bluuebunny/crossref_metadata_2025 huggingface dataset:
Process Improvement Approaches for Increasing the Response of Emergency Departments against the COVID-19 Pandemic: A Systematic Review
Authors: Ortíz-Barrios Miguel Angel , Coba-Blanco Dayana Milena , Alfaro-Saíz Juan-José , Stand-González Daniela
Published: August 2021

The COVID-19 pandemic has strongly affected the dynamics of Emergency Departments (EDs) worldwide and has accentuated the need for tackling different operational inefficiencies that decrease the quality of care provided to infected patients. The EDs continue to struggle against this outbreak by implementing strategies maximizing their performance within an uncertain healthcare environment. The efforts, however, have remained insufficient in view of the growing number of admissions and increased severity of the coronavirus disease. Therefore, the primary aim of this paper is to review the literature on process improvement interventions focused on increasing the ED response to the current COVID-19 outbreak to delineate future research lines based on the gaps detected in the practical scenario. Therefore, we applied the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines to perform a review containing the research papers published between December 2019 and April 2021 using ISI Web of Science, Scopus, PubMed, IEEE, Google Scholar, and Science Direct databases. The articles were further classified taking into account the research domain, primary aim, journal, and publication year. A total of 65 papers disseminated in 51 journals were concluded to satisfy the inclusion criteria. Our review found that most applications have been directed towards predicting the health outcomes in COVID-19 patients through machine learning and data analytics techniques. In the overarching pandemic, healthcare decision makers are strongly recommended to integrate artificial intelligence techniques with approaches from the operations research (OR) and quality management domains to upgrade the ED performance under social-economic restrictions.
Bayesian Sequential Monitoring of Single-Arm Trials: A Comparison of Futility Rules Based on Binary Data
Authors: Sambucini Valeria
Published: August 2021

In clinical trials, futility rules are widely used to monitor the study while it is in progress, with the aim of ensuring early termination if the experimental treatment is unlikely to provide the desired level of efficacy. In this paper, we focus on Bayesian strategies to perform interim analyses in single-arm trials based on a binary response variable. Designs that exploit both posterior and predictive probabilities are described and a slight modification of the futility rules is introduced when a fixed historical response rate is used, in order to add uncertainty in the efficacy probability of the standard treatment through the use of prior distributions. The stopping boundaries of the designs are compared under the same trial settings and simulation studies are performed to evaluate the operating characteristics when analogous procedures are used to calibrate the probability cut-offs of the different decision rules.
Health-Related Quality of Life in Patients with Health Conditions in Lebanese Community Setting
Authors: Dimassi Hani , Nasser Soumana C. , Issa Aline , Adrian Sarine S. , Hazimeh Bassima
Published: August 2021

Background: The measurement of health-related quality of life (HRQoL) provides utility scores that could be used for health economics assessment. The aim of this study was to measure HRQoL in Lebanese patients with certain medical conditions, and to determine demographic and medical factors affecting such health utility scores. Method: This was a prospective cross-sectional pilot study conducted to gather information on the socioeconomic status, health condition and quality of life of participants with common diseases during their community pharmacy visit. The EuroQol-5-Dimension instrument was used to measure utility scores and SPSS v26 was used to perform the statistical analysis. Results: Participants (n = 102) gave an average of 6.8 and 7.4 out of 10 for their current health and for their satisfaction with their treatment, respectively. The mean utility score was 0.762 (SD 0.202). The number of prescribed medications per respondent indicated a significant impact on HRQoL (p = 0.002). On average, the utility scores were low for participants who were 75 years or older (0.15, p < 0.001), and those who were hospitalized in the past 12 months (0.111, p < 0.001). For every unit increase in treatment satisfaction, the quality-of-life score increased by 0.036 unit (p = 0.001). Conclusion: This pilot study measured health utility scores and factors influencing HRQoL in the Lebanese population. Further studies are needed to confirm our findings and to develop and validate tools helping to measure health related quality of life in the population in Lebanon.
Pre-Intervention Effects of a Community-Based Intervention Targeting Alcohol Use (LEF); The Role of Participatory Research and Publicity
Authors: Koning Ina M. , Van der Rijst Vincent G. , De Wit John B. F. , De Kock Charlotte
Published: August 2021

This study explores the impact of the ‘pre-intervention effects’ of a community-based intervention. This refers to participatory research processes and parallel publicity in the media on changes in alcohol use and relevant mechanisms (rules and norms about alcohol, accessibility of alcohol in a formal setting) among adolescents before any intervention is implemented. The aim was to investigate the contribution of these processes (i.e., pre-intervention effects) to changes in intervention-targeted factors before any actual intervention was implemented. In a quasi-experimental study, data were collected twice by means of self-report among adolescents living in two municipalities (control and experimental condition). A regression analysis showed negative pre-intervention main effects on adolescents’ perceived accessibility of alcohol in a formal setting. Moreover, among adolescents aged 15 years and older, the normative decline in strictness of rules and norms was less steep in the experimental condition compared to the control condition. Additionally, adolescents aged 14 years and younger in the experimental condition reported more weekly drinking compared to their peers in the control condition. No differential effects across gender were found. To conclude, applying a co-creational approach in the development of an intervention not only contributes to more effective interventions in the end, but the involvement of and discussions in the community when planning the intervention contribute to changes in targeted factors. This implies that public discussions about the development of intervention strategies should be considered as an essential feature of co-creation in community-based interventions.
Unintentional Injury Burden in Hong Kong: Results from a Representative Population-Based Survey
Authors: Tang Eric Ho Man , Bedford Laura Elizabeth , Yu Esther Yee Tak , Tse Emily Tsui Yee , Dong Weinan , Wu Tingting , Cheung Bernard Man Yung , Wong Carlos King Ho , Lam Cindy Lo Kuen
Published: August 2021

