bluuebunny/crossref_metadata_2025 huggingface dataset:
Accelerometer-Measured Daily Step Counts and Adiposity Indicators among Latin American Adults: A Multi-Country Study
Authors: Ferrari Gerson , Marques Adilson , Barreira Tiago , Kovalskys Irina , Gómez Georgina , Rigotti Attilio , Cortés Lilia , García Martha , Pareja Rossina , Herrera-Cuenca Marianella , Guajardo Viviana , Leme Ana , Guzmán Habinger Juan , Valdivia-Moral Pedro , Suárez-Reyes Mónica , Ihle Andreas , Gouveia Elvio , Fisberg Mauro ,   on behalf of the ELANS Study Group
Published: April 2021

The aim of the present study was to examine the sex-related associations between accelerometer-measured daily step counts and adiposity indicators in adults from eight Latin American countries. We analyzed data from 2524 adults (aged 18–65 years) from the Latin American Study of Nutrition and Health. Device-measured daily step counts were measured by accelerometers (ActiGraph GT3X). The outcomes were body mass index (BMI; (kg/m2), waist and neck circumference (in cm). Overall, the mean of daily steps counts, BMI, waist and neck circumference were 10699.8, 27.3, 89.6, and 35.8. Weak and negative associations were observed between daily steps counts and BMI (r = −0.17; p < 0.05) and waist circumference (r = −0.16; p < 0.05); however, step counts was not associated with neck circumference. Daily steps counts were negatively associated with BMI (β: −0.054; 95%CI: −0.077; −0.012) and waist circumference (−0.098; −0.165; −0.030) independently of age and socioeconomic level. In men, there were significant negative associations between daily steps counts with BMI (−0.075; −0.119; −0.031) and waist circumference (−0.140; −0.233; −0.048), and in women, there was no significant association with either of the body composition indicators. The findings from this study need to be examined in prospective settings that use device-measured from Latin America.
Occupational Exposure in Industrial Painters: Sensitive and Noninvasive Biomarkers to Evaluate Early Cytotoxicity, Genotoxicity and Oxidative Stress
Authors: Cavallo Delia , Ursini Cinzia Lucia , Fresegna Anna Maria , Ciervo Aureliano , Maiello Raffaele , Buresti Giuliana , Paci Enrico , Pigini Daniela , Gherardi Monica , Carbonari Damiano , Sisto Renata , Tranfo Giovanna , Iavicoli Sergio
Published: April 2021

This study aimed to identify sensitive and noninvasive biomarkers of early cyto-genotoxic, oxidative and inflammatory effects for exposure to volatile organic compounds (VOCs) in shipyard painters. On 17 (11 spray and 6 roller) painters (previously characterized for VOCs exposure to toluene, xylenes, ethylbenzene, ethyl acetate) and on 18 controls, we performed buccal micronucleus cytome (BMCyt) assay; Fpg-comet assay on lymphocytes; detection of urinary 8-oxoGua (8-oxo-7,8-dihydroguanine), 8-oxodGuo (8-oxo-7,8-dihydro-2′-deoxyguanosine) and 8-oxoGuo (8-oxo-7,8-dihydroguanosine), and cytokines release on serum. We found induction of cyto-genotoxicity by BMCyt assay and inflammatory effects (IL-6 and TNFα) in roller painters exposed to lower VOC concentrations than spray painters. In contrast, in both worker groups, we found direct and oxidative DNA damage by comet assay (with slightly higher oxidative DNA damage in roller) and significant increase of 8-oxoGuo and decrease of 8-oxodGuo and 8-oxoGua in respect to controls. The cyto-genotoxicity observed only on buccal cells of roller painters could be related to the task’s specificity and the different used protective equipment. Although limited by the small number of subjects, the study shows the usefulness of all the used biomarkers in the risk assessment of painters workers exposed to complex mixtures.
Short-Term Annoyance Due to Night-Time Road, Railway, and Air Traffic Noise: Role of the Noise Source, the Acoustical Metric, and Non-Acoustical Factors
Authors: Weidenfeld Sarah , Sanok Sandra , Fimmers Rolf , Puth Marie-Therese , Aeschbach Daniel , Elmenhorst Eva-Maria
Published: April 2021

Field studies on traffic noise-induced annoyance have predominantly used estimated outside noise levels. We intended to complement existing knowledge with exposure–response relationships that are based on precise indoor noise measurements. Acoustic recordings inside the bedrooms of nightly road traffic and annoyance ratings in the following morning were obtained from 40 suburban residents (mean age 29.1 years ± 11.7; 26 females). We derived exposure–response functions for the probability to be “annoyed at least a little” (%LA). Further analyses compared data from the current study with those from two earlier studies on railway and aircraft noise. Annoyance increased with the number of traffic events and the equivalent sound pressure level. The inclusion of non-acoustical factors (such as assessment of road transport) improved the prediction considerably. When comparing the different traffic noise sources, %LA was higher for road than for air traffic at a given LAeq,night, but higher for road and railway than for air traffic at a given number of noise events. Acoustical as well as non-acoustical factors impact short-term annoyance induced by road, railway, and air traffic. Annoyance varies across noise sources, which may be due to differences in acoustical characteristics or in the temporal noise distribution throughout the night.
Evaluating the Effect of Government Emission Reduction Policy: Evidence from Demonstration Cities in China
Authors: Zhu Yunchan , Han Shuo , Zhang Yimeng , Huang Qi
Published: April 2021

