bluuebunny/crossref_metadata_2025 huggingface dataset:
An active break program (ACTIVA-MENTE) at elementary schools in Chile: study protocol for a pilot cluster randomized controlled trial
Authors: Reyes-Amigo Tomás , Ibarra-Mora Jessica , Aguilar-Farías Nicolás , Gómez-Álvarez Nicolás , Carrasco-Beltrán Hernaldo , Zapata-Lamana Rafael , Hurtado-Almonácid Juan , Páez-Herrera Jacqueline , Yañez-Sepulveda Rodrigo , Cortés Guillermo , Rolle-Cáceres Grissel , Bezerra Andréa
Published: January 2024

Background

Physical inactivity is prevalent in childhood. Schools can be an ideal context to promote the regular practice of physical activity since children spend there a large part of the day. In this sense, an emerging and current trend is active breaks at school. This article presents a study protocol that seeks to assess the feasibility and effectiveness of an intervention with active breaks (ACTIVA-MENTE program) in a school context on physical activity, on-task classroom behavior, and the physical activity enjoyment in schoolchildren.

Methods

The protocol includes children aged 10 to 11 years. Two groups will be randomized (intervention and control groups). The intervention group will use the active break program, ACTIVA-MENTE, which consists of the application of a 4-min, 30-s video with moderate to vigorous-intensity physical activity. These breaks will be taken 6 times a day in the classes for 6 weeks. The total physical activity will be measured with accelerometers (Actigraph wGT3X-BT), the on-task behavior through the Direct Behavior Rating Scale and the level of enjoyment through the Physical Activity Enjoyment Scale.

Discussion

Previous research reported that active breaks have positive results in physical activity levels. This study will be one of the few to design active breaks through videos without depending on the presence of a physical education teacher and it can also provide new findings on the effectiveness of an active break’s structure (e.g., types of exercises and intensity) on the indicated outcomes.

Expected results

It is expected that the ACTIVA-MENTE program can be a suitable program for school settings, potentially increasing physical activity levels, and the commitment to the task, as well as be a pleasant moment for the students.

Clinical trial registration

Clinicaltrials.gov, identifier NCT05403996.
Continuity of care in suicide prevention: current status and future directions
Authors: Arnon Shay , Shahar Golan , Brunstein Klomek Anat
Published: January 2024

Introduction

Continuity of Care (CoC) is central to suicide prevention. The present study aims to review contemporary definitions, operationalization in research, and key components of CoC in the prevention of suicide.

Methods

The present study is a narrative review. A thorough search of available literature on CoC and suicidality was conducted. Studies published between 1995 and 2021 were reviewed and selected based on relevance to CoC and suicidality. Selected research was subsequently summarized to outline definitions of CoC, its operationalization in research, and key components for suicide prevention.

Results

The definition, measurement, and operationalization of CoC in suicide prevention varies tremendously, derailing clinical practice. Key elements of CoC identified across the literature include (1) CoC across multiple levels of care, (2) the role of primary care providers and case managers in CoC of suicidal patients, (3) the importance of follow up contact with suicidal patients post-treatment, and (4) the role of national and institutional guidelines for CoC of suicidal patients. Limitations: There is a dearth of randomized controlled trials and insufficient evidence on specific populations.

Conclusion

CoC refers to a wide, complex concept that must be broken down into specific categories that can provide more nuanced guidance of research and clinical implications.
Managing the unknown or the art of preventing SARS-CoV-2 infection in workplaces in a context of evolving science, precarious employment, and communication barriers. A qualitative situational analysis in Quebec and Ontario
Authors: Côté Daniel , MacEachen Ellen , Huynh Ai-Thuy , León Amelia , Laberge Marie , Meyer Samantha , Majowicz Shannon , Amoako Joyceline , Jahangir Yamin , Dubé Jessica
Published: January 2024

Introduction

The issue of communications in the public space, and in particular, in the workplace, became critical in the early stages of the SARS-CoV-2 pandemic and was exacerbated by the stress of the drastic transformation of the organization of work, the speed with which new information was being made available, and the constant fear of being infected or developing a more severe or even fatal form of the disease. Although effective communication is the key to fighting a pandemic, some business sectors were more vulnerable and affected than others, and the individuals in particular socio-demographic and economic categories were proportionately more affected by the number of infections and hospitalizations, and by the number of deaths. Therefore, the aim of this article is to present data related to issues faced by essential workers interacting with the public and their employers to mitigate the contagion of SARS-CoV-2 (COVID-19) at work.

Methods

Following the constructivist paradigm, an interpretative qualitative design was used to conduct one-on-one interviews with precarious/low-wage, public-contact workers (N= 40), managers (N= 16), and key informants (N= 16) on topics related to their work environments in the context of COVID-19 prevention.

Results

This article has highlighted some aspects of communication in the workplace essential to preventing COVID-19 outbreaks (e.g., access to information in a context of fast-changing instructions, language proficiency, transparency and confidentiality in the workplace, access to clear guidelines). The impact of poor pre-pandemic working relations on crisis management in the workplace also emerged.

