bluuebunny/crossref_metadata_2025 huggingface dataset:
Phylogenetic Position of Haemaphysalis kashmirensis and Haemaphysalis cornupunctata, with Notes on Rickettsia spp.
Authors: Khan Shah , Khan Mehran , Alouffi Abdulaziz , Almutairi Mashal , Numan Muhmmad , Ullah Shafi , Obaid Muhammad , Islam Zia , Ahmed Haroon , Tanaka Tetsuya , Ali Abid
Published: January 2023

Despite high diversity in the Oriental region, ticks of the genus Haemaphysalis have been neglected regarding their genetic data and vector potential. This study aimed to genetically characterize three species of the genus Haemaphysalis: Haemaphysalis cornupunctata, Haemaphysalis kashmirensis, and Haemaphysalis montgomeryi infesting goats and sheep, and Rickettsia spp. associated with these tick species in the Hindu Kush Himalayan range of Pakistan. Altogether, 834 ticks were collected by examining 120 hosts including goats (64/120, 53.3%) and sheep (56/120, 46.6%), in which 86 (71.6%) hosts were found to be tick-infested. The morphologically identified ticks were subjected to DNA extraction and PCR for the amplification of partial 16S rDNA and cox fragments. Rickettsia spp. associated with the collected ticks were detected through the amplification of gltA, ompA and ompB partial fragments. The 16S rDNA of H. cornupunctata and H. montgomeryi showed a maximum identity of 100% with the sequences of the same species, whereas the 16S rDNA of H. kashmirensis showed the highest identity of 93–95% with Haemaphysalis sulcata. The cox sequence of H. montgomeryi displayed 100% identity with the same species. In comparison, the cox sequences of H. cornupunctata and H. kashmirensis showed maximum identities of 87.65–89.22% with Haemaphysalis punctata and 89.34% with H. sulcata, respectively. The gltA sequence of Rickettsia sp. from H. kashmirensis showed the highest identity of 97.89% with Rickettsia conorii subsp. raoultii, while the ompA and ompB fragments from the same DNA samples revealed 100% and 98.16% identity with Rickettsia sp. and “Candidatus Rickettsia longicornii”, respectively. Another gltA sequence amplified from H. montgomeryi ticks showed 100% identity with Rickettsia hoogstraalii, while the attempts to amplify ompA and ompB for R. hoogstraalii were unsuccessful. In the phylogenetic tree, the 16S rDNA of H. cornupunctata clustered with the corresponding species while its cox clustered with H. punctata. Both 16S rDNA and cox sequences of H. kashmirensis clustered with H. sulcata. The gltA sequence of Rickettsia sp. was clustered individually in the spotted fever (SF) group of Rickettsia, while the gltA sequence of R. hoogstraalii was clustered with the same species in the transition group of Rickettsia. In the SF group, the rickettsial ompA and ompB sequence clustered with undetermined Rickettsia sp. and “Candidatus Rickettsia longicornii”, respectively. This is the earliest study regarding the genetic characterization of H. kashmirensis. This study indicated that ticks belong to the genus Haemaphysalis have the potential of harboring and/or transmitting Rickettsia spp. in the region.
Genetic and Structural Diversity of Prokaryotic Ice-Binding Proteins from the Central Arctic Ocean
Authors: Winder Johanna C. , Boulton William , Salamov Asaf , Eggers Sarah Lena , Metfies Katja , Moulton Vincent , Mock Thomas
Published: January 2023

Ice-binding proteins (IBPs) are a group of ecologically and biotechnologically relevant enzymes produced by psychrophilic organisms. Although putative IBPs containing the domain of unknown function (DUF) 3494 have been identified in many taxa of polar microbes, our knowledge of their genetic and structural diversity in natural microbial communities is limited. Here, we used samples from sea ice and sea water collected in the central Arctic Ocean as part of the MOSAiC expedition for metagenome sequencing and the subsequent analyses of metagenome-assembled genomes (MAGs). By linking structurally diverse IBPs to particular environments and potential functions, we reveal that IBP sequences are enriched in interior ice, have diverse genomic contexts and cluster taxonomically. Their diverse protein structures may be a consequence of domain shuffling, leading to variable combinations of protein domains in IBPs and probably reflecting the functional versatility required to thrive in the extreme and variable environment of the central Arctic Ocean.
Evaluation of Midwives’ Practises on Herpetic Infections during Pregnancy: A French Vignette-Based Study
Authors: Mrozik Adrian , Sellier Yann , Lemaitre Déborah , Gaucher Laurent
Published: January 2023

