bluuebunny/crossref_metadata_2025 huggingface dataset:
A Descriptive Study on Causes of Death in Hospitalized Patients in an Acute General Hospital of Southern Italy during the Lockdown due to Covid-19 Outbreak
Authors: Mascolo Pasquale , Feola Alessandro , Sementa Carmen , Leone Sebastiano , Zangani Pierluca , Della Pietra Bruno , Campobasso Carlo Pietro
Published: January 2021

(1) Background: All deaths that occurred in a hospital of Southern Italy (“San Giuseppe Moscati” Hospital of Avellino) with medium jurisdiction (up to 425,000 citizens approximately) in the period from 9 March to 4 May 2020 were analyzed. The primary endpoint of the study was to analyze the causes of death in the period study. Secondary endpoints included: (1) the assessment of overall mortality in the emergency period compared with the same period of the past years (2018–2019) in the jurisdiction area; (2) the assessment of the amounts of deaths with positive and negative reverse transcription-polymerase chain reaction (RT-PCR) of nasopharyngeal and oropharyngeal swabs; (3) the frequency of clinical and radiological features consistent with Covid-19 infection in negative RT-PCR cases. (2) Methods: Patients’ information and laboratory data were collected through the computerized medical record system (My Hospital, Italy) used for the clinical management of all referring patients. Epidemiological, clinical, and radiological data were reviewed along with the results of nasopharyngeal and oropharyngeal swabs. (3) Results: From 9 March to 4 May 2020, 140 deaths (87 males, 53 females) from all causes occurred in total at “San Giuseppe Moscati” Hospital, of which 32 deaths were Covid-19 related. (4) Conclusions: The excess of mortality could be higher than the one reported in the official epidemiological surveys. False negative cases can have a distorting effect on the assessment of the real mortality rate and the excess mortality. Furthermore, many who died from Covid-19 were likely never tested or they had false negative RT-PCR results. Other victims probably died from causes indirectly related to Covid-19.
In Search of the Origins of the Western Mind: McGilchrist and the Axial Age
Authors: Rizzo Susanna , Melleuish Greg
Published: January 2021

This paper considers and analyses the idea propounded by Iain McGilchrist that the foundation of Western rationalism is the dominance of the left side of the brain and that this occurred first in ancient Greece. It argues that the transformation that occurred in Greece, as part of a more widespread transformation that is sometimes termed the Axial Age, was, at least in part, connected to the emergence of literacy which transformed the workings of the human brain. This transformation was not uniform and took different forms in different civilisations, including China and India. The emergence of what Donald terms a “theoretic” culture or what can also be called “rationalism” is best understood in terms of transformations in language, including the transition from poetry to prose and the separation of word and thing. Hence, the development of theoretic culture in Greece is best understood in terms of the particularity of Greek cultural development. This transition both created aporias, as exemplified by the opposition between the ontologies of “being” and “becoming”, and led to the eventual victory of theoretic culture that established the hegemony of the left side of the brain.
Teaching Back Health in the School Setting: A Systematic Review of Randomized Controlled Trials
Authors: Miñana-Signes Vicente , Monfort-Pañego Manuel , Valiente Javier
Published: January 2021

School-based interventions have reported effectiveness on back health; however, there are no specific guidelines for teaching body mechanics and posture in primary and secondary schools. To identify, describe, and analyze the educative features of randomized controlled trials (RCTs) on back health developed to date in the school setting, a systematic review was performed following the preferred reporting items for systematic reviews and meta-analyses (PRISMA) recommendations. RCTs exclusively focused on educational setting electronic databases included PubMed, EMBASE, PEDro, Web of Science, SPORTDiscus, ERIC, and MEDLINE on the Ovid platform. Databases were searched for potentially eligible studies from the earliest date up to 18th March 2020. A total of 584 records were obtained from the database searches. A total of six articles that applied inclusion criteria were assessed for eligibility. All of these studies found improvements in postural habits and the level of knowledge with regard to back health, as well as a reduction in the prevalence of back pain. None of the studies used the student-centered method, and three studies used evaluation instruments with a pilot validation. Research on RCT interventions concerning back health in the school setting is scarce. None of the interventions applied a constructivist or student-centered method. The use of validated and standardized assessment instruments is required.
Novel Insights on the Role of Nitric Oxide in the Ovary: A Review of the Literature
Authors: Budani Maria Cristina , Tiboni Gian Mario
Published: January 2021

Nitric oxide (NO) is formed during the oxidation of L-arginine to L-citrulline by the action of multiple isoenzymes of NO synthase (NOS): neuronal NOS (nNOS), endotelial NOS (eNOS), and inducible NOS (iNOS). NO plays a relevant role in the vascular endothelium, in central and peripheral neurons, and in immunity and inflammatory systems. In addition, several authors showed a consistent contribution of NO to different aspects of the reproductive physiology. The aim of the present review is to analyse the published data on the role of NO within the ovary. It has been demonstrated that the multiple isoenzymes of NOS are expressed and localized in the ovary of different species. More to the point, a consistent role was ascribed to NO in the processes of steroidogenesis, folliculogenesis, and oocyte meiotic maturation in in vitro and in vivo studies using animal models. Unfortunately, there are few nitric oxide data for humans; there are preliminary data on the implication of nitric oxide for oocyte/embryo quality and in-vitro fertilization/embryo transfer (IVF/ET) parameters. NO plays a remarkable role in the ovary, but more investigation is needed, in particular in the context of human ovarian physiology.
Potentially Inappropriate Medication among Older Patients Who Are Frequent Users of Outpatient Services
Authors: Hsu Kung-Chuan , Lu Hai-Lin , Kuan Chi-Ming , Wu Jin-Song , Huang Chyn-Liang , Lin Pu-Hua , Trezise Damien , Wang Tzu-Chueh
Published: January 2021

