bluuebunny/crossref_metadata_2025 huggingface dataset:
Diurnal Nonlinear Recurrence Metrics of Skin Temperature and Their Association with Metabolic Hormones in Contrasting Climate Settings: A Randomized Cross-Over Trial
Authors: Makris Konstantinos C. , Charisiadis Pantelis , Delplancke Thibaut , Efthymiou Nikolaos , Giuliani Alessandro
Published: November 2022

The urban overheating phenomenon in Mediterranean cities is a societal challenge with vast implications for the protection of public health. An additional analysis of the pilot TEMP randomized 2 × 2 cross-over trial was set up, using wearable sensor-based skin temperature measurements (n = 14). The study objectives were to: (i) assess the recurrence patterns of skin temperature measurements in individuals spending time in two climatologically contrasting settings (urban versus mountainous), and (ii) evaluate the association between the diurnal nonlinear recurrence quantification analysis (RQA) metrics and metabolic hormone levels. The intervention was a short-term stay (5–7 days) in a mountainous, climate-cooler setting (range 600–900 m altitude), which is about a 1 h drive from the main urban centres of Cyprus. The RQA analysis showed a blunting phenomenon on the nonlinear temporal dynamics of skin temperature time series observed in the urban setting. Compared with the mountainous setting, a more stable (and thus less adaptive) profile of skin temperature dynamics in the urban setting appeared, being less deterministic and with a smaller degree of complexity. No significant (p > 0.05) associations were observed between the leptin or cortisol and any of the skin temperature dynamical descriptors. However, there were marginal associations between the adiponectin and laminarity (beta = 0.24, 95%CI: −0.02, 0.50, p = 0.07) and with determinism (beta = 0.23, 95%CI: −0.037, 0.50, p = 0.09). We found dysregulations in skin temperature temporal dynamics of the study population while residing in the urban setting when compared with the cooler mountainous setting; these dysregulations took the form of reduced cycle duration and complexity, while skin temperature dynamics became less responsive to perturbations and less regular in magnitude. More research is needed to better understand heat stress temporal dynamics and their influence on human health. Trial registration: This trial is registered with ClinicalTrials.gov; number: NCT03625817.
Using a Modified Delphi Approach and Nominal Group Technique for Organisational Priority Setting of Evidence-Based Interventions That Advance Women in Healthcare Leadership
Authors: Mousa Mariam , Teede Helena J. , Garth Belinda , Winship Ingrid M. , Prado Luis , Boyle Jacqueline A.
Published: November 2022

Background: Few studies address how to prioritise organisational interventions that advance women in leadership. We report on the relevance, feasibility and importance of evidence-based interventions for a large healthcare organisation. This study supports the first stage of implementation in a large National Health and Medical Research Council funded initiative seeking to advance women in healthcare leadership. Methods: An expert multi-disciplinary panel comprised of health professionals and leaders from a large healthcare network in Australia participated. The initial Delphi survey was administered online and results were presented in a Nominal Group Technique workshop. Here, the group made sense of the survey results, then evaluated findings against a framework on implementation criteria. Two further consensus surveys were conducted during the workshop. Results: Five priority areas were identified. These included: 1. A committed and supportive leadership team; 2. Improved governance structures; 3. Mentoring opportunities; 4. Leadership training and development; and 5. Flexibility in working. We describe the overall priority setting process in the context of our findings. Conclusions: With evidence and expert input, we established priorities for advancing women in healthcare leadership with a partnering healthcare organisation. This approach can be adapted in other settings, seeking to advance women in leadership.
Socioeconomic Determinants of Willingness to Pay for Emergency Public Dental Services in Saudi Arabia: A Contingent Valuation Approach
Authors: Hawsawi Halah Saleh , Immurana Mustapha , Al-Hanawi Mohammed Khaled
Published: November 2022

Dental diseases remain major health problems worldwide, leading to pain, discomfort, and even death. In Saudi Arabia, public dental care services (i.e., services provided by government-owned health facilities) are provided free of charge for all Saudi citizens. However, public dental care facilities are overburdened and overcrowded, resulting in long waiting times to access dental care services. The consequent limited access to dental services can prolong discomfort and delay pain management, thereby exacerbating the suffering of patients. Therefore, the aim of this study was to examine the socioeconomic determinants of the willingness to pay for immediate public dental care in the face of a dental emergency in Saudi Arabia. A cross-sectional design was employed to obtain data from adult citizens of Saudi Arabia who were residents of the Holy City of Makkah. A pre-tested online questionnaire was used to obtain the responses from 549 individuals, selected through a snowball sampling technique, from 15 July to 10 August 2021. Descriptive statistics (frequencies and percentages), Pearson’s chi-square test, and binary probit regression were used as estimation techniques. The findings showed that 79.4% of the respondents were willing to pay for immediate public dental services, with the majority (86%) expressing a willingness to pay less than 500 Saudi Riyal (SAR). The binary probit regression estimates showed that respondents who were unemployed, those with a high school level of education or below, and those without private health insurance were less likely to be willing to pay for immediate public dental services. Thus, policies and initiatives aimed at enhancing the willingness to pay for immediate public dental services should target the unemployed, those with a high school level of education or below, and people without private health insurance.
Assessing the Information Potential of MIR Spectral Signatures for Prediction of Multiple Soil Properties Based on Data from the AfSIS Phase I Project
Authors: Gruszczyński Stanisław , Gruszczyński Wojciech
Published: November 2022

