bluuebunny/crossref_metadata_2025 huggingface dataset:
Impact of the digital economy on low carbon sustainability evidence from the Yellow River Basin
Authors: Wang Gaofei , Yuan Qingwen , Jiao Yong
Published: January 2024

As the digital economy increasingly dominates a substantial portion of the national economy, comprehending its role in promoting sustainable development has become an imperative research question—particularly in the context of the Yellow River Basin, where there exists an urgent need to shift toward more sustainable modes of economic growth. Utilizing panel data spanning from 1999 to 2020 for 114 cities in the Yellow River Basin, this study develops a comprehensive evaluation framework for sustainable development, incorporating economic, social, and ecological dimensions. The empirical findings reveal that the digital economy acts as a catalyst for sustainable development. Importantly, these results withstand both endogeneity tests and robustness checks. Further heterogeneity analysis indicates that the positive impact of the digital economy on sustainable development is more pronounced in regions directly traversed by the Yellow River and in areas with higher sustainability levels. Moreover, the enactment and implementation of the 13th Five-Year National Information Plan have emphasized the role of the digital economy in enhancing sustainable development. Mechanism tests also illustrate those elevated levels of personal digital acceptance and government intervention contribution to amplify the digital economy’s positive impact on sustainable development. In conclusion, policy recommendations are put forward, including optimizing industrial structure, strengthening data governance and environmental monitoring, promoting innovation-driven development, and fostering collaborative growth.
Urban innovation, heterogeneous environmental regulations and haze reduction effects–evidence from pilot policies of innovative cities
Authors: Xu Yue
Published: January 2024

Innovation-driven development strategies have injected new momentum into haze management. In addition to its core innovation-driven role, innovative city pilot policy is significant for environmental enhancement and should not be overlooked. To assess the performance of the pilot policy in decreasing haze, a multiperiod double difference model was employed, and a spatial econometric model was used to empirically examine the potential spatial spillover effect of haze management as a regional synergistic concept between 2006 and 2020. Panel data from 282 prefecture-level cities were selected. To investigate and empirically examine the territorial spillover effect of haze reduction as a regional synergistic notion, a spatial econometric model was applied. Based on the study, the pilot construction significantly reduced haze pollution. In China’s eastern and central regions, small cities, and newer industrial bases, the inhibitory effect of pilot policies on haze pollution was more pronounced, according to heterogeneity analysis. Moreover, analysis of the heterogeneous environmental regulations revealed that the enforcement of policies would increase the sense of urgency of local governments, strengthen the concern and responsibility of the government for the environment, and further awaken the public’s concern for the environment, in addition to forcing enterprises to practice clean and sustainable production, thus achieving the effect of accelerated haze reduction. From the spatial perspective, innovative pilot cities have certain spatial spillover effects and thus can increase the effects of policy for neighboring regions, similar economic regions and local transportation regions.
Association between peripheral eosinophilia, JESREC score, and olfactory dysfunction in patients with chronic rhinosinusitis
Authors: Zhang Ling , Li Haifeng , Wang Tao , Wang Zhu , Wu Yang , Guo Siquan , Li Wenjing , Zhou Yeru , Xue Haixiang , You Jianqiang
Published: January 2024

Objective

The purpose was to evaluate the relationship between peripheral eosinophilia, Japan Epidemiological Survey of Refractory Eosinophilic Chronic Rhinosinusitis (JESREC) score, and olfactory dysfunction in chronic rhinosinusitis (CRS) patients and to explore the accuracy and specific cut points of the JESREC score in predicting olfactory dysfunction.

Methods

In this cross-sectional, retrospective study, olfactory function was assessed by the Sniffin’ Sticks 12-item test and multivariate logistic regression analyses were carried out. Receiver operating characteristic curves were plotted to derive accuracy and cutoff values for the JESREC scores of the olfactory dysfunction criterion.

Results

A total of 354 patients [mean (SD) age, 50.0 (14.9) years; 41.8% women] were included in the final analysis. The prevalence of olfactory dysfunction was 46.3%. Individuals who had olfactory dysfunction were more likely to be male (64.6% vs. 52.6%), have eosinophilic chronic rhinosinusitis (ECRS) (39.0% vs. 7.9%), have a longer course of CRS (2.3 years vs. 1.5 years), have higher JESREC scores (8.5 vs. 4.5), and have higher proportions of nasal polyps (78.7% vs. 18.9%) and peripheral eosinophilia (3.3% vs. 1.4%). In logistic analysis, the percentage of eosinophils (1.25, 1.13–1.37), JESREC score (1.31, 1.22–1.40), bilateral lesion (2.06, 1.25–3.41), nasal polyps (15.83, 9.23–27.16), CT shadow (2.73, 1.69–4.43), and ECRS (6.86, 3.68–12.80) were associated with olfactory dysfunction in CRS patients after controlling for covariates, while peripheral neutrophils were not significant. In addition, the area under the curve was 0.778 and the cutoff value for JESREC score for olfactory dysfunction was defined as 5.5.

