bluuebunny/crossref_metadata_2025 huggingface dataset:
Human Dietary Exposure to Heavy Metals via Rice in Nepal
Authors: Shao Yuxiao , Xu Xiaohang , Wang Le , Han Jialiang , Katuwal Hem Bahadur , Jiao Shulin , Qiu Guangle
Published: February 2023

The effects of exposure to heavy metals (HMs) in rice on human health have become a global public health concern, particularly in countries where rice is consumed as a staple food. The concentrations of HMs, including cadmium (Cd), arsenic (As), lead (Pb), and copper (Cu), in commercial rice samples (n = 170) were analyzed to estimate the HM exposure of consumers in Nepal. The geometric mean concentrations of Cd, As, Pb, and Cu in commercial rice were 15.5 ± 16.0, 43.4 ± 19.6, 16.0 ± 14.0, and 1066 ± 1210 μg/kg, respectively, all below the maximum allowable concentrations (MACs) recommended by FAO/WHO. Generally, the average estimated daily intakes (EDIs) of Cd, As, Pb, and Cu were all below the oral reference doses (RfDs). However, young age groups were exposed to high levels of HMs, and the average EDI of As and the P99.9 EDIs of Cu and Cd were above the corresponding RfDs. The mean hazard index and total carcinogenic risk were 1.13 and 1.04 × 10−3 respectively, suggesting a potential non-carcinogenic risk (NCR) and a carcinogenic risk (CR) via rice consumption. Arsenic contributed the most strongly to NCR and Cd to CR. Overall, although the HM levels in rice were generally safe, the Nepalese population may be exposed to an elevated health risk from rice consumption.
Short- and Long-Term Stability of Aromatic Amines in Human Urine
Authors: Mazumder Shrila , Ahamed Rayaj A. , Seyler Tiffany H. , Wang Lanqing
Published: February 2023

Several aromatic amines (AAs) are established by the International Agency for Research on Cancer as carcinogenic (group 1) or probable/possible carcinogens to humans (group 2A/2B). AAs can be found in mainstream and sidestream smoke from combustible tobacco products, as well as in certain environmental pollution and occupational exposure from several chemical industry sectors. Exposure to AAs can be estimated by measuring their concentrations in urine; however, information about the short-term and long-term stabilities of AAs in urine need to be characterized before conducting large-scale population studies on AA exposure and the potentially harmful effects of AA exposure. In this report, the storage stability of o-toluidine, 2,6-dimethylaniline, o-anisidine, 1-aminonaphthalene, 2-aminonaphthalene, and 4-aminobiphenyl fortified in pooled, filtered, non-smokers’ urine is analyzed by isotope dilution gas chromatography-triple quadrupole mass spectrometry (ID GC-MS/MS). The six AAs were measured in urine samples stored at ~20 °C (collection temperature), 4 °C and 10 °C (short-term transit temperatures), and −20 °C and −70 °C (long-term storage temperatures) over a 10-day period. All six analytes were stable for 10 days at transit and long-term storage temperatures but showed reduced recovery at 20 °C. The instability of the target AAs at 20 °C suggests that immediate storage of freshly voided urine at low temperatures is needed to attenuate degradation. A subset of the urine samples was analyzed following a longer storage duration at −70 °C: all AAs were stable for up to 14 months at this temperature. The stability of the six AAs in urine samples can be maintained at the various temperature levels and storage times expected in a typical study set.
Maternal Prepregnancy Obesity Affects Foetal Growth, Birth Outcome, Mode of Delivery, and Miscarriage Rate in Austrian Women
Authors: Syböck Katharina , Hartmann Beda , Kirchengast Sylvia
Published: February 2023

The increasing obesity rates among women of reproductive age create a major obstetrical problem as obesity during pregnancy is associated with many complications, such as a higher rate of caesarean sections. This medical record-based study investigates the effects of maternal prepregnancy obesity on newborn parameters, birth mode, and miscarriage rate. The data of 15,404 singleton births that had taken place between 2009 and 2019 at the public Danube Hospital in Vienna were enrolled in the study. Newborn parameters are birth weight, birth length, head circumference, APGAR scores, as well as pH values of the arterial and venous umbilical cord blood. In addition, maternal age, height, body weight at the beginning and the end of pregnancy, and prepregnancy body mass index (BMI) (kg/m2) have been documented. The gestational week of birth, the mode of delivery, as well as the number of previous pregnancies and births, are included in the analyses. Birth length, birth weight, and head circumference of the newborn increase with increasing maternal BMI. Furthermore, with increasing maternal weight class, there tends to be a decrease in the pH value of the umbilical cord blood. Additionally, obese women have a history of more miscarriages, a higher rate of preterm birth, and a higher rate of emergency caesarean section than their normal-weight counterparts. Consequently, maternal obesity before and during pregnancy has far-reaching consequences for the mother, the child, and thus for the health care system.
People’s Willingness to Pay for Dental Checkups and the Associated Individual Characteristics: A Nationwide Web-Based Survey among Japanese Adults
Authors: Oshima Katsuo
Published: February 2023

