bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparison of Short-Term Post-Thymectomy Outcomes by Time-Weighted Dosages of Drug Requirements between Thymoma and Non-Thymoma Myasthenia Gravis Patients
Authors: Wiboonpong Phattamon , Setthawatcharawanich Suwanna , Korathanakhun Pat , Amornpojnimman Thanyalak , Pruphetkaew Nannapat , Chongphattararot Pensri , Sathirapanya Chutarat , Sathirapanya Pornchai
Published: February 2023

(1) Background: Early thymectomy is suggested in all clinically indicated myasthenia gravis (MG) patients. However, short-term clinical response after thymectomy in MG patients has been limitedly described in the literature. This study aimed to compare the 5-year post-thymectomy outcomes between thymoma (Th) and non-thymoma (non-Th) MG patients. (2) Methods: MG patients aged ≥18 years who underwent transsternal thymectomy and had tissue histopathology reports in Songklanagarind Hospital between 2002 and 2020 were enrolled in a retrospective review. The differences in the baseline demographics and clinical characteristics between ThMG and non-Th MG patients were studied. We compared the time-weighted averages (TWAs) of daily required dosages of pyridostigmine, prednisolone or azathioprine to efficiently maintain daily living activities and earnings between the MG patient groups during 5 consecutive years following thymectomy. Post-thymectomy clinical status, exacerbations or crises were followed. Descriptive statistics were used for analysis with statistical significance set at p < 0.05. (3) Results: ThMG patients had significantly older ages of onset and shorter times from the MG diagnosis to thymectomy. Male gender was the only significant factor associated with ThMG. TWAs of the daily MG treatment drug dosages required showed no differences between the groups. Additionally, the rates of exacerbations and crises were not different, but decremental trends were shown in both groups after the thymectomies. (4) Conclusions: The daily dosage requirements of MG treatment drugs were not different. There was a trend of decreasing adverse event rates despite no statistically significant differences during the first 5 years after thymectomy in ThMG and non-ThMG patients.
Nowcasting COVID-19 Statistics Reported with Delay: A Case-Study of Sweden and the UK
Authors: Altmejd Adam , Rocklöv Joacim , Wallin Jonas
Published: February 2023

The COVID-19 pandemic has demonstrated the importance of unbiased, real-time statistics of trends in disease events in order to achieve an effective response. Because of reporting delays, real-time statistics frequently underestimate the total number of infections, hospitalizations and deaths. When studied by event date, such delays also risk creating an illusion of a downward trend. Here, we describe a statistical methodology for predicting true daily quantities and their uncertainty, estimated using historical reporting delays. The methodology takes into account the observed distribution pattern of the lag. It is derived from the “removal method”—a well-established estimation framework in the field of ecology.
The Relationship between Meaning in Life and Depression among Chinese Junior High School Students: The Mediating and Moderating Effects of Cognitive Failures and Mindfulness
Authors: Li Ying , Jin Yihan , Kong Huiyan , Feng Chao , Cao Lei , Li Tiantian , Wang Yue
Published: February 2023

In recent years, the incidence of depression among adolescents has been increasing yearly, and the severe damage of depression on adolescents’ physical and mental health development has caused extensive concern worldwide. Previous research on adults has confirmed that meaning in life is a crucial buffer factor for depression, and developing meaning in life is an essential task in adolescence. Moreover, prior researchers also pointed out that frequent cognitive failures can induce negative emotions in individuals, whereas mindfulness can regulate individuals’ depression levels. However, few studies have investigated the impact of meaning in life on depression in adolescents and the underlying psychological mechanisms. Accordingly, based on the theoretical framework of the Cognitive Vulnerability–Stress Theory of Depression, this study aimed to explore the relationship between meaning in life and depression in junior high school students, as well as the mediating effect of cognitive failures and the moderating effect of mindfulness. We collected data from 948 adolescents aged 11 to 17 in two junior high schools in Henan Province, China, and tested the theoretical model through the PROCESS macro for SPSS. The results showed that: (1) meaning in life had a significant negative predictive effect on depression (β = −0.24, p < 0.001); (2) cognitive failures partially mediated the relationship between meaning in life and depression (β = 0.31, p < 0.001); (3) the relationship between cognitive failures and depression was moderated by mindfulness (β = −0.05, p < 0.05). This study implied that we could start by cultivating adolescents’ meaning in life and improving their level of mindfulness to prevent and intervene in adolescent depression.
Development and Validation of a Novel Score for Predicting Long-Term Mortality after an Acute Ischemic Stroke
Authors: Lin Ching-Heng , Kuo Ya-Wen , Huang Yen-Chu , Lee Meng , Huang Yi-Wei , Kuo Chang-Fu , Lee Jiann-Der
Published: February 2023

