bluuebunny/crossref_metadata_2025 huggingface dataset:
Application of the JA-CHRODIS Integrated Multimorbidity Care Model (IMCM) to a Case Study of Diabetes and Mental Health
Authors: Forjaz Maria , Rodriguez-Blazquez Carmen , Guerrero-Fernández de Alba Inmaculada , Gimeno-Miguel Antonio , Bliek-Bueno Kevin , Prados-Torres Alexandra , the CHRODIS Expert Group on Multimorbidity on behalf of
Published: December 2019

The Integrated Multimorbidity Care Model (IMCM), developed by the Joint Action on Chronic Diseases and Promoting Healthy Ageing across the Life Cycle (JA-CHRODIS), proposes a set of 16 multidimensional components (i.e., recommendations) to improve the care of persons with multimorbidity in Europe. This study aimed at analyzing the potential applicability of the IMCM. We followed a qualitative approach that comprised two phases: (1) The design of a case study based on empirical clinical data, which consisted of a hypothetical woman with multimorbidity, type 2 diabetes mellitus, mental health, and associated social problems, and (2) the creation of a consensus group to gather the opinions of a multidisciplinary group of experts and consider the potential applicability of the IMCM to our case study. Experts described how care should be delivered to this patient according to each model component, suggested the use of specific rating scales and tools to assess her needs in a comprehensive and regular way, and pointed our crucial health and social resources to improve her care process. Experts also highlighted patient-centered, integrated and tailored care as one of the keystones of quality healthcare. Our results suggest that the IMCM is applicable in complex patients with multimorbidity.
A PISA-2015 Comparative Meta-Analysis between Singapore and Finland: Relations of Students’ Interest in Science, Perceived ICT Competence, and Environmental Awareness and Optimism
Authors: Lin Pei-Yi , Chai Ching Sing , Jong Morris Siu-Yung
Published: December 2019

The aim of the present study is twofold: (1) to identify a factor structure between variables-interest in broad science topics, perceived information and communications technology (ICT) competence, environmental awareness and optimism; and (2) to explore the relations between these variables at the country level. The first part of the aim is addressed using exploratory factor analysis with data from the Program for International Student Assessment (PISA) for 15-year-old students from Singapore and Finland. The results show that a comparable structure with four factors was verified in both countries. Correlation analyses and linear regression were used to address the second part of the aim. The results show that adolescents’ interest in broad science topics can predict perceived ICT competence. Their interest in broad science topics and perceived ICT competence can predict environmental awareness in both countries. However, there is difference in predicting environmental optimism. Singaporean students’ interest in broad science topics and their perceived ICT competences are positive predictors, whereas environmental awareness is a negative predictor. Finnish students’ environmental awareness negatively predicted environmental optimism.
The Relative Associations of Body Image Dissatisfaction among Psychiatric Out-Patients in Singapore
Authors: Satghare Pratika , Mahesh Mithila Valli , Abdin Edimansyah , Chong Siow Ann , Subramaniam Mythily
Published: December 2019

Background: Adults with body image dissatisfaction (BID) are more likely to be depressed, anxious, and suicidal when compared to those without intense dissatisfaction over their appearance. The current study aimed to estimate the prevalence and factors associated with BID among out-patients with mental illness in Singapore. Methods: Data was collected from 310 psychiatric out-patients using a self-administered questionnaire. Measurements used were socio-demographic characteristics, Body Mass Index scores, Body Shape Questionnaire, Binge Eating Scale, Eating Attitudes Test, Beck’s Depression Inventory, Beck’s Anxiety Inventory and Alcohol Use Disorders Identification Test. Results: A prevalence of 30.9% of BID was established among psychiatric out-patients in Singapore. Being female, having higher BMI scores, binge eating behavior, eating disorders, and those diagnosed with depression were positively associated with BID. Conclusion: BID is prevalent among those with psychiatric illnesses which could lead to a higher degree of psychological distress and the emergence of eating disorders.
Neglected Urban Villages in Current Vector Surveillance System: Evidences in Guangzhou, China
Authors: Wu Sijia , Ren Hongyan , Chen Wenhui , Li Tiegang
Published: December 2019