This study aimed to determine the willingness-to-pay (WTP) values for dental checkups and analyze the association between the values and individual characteristics. This cross-sectional study was conducted using a nationwide web-based survey, and 3336 participants were allocated into groups that received regular dental checkups (RDC; n = 1785) and those who did not (non-RDC; n = 1551). There was a statistically significant difference in the WTP value for dental checkups between the RDC (median: 3000 yen [22.51 USD]) and non-RDC groups (2000 yen [15.01 USD]). In the RDC group, age 50–59 years, household income <2 million yen, homemaker and part-time worker employment status, and having children were significantly associated with decreased WTP values; male sex, household incomes ≥8 million yen, and tooth brushing ≥3 times daily were associated with increased WTP values. In the non-RDC group, age ≥30 years, household incomes <4 million yen, and having ≥28 teeth were significantly associated with decreased WTP values; household income ≥8 million yen was associated with increased WTP values. Conclusively, WTP values for dental checkups were lower in the non-RDC group than in the RDC group; in the non-RDC group, those with lower household income aged ≥30 years were more likely to propose lower WTP values, suggesting the need for policy intervention to improve access to RDC.
Suicide Mortality Risk among Patients with Lung Cancer—A Systematic Review and Meta-Analysis
Authors: Hofmann Luisa , Heinrich Michael , Baurecht Hansjörg , Langguth Berthold , Kreuzer Peter M. , Knüttel Helge , Leitzmann Michael F. , Seliger Corinna
Published: February 2023

The risk for suicide in patients with cancer is higher compared to the general population. However, little is known about patients with lung cancer specifically. We therefore implemented a systematic review and random-effects meta-analysis of retrospective cohort studies on suicide in patients with lung cancer. We searched a high number of common databases up to 02/2021. For the systematic review, a total of 23 studies was included. To exclude bias due to patient sample overlap, the meta-analysis was performed on 12 studies. The pooled standardized mortality ratio (SMR) for suicide was 2.95 (95% Confidence Interval (CI) = 2.42–3.60) for patients with lung cancer as compared to the general population. Subgroups with a pronouncedly higher risk for suicide compared to the general population were found for patients living in the USA (SMR = 4.17, 95% CI = 3.88–4.48), with tumors of late stage (SMR = 4.68, 95% CI = 1.28–17.14), and within one year after diagnosis (SMR = 5.00, 95% CI = 4.11–6.08). An increased risk for suicide was found in patients with lung cancer, with subgroups at particular risk. Patients at increased risk should be monitored more closely for suicidality and should receive specialized psycho-oncological and psychiatric care. Further studies should clarify the role of smoking and depressive symptoms on suicidality among lung cancer patients.
A Digital Tool for Measuring Healing of Chronic Wounds Treated with an Antioxidant Dressing: A Case Series
Authors: Comino-Sanz Inés María , Cabello Jaime Rafael , Arboledas Bellón Josefina , Jiménez-García Juan Francisco , Muñoz-Conde Mercedes , Díez Requena María José , Díaz Francisco Javier García , Castro Begoña , Pancorbo-Hidalgo Pedro Luis
Published: February 2023

(1) Abstract: Wound monitoring is an essential aspect in the evaluation of wound healing. This can be carried out with the multidimensional tool HELCOS, which develops a quantitative analysis and graphic representation of wound healing evolution via imaging. It compares the area and tissues present in the wound bed. This instrument is used for chronic wounds in which the healing process is altered. This article describes the potential use of this tool to improve the monitoring and follow-up of wounds and presents a case series of various chronic wounds with diverse etiology treated with an antioxidant dressing. (2) Methods: A secondary analysis of data from a case series of wounds treated with an antioxidant dressing and monitored with the HELCOS tool. (3) Results: The HELCOS tool is useful for measuring changes in the wound area and identifying wound bed tissues. In the six cases described in this article, the tool was able to monitor the healing of the wounds treated with the antioxidant dressing. (4) Conclusions: the monitoring of wound healing with this multidimensional HELCOS tool offers new possibilities to facilitate treatment decisions by healthcare professionals.
Application and Comparison of Different Models for Quantifying the Aquatic Community in a Dam-Controlled River
Authors: Liu Jing , Zang Chao , Zuo Qiting , Han Chunhui , Krause Stefan
Published: February 2023

In order to develop a better model for quantifying aquatic community using environmental factors that are easy to get, we construct quantitative aquatic community models that utilize the different relationships between water environmental impact factors and aquatic biodiversity as follows: a multi-factor linear-based (MLE) model and a black box-based ‘Genetic algorithm-BP artificial neural networks’ (GA-BP) model. A comparison of the model efficiency and their outputs is conducted by applying the models to real-life cases, referring to the 49 groups of seasonal data observed over seven field sampling campaigns in Shaying River, China, and then performing model to reproduce the seasonal and inter-annual variation of the water ecological characteristics in the Huaidian (HD) site over 10 years. The results show that (1) the MLE and GA-BP models constructed in this paper are effective in quantifying aquatic communities in dam-controlled rivers; and (2) the performance of GA-BP models based on black-box relationships in predicting the aquatic community is better, more stable, and reliable; (3) reproducing the seasonal and inter-annual aquatic biodiversity in the HD site of Shaying River shows that the seasonal variation of species diversity for phytoplankton, zooplankton, and zoobenthos are inconsistent, and the inter-annual levels of diversity are low due to the negative impact of dam control. Our models can be used as a tool for aquatic community prediction and can become a contribution to showing how quantitative models in other dam-controlled rivers to assisting in dam management strategies.
Association between Familism and Mental Health in College Adolescents during the COVID-19 Pandemic
Authors: Mayorga-Muñoz Cecilia , Riquelme-Segura Leonor , Delvecchio Elisa , Lee-Maturana Saulyn
Published: February 2023

