bluuebunny/crossref_metadata_2025 huggingface dataset:
Characterization of Quality Properties in Spoiled Mianning Ham
Authors: Zhu Yanli , Wang Wei , Zhang Yulin , Li Ming , Zhang Jiamin , Ji Lili , Zhao Zhiping , Zhang Rui , Chen Lin
Published: June 2022

Deep spoilage is a cyclical and costly problem for the meat industry. Mianning ham is a famous dry-cured meat product in Sichuan, China. The aim of this work was to investigate the physicochemical characteristics, sources of odor, and associated microorganisms that cause spoilage of Mianning ham. High-throughput sequencing and solid-phase microextraction–gas-chromatography (SPME-GC-MS) techniques were used to characterize the physicochemical properties, microbial community structure, and volatile compounds of spoiled Mianning ham and to compare it with normal Mianning ham. The results showed that spoiled ham typically had higher moisture content, water activity (aw), and pH, and lower salt content. The dominant bacterial phylum detected in deeply spoiled ham was Firmicutes (95.4%). The dominant bacterial genus was Clostridium_sensu_stricto_2 (92.01%), the dominant fungal phylum was Ascomycota (98.48%), and the dominant fungal genus was Aspergillus (84.27%). A total of 57 volatile flavor substances were detected in deeply spoiled ham, including 11 aldehydes, 2 ketones, 6 alcohols, 10 esters, 20 hydrocarbons, 6 acids, and 2 other compounds. Hexanal (279.607 ± 127.265 μg/kg) was the most abundant in deeply spoiled ham, followed by Butanoic acid (266.885 ± 55.439 μg/kg) and Nonanal (165.079 ± 63.923 μg/kg). Clostridium_sensu_stricto_2 promoted the formation of five main flavor compounds, Heptanal, (E)-2-Octenal, 2-Nonanone, Hexanal, and Nonanal, in deeply spoiled ham by correlation analysis of microbial and volatile flavor substances.
Dietary Behaviours of University Students during the COVID-19 Pandemic. A Comparative Analysis of Nursing and Engineering Students
Authors: Araujo-Hernández Miriam , García-Navarro E. Begoña , Cáceres-Titos María José
Published: June 2022

The university stage is a crucial stage that influences the decision-making process of students. At this stage, they acquire dietary habits that are guided by their likes, beauty ideals, biological influences, and economic factors. During the COVID-19 pandemic, universities closed and turned to online teaching, changing their life habits under the duress of confinement. The aim of the present work was to identify the dietary behaviours of nursing and engineering degree students at the University of Huelva during the period of confinement, in addition to identifying the factors influencing these habits. The methodological strategy employed was mixed in nature. In this sense, a cross-sectional descriptive study was first performed, followed by a phenomenological qualitative study that was descriptive in nature. Examination of outcomes revealed the presence of four lines of argument founded on the influence of context, life habits, emotional changes experienced during the COVID-19 pandemic, and the factors facilitating or limiting adaption to this period. Taking into account that confinement, restrictive measures, the absence of family, closeness and affection, and training influenced changes to feeding habits and approaches to consumption, universities could carry out interventions oriented in this line to favour healthy eating habits.
Development of β-Cyclodextrin/Konjac-Based Emulsion Gel for a Pork Backfat Substitute in Emulsion-Type Sausage
Authors: Kim Yea-Ji , Shin Dong-Min , Yune Jong-Hyeok , Jung Hyun-Su , Kwon Hyuk-Cheol , Lee Kyung-Woo , Oh Jae-Wook , Kim Beob-Gyun , Han Sung-Gu
Published: June 2022

Emulsion gel has been used to replace animal fats in meat products. Konjac is a widely used gelling agent; however, its low emulsion stability limits its use in meat products. This study aimed to examine the quality characteristics of β-cyclodextrin (CD)-supplemented konjac-based emulsion gel (KEG) (CD-KEG) and its application as a fat substitute in emulsion-type sausages. The supplementation of CD increased hydrogen bonds and hydrophobic interactions with konjac and oil in the gels, respectively. Additionally, CD increased the structural complexity and strength of KEG. Since adding more than 6% of CD to KEG did not increase the gel strength, 6% CD-added KEG was adopted to substitute for pork backfat in manufacturing low-fat emulsion-type sausages. The following formulations of the sausages were prepared: pork backfat 20% (PF20); pork backfat 10% + KEG 10% (KEG10); KEG 20% (KEG20); pork backfat 10% + CD-KEG 10% (CD-KEG10); CD-KEG 20% (CD-KEG20); and pork backfat 5% (PF5). The CD-KEG20 formulation exhibited higher viscosity and viscoelasticity than KEG20, which suggested that CD improves the rheological properties and the thermal stability of meat batter. Additionally, CD-KEG20 showed similar emulsion stability, cooking yield and texture parameters compared with PF20. Therefore, 6% CD-added KEG is a suitable fat substitute for preparing low-fat emulsion-type sausages.
Risk of SARS-CoV-2 Infection Breakthrough among the Non-Vaccinated and Vaccinated Population in Italy: A Real-World Evidence Study Based on Big Data
Authors: Perrella Alessandro , Bisogno Massimo , D’Argenzio Angelo , Trama Ugo , Coscioni Enrico , Orlando Valentina
Published: June 2022

