bluuebunny/crossref_metadata_2025 huggingface dataset:
Effectiveness of Antalgic Therapies in Patients with Vertebral Bone Metastasis: A Protocol for a Systematic Review and Meta-Analysis
Authors: Martin-Perez Antonio Jose , Fernández-González María , Postigo-Martin Paula , Sampedro Pilegaard Marc , Fernández-Lao Carolina , Castro-Martín Eduardo , Martín-Martín Lydia , Lozano-Lozano Mario
Published: April 2021

There is no systematic review that has identified existing studies evaluating the pharmacological and non-pharmacological intervention for pain management in patients with bone metastasis. To fill this gap in the literature, this systematic review with meta-analysis aims to evaluate the effectiveness of different antalgic therapies (pharmacological and non-pharmacological) in the improvement of pain of these patients. To this end, this protocol has been written according to the Preferred Reporting Items for Systematic review and Meta-Analysis Protocols (PRISMA-P) and registered in PROSPERO (CRD42020135762). A systematic search will be carried out in four international databases: Medline (Via PubMed), Web of Science, Cochrane Library and SCOPUS, to select the randomized controlled clinical trials. The Risk of Bias Tool developed by Cochrane will be used to assess the risk of bias and the quality of the identified studies. A narrative synthesis will be used to describe and compare the studies, and after the data extraction, random effects model and a subgroup analyses will be performed according to the type of intervention, if possible. This protocol aims to generate a systematic review that compiles and synthesizes the best and most recent evidence on the treatment of pain derived from vertebral metastasis.
Impact of the 2019 Coronavirus Disease Pandemic on Health-Related Quality of Life and Psychological Status: The Role of Physical Activity
Authors: Alzahrani Hosam , Alshehri Fahad , Alsufiany Muhsen , Allam Hatem H. , Almeheyawi Rania , Eid Marwa M. , Sadarangani Kabir P.
Published: April 2021

This study investigated the impact of the 2019 coronavirus disease (COVID-19) pandemic on health-related quality of life (HRQoL) and psychological status among Saudi adults, and whether physical activity modifies this association. The participants were 518 adults aged ≥18 years (67.4% men). Using an online survey, data regarding demographic information, the impact of COVID-19 (assessed by the Posttraumatic Stress Disorder Checklist for Diagnostic and Statistical Manual of Mental Disorders-5), HRQoL (Short Form-8), psychological distress (Depression, Anxiety and Stress Scale), and physical activity behavior (International Physical Activity Questionnaire-Short Form) were collected. The results demonstrate that adults reporting moderate or high levels of impact of COVID-19 had a lower HRQoL and higher psychological distress than adults reporting a low impact. HRQoL was higher for adults reporting any level impact (low, moderate, or high) of COVID-19 when they participated in recommended levels of physical activity (≥600 metabolic equivalent (MET)-min/week of total physical activity). Psychological distress was lower for adults reporting a high level of impact when they participated in recommended physical activity. Moderate or high levels of impact of COVID-19 were associated with a significantly lower HRQoL and higher psychological distress than the low impact of COVID-19. However, these associations were moderated by the recommended levels of physical activity.
Efficacy of Phytocannabinoids in Epilepsy Treatment: Novel Approaches and Recent Advances
Authors: Farrelly Aaron M. , Vlachou Styliani , Grintzalis Konstantinos
Published: April 2021

Epilepsy is a neurological disorder mainly characterised by recurrent seizures that affect the entire population diagnosed with the condition. Currently, there is no cure for the disease and a significant proportion of patients have been deemed to have treatment-resistant epilepsy (TRE). A patient is deemed to have TRE if two or more antiepileptic drugs (AEDs) fail to bring about seizure remission. This inefficacy of traditional AEDs, coupled with their undesirable side effect profile, has led to researchers considering alternative forms of treatment. Phytocannabinoids have long served as therapeutics with delta-9-THC (Δ9-THC) receiving extensive focus to determine its therapeutic potential. This focus on Δ9-THC has been to the detriment of analysing the plethora of other phytocannabinoids found in the cannabis plant. The overall aim of this review is to explore other novel phytocannabinoids and their place in epilepsy treatment. The current review intends to achieve this aim via an exploration of the molecular targets underlying the anticonvulsant capabilities of cannabidiol (CBD), cannabidavarin (CBDV), delta-9-tetrahydrocannabivarin (Δ9-THCV) and cannabigerol (CBG). Further, this review will provide an exploration of current pre-clinical and clinical data as it relates to the aforementioned phytocannabinoids and the treatment of epilepsy symptoms. With specific reference to epilepsy in young adult and adolescent populations, the exploration of CBD, CBDV, Δ9-THCV and CBG in both preclinical and clinical environments can guide future research and aid in the further understanding of the role of phytocannabinoids in epilepsy treatment. Currently, much more research is warranted in this area to be conclusive.
Evaluation of Eating Habits and Their Impact on Health among Adolescents and Young Adults: A Cross-Sectional Study
Authors: Mizia Sylwia , Felińczak Anna , Włodarek Dariusz , Syrkiewicz-Świtała Magdalena
Published: April 2021

