bluuebunny/crossref_metadata_2025 huggingface dataset:
MCAT Mutations Cause Nuclear LHON-like Optic Neuropathy
Authors: Gerber Sylvie , Orssaud Christophe , Kaplan Josseline , Johansson Catrine , Rozet Jean-Michel
Published: April 2021

Pathological variants in the nuclear malonyl-CoA-acyl carrier protein transacylase (MCAT) gene, which encodes a mitochondrial protein involved in fatty-acid biogenesis, have been reported in two siblings from China affected by insidious optic nerve degeneration in childhood, leading to blindness in the first decade of life. After analysing 51 families with negative molecular diagnostic tests, from a cohort of 200 families with hereditary optic neuropathy (HON), we identified two novel MCAT mutations in a female patient who presented with acute, sudden, bilateral, yet asymmetric, central visual loss at the age of 20. This presentation is consistent with a Leber hereditary optic neuropathy (LHON)-like phenotype, whose existence and association with NDUFS2 and DNAJC30 has only recently been described. Our findings reveal a wider phenotypic presentation of MCAT mutations, and a greater genetic heterogeneity of nuclear LHON-like phenotypes. Although MCAT pathological variants are very uncommon, this gene should be investigated in HON patients, irrespective of disease presentation.
Identifying Invasive Weed Species in Alpine Vegetation Communities Based on Spectral Profiles
Authors: Ajamian Chad , Chang Hsing-Chung , Tomkins Kerrie , Farebrother William , Heim Rene , Rahman Shahriar
Published: April 2021

This study examined the use of hyperspectral profiles for identifying three selected weed species in the alpine region of New South Wales, Australia. The targeted weeds included Orange Hawkweed, Mouse-ear Hawkweed and Ox-eye daisy, which have caused a great concern to regional biodiversity and health of the environment in Kosciuszko National Park. Field surveys using a spectroradiometer were undertaken to measure the hyperspectral profiles of leaves and flowers of the selected weeds and companion native plants. Random Forest (RF) classification was then applied to distinguish which spectral bands would differentiate the weeds from the native plants. Our results showed that an accuracy of 95% was achieved if the spectral profiles of the distinct flowers of the weeds were considered, and an accuracy of 80% was achieved if only the profiles of the leaves were considered. Emulation of the spectral profiles of two multispectral sensors (Sentinel-2 and Parrot Sequoia) was then conducted to investigate whether classification accuracy could potentially be achieved using wider spectral bands.
The Shape of Fluvial Gravels: Insights from Fiji’s Sabeto River
Authors: Gale S. J.
Published: April 2021

This project aims to re-assess our understanding of the shape of fluvial bedload gravels by drawing together existing information on fluvial gravel shape. At its crux, however, is the interpretation of a large, high-quality set of measurements made on bedload gravels from the Sabeto River of western Viti Levu, Fiji. This work reveals that the apparent simplicity displayed by most studies of downstream rounding disguises a complex pattern of stepwise reversals to an angular state, the result of the splitting of cobble- and boulder-sized particles. Particle sphericity changes rapidly during the initial stages of transport. Along the Sabeto, this seems to be the result of attrition, with breakage generating the low and continuing presence of low sphericity particles in the system. Elsewhere, however, sphericity is a consequence of shape sorting and we speculate that rivers globally exist along a sorting–attrition continuum. The form of fluvial gravels is not what would be expected were sorting the dominant control on gravel form. Instead measurements of form display a complex relationship with roundness (and thus with breakage and abrasion). Fluvial gravels appear to evolve to a distinctive shape that may offer a means of distinguishing the products of riverine deposition.
The Tetrapod Fossil Record from the Uppermost Maastrichtian of the Ibero-Armorican Island: An Integrative Review Based on the Outcrops of the Western Tremp Syncline (Aragón, Huesca Province, NE Spain)
Authors: Pérez-Pueyo Manuel , Cruzado-Caballero Penélope , Moreno-Azanza Miguel , Vila Bernat , Castanera Diego , Gasca José Manuel , Puértolas-Pascual Eduardo , Bádenas Beatriz , Canudo José Ignacio
Published: April 2021

The South-Pyrenean Basin (northeastern Spain) has yielded a rich and diverse record of Upper Cretaceous (uppermost Campanian−uppermost Maastrichtian) vertebrate fossils, including the remains of some of the last European dinosaurs prior to the Cretaceous-Paleogene (K-Pg) extinction event. In this work, we update and characterize the vertebrate fossil record of the Arén Sandstone and Tremp formations in the Western Tremp Syncline, which is located in the Aragonese area of the Southern Pyrenees. The transitional and continental successions of these sedimentary units are dated to the late Maastrichtian, and exploration of their outcrops has led to the discovery of numerous fossil remains (bones, eggshells, and tracks) of dinosaurs, including hadrosauroids, sauropods, and theropods, along with other tetrapods such as crocodylomorphs, testudines, pterosaurs, squamates, and amphibians. In particular, this fossil record contains some of the youngest lambeosaurine hadrosaurids (Arenysaurus and Blasisaurus) and Mesozoic crocodylomorphs (Arenysuchus and Agaresuchus subjuniperus) in Europe, complementing the lower Maastrichtian fossil sites of the Eastern Tremp Syncline. In addition, faunal comparison with the fossil record of Hațeg island reveals the great change in the dinosaur assemblages resulting from the arrival of lambeosaurine hadrosaurids on the Ibero-Armorican island, whereas those on Haţeg remained stable. In the light of its paleontological richness, its stratigraphic continuity, and its calibration within the last few hundred thousand years of the Cretaceous, the Western Tremp Syncline is one of the best places in Europe to study the latest vertebrate assemblages of the European Archipelago before the end-Cretaceous mass extinction.
The Role of Iron Carbide in the Abyssal Formation of Hydrocarbons in the Upper Mantle
Authors: Serovaiskii Aleksandr , Kutcherov Vladimir
Published: April 2021

