bluuebunny/crossref_metadata_2025 huggingface dataset:
The Effects of Daily Sleep Condition on Performances of Physical Fitness among Taiwanese Adults: A Cross-Sectional Study
Authors: Hsu Chi-Chieh , Gu Ming , Lee Tian-Shyug , Lu Chi-Jie
Published: March 2020

Physical fitness is a powerful indicator of health. Sleep condition plays an essential role in maintaining quality of life and is an important marker that predicts physical fitness. This study aimed to determine the relationship between sleep conditions (sleep quality, sleep duration, bedtime) and multiple physical fitness indicators (body mass index (BMI), flexibility, abdominal muscle strength and endurance, cardiopulmonary endurance) in a well-characterized population of Taiwanese adults aged 23 to 65. The applied data were obtained from the National Physical Fitness Examination Survey 2014 conducted in Taiwan. We assessed the association of the sleep conditions with physical fitness performances in Taiwanese adults by using the multivariate adaptive regression spline (MARS) method with a total of 69,559 samples. The results show that sleep duration, sleep quality, and bedtime were statistically significant influence factors on physical fitness performances with different degrees. Gender was an important factor that affects the effects of daily sleep conditions on performances of physical fitness. Sleep duration was the most important factor as it was simultaneously correlated with BMI, sit-ups, and sit-and-reach indicators in both genders. Bedtime and sleep quality were only associated with sit-ups performance in both genders.
The Association of Active Living Environments and Mental Health: A Canadian Epidemiological Analysis
Authors: Lukmanji Aysha , Williams Jeanne V.A. , Bulloch Andrew G.M. , Dores Ashley K. , Patten Scott B.
Published: March 2020

Environments that promote use of active transport (walking, biking, and public transport use) are known as “active living environments” (ALE). Using a Canadian national sample, our aim was to determine if ALEs were associated with mental health outcomes, including depressive symptoms, and mood and anxiety disorders. Data from the Canadian Community Health Survey from 2015–2016 was used for demographic characteristics and mental health outcomes (n ≈ 110,000). This data was linked to datasets from the Canadian Urban Environmental Health Research Consortium, reporting ALE and social and material deprivation. Depressive symptoms were evaluated using standard dichotomized scores of 5+ (mild) and 10+ (moderate/severe) from the Patient Health Questionnaire-9. Self-reported diagnosed mood and anxiety disorders were also included. Logistic regression was used to determine the association of mental health outcomes with four classes of ALE. The analysis included adjustments for social and material deprivation, age, sex, chronic conditions, marital status, education, employment, income, BMI, and immigrant status. No association between any mental health outcome and ALE were observed. While the benefits of ALE to physical health are known, these results do not support the hypothesis that more favorable ALE and increased use of active transport is associated with better mental health outcomes.
Prevalence and Characterization of Specific Phobia Disorder in People over 65 Years Old in a Madrid Community Sample (Spain) and its Relationship to Quality of Life
Authors: Ausín Berta , Muñoz Manuel , Castellanos Miguel Ángel , García Sara
Published: March 2020

The prevalence of anxiety disorders over the last year among seniors ranged from 3.6% to 17.2%. The most prevalent disorders are specific phobias. Data are needed concerning the consequences of specific phobia disorder on the level of functioning and quality of life of older people, the age of onset of specific phobia disorder, and the duration of episodes. In total, 555 community-dwelling people aged between 65 and 84 years who lived in Madrid (Spain) were assessed (Composite International Diagnostic Interview for people over 65 years (CIDI65+), WHO Disability Assessment Schedule (WHODAS II), Health of the Nation Outcome Scales for Older Adults (HoNOS65+), World Health Organization Quality of Life Brief (WHOQOL-BREF). Prevalence rates and odds ratio, t-tests, binary logistic regression, and point-biserial correlations were calculated. A total of 12.07% of the sample suffered a specific phobia disorder over the last year. The average age at onset of the specific phobia was 38.78 (sd = 21.61) years. The mean duration of the phobia was approximately 20 (sd = 20) years. A significant effect of the specific phobia was found for the current levels of functioning and quality of life: WHOQOL-BREF total score (p < 0.05), WHODAS II overall score (p < 0.01), and HoNOS65+ total score (p < 0.001). Having specific phobia disorder decreased the level of functioning and negatively affected the quality of life. These data suggest the need for primary healthcare professionals to include the detection of specific phobia disorders in their protocols because people do not receive treatment for this problem, and they might carry it throughout their lives.
Melatonin-Measurement Methods and the Factors Modifying the Results. A Systematic Review of the Literature
Authors: Rzepka-Migut Beata , Paprocka Justyna
Published: March 2020

Melatonin plays an important role in regulating the sleep–wake cycle and adaptation to environmental changes. Concentration measurements in bioliquids such as serum/plasma, saliva and urine are widely used to assess peripheral rhythm. The aim of the study was to compare methods and conditions of determinations carried out with the identification of factors potentially affecting the measurements obtained. We have identified a group of modifiable and unmodifiable factors that facilitate data interpretation. Knowledge of modifiers allows you to carefully plan the test protocol and then compare the results. There is no one universal sampling standard, because the choice of method and biofluid depends on the purpose of the study and the research group.
Evaluation of Prevalence of the Sarcopenia Level Using Machine Learning Techniques: Case Study in Tijuana Baja California, Mexico
Authors: Castillo-Olea Cristián , Garcia-Zapirain Soto Begonya , Zuñiga Clemente
Published: March 2020