Discussion

This study reminds us of the need to develop targeted, tailored messages that, while not providing all the answers, maintain dialog and transparency in workplaces.
The quality of sleep: evaluation among university students
Authors: Angelillo Silvia , Sansone Vincenza , Paduano Giovanna , Lateano Ludovica , Di Giuseppe Gabriella , Nobile Carmelo Giuseppe Angelo
Published: January 2024

Introduction

This study explored the quality of sleep among university students in the South of Italy during the Covid-19 pandemic.

Methods

A cross-sectional study was conducted between March 2022 and January 2023 and involved students over the age of 18, who were invited to complete a self-administered questionnaire using an online application.

Results

Overall, 88% of men and 94.5% of women had Pittsburgh Sleep Quality Index (PSQI) scores of ≥5 and a mean PSQI score of 9.2 ± 3. Students with severe or extremely depression score, with sever or extremely stress score, male and who did not had Covid-19 infection were more likely to have a PSQI global score. Moreover, 62.6% of the students declared a reduction in social relations and 72.3% an increase in the use of social media during the pandemic period. The majority of respondents reported an extremely severe level of depression (68.1%), anxiety (84.4%) and stress (71.9%).

Conclusion

This finding indicate that a relevant percentage of students are poor sleepers with a higher overall PSQI score with depression and stress and underline the role the implementation of public health interventions to promote healthy life styles and in particular focus on the duration of long night sleep.
The impact of additional visual tasks in physical exercise on balance ability among 9–10-year-old children: the mediating effect of visual acuity
Authors: Yin Rongbin , Zhu Guiming , Liu Anqi , Wang Miyu , Li Liangtao , Dai Shengting
Published: January 2024

Purpose

This study aimed to explore the effects of additional visual tasks in physical exercise on the vision and balance ability of children, and to verify whether children’s vision mediated the influence of physical exercise on their balance ability.

Methods

The study randomly selected 86 students aged 9–10 years old from a school in Suzhou city, dividing them into an experimental group (n = 43) and a control group (n = 43). The experimental group participated in physical exercise with additional visual tasks, while the control group engaged in routine physical exercise. The experiment lasted for 16 weeks, with kinetic visual acuity (KVA), uncorrected distance visual acuity (UDVA), static balance, and dynamic balance measured before and after the experiment.

Results

The results showed that after the experiment, the experimental group had significantly improved kinetic visual acuity (KVA), uncorrected distance visual acuity (UDVA), static balance, and dynamic balance. In contrast, the control group had significantly decreased kinetic visual acuity, no significant improvement in uncorrected distance visual acuity, and no significant difference in dynamic balance and static balance. In the experimental group, there was a moderate positive correlation between kinetic visual acuity and uncorrected distance visual acuity, and a moderate positive correlation between uncorrected distance visual acuity and both static and dynamic balance. The study also found that uncorrected distance visual acuity partially mediated the effect of additional visual tasks during physical exercise on static and dynamic balance among children.

Conclusion

In conclusion, adding visual tasks to physical exercise had a positive effect on improving children’s vision and balance ability. Kinetic visual acuity and uncorrected distance visual acuity were positively correlated, and uncorrected distance visual acuity was positively correlated with both static and dynamic balance. Uncorrected distance visual acuity partially mediated the effect of physical exercise on children’s balance ability.
A mixed-methods study protocol on factors contributing to suicide clusters among Native American youth in a northern plains reservation
Authors: Brockie Teresa , Kahn-John Michelle , Mata Lopez Laura , Bell Eleesha , Brockie Truth , Brockie Terry , Decker Ellie , Glass Nancy , Has Eagle Hannah , Helgeson Kenneth , Main Nona J. , Kazemi Mina , Perez-Monteau Reyna , Myrick Alicia , Nelson Katie E. , Ricker Adriann , Rider Tammy , Roberts Teeah , Wilson Deborah H. , Yazzie Karen , Perrin Nancy
Published: January 2024

Introduction

Suicide and suicide clusters within Native American Reservation communities are devastating to the entire community and increase individuals’ risk for suicide over the lifespan. The objective of this paper is to describe the Indigenous community-based participatory research protocol implemented in partnership with the Fort Belknap Indian Community in Montana, United States. The study protocol was developed to understand suicide risk and protective factors, and community-derived solutions, in a reservation community with history of a suicide cluster and high rates of youth suicide.

Methods

In this mixed-methods study, qualitative data from youth, adults, and service providers and quantitative data from 200 adolescents and young adults (aged 14–24 years) were collected in Fort Belknap, Montana from May – December of 2022. Qualitative data were collected first via in-depth interviews and focus groups. Survey questions included validated and pre-tested measures of factors youth experience across socio-ecological levels. Thematic analysis was applied to the qualitative data; and logistic regression models were used to examine relationships within the quantitative data.