Unintentional injuries are major causes of mortality and morbidity. Although generally perceived as accidents, it is possible to identify those at higher risk and implement appropriate prevention measures. This study aims to investigate the common causes of unintentional injuries and their associated risk factors among a large representative sample. Data of 12,022 individuals who completed the Hong Kong Population Health Survey 2014/15 were extracted. The primary outcome was the prevalence of having unintentional injury(-ies) in the previous 12 months that was severe enough to limit daily activities. Multivariable logistic regression analyses were conducted to identify associations between injuries and sociodemographic, clinical and lifestyle factors. 14.5% of respondents reported episode(s) of unintentional injury in the past 12 months in the population level. The main causes of top three most severe unintentional injuries were sprains (24.0%), falls (19.9%) and being hit/struck (19.6%). 13.2% injury episodes were work-related among the most severe episode. Factors independently associated with significantly higher risks of injury included currently employed, homemaker or student, born in Hong Kong (as compared with immigrants), doctor-diagnosed chronic conditions, harmful alcohol consumption, insufficient sleep, and disturbed sleep. To summarize, unintentional injuries are highly prevalent and associated with harmful drinking, insufficient sleep, and disturbed sleep, which are potential modifiable risk factors for prevention.
Efficacy of Removing Bacteria and Organic Dirt from Hands—A Study Based on Bioluminescence Measurements for Evaluation of Hand Hygiene When Cooking
Authors: Mihalache Octavian Augustin , Borda Daniela , Neagu Corina , Teixeira Paula , Langsrud Solveig , Nicolau Anca Ioana
Published: August 2021

The objective of this study was to evaluate the efficacy of dirt removal (bacteria and organic matter) of several hand-cleaning procedures. The results from the hand hygiene experiment indicated that washing hands with warm water and soap for 20 s is the most effective method investigated when hands are either dirty or greasy. Even if not proper washing, rinsing under running water for 5 s is a cleaning procedure that may significantly reduce the probability of cross-contamination, as it removes 90% of the hands’ dirt. Although less effective than water and soap, the usage of antibacterial wipes was significantly more effective than wet wipes, indicating that they are a better choice when water and soap are not available. The results of this study enable us to inform consumers about the effectiveness of hand-cleaning procedures applied in their homes when cooking. Moreover, it can make consumers understand why, during the COVID-19 pandemic, authorities recommended washing hands as a preventive measure of infection and using an anti-bacterial hand gel or wiping hands with an antimicrobial wipe if water and soap are not available.
Could Kallikrein-Related Serine Peptidase 3 Be an Early Biomarker of Environmental Exposure in Young Women?
Authors: Raimondo Salvatore , Gentile Mariacira , Esposito Giusy , Gentile Tommaso , Ferrara Ida , Crescenzo Claudia , Palmieri Mariangela , Cuomo Felice , De Filippo Stefania , Lettieri Gennaro , Piscopo Marina , Montano Luigi
Published: August 2021

Bisphenols and phthalates affect androgen receptor-mediated signaling that directly regulates Kallikrein-Related serine Peptidase 3 (KLK3) secretion, indicating that environmental factors may play a role in KLK3 secretion. With the aim of obtaining preliminary data on whether KLK3 could serve as an early marker of environmental pollution effects, in 61 and 58 healthy women living in a high environmental impact (HEI) and low environmental impact (LEI) area, respectively, serum KLK3 levels at different phases of menstrual cycle were measured. KLK3 values resulted in always being higher in the HEI group with respect to the LEI group. These differences were particularly relevant in the ovulatory phase (cycle day 12°–13°) of the menstrual cycle. The differences in KLK3 values during the three phases of the menstrual cycle were significant in the LEI group differently from the HEI group. In addition, higher progesterone levels were observed in the LEI group with respect to the HEI group in the luteal phase, indicating an opposite trend of KLK3 and progesterone in this phase of the menstrual cycle. Although changes in KLK3 could also depend on other factors, these preliminary data could be an early indication of an expanding study of the role of biomarkers in assessing early environmental effects for female reproductive health.
Environmental Performance of the Tourism Sector from a Gender Diversity Perspective
Authors: Fernández-Torres Yakira , Gutiérrez-Fernández Milagros , Gallego-Sosa Clara
Published: August 2021