The effectiveness of government environmental policies is pivotal to environmental quality and provides the reference for further policy design. This paper estimates the effect of comprehensive demonstration of fiscal policy for ECER (Energy Conservation and Emission Reduction) on pollution emissions in Chinese cities with the sample period from 2003 to 2016, which is an important practice for policy integration. We find that this policy reduces the industrial SO2 (sulfur dioxide) emission by 23.8% on average and the industrial wastewater emission by 17.5% on average. This policy, implemented by Chinese government, has effectively achieved its target for emission reduction. A series of robustness checks are also conducted to verify the baseline results. Mechanism analysis indicates that this policy has the effect by the change in the industry structure and the enhancement of fiscal capacity, especially the capacity of fiscal revenue. Some policy recommendations, such as laying emphasis on the policy integration, integrating the financial resources of governments and expanding the demonstration effect, are proposed in order to facilitate green development in Chinese cities.
Relationship of Test Positivity Rates with COVID-19 Epidemic Dynamics
Authors: Furuse Yuki , Ko Yura K. , Ninomiya Kota , Suzuki Motoi , Oshitani Hitoshi
Published: April 2021

Detection and isolation of infected people are believed to play an important role in the control of the COVID-19 pandemic. Some countries conduct large-scale screenings for testing, whereas others test mainly people with high prior probability of infection such as showing severe symptoms and/or having an epidemiological link with a known or suspected case or cluster of cases. However, what a good testing strategy is and whether the difference in testing strategy shows a meaningful, measurable impact on the COVID-19 epidemic remain unknown. Here, we showed that patterns of association between effective reproduction number (Rt) and test positivity rate can illuminate differences in testing situation among different areas, using global and local data from Japan. This association can also evaluate the adequacy of current testing systems and what information is captured in COVID-19 surveillance. The differences in testing systems alone cannot predict the results of epidemic containment efforts. Furthermore, monitoring test positivity rates and severe case proportions among the nonelderly can predict imminent case count increases. Monitoring test positivity rates in conjunction with the concurrent Rt could be useful to assess and strengthen public health management and testing systems and deepen understanding of COVID-19 epidemic dynamics.
Seroprevalence of SARS-CoV-2 Infection and Adherence to Preventive Measures in Cuenca, Ecuador, October 2020, a Cross-Sectional Study
Authors: Acurio-Páez David , Vega Bernardo , Orellana Daniel , Charry Ricardo , Gómez Andrea , Obimpeh Michael , Verhoeven Veronique , Colebunders Robert
Published: April 2021

A door-to-door survey was organised in Cuenca, Ecuador, to determine the prevalence of COVID-19 infection and adherence of the population to COVID-19 preventive measures. A total of 2457 persons participated in the study; 584 (23.7%) reported having experienced at least one flu-like symptom since the onset of the pandemic. The maximum SARS-CoV-2 seroprevalence in Cuenca was 13.2% (CI: 12–14.6%) (IgM or IgG positive). Considering PCR confirmed infections, the prevalence was 11% (CI: 10–12.4%). There was no significant difference in seroprevalence between rural and urban areas. Participants aged 35–49 years old, living with a COVID-19 positive person, at least six people in a household, physical contact with someone outside the household, a contact with a person outside the home with flu-like symptoms, using public transport, and not having enough resources for living, significantly increased the odds for SARS-CoV-2 seropositivity. Overall, there was good adherence to COVID-19 preventive measures. Having known someone who tested positive for COVID-19, having a primary or secondary level of education, and having enough resources for living, significantly increased the odds for higher adherence. In conclusion, despite good overall adherence of the population of Cuenca with COVID-19 preventive measures, our study suggests high ongoing COVID-19 transmission in Cuenca, particularly in certain parishes. Prevention should not only focus on behavioural change, but on intensified testing strategies in demographical risk groups.
The Influence of the Physiotherapeutic Program on Selected Static and Dynamic Foot Indicators and the Balance of Elderly Women Depending on the Ground Stability
Authors: Matla Joanna , Filar-Mierzwa Katarzyna , Ścisłowska-Czarnecka Anna , Jankowicz-Szymańska Agnieszka , Bac Aneta
Published: April 2021

Seniors are a constantly growing group of people in many societies. It is necessary to develop physiotherapeutic programs to improve their mobility. The aim of this study was to assess the impact of the physiotherapeutic program conducted unstable ground on selected indicators of motor functions of elderly women. Sixty women (60–80 years) participated in the research. Group A (N = 20) underwent a 12-week physiotherapeutic program on stable ground, group B (N = 20) followed an exercise program on unstable ground, and group C (N = 20) (control group) had no therapeutic intervention. The effects of the therapy were assessed by using a FreeMed platform (foot load analysis) and a Biosway balance system. The results were compared using ANOVA (the one-way analysis), the Kruskal–Wallis test and also the post hoc tests (Tukey’s test and the multiple comparison test). In group A, a statistically significant change was observed in the static test and balance assessment, in group B this was observed in the static and dynamic foot tests and balance assessment, in group C, no statistical significance was achieved. The authors’ physiotherapeutic program had a statistically significant effect on changes in the balance and selected indicators of the motor functions of the examined people. Comparing the results before and after the therapy more improvement changes were noted in women training on an unstable ground compared to women training on a stable ground.
Trends, Characteristics and Treatment Outcomes of Patients with Drug-Resistant Tuberculosis in Uzbekistan: 2013–2018
Authors: Safaev Khasan , Parpieva Nargiza , Liverko Irina , Yuldashev Sharofiddin , Dumchev Kostyantyn , Gadoev Jamshid , Korotych Oleksandr , Harries Anthony D.
Published: April 2021