(1) Background: One out of two pregnant women has a history of herpes infection. Initial infections have a high risk of neonatal transmission. Our objective was to analyse the professional practises of midwives regarding the management of herpes infections during pregnancy in France; (2) Methods: A national survey conducted via an online self-questionnaire, including clinical vignettes for which the midwives proposed a diagnosis, a drug treatment, a mode of birth, and a prognosis. These responses were used to evaluate the conformity of the responses to the guidelines, as well as the influence of certain criteria, such as mode of practise and experience; (3) Results: Of 728 responses, only 26.1% of the midwives reported being aware of the 2017 clinical practise guidelines. The midwives proposed taking the appropriate actions in 56.1% of the responses in the case of a recurrence, and in 95.1% of the responses in the case of a primary infection. For the specific, high-risk case of a nonprimary initial infection at 38 weeks of gestation, reporting knowledge of the recommendations improved the compliance of the proposed care by 40% (p = 0.02). However, 33.8% of the midwives underestimated the neonatal risk at term after a primary initial infection, and 43% underestimated the risk after a primary initial infection at term; (4) Conclusions: The majority of reported practises were compliant despite a low level of knowledge of the guidelines. The dissemination of guidelines may be important to improve information and adherence to appropriate therapeutic practise.
Musculoskeletal Pain in the Neck and Lower Back Regions among PHC Workers: Association between Workload, Mental Disorders, and Strategies to Manage Pain
Authors: Cezar-Vaz Marta Regina , Xavier Daiani Modernel , Bonow Clarice Alves , Vaz Jordana Cezar , Cardoso Letícia Silveira , Sant’Anna Cynthia Fontella , da Costa Valdecir Zavarese , Nery Carlos Henrique Cardona , Alves Aline Soares , Vettorello Joice Simionato , de Souza Jociel Lima , Loureiro Helena Maria Almeida Macedo
Published: January 2023

Scientific evidence indicates that workers in the health sector are commonly exposed to work-related musculoskeletal pain. Objectives: We aimed to identify the relationship between the presence and intensity of musculoskeletal pain in the neck and lumbar regions reported by Primary Health Care (PHC) workers with workloads and occupational risks, analyze musculoskeletal pain in the presence and absence of self-reported mental disorders based on a medical diagnosis, and identify workers’ strategies to manage pain. Method: This cross-sectional study addressed 338 health professionals working in PHC outpatient services in the extreme South of Brazil. One questionnaire addressed sociodemographic questions concerning occupation, occupational risks, and mental disorders. The Nordic Musculoskeletal Questionnaire was used to assess self-reported musculoskeletal pain. The National Aeronautics and Space Administration Task Load Index (NASA-TLX) measured the workload. A descriptive and inferential analysis was performed using SPSS version 21.0. Results: Most (55.3%) participants reported neck and (64.5%) lower back pain in the previous 12 months, and 22.5% and 30.5% reported intense neck and lower back pain, respectively, in the previous 12 months. The results showed different independent associations with increased musculoskeletal pain among health workers. Dentists presented the highest prevalence of neck pain, while female workers presented the highest prevalence of lower back pain. Furthermore, the perception of ergonomic risk and virtually all self-reported mental disorders (except panic syndrome for neck pain) were associated with pain in the neck and lower back regions and a higher frustration level (mental demand). Additionally, professionals with graduate degrees, nurses, and professionals working the longest in PHC services reported seeking complementary therapies more frequently, while physicians and those with self-reported mental disorders self-medicated more frequently.
Caregiver Burden in Informal Caregivers of Patients in Saudi Arabia Receiving Hemodialysis: A Mixed-Methods Study
Authors: Alshammari Bushra , Noble Helen , McAneney Helen , Alshammari Farhan , O’Halloran Peter
Published: January 2023

(1) Background: Long-term caregiving for patients receiving hemodialysis (HD), is associated with physical and psychological stress, which may impact on the well-being and quality of life of caregivers. Due to a lack of understanding of the experiences of informal caregivers of patients receiving HD, especially in Saudi Arabia, this study aimed to measure burden in informal caregivers of patients receiving HD, examine the factors that predict caregiver burden (CB), and explore the experience of burden in caregivers of patients receiving HD. (2) Methods: This study used a mixed-methods, sequential, explanatory design, which consisted of two phases. Phase 1 involved a cross-sectional study design, with a convenience sample of 61 caregivers of patients on maintenance HD for at least 3 months. All caregivers in the study completed the Arabic version of the Zarit Burden Interview to identify caregiver burden. Phase 2 of the study involved a qualitative descriptive design involving semi-structured interviews with nine caregivers. (3) Results: Study findings indicate that caregivers did not experience severe burden. Being older, a female caregiver and having comorbidities was positively associated with increased levels of caregiver burden. In the qualitative phase of the study, a number of important factors emerged that may contribute to a reduction in caregiver burden, including social support, cultural acceptance, and religious influences. (4) Conclusion and impact: CB was found to be low when a comparison was made with other studies using similar populations. Understanding the factors that influence caregiver burden will contribute to the accurate assessment of caregiver burden and help reduce burden in informal caregivers, patients with renal failure, and others with chronic illnesses worldwide.
Acknowledgment to the Reviewers of Healthcare in 2022
Authors:   Healthcare Editorial Office
Published: January 2023

High-quality academic publishing is built on rigorous peer review [...]
A Longitudinal Study Exploring the Role of Mental Health Symptoms and Social Support Regarding Life Satisfaction 18 Months after Initiation of Gender-Affirming Hormone Treatment
Authors: Aldridge Zoë , Thorne Nat , Bouman Walter Pierre , Witcomb Gemma L. , Arcelus Jon
Published: January 2023