The aim of the study was to assess the predictive potential of mid-infrared (MIR) spectral response in the estimation of 60 soil properties. It is important to know the accuracy limitations in estimating various soil characteristics using various models in conditions of high spatial variability of the environment. To fully assess this potential, three types of algorithms were used in modeling, i.e., partial least squares (PLSR), one-dimensional convolutional neural network (1DCNN), and generalized regression neural network (GRNN). The research used data from 19 sub-Saharan African countries collected as part of the Africa Soil Information Service (AfSIS) Phase I project. The repositories provide 18,250 MIR reflectance recordings and nearly two thousand analytical data records from the determination of many soil properties by reference methods. The modeled subset of these properties included texture (three variables), bulk density, moisture content at soil water characteristic curves (SWCC, 4 variables), total and organic C and total N content (3 variables), total elemental content (32 variables), elemental content in bioavailable forms (12 variables), electrical conductivity, exchangeable acidity, exchangeable bases, pH, and phosphorus sorption index. It is not possible to indicate a universal optimal prediction model for all soil variables. The best prediction results are provided by all regression models for total and organic C, total Fe, total Al and bioavailable Al content, and pH. For bulk density, total N and total K content satisfactory results are provided by specific model type. Many other properties, i.e., texture, SWCC, total Ga, Rb, Na, Ca, Cu, Pb, Hg content, and bioavailable Ca and K content, can be predicted with accuracies sufficient for some less demanding tasks.
The Bibliometric Analysis of Studies on Physical Literacy for a Healthy Life
Authors: Mendoza-Muñoz María , Vega-Muñoz Alejandro , Carlos-Vivas Jorge , Denche-Zamorano Ángel , Adsuar José Camelo , Raimundo Armando , Salazar-Sepúlveda Guido , Contreras-Barraza Nicolás , Muñoz-Urtubia Nicolás
Published: November 2022

This article empirically provides a global overview of physical literacy, which allows for the understanding of the structure of the epistemic community studying literacy for healthy living. Publications registered in the Web of Science are analyzed using bibliometrics (spatial, productive, and relational) based on data from 391 records, published between 2007 and April 2022, applying five bibliometric laws and using VOSviewer software for data and metadata processing and visualization. In terms of results, we observe an exponential increase in scientific production in the last decade, with a concentration of scientific discussion on physical literacy in seven journals; a production distributed in 46 countries situated on the five continents, but concentrated in Canada and the United States; co-authored research networks composed of 1256 researchers but with a production concentrated of around 2% of these, and an even smaller number of authors with high production and high impact. Finally, there are four thematic blocks that, although interacting, constitute three specific knowledge production communities that have been delineated over time in relation to health and quality of life, fitness and physical competence, education, and fundamental movement skills.
An Elastic Foot Orthosis for Limiting the Increase of Shear Modulus of Lower Leg Muscles after a Running Task: A Randomized Crossover Trial
Authors: Sakamoto Kodai , Sasaki Megumi , Tsujioka Chie , Kudo Shintarou
Published: November 2022

Background: Excessive foot pronation may be attributed to an increasing burden on leg muscles during running, which might be a factor in medial tibial stress syndrome. We developed an elastic foot orthosis (EFO) that can decrease foot pronation and aimed to identify whether this orthosis could limit the increase in lower leg muscle hardness after running. Methods: Twenty-one healthy volunteers participated in this randomized crossover trial with an elastic or sham foot orthosis (SFO). All volunteers ran on a treadmill for 60 min while wearing either orthosis. Muscle hardness of the posterior lower leg was assessed using shear wave elastography before and after running. The Wilcoxon signed rank test was used to compare muscle hardness between the two orthotic conditions. Results: No significant differences were observed between the two orthotic conditions before running (p > 0.05). After running, the flexor digitorum longus (FDL) hardness in the EFO group was significantly lower than that in the SFO group (p < 0.01). No significant changes were observed in the other muscles. Conclusion: The results suggest that the EFO can restrict the increase in FDL hardness with running. The EFO may be an effective orthotic treatment for medial tibial stress syndrome.
The Effect of a Combined Exercise Program on Postural Control and Fine Motor Skills in Parkinson’s Disease: Study Design
Authors: De Maio Marianna , Castellani Loriana , Cugusi Lucia , Cortis Cristina , Fusco Andrea
Published: November 2022