Uzbekistan has a high burden of drug-resistant tuberculosis (TB). Although conventional treatment for multidrug-resistant TB (MDR-TB) and extensively drug-resistant TB (XDR-TB) has been available since 2013, there has been no systematic documentation about its use and effectiveness. We therefore documented at national level the trends, characteristics, and outcomes of patients with drug-resistant TB enrolled for treatment from 2013–2018 and assessed risk factors for unfavorable treatment outcomes (death, failure, loss to follow-up, treatment continuation, change to XDR-TB regimen) in patients treated in Tashkent city from 2016–2017. This was a cohort study using secondary aggregate and individual patient data. Between 2013 and 2018, MDR-TB numbers were stable between 2347 and 2653 per annum, while XDR-TB numbers increased from 33 to 433 per annum. At national level, treatment success (cured and treatment completed) for MDR-TB decreased annually from 63% to 57%, while treatment success for XDR-TB increased annually from 24% to 57%. On multivariable analysis, risk factors for unfavorable outcomes, death, and loss to follow-up in drug-resistant TB patients treated in Tashkent city included XDR-TB, male sex, increasing age, previous TB treatment, alcohol abuse, and associated comorbidities (cardiovascular and liver disease, diabetes, and HIV/AIDS). Reasons for these findings and programmatic implications are discussed.
Predictors of Adherence to Lifestyle Recommendations in Stroke Secondary Prevention
Authors: Lennon Olive , Hall Patricia , Blake Catherine
Published: April 2021

The risk of recurrent vascular events is high following ischaemic stroke or transient ischaemic attack (TIA). Unmanaged modifiable risk factors present opportunities for enhanced secondary prevention. This cross-sectional study (n = 142 individuals post-ischaemic stroke/TIA; mean age 63 years, 70% male) describes adherence rates with risk-reducing behaviours and logistical regression models of behaviour adherence. Predictor variables used in the models com-prised age, sex, stroke/TIA status, aetiology (TOAST), modified Rankin Scale, cardiovascular fit-ness (VO2peak) measured as peak oxygen uptake during incremental exercise (L/min) and Hospital Anxiety and Depression Score (HADS). Of the study participants, 84% abstained from smoking; 54% consumed ≥ 5 portions of fruit and vegetables/day; 31% engaged in 30 min moderate-to-vigorous physical activity (MVPA) at least 3 times/week and 18% were adherent to all three behaviours. VO2peak was the only variable predictive of adherence to all three health behaviours (aOR 12.1; p = 0.01) and to MVPA participation (aOR 7.5; p = 0.01). Increased age (aOR 1.1; p = 0.03) and lower HADS scores (aOR 0.9; p = 0.02) were predictive of smoking abstinence. Men were less likely to consume fruit and vegetables (aOR 0.36; p = 0.04). Targeted secondary prevention interventions after stroke should address cardiovascular fitness training for MVPA and combined health behaviours; management of psychological distress in persistent smokers and consider environmental and social factors in dietary interventions, notably in men.
Stress and Mental Health among Children/Adolescents, Their Parents, and Young Adults during the First COVID-19 Lockdown in Switzerland
Authors: Mohler-Kuo Meichun , Dzemaili Shota , Foster Simon , Werlen Laura , Walitza Susanne
Published: April 2021

The present study aimed to assess various stressful situations and the psychological impact of the first COVID-19 pandemic lockdown among youths in Switzerland. We included samples of 1627 young adults aged 19–24 from the Swiss Youth Epidemiological Study on Mental Health and 1146 children and adolescents aged 12–17 years and their parents. We assessed symptoms of various mental health problems, internet use, and perceived stress during the first COVID-19 lockdown. In the analyses, data were weighted to be representative of the Swiss population. During the first lockdown in Switzerland, the most common sources of perceived stress were the disruption of social life and important activities, uncertainty about how long the state of affairs would last, and the pandemic itself. In addition, around one-fifth of the young adults met the criteria for at least one of the mental health problems (attention deficit hyperactivity disorder, depression, generalized anxiety disorder), while one-third of children/adolescents screened positive for at least one of the mental health problems (attention deficit hyperactivity disorder, oppositional defiant disorder, depression, anxiety). Moreover, 30.1% of children and 21.3% of young adults met the criteria for problematic internet use. The study showed considerable stress perceived by young adults and symptoms of mental health problems, especially among females, during the first COVID-19 lockdown in Switzerland.
Does Quality of Life Act as a Protective Factor against Believing Health Rumors? Evidence from a National Cross-Sectional Survey in China
Authors: Wang Haixia , Zou Xiqian , Lai Kaisheng , Luo Weiping , He Lingnan
Published: April 2021