The article presents a study based on timeline data analysis of the level of sarcopenia in older patients in Baja California, Mexico. Information was examined at the beginning of the study (first event), three months later (second event), and six months later (third event). Sarcopenia is defined as the loss of muscle mass quality and strength. The study was conducted with 166 patients. A total of 65% were women and 35% were men. The mean age of the enrolled patients was 77.24 years. The research included 99 variables that consider medical history, pharmacology, psychological tests, comorbidity (Charlson), functional capacity (Barthel and Lawton), undernourishment (mini nutritional assessment (MNA) validated test), as well as biochemical and socio-demographic data. Our aim was to evaluate the prevalence of the level of sarcopenia in a population of chronically ill patients assessed at the Tijuana General Hospital. We used machine learning techniques to assess and identify the determining variables to focus on the patients’ evolution. The following classifiers were used: Support Vector Machines, Linear Support Vector Machines, Radial Basis Function, Gaussian process, Decision Tree, Random Forest, multilayer perceptron, AdaBoost, Gaussian Naive Bayes, and Quadratic Discriminant Analysis. In order of importance, we found that the following variables determine the level of sarcopenia: Age, Systolic arterial hypertension, mini nutritional assessment (MNA), Number of chronic diseases, and Sodium. They are therefore considered relevant in the decision-making process of choosing treatment or prevention. Analysis of the relationship between the presence of the variables and the classifiers used to measure sarcopenia revealed that the Decision Tree classifier, with the Age, Systolic arterial hypertension, MNA, Number of chronic diseases, and Sodium variables, showed a precision of 0.864, accuracy of 0.831, and an F1 score of 0.900 in the first and second events. Precision of 0.867, accuracy of 0.825, and an F1 score of 0.867 were obtained in event three with the same variables. We can therefore conclude that the Decision Tree classifier yields the best results for the assessment of the determining variables and suggests that the study population’s sarcopenia did not change from moderate to severe.
Histologic, Histomorphometric, and Clinical Analysis of the Effects of Growth Factors in a Fibrin Network Used in Maxillary Sinus Augmentation
Authors: Cinar Ihsan Caglar , Gultekin Bahattin Alper , Saglanmak Alper , Yalcin Serdar , Olgac Vakur , Mijiritsky Eitan
Published: March 2020

This randomized controlled clinical trial evaluated the effect of mineralized plasmatic matrix (MPM), comprised of synthetic graft and platelet concentrates, on new bone formation and volume stability over time in maxillary sinus lifting (MSL). Unilateral MSL was performed in 20 patients with either beta-tricalcium phosphate (β-TCP) or MPM grafts (10 sinuses each). Six months postsurgery, specimens were obtained with a trephine bur prior to implant placement in 39 cases. Volumetric changes in sinus augmentation were analyzed between 1 week (T-I) and 6 months (T-II) postsurgery. Histomorphometric and histological analyses of biopsy samples revealed mean new bone percentages of 35.40% ± 9.09% and 26.92% ± 7.26% and residual graft particle areas of 23.13% ± 6.16% and 32.25% ± 8.48% in the MPM and β-TCP groups, respectively (p < 0.05). The mean soft-tissue areas in the MPM and β-TCP groups were 41.48% ± 8.41% and 40.83% ± 8.86%, respectively (p > 0.05). Graft reductions between baseline and 6-months postprocedure in the β-TCP and MPM groups were 17.12% ± 13.55% and 14.41% ± 12.87%, respectively, with significant graft volume reduction observed in both groups (p < 0.05) while there is no significant difference between MPM and β-TCP groups (p > 0.05). Thus, MPM, representing growth factors in a fibrin network, increases new bone formation and has acceptable volume stability in MSL procedures
Biomonitoring of Metals in Children Living in an Urban Area and Close to Waste Incinerators
Authors: Di Ciaula Agostino , Gentilini Patrizia , Diella Giusy , Lopuzzo Marco , Ridolfi Ruggero
Published: March 2020

The impact of waste incinerators is usually examined by measuring environmental pollutants. Biomonitoring has been limited, until now, to few metals and to adults. We explored accumulation of a comprehensive panel of metals in children free-living in an urban area hosting two waste incinerators. Children were divided by georeferentiation in exposed and control groups, and toenail concentrations of 23 metals were thereafter assessed. The percentage of children having toenail metal concentrations above the limit of detection was higher in exposed children than in controls for Al, Ba, Mn, Cu, and V. Exposed children had higher absolute concentrations of Ba, Mn, Cu, and V, as compared with those living in the reference area. The Tobit regression identified living in the exposed area as a significant predictor of Ba, Ni, Cu, Mn, and V concentrations, after adjusting for covariates. The concentrations of Ba, Mn, Ni, and Cu correlated with each other, suggesting a possible common source of emission. Exposure to emissions derived from waste incinerators in an urban setting can lead to body accumulation of specific metals in children. Toenail metal concentration should be considered a noninvasive and adequate biomonitoring tool and an early warning indicator which should integrate the environmental monitoring of pollutants.
Investing Time and Resources for Work–Life Balance: The Effect on Talent Retention
Authors: Rodríguez-Sánchez José-Luis , González-Torres Thais , Montero-Navarro Antonio , Gallego-Losada Rocío
Published: March 2020