The existence of iron carbide in the upper mantle allows an assumption to be made about its possible involvement in the abyssal abiogenic synthesis of hydrocarbons as a carbon donor. Interacting with hydrogen donors of the mantle, iron carbide can form hydrocarbon fluid. In order to investigate the role of iron carbide in the abiogenic synthesis of hydrocarbons, the chemical reaction between cementite Fe3C and water was modeled under thermobaric conditions, corresponding to the upper mantle. A series of experiments were conducted using a high-pressure high-temperature Toroid-type large reactive volume unit with further analysis by means of gas chromatography. The results demonstrated the formation of hydrocarbon fluid in a wide range of thermobaric conditions (873–1223 K, 2.5–6.0 GPa) corresponding to the upper mantle. A strong correlation between the composition of the fluid and the pT conditions of the synthesis was illustrated in the investigation. The higher temperature of the synthesis resulted in the formation of a “poor” hydrocarbon mixture, primarily comprising methane, while a higher pressure yielded the opposite effect, converting iron carbide into a complex hydrocarbon system, containing normal and iso-alkanes up to C7 and benzene. This correlation explains the diversity of hydrocarbon systems produced experimentally, thus expanding the thermobaric range of the possible existence of complex hydrocarbon systems in the upper mantle. The results support the suggestion that the carbide—water reaction can be a source of both the carbon and hydrogen required for the abyssal abiogenic synthesis of hydrocarbons.
Aquatic Exercise Positively Affects Physiological Frailty among Postmenopausal Women: A Randomized Controlled Clinical Trial
Authors: Kim Ji-Hyeon , Ha Min-Seong , Ha Soo-Min , Kim Do-Yeon
Published: April 2021

Frailty is a risk factor associated with aging. Physical exercise is an important lifestyle factor that can help to avoid risks associated with aging. Therefore, we aimed to determine the effects of aquatic exercise for 12 weeks on body composition, cardiovascular disease risk factors, insulin resistance, and aging-related sex hormones in elderly South Korean women. Twenty-two women aged 70–82 years were randomly assigned to groups that participated or did not participate (controls; n = 10 in aquatic exercise for 60 min, three times per week for 12 weeks (n = 12). Exercise intensity defined as the rating of perceived exertion (RPE), was increased from 12–13 to 13–14, and to 14–15 during weeks 1–4, 5–8, and 9–12, respectively. Body composition (skeletal muscle mass, ratio (%) body fat, and waist circumference), cardiovascular disease risk factors (total, high-density lipoprotein, and low-density lipoprotein cholesterol), insulin resistance (glucose, insulin, and homeostatic model assessment of insulin resistance [HOMA-IR]), and aging-related sex hormone changes (dehydroepiandrosterone-sulfate [DHEA-S]) and sex hormone-binding globulin [SHBG]) were assessed. Aquatic exercise safely improved body composition, reduced insulin resistance, and positively affected the sex hormones DHEA-S and SHBG as well as blood lipid profiles. Our findings suggested that the aquatic exercise program positively altered blood lipids, regulated glucose levels, and sex hormone levels. Therefore, regular, and continuous aquatic exercise is recommended to prevent frailty, decrease cardiovascular risk, and provide older women with an optimal quality of life as they age.
Needs Assessment for Interprofessional Education: Implications for Integration and Readiness for Practice
Authors: Almalki Abdulraheem , Park Yoon Soo , Tekian Ara
Published: April 2021

Interprofessional education (IPE) is an important concept to promote health professionals for interprofessional collaboration. Successful implementation of IPE in health education programs requires consideration of readiness and effectiveness and faces some challenges/barriers. The aim of this study was to examine the perception, understanding and attitude of health profession students and faculty members toward IPE. A cross-sectional study was conducted with students and faculty members from six health professions at Taif University. The study involved administration of the Readiness for Inter-Professional Learning Scale (RIPLS) questionnaire to all students. In addition, focus groups were conducted separately with both students and faculty members. The study showed that only 10 participants (four students, six faculty members) indicated their previous knowledge of IPE. IPE remains a new approach for the majority of students and faculty members. There was no significant difference in the readiness of IPE between professions. Students and faculty members showed positive attitudes toward the IPE curriculum and they believe that it will improve medical education at our university.
Environmental Cadmium Exposure and Dental Indices in Orthodontic Patients
Authors: Chen Hui-Ling , Fang Jason Chen-Chieh , Chang Chia-Jung , Wu Ti-Feng , Wang I-Kuan , Fu Jen-Fen , Huang Ya-Ching , Yen Ju-Shao , Weng Cheng-Hao , Yen Tzung-Hai
Published: April 2021