A high quality of life (QoL), an individual’s subjective assessment of overall life condition, has been shown to have a protective effect against negative behaviors. However, whether QoL protects people from the harmful impact of health rumors is still unknown. In this study, a national survey in China (n = 3633) was conducted to explore the relationship between health rumor belief (HRB) and QoL, which includes physical, psychological, social, and environmental domains. The results show that people with a poor perception of their physical health are more likely to believe health rumors. Additionally, those who had better self-reported satisfaction in social relationships were more susceptible to health rumors. Furthermore, women and older adults showed a greater belief in health rumors. This study expands upon our understanding of how people with different QoL levels interact with false health-related information. Based on health-rumor-susceptible groups, several essential online and offline strategies to govern health rumors are also proposed.
Agreement and Disparities between Women and Stop-Smoking Specialists about How to Promote Adherence to Nicotine Replacement Therapy in Pregnancy
Authors: McDaid Lisa , Thomson Ross , Emery Joanne , Coleman Tim , Cooper Sue , Phillips Lucy , Naughton Felix
Published: April 2021

Evidence for the effectiveness of nicotine replacement therapy (NRT) for smoking-cessation in pregnancy is weak. This has been attributed to insufficient dosing and low adherence. This study investigated the acceptability of key messages and delivery modes for a behavioral intervention to increase NRT adherence in pregnancy. Semi-structured telephone interviews were carried out with pregnant or postpartum women aged ≥16 from across England, who had been offered NRT during pregnancy as part of a quit attempt and who struggled to quit (n = 10), and a focus group with stop-smoking specialists from across England (n = 6). The two data sources were coded separately using a thematic approach and then integrated to compare perspectives. Women and specialists agreed on message tone and delivery modes. However, views diverged on the most influential sources for certain messages and whether some information should be given proactively or reactively. There was also disagreement over which messages were novel and which were routinely delivered. This study demonstrates the value of capturing and integrating different perspectives and informational requirements when developing behavior-change interventions. The findings provide useful insights for designing a pregnancy-specific NRT adherence intervention that is acceptable to both those who will deliver and receive it.
The Impact of Health Information Exposure and Source Credibility on COVID-19 Vaccination Intention in Germany
Authors: Gehrau Volker , Fujarski Sam , Lorenz Hannah , Schieb Carla , Blöbaum Bernd
Published: April 2021

Due to the novelty and high transmission rate of the coronavirus disease 2019 (COVID-19), direct medical countermeasures are urgently needed. Among actions against the further outbreak of COVID-19, vaccination has been considered as a chief candidate. However, the rapid development of COVID-19 vaccines has led to concern about their safety and thus to public vaccine hesitancy. Strategic heath communication channels, which are widely used and highly trusted, can contribute to more effective promotions of vaccination intention and to the reduction of misleading information about COVID-19 vaccines. Therefore, this study examines the relationship between the exposure to and credibility of different health information sources and the COVID-19 vaccination intention among 629 German adults. Descriptive statistical analysis and multiple linear regressions are employed to examine the research questions. Results reveal that, aside from reliable information from experts and health authorities, local newspapers also have a positive impact on COVID-19 vaccination intention. However, this effect diminishes to some extent when age is considered. In addition, alternative information sources pose a noticeable threat to COVID-19 vaccination intention. Therefore, a close cooperation between healthcare experts, health authorities, and mass media with regard to information dissemination is conducive for vaccination campaigns and for the fight against misleading claims about COVID-19 vaccines.
Risks of Major Mental Disorders and Irritable Bowel Syndrome among the Offspring of Parents with Irritable Bowel Syndrome: A Nationwide Study
Authors: Yeh Ta-Chuan , Bai Ya-Mei , Tsai Shih-Jen , Chen Tzeng-Ji , Liang Chih-Sung , Chen Mu-Hong
Published: April 2021

Irritable bowel syndrome (IBS) is a functional bowel disorder that is highly comorbid with mental disorders. However, few studies have examined the risk of attention-deficit/hyperactivity disorder (ADHD), autism spectrum disorder (ASD), bipolar disorder, major depressive disorder (MDD), and schizophrenia in the offspring of parents with IBS. We used nationally representative cross-sectional survey data to analyze cross-generational transmission patterns of both IBS and major mental disorders. Odds ratio (OR) was calculated by using logistic regression models with adjustment for potential confounding factors. Offspring of parents with IBS were more likely to develop IBS themselves (OR = 2.41, 95% confidence interval (CI), 2.09–2.78), ADHD (OR = 1.33, 95% CI, 1.08–1.62), and MDD (OR = 1.32, 95% CI, 1.04–1.68) than the controls. Data stratification by parental sex revealed that paternal IBS increased risk of ADHD (OR = 1.34, 95% CI, 1.01–1.77) in the offspring, while maternal IBS increased the risk of MDD (OR = 1.51, 95% CI, 1.11–2.06). This is the first study to reveal parental IBS is associated with IBS, ADHD, and MDD among offspring, suggesting the necessity for early implementation of prevention strategies for at-risk children.
Invasive Weed Asystasia gangetica as a Potential Biomonitor and a Phytoremediator of Potentially Toxic Metals: A Case Study in Peninsular Malaysia
Authors: Yap Chee Kong , Chew Weiyun , Al-Mutairi Khalid Awadh , Al-Shami Salman Abdo , Nulit Rosimah , Ibrahim Mohd Hafiz , Wong Koe Wei , Bakhtiari Alireza Riyahi , Sharifinia Moslem , Cheng Wan Hee , Okamura Hideo , Ismail Mohamad Saupi , Saleem Muhammad
Published: April 2021