Conclusions

Peripheral eosinophilia and high JESREC scores were significantly associated with the risk of olfactory dysfunction in CRS patients, and special attention should be paid to patients with a JESREC score ≥6.
Assessing the sustainability of the blue swimming crab (Portunus pelagicus) on the Eastern Coast of Lampung: a holistic approach to conservation and resource stewardship
Authors: Yulianto Herman , Ihsan Yudi Nurul , Sumiarsa Dadan , Ansari Andrianto , Hendarmawan
Published: January 2024

In response to the escalating demand for blue swimming crabs (BSC) and the consequential impact on their habitat and population, this study advocates for sustainable management through a holistic approach. Our comprehensive framework integrates ecological conservation, socioeconomic well-being, and governance principles, aiming to establish a policy framework for the sustainable management of BSC in the Eastern Coast of Lampung. The research emphasizes the urgent issue of overexploitation, with an exploitation rate of 0.71, requiring immediate attention to prevent stock depletion and maintain ecosystem health. Findings reveal that male BSC, measured by carapace width, typically reaches the length at first catch (Lc50) at approximately 118.69 mm, while for females, it is about 122.70 mm—indicating that BSC is often caught larger than the 10 cm legal requirement set by the Ministry of Marine and Fisheries of Indonesia. Economic analysis demonstrates the profitability of the blue swimming crab business on Lampung's east coast, with a favorable crab capture per trip (4.63) and total costs ratio (1.18). The study area, featuring an extensive mangrove forest, hosts a crucial crustacean population, contributing significantly to BSC's diet. Beyond ecological significance, mangrove conservation enhances our understanding of environmental sustainability, particularly in carbon stock contributions. Addressing sustainability challenges requires a multi-faceted approach, including precise fishing technologies, effective regulation enforcement, and improved monitoring. Collaborative efforts among government authorities, fishing communities, and conservation groups are essential for balancing economic interests with the long-term ecological health of BSC populations in the study area.
Periostin expression in uninvolved skin as a potential biomarker for rapid cutaneous progression in systemic sclerosis patients: a preliminary explorative study
Authors: De Luca Giacomo , Campochiaro Corrado , Burastero Samuele E. , Matucci-Cerinic Marco , Doglioni Claudio , Dagna Lorenzo
Published: January 2024

Objectives

This study aimed to evaluate periostin serum levels and skin expression in patients with systemic sclerosis (SSc).

Methods

We enrolled 35 patients with diffuse (d-SSc) or limited (l-SSc) SSc, 15 patients with very early diagnosis of systemic sclerosis (VEDOSS), and 30 sex-matched healthy controls. Periostin serum levels were determined by an enzyme-linked immunosorbent assay (ELISA). Periostin skin expression was determined by immunohistochemistry (IHC) on paired involved and uninvolved 5-mm skin biopsy samples in a subgroup of 10 d-SSc and 10 L-SSc patients. A 12-month follow-up was considered.

Results

We included 50 patients (mean age 53.1 ± 16.1 years; women 94%; mean disease duration 38.2 ± 45.1 months; anti-centromere 50%; anti-Scl70 40%), 35 of them with a definite SSc (68.8% l-SSc; 31.4% d-SSc; mean mRSS 9.0 ± 7.2) and 15 with VEDOSS; 30 controls were also included in this study. Periostin serum levels were higher in SSc patients compared to controls (32.7 ± 8.0 ng/mL vs. 27.7 ± 7.3 ng/mL; p < 0.001), while these levels were comparable among different groups of patients (29.7 ± 6.9 ng/mL in VEDOSS, 33.4 ± 7.8 ng/mL in lc-SSc; and 34.0 ± 8.5 in dc-SSc; p = ns). SSc patients with digital ulcers had higher periostin serum levels (36.2 ± 7.9 ng/mL vs. 30.6 ± 7.3 ng/mL, p < 0.02). Samples from the involved skin of l-SSc and d-SSc patients showed a significant dermal expression of periostin; an identical periostin expression was evident in the uninvolved skin of patients with d-SSc. In 7 out of 10 L-SSc patients, periostin expression was absent on uninvolved skin. In the remaining three l-SSc patients, a mild periostin expression on IHC was detectable on uninvolved skin and all of these three l-SSc patients presented a dramatic skin progression.

Conclusion

Periostin skin expression may be a useful biomarker to indicate the presence of a disease at a higher risk of rapid cutaneous involvement.
High-frequency rTMS over bilateral primary motor cortex improves freezing of gait and emotion regulation in patients with Parkinson’s disease: a randomized controlled trial
Authors: Song Wenjing , Zhang Zixuan , Lv Bingchen , Li Jinyu , Chen Hao , Zhang Shenyang , Zu Jie , Dong Liguo , Xu Chuanying , Zhou Manli , Zhang Tao , Xu Ran , Zhu Jienan , Shen Tong , Zhou Su , Cui Chenchen , Huang Shuming , Wang Xi , Nie Yujing , Aftab Kainat , Xiao Qihua , Zhang Xueling , Cui Guiyun , Zhang Wei
Published: January 2024

Background

Freezing of gait (FOG) is a common and disabling phenomenon in patients with Parkinson’s disease (PD), but effective treatment approach remains inconclusive. Dysfunctional emotional factors play a key role in FOG. Since primary motor cortex (M1) connects with prefrontal areas via the frontal longitudinal system, where are responsible for emotional regulation, we hypothesized M1 may be a potential neuromodulation target for FOG therapy. The purpose of this study is to explore whether high-frequency rTMS over bilateral M1 could relieve FOG and emotional dysregulation in patients with PD.