Aging is accompanied by changes in organ degeneration, and susceptibility to multiple diseases, leading to the frequent occurrence of adverse drug reactions resulting from polypharmacy (PP) and potentially inappropriate medications (PIM) in older patients. This study employs a retrospective cohort design and investigates the association of PP with PIM among older patients with high rates of medical utilization. Using records from a national pharmaceutical care database, an experimental group is formed from patients meeting these criteria, who are then offered home pharmaceutical care. Correspondingly, a control group is formed by identifying older patients with regular levels of use of medical services who had been dispensed medications at community pharmacies. Multivariate logistic regression is performed to assess the association between the rate of PIM and variables, including age, gender, and PP. The study finds that experimental PP participants had a higher rate of PIM prescription (odds ratio (OR) = 5.4) than non-PP control participants (all p < 0.001). In clinical practice, additional caution is required to avoid PIMs. Patients engaged in continuously using long-term medication should take precautions in daily life to alleviate related discomforts. Pharmacists should serve as a bridge between patients and physicians to enhance their health and improve their quality of life.
Assessing the Policy Environment for Active Mobility in Cities—Development and Feasibility of the PASTA Cycling and Walking Policy Environment Score
Authors: Kahlmeier Sonja , Boig Esther Anaya , Castro Alberto , Smeds Emilia , Benvenuti Fabrizio , Eriksson Ulf , Iacorossi Francesco , Nieuwenhuijsen Mark J. , Panis Luc Int , Rojas-Rueda David , Wegener Sandra , de Nazelle Audrey
Published: January 2021

The importance of setting a policy focus on promoting cycling and walking as sustainable and healthy modes of transport is increasingly recognized. However, to date a science-driven scoring system to assess the policy environment for cycling and walking is lacking. In this study, spreadsheet-based scoring systems for cycling and walking were developed, including six dimensions (cycling/walking culture, social acceptance, perception of traffic safety, advocacy, politics and urban planning). Feasibility was tested using qualitative data from pre-specified sections of semi-standardized interview and workshop reports from a European research project in seven cities, assessed independently by two experts. Disagreements were resolved by discussions of no more than 75 minutes per city. On the dimension “perception of traffic safety”, quantitative panel data were used. While the interrater agreement was fair, feasibility was confirmed in general. Validity testing against social norms towards active travel, modal split and network length was encouraging for the policy area of cycling. Rating the policy friendliness for cycling and walking separately was found to be appropriate, as different cities received the highest scores for each. Replicating this approach in a more standardized way would pave the way towards a transparent, evidence-based system for benchmarking policy approaches of cities towards cycling and walking.
Moderate-to-Vigorous Physical Activity in Primary School Children: Inactive Lessons Are Dominated by Maths and English
Authors: Daly-Smith Andy , Hobbs Matthew , Morris Jade L. , Defeyter Margaret A. , Resaland Geir K. , McKenna Jim
Published: January 2021

Background: A large majority of primary school pupils fail to achieve 30-min of daily, in-school moderate-to-vigorous physical activity (MVPA). The aim of this study was to investigate MVPA accumulation and subject frequency during academic lesson segments and the broader segmented school day. Methods: 122 children (42.6% boys; 9.9 ± 0.3 years) from six primary schools in North East England, wore uniaxial accelerometers for eight consecutive days. Subject frequency was assessed by teacher diaries. Multilevel models (children nested within schools) examined significant predictors of MVPA across each school-day segment (lesson one, break, lesson two, lunch, lesson three). Results: Pupils averaged 18.33 ± 8.34 min of in-school MVPA, and 90.2% failed to achieve the in-school 30-min MVPA threshold. Across all school-day segments, MVPA accumulation was typically influenced at the individual level. Lessons one and two—dominated by maths and English—were less active than lesson three. Break and lunch were the most active segments. Conclusion: This study breaks new ground, revealing that MVPA accumulation and subject frequency varies greatly during different academic lessons. Morning lessons were dominated by the inactive delivery of maths and English, whereas afternoon lessons involved a greater array of subject delivery that resulted in marginally higher levels of MVPA.
A Community Audit of 300 “Drop-Out” Instances in Children Undergoing Ponseti Clubfoot Care in Bangladesh—What Do the Parents Say?
Authors: Evans Angela Margaret , Chowdhury Mamun , Khan Sharif
Published: January 2021