While positive changes in mental health have been found following gender-affirming hormone treatment (GAHT), it is unclear how pre-GAHT mental health and social support can influence treatment outcomes. To address this, a retrospective longitudinal design was used in which 137 participants completed measures of social support, anxiety, and depression prior to GAHT (T0) and a measure of life satisfaction 18 months after GAHT (T1). The data showed no significant differences in life satisfaction at T1 based on T0 caseness of anxiety or depression. It was also found that T1 life satisfaction was not predicted by levels of anxiety, depression, or social support at T0. The lack of significant differences in life satisfaction at 18 months post-GAHT based on pre-GAHT mental health, coupled with no evidence for the predictive role social support suggest that these factors are not central to long-term life satisfaction. For many, lower mental wellbeing may be part of the experience of awaiting GAHT and should not be regarded as indicative of longer-term issues. Instead, facilitation of social support connections and mental health support should be offered both concurrently with, and for those awaiting, GAHT.
The Association between Emergency Department Overcrowding and Delay in Treatment: A Systematic Review
Authors: Darraj Adel , Hudays Ali , Hazazi Ahmed , Hobani Amal , Alghamdi Alya
Published: January 2023

Emergency department (ED) overcrowding is a global health issue that is associated with poor quality of care and affects the timeliness of treatment initiation. The purpose of this systematic review is to assess the association between overcrowding and delay in treatment. A systematic review was conducted using four databases (CINAHL, PubMed, Scopus, Cochrane Library), following the preferred reporting items for systematic reviews and meta-analysis (PRISMA). A structured search was conducted to identify peer-reviewed articles aimed at assessing the relationship between overcrowding and delay in treatment, published between January 2000 and January 2021. Only studies that were conducted in the ED settings were included, and that includes both triage and observation rooms. The studies were appraised using two quality appraisal tools including the critical appraisal skills programme (CASP) for cohort studies and the Joanna Briggs Institute (JBI) checklist tool for cross-sectional studies. A total of 567 studies screened, and 10 met the inclusion criteria. Of these studies, 8 were cohorts and 2 were cross-sectionals. The majority reported that overcrowding is associated with a delay in the initiation of antibiotics for patients with sepsis and pneumonia. The review identified that overcrowding might impact time-to-treatment and, thus, the quality of care delivered to the patient. However, further research aimed at finding feasible solutions to overcrowding is encouraged.
Cytokine Levels and Severity of Illness Scoring Systems to Predict Mortality in COVID-19 Infection
Authors: Onuk Sevda , Sipahioğlu Hilal , Karahan Samet , Yeşiltepe Ali , Kuzugüden Sibel , Karabulut Aycan , Beştepe Dursun Zehra , Akın Aynur
Published: January 2023

Various scoring systems and cytokines have been cited as predicting disease severity in COVID-19 infection. This study analyzed the link between mortality rate, levels of cytokines, and scoring systems such as the Glasgow Coma Scale (GCS), Acute Physiologic Assessment and Chronic Health Evaluation II (APACHE II), Sequential Organ Failure Assessment (SOFA), and Charlson Comorbidity Index in patients infected with COVID-19. Adult patients infected with COVID-19 were followed up in the intensive care unit (ICU) and analyzed prospectively. We measured serum cytokine levels (Interleukin-10 (IL-10), Interleukin-8 (IL-8), Interleukin-6 (IL-6), Interleukin-1β (IL-1β), tumor necrosis factor-alpha (TNF-α) and High mobility group box 1 (HMGB-1)) and recorded GCS, APACHE II, SOFA, and Charlson comorbidity index scores on admission to the ICU. Receiver operating curve (ROC) analysis was performed to predict mortality from IL-1β, IL-6 IL-10, IL-8, TNF-α, and HMGB-1 values. Study participants were grouped as follows: Group A, survivors, and Group B, deceased, during the 28-day follow-up. The mean age was 65.69 (±13.56) in Group A (n = 36) and 70.85 (±10.06) in Group B (n = 27). The female/male ratio was 23/40. Age, sex, body mass index (BMI), comorbid illnesses, GCS, APACHE II, SOFA, and Charlson scores, duration of hospitalization or ICU admission, therapeutic choices, and lymphocyte, PMNL, NLR, platelet, D-dimer, fibrinogen, GGT, CRP, procalcitonin, and lactate levels were similar between the groups. The frequency of acute kidney injury (AKI) was higher in Group B (p = 0.005). Serum IL-10, IL-8, IL-6, IL-1β, TNF-α, HMGB-1, ferritin, and LDH values were higher, and PaO2/FiO2 was lower in Group B than in Group A. ROC analysis showed that there was an association between serum IL-1β (>1015.7), serum IL-6 (>116.7), serum IL-8 (>258.4), serum IL-10 (>247.5), serum TNF-α (>280.7), and serum HMGB-1 (>23.5) and mortality. AKI gave rise to a greater risk of mortality (odds ratio: 7.081, p = 0.014). Mortality was associated with serum IL-10, IL-8, IL-6, IL-1β, TNF-α, and HMGB-1 but not with GCS, APACHE II, SOFA, or Charlson comorbidity index scores. AKI increased the risk of mortality by seven times. Our findings suggest that cytokine levels (serum IL-10, IL-8, IL-6, IL-1β, TNF-α, and HMGB-1) were predictors of mortality in COVID-19 infection. In addition, our results might give an opinion about the course of COVID-19 infection.
Optimizing Large-Scale COVID-19 Nucleic Acid Testing with a Dynamic Testing Site Deployment Strategy
Authors: He Xiaozhou , Luo Li , Tang Xuefeng , Wang Qingyi
Published: January 2023

