bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluation of Glycemic Index of Six Different Samples of Commercial and Experimental Pasta Differing in Wheat Varieties and Production Processes
Authors: Pandolfo Amalia , Messina Bernardo , Russo Giuseppe
Published: September 2021

Pasta is a staple food of the Mediterranean Diet, and it is traditionally made of durum wheat semolina. In Sicily, durum wheat production and its transformation into semolina, bread, and pasta are well-developed economic sectors. For pasta, there is a wide supply of commercial brands, whether coming from conventional industrial manufacturing or from medium to small and local handcrafted production. Both conventional durum wheat and local durum wheat landraces, such as Timilia and Russello, are used for pasta production, but local landraces are, for the most, transformed into handcrafted pasta. The market of local landraces durum wheat pasta has risen in recent decades, in Sicily and in Italy as well, boosted by a perceived high nutritional and healthy value of these wheat derivatives. In particular, a popular and scientifically unproven idea suggests that a reduced glycemic response might be elicited by these pasta landraces. Therefore, to test this hypothesis, the main objective of the present study was the evaluation of the glycemic index (GI) of four samples of Timilia and Russello handcrafted pasta and two samples of conventional durum wheat pasta. The study enrolled fourteen healthy weight male and female volunteers aged from 18 to 46; eight test sessions were performed twice a week, every session testing a pasta sample (six sessions) or the glucose solution chosen as reference food (two sessions). The standard methodology for GI measurement was followed during each step of the study. The six tested pasta samples were characterized regarding their composition (protein, fiber, and starch content) and their whole production processes (milling method and milling diagram of flour or semolina, drying temperature, and diagram of pasta shape). The six tested pasta samples showed GI values ranging from low (34.1) to intermediate (63.1). Timilia and Russello pasta are the first GI calculations available. The two samples made of conventional grains showed lower values of GI (34.1 and 37.8). The results do not support the popular idea of a reduced glycemic response elicited by Timilia and Russello wheat landrace pasta; the tested samples showed GI values in the range of 56.2 to 63.1. However, some consideration should be made of factors other than wheat varieties and related to production processes that may have affected the final GIs of the pastas. Even if the study is not designed to discriminate among factors related to wheat varieties or processes used to produce different pasta, it is a preliminary step in the characterization of the healthy potential of the local wheat landraces, popularly called ancient grain. A future implementation of the local wheat landraces supply chain should pay attention to all the factors above, from a better seed identity certification to the production process in order to further improve the healthy value of these staples of the Mediterranean Diet.
Tensor-Decomposition-Based Unsupervised Feature Extraction in Single-Cell Multiomics Data Analysis
Authors: Taguchi Y-h. , Turki Turki
Published: September 2021

Analysis of single-cell multiomics datasets is a novel topic and is considerably challenging because such datasets contain a large number of features with numerous missing values. In this study, we implemented a recently proposed tensor-decomposition (TD)-based unsupervised feature extraction (FE) technique to address this difficult problem. The technique can successfully integrate single-cell multiomics data composed of gene expression, DNA methylation, and accessibility. Although the last two have large dimensions, as many as ten million, containing only a few percentage of nonzero values, TD-based unsupervised FE can integrate three omics datasets without filling in missing values. Together with UMAP, which is used frequently when embedding single-cell measurements into two-dimensional space, TD-based unsupervised FE can produce two-dimensional embedding coincident with classification when integrating single-cell omics datasets. Genes selected based on TD-based unsupervised FE are also significantly related to reasonable biological roles.
Genome-Wide Identification and Transcriptional Expression Profiles of Transcription Factor WRKY in Common Walnut (Juglans regia L.)
Authors: Hao Fan , Yang Ge , Zhou Huijuan , Yao Jiajun , Liu Deruilin , Zhao Peng , Zhang Shuoxin
Published: September 2021

The transcription factor WRKY is widely distributed in the plant kingdom, playing a significant role in plant growth, development and response to stresses. Walnut is an economically important temperate tree species valued for both its edible nuts and high-quality wood, and its response to various stresses is an important factor that determines the quality of its fruit. However, in walnut trees themselves, information about the WRKY gene family remains scarce. In this paper, we perform a comprehensive study of the WRKY gene family in walnut. In total, we identified 103 WRKY genes in the common walnut that are clustered into 4 groups and distributed on 14 chromosomes. The conserved domains all contained a WRKY domain, and motif 2 was observed in most WRKYs, suggesting a high degree of conservation and similar functions within each subfamily. However, gene structure was significantly differentiated between different subfamilies. Synteny analysis indicates that there were 56 gene pairs in J. regia and A. thaliana, 76 in J. regia and J. mandshurica, 75 in J. regia and J. microcarpa, 76 in J. regia and P. trichocarpa, and 33 in J. regia and Q. robur, indicating that the WRKY gene family may come from a common ancestor. GO and KEGG enrichment analysis showed that the WRKY gene family was involved in resistance traits and the plant-pathogen interaction pathway. In anthracnose-resistant F26 fruits (AR) and anthracnose-susceptible F423 fruits (AS), transcriptome and qPCR analysis results showed that JrWRKY83, JrWRKY73 and JrWRKY74 were expressed significantly more highly in resistant cultivars, indicating that these three genes may be important contributors to stress resistance in walnut trees. Furthermore, we investigate how these three genes potentially target miRNAs and interact with proteins. JrWRKY73 was target by the miR156 family, including 12 miRNAs; this miRNA family targets WRKY genes to enhance plant defense. JrWRKY73 also interacted with the resistance gene AtMPK6, showing that it may play a crucial role in walnut defense.
Exploring Barriers and Facilitators of Adherence to Artemisinin-Based Combination Therapies for the Treatment of Uncomplicated Malaria in Children in Freetown, Sierra Leone
Authors: Banek Kristin , DiLiberto Deborah D. , Webb Emily L. , Smith Samuel Juana , Chandramohan Daniel , Staedke Sarah G.
Published: September 2021

