bluuebunny/crossref_metadata_2025 huggingface dataset:
The Characteristics of Mercury Flux at the Interfaces between Two Typical Plants and the Air in Leymus chinensis Grasslands
Authors: Wang Zhaojun , Li Xu , Zhang Gang , Wang Lei , Qi Weihao , Feng Zhili , Xiao Tingting , Yan Mengping , Wang Deli
Published: September 2021

Mercury is a global pollutant. The mercury exchanges between vegetation and the atmosphere are important for the global mercury cycle. Grassland ecosystems occupy more than 25% of the global land area and have different succession processes and ecological functions. The current research regarding mercury exchanges between forests and the atmosphere have attracted much attention, but the research regarding grasslands tends to be rare. To reveal the characteristics of mercury exchanges in grasslands, this study conducted field in-situ monitoring experiments in a Leymus meadow grassland regions of the Songnen Plains in northeastern China. The exchange flux values of the GEM (gaseous element mercury) between the plants and the atmosphere were measured using a dynamic flux bag method (DFB). The experiments were conducted for the purpose of assessing the mercury flux levels between the vegetation and the atmosphere in a typical Leymus chinensis meadow. The goal was to further the understanding of the change characteristics and influential factors and to describe the source and sink actions and dynamics between the grassland vegetation and the atmosphere. The diurnal variation characteristics were as follows: High during the day and low at night, with peaks generally appearing at noon. The growing period was characterized by absorption peaks of atmospheric mercury by the plants. The breeding period was characterized by the peak release of atmospheric mercury by the plants. The change characteristics were as follows: During the growing period, the duration of the plants in a mercury absorption state exceeded 96.5%, which was represented as the net sink of the atmospheric mercury. During the breeding period, the time of mercury release ranged between 46.4% and 66.8%, making the breeding period the net source of atmospheric mercury. The results of this study’s analysis indicated that each environmental factor was correlated with the mercury flux, and the environmental factors had different effects on the mercury flux during the different stages of plant growth. The atmospheric mercury concentration levels were the main factor during the growing period. Atmospheric humidity was the main factor during the breeding period. Solar radiation was the decisive factor during the entire experimental period.
Exploring Barriers to Participation in Pediatric Rehabilitation: Voices of Children and Young People with Disabilities, Parents, and Professionals
Authors: Teleman Britta , Vinblad Elin , Svedberg Petra , Nygren Jens M. , Larsson Ingrid
Published: September 2021

In order to develop suitable support for participation in pediatric rehabilitation, it is important to understand what barriers need to be bridged from the perspectives of both children and adults. The aim of this study was to explore barriers to participation in pediatric rehabilitation services, according to children and young people with disabilities, parents to children with disabilities, and professionals. Data was collected in individual interviews (n = 48) and focus groups (n = 8), which were analyzed with qualitative content analysis to extract barriers to participation. Identified barriers include three categories: (1) insufficient access (controlling adults, adult-centered healthcare); (2) insufficient trust (low level of trust in adults, low level of trust in children, low self-confidence in children); and (3) insufficient involvement (norms of non-participation, low level of commitment in children). The participant groups had divergent conceptions of where and how barriers originate, and for what situations child participation is appropriate. Adult-centered healthcare and parental presence were described as barriers by all participant groups. Understanding differences in the perceptions of barriers and their origins is crucial when striving to change norms of non-participation. The findings can inform the development of new support tools and participatory formats in pediatric rehabilitation.
Effects of a 10-Week Combined Coordination and Agility Training Program on Young Male Soccer Players
Authors: González-Fernández Francisco Tomás , Sarmento Hugo , Castillo-Rodríguez Alfonso , Silva Rui , Clemente Filipe Manuel
Published: September 2021

The current literature has shown how working on coordination and agility produces effects on specific aspects in team sports. The purpose of this study was to examine the effects of a ten-week coordination training program applied to soccer on different tests that evaluate speed (30 m speed test), agility (Illinois Agility Test (IAT)) and lower body strength (countermovement jump (CMJ)). Forty U16 male soccer players from two nonprofessional teams (twenty in the control group (CG) (aged = 14.70 ± 0.47, body weight = 60.15 ± 8.07 kg, height = 1.71 ± 0.06 m) and twenty in the experimental group (EG) (aged = 14.50 ± 0.51, body weight = 58.08 ± 9.78 kg, height = 1.69 ± 0.06 m)) performed a combined coordination and agility program during 10 min every training day (3 days a week) for 10 weeks. The results of this study showed that coordination training produced adaptations in the power (CMJ of EG (p = 0.001)) and agility capacities (IAT of EG (p = 0.002)) of young soccer players, but not on speed performance at longer distances (CG, p = 0.20 and EG, p = 0.09). Despite the benefits of the training program, a combination of training methods that includes power, agility, speed, and strength can enhance such improvements.
From a Symptom-Based to a Person-Centered Approach in Treating Depressive Disorders in Adolescence: A Clinical Case Formulation Using the Psychodynamic Diagnostic Manual (PDM-2)’s Framework
Authors: Tanzilli Annalisa , Giovanardi Guido , Patriarca Eleonora , Lingiardi Vittorio , Williams Riccardo
Published: September 2021