SARS-CoV-2 infection after vaccination can occur because COVID-19 vaccines do not offer 100% protection. The study aim was to assess duration of vaccination coverage, disease symptoms and type of hospitalization among non-vaccinated and vaccinated subjects to evaluate the vaccination trend over time. A retrospective cohort study was carried out among people testing COVID-19 positive in Campania Region using information from the Health Information System of Campania Region (Sinfonia). Vaccination status was assessed considering: no vaccination, partial vaccination and effective vaccination. Univariate and multivariate logistic regression models were constructed to evaluate the association between ICU admissions caused by COVID-19 and gender, age groups and vaccine type. Vaccine coverage duration trends were investigated using segmented linear regression and breakpoint estimations. Vaccination coverage was assessed by analyzing COVID-19 positive subjects in the 9 months after an effective dose vaccination. A significant risk of hospitalization in the ICU was caused by vaccination status: subjects non-vaccinated (OR: 7.14) and partially vaccinated (OR: 3.68) were 3 and 7 times more at risk of hospitalization, respectively, than subjects effectively vaccinated. Regarding subjects with an effective vaccination, the vaccine’s ability to protect against infection in the months following vaccination decreased. The risk of contracting COVID-19 after vaccination was higher 5 months (β = 1441, p < 0.001) and 7 months (β = 3110, p < 0.001) after administration of an effective dose. COVID-19 vaccines were demonstrated to protect from symptomatic infection by significantly reducing hospitalization risk, and their full protection against SARS-CoV-2 was demonstrated to decrease after 5 months regardless of age, gender or vaccine type.
Predicting the Mortality of ICU Patients by Topic Model with Machine-Learning Techniques
Authors: Chiu Chih-Chou , Wu Chung-Min , Chien Te-Nien , Kao Ling-Jing , Qiu Jiantai Timothy
Published: June 2022

Predicting clinical patients’ vital signs is a leading critical issue in intensive care units (ICUs) related studies. Early prediction of the mortality of ICU patients can reduce the overall mortality and cost of complication treatment. Some studies have predicted mortality based on electronic health record (EHR) data by using machine learning models. However, the semi-structured data (i.e., patients’ diagnosis data and inspection reports) is rarely used in these models. This study utilized data from the Medical Information Mart for Intensive Care III. We used a Latent Dirichlet Allocation (LDA) model to classify text in the semi-structured data of some particular topics and established and compared the classification and regression trees (CART), logistic regression (LR), multivariate adaptive regression splines (MARS), random forest (RF), and gradient boosting (GB). A total of 46,520 ICU Patients were included, with 11.5% mortality in the Medical Information Mart for Intensive Care III group. Our results revealed that the semi-structured data (diagnosis data and inspection reports) of ICU patients contain useful information that can assist clinical doctors in making critical clinical decisions. In addition, in our comparison of five machine learning models (CART, LR, MARS, RF, and GB), the GB model showed the best performance with the highest area under the receiver operating characteristic curve (AUROC) (0.9280), specificity (93.16%), and sensitivity (83.25%). The RF, LR, and MARS models showed better performance (AUROC are 0.9096, 0.8987, and 0.8935, respectively) than the CART (0.8511). The GB model showed better performance than other machine learning models (CART, LR, MARS, and RF) in predicting the mortality of patients in the intensive care unit. The analysis results could be used to develop a clinically useful decision support system.
Development of a General Health Score Based on 12 Objective Metabolic and Lifestyle Items: The Lifestyle and Well-Being Index
Authors: Pano Octavio , Sayón-Orea Carmen , Hershey María Soledad , Bes-Rastrollo Maira , Martínez-González Miguel A. , Martínez J. Alfredo
Published: June 2022

Healthy and unhealthy lifestyles are tightly linked to general health and well-being. However, measurements of well-being have failed to include elements of health and easy to interpret information for patients seeking to improve lifestyles. Therefore, this study aimed to create an index for the assessment of general health and well-being along with two cut-off points: the lifestyle and well-being index (LWB-I). This was a cross-sectional analysis of 15,168 individuals. Internally valid multivariate linear models were constructed using key lifestyle features predicting a modified Short Form 36 questionnaire (SF-36) and used to score the LWB-I. Categorization of the LWB-I was based on self-perceived health (SPH) and analyzed using receiver operating characteristic curve analysis. Optimal cut-points identified individuals with poor and excellent SPH. Lifestyle and well-being were adequately accounted for using 12 lifestyle items. SPH groups had increasingly healthier lifestyle features and LWB-I scores; optimal cut-point for poor SPH were scores below 80 points (AUC: 0.80 (0.79, 0.82); sensitivity 75.7%, specificity 72.3%)) and above 86 points for excellent SPH (AUC: 0.67 (0.66, 0.69); sensitivity 61.4%, specificity 63.3%). Lifestyle and well-being were quantitatively scored based on their associations with a general health measure in order to create the LWB-I along with two cut points.
Post-Work Recovery from Fatigue and Sleep Episodes among Nurses Who Are Engaged in 16-Hour Night Shifts: A Prospective Observational Study
Authors: Konya Issei , Watanabe Kazuhiro , Shishido Inaho , Sugimura Naotaka , Matsushita Yuta , Yamaguchi Shinya , Yano Rika
Published: June 2022

