bluuebunny/crossref_metadata_2025 huggingface dataset:
Using a Contemporary Portable Metabolic Gas Exchange System for Assessing Energy Expenditure: A Validity and Reliability Study
Authors: McClung Holly L. , Tharion William J. , Walker Leila A. , Rome Maxwell N. , Hoyt Reed W. , Looney David P.
Published: February 2023

There are several methods available to assess energy expenditure, all associated with inherent pros and cons that must be adequately considered for use in specific environments and populations. A requirement of all methods is that they must be valid and reliable in their capability to accurately measure oxygen consumption (VO2) and carbon dioxide production (VCO2). The purpose of this study was to evaluate the reliability and validity of the mobile CO2/O2 Breath and Respiration Analyzer (COBRA) relative to a criterion system (Parvomedics TrueOne 2400®, PARVO) with additional measurements to compare the COBRA to a portable system (Vyaire Medical, Oxycon Mobile®, OXY). Fourteen volunteers with a mean of 24 years old, body weight of 76 kg, and a VO2peak of 3.8 L∙min−1 performed four repeated trials of progressive exercises. Simultaneous steady-state measurements of VO2, VCO2, and minute ventilation (VE) by the COBRA/PARVO and OXY systems were conducted at rest, while walking (23–36% VO2peak), jogging (49–67% VO2peak), and running (60–76% VO2peak). Data collection was randomized by the order of system tested (COBRA/PARVO and OXY) and was standardized to maintain work intensity (rest to run) progression across study trials and days (two trials/day over two days). Systematic bias was examined to assess the accuracy of the COBRA to PARVO and OXY to PARVO across work intensities. Intra- and inter-unit variability were assessed with interclass correlation coefficients (ICC) and a 95% limit of agreement intervals. The COBRA and PARVO produced similar measures for VO2 (Bias ± SD, 0.01 ± 0.13 L·min−1; 95% LoA, (−0.24, 0.27 L·min−1); R2 = 0.982), VCO2 (0.06 ± 0.13 L·min−1; (−0.19, 0.31 L·min−1); R2 = 0.982), VE (2.07 ± 2.76 L·min−1; (−3.35, 7.49 L·min−1); R2 = 0.991) across work intensities. There was a linear bias across both the COBRA and OXY with increased work intensity. The coefficient of variation for the COBRA ranged from 7 to 9% across measures for VO2, VCO2, and VE. COBRA was reliable across measurements for VO2 (ICC = 0.825; 0.951), VCO2 (ICC = 0.785; 0.876), and VE (ICC = 0.857; 0.945) for intra-unit reliability, respectively. The COBRA is an accurate and reliable mobile system for measuring gas exchange at rest and across a range of work intensities.
Vision Transformers (ViT) for Blanket-Penetrating Sleep Posture Recognition Using a Triple Ultra-Wideband (UWB) Radar System
Authors: Lai Derek Ka-Hei , Yu Zi-Han , Leung Tommy Yau-Nam , Lim Hyo-Jung , Tam Andy Yiu-Chau , So Bryan Pak-Hei , Mao Ye-Jiao , Cheung Daphne Sze Ki , Wong Duo Wai-Chi , Cheung James Chung-Wai
Published: February 2023

Sleep posture has a crucial impact on the incidence and severity of obstructive sleep apnea (OSA). Therefore, the surveillance and recognition of sleep postures could facilitate the assessment of OSA. The existing contact-based systems might interfere with sleeping, while camera-based systems introduce privacy concerns. Radar-based systems might overcome these challenges, especially when individuals are covered with blankets. The aim of this research is to develop a nonobstructive multiple ultra-wideband radar sleep posture recognition system based on machine learning models. We evaluated three single-radar configurations (top, side, and head), three dual-radar configurations (top + side, top + head, and side + head), and one tri-radar configuration (top + side + head), in addition to machine learning models, including CNN-based networks (ResNet50, DenseNet121, and EfficientNetV2) and vision transformer-based networks (traditional vision transformer and Swin Transformer V2). Thirty participants (n = 30) were invited to perform four recumbent postures (supine, left side-lying, right side-lying, and prone). Data from eighteen participants were randomly chosen for model training, another six participants’ data (n = 6) for model validation, and the remaining six participants’ data (n = 6) for model testing. The Swin Transformer with side and head radar configuration achieved the highest prediction accuracy (0.808). Future research may consider the application of the synthetic aperture radar technique.
Morphological and Spectral Features of Ionospheric Structures at E- and F-Region Altitudes over Poker Flat Analyzed Using Modeling and Observations
Authors: Vaggu Pralay Raj , Deshpande Kshitija B. , Datta-Barua Seebany , Bust Gary S. , Hampton Donald L. , Rubio Aurora López , Conroy James P.
Published: February 2023