Methods

This study is a single-center, randomized double-blind clinical trial. Forty-eight patients with PD and FOG from the Affiliated Hospital of Xuzhou Medical University were randomly assigned to receive 10 sessions of either active (N = 24) or sham (N = 24) 10 Hz rTMS over the bilateral M1. Patients were evaluated at baseline (T0), after the last session of treatment (T1) and 30 days after the last session (T2). The primary outcomes were Freezing of Gait Questionnaire (FOGQ) scores, with Timed Up and Go Test (TUG) time, Standing-Start 180° Turn (SS-180) time, SS-180 steps, United Parkinson Disease Rating Scales (UPDRS) III, Hamilton Depression scale (HAMD)-24 and Hamilton Anxiety scale (HAMA)-14 as secondary outcomes.

Results

Two patients in each group dropped out at T2 and no serious adverse events were reported by any subject. Two-way repeated ANOVAs revealed significant group × time interactions in FOGQ, TUG, SS-180 turn time, SS-180 turning steps, UPDRS III, HAMD-24 and HAMA-14. Post-hoc analyses showed that compared to T0, the active group exhibited remarkable improvements in FOGQ, TUG, SS-180 turn time, SS-180 turning steps, UPDRS III, HAMD-24 and HAMA-14 at T1 and T2. No significant improvement was found in the sham group. The Spearman correlation analysis revealed a significantly positive association between the changes in HAMD-24 and HAMA-14 scores and FOGQ scores at T1.

Conclusion

High-frequency rTMS over bilateral M1 can improve FOG and reduce depression and anxiety in patients with PD.
Application of deep brain stimulation for the treatment of childhood-onset dystonia in patients with MEPAN syndrome
Authors: Nataraj Jaya , MacLean Jennifer A. , Davies Jordan , Kurtz Joshua , Salisbury Amanda , Liker Mark A. , Sanger Terence D. , Olaya Joffre
Published: January 2024

Introduction

Mitochondrial Enoyl CoA Reductase Protein-Associated Neurodegeneration (MEPAN) syndrome is a rare inherited metabolic condition caused by MECR gene mutations. This gene encodes a protein essential for fatty acid synthesis, and defects cause progressively worsening childhood-onset dystonia, optic atrophy, and basal ganglia abnormalities. Deep brain stimulation (DBS) has shown mixed improvement in other childhood-onset dystonia conditions. To the best of our knowledge, DBS has not been investigated as a treatment for dystonia in patients with MEPAN syndrome.

Methods

Two children with MEPAN were identified as possible DBS candidates due to severe generalized dystonia unresponsive to pharmacotherapy. Temporary depth electrodes were placed in six locations bilaterally and tested during a 6-day hospitalization to determine the best locations for permanent electrode placement. The Burke-Fahn-Marsden Dystonia Rating Scale (BFMDRS) and Barry-Albright Dystonia Scale (BADS) were used for preoperative and postoperative testing to quantitatively assess dystonia severity changes. Patient 1 had permanent electrodes placed at the globus pallidus internus (GPi) and pedunculopontine nucleus (PPN). Patient 2 had permanent electrodes placed at the GPi and ventralis intermedius nucleus of the thalamus (VIM).

Results

Both patients successfully underwent DBS placement with no perioperative complications and significant improvement in their BFMDRS score. Patient 2 also demonstrated improvement in the BADS.

Discussion

We demonstrated a novel application of DBS in MEPAN syndrome patients with childhood-onset dystonia. These patients showed clinically significant improvements in dystonia following DBS, indicating that DBS can be considered for dystonia in patients with rare metabolic disorders that currently have no other proven treatment options.
Acquired tonsillar herniation related to spontaneous intracranial hypotension: case reports
Authors: Chen Lili , Wu Haijian , Hu Xingyue , Ying Guangyu
Published: January 2024

Background

Acquired prolapse of the cerebellar tonsils in spontaneous intracranial hypotension (SIH) patients is rare. This study aims to evaluate neuroimaging changes of acquired prolapse of the cerebellar tonsils below the foramen magnum in SIH patients due to spontaneous spinal cerebrospinal fluid leakage, which was treated by targeted epidural blood patches (EBP).

Methods

We retrospectively reviewed clinical and neuroimaging characteristics of 5 cases of SIH with acquired prolapse of the cerebellar tonsils that received targeted EBP in our institution from January 2013 to December 2016.

Results

Of these SIH patients, all of them suffered from an orthostatic headache. Initial cranial MRI demonstrated descent of the cerebellar tonsils ≥5 mm. Intrathecal gadolinium-enhanced spinal MR myelography and/or spinal MR hydrography were performed to evaluate the level of spinal cerebrospinal fluid leakage. Symptoms were alleviated in all 5 patients after two (n = 4), or three (n = 1) targeted EBP during hospitalization. Follow-up cranial MRI revealed that the descent of cerebellar tonsils was reversed after EBP treatment.