According to the health field concept, the most important factor affecting health is a lifestyle. The current upward trend in overweight and obesity among younger populations is a consequence of inadequate lifestyle habits. The study aimed to characterise youth nutrition behaviour and knowledge in the context of the risk of developing overweight or obesity. The study group consisted of 307 high school students, 59% females and 41% males, aged between 15 and 19. Nutrition behaviours were studied using the standardised Questionnaire of Eating Behaviour. Body weight and body height were measured with a body composition analyser and a body height meter, respectively. It was observed that the average body mass index was 21.7 ± 3.4 kg/m2 for the females and 22.3 ± 3.1 kg/m2 for the males (p = 0.036). Disturbed weight-to-height ratios (i.e., overweight and obesity) were found in 15.6% of the females and 16.5% of the males. The diets of approximately 90% of these youth were characterised by excessively low pro-health product content. The males showed a significantly higher intensity of adverse health traits compared to the females (8.1% vs. 0.7%, p = 0.002). More than half of the males presented insufficient knowledge about food and nutrition (53.5% vs. 30.8%, p < 0.001). Regardless of gender, the study showed a positive correlation between adolescents’ level of knowledge and the pro-health diet index (gamma coefficient: 0.42, p < 0.001) and a negative correlation between their level of knowledge and the unhealthy diet index (gamma coefficient: −0.66, p < 0.001). The level of knowledge was closely related to the indicators of the intensities and adverse health characteristics of their diets. These results indicate the need for educational programs to raise awareness among youth in civilisation backgrounds.
Economic Crisis: A Factor for the Delayed Diagnosis of Breast Cancer
Authors: Petrovici Iasmina , Ionica Mihaela , Neagoe Octavian C.
Published: April 2021

Considering the constant increase in breast cancer patients, identifying factors that influence the moment of diagnosis is essential for optimizing therapeutic management and associated cost. The purpose of the study is to evaluate the impact of the economic crisis on the moment of a breast cancer diagnosis. This retrospective observational study analyzed a cohort of 4929 patients diagnosed with breast cancer over the course of 19 years in the Western region of Romania. The time interval was divided based on the onset of the economic crisis into 3 periods: pre-crisis (2001–2006), crisis (2007–2012), and post-crisis (2013–2019). The disease stage at the moment of diagnosis was considered either early (stages 0, I, II) or advanced (stages III, IV). Although recording a similar mean number of patients diagnosed per year during the pre- and crisis periods, a significantly higher percentage of patients were diagnosed with late-stage breast cancer during the economic crisis period compared to the previous interval (46.9% vs. 56.3%, p < 0.01). This difference was further accentuated when accounting for environmental setting, with 65.2% of patients from a rural setting being diagnosed with advanced disease during the crisis interval. An overall improvement of 12% in early-stage breast cancer diagnosis was recorded in the post-crisis period (55.7%, p < 0.001). The findings of this study support periods of economic instability as potential factors for a delay in breast cancer diagnosis and highlight the need for the development of specific strategies aimed at reducing cancer healthcare and associated financial burden in times of economic crisis.
Sadness and Other Health Complaints among Swedish Adolescents: A Cross-Sectional Study
Authors: Garnow Tide , Einberg Eva-Lena , Edberg Anna-Karin , Garmy Pernilla
Published: April 2021

Health complaints are increasing among adolescents and are recognized as a global public health issue. Health complaints are an indicator for subjective ill-being, but little is known about the relationship between sadness and other health complaints. The aim of this study was to investigate sadness and other health complaints among Swedish adolescents. A survey with a cross-sectional design was completed by adolescents (n = 1489, 15–17 years old) in the south of Sweden. A logistic regression analysis was used to analyze the relationship between sadness and other health complaints. The result show that sadness and other health complaints were common among adolescents, and sadness was related to health complaints (headache (OR: 1.58), sleeping difficulties (OR: 2.00), reduced appetite (OR: 1.43), tension (OR: 2.44), and concentration difficulties (OR: 2.75)). When adolescents express sadness or other health complaints it is important to reflect on what these complaints are an expression of, and take into account the body as physical and psychological intertwined. This might entail person-centered support that hopefully leads to an improvement in adolescents’ well-being. Future research that profoundly highlights adolescents’ existential health is needed.
Measuring Attitudes toward Suicide Prevention among Occupational Staff Frequently Exposed to Suicidal Individuals: Psychometric Evaluation and Validation
Authors: Ramberg Inga-Lill , Hökby Sebastian , Karlsson Linda , Hadlaczky Gergö
Published: April 2021

As the attitudes of healthcare staff are thought to influence the quality and effectiveness of interventions targeting patients’ suicide risk, attitudes are often used as an outcome in the evaluation of suicide-preventive training. Due to various problems related to the validity and reliability of commonly used scales, there is a lack of overall agreement on how to measure these attitudes. Confirmatory factor analysis (CFA) was used to cross-validate previously used models and to investigate new models to measure professionals’ attitudes toward work with suicidal individuals and to test the longitudinal stability of the models by analyzing new sets of data. The population in the first study consisted of a heterogenous group of 1350 professionals who managed suicidal individuals relatively frequently. The second study included 640 professionals. The results of the cross-validation of previous models were described and a new questionnaire measuring attitudes toward suicide prevention, suicidal individuals, and organizational-facilitated self-efficacy (OSAQ-12) was presented. The three presented models retained a good fit and were stable over time. Valid and reliable measurement models that measure aspects of attitudes toward suicide are a prerequisite for conducting both cross-sectional and intervention studies.
Nicotine Replacement Therapy during Pregnancy and Child Health Outcomes: A Systematic Review
Authors: Blanc Julie , Tosello Barthélémy , Ekblad Mikael O. , Berlin Ivan , Netter Antoine
Published: April 2021