Introduction: Drop-out before treatment completion is a vexing problem for all clubfoot clinics. We and others have previously identified better engagement with parents as a crucial method of ameliorating incomplete clubfoot treatment, which increases deformity relapse. Materials and methods: The novel use of community facilitators enabled an audit of over 300 families who had dropped-out from a child’s clubfoot treatment. A questionnaire standardized the parent interviews. Parents were encouraged to present for clinical review of their child’s clubfeet. Results: When treatment was discontinued for six months, 309 families were audited. A social profile of families was developed, showing that most lived in tin houses with one working family member, indicating low affluence. Family issues, brace difficulty, travel distances, and insufficient understanding of ongoing bracing and follow-up were the main reasons for discontinuing treatment. Overt deformity relapse was found in 9% of children, while half of the children recommenced brace use after review. Conclusions: Identifying families at risk of dropping out from clubfoot care enables support to be instigated. Our findings encourage clinicians to empathize with parents of children with clubfoot deformity. The parent load indicator, in parallel with the initial clubfoot severity assessment, may help clinicians to better appreciate the demand that treatment will place on parents, the associated risk of drop-out, and the opportunity to enlist support.
The Impact of Policy Measures on Human Mobility, COVID-19 Cases, and Mortality in the US: A Spatiotemporal Perspective
Authors: Li Yun , Li Moming , Rice Megan , Zhang Haoyuan , Sha Dexuan , Li Mei , Su Yanfang , Yang Chaowei
Published: January 2021

Social distancing policies have been regarded as effective in containing the rapid spread of COVID-19. However, there is a limited understanding of policy effectiveness from a spatiotemporal perspective. This study integrates geographical, demographical, and other key factors into a regression-based event study framework, to assess the effectiveness of seven major policies on human mobility and COVID-19 case growth rates, with a spatiotemporal emphasis. Our results demonstrate that stay-at-home orders, workplace closures, and public information campaigns were effective in decreasing the confirmed case growth rate. For stay-at-home orders and workplace closures, these changes were associated with significant decreases (p < 0.05) in mobility. Public information campaigns did not see these same mobility trends, but the growth rate still decreased significantly in all analysis periods (p < 0.01). Stay-at-home orders and international/national travel controls had limited mitigation effects on the death case growth rate (p < 0.1). The relationships between policies, mobility, and epidemiological metrics allowed us to evaluate the effectiveness of each policy and gave us insight into the spatiotemporal patterns and mechanisms by which these measures work. Our analysis will provide policymakers with better knowledge regarding the effectiveness of measures in space–time disaggregation.
Mechanisms of Moral Disengagement in the Transition from Cybergossip to Cyberaggression: A Longitudinal Study
Authors: Falla Daniel , Ortega-Ruiz Rosario , Romera Eva M.
Published: January 2021

The internet is an area where young people establish relationships and develop socially, emotionally and morally, but it also gives rise to certain forms of online behaviour, such as cybergossip, which are associated with cyberaggression and other risky behaviour. The aims of this study were to verify whether a longitudinal association exists between cybergossip and cyberaggression, and to discover which mechanisms of moral disengagement may mediate this relationship. The final sample consisted of 1392 students (50% girls; Mage = 13.47; SD = 0.77), who were surveyed in a three-wave longitudinal study at six-month intervals. The results obtained confirmed a direct, positive relationship between cybergossip, subsequent cyberaggression and the mediation exerted by cognitive restructuring in this transition. We discuss the importance of recognizing and detecting the fine distinction between online gossip and cyberaggression with the intention of doing harm, and focus on the justifications used by young people to normalize online bullying. To sum up, there is a clear need to encourage ethical, responsible behaviour in online interactions in order to achieve well-balanced, more sustainable relationships in classrooms.
Good Places to Live and Sleep Well: A Literature Review about the Role of Architecture in Determining Non-Visual Effects of Light
Authors: Bellia Laura , Fragliasso Francesca
Published: January 2021

Light plays a crucial role in affecting the melatonin secretion process, and consequently the sleep–wake cycle. Research has demonstrated that the main characteristics of lighting affecting the so-called circadian rhythms are spectrum, light levels, spatial pattern and temporal pattern (i.e., duration of exposure, timing and previous exposure history). Considering that today people spend most of their time in indoor environments, the light dose they receive strictly depends on the characteristics of the spaces where they live: location and orientation of the building, dimensions of the windows, presence of external obstructions, geometric characteristics of the space, optical properties of walls and furniture. Understanding the interaction mechanism between light and architecture is fundamental to design non-visually comfortable spaces. The goal of the paper is to deepen this complex issue. It is divided into two parts: a brief historical excursus about the relationship between lighting practice and architecture throughout the centuries and a review of the available research works about the topic. The analysis demonstrates that despite the efforts of the research, numerous open questions still remain, and they are mostly due to the lack of a shared and clear method to evaluate the effects of lighting on circadian rhythm regulation.
An Association between Lower Extremity Function and Cognitive Frailty: A Sample Population from the KFACS Study
Authors: Kim Gwon-Min , Kim Bo-Kun , Kim Du-Ri , Liao Yung , Park Jong-Hwan , Park Hyuntae
Published: January 2021