Familism, also known in the literature as allocentrism, is the cultural propensity of a society to place the family at the center of its value system. Adherence to this value has been related to less depressive symptomatology in young people; however, these results are not conclusive, since it has also been found that the influence of familism on depressive symptoms is more indirect than direct. This study aimed to explore the direct relationships between familism (allocentrism and idiocentrism) and mental health (depression, anxiety, and stress). Methodologically, the study had a non-experimental, cross-sectional, descriptive, and correlational design. A sample of 451 Chilean university students responded to an instrument composed of the subscales allocentrism, idiocentrism, depression, anxiety, and stress during the COVID-19 pandemic. The results showed that family allocentrism was positively and significantly associated with depression (γ = 0.112, p < 0.05), anxiety (γ = 0.209, p < 0.001), and stress (γ = 0.212, p < 0.001), and family idiocentrism was negatively and significantly linked with depression (γ = −0.392, p < 0.001), anxiety (γ = −0.368, p < 0.001), and stress (γ = −0.408, p < 0.001). These findings contribute to supporting actions to reduce negative symptomatology and promote greater well-being in university students.
Impact of Virtual Reality Cognitive and Motor Exercises on Brain Health
Authors: Sokołowska Beata
Published: February 2023

Innovative technologies of the 21st century have an extremely significant impact on all activities of modern humans. Among them, virtual reality (VR) offers great opportunities for scientific research and public health. The results of research to date both demonstrate the beneficial effects of using virtual worlds, and indicate undesirable effects on bodily functions. This review presents interesting recent findings related to training/exercise in virtual environments and its impact on cognitive and motor functions. It also highlights the importance of VR as an effective tool for assessing and diagnosing these functions both in research and modern medical practice. The findings point to the enormous future potential of these rapidly developing innovative technologies. Of particular importance are applications of virtual reality in basic and clinical neuroscience.
Comparison of Safety and Efficacy of Hydrus and iStent Combined with Phacoemulsyfication in Open Angle Glaucoma Patients: 24-Month Follow-Up
Authors: Jabłońska Joanna , Lewczuk Katarzyna , Rękas Marek Tadeusz
Published: February 2023

The paper presents the results of a 24-month-long observation comparing the effectiveness and safety of two micro-invasive glaucoma surgery (MIGS) devices: Hydrus Microstent and iStent Trabecular Bypass in combination with cataract phacoemulsification in the treatment of open-angle glaucoma. We also analyzed the impact of preoperative factors on achieving surgical success in both surgical methods. The prospective, comparative, non-randomized study included 65 glaucoma surgeries. In 35 patients (53.8%), an iStent implant procedure was performed, while 30 patients (46.2%) underwent a Hydrus implant procedure. The demographic data was similar in both treatment groups. At 24 months after surgery, the mean IOP in the iStent group was 15.9 ± 3.0 mmHg and in the Hydrus group 16.2 ± 1.8 mmHg. The difference between the mean iStent vs Hydrus after two years of treatment was −0.3 (p = 0.683). At the 24 month follow-up, the average change in the number of antiglaucoma medications used was 71.7% in the iStent group and 79.6% in the Hydrus group. The difference in mean percentage change between groups was 7.9% in favor of Hydrus. Patients under the age of 70 may benefit from a greater risk reduction in the Hydrus group (HR = 0.81), while those over the age of 70 may benefit from a risk reduction in the iStent group (HR = 1.33). IOP cases with >18 mmHg before the surgery have a better chance of surgical success with the Hydrus method (HR = 0.28), and with IOP < 18 mmHg in the iStent group (HR = 1.93). Cases with more drugs (≥3 drugs) are more favorable in the Hydrus group (HR = 0.23), while those with a maximum of two drugs have a better prognosis in the iStent group (HR = 2.23). The most common postoperative complication was the presence of erythrocytes in the anterior chamber (AC), found in 40.0% of operated eyes in the Hydrus group. The profile of observed complications and significant improvement in visual acuity allows us to consider both implants as a safe way of treating patients with early or moderate glaucoma and co-existing cataracts.
Ecological Impacts Associated with the Qinghai–Tibet Railway and Its Influencing Factors: A Comparison Study on Diversified Research Units
Authors: Zhang Lili , Miao Yi , Wei Haoxuan , Dai Teqi
Published: February 2023

The ecological impacts of the construction and operation of the main transport infrastructure on the Qinghai–Tibet Plateau cannot be disregarded. Based on different sections, buffers, bilateral sides, and periods, the authors of this study explored the ecological changes along the Qinghai–Tibet Railway through an integrated analysis of the landscape fragmentation index and ecological service value calculation from 2000 to 2020, as well as the influencing factors of differentiated trends, using multinomial logistic regression. It was discovered that there was heterogeneity among the sections, buffers, and bilateral sides in both the landscape fragmentation index and the ecological service value. It was also found that there was recoverability in the operation period, compared to the construction period. The negative correlation between the landscape fragmentation index and the ecological service value was only significant in 2020, which was not enough to fully explain the negative effect between them. Distinct human and natural circumstances have resulted in different consequences. However, regions far away from the main settlement areas, and with lower population densities, could aid in the simultaneous recovery of the ecological service value and landscape fragmentation index. According to these findings, prior studies may have exaggerated the ecological impact of the Qinghai–Tibet Railway. However, it should be highlighted that, in a location with a delicate ecological environment, it is still crucial to consider regional development, infrastructure construction, and ecological protection synchronously.
“I Had to Do It All Alone”: Hispanic Perspectives on Navigating Breast Cancer Treatment
Authors: Ko Eunjeong , Nguyen-Grozavu France , Valadez Galindo Andrea
Published: February 2023