Tobacco smoking in pregnancy is a worldwide public health problem. A majority of pregnant smokers need assistance to stop smoking. Most scientific societies recommend nicotine replacement therapy (NRT) during pregnancy but this recommendation remains controversial because of the known fetal toxicity of nicotine. The objective of this systematic review was to provide an overview of human studies about child health outcomes associated with NRT use during pregnancy. The electronic databases MEDLINE, the Cochrane Database, Web of Science, and ClinicalTrials.gov were searched from the inception of each database until 26 December 2020. A total of 103 articles were identified through database searching using combination of keywords. Out of 75 screened articles and after removal of duplicates, ten full-text articles were assessed for eligibility and five were included in the qualitative synthesis. NRT prescription seems to be associated with higher risk of infantile colic at 6 months as in case of smoking during pregnancy, and with risk of attention-deficit/hyperactivity disorder. No association between NRT during pregnancy and other infant health disorders or major congenital anomalies has been reported. Well-designed controlled clinical trials with sufficient follows-up are needed to provide more information on the use of NRT or other pharmacotherapies for smoking cessation during pregnancy on post-natal child health outcomes.
Development of a Questionnaire for the Search for Occupational Causes in Patients with Non-Hodgkin Lymphoma: The RHELYPRO Study
Authors: Matrat Mireille , Gain Murielle , Haioun Corinne , Le Bras Fabien , Nisse Catherine , Morschhauser Franck , Clin Bénédicte , Baldi Isabelle , Verdun-Esquer Catherine , Garnier Robert , Laborde-Castérot Hervé , Hérin Fabrice , Esquirol Yolande , Andujar Pascal , Belacel Milia , Chouaïd Christos , Chauvet Claire , Lasfargues Gérard , Pairon Jean-Claude
Published: April 2021

Non-Hodgkin lymphoma (NHL), multiple myeloma and chronic lymphocytic leukemia are possibly related to environmental and/or occupational exposure. The primary objective of this study was to develop a questionnaire for screening patients with these blood disorders who might benefit from a specialized consultation for possible recognition of the disease as an occupational disease. The study included 205 subjects (male gender, 67.3%; mean age, 60 years; NHL, 78.5%). The questionnaire performed very satisfactorily in identifying the exposures most frequently retained by experts for their potential involvement in the occurrence of NHL. Its sensitivity and specificity in relation to the final expertise were 96% and 96% for trichloroethylene, 85% and 82% for benzene, 78% and 87% for solvents other than trichloroethylene and dichloromethane, 87% and 95% for pesticides, respectively. Overall, 15% of the subjects were invited to ask National Social Insurance for compensation as occupational disease. These declarations concerned exposure to pesticides (64%), solvents (trichloroethylene: 29%; benzene: 18%; other than chlorinated solvents: 18%) and sometimes multiple exposures. In conclusion, this questionnaire appears as a useful tool to identify NHL patients for a specialized consultation, in order to ask for compensation for occupational disease.
Emergency Medical Services (EMS) Transportation of Trauma Patients by Geographic Locations and In-Hospital Outcomes: Experience from Qatar
Authors: Al-Thani Hassan , Mekkodathil Ahammed , Hertelendy Attila J. , Howland Ian , Frazier Tim , El-Menyar Ayman
Published: April 2021

Background: Prehospital care provided by emergency medical services (EMS) plays an important role in improving patient outcomes. Globally, prehospital care varies across countries and even within the same country by the geographic location and access to medical services. We aimed to explore the prehospital trauma care and in-hospital outcomes within the urban and rural areas in the state of Qatar. Methods: A retrospective analysis was conducted utilizing data from the Qatar National Trauma Registry for trauma patients who were transported by EMS to a level 1 trauma center between 2017 and 2018. Data were analyzed and compared between urban and rural areas and among the different municipalities in which the incidents occurred. Results: Across the study duration, 1761 patients were transported by EMS. Of that, 59% were transported from an urban area and 41% from rural areas. There were significant differences in the on-scene time and total prehospital time as a function of urban and rural areas and municipalities; however, the response time across the study groups was comparable. There were no significant differences in blood transfusion, intubation, hospital length of stay, and mortality. Conclusion: Within different areas in Qatar, the EMS response time and in-hospital outcomes were comparable. This indicates that the provision of prehospital care across the country is similar. The prehospital and acute in-hospital care are accessible for everyone in the country at no cost. Understanding the differences in EMS utilization and prehospital times contributes to the policy development in terms of equitable distribution of healthcare resources.
Impact of Technology Innovation on Air Quality—An Empirical Study on New Energy Vehicles in China
Authors: Hu Haoxuan , Zhang Yuchen , Rao Xi , Jin Yinghua
Published: April 2021