Medication adherence is an essential step in the malaria treatment cascade. We conducted a qualitative study embedded within a randomized controlled trial comparing the adherence to the recommended dosing of two artemisinin-based combination therapies (ACT) to treat uncomplicated malaria in Freetown, Sierra Leone. This study explored the circumstances and factors that influenced caregiver adherence to the ACT prescribed for their child in the trial. In-depth interviews were conducted with 49 caregivers; all interviews were recorded, transcribed, and translated. Transcripts were coded and aggregated into themes, applying a thematic content approach. We identified four key factors that influenced optimal treatment adherence: (1) health system influences, (2) health services, (3) caregivers’ experiences with malaria illness and treatment, and (4) medication characteristics. Specifically, caregivers reported confidence in the health system as facilities were well maintained and care was free. They also felt that health workers provided quality care, leading them to trust the health workers and believe the test results. Ease of medication administration and perceived risk of side effects coupled with caregivers’ prior experience treating malaria influenced how medications were administered. To ensure ACTs achieve maximum effectiveness, consideration of these contextual factors and further development of child-friendly antimalarials are needed.
What Are the Factors Associated with Nonadherence to Medications in Patients with Chronic Diseases?
Authors: Al Bawab Abdel Qader , Al-Qerem Walid , Abusara Osama , Alkhatib Nimer , Mansour Maha , Horne Robert
Published: September 2021

Introduction: Adherence to medications is very crucial for an optimized clinical outcome in the management of chronic diseases. Beliefs about medications and other factors can significantly affect adherence to chronic medications. The objective of the present research was to identify the associated factors of adherence to medication in Jordanian patients with chronic diseases utilizing a stepwise binary logistical regression model. Methods: A cross-sectional study was carried out between November 2018 and March 2020. The participants were reached from secondary and tertiary care setting clinics in Jordan. The recruited patients were asked to report their attitudes of adherence to medications and beliefs about medications via filling out the MARS-5 and BMQ-specific tools. Sociodemographic data were also collected from the recruited patients and included in the regression model. A stepwise binary logistical regression model was applied to identify the associated factors of adherence to chronic medications in the tested sample. Results: A total of 485 patients who met the inclusion criteria were recruited. The mean age of the participants was 57.14 (age ranged from 22 to 82 years). Around 39% of the participants were older than 65 years. Most of the patients were either hypertensive or diabetic (35.7% and 32.2%, respectively). The logistic regression model indicated that necessity beliefs are strongly associated with adherence (OR 4.22), while concerns beliefs, dosage frequency and having medical insurance were negatively associated with adherence (OR 0.73, 0.74 and 0.26, respectively), with a p-value ≤ 0.05. Conclusions: Both the MARS-5 and BMQ-specific questionnaires were applied successfully on the tested sample. Better attention should be paid to the logistic regression model variables that were associated with adherence in order to guarantee optimal treatment outcomes in the treatment of chronic diseases.
He Tamariki Kokoti Tau: Families of Indigenous Infants Talk about Their Experiences of Preterm Birth and Neonatal Intensive Care
Authors: Adcock Anna , Cram Fiona , Edmonds Liza , Lawton Beverley
Published: September 2021

Māori (Indigenous peoples of Aotearoa New Zealand) bear an unequal burden of poor perinatal health outcomes, including preterm birth. An infant arriving preterm disrupts the birth imaginary of whānau (family collectives) and situates them in a foreign health environment that may not be culturally safe and nurturing. A cross-sectional interpretative phenomenological analysis of first interviews with 19 whānau participating in a Kaupapa Māori (by, with, for Māori) qualitative longitudinal study of preterm birth identified themes from their experiences and the meanings they attributed to them. Preterm birth was an emotional roller coaster, with the birth imaginary and anticipated roles disrupted as health practitioners took over the care of their infants. Whānau expressed the desire to be close to their infants, holding them, loving them, nurturing them, and emplacing them within whakapapa (genealogy, continual layering of foundations) networks. When health practitioners or hospital policies inhibited this intimacy by isolating, excluding, or discriminating, whānau were frustrated. Being familiar with hospital routines, staff, peers, infant cares, and being wrapped in wider whānau support were key for whānau coping. Whakawhanaungatanga (processes of establishing relationships) create safe spaces for whānau to be themselves. This quietens the ‘storm’ and returns whānau to a sense of calm, through the reclamation of their environment.
A Formative Assessment of Social Determinants of Health Related to Early Childhood Caries in Two American Indian Communities
Authors: Elwell Kristan , Camplain Carolyn , Kirby Christine , Sanderson Katharine , Grover Gloria , Morrison Gerlinda , Gelatt Amy , Baldwin Julie A.
Published: September 2021