Background: Depressive disorders in adolescence are among the most challenging clinical syndromes to diagnostically identify and treat in psychotherapy. The Psychodynamic Diagnostic Manual, Second Edition (PDM-2) proposes an integration between nomothetic knowledge and an idiographic understanding of adolescent patients suffering from depression to promote a person-centered approach. This single-case study was aimed at describing and discussing the clinical value of an accurate diagnostic assessment within the PDM-2 framework. Method: Albert, a 16-year-old adolescent with a DSM-5 diagnosis of major depressive disorder, was assessed using instruments from various perspectives: the Structured Clinical Interview for DSM-5; the Psychodynamic Chart-Adolescent of the PDM-2, and other clinician-report instruments; and the Shedler–Westen Assessment Procedure for Adolescents and Defense Mechanisms Rating Scale Q-sort, coded by external observers. Results: Albert’s assessment revealed impairments in various mental capacities, especially in regulating self-esteem. He presented a borderline personality organization at a high level and an emerging narcissistic personality syndrome. Conclusions: The case discussion showed the importance of providing clinically meaningful assessments to plan for effective treatments in youth populations. Especially, it is necessary to understand the adolescent’s unique characteristics in terms of mental and personality functioning and consider the developmental trajectories and adaptation processes that characterize this specific developmental period.
Occupational Risk of Airborne Mycobacterium tuberculosis Exposure: A Situational Analysis in a Three-Tier Public Healthcare System in South Africa
Authors: Matuka Dikeledi O. , Duba Thabang , Ngcobo Zethembiso , Made Felix , Muleba Lufuno , Nthoke Tebogo , Singh Tanusha S.
Published: September 2021

This study aimed to detect airborne Mycobacterium tuberculosis (MTB) at nine public health facilities in three provinces of South Africa and determine possible risk factors that may contribute to airborne transmission. Personal samples (n = 264) and stationary samples (n = 327) were collected from perceived high-risk areas in district, primary health clinics (PHCs) and TB facilities. Quantitative real-time (RT) polymerase chain reaction (PCR) was used for TB analysis. Walkabout observations and work practices through the infection prevention and control (IPC) questionnaire were documented. Statistical analysis was carried out using Stata version 15.2 software. Airborne MTB was detected in 2.2% of samples (13/572), and 97.8% were negative. District hospitals and Western Cape province had the most TB-positive samples and identified risk areas included medical wards, casualty, and TB wards. MTB-positive samples were not detected in PHCs and during the summer season. All facilities reported training healthcare workers (HCWs) on TB IPC. The risk factors for airborne MTB included province, type of facility, area or section, season, lack of UVGI, and ineffective ventilation. Environmental monitoring, PCR, IPC questionnaire, and walkabout observations can estimate the risk of TB transmission in various settings. These findings can be used to inform management and staff to improve the TB IPC programmes.
Is the Efficiency Score an Indicator for Incident Hypertension in the Community Population of Western China?
Authors: Yu Yangwen , Chen Yun , Wang Yiying , Yu Lisha , Liu Tao , Fu Chaowei
Published: September 2021

We aimed to explore the association between the efficiency score and the risk of hypertension. We conducted a prospective cohort study of 2412 adults aged 40 years or above without hypertension in Guizhou, China from 2010 to 2020. The data envelopment analysis input-oriented DEA-CCR model was used to calculate the efficiency scores. The Cox regression model was used to assess the relationship between the efficiency score and incident hypertension. The dose–response relationship was evaluated by restricted cubic spline. Quantile regression was used to analyze the effect of efficiency scores on SBP and DBP. A total of 857 new hypertension cases were identified with a mean follow-up of 6.88 years. The efficiency score was lower in the new hypertension cases than participants without hypertension (0.70 vs. 0.67). After adjusting for possible confounding factors, the HR of hypertension risk was 0.20 (95%CI: 0.09, 0.42) for per 0.1 increase in the efficiency score. The dose–response relationship showed a non-linear relationship between the efficiency score and hypertension risk. Our results showed that the efficiency score was a cost-effective tool to identify those at a high risk of hypertension, and suggested targeted preventive measures should be undertaken.
The Expert Caregiver Intervention Targeting Former Caregivers in Finland: A Co-Design and Feasibility Study Using Mixed Methods
Authors: Åkerman Sarah , Nyqvist Fredrica , Coll-Planas Laura , Wentjärvi Annika
Published: September 2021

Informal caregivers face risks of social isolation. Given the high prevalence of informal caregivers in Europe, a considerable proportion of the population are also former caregivers. The Finnish Expert Caregiver intervention sought to train former caregivers to become volunteers aiming to support current caregivers through mainly peer support. The aims of this mixed method non-controlled exploratory intervention study were to assess the feasibility of the Finnish Expert Caregiver intervention by co-designing and implementing the intervention, and by assessing demand and practicality with special attention to the impact of COVID-19. The findings imply that the intervention was feasible as it resulted in a co-designed training course consisting of 30 h with 25 participants enrolling and 19 of them trying volunteering activities. The participants reported high scores on well-being at all timepoints of study, however, without statistically significant differences. The analysis of the focus group interviews revealed that the Expert Caregivers experienced the intervention as meaningful and offered them a sense of belonging with the other participants. Apart from using their caregiving past as an asset, the participants also took advantage of other personal skills and resources. Risks of adverse effects were related to the participants’ expectations on their own contribution, demanding peer support recipients, poorly functioning peer support groups, and insufficient distance to one’s caregiving past. The participants stressed the need for continuing support from intervention facilitators. Future studies with larger samples should investigate whether the effects differ between subgroups of participants and explore the perspective of the peer support recipients.
Ecuadorian Journalists Mental Health Influence on Changing Job Desire: A Cross Sectional Study
Authors: Bustamante-Granda Byron Fernando , Rodríguez-Hidalgo Claudia , Cisneros-Vidal María Aranzazu , Rivera-Rogel Diana , Torres-Montesinos Claudia
Published: September 2021