The COVID-19 epidemic has spread worldwide, infected more than 0.6 billion people, and led to about 6 million deaths. Conducting large-scale COVID-19 nucleic acid testing is an effective measure to cut off the transmission chain of the COVID-19 epidemic, but it calls for deploying numerous nucleic acid testing sites effectively. In this study, we aim to optimize the large-scale nucleic acid testing with a dynamic testing site deployment strategy, and we propose a multiperiod location-allocation model, which explicitly considers the spatial–temporal distribution of the testing population and the time-varied availability of various testing resources. Several comparison models, which implement static site deployment strategies, are also developed to show the benefits of our proposed model. The effectiveness and benefits of our model are verified with a real-world case study on the Chenghua district of Chengdu, China, which indicates that the optimal total cost of the dynamic site deployment strategy can be 15% less than that of a real plan implemented in practice and about 2% less than those of the other comparison strategies. Moreover, we conduct sensitivity analysis to obtain managerial insights and suggestions for better testing site deployment in field practices. This study highlights the importance of dynamically deploying testing sites based on the target population’s spatial–temporal distribution, which can help reduce the testing cost and increase the robustness of producing feasible plans with limited medical resources.
Body Image Assessment Tools in Pregnant Women: A Systematic Review
Authors: Salzer Eduardo Borba , Meireles Juliana Fernandes Filgueiras , Toledo Alesandra Freitas Ângelo , de Siqueira Marcela Rodrigues , Ferreira Maria Elisa Caputo , Neves Clara Mockdece
Published: January 2023

Pregnancy is a remarkable time and generates several changes in women in a short period. Body image is understood as the mental representation of the body itself, and, although bodily changes are considered healthy, they can impact pregnant women’s body image. Problems related to body image during pregnancy can affect the health of the mother and fetus; thus, it is essential for health professionals to detect potential disorders as soon as possible. The objective of this systematic review was to identify instruments for assessing body image in pregnant women, highlighting their main characteristics. To this end, we applied the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses to searches in the EMBASE, PubMed, and American Psychological Association databases from 5 January to 10 August 2021. We included studies on adult pregnant women without comorbidities in the validation and adaptation of (sub)scales that analyze components of body image. We excluded studies that considered nonpregnant, adolescent, postpartum, and/or clinical populations, as well as smoking/drug use studies that were not validation studies or did not assess any aspect of body image. We investigated the quality of the studies using the Quality Assessment Tool for Studies with Diverse Designs. In all, we examined 13 studies. The results point to a growing concern over body image during pregnancy, as there has been an increase in the number of validation and adaptation studies involving scales for different cultures that scrutinize different constructs. The findings suggest that the listed instruments be used in future research.
Understanding Protective Factors for Men at Risk of Suicide Using the CHIME Framework: The Primacy of Relational Connectedness
Authors: Boydell Katherine M. , Nicolopoulos Alexandra , Macdonald Diane , Habak Stephanie , Christensen Helen
Published: January 2023

Suicide is a global problem, ranking among the leading causes of death in many countries across the world. Most people who die by suicide are “under the radar”, having never seen a mental health professional or been diagnosed with a mental illness. This article describes the protective factors for men experiencing suicidal thoughts, plans, and/or attempts who are “under the radar”. Using in-depth qualitative interviews, we aimed to understand stakeholder perspectives on the protective factors that influence men’s wellbeing. The pervasiveness of relational connectedness in men’s narratives was identified as a central protective factor. Other key protective factors included meaningful activity, empowerment, and hope. These results have the potential to facilitate the development of focused community initiatives. More generally, the current research offers an example of a qualitative inquiry into men’s wellbeing that focuses on strengths and positive factors in their lives and may provide a guide for future community-based suicide prevention research.
Trends and Drivers of Unmet Need for Family Planning in Currently Married Tanzanian Women between 1999 and 2016
Authors: Rwabilimbo Abdon Gregory , Ahmed Kedir Y. , Mshokela Jackline Boniphace , Arora Amit , Ogbo Felix Akpojene ,   on behalf of the Global Maternal and Child Health Research Collaboration (GloMACH)
Published: January 2023

The current study investigated the trends and factors associated with the unmet need for family planning (FP) for limiting and spacing births among married Tanzanian women between 1999 and 2016. The study used Tanzania Demographic and Health Survey (TDHS) data for the years 1999 (N = 2653), 2004–2005 (N = 2950), 2010 (N = 6412), and 2015–2016 (N = 8210). Trends in the unmet need for FP were estimated over the study period. Multivariable multinomial logistic regression models were used to investigate the association between community-level, predisposing, enabling, and need factors with the unmet need for FP in Tanzania. The results showed no significant change in percentage of married women with an unmet need for birth spacing between 1999 and 2016. The proportion of married women with an unmet need for limiting births decreased from 9.5% (95% confidence interval (CI): 7.9%, 10.6%) in 1999 to 6.6% (95% CI: 5.9%, 7.3%) in 2016. Residing in a rural area, parity between 1–4 and 5+, visiting a health facility for any health services within twelve months, and planning to have more children (after two years and/or undecided) were factors positively associated with the unmet need for FP-spacing. Women with parity of 5+ were more likely to experience an unmet need for FP-limiting. Women’s age between 25–34 and 35–49 years, women’s employment status, watching television, women’s autonomy of not being involved in household decisions, and planning to have more children were factors associated with lower odds of having an unmet need for FP-spacing. Women’s age between 25–34 years, watching television, autonomy, and planning to have more children were factors with lower odds of having an unmet need for FP-limiting. Improving FP uptake among married Tanzanian women can reduce the unmet need for FP. Therefore, reducing unmet needs for FP is attainable if government policies and interventions can target women residing in rural areas and other modifiable risk factors, such as parity, health facility visits, planning to having more children, employment, watching television, and women’s autonomy.
Alterations in Serum Concentration of Soluble CD163 within Five Study Days from ICU Admission Are Associated with In-Hospital Mortality of Septic Patients—A Preliminary Study
Authors: Mierzchała-Pasierb Magdalena , Lipińska-Gediga Małgorzata , Lewandowski Łukasz , Krzystek-Korpacka Małgorzata
Published: January 2023