Conclusion

Acquired tonsillar herniation can occur in patients with SIH and spinal cerebrospinal fluid leakage. Symptoms of these patients may be resolved and radiologic findings may be reversed after EBP treatment.
Imagining emotions in storyworlds: physiological narrated perception and emotional mental imagery
Authors: Martínez María-Angeles
Published: January 2024

Research into narrative experiencing acknowledges the role played by mental imagery in readers’ emotional responses and feelings of embodiment. In narratives, mental imagery is frequently evoked through narrated perception, or the textual presentation of sensory perception, as in “The silence in the house was complete”. Narrated perception spans the five senses – sight, hearing, smell, touch, and taste; however, little attention has been paid to the narrated description of characters’ basic physiological processes, that is, those connected to the invisible systems – respiratory, digestive, cardio-vascular, muscular – and their relevance to the mental construction of narrative emotions. This study explores the presentation of fictional characters’ physiological processes as a prompt for readers’ embodied experience of storyworlds through the metonymic activation of self-relevant emotion schemata. To this purpose, the presentation of characters’ internal physiological processes in two fictional samples of similar length – Rosemary Timperley’s 1955 ghost story “Harry” and chapter one in Ewan McEwan’s 2002 novel Atonement – is analysed. The findings suggests that these descriptions enrich the imagined nature of narrative emotions through underspecification, and increase opportunities for perceived self-relevance and engagement.
Twenty questions from the surgeon to the radiologist to better plan an open partial horizontal laryngectomy
Authors: Crosetti Erika , Succo Giovanni , Sapino Silvia , Bertotto Ilaria , Cirillo Stefano , Petracchini Massimo , Fondello Gabriele , Arrigoni Giulia , Tascone Martina , Piazza Cesare , Farina Davide , Ravanelli Marco
Published: January 2024

Open partial horizontal laryngectomies (OPHLs) represent a valuable therapeutic option for tumors of the intermediate T-category and, in selected cases, for locally advanced tumors with low-volume extra-laryngeal extension. The eligibility of patients treated with this type of surgery has increased with the introduction of the modular approach to OPHL planning. This strategy follows the introduction of the classification proposed by the European Laryngological Society, based on the extent of horizontal resection. Optimization of the selection is the result of a meticulous work-up process involving close cooperation between experienced surgeons and radiologists, followed by final quality control by pathologists. Computed tomography and magnetic resonance imaging are study methods whose pearls and pitfalls are well known, especially when performed at a high level of expertise. In this paper, based on the experience of two high-volume centers, a checklist of 20 questions addressed by the surgeon to the radiologist before planning an OPHL was proposed. Considerations regarding case selection are reported for each of the questioned parameters. A very simple question-and-answer process is easy to understand and mainly addressed by less experienced colleagues who wish to increase their knowledge and skills in performing this type of surgery.
Psychological mechanisms of English academic stress and academic burnout: the mediating role of rumination and moderating effect of neuroticism
Authors: Zuo Xiaoyi , Zhao LuLu , Li Yue , He Wanting , Yu Chengfu , Wang Zhenhai
Published: January 2024

Introduction

Academic stress is a significant and prevalent phenomenon among college students. According to the Demands-Resources Model, when individuals are unable to cope with stress that exceeds their capacity, burnout may occur. Although English courses hold a significant position in university education, there has been limited research on the mechanisms linking English academic stress to English academic burnout.

Methods

This study recruited 1,130 undergraduate students taking English courses. Participants completed online questionnaires assessing English academic stress, rumination, English academic burnout, and neuroticism traits. A moderated mediation model was constructed to examine the relationship among these variables.

Results

The results indicate that (1) Rumination serves as a mediator in the relationship between English academic stress and burnout; (2) neuroticism significantly moderates the pathway between English academic stress and rumination. Specifically, students with high neuroticism tendencies are more prone to developing rumination when faced with high levels of English academic stress.

Conclusion

These findings offer valuable insights into the psychological mechanisms underlying the association between English learning stress and academic burnout. They emphasize the importance of addressing rumination as a mediator and considering individuals’ levels of neuroticism in interventions aimed at preventing and alleviating academic burnout among university students.
The possible positive effects of physical exercise on the global motion perception aging: the cognitive mechanism
Authors: Liang Ziping , Zhang Lei , Wang Pengpeng , Zhang Yuping , Xia Yaoyuan , Jin Hua
Published: January 2024

Background

Sensitivity to global motion perception (GMP) decreases gradually with age, and the mechanism to effectively alleviate its aging process is still unclear. This study aimed to examine the impact and mechanism of exercise on GMP aging.

Methods

This study adopted the global motion direction discrimination task and used motion coherence thresholds to assess GMP sensitivity. It adopted the perceptual template model (PTM) to fit the GMP processing efficiency.

Results

The threshold for the elderly group with no exercise was higher than that of the elderly group with exercise, while the threshold of the latter was higher than that of the youth group. The results of the model fitting showed that both models, Aa and Af, corresponding to the elderly group with exercise and the elderly group with no exercise, respectively, were the best-fitted models when compared with that of the youth group. Compared to the elderly group with no exercise, models Aa and Af, were the best-fitted models.

Conclusion

These results showed that good exercise habits might have a certain degree of positive effect on GMP aging, by lower their internal additive noise (Aa), and improve the ability to eliminate external noise (Af).
Genetics of psycho-emotional well-being: genome-wide association study and polygenic risk score analysis
Authors: Yakovchik Anna Yurievna , Tolynyova Darya V. , Kashtanova Daria A. , Sutulova Ekaterina R. , Ivanov Mikhail V. , Mamchur Alexandra A. , Erema Veronika V. , Matkava Lorena R. , Terekhov Mikhail V. , Rumyantseva Antonina M. , Blinova Olga I. , Akinshina Aleksandra I. , Mitrofanov Sergey I. , Yudin Vladimir S. , Makarov Valentin V. , Keskinov Anton А. , Kraevoy Sergey A. , Yudin Sergey M.
Published: January 2024

Background

Psycho-emotional well-being is essential for living a life of satisfaction and fulfillment. However, depression and anxiety have become the leading mental health issues worldwide, according to the World Health Organization. Both disorders have been linked to stress and other psychological factors. Their genetic basis remains understudied.