The tourism sector is a driver of economic development characterised by its environmental impact. It is a prevalent part of the 2030 Agenda, given its potential to help meet the Sustainable Development Goals (SDGs). At the same time, board gender diversity is considered essential for companies to implement environmentally sustainable initiatives. However, analysis of the relationship between the role of women on boards and environmental performance has been neglected in the tourism literature. This paper adopts a novel approach to the study of this sector by analysing the relationship between gender diversity on the board of directors and companies’ environmental practices. A fixed effects model is estimated using an international sample of 120 listed tourism companies for the period 2002 to 2019. The results show that boards that are more gender diverse and have a greater female presence are associated with poorer environmental performance and a weaker implementation of policies and practices to reduce resource use and emissions. However, board gender diversity aids performance in environmental innovation.
Alzheimer’s Disease Caregiver Characteristics and Their Relationship with Anticipatory Grief
Authors: Pérez-González Alba , Vilajoana-Celaya Josep , Guàrdia-Olmos Joan
Published: August 2021

In Alzheimer’s disease, two fundamental aspects become important for caregivers: ambiguity and ambivalence. Thus, anticipatory grief is considered an active psychological process that is very different from the mere anticipation of death. The present study aims to determine which characteristics of family caregivers of people with dementia, such as age, gender, educational level, relationship with the person with dementia, years with dementia or years as a caregiver, are related to the presence of anticipatory grief. A cross-sectional design was employed. The sample consisted of a total of 129 subjects who cared for a family member with dementia. A sociodemographic data sheet and a battery of tests measure the presence of anticipatory grief, caregiver burden and/or psychopathology. The results obtained allowed us to confirm some of the hypotheses regarding the anticipatory grief construct, the importance of the care time factor, in years and per day, as well as the relevance of the previous demographic and psychopathological profile (being female, spouse function and possible depressive symptomatology). Likewise, from the prediction analyzes performed, it seems that these variables can predict anticipatory grief. These results propose interesting opportunities to formulate care proposals to professionals and family caregivers in relation to care tasks and caregiver skills.
Viewing Nature Lets Your Mind Run Free: Three Experiments about the Influence of Viewing a Nature Video on Cognitive Coping with Psychological Distress
Authors: Meuwese Daphne , Maas Jolanda , Krabbendam Lydia , Dijkstra Karin
Published: August 2021

Viewing nature has restorative qualities that might help people cope with their personal struggles. Three lab experiments (N = 506) studied whether environment (nature vs. built) influences cognitive coping with psychological distress. Psychological distress was induced with an autobiographical recall task about serious regret, whereafter participants were randomly assigned to view a nature or built video. Cognitive coping (i) Quantity, (ii) Content, and (iii) Quality were hereafter assessed as well as extent and vividness of the regretful memory during the video. Results showed a higher cognitive coping Quantity (Study 1 and 3) and a higher cognitive coping Quality (All studies) for the nature (vs. built) condition. Regarding cognitive coping Content, results varied across the studies. Additionally, participants reported to have thought about the experienced psychological distress to a greater extent while viewing the nature (vs. built) video. Yet they did rate viewing nature as more relaxing. We propose a two-step pathway as an underlying mechanism of restoration. In the first step the capacity for directed attention replenishes. Secondly, this renewed capacity is directed towards internal processes, creating the optimal setting for reflection. Hence, viewing nature allows people to truly process whatever is occupying their minds, which is ultimately relieving and beneficial for mental health.
Review: Prevalence of Addictions among Transgender and Gender Diverse Subgroups
Authors: Ruppert Ryan , Kattari Shanna K. , Sussman Steve
Published: August 2021

We conducted an analysis of the prevalence of substance and behavioral addictions across different transgender and gender diverse (TGD) subgroups. We performed a scoping review using MEDLINE and Google Scholar databases and examined 12 addictions, including alcohol, nicotine, cannabis, illicit drugs, gambling, eating/food, internet, sex, love, exercise, work, and shopping. We presented prevalence rates for each addiction as a function of an individual’s gender identity (stratified into transgender females, transgender males, and gender nonconforming), and used cisgender women and men as reference groups. We included 55 studies in our final analysis, the majority of which investigated substance use disorders among TGD subgroups. Overall findings indicated that substantial differences in substance use exist among US TGD subgroups. There were far fewer publications that examined the prevalence of behavioral addictions across TGD subgroups. However, despite limited research in this area, findings still suggest that notable differences in behavioral addictions may exist between individual TGD subgroups. The conclusions of our review may provide clinicians with a better ability to screen for and treat at-risk individuals within the TGD community.
Age-Related Difficulty of Listening Effort in Elderly
Authors: Kwak Chanbeom , Han Woojae
Published: August 2021

