bluuebunny/crossref_metadata_2025 huggingface dataset:
Periodontal Conditions and Pathogens Associated with Pre-Eclampsia: A Scoping Review
Authors: Gare Jocelyne , Kanoute Aida , Meda Nicolas , Viennot Stephane , Bourgeois Denis , Carrouel Florence
Published: July 2021

Background: Pre-eclampsia, the second most frequent direct source of maternal mortality, is a multisystem gestational disorder characterized by proteinuria and maternal hypertension after the 20th gestational week. Although the causes of pre-eclampsia are still discussed, research has suggested that the placenta has a central place in the pathogenesis of this disease. Moreover, current surveys indicated that periodontal disorders observed during the pregnancy and more particularly, periodontal pathogens could be link to the risk of pre-eclampsia. Objectives: This article aims to review recent studies focusing on periodontal conditions and pathogens associated with pre-eclampsia. Methods: The process followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guidelines. Results: Metabolic conditions, immunological changes, fluctuating progesterone and estrogen levels of the pregnant woman induce a dysbiosis of the oral microbiota and contribute to increase inflammation of periodontal tissues. Periodontal pathogens could diffuse through the bloodstream inducing a placenta inflammatory response as well as inflammatory molecules produced in response to periodontopathogens could migrate through the bloodstream leading to a placenta inflammatory response. Also, periodontopathogens can colonize the vaginal microbiota through the gastrointestinal tract or during oro-genital contacts. Conclusion: A cumulative bi-directional relationship between periodontal conditions, pathogens and the pre-eclampsia exists.
Female Genital Mutilation Consequences and Healthcare Received among Migrant Women: A Phenomenological Qualitative Study
Authors: González-Timoneda Alba , González-Timoneda Marta , Cano Sánchez Antonio , Ruiz Ros Vicente
Published: July 2021

European healthcare systems are increasingly being challenged to respond to female genital mutilation (FGM). This study explores the FGM experiences of migrant women coming from FGM-practicing countries residing in a European host country. A qualitative phenomenological study was carried out and 23 participants were included. Data were collected through 18 face-to-face open-ended interviews and a focus group and were analysed using Giorgi’s four-step phenomenological approach. Three main themes were derived: “FGM consequences”, “healthcare received” and “tackling FGM”. Participants highlighted obstetric, gynaecological and genitourinary consequences such as haemorrhages, perineal tears, caesarean delivery, risk of infection, dysmenorrhea, urinary tract infections and dysuria; consequences for sexuality, mainly, dyspareunia, loss of sexual interest and decreased quality of sexual intercourse; and psychological consequences such as loss of self-esteem, feelings of humiliation and fear of social and familial rejection. Women perceived a profound lack of knowledge about FGM from health providers and a lack of sensitive and empathetic care. Some women perceived threatening and disproportionate attitudes and reported negative experiences. Participants highlighted the importance of educating, raising awareness and improving prevention and detection strategies. The findings disclose the need to improve training and institutional plans to address structural and attitudinal barriers to health equity across migrant families in their host countries.
Disasters, Gender, and HIV Infection: The Impact of the 2010 Haiti Earthquake
Authors: Llorente-Marrón Mar , Fontanil-Gómez Yolanda , Díaz-Fernández Montserrat , Solís García Patricia
Published: July 2021

Although disasters threaten all people who experience them, they do not affect all members of society in the same way. Its effects are not solely restricted to the economic sphere; they also affect the physical and mental health of those who suffer from them, having a particular impact on women and limiting their life chances. The aim of this study was to examine the impact the 2010 Haiti earthquake had on the seropositivity of female survivors. Method: Using data from the Demographic and Health Survey, this study examines the impact of the 2010 Haiti earthquake on gender relations associated with the probability of being HIV positive through the differences-in-differences strategy. Results: A differential of four percentage points is observed in the probability of HIV seropositivity between men and women, favoring men. Additionally, it is observed that the probability of seropositivity intensifies when the cohabitation household is headed by a woman. Conclusion: Disasters are not indifferent to the gender of the people affected. In the second decade of the 21st century, the conclusions obtained show, once again, the need for incorporating the gender perspective into the management of natural hazards in the field of health. This is the case of the differential exposure to HIV after the earthquake in Haiti.
Evidence-Based Effects of High-Intensity Interval Training on Exercise Capacity and Health: A Review with Historical Perspective
Authors: Atakan Muhammed Mustafa , Li Yanchun , Koşar Şükran Nazan , Turnagöl Hüseyin Hüsrev , Yan Xu
Published: July 2021