China’s high economic growth has been accompanied by deteriorating air quality in recent decades. This paper aims to explore the relation between technology innovation (defined as the invention patent counts of each region) of new energy vehicles (NEVs) in China and air quality. A panel fixed effect model is used to analyze this relation and the mediating effect methods are used to examine the role of the output of NEVs (defined as the annual production quantity of NEVs in each region (unit: thousand)). The results of our study show: (1) the impact of the technology innovation of NEVs on air quality is positive and statistically significant; (2) the mediating role of the output of NEVs is confirmed in the relation between NEVs innovation and air quality improvement; (3) the technology innovation of NEVs has a more notable impact on the air quality in the regions with higher vehicle and vessel tax (VVT). The present study implicates for the first time that the technology innovation of NEVs can enhance air quality with the mediating role of the output of NEVs and the moderating role of VVT.
Early Interventions and Impact of COVID-19 in Spain
Authors: Alfonso Viguria Uxue , Casamitjana Núria
Published: April 2021

The health crisis emerging from China in January 2020 has spread around the world resulting in a disruption of daily life activity in many countries. In response to this health threat, different measures have been implemented by national governments to minimize the possible health consequences. This article explores the initial impact of the COVID-19 pandemic in Spain, providing an epidemiological overview and reviewing the early measures developed to control its spread. On 1 April, Spain was the country with the second highest incidence in the world; with 104,118 positive cases detected and 9387 deaths recorded. Among these, 20.2% of positive cases were among healthcare professionals. In addition to the unprecedented health crisis, the lockdown interventions employed were considered to be among the strictest measures implemented through European countries. These measures were initially successful in controlling local transmission, but resulted in severe economic and social impacts. A critical review of the actions taken and their impact on the Spanish population could contribute to guide and inform decision-making in future pandemic situations.
A Cross-Sectional Study of Foot Growth and Its Correlation with Anthropometric Parameters in a Representative Cohort of Schoolchildren from Southern Spain
Authors: González-Elena María Luisa , Fernández-Espejo Emilio , Castro-Méndez Aurora , Guerra-Martín María Dolores , Córdoba-Fernández Antonio
Published: April 2021

Background: The relationship between growth of the foot and other anthropometric parameters during body development until puberty has been scarcely studied. Some studies propose that growth of the foot in length may be an early index of puberty. The objective of this cross-sectional study was to analyze the relationship between the growth of the foot in length and width with other anthropometric parameters, in prepubertal and early pubertal schoolchildren (Tanner stage II). Methods: Using an instrument that was designed and calibrated for this purpose, maximum foot length, width and height were obtained in 1005 schoolchildren. Results: The findings indicate that the age of onset of pubertal foot growth spur was 7–8 years in girls, and 8–9 years in boys. Growth in foot length stabilized in both sexes after 12 years of age. In boys, a strong correlation was found between height and foot length (r = 0.884; p < 0.047), and between body mass index (BMI) and forefoot width at 12 years of age (r = 0.935; p < 0.020). A strong correlation was found between height and forefoot width at 6 years in girls (r = 0.719; p < 0.001), as well as between BMI and metatarsal width in 10 years-old girls (r = 0.812; p <0.001). Conclusions: The average increase in foot length and width that precedes the onset of Tanner’s stage II in both girls and boys can be considered as a useful biological indicator of the onset of puberty.
Effects of Loving-Kindness Meditation on Doctors’ Mindfulness, Empathy, and Communication Skills
Authors: Chen Hao , Liu Chao , Cao Xinyi , Hong Bo , Huang Ding-Hau , Liu Chia-Yi , Chiou Wen-Ko
Published: April 2021

Background: In the context of increasing doctor–patient tensions in China, the objective of this study was to explore and examine the effects of loving-kindness meditation (LKM) on doctors’ mindfulness, empathy, and communication skills. Methods: A total of 106 doctors were recruited from a hospital in China, and randomly divided into an LKM training group (n = 53) and waiting control group (n = 53). The LKM training group received 8 weeks of LKM training intervention, whereas the control group received no intervention. Three major variables (mindfulness, empathy, and communication skills) were measured before (pre-test) and after (post-test) the LKM training intervention. Results: The empathy and communication skills of the LKM group were significantly improved compared with those of the control group, but the level of mindfulness did not significantly change. Conclusions: The results suggested that LKM may contribute to improving physicians’ empathy and communication skills. However, the mechanisms that underlie the effects of the LKM on mindfulness, empathy, and communication skills and other psychological constructs needs further elucidation.
The Impact of Nationality on the Psychophysiological Stress Response and Academic Fulfilment in the Final Degree Dissertation
Authors: Ramírez-Adrados Ana , Martínez-Pascual Beatriz , Gonzalez-de-Ramos Cristina , Fernández-Martínez Silvia , Fernández-Elías Valentín Emilio , Clemente-Suárez Vicente Javier
Published: April 2021