The study of work–life balance has undergone significant development in recent years as a result of changes in society and the growing importance of human resources (HR) for companies. Taking into account that human capital represents a critical success factor for businesses, the current context requires the development and implementation of HR management strategies aimed at attracting and retaining the most talented workers in order to obtain the expected results. The objective of this paper is to present an integrated model of work–life balance strategies, including the impacts of the different policies and practices on the retention of talented HR, which can be a basis for further academic developments on this subject, as well as a roadmap for managers. Hence, we will analyze a case study carried out in a multinational company—a leader in the technology and tourism sectors, and importantly dependent on valuable human capital, for which the HR strategy aims to improve the performance of the firm in the medium and long term through analysis, planning, and flexibility.
Effects of HIV-Related Discrimination on Psychosocial Syndemics and Sexual Risk Behavior among People Living with HIV
Authors: Chan Randolph C. H. , Operario Don , Mak Winnie W. S.
Published: March 2020

In the context of HIV-related stigma and discrimination, people living with HIV (PLHIV) might be vulnerable to a ‘syndemic’ of co-occurring psychosocial challenges that can affect sexual behavior. The present study examined how HIV-related discrimination contributes to co-occurring psychosocial syndemic problems and results in inconsistent condom use among PLHIV in Hong Kong. Two-hundred and ninety-one PLHIV were recruited to complete a self-report questionnaire. More than one-quarter of the sample experienced two or more psychosocial syndemic problems, and 74.1% of the participants who had sex with steady partners reported inconsistent condom use over the past three months. The results indicated that HIV-related discrimination was positively predictive of the number of psychosocial syndemic problems. HIV-related discrimination and psychosocial syndemics were associated with increased odds of inconsistent condom use with steady partners (AOR = 5.40 and AOR = 3.09 respectively). Findings from structural equation modeling showed that psychosocial syndemics mediated the effect of HIV-related discrimination on condom use consistency with steady partners. PLHIV in Hong Kong suffered from the syndemic effects of stigma, social isolation, and poor mental health, which rendered them vulnerable to condomless sex. In order to curb the rapidly increasing incidence of HIV, multi-level strategies should be adopted to concurrently address the structural inequities and psychosocial syndemics faced by PLHIV.
Team Efficiency in Organizations: A Group Perspective on Initiative
Authors: Lisbona Ana , Las-Hayas Abel , Palací Francisco J. , Bernabé Miguel , Morales Francisco J. , Haslam Alexander
Published: March 2020

Organizational research has shown that personal initiative is related to both climate for initiative and work engagement. Yet little is known about what happens to this relationship once the focus shifts to the team level. When organizational and team goals are involved this renders the relationship more complex, and team identification and organizational identification are likely to be key to understanding it. In this paper we develop a model to deal with these complexities. This predicts (a) that team identification will impact on team initiative through team work engagement while (b) organizational identification will impact on team initiative through climate for initiative. It is also expected that team initiative will, in turn, impact on team productivity, and on radical innovation as evaluated by the team leader. This model was tested in a field study with 327 participants of 76 workteams belonging to 50 organizations. Results of SEM and regression analysis supported our main hypotheses. Findings showed that initiative is related to performance and also underline the importance of initiative at a team level. At the same time they suggest that to develop teams with high levels of initiative it is important to promote both organizational and team identification.
Feasibility Evaluation of Designated Quantities for Chemicals Requiring Preparation for Accidents in the Korean Chemical Accident Prevention System
Authors: Ahn Mun Seob , Lee Hyo Eun , Cheon Kwang Soo , Joo Huoung Gi ,   Ochang Chemical Safety Community, Son Bu-Soon
Published: March 2020

To prevent chemical accidents, the United States (US), the European Union (EU), and the Republic of Korea operate legal systems, such as risk management plans (RMP) and process safety management (PSM), to prevent chemical accidents inside and outside the workplace. The duty to implement chemical accident prevention systems and the criteria for being a target workplace are dependent on the designated quantities of chemicals handled. A chemical accident prevention system is obligatory for storage and handling of legally declared chemicals in the workplace. Benzene, toluene, xylene, methyl ethyl ketone, and ethyl acetate are all flammable materials that are commonly used as solvents in the chemical industry. These substances are grouped into flammable substances groups in the US and the EU, and are managed with the same designated quantities. However, in Korea, the designated quantities are: benzene, 10,000 kg; toluene, xylene, and methyl ethyl ketone, 200,000 kg; and ethyl acetate, 20,000 kg. In order to evaluate the validity of the chemical quantities, fire explosion scenarios during chemical accidents were modeled using two modeling programs, Areal Location of Hazardous Atmosphere (ALOHA) and Korea Off-Site Risk Assessment Supporting Tool (KORA) software, under the same conditions. Similar damage radii were found for the five flammable materials with both pool fires and vapor cloud explosions (VCE). Based on these damage radii, the designated quantities of five substances were calculated and included in the range (10,000 to 13,500 kg). The results show that current designated quantities underestimate chemical substances, and for the prevention of accidents and post-management after chemical accidents, it is necessary to manage flammable substances under one grouping.
The Impact of Business Cycle on Health Financing: Subsidized, Voluntary and Out-of-Pocket Health Spending
Authors: Dong Hao , Li Zhenghui , Failler Pierre
Published: March 2020