Numerous urban villages (UVs) with substandard living conditions that cause people to live there with vulnerability to health impacts, including vector-borne diseases such as dengue fever (DF), are major environmental and public health concerns in highly urbanized regions, especially in developing countries. It is necessary to explore the relationship between UVs and vector for effectively dealing with these problems. In this study, land-use types, including UVs, normal construction land (NCL), unused land (UL), vegetation, and water, were retrieved from the high-resolution remotely sensed imagery in the central area of Guangzhou in 2017. The vector density from May to October in 2017, including Aedes. albopictus (Ae. albopictus)’s Breteau index (BI), standard space index (SSI), and adult density index (ADI) were obtained from the vector surveillance system implemented by the Guangzhou Center for Disease Control and Prevention (CDC). Furthermore, the spatial and temporal patterns of vector monitoring sites and vector density were analyzed on a fine scale, and then the Geodetector tool was further employed to explore the relationships between vector density and land-use types. The monitoring sites were mainly located in NCL (55.70%–56.44%) and UV (13.14%–13.92%). Among the total monitoring sites of BI (79), SSI (312), and ADI (326), the random sites accounted for about 88.61%, 97.12%, and 98.47%, respectively. The density of Ae. albopictus was temporally related to rainfall and temperature and was obviously differentiated among different land-use types. Meanwhile, the grids with higher density, which were mostly concentrated in the Pearl River fork zone that collects a large number of UVs, showed that the density of Ae. albopictus was spatially associated with the UVs. Next, the results of the Geodetector illustrated that UVs posed great impact on the density of Ae. albopictus across the central region of Guangzhou. We suggest that the number of monitoring sites in the UVs should be appropriately increased to strengthen the current vector surveillance system in Guangzhou. This study will provide targeted guidance for local authorities, making more effective control and prevention measures on the DF epidemics.
Design and Preparation of Chitosan-Crosslinked Bismuth Ferrite/Biochar Coupled Magnetic Material for Methylene Blue Removal
Authors: Cai Xiaoxi , Li Jiang , Liu Yunguo , Hu Xinjiang , Tan Xiaofei , Liu Shaobo , Wang Hui , Gu Yanling , Luo Lerong
Published: December 2019

Biochar obtained by pyrolysis of the fiber plant kenaf was mixed with bismuth ferrite (BiFeO3) in a chitosan-containing acetic acid solution, magnetized, and modified to prepare a chitosan-crosslinked BiFeO3/biochar coupled magnetic material. The adsorption properties of the composite were investigated using methylene blue dissolved in water, and the effects of external conditions, such as pH, methylene blue concentration, reaction time, and temperature, on the adsorption performance were studied. The adsorption data were fitted and analyzed with kinetic and isotherm models, and the results showed that the BiFeO3/biochar coupled magnetic material effectively adsorbed methylene blue. The amounts adsorbed onto this magnetic material increased with increasing initial methylene blue concentration, reaction time, and temperature, and the adsorption performance improved under neutral and alkaline conditions. The pseudo-first-order kinetic and Langmuir isotherm models satisfactorily fitted the adsorption data, showing that the adsorption of methylene blue involved both chemical and physical adsorption. The maximum adsorption capacity of methylene blue onto the BiFeO3/biochar coupled magnetic material reached 18.942 mg·g−1 at 25 °C, confirming the excellent dye binding activity of this material.
Availability of Real-World Data in Italy: A Tool to Navigate Regional Healthcare Utilization Databases
Authors: Skrami Edlira , Carle Flavia , Villani Simona , Borrelli Paola , Zambon Antonella , Corrao Giovanni , Trerotoli Paolo , Guardabasso Vincenzo , Gesuita Rosaria
Published: December 2019

The purpose of the study was to map and describe the healthcare utilization databases (HUDs) available in Italy’s 19 regions and two autonomous provinces and develop a tool to navigate through them. A census of the HUDs covering the population of a single region/province and recording local-level data was conducted between January 2014 and October 2016. The characteristics of each HUD regarding the start year, data type and completeness, data management system (DMS), data protection procedures, and data quality control adopted were collected through interviews with the database managers using a standard questionnaire or directly from the website of the regional body managing them. Overall, 352 HUDs met the study criteria. The DMSs, anonymization procedures of personal identification data, and frequency of data quality control were fairly homogeneous within regions, whereas the number of HUDs, data availability, type of identification code, and anonymization procedures were considerably heterogeneous across regions. The study provides an updated inventory of the available regional HUDs in Italy and highlights the need for greater homogeneity across regions to improve comparability of health data from secondary sources. It could represent a reference model for other countries to provide information on the available HUDs and their features, enhancing epidemiological studies across countries.
Ethical Leadership and Young University Teachers’ Work Engagement: A Moderated Mediation Model
Authors: Zeng Jianji , Xu Guangyi
Published: December 2019

This paper aims to examine the mediating role of organizational trust in the relationship between ethical leadership and young teachers’ work engagement, and the moderating effect of supervisor–subordinate (S–S) guanxi. S–S guanxi is a special interpersonal relationship in Chinese organizations. The sample in this study comprises 205 young teachers from 15 Chinese universities. The results reveal that organizational trust mediates the relationship between ethical leadership and young teachers’ work engagement. Moreover, S–S guanxi strengthens the positive relationship between organizational trust and young teachers’ work engagement, and the indirect effect of ethical leadership on young teachers’ work engagement through organizational trust. Based upon these findings, several theoretical and practical implications are discussed.
Exploring the Knowledge, Attitudes, and Behavioural Responses of Healthcare Students towards Mental Illnesses—A Qualitative Study
Authors: Riffel Taylor , Chen Shu-Ping
Published: December 2019