Background: Long-term mortality prediction can guide feasible discharge care plans and coordinate appropriate rehabilitation services. We aimed to develop and validate a prediction model to identify patients at risk of mortality after acute ischemic stroke (AIS). Methods: The primary outcome was all-cause mortality, and the secondary outcome was cardiovascular death. This study included 21,463 patients with AIS. Three risk prediction models were developed and evaluated: a penalized Cox model, a random survival forest model, and a DeepSurv model. A simplified risk scoring system, called the C-HAND (history of Cancer before admission, Heart rate, Age, eNIHSS, and Dyslipidemia) score, was created based on regression coefficients in the multivariate Cox model for both study outcomes. Results: All experimental models achieved a concordance index of 0.8, with no significant difference in predicting poststroke long-term mortality. The C-HAND score exhibited reasonable discriminative ability for both study outcomes, with concordance indices of 0.775 and 0.798. Conclusions: Reliable prediction models for long-term poststroke mortality were developed using information routinely available to clinicians during hospitalization.
Task-Involving Motivational Climate and Enjoyment in Youth Male Football Athletes: The Mediation Role of Self-Determined Motivation
Authors: Amaro Nuno , Monteiro Diogo , Rodrigues Filipe , Matos Rui , Jacinto Miguel , Cavaco Beatriz , Jorge Sandro , Antunes Raúl
Published: February 2023

Background: This study aimed at examining the mediation role of self-determined motivation (identified and integrated regulation and intrinsic motivation) in the association between task-involving climate and enjoyment in youth male football athletes. Methods: A total of 109 youth males (M = 14.38; SD = 1.55) were recruited to participate in this study. The survey included sociodemographic data and validated instruments such as the Motivational Climate Sport Youth Scale, the Behavioral Regulation Sport Questionnaire, and the Sports Enjoyment Scale. Results: The results showed that the task-involving climate was a positive and significant predictor of integrated regulation and intrinsic motivation. In addition, integrated regulation and intrinsic motivation were positive and significant predictors of enjoyment. The results of the mediation analysis revealed a partial mediation role of self-determined motivation in the relationship between task-involving climate and enjoyment. Significant indirect effects only occurred through intrinsic motivation. Conclusions: Providing higher levels of enjoyment in the sport context could be an excellent option for leisure activities for children and youth, as long as self-determined motivation and task-involving climates provided by the coaches are present.
The Spanish Version of the Childhood Anxiety Sensitivity Index: Factorial Dimensions and Invariance across Gender in a Sample of Adolescents
Authors: Chorot Paloma , Valiente Rosa M. , Sandín Bonifacio
Published: February 2023

Anxiety sensitivity is a transdiagnostic construct that has been associated with the etiology of emotional disorders, especially panic and other anxiety disorders. Although it is well known that, for the adult population, the factor structure of anxiety sensitivity includes three separate facets (physical, cognitive, and social concerns), the facets of anxiety sensitivity for adolescents have not yet been established. The main goal of the present study was to examine the factor structure of the Spanish version of the Childhood Anxiety Sensitivity Index (CASI). A large sample of nonclinical adolescents completed the Spanish version of the CASI in school settings (N = 1655; aged 11–17 years; 800 boys and 855 girls). Exploratory and confirmatory factor analyses of the full scale (CASI-18) indicate that a three first-order factor solution represents appropriately the three anxiety sensitivity facets previously defined for the adult population. The 3-factor structure had a better fit and was more parsimonious than a 4-factor solution. Results also indicate that the 3-factor structure remains invariant across genders. Girls scored significantly higher than boys on the total scale and on all three dimensions of anxiety sensitivity. In addition, the present study provides information concerning normative data for the scale. The CASI holds promise as a useful tool for assessing general and specific facets of anxiety sensitivity. It could be helpful for the assessment of this construct in clinical and preventive settings. The limitations of the study and suggestions for further research are outlined.
Employees Working from Home: Do Leadership Factors Influence Work-Related Stress and Musculoskeletal Pain?
Authors: Oakman Jodi , Lambert Katrina A. , Weale Victoria P. , Stuckey Rwth , Graham Melissa
Published: February 2023

In March 2020, the COVID-19 pandemic necessitated a rapid public health response, which included mandatory working from home (WFH) for many employees. However, given the rapid change from traditional ways of working, evidence is limited on the role of leaders, managers, and supervisors in supporting their employees’ physical and mental health whilst WFH. The study aimed to examine the impact of leaders through their management of psychosocial working conditions on employees’ stress and musculoskeletal pain (MSP) levels whilst WFH. Methods: Data from 965 participants (230 males, 729 females, 6 other) involved in the Employees Working from Home (EWFH) study, collected in October 2020, and April and November 2021, were analysed. Generalised mixed-effect models were used to test relationships between psychosocial leadership factors and employees’ stress and MSP levels. Results: Higher quantitative demands are associated with increased stress (B: 0.289, 95%CI 0.245, 0.333), presence of MSP (OR: 2.397, 95%CI 1.809, 3.177), and increased MSP levels (RR: 1.09, 95%CI 1.04, 1.14). Higher levels of vertical trust decreased stress (B: −0.094, 95%CI −0.135, −0.052) and presence of MSP (OR: 0.729, 95%CI 0.557, 0.954). Role clarity decreased stress (B: −0.055, 95%CI −0.104, −0.007) and levels of MSP (RR: 0.93, 95%CI 0.89, 0.96). Working with interruptions was associated with increased stress (B: 0.199, 95%CI 0.119, 0.280) and MSP (OR: 1.834, 95%CI 1.094, 3.072). Conclusion: Leaders will need to take a broad view of job design, taking into account physical and psychosocial aspects of work, to effectively support employees WFH and manage stress and MSP.
Association between Urban Educational Policies and Migrant Children’s Social Integration in China: Mediated by Psychological Capital
Authors: Lv Cixian , Yang Peijin , Xu Jingjing , Sun Jia , Ming Yuelong , Zhi Xiaotong , Wang Xinghua
Published: February 2023