Background: CD163, a cell membrane surface molecule specifically expressed by macrophages with an anti-inflammatory phenotype, participates in innate immunity. The purpose of the study was to evaluate the clinical utility of sCD163 in septic patients in comparison to other parameters associated with infections, mainly PCT, CRP and IL-18. Methods: Serum samples were obtained from 40 septic patients on the ICU admission day, 3rd and 5th study days. The control group consisted of 30 healthy volunteers from whom the specimen was collected once. An enzyme-linked immunosorbent assay (ELISA) was used to determine the concentrations of sCD163 and IL-18. CRP and PCT records, among others, were provided by the hospital. Results: Septic shock was associated with the highest concentrations of sCD163 and IL-18. Admission values of sCD163 significantly contributed to mortality prediction in septic patients. Conclusions: The concentration of sCD163 determined on the ICU admission day may potentially be utilized in estimation of the odds of death among septic patients.
The Role of Emotion Regulation as a Potential Mediator between Secondary Traumatic Stress, Burnout, and Compassion Satisfaction in Professionals Working in the Forced Migration Field
Authors: Tessitore Francesca , Caffieri Alessia , Parola Anna , Cozzolino Mauro , Margherita Giorgia
Published: January 2023

Background: Professionals working with refugees are vicariously exposed to complex traumatic experiences lived by forced migrants, which can lead to the risk of developing secondary traumatic stress, burnout, and a poor compassion satisfaction. The current study aimed to explore the effects of secondary traumatic stress on burnout and compassion satisfaction in 264 Italian professionals working with refugees and forced migrants. Moreover, it examined the mediating role of emotion regulation between secondary traumatic stress and both burnout and compassion satisfaction. Methods: A structural equation modeling (SEM) was performed to test the hypothesis. Results: The results showed that increased levels of secondary traumatic stress were associated with an increase of burnout both directly and indirectly through the mediation of emotion regulation. Emotion regulation also totally mediated the relationship between secondary traumatic stress and compassion satisfaction. Conclusions: The results suggested that prevention or interventions programs targeting emotion regulation might be important to improve the professional quality of life of operators working with refugees and forced migrants.
Prevalence and Associations of Type 2 Diabetes Risk and Sociodemographic Factors in Saudi Arabia: A Web-Based Cross-Sectional Survey Study
Authors: Bamogaddam Reem F. , Mohzari Yahya , Aldosari Fahad M. , Alrashed Ahmed A. , Almulhim Abdulaziz S. , Kurdi Sawsan , Alohaydib Munirah H. , Alotaibi Ohoud M. , Alotaibi Amani Z. , Alamer Ahmad
Published: January 2023

Type 2 diabetes mellitus (T2DM) is a chronic disease with ever-increasing prevalence worldwide. In our study, we evaluated the prevalence of the risk of developing T2DM in Saudi Arabia and investigated associations between that risk and various sociodemographic characteristics. To those ends, a web-based cross-sectional survey of Saudi nationals without diabetes, all enrolled using snowball sampling, was conducted from January 2021 to January 2022. The risk of developing T2DM was evaluated using a validated risk assessment questionnaire (ARABRISK), and associations of high ARABRISK scores and sociodemographic variables were explored in multivariable logistic regression modeling. Of the 4559 participants, 88.1% were 18 to 39 years old, and 67.2% held a college or university degree. High ARABRISK scores were observed in 7.5% of the sample. Residing in a midsize city versus a large city was associated with a lower ARABRISK risk score (p = 0.007), as were having private instead of governmental insurance (p = 0.005), and being unemployed versus employed (p < 0.001). By contrast, being married (p < 0.001), divorced or widowed (p < 0.001), and/or retired (p < 0.001) were each associated with a higher ARABRISK score. A large representative study is needed to calculate the risk of T2DM among Saudi nationals.
Analysis of Pollution Characteristics and Emissions Reduction Measures in the Main Cotton Area of Xinjiang
Authors: Fang Chunsheng , Li Zhuoqiong , Shi Weihao , Wang Ju
Published: January 2023

