bluuebunny/crossref_metadata_2025 huggingface dataset:
Machine Learning Approaches for Predicting Acute Respiratory Failure, Ventilator Dependence, and Mortality in Chronic Obstructive Pulmonary Disease
Authors: Liao Kuang-Ming , Liu Chung-Feng , Chen Chia-Jung , Shen Yu-Ting
Published: December 2021

Chronic obstructive pulmonary disease (COPD) is one of the leading causes of mortality and contributes to high morbidity worldwide. Patients with COPD have a higher risk for acute respiratory failure, ventilator dependence, and mortality after hospitalization compared with the general population. Accurate and early risk detection will provide more information for early management and better decision making. This study aimed to build prediction models using patients’ characteristics, laboratory data, and comorbidities for early detection of acute respiratory failure, ventilator dependence, and mortality in patients with COPD after hospitalization. We retrospectively collected the electronic medical records of 5061 patients with COPD in three hospitals of the Chi Mei Medical Group, Taiwan. After data cleaning, we built three prediction models for acute respiratory failure, ventilator dependence, and mortality using seven machine learning algorithms. Based on the AUC value, the best model for mortality was built by the XGBoost algorithm (AUC = 0.817), the best model for acute respiratory failure was built by random forest algorithm (AUC = 0.804), while the best model for ventilator dependence was built by LightGBM algorithm (AUC = 0.809). A web service application was implemented with the best models and integrated into the existing hospital information system for physician’s trials and evaluations. Our machine learning models exhibit excellent predictive quality and can therefore provide physicians with a useful decision-making reference for the adverse prognosis of COPD patients.
Litterfall and Accumulated Nutrients in Pinus taeda Plantation and Native Forest in Southern Brazil
Authors: Kulmann Matheus Severo de Souza , Dick Grasiele , Valdir Schumacher Mauro
Published: December 2021

The dynamics of the production, chemical composition, and accumulated nutrients in litterfall are essential to understand the availability of nutrients and, consequently, possible gains in productivity in different forest types. Thus, the objective of the present study was to evaluate the litterfall and the accumulated nutrients in litterfall in a Pinus taeda plantation and native forest from southern Brazil. Two forest types: (i) an eight-year-old Pinus taeda L. plantation; and (ii) a native forest fragment, located in southern Brazil, were studied for four years. The monthly and annual litterfall production, chemical composition, accumulated nutrients, and nutrient use efficiency of the litterfall were evaluated. The Pinus taeda plantation showed higher values of leaves/needles litterfall and N, P, K, Ca and Mg use efficiency. This demonstrates that Pinus taeda plantations have a high production of needle biomass, which, in turn, has increased cell division, favoring the entry of these nutrients into the soil via decomposition. Our results show that total litterfall production did not significantly influence the accumulated nutrient and nutrient efficiency of litterfall, demonstrating that evaluating litterfall fractionation, such as leaves/needles, twigs and miscellaneous, is essential to understand the quantity and quality of litterfall and, thus, the nutrient cycling, which can contribute to possible silvicultural practices to be implemented, which can provide growth gains in forest types.
Morphological and Phylogenetic Analyses Reveal a New Species of Ceratocystiopsis (Ophiostomataceae, Ophiostomatales) Associated with Ips subelongatus in Inner Mongolia (China) with Weak Host Pathogenicity
Authors: Wang Zheng , Liu Ya , Liu Caixia , Liu Zhenyu , Liang Lijun , Lu Quan
Published: December 2021

Ophiostomatoid fungi are known for their associations with bark beetles, and some species are important sources of tree diseases. Ceratocystiopsis is a genus of the ophiostomatoid fungi in order Ophiostomatales. The shortage of DNA barcodes for many species in this genus has resulted in the presence of many unnamed cryptic species. In this study, Ceratocystiopsis subelongati sp. nov. associated with Ips subelongatus infesting Pinus sylvestris var. mongolica in Inner Mongolia, China, was identified and described based on phylogenetic inference of multi-gene DNA sequences and morphological characteristics. The species is characterized by a hyalorhinocladiella- to sporothrix-like asexual state and an optimal growth temperature of 30 °C. Artificial inoculation tests in the field showed that it is mildly pathogenic to five-year-old larch trees, the main host of I. subelongatus. It is also the first described Ceratocystiopsis species associated with I. subelongatus in China. This discovery should provide new avenues for studying the symbiosis between bark beetles and ophiostomatoid fungi.
Root Biomass Distribution and Soil Physical Properties of Short-Rotation Coppice American Sycamore (Platanus occidentalis L.) Grown at Different Planting Densities
Authors: Ile Omoyemeh Jennifer , Aguilos Maricar , Morkoc Suna , Heitman Joshua , King John S.
Published: December 2021