China’s urban educational policies have been established to solve the problems of potential discrimination and inequitable access to education, disrupting migrant children who move from rural areas to urban cities and who tend to suffer from a range of mental health issues. However, little is known regarding how China’s urban educational policies affect migrant children’s psychological capital and social integration. This paper aims to explore the effect of urban education policies on improving migrant children’s psychological capital level in China. The second objective of this paper is to examine whether policies can encourage them to integrate into urban society in a positive way. This paper thoroughly analyzes the impact of China’s urban educational policies on three dimensions of social integration of migrant children (identification, acculturation, and psychological integration), and also verifies the mediating effects of psychological capital on the relationships between these variables. The subjects of this study are 1770 migrant children in grades 8–12, who are sourced from seven coastal cities in China. Multiple regression analysis and mediation effect tests are employed to analyze the data. This study reveals that migrant children’s identification with educational policies has a significant positive impact on their psychological capital. Psychological capital has partial mediating effects on the relationship between identification with educational policies and the three dimensions of social integration. In other words, identification with educational policies indirectly affects the process of social integration of migrant children through psychological capital. Based on this, for the purpose of promoting the positive impacts of educational policies of inflow cities on the social integration of migrant children, this study makes the following recommendations: (a) at the micro-level, the psychological capital of individual migrant children should be enhanced; (b) at the meso-level, the partnerships between migrant children and urban children should be taken seriously; and (c) at the macro-level, the urban educational policies related to migrant children should be improved. This paper not only makes policy recommendations for improving the educational policies of inflow cities, but also offers a Chinese perspective on the research related to the tricky issue facing all countries around the world, the social integration of migrant children.
Impact of Coronavirus Disease COVID-19 on the Relationship between Healthcare Expenditures and Sustainable Economic Growth
Authors: Vysochyna Alina , Vasylieva Tetiana , Dluhopolskyi Oleksandr , Marczuk Marcin , Grytsyshen Dymytrii , Yunger Vitaliy , Sulimierska Agnieszka
Published: February 2023

The coronavirus disease (COVID-19) pandemic led to a catastrophic burden on the healthcare system and increased expenditures for the supporting medical infrastructure. It also had dramatic socioeconomic consequences. The purpose of this study is to identify the empirical patterns of healthcare expenditures’ influence on sustainable economic growth in the pandemic and pre-pandemic periods. Fulfilment of the research task involves the implementation of two empirical blocks: (1) development of a Sustainable Economic Growth Index based on public health, environmental, social, and economic indicators using principal component analysis, ranking, Fishburne approach, and additive convolution; (2) modelling the impact of different kinds of healthcare expenditures (current, capital, general government, private, out-of-pocket) on the index using panel data regression modelling (random-effects GLS regression). Regression results in the pre-pandemic period show that the growth of capital, government, and private healthcare expenditures positively influence sustainable economic growth. In 2020–2021, healthcare expenditures did not statistically significantly influence sustainable economic growth. Consequently, more stable conditions allowed capital healthcare expenditures to boost economic growth, while an excessive healthcare expenditure burden damaged economic stability during the COVID-19 pandemic. In the pre-pandemic period, public and private healthcare expenditures ensured sustainable economic growth; out-of-pocket healthcare expenditures dominantly contributed to the pandemic period.
The Effect of Social Support on Depression among Economically Disadvantaged College Students: The Mediating Role of Psychological Resilience and the Moderating Role of Geography
Authors: Yu Xianglian , Xiong Fen , Zhang Hanbing , Ren Zhihong , Liu Lianzhong , Zhang Lin , Zhou Zongkui
Published: February 2023

The study examined the influence of social support on depression, including the mediating role of psychological resilience and the moderating role of geography. Questionnaires were completed by 424 economically disadvantaged college students in two provinces, X, a coastal province, and Y, an inland province. The results indicated that (1) the social support of economically disadvantaged college students was positively correlated to psychological resilience (β = 0.62, t = 11.22, p < 0.001); (2) the psychological resilience of economically disadvantaged college students was negatively correlated with depression (β = −0.24, t = −10.3, p < 0.001); (3) the social support of economically disadvantaged college students was negatively correlated with depression (β = −0.08, t = −2.85, p < 0.001); (4) the psychological resilience of economically disadvantaged college students played a partial mediating role between social support and depression; and (5) geography played a moderating role in the effect of social support on depression.
Obesity and Its Association with Undiagnosed Diabetes Mellitus, High Blood Pressure and Hypercholesterolemia in the Malaysian Adult Population: A National Cross-Sectional Study Using NHMS Data
Authors: Koo Hui Chin , Tan Lay Kim , Lim Geok Pei , Kee Chee Cheong , Omar Mohd Azahadi
Published: February 2023