Parkinson’s disease (PD) is a progressive and neurodegenerative disorder defined by physical symptoms such as hand disability and postural instability. To counteract the detrimental effects of PD, physical activity programs showed improvements in overall aspects of physical functioning. Therefore, this protocol will aim to evaluate the effect a of postural and fine motor skills training program in older adults with PD. PD individuals, with mild to moderate stage PD, aged between 65 to 80 years, will be voluntary selected from the Nursing Home Residences and Rehabilitation Centers. Subsequently, they will be randomly assigned to intervention group (PD) to receive a combined training program (postural control and fine motor skills exercises) or to the Control group (CON) to receive a stretching program. Before (PRE) and after (POST) a 12-week program both groups will perform wobble board (WB) and grooved pegboard (GPT) tests. Different performances between groups will be expected: (1) no significant differences between PD and CON group for WB and GPT test values before the beginning of the training intervention (PRE); (2) significantly better WB and GPT test values in PD subjects after the training intervention (POST) when compared to the base values (PRE); and (3) no significant differences in WB and GPT test values in CON subjects after the training intervention (POST) when compared to the base values (PRE). The findings of the present study protocol could be used for future studies investigating clinical populations, such as PD, and the effects of different rehabilitative interventions aiming to improve postural control and fine motor skills performances assessed by WB and GPT tests.
Psychophysiological Assessment of Children with Cerebral Palsy during Robotic-Assisted Gait Training through Infrared Imaging
Authors: Perpetuini David , Russo Emanuele Francesco , Cardone Daniela , Palmieri Roberta , Filippini Chiara , Tritto Michele , Pellicano Federica , De Santis Grazia Pia , Pellegrino Raffaello , Calabrò Rocco Salvatore , Filoni Serena , Merla Arcangelo
Published: November 2022

Cerebral palsy (CP) is a non-progressive neurologic pathology representing a leading cause of spasticity and concerning gait impairments in children. Robotic-assisted gait training (RAGT) is widely employed to treat this pathology to improve children’s gait pattern. Importantly, the effectiveness of the therapy is strictly related to the engagement of the patient in the rehabilitation process, which depends on his/her psychophysiological state. The aim of the study is to evaluate the psychophysiological condition of children with CP during RAGT through infrared thermography (IRT), which was acquired during three sessions in one month. A repeated measure ANOVA was performed (i.e., mean value, standard deviation, and sample entropy) extracted from the temperature time course collected over the nose and corrugator, which are known to be indicative of the psychophysiological state of the individual. Concerning the corrugator, significant differences were found for the sample entropy (F (1.477, 5.907) = 6.888; p = 0.033) and for the mean value (F (1.425, 5.7) = 5.88; p = 0.047). Regarding the nose tip, the sample entropy showed significant differences (F (1.134, 4.536) = 11.5; p = 0.041). The findings from this study suggests that this approach can be used to evaluate in a contactless manner the psychophysiological condition of the children with CP during RAGT, allowing to monitor their engagement to the therapy, increasing the benefits of the treatment.
Smart Wearable Systems for the Remote Monitoring of Selected Vascular Disorders of the Lower Extremity: A Systematic Review
Authors: Souza Julio , Escadas Sara , Baxevani Isidora , Rodrigues Daniel , Freitas Alberto
Published: November 2022

This systematic review aims at providing an overview of the state of the art regarding smart wearable systems (SWS) applications to monitor the status of patients suffering from vascular disorders of the lower extremity. Peer-reviewed literature has been analyzed to identify employed data collection methods, system characteristics, and functionalities, and research challenges and limitations to be addressed. The Medline (PubMed) and SCOPUS databases were considered to search for publications describing SWS for remote or continuous monitoring of patients suffering from intermittent claudication, venous ulcers, and diabetic foot ulcers. Publications were first screened based on whether they describe an SWS applicable to the three selected vascular disorders of the lower extremity, including data processing and output to users. Information extracted from publications included targeted disease, clinical parameters to be measured and wearable devices used; system outputs to the user; system characteristics, including capabilities of remote or continuous monitoring or functionalities resulting from advanced data analyses, such as coaching, recommendations, or alerts; challenges and limitations reported; and research outputs. A total of 128 publications were considered in the full-text analysis, and 54 were finally included after eligibility criteria assessment by four independent reviewers. Our results were structured and discussed according to three main topics consisting of data collection, system functionalities, and limitations and challenges.
Implementation of Health Information Systems to Improve Patient Identification
Authors: Popescu Catalin , EL-Chaarani Hani , EL-Abiad Zouhour , Gigauri Iza
Published: November 2022

Wellbeing can be ensured in society through quality healthcare, a minimum of medical errors, and the improved performance of healthcare professionals. To this end, health information systems have been implemented in hospitals, with this implementation representing progress in medicine and information technologies. As a result, life expectancy has significantly increased, standards in healthcare have been raised, and public health has improved. This progress is influenced by the process of managing healthcare organizations and information systems. While hospitals tend to adapt health information systems to reduce errors related to patient misidentification, the rise in the occurrence and recording of medical errors in Lebanon resulting from failures to correctly identify patients reveals that such measures remain insufficient due to unknown factors. This research aimed to investigate the effect of health information systems (HISs) and other factors related to work-related conditions on reductions in patient misidentification and related consequences. The empirical data were collected from 109 employees in Neioumazloum Hospital in Lebanon. The results revealed a correlation between HISs and components and the effects of other factors on patient identification. These other factors included workload, nurse fatigue, a culture of patient safety, and lack of implementation of patient identification policies. This paper provides evidence from a Lebanese hospital and paves the way for further studies aiming to explore the role of information technologies in adopting HISs for work performance and patient satisfaction. Improved care for patients can help achieve health equality, enhance healthcare delivery performance and patient safety, and decrease the numbers of medical errors.
Barriers and Facilitators of Hepatitis C Care in Persons Coinfected with Human Immunodeficiency Virus
Authors: Bar Nir , Bensoussan Noa , Rabinowich Liane , Levi Sharon , Houri Inbal , Ben-Ami Shor Dana , Shibolet Oren , Mor Orna , Weitzman Ella , Turner Dan , Katchman Helena
Published: November 2022