Short rotation woody crops (SRWCs) provide sustainable, renewable biomass energy and offer potential ecosystem services, including increased carbon storage, reduced greenhouse gas emissions, and improved soil health. Establishing SRWCs on degraded lands has potential to enhance soil properties through root and organic matter turnover. A better understanding of SRWC planting density and its associated root turnover impacts on soil–air–water relations can improve management. In this study, we investigate the effects of planting density for a low-input American sycamore SRWC (no fertilization/irrigation) on soil physical properties for a degraded agricultural site in the North Carolina piedmont. The objectives were (1) to estimate the distributions of coarse and fine root biomass in three planting densities (10,000, 5000, and 2500 trees per hectare (tph)) and (2) to assess the effects of planting density on soil hydraulic properties and pore size distribution. Our results show that planting at 10,000 tph produced significantly higher amounts of fine root biomass than at lower planting densities (p < 0.01). In the 25,000 tph plots, there was significantly higher amounts of coarse root biomass than for higher planting densities (p < 0.05). The 10,000 tph plots had lower plant available water capacity but larger drainable porosity and saturated hydraulic conductivity compared with lower planting densities (<0.05). The 10,000 tph plots total porosity was more dominated by larger pore size fractions compared with the 5000 and 2500 tph. Generally, our findings show similar patterns of soil hydraulic properties and pore size distributions for lower planting densities. The results from 10,000 tph indicate a higher air-filled pore space at field capacity and more rapid drainage compared with lower planting densities. Both characteristics observed in the 10,000 tph are favorable for aeration and oxygen uptake, which are especially important at wet sites. Overall, the results suggest that improved soil health can be achieved from the establishment of American sycamore SRCs on marginal lands, thereby providing a green pathway to achieving environmental sustainability with woody renewable energy.
Fog-Based CDN Framework for Minimizing Latency of Web Services Using Fog-Based HTTP Browser
Authors: Ibrahim Ahmed H. , Fayed Zaki T. , Faheem Hossam M.
Published: December 2021

Cloud computing has been a dominant computing paradigm for many years. It provides applications with computing, storage, and networking capabilities. Furthermore, it enhances the scalability and quality of service (QoS) of applications and offers the better utilization of resources. Recently, these advantages of cloud computing have deteriorated in quality. Cloud services have been affected in terms of latency and QoS due to the high streams of data produced by many Internet of Things (IoT) devices, smart machines, and other computing devices joining the network, which in turn affects network capabilities. Content delivery networks (CDNs) previously provided a partial solution for content retrieval, availability, and resource download time. CDNs rely on the geographic distribution of cloud servers to provide better content reachability. CDNs are perceived as a network layer near cloud data centers. Recently, CDNs began to perceive the same degradations of QoS due to the same factors. Fog computing fills the gap between cloud services and consumers by bringing cloud capabilities close to end devices. Fog computing is perceived as another network layer near end devices. The adoption of the CDN model in fog computing is a promising approach to providing better QoS and latency for cloud services. Therefore, a fog-based CDN framework capable of reducing the load time of web services was proposed in this paper. To evaluate our proposed framework and provide a complete set of tools for its use, a fog-based browser was developed. We showed that our proposed fog-based CDN framework improved the load time of web pages compared to the results attained through the use of the traditional CDN. Different experiments were conducted with a simple network topology against six websites with different content sizes along with a different number of fog nodes at different network distances. The results of these experiments show that with a fog-based CDN framework offloading autonomy, latency can be reduced by 85% and enhance the user experience of websites.
Evaluation of Heat Decarbonization Strategies and Their Impact on the Irish Gas Network
Authors: Chandrasekar Aruna , Syron Eoin
Published: December 2021

Decarbonization of the heating sector is essential to meet the ambitious goals of the Paris Climate Agreement for 2050. However, poorly insulated buildings and industrial processes with high and intermittent heating demand will still require traditional boilers that burn fuel to avoid excessive burden on electrical networks. Therefore, it is important to assess the impact of residential, commercial, and industrial heat decarbonization strategies on the distribution and transmission gas networks. Using building energy models in EnergyPlus, the progressive decarbonization of gas-fueled heating was investigated by increasing insulation in buildings and increasing the efficiency of gas boilers. Industrial heat decarbonization was evaluated through a progressive move to lower-carbon fuel sources using MATLAB. The results indicated a maximum decrease of 19.9% in natural gas utilization due to the buildings’ thermal retrofits. This, coupled with a move toward the electrification of heat, will reduce volumes of gas being transported through the distribution gas network. However, the decarbonization of the industrial heat demand with hydrogen could result in up to a 380% increase in volumetric flow rate through the transmission network. A comparison between the decarbonization of domestic heating through gas and electrical heating is also carried out. The results indicated that gas networks can continue to play an essential role in the decarbonized energy systems of the future.
Structural Insight into the Mechanism of PALB2 Interaction with MRG15
Authors: Redington Jennifer , Deveryshetty Jaigeeth , Kanikkannan Lakshmi , Miller Ian , Korolev Sergey
Published: December 2021