This study aimed to report the prevalence of obesity, classified using Asian cut-off, and its relationships with undiagnosed diabetes mellitus, high blood pressure, and hypercholesteremia. We analyzed the nationally representative data from 14,025 Malaysian adults who participated in the NHMS 2015. The relationship between obesity and undiagnosed diabetes mellitus, high blood pressure, and hypercholesteremia was determined using multivariable logistic regressions, and lifestyle risk factors and sociodemographic characteristics were adjusted. The undiagnosed high blood pressure group showed the highest proportionate of overweight/obese (80.0%, 95% CI: 78.1–81.8) and central obesity (61.8%, 95% CI: 59.3–64.2). Inverse association was observed between underweight with undiagnosed high blood pressure (aOR: 0.40, 95% CI: 0.26–0.61) and hypercholesterolemia (aOR: 0.75, 95% CI: 0.59–0.95) groups. In contrast, positive relationships were shown between overweight/obese and risk of undiagnosed diabetes mellitus (aOR: 1.65, 95% CI: 1.31–2.07), high blood pressure (aOR: 3.08, 95% CI: 2.60–3.63), and hypercholesterolemia (aOR: 1.37, 95% CI: 1.22–1.53). Likewise, central obesity was positively associated with a risk of undiagnosed diabetes mellitus (aOR: 1.40, 95% CI: 1.17–1.67), high blood pressure (aOR: 2.83, 95% CI: 2.45–3.26), and hypercholesterolemia (aOR: 1.26, 95% CI: 1.12–1.42). Our findings indicated the importance of periodical health examinations to assess the risk of non-communicable diseases among the general and abdominal obese Malaysian adults.
HyFormer: Hybrid Transformer and CNN for Pixel-Level Multispectral Image Land Cover Classification
Authors: Yan Chuan , Fan Xiangsuo , Fan Jinlong , Yu Ling , Wang Nayi , Chen Lin , Li Xuyang
Published: February 2023

To effectively solve the problems that most convolutional neural networks cannot be applied to the pixelwise input in remote sensing (RS) classification and cannot adequately represent the spectral sequence information, we propose a new multispectral RS image classification framework called HyFormer based on Transformer. First, a network framework combining a fully connected layer (FC) and convolutional neural network (CNN) is designed, and the 1D pixelwise spectral sequences obtained from the fully connected layers are reshaped into a 3D spectral feature matrix for the input of CNN, which enhances the dimensionality of the features through FC as well as increasing the feature expressiveness, and can solve the problem that 2D CNN cannot achieve pixel-level classification. Secondly, the features of the three levels of CNN are extracted and combined with the linearly transformed spectral information to enhance the information expression capability, and also used as the input of the transformer encoder to improve the features of CNN using the powerful global modelling capability of the Transformer, and finally the skip connection of the adjacent encoders to enhance the fusion between different levels of information. The pixel classification results are obtained by MLP Head. In this paper, we mainly focus on the feature distribution in the eastern part of Changxing County and the central part of Nanxun District, Zhejiang Province, and conduct experiments based on Sentinel-2 multispectral RS images. The experimental results show that the overall accuracy of HyFormer for the study area classification in Changxing County is 95.37% and that of Transformer (ViT) is 94.15%. The experimental results show that the overall accuracy of HyFormer for the study area classification in Nanxun District is 95.4% and that of Transformer (ViT) is 94.69%, and the performance of HyFormer on the Sentinel-2 dataset is better than that of the Transformer.
Telemedicine Use and the Perceived Risk of COVID-19: Patient Experience
Authors: Hosseinzadeh Hassan , Ratan Zubair Ahmed , Nahar Kamrun , Dadich Ann , Al-Mamun Abdullah , Ali Searat , Niknami Marzieh , Verma Iksheta , Edwards Joseph , Shnaigat Mahmmoud , Malak Md Abdul , Rahman Md Mustafizur , Okely Anthony
Published: February 2023

Introduction: The COVID-19 outbreak resulted in an increased demand for telemedicine worldwide. Telemedicine is a technology-based virtual platform that allows the exchange of clinical data and images over remote distances. This study aims to examine the impact of the perceived risk of COVID-19 on telemedicine use in Bangladesh. Methods: This explanatory study was conducted in hospital settings across Dhaka city in Bangladesh. Patients were eligible to participate if they were aged 18 years or over and had used telemedicine in a hospital at least once since the COVID-19 outbreak. Outcome variables included sociodemographic, the perceived risk of COVID-19, and telehealth use. Study data were collected using an online and paper-based survey. Results: A total of 550 patients participated in this study, mostly male (66.4%), single (58.2%), and highly educated (74.2%). The means of the different domains of telemedicine use reflected a high degree of perceived benefit, accessibility, and satisfaction but a lower degree of privacy and discomfort, care personnel expertise, and usability. COVID 19 perceived risk predicted between 13.0% and 26.6% of variance in telemedicine domains, while the effects of demographic variables were controlled or removed. The perceived risk of COVID-19 was negatively correlated with privacy and discomfort, as well as care personnel concerns. Low and high levels of perceived COVID-19 risk were less likely to encourage the use of telemedicine as a risk reduction tool. Discussion: The participants were mainly satisfied with telemedicine, finding it beneficial and accessible; however, many were concerned about privacy, care personnel expertise, and its usability. The perceived risk of COVID-19 was a strong predictor (contributor) of telemedicine use, suggesting that risk perception can be used to encourage telemedicine use as a risk reduction strategy during pandemics; however, a medium level of risk was more promising.
Developmental Trajectories and Predictors of Incident Dementia among Elderly Taiwanese People: A 14-Year Longitudinal Study
Authors: Fan Yen-Chun , Lin Sheng-Feng , Chou Chia-Chi , Bai Chyi-Huey
Published: February 2023