In the United States, children from diverse ethnic groups and those with low socioeconomic status are at a significantly increased risk for early childhood caries. Despite the efforts focused on decreasing early childhood caries in American Indian (AI) populations, these children have the highest incidence of dental caries of any ethnic group, with four times the cases of untreated dental caries compared to white children. This qualitative formative assessment was conducted in two AI communities. Semi-structured interviews (n = 57) were conducted with caregivers and providers to understand the social and community contexts in which oral health behaviors and practices occur from the perspective of the caregivers, oral health care providers, and social service providers in the communities. The analysis was informed by the social determinants of health framework. The key social determinants of pediatric oral health relevant to our study communities included limited access to: oral health promoting nutritious foods, transportation for oral health appointments, and pediatric specialty care. This formative assessment provided locally and contextually relevant information to shape the development of an oral health clinical trial intervention to address early childhood caries in these two communities.
Effectiveness of Plasma-Treated Hydrogen Peroxide Mist Disinfection in Various Hospital Environments
Authors: Choi Jongbong , Lee Minhyuk , Lee Yangsoon , Song Yeongtak , Cho Yongil , Lim Tae Ho
Published: September 2021

Hospital environments are associated with a high risk of infection. As plasma-treated hydrogen peroxide mist disinfection has a higher disinfection efficacy, we tested the efficacy of plasma-treated hydrogen peroxide mist disinfection on several surfaces in various hospital environments. Disinfection was performed in 23 rooms across different hospital environments, including hospital wards, outpatient departments (OPDs), and emergency rooms. A total of 459 surfaces were swabbed before/after disinfection. Surfaces were also divided into plastic, metal, wood, leather, ceramic, silicone, and glass for further analyses. Only gram-positive bacteria were statistically analyzed because the number of gram-negative bacteria and mold was insufficient. Most colony-forming units (CFUs) of gram-positive bacteria were observed in OPDs and on leather materials before disinfection. The proportion of surfaces that showed a percentage decrease in CFU values of more than 90% after disinfection were as follows: OPDs (85%), hospital wards (99%), and emergency rooms (100%); plastic (97%), metal (83%), wood (84%), leather (81%), and others (87%). Plasma-treated hydrogen peroxide mist disinfection resulted in a significant decrease in the CFU values of gram-positive bacteria in various environments. Plasma-treated hydrogen peroxide mist disinfection is an effective and efficient method of disinfecting various hospital environments.
The Prevalence and Overlaps of Temporomandibular Disorders in Patients with Myofascial Pain with Referral—A Pilot Study
Authors: Kuć Joanna , Szarejko Krzysztof Dariusz , Gołębiewska Maria
Published: September 2021

The aim of the study was to evaluate the temporomandibular joint, the prevalence of single and multiple diagnosis and potential sided domination of temporomandibular dysfunction in patients with temporomandibular disorder—myofascial pain with referral. The study group enrolled 50 people—37 females and 13 males between 18 and 25 years old with an average age of 23.36 ± 2.14. The patients underwent joint vibration analysis. Sixty seven percent of all examined tem-poromandibular joints were classified as group I according to Mark Piper’s classification. Class IIIA appeared in 17% of joints. Eight percent of temporomandibular joints were classified as class IVA. There were no statistically significant differences in the prevalence of temporomandibular disorder with respect to gender (p = 0.838639). The relatively high prevalence of multiple diagnoses proved the overlapping nature of muscle and intraarticular disorders. Twenty eight percent of the subjects suffered from a combination of myofascial pain with referral and bilateral temporoman-dibular dysfunction. In 62% of the patients a lack of intraarticular disorders was reported. The suggestion that there exists sided domination in the occurrence of temporomandibular disorders has not been confirmed. Due to the small sample size, such differences cannot be excluded. Fur-ther research is needed.
Previous Intensive Running or Swimming Negatively Affects CPR Effectiveness
Authors: Abraldes J. Arturo , Fernandes Ricardo J. , Morán-Navarro Ricardo
Published: September 2021