Background: The stigma of mental illness causes delays in seeking help, and often compromises victims’ therapeutic relationships with healthcare providers. The knowledge, attitudes, and behavioural responses of future healthcare professionals toward individuals with mental illnesses are explored here to suggest steps that will reduce mental illness stigma in healthcare providers. Methods: A generic qualitative approach—Qualitative Description—was used. Eighteen students from nine healthcare programs at a Canadian University participated in individual semi-structured interviews. Participants answered questions regarding their knowledge, attitudes, and behavioural responses towards individuals with mental illnesses. Thematic content analysis guided the data analysis. Results: Four main themes were constructed from the data: positive and negative general perceptions toward mental illness; contact experiences with mental illnesses; mental illness in a healthcare setting; and learning about mental illness in healthcare academia. Conclusions: Students showed well-rounded mental health knowledge and mostly positive behaviours toward individuals with mental illnesses. However, some students hold stigmatizing attitudes and do not feel prepared through their academic experiences to work with individuals with mental illnesses. Mental health education can reduce the stigma toward mental illness and improve the care delivered by healthcare professionals.
Reconstructing Personal Stories in Virtual Reality as a Mechanism to Recover the Self
Authors: Georgieva Iva , Georgiev Georgi V.
Published: December 2019

Advances in virtual reality present opportunities to relive experiences in an immersive medium that can change the way we perceive our life stories, potentially shaping our realities for the better. This paper studies the role of virtual reality as a tool for the creation of stories with the concept of the self as a narrator and the life of the self as a storyline. The basis of the study is the philosophical notion of the self-narrative as an explanatory story of the events in one’s life that constitutes the notion of one’s self. This application is suitable for cases when individuals need to recreate their self, such as during recovery after traumatic events. The analysis of the effects of virtual reality shows that it enables a person to engage in a process of deeper self-observation to understand and explain adverse events and to give meaning to these events to form a new story, which can complement the therapeutic outcomes of exposure treatments. This study proposes concrete examples of immersive scenarios used to reconstruct personal stories. Several possible levels of experience are proposed to suggest that recovery can be achieved through the gradual retelling of the self-narrative, addressing all of the underlying narratives. Considering the ethical challenges that might arise, this paper explores the ways in which immersion in virtual reality can benefit a person’s view toward life as a story and his or her self as its author, comparing this idea with previous research on the application of virtual reality for trauma treatment. The analysis also emphasizes the perception of narrative authorship in virtual reality as an essential method for recovering the self-narrative and improving a patient’s mental health during self-actualization.
An Eye Tracking Analysis on Diagnostic Performance of Digital Fundus Photography Images between Ophthalmologists and Optometrists
Authors: Mohamad Shahimin Mizhanim , Razali Azalia
Published: December 2019

To investigate the parameters of eye movement between ophthalmologists and optometrists while diagnosing digital fundus photographs, sixteen participants (eight ophthalmologists and eight optometrists) were recruited in this study. Every participant’s eye movement during diagnosis of a randomized set of fundus photographs displayed on an eye tracker were recorded. Fixation metrics (duration, count and rate) and scan path patterns were extracted from the eye tracker. These parameters of eye movement and correct diagnosis score were compared between both groups. Correlation analyses between fixation metrics and correct diagnosis score were also performed. Although fixation metrics between ophthalmologists and optometrists were not statistically different (p > 0.05), these parameters were statistically different when compared between different area of interests. Both participant groups had a similar correct diagnosis score. No correlation was found between fixation metrics and correct diagnosis score between both groups, except for total fixation duration and ophthalmologists’ diagnosis score of diabetic retinopathy photographs. The ophthalmologists’ scan paths were simpler, with larger saccades, and were distributed at the middle region of the photographs. Conversely, optometrists’ scan paths were extensive, with shorter saccades covering wider fundus areas, and were accumulated in some unrelated fundus areas. These findings indicated comparable efficiency and systematic visual search patterns between both the groups. Understanding visual search strategy could expedite the creation of a novel training routine for interpretation of ophthalmic diagnostic imaging.
Quality of Leadership and Organizational Climate in a Sample of Spanish Workers. The Moderation and Mediation Effect of Recognition and Teamwork
Authors: Pérez-Vallejo Carlos , Fernández-Muñoz Juan José
Published: December 2019

The purpose of this study is to analyze the relationships between the quality of leadership, achievement recognition, and teamwork with the organizational climate and quality of life at work. A questionnaire was prepared that included all items of the variables in this study of the scales ECO IV and ISTAS21. The sample selected was composed by 1179 workers of a multinational company; mediation and moderation analysis was applied with Process v3.4. The results of this study suggest that teamwork exerts significantly the expected mediating effect in the relationship between the quality of leadership and the organizational climate. However, recognition of achievement does not produce moderation in the relationship between leadership quality with the organizational climate. To sum up, leadership quality, teamwork, and recognition of achievements improve the perception of the organizational climate and quality of life at work. Therefore, the organization must establish its own leadership style that allows it to achieve its objectives and improve the quality of life of workers.
Risk of Cardiovascular Disease Due to General Anesthesia and Neuraxial Anesthesia in Lower-Limb Fracture Patients: A Retrospective Population-Based Cohort Study
Authors: Yeh Han-Wei , Yeh Liang-Tsai , Chou Ying-Hsiang , Yang Shun-Fa , Ho Sai-Wai , Yeh Ying-Tung , Yeh Ying-Ting , Wang Yu-Hsun , Chan Chi-Ho , Yeh Chao-Bin
Published: December 2019