Hepatitis C virus (HCV) and human immunodeficiency virus (HIV) are often co-transmitted. Viral coinfection results in worse outcomes. Persons who inject drugs (PWIDs) face barriers to medical treatment, but HCV treatment is indicated and effective even with ongoing active drug use. We aimed to assess access to HCV care and treatment results in patients coinfected with HIV-HCV. This is a real-world retrospective single-center study of patients followed in the HIV clinic between 2002 and 2018. Linkage to care was defined as achieving care cascade steps: (1) hepatology clinic visit, (2) receiving prescription of anti-HCV treatment, and (3) documentation of sustained virologic response (SVR). Of 1660 patients with HIV, 254 with HIV-HCV coinfection were included. Only 39% of them achieved SVR. The rate limiting step was the engagement into hepatology care. Being a PWID was associated with ~50% reduced odds of achieving study outcomes, active drug use was associated with ~90% reduced odds. Older age was found to facilitate treatment success. Once treated, the rate of SVR was high in all populations. HCV is undertreated in coinfected young PWIDs. Further efforts should be directed to improve access to care in this marginalized population.
Research on the Vitality Evaluation of Parks and Squares in Medium-Sized Chinese Cities from the Perspective of Urban Functional Areas
Authors: Wang Tongwen , Li Ya , Li Haidong , Chen Shuaijun , Li Hongkai , Zhang Yunxing
Published: November 2022

Medium-sized cities are increasingly committed to the planning and construction of urban public spaces to meet people’s demand for high-quality urban life. Parks and squares are important parts of urban public spaces, and their vitality represents the quality of public spaces to a certain extent and reflects the happiness index of urban residents. At present, the functional areas and transportation networks of medium-sized cities are still developing. Due to the influence of urban construction, the planning of parks and squares in medium-sized cities has not yet caught up to that in larger cities. This study analyzed a medium-sized city, Jiaozuo, as an example, with the help of point of interest (POI) data, OpenStreetMap road network density data and WorldPop population data. The vitality of parks and squares in different functional spaces in the main urban area in Jiaozuo was quantitatively evaluated in terms of the four following aspects: urban space functional area characteristics, travel vitality index of urban residents, park and square attractiveness and the regional service levels of parks and squares. The effects of functional mixing, traffic network density, population density and spatial distribution on the vitality of parks and squares in medium-sized cities were also studied. The results showed that (1) the functional mixing in the main urban area in Jiaozuo was characterized by a spatial distribution of high in the center and low in the surrounding areas, with the highest functional mixing in the central part of the Jiefang District; (2) the travel dynamics of urban residents were characterized by a clear development of concentric circles radiating in a circular pattern; (3) the levels of service in parks and squares were particularly high in Jiefang District, with a spatial distribution of Jiefang District > Shanyang District > Macun District > Zhongzhan District; (4) under the condition that the service levels of each district were the same, the vitality values of the existing parks and squares in each district were compared and, from high to low, were Jiefang District (1.0–3.5), Shanyang District (0.2–2.0), Macun District (0–1.4) and Zhongzhan District (0–1.2). Functional mixing, road networks and population density had significant impacts on the vitality of parks and squares. Based on our study on the division of urban functional areas, we expanded the study to include urban microspaces. By evaluating the vitality of existing parks and squares and analyzing the influencing factors of spatial vitality, we found that it would be helpful to adopt targeted strategies to improve spatial vitality. Considering the spatial layouts of parks and squares, planning and constructing high-vitality parks and squares would be conducive to the future development of medium-sized cities. The existence of high-vitality spaces could also help to realize the sustainable development of cities.
Uncertainty, Existential Immobility and Well-Being: Experiences of Women Seeking Asylum in Norway
Authors: Willmann-Robleda Zubia
Published: November 2022

In recent years, European countries have made their asylum systems increasingly stricter. Norway has been no exception, taking additional measures to tighten its asylum system to make it less attractive to seek asylum. How does the asylum procedure and living in asylum centres influence psychosocial well-being and, in turn, the prospects of incorporation into a new society? This article identifies the main challenges that a group of women face while seeking asylum and living in asylum centres in Norway, and it explores the influence that these challenges have on their mental health and well-being. To do this, it draws on ethnographic fieldwork conducted during approximately one year (2017–2018) with nine women—of different nationalities, ages and backgrounds—living in asylum centres in Norway. The analysis shows five main elements of the Norwegian asylum and reception system that result in the main challenges that the women deal with during their wait in the asylum centres. These elements are the wait and uncertainty around their asylum application coupled with the inability to influence their circumstances, the limitations to engage in meaningful activities as well as the financial and mobility limitations imposed by the Norwegian authorities. The interconnections of these five elements make the women often feel powerless, unable to influence their circumstances and feel stuck in the present, unable to plan their future, thus, experiencing high levels of uncertainty and existential immobility (Hage 2009). This, in turn, leads to frustration, apathy and even depression in the women, which can have a negative effect on their future incorporation into the Norwegian society.
Associations between Prenatal Exposure to Phthalates and Features of the Metabolic Syndrome in Males from Childhood into Adulthood
Authors: Berman Ye’elah E. , Doherty Dorota A. , Mori Trevor A. , Beilin Lawrence J. , Ayonrinde Oyekoya T. , Adams Leon A. , Huang Rae-Chi , Olynyk John K. , Keelan Jeffrey A. , Newnham John P. , Hart Roger J.
Published: November 2022