Survival outcomes increase significantly when cardiopulmonary resuscitation (CPR) is provided correctly, but rescuers’ fatigue can compromise its delivery. We investigated the effect of two exercise modes on CPR effectiveness and physiological outputs. After 4 min baseline conditions, 30 lifeguards randomly performed a 100 m run and a combined water rescue before 4 min CPR (using an adult manikin and a 30:2 compression–ventilation ratio). Physiological variables were continuously measured during baseline and CPR using a portable gas analyzer (K4b2, Cosmed, Rome, Italy) and CPR effectiveness was analyzed using two HD video cameras. Higher oxygen uptake (23.0 ± 9.9 and 20.6 ± 9.1 vs. 13.5 ± 6.2 mL·kg·min−1) and heart rate (137 ± 19 and 133 ± 15 vs. 114 ± 15 bpm), and lower compression efficacy (63.3 ± 29.5 and 62.2 ± 28.3 vs. 69.2 ± 28.0%), were found for CPRrun and CPRswim compared to CPRbase. In addition, ventilation efficacy was higher in the rescues preceded by intense exercise than in CPRbase (49.5 ± 42.3 and 51.9 ± 41.0 vs. 33.5 ± 38.3%), but no differences were detected between CPRrun and CPRswim. In conclusion, CPRrun and CPRswim protocols induced a relevant physiological stress over each min and in the overall CPR compared with CPRbase. The CPRun protocol reduces the compression rate but has a higher effectiveness percentage than the CPRswim protocol, in which there is a considerably higher compression rate but with less efficacy.
Discrepancies in Infectivity of Flavivirus and SARS-CoV-2 Clinical Samples: An Improved Assay for Infectious Virus Shedding and Viremia Assessment
Authors: Fukuta Mizuki , Nguyen Co Thach , Nguyen Thi Thu Thuy , Nguyen Thi Thanh Ngan , Vu Thi Bich Hau , Takemura Taichiro , Nguyen Le Khanh Hang , Inoue Shingo , Morita Kouichi , Le Thi Quynh Mai , Hasebe Futoshi , Moi Meng Ling
Published: September 2021

Infectivity and neutralizing antibody titers of flavivirus and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are frequently measured using the conventional plaque assay. While the assay is useful in the determination of infectivity, conventional plaque assays generally possess lower sensitivity and are time-consuming compared to nucleic acid amplification tests. In this study, a microcrystalline cellulose (MCC), Avicel, was evaluated as an alternative to the conventional virus overlay medium, methylcellulose, for a plaque assay. The plaque assay was performed using dengue and COVID-19 clinical samples and laboratory-established flavivirus and SARS-CoV-2 strains. In virus titration of clinical samples, the plaques were significantly larger, and the virus titers were higher when Avicel MCC-containing overlay medium was used than with conventional methylcellulose overlay medium. In addition, for some clinical samples and laboratory virus strains, infectious particles were detected as plaques in the Avicel MCC-containing medium, but not in the conventional methylcellulose medium. The results suggest that the viremia titer determined using the new overlay medium containing Avicel MCC may better reflect the innate infectious and plaque-forming capabilities of clinical samples and better reflect virus infectivity.
A Health Technology Assessment in Maxillofacial Cancer Surgery by Using the Six Sigma Methodology
Authors: Ricciardi Carlo , Orabona Giovanni Dell’Aversana , Picone Ilaria , Latessa Imma , Fiorillo Antonella , Sorrentino Alfonso , Triassi Maria , Improta Giovanni
Published: September 2021

Squamous cell carcinoma represents the most common cancer affecting the oral cavity. At the University of Naples “Federico II”, two different antibiotic protocols were used in patients undergoing oral mucosa cancer surgery from 2006 to 2018. From 2011, there was a shift; the combination of Cefazolin plus Clindamycin as a postoperative prophylactic protocol was chosen. In this paper, a health technology assessment (HTA) is performed by using the Six Sigma and DMAIC (Define, Measure, Analyse, Improve, Control) cycle in order to compare the performance of the antibiotic protocols according to the length of hospital stay (LOS). The data (13 variables) of two groups were collected and analysed; overall, 136 patients were involved. The American Society of Anaesthesiologist score, use of lymphadenectomy or tracheotomy and the presence of infections influenced LOS significantly (p-value < 0.05) in both groups. Then, the groups were compared: the overall difference between LOS of the groups was not statistically significant, but some insights were provided by comparing the LOS of the groups according to each variable. In conclusion, in light of the insights provided by this study regarding the comparison of two antibiotic protocols, the utilization of DMAIC cycle and Six Sigma tools to perform HTA studies could be considered in future research.
Fear of COVID-19 in Patients with Acute Myocardial Infarction
Authors: Marotta Marco , Gorini Francesca , Parlanti Alessandra , Chatzianagnostou Kyriazoula , Mazzone Annamaria , Berti Sergio , Vassalle Cristina
Published: September 2021