Engaging in regular exercise results in a range of physiological adaptations offering benefits for exercise capacity and health, independent of age, gender or the presence of chronic diseases. Accumulating evidence shows that lack of time is a major impediment to exercise, causing physical inactivity worldwide. This issue has resulted in momentum for interval training models known to elicit higher enjoyment and induce adaptations similar to or greater than moderate-intensity continuous training, despite a lower total exercise volume. Although there is no universal definition, high-intensity interval exercise is characterized by repeated short bursts of intense activity, performed with a “near maximal” or “all-out” effort corresponding to ≥90% of maximal oxygen uptake or >75% of maximal power, with periods of rest or low-intensity exercise. Research has indicated that high-intensity interval training induces numerous physiological adaptations that improve exercise capacity (maximal oxygen uptake, aerobic endurance, anaerobic capacity etc.) and metabolic health in both clinical and healthy (athletes, active and inactive individuals without any apparent disease or disorder) populations. In this paper, a brief history of high-intensity interval training is presented, based on the novel findings of some selected studies on exercise capacity and health, starting from the early 1920s to date. Further, an overview of the mechanisms underlying the physiological adaptations in response to high-intensity interval training is provided.
Alcohol-Related Behaviour in Freshmen University Students in Sardinia, Italy
Authors: Mereu Alessandra , Liori Arianna , Dessì Claudio , Girau Mariano , Mc Gilliard Derrick Clifford , Sotgiu Alessandra , Agabio Roberta , Contu Paolo , Sardu Claudia
Published: July 2021

This study aims to provide a picture of University of Cagliari students’ alcohol-related behaviour and to explore factors associated with it. Data were collected by administering a questionnaire to 992 freshmen university students from different programs consisting of twelve closed questions, including three questions from the Alcohol Use Disorders Identification Test for Consumption (AUDIT-C short form). Three subgroups of alcohol-related behaviour were distinguished (risky drinkers, social drinkers and abstainers). In order to explore factors associated with patterns of alcohol consumption, a multivariate logistic regression was performed. The prevalence of risky drinkers was 35%. A binge-drinking behaviour at least once in the last twelve months was declared by 65% (more widespread in men and in students living away from their parents). Risky consumption is significantly associated with age of onset of alcohol use, living away from parents’ home, drinking outside meals and attending health courses. Regarding the levels of daily alcohol consumption perceived as a health risk, 66% of men and 88% of women indicate values higher than those recommended. The results underline the need for tailored prevention measures. University could be a promising setting to implement actions according to a health promotion perspective, to empower students to control their alcohol consumption.
Influence of Zooplankton and Environmental Factors on Clear-Water Phase in Lake Paldang, South Korea
Authors: Sim Younbo , Byeon Myeong Seop , Kim Keonhee , Yu Soon Ju , Im Jong Kwon
Published: July 2021

Lake Paldang is a complex water system with both fluvial and lacustrine characteristics and the largest artificial dam lake in South Korea. In this study, the different occurrence patterns and causes of the clear-water phase (CWP) were investigated using water quality and hydrological factors at four sites in Lake Paldang. Among the environmental and other factors associated with CWP occurrence, secchi depth and turbidity exhibited significant correlations with precipitation, hydraulic retention time (HRT), and individual and relative abundance (RA) of zooplankton (Cladocera) (p < 0.01). Hence, a change in the HRT because of precipitation could alter the CWP. The Cladocera individuals and RA showed significant correlations with the water temperature, indicating that the emergence of Cladocera in spring as the water temperature rises could cause the CWP. Sensitivity assessments conducted using Bayesian models demonstrated different CWP occurrence sensitivity relationships for the river-type, lake-type, and shallow and deep sites. Turbidity, secchi depth, and zooplankton factors also showed sensitive relationships with CWP occurrence for all sites. The sensitivity to precipitation and HRT was higher in the river-type sites. The lake-type sites, with common Cladocera emergence and long HRT, favored CWP occurrence. Thus, CWP occurrence was dependent on the site characteristics and climate conditions.
Autism Spectrum Disorder (ASD) and the Family Inclusive Airport Design Experience
Authors: Cerdan Chiscano Monica
Published: July 2021

The literature on air travellers with psychiatric disorders is limited. This perspective article highlights various travel-related aspects of autism spectrum disorder (ASD). The airport experience can be stressful for families of children with autism spectrum disorder (FwASDs). The aim of this study was to explore the airport experience of FwASDs using the value co-creation process approach to assist airport managers in designing improved experiences for this specific passenger segment. This study responds to the current climate in which airports are developing awareness programmes in relation to children who require special assistance at airports. The prevalence of children with ASD is 1/68. While a number of airports throughout the world have adopted procedures addressing the needs of those with cognitive impairment, these advances are far from universal. As part of an academic–industry collaboration between Vueling airlines and the Spanish airport operator Aena, 25 FwASDs took part in an inclusive airport research project in the city of Barcelona from November 2015 to April 2016. Employing a qualitative methodology that incorporated focus groups, ethnographic techniques, and post-experience surveys, the study contributes to extending the body of knowledge on the management of the value co-creation process for challenging passenger segments within the airport context. The study explains how ensuring adequate resource allocation to this passenger segment can improve the family-inclusive design of the airport experience and offers managerial recommendations.
Exploring the Relationship of Health Beliefs and Self-Care Behaviors Related to Diabetic Foot Ulcers of Type II Diabetes Mellitus Patients: A Cross-Sectional Study
Authors: Tsai Meng-Chien , Chuang Hsiao-Ling , Huang Cheng-Yi , Lee Shu-Hsin , Liao Wen-Chun , Lee Meng-Chih , Kuo Ching-Pyng
Published: July 2021