Methods

In 2020–2021, the psycho-emotional well-being of 30,063 Russians with no known psychiatric history was assessed using the Hospital Anxiety and Depression Scale (HADS) for general mental health and the HADS subscale A (anxiety) for anxiety. Following the original instructions, an anxiety score of ≥11 points was used as the anxiety threshold. A genome-wide association study was performed to find associations between anxiety and HADS/HADS-A scores using linear and logistic regressions based on HADS/HADS-A scores as binary and continuous variables, respectively. In addition, the links between anxiety, sociodemographic factors (such as age, sex, and employment), lifestyle (such as physical activity, sleep duration, and smoking), and markers of caffeine and alcohol metabolism were analyzed. To assess the risk of anxiety, polygenic risk score modeling was carried out using open-access software and principal component analysis (PCA) to simplify the calculations (ROC AUC = 89.4 ± 2.2% on the test set).

Results

There was a strong positive association between HADS/HADS-A scores and sociodemographic factors and lifestyle. New single-nucleotide polymorphisms (SNPs) with genome-wide significance were discovered, which had not been associated with anxiety or other stress-related conditions but were located in genes previously associated with bipolar disorder, schizophrenia, or emotional instability. The CACNA1C variant rs1205787230 was associated with clinical anxiety (a HADS-A score of ≥11 points). There was an association between anxiety levels (HADS-A scores) and genes involved in the activity of excitatory neurotransmitters: PTPRN2 (rs3857647), DLGAP4 (rs8114927), and STK24 (rs9517326).

Conclusion

Our results suggest that calcium channels and monoamine neurotransmitters, as well as SNPs in genes directly or indirectly affecting neurogenesis and synaptic functions, may be involved in the development of increased anxiety. The role of some non-genetic factors and the clinical significance of physiological markers such as lifestyle were also demonstrated.
Depression, anxiety, stress symptoms and their determinants among secondary students with vision impairment in rural Northwestern China during the COVID-19 pandemic
Authors: Li Dongfeng , Chan Ving Fai , Wang Huan , Zhang Huiping , Virgili Gianni , Whitestone Noelle , Xiao Baixiang , Singh Manpreet K. , She Xinshu , Mackenzie Graeme , Boswell Matthew , Mavi Sonia , Rozelle Scott , Congdon Nathan
Published: January 2024

Objective

The measures implemented to control the spread of Coronavirus disease 2019 (COVID-19) could affect children’s mental and vision health. Youth particularly from minority and socioeconomically disadvantaged backgrounds were more likely to be impacted by these measures. This study aimed to examine the mental health of children with vision impairment and associated factors in North-western China during the COVID-19 pandemic.

Methods

A cross-sectional study was conducted among 2,036 secondary school children living in Ningxia Hui Autonomous Region. Participants completed a survey on sociodemographic and lifestyle information and answered the Chinese version of the 21-item Depression Anxiety Stress Scales (DASS-21) questionnaire. Presenting visual acuity was measured by a trained enumerator. Multivariate logistic regression analysis was used to identify potential risk factors for mental health problems.

Results

Responses from 1,992 (97.8%) children were included in the analysis after excluding those with incomplete mental health outcome data. The prevalence of depression, anxiety and stress symptoms within the dataset were 28.9, 46.4, and 22.3%, respectively. The distribution of children with different stress levels differed significantly between those with and without vision impairment (p = 0.03). Multivariable logistic regression analyses revealed that depression symptoms decreased with higher parental education (OR, 0.76, 95% confidence intervals (CI):0.63–0.96), longer sleep duration (OR, 0.90, 95% CI: 0.81–0.97) and longer study time (OR, 0.82, 95% CI: 0.74–0.91), whereas they increased with higher recreational screen time (OR, 1.19, 95% CI: 1.08–1.32). Anxiety symptoms decreased with higher parental education (OR, 0.80, 95% CI: 0.66–0.96) and increased with higher recreational screen time (OR, 1.15, 95% CI: 1.04–1.27) and being a left-behind child (OR, 1.26, 95% CI: 1.04–1.54). In addition, stress symptoms decreased with longer sleep duration (OR, 0.92, 95%CI: 0.85–0.99) and increased with higher number of siblings (OR, 1.10, 95% CI: 1.01–1.19), higher recreational screen time (OR, 1.15, 95% CI: 1.04–1.28) and older age (OR,1.12, 95% CI: 1.004–1.24).

Conclusion

A considerable proportion of our sample experienced mental health problems during the pandemic. Healthcare planners in China should consider interventions such as reducing recreational screen time, ensuring sufficient sleep, and timely detection of mental health symptoms among socioeconomically disadvantaged groups.
Review of Israel’s action and response during the COVID-19 pandemic and tabletop exercise for the evaluation of readiness and resilience—lessons learned 2020–2021
Authors: Muhsen Khitam , Cohen Dani , Glatman-Freedman Aharona , Husseini Sari , Perlman Saritte , McNeil Carrie
Published: January 2024

Background

Reevaluating response plans is essential to ensuring consistent readiness and resilience to the COVID-19 pandemic. The “During Action Review” and Tabletop (DART) methodology provides a retrospective and prospective assessment to inform the adaptive response. Israel introduced COVID-19 vaccinations in December 2020 and was the first country to implement booster vaccination to address waning immunity and surges caused by new variants. We assessed Israel’s readiness and resilience related to COVID-19 response while capturing the pre-vaccination and vaccination periods.