Electron density irregularities in the ionosphere modify the phase and amplitude of trans-ionospheric radio signals. We aim to characterize the spectral and morphological features of E- and F-region ionospheric irregularities likely to produce these fluctuations or “scintillations”. To characterize them, we use a three-dimensional radio wave propagation model—“Satellite-beacon Ionospheric scintillation Global Model of upper Atmosphere” (SIGMA), along with the scintillation measurements observed by a cluster of six Global Positioning System (GPS) receivers called Scintillation Auroral GPS Array (SAGA) at Poker Flat, AK. An inverse method is used to derive the parameters that describe the irregularities by estimating the best fit of model outputs to GPS observations. We analyze in detail one E-region and two F-region events during geomagnetically active times and determine the E- and F-region irregularity characteristics using two different spectral models as input to SIGMA. Our results from the spectral analysis show that the E-region irregularities are more elongated along the magnetic field lines with rod-shaped structures, while the F-region irregularities have wing-like structures with irregularities extending both along and across the magnetic field lines. We also found that the spectral index of the E-region event is less than the spectral index of the F-region events. Additionally, the spectral slope on the ground at higher frequencies is less than the spectral slope at irregularity height. This study describes distinctive morphological and spectral features of irregularities at E- and F-regions for a handful of cases performed using a full 3D propagation model coupled with GPS observations and inversion.
Microfluidic Chip with Fiber-Tip Sensors for Synchronously Monitoring Concentration and Temperature of Glucose Solutions
Authors: Qu Jian , Liu Yi , Li Yan , Li Jinjian , Meng Songhe
Published: February 2023

Monitoring the properties of fluids in microfluidic chips often requires complex open-space optics technology and expensive equipment. In this work, we introduce dual-parameter optical sensors with fiber tips into the microfluidic chip. Multiple sensors were distributed in each channel of the chip, which enabled the real-time monitoring of the concentration and temperature of the microfluidics. The temperature sensitivity and glucose concentration sensitivity could reach 314 pm/°C and −0.678 dB/(g/L), respectively. The hemispherical probe hardly affected the microfluidic flow field. The integrated technology combined the optical fiber sensor with the microfluidic chip and was low cost with high performance. Therefore, we believe that the proposed microfluidic chip integrated with the optical sensor is beneficial for drug discovery, pathological research and material science investigation. The integrated technology has great application potential for micro total analysis systems (μ-TAS).
Smart Wearable Systems for Health Monitoring
Authors: Deng Zhiyong , Guo Lihao , Chen Ximeng , Wu Weiwei
Published: February 2023

Smart wearable systems for health monitoring are highly desired in personal wisdom medicine and telemedicine. These systems make the detecting, monitoring, and recording of biosignals portable, long-term, and comfortable. The development and optimization of wearable health-monitoring systems have focused on advanced materials and system integration, and the number of high-performance wearable systems has been gradually increasing in recent years. However, there are still many challenges in these fields, such as balancing the trade-off between flexibility/stretchability, sensing performance, and the robustness of systems. For this reason, more evolution is required to promote the development of wearable health-monitoring systems. In this regard, this review summarizes some representative achievements and recent progress of wearable systems for health monitoring. Meanwhile, a strategy overview is presented about selecting materials, integrating systems, and monitoring biosignals. The next generation of wearable systems for accurate, portable, continuous, and long-term health monitoring will offer more opportunities for disease diagnosis and treatment.
An Adaptive Traffic-Flow Management System with a Cooperative Transitional Maneuver for Vehicular Platoons
Authors: Hota Lopamudra , Nayak Biraja Prasad , Sahoo Bibhudatta , Chong Peter H. J. , Kumar Arun
Published: February 2023

Globally, the increases in vehicle numbers, traffic congestion, and road accidents are serious issues. Autonomous vehicles (AVs) traveling in platoons provide innovative solutions for efficient traffic flow management, especially for congestion mitigation, thus reducing accidents. In recent years, platoon-based driving, also known as vehicle platoon, has emerged as an extensive research area. Vehicle platooning reduces travel time and increases road capacity by reducing the safety distance between vehicles. For connected and automated vehicles, cooperative adaptive cruise control (CACC) systems and platoon management systems play a significant role. Platoon vehicles can maintain a closer safety distance due to CACC systems, which are based on vehicle status data obtained through vehicular communications. This paper proposes an adaptive traffic flow and collision avoidance approach for vehicular platoons based on CACC. The proposed approach considers the creation and evolution of platoons to govern the traffic flow during congestion and avoid collisions in uncertain situations. Different obstructing scenarios are identified during travel, and solutions to these challenging situations are proposed. The merge and join maneuvers are performed to help the platoon’s steady movement. The simulation results show a significant improvement in traffic flow due to the mitigation of congestion using platooning, minimizing travel time, and avoiding collisions.
Advances of Imidazolium Ionic Liquids for the Extraction of Phytochemicals from Plants
Authors: Gong Jiahui , Liang Chunyu , Majeed Zahid , Tian Mengfei , Zhao Chunjian , Luo Meng , Li Chunying
Published: February 2023