The present study identifies the combined effects of aging and listening environment related factors, such as directionality, types of stimuli, and the presence of background noise. A total of 50 listeners with normal hearing (25 older adults and 25 young adults) participated in a series of tasks. The detection task using tone and speech and a speech segregation task with two levels of background noise were conducted while sound was randomly presented via eight directional speakers. After completing each task, a subjective questionnaire using a seven-point Likert scale was asked to measure the amount of the subjects’ listening effort in terms of speech, spatial, and hearing quality. As expected, the amount of listening effort required in all the experiments for the older group was significantly higher than for their young counterparts. The effects of aging and types of stimuli (tone and speech) also showed different patterns of listening effort for the older adults and younger adults. The combined interaction of aging, directionality, and presence of background noise led to a significantly different amount of listening effort for the older group (90.1%) compared to the younger group (53.1%), even in the same listening situation. These current results, when summarized, indicated weak tone detection ability at high frequencies occurred in the elderly population but the elderly could improve their ability by using speech sounds with broad-band spectrum energy. We suggest that a warning signal when using speech rather than a single tone is more advantageous for the elderly in a public environment. It is also better to converse with the elderly by avoiding situations where noise from behind can interrupt.
Health Technology Assessment Development in Vietnam: A Qualitative Study of Current Progress, Barriers, Facilitators, and Future Strategies
Authors: Lee Hwa-Young , Nguyen Thuy Thi-Thu , Park Saeun , Hoang Van Minh , Kim Woong-Han
Published: August 2021

Introduction: To make more efficient use of limited resources, Vietnam incorporated health technology assessment (HTA) into the decision-making process for the health insurance benefit package in 2014. We evaluated progress in HTA institutionalization in Vietnam based on the theoretical framework developed by the National Institute for Health and Care Excellence and the Health Intervention and Technology Assessment Program, identified negative and conducive factors for HTA development, and finally suggested policy recommendations that fit the Vietnamese context. Methods: Semi-structured in-depth qualitative interviews were conducted between December 2017 and March and April 2018 with a purposive sample of 24 stakeholders involved in decision-making for health insurance reimbursement. We employed thematic analysis to examine themes within the data. Results: Despite a variety of activities (e.g., training and advising/mentoring) and a substantial level of output (e.g., policy statements, focal points assigned, and case studies/demonstration projects), Vietnam has not yet reached the policy decision stage based on HTA with scientific integrity and active stakeholder participation. Most respondents, except some clinicians, supported the use of HTA. The lack of capacity of human resources in the government sector and academia, the limited data infrastructure, the absence of guidelines, the government’s interest in immediate budget-saving, and public resistance were identified as barriers to the advancement of HTA. Conclusions: A structured data repository, guidelines based on the Vietnamese context for both policy decision-making at the central level and daily clinical decision-making at the micro-level, and integration of a participatory process into HTA are suggested as priorities for HTA institutionalization in Vietnam.
Dying “from” or “with” COVID-19 during the Pandemic: Medico-Legal Issues According to a Population Perspective
Authors: De-Giorgio Fabio , Grassi Vincenzo M. , Bergamin Eva , Cina Alessandro , Del Nonno Franca , Colombo Daniele , Nardacci Roberta , Falasca Laura , Conte Celeste , d’Aloja Ernesto , Damiani Gianfranco , Vetrugno Giuseppe
Published: August 2021

There is still a lack of knowledge concerning the pathophysiology of death among COVID-19-deceased patients, and the question of whether a patient has died with or due to COVID-19 is still very much debated. In Italy, all deaths of patients who tested positive for SARS-CoV-2 are defined as COVID-19-related, without considering pre-existing diseases that may either contribute to or even cause death. Our study included nine subjects from two different nursing homes (Cases 1–4, Group A; Cases 5–9, Group B). The latter included patients who presumably died from CO poisoning due to a heating system malfunction. All subjects tested positive for COVID-19 both ante- and post-mortem and were examined using post-mortem computed tomography prior to autopsy. COVID-19 was determined to be a contributing cause in the deaths of four out of nine subjects (death due to COVID-19; i.e., pneumonia and sudden cardiac death). In the other five cases, for which CO poisoning was identified as the cause of death, the infection presumably had no role in exitus (death with COVID-19). In our attempt to classify our patients as dying with or due to COVID-19, we found the use of complete assessments (both histological analyses and computed tomography examination) fundamental.
Non-Pharmacological Nursing Interventions for Prevention and Treatment of Delirium in Hospitalized Adult Patients: Systematic Review of Randomized Controlled Trials
Authors: Lee Yoonyoung , Lee Jongmin , Kim Jeounghee , Jung Youngsun
Published: August 2021

Delirium is a common neurobehavioral complication in hospitalized patients that can occur in the acute phase and lead to poor long-term outcomes. The purpose of this study was to identify non-pharmacological nursing interventions for the prevention and treatment of delirium in hospitalized adult patients. We conducted a systematic review to synthesize the findings of published studies. We searched the PubMed, EMBASE, CINAHL, and Cochrane Library CENTRAL databases for randomized controlled trials in January 2021. We report this systematic review according to the PRISMA 2009 checklist. The study was registered on PROSPERO (CRD42021226538). Nine studies were systematically reviewed for non-pharmacological nursing interventions for the prevention and treatment of delirium. The types of non-pharmacological nursing interventions included multicomponent intervention, multidisciplinary care, multimedia education, music listening, mentoring of family caregivers concerning delirium management, bright light exposure, ear plugs, and interventions for simulated family presence using pre-recorded video messages. These results could help nurses select and utilize non-pharmacological nursing interventions for the prevention and treatment of delirium in clinical nursing practice.
Carbon Monoxide Poisoning in Kuwait: A Five-Year, Retrospective, Epidemiological Study
Authors: Al-Matrouk Abdullah , Al-Hemoud Ali , Al-Hasan Mohammed , Alabouh Yaqoub , Dashti Amal , Bojbarah Haider
Published: August 2021