Methods

A DART analysis was conducted between December 2020 and August 2021 among experts involved in the management of the COVID-19 pandemic in Israel. During the retrospective stage, a role-based questionnaire and discussions were undertaken in a participant-led review of the response, focusing on epidemiology and surveillance, risk communication, and vaccines. The prospective stage included tabletop exercises to evaluate short to long-term simulated scenarios.

Results

Participants emphasized the pivotal role of Israel globally by sharing experiences with the pandemic, and vaccination. Perceived strengths included multi-sectoral collaboration between the Ministry of Health, healthcare providers, academia, military, and others, stretching capacities, expanding laboratory workload, and establishing/maintaining surveillance. The vaccine prioritization plan and strong infrastructure, including computerized databases, enabled real-life assessment of vaccine uptake and impact. Challenges included the need to change case definitions early on and insufficient staffing. Quarantine of patients and contacts was particularly challenging among underprivileged communities. Risk communication approaches need to focus more on creating norms in behavior. Trust issues and limited cooperation were noted, especially among ethnic and religious minorities. To ensure readiness and resiliency, participants recommended establishing a nationally deployed system for bringing in and acting upon feedback from the field, especially concerning risk communication and vaccines.

Conclusion

Our study appraised strengths and weaknesses of the COVID-19 pandemic response in Israel and led to concrete recommendations for adjusting responses and future similar events. An efficient response comprised multi-sectoral collaboration, policy design, infrastructure, care delivery, and mitigation measures, including vaccines, while risk communication, trust issues, and limited cooperation with minority groups were perceived as areas for action and intervention.
Prevalence and associated factors of severity levels of anemia among women of reproductive age in sub-Saharan Africa: a multilevel ordinal logistic regression analysis
Authors: Tirore Lire Lemma , Areba Abriham Shiferaw , Habte Aklilu , Desalegn Mitiku , Kebede Abraham Sahilemichael
Published: January 2024

Background

Sub-Saharan Africa is the most anemia-prone region, with several of the sub-region’s countries having a substantial prevalence of the anemia among women of reproductive age. Nonetheless, no adequate study has been conducted to illustrate severity levels and associated factors of anemia among women of reproductive age. Therefore, this study presents the most recent estimates on the prevalence and severity levels of anemia and its associated factors among women of reproductive age in 21 Sub-Saharan Africa countries.

Methods

This study used the most recent Demographic Health Survey (DHS) datasets, which were collected in 21 sub-Saharan African countries between 2015 and 2022. A total of 171,348 women of reproductive age were included in the analysis. Multilevel (three-level) ordinal logistic regression was done to identify factors associated with severity levels of anemia.

Results

The pooled prevalence of anemia was 41.74%. The pooled prevalence of mild, moderate and severe anemia was 23.45, 17.05 and 1.24, respectively. Women who were living at distance to a health facility (AOR = 1.07), women living in the poorest households (AOR = 1.49), women living in the households with unimproved toilet (AOR = 1.12) and in households that were using solid cooking fuel (AOR = 1.10), pregnant women (AOR = 1.72) and those who have given birth to more than one children within 3 years (AOR = 1.43) had greater odds of higher levels of anemia as compared to their counterparts. Women who were in the age groups of 20–24 (AOR = 0.81), 25–29 (AOR = 0.78), 30–34 (AOR = 0.79), 35–39 (AOR = 0.88), and 45–49 (AOR = 0.89), women who have attended primary school (AOR = 0.50), secondary (AOR = 0.57) and higher education (AOR = 0.76) and who were living in rural area (AOR = 1.07) had lower odds of higher levels of anemia as compared to their counterparts.

Conclusion

Considering individual, household and community contexts is necessary while formulating and implementing anemia prevention and control policies. Adolescent women, and women who did not attend education and at a distance to a health facility should get especial attention while implementing anemia prevention and control programs.
Cross-sectional comparison of health care delivery and reimbursement between segregated and nonsegregated communities in Hungary
Authors: Kasabji Feras , Vincze Ferenc , Lakatos Kinga , Pálinkás Anita , Kőrösi László , Ulicska László , Kósa Karolina , Ádány Róza , Sándor János
Published: January 2024

Introduction

Spatially segregated, socio-economically deprived communities in Europe are at risk of being neglected in terms of health care. In Hungary, poor monitoring systems and poor knowledge on the health status of people in these segregated areas prevent the development of well-informed effective interventions for these vulnerable communities.

Aims

We used data available from National Health Insurance Fund Management to better describe health care performance in segregated communities and to develop more robust monitoring systems.

Methods

A cross-sectional study using 2020 health care data was conducted on each general medical practice (GMP) in Hungary providing care to both segregated and nonsegregated (complementary) adult patients. Segregated areas were mapped and ascertained by a governmental decree that defines them as within settlement clusters of adults with low level of education and income. Age, sex, and eligibility for exemption certificate standardized indicators for health care delivery, reimbursement, and premature mortality were computed for segregated and nonsegregated groups of adults and aggregated at the country level. The ratio of segregation and nonsegregation specific indicators (relative risk, RR) was computed with the corresponding 95% confidence intervals (95% CI).