Objective: Diabetic foot ulcers are an invasive complication of diabetes and are increasing. This study investigates the relationship between health beliefs and foot self-care behaviors, among people with type II diabetes. Methods: A cross-sectional design was adopted, and 98 patients were recruited from outpatient clinics of the endocrine department. The questionnaires of Demographic, Diabetes Foot Ulcer Health Belief Scale (Health Beliefs, DFUHBS), and Diabetes Foot Self-Care Behavior Scale (Self Care, DFSBS) were used to collect data. Results: Among the subjects living alone or who had diabetes less than ten years, the score of DFSBS was significantly lower than among those living with families or who had diabetes for ten years or more. The frequency of performing diabetes foot self-care behavior, among males was lower than among females significantly. Although there was no significant difference in the Health Belief total score, there were differences in the benefit subscale. Those who had junior high school level or less or had diabetes less than ten years, their score was significantly lower than those with senior high school level or more or had diabetes ten years or more. In a multivariable regression model, living with family, diabetes duration, and health beliefs explained 42.9% of the variance of diabetic-foot self-care behaviors. Conclusions: Living alone, shorter duration of diabetes, male gender, and lower health belief scores predict less adequate diabetic foot self-care behavior. Health care providers should assess these factors when designing individual care plans.
Influence of Menstrual Cycle Estradiol-β-17 Fluctuations on Energy Substrate Utilization-Oxidation during Aerobic, Endurance Exercise
Authors: Willett Hannah N. , Koltun Kristen J. , Hackney Anthony C.
Published: July 2021

This study examined the effect of estradiol-β-17 across the menstrual cycle (MC) during aerobic exercise on energy substrate utilization and oxidation. Thirty-two eumenorrheic (age = 22.4 ± 3.8 y (mean ± SD)), physically active women participated in two steady-state running sessions at 65% of VO2max, one during the early follicular and one during the luteal phase of the MC. Blood samples were collected at rest before each exercise session and analyzed for Estradiol-β-17 to confirm the MC phase. Carbohydrate (CHO) utilization and oxidation values were significantly lower (p < 0.05) in the luteal (utilization: 51.6 ± 16.7%; oxidation: 1.22 ± 0.56 g/min; effect size (ES) = 0.45, 0.27) than follicular phase (utilization: 58.2 ± 15.1%; oxidation: 1.38 ± 0.60 g/min) exercise sessions. Conversely, fat utilization and oxidation values were significantly (p < 0.05) higher in the luteal (utilization: 48.4 ± 16.7%; oxidation: 0.49 ± 0.19 g/min; ES = 0.45,0.28) than follicular phase (utilization: 41.8 ± 15.1%; oxidation: 0.41 ± 0.14 g/min). Estradiol-β-17 concentrations were significantly (p < 0.01) greater during the luteal (518.5 ± 285.4 pmol/L; ES = 0.75) than follicular phase (243.8 ± 143.2 pmol/L). Results suggest a greater use of fat and reduced amount of CHO usage during the luteal versus follicular phase, directly related to the change in resting estradiol-β-17. Future research should investigate the role these changes may play in female athletic performance.
Fear of COVID-19 and COVID-19 Stress and Association with Sociodemographic and Psychological Process Factors in Cases under Surveillance in a Frontline Worker Population in Borneo
Authors: Pang Nicholas Tze Ping , Nold Imon Gracyvinea , Johoniki Elisa , Mohd Kassim Mohd Amiruddin , Omar Azizan , Syed Abdul Rahim Syed Sharizman , Hayati Firdaus , Jeffree Mohammad Saffree , Ng Jun Rong
Published: July 2021

COVID-19 stress and fear of COVID-19 is an increasingly researched construct in the general population. However, its prevalence and association with sociodemographic factors and psychological process variables has not been explored in frontline workers under surveillance in a Bornean population. This study was a cross-sectional study using a sociodemographic questionnaire incorporating two specific epidemiological risk variables, namely specific questions about COVID-19 surveillance status (persons under investigation (PUI), persons under surveillance (PUS), and positive cases) and the nature of frontline worker status. Furthermore, five other instruments were used, with three measuring psychopathology (namely depression, anxiety and stress, fear of COVID-19, and stress due to COVID-19) and two psychological process variables (namely psychological flexibility and mindfulness). Kruskal–Wallis and Mann–Whitney tests were performed to assess if there were significant differences in psychopathology and psychological process variables between sociodemographic and epidemiological risk variables. Hierarchical multiple regression was further performed, with depression, anxiety, and stress as dependent variables. There were significant differences in the fear of COVID-19 between positive cases, PUI, and PUS. The fear of COVID-19 scores were higher in positive cases compared to in PUS and PUI groups. Upon hierarchical multiple regression, mindfulness and psychological flexibility were significant predictors of depression, anxiety, and stress after controlling for sociodemographic and epidemiological risk factors. This study demonstrates that exposure to COVID-19 as persons under investigation or surveillance significantly increases the fear of COVID-19, and brief psychological interventions that can positively influence mindfulness and psychological flexibility should be prioritized for these at-risk groups to prevent undue psychological morbidity in the long run.
Demographics, Socioeconomic Status, Social Distancing, Psychosocial Factors and Psychological Well-Being among Undergraduate Students during the COVID-19 Pandemic
Authors: Silva Andréa Neiva da , Guedes Carla Ribeiro , Santos-Pinto Cláudia Du Bocage , Miranda Elaine Silva , Ferreira Larissa Machado , Vettore Mario Vianna
Published: July 2021