The purpose of this study was to analyze the relationship between elevated cardiovascular disease (CVD) risk and type of anesthesia by using the National Health Insurance Research Database (NHIRD) of Taiwan in a one-year follow-up period. We assessed whether general anesthesia (GA) or neuraxial anesthesia (NA) increased CVD occurrence in lower-limb fracture patients. Approximately 1 million patients were randomly sampled from the NHIRD registry. We identified and enrolled 3437 lower-limb fracture patients who had received anesthesia during operations conducted in the period from 2010 to 2012. Next, patients were divided into two groups, namely GA (n = 1504) and NA (n = 1933), based on the anesthetic technique received during surgery. Our results revealed that those receiving GA did not differ in their risk of CVD relative to those receiving NA, adjusted HR = 1.24 (95% CI: 0.80–1.92). Patients who received GA for more than 2 h also did not differ in their risk of CVD relative to those receiving NA for less than 2 h, adjusted HR = 1.43 (95% CI: 0.81–2.50). Moreover, in the GA group (i.e., patients aged ≥65 years and women), no significant difference for the risk of CVD events was observed. In conclusion, in our study, the difference in the risk of CVD between lower-limb fracture patients receiving NA and GA was not statistically significant. The incidence rate of CVD seemed to be more correlated with patients’ underlying characteristics such as old age, comorbidities, or admission to the intensive care unit. Due to the limited sample size in this study, a database which reviews a whole national population will be required to verify our results in the future.
Homicides during the Barranquilla Carnival, Colombia: A 10 Year Time-Series Analysis
Authors: Guarin-Ardila Jhon Albert , Montero-Ariza Rossycela , Astudillo-García Claudia Iveth , Fernández-Niño Julián Alfredo
Published: December 2019

Homicides are currently the third leading cause of death among young adults, and an increase has been reported during holidays. The aim of the present study was to explore whether an association exists between Carnival in Barranquilla, Colombia, and an increase in homicides in the city. We used mortality records to identify the number of daily homicides of men and women throughout the week of Carnival, and we compared those with records from all of standard days between 1 January 2005 and 31 December 2015. Conditional fixed-effects models were used, stratified by time and adjusted by weather variables. The average number of homicides on Carnival days was found to be higher than on a standard day, with an OR of 2.34 (CI 95%: 1.19–4.58) for the occurrence of at least one male homicide per day during Carnival, and 1.22 (CI 95%: 1.22–7.36) for female homicides, adjusted by weather variables. The occurrence of homicides during Carnival was observed and was similar to findings for other holidays. Given that violence is a multifactorial phenomenon, the identification of the factors involved serves as a basis for evaluating whether current strategies have a positive effect on controlling it.
Stand-Biased Desk Intervention on Sleep Quality of High School Students: A Pilot Study Using Tri-Axial Accelerometery
Authors: Rhee Joohyun , Benden Mark E.
Published: December 2019

Prolonged sitting is related to a sedentary inactive lifestyle and related to obesity and many metabolic problems caused by inactivity. The problem gets more serious for people who spent most of their work time in a seated position like students or office workers. In this study, we provided standing desk and stool to the local public high school and observed the changes in their behavior in terms of physical activity using tri-axial accelerometer before and after intervention. Previously published study using the same dataset under the larger project reported increased physical activity during school hours. In this study, we extracted more diverse features directly from the raw data instead of using data processed by the software that manufacturer provided. Hence, we were able to analyze the same features (sedentary, physically active time) as well as sleep-related variables. Of the interest, sleep is another important feature that can tell us about participants’ health conditions. Even if the intervention contributed to updating their behavioral patterns, the result might be nullified in the long run if their sleep pattern was compromised. The quantity and quality of sleep was not changed after the intervention. Therefore, the efficacy of standing desks has been confirmed again.
Reply to Learning by Doing….Errors! Comment on Gil-Lacruz, M.; Gracia-Pérez, M.L.; Gil-Lacruz, A.I. Learning by Doing and Training Satisfaction: An Evaluation by Health Care Professionals. Int. J. Environ. Res. Public Health 2019, 16, 1397
Authors: Gil-Lacruz Marta , Gracia-Pérez María Luisa , Gil-Lacruz Ana Isabel
Published: December 2019

We would like to thank the reviewer for the positive and constructive comments on our work and offer the following response: [...]
Menopause-Specific Quality of Life among Emirati Women
Authors: Smail Linda , Jassim Ghufran , Shakil Anam
Published: December 2019

To investigate the quality of life (QOL) of menopausal Emirati women aged 40–64 years and determine its relationship with their sociodemographic characteristics. A community-based cross-sectional study was conducted on 70 Emirati women using multistage stratified clustered random sampling. The participants were interviewed face-to-face using a structured questionnaire comprising sociodemographic variables, reproductive characteristics, and the Menopause-Specific Quality of Life (MENQOL) questionnaire. The most common symptom among the study participants was ‘aching in the muscles’. The participants had a moderate level of bothersome symptoms; in addition, vasomotor symptoms were reported by 61%, while sexual symptoms were only reported by one-third of the participants. There were no significant differences between the menopausal status in any of the four domains of the MENQOL questionnaire. Additionally, there were no significant differences between the mean scores of the four MENQOL domains and all predictors. This study highlights the importance of educating women about menopause and its symptoms.
Respiratory Symptoms and Lung Function among Ethiopian Women in Relation to Household Fuel Use
Authors: Tamire Mulugeta , Addissie Adamu , Kumie Abera , Husmark Emma , Skovbjerg Susann , Andersson Rune , Lärstad Mona
Published: December 2019