Journalist’s mental health could predict their job change. This study aims at determining the prevalence of mental health issues and their association with perception of aptitude for covering emergencies and difficulty in seeing a corpse, and also to determine the mental health factors associated with job change. An ad hoc survey, GHQ-28 (Somatization, Anxiety-Insomnia, Social Dysfunction, Depression), MBI-P (Burnout, Emotional Exhaustion, Depersonalization, personal accomplishment) and Brief scale to diagnose Post-Traumatic Stress Disorder and Suicide Risk were applied to 196 journalists (female = 51.6%). Descriptive analysis, correlations (Pearson and Spearman), T-test and binary logistic regression were performed. It was found that one third part of journalists perceive themselves as having low aptitude to cover emergencies and difficulty in seeing a corpse, 17.3% would consider changing jobs and 42.1% could only access free mental health services. The most frequent mental health problems are: low personal accomplishment, emotional exhaustion and post-traumatic stress disorder (11.2 to 17.3%). People who want to change jobs present more: social dysfunction, depression, emotional exhaustion, depersonalization, low personal accomplishment, post-traumatic stress disorder and suicide risk. The two mental health factors associated with desire of changing jobs are high emotional exhaustion, and low personal accomplishment. These results guide the psychosocial risk prevention processes for journalists, as well as the training needs that universities could consider to protect the mental health of this vulnerable group.
The Depression Anxiety Stress Scale 21: Development and Validation of the Depression Anxiety Stress Scale 8-Item in Psychiatric Patients and the General Public for Easier Mental Health Measurement in a Post COVID-19 World
Authors: Ali Amira Mohammed , Alkhamees Abdulmajeed A. , Hori Hiroaki , Kim Yoshiharu , Kunugi Hiroshi
Published: September 2021

Despite extensive investigations of the Depression Anxiety Stress Scales-21 (DASS-21) since its development in 1995, its factor structure and other psychometric properties still need to be firmly established, with several calls for revising its item structure. Employing confirmatory factor analysis (CFA), this study examined the factor structure of the DASS-21 and five shortened versions of the DASS-21 among psychiatric patients (N = 168) and the general public (N = 992) during the COVID-19 confinement period in Saudi Arabia. Multigroup CFA, Mann Whitney W test, Spearman’s correlation, and coefficient alpha were used to examine the shortened versions of the DASS-21 (DASS-13, DASS-12, DASS-9 (two versions), and DASS-8) for invariance across age and gender groups, discriminant validity, predictive validity, item coverage, and internal consistency, respectively. Compared with the DASS-21, all three-factor structures of the shortened versions expressed good fit, with the DASS-8 demonstrating the best fit and highest item loadings on the corresponding factors in both samples (χ2(16, 15) = 16.5, 67.0; p = 0.420, 0.001; CFI = 1.000, 0.998; TLI = 0.999, 0.997; RMSEA = 0.013, 0.059, SRMR = 0.0186, 0.0203). The DASS-8 expressed configural, metric, and scalar invariance across age and gender groups. Its internal consistency was comparable to other versions (α = 0.94). Strong positive correlations of the DASS-8 and its subscales with the DASS-21 and its subscales (r = 0.97 to 0.81) suggest adequate item coverage and good predictive validity of this version. The DASS-8 and its subscales distinguished the clinical sample from the general public at the same level of significance expressed by the DASS-21 and other shortened versions, supporting its discriminant validity. Neither the DASS-21 nor the shortened versions distinguished patients diagnosed with depression and anxiety from each other or from other psychiatric conditions. The DASS-8 represents a valid short version of the DASS-21, which may be useful in research and clinical practice for quick identification of individuals with potential psychopathologies. Diagnosing depression/anxiety disorders may be further confirmed in a next step by clinician-facilitated examinations. Brevity of the DASS-21 would save time and effort used for filling the questionnaire and support comprehensive assessments by allowing the inclusion of more measures on test batteries.
Detection of COVID-19 in Chest X-ray Images: A Big Data Enabled Deep Learning Approach
Authors: Awan Mazhar Javed , Bilal Muhammad Haseeb , Yasin Awais , Nobanee Haitham , Khan Nabeel Sabir , Zain Azlan Mohd
Published: September 2021