Cancer patients are at a high risk for COVID infection and its corresponding impacts on treatment delay, social isolation, and psychological distress. Hispanic breast cancer patients may be more vulnerable due to a lack of resources and language barriers, widening disparities in cancer care. This qualitative study explored the challenges and obstacles to cancer care during the COVID pandemic among 27 Hispanic females from a United States–Mexico border region. Data were collected via individual in-depth interviews and analyzed using thematic analysis. The majority of the participants were interviewed in Spanish. More than half (55.6%, n = 15) were diagnosed with breast cancer within the prior year to the interview. One-third of the participants (33.3%, n = 9) reported that COVID somewhat to greatly impacted their cancer care. Study findings revealed potential barriers and challenges for cancer care at multiple levels (e.g., medical, psychosocial, financial level) during the COVID pandemic. Five major themes reported include: (1) delays in testing and access to care; (2) fear of COVID infection; (3) social isolation and reduced social support; (4) challenges in navigating treatments alone; and (5) financial hardships. Our findings highlight the importance for health care practitioners to understand various challenges encountered by underserved Hispanic breast cancer patients due to COVID. Screening for psychological distress and exploring approaches to expand social support to address these challenges are discussed.
Interaction between Occupational and Non-Occupational Arsenic Exposure and Tobacco Smoke on Lung Cancerogenesis: A Systematic Review
Authors: Folesani Giuseppina , Galetti Maricla , Petronini Pier Giorgio , Mozzoni Paola , La Monica Silvia , Cavallo Delia , Corradi Massimo
Published: February 2023

Although a higher lung cancer risk has been already associated with arsenic exposure, the contribution of arsenic and its compounds to the carcinogenic effects of other agents, such as tobacco smoke, is not well characterized. This systematic review examined the relationship between occupational and non-occupational arsenic exposure and tobacco smoking on lung cancer risk using papers published from 2010 to 2022. Two databases, PUBMED and Scifinder, were used for the searches. Among the sixteen human studies included, four were about occupational exposure, and the others were about arsenic in drinking water. Furthermore, only three case-control studies and two cohort studies evaluated an additive or multiplicative interaction. The interaction between arsenic exposure and tobacco smoke seems to be negligible at low arsenic concentrations (<100 μg/L), while there is a synergistic effect at higher concentrations. Finally, it is not yet possible to assess whether a linear no-threshold (LNT) model for lung cancer risk can be applied to the co-exposure to arsenic and tobacco smoke. Although the methodological quality of the included studies is good, these findings suggest that rigorous and accurate prospective studies on this topic are highly needed.
Determinants of Deteriorated Self-Perceived Health Status among Informal Settlement Dwellers in South Africa
Authors: Mokhele Tholang , Mutyambizi Chipo , Manyaapelo Thabang , Ngobeni Amukelani , Ndinda Catherine , Hongoro Charles
Published: February 2023

Self-perceived health (SPH) is a widely used measure of health amongst individuals that indicates an individual’s overall subjective perception of their physical or mental health status. As rural to urban migration increases, the health of individuals within informal settlements becomes an increasing concern as these people are at high health and safety risk due to poor housing structures, overcrowding, poor sanitation and lack of services. This paper aimed to explore factors related to deteriorated SPH status among informal settlement dwellers in South Africa. This study used data from the first national representative Informal Settlements Survey in South Africa conducted by the Human Sciences Research Council (HSRC) in 2015. Stratified random sampling was applied to select informal settlements and households to participate in the study. Multivariate logistic regression and multinomial logistic regression analyses were performed to assess factors affecting deteriorated SPH among the informal settlement dwellers in South Africa. Informal settlement dwellers aged 30 to 39 years old (OR = 0.332 95%CI [0.131–0.840], p < 0.05), those with ZAR 5501 and more household income per month (OR = 0.365 95%CI [0.144–0.922], p < 0.05) and those who reported using drugs (OR = 0.069 95%CI [0.020–0.240], p < 0.001) were significantly less likely to believe that their SPH status had deteriorated compared to the year preceding the survey than their counterparts. Those who reported always running out of food (OR = 3.120 95%CI [1.258–7.737], p < 0.05) and those who reported having suffered from illness or injury in the past month preceding the survey (OR = 3.645 95%CI [2.147–6.186], p < 0.001) were significantly more likely to believe that their SPH status had deteriorated compared to the year preceding the survey than their counterparts. In addition, those who were employed were significantly (OR = 1.830 95%CI [1.001–3.347], p = 0.05) more likely to believe that their SPH status had deteriorated compared to the year preceding the survey than those who were unemployed with neutral SPH as a base category. Overall, the results from this study point to the importance of age, employment, income, lack of food, drug use and injury or illness as key determinants of SPH amongst informal settlement dwellers in South Africa. Given the rapid increasing number of informal settlements in the country, our findings do have implications for better understanding the drivers of deteriorating health in informal settlements. It is therefore recommended that these key factors be incorporated into future planning and policy development aimed at improving the standard of living and health of these vulnerable residents.
The Influence of Everyday Acoustic Environments on the Challenging Behavior in Dementia: A Participatory Observation Study in Nursing Homes
Authors: Talebzadeh Arezoo , Decoutere Ine , Vander Mynsbrugge Tara , Botteldooren Dick , Devos Paul , Aletta Francesco , Van de Velde Dominique , De Vriendt Patricia
Published: February 2023