In this review, we present the research from 2013 to 2022 about the character of ionic liquids, the categories of phytochemicals, and the reasons for selecting imidazolium ionic liquids for phytochemical extraction. Then we introduce the structural formulae of the imidazolium ionic liquids commonly used in the extraction of phytochemicals, the methods used to prepare imidazolium ionic liquids, and a comprehensive introduction of how imidazolium ionic liquids are applied to extract phytochemicals from plants. Importantly, we discuss the strategies for studying the extraction mechanisms of imidazolium ionic liquids to extract phytochemicals, and the recovery methods regarding imidazolium ionic liquids and their recyclability are analyzed. Then the toxicity in imidazolium ionic liquids is pointed out. Finally, the challenges and prospects of extracting phytochemicals by imidazolium ionic liquids are summarized, and they are expected to provide some references for researchers.
Lifestyle Habits in Elementary and High School Education Students: A Systematic Review
Authors: Melguizo-Ibáñez Eduardo , González-Valero Gabriel , Zurita-Ortega Félix , Ubago-Jiménez José Luis , Puertas-Molero Pilar , Alonso-Vargas José Manuel
Published: February 2023

Currently, there is concern about following an active and healthy lifestyle in the adolescent population. This is why the present research aims to conduct a systematic review covering the period 2017–2022 in order to analyse the levels of physical activity and adherence to the Mediterranean diet in the adolescent population. A search of the scientific literature was carried out in the Web of Sciences and Scopus databases during the month of December 2022. The search was carried out in the main collection of the database, limiting the time range to the last five years (2017–2022). The following structure was used to carry out the research search: “Physical Activit*” and “Mediterranean Diet” and “Adolescents”. In conclusion, it has been noted that the practice of any sport shows numerous benefits in anthropometric, respiratory, and physical factors. In addition, increased physical activity time is positively associated with increased adherence to the Mediterranean Diet, which has numerous academic, physical, and psychological health benefits.
Profiling Tourist Segmentation of Heritage Destinations in Emerging Markets: The Case of Tequila Visitors
Authors: Coelho Alfredo , Castillo Girón Victor Manuel
Published: February 2023

The purpose of this paper is to explore the main profiles of tourist segments in the agave-tequila industry in Mexico. The blue agave landscape and the ancient tequila facilities are part of the UNESCO’s World Cultural Heritage. Heritage sites may operate as a brand and generate tourism externalities. Investigations combining heritage and sustainable tourism are a promising research field, still underexplored, particularly in emerging destinations. This study contributes to the debate on heritage and sustainable tourism through the identification of different tourist profiles visiting the Tequila region. The study applies a market segmentation approach grounded in the concept of ‘involvement’. Involvement is a good predictor of tourist behavior. Therefore, our investigation identifies distinctive homogenous segments with different levels of tourist involvement. The data in the empirical study was collected through a questionnaire applied to a sample of 700 domestic and international visitors to the city of Tequila. The questionnaire was directly administered to collect data during a 6-month period in order to avoid seasonal issues. Cluster analysis was performed to identify three distinct segments on the basis of the degree of tourists’ ‘involvement’. Findings suggest that the agave landscape and knowledge about tequila are the most salient attributes for high- and low-involved visitors. As those factors are closely related to cultural heritage, the study provides guidance for policy makers and marketers protecting and/or promoting the agave-tequila industry. This research project is an initial attempt to segment agave-tequila tourists and creates a pathway for further investigations into this area.
Innovative Technology Method Based on Evolutionary Game Model of Enterprise Sustainable Development and CNN–GRU
Authors: Zhang Hongni , Xu Xiangyi
Published: February 2023

Realizing the sustainable innovation growth of enterprises is one of the important research directions of management science. Traditional enterprise growth innovation methods cannot effectively estimate the emotional tendency of online public opinion (PO), and they cannot guide the effective growth of enterprises. For this reason, This paper proposes an enterprise growth innovation technology based on the evolutionary game (EG) model of sustainable development and deep learning (DL). Firstly, by obtaining the game payment matrix between network users and enterprises, combined with the deep neural network model, the PO evolution model of the enterprise growth network was constructed and solved. Then, a convolutional neural network (CNN) model was used to extract sequence features from global information, and a gated recurrent unit (GRU) was used to consider the context. A DL network model based on CNN–GRU was proposed. Finally, by introducing the EG model, a stable strategy was generated through the dynamic adjustment of the whole system, which improved the accuracy of online PO judgment. Through simulation experiments, the enterprise growth innovation method proposed in this paper was compared with the other three methods. The results show that the accuracy, precision, recall, and f1 value of this method are 92.21%, 89.33%, 91.86%, and 91.64%, respectively, which are better than the other three methods. This method is of great significance for promoting enterprise innovation technology and sustainable development of enterprises.
Confinement Potential in a Soft-Wall Holographic Model with a Hydrogen-like Spectrum
Authors: Afonin Sergey , Solomko Timofey
Published: February 2023