Diverse types of healthcare systems in countries offer opportunities to explore the heterogeneous sources of health financing. This paper widely explores the effect of the business cycle on subsidized, voluntary and out-of-pocket health spending in 34 countries with different types of healthcare systems, by the methodology of hierarchical linear modeling (HLM). We use a panel of annual data during the years from 2000 to 2016. It further examines the business cycle-health financing mechanism by inquiring into the mediating effect of external conditions and innovative health financing, based on the structural equation modeling (SEM). The empirical results reveal that the business cycle harms subsidized spending, whereas its effect on voluntary and protective health spending is positive. Results related to the SEM indicate that the mediating effect of external conditions on the relationship between the business cycle and health financing is negative. However, we find that the business cycle plays a positive effect on health financing through innovative health financing channels. Thus, designing and implementing efforts to shift innovative health financing have substantial effects on the sustainability of healthcare systems.
Impacts of Emergency Medical Technician Configurations on Outcomes of Patients with Out-Of-Hospital Cardiac Arrest
Authors: Fang Pin-Hui , Lin Yu-Yuan , Lu Chien-Hsin , Lee Ching-Chi , Lin Chih-Hao
Published: March 2020

Paramedics can provide advanced life support (ALS) for patients with out-of-hospital cardiac arrest (OHCA). However, the impact of emergency medical technician (EMT) configuration on their outcomes remains debated. A three-year cohort study consisted of non-traumatic OHCA adults transported by ALS teams was retrospectively conducted in Tainan City using an Utstein-style population database. The EMT-paramedic (EMT-P) ratio was defined as the EMT-P proportion out of all on-scene EMTs. Among the 1357 eligible cases, the median (interquartile range) number of on-scene EMTs and the EMT-P ratio were 2 (2–2) persons and 50% (50–100%), respectively. The multivariate analysis identified five independent predictors of sustained return of spontaneous circulation (ROSC): younger adults, witnessed cardiac arrest, prehospital ROSC, prehospital defibrillation, and comorbid diabetes mellitus. After adjustment, every 10% increase in the EMT-P ratio was on average associated with an 8% increased chance (adjusted odds ratio [aOR], 1.08; p < 0.01) of sustained ROSC and a 12% increase change (aOR, 1.12; p = 0.048) of favorable neurologic status at discharge. However, increased number of on-scene EMTs was not linked to better outcomes. For nontraumatic OHCA adults, an increase in the on-scene EMT-P ratio resulted in a higher proportion of improved patient outcomes.
Erratum: Pu, G., et al. Study on the Use of Cooking Oil in Chinese Dishes. Int. J. Environ. Res. Public Health 2019, 16, 3367
Authors: Pu Gangwei , Zheng Mo , Lu Shijun , Huang Jiazhang
Published: March 2020

In the original version of our article [...]
Mindfulness and Coaching to Improve Learning Abilities in University Students: A Pilot Study
Authors: Corti Lorenza , Gelati Carmen
Published: March 2020

This pilot study investigated the effects of a short 10-module intervention called MEL (Mindful Effective Learning), which integrates mindfulness, coaching, and training on study strategies, to improve learning abilities among university students. Inspired by ample research on the learning topics that points out how effective learning and good academic results depend simultaneously on self-regulation while studying combined with emotional and motivational factors, the intervention aimed to train students simultaneously in these three aspects. The intervention group participants (N = 21) and the control group participants (N = 24) were surveyed pre- and post-intervention with the Italian questionnaire AMOS (Abilities and Motivation to Study) and the Italian version of the Mindful Attention Awareness Scale (MAAS). The results showed that, regarding self-regulation in study, trained students improved their self-awareness, self-evaluation ability, metacognition skills, and organizational and elaborative ability to manage study materials; regarding emotional aspects, they improved their anxiety control; regarding motivation they developed an incremental theory of Self and improved their confidence in their own intelligence. Moreover, two follow-up self-report surveys were conducted, and trained students reported positive assessments of the MEL intervention. Findings suggest that a short intervention based on mindfulness and coaching and training on study strategies may improve students’ effective learning.
A Discrete Choice Experiment on Women’s Preferences for Water Immersion During Labor and Birth: Identification, Refinement and Selection of Attributes and Levels
Authors: Poder Thomas G. , Carrier Nathalie , Roy Mathieu , Camden Chantal
Published: March 2020