The aim of this study was to identify dementia trajectories and their associated predictors among elderly Taiwanese people over a 14-year period using a nationwide representative longitudinal study. This retrospective cohort study was performed using the National Health Insurance Research Database. Group-based trajectory modeling (GBTM) was used to distinguish the specific trajectory groups of incident dementia during 2000–2013. All 42,407 patients were classified by GBTM to identify the trajectory of incident dementia, which included high- (n = 11,637, 29.0%), moderate- (n = 19,036, 44.9%), and low-incidence (n = 11,734, 26.1%) groups. Those diagnosed with hypertension (adjusted odds ratio [aOR] = 1.43; 95% confidence interval [CI] = 1.35–1.52), stroke (aOR = 1.45, 95% CI = 1.31–1.60), coronary heart disease (aOR = 1.29, 95% CI = 1.19–1.39), heart failure (aOR = 1.62, 95% CI = 1.36–1.93), and chronic obstructive pulmonary disease (aOR = 1.10, 95% CI = 1.02–1.18) at baseline revealed tendencies to be classified into high-incidence groups in dementia risk. The results from a 14-year longitudinal study identified three distinct trajectories of incident dementia among elderly Taiwanese people: patients with cardiovascular disease risk factors and cardiovascular disease events tended to be classified into high-incidence dementia groups. Early detection and management of these associated risk factors in the elderly may prevent or delay the deterioration of cognitive decline.
Modelling and Mitigating Secondary Crash Risk for Serial Tunnels on Freeway via Lighting-Related Microscopic Traffic Model with Inter-Lane Dependency
Authors: Yu Shanchuan , Chen Yu , Song Lang , Xuan Zhaoze , Li Yi
Published: February 2023

This paper models and mitigates the secondary crash (SC) risk for serial tunnels on the freeway which is incurred by traffic turbulence after primary crash (PC) occurrence and location-heterogeneous lighting conditions along serial tunnels. A traffic conflict approach is developed where SC risk is quantified using a surrogate safety measure based on the simulated vehicle trajectories after PC occurs from a lighting-related microscopic traffic model with inter-lane dependency. Numerical examples are presented to validate the model, illustrate SC risk pattern over time, and evaluate the countermeasures for SC, including adaptive tunnel lighting control (ATLC) and advanced speed and lane-changing guidance (ASLG) for connected vehicles (CVs). The results demonstrate that the tail of the stretching queue on the PC occurrence lane, the adjacent lane of the PC-incurred queue, and areas near tunnel portals are high-risk locations. In serial tunnels, creating a good lighting condition for drivers is more effective than advanced warnings in CVs to mitigate SC risk. Combined ATLC and ASLG is promising since ASLG informs CVs of an immediate response to traffic turbulence on the lane where PC occurs and ATLC alleviates SC risks on adjacent lanes via smoothing the lighting condition variations and reducing inter-lane dependency.
Metabolic Mechanism of Bacillus sp. LM24 under Abamectin Stress
Authors: Zhu Yueping , Xie Qilai , Ye Jinshao , Wang Ruzhen , Yin Xudong , Xie Wenyu , Li Dehao
Published: February 2023

Abamectin (ABM) has been recently widely used in aquaculture. However, few studies have examined its metabolic mechanism and ecotoxicity in microorganisms. This study investigated the molecular metabolic mechanism and ecotoxicity of Bacillus sp. LM24 (B. sp LM24) under ABM stress using intracellular metabolomics. The differential metabolites most affected by the bacteria were lipids and lipid metabolites. The main significant metabolic pathways of B. sp LM24 in response to ABM stress were glycerolipid; glycine, serine, and threonine; and glycerophospholipid, and sphingolipid. The bacteria improved cell membrane fluidity and maintained cellular activity by enhancing the interconversion pathway of certain phospholipids and sn-3-phosphoglycerol. It obtained more extracellular oxygen and nutrients to adjust the lipid metabolism pathway, mitigate the impact of sugar metabolism, produce acetyl coenzyme A to enter the tricarboxylic acid (TCA) cycle, maintain sufficient anabolic energy, and use some amino acid precursors produced during the TCA cycle to express ABM efflux protein and degradative enzymes. It produced antioxidants, including hydroxyanigorufone, D-erythroascorbic acid 1′-a-D-xylopyranoside, and 3-methylcyclopentadecanone, to alleviate ABM-induced cellular and oxidative damage. However, prolonged stress can cause metabolic disturbances in the metabolic pathways of glycine, serine, threonine, and sphingolipid; reduce acetylcholine production; and increase quinolinic acid synthesis.
A Study on the Entire Take-Over Process-Based Emergency Obstacle Avoidance Behavior
Authors: Li Yi , Xuan Zhaoze , Li Xianyu
Published: February 2023