It is well known that the soft-wall holographic model for QCD successfully reproduces not only the linear Regge spectrum, but also, via the holographic Wilson confinement criterion, the “linear plus Coulomb” confinement potential, which is similar to the Cornell potential. This property could be interpreted as a holographic counterpart of the hadron string picture, where the linearly rising potential and Regge-like spectrum are directly related. However, such a relation does not exist in the bottom-up holographic approach. Namely, the Cornell-like potentials arise in a broad class of bottom-up holographic models. The standard soft-wall model is merely a particular representative of this class. This fact is relatively unknown, so we provide a comprehensive discussion of the point. As an example, we consider a soft-wall-like model with linear dilaton background in the metric. This model leads to a hydrogen-like spectrum. A “linear plus Coulomb” confinement potential within this model is calculated. The calculation of renormalized potential at short distances turns out to be complicated by a new subtlety that was skipped in general discussions of the issue existing in the literature. However, the confinement potential of the model is shown to be not very different from the potential obtained in the standard soft-wall model with a quadratic background.
A DNA Vaccine Encoding the Full-Length Spike Protein of Beta Variant (B.1.351) Elicited Broader Cross-Reactive Immune Responses against Other SARS-CoV-2 Variants
Authors: Zhao Gan , Zhang Zhiyu , Ding Yuan , Hou Jiawang , Liu Ying , Zhang Mengying , Sui Cheng , Wang Limei , Xu Xin , Gao Xiaoming , Kou Zhihua
Published: February 2023

The SARS-CoV-2 pandemic remains an ongoing threat to global health with emerging variants, especially the Omicron variant and its sub-lineages. Although large-scale vaccination worldwide has delivered outstanding achievements for COVID-19 prevention, a declining effectiveness to a different extent in emerging SARS-CoV-2 variants was observed in the vaccinated population. Vaccines eliciting broader spectrum neutralizing antibodies and cellular immune responses are urgently needed and important. To achieve this goal, rational vaccine design, including antigen modeling, screening and combination, vaccine pipelines, and delivery, are keys to developing a next-generation COVID-19 vaccine. In this study, we designed several DNA constructs based on codon-optimized spike coding regions of several SARS-CoV-2 variants and analyzed their cross-reactive antibodies, including neutralizing antibodies, and cellular immune responses against several VOCs in C57BL/6 mice. The results revealed that different SARS-CoV-2 VOCs induced different cross-reactivity; pBeta, a DNA vaccine encoding the spike protein of the Beta variant, elicited broader cross-reactive neutralizing antibodies against other variants including the Omicron variants BA.1 and BA.4/5. This result demonstrates that the spike antigen from the Beta variant potentially serves as one of the antigens for multivalent vaccine design and development against variants of SARS-CoV-2.
Comparison of triangle flap and comma-shaped flap of clinical results after third molar surgery
Authors: Nguyen Ha Quoc Trung , Nguyen Thi Hoang Yen , Tran Tan Tai
Published: February 2023

Background: The extraction of the mandibular third molar is a common oral surgical procedure. Postoperative complications after third molar surgery such as swelling, pain, and trismus have a considerable influence on the quality of life in patients. Methods to alleviate these complications have been the focus of a lot of studies. Aim: To evaluate the surgical wound and postoperative complications after third molar surgery by comparing two different flaps: triangle flap and comma-shaped flap. Materials and Methods: a clinical trial with a split-mouth design. Thirty healthy patients were subjected to surgical extraction of both impacted mandibular third molars, located in a similar clinical and radiographic position. Two different flaps are used: triangle flap and comma-shaped flap. Result: The parameters of pain, swelling, and trismus in the comma-shaped flap group were greater than in the triangle flap group on postoperative days 1 and 2, with a statistically significant difference (p<0.05). On day 7, no significant interference was found between the 2 groups for all parameters of pain, swelling, and trismus (p>0.05). Conclusion: The comma-shaped flap is better than the triangle flap concerning postoperative pain, swelling, and trismus.
Key words: Lower third molar surgery, split-mouth design, comma-shaped flap, triangle flap
Alterações físico-químicas induzidas por processo germinativo de sementes de milho de pericarpo roxo
Authors: Andressa Irene , Nascimento Glauce Kelly Silva , Dos Santos Tatiane Monteiro , Oliveira Josimar Rodrigues , Benassi Vivian Machado , Schmiele Marcio
Published: February 2023

A germinação é uma técnica factível e de baixo custo capaz de melhorar as características sensoriais, nutricionais e tecnológicas do milho. O presente trabalho teve como objetivo avaliar os parâmetros morfométricos, curva de maceração, vigor das sementes, tamanho de radícula, composição centesimal, compostos fenólicos totais (CFT), parâmetros de cor instrumental (L*, a* e b*) e análise de imagem por microscopia eletrônica de varredura (MEV) do amido nas sementes de milho crioulo de pericarpo roxo oriundas da região de Couto de Magalhães de Minas-MG submetidos ao processo de germinação. As sementes apresentaram 35 % de umidade ao final da maceração, o que está diretamente relacionado aos parâmetros morfométricos e físico-químicos do grão. Além disso, as sementes de milho crioulo de pericarpo roxo apresentaram vigor germinativo satisfatório (89,4 %), considerado similar às sementes comerciais. A germinação promoveu redução do teor proteico e lipídico das amostras germinadas (8,36 ± 0,73 g.100g-1 de proteína e 3,44 ± 0,38 g.100g-1 de lipídios) em relação ao controle (farinha de milho não germinado, 10,29 ± 0,49 g.100g-1 de proteína e 5,27 ± 0,42 g.100g-1 de lipídios). Além disso, houve alterações significativas (p<0,05) dos parâmetros de cor instrumental avaliados da farinha de milho germinada (L*: 81,97±0,36; a*: 3,16±0,15; b*: 18,97±0,15) quando comparada ao controle (L*: 71,26±1,22; a*: 6,15±0,27; b*: 25,50±0,19). No entanto, as amostras de milho germinado apresentaram incremento de 50,83 % dos CFT com relação ao milho não germinado. Nesse sentido, a germinação do milho de pericarpo roxo favoreceu a liberação de compostos fenólicos, apresentando-se uma técnica promissora para agregar valor a um produto regional e com potencial para a elaboração de novos produtos.
Changes in Mangrove Blue Carbon under Elevated Atmospheric CO
2
Authors: Gu Xiaoxuan , Qiao Peiyang , Krauss Ken W. , Lovelock Catherine E. , Adams Janine B. , Chapman Samantha K. , Jennerjahn Tim C. , Lin Qiulian , Chen Luzhen
Published: February 2023