Discussion

This study will add a multi-dimensional perspective to our current understanding of (1) risk and protective factors for suicide, community-derived postvention solutions, and insights on community assets, and (2) the current health and psychosocial status of youth in the Fort Belknap community. This study may serve as an exemplar of co-created, culturally safe solutions designed to address mental health resource gaps. Next steps include development of a suicide crisis response tool kit and a culturally aligned postvention intervention that will enhance individual, family, and community survivance.
Extended Medicaid coverage will improve access but insufficient to enhance postpartum care utilization: a secondary analysis of the 2016–2019 Arizona Medicaid claims
Authors: Okechukwu Abidemi , Abraham Ivo , Okechukwu Chinedu , Magrath Priscilla , Marrero David G. , Farland Leslie V. , Alaofe Halimatou
Published: January 2024

Introduction

Postpartum Medicaid eligibility extensions may increase access to healthcare for low-income women. However, its implications for healthcare utilization are unknown.

Methods

We analyzed the linked-infant birth certificate and claims data of women whose childbirths were paid for by Medicaid between 2016 and 2019 in Arizona, United States. We evaluated associations between postpartum care visits and Medicaid insurance type and assessed effect modification by the delivery route and type of residence.

Results

Women with pregnancy-related Medicaid insurance were less likely to attend postpartum visits, with an adjusted odds ratio (aOR) of 0.70 and a 95% confidence interval (CI) of 0.66 to 0.74 than those with continuous Medicaid insurance. Younger age, rural residence [aOR 0.83, CI 0.78, 0.88], vaginal delivery route [aOR 0.11, CI 0.10, 0.12], and the absence of complications during/after childbirth [aOR 0.58, CI 0.49, 0.70] were associated with the absence of postpartum care visit. Low-income women who lost their pregnancy-related Medicaid coverage after 60 days in Arizona experienced lower rates of postpartum care utilization.

Discussion

Interventions to improve postpartum utilization should be considered beyond extending postpartum Medicaid coverage for low-income women.
Association between household income levels and nutritional intake of allergic children under 6 years of age in Korea: 2019 Korea National Health and Nutrition Examination Survey and application of machine learning
Authors: Jeong Seungpil , Choi Yean Jung
Published: January 2024

Introduction

This study investigated the prevalence of allergic diseases in Korean children aged 6 and below, focusing on the interplay between nutritional status, household income levels, and allergic disease occurrence.

Methods

This study used data from the 2019 Korea National Health and Nutrition Examination Survey, a nationwide comprehensive survey, and included a representative sample of 30,382 children under the age of 6 to investigate in detail the relationship between allergic diseases, nutritional intake, and socioeconomic factors. Logistic regression analysis was performed to identify factors associated with allergic diseases, including gender, BMI, eating habits, dietary supplement intake, and nutrient consumption. To predict childhood asthma, 14 machine learning models were compared using the ‘pycaret’ package in Python.

Results

We discerned that 24.7% were diagnosed with allergic conditions like atopic dermatitis, asthma, and allergic rhinitis. Notably, household income exhibited a significant influence, with the lowest income quartile exhibiting higher prevalence rates of asthma, allergic rhinitis, and multiple allergic diseases. In contrast, the highest income quartile displayed lower rates of allergic rhinitis. Children diagnosed with allergic diseases demonstrated compromised intake of essential nutrients such as energy, dietary fiber, vitamin B1, sodium, potassium, and iron. Particularly noteworthy were the deficits in dietary fiber, vitamin A, niacin, and potassium intake among children aged 3–5 with allergies. Logistic regression analysis further elucidated that within low-income families, female children with higher BMIs, frequent dining out, dietary supplement usage, and altered consumption of vitamin B1 and iron faced an elevated risk of allergic disease diagnosis. Additionally, machine learning analysis pinpointed influential predictors for childhood asthma, encompassing BMI, household income, subjective health perception, height, and dietary habits.

Discussion

Our findings underscore the pronounced impact of income levels on the intricate nexus between allergic diseases and nutritional status. Furthermore, our machine learning insights illuminate the multifaceted determinants of childhood asthma, where physiological traits, socioeconomic circumstances, environmental factors, and dietary choices intertwine to shape disease prevalence. This study emphasizes the urgency of tailored nutritional interventions, particularly in socioeconomically disadvantaged populations, while also underscoring the necessity for comprehensive longitudinal investigations to unravel the intricate relationship between allergic diseases, nutritional factors, and socioeconomic strata.
Dietary habits, physical activity, and self-reported rhinosinusitis in children and adolescents
Authors: Pazdro-Zastawny Katarzyna , Krajewska Joanna , Kolator Mateusz , Basiak-Rasała Alicja , Górna Sara , Zatoński Tomasz
Published: January 2024

Background

Pediatric paranasal rhinosinusitis is one of the more common pediatric diseases of the upper respiratory tract and it entails significant morbidity. Most commonly, it is caused by a viral infection of the nasal mucosa, which spreads through the natural passages within the cavities of the paranasal sinuses, leading to inflammation of the mucosa that lines the nasal cavity and paranasal sinuses.