Coronavirus disease (COVID-19) spreads from one person to another rapidly. A recently discovered coronavirus causes it. COVID-19 has proven to be challenging to detect and cure at an early stage all over the world. Patients showing symptoms of COVID-19 are resulting in hospitals becoming overcrowded, which is becoming a significant challenge. Deep learning’s contribution to big data medical research has been enormously beneficial, offering new avenues and possibilities for illness diagnosis techniques. To counteract the COVID-19 outbreak, researchers must create a classifier distinguishing between positive and negative corona-positive X-ray pictures. In this paper, the Apache Spark system has been utilized as an extensive data framework and applied a Deep Transfer Learning (DTL) method using Convolutional Neural Network (CNN) three architectures —InceptionV3, ResNet50, and VGG19—on COVID-19 chest X-ray images. The three models are evaluated in two classes, COVID-19 and normal X-ray images, with 100 percent accuracy. But in COVID/Normal/pneumonia, detection accuracy was 97 percent for the inceptionV3 model, 98.55 percent for the ResNet50 Model, and 98.55 percent for the VGG19 model, respectively.
Multiple Socioeconomic Circumstances and Initiation of Cardiovascular Medication among Ageing Employees
Authors: Salonsalmi Aino , Mauramo Elina , Lahelma Eero , Rahkonen Ossi , Pietiläinen Olli
Published: September 2021

There are persisting socioeconomic differences in cardiovascular diseases, but studies on socioeconomic differences in the initiation of cardiovascular medication are scarce. This study examined the associations between multiple socioeconomic circumstances and cardiovascular medication. The Helsinki Health Study baseline survey (2000–2002) of 40–60-year-old employees was linked with cardiovascular medication data from national registers. The analyses included 5805 employees concerning lipid medication and 4872 employees concerning hypertension medication. Medication purchases were followed for 10 years. The analyses were made using logistic regression, and the odds ratios (ORs) and their 95% confidence intervals (CIs) were calculated for childhood, conventional and material socioeconomic circumstances. Low parental education showed an association with lipid medication among women only (OR 1.34, 95% CI 1.11–1.61), whereas childhood economic difficulties showed more widespread associations. Low education and occupational class were associated with an increased risk of both hypertension (education: OR 1.58, 1.32–1.89; occupational class: 1.31, 1.08–1.59) and lipid medication (education: 1.34, 1.12–1.61; occupational class: 1.38, 1.13–1.67). Rented housing (1.35, 1.18–1.54 for hypertension medication; 1.21, 1.05–1.38 for lipid medication) and current economic difficulties (1.59, 1.28–1.98 for hypertension medication; 1.35, 1.07–1.71 for lipid medication) increased the risk. Several measures of socioeconomic circumstances acting at different stages of the life course were associated with cardiovascular medication, with individuals in disadvantageous socioeconomic circumstances having elevated risks.
Health and Wellbeing Benefits from Nature Experiences in Tropical Settings Depend on Strength of Connection to Nature
Authors: Oh Rachel R. Y. , Fielding Kelly S. , Chang Chia-Chen , Nghiem Le T. P. , Tan Claudia L. Y. , Quazi Shimona A. , Shanahan Danielle F. , Gaston Kevin J. , Carrasco Roman L. , Fuller Richard A.
Published: September 2021

A growing number of policies and programmes in cities aim to increase the time people spend in nature for the health and wellbeing benefits delivered by such interactions. Yet, there is little research investigating the extent to which, and for whom, nature experiences deliver such benefits outside Europe, North America, and Australia. Here, we assessed the relationships between nature dose (frequency, duration, and intensity) and three mental wellbeing (depression, stress, and anxiety) and two physical health (high blood pressure, diabetes) outcomes in Singapore, an intensely urbanised tropical city. Our analyses accounted for individual factors, including socio-economic status, nature connection (nature relatedness), and whether people with poor health are prevented by their condition from visiting green spaces. Our results show that the association between nature dose (specifically duration) and mental wellbeing is moderated by a nature connection. Specifically, people with a stronger nature connection were less likely to be depressed, stressed, and anxious, regardless of the duration of their nature dose. For those with a weaker connection to nature, spending longer in nature was associated with being more depressed, stressed, and anxious. We did not find a relationship between nature dose and high blood pressure or diabetes. Our results highlight that the relationship between nature dose and wellbeing might vary substantially among cities.
Development of a Suicide Prediction Model for the Elderly Using Health Screening Data
Authors: Cho Seo-Eun , Geem Zong Woo , Na Kyoung-Sae
Published: September 2021

Suicide poses a serious problem globally, especially among the elderly population. To tackle the issue, this study aimed to develop a model for predicting suicide by using machine learning based on the elderly population. To obtain a large sample, the study used the big data health screening cohort provided by the National Health Insurance Sharing Service. By applying a machine learning technique, a predictive model that comprehensively utilized various factors was developed to select the elderly aged > 65 years at risk of suicide. A total of 48,047 subjects were included in the analysis. Individuals who died by suicide were older, and the number of men was significantly greater. The suicide group had a more prominent history of depression, with the use of medicaments significantly higher. Specifically, the prescription of benzodiazepines alone was associated with a high suicide risk. Furthermore, body mass index, waist circumference, total cholesterol, and low-density lipoprotein level were lower in the suicide group. We developed a model for predicting suicide by using machine learning based on the elderly population. This suicide prediction model can satisfy the performance to some extent by employing only the medical service usage behavior without subjective reports.
Collaborative Assessment and Health Risk of Heavy Metals in Soils and Tea Leaves in the Southwest Region of China
Authors: Liu Juan , Lu Weihong , Zhang Naiming , Su Dan , Zeer Ladu , Du Hongdie , Hu Kelin
Published: September 2021