A marked decline in myocardial infarction (AMI) hospitalizations was observed worldwide during the COVID-19 outbreak. The pandemic may have generated fear and adverse psychological consequences in these patients, delaying hospital access. The main objective of the study was to assess COVID fear through the FCV-19S questionnaire (a self-report measure of seven items) in 69 AMI patients (65 ± 11 years, mean ± SD; 59 males). Females presented higher values of each FCV-19S item than males. Older subjects (>57 years, 25th percentile) showed a higher total score with respect to those in the first quartile. The percentage of patients who responded “agree” and “strongly agree” in item 4 (“I am afraid of losing my life because of the coronavirus”) and 3 (“My hands become clammy when I think about the coronavirus”) was significantly greater in the elderly than in younger patients. When cardiovascular (CV) patients were compared to a previously published general Italian population, patients with CV disease exhibited higher values for items 3 and 4. Measures should be put in place to assist vulnerable and high CV risk patients, possibly adding psychologists to the cardiology team.
How Important Is Behavioral Change during the Early Stages of the COVID-19 Pandemic? A Mathematical Modeling Study
Authors: Lee Jongmin , Lee Seok-Min , Jung Eunok
Published: September 2021

How important is the speed and intensity of behavioral change due to government policies, such as enhanced social distancing or lockdown, when an emerging infectious disease occurs? In this study, we introduce a deterministic SEIR model considering the behavior-changed susceptible group to investigate the effect of the speed and intensity of behavioral change on the transmission dynamics of COVID-19. We used epidemiological data from South Korea and Italy for the simulation study, because South Korea and Italy were the first countries to report an outbreak of COVID-19 after China and the prevention and response policy of each government were similar during the first outbreak of COVID-19. Simulation results showed that it took approximately twenty fewer days in Korea than in Italy until 90% of susceptible individuals changed their behavior during the first outbreak. It was observed that the behavior-changed susceptible individuals reduced the COVID-19 transmission rate by up to 93% in Korea and 77% in Italy. Furthermore, if the intensity and speed of behavioral change in Italy were the same as in Korea, the expected number of cumulative confirmed cases would have been reduced by approximately 95%, from 210,700 to 10,700, until the end of the lockdown period. We assumed that behavioral change is influenced by the number of confirmed cases and does not take into account social and cultural differences, as well as the state of the healthcare system, between the two countries. Our mathematical modeling showed how important the high intensity and fast speed of behavioral change to reduce the number of confirmed cases in the early period of an epidemic are.
Factors Influencing Turnover Intention among Male Nurses in Korea
Authors: Kim Su Ol , Moon Sun-Hee
Published: September 2021

The study examined predictors of male nurse turnover intention in Korea using data collected from Korean hospitals. The results were obtained based on a secondary analysis of data previously collected from 306 male nurses in 16 regions of Korea from December 2014 to February 2015. Our findings suggest that male nurse turnover intention is predicted by (1) individual factors: single (B = 0.93, p = 0.008); (2) organizational factors: organizational commitment (B = −0.36, p < 0.001), job satisfaction (B = −0.27, p = 0.001), and job stress (B = 0.24, p < 0.001); and (3) social factors: hospital location in medium-categorized cities (B = 0.70, p = 0.012) and kinship responsibility (B = 0.13, p = 0.026). These factors accounted for 56.9% of the total variance. To lower the rate of turnover intention among male nurses, strategic interventions should be implemented based on the factors identified in this study.
Agreement ℜ of Four Analytical Methods Applied to Pb in Soils from the Small City of St. John’s, Newfoundland, Canada
Authors: Gonzales Christopher R. , Paltseva Anna A. , Bell Trevor , Powell Eric T. , Mielke Howard W.
Published: September 2021

In the small city of St. John’s, NL (2020 population ~114,000), 100% of the soils of the pre-1926 properties exceeded the Canadian soil Pb standard, 140 mg/kg. The Pb was traced to high-Pb coal ash used for heating and disposed on the soils outside. Analytical instruments became available in the late 1960s and 1970s and were first used for blood Pb and clinical studies and repurposed for measuring environmental Pb. The environmental research part of this study compared four common soil Pb analysis methods on the same set (N = 96) of St. John’s soil samples. The methods: The US EPA method 3050B, portable X-ray fluorescence spectrometry (pXRF), The Chaney–Mielke leachate extraction (1 M nitric acid), and the relative bioaccessibility leaching procedure (US EPA method 1340). Correlation is not the same as agreement ℜ. There is strong agreement (Berry–Mielke’s Universal ℜ) among the four soil Pb analytical methods. Accordingly, precaution is normally advisable to protect children from the high-Pb garden soils and play areas. A public health reality check by Health Canada surveillance of St. John’s children (N = 257) noted remarkably low blood Pb. The low blood Pb of St. John’s’ children is contrary to the soil Pb results. Known urban processes causing the rise of environmental Pb and children’s Pb exposure includes particle size, aerosol emission by traffic congestion, and quantities of leaded petrol during the 20th century. Smaller cities had minor traffic congestion and limited combustion particles from leaded petrol. From the perspective of the 20th century era of urban Pb pollution, St. John’s, NL, children have blood Pb characteristics of a small city.
Association between Statins and Retinal Vascular Occlusion: A Population-Based Cohort Study
Authors: Chien Chien-Cheng , Chen Po-Huang , Chung Chi-Hsiang , Sun Chien-An , Chien Wu-Chien , Chien Ke-Hung
Published: September 2021