Methods

The objective of this cohort study was to assess whether there is a correlation between pediatric rhinosinusitis, physical activity, and selected dietary habits among pupils aged 6 to 16 years from elementary schools in Wrocław, Poland. This study – as part of the pro-health program “Let us Get the Kids Moving” – is also aimed at establishing factors that potentially predispose children to developing RS. The survey study was conducted on a group of 2,458 children and adolescents from elementary schools in Wrocław. The age of the examined children ranged from 6 to 17 years (mean = 10.8 years; standard deviation = 2.7).

Results

Rhinosinusitis was more common in the children aged 13–17 years than in those aged 6–9 years (6.4% vs. 1.5%; p < 0.001) or 10–12 years (6.4 vs. 2.6%; p < 0.001). The study revealed a significant positive correlation between rhinosinusitis development and several variables: age > 11 years, attending swimming classes fewer than 1–2 times a week, using a computer, consuming milk, salty snacks, and carbonated sweet drinks, consuming fruit fewer than 1–2 times a week, not attending physical education classes, eating fewer than 4 meals, and not eating breakfast at home (p < 0.05).

Conclusion

It is of great importance to establish preventive measures against recurrent upper respiratory tract infections that may predispose children to rhinosinusitis. Introducing healthier, traditional dietary habits and regular physical activity in children and adolescents may result in normal and adequate immune response and proper functioning of the inflammatory control system.
The legal path for priority setting in Chile: a critical analysis to improve health planning and stewardship
Authors: Espinoza Manuel Antonio , Cabieses Baltica , Goic Carolina , Andrade Alejandro
Published: January 2024

Health systems have committed their path to universal health coverage using health planning to accomplish their goals of efficiency, equity and sustainability. Chile, a high-income country with a public-private mix health system, has made significant progress through several successive health policies implemented in the last 20 years which have been consistent with this approach. However, in the last 5 years, the national congress has produced several disease-specific laws, which have been mainly promoted by the civil society. These laws indicate the actions the health authority must perform to tackle the needs of the affected population, which ultimately determine the priorities of the health system. We argue that this legal pattern has become an alternative path to priority-setting, as opposed to health planning. We claim this “legal path” is a mechanism used by civil society in a context where the health authority fails to implement a robust and legitimate prioritization process. Although these laws have brought benefits to patients suffering the corresponding conditions, we highlight this approach does not guarantee improvements in equity, efficiency and health system performance. Instead, we advocate for taking back the control of the priority-setting based on health planning, through a new institutionalization of health technology assessment and quality of care.
Determinants of factors affecting readiness of academic institutions to conduct knowledge translation in low- and middle-income countries
Authors: Kalbarczyk Anna , Rao Aditi , Alonge Olakunle O.
Published: January 2024

Introduction

Capacity building strategies have been used to improve uptake of knowledge translation (KT) activities among academic institutions, but little is known about their effectiveness, contextual responsiveness, and adaptability. Many of these strategies target individuals while few address institutional gaps. This research describes the determinants for conducting KT (or readiness to conduct such activities) at the institutional level across diverse LMIC contexts to inform the development of capacity building strategies.

Methods

We conducted a survey to assess organizational readiness to conduct KT to public health researchers and practitioners from six academic institutions in Bangladesh, Ethiopia, DRC, India, Indonesia and Nigeria and members of a global knowledge-to-action working group. We assessed the frequency of barriers and facilitators to KT and their relationship to age, gender, country, and KT experience. We then performed logistic regression to identify determinants of five underlying factors demonstrated to influence KT readiness in LMICs (Institutional Climate, Organization Change Efficacy, Prioritization and Cosmopolitanism, Self-Efficacy and Financial Resource) along with their composite score, which represented an overall readiness score to conduct KT.

Results

A total of 111 responses were included in the final analysis. Participants represented 10 LMICs; a majority were 30–49 years old (57%) and most were male (53%). Most participants had professional foci in research (84%), teaching (62%), and project coordination (36%) and 59% indicated they had experience with KT. Common facilitators included motivated faculty (57%) and dedicated personnel (40%). Funding (60%), training (37%), and time (37%) were the most frequently reported barriers. In the adjusted model, age, gender, country, and professional focus were significantly associated with at least one factor. Prior experience with KT was significantly and positively (OR = 9.07; CI: 1.60–51.58; p < 0.05) associated with the overall KT readiness to conduct KT.