The COVID-19 pandemic impacted on academic routine because of the social distancing measures. This study examined the relationships of sociodemographic characteristics, social distancing aspects and psychosocial factors on psychosocial well-being among undergraduate students during the social distancing period due to COVID-19. A web-based survey was conducted of undergraduate students at a public university in Brazil (n = 620). Demographics, socioeconomic status (SES), social distancing factors, negative affectivity (DASS-21), sense of coherence (SOC-13), social support and psychosocial well-being (GHQ-12) were measured. The direct and indirect links between was variables was tested using structural equation modelling. The estimated model showed that greater social support, higher sense of coherence and lower negative affectivity were directly associated with better psychological well-being. Female gender, higher SES, not working during the social distancing period and availability of online modules were indirectly associated with psychological well-being through psychosocial factors. Working during the social distancing period and availability of online modules mediated the link of age, gender, SES with psychological well-being. Our findings suggest the need to provide psychological support, online teaching and financial aid to undergraduate students during the social distancing period due to COVID-19 pandemic to improve their psychological well-being.
Participants Attrition in a Longitudinal Study: The Malaysian Cohort Study Experience
Authors: Abdullah Noraidatulakma , Kamaruddin Mohd Arman , Goh Ying-Xian , Othman Raihannah , Dauni Andri , Jalal Nazihah Abd , Yusuf Nurul Ain Mhd , Kamat Salywana A. , Basri Nor Hazlinawati , Jamal Rahman
Published: July 2021

The attrition rate of longitudinal study participation remains a challenge. To date, the Malaysian Cohort (TMC) study follow-up rate was only 42.7%. This study objective is to identify the cause of attrition among TMC participants and the measures to curb it. A total of 19,343 TMC participants from Kuala Lumpur and Selangor that was due for follow-up were studied. The two most common attrition reasons are undergoing medical treatment at another government or private health center (7.0%) and loss of interest in participating in the TMC project (5.1%). Those who were inclined to drop out were mostly Chinese, aged 50 years and above, unemployed, and had comorbidities during the baseline recruitment. We have also contacted 2183 participants for the home recruitment follow-up, and about 10.9% agreed to join. Home recruitment slightly improved the overall follow-up rate from 42.7% to 43.5% during the three-month study period.
Effect of Chinese Corporate Average Fuel Consumption and New Energy Vehicle Dual-Credit Regulation on Passenger Cars Average Fuel Consumption Analysis
Authors: Zhang Haoyi , Zhao Fuquan , Hao Han , Liu Zongwei
Published: July 2021

The large sales volume and a great number of passenger car ownership in China have brought a series of environmental and energy problems. In response to these problems, Corporate Average Fuel Consumption and New Energy Vehicle Dual-credit Regulation has been put forward in China. However, it is found that although the purpose of the Dual-credit Regulation is controlling the fuel consumption and promoting the development of the energy vehicle market, the fuel consumption restriction for fossil-fueled passenger cars is relaxed compared to CAFC (Corporate Average Fuel Consumption) regulation alone. Moreover, this effect of relaxation is more obvious when the market share of new energy vehicles increases. To quantitatively estimate the relaxation effect of the fuel consumption restriction, a method of quantifying the relaxation effect is designed, and three different scenarios of new energy vehicle market development have been presumed in this paper. It is found that there are three main factors related to new energy vehicles that cause the relaxation of fuel consumption restriction, and the effect might become obvious and severe after 2025 if the market share of new energy vehicles develops very rapidly. These results may affect the development of the automotive industry and needed to be concerned.
Prevalence of Missing Values and Protest Zeros in Contingent Valuation in Dental Medicine
Authors: Sendi Pedram , Ramadani Arta , Bornstein Michael M.
Published: July 2021

Background: The number of contingent valuation (CV) studies in dental medicine using willingness-to-pay (WTP) methodology has substantially increased in recent years. Missing values due to absent information (i.e., missingness) or false information (i.e., protest zeros) are a common problem in WTP studies. The objective of this study is to evaluate the prevalence of missing values in CV studies in dental medicine, to assess how these have been dealt with, and to suggest recommendations for future research. Methods: We systematically searched electronic databases (MEDLINE, Web of Science, Cochrane Library, PROSPERO) on 8 June 2021, and hand-searched references of selected reviews. CV studies in clinical dentistry using WTP for valuing a good or service were included. Results: We included 49 WTP studies in our review. Out of these, 19 (38.8%) reported missing values due to absent information, and 28 (57.1%) reported zero values (i.e., WTP valued at zero). Zero values were further classified into true zeros (i.e., representing the underlying preference of the respondent) or protest zeros (i.e., false information as a protest behavior) in only 9 studies. Most studies used a complete case analysis to address missingness while only one study used multiple imputation. Conclusions: There is uncertainty in the dental literature on how to address missing values and zero values in CV studies. Zero values need to be classified as true zeros versus protest zeros with follow-up questions after the WTP elicitation procedure, and then need to be handled differently. Advanced statistical methods are available to address both missing values due to missingness and due to protest zeros but these are currently underused in dental medicine. Failing to appropriately address missing values in CV studies may lead to biased WTP estimates of dental interventions.
COVID-19 Pandemic-Related Anxiety in Pregnant Women
Authors: Nowacka Urszula , Kozlowski Szymon , Januszewski Marcin , Sierdzinski Janusz , Jakimiuk Artur , Issat Tadeusz
Published: July 2021