Background: Carbon monoxide (CO) poisoning is a major public health concern and a common cause of death worldwide. However, to our knowledge, no studies have been conducted on CO poisoning exposure and mortality in Kuwait. Objectives: Using epidemiological and forensic data analysis, we investigated the prevalence and characteristics of CO poisoning-associated deaths in Kuwait over five years (2014–2018), using official police data. Methods: The Forensic Toxicology Laboratory analyzed 203 blood specimens of deceased individuals for potential CO poisoning during the study period. We obtained demographic information of the deceased and other information regarding the source of the CO, the type of death and the seasonal and geographical distribution of fatalities. The percentage of carboxyhemoglobin (COHb%) was assessed using a CO-oximeter. Results: CO poisoning was confirmed in ~29% (59 cases) of the analyzed specimens, of which CO poisoning was accidental in the majority of cases (~95%) and homicidal in the remaining of cases (~5%), with no reported suicides. The five-year cumulative mean of COHb% in the blood specimens of the 59 confirmed cases was ~63%. Most of the deceased were males (~68%). The mean age of male and female victims per year were similar (~23–38 years). Fatalities were more common (~44%) during the winter (December–February). Uncontrolled home fires and coal stoves contributed to the primary sources of CO poisoning at 61% and 22%, respectively. Recommendations: Based on our findings, we propose that the local government should mandate the installation of smoke alarms and CO detectors in residential settings and endorse health education, informing the local population about the causes of fire and potential for CO poisoning, with an emphasis on prevention. Practical measures that can be applied include proper installation and regular maintenance of home-heating appliances and appropriate ventilation. The present study could greatly benefit the government in directing efforts toward decreasing CO poisoning incidents in Kuwait in the future.
The Effectiveness and Safety of Mind-Body Modalities for Mental Health of Nurses in Hospital Setting: A Systematic Review
Authors: Jung Su-Eun , Ha Da-Jung , Park Jung-Hyun , Lee Boram , Kim Myo-Sung , Sim Kyo-Lin , Choi Yung-Hyun , Kwon Chan-Young
Published: August 2021

The mental health of nurses including burnout is an important issue. The purpose of this systematic review was to evaluate whether mind-body modalities improve burnout and other mental health aspects of nurses. A comprehensive search was conducted using six electronic databases. Randomized controlled trials using mind-body modalities on the mental health of nurses, up to January 2021, were included. The methodological quality of the included studies was assessed using the Cochrane Risk of Bias tool. Seventeen studies were included in the review. Data on mindfulness-based interventions (MBIs) and yoga were available for burnout, and there was no evidence that multimodal resilience programs including MBIs statistically significantly improved burnout levels compared to no intervention or active control groups. However, one study reported that yoga could significantly improve emotional exhaustion and depersonalization, which are subscales of burnout, compared to usual care. In addition, the effects of MBIs, relaxation, yoga, and music on various mental health outcomes and stress-related symptoms have been reported. In conclusion, there was some evidence that yoga was helpful for improvement in burnout of nurses. However, due to the heterogeneity of interventions and outcomes of the studies included, further high-quality clinical trials are needed on this topic in the future.
Knowledge, Attitudes, and Practices Related to Dietary Supplementation, before and during the COVID-19 Pandemic: Findings from a Cross-Sectional Survey in the Lebanese Population
Authors: Mohsen Hala , Yazbeck Nour , Al-Jawaldeh Ayoub , Bou Chahine Nazih , Hamieh Houssein , Mourad Youmna , Skaiki Farouk , Salame Hassan , Salameh Pascale , Hoteit Maha
Published: August 2021

At the start of 2020, a new coronavirus (COVID-19) invaded the world leading to the death of 3.92 million people. Sadly, to date, no remedy has been discovered for this virus. Preventive vaccines have been under investigation, but were unavailable until December 2020. Clinical deficiencies of nutrients may increase susceptibility to infections. This knowledge may have provided an incentive for some dietary supplement (DS) manufacturers to advertise their products as COVID-19 preventatives or cures without any substantiation, targeting mainly social media fans. The objective of this research was to assess the usage, knowledge and attitudes towards dietary supplementation before and during the COVID-19 pandemic among Lebanese people. A cross-sectional study was conducted based on a convenience sample (N = 2966) and information from participants aged 18 years and above was collected about periods before and during the pandemic. Our findings showed that attitudes towards DSs changed when the pandemic emerged and people believed that DSs can improve their health and strengthen their immunity. Despite the rise in DS prescription by healthcare professionals, the prevalence of DS use decreased from 73.3% before the pandemic to 69.9% during the pandemic (p < 0.001). Study results declared that the weekly or the daily estimated intake had increased during the pandemic as compared to before the pandemic, from 14% to 15.6% for antioxidants (p = 0.014), from 35.3% to 42.1% for vitamin C (p < 0.001), from 35.5% to 41% for vitamin D (p < 0.001), from 15.2% to 17.5% for vitamin E (p = 0.002), and from 18.8% to 29.3% for zinc (p < 0.001) and other vitamins and minerals (from 9% to 10.9%, p < 0.001). Binary logistic regression indicated that the use of DSs during the pandemic was 4 times higher among those infected with COVID-19, 30 times higher among those who used to take DSs before pandemic, and 1.5 times higher among those who worked in the medical sector. To conclude, there is a crucial need to increase awareness among Lebanese people regarding the use of DSs.
Microbial Quality of Treated Wastewater and Borehole Water Used for Irrigation in a Semi-Arid Area
Authors: Kgopa Pholosho Mmmateko , Mashela Phatu William , Manyevere Alen
Published: August 2021