Challenging behavior (CB) is a group of behaviors, reactions and symptoms due to dementia, which can be challenging for the caregivers. The study aims to research the influence of acoustics on CB in people with dementia (PwD). An ethnographic method was used to study the daily life of PwD in their nursing homes with a specific focus on how people react to everyday environmental sounds. Thirty-five residents were included in the sample based on purposeful, homogeneous group characteristics and sampling. Empirical data were collected using 24/7 participatory observations. The collected data were analyzed using a phenomenological–hermeneutical method: a naïve understanding, a structural analysis and a comprehensive understanding. The result shows that the onset of CB depends on whether the resident feels safe and is triggered by an excess or lack of stimuli. The excess or shortage of stimuli and whether and when it affects a person is personal. It depends on various factors, the person’s state and the time of day, the nature of the stimuli, familiarity, or strangeness is also a determining factor for the onset and progression of CB. The results can form an essential basis for developing soundscapes to make the PwD feel safe and reduce CB.
Dietary Intake of Salt from Meat Products in Serbian Population
Authors: Jelena Milešević , Slobodan Lilić , Danijela Vranić , Milica Zeković , Branka Borović , Marija Glibetić , Mirjana Gurinović , Dragan Milićević
Published: February 2023

Salt intake above 5 g/day correlates with prevalence of hypertension and cardiovascular diseases (CVD). CVD, the leading cause of mortality and morbidity in Europe, account for 45% of all deaths, while, in Serbia in 2021, CVD accounted for 47.3%. The objective was to investigate salt content labelled on meat products from the Serbian market and estimate dietary exposure to salt from meat products in the Serbian population using consumption data. Data on salt content were collected from 339 meat products and classified in eight groups. Consumption data were collected using the EFSA EU Menu methodology (2017–2021) from 576 children and 3018 adults (145 pregnant women) in four geographical regions of Serbia. The highest salt content was in dry fermented sausages and dry meat, average 3.78 ± 0.37 g/100 g and 4.40 ± 1.21 g/100 g, respectively. The average intake of meat products is 45.21 ± 39.0 g/day and estimated daily salt intake from meat products per person is 1.192 g, which is 24% of the daily recommended amount. The actual meat product consumption and content of salt in meat products in Serbia present a risk factor for development of CVD and related comorbidities. A targeted strategy, policy and legislation for salt reduction are needed.
Pelvic Floor Disorders and Pelvic Floor Muscle Exercise: A Survey on Knowledge, Attitude, and Practice among Pregnant Women in Northwest Ethiopia
Authors: Tennfjord Merete Kolberg , Kassie Belayneh Ayanaw , Gashaw Zelalem Mengistu , Asaye Mengstu Melkamu , Muche Haymanot Alem , Fenta Tibebu Tadesse , Chala Kalkidan Nigussie , Mæland Karolina S.
Published: February 2023

The purpose of the study was to investigate 1: overall knowledge of pelvic organ prolapse (POP) and urinary incontinence (UI) as well as knowledge, attitudes, and practice of pelvic floor muscle exercise (PFME); and 2: the association of these factors with parity in pregnant women in Gondar, Ethiopia. A facility-based cross-sectional study was performed in the Central Gondar zone, northwest Ethiopia between February and April 2021. The associations between parity and knowledge of POP and UI, and knowledge, attitude, and practice towards PFME were estimated using logistics regression models and presented as crude and adjusted odds ratios with 95% confidence intervals. Nulliparous women were used as the reference. Adjustments were made for maternal age, antenatal care visits, and level of education. The study sample comprised 502 pregnant women: 133 nulliparous, and 369 multiparous. We found no association between parity and knowledge of POP, UI, or knowledge, attitude, and practice toward PFME. The sum score indicated poor knowledge about both POP, UI, and PFME in the study population, and poor attitude and practice of PFME. Despite a high attendance in antenatal care services, knowledge, attitude, and practice were poor, indicating a need for quality improvement of the services.
Effects of Workplace Ostracism on Burnout among Nursing Staff during the COVID-19 Pandemic, Mediated by Emotional Labor
Authors: Yang Feng-Hua , Tan Shih-Lin
Published: February 2023

This study investigated the effects of workplace ostracism on emotional labor and burnout among current nursing staff during the COVID-19 pandemic, as well as the relationship between the surface acting and deep acting of emotional labor as the mediators of workplace ostracism and burnout. The sample for this study consisted of 250 nursing staff recruited from Taiwanese medical institutions, and the questionnaire was divided into two stages. The first stage included questions about ostracism and personal data, and then two months later the same respondents completed part two of the questionnaire regarding emotional labor and burnout, which solved the problem of common-method variance (CMV). The results of this study indicate that ostracism had a positive and significant effect on burnout and surface acting, but its negative effect on deep acting was not supported. While surface acting showed partial mediation between ostracism and burnout, deep acting did not have a significant mediating effect between ostracism and burnout. These results can provide a reference for practice and researchers.
Theoretically Guided Iterative Design of the Sense2Quit App for Tobacco Cessation in Persons Living with HIV
Authors: Schnall Rebecca , Trujillo Paul , Alvarez Gabriella , Michaels Claudia L. , Brin Maeve , Huang Ming-Chun , Chen Huan , Xu Wenyao , Cioe Patricia A.
Published: February 2023