The COVID-19 pandemic outbreak influenced general and mental health worldwide. The objective of this study was to assess the anxiety level during the COVID-19 pandemic among pregnant women and compare it between COVID-infected and non-infected groups. We prospectively assessed the daily routine and anxiety level using a bespoke questionnaire and GAD-7 scale validated for pregnant women. With logistic regression, we established possible risk factors of generalized anxiety disorder spectrum and main causes of concern. The dataset included 439 responders of our survey. Of which, 21% had COVID-19 infection during pregnancy; 38% were screened for possible generalized anxiety disorder and the proportion was higher in women who suffered from COVID-19 (48% vs. 35%, p = 0.03). Pre-pregnancy anxiety or depression diagnosis and intentional social contact avoidance increased the risk of anxiety (aOR 3.4 and 3.2). Fetal wellbeing was the main concern for 66% of the responders. The COVID-19 pandemic and related restrictions substantially altered daily lives of pregnant women, exaggerating the prevalence of anxiety compared with the pre-COVID-19 studies (38% vs. 15%). COVID-19 infection during pregnancy was associated with increased levels of generalized anxiety scores. Patient-tailored psychological support should be a mainstay of comprehensive antenatal medical care in order to avoid anxiety- and stress-related complications.
Allostatic Load and Exposure Histories of Disadvantage
Authors: Prior Lucy
Published: July 2021

The stress pathway posits that those in disadvantaged circumstances are exposed to a higher degree of stressful experiences over time resulting in an accumulated biological burden which subsequently relates to poorer health. Trajectories of disadvantage, in the form of neighbourhood deprivation and structural social capital, are evaluated in their relation to allostatic load representing the cumulative “wear and tear” of chronic stress. This paper uses data from the British Household Panel Survey and Understanding Society in a latent class growth analysis. We identify groups of exposure trajectories over time using these classes to predict allostatic load at the final wave. The results show that persistent exposure to higher deprivation is related to worse allostatic load. High structural social capital over time relates to lower allostatic load, in line with a stress buffering effect, though this relationship is not robust to controlling for individual sociodemographic characteristics. By demonstrating a gradient in allostatic load by histories of deprivation, this analysis supports a biological embedding of disadvantage through chronic exposure to stressful environments as an explanation for social health inequalities.
Do Cardiovascular Diseases Significantly Influence Healthy Aging?
Authors: Apostu Simona-Andreea , Vasile Valentina , Sava Valentin
Published: July 2021

Population development is reflected by sustainable development indicators, among them are the indicators describing longevity and healthy aging. Longevity is reflected by life expectancy, and healthy aging is reflected by healthy life expectancy; high values of these indicators reflect good conditions of living for people. Life expectancy and healthy life expectancy analyses are of big interest among academics, policymakers, medical researchers, and others in order to direct the flow of funds in the most effective way possible to the population groups in most need. High life expectancy and low birth rate will lead to aging of the population, having profound implications on the school age population, politics, healthcare, labor force, social protection, social security issues, and public finances. Healthy life expectancy reflects health conditions, including the impacts of mortality and morbidity. As cardiovascular disease causes more than half of all deaths across Europe, this paper examines the influence of cardiovascular disease on longevity and healthy aging across Europe. The methodology was chosen so as to test the research hypotheses: (a) principal component analysis provided the socio-economic factors that are correlated to longevity and healthy aging; (b) regression analysis identified the relationship between healthy aging and cardiovascular disease; and (c) hierarchical cluster analysis allowed us to find common features of the groups of countries according to healthy aging and longevity.
Assessment of Unstimulated Whole Salivary Tumor Necrosis Factor Alpha (TNF-α) and Cellular Micronuclei Levels in Snuff (Naswar) Users and Non-Users for Early Diagnosis of Oral Squamous Cell Carcinoma
Authors: Muhammad Waqar , Khan Muhammad M. , Zafar Shafaq , Alqutub Montaser N. , AlMubarak Abdulrahman M. , Mokeem Sameer , Khan Zafar A. , Usman Muhammad K. , Ahmed Naseer , Aldahiyan Nada , Vohra Fahim , Abduljabbar Tariq
Published: July 2021