The present study aimed to define the physical function and lipid profile for physical and cognitive frailty in community-dwelling Korean older adults. A total of 229 participants (age = 76.76 ± 3.72 years; body mass index = 24.83 ± 3.15) were classified into four groups: robust, pre-frailty, cognitive decline, and cognitive frailty. An analysis on the four groups was performed to measure their physical and cognitive function, as well as blood biomarkers. The area under (AUC) the receiver operating characteristic curve (ROC) indicated that the 6-min Walk Test (6MWT), Timed Up and Go test (TUG), and Five Times Sit-to-Stand test (FTSS) had the potential to distinguish the capacity of an old adult to predict cognitive frailty. The 6MWT had a higher sensitivity and the TUG and FTSS tests had greater specificity. With cognitive frailty as a categorical variable, cognitive frailty status was a significant predictor of the TUG (odds ratio (OR) 2.897; 95% confidence interval (CI), 1.283–6.541), FTSS (OR 3.337; 95% CI 1.451–7.673), and 6MWT (OR 0.204; 95% CI 0.070–0.591) tests. Our findings indicate that the 6MWT, TUG, and FTSS tests are closely related to cognitive frailty and can provide potential prognostic cutoff points.
How Does the Pandemic Facilitate Mobile Payment? An Investigation on Users’ Perspective under the COVID-19 Pandemic
Authors: Zhao Yuyang , Bacao Fernando
Published: January 2021

Owing to the convenience, reliability and contact-free feature of Mobile payment (M-payment), it has been diffusely adopted in China during the COVID-19 pandemic to reduce the direct and indirect contacts in transactions, allowing social distancing to be maintained and facilitating stabilization of the social economy. This paper aims to comprehensively investigate the technological and mental factors affecting users’ adoption intentions of M-payment under the COVID-19 pandemic, to expand the domain of technology adoption under the emergency situation. This study integrated Unified Theory of Acceptance and Use of Technology (UTAUT) with perceived benefits from Mental Accounting Theory (MAT), and two additional variables (perceived security and trust) to investigate 739 smartphone users’ adoption intentions of M-payment during the COVID-19 pandemic in China. The empirical results showed that users’ technological and mental perceptions conjointly influence their adoption intentions of M-payment during the COVID-19 pandemic, wherein perceived benefits are significantly determined by social influence and trust, corresponding with the situation of pandemic. This study initially integrated UTAUT with MAT to develop the theoretical framework for investigating users’ adoption intentions. Meanwhile, this study originally investigated the antecedents of M-payment adoption under the pandemic situation and indicated that users’ perceptions will be positively influenced when technology’s specific characteristics can benefit a particular situation.
Research on a Novel Hybrid Decomposition–Ensemble Learning Paradigm Based on VMD and IWOA for PM2.5 Forecasting
Authors: Guo Hengliang , Guo Yanling , Zhang Wenyu , He Xiaohui , Qu Zongxi
Published: January 2021

The non-stationarity, nonlinearity and complexity of the PM2.5 series have caused difficulties in PM2.5 prediction. To improve prediction accuracy, many forecasting methods have been developed. However, these methods usually do not consider the importance of data preprocessing and have limitations only using a single forecasting model. Therefore, this paper proposed a new hybrid decomposition–ensemble learning paradigm based on variation mode decomposition (VMD) and improved whale-optimization algorithm (IWOA) to address complex nonlinear environmental data. First, the VMD is employed to decompose the PM2.5 sequences into a set of variational modes (VMs) with different frequencies. Then, an ensemble method based on four individual forecasting approaches is applied to forecast all the VMs. With regard to ensemble weight coefficients, the IWOA is applied to optimize the weight coefficients, and the final forecasting results were obtained by reconstructing the refined sequences. To verify and validate the proposed learning paradigm, four daily PM2.5 datasets collected from the Jing-Jin-Ji area of China are chosen as the test cases to conduct the empirical research. The experimental results indicated that the proposed learning paradigm has the best results in all cases and metrics.
Differences in Characteristics, Hospital Care and Outcomes between Acute Critically Ill Emergency Department Patients with Early and Late Do-Not-Resuscitate Orders
Authors: Chang Julia Chia-Yu , Yang Che , Lai Li-Ling , Chen Ying-Ju , Huang Hsien-Hao , Fan Ju-Sing , Hsu Teh-Fu , Yen David Hung-Tsang
Published: January 2021

Background: A do-not-resuscitate (DNR) order is associated with an increased risk of death among emergency department (ED) patients. Little is known about patient characteristics, hospital care, and outcomes associated with the timing of the DNR order. Aim: Determine patient characteristics, hospital care, survival, and resource utilization between patients with early DNR (EDNR: signed within 24 h of ED presentation) and late DNR orders. Design: Retrospective observational study. Setting/Participants: We enrolled consecutive, acute, critically ill patients admitted to the emergency intensive care unit (EICU) at Taipei Veterans General Hospital from 1 February 2018, to 31 January 2020. Results: Of the 1064 patients admitted to the EICU, 619 (58.2%) had EDNR and 445 (41.8%) LDNR. EDNR predictors were age >85 years (adjusted odd ratios (AOR) 1.700, 1.027–2.814), living in long-term care facilities (AOR 1.880, 1.066–3.319), having advanced cardiovascular diseases (AOR 2.128, 1.039–4.358), “medical staff would not be surprised if the patient died within 12 months” (AOR 1.725, 1.193–2.496), and patients’ family requesting palliative care (AOR 2.420, 1.187–4.935). EDNR patients underwent lesser endotracheal tube (ET) intubation (15.6% vs. 39.9%, p < 0.001) and had reduced epinephrine injection (19.9% vs. 30.3%, p = 0.009), ventilator support (16.7% vs. 37.9%, p < 0.001), and narcotic use (51.1% vs. 62.6%, p = 0.012). EDNR patients had significantly lower 7-day (p < 0.001), 30-day (p < 0.001), and 90-day (p = 0.023) survival. Conclusions: EDNR patients underwent decreased ET intubation and had reduced epinephrine injection, ventilator support, and narcotic use during EOL as well as decreased length of hospital stay, hospital expenditure, and survival compared to LDNR patients.
The Obesity Paradox Predicts the Second Wave of COVID-19 to Be Severe in Western Countries
Authors: Krams Indrikis A. , Jõers Priit , Luoto Severi , Trakimas Giedrius , Lietuvietis Vilnis , Krams Ronalds , Kaminska Irena , Rantala Markus J. , Krama Tatjana
Published: January 2021