The tumor suppressor protein partner and localizer of BRCA2 (PALB2) orchestrates the interactions between breast cancer susceptibility proteins 1 and 2 (BRCA1, -2) that are critical for genome stability, homologous recombination (HR) and DNA repair. PALB2 mutations predispose patients to a spectrum of cancers, including breast and ovarian cancers. PALB2 localizes HR machinery to chromatin and links it with transcription through multiple DNA and protein interactions. This includes its interaction with MRG15 (Morf-related gene on chromosome 15), which is part of many transcription complexes, including the HAT-associated and the HDAC-associated complexes. This interaction is critical for PALB2 localization in actively transcribed genes, where transcription/replication conflicts lead to frequent replication stress and DNA breaks. We solved the crystal structure of the MRG15 MRG domain bound to the PALB2 peptide and investigated the effect of several PALB2 mutations, including patient-derived variants. PALB2 interacts with an extended surface of the MRG that is known to interact with other proteins. This, together with a nanomolar affinity, suggests that the binding of MRG15 partners, including PALB2, to this region is mutually exclusive. Breast cancer-related mutations of PALB2 cause only minor attenuation of the binding affinity. New data reveal the mechanism of PALB2-MRG15 binding, advancing our understanding of PALB2 function in chromosome maintenance and tumorigenesis.
Functional Conservation and Divergence of Five AP1/FUL-like Genes in Marigold (Tagetes erecta L.)
Authors: Zhang Chunling , Sun Yalin , Yu Xiaomin , Li Hang , Bao Manzhu , He Yanhong
Published: December 2021

Members of AP1/FUL subfamily genes play an essential role in the regulation of floral meristem transition, floral organ identity, and fruit ripping. At present, there have been insufficient studies to explain the function of the AP1/FUL-like subfamily genes in Asteraceae. Here, we cloned two euAP1 clade genes TeAP1-1 and TeAP1-2, and three euFUL clade genes TeFUL1, TeFUL2, and TeFUL3 from marigold (Tagetes erecta L.). Expression profile analysis demonstrated that TeAP1-1 and TeAP1-2 were mainly expressed in receptacles, sepals, petals, and ovules. TeFUL1 and TeFUL3 were expressed in flower buds, stems, and leaves, as well as reproductive tissues, while TeFUL2 was mainly expressed in flower buds and vegetative tissues. Overexpression of TeAP1-2 or TeFUL2 in Arabidopsis resulted in early flowering, implying that these two genes might regulate the floral transition. Yeast two-hybrid analysis indicated that TeAP1/FUL proteins only interacted with TeSEP proteins to form heterodimers and that TeFUL2 could also form a homodimer. In general, TeAP1-1 and TeAP1-2 might play a conserved role in regulating sepal and petal identity, similar to the functions of MADS-box class A genes, while TeFUL genes might display divergent functions. This study provides a theoretical basis for the study of AP1/FUL-like genes in Asteraceae species.
Controls on the Spatial Distribution of Trace Metal Concentrations along the Bedrock-Dominated South Fork New River, North Carolina
Authors: Miller Jerry R. , Watkins Xaviera , O'Shea Thomas , Atterholt Cynthia
Published: December 2021

In marked contrast to alluvial rivers, few studies have examined the physical and geochemical controls on the spatial distribution of toxic trace metals along bedrock channels. This study examined the factors controlling the geographical pattern of selected trace metal (Cu, Cr, and Zn) concentrations along the bedrock-dominated channel of the South Fork New River (SFNR). The SFNR is located in the Blue Ridge Physiographic Province of North Carolina, and is representative of many rivers in mountainous terrains that are often subjected to the influx of toxic trace metals from historic and contemporary mining operations. The topography of the SFNR’s channel bed is highly variable and can be subdivided into pool and shallow bedrock reaches. The latter contained localized cascades characterized by topographically higher bedrock ribs that are separated by topographic lows, both of which are oriented oblique to flow. Accumulations of bed sediments are predominantly associated with the traverse bedrock ribs that generate high hydraulic roughness. Except for a few localized zones of enrichment, sediment-associated trace metal concentrations tended to vary within a narrow range of background values over the 36 km study reach. Elevated trace metal concentrations were closely linked to zones of high Fe and Mn concentrations, and were associated with pools located within or immediately downstream of bedrock cascades. The elevated concentrations of the metals appear to be derived from the erosion of lithologic units within the cascades that contain sulfidic layers or zones of mafic mineral enrichment, and which are known to occur in the underlying bedrock. Once eroded, these minerals and/or rock fragments were deposited within low-velocity zones created by the transverse ribs or within downstream pools. The enrichment of trace metals downstream of the cascades may also be due to the formation of Fe and Mn oxyhydroxides as turbulent flows aerate river waters as they traverse the cascades. Chemically reactive fine-grained (<63 µm) sediments had a relatively limited influence on the downstream variations in metal concentrations, presumably because the channel bed sediments are composed primarily of sand-sized and larger particles. Although a principal component analysis (PCA) suggested that reach-scale variations in channel and valley morphology may have partly influenced downstream variations in trace metal concentrations, the geographical patterns were primarily controlled by local geological and geomorphic factors associated with the bedrock cascades. The design of future sampling programs along such coarse-grained, bedrock rivers should consider the significance of these local controls on trace metal storage to effectively characterize and interpret downstream patterns in metal concentrations.
Using GIS to Estimate Population at Risk Because of Residence Proximity to Asbestos Processing Facilities in Colombia
Authors: Lysaniuk Benjamin , Cely-García María Fernanda , Giraldo Margarita , Larrahondo Joan M. , Serrano-Calderón Laura Marcela , Guerrero-Bernal Juan Carlos , Briceno-Ayala Leonardo , Cruz Rodriguez Esteban , Ramos-Bonilla Juan Pablo
Published: December 2021