Phthalate metabolites are detectable within the majority of the population. Evidence suggests that a prenatal exposure to phthalates may be associated with the subsequent risks of obesity and elevated blood pressure. We hypothesised that a prenatal exposure to phthalates would lead to an increase in adverse cardiometabolic parameters through childhood and adulthood. The maternal serum phthalate measurements from the stored samples taken from Gen1 mothers at 18 and 34 weeks gestation were examined in relation to the cardiometabolic measures in 387 male offspring from the Raine Study. Data from the Gen2 follow-ups between 3 and 27 years were used. The primary outcomes were analysed longitudinally using linear mixed models for the repeated measures. Non-alcoholic fatty liver disease (NAFLD) was assessed at 17 years using logistic regression. A consistent positive relationship was observed between a prenatal exposure to mono-carboxy-iso-octyl phthalate (MCiOP) through adolescence into adulthood with systolic blood pressure. There were no other consistent cardiovascular associations. Mid-levels of prenatal exposures to Mono-n-butyl phthalate (MnBP) were associated with a greater incidence of NAFLD. Detectable Mono-3-carboxypropyl phthalate (MCPP) was associated with a lower serum HDL-C through late childhood into adulthood, while a higher prenatal exposure to mono-iso-butyl phthalate (MiBP), was associated with a higher LDL-C at 22 years of age. A mid-level prenatal exposure to mono-2-ethylhexyl phthalate (MEHP) metabolites was associated with higher insulin in adulthood, while a higher prenatal exposure to the sum of the Di-(2-ethyl-hexyl) phthalate (DEHP) and Di-iso-nonyl phthalate (DiNP) metabolites was associated with higher fasting serum glucose in adulthood. In conclusion, our study demonstrated that higher prenatal phthalate exposures to some phthalate metabolites was associated with some adverse metabolic profiles through adolescence into adulthood, although the consistent themes were limited to a few metabolites and the outcomes of systolic blood pressure, fasting insulin and glucose.
The Association between Food Security Status and Psychological Distress and Loneliness among Full-Time Undergraduate Students at a Minority-Serving Institution
Authors: Guzman Pedro G. , Lange James E. , McClain Amanda C.
Published: November 2022

Little is known about the relationship of food security (FS) status with mental health among students at minority-serving institutions. We aimed to elucidate the association of FS status with psychological distress and loneliness among full-time undergraduate students at a minority-serving institution. We used data from the National Collegiate Health Assessment III (n = 441). To assess FS, students responded to the USDA 6-item short form (range: 0–6) and responses were categorized as high (0), marginal (1) or low/very low (2–6) FS. The Kessler 6 scale assessed psychological distress (range: 0–24). The UCLA loneliness scale assessed loneliness (range: 3–9). Higher scores indicated higher psychological distress and loneliness. Using adjusted linear regression models, we examined the association of FS with psychological distress and loneliness. Compared to students with high FS (mean (SD): 9.4 (0.8)), students with marginal (11.4 (1.0); p < 0.05) or low/very low (11.8 (0.8); p < 0.01) FS had higher psychological distress scores. Compared to students with high FS (5.5 (0.3)), students with low/very low FS (6.0 (0.3); p < 0.05) had higher loneliness scores. Future studies should further explore these relationships using mixed methods, to provide complementary quantitative findings with the emic perspective of students and their experiences, which can inform programming to prevent and reduce food insecurity.
“Everything…Fell Apart Once COVID-19 Hit”—Leveraging the COVID-19 Response to Strengthen Public Health Activities toward Ending the HIV Epidemic: A Qualitative Study
Authors: Devlin Samantha A. , Garcia Moctezuma , Fujimoto Kayo , Hallmark Camden , McNeese Marlene , Schneider John , McNulty Moira C.
Published: November 2022