The invasive weed Asystasia gangetica was investigated for its potential as a biomonitor and as a phytoremediator of potentially toxic metals (PTMs) (Cd, Cu, Ni, Pb, and Zn) in Peninsular Malaysia owing to its ecological resistance towards unfavourable environments. The biomonitoring potential of PTMs was determined based on the correlation analysis of the metals in the different parts of the plant (leaves, stems, and roots) and its habitat topsoils. In the roots, the concentrations (mg/kg dry weight) of Cd, Cu, Ni, Pb, and Zn ranged from 0.03 to 2.18, 9.22 to 139, 0.63 to 5.47, 2.43 to 10.5, and 50.7 to 300, respectively. In the leaves, the concentrations (mg/kg dry weight) of Cd, Cu, Ni, Pb, and Zn ranged from 0.03 to 1.16, 7.94 to 20.2, 0.03 to 6.13, 2.10 to 21.8, and 18.8 to 160, respectively. In the stems, the concentrations (mg/kg dry weight) of Cd, Cu, Ni, Pb, and Zn ranged from 0.03 to 1.25, 5.57 to 11.8, 0.23 to 3.69, 0.01 to 7.79, and 26.4 to 246, respectively. On the other hand, the phytoremediation potential of the five metals was estimated based on the bioconcentration factor (BCF) and the translocation factor (TF) values. Correlation analysis revealed that the roots and stems could be used as biomonitors of Cu, the stems as biomonitors of Ni, the roots and leaves as biomonitors of Pb, and all three parts of the plant as biomonitors of Zn. According to the BCF values, in the topsoil, the “easily, freely, leachable, or exchangeable” geochemical fractions of the five metals could be more easily transferred to the roots, leaves, and stems when compared with total concentrations. Based on the TF values of Cd, Ni, and Pb, the metal transfer to the stems (or leaves) from the roots was efficient (>1.0) at most sampling sites. The results of BCF and TF showed that A. gangetica was a good phytoextractor for Cd and Ni, and a good phytostabilizer for Cu, Pb, and Zn. Therefore, A. gangetica is a good candidate as a biomonitor and a phytoremediator of Ni, Pb, and Zn for sustainable contaminant remediation subject to suitable field management strategies.
Children with Cerebral Palsy Have Similar Walking and Running Quality Assessed by an Overall Kinematic Index
Authors: Kelly Devin K. , McMulkin Mark L. , Franklin Corinna , Cooney Kevin M.
Published: April 2021

Running ability is critical to maintaining activity participation with peers. Children and adolescents with cerebral palsy (CP) are often stated to run better than they walk, but running is not often quantitatively measured. The purpose of this study was to utilize overall gait deviation indices to determine if children with diplegic CP run closer to typically developing children than they walk. This retrospective comparative study utilized 3D running kinematics that were collected after walking data at two clinical motion analysis centers for children with diplegic cerebral palsy. Separate walking and running Gait Deviation Indices (GDI Walk and GDI* Run), overall indices of multiple plane/joint motions, were calculated and scaled for each participant so that a typically developing mean was 100 with standard deviation of 10. An analysis of variance was used to compare the variables Activity (walking vs running) and Center (data collected at two different motion analysis laboratories). Fifty participants were included in the study. The main effect of Activity was not significant, mean GDI Walk = 76.4 while mean GDI* Run = 77.1, p = 0.84. Mean GDI scores for walking and running were equivalent, suggesting children with diplegic cerebral palsy as a group have similar walking and running quality. However, individual differences varied between activities, emphasizing the need for individual assessment considering specific goals related to running.
Scaling Up Molecular Diagnostic Tests for Drug-Resistant Tuberculosis in Uzbekistan from 2012–2019: Are We on the Right Track?
Authors: Yuldashev Sharofiddin , Parpieva Nargiza , Alimov Salikhdjan , Turaev Laziz , Safaev Khasan , Dumchev Kostyantyn , Gadoev Jamshid , Korotych Oleksandr , Harries Anthony
Published: April 2021

Uzbekistan has a large burden of drug-resistant tuberculosis (TB). To deal with this public health threat, the National TB Program introduced rapid molecular diagnostic tests such as Xpert MTB/RIF (Xpert) and line probe assays (LPAs) for first-line and second-line drugs. We documented the scale-up of Xpert and LPAs from 2012–2019 and assessed whether this led to an increase in patients with laboratory-confirmed multidrug-resistant/rifampicin-resistant TB (MDR/RR-TB) and extensively drug-resistant TB (XDR-TB). This was a descriptive study using secondary program data. The numbers of GeneXpert instruments cumulatively increased from six to sixty-seven, resulting in annual assays increasing from 5574 to 107,330. A broader use of the technology resulted in a lower proportion of tests detecting Mycobacterium tuberculosis with half of the positive results showing rifampicin resistance. LPA instruments cumulatively increased from two to thirteen; the annual first-line assays for MDR-TB increased from 2582 to 6607 while second-line assays increased from 1435 in 2016 to 6815 in 2019 with about one quarter to one third of diagnosed patients showing second-line drug resistance. Patient numbers with laboratory-confirmed MDR-TB remained stable (from 1728 to 2060) but there was a large increase in patients with laboratory-confirmed XDR-TB (from 31 to 696). Programmatic implications and ways forward are discussed.
Exploring Lived Experiences of Adolescents Presenting with Self-Harm and Their Views about Suicide Prevention Strategies: A Qualitative Approach
Authors: Naz Anum , Naureen Amna , Kiran Tayyeba , Husain Muhammad Omair , Minhas Ayesha , Razzaque Bushra , Tofique Sehrish , Husain Nusrat , Furber Christine , Chaudhry Nasim
Published: April 2021