The recent enactment of the law banning asbestos in Colombia raises a significant number of challenges. The largest factories that have historically processed asbestos include five asbestos-cement facilities located in the cities of Sibaté (Cundinamarca), Cali (Valle del Cauca), and Barranquilla (Atlántico), and Manizales (Caldas), which has two, as well as a friction products facility in Bogotá D.C. An asbestos chrysotile mine has also operated in Colombia since 1980 in Campamento (Antioquia). In the framework of developing the National Asbestos Profile for Colombia, in this study, we estimated the population residing in the vicinity of asbestos processing plants or the mine and, therefore, potentially at risk of disease. Using a geographic information system, demographic data obtained from the last two general population censuses were processed to determine the number of people living within the concentric circles surrounding the asbestos facilities and the mine. In previous studies conducted in different countries of the world, an increased risk of asbestos-related diseases has been reported for people living at different distance bands from asbestos processing facilities. Based on these studies, circles of 500, 1000, 2000, 5000, and 10,000 m radii, centered on the asbestos processing facilities and the mine that operated in Colombia, were combined with the census data to estimate the number of people living within these radii. Large numbers of people were identified. It is estimated that in 2005, at the country level, 10,489 people lived within 500 m of an asbestos processing facility or mine. In 2018, and within a distance of 10,000 m, the number of people was 6,724,677. This information can aid public health surveillance strategies.
Assessing Mechanisms Underlying the Sharing of Official and Unofficial Information during a Pandemic
Authors: Tsang Stephanie Jean , Zhao Xinyan , Chen Yi-Ru Regina
Published: December 2021

The COVID-19 disease outbreak has seen mixed information flows comprising top-down communication from health authorities to the public and citizen-to-citizen communication. This study aimed to identify mechanisms underlying the sharing of official versus unofficial information during the outbreak. Survey findings based on a nationally representative U.S. sample (N = 856) showed that individuals’ predispositions affected their information consumption and affective experiences, leading to distinct types of information-sharing behaviors. While anger toward the U.S. government’s outbreak response was directly associated with unofficial information sharing, anxiety was directly associated with official information sharing. These findings enhance our understanding of the propagation of different kinds of pandemic information and provide implications for public education on information verification based on source authoritativeness.
Effects of Coworkers’ Helping Behavior on Employees’ Knowledge Sharing and Creativity: The Moderating Role of Interactional Justice
Authors: Lee Soojin , Byun Gukdo , Kim Suzi
Published: December 2021

Although it is important to examine how creative performance can be achieved by facilitating knowledge sharing activities among its members, few studies have examined these relationships. Therefore, this study analyzed the effects of coworkers’ helping behavior on knowledge sharing and creativity. It also attempted to demonstrate the moderating role of interactional justice as a situational variable that positively affects coworkers’ helping behavior. Using data from 200 full-time supervisor–subordinate dyads in a large public institution located in South Korea, we performed multiple regression analysis and the bootstrapping method to test our hypotheses. The results of this study presented that coworkers’ helping behavior encouraged individuals to share knowledge and increase their creative performance. Moreover, this study demonstrated that the positive effect of coworkers’ helping behavior on employees’ creativity through their knowledge sharing was stronger when interactional justice was high rather than low. Therefore, this research contributes to finding the critical factors that enable a company to gain a competitive advantage by providing the impact of coworkers’ helping behavior and supervisors’ interactional justice on knowledge sharing and creativity among employees.
Tools for Assessing Cardiovascular Disease Risk Factors in Underserved Young Adult Populations: A Systematic Review
Authors: Opoku-Acheampong Audrey A. , Rosenkranz Richard R. , Adhikari Koushik , Muturi Nancy , Logan Cindy , Kidd Tandalayo
Published: December 2021

Cardiovascular disease (CVD, i.e., disease of the heart and blood vessels) is a major cause of death globally. Current assessment tools use either clinical or non-clinical factors alone or in combination to assess CVD risk. The aim of this review was to critically appraise, compare, and summarize existing non-clinically based tools for assessing CVD risk factors in underserved young adult (18–34-year-old) populations. Two online electronic databases—PubMed and Scopus—were searched to identify existing risk assessment tools, using a combination of CVD-related keywords. The search was limited to articles available in English only and published between January 2008 and January 2019. Of the 10,383 studies initially identified, 67 were eligible. In total, 5 out of the 67 articles assessed CVD risk in underserved young adult populations. A total of 21 distinct CVD risk assessment tools were identified; six of these did not require clinical or laboratory data in their estimation (i.e., non-clinical). The main non-clinically based tools identified were the Heart Disease Fact Questionnaire, the Health Beliefs Related to CVD-Perception measure, the Healthy Eating Opinion Survey, the Perception of Risk of Heart Disease Scale, and the WHO STEPwise approach to chronic disease factor surveillance (i.e., the STEPS instrument).
Comparison of Effects of N95 Respirators and Surgical Masks to Physiological and Psychological Health among Healthcare Workers: A Randomized Controlled Trial
Authors: Su Che-Yu , Peng Chiung-Yu , Liu Hsin-Liang , Yeh I-Jeng , Lee Chi-Wei
Published: December 2021