Background. Previous studies have shown that environmental cadmium exposure could disrupt salivary gland function and is associated with dental caries and reduced bone density. Therefore, this cross-sectional study attempted to determine whether tooth decay with tooth loss following cadmium exposure is associated with some dental or skeletal traits such as malocclusions, sagittal skeletal pattern, and tooth decay. Methods. Between August 2019 and June 2020, 60 orthodontic patients with no history of previous orthodontics, functional appliances, or surgical treatment were examined. The patients were stratified into two groups according to their urine cadmium concentrations: high (>1.06 µg/g creatinine, n = 28) or low (<1.06 µg/g creatinine, n = 32). Results. The patients were 25.07 ± 4.33 years old, and most were female (female/male: 51/9 or 85%). The skeletal relationship was mainly Class I (48.3%), followed by Class II (35.0%) and Class III (16.7%). Class I molar relationships were found in 46.7% of these patients, Class II molar relationships were found in 15%, and Class III molar relationships were found in 38.3%. The mean decayed, missing, and filled surface (DMFS) score was 8.05 ± 5.54, including 2.03 ± 3.11 for the decayed index, 0.58 ± 1.17 for the missing index, and 5.52 ± 3.92 for the filled index. The mean index of complexity outcome and need (ICON) score was 53.35 ± 9.01. The facial patterns of these patients were within the average low margin (26.65 ± 5.53 for Frankfort–mandibular plane angle (FMA)). There were no significant differences in the above-mentioned dental indices between patients with high urine cadmium concentrations and those with low urine cadmium concentrations. Patients were further stratified into low (<27, n = 34), average (27–34, n = 23), and high (>34, n = 3) FMA groups. There were no statistically significant differences in the urine cadmium concentration among the three groups. Nevertheless, a marginally significant p-value of 0.05 for urine cadmium concentration was noted between patients with low FMA and patients with high FMA. Conclusion. This analysis found no association between environmental cadmium exposure and dental indices in our orthodontic patients.
Sentimental Analysis of COVID-19 Tweets Using Deep Learning Models
Authors: Chintalapudi Nalini , Battineni Gopi , Amenta Francesco
Published: April 2021

The novel coronavirus disease (COVID-19) is an ongoing pandemic with large global attention. However, spreading false news on social media sites like Twitter is creating unnecessary anxiety towards this disease. The motto behind this study is to analyses tweets by Indian netizens during the COVID-19 lockdown. The data included tweets collected on the dates between 23 March 2020 and 15 July 2020 and the text has been labelled as fear, sad, anger, and joy. Data analysis was conducted by Bidirectional Encoder Representations from Transformers (BERT) model, which is a new deep-learning model for text analysis and performance and was compared with three other models such as logistic regression (LR), support vector machines (SVM), and long-short term memory (LSTM). Accuracy for every sentiment was separately calculated. The BERT model produced 89% accuracy and the other three models produced 75%, 74.75%, and 65%, respectively. Each sentiment classification has accuracy ranging from 75.88–87.33% with a median accuracy of 79.34%, which is a relatively considerable value in text mining algorithms. Our findings present the high prevalence of keywords and associated terms among Indian tweets during COVID-19. Further, this work clarifies public opinion on pandemics and lead public health authorities for a better society.
Erratum: Eli, B., et al. Depression in Children and Adolescents on the Qinghai-Tibet Plateau: Associations with Resilience and Prosocial Behavior. Int. J. Environ. Res. Public Health 2021, 18, 440
Authors: Eli Buzohre , Zhou Yueyue , Liang Yiming , Cheng Jin , Wang Jiazhou , Huang Changbing , Xuan Xi , Liu Zhengkui
Published: April 2021

There was a small mistake in the sixth paragraph of the Discussion: the positions of two words (“positively” and “negatively”) should be exchanged [...]
Obesity, Mediterranean Diet, and Public Health: A Vision of Obesity in the Mediterranean Context from a Sociocultural Perspective
Authors: Medina Francesc Xavier , Solé-Sedeno Josep M. , Bach-Faig Anna , Aguilar-Martínez Alicia
Published: April 2021

Obesity is a disease that straddles medico-nutritional, psychological, and socio-cultural boundaries. There is a clear relationship between lifestyle and obesity, and today the Mediterranean diet in the Mediterranean area may represent an interesting corrective asset. However, we should not be under any misapprehension about the model’s capacity for action in non-nutritional terms. Our societies are experiencing a process of rapid change, and the Mediterranean area is no exception. The aim of this article is to present a view of obesity in the Mediterranean context from an open, mainly socio-cultural perspective, but from different points of view (medical, nutritional), seeking points of convergence and elements that contribute to the understanding of and approach to the disease in the context of the Mediterranean diet. As a public health and a multidimensional social problem, obesity must be dealt with in a holistic, open, and cross-disciplinary manner to ensure that it can be understood coherently. The only way to keep the usefulness of the Mediterranean diet within desirable limits will be our societies’ vitality and interest in rapidly adapting the Mediterranean diet to social change, thus providing valid answers to today’s needs.
Drivers’ Attention Strategies before Eyes-off-Road in Different Traffic Scenarios: Adaptation and Anticipation
Authors: Liu Zhuofan , Yuan Wei , Ma Yong
Published: April 2021