Retinal vascular occlusion (RVO), including retinal arterial occlusion and retinal vein occlusion, is a common retinal vascular disease that causes visual disturbance. The exact pathogenesis of RVO remains unclear. In all types of RVO patients, hyperlipidemia is more than twofold more common than in controls. Statins have been used to control blood cholesterol levels and have been found to reduce the risk of cardiovascular morbidity and mortality. Moreover, the immunomodulatory functions of statins may play a role in treating inflammatory diseases. This study aimed to evaluate whether patients taking statins have a lower risk of developing RVO compared to patients not taking statins. Adult patients with statins usage on the index date identified from the Taiwan National Health Insurance Research Database (NHIRD) between 2000 and 2013 were included. A threefold matched group was selected using age, sex, and year of index date for comparison. During the mean follow-up period of 12.87 ± 1.88 years, the cumulative incidence of RVO was significantly lower in the statin-user group (29.96 per 105 person-years [PYs]) than in the non-statin-user group (39.35 per 105 PYs). The results showed a lower cumulative incidence rate of RVO in patients prescribed statins than in those not prescribed statins (log-rank test, p = 0.020). The adjusting hazard ratio (HR) was significantly greater for RVO in the statin-user group (adjusted HR, 0.704; 95% CI, 0.591–0.873). Statin users had a decreased risk for all types of RVO development, including central retinal artery occlusion, arterial branch occlusion, central retinal vein occlusion, and branch retinal vein occlusion. In conclusion, patients undergoing statin treatment have a lower risk of developing RVO compared to patients not taking statins.
Healthcare Professionals’ Perspectives of Patients’ Experiences of the Self-Management of Type 2 Diabetes in the Rural Areas of Pakistan: A Qualitative Analysis
Authors: Ansari Rashid , Harris Mark , Hosseinzadeh Hassan , Zwar Nicholas
Published: September 2021

The main objective of this research work was to explore the healthcare professionals’ perspectives of type 2 diabetes patients’ experiences of self-management of diabetes in the rural area of Pakistan. In this study, we have carried out a methodological approach to use a self-management framework to direct the interview guide for healthcare professionals to examine their perceptions and expectations of their diabetes patients’ adherence to the medications prescribed. Twenty healthcare professionals were recruited in this study consisting of ten general practitioners and ten nurses from various clinics (medical centres) of Al-Rehman Hospital at Abbottabad, Pakistan. This qualitative study explored the feelings and opinions of general practitioners on patients’ compliance and adherence by using the semi-structured interview guide using a methodological framework. All interviews of participants were audiotaped and transcribed for content analysis. Six major themes were identified: patient–doctor relationship; patient’s non-adherence to diet and exercise; conflicts with the patients; low self-efficacy and feeling of “resignation with poor care”; the influence of culture on patients’ self-management activities and lack of support for patients by health care providers, patients, and their families. We have derived relevant solutions from qualitative studies and considered that communication, tailored, and shared care is the best approach for patient adherence to treatment. GPs felt that a structured consultation and follow-up in a multidisciplinary team might help to increase adherence. The results of this qualitative health research highlighted the challenges healthcare professionals are facing in rural Pakistan in managing patients with type 2 diabetes and supporting their management activities. Healthcare professionals and patients may benefit by adopting a methodological framework approach to ensure meaningful participation and adjusting the patient–doctor relationship, and setting up achievable management and self-management goals.
Amino Acids and the Early Mammalian Embryo: Origin, Fate, Function and Life-Long Legacy
Authors: Leese Henry J. , McKeegan Paul J. , Sturmey Roger G.
Published: September 2021

Amino acids are now recognised as having multiple cellular functions in addition to their traditional role as constituents of proteins. This is well-illustrated in the early mammalian embryo where amino acids are now known to be involved in intermediary metabolism, as energy substrates, in signal transduction, osmoregulation and as intermediaries in numerous pathways which involve nitrogen metabolism, e.g., the biosynthesis of purines, pyrimidines, creatine and glutathione. The amino acid derivative S-adenosylmethionine has emerged as a universal methylating agent with a fundamental role in epigenetic regulation. Amino acids are now added routinely to preimplantation embryo culture media. This review examines the routes by which amino acids are supplied to the early embryo, focusing on the role of the oviduct epithelium, followed by an outline of their general fate and function within the embryo. Functions specific to individual amino acids are then considered. The importance of amino acids during the preimplantation period for maternal health and that of the conceptus long term, which has come from the developmental origins of health and disease concept of David Barker, is discussed and the review concludes by considering the potential utility of amino acid profiles as diagnostic of embryo health.
Precarious Suicide Behavior According to Housing Price Gap: A Case Study on South Korea
Authors: Kang Sungik , Woo Hosung , Koo Ja-Hoon
Published: September 2021