Results

Broad variations between GMPs were detected for each indicator. Segregated groups had a significantly higher rate of health care service use than complementary groups (RR = 1.22, 95% CI: 1.219;1.223) while suffering from significantly reduced health care reimbursement (RR = 0.940, 95% CI: 0.929;0.951). The risk of premature mortality was significantly higher among segregated patients (RR = 1.184, 95% CI: 1.087;1.289). Altogether, living in a segregated area led to an increase in visits to health care services by 18.1% with 6.6% less health spending.

Conclusion

Adults living in segregated areas use health care services more frequently than those living in nonsegregated areas; however, the amount of health care reimbursement they receive is significantly lower, suggesting lower quality of care. The health status of segregated adults is remarkably lower, as evidenced by their higher premature mortality rate. These findings demonstrate the need for intervention in this vulnerable group. Because our study reveals serious variation across GMPs, segregation-specific monitoring is necessary to support programs sensitive to local issues and establish necessary benchmarks.
The challenges of epidemiologic translation: communicating with physicians, policymakers, and the public
Authors: Levin Jeff
Published: January 2024

Translational epidemiology refers to the practical application of population-health research findings to efforts addressing health disparities and other public health issues. A principal focus of epidemiologic translation is on the communication of results to constituencies who can best make use of this information to effect positive health-related change. Indeed, it is contended that findings from epidemiologic research are of greatest use only if adequately communicated to health professionals, legislators and policymakers, and the public. This paper details the challenges faced by efforts to communicate findings to the these constituencies, especially three types of miscommunication that can derail efforts at translation. These include perceived misinformation, perceived disinformation, and perceived censorship. Epidemiologists are ethically obliged to avoid these types of miscommunication, and, accordingly, are advised to place greater emphasis on messaging and media outreach to physicians, government officials, medical educators, and the general public.
Effects of medical consortium policy on health services: an interrupted time-series analysis in Sanming, China
Authors: Yang Xinmei , Chen Yang , Li Chengyue , Hao Mo
Published: January 2024

Objectives

China has implemented reforms to enhance the operational efficiency of three-level medical services through medical consortiums (MCs). This study evaluated the impact of MCs reform on health services in Sanming, China.

Methods

An interrupted time-series analysis (ITSA) was conducted to assess the impact of MCs on changes in health service levels and trends across the overall situation of MCs and different institutional types within MCs, including county hospitals and grassroots medical institutions. The evaluation focused on various indicators such as outpatient and emergency visits, inpatients, average length of stay, occupancy rate of hospital beds, and hospital bed turnover times. Monthly data were collected from April 2015 to June 2019 through reports on the Sanming Municipal Health Commission website and the Sanming public hospital management monitoring platform.

Results

After the intervention of MCs reform, a significant increase was observed in the total number of inpatients (β3 = 174.28, p < 0.05). However, no statistically significant change was observed in the total number of outpatient and emergency visits (β3 = 155.82, p = 0.91). Additionally, the implementation of MCs reform led to an amplification in service volumes provided by county hospitals, with significant increases in the number of outpatient and emergency visits (β3 = 1376.54, p < 0.05) and an upward trend in the number of inpatients (β3 = 98.87, p < 0.01). However, no significant changes were observed under the MCs policy for grassroots medical institutions regarding the number of outpatient and emergency visits (β3 = −1220.72, p = 0.22) and number of inpatients (β3 = 75.42, p = 0.09).

Conclusion

The Sanming MCs reform has achieved some progress in augmenting service volumes. Nevertheless, it has not led to an increase in service volumes at the grassroots medical institutions. There persists an insufficiency in the efficiency of services and a need for further improvement in primary healthcare. To address these concerns, it is imperative for county hospitals to offer targeted assistance that can enhance motivation among grassroots medical institutions. Besides the MCs should explore initiatives, including improved management of medical equipment, allocation of funding, and personnel resources.
Child opportunity index is associated with pediatric firearm injury in Philadelphia, Pennsylvania
Authors: Reddy Anireddy R.
Published: January 2024

Introduction

Firearm injury is the leading cause of death in children. This study uses geospatial mapping to illustrate the burden of pediatric firearm injury in Philadelphia and assesses the relationship between Child Opportunity Index (COI) and injury, hypothesizing that lower COI zip codes would have higher injury and mortality rates.

Methods

Pediatric firearm injury data for children aged 0–19 years in Philadelphia, from 2015 to February 2023, was visualized by race/ethnicity, fatal versus non-fatal status, and COI for zip code. COI was then dichotomized as “High” or “Low” based on nationally normed scores and used to compare incidence and odds of mortality. Injury incidence rates by COI were calculated using weighted Poisson regression, to adjust for the total number of children in each COI category. Odds of mortality by COI, adjusted for age, sex and race/ethnicity, were calculated using multivariable logistic regression.

Results

Of 2,339 total pediatric firearm injuries, 366 (16%) were fatal. Males (89%), adolescents (95%) and Black children (88%) were predominately affected. Geospatial mapping showed highest burden in North and West Philadelphia, which corresponded with areas of low COI. The incidence rate ratio (IRR) of injury in low COI zip codes was 2.5 times greater than high COI (IRR 2.5 [1.93–3.22]; p < 0.01). After adjusting for age, sex, and race/ethnicity, odds of mortality in low COI zip codes was nearly twice that of high COI zip codes (aOR 1.95 [0.77–4.92]), though did not demonstrate statistical significance (p = 0.16).

