 2021 were searched, with terms related to “COVID-19”, “suicide”, or “self-harm”. An unsupervised machine learning approach and topic modelling were used to identify topics from unique tweets, with each topic further grouped into themes using manually conducted thematic analysis by the study investigators. A total of 35,904 tweets related to suicide and COVID-19 were processed into 42 topics and six themes. The main themes were: (1) mixed reactions to COVID-19 public health policies and their presumed impact on suicide; (2) biopsychosocial impact of COVID-19 pandemic on suicide and self-harm; (3) comparing mortality rates of COVID-19, suicide, and other leading causes of death; (4) mental health support for individuals at risk of suicide; (5) reported cases and public reactions to news related to COVID-19, suicide, and homicide; and (6) figurative usage of the word suicide. The general public was generally concerned about governments’ responses as well as the perturbing effects on mental health, suicide, the economy, and at-risk populations.
Inhibition of Viral RNA-Dependent RNA Polymerases by Nucleoside Inhibitors: An Illustration of the Unity and Diversity of Mechanisms
Authors: Barik Sailen
Published: October 2022

RNA-dependent RNA polymerase (RdRP) is essential for the replication and expression of RNA viral genomes. This class of viruses comprise a large number of highly pathogenic agents that infect essentially all species of plants and animals including humans. Infections often lead to epidemics and pandemics that have remained largely out of control due to the lack of specific and reliable preventive and therapeutic regimens. This unmet medical need has led to the exploration of new antiviral targets, of which RdRP is a major one, due to the fact of its obligatory need in virus growth. Recent studies have demonstrated the ability of several synthetic nucleoside analogs to serve as mimics of the corresponding natural nucleosides. These mimics cause stalling/termination of RdRP, or misincorporation, preventing virus replication or promoting large-scale lethal mutations. Several such analogs have received clinical approval and are being routinely used in therapy. In parallel, the molecular structural basis of their inhibitory interactions with RdRP is being elucidated, revealing both traditional and novel mechanisms including a delayed chain termination effect. This review offers a molecular commentary on these mechanisms along with their clinical implications based on analyses of recent results, which should facilitate the rational design of structure-based antiviral drugs.
Treadmill Exercise Reduces Neuroinflammation, Glial Cell Activation and Improves Synaptic Transmission in the Prefrontal Cortex in 3 × Tg-AD Mice
Authors: Mu Lianwei , Xia Dongdong , Cai Jiajia , Gu Boya , Liu Xiaojie , Friedman Vladislav , Liu Qing-Song , Zhao Li
Published: October 2022

Physical exercise improves memory and cognition in physiological aging and Alzheimer’s disease (AD), but the mechanisms remain poorly understood. Here, we test the hypothesis that Aβ oligomer accumulation, neuroinflammation, and glial cell activation may lead to disruption of synaptic transmission in the prefrontal cortex of 3 × Tg-AD Mice, resulting in impairment of learning and memory. On the other hand, treadmill exercise could prevent the pathogenesis and exert neuroprotective effects. Here, we used immunohistochemistry, western blotting, enzyme-linked immunosorbent assay, and slice electrophysiology to analyze the levels of GSK3β, Aβ oligomers (Aβ dimers and trimers), pro-inflammatory cytokines (IL-1β, IL-6, and TNFα), the phosphorylation of CRMP2 at Thr514, and synaptic currents in pyramidal neurons in the prefrontal cortex. We show that 12-week treadmill exercise beginning in three-month-old mice led to the inhibition of GSK3β kinase activity, decreases in the levels of Aβ oligomers, pro-inflammatory cytokines (IL-1β, IL-6, and TNFα), and the phosphorylation of CRMP2 at Thr514, reduction of microglial and astrocyte activation, and improvement of excitatory and inhibitory synaptic transmission of pyramidal neurons in the prefrontal cortex of 3 × Tg-AD Mice. Thus, treadmill exercise reduces neuroinflammation, glial cell activation and improves synaptic transmission in the prefrontal cortex in 3 × Tg-AD mice, possibly related to the inhibition of GSK3β kinase activity.
Inflammation in Pulmonary Hypertension and Edema Induced by Hypobaric Hypoxia Exposure
Authors: El Alam Samia , Pena Eduardo , Aguilera Diego , Siques Patricia , Brito Julio
Published: October 2022