The distribution of drivers’ visual attention prior to diverting focus from the driving task is critical for safety. The object of this study is to investigate drivers’ attention strategy before they occlude their vision for different durations under different driving scenarios. A total of 3 (scenarios) × 3 (durations) within-subjects design was applied. Twenty-three participants completed three durations of occlusion (0, 1, and 2 s) test drive in a motion-based driving simulator under three scenarios (urban, rural, motorway). Drivers’ occlusion behaviour, driving behaviour, and visual behaviour in 6 s before occlusion was analyzed and compared. The results showed that drivers tended to slow down and increased their attention on driving task to keep safety in occlusion 2 s condition. The distribution of attention differed among different driving scenarios and occlusion durations. More attention was directed to Forward position and Speedometer in occlusion conditions, and a strong shift in attention from Forward position to Road users and Speedometer was found in occlusion 2 s condition. Road users was glanced more frequently in urban road with a higher percentage of attention transitions from Forward position to Road users. While gaze switching to Speedometer with a higher intensity was found on motorway. It suggests that drivers could adapt their visual attention to driving demand and anticipate the development of upcoming situations by sampling enough driving-related information before eyes-off-road. Moreover, the adaptation and anticipation are in accordance with driving situation and expected eyes-off-road duration. Better knowledge about attentional strategies before attention away from road contributes to more efficient and safe interaction with additional tasks.
Physical Activity and Resilience among College Students: The Mediating Effects of Basic Psychological Needs
Authors: Xu Shanshan , Liu Zongyu , Tian Siyu , Ma Zhiyao , Jia Cunxian , Sun Guoxiao
Published: April 2021

Considering the significance of resilience in coping with adversity, how to improve college students’ resilience is worthy of attention. Previous studies have revealed that physical activity can promote resilience; however, few studies examined the mediating factors between them. The purpose of this study was to investigate the effect of physical activity on resilience, as well as the mediating effects of competence need, autonomy need, and relatedness need between physical activity and resilience. The study involved 2375 college students (1110 males and 1265 females), with an average age of 20.25 years (SD = 2.04). Participants completed the International Physical Activity Questionnaire Short Form, Basic Needs Satisfaction in General Scale, and Connor-Davidson Resilience Scale. Results showed that physical activity was positively associated with resilience, and the three basic needs played significant mediating roles between physical activity and resilience. The indirect effect of competence need was significantly greater than that of autonomy need and relatedness need. To conclude, physical activity plays an important role in resilience among college students, and the satisfaction of competence, autonomy, and relatedness needs mediates the relationship between physical activity and resilience, among which, competence need appears as the strongest mediator.
Cumulative Pesticides Exposure of Children and Their Parents Living near Vineyards by Hair Analysis
Authors: Polledri Elisa , Mercadante Rosa , Consonni Dario , Fustinoni Silvia
Published: April 2021

The aim of the present work was the application of hair biomonitoring to investigate exposure to pesticides in children and their parents residing in a vineyard area. Thirty-three children and 16 parents were involved in the study. Hair samples were self-collected before and after the application season (PRE- and POST-EXP samples). Information on study subjects and the use of pesticides in the area were obtained. Thirty-nine pesticides were analyzed by liquid chromatography tandem mass spectrometry, and thirty-one pesticides were quantifiable in at least one hair sample. Most frequently detected pesticides were chlorpyrifos, cycloxidim, dimethomorph, metalaxyl, spiroxamine, and tetraconazole. From PRE-EXP to POST-EXP the percentage of quantification and/or the concentration of pesticides increased; the concentration was typically in the low pg/mg hair range with comparable levels in children and parents. An inverse correlation was found between the total exposure to pesticides in POST-EXP hair samples and the distance between home and the treated fields (Spearman ρ = −0.380, p = 0.01). The results of this study show that the majority of the study pesticides were measured in the hair of subjects living in the close proximity of treated vineyards, supporting the determination of pesticides in hair for the purpose of biomonitoring cumulative exposure in the general population.
The Role of Parent/Caregiver with Children Affected by Rare Diseases: Navigating between Love and Fear
Authors: Gómez-Zúñiga Beni , Pulido Rafael , Pousada Modesta , Armayones Manuel
Published: April 2021