Discussion

Different KT readiness factors are relevant for younger (institutional climate) vs. older (self-efficacy) academic professionals, suggesting value in cross-generational collaborations. Leadership and gender were both relevant for organizational change efficacy indicating a need to engage leaders and promote women to influence organizational change. Institutions in different countries may be at different stages of change; readiness assessments can be used to systematically identify needs and develop targeted strategies.
Digital tool assessment for the community management of patients with pulmonary tuberculosis in Yiwu city, China: evidence from real world data in 2020
Authors: Zhou Lin , Zhou Yuli , Ding Yunfang , Peng Ying , Wang Wei , Chen Bin , Gong Shuiying , Liu Kui , Dong Xuanjun
Published: January 2024

Background

High-quality medication compliance is critical for the cure of pulmonary tuberculosis (PTB); however, the implementation of directly observed treatment (DOT) under direct interview still faces huge difficulties. Assessment of the effect of digital tool during community management has not been performed in eastern China.

Methods

All drug-sensitive PTB cases notified in Yiwu city from June to December 2020 were divided into the routine group and digital tool group based on patients’ willingness. The variables influencing the on-time completion level of home visits, medication adherence and treatment outcomes were estimated.

Results

A total of 599 eligible patients were enrolled, with 268 participating in the routine group and 331 using a digital tool. Most participants were men (n = 357, 59.6%), and nearly all were new cases (n = 563, 94.0%). Participants’ mean age was 44.22 ± 20.32 years. There were significant differences in age, diagnostic type, and source of patients between the two groups. During the study period, the digital tool group had a higher on-time completion rate of home visits (91.5% vs. 82.5%) and medication adherence rate (94.3% vs. 89.6%) than the routine group, whereas there was no significant difference in the treatment success rate between the two groups (91.2% vs. 86.8%). Multivariate logistic regression analysis demonstrated that the digital tool group showed a more positive function in the on-time completion status of home visits, with an adjusted odds ratio of 0.41 (95% confidence interval: 0.25–0.70).

Conclusion

Digital tools can be employed to improve the on-time completion rate of home visits in Yiwu city. Further large-scale studies that use digital tools for community management are warranted.
The Acti-Pair program helps men with prostate cancer increase physical activity with peer support: a mixed method pilot study
Authors: Baudot Amandine , Barth Nathalie , Colas Claire , Garros Maël , Garcin Arnauld , Oriol Mathieu , Collange Fanny , Bongue Bienvenu , Roche Frederic , Chauvin Franck , Bourmaud Aurelie , Hupin David
Published: January 2024

Background

Although the health benefits of physical activity (PA) are recognized, prostate cancer patients do not follow PA recommendations. Barriers to PA, whether physical, environmental or organizational, are known. Furthermore, even when these barriers are overcome, this achievement is not systematically accompanied by lifestyle change. Many strategies have shown to be effective in increasing patient adherence to PA. This study aims to assess the feasibility and the viability of the Acti-Pair program which combines three strategies: peer support, a personalized and realistic PA project, and support from health and adapted physical activity professionals in a local context.

Methods and analysis

We conducted a pilot study utilizing a mixed qualitative and quantitative methodology, employing feasibility and viability assessments. Quantitative assessments included recruitment, retention adherence rates, process and potential effectiveness (PA and motivation) indicators; while qualitative methods were used to evaluate the program's practicality, suitability and usefulness. Indicators of potential effectiveness were assessed before and after the intervention using a Wilcoxon test for matched data. Qualitative data were collected through semistructured interviews conducted by two researchers with various program stakeholders. The study lasted for 3 years.

Results

Twenty-four patients were recruited over a 25-month period. Forty-two percent of patients completed the program 3 months after the beginning. We recruited 14 peers and trained nine peers over a 10-month period. The program was coordinated extensively by adapted PA professionals, while health professionals were involved in recruiting patients and peers. Self-reporting of moderate to vigorous PA was increased after the Acti-Pair program initiation [42.86 (30.76) at baseline to 53.29 (50.73)]. Intrinsic motivation significantly increased after participation in the Acti-Pair program [1.76 (1.32) before the intervention vs. 2.91 (1.13) after the intervention]. The key player to support the Acti-Pair program in the field has been the PA support system. The main challenge has been the difficulty of health professionals in promoting PA.

Discussion

This pilot study has shown that the Acti-Pair program is feasible and viable. It will allow us to extend the peer support intervention to other contexts and assess the effectiveness of this intervention and its generalization.
Association between urine uranium and asthma prevalence
Authors: Huang Dongdong , Wang Saibin
Published: January 2024

Background

Previous studies showed that urine uranium (U) is associated with asthma prevalence in adults. However, the association between them among the general population is unclear. Therefore, this study aimed to explore this unclear association.

Methods

The data of the participants were collected from the 2007–2016 National Health and Nutrition Examination Survey (NHANES) performed in the United States. Continuous variables with a skewed distribution were analyzed using Ln-transformation. The association between urine U and asthma prevalence was analyzed by multiple regression analysis, and the linear association between them was evaluated by smoothed curve fitting. The subgroup analysis was performed using the hierarchical multivariate regression analysis.