Nowadays, conditional automated driving vehicles still need drivers to take-over in the scenarios such as emergency hazard events or driving environments beyond the system’s control. This study aimed to explore the changing trend of the drivers’ takeover behavior under the influence of traffic density and take-over budget time for the entire take-over process in emergency obstacle avoidance scenarios. In the driving simulator, a 2 × 2 factorial design was adopted, including two traffic densities (high density and low density) and two kinds of take-over budget time (3 s and 5 s). A total of 40 drivers were recruited, and each driver was required to complete four simulation experiments. The driver’s take-over process was divided into three phases, including the reaction phase, control phase, and recovery phase. Time parameters, dynamics parameters, and operation parameters were collected for each take-over phase in different obstacle avoidance scenarios. This study analyzed the variability of traffic density and take-over budget time with take-over time, lateral behavior, and longitudinal behavior. The results showed that in the reaction phase, the driver’s reaction time became shorter as the scenario urgency increased. In the control phase, the steering wheel reversal rate, lateral deviation rate, braking rate, average speed, and takeover time were significantly different at different urgency levels. In the recovery phase, the average speed, accelerating rate, and take-over time differed significantly at different urgency levels. For the entire take-over process, the entire take-over time increased with the increase in urgency. The lateral take-over behavior tended to be aggressive first and then became defensive, and the longitudinal take-over behavior was defensive with the increase in urgency. The findings will provide theoretical and methodological support for the improvement of take-over behavior assistance in emergency take-over scenarios. It will also be helpful to optimize the human-machine interaction system.
Subtypes of Adult-Onset Asthma at the Time of Diagnosis: A Latent Class Analysis
Authors: Mäkikyrö Elina M. S. , Jaakkola Maritta S. , Lajunen Taina K. , Malmberg L. Pekka , Jaakkola Jouni J. K.
Published: February 2023

Introduction: Only a few previous studies have investigated the subtypes of adult-onset asthma. No previous study has assessed whether these subtypes are different between men and women, or whether these subtypes have different risk factors. Methods: We applied latent class analyses to the Finnish Environment and Asthma Study population, including 520 new cases of adult-onset asthma. We formed subtypes separately between women and men and analyzed the following determinants as potential predictors for these subtypes: age, body mass index, smoking, and parental asthma. Results: Among women, the subtypes identified were: 1. Moderate asthma, 2. Cough-variant asthma, 3. Eosinophilic asthma, 4. Allergic asthma, and 5. Difficult asthma. Among men, the subtypes were: 1. Mild asthma, 2. Moderate asthma, 3. Allergic asthma, and 4. Difficult asthma. Three of the subtypes were similar among women and men: Moderate, Allergic, and Difficult asthma. In addition, women had two distinct subtypes: Cough-variant asthma, and Eosinophilic asthma. These subtypes had different risk factor profiles, e.g., heredity was important for Eosinophilic and Allergic asthma (RR for Both parents having asthma in Eosinophilic 3.55 (1.09 to 11.62)). Furthermore, smoking increased the risk of Moderate asthma among women (RR for former smoking 2.21 (1.19 to 4.11)) and Difficult asthma among men but had little influence on Allergic or Cough-variant asthma. Conclusion: This is an original investigation of the subtypes of adult-onset asthma identified at the time of diagnosis. These subtypes differ between women and men, and these subtypes have different risk factor profiles. These findings have both clinical and public health importance for the etiology, prognosis, and treatment of adult-onset asthma.
Effects of Tai Chi on Sleep Quality as Well as Depression and Anxiety in Insomnia Patients: A Meta-Analysis of Randomized Controlled Trials
Authors: Yang Min , Yang Jiaqi , Gong Mingjun , Luo Rui , Lin Qinqin , Wang Baihui
Published: February 2023

To systematically review the effects of Tai chi on sleep quality, depression, and anxiety in patients with insomnia. The electronic databases including PubMed, Cochrane Library, Web of Science, Embase, China National Knowledge Infrastructure (CNKI), WanFang Data, Chinese Biomedical Literature Database (CBM), and VIP Database for Chinese Technical Periodicals (VIP) were retrieved and screened by computer. Randomized controlled trials (RCT) on patients with insomnia who practiced Tai chi were collected, and the RCT risk of bias assessment criteria was used to evaluate the methodological quality of the included studies. The combined effect size was expressed as the weighted mean difference (WMD), with a confidence interval of 95% (CI). Review Manager 5.4 and Stata16.0 were used for heterogeneity analysis and sensitivity analysis. Tai chi reduced the patients’ Pittsburgh sleep quality index (PSQI) score (WMD = −1.75, 95% CI: −1.88, −1.62, p < 0.001); Hamilton depression scale (HAMD) score (WMD = −5.08, 95% CI: −5.46, −4.69, p < 0.001), Hamilton anxiety scale (HAMA) score (WMD = −2.18, 95% CI: −2.98, −1.37, p < 0.001), and self-rating anxiety scale (SAS) score (WMD = −7.01, 95% CI: −7.72, −6.29, p < 0.001). Tai chi exercise has a good preventive and ameliorating effect on insomnia, which can relieve patients’ depression and anxiety, simultaneously enhancing various functions of the body. However, most of the included studies reported random assignment with some lack of specific descriptions, and the blinding of participants was difficult to achieve due to the nature of exercise, which may cause bias. Therefore, more high-quality, multi-center, and bigger-sample studies need to be included in the future to further verify the results.
Relationship between Joint and Ligament Structures of the Subtalar Joint and Degeneration of the Subtalar Articular Facet
Authors: Togashi Ryoya , Edama Mutsuaki , Shagawa Mayuu , Osanami Haruki , Yokota Hirotake , Hirabayashi Ryo , Sekine Chie , Ishigaki Tomonobu , Akuzawa Hiroshi , Yamada Yuki , Toriumi Taku , Kageyama Ikuo
Published: February 2023