Poor recovery from fatigue among shift-working nurses can cause a transition from acute to chronic fatigue. We aimed to clarify the relationship between nurses’ recovery from fatigue and sleep episodes after 16 h night shifts while considering age. This prospective study included 62 nurses who worked 16 h night shifts. Fatigue was assessed by a questionnaire before, during, and after the night shift, and the morning following the night shift. Sleep episodes were continuously measured using a wearable device. We performed a hierarchical cluster analysis of multivariate sleep parameters in first and main sleep episodes after night shifts. A linear mixed model was used to estimate the difference between clusters in recovery from fatigue after the night shift, considering age. The participants were classified into a high sleep quality group (HSQG) and low sleep quality group (LSQG) in sleep episodes after the night shift. There was a significant main effect of clusters, and HSQG was significantly more effective than LSQG in recovering from fatigue. However, no main effects of age or interaction were observed. The quality of first and main sleep episodes at home was associated with recovery from the night shift to the next day, regardless of age.
Effects of Aquatic Training and Bicycling Training on Leg Function and Range of Motion in Amateur Athletes with Meniscal Allograft Transplantation during Intermediate-Stage Rehabilitation
Authors: Chen Yake , Kim Yonghwan , Choi Moonyoung
Published: June 2022

Meniscal allograft transplantation (MAT) is a treatment modality for restoring knee function in patients with irreversible meniscal injury. Strengthening programs to promote functional recovery are treated with caution during the intermediate rehabilitation phase following MAT. This study analyzed the effects of aquatic training (AQT) and bicycling training (BCT) during the intermediate stage of rehabilitation in amateur athletes that underwent MAT. Participants (n = 60) were divided into AQT (n = 30) and BCT (n = 30) groups. Both groups performed training three times per week from 6 to 24 weeks following surgery. International Knee Documentation Committee Subjective Knee Evaluation Form (IKDC) score, knee joint range of motion (ROM), isokinetic knee strength, and Y-balance test (YBT) performance were evaluated. All measured variables for the AQT and BCT groups improved significantly after training compared with pre-training values. The IKDC score and YBT were significantly higher for AQT than for BCT. The knee flexion ROM and isokinetic muscle strength were significantly improved in the BCT group compared to those in the AQT group. The AQT group exhibited greater improvement in dynamic balance, whereas BCT provided greater improvement in isokinetic muscle strength. AQT and BCT were effective in reducing discomfort and improving knee symptoms and functions during intermediate-stage rehabilitation following MAT in amateur athletes.
Early Response of ‘Mexican’ Lime, ‘Fina’ Clementine Mandarin, and ‘Campbell’ Valencia Orange on Selected Rootstocks Grown under Fertigation Practices in an Oxisol in Puerto Rico
Authors: Tirado-Corbalá Rebecca , Román-Paoli Elvin , Segarra-Carmona Alejandro E. , Estévez de Jensen Consuelo , Rivera-Ocasio Dania
Published: June 2022

In Puerto Rico, Huanglongbing (HLB), detected in 2009, continues to produce losses in orchards across the island. Efforts to produce clean propagation materials and select different combinations of scions and rootstocks to mitigate the disease have been a priority. In 2016, an experiment was established in Isabela in Coto clay series soils at 120 m to assess ‘Mexican’ lime, ‘Fina’ clementine mandarin, and ‘Campbell’ Valencia orange grafted in ‘Swingle’ citrumelo, ‘HRS 812’, and ‘HRS 897’. Tree growth parameters, tree fruit production, HLB incidences, and tree mortality were evaluated under a fertigation system. Higher fruit production was obtained with ‘Fina’ clementine mandarin and ‘Campbell’ Valencia orange when grafted in ‘HRS 812’ followed by ‘HRS 897’. ‘Mexican’ lime had higher fruit production when grafted in ‘HRS 897’. On the basis of total fruit production and HLB incidence, ‘HRS 812’ was outstanding, yielding fruits with higher values even though they were infected with HLB. Moreover, ‘HRS 897’ rootstock was demonstrated to be a potential rootstock for the Puerto Rico conditions.
Perceived Gap of Age-Friendliness among Community-Dwelling Older Adults: Findings from Malaysia, a Middle-Income Country
Authors: Chang Chee-Tao , Lim Xin-Jie , Supramaniam Premaa , Chew Chii-Chii , Ding Lay-Ming , Rajan Philip
Published: June 2022