COVID-19 caused widespread disruption of activities for Ending the HIV Epidemic (EHE). In this study we assessed public health perspectives on leveraging the COVID-19 response to advance the goals of EHE. We conducted a qualitative study with 33 public health partners in the Midwestern and Southern United States from October 2020 to February 2022. Participants were asked how the strategies developed for COVID-19 could be applied to the HIV epidemic. Interviews were recorded, transcribed, and examined using rapid qualitative analysis. Four themes emerged: (1) Rebuilding teams and adapting culture for success in EHE activities; (2) Recognizing and modernizing the role of disease intervention specialists (DIS); (3) Enhanced community awareness of the public health role in disease response and prevention; and (4) Leveraging COVID-19 data systems and infrastructure for EHE activities. The COVID-19 pandemic called attention to the dearth of public health funding and outdated information technology (IT) infrastructure used for HIV activities. It also led to greater public health knowledge, including increased familiarity with partner services and molecular epidemiology of HIV, and opportunities to develop new data systems for surveillance that can be applied to efforts for EHE.
Tobacco Whack-A-Mole: A Consumption Taxonomy of Cigar & Other Combustible Tobacco Products among a Nationally Representative Sample of Young Adults
Authors: Sterling Kymberle Landrum , Masyn Katherine , Moore Stephanie Pike , Fryer Craig S. , Trapl Erika , Shang Ce , Gunzler Douglas
Published: November 2022

Introduction: Little filtered cigars and cigarillos (LCCs) are consumed infrequently, co-administered with marijuana, and concurrently used with other tobacco products. Reliance on the past 30-day use estimate, a marker of tobacco user status, may underestimate the dynamic nature of intermittent LCC and other tobacco product use. We developed a framework to capture the intermittent nature of exclusive LCC use and dual/poly use with cigarettes and large cigars using broader timing of last product use categories and product use modality (e.g., with marijuana). Methods: Data come from the baseline C’RILLOS study, a U.S. nationally representative sample of young adults aged 18–34 (n = 1063) collected in October 2019. We developed a consumption taxonomy framework that accounted for respondents’ modality of LCC use (i.e., use with tobacco, LCC-T, or use with marijuana as blunts, LCC-B), the exclusive use of LCCs and other tobacco products (i.e., cigarettes, and large cigars) or their co-use and the timing of last product use (i.e., ever and past 30 days, past 3 months, past 6 months, greater than 6 months). Results: Seventy-five percent of our sample reported ever use of any combustible tobacco product, including LCCs. The most common ever use pattern was poly use of LCC-T + LCC-B + cigarettes (16%). Our consumption taxonomy framework demonstrated the fluid nature of combustible tobacco product use among LCC users. For instance, among past 30-day cigarette users, 48% reported using LCC-T, 39% reported using LCC-B, and 32% reported using large cigars in the past 3 months or more. Discussion: The tobacco use field currently classifies ‘tobacco users’ based on the product they smoked in the past 30 days. Any tobacco product use beyond the past 30-day period is considered ‘discontinued use’ and not the focus of intervention or tobacco regulatory science decisions. We documented the substantial proportion of young adult LCC, cigarette, and large cigar users who either exclusively or dual/poly used these combustible products in recent (e.g., past 3 months) periods. To prevent underestimation of use, surveillance measures should assess the use modality, timing of last product use, and exclusive/multiple product use to more accurately identify the smoking status of young adult LCC users.
A Treatment Model for Young Adults with Severe Mental Disorders in a Community Mental Health Center: The Crisalide Project and the Potential Space
Authors: Grasso Maria , Giammetta Rosalia , Gabriele Giuseppina , Mazza Marianna , Caroppo Emanuele
Published: November 2022

In line with priorities set by the Italian Ministry of Health and international literature, the “Crisalide project” provides specific care pathways aimed at young adults (YA) with severe mental disorders (SMD). As described in Materials and Methods, it consists of three lines of activity: transition to adult mental health services (TSMREE/CSM 17–19); Diagnostic, Therapeutic, and Assistance Pathways for Young Adults (PDTA-YA); high-intensity treatment center for young adults “Argolab2 Potential Space”. The aim of the study is to assess the results relating to the first three years of implementation of this clinical-organizational model (2018/2020) according to the process indicators identified by the ministry. Among the population aged 18–30 under treatment, results show increased prevalence (30%) and incidence (26%); 0% treatment conclusions due to the expiration of the conventional time limit; 0% involuntary hospitalizations (TSO); 0% STPIT hospitalizations; 0% repeated hospitalizations; 0% hospitalizations in the common mental disorders diagnostic group. Among the population of Argolab2 Potential Space, 45.4% have resumed studies; 40.9% have had a first work experience; 22.7% have obtained educational or training qualifications, and 18.2% live in independent houses. At a time when the academic literature underlines the terrible impact of the COVID-19 pandemic on this population, the present study confirms that specific treatment processes for young populations are a protective factor.
Competition: A Missing Component of Fruit Fly (Diptera: Tephritidae) Risk Assessment and Planning
Authors: Clarke Anthony R. , Measham Penelope F.
Published: November 2022