Since the onset of the coronavirus disease 2019 pandemic, wearing facemasks has become more important for healthcare workers. This study aimed to investigate and compare the influence of wearing N95 respirators and surgical masks for 8 h on physiological and psychological health. Sixty-eight healthcare workers were randomly assigned to the N95 respirator or surgical mask groups. Physiological parameters of participants were measured by Tensor Tip MTX at baseline and at the 2nd, 4th, 6th and 8th h of wearing the facemasks. The symptoms after wearing facemasks were also determined via the questionnaire. There were no significant changes in physiological parameters at most time checkpoints in both groups. Significant differences were observed in terms of heart rate at the 8th h, time trends (adjusted difference of least squares means were −8.53 and −2.01), and interaction of time and mask type between the two groups (p-value for interaction was 0.0146). The values of these physiological parameters were within normal ranges. The N95 respirator group had significantly higher incidences of shortness of breath, headache, dizziness, difficulty talking and fatigue that spontaneously resolved. In conclusion, healthcare workers who wore either N95 respirators or surgical masks during an 8 h shift had no obvious harmful effects on physiological and psychological health. Additionally, the N95 respirator group did not show a higher risk than the surgical mask group.
Diagnostic Test Accuracy of First-Void Urine Human Papillomaviruses for Presence Cervical HPV in Women: Systematic Review and Meta-Analysis
Authors: Bober Peter , Firment Peter , Sabo Ján
Published: December 2021

First-void urine usually contains exfoliated cells of the debris and mucus from the female genital organs and cervix, i.e., high concentration of human papillomavirus deoxyribonucleic acid (HPV DNA). We conducted a meta-analysis of published data and determined an accuracy of HPV detection in first-void urine compared to the women’s cervix. According to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we carried out a comprehensive literature search. Eligible articles published from 2011 until 2021 were gathered by searching Embase, PubMed and Cochrane Library Central databases. The patient selection, index test, standard test, and patient flow were the factors involved in quality evaluation. A meta-analysis of 15 studies (3412 women) based on 5054 potential records was conducted. Pooled sensitivity for high-risk HPV detection in urine of 78% (70–84%) and specificity of 89% (81–94%) were calculated. Any HPV detection in urine of 87% (74–94%) and 91% (83–96%) were pooled sensitivity and specificity, respectively. HPV 16 and 18 had a pooled sensitivity of 77% (76–77%) and specificity of 98% (98–98%). Meta-analysis indicated variations between the pooled specificities and sensitivities. In meta-regression analysis, a heterogeneity in accuracy by using covariates (bias in patient selection, purpose, sample timing, storage temperature and HPV detection method) were not detected. Our meta-analysis demonstrates the accuracy of detection of HPV in urine for the presence of cervical HPV. Although progress is continuously made in urinary HPV detection, further studies are needed to evaluate and to improve the accuracy of the first-void urine test in order to be comparable with other screening methods.
Opioid Analgesic Prescription in French Children: A National Population-Based Study
Authors: Choufi Samira , Mounier Simon , Merlin Etienne , Rochette Emmanuelle , Delorme Jessica , Authier Nicolas , Chenaf Chouki
Published: December 2021

Codeine use was restricted in 2013 and is currently contraindicated for children below the age of 12 years. We examined how the prescription of opioid analgesics in children in France evolved between 2012 and 2018. Our population-based study from the SNIIRAM database (National System of Health Insurance Inter-Regime Information) was designed to determine trends in opioid prescription from 2012 to 2018 in all French children. The number of children who received at least one opioid prescription gradually declined from 452,665 in 2012 (347.5 children per 10,000) to 169,338 in 2018 (130.3 children per 10,000). This decrease was especially marked for codeine (36 children per 10,000 in 2018 vs. 308.5 children per 10,000 in 2012), whereas the number of tramadol prescriptions increased by 171% in 2018 (94.6 children per 10,000). Despite the increase, strong opioids still formed only a small proportion of prescriptions (2.6 children per 10,000 given opioids in 2018). Overall opioid prescriptions in French children dramatically decreased between 2012 and 2018, probably owing to restrictions on the use of codeine. Codeine has been partly replaced by tramadol. Morphine is still probably underused. This suggests that opioids are being used less often for pain management in children.
Active Ageing: The Need to Address Sub-National Diversity. An Evidence-Based Approach for Italy
Authors: Zannella Marina , Principi Andrea , Lucantoni Davide , Barbabella Francesco , Di Rosa Mirko , Domínguez-Rodríguez Antía , Socci Marco
Published: December 2021