Background: The United Nations predicts that the global population aged 65 years or above will double from 703 million in 2019 to 1.5 billion by 2050. In Malaysia, the older population has reached 2.4 million, accounting for nearly 8% of the population. This study aimed to evaluate the perceptions of the elderly on the importance and availability of the age-friendly features in eight domains specified by the Global Network of Age-Friendly City and Communities. Methods: This was a cross-sectional study conducted by structured face-to-face and or telephone interviews. Gap score analysis was performed for 32 items of the 8 age-friendly domains. The gap scores were categorized as follows: 0 = not important OR important and element available; 1 = important but unsure whether the element is available; 2 = important but element not available. The gap scores were then dichotomized into “yes” and “no”, and multivariate logistic regression analysis was subsequently performed. Results: From the 1061 respondents, the housing (55.4%) and transportation (50.7%) domains reported the highest mean perceived gap scores. Out of the 32 elements, the highest mean gap percent scores were observed in elderly priority parking bays (83.8%), home visits by healthcare professionals (78.9%), financial assistance for home modification and purchase (66.3%), and affordable housing options (63.6%). Respondents in the city center reported higher gap scores for modified restrooms, parks, volunteer activities, and the internet; respondents in the non-city center reported higher gap scores for nursing homes, healthcare professionals, and cultural celebrations. Age, location, marital status, income, duration of stay, physical exercise, internet access, and intention to continue working were found to be associated with a higher perceived gap in specific domains. Conclusion: The most significant unmet needs were detected in the housing, transportation, and employment opportunities domains. Considerable disparities in the perceived gap were detected between the older population in the city center and non-city center. To address shortcomings in the local age-friendly setting, coordinated municipal policies, political commitment, and benchmarking of existing age-friendly cities are warranted.
Income Disparities in Obesity Trends among U.S. Adults: An Analysis of the 2011–2014 California Health Interview Survey
Authors: Gong Shaoqing , Wang Liang , Zhou Zhongliang , Wang Kesheng , Alamian Arsham
Published: June 2022

The aim of this study was to examine income disparities in obesity trends among California adults. Data were obtained from the 2011–2014 California Health Interview Survey (n = 83,175 adults). Obesity for adults was defined as a body mass index of 30 kg/m2 or above. Family income was categorized as below 100%, 100% to 299%, or 300% and above of the federal poverty level (FPL). Weighted multiple logistic regression analyses were used to examine the association between family income and obesity across survey years after controlling for age, sex, race/ethnicity, smoking status, marital status, education, physical activity, and healthy diet. Obesity prevalence among California adults increased slightly from 25.1% in 2011 to 27.0% in 2014. Compared to 300% FPL or above, <100% FPL and 100–299% FPL were associated with increased odds of obesity, respectively (OR = 1.35, 95% CI = 1.22–1.50, for 100–299% FPL; OR = 1.18, 95% CI = 1.10–1.27, for 300% FPL or above). Each year, lower FPL was associated with higher odds of obesity, except for the year 2014. An inverse association between obesity and family income in each survey year was observed, with the magnitude of the income disparity decreasing from 2011 to 2014. The findings of this study show that family income was negatively associated with obesity among adults in California from 2011–2014, and the magnitude of the income disparity in obesity prevalence decreased over this period. Future studies need to examine potential risk factors associated with the decreasing trend.
Trends and Insights from Transportation Congestion Pricing Policy Research: A Bibliometric Analysis
Authors: Singichetti Bhavna , Dodd Adam , Conklin Jamie L. , Hassmiller Lich Kristen , Sabounchi Nasim S. , Naumann Rebecca B.
Published: June 2022

Toll-based congestion pricing (CP) policies are increasingly implemented globally for alleviating road traffic congestion. Several interconnected factors affecting or induced by CP implementation include air quality/emissions, travel time, and road user safety. We sought to examine and characterize research output and patterns across several domains (e.g., health, policy acceptability) surrounding toll-based CP policies, in order to identify where research has focused and where gaps exist. We conducted a structured review and identified 2333 relevant publications, using semi-supervised and machine learning strategies combined with manual review. Annual publication counts peaked in 2015 (n = 122). Themes identified from title and abstract terms included policy implementation characteristics, advanced transportation modeling methods and approaches, and public perception and acceptability. Authorship networks indicated a lack of interdisciplinary research. Country analyses identified the US, China, and the UK as the most frequently represented countries, and underrepresentation from low-income countries. Findings indicate that research focused on specific road user types (e.g., pedestrians) and safety impacts, and equity considerations were relatively sparse compared to other topics (e.g., policy economics, public perception). Additional research on these critical topics is necessary to ensure that such policies are designed to promote positive and equitable effects on road user health and safety.
Development and Assessment of Professional Competences among Polish Nursing Students during a 3-Year Education Cycle Trying
Authors: Brodowicz-Król Magdalena , Kaczoruk Monika , Kaczor-Szkodny Paulina , Zarzycka Danuta
Published: June 2022

The essence of the profile of nursing professional competences are basic behavioral characteristics, as well as mastering practical skills. The aim of this study was determination of the development of professional competences of perceiving a patient by first-, second-and third-year students of licentiate nursing study. The study was of a longitudinal character, and lasted for 3 years. The research instrument used was the Ascent to Competence Scale, and traditional assessment of students’ knowledge and skills. A statistically significant relationship was observed between the average grade in practical education from all three years, and competences in student–teacher relationship. Higher grades in theoretical education were accompanied by lower results obtained by students in the area of nursing competences. The respondents’ opinions concerning the development of knowledge and professional skills were relatively high among first-year students, which may be related with a sharp increase in nursing knowledge, whereas third-year students considered it important to perceive a considerable development of professional competences. The results of this study can help in the design of education programs meeting quality standards, and alignment with students and population health needs, which is adequate to the assumptions of the WHO Global Strategic Directions for Nursing and Midwifery 2021–2025.
Comparison of Vitamin D Levels in Premature Infants with and without Retinopathy of Prematurity
Authors: Boskabadi Hassan , Abrishami Majid , shoeibi Nasser , sanei Zahra , Moradi Ali , Zakerihamidi Maryam
Published: June 2022