In this paper, we propose a vision of the role of parent/caregiver with children affected by a rare disease. This vision is rooted in data obtained from our own research; however, our analysis and interpretation of this data have been subsequently checked against existing theoretical models. The research aims to explore how parents who look after children with a rare disease experience their role as caregivers and how they assimilate their role identity in this task. Semi-structured interviews were performed with parents of 10 children, and a qualitative data analysis was conducted using grounded theory. We have identified ten main categories using a grounded theory approach: stress, disorientation, insecurity, isolation, faith, trust, attention, communication with professionals, private proactivity and public proactivity. Our results also show that when parents perceive a greater burden due to looking after a child with a rare disease, the result is a change in the usual parental role. In our contribution, we offer a general outline of how parents build a role identity centred on caring for a child with a rare disease. We posit that this role identity is the outcome of the parents’ success or failure in gradually overcoming fear through love. We have conceptualized this process as navigating between love and fear.
Pensions and Depressive Symptoms of Older Adults in China: The Mediating Role of Intergenerational Support
Authors: He Hui , Xu Ling , Fields Noelle
Published: April 2021

This study aimed to investigate the relations between pensions and depressive symptoms of Chinese older people, and whether intergenerational support mediated such association. Secondary data was drawn from Chinese Longitudinal Aging Social Survey (CLASS) 2014 (N = 6687). Depressive symptoms were measured by 12-item version of the Centre for Epidemiological Studies Depression scale (CES-D). Intergenerational support was measured by financial, instrumental, and emotional support. About 80.1% of the participants had pension and the mean score of depressive symptoms of the participants was 17.10 (SD = 4.35) with a range from 12 to 36. The results from hierarchical linear regression revealed that there was significantly association between pensions and lower levels of depressive symptoms (B = −0.645, p < 0.000). Findings of mediation analyses also indicated that financial support from adult children played a mediating role between pensions and depressive symptoms (B = −0.039, 95% CI [−0.064, −0.018], z = −3.082, p = 0.002). Findings from this study enrich our theoretical and practical understanding of the roles of intergenerational support, and offer implications for social insurance policy, social work, and family support interventions for Chinese older adults.
SARS-CoV-2 and the Risk Assessment Document in Italian Work; Specific or Generic Risk Even If Aggravated?
Authors: Cirrincione Luigi , Rapisarda Venerando , Mazzucco Walter , Provenzano Rosanna , Cannizzaro Emanuele
Published: April 2021

In December 2019, several cases of atypical pneumonia were detected in Wuhan city, Hubei province, inland China. The initial outbreak was of considerable size first in China subsequently spread to the rest of the world. Immediately after the epidemic (which according to the World Health Organization had risen to pandemic status), the problem of whether or not to update the occupational risk assessment arose, also considering how the biological risk from SARS CoV-2 should be understood: specific or generic. To this end, we conducted a literature review to identify national health legislation and policies, examining how Italy has addressed the COVID-19 emergency in occupational health planning, in order to develop considerations on the need to update the Risk Assessment Document following the pandemic status. The data that emerged from the review of current legislation allowed us to conclude that the risk from SARS-CoV-2 is in most work activities to be understood as a generic or aggravated generic risk, requiring the employer to apply and control the preventive measures suggested by health authorities to contain the spread of the virus.
Psychological Responses According to Gender during the Early Stage of COVID-19 in Spain
Authors: del Río-Casanova Lucía , Sánchez-Martín Milagrosa , García-Dantas Ana , González-Vázquez Anabel , Justo Ania
Published: April 2021

Background: Current research has pointed out an increased risk of mental health problems during the COVID-19 pandemic in women compared to men, however the reason for this difference remains unclear. The aim of this research is to study early psychological responses to the pandemic in the Spanish general population, focusing on gender differences. Methods: Nine to 14 days after the declaration of a state of emergency an online survey was conducted assessing sociodemographic, health, behavioral and COVID-19-related variables. Mental health status was evaluated by the Depression, Anxiety and Stress Scale (DASS-21), the Impact of Event Scale-Revised (IES-R), and the Self-Care Scale (SCS). Results: The study included 3520 respondents: 2611 women and 909 men. Women scored significantly higher in DASS-21 and IES-R (p < 0.05) and were more likely to somatize, suffer from hypochondriasis, sleeping disturbances and claustrophobia (p < 0.05). Being a woman can be considered a risk factor for intrusive thoughts, avoidance mechanisms, stress and anxiety (Odd Ratio = 2.7/2.3/2.3/1.6). The risk of presenting posttraumatic symptoms and emotional distress was greater in women (Odd Ratio = 6.77/4.59). General linear models to predict IES-R and DASS-21 scores clarified which variables were gender specific, such as main concerns. Conclusions: This study provides evidence that at early stages of the pandemic, women mental health was more impacted and that both genders show different concerns. Gender perspective in secondary and tertiary prevention strategies must be taken into account when facing the distress associated with the pandemic.
Female Genital Mutilation/Cutting among Somali Women in the U.S. State of Arizona: Evidence of Treatment Access, Health Service Use and Care Experiences
Authors: Michlig Georgia , Warren Nicole , Berhe Merry , Johnson-Agbakwu Crista
Published: April 2021