Suicide is a serious global public health problem and the third leading cause of death in those 15–35 years old. Self-harm is the major predictor of future suicide attempts and completed suicide yet remains poorly understood. There is limited evidence on effective interventions for adolescents who present with self-harm. To identify and develop acceptable preventive and therapeutic interventions it is essential to understand the factors that contribute to self-harm and suicide in young people, in the context of their emotions, interpersonal difficulties, available support and prevention strategies. This qualitative study aimed at exploring the lived experiences of adolescents presenting with self-harm and their views about potential prevention strategies. Semi-structured interviews with 16 adolescents (12–18 years) presenting with a self-harm episode in a public hospital in Pakistan. A topic guide was developed to facilitate the interviews. The following themes emerged using the framework analysis; predisposing factors (interpersonal conflicts, emotional crisis etc.), regret and realization that self-harm is not the only option, perceived impact of self-harm, and suggestions for suicide prevention strategies (sharing, distraction techniques, involvement of family). This study may help in refining a contextual and culturally based explanatory model of self-harm in adolescents and in informing development of culturally acceptable interventions.
Parent–Infant Skin-to-Skin Contact and Stress Regulation: A Systematic Review of the Literature
Authors: Ionio Chiara , Ciuffo Giulia , Landoni Marta
Published: April 2021

Several studies have focused on neonatal maternal separation (MS) to investigate behavioural and neuroendocrine reactions to lack of contact, but only a few have focused on early separation in the first days or weeks after birth. This literature review investigates the vital importance of contact and touch by exploring how skin-to-skin contact (SSC) regulates stress in the mother–infant relationship. Various databases such as PubMed, Scopus, and ScienceDirect were searched for literature published between 2015 and 2020. From 1141 articles, 22 were declared eligible. The reviewed articles showed how SSC regulates child stress by biological indicators such as the autonomic nervous system (ANS), heart rate variability (HRV), cortisol, and oxytocin. This research concludes the importance of SSC for stress regulation, especially during the COVID-19 pandemic. With no research to date indicating a possible risk of neonatal COVID-19 transmission following SSC, SSC should continue to be practiced for all women, as recommended by the WHO.
Inclusive Communication Model Supporting the Employment Cycle of Individuals with Autism Spectrum Disorders
Authors: Tomczak Michał T. , Szulc Joanna Maria , Szczerska Małgorzata
Published: April 2021

Difficulties with interpersonal communication experienced by individuals with autism spectrum disorders (ASD) significantly contribute to their underrepresentation in the workforce as well as problems experienced while in employment. Consistently, it is vital to understand how communication within the employment cycle of this group can be improved. This study aims to identify and analyze the possibilities of modifying the communication processes around recruitment, selection, onboarding, and job retention to address the specific characteristics and needs of the representatives of this group. This qualitative study is based on 15 in-depth interviews conducted with 21 field experts, i.e.,: therapists, job trainers, and entrepreneurs employing people with ASD. The findings of this research informed the creation of an inclusive communication model supporting the employment cycle of individuals with ASD. The most important recommendations within the model that was created include the modification of job advertisements, use of less structured job interviews, providing opportunities for mentorship, and supportive and non-direct, electronically mediated communication. To apply the above-mentioned solutions and take full advantage of the talents of people with ASD, it is also necessary to provide tailored sensitivity and awareness training programs for their direct addressees as well as their neurotypical colleagues, including managerial staff.
Characteristics of Gait Variability in the Elderly While Walking on a Treadmill with Gait Speed Variation
Authors: Kim Bohyun , Youm Changhong , Park Hwayoung , Lee Myeounggon , Noh Byungjoo
Published: April 2021

Gait variability (GV), which is a variable for predicting mobility issues and risk of falling in elderly people, is defined as the fluctuation in spatiotemporal characteristics from one step to the next in walking. The goal of this study was to analyze the age- and sex-related spatiotemporal variability characteristics of elderly individuals using the measurements taken while walking on a treadmill for one minute based on gait speed variation. Gait testing was conducted on 225 healthy male and female individuals aged 60–79 years who were able to walk and move on their own and, specifically, walk on a treadmill for one minute. The test was performed at three speed conditions—the preferred speed of the participant, 20% higher than the preferred speed, and 20% lower than the preferred speed—and data were recorded using shoe-type data loggers. The different age groups and sex could be distinguished using the coefficient of variance (CV) of the double support phase and gait asymmetry (GA) at the preferred speed, and CVs of stride length and stance phase at faster speed. The results indicated that the values of GV obtained from the test were used to determine the variation in gait characteristics of elderly individuals.
The Economic Impact of the SARS-COV-2 (COVID-19) Pandemic in Spain
Authors: Pinilla Jaime , Barber Patricia , Vallejo-Torres Laura , Rodríguez-Mireles Silvia , López-Valcárcel Beatriz G. , Serra-Majem Luis
Published: April 2021