Background: Retinopathy of prematurity (RoP) is a cause of newborn blindness. Several predisposing factors have been reported to contribute to the disease process. The current study aimed to compare serum vitamin D levels in infants with and without RoP. Methods: This case-control study was conducted on 154 very low birth weight (VLBW) infants admitted to Ghaem hospital, Mashhad, Iran, during 2016–2019. Retinal examination for RoP was done at the 32nd week of pregnancy and vitamin D level was determined using the infants’ first-day serum samples. A researcher-made questionnaire including maternal, infant, laboratory, and retinal examination information was used as the data collection tool. Results: Out of 154 infants in the study, 56 (36.4%) were normal while 98 (63.6%) had RoP. Based on the severity of retinopathy, 43 infants (43.9%) were at stage I, 48 (49%) at stage II, and 7 (7.1%) at stage III. Significant differences in neonatal (P<0.001) and maternal (P=0.015) vitamin D levels, first and fifth minute Apgar scores (P=0.034 and P=0.001, respectively), and weight (P=0.014) were found between the infants with and without RoP. Conclusion: The incidence of RoP was higher in infants with lower gestational age, lower birth weight, low first and fifth minutes Apgar scores, and male sex. Low serum levels of vitamin D in premature infants and their mothers were associated with incidence of RoP. The higher the stage of RoP, the greater was the severity of vitamin D deficiency. Thus, controlling the maternal vitamin D level during pregnancy, consumption of vitamin D supplements, and investigation of serum vitamin D levels in premature infants are recommended. Early correction of vitamin D deficiency may lead to reduction of RoP.
Ranking Universities of Medical Sciences as Public Health Services Provider Institutions in Iran: A Result-Chain Analysis
Authors: Jahanmehr Nader , Rashidian Arash , Farzadfar Farshad , Khosravi Ardeshir , Shariati Mohammad , Akbari Sari Ali , Damiri Soheila , Majdzadeh Reza
Published: June 2022

Background: Universities of medical sciences (UMSs) in Iran have geographic catchment areas (normally a province) in which they are responsible for public health services as well as provision of care by public providers. The present study strived to analyze and rank the performance of the medical sciences universities in improving the public health and primary healthcare. Methods: Data on 41 indicators on the output (16 indicators), outcome (16 indicators), and impact (9 indicators) levels were extracted from various data sources. Principal component analysis (PCA) was used to calculate the weight for each of the indicators. The score range for each level of performance is between 0 and 1. A score of 1 indicates the highest and a score of 0 indicates the lowest level of performance. Finally, the UMSs were ranked by their scores. Results: The national mean performance scores of the UMSs on the output, outcome, impact, and the composite indicator levels were 0.756, 0.641, 0.561, and 0.563, respectively. The results show that the changes in performance scores at different levels of the results chain are remarkable. Conclusion: The national mean performance of the UMSs of Iran is not satisfactory. However, there is considerable dispersion in their performance. Designing effective interventions in proportion to the conditions of universities on different levels of the results chain, developing a robust information system, conducting continuous monitoring and evaluation of public health are recommended for balanced improvements in public health and primary healthcare indicators in the country.
Tops and Trends in Iranian Cancer Research: A Bibliometric Analysis
Authors: CheshmehSohrabi Mozaffar , Shabani Rasoul , Shirdavani Shiva
Published: June 2022

Background: Detecting the main actors and important topics of Iranian cancer research is essential for Iranian policymakers, clinicians, and researchers. This study was conducted to demonstrate the trends and tops in Iranian cancer research from 1960 to 2018. Methods: A total of 22,370 Iranian cancer articles in Web of Science (WoS), PubMed, and Scopus, from 1960 through 2018, were extracted and preprocessed based on data mining techniques and analyzed using the collaboration network analysis, keywords analysis, and bibliometrics methods. Results: The results reveal that, Tehran University of Medical Sciences (11.46%) among organizations, Asian Pacific Journal of Cancer Prevention (5%) among journals, Malekzadeh R (1.09%) among authors, and Breast cancer (10.37%) among topics ranked the first. The trend of Iranian cancer research represents three periods: 1) germinating period, from 1970 to 2000, 2) developing period, from 2002 to 2014, and 3) flourishing period, from 2014 to 2018. It is expected that this trend will continue. The results indicate an average 12.8% increase in the logarithm of the count of articles published by Iranian cancer researchers each year. The findings are contextualized with Price’s publications trends principal for determining global and Iranian cancer research publication trends. Conclusion: The number of research papers published by Iranian researchers on cancer is increasing. In order to maintain the publication growth in this field, greater participation by other Iranian institutions is suggested. Although the quantity and quality of papers are increasing in some topics, certain topics and types of cancers should be still further studied and the Iranian policymakers should be encouraged to invest more in these topics.
Clinical Features and Prognosis in ANCA Associated Vasculitis Patients with Acute Kidney Injury
Authors: Chen Yue , Lu Yuqiu , Zhou Ying , Yu Chen
Published: June 2022