The collaborative assessment and health risk evaluation of heavy metals (HMs) enrichment in soils and tea leaves are crucial to guarantee consumer safety. However, in high soil HM geochemical background areas superimposed by human activities, the health risk associated with HMs in soil–tea systems is not clear. This study assessed the HMs concentration (i.e., chromium (Cr), cadmium (Cd), arsenic (As), and lead (Pb)) in tea leaves and their relationship with soil amounts in the southwest region of China to evaluate the associated health risk in adults. The results revealed that the average soil concentration of Cr was the highest (79.06 mg kg−1), followed by Pb (29.27 mg kg−1), As (14.87 mg kg−1), and Cd (0.18 mg kg−1). Approximately 0.71, 4.99, 7.36, and 10.21% of soil samples exceeded the threshold values (NY/T 853-2004) for Pb, Cr, As, and Cd, respectively. Furthermore, the average concentration of Pb, As, and Cd in tea leaves was below the corresponding residue limits, but Cr was above the allowed limits. Correlation analysis revealed that the Pb, Cr, As, and Cd amounts in tea leaves were positively correlated to their soil amounts (p < 0.01) with an R2 of 0.203 **, 0.074 **, 0.036 **, and 0.090 **, respectively. Additionally, approximately 40.38% of the samples were found to be contaminated. Furthermore, spatial distribution statistical analysis revealed that Lancang was moderately contaminated, while Yingjiang, Zhenkang, Yongde, Zhenyuan, Lüchun, Jingdong, Ximeng, and Menglian were slightly contaminated areas. The target hazard quotients (THQ; health risk assessment) of Pb, Cr, As, and Cd and the hazard index (HI) of all the counties were below unity, suggesting unlikely health risks from tea consumption.
Health-Related Quality of Life (HRQoL) Outcomes Following Injury in Childhood and Adolescence Using EuroQol (EQ-5D) Responses with Pooled Longitudinal Data
Authors: Dipnall Joanna F. , Rivara Frederick P. , Lyons Ronan A. , Ameratunga Shanthi , Brussoni Mariana , Lecky Fiona E. , Bradley Clare , Beck Ben , Lyons Jane , Schneeberg Amy , Harrison James E. , Gabbe Belinda J.
Published: September 2021

Background: Injury is a leading contributor to the global disease burden in children, affecting their health-related quality of life (HRQoL)—yet valid estimates of burden are absent. Methods: This study pooled longitudinal data from five cohort studies of pediatric injury survivors (5–17 years) at baseline, 1-, 4-, 6-, 12-, and 24- months (n = 2334). HRQoL post-injury was measured using the 3-level EQ-5D utility score (EQ-5D) and five health states (mobility, self-care, activity, pain, anxiety and depression (anxiety)). Results: Mean EQ-5D post-injury did not return to baseline level (0.95) by 24 months (0.88) and was lower for females over time (−0.04, 95%CI −0.05, −0.02). A decreased adjusted risk ratio over time (ARR) was observed for intentional injuries (pain: 0.85, 95%CI 0.73,0.98; anxiety: 0.62, 95%CI 0.49,0.78); spinal cord injuries (mobility: 0.61, 95%CI 0.45,0.83), self-care: 0.76, 95%CI 0.63,0.91, activity: 0.64, 95%CI 0.47,0.88); moderate/severe traumatic brain injury (activity: 0.83, 95%CI 0.71,0.96). ARRs were also low for certain fractures, with various health states affected. Conclusions: HRQoL outcomes over time for children and adolescents post-injury differed across key demographic and injury related attributes. HRQoL did not reach levels consistent with full health by 24 months with recovery plateauing from 6 to 24 months. Tailored interventions are required to respond to the varying post-injury recovery trajectories in this population.
Revisiting Candidacy: What Might It Offer Cancer Prevention?
Authors: Batchelor Samantha , Miller Emma R. , Lunnay Belinda , Macdonald Sara , Ward Paul R.
Published: September 2021

The notion of candidacy emerged three decades ago through Davison and colleagues’ exploration of people’s understanding of the causes of coronary heart disease. Candidacy was a mechanism to estimate one’s own or others risk of disease informed by their lay epidemiology. It could predict who would develop illness or explain why someone succumbed to it. Candidacy’s predictive ability, however, was fallible, and it was from this perspective that the public’s reticence to adhere to prevention messages could be explained, as ultimately anybody could be ‘at-risk’. This work continues to resonate in health research, with over 700 citations of Davison’s Candidacy paper. Less explored however, is the candidacy framework in its entirety in other illness spheres, where prevention efforts could potentially impact health outcomes. This paper revisits the candidacy framework to reconsider it use within prevention. In doing so, candidacy within coronary heart disease, suicide prevention, diabetes, and cancer will be examined, and key components of candidacy and how people negotiate their candidacy within differing disease contexts will be uncovered. The applicability of candidacy to address modifiable breast cancer risk factors or cancer prevention more broadly will be considered, as will the implications for public health policy.
Uterine Adenomyosis: From Disease Pathogenesis to a New Medical Approach Using GnRH Antagonists
Authors: Donnez Jacques , Stratopoulou Christina Anna , Dolmans Marie-Madeleine
Published: September 2021