With cotton production in Xinjiang increasing annually, the impact on the environment of agricultural waste produced to improve production has been reflected. This study selected Bozhou of Xinjiang, the main cotton producing region in northern Xinjiang, as the research object, and collected hourly concentration data of six pollutants from 2017 to 2021, and analyzed the spatial and temporal distribution characteristics of each pollutant. At the same time, Morlet wavelet analysis was used to further analyze the variation period of PM2.5 (PM particles with aerodynamic diameters less than 2.5 μm) concentration. The Weather Research and Forecasting model coupled with the Community Multiscale Air Quality (WRF-CMAQ) model was used to evaluate the emissions reduction measures for the most polluted month. The results showed that the concentration of particulate matter (PM particles with aerodynamic diameters less than 2.5 μm and 10 μm) decreased from the southern mountains to the north; moreover, the concentrations of CO (carbon monoxide), NO2 (nitrogen dioxide), and SO2 (sulfur dioxide) in the suburbs were higher than those in the urban center. The concentration of O3 (Ozone) was the highest in summer, while the concentrations of other pollutants were high in autumn and winter. Under the time scale of a = 13, 24, PM2.5 had significant periodic fluctuation. The health risk values of PM2.5 and PM10 in this study were within the scope of the United States Environmental Protection Agency (USEPA) criteria, but it is still necessary to keep a close watch on them. In the context of emissions reduction measures, agricultural sources reduced by 20%, residential sources by 40%, industrial sources by 20%, and transportation sources by 20%; no change in the power source remains. Under these conditions, the daily average value of each pollutant met the first level of the national ambient air quality standard. The research results provide a reference for the local government to formulate heavy pollution emissions reduction policies.
Does Digital Capability Promote Sustainable Development of New Ventures? The Dual Impact of Green Knowledge Creation and Green Pressure
Authors: Zhuge Kai , Lin Weiwei , Yuan Yongzhi , He Huitao , Zhang Yong
Published: January 2023

With the environmental problems brought about by the extensive economic development model attracting more and more global attention, sustainable development has become a hot topic in transformation and development of contemporary enterprises. In the context of the digital economy, there is a lack of conclusive evidence regarding whether and how enterprises rely on digital capabilities to improve green efficiency and achieve sustainable development, especially for new ventures. Therefore, based on the knowledge creation spiral theory, this paper examines the relationship between digital capabilities, green knowledge creation, and sustainable development of new ventures. The study tested its hypotheses on a sample of 316 Chinese new ventures. The results showed that digital capabilities can positively affect environmental, economic, and social performance of new ventures and support their sustainable development; green knowledge creation plays a mediating role in the relationship between digital capabilities and sustainable development, and green pressure positively moderates the relationship between green knowledge creation and sustainable development; furthermore, green pressure also moderates the process of digital capabilities influencing sustainable development through green knowledge creation, and that moderated mediation role is significant. According to the bootstrap mediating effect test, both the direct effect and indirect effect are significant. Overall, our research results provide important insights for new ventures to promote sustainable development through digitalization. Therefore, managers should pay more attention to digital construction in the strategic layout of new ventures, and they should advocate the concept of green knowledge so that the goal of sustainable development can be achieved with the drive for digitalization.
Integrated Sustainable Management of Petrochemical Industrial Air Pollution
Authors: Keawboonchu Jutarat , Thepanondh Sarawut , Kultan Vanitchaya , Pinthong Nattaporn , Malakan Wissawa , Robson Mark Gregory
Published: January 2023

The emission inventory, emission factor, and spatial concentration distribution of volatile organic compounds (VOCs) from a petrochemical industry (aromatics plant) were intensively evaluated in this study to elucidate the potential sources of BTX emission and their contribution to ambient concentrations. Five emission groups were quantified through direct measurement and emission models. These data were then used as input for the AERMOD dispersion model for the source apportionment analysis. The source to ambient contribution analysis revealed that a wastewater treatment facility and organic liquid storage tank were major contributors accounting for about 20.6–88.4% and 10.3–75.4% to BTX environmental concentrations, respectively. The highest annual ambient concentrations of benzene (B), toluene (T), and xylenes (X) were predicted as 9.0, 2.8, and 57.9 µg/m3 at the fence line of the plant boundary, respectively. These findings assist policymakers in prioritizing the appropriate control measures to the right source by considering not just the amount released but also their contribution to ambient concentrations. This study suggested that the wastewater treatment unit should be changed to the closed system which will benefit reduction in its emission (45.05%) as well as effectively minimizing ambient VOC concentration by 49.96% compared to its normal operation.
Understanding for Prevention: Qualitative and Quantitative Analyses of Suicide Notes and Forensic Reports
Authors: Mejías-Martín Yolanda , Martí-García Celia , Rodríguez-Mejías Yolanda , Esteban-Burgos Ana Alejandra , Cruz-García Víctor , García-Caro María Paz
Published: January 2023

Suicide risk is associated with vulnerabilities and specific life events. The study’s objective was to explore the relevance of data from forensic documentation on suicide deaths to the design of person-centered preventive strategies. Descriptive and thematic analyses were conducted of forensic observations of 286 deaths by suicide, including some with suicide notes. Key findings included the influence of health-and family-related adverse events, emotional states of loss and sadness, and failures of the health system to detect and act on signs of vulnerability, as confirmed by the suicide notes. Forensic documentation provides useful information to improve the targeting of preventive campaigns.
Effects of Ambient Temperature, Relative Humidity, and Precipitation on Diarrhea Incidence in Surabaya
Authors: Wibawa Bima Sakti Satria , Maharani Aussie Tahta , Andhikaputra Gerry , Putri Marsha Savira Agatha , Iswara Aditya Prana , Sapkota Amir , Sharma Ayushi , Syafei Arie Dipareza , Wang Yu-Chun
Published: January 2023