Background: Renal involvement in patients with anti-neutrophil cytoplasmic antibody (ANCA) associated vasculitis (AAV) often presents as acute kidney injury (AKI), which is closely related to the prognosis of critically ill patients. Nevertheless, there are few researches on the subgroup of AVV patients with AKI. The study aimed to explore clinical features and prognosis in AAV patients with AKI. Methods: A retrospective analysis of AAV patients was conducted. The enrolled patients were grouped according to whether AKI on admission occurred or not. Demographic, clinical data and follow-up records were gathered from medical histories. Survival rates of AAV patients with AKI and risk factors of all AAV patients were studied. Results: (1) In the AKI group, the levels of hemoglobin, evaluated glomerular filtration rate (eGFR), serum albumin and complement 3 were significantly lower (P<0.05); the proportions of microscopic polyangiitis (MPA) and levels of serum creatinine (SCr) on admission, red blood cell (RBC) counts in urine, 24-hour urine protein excretion (UPE) and Birmingham Vasculitis Activity Score (BVAS) were significantly higher (P<0.05). There was a significantly lower incidence of otorhinolaryngologic involvement in the AKI group (P<0.05). (2) There were significantly lower survival rates and renal survival rates in the AKI group (P<0.05). (3) Higher creatinine and AKI were risk factors for poor prognosis in AAV patients. Conclusion: AAV patients with AKI have more severe kidney damage, higher disease activity and worse prognosis. More attention should be paid to AAV patients with AKI for both remission induction and infection prevention.
Healthcare Utilization and Expenditures among Iranian Chemical Warfare Survivors Exposed to Sulfur Mustard
Authors: Mehdizadeh Parisa , Ghanei Mostafa , Pourreza Abolghasem , Akbari-sari Ali , Mousavi Batool , Daroudi Rajabali
Published: June 2022

Background: This study aims to explore the healthcare utilization (HCU) and expenditures from complementary health insurance among Iranian people who survived sulfur mustard (SM) exposure during the Iran-Iraq war. Methods: This study was conducted between March 21, 2018 and March 21, 2019 using secondary data. Data on the HCU and expenditure of war survivors after their exposure to SM were obtained from the Iran Veterans and Martyr Affair Foundation (VMAF) database and the national complementary insurance organization that covers their medical expenses. Multiple linear and zero-inflated poison regression (ZIP) models were used to estimate the costs and HCU. Analyses were performed in R software version 3.6.3. Results: Among 58880 survivors who were included in study, 36383 (61.7%) used at least one service during a year. The total frequency of HCU was 15.6 services per person per year. The annual mean medical cost of each survivor was US$807.6 (±2901.2). The highest number of utilizations was related to medicine and physician visits. The highest median cost was related to rehabilitation (US$151.7), medical equipment (US$84.5), medicine (US$83.3) and inpatient services (US$ 48.8). With increasing age, disability, weight, severity of injury in lung or eye injuries, the rate of health service utilization rose significantly. Conclusion: Over 30 years after the Iran-Iraq war, Iranian people who were exposed to SM and survived still suffer from injuries and pose a significant drain on healthcare resources.
A Comprehensive Survey of the Relationship between Helicobacter pylori Infection and Atherosclerosis in the Iranian Population: A Systematic Review and Meta-analysis
Authors: Keikha Masoud , Karbalaei Mohsen
Published: June 2022

Background: Helicobacter pylori is a gram-negative, spiral-shaped, and microaerophilic bacterium that inhabits the human gastric mucosa and is considered to be the most important etiologic agent for gastrointestinal disorders. Recently, however, there is ample evidence to suggest an association between H. pylori infection and extragastric complications, particularly atherosclerosis. The aim of this study was to evaluate the rate of H. pylori infection and the risk of atherosclerosis in an Iranian population. Methods: We conducted a comprehensive electronic search on PubMed, Scopus, Google scholar, IranMedex, SID, ISC, and Magiran to find the main published documents related to the relationship between H. pylori and atherosclerosis in Iran. A summary odds ratio with 95% confidence interval was used to investigate the potential association between H. pylori and atherosclerosis. In addition, the heterogeneity between studies was assessed by the I 2 index and the Cochrane Q-test. Publication bias was determined using a funnel plot. Results: A total of 12 studies met our inclusion criteria and were included in the present study. The results showed that there is a significant positive relationship between infection with this bacterium and the two-fold risk of developing atherosclerosis in the Iranian population (OR: 1.44; 95% CI: 1.07–1.95). However, the heterogeneity was significant and we observed a slight publication bias. Conclusion: We confirmed a positive relationship between H. pylori infection and atherosclerosis in the Iranian population, which is similar to other reports from Western countries. Most likely, H. pylori infection can increase the risk of developing atherosclerosis.
Impact of COVID 19 response on public health literacy and communication
Authors: Hange Namrata , Agoli Arjola Musta , Pormento Maria Kezia Lourdes , Sharma Amrit , Somagutta Manoj Reddy , Paikkattil Nidhin , Jadhav Amol , Bethineedi Deepak , Pisude Pravin
Published: June 2022

With unaddressed challenges of pandemic with re-emergence of coronavirus disease 2019 (COVID-19) waves, public health literacy and communication have proved to be a prerequisite for effective communication as part of the control strategy. Hence this article addressed the impact of COVID 19 response policies on public health literacy. Considering the rapid transmission of COVID-19, taking lives needs urgent attention from the population›s perspective to be more vigilant about health information and incorporate that into their daily routines. To be responsible and resilient globally, governments and states are formulating different health policies and related plans to prevent and control the spread of the pandemic. This article has recommended short-term measures, including smart focused IEC targeted on vaccination and motivational sessions for health care workers and front line workers. Targeted Long-term measures included healthcare system reforms inclusive of resources, workforce, capacity building with particular focus on lifestyle measures addressing non-communicable disease prevention.
Revisiting health promotion settings: An innovative model from Sri Lanka to integrate healthy settings using mHealth
Authors: Wijesinghe Millawage Supun Dilara , Weerasinghe WM Prasad Chathuranga , Gunawardana Balangoda Muhamdiramlage Indika , Rajapaksha RM Nayani Umesha , Vithana VCN , Karunaratne SASC , Koggalage Dinesh , Karunapema Palitha
Published: June 2022