The aim of the study was to investigate the unstimulated whole saliva (UWS) tumor necrosis factor alpha (TNF-α) and cellular micronuclei in snuff dippers (Naswar) compared to healthy control subjects. The case control study was conducted over 9 months at a tertiary care center. Sixty patients were divided into two groups: Snuff dippers (SD) (Naswar) and non-snuff dippers (NSD) (control subjects). The included self-reported SD used Snuff twice daily for more than 12 months. UWS was collected and salivary TNF-α assessment was performed using enzyme-linked immunosorbent assay (ELISA). For cellular micronuclei, buccal mucosa was brushed to obtain cells in Naswar users, fixed with a dibutylphthalate polystyrene xylene (DPX) mounting to view micronuclei. Means and standard deviations were compared using the t-test and outcomes were related using Pearson correlation, considering p ≤ 0.05 as significant. The mean age of participants was 38.85 ± 11.56 years. The mean duration of snuff use was 20.43 ± 12.79 years and the common site for Naswar placement was the lower vestibule (n = 19, 63.3%). TNF-α levels among SD were 9.6 ± 3.3 pg/mL, which were significantly higher than levels in NSD, 5.2 ± 3 pg/mL (p < 0.05). The number of cellular micronuclei in SD was 30.7 ± 7.8, which was comparatively higher than in NSD, which was 9.2 ± 3.3 (p < 0.05). The duration of snuff use was positively correlated to TNF-α levels (p = 0.048) rather than the micronuclei number (p = 0.97). SD showed higher levels of TNF-α and cellular micronuclei compared with NSD (control subjects); a positive correlation was shown with the duration of snuff use. We conclude that TNF-α and micronuclei are potential salivary biomarkers for an oral biological effect in snuff (Naswar) users.
The Institute for Medical Technology Assessment Productivity Cost Questionnaire (iPCQ) and the Medical Consumption Questionnaire (iMCQ): Translation and Cognitive Debriefing of the Arabic Version
Authors: Al-Aqeel Sinaa A. , AlAujan Shiekha S. , Almazrou Saja H.
Published: July 2021

The aim of this study was to translate the Institute for Medical Technology Assessment Productivity Cost Questionnaire (iPCQ) and the Medical Consumption Questionnaire (iMCQ) from English into Arabic and perform cognitive debriefing in a Saudi Arabian setting. We conducted the translation according to guidelines, including two independent forward translations and a backward translation. Cognitive debriefing was carried out in two stages. First, the pre-final translated versions of the two questionnaires were tested on a group of respondents (n = 5) using face-to-face or telephone interviews. The participants completed a copy of the questionnaires, identified items or questions that were confusing or misunderstood, and then answered a series of open-ended questions about their understanding of each instruction, question and response option. Second, another group of participants (n = 17) completed the questionnaire and circled any word that was confusing or difficult to understand and provided comments on the questionnaires. The Arabic translation and linguistic validation were realized without any major difficulties. The few changes made after cognitive debriefing generally related to changing one word to a more appropriate Arabic word. The final Arabic translation needs to be validated for psychometric properties such as validity and reliability before being recommended for use in future research.
“Healthcare Kamikazes” during the COVID-19 Pandemic: Purpose in Life and Moral Courage as Mediators of Psychopathology
Authors: Echeverria Iván , Peraire Marc , Haro Gonzalo , Mora Rafael , Camacho Isabel , Almodóvar Isabel , Mañes Vicente , Zaera Ignacio , Benito Ana
Published: July 2021

Although the required personal protective equipment was not available during the first wave of the COVID-19 pandemic, Spanish healthcare workers continued to work, being dubbed as ‘healthcare kamikazes’. Two possible reasons are moral courage and purpose in life that, in turn, would modulate the appearance of psychopathology. Cross-sectional study was carried out in 90 Spanish and 59 Mexican healthcare professionals, and 56 medical and nursing students. Spanish professionals had suffered more work and overall exposure (M = 8.30; SD = 2.57 and M = 9.03; SD = 2.66) than Mexican (M = 5.10; SD = 1.87 and M = 5.55; SD = 2.35). Mexican professionals had fewer anxiety disorders (30.5%; n = 18) and a lower depression score (M = 4.45; SD = 5.63) than the Spanish (43.7%; n = 38; and M = 8.69; SD = 8.07). Spanish professionals more often experienced acute stress disorder (32.6%; n = 29). Purpose in life, in addition to having a direct protective effect on psychopathology, also modulated the relationship between personal and family exposure and psychopathology. In conclusion, purpose in life protects against the appearance of psychopathology in healthcare workers with personal and family exposure to SARS-CoV-2.
Can Physical Activity Reduce the Risk of Cognitive Decline in Apolipoprotein e4 Carriers? A Systematic Review
Authors: Perez-Lasierra Jose Luis , Casajús Jose Antonio , Casasnovas José Antonio , Arbones-Mainar Jose Miguel , Lobo Antonio , Lobo Elena , Moreno-Franco Belén , Gonzalez-Agüero Alejandro
Published: July 2021