Uterine adenomyosis is a common chronic disorder frequently encountered in reproductive-age women, causing heavy menstrual bleeding, intense pelvic pain, and infertility. Despite its high prevalence, its etiopathogenesis is not yet fully understood, so there are currently no specific drugs to treat the disease. A number of dysregulated mechanisms are believed to contribute to adenomyosis development and symptoms, including sex steroid signaling, endometrial proliferation and invasiveness, and aberrant immune response. Abnormal sex steroid signaling, particularly hyperestrogenism and subsequent progesterone resistance, are known to play a pivotal role in its pathogenesis, which is why various antiestrogenic agents have been used to manage adenomyosis-related symptoms. Among them, gonadotropin-releasing hormone (GnRH) antagonists are swiftly gaining ground, with recent studies reporting efficient lesion regression and symptom alleviation. The aim of the present review is to compile available information on the pathogenesis of adenomyosis, explore the etiology and mechanisms of hyperestrogenism, and discuss the potential of antiestrogenic therapies for treating the disease and improving patient quality of life.
The Onset of Menstruation and Social Networking Site Use in Adolescent Girls: The Mediating Role of Body Mass Index
Authors: Lv Chenyu , Turel Ofir , He Qinghua
Published: September 2021

Evidence suggests that girls spend much time on social networking sites (SNS), often more than boys do. It has been proposed that this may have to do with sex-based differences in the need and approaches for socialization. We posit that adolescent girls are also unique in that they are developing physiologically and start menstruating. Based on prior research, we hypothesize that the onset of menstruation can drive physiological changes (increased body mass index (BMI)), which together with common behavioral–psychological (social and emotional) responses to menstruation can contribute to an increase in SNS use. We therefore aim to test whether BMI partially mediates the relationship between menstruation and SNS use in adolescent girls. Results based on a large nationally representative sample in the United Kingdom suggest that the age of menarche was negatively associated with daily hours of SNS use, and that BMI elevation partially mediated this association. These results extend the negative effects of the early onset of menstruation and imply that BMI control strategies may help to reduce the use of SNS in girls who experience menarche at an earlier age.
Health Literacy Levels among Italian Students: Monitoring and Promotion at School
Authors: Velasco Veronica , Gragnano Andrea ,   Gruppo Regionale HBSC Lombardia 2018, Vecchio Luca Piero
Published: September 2021

Health literacy was identified as an important determinant of health, particularly for adolescents. However, more efforts are needed to monitor this construct and provide inputs for policy development. This study aims to: (a) Assess the validity and reliability of the Italian version of the Health Literacy for School-Aged Children (HLSAC-I); (b) Identify the health literacy levels among Italian students and compare them with other countries’ levels; and (c) Identify the associations between health literacy and multiple social determinants (social stratifiers, family, and school connectedness). Data came from the Health Behaviour School-Aged Children survey, carried out in the Lombardy region in northern Italy in 2018. A representative sample of 2,287 13- and 15-year-old Lombardian students was involved. The results support the validity and reliability of the HLSAC-I. A total of 18.7% of the sample reported low levels, and only 6.8% reported high levels. Italian students reported the lowest levels of health literacy compared with other countries. School connectedness and educational approach are the most relevant associated factors. This study confirms a school’s role in reducing inequalities and promoting health. It highlights the importance of monitoring health literacy and implementing health promotion policies at school through a whole-school approach.
Reduction in Accommodative Response of Schoolchildren by a Double-Mirror System
Authors: Yeh Shang-Min , Lo Chen-Cheng , Lee Chi-Hung , Chen Yu-Jung , Lin Feng-Chi , Huang Shuan-Yu
Published: September 2021

Purpose: This study first proposed the application of a double-mirror system (DMS) to extend viewing distance and investigate the accommodative response of schoolchildren under a DMS. Method: Fifty-seven subjects aged between 7 and 12 years old were recruited in this study, and the experiment was divided into two stages. The first stage consisted of a case history inquiry, a refraction state, and a visual function examination. In the second stage, the subjects gazed at an object at distances of 0.4 m, 2.285 m, and through a DMS, respectively, and their accommodative responses were measured using an open-field autorefractor. Results: There was no significant difference in the schoolchildren’s accommodative response between subjects gazing at an object at 2.285 m (0.14 ± 0.35 D, p > 0.05) and those gazing at it through a DMS (0.20 ± 0.35 D). However, their accommodative response showed a significant difference between subjects gazing at an object at 0.4 m and 2.285 m and those gazing at it at 0.4 m and through a DMS. Conclusion: In this experiment, the results of the children’s accommodative response measured at 2.285 m or through a DMS are very similar. The viewing distance can be extended by a DMS, resulting in accommodative relaxation. This result may have potential applications in myopia control.
Augmented Reality-Assisted Craniotomy for Parasagittal and Convexity En Plaque Meningiomas and Custom-Made Cranio-Plasty: A Preliminary Laboratory Report
Authors: Montemurro Nicola , Condino Sara , Cattari Nadia , D’Amato Renzo , Ferrari Vincenzo , Cutolo Fabrizio
Published: September 2021