The current study investigated the distribution of microbial populations and diversity in treated wastewater used for irrigation at the University of Limpopo Experimental Farm (ULEF), from different stages of post treatment disposal at Mankweng Wastewater Treatment Plant (MWTP) in Limpopo Province, South Africa. The study was arranged in a 4 × 5 factorial experiment, which studied the interactive effects of four collection points and five months of sampling, with borehole water used as a reference point. Water samples were analyzed for bacteria, helminths, and protozoa. All data were transformed and subjected to factorial analysis of variance. The site–time interactions were significant for Salmonella spp. and Ascaris lumbricoides, whereas collection point was significant for all variables. In conclusion, movement and storage of water post treatment at MWTP were able to improve the microbial quality of the treated wastewater disposed for irrigation at ULEF.
Salmonella enterica Serovar Enteritidis Control in Poultry Litter Mediated by Lytic Bacteriophage Isolated from Swine Manure
Authors: Rogovski Paula , Silva Raphael da , Cadamuro Rafael Dorighello , Souza Estêvão Brasiliense de , Savi Beatriz Pereira , Viancelli Aline , Michelon William , Tápparo Deisi Cristina , Treichel Helen , Rodríguez-Lazaro David , Fongaro Gislaine
Published: August 2021

We report the use of bacteriophages for control of Salmonella Enteritidis in poultry production. Phage was isolated by the double-agar plate assay from agricultural waste samples, and one isolate, named SM1, was selected and propagated for application in poultry litter. Two experimental protocols were tested: single treatment and repeated treatment (re-application of phage SM1 after 6 h and 12 h). Each treatment cycle involved 25 g of poultry litter placed in plastic boxes and contaminated with 105 Colony Forming Units mL−1 (CFU mL−1) of S. Enteritidis, in independent duplicates. The contaminated litter was treated with 106 Plaque Forming Units mL−1 (PFU mL−1) of SM1 phage by dripping. Repeated application of phage SM1 reduced Salmonella counts by over 99.9%; the phage persisted in poultry litter for over 35 days. This study illustrates the application of SM1 treatment as a promising technology for bacterial control in production matrices that could allow safe and sustainable use of agricultural waste products as biofertilizers.
Access to Water and Sanitation Infrastructures for Primary Schoolchildren in the South-Central Part of Côte d’Ivoire
Authors: Kouamé Parfait K. , Galli Anaïs , Peter Maryna , Loss Georg , Wassa Diarassouba , Bonfoh Bassirou , Utzinger Jürg , Winkler Mirko S.
Published: August 2021

In rural settings of Côte d’Ivoire, access to water, sanitation, and hygiene (WASH) at schools is often lacking. The purpose of this study was to assess the availability, quality, and use of WASH infrastructure in schools in the south-central part of Côte d’Ivoire, and to determine the hygiene practices of schoolchildren. A cross-sectional study was conducted in 20 primary schools with (n = 10) or without (n = 10) direct access to drinking water. The survey was comprised of a questionnaire directed at schoolchildren aged 8–17 years, an assessment of the WASH infrastructure, and the testing of drinking water samples for Escherichia coli and total coliforms. Overall, 771 schoolchildren were enrolled in the study. One out of four children (24.9%) reported that they used available toilets. Among those children not using toilets, more than half (57.5%) reported that they practised open defecation. Drinking water infrastructure was limited in most schools because of poor storage tanks, the low flow of water, or broken wells. All drinking water samples (n = 18) tested positive for total coliforms and 15 (83.3%) tested positive for E. coli. The lack of WASH infrastructures in primary schools in the south-central part of Côte d’Ivoire, in combination with poor hygiene practices, might govern disease transmission and absenteeism at school, especially among females.
The Influences of Community-Enriched Environment on the Cognitive Trajectories of Elderly People
Authors: Yu Shuyang , Wei Meng
Published: August 2021

To examine the influences of community-enriched environment on the cognitive trajectories of the elderly in China, using panel data of 10,057, 3994, 2387, and 1749 older persons aged 65–104 years of the 2005, 2008, 2011, and 2014 waves from the Chinese Longitudinal Health Longevity Survey (CLHLS) and a growth curve model, the authors analyzed the changing trend of elderly people’s cognitive abilities with age. The influences of community-enriched environments on cognitive abilities were also investigated. Results show that when all the factors are out of consideration except age, for an older person aged 82.5 years, as he/she grows one year older, his/her cognitive abilities will be reduced by 0.139 points, while for one aged 92.5 years, they will be reduced by 0.199 points, which means cognitive abilities decline rapidly as the individuals grow older. The elderly people from communities with enriched environments have higher cognitive levels and slower declining speeds of cognitive abilities than the other elderly people, proving the long-term ability of such environments to facilitate cognitive abilities. An increase in the stimulation of the enriched environment is needed to prevent or slow down the degeneration of cognitive abilities.
The Height of Children and Adolescents in Colombia. A Review of More than Sixty Years of Anthropometric Studies, 1957–2020
Authors: Meisel-Roca Adolfo , Granger Angela
Published: August 2021