Exposure to household air pollution has been linked to chronic obstructive pulmonary disease, respiratory symptoms and reduced lung function. This study aims to assess respiratory symptoms and lung function among Ethiopian women in relation to exposure to HAP. We conducted a cross-sectional study among non-smoking women responsible for household cooking. Data was collected on socio-demographic characteristics, respiratory symptoms and risk factors using a validated questionnaire. Spirometry with reversibility testing was performed according to American Thoracic Society/European Respiratory Society guidelines. We used independent t-test and multivariable logistic regression to compare the means and measure association respectively. A total of 545 women participated in the study out of which 231 (42.3%) performed spirometry with at least three acceptable manoeuvres. Everyone in the rural group and 43% of the urban group were exposed to HAP from solid fuels during cooking. The odds of developing at least one respiratory symptom when compared with those using cleaner fuels are twice as high for women cooking within the living house. We also found significantly lower forced expiratory volume in the first second (FEV1) (L) among solid fuels users compared with cleaner energy users. Given the larger population settlement in the rural areas and the use of solid fuel as the only energy source, there is a higher risk of developing chronic respiratory health problems for those women in Ethiopia.
Ethylene Oxide Exposure Attribution and Emissions Quantification Based on Ambient Air Measurements near a Sterilization Facility
Authors: Olaguer Eduardo P. , Robinson Amy , Kilmer Susan , Haywood James , Lehner Doreen
Published: December 2019

Ethylene oxide (EtO) is a known carcinogen and mutagen associated with increased incidence of breast and blood cancers. The largest medical sterilization facility in Michigan had been assessed by the U.S. Environmental Protection Agency as imposing an additional cancer risk greater than one in one thousand in nearby neighborhoods. This prompted the Michigan Department of Environmental Quality (now referred to as the Department of Environment, Great Lakes, and Energy) to conduct an air quality modeling study of the ambient EtO impacts of the sterilization facility, followed by 24 h Summa canister sampling and TO-15 analysis in two phases. Inverse modeling of the measured 24 h EtO concentrations during the second phase yielded estimates of 594 lbs/year for the facility’s total emissions of EtO and 0.247 µg/m3 for the urban background concentration. The inverse-modeled emissions are similar to reported emissions by the facility operator based on indoor air measurements and simple mass balance assumptions, while the inferred background concentration agrees with estimates from other field investigations. The estimated peak 24 h exposure to EtO caused by the sterilization facility in nearby neighborhoods was 1.83 μg/m3 above the background level, corresponding to an additional cancer risk of approximately one in one hundred, if assumed to represent annual mean exposure.
Chess Players Increase the Theta Power Spectrum When the Difficulty of the Opponent Increases: An EEG Study
Authors: Fuentes-García Juan Pedro , Villafaina Santos , Collado-Mateo Daniel , Cano-Plasencia Ricardo , Gusi Narcis
Published: December 2019

The present study aimed to analyze differences in the electroencephalogram (EEG) power spectrum (theta, alpha, and beta) between participants who won (winning group) and those who lost (losing group) in three different chess games: against their same Elo (100% chess games), 25% over their Elo (125% chess games), and 25% under their Elo (75% chess games). EEG was assessed at baseline and during the chess games. Method: 14 male chess players (age: 35.36 ± 13.77 and Elo: 1921 ± 170) played three games of 3 min, plus two additional seconds per move, while EEG was assessed. There were three difficulty levels (75%, 100%, and 125%), with two games (one with white pieces and another with black pieces) per level. The winning group showed higher theta power in the frontal, central, and posterior brain regions when difficulty increased (p-value < 0.05). Besides this, alpha power showed higher values (p-value < 0.05) in 125% games than in 75% chess games in C3, T3, T4, T5, and T6. The losing group showed a significant decrease (p-value < 0.05) in the beta and alpha power spectrum in frontal, central, parietotemporal, and occipital areas, when the opponent’s difficulty increased. Moreover, between groups, analyses showed higher theta power in the losing group than in the winning group, in C3, T5, T6, P4, and Pz (p-value < 0.05). Therefore, the winning group was able to adapt to each difficulty level, increasing theta power in the frontal, central, and posterior brain areas, as the efficiency hypothesis postulated. These changes were not observed in the losing group. Moreover, increases in alpha power during the most difficult games, in comparison with the easier, could have been caused by creative ideation and divergent thinking, as participants looked for alternative solutions against a higher-skilled opponent.
The Impact of the Chronic Disease Self-Management Program on Health Literacy: A Pre-Post Study Using a Multi-Dimensional Health Literacy Instrument
Authors: Muscat Danielle Marie , Song Wenbo , Cvejic Erin , Ting Jie Hua Cecilia , Medlin Joanne , Nutbeam Don
Published: December 2019