While there is consensus that blue carbon ecosystems, such as mangroves, have an important role in mitigating some aspects of global climate change, little is known about mangrove carbon cycling under elevated atmospheric CO
2
concentrations (
e
CO
2
). Here, we review studies in order to identify pathways for how
e
CO
2
might influence mangrove ecosystem carbon cycling. In general,
e
CO
2
alters plant productivity, species community composition, carbon fluxes, and carbon deposition in ways that enhance mangrove carbon storage with
e
CO
2
. As a result, a negative feedback to climate change exists whereby
e
CO
2
adds to mangrove’s ability to sequester additional carbon, which in turn reduces the rate by which CO
2
builds. Furthermore,
e
CO
2
affects warming and sea-level rise (SLR) through alternate pathways, which coinfluence the mangrove response in both antagonistic (i.e., warming = greater carbon loss to decomposition) and synergistic (i.e., SLR = greater soil carbon burial) ways.
e
CO
2
is projected to become a more prominent driver in the future before reaching a steady state. However, given the complexity of the interactions of biological and environmental factors with
e
CO
2
, long-term field observations and in situ simulation experiments can help to better understand the mechanisms for proper model initialization to predict future changes in mangrove carbon sequestration.
Interfacial Challenges and Strategies toward Practical Sulfide-Based Solid-State Lithium Batteries
Authors: Guo Ruiqi , Zhang Kun , Zhao Wenbin , Hu Zhifan , Li Shuqiang , Zhong Yuxi , Yang Rong , Wang Xinran , Wang Jiantao , Wu Chuan , Bai Ying
Published: February 2023

All-solid-state lithium batteries are considered as the priority candidates for next-generation energy storage devices due to their better safety and higher energy density. As the key part of solid-state batteries, solid-state electrolytes have made certain research progress in recent years. Among the various types of solid-state electrolytes, sulfide electrolytes have received extensive attention because of their high room-temperature ionic conductivity and good moldability. However, sulfide-based solid-state batteries are still in the research stage. This situation is mainly due to the fact that the application of sulfide electrolytes still faces challenges in particular of interfacial issues, mainly including chemical and electrochemical instability, unstable interfacial reaction, and solid–solid physical contact between electrolyte and electrode. Here, this review provides a comprehensive summary of the existing interfacial issues in the fabrication of sulfide-based solid-state batteries. The in-depth mechanism of the interfacial issues and the current research progress of the main coping strategies are discussed in detail. Finally, we also present an outlook on the future development of sulfide-based solid-state batteries to guide the rational design of next-generation high-energy solid-state batteries.
Catastrophic Failure Assessment of Sealed Cabin for Ultra large Manned Spacecraft in M/OD Environment
Authors: Wu Jiangkai , Han Zengyao , Chi Runqiang , Zheng Shigui , Zhang Yong
Published: February 2023

Hypervelocity impacts of Micrometeoroid and Orbital Debris (M/OD) may lead to catastrophic failure of long-term flight manned spacecraft in orbit. Risk assessment for manned spacecraft in M/OD environment is of great significance for the safety of human space missions. For typical catastrophic failure modes of manned spacecraft such as gas-leakage-induced astronaut hypoxia, sealed cabin fracture, and spacecraft breakup, catastrophic failure assessment method using critical perforation diameters and critical crack lengths of sealed cabins and critical fragment size of spacecraft breakup as failure criteria are proposed. In addition, corresponding modules of catastrophic failure assessment were developed and integrated with Meteoroid and Orbital Debris Assessment and Optimization System Tools, providing an effective assessment tool for researching on the safety of manned spacecraft. On the basis of which, catastrophic failure evaluation of sealed cabin for a specific ultralarge manned spacecraft in the M/OD environment was conducted, providing references for on-orbit mission safety evaluation.
Trends in Substance Use and Abuse During COVID-19 Among the General Population
Authors: Shankar Rajashree , Bhattacharya Vandana
Published: February 2023