In this article, we present a review of the studies on the heights of children and teenagers in Colombia published since 1957. We focus on examining the geographic coverage, features of the population studied, height measurement techniques, authors’ profiles, and growth patterns in children. This relatively recent literature has been developed mainly by medical doctors who carried out rigorous measurements with highly specific time and space horizons. The first studies emphasized the differences among socioeconomic levels. Later, there was an interest in minority groups, such as indigenous people and Afro-descendants. Although most of the research lacked long-term vision, the overall balance shows that the country has been improving in anthropometric indicators over time, across territories, and in different socioeconomic groups.
Relationship between Running Spatiotemporal Kinematics and Muscle Performance in Well-Trained Youth Female Athletes. A Cross-Sectional Study
Authors: Castillo-Domínguez Alejandro , García-Romero Jerónimo C. , Páez-Moguer Joaquín , Ponce-García Tomás , Medina-Alcántara Miguel , Alvero-Cruz José Ramón
Published: August 2021

The purpose of this cross-sectional study was to analyse the relationship of neuromuscular performance and spatiotemporal parameters in 18 adolescent distance athletes (age, 15.5 ± 1.1 years). Using the OptoGait system, the power, rhythm, reactive strength index, jump flying time, and jump height of the squat jump, countermovement jump, and eight maximal hoppings test (HT8max) and the contact time (CT), flying time (FT), step frequency, stride angle, and step length of running at different speeds were measured. Maturity offset was determined based on anthropometric variables. Analysis of variance (ANOVA) of repeated measurements showed a reduction in CT (p < 0.000) and an increase in step frequency, step length, and stride angle (p < 0.001), as the velocity increased. The HT8max test showed significant correlations with very large effect sizes between neuromuscular performance variables (reactive strength index, power, jump flying time, jump height, and rhythm) and both step frequency and step length. Multiple linear regression found this relationship after adjusting spatiotemporal parameters with neuromuscular performance variables. Some variables of neuromuscular performance, mainly in reactive tests, were the predictors of spatiotemporal parameters (CT, FT, stride angle, and VO). Rhythm and jump flying time in the HT8max test and power in the countermovement jump test are parameters that can predict variables associated with running biomechanics, such as VO, CT, FT, and stride angle.
The Impact of Physical Performance on Functional Movement Screen Scores and Asymmetries in Female University Physical Education Students
Authors: Koźlenia Dawid , Domaradzki Jarosław
Published: August 2021

Association between physical performance and movement quality remains ambiguous. However, both affect injury risk. Furthermore, existing research rarely regards women. Therefore, this study aimed to assess the impact of physical performance components on FMS scores and asymmetries among young women—University Physical Education Students. The study sample was 101 women, 21.72 ± 1.57 years, body mass index 21.52 ± 2.49 [kg/m2]. The FMS test was conducted to assess the movement patterns quality. Physical performance tests were done to evaluate strength, power, flexibility. Flexibility has the strongest correlation with FMS overall (r = 0.25, p = 0.0130) and single tasks scores. A higher level of flexibility and strength of abdominal muscles are associated with fewer asymmetries (r = −0.31, p = 0.0018; r = −0.27, p = 0.0057, respectively). However, the main findings determine that flexibility has the strongest and statistically significant impact on FMS overall (ß = 0.25, p = 0.0106) and asymmetries (ß = −0.30, p = 0.0014). Additionally, a significant effect of abdominal muscles strength on FMS asymmetries were observed (ß = −0.29, p = 0.0027). Flexibility and abdominal muscles strength have the most decisive impact on movement patterns quality. These results suggest possibilities for shaping FMS scores in young women.
Advancing Our Understanding of Dental Care Pathways of Refugees and Asylum Seekers in Canada: A Qualitative Study
Authors: Nurelhuda Nazik M. , Keboa Mark T. , Lawrence Herenia P. , Nicolau Belinda , Macdonald Mary Ellen
Published: August 2021

The burden of oral diseases and need for dental care are high among refugees and asylum seekers (humanitarian migrants). Canada’s Interim Federal Health Program (IFHP) provides humanitarian migrants with limited dental services; however, this program has seen several fluctuations over the past decade. An earlier study on the experiences of humanitarian migrants in Quebec, Canada, developed the dental care pathways of humanitarian migrants model, which describes the care-seeking processes that humanitarian migrants follow; further, this study documented shortfalls in IFHP coverage. The current qualitative study tests the pathway model in another Canadian province. We purposefully recruited 27 humanitarian migrants from 13 countries in four global regions, between April and December 2019, in two Ontario cities (Toronto and Ottawa). Four focus group discussions were facilitated in English, Arabic, Spanish, and Dari. Analysis revealed barriers to care similar to the Quebec study: Waiting time, financial, and language barriers. Further, participants were unsatisfied with the IFHP’s benefits package. Our data produced two new pathways for the model: transnational dental care and self-medication. In conclusion, the dental care needs of humanitarian migrants are not currently being met in Canada, forcing participants to resort to alternative pathways outside the conventional dental care system.
Development of a Human Estrogen Receptor Dimerization Assay for the Estrogenic Endocrine-Disrupting Chemicals Using Bioluminescence Resonance Energy Transfer
Authors: Kim Hye Mi , Seo Hyeyeong , Park Yooheon , Lee Hee-Seok , Lee Seok-Hee , Ko Kwang Suk
Published: August 2021