Exposure to high altitudes generates a decrease in the partial pressure of oxygen, triggering a hypobaric hypoxic condition. This condition produces pathophysiologic alterations in an organism. In the lung, one of the principal responses to hypoxia is the development of hypoxic pulmonary vasoconstriction (HPV), which improves gas exchange. However, when HPV is exacerbated, it induces high-altitude pulmonary hypertension (HAPH). Another important illness in hypobaric hypoxia is high-altitude pulmonary edema (HAPE), which occurs under acute exposure. Several studies have shown that inflammatory processes are activated in high-altitude illnesses, highlighting the importance of the crosstalk between hypoxia and inflammation. The aim of this review is to determine the inflammatory pathways involved in hypobaric hypoxia, to investigate the key role of inflammation in lung pathologies, such as HAPH and HAPE, and to summarize different anti-inflammatory treatment approaches for these high-altitude illnesses. In conclusion, both HAPE and HAPH show an increase in inflammatory cell infiltration (macrophages and neutrophils), cytokine levels (IL-6, TNF-α and IL-1β), chemokine levels (MCP-1), and cell adhesion molecule levels (ICAM-1 and VCAM-1), and anti-inflammatory treatments (decreasing all inflammatory components mentioned above) seem to be promising mitigation strategies for treating lung pathologies associated with high-altitude exposure.
Non-Reproducibility of Oral Rotenone as a Model for Parkinson’s Disease in Mice
Authors: Niederberger Ellen , Wilken-Schmitz Annett , Manderscheid Christine , Schreiber Yannick , Gurke Robert , Tegeder Irmgard
Published: October 2022

Oral rotenone has been proposed as a model for Parkinson’s disease (PD) in mice. To establish the model in our lab and study complex behavior we followed a published treatment regimen. C57BL/6 mice received 30 mg/kg body weight of rotenone once daily via oral administration for 4 and 8 weeks. Motor functions were assessed by RotaRod running. Immunofluorescence studies were used to analyze the morphology of dopaminergic neurons, the expression of alpha-Synuclein (α-Syn), and inflammatory gliosis or infiltration in the substantia nigra. Rotenone-treated mice did not gain body weight during treatment compared with about 4 g in vehicle-treated mice, which was however the only robust manifestation of drug treatment and suggested local gut damage. Rotenone-treated mice had no deficits in motor behavior, no loss or sign of degeneration of dopaminergic neurons, no α-Syn accumulation, and only mild microgliosis, the latter likely an indirect remote effect of rotenone-evoked gut dysbiosis. Searching for explanations for the model failure, we analyzed rotenone plasma concentrations via LC-MS/MS 2 h after administration of the last dose to assess bioavailability. Rotenone was not detectable in plasma at a lower limit of quantification of 2 ng/mL (5 nM), showing that oral rotenone had insufficient bioavailability to achieve sustained systemic drug levels in mice. Hence, oral rotenone caused local gastrointestinal toxicity evident as lack of weight gain but failed to evoke behavioral or biological correlates of PD within 8 weeks.
Evaluating Thera-101 as a Low-Volume Resuscitation Fluid in a Model of Polytrauma
Authors: Shah Jessica Stukel , Macaitis Joseph , Lundquist Bridney , Johnstone Brian , Coleman Michael , Jefferson Michelle A. , Glaser Jacob , Rodriguez Annette R. , Cardin Sylvain , Wang Heuy-Ching , Burdette Alexander
Published: October 2022

Traumatic brain injury (TBI) and hemorrhage remain challenging to treat in austere conditions. Developing a therapeutic to mitigate the associated pathophysiology is critical to meet this treatment gap, especially as these injuries and associated high mortality are possibly preventable. Here, Thera-101 (T-101) was evaluated as low-volume resuscitative fluid in a rat model of TBI and hemorrhage. The therapeutic, T-101, is uniquely situated as a TBI and hemorrhage intervention. It contains a cocktail of proteins and microvesicles from the secretome of adipose-derived mesenchymal stromal cells that can act on repair and regenerative mechanisms associated with poly-trauma. T-101 efficacy was determined at 4, 24, 48, and 72 h post-injury by evaluating blood chemistry, inflammatory chemo/cytokines, histology, and diffusion tensor imaging. Blood chemistry indicated that T-101 reduced the markers of liver damage to Sham levels while the levels remained elevated with the control (saline) resuscitative fluid. Histology supports the potential protective effects of T-101 on the kidneys. Diffusion tensor imaging showed that the injury caused the most damage to the corpus callosum and the fimbria. Immunohistochemistry suggests that T-101 may mitigate astrocyte activation at 72 h. Together, these data suggest that T-101 may serve as a potential field deployable low-volume resuscitation therapeutic.