While COVID-19 infection and mortality rates are soaring in Western countries, Southeast Asian countries have successfully avoided the second wave of the SARS-CoV-2 pandemic despite high population density. We provide a biochemical hypothesis for the connection between low COVID-19 incidence, mortality rates, and high visceral adiposity in Southeast Asian populations. The SARS-CoV-2 virus uses angiotensin-converting enzyme 2 (ACE2) as a gateway into the human body. Although the highest expression levels of ACE2 are found in people’s visceral adipose tissue in Southeast Asia, this does not necessarily make them vulnerable to COVID-19. Hypothetically, high levels of visceral adiposity cause systemic inflammation, thus decreasing the ACE2 amount on the surface of both visceral adipocytes and alveolar epithelial type 2 cells in the lungs. Extra weight gained during the pandemic is expected to increase visceral adipose tissue in Southeast Asians, further decreasing the ACE2 pool. In contrast, weight gain can increase local inflammation in fat depots in Western people, leading to worse COVID-related outcomes. Because of the biological mechanisms associated with fat accumulation, inflammation, and their differential expression in Southeast Asian and Western populations, the second wave of the pandemic may be more severe in Western countries, while Southeast Asians may benefit from their higher visceral fat depots.
Attitudes towards Risk Prediction in a Help Seeking Population of Early Detection Centers for Mental Disorders—A Qualitative Approach
Authors: Mantell Pauline Katharina , Baumeister Annika , Ruhrmann Stephan , Janhsen Anna , Woopen Christiane
Published: January 2021

Big Data approaches raise hope for a paradigm shift towards illness prevention, while others are concerned about discrimination resulting from these approaches. This will become particularly important for people with mental disorders, as research on medical risk profiles and early detection progresses rapidly. This study aimed to explore views and attitudes towards risk prediction in people who, for the first time, sought help at one of three early detection centers for mental disorders in Germany (Cologne, Munich, Dresden). A total of 269 help-seekers answered an open-ended question on the potential use of risk prediction. Attitudes towards risk prediction and motives for its approval or rejection were categorized inductively and analyzed using qualitative content analysis. The anticipated impact on self-determination was a driving decision component, regardless of whether a person would decide for or against risk prediction. Results revealed diverse, sometimes contrasting, motives for both approval and rejection (e.g., the desire to control of one’s life as a reason for and against risk prediction). Knowledge about a higher risk as a potential psychological burden was one of the major reasons against risk prediction. The decision to make use of risk prediction is expected to have far-reaching effects on the quality of life and self-perception of potential users. Healthcare providers should empower those seeking help by carefully considering individual expectations and perceptions of risk prediction.
Performance of Chlorella Vulgaris Exposed to Heavy Metal Mixtures: Linking Measured Endpoints and Mechanisms
Authors: Expósito Nora , Carafa Roberta , Kumar Vikas , Sierra Jordi , Schuhmacher Marta , Papiol Gemma Giménez
Published: January 2021

Microalgae growth inhibition assays are candidates for referent ecotoxicology as a fundamental part of the strategy to reduce the use of fish and other animal models in aquatic toxicology. In the present work, the performance of Chlorella vulgaris exposed to heavy metals following standardized growth and photosynthesis inhibition assays was assessed in two different scenarios: (1) dilutions of single heavy metals and (2) an artificial mixture of heavy metals at similar levels as those found in natural rivers. Chemical speciation of heavy metals was estimated with Visual MINTEQ software; free heavy metal ion concentrations were used as input data, together with microalgae growth and photosynthesis inhibition, to compare different effects and explain possible toxicity mechanisms. The final goal was to assess the suitability of the ecotoxicological test based on the growth and photosynthesis inhibition of microalgae cultures, supported by mathematic models for regulatory and decision-making purposes. The C. vulgaris algae growth inhibition test was more sensitive for As, Zn, and Pb exposure whereas the photosynthesis inhibition test was more sensitive for Cu and Ni exposure. The effects on growth and photosynthesis were not related. C. vulgaris evidenced the formation of mucilaginous aggregations at lower copper concentrations. We found that the toxicity of a given heavy metal is not only determined by its chemical speciation; other chemical compounds (as nutrient loads) and biological interactions play an important role in the final toxicity. Predictive mixture effect models tend to overestimate the effects of metal mixtures in C. vulgaris for both growth and photosynthesis inhibition tests. Growth and photosynthesis inhibition tests give complementary information, and both are a fast, cheap, and sensitive alternative to animal testing. More research is needed to solve the challenge of complex pollutant mixtures as they are present in natural environments, where microalgae-based assays can be suitable monitoring tools for pollution management and regulatory purposes.
Association of the Use of the Mobile Phone with Physical Fitness and Academic Performance: A Cross-Sectional Study
Authors: Bravo-Sánchez Alfredo , Morán-García Javier , Abián Pablo , Abián-Vicén Javier
Published: January 2021