This study assessed the impact of the Chronic Disease Self-Management Program (CDSMP) on different domains of health literacy using a pre-post study design. Participants aged over 16 years and with one or more self-reported chronic diseases were recruited for the CDSMP in western Sydney (a highly diverse area of New South Wales, Australia) between October 2014 and September 2018. Health literacy was assessed pre- and immediately post-intervention using the Health Literacy Questionnaire (HLQ), with differences in mean scores for each HLQ domain analysed using paired sample t-tests. A total of 486 participants were recruited into the CDSMP. Of those, 316 (65.0%) completed both pre- and post-intervention surveys and were included in the analysis. The median age of the participants was 68 years, the majority were female (62.5%), and most were born in a country other than Australia (80.6%). There were statistically significant (P < 0.001) improvements across all nine domains of the HLQ. This is the first study evaluating the potential impact of the CDSMP on improving different domains of health literacy amongst a diverse sample of participants with chronic diseases using a multi-dimensional instrument. The absence of a control population in this study warrants caution when interpreting the results.
Effectiveness of a Comprehensive Health Literacy Consultation Skills Training for Undergraduate Medical Students: A Randomized Controlled Trial
Authors: Kaper Marise S. , Reijneveld Sijmen A. , van Es Frank D. , de Zeeuw Janine , Almansa Josué , Koot Jaap A.R. , de Winter Andrea F.
Published: December 2019

Comprehensible communication by itself is not sufficient to overcome health literacy related problems. Future doctors need a larger scope of capacities in order to strengthen a patient’s autonomy, participation, and self-management abilities. To date, such comprehensive training-interventions are rarely embedded in curricula, nor systematically evaluated. We assessed whether comprehensive training increased these health literacy competencies, in a randomized controlled trial (RCT), with a waiting list condition. Participants were international undergraduate medical students of a Dutch medical faculty (intervention: 39; control: 40). The 11-h-training-intervention encompassed a health literacy lecture and five interactive small-group sessions to practise gathering information and providing comprehensible information, shared decision-making, and enabling of self-management using role-play and videotaped conversations. We assessed self-reported competencies (knowledge and awareness of health literacy, attitude, self-efficacy, and ability to use patient-centred communication techniques) at baseline, after a five and ten-week follow-up. We compared students’ competencies using multi-level analysis, adjusted for baseline. As validation, we evaluated demonstrated skills in videotaped consultations for a subsample. The group of students who received the training intervention reported significantly greater health literacy competencies, which persisted up to five weeks afterwards. Increase was greatest for providing comprehensible information (B: 1.50; 95% confidence interval, CI 1.15 to 1.84), shared decision-making (B: 1.08; 95% CI 0.60 to 1.55), and self-management (B: 1.21; 95% CI 0.61 to 1.80). Effects regarding demonstrated skills confirmed self-rated competency improvement. This training enhanced a larger scope of health literacy competences and was well received by medical students. Implementation and further evaluation of this training in education and clinical practice can support sustainable health literacy capacity building of future doctors and contribute to better patient empowerment and outcomes of consultations.
Integrated Hazard Modeling for Simulating Torrential Stream Response to Flash Flood Events
Authors: Munir Bilal Ahmad , Ahmad Sajid Rashid , Hafeez Sidrah
Published: December 2019

This study aims to monitor the flash flood response of Vidor/Wadore hill torrent in Pakistan by the integration of Personal Computer Storm Water Management Model PCSWMM (hydrologic) and HEC-RAS 5.x (hydraulic) models. The method leverages remote sensing and GIS derive estimates of measured and inferred parameters of Vidor rural catchment to quantify the flash flood events of the last four years: 2014–2017. The calibration of the PCSWMM is performed using the sensitivity-based radio tuning calibration (SRTC) tool. The Nash–Sutcliffe efficiency (NSE), coefficient of determination (R2), and relative error (RE) values were found between 0.75–0.97, 0.94–0.98, and −0.22–−0.09 respectively. The statistical indicators prove the accuracy of PCSWMM for rural catchments. The runoff response of Vidor torrent is also analyzed for 0.5/12.7, 1.5/38.1, and 2.0/50.8-inch/mm rainfall hyetographs. The generated hydrographs are used to simulate 2D-module in HEC-RAS 5.x for floodplain demarcation in the piedmont area. The accuracy of the flood extent is analyzed using spatial overlay analogy in the ArcGIS environment by comparing simulated and historically available flood extents. The simulated flood extent shows 76% accuracy with historic flood extent. The impact of flash flood events shows wheat, maize, and fruit orchards are the most effected agriculture in piedmont area. The results revealed that the integration of hydrological, hydraulic, and geospatial modeling approaches can be used to model a full picture of catchment response during flash flood events.
Can Urban Street Network Characteristics Indicate Economic Development Level? Evidence from Chinese Cities
Authors: LOBsang Tashi , Zhen Feng , Zhang Shanqi
Published: December 2019