Background: The COVID-19 pandemic has hit both the Spanish economy and the population’s health hard. The result is an unprecedented economic and social crisis due to uncertainty about the remedy and the socioeconomic effects on people’s lives. Methods: We performed a retrospective analysis of the macroeconomic impact of the COVID-19 pandemic in 2020 using key indicators of the Spanish economy for the 17 Autonomous Communities (ACs) of the country. National statistics were examined in the search for impacts or anomalies occurring since the beginning of the pandemic. To estimate the strength of the impact on each of the indicators analyzed, we used Bayesian structural time series. We also calculated the correlation between the rate of GDP decline during 2020 and the cumulative incidence of COVID-19 cases per 100,000 inhabitants in the ACs. Results: In 2020, the cumulative impact on the gross domestic product was of −11.41% (95% credible interval: −13.46; −9.29). The indicator for business turnover changed by −9.37% (−12.71; −6.07). The Spanish employment market was strongly affected; our estimates showed a cumulative increase of 11.9% (4.27; 19.45) in the rate of unemployment during 2020. The worst indicators were recorded in the ACs most economically dependent on the services sector. There was no statistical association between the incidence of COVID-19 in 2020 and the fall in GDP in the ACs. Conclusions: Our estimates portray a dramatic situation in Spain, where the COVID-19 crisis has had more serious economic and health consequences than in other European countries. The productive system in Spain is too dependent on sectors vulnerable to the pandemic, and it is necessary to design and implement profound changes through the European Next Generation program.
Role of Callous and Unemotional (CU) Traits on the Development of Youth with Behavioral Disorders: A Systematic Review
Authors: Squillaci Myriam , Benoit Valérie
Published: April 2021

Numerous studies have shown that youth with behavioral disorders (BD) present an increased risk for developing severe and persistent antisocial behaviors in adulthood. Retrospective research notes that not all children and adolescents follow a negative trajectory and explains this heterogeneity in particular by the severity of CU traits. Our study examines how these traits affect the functioning of children and adolescents with BD. Method: A systematic literature review conducted through various databases and using different keywords made it possible to analyze 52 studies published from 2015 to 2020 that measured the bidirectional effects of CU traits on the functioning of young. Results: Out of the 52 studies, 47 analyzed links between CU traits and neurobiological or mental health, 20 examined family and school contexts, eight focused on social adjustment, 10 on social interactions and 19 measured links with cognitive functioning, especially executive functions. Conclusion: Consistent with previous recommendations in the field, our findings emphasize the importance of assessing the presence of UC traits in early childhood to prevent the emergence of comorbid disorders and to target multimodal (early) interventions to influence the life trajectories of youth with high CU traits.
Promoting Sustainable Mobility: A Perspective from Car and Public Transport Users
Authors: Dėdelė Audrius , Miškinytė Auksė
Published: April 2021

Sustainable mobility is becoming a key factor in improving the quality of life of the residents and increasing physical activity (PA) levels. The current situation of sustainable mobility and its analysis is a first step in understanding the factors that would encourage residents to discover and choose alternative modes of travel. The present study examined the factors that encourage the choice of active modes of travel among urban adult population. Walking and cycling were analyzed as the most sustainable forms of urban mobility from the perspective of car and public transport (PT) users. Total of 902 subjects aged 18 years or older were analyzed in the study to assess commuting habits in Kaunas city, Lithuania. The majority (61.1%) of the respondents used a passenger vehicle, 28.2% used PT, and only 13.5% used active modes of travel. The results showed that safer pedestrian crossings, and comfortable paths were the most significant factors that encourage walking. A wider cycling network, and bicycle safety were the most important incentives for the promotion of cycling. Our findings show that the main factors encouraging walking and cycling among car and PT users are similar, however, the individual characteristics that determine the choice of these factors vary significantly.
Association between Social Integration and Face Mask Use Behavior during the SARS-CoV-2 Pandemic in Japan: Results from U-CORONA Study
Authors: Nawa Nobutoshi , Yamaoka Yui , Koyama Yuna , Nishimura Hisaaki , Sonoda Shiro , Kuramochi Jin , Miyazaki Yasunari , Fujiwara Takeo
Published: April 2021

Face mask use is a critical behavior to prevent the spread of SARS-CoV-2. We aimed to evaluate the association between social integration and face mask use during the COVID-19 pandemic in a random sample of households in Utsunomiya City, Greater Tokyo, Japan. Data included 645 adults in the Utsunomiya COVID-19 seROprevalence Neighborhood Association (U-CORONA) study, which was conducted after the first wave of the pandemic, between 14 June 2020 and 5 July 2020, in Utsunomiya City. Social integration before the pandemic was assessed by counting the number of social roles, based on the Cohen’s social network index. Face mask use before and during the pandemic was assessed by questionnaire, and participants were categorized into consistent mask users, new users, and current non-users. Multinomial logistic regression analysis was used to examine the association between lower social integration score and face mask use. To account for possible differential non-response bias, non-response weights were used. Of the 645 participants, 172 (26.7%) were consistent mask users and 460 (71.3%) were new users, while 13 (2.0%) were current non-users. Lower social integration level was positively associated with non-users (RRR: 1.76, 95% CI: 1.10, 2.82). Social integration may be important to promote face mask use.
Real-Time Monitoring the Effect of Cytopathic Hypoxia on Retinal Pigment Epithelial Barrier Functionality Using Electric Cell-Substrate Impedance Sensing (ECIS) Biosensor Technology
Authors: Guerra Michael H. , Yumnamcha Thangal , Ebrahim Abdul-Shukkur , Berger Elizabeth A. , Singh Lalit Pukhrambam , Ibrahim Ahmed S.
Published: April 2021