Physical activity (PA) reduces the risk of cognitive decline (CD) in the general population. However, little is known about whether the presence of the apolipoprotein E epsilon 4 allele (APOE e4) could modify this beneficial effect. The aim of this systematic review was to analyze and synthetize the scientific evidence related to PA levels and CD risk in cognitively healthy APOE e4 carriers. Four electronic databases were analyzed. Only original articles with longitudinal study design were selected to analyze the relationship between PA and CD in APOE e4 carriers. Five studies were included in the systematic review. All studies except one stated that PA is a protective factor against CD in APOE e4 carriers. Moreover, partial support was found for the hypothesis that a greater amount and intensity of PA are more beneficial in CD prevention. The results support the idea that PA is a protective factor against CD in APOE e4 carriers. Nevertheless, it would be necessary to carry out further studies that would allow these findings to be contrasted.
Pollution Assessment of Potentially Toxic Elements (PTEs) in Soils around the Yanzhuang Gold Mine Tailings Pond, Pinggu County, Beijing, China
Authors: Zhao Guangjie , Li Xianqing , Zhu Jiewang , Zhao Xueyan , Zhang Jizhen , Zhai Jia
Published: July 2021

The accumulation of tailings from gold mining and smelting may result in PTE pollution. We investigated PTE contamination from a large amalgamated gold mine tailings pond in Pinggu County, Beijing. In November 2017, 30 soil samples were collected around the tailings pond. The concentrations and pollution degree of PTEs in the samples and the sources of Sb, As, Cd, Cu, Pb, Zn and Hg were analyzed. The average concentration of these elements in soil samples near the tailings pond (16.24, 28.29, 0.99, 171.04, 263.25, 99.73, 0.72 mg/kg, respectively) were higher than their corresponding standard values and background values of the study area. The geoaccumulation index showed that the pollution degree of As, Pb and Hg was moderate, while Sb and Cu present non-pollution to moderate pollution. The average EF values of the elements were Sb (38.31), As (4.23), Cd (0.71), Cu (3.68), Pb (21.24), Zn (0.82) and Hg (5.29), respectively. The environmental risk assessment developed throughout the PERI method indicated that Sb, As, Hg and Pb were the main pollutants in the study area. The three quantitative risk indicators (RI, Igeo and EF) were positively correlated, and all of them indicated that PTEs had significant pollution to the local area. Thus, Sb, As, Pb, Cu, and Hg pollution should be highly concerning. Multivariate statistical analysis shows that the pollution of PTEs was mainly caused by the accumulation of tailings ponds after gold mining and smelting. The research result is of great significance for the prevention and control of soil pollution of PTEs near the tailings pond.
Seasonal SUHI Analysis Using Local Climate Zone Classification: A Case Study of Wuhan, China
Authors: Shi Lingfei , Ling Feng , Foody Giles M. , Yang Zhen , Liu Xixi , Du Yun
Published: July 2021

The surface urban heat island (SUHI) effect poses a significant threat to the urban environment and public health. This paper utilized the Local Climate Zone (LCZ) classification and land surface temperature (LST) data to analyze the seasonal dynamics of SUHI in Wuhan based on the Google Earth Engine platform. In addition, the SUHI intensity derived from the traditional urban–rural dichotomy was also calculated for comparison. Seasonal SUHI analysis showed that (1) both LCZ classification and the urban–rural dichotomy confirmed that Wuhan’s SHUI effect was the strongest in summer, followed by spring, autumn and winter; (2) the maximum SUHI intensity derived from LCZ classification reached 6.53 °C, which indicated that the SUHI effect was very significant in Wuhan; (3) LCZ 8 (i.e., large low-rise) had the maximum LST value and LCZ G (i.e., water) had the minimum LST value in all seasons; (4) the LST values of compact high-rise/midrise/low-rise (i.e., LCZ 1–3) were higher than those of open high-rise/midrise/low-rise (i.e., LCZ 4–6) in all seasons, which indicated that building density had a positive correlation with LST; (5) the LST values of dense trees (i.e., LCZ A) were less than those of scattered trees (i.e., LCZ B) in all seasons, which indicated that vegetation density had a negative correlation with LST. This paper provides some useful information for urban planning and contributes to the healthy and sustainable development of Wuhan.
Mental Health Crisis and Stress Coping among Healthcare College Students Momentarily Displaced from Their Campus Community Because of COVID-19 Restrictions in Japan
Authors: Tahara Masatoshi , Mashizume Yuki , Takahashi Kayoko
Published: July 2021

College students are one of the most affected groups by self-quarantine due to COVID-19, as they may live in loneliness and anxiety, increasing their risk of mental health crisis. This study aimed to identify risk factors for poor mental health and stress coping strategies among healthcare college students during the COVID-19 pandemic in Japan. A cross-sectional survey was conducted over 7 consecutive days starting on 28 April 2020 using a web-based questionnaire. The survey assessed socioeconomic characteristics and the General Health Questionnaire-12 score, self-reported health status, anxiety, and satisfaction with daily life, work, leisure, and new activities. Approximately 70% of 223 respondents had poor mental health. Less communication with friends was the main risk factor for mental health problems. Good health status and satisfaction with leisure and new activities were associated with reduced risk of mental health problems. Students with poor mental health tended to seek social support as a stress coping strategy. This study showed that the mental health of students declined during self-quarantine, and loneliness could be the major reason. There is a need for a new form of communication and learning that deals with the isolation and loneliness of students, especially for students living alone.
Can Watching Online Videos Be Addictive? A Qualitative Exploration of Online Video Watching among Chinese Young Adults
Authors: Yang Zeyang , Griffiths Mark D. , Yan Zhihao , Xu Wenting
Published: July 2021