The street network is considered the skeleton of the city structure; it determines the efficiency and productivity of the city in that it acts like blood vessels transporting people, goods, and information. The relationship between street networks and economic development is an important research topic in urban geography. In recent years, complex network theory has been successfully used for understanding the characteristics of street network structure. However, researchers lack an analytical framework and methods for studying the relationship between the morphological structure of urban streets and the economic development level of cities. Accordingly, this paper proposes a methodological framework for first, quantitatively characterizing the urban morphological structure based on open street network data, and second, exploring the relationship between the morphological structure of the urban street and the urban economic development level. The proposed methodology was applied to 31 provincial capital cities in China. The results indicate that urban morphological structure can be quantitatively described by betweenness and closeness centrality extracted from street networks. Cities with similar structures have similar levels of economic development. Moreover, the results suggest a significant positive correlation between street network betweenness centrality Gini coefficients and cities’ economic development levels, indicating that the street network may affect city productivity. This study makes two major contributions to the scholarly literature. Methodologically, the proposed framework provides technical and methodological support for a better understanding of the relationship between cities’ economic development and urban street structure. Empirically, the demonstrated case study may guide decision-making involving regional development and the optimization of urban space.
ACYOTB Plugin: Tool for Accurate Orthorectification in Open-Source Environments
Authors: Baiocchi Valerio , Giannone Francesca , Monti Felicia , Vatore Felicia
Published: December 2019

High-resolution satellite images must undergo a geometric rectification process in order to be used for metrical purposes. This operation, called orthorectification, is necessary because of deformations mainly due to camera distortions and acquisition geometry. To correctly orthorectify an image, it is necessary to accurately reconstruct the photogrammetric-acquisition characteristics and the image position with respect to a reference system connected to the ground. This operation, called orientation, can be done using various mathematical models such as rigorous, rational polynomial function (RPF), and rational polynomial coefficient, or, according to some authors, rapid positioning coefficient (RPC) models. Orientation and orthorectification are usually performed within specific commercial software, but in QGIS, these complex operations can be performed using the open libraries of the Orfeo Tool Box (OTB). Unfortunately, instructions given by OTB developers lead to scarce results. In fact, the procedure proposed in OTB does not allow for the full exploitation of the potential of RPC models, on which OTB itself is based. As OTB is open-source software, a plugin was developed to overcome these limitations and exploit its full potential. In fact, OTB interfaces are unfortunately essential, and some necessary functions are missing. Therefore, a new QGIS plugin was developed in order to run the entire process in the most photogrammetrically and statistically correct way, and, at the same time, to simplify the relative procedures.
Pseudoxanthoma Elasticum, Kidney Stones and Pyrophosphate: From a Rare Disease to Urolithiasis and Vascular Calcifications
Authors: Letavernier Emmanuel , Bouderlique Elise , Zaworski Jeremy , Martin Ludovic , Daudon Michel
Published: December 2019

Pseudoxanthoma elasticum is a rare disease mainly due to ABCC6 gene mutations and characterized by ectopic biomineralization and fragmentation of elastic fibers resulting in skin, cardiovascular and retinal calcifications. It has been recently described that pyrophosphate (a calcification inhibitor) deficiency could be the main cause of ectopic calcifications in this disease and in other genetic disorders associated to mutations of ENPP1 or CD73. Patients affected by Pseudoxanthoma Elasticum seem also prone to develop kidney stones originating from papillary calcifications named Randall’s plaque, and to a lesser extent may be affected by nephrocalcinosis. In this narrative review, we summarize some recent discoveries relative to the pathophysiology of this mendelian disease responsible for both cardiovascular and renal papillary calcifications, and we discuss the potential implications of pyrophosphate deficiency as a promoter of vascular calcifications in kidney stone formers and in patients affected by chronic kidney disease.
Formin-like 1 (FMNL1) Is Associated with Glioblastoma Multiforme Mesenchymal Subtype and Independently Predicts Poor Prognosis
Authors: Higa Nayuta , Shinsato Yoshinari , Kamil Muhammad , Hirano Takuro , Takajo Tomoko , Shimokawa Michiko , Minami Kentaro , Yamamoto Masatatsu , Kawahara Kohichi , Yonezawa Hajime , Hirano Hirofumi , Furukawa Tatsuhiko , Yoshimoto Koji , Arita Kazunori
Published: December 2019

Glioblastoma multiforme (GBM), the most common primary malignant brain tumor in adults, is characterized by rapid proliferation, aggressive migration, and invasion into normal brain tissue. Formin proteins have been implicated in these processes. However, the role of formin-like 1 (FMNL1) in cancer remains unclear. We studied FMNL1 expression in glioblastoma samples using immunohistochemistry. We sought to analyze the correlation between FMNL1 expression, clinicopathologic variables, and patient survival. Migration and invasion assays were used to verify the effect of FMNL1 on glioblastoma cell lines. Microarray data were downloaded from The Cancer Genome Atlas and analyzed using gene set enrichment analysis (GSEA). FMNL1 was an independent predictor of poor prognosis in a cohort of 217 glioblastoma multiforme cases (p < 0.001). FMNL1 expression was significantly higher in the mesenchymal subtype. FMNL1 upregulation and downregulation were associated with mesenchymal and proneural markers in the GSEA, respectively. These data highlight the important role of FMNL1 in the neural-to-mesenchymal transition. Conversely, FMNL1 downregulation suppressed glioblastoma multiforme cell migration and invasion via DIAPH1 and GOLGA2, respectively. FMNL1 downregulation also suppressed actin fiber assembly, induced morphological changes, and diminished filamentous actin. FMNL1 is a promising therapeutic target and a useful biomarker for GBM progression.
Increase in IGF-1 Expression in the Injured Infraorbital Nerve and Possible Implications for Orofacial Neuropathic Pain
Authors: Sugawara Shiori , Shinoda Masamichi , Hayashi Yoshinori , Saito Hiroto , Asano Sayaka , Kubo Asako , Shibuta Ikuko , Furukawa Akihiko , Toyofuku Akira , Iwata Koichi
Published: December 2019