Conclusion

Child opportunity index is associated with pediatric firearm injury in Philadelphia, Pennsylvania.
The role of valorised plant proteins and phenolic compounds on the digestibility of foods: a short review of recent trends and future opportunities in addressing sustainability issues
Authors: Brennan Charles Stephen
Published: January 2024

During the last 2–3 decades there has been increasing attention from academics, professionals and consumers about how phenolic compounds from plant based foods could enhance the nutritional quality of foods. This mini-review evaluates the focus given to the interactions phenolics have on the metabolic functions in foods and how these phenolic compounds can manipulate digestibility of both carbohydrates and proteins, and how this in turn can modulate metabolic disorders as well as microbiota. With an emphasis on research published in the last decade, the article also examines the potential of valorisation strategies to reutilise fractions which may have traditionally been lost in the food production operations. The reason for this focus is related to the pressing requirements of sustainability within the resource hungry food industry, and how we can create a culture of regenerative food innovation within the sectors.
“If less is more, how you keeping score?” Outlines of a life cycle assessment method to assess sufficiency
Authors: André Hampus
Published: January 2024

It is increasingly clear that reaching environmental sustainability requires not only efficiency (reduced environmental impact per functionality) but also sufficiency measures (reduced environmental impact through reduced or changed functionality). Life cycle assessment (LCA) is a widely used tool to study environmental impacts related to consumption. However, because of the LCA convention of only comparing alternative products with equal functionality, it is currently inept as a method for assessing the environmental impacts of sufficiency measures. Against this background, this short paper aims to stimulate a discussion on how sufficiency measures can be assessed with LCA methodology. By analyzing the very few LCAs of explicit sufficiency measures in terms of the components of a functional unit (what function is provided, how much, for how long, and how well) features of a potential new branch of LCA methodology are outlined, called Sufficiency LCA. In Sufficiency LCA, product alternatives need to be similar enough so that the what component of the functional unit can be equal, while the other components, how much, how long, and how well, are allowed to be non-equal. Thus, a key feature of Sufficiency LCA concerns functional non-equivalence of compared product alternatives, which is not allowed or neglected in conventional LCA, but which could be allowed, acknowledged and quantified in Sufficiency LCA. Developing Sufficiency LCA could be critical considering that sufficiency measures are expected to be required, and that LCA is expected to be serviceable as decision-making support, in the transition toward environmental sustainability.
The radiative association of PO/PH+ and the photodissociation of PH+
Authors: Chen Yang , Lin Xiaohe , Xiao Lidan , Li Zijian , Zhang Songbin , Cheng Yongjun , Wu Yong , Yan Bing
Published: January 2024

The potential energy curves (PECs) and transition dipole moments (TDMs) of PH+ and PO are computed with the multireference configuration interaction method, and the cross-sections for the radiative association (RA) of PH+ and PO, which is the most efficient way to form the ground states, are presented via the quantum mechanical (QM) theory and computed using ab initio molecular data. The thermal rate coefficients are also expressed and fitted with the standard formula kT=AT300αe−βT in the range of 10 K–15,000 K. Meanwhile, the photodissociation, that is the inverse process of RA for PH+, is also studied, including eight photodissociation channels for the computation of state-resolved cross-sections. Careful comparisons with the Leiden Observatory database are made. Considering the cross-sections mentioned above, the local thermodynamic equilibrium cross-sections at the temperatures of 0, 500, 1,000, and 2,000 K are also shown. We expect the results to be helpful for studies of phosphorus chemistry in the interstellar medium and planetary atmospheres.
Percutaneous microchannel unilateral approach bilateral micro decompression for adjacent segmental degeneration after lumbar fusion at 10 years: a case report and review of literature
Authors: Zhang Tingxin , Gao Gang , Gao Feng , Guo Nana , Wang Yongjiang
Published: January 2024

Background

Adjacent segmental degeneration after lumbar fusion is one of the common long-term complications after lumbar fusion. With the continuous development of adjacent segmental degeneration, patients who fail conservative treatment often need reoperation to relieve symptoms. In recent years, the technique of bilateral microdecompression through unilateral approach under microchannel has been widely used in the treatment of lumbar degenerative diseases. However, the efficacy of this procedure for adjacent-segment degeneration after lumbar fusion has not been established. Here, we report a case of bilateral microscopic decompression via a unilateral approach through a microchannel in a patient with adjacent segmental degeneration after lumbar fusion.

Case report

A 70-year-old male patient was admitted to hospital because of lumbago accompanied by left lower extremity pain, numbness and weakness for 2 years, which aggravated for 2 months. Ten years ago, he underwent PLIF for lumbar spinal stenosis, and recovered well after the operation. According to imaging data and physical examination, the diagnosis was adjacent segmental degeneration after lumbar fusion. Bilateral microdecompression was performed through a unilateral approach under a microchannel. Good clinical outcomes was observed through 1-year postoperative follow-up.

Conclusions

This report reports the successful treatment of a patient with ASD 10 years after lumbar fusion. Bilateral microdecompression via a unilateral approach under a microchannel is a safe and effective method for the treatment of ASD after lumbar fusion with good surgical outcomes.