Watching online videos (including short-form videos) has become the most popular leisure activity in China. However, a few studies have reported the potential negative effects of online video watching behaviors (including the potential for ‘addiction’) among a minority of individuals. The present study investigated online video watching behaviors, motivational factors for watching online videos, and potentially addictive indicators of watching online videos. Semi-structured interviews were conducted among 20 young Chinese adults. Qualitative data were analyzed using thematic analysis. Eight themes were identified comprising: (i) content is key; (ii) types of online video watching; (iii) platform function hooks; (iv) personal interests; (v) watching becoming habitual; (vi) social interaction needs; (vii) reassurance needs; and (viii) addiction-like symptoms. Specific video content (e.g., mukbang, pornography), platform-driven continuous watching, and short-form videos were perceived by some participants as being potentially addictive. Specific features or content on Chinese online video platforms (e.g., ‘Danmu’ scrolling comments) need further investigation. Future studies should explore users’ addictive-like behaviors in relation to specific types of online video content and their social interaction on these platforms.
Understanding Cervical Cancer Screening Barriers among Migrant Women: A Qualitative Study with Healthcare and Community Workers in Portugal
Authors: Marques Patrícia , Gama Ana , Santos Mário , Heleno Bruno , Vermandere Heleen , Dias Sónia
Published: July 2021

Cervical cancer screening (CCS) has been proven to reducing mortality of cervical cancer; yet migrant women show a lower participation in screening compared to non-migrants. This study explores the perspectives of healthcare workers and community workers on the factors influencing the CCS participation of migrant women living in Portugal. A qualitative study with online focus groups was conducted. Healthcare workers experienced in CCS and community workers working with migrant communities were purposively sampled. A semi-structured guide was used covering the participation of migrant women in CCS, barriers, and strategies to overcome them. Data were analyzed using content analysis. Participants considered that migrant women have low participation in CCS related to insufficient knowledge, low risk perception, and lack of interest on preventive care. Other barriers such as difficulties in accessing the healthcare services, relationship with healthcare workers, language, and cultural differences were highlighted. Promoting continuity of care, disseminating culturally tailored information, and use of self-sampling methods were suggested to improve participation in CCS. Inequalities in access to CCS among migrant women are mostly caused by information gaps and healthcare system-related barriers. Building a migrant-friendly healthcare system that creates opportunities for healthcare workers to establish relationships with their patients and delivering culturally and linguistically adapted information may contribute to overcoming those barriers and increasing the participation of migrant women in screening.
Designing an eHealth Well-Being Program: A Participatory Design Approach
Authors: van Hierden Yannick , Dietrich Timo , Rundle-Thiele Sharyn
Published: July 2021

In recent years, the relevance of eHealth interventions has become increasingly evident. However, a sequential procedural application to cocreating eHealth interventions is currently lacking. This paper demonstrates the implementation of a participatory design (PD) process to inform the design of an eHealth intervention aiming to enhance well-being. PD sessions were conducted with 57 people across four sessions. Within PD sessions participants experienced prototype activities, provided feedback and designed program interventions. A 5-week eHealth well-being intervention focusing on lifestyle, habits, physical activity, and meditation was proposed. The program is suggested to be delivered through online workshops and online community interaction. A five-step PD process emerged; namely, (1) collecting best practices, (2) participatory discovery, (3) initial proof-of-concept, (4) participatory prototyping, and (5) pilot intervention proof-of-concept finalisation. Health professionals, behaviour change practitioners and program planners can adopt this process to ensure end-user cocreation using the five-step process. The five-step PD process may help to create user-friendly programs.
Immunological and Biochemical Interplay between Cytokines, Oxidative Stress and Schistosomiasis
Authors: Masamba Priscilla , Kappo Abidemi Paul
Published: July 2021

The host–parasite schistosome relationship relies heavily on the interplay between the strategies imposed by the schistosome worm and the defense mechanisms the host uses to counter the line of attack of the parasite. The ultimate goal of the schistosome parasite entails five important steps: evade elimination tactics, survive within the human host, develop into adult forms, propagate in large numbers, and transmit from one host to the next. The aim of the parasitized host on the other hand is either to cure or limit infection. Therefore, it is a battle between two conflicting aspirations. From the host’s standpoint, infection accompanies a plethora of immunological consequences; some are set in place to defend the host, while most end up promoting chronic disease, which ultimately crosses paths with oxidative stress and cancer. Understanding these networks provides attractive opportunities for anti-schistosome therapeutic development. Hence, this review discusses the mechanisms by which schistosomes modulate the human immune response with ultimate links to oxidative stress and genetic instability.