This study aimed to clarify the relationship between the joint and ligament structures of the subtalar joint and degeneration of the subtalar articular facet. We examined 50 feet from 25 Japanese cadavers. The number of articular facets, joint congruence, and intersecting angles were measured for the joint structure of the subtalar joint, and the footprint areas of the ligament attachments of the cervical ligament, interosseous talocalcaneal ligament (ITCL), and anterior capsular ligament were measured for the ligament structure. Additionally, subtalar joint facets were classified into Degeneration (+) and (−) groups according to degeneration of the talus and calcaneus. No significant relationship was identified between the joint structure of the subtalar joint and degeneration of the subtalar articular facet. In contrast, footprint area of the ITCL was significantly higher in the Degeneration (+) group than in the Degeneration (−) group for the subtalar joint facet. These results suggest that the joint structure of the subtalar joint may not affect degeneration of the subtalar articular facet. Degeneration of the subtalar articular facet may be related to the size of the ITCL.
SARS-CoV2 Infection and Comorbidity in Inmates: A Study of Central Italy
Authors: Altobelli Emma , Galassi Francesca , Mastrodomenico Marianna , Frabotta Fausto , Marzi Francesca , Angelone Anna Maria , Marziliano Ciro
Published: February 2023

Background and Objective: The presence of multiple chronic diseases is associated with an increase in mortality when related to COVID-19 infection. The aims of our study were: (i) to evaluate the association between the severity of the COVID-19 disease, defined as symptomatic hospitalized in prison or symptomatic hospitalized out of prison, and the presence of one or more comorbidities in two prisons in central Italy: L’Aquila and Sulmona; (ii) to describe the profiles of inmates using multiple correspondence analysis (MCA). Methods: A database was created including age, gender and clinical variables. The database containing anonymized data was password-protected. The Kruskal–Wallis test was used to evaluate a possible association between diseases and the severity of COVID-19 stratified by age groups. We used MCA to describe a possible characteristic profile of inmates. Results: Our results show that in the 25–50-year-old age group (COVID-19-negative) in the L’Aquila prison, 19/62 (30.65%) were without comorbidity, 17/62 (27.42%) had 1–2 comorbidities and only 3.23% had >2 diseases. It is interesting to note that in the elderly group, the frequency of 1–2 or >2 pathologies was higher than in the younger group, and only 3/51 (5.88%) inmates did not have comorbidities and were COVID-19 negative (p = 0.008). The MCA identified the following profiles: the prison of L’Aquila showed a group of women over 60 with diabetes, cardiovascular and orthopedic problems, and hospitalized for COVID-19; the Sulmona prison presented a group of males over 60 with diabetes, cardiovascular, respiratory, urological, gastrointestinal and orthopedic problems, and hospitalized or symptomatic due to COVID-19. Conclusions: our study has demonstrated and confirmed that advanced age and the presence of concomitant pathologies have played a significant role in the severity of the disease: symptomatic hospitalized in the prison; symptomatic hospitalized out of the prison.
Amazon Amandaba—Sociodemographic Factors, Health Literacy, Biochemical Parameters and Self-Care as Predictors in Patients with Type 2 Diabetes Mellitus: A Cross-Sectional Study
Authors: Tavares Victória Brioso , Farias Aline Lobato de , Silva Amanda Suzane Alves da , Souza Josiel de Souza e , Silva Hilton Pereira da , Bastos Maria do Socorro Castelo Branco de Oliveira , Melo-Neto João Simão de
Published: February 2023

Background: Health literacy (HL) and its domains (functional, critical, and communicative) appear to be related to self-care adherence in people with type 2 diabetes mellitus (DM2). This study aimed to verify if sociodemographic variables are predictors of HL, if HL and the sociodemographic factors affect biochemical parameters together, and if HL domains are predictors of self-care in DM2. Methods: We used the baseline assessment data from 199 participants ≥ 30 years in the project, “Amandaba na Amazônia: Culture Circles as a Strategy to Encourage Self-care for DM in Primary Health Care,” which took place in November and December 2021. Results: In the HL predictor analysis, women (p = 0.024) and higher education (p = 0.005) were predictors of better functional HL. The predictors of biochemical parameters were: glycated hemoglobin control with low critical HL (p = 0.008); total cholesterol control with female sex (p = 0.004), and low critical HL (p = 0.024); low-density lipoprotein control with female sex (p = 0.027), and low critical HL (p = 0.007); high-density lipoprotein control with female sex (p = 0.001); triglyceride control with low Functional HL (p = 0.039); high levels of microalbuminuria with female sex (p = 0.014). A low critical HL was a predictor of a lower specific diet (p = 0.002) and a low total HL of low medication care (p = 0.027) in analyses of HL domains as predictors of self-care. Conclusion: Sociodemographic factors can be used to predict HL, and HL can predict biochemical parameters and self-care.
Research Progress, Hotspots, and Trends of Using BIM to Reduce Building Energy Consumption: Visual Analysis Based on WOS Database
Authors: Liu Xun , Ding Zhenhan , Li Xiaobo , Xue Zhiyuan
Published: February 2023