Disruption of retinal pigment epithelial (RPE barrier integrity is a hallmark feature of various retinal blinding diseases, including diabetic macular edema and age-related macular degeneration, but the underlying causes and pathophysiology are not completely well-defined. One of the most conserved phenomena in biology is the progressive decline in mitochondrial function with aging leading to cytopathic hypoxia, where cells are unable to use oxygen for energy production. Therefore, this study aimed to thoroughly investigate the role of cytopathic hypoxia in compromising the barrier functionality of RPE cells. We used Electric Cell-Substrate Impedance Sensing (ECIS) system to monitor precisely in real time the barrier integrity of RPE cell line (ARPE-19) after treatment with various concentrations of cytopathic hypoxia-inducing agent, Cobalt(II) chloride (CoCl2). We further investigated how the resistance across ARPE-19 cells changes across three separate parameters: Rb (the electrical resistance between ARPE-19 cells), α (the resistance between the ARPE-19 and its substrate), and Cm (the capacitance of the ARPE-19 cell membrane). The viability of the ARPE-19 cells and mitochondrial bioenergetics were quantified with 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl-2H-tetrazolium bromide (MTT) assay and seahorse technology, respectively. ECIS measurement showed that CoCl2 reduced the total impedance of ARPE-19 cells in a dose dependent manner across all tested frequencies. Specifically, the ECIS program’s modelling demonstrated that CoCl2 affected Rb as it begins to drastically decrease earlier than α or Cm, although ARPE-19 cells’ viability was not compromised. Using seahorse technology, all three concentrations of CoCl2 significantly impaired basal, maximal, and ATP-linked respirations of ARPE-19 cells but did not affect proton leak and non-mitochondrial bioenergetic. Concordantly, the expression of a major paracellular tight junction protein (ZO-1) was reduced significantly with CoCl2-treatment in a dose-dependent manner. Our data demonstrate that the ARPE-19 cells have distinct dielectric properties in response to cytopathic hypoxia in which disruption of barrier integrity between ARPE-19 cells precedes any changes in cells’ viability, cell-substrate contacts, and cell membrane permeability. Such differences can be used in screening of selective agents that improve the assembly of RPE tight junction without compromising other RPE barrier parameters.
Functions of Thrombospondin-1 in the Tumor Microenvironment
Authors: Kaur Sukhbir , Bronson Steven M. , Pal-Nath Dipasmita , Miller Thomas W. , Soto-Pantoja David R. , Roberts David D.
Published: April 2021

The identification of thrombospondin-1 as an angiogenesis inhibitor in 1990 prompted interest in its role in cancer biology and potential as a therapeutic target. Decreased thrombospondin-1 mRNA and protein expression are associated with progression in several cancers, while expression by nonmalignant cells in the tumor microenvironment and circulating levels in cancer patients can be elevated. THBS1 is not a tumor suppressor gene, but the regulation of its expression in malignant cells by oncogenes and tumor suppressor genes mediates some of their effects on carcinogenesis, tumor progression, and metastasis. In addition to regulating angiogenesis and perfusion of the tumor vasculature, thrombospondin-1 limits antitumor immunity by CD47-dependent regulation of innate and adaptive immune cells. Conversely, thrombospondin-1 is a component of particles released by immune cells that mediate tumor cell killing. Thrombospondin-1 differentially regulates the sensitivity of malignant and nonmalignant cells to genotoxic stress caused by radiotherapy and chemotherapy. The diverse activities of thrombospondin-1 to regulate autophagy, senescence, stem cell maintenance, extracellular vesicle function, and metabolic responses to ischemic and genotoxic stress are mediated by several cell surface receptors and by regulating the functions of several secreted proteins. This review highlights progress in understanding thrombospondin-1 functions in cancer and the challenges that remain in harnessing its therapeutic potential.
Chemokine-Cytokine Networks in the Head and Neck Tumor Microenvironment
Authors: Nisar Sabah , Yousuf Parvaiz , Masoodi Tariq , Wani Nissar A. , Hashem Sheema , Singh Mayank , Sageena Geetanjali , Mishra Deepika , Kumar Rakesh , Haris Mohammad , Bhat Ajaz A. , Macha Muzafar A.
Published: April 2021

Head and neck squamous cell carcinomas (HNSCCs) are aggressive diseases with a dismal patient prognosis. Despite significant advances in treatment modalities, the five-year survival rate in patients with HNSCC has improved marginally and therefore warrants a comprehensive understanding of the HNSCC biology. Alterations in the cellular and non-cellular components of the HNSCC tumor micro-environment (TME) play a critical role in regulating many hallmarks of cancer development including evasion of apoptosis, activation of invasion, metastasis, angiogenesis, response to therapy, immune escape mechanisms, deregulation of energetics, and therefore the development of an overall aggressive HNSCC phenotype. Cytokines and chemokines are small secretory proteins produced by neoplastic or stromal cells, controlling complex and dynamic cell–cell interactions in the TME to regulate many cancer hallmarks. This review summarizes the current understanding of the complex cytokine/chemokine networks in the HNSCC TME, their role in activating diverse signaling pathways and promoting tumor progression, metastasis, and therapeutic resistance development.