Background. Female genital mutilation/cutting (FGM/C) is associated with adverse sexual, reproductive and psychological sequelae. The aim of this study was to quantitatively explore factors related to satisfaction with FGM/C-related care in the US focusing on access to care, health service utilization, and women’s experiences. Methods. A community-based survey of 879 Ethnic Somali and Somali Bantu women using snowball sampling was conducted in Arizona. Bivariate, multivariable and ordered logistics analyses assessed the relationship between the aforementioned factors measured along six dimensions: non-discrimination, physical, economic, informational, health system accessibility and individual-level health service use factors. Findings. Most participants possessed FGM/C (77.4%), namely Type III (40.2%). FGM/C related health service use was low (14.3%). Perceived discrimination was associated with reduced satisfaction in care (OR = 0.22; CI 0.13–0.37). For FGM/C-specific variables, only recollection of adverse physical or psychological events at the time of circumcision predicted service use (OR = 3.09; CI 1.67–5.68). Somali Bantu (OR = 0.10; CI 0.02–0.44) and highly acculturated women (OR = 0.39; CI 0.17–0.86) had lower odds of service use. Conclusions. Achieving respectful care and outreach to women affected by FGM/C has contextual complexity. However, the clinical implications and insights provided may have broader impacts on advancing health equity for FGM/C-affected women.
A Wearable Sensor-Based Platform for Surgeon Posture Monitoring: A Tool to Prevent Musculoskeletal Disorders
Authors: Carbonaro Nicola , Mascherini Gabriele , Bartolini Ilenia , Ringressi Maria Novella , Taddei Antonio , Tognetti Alessandro , Vanello Nicola
Published: April 2021

Surgeons are workers that are particularly prone to the development of musculoskeletal disorders. Recent advances in surgical interventions, such as laparoscopic procedures, have caused a worsening of the scenario, given the harmful static postures that have to be kept for long periods. In this paper, we present a sensor-based platform specifically aimed at monitoring the posture during actual surgical operations. The proposed system adopts a limited number of Inertial Measurement Units (IMUs) to obtain information about spine and neck angles across time. Such a system merges the reliability of sensor-based approaches and the validity of state-of-the-art scoring procedure, such as RULA. Specifically, three IMUs are used to estimate the flexion, lateral bending, and twisting angles of spine and neck. An ergonomic risk index is thus estimated in a time varying fashion borrowing relevant features from the RULA scoring system. The detailed functioning of the proposed systems is introduced, and the assessment results related to a real surgical procedure, consisting of a laparoscopy and mini-laparotomy sections, are shown and discussed. In the exemplary case study introduced, the surgeon kept a high score, indicating the need for an intervention on the working procedures, for a large time fraction. The system allows separately analyzing the contribution of spine and neck, also specifying the angle configuration. It is shown how the proposed approach can provide further information, as related to dynamical analysis, which could be used to enlarge the features taken into account by currently available approaches for ergonomic risk assessment. The proposed system could be adopted both for training purposes, as well as for alerting surgeons during actual surgical operations.
An Analysis of the Areas Occupied by Vessels in the Ocular Surface of Diabetic Patients: An Application of a Nonparametric Tilted Additive Model
Authors: Boroumand Farzaneh , Shakeri Mohammad Taghi , Banaee Touka , Pourreza Hamidreza , Doosti Hassan
Published: April 2021

(1) Background: As diabetes melllitus (DM) can affect the microvasculature, this study evaluates different clinical parameters and the vascular density of ocular surface microvasculature in diabetic patients. (2) Methods: In this cross-sectional study, red-free conjunctival photographs of diabetic individuals aged 30–60 were taken under defined conditions and analyzed using a Radon transform-based algorithm for vascular segmentation. The Areas Occupied by Vessels (AOV) images of different diameters were calculated. To establish the sum of AOV of different sized vessels. We adopt a novel approach to investigate the association between clinical characteristics as the predictors and AOV as the outcome, that is Tilted Additive Model (TAM). We use a tilted nonparametric regression estimator to estimate the nonlinear effect of predictors on the outcome in the additive setting for the first time. (3) Results: The results show Age (p-value = 0.019) and Mean Arterial Pressure (MAP) have a significant linear effect on AOV (p-value = 0.034). We also find a nonlinear association between Body Mass Index (BMI), daily Urinary Protein Excretion (UPE), Hemoglobin A1C, and Blood Urea Nitrogen (BUN) with AOV. (4) Conclusions: As many predictors do not have a linear relationship with the outcome, we conclude that the TAM will help better elucidate the effect of the different predictors. The highest level of AOV can be seen at Hemoglobin A1C of 9% and AOV increases when the daily UPE exceeds 600 mg. These effects need to be considered in future studies of ocular surface vessels of diabetic patients.
The Impact of Dietary Knowledge on Health: Evidence from the China Health and Nutrition Survey
Authors: Sun Yangyang , Dong Daxin , Ding Yulian
Published: April 2021