In 2018, the suicide rate in South Korea was the highest among the Organisation for Economic Co-operation and Development countries, and socioeconomic inequality has intensified. This study analyzes the impact relationship between suicidal impulses and economic inequality in South Korea. This study measures suicidal impulses thoughts National Health Survey Data and economic inequality based on the housing prices gap in the country. The primary analysis results were as follows: First, suicidal impulses were positively associated with the high index of housing price inequality; this correlation has become tight in recent years. Second, it was confirmed that the higher the income level, the higher the correlation between suicidal impulses with the index of housing price inequality. Third, the correlation between housing price inequality with suicidal impulse increased consistently in highly urbanized areas, but the statistical significance was low in non-urban areas.
A Vision of Future Healthcare: Potential Opportunities and Risks of Systems Medicine from a Citizen and Patient Perspective—Results of a Qualitative Study
Authors: Lemmen Clarissa , Simic Dusan , Stock Stephanie
Published: September 2021

Advances in (bio)medicine and technological innovations make it possible to combine high-dimensional, heterogeneous health data to better understand causes of diseases and make them usable for predictive, preventive, and precision medicine. This study aimed to determine views on and expectations of “systems medicine” from the perspective of citizens and patients in six focus group interviews, all transcribed verbatim and content analyzed. A future vision of the use of systems medicine in healthcare served as a stimulus for the discussion. The results show that although certain aspects of systems medicine were seen positive (e.g., use of smart technology, digitalization, and networking in healthcare), the perceived risks dominated. The high degree of technification was perceived as emotionally burdensome (e.g., reduction of people to their data, loss of control, dehumanization). The risk-benefit balance for the use of risk-prediction models for disease events and trajectories was rated as rather negative. There were normative and ethical concerns about unwanted data use, discrimination, and restriction of fundamental rights. These concerns and needs of citizens and patients must be addressed in policy frameworks and health policy implementation strategies to reduce negative emotions and attitudes toward systems medicine and to take advantage of its opportunities.
The COVID-19 Pandemic: A Longitudinal Study on the Emotional-Behavioral Sequelae for Children and Adolescents with Neuropsychiatric Disorders and Their Families
Authors: Raffagnato Alessia , Iannattone Sara , Tascini Benedetta , Venchiarutti Martina , Broggio Alessia , Zanato Silvia , Traverso Annalisa , Mascoli Cataldo , Manganiello Alexa , Miscioscia Marina , Gatta Michela
Published: September 2021

This study aimed to investigate the immediate and short-term impact of the pandemic on the psychological well-being of Italian children and adolescents with psychiatric disorders and their families. Overall, 56 patients aged 6–18 (M = 13.4 years, SD = 2.77) and their parents were evaluated during the COVID-19 lockdown (T0) and after 4 months (T1). An ad hoc data sheet, Youth Self-Report 11–18 (YSR), Child Behavior Checklist 6–18 (CBCL), and Depression Anxiety Stress Scale-21 (DASS-21) were administered. Patients, mainly suffering from internalizing disorders, overall demonstrated a good adaptation to the pandemic context. Moreover, patients with behavioral disorders showed a greater psychological discomfort at both T0 and T1 compared to patients with internalizing disorders. Over time, patients presented an improvement on the emotional side, as proven by a significant decrease in internalizing and post-traumatic stress problems. Finally, no significant differences were found in the emotional-behavioral profile of patients according to the means of conducting neuropsychiatric interventions during the lockdown (i.e., in person/remotely/interrupted), thus allowing us to exclude important negative effects caused by the transition to remote therapy. Concerning parents, an inverse relationship emerged between the DASS-21 scores and the level of resilience, which therefore represents a protective factor against psychological maladjustment. Over time, an improvement in the psychological well-being of parents was observed, as shown by a significant decrease in mothers’ anxiety and fathers’ stress.
Association of Sedentary Behavior and Physical Activity with Depression in Sport University Students
Authors: Zhou Huixuan , Dai Xiaotong , Lou Litian , Zhou Chan , Zhang Wei
Published: September 2021

Background: Sports university students are usually expected to lead an active life and have a lower risk of depression. Therefore, there are few studies on depression and its risk factors among this population. This study aimed to investigate depression and its association with sedentary behavior and physical activity in sports university students. Methods: A cross-sectional survey was conducted among undergraduates majoring in physical education in a sports university in Beijing in March 2021. Students were asked about sociodemographic information, domain-specific sedentary behavior, physical activity, and depression (using a nine-item Patient Health Questionnaire). Chi-squared test and logistic regression were carried out to analyze the data. Results: Among a total of 584 participants, the detection rate of depression was 49.1%. The median of total sedentary time was 7.29 h per day. After adjusting for covariates, recreational screen time (OR = 1.540, p = 0.035), sedentary time spent completing schoolwork (OR = 0.658, p = 0.038), and participation in vigorous physical activity everyday (OR = 0.415, p = 0.001) and a few times per week (OR = 0.423, p < 0.001) were significantly associated with depression. Conclusions: Sports university students are not immune to depression and inactive lifestyles. Excessive recreational screen time may have an adverse effect on depression, which is somewhat independent of physical activity.
“Medical Student Syndrome”—A Myth or a Real Disease Entity? Cross-Sectional Study of Medical Students of the Medical University of Silesia in Katowice, Poland
Authors: Szczurek Katarzyna , Furgał Natalia , Szczepanek Dawid , Zaman Rashid , Krysta Krzysztof , Krzystanek Marek
Published: September 2021