Tephritid fruit flies are internationally significant pests of horticulture. Because they are also highly invasive and of major quarantine concern, significant effort is placed in developing full or partial pest risk assessments (PRAs) for fruit flies, while large investments can be made for their control. Competition between fruit fly species, driven by the need to access and utilise fruit for larval development, has long been recognised by researchers as a fundamental component of fruit fly biology, but is entirely absent from the fruit fly PRA literature and appears not be considered in major initiative planning. First presenting a summary of the research data which documents fruit fly competition, this paper then identifies four major effects of fruit fly competition that could impact a PRA or large-scale initiative: (i) numerical reduction of an existing fruit fly pest species following competitive displacement by an invasive fruit fly; (ii) displacement of a less competitive fruit fly pest species in space, time or host; (iii) ecological resistance to fruit fly invasion in regions already with competitively dominant fruit fly species; and (iv) lesser-pest fruit fly resurgence following control of a competitively superior species. From these four major topics, six more detailed issues are identified, with each of these illustrated by hypothetical, but realistic biosecurity scenarios from Australia/New Zealand and Europe. The scenarios identify that the effects of fruit fly competition might both positively or negatively affect the predicted impacts of an invasive fruit fly or targeted fruit fly control initiative. Competition as a modifier of fruit fly risk needs to be recognised by policy makers and incorporated into fruit fly PRAs and major investment initiatives.
Epidemiological, Entomological, and Climatological Investigation of the 2019 Dengue Fever Outbreak in Gewane District, Afar Region, North-East Ethiopia
Authors: Mekuriaw Wondemeneh , Kinde Solomon , Kindu Bezabih , Mulualem Yibeyin , Hailu Girma , Gebresilassie Araya , Sisay Chalachw , Bekele Fitsum , Amare Hiwot , Wossen Mesfin , Woyessa Adugna , Cross Chad L. , Messenger Louisa A.
Published: November 2022

Dengue Fever (DF) is an important arthropod-borne viral infection that has repeatedly occurred as outbreaks in eastern and northeastern Ethiopia since 2013. A cross-sectional epidemiological outbreak investigation was carried out from September to November 2019 on febrile patients (confirmed malaria negative) who presented with suspected and confirmed DF at both public and private health facilities in Gewane District, Afar Region, northeastern Ethiopia. Entomological investigation of containers found in randomly selected houses belonging to DF-positive patients was undertaken to survey for the presence of Aedes larvae/pupae. A total of 1185 DF cases were recorded from six health facilities during the 3-month study period. The mean age of DF cases was 27.2 years, and 42.7% of cases were female. The most affected age group was 15–49 years old (78.98%). The total case proportions differed significantly across age groups when compared to the population distribution; there were approximately 15% and 5% higher case proportions among those aged 15–49 years and 49+ years, respectively. A total of 162 artificial containers were inspected from 62 houses, with 49.4% found positive for Aedes aegypti larva/pupae. Aedes mosquitoes were most commonly observed breeding in plastic tanks, tires, and plastic or metal buckets/bowls. World Health Organization entomological indices classified the study site as high risk for dengue virus outbreaks (House Index = 45.2%, Container Index = 49.4%, and Breteau Index = 129). Time series climate data, specifically rainfall, were found to be significantly predictive of AR (p = 0.035). Study findings highlight the importance of vector control to prevent future DF outbreaks in the region. The scarcity of drinking water and microclimatic conditions may have also contributed to the occurrence of this outbreak.
Endoscopic Enucleation of Prostate Could Increase Testosterone Levels in Hypotestosteronemic Patients with Bladder Outlet Obstruction
Authors: Li Yun-Ren , Tsao Shu-Han , Chen Chien-Lun , Hou Chen-Pang , Tsui Ke-Hung , Juang Horng-Heng , Lin Yu-Hsiang
Published: November 2022

Background: We evaluated the impact of endoscopic enucleation of the prostate on testosterone levels in hypotestosteronemic patients with bladder outlet obstruction. Methods: We enrolled 294 men with lower urinary tract symptoms (LUTS) who received surgery between January 2019 and December 2020 in simple tertiary centre. The inclusion criteria were as follows: being a male patient aged 45–95 years and having recurrent urinary tract infection, having previously failed medical treatment for LUTS or urine retention, and undergoing bipolar or thulium laser enucleation of the prostate. The preoperative and postoperative data were retrospectively reviewed. Results: This study included 112 men with a mean age of 69.4 years. The mean preoperative and postoperative testosterone levels were 4.8 and 4.98, respectively. Of the patients, 88 (78.6%) received ThuLEP and 24 received BipolEP. We divided the patients into two groups according to preoperative serum testosterone levels: normal-testosterone (≥3 ng/mL) and low-testosterone (<3 ng/mL) groups. A significant change in testosterone levels (p = 0.025) was observed in the low-testosterone group. In contrast, no significant difference in testosterone levels was noted in the normal-testosterone group (p = 0.698). Conclusions: Endoscopic enucleation surgery of the prostate could improve postoperative testosterone levels in hypotestosteronemic patients with bladder outlet obstruction.
Influence of Vitamin D and C on Bone Marrow Edema Syndrome—A Scoping Review of the Literature
Authors: Eidmann Annette , Eisert Marius , Rudert Maximilian , Stratos Ioannis
Published: November 2022