Promoting a healthy diet through education is part of the Healthy China 2030 action plan. However, studies examining how dietary knowledge affects public health in China are sparse. This study employs multiple waves of the China Health and Nutrition Survey (CHNS) data to examine the impacts of dietary knowledge on Chinese adults’ health, with a particular emphasis on how the impacts of dietary knowledge vary across different demographic groups. Moreover, we contribute to the literature by incorporating the spouse’s dietary knowledge into the analysis framework to inspect the relationship between a spouse’s dietary knowledge and an individual’s health. Our results indicate that dietary knowledge significantly improves an individual’s health status. However, there is no evidence that an individual’s health is influenced by his/her spouse’s dietary knowledge. Moreover, we find that individuals with a lower level of education and rural residents benefit more from increasing dietary knowledge. Policy implications of this study are also discussed.
Physical and Psychological Factors Contributing to Incidental Falls in Older Adults Who Perceive Themselves as Unhealthy: A Cross-Sectional Study
Authors: Byun Mikyong , Kim Jiyeon , Kim Ji Eun
Published: April 2021

Falls have become one of the common causes of morbidity and mortality in the elderly. Advanced age is a strong predictor of falls. Additionally, those who perceive themselves as unhealthy are more likely to suffer from incidental falls in accordance with aging. We aimed to compare individual, physical, and psychological factors between older adults with and without a fall history. Then, we tried to identify physical and psychological variables associated with falls by controlling for individual characteristics. We analyzed public data from the 2017 National Survey of Older Persons in South Korea. Seniors aged 65 years and over who considered themselves in poor health status were eligible. A total of 2765 women and 1280 men (n = 4045) were enrolled, and 940 adults suffered a fall within a year (the average number of falls was 2.5). We applied individual variable-adjusted models and discovered that hearing discomfort (odds ratio (OR) 1.30, 95% confidence interval (CI) 1.09–1.55), limited activities of daily living (ADL) (OR 1.40, 95% CI 1.13–1.74), limited instrumental activities of daily living (IADL) (OR 1.34, 95% CI 1.13–1.61), and depression (OR 1.44, 95% CI 1.23–1.69) significantly increased risk for falls on multivariate logistic regression. Our findings suggest that hearing discomfort, limited ADL/IADL, and depression need to be addressed observantly to prevent falls in the elderly who consider themselves unhealthy.
Electrophysiological Brain-Cardiac Coupling in Train Drivers during Monotonous Driving
Authors: Lees Ty , Chalmers Taryn , Burton David , Zilberg Eugene , Penzel Thomas , Lal Shail , Lal Sara
Published: April 2021

Electrophysiological research has previously investigated monotony and the cardiac health of drivers independently; however, few studies have explored the association between the two. As such the present study aimed to examine the impact of monotonous train driving (indicated by electroencephalogram (EEG) activity) on an individual’s cardiac health as measured by heart rate variability (HRV). Sixty-three train drivers participated in the present study, and were required to complete a monotonous train driver simulator task. During this task, a 32 lead EEG and a three-lead electrocardiogram were recorded from each participant. In the present analysis, the low (LF) and high frequency (HF) HRV parameters were associated with delta (p < 0.05), beta (p = 0.03) and gamma (p < 0.001) frequency EEG variables. Further, total HRV was associated with gamma activity, while sympathovagal balance (i.e., LF:HF ratio) was best associated fronto-temporal delta activity (p = 0.02). HRV and EEG parameters appear to be coupled, with the parameters of the delta and gamma EEG frequency bands potentially being the most important to this coupling. These relationships provide insight into the impact of a monotonous task on the cardiac health of train drivers, and may also be indicative of strategies employed to combat fatigue or engage with the driving task.
Exploring Investment Behavior of Women Entrepreneur: Some Future Directions
Authors: Baig Umair , Hussain Batool Muhammad , Davidaviciene Vida , Meidute-Kavaliauskiene Ieva
Published: April 2021

This study aims to explore the investment behavior of female entrepreneurs as the new competitor in the investment field and to determine the underlying factors that influence their investment attitudes. A qualitative investigation approach was employed for the study that includes 18 in-depth exploratory interviews to ascertain the fundamental determinants of the investment behavior represented by female entrepreneurs, an emergent section in investment. The accumulated data was analyzed through manual coding procedures. The study revealed that female entrepreneurs are not inclined to take risk in their business for investment decisions, they are somewhat conservative and risk averse. This research also asserts that if they spend quality time and get better training about the nuances of different investment tools, so they will also take risks in investment activities. Two big cosmopolitan cities Karachi and Lahore in Pakistan were selected as sample for this study. Research in other countries considering the culture and ethnicity must be conducted to expand the scope of understanding the investment behaviors of female entrepreneurs. This study outcomes would help the investment manager to understand women’s psychology to develop significant portfolio recommendations, service providers to develop consultancy training centers, policy makers to mitigate their risk and maximize their return opportunities. Hence, intending to provide opportunities for gender equalities, this research appears to be the first in Pakistan to adopt the inductive approach in this domain.
Astragalin Inhibits Cigarette Smoke-Induced Pulmonary Thrombosis and Alveolar Inflammation and Disrupts PAR Activation and Oxidative Stress-Responsive MAPK-Signaling
Authors: Kim Yun-Ho , Kang Min-Kyung , Lee Eun-Jung , Kim Dong Yeon , Oh Hyeongjoo , Kim Soo-Il , Oh Su Yeon , Na Woojin , Shim Jae-Hoon , Kang Il-Jun , Kang Young-Hee
Published: April 2021