While active ageing has emerged as a main strategy to address the challenges of population ageing in Europe, recent research has stressed the need to increase knowledge on within-country differences to promote active ageing through appropriate policy responses. This article draws on the Active Ageing Index (AAI) to capture recent trends in active ageing in Italy with a focus on sub-national diversity. To this end, we compute AAI breakdowns by region separately for men and women for four different years: 2007, 2009, 2012 and 2018. Then, we use linear regression to describe the geographical and sex-specific patterns of change in the AAI over the considered period. The results demonstrate the diversity of regional outcomes and trends in the active ageing of Italian men and women, indicating that the widening geographic gap deserves further consideration by national and regional authorities in designing and implementing active ageing policies. By showing the persistence of disparities in the value of the indicator to the disadvantage of women, results also suggest the need to further integrate both the gender dimension and the life-cycle perspective into active ageing strategies. This article provides an example of how the AAI can be used as a practical tool by policy makers to monitor active ageing trends and outcomes at the sub-national level, and to identify target areas that require further action.
Protection of Water Resources from Agriculture Pollution: An Integrated Methodological Approach for the Nitrates Directive 91–676-EEC Implementation
Authors: Massarelli Carmine , Losacco Daniela , Tumolo Marina , Campanale Claudia , Uricchio Vito Felice
Published: December 2021

Nitrogen is a vital nutrient helpful to plants and crop growth. However, among the leading causes of water resources pollution is the excess nitrogen from agricultural sources. In European Union countries, the Nitrates Directive has been approved to reduce this problem monitoring of water bodies with regard to nitrate concentrations, designation of Nitrate Vulnerable Zones (NVZs), and establishing codes of good agricultural practices and measures to prevent and reduce water pollution from nitrates. In light of this, we propose an integrated methodological approach to better manage a environmental issue as the perimeter of NVZs with the prospective that our approach could be used in the future by other member states representing a Best Practice in that direction. The methodology is based on data integration applied in a GIS environment. Different available data representing the knowledge of the territory were harmonised, systematised and georeferenced, in order to increase the environmental framework, preserve the contamination of the water resource and give indications on the measures to be implemented to apply in the best way possible the Nitrates Directive. Finally, it was also possible to overcome the infringement procedure in progress for Italy and the Puglia region and proceed to new designation of NVZs.
Evaluating Knowledge of Human Microbiota among University Students in Jordan, an Online Cross-Sectional Survey
Authors: Abu-Humaidan Anas H. A. , Alrawabdeh Jawad A. , Theeb Laith S. , Hamadneh Yazan I. , Omari Mohammad B.
Published: December 2021

Human microbiota have a significant impact on the health of individuals, and reciprocally, lifestyle choices of individuals have an important effect on the diversity and composition of microbiota. Studies assessing microbiota knowledge among the public are lacking, although it is hypothesized that this knowledge can motivate healthier behavior. Hence, this study aimed to measure microbiota knowledge among university students, and the effect of this knowledge on behavioral beliefs. A descriptive cross-sectional study was conducted among students from various fields of study enrolled at the University of Jordan, using an online questionnaire. The questionnaire consisted of 3 parts: demographics, general knowledge of microbiota, and behavioral beliefs related to microbiota. Four hundred and two responses were collected from verified university students. Participants were divided into two groups depending on whether they took a formal microbiology course (45 h) or not. Results from those two groups were compared using appropriate statistical methods. Results showed that most participants, even those who did not take a formal microbiology course, displayed good knowledge of what microbiota is and how they can be influenced by personal and environmental factors. Participants who took a microbiology course had significantly higher microbiota knowledge scores and were more aware of the effect of antibiotics on microbiota. Participants’ behavioral beliefs regarding their antibiotic use, but not their diet and lifestyle choices, were affected by their knowledge of microbiota. The study indicates that disseminating knowledge regarding microbiota and microbiology in general, can improve behaviors related to antibiotic use.
Smoking Prevalence among Physicians: A Systematic Review and Meta-Analysis
Authors: Besson Anaïs , Tarpin Alice , Flaudias Valentin , Brousse Georges , Laporte Catherine , Benson Amanda , Navel Valentin , Bouillon-Minois Jean-Baptiste , Dutheil Frédéric
Published: December 2021

Background: Smoking is a major public health problem. Although physicians have a key role in the fight against smoking, some of them are still smoking. Thus, we aimed to conduct a systematic review and meta-analysis on the prevalence of smoking among physicians. Methods: PubMed, Cochrane, and Embase databases were searched. The prevalence of smoking among physicians was estimated and stratified, where possible, by specialties, continents, and periods of time. Then, meta-regressions were performed regarding putative influencing factors such as age and sex. Results: Among 246 studies and 497,081 physicians, the smoking prevalence among physicians was 21% (95CI 20 to 23%). Prevalence of smoking was 25% in medical students, 24% in family practitioners, 18% in surgical specialties, 17% in psychiatrists, 16% in medical specialties, 11% in anesthesiologists, 9% in radiologists, and 8% in pediatricians. Physicians in Europe and Asia had a higher smoking prevalence than in Oceania. The smoking prevalence among physicians has decreased over time. Male physicians had a higher smoking prevalence. Age did not influence smoking prevalence. Conclusion: Prevalence of smoking among physicians is high, around 21%. Family practitioners and medical students have the highest percentage of smokers. All physicians should benefit from targeted preventive strategies.
Exercise Dosage in Reducing the Risk of Dementia Development: Mode, Duration, and Intensity—A Narrative Review
Authors: Wang Sukai , Liu Hong-Yu , Cheng Yi-Chen , Su Chun-Hsien
Published: December 2021