Endocrine-disrupting chemicals (EDCs) are found in food and various other substances, including pesticides and plastics. EDCs are easily absorbed into the body and have the ability to mimic or block hormone function. The radioligand binding assay based on the estrogen receptors binding affinity is widely used to detect estrogenic EDCs but is limited to radioactive substances and requires specific conditions. As an alternative, we developed a human cell-based dimerization assay for detecting EDC-mediated ER-alpha (ERα) dimerization using bioluminescence resonance energy transfer (BRET). The resultant novel BRET-based on the ERα dimerization assay was used to identify the binding affinity of 17β-estradiol (E2), 17α-estradiol, corticosterone, diethylhexyl phthalate, bisphenol A, and 4-nonylphenol with ERα by measuring the corresponding BRET signals. Consequently, the BRET signals from five chemicals except corticosterone showed a dose-dependent sigmoidal curve for ERα, and these chemicals were suggested as positive chemicals for ERα. In contrast, corticosterone, which induced a BRET signal comparable to that of the vehicle control, was suggested as a negative chemical for ERα. Therefore, these results were consistent with the results of the existing binding assay for ERα and suggested that a novel BRET system can provide information about EDCs-mediated dimerization to ERα.
Dental Fear and Associated Factors among Children and Adolescents: A School-Based Study in Lithuania
Authors: Slabšinskienė Eglė , Kavaliauskienė Aistė , Žemaitienė Miglė , Vasiliauskienė Ingrida , Zaborskis Apolinaras
Published: August 2021

Dental fear is a challenging problem in dentistry and many contributing factors have been identified. Although this problem among children and adolescents has been studied in the literature for a long time, few such studies have been conducted in Lithuania. This study aimed to evaluate the prevalence of dental fear and examine its association with gender, age and several psychological and social factors among children and adolescents in Lithuania. The cross-sectional survey included a randomly selected sample (n = 1590) of children aged 11–14 and adolescents aged 15–18. The data were supplemented by interviewing the parents of these subjects (n = 1399). Dental fear was measured with a single five-score question. The data collection also included questions on oral health, socioeconomic status, oral health-related quality of life and self-esteem. Poisson regression analysis was used to assess the association between perception of dental fear and potential predictor variables. It was found that 32.2% (95% CI: 29.9–34.4%) of children and adolescents reported no fear of dental treatment, 12.5% (10.8–14.2%) of their peers were highly afraid of dental treatment, and other subjects assessed their dental fear gradually. Girls reported greater dental fear scores than boys, but the level of dental fear did not depend on the age. We identified the groups of subjects by gender and age, and a higher level of dental fear was significantly associated with untreated caries experience, a delay in the age of the subject’s first visit to the dentist, low self-esteem, low oral health-related quality of life, low overall life satisfaction and low family affluence. The results also suggested that dental fear could originate from previous toothache, dentists’ actions, high sensitivity in the child and poor psychological readiness for treatment. It was concluded that dental fear among Lithuanian children and adolescents is a common problem that is associated with gender and several dental, psychological and social factors. The findings indicate that school-based health policies, paediatric dentists and parents should be encouraged to focus on the psychosocial factors associated with dental fear because most of them can be prevented.
Indoor Air Quality Evaluation Using Mechanical Ventilation and Portable Air Purifiers in an Academic Dentistry Clinic during the COVID-19 Pandemic in Greece
Authors: Tzoutzas Ioannis , Maltezou Helena C. , Barmparesos Nikolaos , Tasios Panagiotis , Efthymiou Chrysanthi , Assimakopoulos Margarita Niki , Tseroni Maria , Vorou Rengina , Tzermpos Fotios , Antoniadou Maria , Panis Vassilios , Madianos Phoebus
Published: August 2021

The coronavirus disease 2019 (COVID-19), which is mainly transmitted through droplets without overlooking other sources of transmission, rendered attention on the air quality in indoor areas and more specifically in healthcare settings. The improvement of indoor air quality (IAQ) is ensured by frequent changes of the air that must be carried out in healthcare areas and with assistance from special devices that undertake the filtration of the air and its purification through special filters and lamps. In this research, the performance of air purifiers is assessed in terms of the limitation of PM2.5, PM10, VOCs and CO2 in a postgraduate clinic of the Dentistry School of the National and Kapodistrian University of Athens in parallel with mechanical ventilation. Our findings indicate that the use of mechanical ventilation plays a key role on the results, retaining good IAQ levels within the clinic and that air purifiers show a positive impact on IAQ by mainly reducing the levels of PM2.5 and secondly of TVOC.