The aim of this study was to analyse the association of the use of the mobile phone with physical fitness (PF) and academic performance in secondary school students and its gender-related differences. A total of 501 high school students participated in the study (236 girls and 265 boys; 12–18 years). Use of the mobile phone and sample distributions were done with the Mobile-Related Experience Questionnaire (CERM): low use of mobile phone (LMP = 10–15 points), medium use of mobile phone (MMP = 16–23 points) and high use of mobile phone (HMP = 24–40 points). PF via Eurofit test battery and academic performance were recorded, and gender was used as a differentiating factor. The HMP group registered lower values than the LMP group for academic performance (Spanish: 4.78 ± 2.26 vs. 3.90 ± 1.96 points; p = 0.007, Mathematics: 4.91 ± 2.23 vs. 4.00 ± 1.84 points; p = 0.007) and PF (Abdominals: 6.83 ± 2.40 vs. 5.41 ± 2.46 points; p < 0.001, Broad jump: 6.24 ± 3.02 vs. 4.94 ± 2.28 points; p = 0.013). The boy students showed greater values than girl students for PF in the LMP (medicine-ball-throw: 6.34 ± 2.24 vs. 5.28 ± 1.86 points, p = 0.007) and MMP (medicine-ball-throw: 6.49 ± 2.52 vs. 5.02 ± 1.68 points; p < 0.001) groups, but no gender-related differences were found in the HMP group. In conclusion, high use of the mobile phone was related to worse results in the PF tests and academic performance. Gender-related differences were found for academic performance regardless of the use of the mobile, but for physical fitness no gender differences were found in HMP group.
Cardiovascular Disease Risk in Bears and Other Gay Men: A Descriptive Study from Poland
Authors: Mijas Magdalena , Koziara Karolina , Galbarczyk Andrzej , Jasienska Grazyna
Published: January 2021

A risk of cardiovascular disease (CVD) is increased by multiple factors including psychosocial stress and health behaviors. Sexual minority men who identify as Bears form a subculture distinguished by characteristics associated with increased CVD risk such as elevated stress and high body weight. However, none of the previous studies comprehensively investigated CVD risk in this population. Our study compared Bears (N = 31) with other gay men (N = 105) across a wide range of CVD risk factors. Logistic regression and analysis of covariance (ANCOVA) models were performed to compare both groups concerning behavioral (e.g., physical activity), medical (e.g., self-reported hypertension), and psychosocial (e.g., depressiveness) CVD risk factors. Bears were characterized by older age and higher body mass index (BMI) than the control group. We also observed higher resilience, self-esteem, as well as greater prevalence of self-reported hypertension, diabetes, and hypercholesterolemia in Bears. None of these differences remained statistically significant after adjusting for age and, in the case of self-reported diagnosis of diabetes, both age and BMI. Our study demonstrates that Bears are characterized by increased CVD risk associated predominantly with older age and higher BMI. Health promotion interventions addressed to this community should be tailored to Bears’ subcultural norms and should encourage a healthier lifestyle instead of weight loss.
Evaluation of the Heart Failure in Internet Patient Information: Descriptive Survey Study
Authors: Lee Kyoung Suk , Cho Yoo Mi , Oh Sung Hee , Jung Mi Sook , Yoon Ju Young
Published: January 2021

Patients with heart failure (HF) may not receive enough HF education from their clinicians throughout the course of the illness. Given that information is readily accessible on the Internet, patients with HF may seek HF information online. However, the relevance of online information for patients, the health literacy demand, and quality of the information is unknown. The purpose of this study was to compare the HF topics available online with topics HF patients perceived to be important and to evaluate the health literacy demand and quality of online HF information. The most popular search engines and a website that ranks the popularity of the websites were searched to identify websites with HF information. The health literacy demand and quality of the information were evaluated using the Patient Education Material Evaluation Tool for Print Materials and the DISCERN tool, respectively. First, the HF Patients’ Learning Needs Inventory (HFPLNI) was used to determine whether the websites included the 46 topics identified in this inventory. Patients with HF (n = 126) then completed the HFPLNI to rate the perceived importance on each topic. A chi-square test was used to compare the differences between the topics on the websites and those patients perceived to be important. Of the 46 topics, 39 were less likely to be included on the websites even though patients perceived that they were important topics. Information on the websites (n = 99) was not written could not be easily understood by patients and did not meet the overall health literacy demands of 58.0% and 19.8% of the patients, respectively. Only one-fifth of the websites were rated as fair to good quality. Online HF information had high health literacy demand and was poor quality with mostly generic HF information, which did not meet patients’ information needs. Websites need to be developed reflecting patients’ learning needs with low health literacy demand and good quality.
A Nationwide Population-Based Study on the Incidence of Parapharyngeal and Retropharyngeal Abscess—A 10-Year Study
Authors: Yang Tzong-Hann , Xirasagar Sudha , Cheng Yen-Fu , Wu Chuan-Song , Kao Yi-Wei , Lin Herng-Ching
Published: January 2021