With the development of engineering technology, building information modeling (BIM) has attracted more and more attention and has been studied by many experts on building energy consumption in recent years. It is necessary to analyze and forecast the application trend and prospect of BIM technology in building energy consumption. Based on 377 articles published in the WOS database, this study adopts the technique of combining scientometrics and bibliometrics to obtain relevant research hotspots and quantitative analysis results. The findings demonstrate that the building energy consumption field has made extensive use of BIM technology. However, there are still some limitations that can be improved, and the use of BIM technology in construction renovation projects should be emphasized. This study can help readers better understand the application status of BIM technology and its trajectory of development with regard to building energy consumption, providing a valuable reference for future research.
Predictive Value of Cardiovascular Health Score for Health Outcomes in Patients with PCI: Comparison between Life’s Simple 7 and Life’s Essential 8
Authors: Gao Xueqin , Ma Xinrui , Lin Ping , Wang Yini , Zhao Zhenjuan , Zhang Rui , Yu Bo , Hao Yanhua
Published: February 2023

The American Heart Association recently published an updated algorithm for quantitative assessments of cardiovascular health (CVH) metrics, namely Life’s Essential 8 (LE8). This study aimed to compare the predictive value between Life’s Simple 7 (LS7) and LE8 and predict the likelihood of major adverse cardiac events (MACEs) in patients undergoing percutaneous coronary intervention (PCI) to determine the utility of the LE8 in predicting CVH outcomes. A total of 339 patients with acute coronary syndrome (ACS) who had undergone PCI were enrolled to assess the CVH scores using the LS7 and LE8. Multivariable Cox regression analysis was employed to evaluate the predictive value of the two different CVH scoring systems at 2 years for MACEs. Multivariable Cox regression analysis revealed that both the LS7 and LE8 scores were protective factors for MACEs (HR = 0.857, [95%CI: 0.78–0.94], HR = 0.964, [95%CI: 0.95–0.98]; p < 0.05, respectively). Receiver operator characteristic analysis indicated that the area under the curve (AUC) of LE8 was higher than that of LS7 (AUC: 0.662 vs. 0.615, p < 0.05). Lastly, in the LE8 score, diet, sleep health, serum glucose levels, nicotine exposure, and physical activity were found to be correlated with MACEs (HR = 0.985, 0.988, 0.993, 0.994, 0.994, respectively). Our study established that LE8 is a more reliable assessment system for CVH. This population-based prospective study reports that an unfavorable cardiovascular health profile is associated with MACEs. Future research is warranted to evaluate the effectiveness of optimizing diet, sleep health, serum glucose levels, nicotine exposure, and physical activity in reducing the risk of MACEs. In conclusion, our findings corroborated the predictive value of Life’s Essential 8 and provided further evidence for the association between CVH and the risk of MACEs.
How Can Climate Change Anxiety Induce Both Pro-Environmental Behaviours and Eco-Paralysis? The Mediating Role of General Self-Efficacy
Authors: Innocenti Matteo , Santarelli Gabriele , Lombardi Gaia Surya , Ciabini Lorenzo , Zjalic Doris , Di Russo Mattia , Cadeddu Chiara
Published: February 2023

While it has been shown that climate change anxiety (emotional distress response to climate change) can enhance pro-environmental behaviours (PEBs) in some subjects, in others it can induce eco-paralysis, thus leading individuals to avoid any form of engagement in actions against climate change. This study aims to clarify which factors influence the relationship between climate change anxiety and the disposition to PEBs, focusing on the role of self-efficacy as a mediating factor. A cross-sectional study was conducted on 394 healthy subjects living in Italy who completed the Pro-Environmental Behaviours Scale (PEBS), the General Self-Efficacy scale (GSE), and the Climate Change Anxiety Scale (CCAS). As a result, the mediation model showed a positive direct effect of the cognitive impairment subscale of CCAS on PEBS and an indirect negative effect of the cognitive impairment subscale of CCAS on PEBS mediated by GSE. These findings show that climate change anxiety has simultaneously two different effects on individuals: it directly encourages PEBs, and indirectly may have detrimental effects on PEBs such as eco-paralysis. Consequently, therapeutic approaches to treat climate change anxiety should not be aimed at rationalising irrational thoughts but rather at helping patients develop coping strategies such as PEBs which, in turn, foster self-efficacy.
Optimal Environmental Policy for Heterogeneous Governments in China
Authors: Wang Ren , Bian Yuxiang , Gao Han , Hou Jie
Published: February 2023

The purpose of the article is to study how the shift in the developing philosophy of China’s central leadership has impacted the management style of China’s local governments and, in turn, the country’s economic and environmental equilibrium. We use a real business cycle model with environmental variables and divide governments into those with/without environmental concerns and into those with long- and short-term policy horizons. We find that forcing local governments to plan in the long run is effective only when those governments are simultaneously mandated to consider the environment to be as important as the economy. Theoretical results show that both output and pollution levels are highest under governments without environmental obligations, intermediate under long-term governments with environmental obligations, and lowest under short-term governments with such obligations.