Senile dementia, also known as dementia, is the mental deterioration which is associated with aging. It is characterized by a decrease in cognitive abilities, inability to concentrate, and especially the loss of higher cerebral cortex function, including memory, judgment, abstract thinking, and other loss of personality, even behavior changes. As a matter of fact, dementia is the deterioration of mental and intellectual functions caused by brain diseases in adults when they are mature, which affects the comprehensive performance of life and work ability. Most dementia cases are caused by Alzheimer’s disease (AD) and multiple infarct dementia (vascular dementia, multi-infarct dementia). Alzheimer’s disease is characterized by atrophy, shedding, and degenerative alterations in brain cells, and its occurrence is linked to age. The fraction of the population with dementia is smaller before the age of 65, and it increases after the age of 65. Since women live longer than men, the proportion of women with Alzheimer’s disease is higher. Multiple infarct dementia is caused by a cerebral infarction, which disrupts blood supply in multiple locations and impairs cerebral cortex function. Researchers worldwide are investigating ways to prevent Alzheimer’s disease; however, currently, there are no definitive answers for Alzheimer’s prevention. Even so, research has shown that we can take steps to reduce the risk of developing it. Prospective studies have found that even light to moderate physical activity can lower the risk of dementia and Alzheimer’s disease. Exercise has been proposed as a potential lifestyle intervention to help reduce the occurrence of dementia and Alzheimer’s disease. Various workout modes will be introduced based on various physical conditions. In general, frequent exercise for 6–8 weeks lessens the risk of dementia development.
Physiological Changes and Pathological Pain Associated with Sedentary Lifestyle-Induced Body Systems Fat Accumulation and Their Modulation by Physical Exercise
Authors: Verdú Enrique , Homs Judit , Boadas-Vaello Pere
Published: December 2021

A sedentary lifestyle is associated with overweight/obesity, which involves excessive fat body accumulation, triggering structural and functional changes in tissues, organs, and body systems. Research shows that this fat accumulation is responsible for several comorbidities, including cardiovascular, gastrointestinal, and metabolic dysfunctions, as well as pathological pain behaviors. These health concerns are related to the crosstalk between adipose tissue and body systems, leading to pathophysiological changes to the latter. To deal with these health issues, it has been suggested that physical exercise may reverse part of these obesity-related pathologies by modulating the cross talk between the adipose tissue and body systems. In this context, this review was carried out to provide knowledge about (i) the structural and functional changes in tissues, organs, and body systems from accumulation of fat in obesity, emphasizing the crosstalk between fat and body tissues; (ii) the crosstalk between fat and body tissues triggering pain; and (iii) the effects of physical exercise on body tissues and organs in obese and non-obese subjects, and their impact on pathological pain. This information may help one to better understand this crosstalk and the factors involved, and it could be useful in designing more specific training interventions (according to the nature of the comorbidity).
Effort–Reward Imbalance at Work and Drug Misuse: Evidence from a National Survey in the U.S.
Authors: Li Jian , Matthews Timothy A. , Chen Liwei , Seamans Marissa , Leineweber Constanze , Siegrist Johannes
Published: December 2021

With the rise of drug misuse among workers in recent years, preliminary research on potential risk factors in the workplace of single-type of drug misuse has been reported. This is the first study to examine cross-sectional associations of work stress, in terms of effort–reward imbalance, with multiple drug misuse (including any drug misuse, opioid misuse, sedatives misuse, cannabis misuse, and other drug misuse) during the past 12 months in a national sample of U.S. workers. Data of 2211 workers were derived from the nationally representative and population-based Midlife in the United States (MIDUS) study. Internal consistency reliability and factorial validity of a 17-item effort–reward imbalance measure were robust and satisfactory. After adjustment for relevant covariates, logistic regression analyses showed that workers experiencing effort–reward imbalance at work had significantly higher odds of any drug misuse (OR and 95% CI = 1.18 (1.03, 1.37)), especially opioid misuse (OR and 95% CI = 1.35 (1.07, 1.69)) and other drug misuse (OR and 95% CI = 1.36 (1.01, 1.83)). The findings suggest that a stressful work environment may act as a determinant of drug misuse, and further prospective evidence is needed.
Measuring Self-Reported Access to Assistive Technology Using the WHO Rapid Assistive Technology Assessment (rATA) Questionnaire: Protocol for a Multi-Country Study
Authors: Zhang Wei , Eide Arne H. , Pryor Wesley , Khasnabis Chapal , Borg Johan
Published: December 2021