The use of mobile health (mHealth technology) can be an effective intervention when considering chronic illnesses. Qualitative research methods were used to identify specific content and features for a mobile app for smoking cessation amongst people living with HIV (PWH). We conducted five focus group sessions followed by two Design Sessions with PWH who were or are currently chronic cigarette smokers. The first five groups focused on the perceived barriers and facilitators to smoking cessation amongst PWH. The two Design Sessions leveraged the findings from the focus group sessions and were used to determine the optimal features and user interface of a mobile app to support smoking cessation amongst PWH. Thematic analysis was conducted using the Health Belief Model and Fogg’s Functional Triad. Seven themes emerged from our focus group sessions: history of smoking, triggers, consequences of quitting smoking, motivation to quit, messages to help quit, quitting strategies, and mental health-related challenges. Functional details of the app were identified during the Design Sessions and used to build a functional prototype.
A Cluster-Randomised Stepped-Wedge Impact Evaluation of a Pragmatic Implementation Process for Improving the Cultural Responsiveness of Non-Aboriginal Alcohol and Other Drug Treatment Services: A Pilot Study
Authors: Farnbach Sara , Henderson Alexandra , Allan Julaine , Wallace Raechel , Shakeshaft Anthony
Published: February 2023

There is limited evidence regarding implementing organisational improvements in the cultural responsiveness of non-Aboriginal services. Using a pragmatic implementation process to promote organisational change around cultural responsiveness, we aimed to (i) identify its impact on the cultural responsiveness of participating services; (ii) identify areas with the most improvement; and (iii) present a program logic to guide cultural responsiveness. A best-evidence guideline for culturally responsive service delivery in non-Aboriginal Alcohol and other Drug (AoD) treatment services was co-designed. Services were grouped geographically and randomised to start dates using a stepped wedge design, then baseline audits were completed (operationalization of the guideline). After receiving feedback, the services attended guideline implementation workshops and selected three key action areas; they then completed follow-up audits. A two-sample Wilcoxon rank-sum (Mann–Whitney) test was used to analyse differences between baseline and follow-up audits on three key action areas and all other action areas. Improvements occurred across guideline themes, with significant increases between median baseline and follow-up audit scores on three key action areas (median increase = 2.0; Interquartile Range (IQR) = 1.0–3.0) and all other action areas (median increase = 7.5; IQR = 5.0–11.0). All services completing the implementation process had increased audit scores, reflecting improved cultural responsiveness. The implementation process appeared to be feasible for improving culturally responsive practice in AoD services and may be applicable elsewhere.
Use of Intrinsic Capacity Domains as a Screening Tool in Public Health
Authors: Nascimento Livia Maria do , Cruz Thainá Gabriele Camargo da , Silva Juliana Fernanda de Lima e , Silva Letícia Prado , Inácio Beatriz Bigatão , Sadamitsu Carolina Masumi Oki , Scheicher Marcos Eduardo
Published: February 2023

The World Health Organization (WHO) created the concept of Integrated Care for Older People and one of its constructs is intrinsic capacity (IC). The study aimed to carry out a screening with the tools designated by the WHO to assess the IC domains and whether they can be used as indicators for decision-making on integrated care for older people based on risk categorization. The interaction between the risk category and the domain scores was verified. One hundred and sixty three (163) community-dwelling older people of both genders were evaluated. Domains assessed: cognitive, psychological, vitality, locomotion, and sensory. Scores indicating a low, moderate and high risk were assigned to each domain. For all domains, there were individuals in all risk groups. Effect of risk on the domains: cognitive [χ2(2) = 134.042; p < 0.001], psychological [χ2(2) = 92.865; p < 0.001], vitality [χ2(2) = 129.564; p < 0.001], locomotion [χ2(2) = 144.101; p < 0.001], and sensory [χ2(2) = 129.037; p < 0.001]. Scores of the CI domains were affected by the risk category. There were individuals in all risk groups, demonstrating the importance of screening as a public health strategy, making it possible to know which risk category each elderly person belongs to and thus develop strategies in the short-, medium- and long-term.
Two Decades of Land-Use Dynamics in an Urbanizing Tropical Watershed: Understanding the Patterns and Drivers
Authors: Wiwoho Bagus Setiabudi , Phinn Stuart , McIntyre Neil
Published: February 2023