Results

A total of 13,581 participants were included in our analysis. The multivariate regression analysis showed that LnU was independently and positively correlated with asthma prevalence in the general population (OR = 1.12; 95% CI: 1.04–1.20; p = 0.002). The subgroup analysis revealed that college graduate or above showed a stronger association between LnU and asthma prevalence (<9th grade: OR = 0.84; 95% CI: 0.61–1.14; 9–11th grade: OR = 1.23; 95% CI: 0.99–1.52; high school grade: OR = 1.00; 95% CI: 0.84–1.19; college: OR = 1.04; 95% CI: 0.91–1.19; ≥college graduate: OR = 1.32; 95% CI: 1.11–1.57; P for interaction = 0.0389).

Conclusion

Our research suggested that urinary U levels are positively associated with asthma prevalence among the general population of the United States, and the association is especially strong among people with high levels of education.
Which variables and determinants influence online food delivery consumption among workers and students? Results from the DELIvery Choice In OUr Society (DELICIOUS) cross-sectional study
Authors: Giacomini Gianmarco , Scacchi Alessandro , Ragusa Paolo , Prinzivalli Alessandro , Elhadidy Heba Safwat Mhmoued Abdo , Gianino Maria Michela
Published: January 2024

Introduction

Online food delivery (OFD) applications provide easy access to food, eliminating the need for cooking and meal planning. However, they predominantly promote processed and calorie-dense foods, potentially impacting diet and health. This study aimed to describe the use of OFD services in a sample of Italian workers and students, to explore potential determinants of OFD usage and to assess possible differences in use between these two categories.

Methods

Data were collected through an online survey (convenience sampling) distributed on social media platforms between July 12, 2022, and February 1, 2023. The sample included individuals aged 18 and above, currently residing in Italy. The sample was stratified according to worker/student status. Descriptive analyses were performed on key variables. A multivariable logistic regression analysis was conducted to assess the effects of variables on OFD usage, treated as a dichotomous variable (usage or non-usage).

Results

This study analyzed 3,502 questionnaires (2,594 from workers and 908 from students) after excluding 323 non-student and non-worker responses. Positive associations with OFD use included higher income, remote working, smoking, elevated BMI, depression risk, and impulsive buying among workers, while being female, frequent screen-watching during meals, daily smoking, higher BMI, and impulsive buying were associated with OFD use among students. Factors negatively associated with OFD use included older age (workers and students), living in suburbs (workers and students) or in an outline town (workers), being single (workers and students), adhering to the Mediterranean diet (students), having low health literacy (students), and job dissatisfaction (workers).

Discussion

OFD consumption was associated with some risky behaviors and conditions, such as high BMI or smoking, suggesting that it might be influenced by individual tendencies. Healthier habits, such as physical activity, did not significantly impact OFD usage, especially among workers. Whereas, among students, factors such as low health literacy and better eating habits were associated with less use of OFD, so that they could be more prone to use OFD in a measured way. Further research is needed to better understand potential associations between OFD and risky habits, as well as its role in promoting access to healthy food in underserved areas.
Towards integrated sustainability for China’s rural revitalization: an analysis of income inequality and public health
Authors: Lin Jie , Gong Kuiyuan , Chen Chuangbin
Published: January 2024

Introduction

Ensuring healthy lives and promoting well-being are paramount among the priorities outlined in the 17 Sustainable Development Goals (SDGs) established by the United Nations. In China, rural revitalization stands as a pivotal national strategy aimed at fostering prosperity and sustainable development in rural areas. Despite its comprehensive evaluation system, which encompasses industry, ecology, culture, organization, and livelihood, the current index system overlooks the critical dimension of public health in rural areas. The existing body of literature predominantly focuses on the correlation between income and health, leaving a gap in understanding the relationship between income inequality and health from the perspective of villagers. This study addresses this gap by utilizing data from 3,771 villager samples and 302 village samples obtained from the 2019 China Rural Revitalization Survey (CRRS) to explore the correlation between income inequality and public health in China’s rural areas.

Methods

We employ the Ordered Logistic Regression (Ologit) model in the baseline regression and heterogeneity analysis. Additionally, a mediating effect analysis, using the Sobel test, examines the role of villagers’ health awareness as a mediating variable in the correlation between income inequality and villagers’ health.

Results

The empirical findings of this study unveil a statistically significant adverse influence of income inequality on public health in China’s rural areas. Furthermore, the research identifies that participation in regular exercise and the attainment of higher education levels serve as effective measures to alleviate the detrimental impact of income inequality on the health of rural residents. Additionally, income inequality is observed to shape villagers’ health awareness, thereby influencing their overall health status.