In 2018, the World Health Assembly adopted a resolution on improving access to assistive technology (AT), and mandated the WHO to prepare a global report on assistive technology based on the best available evidence and international experience. As limited data on access to AT at country and global levels were available, there was a need to conduct representative population surveys in order to inform the development of the global report, national AT programs, and global initiatives. The objective of this protocol is to describe a multi-country study of access to assistive technology in six self-reported areas: use, source, payer, satisfaction, unmet need, and barriers. In collaboration with WHO Regional and Country offices, Member States, and other stakeholders, the Assistive Technology Access team in WHO coordinates the study. Data are collected through household surveys using the rapid Assistive Technology Assessment (rATA) questionnaire. Findings from the surveys will be published in the global report.
Associations of Medical Visits with Dentist Visits: A Register-Linkage Study of a Working-Age Population in Finland
Authors: Nurminen Mikko , Blomgren Jenni
Published: December 2021

Studies have usually addressed the utilization of either medical or dental services, and less is known about how medical and dentist visits are associated. As oral health is linked to systemic health, knowledge on care coordination between dental and medical services is important to gain understanding of the overall functioning of health care. Register data on 25–64-year-old residents of the city of Oulu, Finland, were used for the years 2017–2018 (N = 91,060). Logit models were estimated to analyze the probability of dentist visits, according to the number of medical visits in total and by three separate health care sectors. The majority, 61%, had visited both a medical professional and a dentist. All sectors combined, as few as one to two visits increased the odds of dentist visits (OR: 1.43, CI: 1.33, 1.53). When separated by medical professionals’ health care sectors, for one to two visits, the strongest association was found with public (OR: 1.17, CI: 1.12, 1.22) and private sector (OR: 1.35, CI: 1.30, 1.41). For occupational health service visits, the odds increased only after six or more visits. The results support the idea of integrated medical and dental care. However, the result may also arise from individual health behavior where health-conscious persons seek both medical and dental care independently.
The Perception of African Immigrant Women Living in Spain Regarding the Persistence of FGM
Authors: Berthe-Kone Ousmane , Ventura-Miranda María Isabel , López-Saro Sara María , García-González Jessica , Granero-Molina José , Jiménez-Lasserrotte María del Mar , Fernández-Sola Cayetano
Published: December 2021

Approximately 200 million women and girls have undergone female genital mutilation (FGM) worldwide. Migration has spread the practice of FGM around the world, thus making it a global public health issue. The objective of this descriptive qualitative study was to explore the perceptions of Sub-Saharan immigrant women in Spain in relation to the causes of the persistence of FGM. In-depth interviews were carried out with 13 female FGM survivors of African origin, followed by inductive data analysis using ATLAS.ti software. Two main themes emerged from the analysis: (1) A family ritual symbolic of purification and (2) a system of false beliefs and deception in favour of FGM. The FGM survivors living in Europe are aware that FGM is a practice that violates human rights yet persists due to a system of false beliefs rooted in family traditions and deception that hides the reality of FGM from young girls or forces them to undergo the practice. The ritualistic nature of FGM and the threat of social exclusion faced by women who have not had it performed on them contributes to its persistence nowadays.
The Growth Factors in Advanced Platelet-Rich Fibrin (A-PRF) Reduce Postoperative Complications after Mandibular Third Molar Odontectomy
Authors: Starzyńska Anna , Kaczoruk-Wieremczuk Magdalena , Lopez Michele Antonio , Passarelli Pier Carmine , Adamska Paulina
Published: December 2021

Surgical removal of impacted mandibular third molars constitutes one of the most frequently performed procedures within oral surgery. This surgery procedure is associated with many post-operative complications. Advanced platelet-rich fibrin (A-PRF) belongs to the second generation of platelet concentrates and is rich in numerous growth factors. The aim of this study was to assess the influence of A-PRF on selected clinical features following the surgical removal of impacted mandibular third molars. The research was conducted on 100 generally healthy patients, who underwent a lower third molar odontectomy in Department of Oral Surgery, Medical University of Gdańsk, Poland, between 2018 and 2019. The research group consisted of 50 patients (immediate A-PRF socket filling) and control group (50 patients without A-PRF socket filling). During the study, the following clinical features were assessed: pain (visual analog scale), analgesics intake, the presence of trismus, edema, hematomas within the surrounding tissues (e.g., cheek), prevalence of pyrexia, dry socket, secondary bleeding, presence of hematomas, skin warmth in the post-operative area, and bleeding time observed by the patient were analyzed on the 3rd, 7th, and 14th day after the procedure. There was a significant association between A-PRF socket filling and pain intensity, the analgesics intake, trismus, and edema on the 3rd and the 7th day (p < 0.05). The presence of hematomas and skin warmth on the 3rd day after the surgery (p < 0.05) were also statistically associated with A-PRF use. The study showed that in reducing the incidence of postoperative complications, A-PRF was more important than the position of the tooth or the duration of the procedure. The growth factors in A-PRF reduce postoperative complications, such as pain, trismus, edema, analgesics intake, presence of hematomas, and skin warmth, after mandibular wisdom teeth odontectomy.