Bone marrow edema syndrome (BMES) is a rare disease with a largely unknown etiology. The aim of this scoping review is to systematically evaluate and combine the available evidence about vitamin D and C and BMES. The analysis of the manuscripts was based on country of origin, number of patients, gender, study type, epidemiology, localization, bone mineral density measurements, vitamin status and therapy. Sixty studies were included. The overall number of patients was 823 with a male-to-female ratio of 1.55:1 and a mean age of 40.9 years. Studies were very heterogeneous and of diverging scientific scope with a weak level of evidence. The hip was the most affected joint, followed by the foot and ankle and the knee; 18.3% of patients suffered from multifocal BMES. Sixteen studies reported on vitamin D levels, resulting in a high prevalence of vitamin D deficiency (47%) and insufficiency (17.9%) among BMES patients. Three BME manuscripts were associated with vitamin C deficiency. Current therapeutic interventions include conservative measures (mainly unloading), various osteoactive drugs and iloprost. In summary, data about BMES in association with vitamin status is limited. A causal relationship between vitamin D or vitamin C status, osteopenia, and BMES cannot be determined from the existing literature.
Obturator Manufacturing for Oronasal Fistula after Cleft Palate Repair: A Review from Handicraft to the Application of Digital Techniques
Authors: Chen Jiali , Yang Renjie , Shi Bing , Xu Yichen , Huang Hanyao
Published: November 2022

An oronasal fistula (ONF) is an abnormal structure between the oral and nasal cavities, which is a common complication of cleft palate repair due to the failure of wound healing. When some patients with ONF are unsuitable for secondary surgical repair, the obturator treatment becomes a potential method. The objectives of the obturator treatment should be summarized as filling the ONF comfortably and cosmetically restoring the dentition with partial function. The anatomy of patients with cleft palate is complex, which may lead to a more complex structure of the ONF. Thus, the manufacturing process of the obturator for these patients is more difficult. For performing the design and fabrication process rapidly and precisely, digital techniques can help, but limitations still exist. In this review, literature searches were conducted through Medline via PubMed, Wiley Online Library, Science Direct, and Web of Science, and 122 articles were selected. The purpose of this review was to introduce the development of the obturator for treating patients with ONF after cleft palate repair, from the initial achievement of the obstruction of the ONF to later problems such as fixation, velopharyngeal insufficiency, and infection, as well as the application of digital technologies in obturator manufacturing.
Dynamic Responsive Inguinal Scaffold Activates Myogenic Growth Factors Finalizing the Regeneration of the Herniated Groin
Authors: Amato Giuseppe , Romano Giorgio , Rodolico Vito , Puleio Roberto , Calò Pietro Giorgio , Di Buono Giuseppe , Cicero Luca , Romano Giorgio , Goetze Thorsten Oliver , Agrusa Antonino
Published: November 2022

Background: Postoperative chronic pain caused by fixation and/or fibrotic incorporation of hernia meshes are the main concerns in inguinal herniorrhaphy. As inguinal hernia is a degenerative disease, logically the treatment should aim at stopping degeneration and activating regeneration. Unfortunately, in conventional prosthetic herniorrhaphy no relationship exists between pathogenesis and treatment. To overcome these incongruences, a 3D dynamic responsive multilamellar scaffold has been developed for fixation-free inguinal hernia repair. Made of polypropylene like conventional flat meshes, the dynamic behavior of the scaffold allows for the regeneration of all typical inguinal components: connective tissue, vessels, nerves, and myocytes. This investigation aims to demonstrate that, moving in tune with the groin, the 3D scaffold attracts myogenic growth factors activating the development of mature myocytes and, thus, re-establishing the herniated inguinal barrier. Methods: Biopsy samples excised from the 3D scaffold at different postoperative stages were stained with H&E and Azan–Mallory; immunohistochemistry for NGF and NGFR p75 was performed to verify the degree of involvement of muscular growth factors in the neomyogenesis. Results: Histological evidence of progressive muscle development and immunohistochemical proof of NFG and NFGRp75 contribution in neomyogenesis within the 3D scaffold was documented and statistically validated. Conclusion: The investigation appears to confirm that a 3D polypropylene scaffold designed to confer dynamic responsivity, unlike the fibrotic scar plate of static meshes, attracts myogenic growth factors turning the biological response into tissue regeneration. Newly developed muscles allow the scaffold to restore the integrity of the inguinal barrier.
Hybrid Optimized Fuzzy Pitch Controller of a Floating Wind Turbine with Fatigue Analysis
Authors: Serrano Carlos , Sierra-Garcia Jesus-Enrique , Santos Matilde
Published: November 2022

Floating offshore wind turbines (FOWTs) are systems with complex and highly nonlinear dynamics; they are subjected to heavy loads, making control with classical strategies a challenge. In addition, they experience vibrations due to wind and waves. Furthermore, the control of the blade angle itself may generate vibrations. To address this issue, in this work we propose the design of an intelligent control system based on fuzzy logic to maintain the rated power of an FOWT while reducing the vibrations. A gain scheduling incremental proportional–derivative fuzzy controller is tuned by genetic algorithms (GAs) and combined with a fuzzy-lookup table to generate the pitch reference. The control gains optimized by the GA are stored in a database to ensure a proper operation for different wind and wave conditions. The software Matlab/Simulink and the simulation tool FAST are used. The latter simulates the nonlinear dynamics of a real 5 MW barge-type FOWT with irregular waves. The hybrid control strategy has been evaluated against the reference baseline controller embedded in FAST in different environmental scenarios. The comparison is assessed in terms of output power and structure stability, with up to 23% and 33% vibration suppression rate for tower top displacement and platform pitch, respectively, with the new control scheme. Fatigue damage equivalent load (DEL) of the blades has been also estimated with satisfactory results.