The health promotion settings approach has been recognised as an effective method of health promotion in the recent era, and mobile health (mHealth) is a highly evolving field in the health sector. The health promotion settings are shifting the focus away from the individuals and moving towards a more holistic model of health promotion. We identified five settings in Sri Lanka to promote a mHealth model, including villages, schools, preschools, workplaces, and hospitals. The specified model using mHealth helps monitor the activities at various levels of healthcare, including regional, district and national levels. The model also maps the location of the healthy settings, which provide a visual picture to the policymakers, helpful in planning and decision-making.
The case to scale up edutainment as an effective public health communication intervention to combat the COVID-19 pandemic in Zimbabwe
Authors: Dzinamarira Tafadzwa , Nachipo Brian , Nyathi Albert , Madziva Roda , Herrera Helena , Sigel Hugh , Musuka Godfrey
Published: June 2022

Efforts to control the coronavirus disease 2019 (COVID-19) pandemic have been negatively affected by myths, misconceptions and misinformation, fuelled by an "infodemic" spread via social media platforms. In response, The Zimbabwean COVID-19 response built on its experience with past public health communication strategies to employ edutainment strategies for COVID-19 awareness campaigns. This article discusses the different strategies and how they were employed. In this perspective piece, the authors discuss edutainment as an effective vehicle for reaching wider sectors of society. In tackling complex social issues with simple language, integrated into various entertainment formats, edutainment can bring about change in contexts where traditional strategies and actions may prove unsuccessful.
Age discrimination perceived by hospitalized older adult patients in Iran: A qualitative study
Authors: Gholamzadeh Sakineh , Shaygan Maryam , Naderi Zeinab , Hosseini Fahimeh Alsadat
Published: June 2022

Background: The quality of care that older adult patients receive during hospitalization is directly associated with the perception, knowledge, and skills of the healthcare team. This qualitative study was conducted to explore the concept of age discrimination perceived by hospitalized older adult patients. Methods: The present exploratory qualitative study was conducted using conventional content analysis. The purposive sampling method was used to recruit participants and the sampling continued until data saturation. A total of 21 individuals comprising of 12 hospitalized older adult patients, 5 family caregivers, 3 nurses, and a physician were enrolled in the study. Data were collected through 21 face-to-face, semi-structured, in-depth interviews. Data were analyzed using the qualitative content analysis method as described by Elo and Kyngäs. Results: The analysis of the interview data resulted in 4 main categories, namely injustice perceptions, interactional injustice, procedural injustice, and organizational injustice. Conclusion: The findings of the study indicated that older adult patients perceive the occurrence of age discrimination by healthcare teams and inequalities in the provided care in hospitals. It is therefore important to address ageism and subsequent inequalities through short and long-term policies and plans, as well as standardization and transformation of the present condition of hospitals to become an age-friendly environment.
Gender Interaction in Association of Perceived Social Support and Health-Related Quality of Life Among Iranian Older People: A Cross-sectional Survey
Authors: Tajvar Maryam , Fletcher Astrid , Grundy Emily , Karami Badrye , Mohabbati Fatemeh
Published: June 2022

Background: The purpose of this study was to examine the relationship between perceived social support (PSS) and dimensions of health-related quality of life (HRQoL) and to examine possible gender interaction in the mentioned associations. Methods: A community-based cross-sectional study conducted among 644 participants over the age of 60 years old in Tehran. The data were collected through face-to-face interviews conducted in their own homes, by using a structured multi-sectional questionnaire. The version 1 of the SF-12 scale was used to measure the HRQoL, consisting of two summary measures; PCS (Physical Component Score) and MCS (Mental Component Score). The Persian version of the Social Provisions Scale (SPS) was used to measure PSS. Four multilevel mixed-effects logistic regression models were used to examine the associations. Results: Older people with poor SPS score were 1.8 times more likely to be in the worst quartile of the MCS distribution (CI=1.11-2.93, P=0.021), and twice as likely to be in the worst quartile of the PCS distribution (CI=1.18-3.54, P=0.011). We found strong evidence to support the hypothesis of gender interaction in the association between economic status and PCS [Men: OR 0.28, CI (0.11-0.71); Women: OR 1.00, CI (0.53-1.88); P of Interaction 0.021], and a borderline evidence for gender interaction in the association between physical activity and PCS [Men: OR 5.32, CI (2.14-13.20); Women: OR 1.80, CI (0.82-3.93); P of Interaction 0.051]. Conclusions: Social support could be regarded as one of the main social determinants affecting HRQoL among older people. Men with poor economic status and poor physical activity, compared to women, are more likely to suffer from poor quality of life, thus men should be prioritized in financial support and life style and physical activity interventions.
Influence of grit and healthy lifestyle behaviors on anxiety and depression in US adults at the beginning of the COVID-19 pandemic: Cross-sectional study
Authors: Toczko Mike , Merrigan Justin , Boolani Ali , Guempel Bishop , Milani Italia , Martin Joel
Published: June 2022