Background: This report discusses the utility of a wearable augmented reality platform in neurosurgery for parasagittal and convexity en plaque meningiomas with bone flap removal and custom-made cranioplasty. Methods: A real patient with en plaque cranial vault meningioma with diffuse and extensive dural involvement, extracranial extension into the calvarium, and homogeneous contrast enhancement on gadolinium-enhanced T1-weighted MRI, was selected for this case study. A patient-specific manikin was designed starting with the segmentation of the patient’s preoperative MRI images to simulate a craniotomy procedure. Surgical planning was performed according to the segmented anatomy, and customized bone flaps were designed accordingly. During the surgical simulation stage, the VOSTARS head-mounted display was used to accurately display the planned craniotomy trajectory over the manikin skull. The precision of the craniotomy was assessed based on the evaluation of previously prepared custom-made bone flaps. Results: A bone flap with a radius 0.5 mm smaller than the radius of an ideal craniotomy fitted perfectly over the performed craniotomy, demonstrating an error of less than ±1 mm in the task execution. The results of this laboratory-based experiment suggest that the proposed augmented reality platform helps in simulating convexity en plaque meningioma resection and custom-made cranioplasty, as carefully planned in the preoperative phase. Conclusions: Augmented reality head-mounted displays have the potential to be a useful adjunct in tumor surgical resection, cranial vault lesion craniotomy and also skull base surgery, but more study with large series is needed.
Spatiotemporal Evolution and Trend Prediction of Tourism Economic Vulnerability in China’s Major Tourist Cities
Authors: Huang Chengkun , Lin Feiyang , Chu Deping , Wang Lanlan , Liao Jiawei , Wu Junqian
Published: September 2021

The evaluation and trend prediction of tourism economic vulnerability (TEV) in major tourist cities are necessary for formulating tourism economic strategies scientifically and promoting the sustainable development of regional tourism. In this study, 58 major tourist cities in China were taken as the research object, and an evaluation index system of TEV was constructed from two aspects of sensitivity and adaptive capacity. On the basis of the entropy weight method, TOPSIS model, obstacle diagnosis model, and BP neural network model, this study analyzed the spatiotemporal patterns, obstacle factors, and future trends of TEV in major tourist cities in China from 2004 to 2019. The results show three key findings: (1) In terms of spatiotemporal patterns, the TEV index of most of China’s tourist cities has been on the rise from 2004 to 2019. Cities throughout the coast of China’s Yangtze River Delta and the Pearl River Delta urban agglomeration show high vulnerability, whereas low vulnerability has a scattered distribution in China’s northeast, central, and western regions. (2) The proportion of international tourists out of total tourists, tourism output density, urban industrial sulfur dioxide emissions per unit area, urban industrial smoke and dust emission per unit area, and discharge of urban industrial wastewater per unit area are the five major obstacles affecting the vulnerability degree of the tourism economy. (3) According to the prediction results of TEV from 2021 to 2030, although the TEV of many tourist cities in China is increasing year by year, cities with low TEV levels occupy the dominant position. Research results can provide reference for tourist cities to prevent tourism crises from occurring and to reasonably improve the resilience of the tourism economic system.
HiIndex: An Efficient Spatial Index for Rapid Visualization of Large-Scale Geographic Vector Data
Authors: Liu Zebang , Chen Luo , Yang Anran , Ma Mengyu , Cao Jingzhi
Published: September 2021

In the big data era, rapid visualization of large-scale vector data has become a serious challenge in Geographic Information Science (GIS). To fill the gap, we propose HiIndex, a spatial index that enables real-time and interactive visualization of large-scale vector data. HiIndex improves the state of the art with its low memory requirements, fast construction speed, and high visualization efficiency. In HiIndex, we present a tile-quadtree structure (TQ-tree) which divides the global geographic range based on the quadtree recursion method, and each node in the TQ-tree represents a specific and regular spatial range. In this paper, we propose a quick TQ-tree generation algorithm and an efficient visualization algorithm. Experiments show that the HiIndex is simple in structure, fast in construction, and less in memory occupation, and our approach can support interactive and real-time visualization of billion scale vector data with negligible pre-treatment time.
A GIS-Based Bivariate Logistic Regression Model for the Site-Suitability Analysis of Parcel-Pickup Lockers: A Case Study of Guangzhou, China
Authors: Zheng Zilai , Morimoto Takehiro , Murayama Yuji
Published: September 2021

The site-suitability analysis (SSA) of parcel-pickup lockers (PPLs) is becoming a critical problem in last-mile logistics. Most studies have focused on the site-selection problem to identify the best site from given potential sites in specific areas, while few have solved the site-search problem to determine the boundary of the suitable area. A GIS-based bivariate logistic regression (LR) model using the supervised machine-learning (ML) algorithm was developed for suitability classification in this study. Eight crucial factors were selected from 27 candidate variables using stepwise methods with a training dataset in the best LR model. The variable of the proximity to residential buildings was more important than that to various commercial buildings, transport services, and roads. Among the four types of residential buildings, the most crucial factor was the proximity to residential quarters. A test dataset was employed for the validation process, showing that the best LR model had excellent performance. The results identified the suitable areas for PPLs, accounting for 8% of the total area of Guangzhou (GZ). A decision-maker can focus on these suitable areas as the site-selection ranges for PPLs, which significantly reduces the difficulty of analysis and time costs. This method can quickly decompose a large-scale area into several small-scale suitable areas, with relevance to the problem of selecting sites from various candidate sites.
Novel Simple Conjugation Chemistries for Decoration of GMMA with Heterologous Antigens
Authors: Di Benedetto Roberta , Alfini Renzo , Carducci Martina , Aruta Maria , Lanzilao Luisa , Acquaviva Alessandra , Palmieri Elena , Giannelli Carlo , Necchi Francesca , Saul Allan , Micoli Francesca
Published: September 2021