Conclusion

The study’s outcomes have significant implications for policymakers and governmental authorities, providing valuable insights into some pathways for enhancing public health in rural China. Ultimately, these insights contribute to the broader objective of achieving integrated sustainability in rural China.
Explaining graph convolutional network predictions for clinicians—An explainable AI approach to Alzheimer's disease classification
Authors: Tekkesinoglu Sule , Pudas Sara
Published: January 2024

Introduction

Graph-based representations are becoming more common in the medical domain, where each node defines a patient, and the edges signify associations between patients, relating individuals with disease and symptoms in a node classification task. In this study, a Graph Convolutional Networks (GCN) model was utilized to capture differences in neurocognitive, genetic, and brain atrophy patterns that can predict cognitive status, ranging from Normal Cognition (NC) to Mild Cognitive Impairment (MCI) and Alzheimer's Disease (AD), on the Alzheimer's Disease Neuroimaging Initiative (ADNI) database. Elucidating model predictions is vital in medical applications to promote clinical adoption and establish physician trust. Therefore, we introduce a decomposition-based explanation method for individual patient classification.

Methods

Our method involves analyzing the output variations resulting from decomposing input values, which allows us to determine the degree of impact on the prediction. Through this process, we gain insight into how each feature from various modalities, both at the individual and group levels, contributes to the diagnostic result. Given that graph data contains critical information in edges, we studied relational data by silencing all the edges of a particular class, thereby obtaining explanations at the neighborhood level.

Results

Our functional evaluation showed that the explanations remain stable with minor changes in input values, specifically for edge weights exceeding 0.80. Additionally, our comparative analysis against SHAP values yielded comparable results with significantly reduced computational time. To further validate the model's explanations, we conducted a survey study with 11 domain experts. The majority (71%) of the responses confirmed the correctness of the explanations, with a rating of above six on a 10-point scale for the understandability of the explanations.

Discussion

Strategies to overcome perceived limitations, such as the GCN's overreliance on demographic information, were discussed to facilitate future adoption into clinical practice and gain clinicians' trust as a diagnostic decision support system.
A Bayesian approach for constituent estimation in nucleic acid mixture models
Authors: Tomono Taichi , Hara Satoshi , Nakai Yusuke , Takahara Kazuma , Iida Junko , Washio Takashi
Published: January 2024

Mass spectrometry (MS) is a powerful analytical method used for various purposes such as drug development, quality assurance, food inspection, and monitoring of pollutants in the environment. In recent years, with the active development of antibodies and nucleic acid-based drugs, impurities with various modifications are produced. These can lead to a decrease in drug stability, pharmacokinetics, and efficacy, making it crucial to differentiate these impurities. Previously, attempts have been made to estimate the monoisotopic mass and ion amounts in the spectrum generated by electrospray ionization (ESI). However, conventional methods could not explicitly estimate the number of constituents, and discrete state evaluations, such as the probability that the number of constituents is k or k+1, were not possible. We propose a method where, for each possible number of constituents in the sample, mass spectrometry is modeled using parameters like monoisotopic mass and ion counts. Using Simulated Annealing, NUTS, and stochastic variational inference, we determine the parameters for each constituent number model and the maximum posterior probability. Finally, by comparing the maximum posterior probabilities between models, we select the optimal number of constituents and estimate the monoisotopic mass and ion counts under that scenario.
The usability of virtual reality to train individuals in responding to behaviors related to dementia
Authors: Garcia Linda , Robitaille Annie , Bouchard Stéphane , Rivard Marie-Christine , McCleary Lynn
Published: January 2024

Introduction

Dementia is associated with several behavioral changes globally referred to as Behavioral and Psychological Symptoms of Dementia (BPSD) of which many are recognized to be the expression of unmet needs triggered by environmental factors. BPSD are an extreme source of stress for family care partners and health care providers alike and can be the reason why people living with dementia (PLWD) are placed in long-term care homes (LTCH). The overall goal of this project was to examine whether a virtual environment that includes a virtual LTCH resident with dementia in a lifelike situation could be useful and usable for health care providers and care partners to identify potential triggers to BPSDs while being engaged emotionally with the scenario.

Methods

Twenty-three health care professionals working with PLWD, 25 care partners to PLWD, 27 students in a health-related field, and 11 university/community college faculty members teaching courses relevant to gerontology tested the application which depicted a meal-time scenario. In addition to being asked about the behavioral triggers in the scene, participants were asked about the usefulness and usability of the tool for training. Presence and simulator sickness were also measured.

Results

Results suggest that participants generally felt present and emotionally engaged. They could identify the potential triggers for the observed behaviors in the virtual human with dementia as well as suggest some solutions. The majority (87% of participants) found the tool easy to use. Many participants identified the inability to interact with the virtual humans as a shortfall, and few reported mild to moderate levels of simulator sickness.