Java’s Brantas River Basin (BRB) is an increasingly urbanized tropical watershed with significant economic and ecological importance; yet knowledge of its land-use changes dynamics and drivers as well as their importance have barely been explored. This is the case for many other tropical watersheds in Java, Indonesia and beyond. This study of the BRB (1) quantifies the land-use changes in the period 1995–2015, (2) determines the patterns of land-use changes during 1995–2015, and (3) identifies the potential drivers of land-use changes during 1995–2015. Findings show that from 1995 to 2015, major transitions from forest to shrubs (218 km2), forest to dryland agriculture (512 km2), and from agriculture to urban areas (1484 km2) were observed in the BRB. Responses from land-user questionnaires suggest that drivers include a wide range of economic, social, technological, and biophysical attributes. An agreement matrix provided insight about consistency and inconsistency in the drivers inferred from the Land Change Modeler and those inferred from questionnaires. Factors that contributed to inconsistencies include the limited representation of local land-use features in the spatial data sets and comprehensiveness of land-user questionnaires. Together the two approaches signify the heterogeneity and scale-dependence of the land-use change process.
Progressive Geological Modeling and Uncertainty Analysis Using Machine Learning
Authors: Li Hong , Wan Bo , Chu Deping , Wang Run , Ma Guoxi , Fu Jinming , Xiao Zhuocheng
Published: February 2023

Three-dimensional geological modeling is a process of interpreting geological features from limited sample data and making predictions, which can be converted into a classification task for grid units in the geological space. In sedimentary settings, it is difficult for a single geological classification process to comprehensively express the complex geological spatio-temporal relationships of underground space. In response to this problem, we proposed a progressive geological modeling strategy to reconstruct the subsurface based on a machine learning approach. The modeling work consisted of two-stage classifications. In the first stage, a stratigraphic classifier was built by mapping spatial coordinates into stratigraphic classes, which reflected the geological time information of the geological unit. Then, the obtained stratigraphic class was used as a new feature for the training of the lithologic classifier in the second stage, which allowed the stratigraphic information to be implicitly converted into a new rule condition and enabled us to output the lithologic class with stratigraphic implications. Finally, the joint Shannon entropy of two classifications was calculated to evaluate the uncertainty of the total steps. The experiment built a fine-grained 3D geological model with integrated expression of stratigraphic and lithologic information and validated the effectiveness of the strategy. Moreover, compared with the conventionally trained classifier, the misclassification of the lithologic class between different strata in the progressive classification results has been reduced, with the improvement of the F1-score from 0.75 to 0.78.
Variable Intrinsic Expression of Immunoregulatory Biomarkers in Breast Cancer Cell Lines, Mammospheres, and Co-Cultures
Authors: Montoyo-Pujol Yoel Genaro , García-Escolano Marta , Ponce José J. , Delgado-García Silvia , Martín Tina Aurora , Ballester Hortensia , Castellón-Molla Elena , Martínez-Peinado Pascual , Pascual-García Sandra , Sempere-Ortells José Miguel , Peiró Gloria
Published: February 2023

Advances in immunotherapy have increased interest in knowing the role of the immune system in breast cancer (BC) pathogenesis. Therefore, immune checkpoints (IC) and other pathways related to immune regulation, such as JAK2 and FoXO1, have emerged as potential targets for BC treatment. However, their intrinsic gene expression in vitro has not been extensively studied in this neoplasia. Thus, we evaluated the mRNA expression of tumor-cell-intrinsic CTLA-4, PDCD1 (PD1), CD274 (PD-L1), PDCD1LG2 (PD-L2), CD276 (B7-H3), JAK2, and FoXO1 in different BC cell lines, derived mammospheres, and co-cultures with peripheral blood mononuclear cells (PBMCs) by real-time quantitative polymerase chain reaction (qRT-PCR). Our results showed that intrinsic CTLA-4, CD274 (PD-L1), and PDCD1LG2 (PD-L2) were highly expressed in triple-negative cell lines, while CD276 was predominantly overexpressed in luminal cell lines. In contrast, JAK2 and FoXO1 were under-expressed. Moreover, high levels of CTLA-4, PDCD1 (PD1), CD274 (PD-L1), PDCD1LG2 (PD-L2), and JAK2 were found after mammosphere formation. Finally, the interaction between BC cell lines and peripheral blood mononuclear cells (PBMCs) stimulates the intrinsic expression of CTLA-4, PCDC1 (PD1), CD274 (PD-L1), and PDCD1LG2 (PD-L2). In conclusion, the intrinsic expression of immunoregulatory genes seems very dynamic, depending on BC phenotype, culture conditions, and tumor-immune cell interactions.
Cyclodextrin-Based Displacement Strategy of Sterigmatocystin from Serum Albumin as a Novel Approach for Acute Poisoning Detoxification
Authors: Jakšić Daniela , Šegvić Klarić Maja , Rimac Hrvoje , Kerep Robert , Piantanida Ivo
Published: February 2023

This study demonstrates that sterigmatocystin (STC) interacts non-covalently with various cyclodextrins (CDs), showing the highest binding affinity for sugammadex (a γ-CD derivative) and γ-CD, and an almost order of magnitude lower affinity for β-CD. This difference in affinity was studied using molecular modelling and fluorescence spectroscopy, which demonstrated a better insertion of STC into larger CDs. In parallel, we showed that STC binds to human serum albumin (HSA) (a blood protein known for its role as a transporter of small molecules) with an almost two order of magnitude lower affinity compared to sugammadex and γ-CD. Competitive fluorescence experiments clearly demonstrated an efficient displacement of STC from the STC–HSA complex by cyclodextrins. These results are a proof-of-concept that CDs can be used to complex STC and related mycotoxins. Similarly, as sugammadex extracts neuromuscular relaxants (e.g., rocuronium and vecuronium) from blood and blocks their bioactivity, it could also be used as first aid upon acute intoxication to encapsulate a larger part of the STC mycotoxin from serum albumin.
Proteotranscriptomic Discrimination of Tumor and Normal Tissues in Renal Cell Carcinoma
Authors: Bartha Áron , Darula Zsuzsanna , Munkácsy Gyöngyi , Klement Éva , Nyirády Péter , Győrffy Balázs
Published: February 2023