The description of Medical Student Syndrome is based on the assumption that inexperienced medical students are prone to develop a pathological fear of medical conditions they are taught about. The aim of this study is to examine the sample of students (medical and non-medical) in order to assess and compare their level of hypochondriacal attitudes and health-related anxiety. We also examined other factors which might have had an influence on hypochondria and nosophobia attitudes among students. Methods: The study was conducted in two groups of students: 313 medical students at the Medical University of Silesia and 293 students at non-medical universities in Katowice, Poland. The study used the medical student syndrome self-explanatory questionnaire constructed for the study, taking into account the specificity of the group and the research problem. The research questionnaire was completed in an online survey by 606 students. Results: The results of the study showed that medical students obtained the same scores on a nosophobic scale as the non-medical students (p = 0.5). The analysis of hypochondriacal behavior showed significantly higher results in the non-medical student group (p = 0.02). In the entire study group, females and participants with mental disorders obtained higher scores in relation to nosophobia. Symptoms of depression and anxiety were more common in the group of medical students. Conclusions: Medical studies are not a risk factor for the occurrence of health anxiety and hypochondrial attitudes. Such factors are female gender and having a mental illness.
Evaluating the Potential Use of Smartphone Apps for Diabetes Self-Management in an Underserved Population: A Qualitative Approach
Authors: Luo Jenny , White-Means Shelley
Published: September 2021

Health disparities cause a higher rate of diabetes development in poor and minority groups and also limit the care these people receive. Smartphone applications (apps) may be a low-cost, accessible resource to patients with diabetes who experience barriers to traditional health care. Currently, little is known about using health apps to help underserved patients in the United States. This study aimed to investigate the willingness to use diabetes apps in patients with limited access to primary care providers. Fifteen personal interviews were collected and analyzed according to the interpretative phenomenological analysis framework. The interviews produced three overall themes: (1) Despite having little previous knowledge about health apps, patients were all willing to try at least one diabetes-related app; (2) app functions should be individualized to each patient’s needs for maximum benefit; and (3) barriers to app use were varied but commonly included knowledge and technological challenges and security issues. Underserved patients with diabetes expressed a willingness to try health apps, despite limited experience with the technology. Choosing apps individualized to each patient’s needs, instead of a blanket multifunctional app, would provide the greatest benefit for patient-driven diabetes management. Smartphone apps may be a feasible, low-cost resource for patients with limited access to traditional healthcare.
Association between Urban Upbringing and Compulsive Internet Use in Japan: A Cross-Sectional, Multilevel Study with Retrospective Recall
Authors: Yasuma Naonori , Nishi Daisuke , Watanabe Kazuhiro , Ishikawa Hanako , Tachimori Hisateru , Takeshima Tadashi , Umeda Maki , Kawakami Norito
Published: September 2021

The purpose of this study was to show the association between urban upbringing and compulsive internet use (CIU). The interview data of the sample (N = 2431) was obtained from the World Mental Health Japan Second Survey and a multilevel model was used to investigate the association. Multiple imputation was also conducted in this study. Growing up in a large city was significantly associated with higher Compulsive Internet Use Scale (CIUS) scores (γ = 1.65, Standard Error (SE) = 0.45) and Mild CIU + Severe CIU (Exp(γ) = 1.44; 95% Confidence Interval (CI) (1.04–2.00)) compared to growing up in a small municipality after adjusting for both sociodemographic characteristics and psychopathology. This study showed a possible association between urban upbringing and CIU. Future studies with longitudinal design are needed to better understand this association.
Analysis of the Way and Correctness of Using Automated External Defibrillators Placed in Public Space in Polish Cities—Continuation of Research
Authors: Ślęzak Daniel , Robakowska Marlena , Żuratyński Przemysław , Synoweć Joanna , Pogorzelczyk Katarzyna , Krzyżanowski Kamil , Błażek Magdalena , Woroń Jarosław
Published: September 2021

Immediate resuscitation is required for any sudden cardiac arrest. To improve the survival of the patient, a device to be operated by witnesses of the event—automated external defibrillator (AED)—has been produced. The aim of this study is to analyze the way and correctness of use of automated external defibrillators placed in public spaces in Polish cities. The data analyzed (using Excel 2019 and R 3.5.3 software) are 120 cases of use of automated external defibrillators, placed in public spaces in the territory of Poland in 2008–2018. The predominant location of AED use is in public transportation facilities, and the injured party is the traveler. AED use in non-hospital settings is more common in male victims aged 50–60 years. Owners of AEDs inadequately provide information about their use. The documentation that forms the basis of the emergency medical services intervention needs to be refined. There is no mention of resuscitation performed by a witness of an event or of the use of an AED. In addition, Poland lacks the legal basis for maintaining a register of automated external defibrillators. There is a need to develop appropriate documents to determine the process of reporting by the owners of the use of AEDs in out-of-hospital conditions (OHCA).