Background: COVID-19 pandemic has brought many public health issues, including substance use and abuse. Individuals abusing substances are vulnerable to severe infections caused by SARS-CoV-2 virus as well as impairment of the immune system, mental health, and physical health. Despite considerable efforts to minimize and prevent substance use, the use of tobacco, alcohol, and illicit substances is ever increasing resulting in morbidity and mortality which significantly leads to socio-economic costs. Methods: A quantitative review of the literature searched in PubMed and Google Scholar databases yielded a total of 1416 studies among which 27 cross-sectional studies, conducted on the general population of 15 and above years of age, were selected based on the eligibility criteria. Findings: A sample of 1,021,118 individuals were investigated in this study. The most commonly used substances were marijuana (100%), methadone (69.86%), and large cigar (60%). A total of 26 substances were reported to have been used during pandemic, 13 of which showed trends in usage (increased/decreased/no change). Of the total sample, 45.89% were males, 54.14% females, and 1.28% others. Conclusion: Everyone and anyone is susceptible to alcohol, tobacco, and other substance use and abuse at different stages of their lives. Therefore, the need for effective preventive strategies is critical in community efforts to combat substance abuse. Combined efforts from local and global stakeholders will lead to curbing the issue of substance use and abuse worldwide.
Comparison of Psychopathologic Characteristics between Individuals Undergoing Methadone Maintenance Treatment, Opioid Dependents, and Control Group
Authors: Jomehpour Hamid , Pouriran Mohammad Amin , Heydari Yazdi Aazam Sadat , Baghban Haghighi Mehri , Dastgheib Masume Sadat , Omidvar-Tehrani Sahar , Talaei Ali
Published: February 2023

Background: Methadone maintenance treatment (MMT) can theoretically reduce the psychosocial harms of opioid dependency. The increasing number of MMT clinics in Iran during the last two decades was not accompanied by a reduction in addiction rates. Therefore, this study was conducted to compare the psychopathological characteristics of individuals on MMT, opioid dependents, and a control group in the Iranian population. Methods: This cross-sectional study was conducted in Mashhad to evaluate the psychopathological profile of 99 participants (33 opioid-dependent individuals [ODI], 33 MMT clients, and 33 controls) using the Symptom Checklist-90-Revised (SCL-90-R) questionnaire and demographic form. Parametric and non-parametric tests were used to compare the mean score of symptoms between the three groups. The Spearman correlation test was used to test the correlation of psychological features with age and dependency duration. Findings: There was no significant difference between MMT clients and ODI regarding the Global Severity Index (GSI) and nine items of the SCL-90-R questionnaire. However, a significant difference was found between the controls and two other groups (P<0.001). Paranoid ideation in the ODI was more frequent compared to MMT clients significantly (P=0.015). Psychological characteristics had a direct correlation with dependency duration and an inverse correlation with age (P<0.05). Conclusion: Psychopathologic features observed in the dependent patients and MMT clients were significantly higher than in the control group. It seems that the psychopathology profile in MMT clients was not better than dependent individuals in Iran.
Gastric Obstruction by Opium Packets: A Case Report
Authors: Ramazani Yeganeh , Nemati Ahmad , Moshiri Mohammad , Motie Mohammad Reza , Jomehpour Hamid , Etemad Leila
Published: February 2023

Background: We reported a case of gastric obstruction in a body packer who swallowed a large number of opium packets. Case Report: A 36-year-old man opium addict visited the emergency department with epigastric pain for three days. He swallowed nearly 90 packets of opium for smuggling purposes four days earlier. He self-administered laxatives. In contrast, many times vomiting, he defecated only four packets and vomited one packet. The abdominal X-rays showed some amounts of fluid-air levels and multiple cylindrical opacities with the double-condom sign, corresponding to the distended stomach. Due to the worsening of his abdominal symptoms, he underwent an urgent laparotomy and 84 packets (4-6 cm in size and 8-10 g/ packet of opium) with a total weight of 870 g. They were wrapped in some layers of plastic and tied at the ends. He was discharged in stable condition. Conclusion: A large number of ingested drug packets can induce gastrointestinal obstruction.
Evaluating the Relationship Between Structural Determinants of Health and Quality of Sexual Life in Women: A Systematic Review
Authors: Bagherinia Marzieh , Dolatian Mahrokh , Mahmoodi Zoherh , Ozgoli Giti , Alavi Majd Hamid
Published: February 2023

Objectives: Quality of sexual life can be influenced by cultural and social contexts. This study aimed to investigate the relationship between structural determinants of health (such as education, income level, job, culture, and ethnicity) and quality of sexual life in women. Methods: In this systematic review, we searched six databases, including Web of Science, Scopus, ProQuest, PubMed/Medline (NLM), Cochrane, Embase, and Cochrane Central Register of Controlled Trials (CENTRAL) to obtain all the related observational studies (cross-sectional, cohort, and case-control). Results: Nine studies met the inclusion criteria. Based on the Newcastle-Ottawa Scale (NOS), the risk of bias in most of the included studies was fair. According to the results, the relationship between education level and quality of sexual life among women was significant in four studies. Also, in one study, job and income level were significantly correlated with women’s quality of sexual life. Conclusions: Based on the results, structural determinants of health, including education, job, and income level were significantly related with women’s quality of sexual life.
Anti-cancer Effects of Methotrexate in Combination With Melissa officinalis on HeLa Cancer Cell Line
Authors: Faraji Parviz , Araj-Khodaei Mostafa , Jafari Amir , Ghaffari Maryam , Mohammadinasab Reza , Hamedeyazdan Sanaz , de la Guardia Miguel , Ezzati Nazhad Dolatabadi Jafar
Published: February 2023