Insulin-like growth factor-1 (IGF-1) is upregulated in the injured peripheral nerve bundle and controls nociceptive neuronal excitability associated with peripheral nerve injury. Here, we examined the involvement of IGF-1 signaling in orofacial neuropathic pain following infraorbital nerve injury (IONI) in rats. IONI promoted macrophage accumulation in the injured ION, as well as in the ipsilateral trigeminal ganglion (TG), and induced mechanical allodynia of the whisker pad skin together with the enhancement of neuronal activities in the subnucleus caudalis of the spinal trigeminal nucleus and in the upper cervical spinal cord. The levels of IGF-1 released by infiltrating macrophages into the injured ION and the TG were significantly increased. The IONI-induced the number of transient receptor potential vanilloid (TRPV) subfamily type 4 (TRPV4) upregulation in TRPV subfamily type 2 (TRPV2)-positive small-sized, and medium-sized TG neurons were inhibited by peripheral TRPV2 antagonism. Furthermore, the IONI-induced mechanical allodynia was suppressed by TRPV4 antagonism in the whisker pad skin. These results suggest that IGF-1 released by macrophages accumulating in the injured ION binds to TRPV2, which increases TRPV4 expression in TG neurons innervating the whisker pad skin, ultimately resulting in mechanical allodynia of the whisker pad skin.
Sphingosine-1-Phosphate Enhances α1-Adrenergic Vasoconstriction via S1P2–G12/13–ROCK Mediated Signaling
Authors: Panta Cecília R. , Ruisanchez Éva , Móré Dorottya , Dancs Péter T. , Balogh Andrea , Fülöp Ágnes , Kerék Margit , Proia Richard L. , Offermanns Stefan , Tigyi Gábor J. , Benyó Zoltán
Published: December 2019

Sphingosine-1-phosphate (S1P) has been implicated recently in the physiology and pathology of the cardiovascular system including regulation of vascular tone. Pilot experiments showed that the vasoconstrictor effect of S1P was enhanced markedly in the presence of phenylephrine (PE). Based on this observation, we hypothesized that S1P might modulate α1-adrenergic vasoactivity. In murine aortas, a 20-minute exposure to S1P but not to its vehicle increased the Emax and decreased the EC50 of PE-induced contractions indicating a hyperreactivity to α1-adrenergic stimulation. The potentiating effect of S1P disappeared in S1P2 but not in S1P3 receptor-deficient vessels. In addition, smooth muscle specific conditional deletion of G12/13 proteins or pharmacological inhibition of the Rho-associated protein kinase (ROCK) by Y-27632 or fasudil abolished the effect of S1P on α1-adrenergic vasoconstriction. Unexpectedly, PE-induced contractions remained enhanced markedly as late as three hours after S1P-exposure in wild-type (WT) and S1P3 KO but not in S1P2 KO vessels. In conclusion, the S1P–S1P2–G12/13–ROCK signaling pathway appears to have a major influence on α1-adrenergic vasoactivity. This cooperativity might lead to sustained vasoconstriction when increased sympathetic tone is accompanied by increased S1P production as it occurs during acute coronary syndrome and stroke.
Vascular Diseases and Gangliosides
Authors: Sasaki Norihiko , Toyoda Masashi
Published: December 2019

Vascular diseases, such as myocardial infarction and cerebral infarction, are most commonly caused by atherosclerosis, one of the leading causes of death worldwide. Risk factors for atherosclerosis include lifestyle and aging. It has been reported that lifespan could be extended in mice by targeting senescent cells, which led to the suppression of aging-related diseases, such as vascular diseases. However, the molecular mechanisms underlying the contribution of aging to vascular diseases are still not well understood. Several types of cells, such as vascular (endothelial cell), vascular-associated (smooth muscle cell and fibroblast) and inflammatory cells, are involved in plaque formation, plaque rupture and thrombus formation, which result in atherosclerosis. Gangliosides, a group of glycosphingolipids, are expressed on the surface of vascular, vascular-associated and inflammatory cells, where they play functional roles. Clarifying the role of gangliosides in atherosclerosis and their relationship with aging is fundamental to develop novel prevention and treatment methods for vascular diseases based on targeting gangliosides. In this review, we highlight the involvement and possible contribution of gangliosides to vascular diseases and further discuss their relationship with aging.