The aims of this study were: i. to analyze the effect of nationality on the psychophysiological stress response of physiotherapy last year students in their final degree dissertations; and ii. to analyze the relationship between the stress response and academic results according to nationality. We evaluated the autonomic stress response, cortical arousal, distress subjective perception, and objective and subjective academic fulfilment in Spanish, Italian, and French physiotherapy students during their final degree dissertation. Results showed a large anticipatory anxiety response before the dissertation in the three student groups. Only the Spanish group showed an increased tendency in the habituation process, reducing the psychophysiological stress response during the dissertation, while the Italian and French groups maintained a large sympathetic activation until the end of the dissertation. Cortical arousal and subjective perception of distress were similar in the three nationalities. In addition, no correlation between academic fulfilment and autonomic modulation was found. We concluded that there was no nationality effect in the psychophysiological stress response of physiotherapy last year students in their final degree dissertation, all of them showing a large anticipatory anxiety response.
Using Pressure-Driven Membrane Processes to Remove Emerging Pollutants from Aqueous Solutions
Authors: Hidalgo Asunción María , León Gerardo , Murcia María Dolores , Gómez María , Gómez Elisa , Gómez José Luis
Published: April 2021

Currently, there is great concern about global water pollution. Wastewater generally contains substances called emerging pollutants, and if the removal of these pollutants is not given sufficient attention, the pollutants can enter into the water cycle and reach the water supply for domestic use, causing adverse effects on the well-being of people. In order to avoid this menace, a multitude of techniques to reduce the high concentration levels of these substances dissolved in water are being researched and developed. One of the most-used techniques for this goal is the physical-chemical separation of contaminants in water through membrane technology. In this study, different membranes were tested with the objective of investigating the removal of three emerging pollutants: caffeine, metformin, and methyl-paraben. Initially, a nanofiltration (NF) membrane was selected, and the influence of pressure was evaluated in the rejection coefficients and permeate fluxes. Next, a screening of three new membranes to remove methyl paraben was completed. The influence of the operating variables, working pressure, and methyl paraben-feed concentration was checked. Finally, the solution-diffusion model was applied to predict the behavior of the different membranes in the removal of methyl paraben. A good correlation between experimental and calculated values of permeate flux and methyl paraben concentration was obtained.
Association of Lumbar Paraspinal Muscle Morphometry with Degenerative Spondylolisthesis
Authors: Lee Eun Taek , Lee Seung Ah , Soh Yunsoo , Yoo Myung Chul , Lee Jun Ho , Chon Jinmann
Published: April 2021

The objective of this study was to assess the cross-sectional areas (CSA) of lumbar paraspinal muscles and their fatty degeneration in adults with degenerative lumbar spondylolisthesis (DLS) diagnosed with chronic radiculopathy, compare them with those of the same age- and sex-related groups with radiculopathy, and evaluate their correlations and the changes observed on magnetic resonance imaging (MRI). This retrospective study included 62 female patients aged 65–85 years, who were diagnosed with lumbar polyradiculopathy. The patients were divided into two groups: 30 patients with spondylolisthesis and 32 patients without spondylolisthesis. We calculated the CSA and fatty degeneration of the erector spinae (ES) and multifidus (MF) on axial T2-weighted magnetic resonance (MR) images from the inferior end plate of the L4 vertebral body levels. The functional CSA (FCSA): CSA ratio, skeletal muscle index (SMI), and MF CSA: ES CSA ratio were calculated and compared between the two groups using an independent t-test. We performed logistic regression analysis using spondylolisthesis as the dependent variable and SMI, FCSA, rFCSA, fat infiltration rate as independent variables. The result showed more fat infiltration of MF in patients with DLS (56.33 vs. 44.66%; p = 0.001). The mean FCSA (783.33 vs. 666.22 mm2; p = 0.028) of ES muscle was a statistically larger in the patients with DLS. The ES FCSA / total CSA was an independent predictor of lumbar spondylolisthesis (odd ratio =1.092, p = 0.016), while the MF FCSA / total CSA was an independent protective factor (odd ratio =0.898, p = 0.002)
Downstream Complications and Healthcare Expenditure after Invasive Procedures for Lung Lesions in Taiwan
Authors: Yang Szu-Chun , Lai Ching-Han , Kuo Chin-Wei , Lin Chien-Chung , Lai Wu-Wei , Wang Jung-Der
Published: April 2021

This study aimed to estimate the downstream complications and healthcare expenditure after invasive procedures for lung lesions, which in turn could be used for future cost-effectiveness analyses of lung cancer screening in Taiwan. We interlinked the Taiwan National Beneficiary Registry with the National Health Insurance Reimbursement databases to identify non-lung cancer individuals aged 50–80 years who underwent invasive lung procedures within one month after non-contrast chest computed tomography between 2014 and 2016. We directly matched one individual with 10 controls by age, gender, calendar year, residence area, comorbidities, and the past one-year healthcare expenditure to calculate incremental one-month complication rates and attributable costs. A total of 5805 individuals who underwent invasive lung procedures were identified and matched with 58,050 controls. The incremental one-month complication rates were 13.4% (95% CI: 10.9% to 15.8%), 10.7% (95% CI: 9.2% to 12.1%), and 4.4% (95% CI: 2.0% to 6.7%) for thoracic surgery, bronchoscopy, and needle biopsy, respectively. The incremental one-month healthcare expenditure for minor, intermediate, and major complications were NT$1493 (95% CI: NT$-3107 to NT$6092), NT$18,422 (95% CI: NT$13,755 to NT$23,089), and NT$58,021 (95% CI: NT$46,114 to NT$69,929), respectively. Individuals aged 60–64 years incurred the highest incremental costs. Downstream complications and the healthcare expenditure after invasive procedures for lung lesions would be substantial for non-lung cancer individuals 50–80 years of age. These estimates could be used in modeling the cost-effectiveness of the national lung screening program in Taiwan.
Thai Older People’s Willingness (Intention) to Participate in a Care Prevention, Community Group Exercise Program: An Assessment before Implementing an Intervention Trial in Chiang Mai, Northern Thailand
Authors: Aung Thin Nyein Nyein , Aung Myo Nyein , Moolphate Saiyud , Koyanagi Yuka , Mulati Nadila , Supakankunti Siripen , Yuasa Motoyuki
Published: April 2021