Outer Membrane Vesicles (OMV) constitute a promising platform for the development of efficient vaccines. OMV can be decorated with heterologous antigens (proteins or polysaccharides), becoming attractive novel carriers for the development of multicomponent vaccines. Chemical conjugation represents a tool for linking antigens, also from phylogenetically distant pathogens, to OMV. Here we develop two simple and widely applicable conjugation chemistries targeting proteins or lipopolysaccharides on the surface of Generalized Modules for Membrane Antigens (GMMA), OMV spontaneously released from Gram-negative bacteria mutated to increase vesicle yield and reduce potential reactogenicity. A Design of Experiment approach was used to identify optimal conditions for GMMA activation before conjugation, resulting in consistent processes and ensuring conjugation efficiency. Conjugates produced by both chemistries induced strong humoral response against the heterologous antigen and GMMA. Additionally, the use of the two orthogonal chemistries allowed to control the linkage of two different antigens on the same GMMA particle. This work supports the further advancement of this novel platform with great potential for the design of effective vaccines.
Mechanisms of Connexin Regulating Peptides
Authors: King D. Ryan , Sedovy Meghan W. , Leng Xinyan , Xue Jianxiang , Lamouille Samy , Koval Michael , Isakson Brant E. , Johnstone Scott R.
Published: September 2021

Gap junctions (GJ) and connexins play integral roles in cellular physiology and have been found to be involved in multiple pathophysiological states from cancer to cardiovascular disease. Studies over the last 60 years have demonstrated the utility of altering GJ signaling pathways in experimental models, which has led to them being attractive targets for therapeutic intervention. A number of different mechanisms have been proposed to regulate GJ signaling, including channel blocking, enhancing channel open state, and disrupting protein-protein interactions. The primary mechanism for this has been through the design of numerous peptides as therapeutics, that are either currently in early development or are in various stages of clinical trials. Despite over 25 years of research into connexin targeting peptides, the overall mechanisms of action are still poorly understood. In this overview, we discuss published connexin targeting peptides, their reported mechanisms of action, and the potential for these molecules in the treatment of disease.
Dietary Isothiocyanates, Sulforaphane and 2-Phenethyl Isothiocyanate, Effectively Impair Vibrio cholerae Virulence
Authors: Krause Klaudyna , Pyrczak-Felczykowska Agnieszka , Karczewska Monika , Narajczyk Magdalena , Herman-Antosiewicz Anna , Szalewska-Pałasz Agnieszka , Nowicki Dariusz
Published: September 2021

Vibrio cholerae represents a constant threat to public health, causing widespread infections, especially in developing countries with a significant number of fatalities and serious complications every year. The standard treatment by oral rehydration does not eliminate the source of infection, while increasing antibiotic resistance among pathogenic V. cholerae strains makes the therapy difficult. Thus, we assessed the antibacterial potential of plant-derived phytoncides, isothiocyanates (ITC), against V. cholerae O365 strain. Sulforaphane (SFN) and 2-phenethyl isothiocyanate (PEITC) ability to inhibit bacterial growth was assessed. Minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) values indicate that these compounds possess antibacterial activity and are also effective against cells growing in a biofilm. Tested ITC caused accumulation of stringent response alarmone, ppGpp, which indicates induction of the global stress response. It was accompanied by bacterial cytoplasm shrinkage, the inhibition of the DNA, and RNA synthesis as well as downregulation of the expression of virulence factors. Most importantly, ITC reduced the toxicity of V. cholerae in the in vitro assays (against Vero and HeLa cells) and in vivo, using Galleria mellonella larvae as an infection model. In conclusion, our data indicate that ITCs might be considered promising antibacterial agents in V. cholerae infections.
Emerging Functions for snoRNAs and snoRNA-Derived Fragments
Authors: Wajahat Maliha , Bracken Cameron Peter , Orang Ayla
Published: September 2021

The widespread implementation of mass sequencing has revealed a diverse landscape of small RNAs derived from larger precursors. Whilst many of these are likely to be byproducts of degradation, there are nevertheless metabolically stable fragments derived from tRNAs, rRNAs, snoRNAs, and other non-coding RNA, with a number of examples of the production of such fragments being conserved across species. Coupled with specific interactions to RNA-binding proteins and a growing number of experimentally reported examples suggesting function, a case is emerging whereby the biological significance of small non-coding RNAs extends far beyond miRNAs and piRNAs. Related to this, a similarly complex picture is emerging of non-canonical roles for the non-coding precursors, such as for snoRNAs that are also implicated in such areas as the silencing of gene expression and the regulation of alternative splicing. This is in addition to a body of literature describing snoRNAs as an additional source of miRNA-like regulators. This review seeks to highlight emerging roles for such non-coding RNA, focusing specifically on “new” roles for snoRNAs and the small fragments derived from them.