Background: Diarrhea remains a common infectious disease caused by various risk factors in developing countries. This study investigated the incidence rate and temporal associations between diarrhea and meteorological determinants in five regions of Surabaya, Indonesia. Method: Monthly diarrhea records from local governmental health facilities in Surabaya and monthly means of weather variables, including average temperature, precipitation, and relative humidity from Meteorology, Climatology, and Geophysical Agency were collected from January 2018 to September 2020. The generalized additive model was employed to quantify the time lag association between diarrhea risk and extremely low (5th percentile) and high (95th percentile) monthly weather variations in the north, central, west, south, and east regions of Surabaya (lag of 0–2 months). Result: The average incidence rate for diarrhea was 11.4 per 100,000 during the study period, with a higher incidence during rainy season (November to March) and in East Surabaya. This study showed that the weather condition with the lowest diarrhea risks varied with the region. The diarrhea risks were associated with extremely low and high temperatures, with the highest RR of 5.39 (95% CI 4.61, 6.17) in the east region, with 1 month of lag time following the extreme temperatures. Extremely low relative humidity increased the diarrhea risks in some regions of Surabaya, with the highest risk in the west region at lag 0 (RR = 2.13 (95% CI 1.79, 2.47)). Extremely high precipitation significantly affects the risk of diarrhea in the central region, at 0 months of lag time, with an RR of 3.05 (95% CI 2.09, 4.01). Conclusion: This study identified a high incidence of diarrhea in the rainy season and in the deficient developed regions of Surabaya, providing evidence that weather magnifies the adverse effects of inadequate environmental sanitation. This study suggests the local environmental and health sectors codevelop a weather-based early warning system and improve local sanitation practices as prevention measures in response to increasing risks of infectious diseases.
Inclusion of Cultural and Linguistic Diversity in COVID-19 Public Health Research: Research Design Adaptations to Seek Different Perspectives in Victoria, Australia
Authors: Gibbs Lisa , Thomas Alexander J. , Coelho Alison , Al-Qassas Adil , Block Karen , Meagher Niamh , Eisa Limya , Fletcher-Lartey Stephanie , Ke Tianhui , Kerr Phoebe , Kwong Edwin Jit Leung , MacDougall Colin , Malith Deng , Marinkovic Chavez Katitza , Osborne Deborah , Price David J. , Shearer Freya , Stoove Mark , Young Kathryn , Zhang Yanqin , Gibney Katherine B. , Hellard Margaret
Published: January 2023

Participation of people from culturally and linguistically diverse (CALD) communities in public health research is often limited by challenges with recruitment, retention and second-language data collection. Consequently, people from CALD communities are at risk of their needs being marginalised in public health interventions. This paper presents intrinsic case analyses of two studies which were adapted to increase the cultural competence of research processes. Both cases were part of the Optimise study, a major mixed methods research study in Australia which provided evidence to inform the Victorian state government’s decision-making about COVID-19 public health measures. Case study 1 involved the core Optimise longitudinal cohort study and Case study 2 was the CARE Victorian representative survey, an Optimise sub-study. Both case studies engaged cultural advisors and bilingual staff to adjust the survey measures and research processes to suit target CALD communities. Reflexive processes provided insights into the strengths and weaknesses of the inclusive strategies. Selected survey results are provided, demonstrating variation across CALD communities and in comparison to participants who reported speaking English at home. While in most cases a gradient of disadvantage was evident for CALD communities, some patterns were unexpected. The case studies demonstrate the challenge and value of investing in culturally competent research processes to ensure research guiding policy captures a spectrum of experiences and perspectives.
Can Agricultural Socialized Services Promote the Reduction in Chemical Fertilizer? Analysis Based on the Moderating Effect of Farm Size
Authors: Chen Xiaoxuan , Liu Tongshan
Published: January 2023

On the basis of the data of 855 farmer households in the 2020 China Land Economic Survey, this paper uses an extended regression model to empirically study the impact of agricultural socialized services on the reduction in chemical fertilizer and the moderating effect of farm size in the above impact path. The results show that adoption of agricultural socialized services by farmers can significantly promote reduction in chemical fertilizer. The moderating effect test shows that the farm size is instrumental in strengthening the effect of promoting agricultural socialized services on the reduction in chemical fertilizer. The effect of technology-intensive services on fertilizer reduction was more pronounced than that of labor-intensive services. Agricultural socialized services have a greater effect on the reduction in chemical fertilizer for farmers with a higher degree of part-time employment, but farm size can significantly enhance the fertilizer reduction effect generated by the adoption of agricultural socialized services by farmers with a lower degree of part-time employment. Therefore, we recommend further developing agricultural socialized services, strengthening the supply of agricultural green production services, and playing the role of agricultural socialized services in chemical fertilizer reduction. We also posit that encouraging large-scale farmers to adopt agricultural socialized services would further promote fertilizer reduction.
Oral Health Workforce in Africa: A Scarce Resource
Authors: Gallagher Jennifer E. , Mattos Savage Grazielle C. , Crummey Sarah C. , Sabbah Wael , Varenne Benoit , Makino Yuka
Published: January 2023