Background: Sustainability of a current family-based long-term care model in Thailand has been challenged by demographic aging, and the rising burden of non-communicable diseases and age-related morbidities. In order to overcome these challenges, a community-integrated intermediary care (CIIC) service model, including functional training as one of the interventions, was introduced. To increase program uptake and adherence, it is vital to understand the facilitators and barriers for joining this group exercise. Therefore, we aimed to explore the determinants of older adults’ willingness to participate in it. Methods: A total of 1509 participants from an intervention arm of a cluster randomized trial were interviewed with a structured questionnaire. A descriptive analysis and binary logistic regression were applied. Results: More than half of participants (51.4%) were willing to join community-based care prevention, functional training exercise program. Significant associated motivators were being of younger age, female, married, working seniors, original community residents, having (regular and irregular) exercise habits, history of a fall in the last six months, needs for walking aids and secondary caregivers. Conclusion: Our findings highlighted both personal and social factors motivated old people to access health promotion activities. It might help design or implement effective programs to promote healthy aging among community-dwelling seniors in Thailand. This research is analysis of baseline results from a Community Integrated Intermediary Care project. TCTR20190412004.
Correction: Lättman, K., et al. Perceived Accessibility, Satisfaction with Daily Travel, and Life Satisfaction among the Elderly. Int. J. Environ. Res. Public Health 2019, 16, 4498
Authors: Lättman Katrin , Olsson Lars E. , Friman Margareta , Fujii Satoshi
Published: April 2021

There were errors in the original article [...]
Home Mechanical Ventilation: A Patient’s Perspective Survey Study
Authors: Kwiatosz-Muc Magdalena , Kopacz Bożena
Published: April 2021

Background: An increasing number of patients included in home mechanical ventilation (HMV) care has been under observation for many years. The study aimed to assess the patients opinion concerning the expected and perceived quality of care in an HMV system and a patient’s satisfaction with care. Methods: In 2017, patients treated with HMV were surveyed in Poland with the modified SERVQUAL questionnaire. Results: One hundred correctly completed surveys were analyzed. Patient Satisfaction Index was high. In every examined area, the expectations were statistically significant larger than the perception of the services. The biggest gap was in the tangibility dimension and the smallest gap was in the empathy dimension. Perceived respect and understanding for a patient’s needs are close to the expectations. Conclusions: The level of satisfaction with health care among patients treated with HMV in majority of investigated components is high. Moreover, the difference between perceived and expected quality of health care in the HMV system was relatively small in the opinion of the patients themselves. Further investigations with alternative methods are needed.
Xylo-Oligosaccharides in Prevention of Hepatic Steatosis and Adipose Tissue Inflammation: Associating Taxonomic and Metabolomic Patterns in Fecal Microbiomes with Biclustering
Authors: Hintikka Jukka , Lensu Sanna , Mäkinen Elina , Karvinen Sira , Honkanen Marjaana , Lindén Jere , Garrels Tim , Pekkala Satu , Lahti Leo
Published: April 2021

We have shown that prebiotic xylo-oligosaccharides (XOS) increased beneficial gut microbiota (GM) and prevented high fat diet-induced hepatic steatosis, but the mechanisms associated with these effects are not clear. We studied whether XOS affects adipose tissue inflammation and insulin signaling, and whether the GM and fecal metabolome explain associated patterns. XOS was supplemented or not with high (HFD) or low (LFD) fat diet for 12 weeks in male Wistar rats (n = 10/group). Previously analyzed GM and fecal metabolites were biclustered to reduce data dimensionality and identify interpretable groups of co-occurring genera and metabolites. Based on our findings, biclustering provides a useful algorithmic method for capturing such joint signatures. On the HFD, XOS-supplemented rats showed lower number of adipose tissue crown-like structures, increased phosphorylation of AKT in liver and adipose tissue as well as lower expression of hepatic miRNAs. XOS-supplemented rats had more fecal glycine and less hypoxanthine, isovalerate, branched chain amino acids and aromatic amino acids. Several bacterial genera were associated with the metabolic signatures. In conclusion, the beneficial effects of XOS on hepatic steatosis involved decreased adipose tissue inflammation and likely improved insulin signaling, which were further associated with fecal metabolites and GM.
Effects of Home Confinement on the Intensity of Physical Activity during the COVID-19 Outbreak in Team Handball According to Country, Gender, Competition Level, and Playing Position: A Worldwide Study
Authors: Hermassi Souhail , Bouhafs El Ghali , Bragazzi Nicola Luigi , Ichimura Shiro , Alsharji Khaled E. , Hayes Lawrence D. , Schwesig René
Published: April 2021