Objectives: To identify attributes (i.e., characteristics describing a scenario) and levels (i.e., each characteristic may be defined by a different level) that would be included in a discrete choice experiment (DCE) questionnaire to evaluate women’s preferences for water immersion during labor and birth. Methods: A mixed-method approach, combining systematic reviews of the literature and patient focus groups to identify attributes and levels explaining women’s preferences. After the focus groups, preference exercises were conducted and led to the creation of the questionnaire, including the DCE. A qualitative validation of the questionnaire was conducted with women from the focus groups and with medical experts. Results: The literature reviews provided 26 attributes to be considered for childbirth in water, and focus groups identified 14 additional attributes. From these 40 attributes, preference exercises allowed us to select four for the DCE, in addition to the birth mode. Labor duration was also included, even if it was not well ranked, as it is the main clinical outcome in the literature. Validation with experts and women did not change the choice of attributes but slightly changed the levels selected. The final six attributes were: birth mode, duration of the labor phase, pain sensation, risk of severe tears in the perineum during the expulsion of the newborn, risk of death of the newborn, and general condition of the newborn (Apgar) score at 5 minutes. Conclusion: This study allowed us to detail all the stages for the design of a DCE questionnaire. To date, this is the first study of this kind in the context of women’s preferences for water immersion during labor and birth.
Concentrations of Formic Acid, Acetic Acid, and Ammonia in Newly Constructed Houses
Authors: Suzuki Norimichi , Nakaoka Hiroko , Eguchi Akifumi , Hanazato Masamichi , Nakayama Yoshitake , Tsumura Kayo , Takaguchi Kohki , Takaya Kazunari , Todaka Emiko , Mori Chisato
Published: March 2020

Herein, the concentrations of formic acid, acetic acid, and ammonia in samples of indoor air for 47 new houses were measured two weeks after completion. The houses were fabricated with light-gauge steel structures. The measurements were performed in living rooms and bedrooms without furniture and outdoors. Air samples were analyzed using ion chromatography. The mean values were 28 (living room), 30 (bedroom), and 20 μg m−3 (outdoor air) for formic acid; 166 (living room), 151 (bedroom), and 51 μg m−3 (outdoor air) for acetic acid; and 73 (living room), 76 (bedroom), and 21 μg m−3 (outdoor air) for ammonia. The total values of the three substances accounted for 39.4–40.7% of the sum of chemical compound values. The analyzed compounds were indicated by two principal components (PC), PC1 (30.1%) and PC2 (9%), with 39.1% total variance. Formic acid, acetic acid, and ammonia were positively aligned with PC1 and negatively aligned with PC2. Factors such as room temperature, aldehydes, and phthalates were positively aligned with PC1 and negatively aligned with PC2. Furthermore, concentrations of formic acid, acetic acid, and ammonia were significantly and positively correlated with room temperature (p < 0.05).
Stroke to Dementia Associated with Environmental Risks—A Semi-Markov Model
Authors: Wang Kung-Jeng , Lee Chia-Min , Hu Gwo-Chi , Wang Kung-Min
Published: March 2020

Background: Most stroke cases lead to serious mental and physical disabilities, such as dementia and sensory impairment. Chronic diseases are contributory risk factors for stroke. However, few studies considered the transition behaviors of stroke to dementia associated with chronic diseases and environmental risks. Objective: This study aims to develop a prognosis model to address the issue of stroke transitioning to dementia associated with environmental risks. Design: This cohort study used the data from the National Health Insurance Research Database in Taiwan. Setting: Healthcare data were obtained from more than 25 million enrollees and covered over 99% of Taiwan’s entire population. Participants: In this study, 10,627 stroke patients diagnosed from 2000 to 2010 in Taiwan were surveyed. Methods: A Cox regression model and corresponding semi-Markov process were constructed to evaluate the influence of risk factors on stroke, corresponding dementia, and their transition behaviors. Main Outcome Measure: Relative risk and sojourn time were the main outcome measure. Results: Multivariate analysis showed that certain environmental risks, medication, and rehabilitation factors highly influenced the transition of stroke from a chronic disease to dementia. This study also highlighted the high-risk populations of stroke patients against the environmental risk factors; the males below 65 years old were the most sensitive population. Conclusion: Experiments showed that the proposed semi-Markovian model outperformed other benchmark diagnosis algorithms (i.e., linear regression, decision tree, random forest, and support vector machine), with a high R2 of 90%. The proposed model also facilitated an accurate prognosis on the transition time of stroke from chronic diseases to dementias against environmental risks and rehabilitation factors.
Meta-Analysis on Intervention Effects of Physical Activities on Children and Adolescents with Autism
Authors: Huang Jinfeng , Du Chunjie , Liu Jianjin , Tan Guangxin
Published: March 2020

This paper aimed to discuss the intervention effects of physical activities on children and adolescents with autism with a meta-analysis so as to serve as a reference to further relevant research on the same topic. As for research methods, by searching in CNKI (China National Knowledge Infrastructure), WanFang data, VIP Database for Chinese Technical Periodicals, PubMed, Scopus, Web of Science, and other databases, this study collected randomized controlled trials (RCTs) on the intervention of physical activities on children and adolescents with autism and used Review Manager 5.3 software to process and analyze the outcome indicators of the literature. As for the result, a total of 12 papers and 492 research targets were selected. The results of the meta-analysis show that physical activity had a significant positive impact on social interaction ability, communication ability, motor skills, and autism degree of autistic children as well as the social skills and communication skills of autistic adolescents. On the other hand, physical activity had no significant effect on the stereotyped behavior of autistic children and adolescents. In conclusion, physical activity intervention is beneficial to children and adolescents with autism, and continuous physical activity intervention can produce greater intervention effect.
Simultaneous Analysis and Dietary Exposure Risk Assessment of Fomesafen, Clomazone, Clethodim and Its Two Metabolites in Soybean Ecosystem
Authors: Pang Kyongjin , Hu Jiye
Published: March 2020