Epidemiological evidence shows that smoking causes a thrombophilic milieu that may play a role in the pathophysiology of chronic obstructive pulmonary disease (COPD) as well as pulmonary thromboembolism. The increased nicotine level induces a prothrombotic status and abnormal blood coagulation in smokers. Since several anticoagulants increase bleeding risk, alternative therapies need to be identified to protect against thrombosis without affecting hemostasis. Astragalin is a flavonoid present in persimmon leaves and green tea seeds and exhibits diverse activities of antioxidant and anti-inflammation. The current study investigated that astragalin attenuated smoking-induced pulmonary thrombosis and alveolar inflammation. In addition, it was explored that molecular links between thrombosis and inflammation entailed protease-activated receptor (PAR) activation and oxidative stress-responsive mitogen-activated protein kinase (MAPK)-signaling. BALB/c mice were orally administrated with 10–20 mg/kg astragalin and exposed to cigarette smoke for 8 weeks. For the in vitro study, 10 U/mL thrombin was added to alveolar epithelial A549 cells in the presence of 1–20 µM astragalin. The cigarette smoking-induced the expression of PAR-1 and PAR-2 in lung tissues, which was attenuated by the administration of ≥10 mg/kg astragalin. The oral supplementation of ≥10 mg/kg astragalin to cigarette smoke-challenged mice attenuated the protein induction of urokinase plasminogen activator, plasminogen activator inhibitor-1and tissue factor, and instead enhanced the induction of tissue plasminogen activator in lung tissues. The astragalin treatment alleviated cigarette smoke-induced lung emphysema and pulmonary thrombosis. Astragalin caused lymphocytosis and neutrophilia in bronchoalveolar lavage fluid due to cigarette smoke but curtailed infiltration of neutrophils and macrophages in airways. Furthermore, this compound retarded thrombin-induced activation of PAR proteins and expression of inflammatory mediators in alveolar cells. Treating astragalin interrupted PAR proteins-activated reactive oxygen species production and MAPK signaling leading to alveolar inflammation. Accordingly, astragalin may interrupt the smoking-induced oxidative stress–MAPK signaling–inflammation axis via disconnection between alveolar PAR activation and pulmonary thromboembolism.
Marine Collagen Hydrolysates Promote Collagen Synthesis, Viability and Proliferation While Downregulating the Synthesis of Pro-Catabolic Markers in Human Articular Chondrocytes
Authors: Bourdon Bastien , Cassé Frédéric , Gruchy Nicolas , Cambier Pierre , Leclercq Sylvain , Oddoux Sarah , Noël Antoine , Lafont Jérôme E. , Contentin Romain , Galéra Philippe
Published: April 2021

Cartilage is a non-innervated and non-vascularized tissue. It is composed of one main cell type, the chondrocyte, which governs homeostasis within the cartilage tissue, but has low metabolic activity. Articular cartilage undergoes substantial stresses that lead to chondral defects, and inevitably osteoarthritis (OA) due to the low intrinsic repair capacity of cartilage. OA remains an incurable degenerative disease. In this context, several dietary supplements have shown promising results, notably in the relief of OA symptoms. In this study, we investigated the effects of collagen hydrolysates derived from fish skin (Promerim®30 and Promerim®60) and fish cartilage (Promerim®40) on the phenotype and metabolism of human articular chondrocytes (HACs). First, we demonstrated the safety of Promerim® hydrolysates on HACs cultured in monolayers. Then we showed that, Promerim® hydrolysates can increase the HAC viability and proliferation, while decreasing HAC SA-β-galactosidase activity. To evaluate the effect of Promerim® on a more relevant model of culture, HAC were cultured as organoids in the presence of Promerim® hydrolysates with or without IL-1β to mimic an OA environment. In such conditions, Promerim® hydrolysates led to a decrease in the transcript levels of some proteases that play a major role in the development of OA, such as Htra1 and metalloproteinase-1. Promerim® hydrolysates downregulated HtrA1 protein expression. In contrast, the treatment of cartilage organoids with Promerim® hydrolysates increased the neosynthesis of type I collagen (Promerim®30, 40 and 60) and type II collagen isoforms (Promerim®30 and 40), the latter being the major characteristic component of the cartilage extracellular matrix. Altogether, our results demonstrate that the use of Promerim® hydrolysates hold promise as complementary dietary supplements in combination with the current classical treatments or as a preventive therapy to delay the occurrence of OA in humans.
Combinatorial Use of Both Epigenetic and Non-Epigenetic Mechanisms to Efficiently Reactivate HIV Latency
Authors: Hokello Joseph , Sharma Adhikarimayum Lakhikumar , Tyagi Mudit
Published: April 2021

The persistence of latent HIV provirus pools in different resting CD4+ cell subsets remains the greatest obstacle in the current efforts to treat and cure HIV infection. Recent efforts to purge out latently infected memory CD4+ T-cells using latency-reversing agents have failed in clinical trials. This review discusses the epigenetic and non-epigenetic mechanisms of HIV latency control, major limitations of the current approaches of using latency-reversing agents to reactivate HIV latency in resting CD4+ T-cells, and potential solutions to these limitations.