This study investigated effects of home confinement on physical activity (PA) in Team Handball during the COVID-19 outbreak. A total of 1359 handball players participated (age: 23 ± 6 years). Participants from Europe, Western Asia, and North Africa answered an online version of the International Physical Activity Questionnaire (IPAQ) considering “before” and “during” confinement. COVID-19 home confinement has had a negative effect on PA (vigorous, moderate, walking, and overall). The largest decrease was in the sum parameter “all PA” (MET (metabolic equivalent of task)-min/week, ηp2 = 0.903; min/week, ηp2 = 0.861). Daily sitting time increased from 2.7 to 5.0 h per weekday (p < 0.001, ηp2 = 0.669). For gender, continent, country, level of handball league, and playing position, no significant differences (group and interaction effects) were observed. The largest change in PA behavior was in walking (minutes per day: ηp2 = 0.755), with males displaying the greatest decrease (from 62 ± 11 to 30 ± 14 min per weekday; d = 2.67). In terms of magnitude, difference between genders was greatest for sitting time (difference in d = 1.20). In conclusion, while COVID-19 measures were essential to preserve public health, PA was compromised and sedentary behavior increased because of these public health measures regardless of gender, playing position, and competition level.
Administration of Strategic Agreements in Public Hospitals: Considerations to Enhance the Quality and Sustainability of Mergers and Acquisitions
Authors: Cerezo-Espinosa de los Monteros Javier , Castro-Torres Antonio , Gómez-Salgado Juan , Fagundo-Rivera Javier , Gómez-Salgado Carlos , Coronado-Vázquez Valle
Published: April 2021

Merger processes between hospitals have high benefit potential for patients, staff and managers. This integration of health centres can improve the quality and safety in patient care. Additionally, cooperative processes enhance the sustainability of the health system, by increasing team spirit, giving innovative ideas and improving staff satisfaction. In this article, the critical factors for successful hospital mergers and acquisitions in the Public Health System were considered to develop a brief guide to help with the organisation of a merger process. Five sections were designed: Strategic administration and objectives, Staff management, New hospital complex structure, Processes and Results. This guide facilitates the communication between a variety of stakeholders, thus improving the engagement between all members of the new healthcare system. This could be particularly important for countries with large regional variance in the organisation of health care and resources.
The Relationship between Health Perception and Health Predictors among the Elderly across European Countries
Authors: Silva Ana F. , Cancela Jose Mª , Mollinedo Irimia , Camões Miguel , Bezerra Pedro
Published: April 2021

This study aimed to investigate the relationship between health perception and health predictors among the elderly. In this study, 376 older adults from four different countries (Hungary, n = 86; Italy, n = 133; Portugal, n = 95; and Spain, n = 62) were analyzed. All subjects completed the EQ-5D-5L to assess their quality-adjusted life years and were assessed in handgrip (HG) and in Timed Up and Go (TUG) tests. A three-way MANOVA was conducted to analyze the groups based on their age, sex, and country. The interaction effects in all included variables were also considered. The Bonferroni test was also executed as a post hoc test. Any interaction results were noticed. Regarding age, lower perceived quality of life scores and higher TUG results were registered in the oldest group, and greater values of left and right HG results were registered in the second-oldest group. Males showed greater left and right HG values than women. Spain showed lower perceived quality of life scores. Portugal and Italy showed greater HG left values, while Portugal had better HG right values. Hungary produced the greatest TUG scores. Quality of life is dependent on the subject’s age and physical fitness, as increasing age was associated with decreased values of HG and TUG. Only strength was different between sexes.
Effect of Employees’ Perceived Green HRM on Their Workplace Green Behaviors in Oil and Mining Industries: Based on Cognitive-Affective System Theory
Authors: Chen Silu , Jiang Wanxing , Li Xin , Gao Han
Published: April 2021

Drawing on cognitive-affective system theory, this study proposes that employees’ perceived green human resource management (HRM) influences their’ workplace green behaviors through two psychological processes: the cognitive and the affective route. By analysing 358 questionnaires collected from Chinese firms in the oil and mining industry, we obtain evidence in support of our predictions, finding that employees’ perceived green HRM positively impacts their voluntary workplace green behaviors and green creativity. Additionally, green psychological climate and harmonious environmental passion are found to partially mediate the relationship between employees’ perceived green HRM and voluntary workplace green behavior while harmonious environmental passion is found to fully mediate the relationship between employees’ perceived green HRM and green creativity. These findings shed light on the importance of green HRM in shaping employees’ proactive workplace green behaviors and uncover how green HRM transforms employees’ cognitive, affective, and motivational (CAM) factors into green actions.
Box Experiment Study of Thermally Enhanced SVE for Benzene
Authors: Zhang Qixiang , Feng Qiyan , Zhu Xueqiang , Zhang Mei , Wang Yanjun , Yang Liu
Published: April 2021