A commercial formulation, 37% dispersible oil suspension (DOS) (fomesafen, clomazone, and clethodim), is being registered in China to control annual or perennial weeds in soybean fields. In this paper, a liquid chromatography tandem mass spectrometry method with QuEChERS (quick, easy, cheap, effective, rugged, and safe) sample preparation was developed for the simultaneous determination of fomesafen, clomazone, clethodim, and its two metabolites (CSO and CSO2) in soybean, green soybean, and soybean straw samples. The mean recoveries of our developed method for the five analytes in three matrices were ranged from 71% to 116% with relative standard deviations (RSDs) less than 12.6%. The limits of quantification (LOQs) were 0.01 mg/kg in soybean, 0.01 mg/kg in green soybean, and 0.02 mg/kg in soybean straw while the limits of detection (LODs) ranged from 0.018 to 0.125 μg/kg for these five analytes. The highest final residual amount of CSO2 in green soybean samples (0.015 mg/kg) appeared in Anhui, and the highest in soybean straw samples was 0.029 mg/kg in Guangxi, whilst the terminal residues of fomesafen, clomazone, clethodim and CSO were lower than LOQs (0.01 mg/kg) in all samples. Furthermore, these terminal residues were all lower than the maximum residue limits (MRLs) set by China (0.1 mg/kg for fomesafen and clethodim, 0.05 mg/kg for clomazone) at harvest. Additional chronic dietary risk was evaluated using a risk quotients (RQs) method based on Chinese dietary habits. The chronic dietary exposure risk quotients were 4.3 for fomesafen, 0.12 for clomazone, and 19.3 for clethodim, respectively, which were significantly lower than 100. These results demonstrated that the dietary exposure risk of fomesafen, clomazone, and clethodim used in soybean according to good agricultural practices (GAP) was acceptable and would not pose an unacceptable health risk to Chinese consumers. These results not only offer insight with respect to the analytes, but also contribute to environmental protection and food safety.
When Multiple Objective Measures of Medication Adherence Indicate Incongruent Adherence Results: An Example with Pediatric Cancer
Authors: Cain Caitlin J. , Meisman Andrea R. , Drucker Kirstin , Isaac Evrosina I. , Verma Tanvi , Griffin Jordyn , Rohan Jennifer M.
Published: March 2020

Previous research suggests that children and adolescents with acute lymphoblastic leukemia (ALL) and lymphoblastic lymphoma (LBL) often have difficulty adhering to complex treatment regimens during the maintenance phase of therapy. Measurement of treatment adherence can be done via objective (e.g., electronic monitoring (EM), pharmacological assays) or subjective methods (patient, parent, or physician reports). This paper provides an illustration of recommended strategies for comparing discrepancies between two objective measures of medication adherence (e.g., behavioral adherence using electronic monitoring versus pharmacological adherence using 6-mercaptopurine (6MP) metabolite data) within a relatively large cohort of pediatric patients with ALL or LBL (N = 139) who had longitudinal data for both measures of medication adherence over a 15-month period. Additionally, individual- and family-level factors such as gender, socioeconomic status, household environment, and dose intensity will be examined to identify possible sources of discrepancies between adherence measures. This information will provide practical advice for physicians, healthcare providers, and psychologists in identifying nonadherence and the caveats therein so patients achieve the best possible health outcomes.
Association of Sleep Duration and Overweight/Obesity among Children in China
Authors: Fan Jing , Ding Caicui , Gong Weiyan , Yuan Fan , Zhang Yan , Feng Ganyu , Song Chao , Liu Ailing
Published: March 2020

To investigate the association of sleep duration with overweight and obesity among children aged 6 to 17 years in China, 2010–2012 data from the China National Nutrition and Health Surveillance (CNHHS) were analyzed. A total of 35,414 children were recruited in the survey. Body mass index (BMI) was converted into three categories: normal weight, overweight and obesity. In multinomial logistic regression model, sleep duration was divided into four groups: very short, short, recommended and long. In restricted cubic splines (RCS), sleep duration was examined as a continuous variable in relation to overweight and obesity. In the very short and short groups, sleep duration was a risk factor for obesity after adjusting for the potential impacts of age, gender, residence, family income, leisure sedentary behavior (SB) and leisure exercise, with OR (Odds Ratio) = 3.01 (95% CI (confidence interval): 2.19–4.15) and OR = 1.24 (95% CI: 1.14–1.35), respectively. The adjusted OR of overweight for short sleep duration relative to a recommended sleep duration was 1.17(95% CI: 1.09–1.26). No significant associations of very short sleep with overweight, of long sleep duration with overweight and obesity were found. The RCS curves between sleep duration and overweight and obesity were both inverted J-shaped. To conclude, the shorter the sleep duration, the higher the risk of overweight and obesity in children. Increasing sleep duration would have a positive effect on reducing overweight and obesity rates in Chinese children.
Analysis of Prehospital Care of Migrants Who Arrive Intermittently at the Coasts of Southern Spain
Authors: Ponce-Blandón José Antonio , Mérida-Martín Tatiana , Jiménez-Lasserrotte Maria del Mar , Jiménez-Picón Nerea , Macías-Seda Juana , Lomas-Campos Maria de las Mercedes
Published: March 2020