Background: The coronavirus disease 2019 (COVID-19) pandemic altered lifestyles and impacted mental health of many adults. Engaging in physical activity, avoiding prolonged sitting, and consuming a healthy diet improve mental health. The current study investigated the association between health-related lifestyle behaviors on feelings of anxiety and depression in adults during the early stages of the COVID-19 pandemic. Methods: Adults (n=796) living in the United States completed an internet-based survey in Spring 2020 that included validated survey instruments for moods, physical activity, sitting and dietary behaviors. Multivariate multiple regression models were used to assess the association between health-related lifestyle behaviors and feelings of anxiety and depression. Results: A majority (70.7%; 95% CI: [0.607, 0.807]) of participants met physical activity (PA) guidelines, 43.7% (95% CI: [0.287, 0.587]) sat for ≥ 8 hours per day, and 87.7% (95% CI [0.807, 0.947]) ate a healthy diet. Our final models explained 6.2% and 9.8% of the variance in anxiety and depression, respectively. Vigorous PA (anxiety: B=-0.111, 95% CI: [-0.171,0.000]; depression: B=-0.111, 95% CI: [-0.186,-0.037]) and dietary behaviors (anxiety: B=-0.112, 95% CI: [-0.180,-0.444]; depression: B=-0.112, 95% CI: [-0.213,-0.076]) were associated with reduced feelings of anxiety and depression while sitting time (anxiety: B=0.119, 95% CI: [0.000,0.199]; depression: B=0.119, 95% CI: [0.199,0.199]) were associated with greater feelings of anxiety and depression. Conclusion: Engaging in vigorous physically activity, reducing sitting time, and consuming a healthy diet was associated with reduced feelings of anxiety and depression during the early part of the pandemic. The aforementioned modifiable lifestyle behaviors are independent of each other suggesting improvements in one behavior may improve feelings of anxiety and depression.
The association between health expenditure, institutions, and economic growth in MENA countries
Authors: Faruk Bashir Umar , Haque Mohammad Imdadul , Tausif Mohammad Rumzi , Khan Md Riyazuddin
Published: June 2022

Background: Expenditure on health is vital in the development of a country. Furthermore, the current COVID-19 pandemic emphasises the importance of health investments in maintaining a healthier economy worldwide. A substantial amount of empirical research on the relationship between health expenditure and economic growth yields conflicting results. The study intends to investigate the relationship between health spending and economic growth and institutions’ role in causing health spending to promote growth. Methods: The study uses longitudinal data to examine the relationship between health spending and economic growth in seven MENA countries from 2000 to 2017. The study uses the Phillips Perron (PP) Fisher chi-square stationarity test, indicating that the data series is not stationary. Following this, we used the Pedroni test for cointegration, and the results show long-run relationships between the variables. Next, Granger causality determines the direction of causality. Finally, panel data methods of panel ordinary least squares (Panel OLS), fully modified OLS (FMOLS), and dynamic OLS (DLOS) supplement the findings. Results: The Pedroni cointegration test (P value<0.0001) indicates that the variables have a long-run cointegrating relationship. On the other hand, the Granger causality test finds no causal relationships between health spending and economic growth. Furthermore, the panel data models show that expenditure on health does not directly contribute to higher economic growth in MENA countries. Conclusion: The findings of this study indicate that health spending does not lead to increased economic growth; this could be due to poor institutional quality. However, for health spending to positively impact economic growth, these investments in health care must be supplemented by other factors, particularly institutions.
The relationship between trait emotional intelligence and problematic alcohol use among college students
Authors: Davis Robert E , Doyle Nicole A , Samuel Krishen D , Wilkerson Amanda H , Nahar Vinayak K
Published: June 2022

Background: Problematic alcohol use among college students is a significant public health concern. Emotional intelligence (EI), or the ability to detect one’s own and others’ emotions and to use this information to direct behavior, is suggested to mitigate problematic alcohol use. The purpose of this study was to examine the relationship between EI and problematic alcohol use among college students while controlling for drug use covariates. Methods: This cross-sectional study utilized an online survey comprised of previously validated measures to determine EI, problematic alcohol use, and drug use among college students from a large, public university in the south-central United States. Regression modeling and independent samples t-test were used to determine the relationship between EI and problematic alcohol use. Results: Problematic alcohol consumption was reported among 27.3% of participants (n=587). In regression modeling, EI demonstrated a significant, protective effect on problematic alcohol use (b=-0.050, P<0.001, 95% CI: -0.076 – -0.023), when adjusting for important covariates. Independent samples t-test showed that students who screened positive for harmful alcohol use reported significantly lower EI values than those who did not (Mean difference=4.53, t=2.98, P=0.003, 95% CI: 1.54–7.51). Conclusion: The findings from this study show that problematic alcohol use is prevalent among college students and EI may provide a protective effect against this deleterious behavior. Given the findings observed in this study, university officials should incorporate EI training into the university curriculum, such as in onboarding courses for freshman and transfer students, to target prevention of potentially harmful alcohol consumption and associated negative health impacts.