Objectives: One of the well-accepted beliefs about natural products, considering the advances of recently appearing new edges and features of herbal medicine, is paying more attention to cancer treatments. However, they have not been properly studied with reasonable/reliable clinical trials in human subjects in most cases. Therefore, seeking in vitro effects of herbs like Melissa officinalis (MO) in cancer therapy to identify the involved possible mechanism in conjugation with configurative/morphological aspects of treated cells seems quite necessary. In this study, we evaluated the co-treatment effect of anti-cancer drug methotrexate (MTX) and MO on HeLa cancer cells. Methods: MTT assay was applied to assess the quantitative cytotoxicity effect of both MTX and Mo. Apoptosis assay via flow cytometry was used to determine the amount of apoptotic and necrotic cells. To further investigate the anti-cancer effects, DAPI staining and DNA ladder assays are used qualitatively to detect changes in the nuclei of cells that are a sign of apoptosis occurring and morphological modifications of DNA. Results: MTX and MO mixture showed high cytotoxicity and apoptosis rate compared to untreated cells. Furthermore, the morphological changes of MTX and MO mixture were more evident than that of single MO, MTX, and control groups. Conclusions: These data regarding cell growth reduction and apoptosis induction in HeLa cancer cells showed that MTX and MO mixture can be an appropriate platform for cancer therapy.
Evaluating Walnut-Fig Syrup as an Innovative Herbal Medicine for Functional Constipation in the Elderly: A Randomized Controlled Clinical Trial
Authors: Joudikhajeh Saeed , Sepehri Bita , Mehdizadeh Esfanjani Robab , Rezaeizadeh Hossein , Ranjbar Yunes , Araj-Khodaei Mostafa
Published: February 2023

Objectives: Functional constipation (FC), or chronic idiopathic constipation, is one of the most common chronic disorders with no specific cause. Although FC is not associated with the progress of severe disease or additional mortality, it significantly decreases the patients’ quality of life. While several medications are available to treat constipation, there is no adequate treatment response in most cases. Herbal remedies are one of the most widely used options for FC. Materials and Methods: In this double-blind controlled trial, all patients, researchers, and analysts were unaware of the ingredients contained in the drugs, as well as the assigned groups. We recruited a total of 90 elderly patients diagnosed with FC according to the Rome IV diagnostic criteria for irritable bowel syndrome (IBS). Patients were divided into two equal groups (n=45 in each) receiving fig-walnut syrup and lactulose syrup. Then, CBC-FBS-TSH-CR-NA-K-CA tests were taken from all patients, and the developed syrups (walnut-fig or lactulose) were prescribed to patients (15 cc half an hour before bedtime). Results: While 43 (95.6%) patients responded to treatment in the intervention group, 41 (91.1%) patients responded to treatment in the conventional treatment group. There was no statistically significant difference between the two groups in terms of response to treatment (P = 0.677). Conclusions: The results showed that the oral syrups developed in this study improved FC in the elderly and had no side effects.
Comparing the Effectiveness of Metoclopramide, Low Dose of Propofol, Ondansetron, and Magnesium Sulfate on Propofol Injection Pain: A Double-Blind Clinical Trial
Authors: Biazar Gelareh , Farzi Farnoush , Ghazanfar Tehran Samaneh , Shahrokhi Rad Reyhaneh , Habibi Mohammad Reza , Khosousi Sani Mahsa , Chohdary Amer , Yaghoobi Alireza , Mirmansouri Ladan
Published: February 2023

Objectives: Despite a variety of strategies, propofol injection pain (PIP) is still one of the most distressing adverse effects of the drug. This study aimed to compare the effectiveness of metoclopramide, low dose of propofol, magnesium sulfate, and ondansetron in the prevention of PIP. Materials and Methods: This double-blind clinical trial was conducted at Al-Zahra hospital an academic and referral center affiliated with Guilan University of Medical Sciences, Rasht, Iran. A total of 120 eligible women candidates for elective gynecologic surgeries were divided into four equal groups of magnesium sulfate (30 mg/kg), ondansetron (4 mg), metoclopramide (10 mg), and propofol (15 mg). The primary outcome of this study was to decrease the pain severity of propofol injection. Results: The participants’ demographic characteristics, including age, American Society of Anesthesiologists classification, and body mass index, had no significant differences between the four groups. A significant decrease in heart rate and mean arterial pressure were observed in four groups; however, the difference was insignificant. The mean pain intensity in the magnesium sulfate group was 1.57 ± 0.9, ondansetron 1.37 ± 0.89, metoclopramide 0.95 ± 0.93, and in propofol group was 1.25 ± 1.1 (P=0.036). Conclusions: Metoclopramide could appropriately alleviate PIP. Considering some additional advantages, including antiemetic properties, preventing esophageal reflux, and less risk of postoperative ileus, this drug could be a safe and acceptable choice.
Evidence-Informed Deliberative Processes for UHC: Progress, Potential and Prudence Comment on "Evidence-Informed Deliberative Processes for Health Benefit Package Design – Part II: A Practical Guide"
Authors: Gopinathan Unni
Published: February 2023