Background: The aim of this study is to identify the sociodemographic characteristics and the most frequent diseases and nursing interventions carried out on migrants arriving by sea at southern Spain. Method: Cross-sectional, descriptive, and retrospective study based on the database of the Spanish Red Cross Intervention Activation System. All migrants who arrived on the coasts of a southern province during 2016 and were assisted by the Red Cross were included. Results: A total of 2027 people were registered, mostly males, aged between 18 and 40 years. Of these, 4.9% required healthcare, and 2.9% were referred to hospital. Highlighted diagnoses were headaches (15.6%), pregnancy (12.8%), and lower-limb wounds (6.4%), and outstanding nursing interventions were “care of wounds” (24.7%), “pain management” (21.9%), and “prenatal care” (15.2%). Statistically significant relationships were found between the diagnosed diseases and gender, geographic area of origin, and seasonal time of the year, as well as between nursing interventions performed and those three variables. Conclusions: Although in general, a good health condition was observed in most of the migrants treated, the most frequent health situations attended were related to dermatological, gynecological, and headache problems. The most performed nursing interventions were related to skin/wound care and promotion of physical comfort, requiring a low need for hospital transfers. Female gender, origin from sub-Saharan Africa and arrival in the summer period carry a greater risk of suffering health problems when migrants reach Spanish coasts.
Priority Setting for Management of Hazardous Biocides in Korea Using Chemical Ranking and Scoring Method
Authors: Choi Yun-Hee , Kang Min-Sung , Huh Da-An , Chae Woo-Ri , Moon Kyong Whan
Published: March 2020

Biocides are non-agricultural chemical agents for the prevention of unhygienic pests. The worldwide demand for biocidal products has been rapidly increasing. Meanwhile, biocides have been causing negative health effects for decades, resulting in public health scares. Therefore, governments around the world have tried to strictly control biocides, and it is necessary to prioritize the health risks of biocides for efficient management. Chemical ranking and scoring (CRS) methods have been developed for the effective management of chemicals. However, existing methods do not use suitable variables to evaluate biocides, thus possibly underestimating or overestimating the actual health risks. We developed a new CRS method that reflects the exposure and toxicity characteristics of biocides. Eleven indicators were chosen as appropriate for prioritizing biocides, and scoring based on the globally harmonized system of classification and labeling of chemicals (GHS) improved the efficiency of the method. Correlations between individual indicators in this study were low (−0.151–0.325), indicating that each indicator was independent and well-chosen for prioritizing biocides. The effect of each indicator on the total score showed that carcinogenicity, mutagenicity, and reproductive toxicity (CMR) chemicals ranked high with r = 0.558. This result demonstrated that the most dangerous toxicants should play a more decisive role in the top ranking than the others. We expect that our method can be efficiently used to screen regulated biocides by prioritizing their health hazards, thus leading to better policy decision making about biocide use.
Assessment of Indoor Air Quality and Users Perception of a Renovated Office Building in Manchester
Authors: Fahad Alomirah Haya , Moda Haruna Musa
Published: March 2020

Building renovations can adversely affect building occupants through the release of biological contaminants, gases and particulates. In this study, the research aim was to monitor the air quality of a renovated building and assess the impact of sick building syndrome (SBS) on the occupants. Post occupancy monitoring of the building was carried out after two months occupancy for the following environmental parameters: airborne microflora using an air sampler (SAS super 180) and a hand-held monitoring device (Graywolf advance sense IQ-610) to measure total volatile organic compounds (TVOC), CO2, CO and temperature and relative humidity in each office environment. In addition, an online (Qualtrics) structured questionnaire was used to assess occupants’ perceptions of the indoor environment. Results of the airborne flora showed 833 cfu/m3 recovered on a Malt Extract Agar (MEA) plate in the morning and 1213 cfu/m3 in the afternoon. A similar result was noticed on a Plate Count Agar (PCA) plate during the morning period (731 cfu/m3) and afternoon (1358 cfu/m3). Results of TVOC monitored over one week showed that the first two days of monitoring had a high reading that peaked at 10,837 ppb and that the CO2 concentration during that period was 1163 ppm. Online questionnaire analysis indicates that a majority of the staff who took part in the survey experienced some form of health abnormality, including headache, shortness of breath, itchy eyes/ears, loss of concentration and so on, especially in the first few weeks of returning to the office. The results from the study indicate that a large proportion (41%) of the respondents experienced thermal discomfort as a result of varying room temperature during their working hours. A high number of female participants experienced some form of SBS as compared to their male counterparts. The study findings show a direct relationship between high airborne mold counts, TVOC and adverse staff health perception of the building. The study raised a number of opportunities for estate managers to improve building performance based on occupants’ preferences.
Effectiveness of Maintenance Immunosuppression Therapies in a Matched-Pair Analysis Cohort of 16 Years of Renal Transplant in the Brazilian National Health System
Authors: Gomes Rosângela Maria , Barbosa Wallace Breno , Godman Brian , Costa Juliana de Oliveira , Ribeiro Junior Nélio Gomes , Simão Filho Charles , Cherchiglia Mariângela Leal , Acurcio Francisco de Assis , Guerra Júnior Augusto Afonso
Published: March 2020