This study aimed to investigate the annual incidence of parapharyngeal and retropharyngeal abscess (PRPA) based on 10-year population-based data. Patients with PRPA were identified from the Taiwan Health Insurance Research Database, a database of all medical claims of a randomly selected, population-representative sample of over two million enrollees of the National Health Insurance system that covers over 99% of Taiwan’s citizens. During 2007–2016, 5779 patients received a diagnosis of PRPA. We calculated the population-wide incidence rates of PRPA by sex and age group (20–44, 45–64, and >64) as well as in-hospital mortality. The annual incidence rate of PRPA was 2.64 per 100,000 people. The gender-specific incidence rates per 100,000 people were 3.34 for males and 1.94 for females with a male:female gender ratio of 1.72. A slight increase in incidence rates among both genders over the study period was noted. Age-specific rates were lowest in the 20–44 age group with a mean annual incidence of 2.00 per 100,000 people, and the highest rates were noted in the age groups of 45–64 and >64 years with mean annual incidences of 3.21 and 3.20, respectively. We found that PRPA is common in Taiwan, males and older individuals are more susceptible to it, and incidence has increased in recent years.
Improving Psychological Comfort of Paramedics for Field Termination of Resuscitation through Structured Training
Authors: Bang Chungli , Mao Desmond Ren Hao , Cheng Rebacca Chew Ying , Pek Jen Heng , Gandhi Mihir , Arulanandam Shalini , Ong Marcus Eng Hock , Quah Stella
Published: January 2021

This study examines the impact of a newly developed structured training on Singapore paramedics’ psychological comfort before the implementation of a prehospital termination of resuscitation (TOR) protocol. Following a before and after study design, the paramedics underwent a self-administered questionnaire to assess their psychological comfort level applying the TOR protocol, 22 months before and one month after a 3-h structured training session. The questionnaire addressed five domains: sociocultural attitudes on resuscitation and TOR, multi-tasking, feelings towards resuscitation and TOR, interactions with colleagues and bystanders and informing survivors. Overall psychological comfort total (PCT) scores and domain-specific scores were compared using the paired t-test with higher scores representing greater comfort. Ninety-six of the 345 eligible paramedics responded. There was no statistically significant change in the mean PCT scores at baseline and post-training; however, the “feelings towards resuscitation and TOR” domain improved by 4.77% (95% CI 1.42 to 8.13 and p = 0.006) and the multi-tasking domain worsened by 4.11% (95% CI −7.82 to −0.41 and p = 0.030). While the structured training did not impact on the overall psychological comfort levels, it led to improvements in the feelings of paramedics towards resuscitation and TOR. Challenges remain in improving paramedics’ psychological comfort levels towards TOR.
Spatial Variation of Survival for Colorectal Cancer in Malaysia
Authors: Ghazali Anis Kausar , Keegan Thomas , Taylor Benjamin M.
Published: January 2021

A patient’s survival may depend on several known and unknown factors and it may also vary spatially across a region. Socioeconomic status, accessibility to healthcare and other environmental factors are likely to contribute to survival rates. The aim of the study was to model the spatial variation in survival for colorectal cancer patients in Malaysia, accounting for individual and socioeconomic risk factors. We conducted a retrospective study of 4412 colorectal cancer (ICD-10, C18-C20) patients diagnosed from 2008 to 2013 to model survival in CRC patients. We used the data recorded in the database of the Malaysian National Cancer Patient Registry-Colorectal Cancer (NCPR-CRC). Spatial location was assigned based on the patients’ central district location, which involves 144 administrative districts of Malaysia. We fitted a parametric proportional hazards model in which the spatially correlated frailties were modelled by a log-Gaussian stochastic process to analyse the spatially referenced survival data, which is also known as a spatial survival model. After controlling for individual and area level characteristics, our findings indicate wide spatial variation in colorectal cancer survival across Malaysia. Better healthcare provision and higher socioeconomic index in the districts where patients live decreased the risk of death from colorectal cancer, but these associations were not statistically significant. Reliable measurement of environmental factors is needed to provide good insight into the effects of potential risk factors for the disease. For example, a better metric is needed to measure socioeconomic status and accessibility to healthcare in the country. The findings provide new information that might be of use to the Ministry of Health in identifying populations with an increased risk of poor survival, and for planning and providing cancer control services.
Research on Spatiotemporal Differentiation and Influence Mechanism of Urban Resilience in China Based on MGWR Model
Authors: Chen Yu , Zhu Mengke , Zhou Qian , Qiao Yurong
Published: January 2021