Clear cell renal carcinoma is the most frequent type of kidney cancer, with an increasing incidence rate worldwide. In this research, we used a proteotranscriptomic approach to differentiate normal and tumor tissues in clear cell renal cell carcinoma (ccRCC). Using transcriptomic data of patients with malignant and paired normal tissue samples from gene array cohorts, we identified the top genes over-expressed in ccRCC. We collected surgically resected ccRCC specimens to further investigate the transcriptomic results on the proteome level. The differential protein abundance was evaluated using targeted mass spectrometry (MS). We assembled a database of 558 renal tissue samples from NCBI GEO and used these to uncover the top genes with higher expression in ccRCC. For protein level analysis 162 malignant and normal kidney tissue samples were acquired. The most consistently upregulated genes were IGFBP3, PLIN2, PLOD2, PFKP, VEGFA, and CCND1 (p < 10−5 for each gene). Mass spectrometry further validated the differential protein abundance of these genes (IGFBP3, p = 7.53 × 10−18; PLIN2, p = 3.9 × 10−39; PLOD2, p = 6.51 × 10−36; PFKP, p = 1.01 × 10−47; VEGFA, p = 1.40 × 10−22; CCND1, p = 1.04 × 10−24). We also identified those proteins which correlate with overall survival. Finally, a support vector machine-based classification algorithm using the protein-level data was set up. We used transcriptomic and proteomic data to identify a minimal panel of proteins highly specific for clear cell renal carcinoma tissues. The introduced gene panel could be used as a promising tool in the clinical setting.
Polarized Anti-Inflammatory Mesenchymal Stem Cells Increase Hippocampal Neurogenesis and Improve Cognitive Function in Aged Mice
Authors: Tfilin Matanel , Gobshtis Nikolai , Fozailoff David , Fraifeld Vadim E. , Turgeman Gadi
Published: February 2023

Age-related decline in cognitive functions is associated with reduced hippocampal neurogenesis caused by changes in the systemic inflammatory milieu. Mesenchymal stem cells (MSC) are known for their immunomodulatory properties. Accordingly, MSC are a leading candidate for cell therapy and can be applied to alleviate inflammatory diseases as well as aging frailty via systemic delivery. Akin to immune cells, MSC can also polarize into pro-inflammatory MSC (MSC1) and anti-inflammatory MSC (MSC2) following activation of Toll-like receptor 4 (TLR4) and TLR3, respectively. In the present study, we apply pituitary adenylate cyclase-activating peptide (PACAP) to polarize bone-marrow-derived MSC towards an MSC2 phenotype. Indeed, we found that polarized anti-inflammatory MSC were able to reduce the plasma levels of aging related chemokines in aged mice (18-months old) and increased hippocampal neurogenesis following systemic administration. Similarly, aged mice treated with polarized MSC displayed improved cognitive function in the Morris water maze and Y-maze assays compared with vehicle- and naïve-MSC-treated mice. Changes in neurogenesis and Y-maze performance were negatively and significantly correlated with sICAM, CCL2 and CCL12 serum levels. We conclude that polarized PACAP-treated MSC present anti-inflammatory properties that can mitigate age-related changes in the systemic inflammatory milieu and, as a result, ameliorate age related cognitive decline.
Influence of the Mediterranean Diet on Healthy Aging
Authors: Andreo-López Maria Carmen , Contreras-Bolívar Victoria , Muñoz-Torres Manuel , García-Fontana Beatriz , García-Fontana Cristina
Published: February 2023

The life expectancy of the global population has increased. Aging is a natural physiological process that poses major challenges in an increasingly long-lived and frail population. Several molecular mechanisms are involved in aging. Likewise, the gut microbiota, which is influenced by environmental factors such as diet, plays a crucial role in the modulation of these mechanisms. The Mediterranean diet, as well as the components present in it, offer some proof of this. Achieving healthy aging should be focused on the promotion of healthy lifestyle habits that reduce the development of pathologies that are associated with aging, in order to increase the quality of life of the aging population. In this review we analyze the influence of the Mediterranean diet on the molecular pathways and the microbiota associated with more favorable aging patterns, as well as its possible role as an anti-aging treatment.
Total Skin Treatment with Helical Arc Radiotherapy
Authors: Nien Hsin-Hua , Hsieh Chen-Hsi , Shueng Pei-Wei , Tien Hui-Ju
Published: February 2023

For widespread cutaneous lymphoma, such as mycosis fungoides or leukemia cutis, in patients with acute myeloid leukemia (AML) and for chronic myeloproliferative diseases, total skin irradiation is an efficient treatment modality for disease control. Total skin irradiation aims to homogeneously irradiate the skin of the entire body. However, the natural geometric shape and skin folding of the human body pose challenges to treatment. This article introduces treatment techniques and the evolution of total skin irradiation. Articles on total skin irradiation by helical tomotherapy and the advantages of total skin irradiation by helical tomotherapy are reviewed. Differences among each treatment technique and treatment advantages are compared. Adverse treatment effects and clinical care during irradiation and possible dose regimens are mentioned for future prospects of total skin irradiation.