The World Health Organization (WHO) African Region (AFR) has 47 countries. The aim of this research was to review the oral health workforce (OHWF) comprising dentists, dental assistants and therapists, and dental prosthetic technicians in the AFR. OHWF data from a survey of all 47 member states were triangulated with the National Health Workforce Accounts and population data. Descriptive analysis of workforce trends and densities per 10,000 population from 2000 to 2019 was performed, and perceived workforce challenges/possible solutions were suggested. Linear regression modelling used the Human Development Index (HDI), years of schooling, dental schools, and levels of urbanization as predictors of dentist density. Despite a growth of 63.6% since 2010, the current workforce density of dentists (per 10,000 population) in the AFR remains very low at 0.44, with marked intra-regional inequity (Seychelles, 4.297; South Sudan 0.003). The stock of dentists just exceeds that of dental assistants/therapists (1:0.91). Workforce density of dentists and the OHWF overall was strongly associated with the HDI and mean years of schooling. The dominant perceived challenge was identified as ‘mal-distribution of the workforce (urban/rural)’ and ‘oral health’ being ‘considered low priority’. Action to ‘strengthen oral health policy’ and provide ‘incentives to work in underserved areas’ were considered important solutions in the region. Whilst utilising workforce skill mix contributes to overall capacity, there is a stark deficit of human resources for oral health in the AFR. There is an urgent need to strengthen policy, health, and education systems to expand the OHWF using innovative workforce models to meet the needs of this region and achieve Universal Health Coverage (UHC).
The Spatio-Temporal Patterns and Driving Forces of Land Use in the Context of Urbanization in China: Evidence from Nanchang City
Authors: Liu Yuxi , Huang Cheng , Zhang Lvshui
Published: January 2023

Land use change has been one of the common problems in the context of urbanization in China. Social economy and land use interact with each other, and it is especially important for human society to adhere to sustainable development, and to deal with the contradictory relationship between the social–economic needs and land use change. The objectives of this study are: (1) Obtain time-series land-use classification data and its spatial distribution in Nanchang City; (2) Identify the characteristics and driving force of spatial–temporal land use changes in Nanchang City from 2000 to 2020; (3) Discuss the relationship between the urban expansion and social economy in Nanchang City. The results show that the spatial distribution of land use in Nanchang City has changed significantly from 2000 to 2020, and the largest area of land-use type in Nanchang City has been cropland. The cropland has continuously declined, and the urban area has increased significantly. A lot of cropland has been transformed into urban areas, and land use degree in Nanchang City has significantly increased. The spatial pattern of land use has greatly changed, and the city spatial pattern has become more aggregated, while the spatial distribution of cropland, forest and grassland has become more fragmented. Moreover, there has been an obvious correlation between social-economic development and the level of land use, and GDP has been the main driver of land use change. The central urban area of Nanchang city has been the main hotspot of land use change.
Behavioral and Psychological Symptoms of Dementia: Prevalence, Symptom Severity, and Caregiver Distress in South-Western Uganda—A Quantitative Cross-Sectional Study
Authors: Kamoga Ronald , Mubangizi Vincent , Owokuhaisa Judith , Muwanguzi Moses , Natakunda Sylivia , Rukundo Godfrey Zari
Published: January 2023

The purpose of the study was to investigate behavioral and psychological symptoms (BPSD) prevalence, severity, and distress experienced by caregivers of people living with dementia (PLWD). A cross-sectional, population-based study was conducted in a rural area in southwestern Uganda. A Neuropsychiatric Inventory Questionnaire (NPI-Q) was used to determine the presence of BPSD as perceived by caregivers of PLWD. We carried out both descriptive and inferential data analysis. A total of 175 caregivers of PLWD were enrolled in this study. Among PLWD, 99% had presented BPSD in the past month. Hallucinations (75%) and dysphoria/depression (81%) were the two BPSD that occurred most frequently. Most participants (70%) stated that PLWD experienced hallucinations of significant severity. Aberrant motor activity was reported by 60% of the participants as the type of BPSD that caused severe distress. There was a high positive correlation (0.82) between the total severity score and total distress scores. Interventions aimed at addressing dysphoria and hallucinations may be essential for the reduction of caregiver distress. These findings point to the need for promoting early screening for BPSDs and the provision of support to caregivers.
All-Cause Standardized Mortality Ratio in Hemodialysis and Peritoneal Dialysis Patients: A Nationwide Population-Based Cohort Study
Authors: Lee Yi-Che , Lin Chi-Wei , Ho Li-Chun , Hung Shih-Yuan , Wang Hao-Kuang , Chang Min-Yu , Liou Hung-Hsiang , Wang Hsi-Hao , Chiou Yuan-Yow , Lin Sheng-Hsiang
Published: January 2023

Patients with end-stage renal disease (ESRD) are at a higher mortality risk compared with the general population. Previous studies have described a relationship between mortality and patients with ESRD, but the data on standardized mortality ratio (SMR) corresponding to different causes of death in patients undergoing hemodialysis (HD) and peritoneal dialysis (PD) are limited. This study was designed as a nationwide population-based retrospective cohort study. Incident dialysis patients between January 2000 and December 2015 in Taiwan were included. Using data acquired from the Taiwan Death Registry, SMR values were calculated and compared with the overall survival. The results showed there were a total of 128,966 patients enrolled, including 117,376 incident HD patients and 11,590 incident PD patients. It was found that 75,297 patients (58.4%) died during the period of 2000–2017. The overall SMR was 5.21. The neoplasms SMR was 2.11; the endocrine, nutritional, metabolic, and immunity disorders SMR was 13.53; the circulatory system SMR was 4.31; the respiratory system SMR was 2.59; the digestive system SMR was 6.1; and the genitourinary system SMR was 27.22. Therefore, more attention should be paid to these diseases in clinical care.