In order to describe the changes of soil temperature field, air flow field and remediation situation with time during the process of thermally enhanced SVE (soil vapor extraction), a remediation experiment of benzene contaminated soil with single extraction pipe was carried out in a box device. The results showed that the whole temperature of the system was raised to 80 °C in 4 h. 43% of benzene were removed in the first 2% of the extraction time. After 24 h, the repair efficiency was close to 100%. The device can efficiently remove benzene from soil. By continuously monitoring the parameters in the operation process of the system, the spatial distribution of temperature and soil gas pollutant concentration with time was plotted. It showed the benzene concentration distribution in the soil gas was more consistent with the temperature distribution before the start of ventilation, and the concentration of benzene in the soil gas dropped rapidly after ventilation, while the temperature distribution was almost unaffected. In the treatment of soil with a benzene content of 17.8 mg∙kg−1, when the soil gas benzene concentration is the highest at 180 min, the peak value is 11,200 mg∙m−3, and the average concentration is 7629.4 mg∙m−3.
A Latent Class Analysis of Gender Attitudes and Their Associations with Intimate Partner Violence and Mental Health in the Democratic Republic of Congo
Authors: Corley Andrew , Glass Nancy , Remy Mitima Mpanano , Perrin Nancy
Published: April 2021

Gender role attitudes, views held by individuals regarding the roles men and women should play in society, are a powerful social determinant of health. However, work remains in elucidating the associations between gender attitudes and intimate partner violence (IPV) perpetration or victimization and mental health problems. We used latent class analysis to classify patterns of responses on survey items on gender attitudes by male and female adults in households that participated in an economic empowerment intervention and evaluation in rural villages in the Democratic Republic of Congo. Attitudes about IPV and gender equality were two subdomains to emerge from analysis and a 3-class model solution was found to best fit response patterns. Results indicated that, as compared to the least gender equitable class, individuals in the moderately gender equitable and fully gender equitable classes had lower odds of having experienced or perpetrated psychological abuse. Individuals within the moderately gender equitable class were at lower odds of having experienced or perpetrated physical or sexual violence. Further, individuals in the moderately gender equitable and fully gender equitable classes had significantly lower mean scores on symptoms associated with PTSD than individuals in the least gender equitable class. Future research should explore the relationships between gender attitudes, partner violence and mental health to build resilient families.
HAPPY MAMA Project (PART 1). Assessing the Reliability of the Italian Karitane Parenting Confidence Scale (KPCS-IT) and Parental Stress Scale (PSS-IT): A Cross-Sectional Study among Mothers Who Gave Birth in the Last 12 Months
Authors: Mannocci Alice , Massimi Azzurra , Scaglietta Franca , Ciavardini Sara , Scollo Michela , Scaglione Claudia , La Torre Giuseppe
Published: April 2021

The purposes of this study were: (1) to adapt two validated questionnaires used to evaluate maternal confidence (KPCS-IT) and maternal stress (PSS-IT) to the Italian context, in order to (2) measure the stress level and the self-efficacy in an Italian sample of mothers. The validation process has provided the construction of an online questionnaire. It was administered on a convenience mothers sample with at least a child aged 0–12 months, twice (T0 and T1) with a two day interval. Assessment of instrument stability over time was estimated by applying test–retest reliability between T0 and T1, and the Cronbach’s alpha coefficient. A cross-sectional study was carried out to assess the second aim. Italian mothers with at least one child living at home aged between 0–12 months were recruited. Statistical reliability methods were applied to assess the internal validity of the two questionnaires. PSS-IT was analyzed using univariate and multivariate statistical analyses in order to study the association between KPCS-IT, demographic and maternal characteristics. Statistical significance was established as p < 0.05. The Cronbach’s alpha reported a good level of internal consistency of the questionnaires: PSS-IT alpha = 0.862; KPCS-IT alpha = 0.801. 32% of the mothers declared low maternal confidence and the mean value of PSS-IT was 35.4 (SD = 8). The significant inverse correlation was found between the PSS-IT and the KPCS-IT (coeff = −0.353; p < 0.001): this means that a high level of perceived self-efficacy reduces the maternal stress level. The study identifies that interventions on maternal confidence can be useful to support mothers in the first months after delivery in order to prevent stress risk: the perceived self-efficacy is as a modifiable factor and the results of the study indicate that it significantly reduces the PSS-IT and EPDS scores. In future, more field trials are necessary in order to assess the realistic and feasible interventions on maternal confidence and competence to prevent maternal distress.
Context-Specific Point-of-Interest Recommendation Based on Popularity-Weighted Random Sampling and Factorization Machine
Authors: Yu Dongjin , Shen Yi , Xu Kaihui , Xu Yihang
Published: April 2021

Point-Of-Interest (POI) recommendation not only assists users to find their preferred places, but also helps businesses to attract potential customers. Recent studies have proposed many approaches to the POI recommendation. However, the lack of negative samples and the complexities of check-in contexts limit their effectiveness significantly. This paper focuses on the problem of context-specific POI recommendation based on the check-in behaviors recorded by Location-Based Social Network (LBSN) services, which aims at recommending a list of POIs for a user to visit at a given context (such as time and weather). Specifically, a bidirectional influence correlativity metric is proposed to measure the semantic feature of user check-in behavior, and a contextual smoothing method to effectively alleviate the problem of data sparsity. In addition, the check-in probability is computed based on the geographical distance between the user’s home and the POI. Furthermore, to handle the problem of no negative feedback in LBSN, a weighted random sampling method is proposed based on contextual popularity. Finally, the recommendation results is obtained by utilizing Factorization Machine with Bayesian Personalized Ranking (BPR) loss. Experiments on a real dataset collected from Foursquare show that the proposed approach has better performance than others.