The maintenance of patients with renal transplant typically involves two or more drugs to prevent rejection and prolong graft survival. The calcineurin inhibitors (CNI) are the most commonly recommended medicines in combinations with others. While immunosuppressive treatment regimens are well established, there is insufficient long-term effectiveness data to help guide future management decisions. The study analyzes the effectiveness of treatment regimens containing CNI after renal transplantation during 16 years of follow-up with real-world data from the Brazilian National Health System (SUS). This was a retrospective study of 2318 SUS patients after renal transplantion. Patients were propensity score-matched (1:1) by sex, age, type and year of transplantation. Kaplan–Meier analysis was used to estimate the cumulative probabilities of survival. A Cox proportional hazard model was used to evaluate factors associated with progression to graft loss. Multivariable analysis, adjusted for diabetes mellitus and race/color, showed a greater risk of graft loss for patients using tacrolimus plus mycophenolate compared to patients treated with cyclosporine plus azathioprine. In conclusion, this Brazilian real-world study, with a long follow-up period using matched analysis for relevant clinical features and the representativeness of the sample, demonstrated improved long-term effectiveness for therapeutic regimens containing cyclosporine plus azathioprine. Consequently, we recommend that protocols and clinical guidelines for renal transplantation should consider the cyclosporine plus azathioprine regimen as a potential first line option, along with others.
Advancing Global Health through Environmental and Public Health Tracking
Authors: Lauriola Paolo , Crabbe Helen , Behbod Behrooz , Yip Fuyuen , Medina Sylvia , Semenza Jan C. , Vardoulakis Sotiris , Kass Dan , Zeka Ariana , Khonelidze Irma , Ashworth Matthew , de Hoogh Kees , Shi Xiaoming , Staatsen Brigit , Knudsen Lisbeth E. , Fletcher Tony , Houthuijs Danny , Leonardi Giovanni S.
Published: March 2020

Global environmental change has degraded ecosystems. Challenges such as climate change, resource depletion (with its huge implications for human health and wellbeing), and persistent social inequalities in health have been identified as global public health issues with implications for both communicable and noncommunicable diseases. This contributes to pressure on healthcare systems, as well as societal systems that affect health. A novel strategy to tackle these multiple, interacting and interdependent drivers of change is required to protect the population’s health. Public health professionals have found that building strong, enduring interdisciplinary partnerships across disciplines can address environment and health complexities, and that developing Environmental and Public Health Tracking (EPHT) systems has been an effective tool. EPHT aims to merge, integrate, analyse and interpret environmental hazards, exposure and health data. In this article, we explain that public health decision-makers can use EPHT insights to drive public health actions, reduce exposure and prevent the occurrence of disease more precisely in efficient and cost-effective ways. An international network exists for practitioners and researchers to monitor and use environmental health intelligence, and to support countries and local areas toward sustainable and healthy development. A global network of EPHT programs and professionals has the potential to advance global health by implementing and sharing experience, to magnify the impact of local efforts and to pursue data knowledge improvement strategies, aiming to recognise and support best practices. EPHT can help increase the understanding of environmental public health and global health, improve comparability of risks between different areas of the world including Low and Middle-Income Countries (LMICs), enable transparency and trust among citizens, institutions and the private sector, and inform preventive decision making consistent with sustainable and healthy development. This shows how EPHT advances global health efforts by sharing recent global EPHT activities and resources with those working in this field. Experiences from the US, Europe, Asia and Australasia are outlined for operating successful tracking systems to advance global health.
Atopic Disease and Anemia in Korean Patients: Cross-Sectional Study with Propensity Score Analysis
Authors: Rhew Kiyon , Brown Joshua D , Oh Jung Mi
Published: March 2020

Atopic disease is associated with chronic inflammation, and anemia has been reported in patients with inflammatory disorders such as rheumatoid arthritis, chronic obstructive pulmonary disease, and irritable bowel disease. The objective of this study was to determine whether atopic disease is associated with an increased risk of anemia. A cross-sectional study with propensity score weighting was conducted using a health insurance review agency claims dataset comprised of randomized patients who used the Korean national health system at least once in 2016. The association between atopic disease (asthma, atopic dermatitis, allergic rhinitis) and anemia (iron deficiency anemia (IDA) and/or anemia of inflammation (AI)) was examined. A total of 1,468,033 patients were included in this study. The IDA/AI prevalence was 3.1% (45,681 patients). After propensity score weighting, there were 46,958 and 45,681 patients in the non-anemic and anemic groups, respectively. The prevalence of IDA/AI in patients with atopic dermatitis, allergic rhinitis, or asthma had an odds ratio (OR) of 1.40 (95% confidence interval (CI), 1.33–1.48; p < 0.001), 1.17 (95% CI, 1.14–1.21; p < 0.001), and 1.32 (95% CI, 1.28–1.36; p < 0.001), respectively. In addition, the prevalence of IDA increased with higher numbers of atopic diseases. In conclusion, the prevalence of IDA/AI was higher in patients with atopic disease, even after adjusting for demographic characteristics and other risk factors. Further study is needed to distinguish between IDA and AI and to enhance understanding of the etiology of anemia in patients with inflammatory conditions.