In their recent article on evidence-informed deliberative processes (EDPs) for health benefit package decisions, Oortwijn et al examine how the different steps of EDP play out in eight countries with relatively mature institutions for using health technology assessment (HTA). This commentary examines how EDP addresses stakeholder involvement in decision-making for equitable progress towards universal health coverage (UHC). It focuses on the value of inclusiveness, the need to pay attention to trade-offs between desirable features of EDP and the need to broaden the scope of processes examined beyond those specifically tied to producing and using HTAs . It concludes that EDPs have contributed to significant progress for health benefit design decisions worldwide and holds much potential in further application. At the same time, this commentary calls for prudence: investments in EDPs should be efficiently deployed to enhance the pre-existing legislative, institutional and political framework that exist to promote fair and legitimate healthcare decisions.
Towards Improved Organizational Governance of Neurotrauma Surveillance Comment on "Neurotrauma Surveillance in National Registries of Low- and Middle-Income Countries: A Scoping Review and Comparative Analysis of Data Dictionaries"
Authors: Schenck Hanna E. , Mangat Halinder S.
Published: February 2023

Neurotrauma surveillance data on burden and severity of disease serves as a tool to define legislations, guide high-yield risk-specific prevention, and evaluate and monitor management strategies for adequate resource allocation. In this scoping review, Barthélemy and colleagues demonstrate the gap in neurotrauma surveillance in low- and middle-income countries (LMICs) and suggest strategies for governance in neurotrauma surveillance. We underline state accountability as well as the need for the close integration of academic and tertiary care clinical practitioners and policy-makers in addressing the public health crisis caused by neurotrauma. Additionally, multiple sources for surveillance must be included, especially in communities where victims may remain without access to formal healthcare. Finally, we offer insights into possible ways of increasing the visibility of neurotrauma on political agendas.
Conditional Cash Transfer to Improve TB Outcomes: Necessary but Not Sufficient Comment on "Does Direct Benefit Transfer Improve Outcomes Among People With Tuberculosis? – A Mixed-Methods Study on the Need for a Review of the Cash Transfer Policy in India"
Authors: Rubinstein Fernando , Blumenfeld Alejandro
Published: February 2023

Tuberculosis (TB) still represents a major public health problem in many regions of the world. TB control can only be achieved through a comprehensive and inclusive response which takes into account both upstream and downstream coordinated interventions related to structural determinants such as poverty, nutrition, sanitation, housing and access to healthcare as well as timely diagnosis and support throughout the course of treatment. Several social and financial support strategies have been proposed to improve TB treatment adherence, including conditional cash transfers (CCTs). In this context, demonstrating that social protection directly improves a specific health outcome using routinely collected data, incomplete registries or surveillance reports brings about many methodological challenges. We briefly discuss this paper and some limitations, describe main findings from our own research in this area and make a call to expand social protection interventions to address structural conditions of those most affected.
Systems Thinking and Complexity Science Methods and the Policy Process in Non-Communicable Disease Prevention: A Systematic Scoping Review
Authors: Astbury Chloe Clifford , Lee Kirsten M. , McGill Elizabeth , Clarke Janielle , Egan Matt , Halloran Afton , Malykh Regina , Rippin Holly , Wickramasinghe Kremlin , Penney Tarra L.
Published: February 2023

Background: Given the complex determinants of non-communicable diseases (NCDs), and the dynamic policy landscape, researchers and policymakers are exploring the use of systems thinking and complexity science (STCS) in developing effective policies. The aim of this review is to systematically identify and analyse existing applications of STCS-informed methods in NCD prevention policy. Methods: Systematic scoping review: We searched academic databases (Medline, Scopus, Web of Science, EMBASE) for all publications indexed by 13 October 2020, screening titles, abstracts and full texts and extracting data according to published guidelines. We summarised key data from each study, mapping applications of methods informed by STCS to policy process domains. We conducted a thematic analysis to identify advantages, limitations, barriers and facilitators to using STCS. Results: 4681 papers were screened and 112 papers were included in this review. The most common policy areas were tobacco control, obesity prevention and physical activity promotion. Methods applied included system dynamics modelling, agent-based modelling and concept mapping. Advantages included supporting evidence-informed decision-making; modelling complex systems and addressing multi-sectoral problems. Limitations included the abstraction of reality by STCS methods, despite aims of encompassing greater complexity. Challenges included resource-intensiveness; lack of stakeholder trust in models; and results that were too complex to be comprehensible to stakeholders. Ensuring stakeholder ownership and presenting findings in a user-friendly way facilitated STCS use. Conclusion: This review maps the proliferating applications of STCS methods in NCD prevention policy. STCS methods have the potential to generate tailored and dynamic evidence, adding robustness to evidence-informed policymaking, but must be accessible to policy stakeholders and have strong stakeholder ownership to build consensus and change stakeholder perspectives. Evaluations of whether, and under what circumstances, STCS methods lead to more effective policies compared to conventional methods are lacking, and would enable more targeted and constructive use of these methods.