Discussion

As the behavioral changes associated with dementia can cause extreme stress for those interacting with PLWD, developing an effective and efficient training tool could significantly improve well-being for all involved. The investigators see the development and testing of an interactive version of this virtual environment as a next step in making this a clinically relevant training tool.
Personalized robots for long-term telerehabilitation after stroke: a perspective on technological readiness and clinical translation
Authors: Huang Yanhuan , Yang Bibo , Wong Thomson Wai-Lung , Ng Shamay S. M. , Hu Xiaoling
Published: January 2024

Stroke rehabilitation, which demands consistent, intensive, and adaptable intervention in the long term, faced significant challenges due to the COVID-19 pandemic. During this time, telerehabilitation emerged as a noteworthy complement to traditional rehabilitation services, offering the convenience of at-home care delivery and overcoming geographical and resource limitations. Self-help rehabilitation robots deliver repetitive and intensive physical assistance, thereby alleviating the labor burden. However, robots have rarely demonstrated long-term readiness for poststroke telerehabilitation services. The transition from research trials to general clinical services presents several challenges that may undermine the rehabilitative gains observed in these studies. This perspective discusses the technological readiness of personal use robots in the context of telerehabilitation and identifies the potential challenges for their clinical translation. The goal is to leverage technology to seamlessly integrate it into standard clinical workflows, ultimately enhancing the outcomes of stroke rehabilitation.
Vhl deletion in Dmp1-expressing cells alters MEP metabolism and promotes stress erythropoiesis
Authors: Emery Janna M. , Chicana Betsabel , Taglinao Hanna , Ponce Citlaly , Donham Cristine , Padmore Hawa , Sebastian Aimy , Trasti Scott L. , Manilay Jennifer O.
Published: January 2024

Introduction

Erythropoiesis occurs in a specialized niche in the bone marrow and is regulated in part by oxygen-sensing signaling pathways. VHL is an E3 ubiquitin ligase that regulates the degradation of hypoxia-inducible factor (HIF) proteins under normoxic conditions. In hypoxia, VHL is inactivated resulting in enhancement of HIF signaling.

Methods and results

To investigate the effects of HIF-activation in bone cells on erythropoiesis, we performed longitudinal analyses of conditional Vhl knockout mice (Dmp1-Cre;Vhlfl/fl; VhlcKO) mice, in which Vhl is deleted primarily in osteocytes but is retained in hematopoietic cells. VhlcKO mice display elevated red blood cell counts and erythropoietin levels starting at 10 weeks of age, resembling polycythemia. Using flow cytometry, we observed increased frequency of CD71loTER119hiFSClo orthochromatophilic erythroblasts and reticulocytes in 10- and 24-week-old VhlcKO bone marrow. Features of extramedullary hematopoiesis were observed in the spleen, including red pulp hyperplasia, the presence of megakaryocytes, and increased frequency of basophilic and polychromatophilic erythroblasts and of mature stress erythroid progenitors. To investigate the mechanisms that drive the accelerated erythropoiesis in the bone marrow, we enumerated myeloid progenitors and observed higher frequencies of megakaryocyte-erythroid progenitors (MEPs) at 6 and 10 weeks of age, but MEP frequency was similar to controls at 24 weeks. Despite this normalization in MEP frequencies, bulk RNA-Seq of MEPs at this age showed upregulation of Epas1 (Hif2a), consistent with a response to hypoxia, as well as genes involved in erythrocyte development. Surprisingly, genes involved in the response to glucose were also upregulated in VhlcKO MEPs.

Discussion

Our studies implicate that HIF-driven alterations in skeletal homeostasis drive changes to the bone marrow microenvironment that influence erythroid cell development and MEP metabolism.
An investigation of data from the first year of the interim Canada Dental Benefit for children <12 years of age
Authors: Schroth Robert J. , Cruz de Jesus Vivianne , Menon Anil , Olatosi Olubukola O. , Lee Victor H. K. , Yerex Katherine , Hai-Santiago Khalida , DeMaré Daniella
Published: January 2024

Introduction

In 2022, the federal government announced a commitment of $5.3B to provide dental care for the uninsured, beginning with children <12 years of age. Now referred to as the Interim Canada Dental Benefit (CDB), the program targets those <12 years of age from families with annual incomes <$90,000 without private dental insurance. The purpose of this study was to review federal data from the Government of Canada on public uptake and applications made to the Canada Revenue Agency (CRA) during the first year of the Interim CDB.

Methods

Data for the first year of the Interim CDB (up to June 30, 2023) were accessed from the Government of Canada Open Data Portal through Open Government Licence—Canada. Rates of children receiving the Interim CDB per 1,000 were calculated by dividing the number of beneficiaries by the total number of children 0–11 years by province or territory, available from Statistics Canada for the year 2021.

Results

During the first year of the program, a total of 204,270 applications were approved, which were made by 188,510 unique applicants for 321,000 children <12 years of age. Over $197M was distributed by the CRA. Overall, the national rate for receiving the Interim CDB was 67.8/1,000 children. Ontario (82.5/1,000), Manitoba (77.1/1,000), Nova Scotia (73.4/1,000), and Saskatchewan (72.3%), all had rates of children with the Interim CDB above the national rate.

Conclusions

Data from the first year of the Interim CDB suggests that this federal funding is increasing access to care for children <12 years by addressing the affordability of dental care. Governments and the oral health professions need to address other dimensions of access to care including accessibility, availability, accommodation, awareness, and acceptability of oral health care.