Urban resilience in the context of COVID-19 epidemic refers to the ability of an urban system to resist, absorb, adapt and recover from danger in time to hedge its impact when confronted with external shocks such as epidemic, which is also a capability that must be strengthened for urban development in the context of normal epidemic. Based on the multi-dimensional perspective, entropy method and exploratory spatial data analysis (ESDA) are used to analyze the spatiotemporal evolution characteristics of urban resilience of 281 cities of China from 2011 to 2018, and MGWR model is used to discuss the driving factors affecting the development of urban resilience. It is found that: (1) The urban resilience and sub-resilience show a continuous decline in time, with no obvious sign of convergence, while the spatial agglomeration effect shows an increasing trend year by year. (2) The spatial heterogeneity of urban resilience is significant, with obvious distribution characteristics of “high in east and low in west”. Urban resilience in the east, the central and the west are quite different in terms of development structure and spatial correlation. The eastern region is dominated by the “three-core driving mode”, and the urban resilience shows a significant positive spatial correlation; the central area is a “rectangular structure”, which is also spatially positively correlated; The western region is a “pyramid structure” with significant negative spatial correlation. (3) The spatial heterogeneity of the driving factors is significant, and they have different impact scales on the urban resilience development. The market capacity is the largest impact intensity, while the infrastructure investment is the least impact intensity. On this basis, this paper explores the ways to improve urban resilience in China from different aspects, such as market, technology, finance and government.
The Bench Press Grip Width Does Not Affect the Number of Repetitions Performed at Different Velocity Loss Thresholds
Authors: Pérez-Castilla Alejandro , Jukic Ivan , Haff G. Gregory , García-Ramos Amador
Published: January 2021

This study aimed (I) to compare the number of repetitions that can be completed to failure (XRM) and before reaching a 15%, 30%, or 45% velocity loss threshold (XVLT) in the bench press exercise performed using different grip widths, and (II) to examine the inter-individual variability in the percentage of completed repetitions with respect to the XRM when the set volume is prescribed based on a fixed number of repetitions (FNR) and several velocity loss thresholds (VLT). Nineteen men performed four separate sessions in a random order where there was a single set of repetitions completed to failure against 75% of the one-repetition maximum during the Smith machine bench press exercise using a narrow, medium, wide, or self-selected grip widths. The XRM (p = 0.545) and XVLTs (p ≥ 0.682) were not significantly affected by grip width. A high and comparable inter-individual variability in the percentage of completed repetitions with respect to the XRM was observed when using both an FNR (median CV = 24.3%) and VLTs (median CV = 23.5%). These results indicate that Smith machine bench press training volume is not influenced by the grip width and that VLTs do not allow a more homogeneous prescription of the set volume with respect to the XRM than the traditional FNR.
Family Orchards and Health-Related Quality of Life in the Elderly. A Protocol for a Study in Las Hurdes (Spain) Based on an Ethnographic Approach
Authors: Madruga Miguel , Carlos-Vivas Jorge , Mendoza-Muñoz María , Adsuar José Carmelo , Mariano-Juárez Lorenzo , Conde-Caballero David
Published: January 2021

Demographic evolution is resulting on an aged population increment in Spain. This growth has been more relevant in rural areas, where the population has traditionally lived under hard socio-economic conditions and leveraging the natural resources such as food from family orchards to survive. Studies that have investigated the possibilities and uses of these traditional family orchards today in relation to health-related quality of life in the elderly are scarce. Based on a previous ethnography, this mixed research aims to describe a protocol that will evaluate the effects of the use of traditional family orchards as a daily resource on fitness and quality of life of the elderly population in Las Hurdes (Spain). Body composition, fitness, mental health, health-related quality of life, and activity-related behaviors of participants will be assessed. The outcomes of this study might enable us to design further tailored physical exercise-based interventions using family orchards as an adequate resource to improve the health-related quality of life and fitness of the elderly in rural areas. In addition, the study detailed here might also be applied to other similar rural areas in Spain and worldwide.
Features of Occupational Health Risks in the Russian Arctic (on the Example of Nenets Autonomous Okrug and Chukotka Autonomous Okrug)
Authors: Gorbanev Sergei , Syurin Sergei , Kovshov Aleksandr
Published: January 2021

Working in the Arctic increases the risk of occupational diseases, which is especially important in the context of acute shortage of manpower in the region. The purpose of the study was to comparatively evaluate the working conditions and occupational pathology in Nenets Autonomous Okrug (NAO) and Chukotka Autonomous Okrug (ChAO) of Russia. We analyzed the results of socio-hygienic monitoring “Working Conditions and Occupational Morbidity” in 2008–2018. Despite similar climatic and socio-economic conditions, significant differences exist in the health risks of the working populations of the two regions. In NAO two-thirds of workers were employed at facilities with satisfactory sanitary and epidemiological well-being, while in ChAO only 13% of workers had such conditions. In NAO, almost all occupational diseases (93.2%) were due to exposure to noise among civil aviation workers. In ChAO, health problems mainly occurred among miners (81.5%). The most common of these were noise effects on the inner ear (35.2%), chronic bronchitis (23.1%), and mono- and polyneuropathies (12.5%). In 2008–2018, the occupational pathology risk in ChAO was higher than in NAO: RR = 2.79; CI 2.09–3.71. Thus, specificity of technological processes and forms of labor organization create significant differences in health risks for workers. It is necessary to use modern mining equipment to decrease the occupational morbidity in ChAO. In NAO, this effect can be achieved by updating the fleet of civil aviation.