bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparative Physicochemical Analysis among 1,4-Butanediol Diglycidyl Ether Cross-Linked Hyaluronic Acid Dermal Fillers
Authors: Zerbinati Nicola , Sommatis Sabrina , Maccario Cristina , Capillo Maria Chiara , Grimaldi Giulia , Alonci Giuseppe , Rauso Raffaele , Guida Stefania , Mocchi Roberto
Published: September 2021

(1) Background: Injectable hyaluronic acid (HA) dermal fillers are used in several chirurgical practices and in aesthetic medicine. HA filler stability can be enhanced through different cross-linking technologies; one of the most frequently cross-linker used is 1,4-butanediol diglycidyl ether (BDDE), also present in the HA-BDDE dermal filler family of the company Matex Lab S.p.A. (Brindisi, Italy). Our overview is focused on their characterization, drawing a correlation between matrix structure, rheological and physicochemical properties related to their cross-linking technologies. (2) Methods: Four different injectable HA hydrogels were characterized through optical microscopic examination and rheological behavior investigation. (3) Results: The cross-linked HA dermal fillers showed a fibrous “spiderweb-like” matrix structure and an elastic and solid-like profile. (4) Conclusions: The comparative analysis represents a preliminary characterization of these injectable medical devices in order to identify their best field of application.
Prison Theatre and an Embodied Aesthetics of Liberation: Exploring the Potentials and Limits
Authors: Woodland Sarah
Published: September 2021

Prison theatre practitioners and scholars often describe the sense of imaginative freedom or “escape” that theatre and drama can facilitate for incarcerated actors, in contrast to the strict regimes of the institution. Despite this, the concept of freedom or liberation is rarely interrogated, being presented instead as a given—a natural by-product of creative practice. Drawing from John Dewey’s (1934) pragmatist aesthetics and the liberatory pedagogies of Bell Hooks (2000) and Paulo Freire (1996), I propose an embodied aesthetics of liberation in prison theatre that adds depth and complexity to claims for freedom through creativity. Reflecting on over twenty years of prison theatre practice and research, I propose that the initial “acts of escape” performed through engaging the imagination are merely the first threshold toward more meaningful forms of freedom. I frame these as the following three intersecting domains: “Acts of unbinding”, which represents the personal liberation afforded by experiences with theatre in prison; “acts of love”, which expresses how the theatre ensemble might represent a “beloved community” (hooks); and “acts of liberation”, which articulates how these experiences of self-and-world creation may ripple out to impact audiences and communities. An aesthetics of liberation in prison theatre can, therefore, be conceived as an embodied movement towards personal and social renewal; an approach that deepens our understanding of its oft-cited humanising potential, and its limits.
The Effect of Primary and Middle School Teachers’ Problematic Internet Use and Fear of COVID-19 on Psychological Need Thwarting of Online Teaching and Psychological Distress
Authors: Yi Jian , Chen I-Hua , Lin Chung-Ying , Li Cheng-Chieh , Liao Xiao-Ling , Wei Zhi-Hui , Gamble Jeffrey Hugh
Published: September 2021

Problematic Internet use (PIU) is a risk factor for psychological distress during COVID-19, as teachers are a psychologically vulnerable population. We explored the role of PIU in terms of primary and middle school teachers’ fear of COVID-19 and psychological need thwarting (PNT) of online teaching. We empirically evaluated the relationships among these research variables in explaining teachers’ psychological distress during COVID-19. Online survey data were collected from 9030 teachers. A high proportion of participants demonstrated psychological distress: depression (20.4%), anxiety (26.4%), and stress (10.2%). Structural equation modeling was used to test our proposed conceptual model, wherein PIU behaviors served as predictors, mediated by fear of COVID-19 and PNT of online teaching, for teachers’ psychological distress. With ideal model fit, the results of the path coefficients indicated that PIU behaviors were associated with fear of COVID-19 (p < 0.001); fear of COVID-19 and PNT of online teaching were associated with psychological distress (p < 0.001); and fear of COVID-19 was also positively associated with PNT of online teaching (p < 0.001). PSU and PSMU had an indirect positive effect on psychological distress through the mediator of fear of COVID-19 and PNT of online teaching. As such, we suggest that school administrators pay greater attention to teachers’ psychological needs through efforts to enhance teachers’ autonomy and relatedness from interpersonal relationships, alleviating PNT of online teaching. Our PNT of online teaching scale may also serve as a contribution for further research and practice.
Validity of Pneumonia Severity Assessment Scores in Africa and South Asia: A Systematic Review and Meta-Analysis
Authors: Al Hussain Sarah Khalid , Kurdi Amanj , Abutheraa Nouf , AlDawsari Asma , Sneddon Jacqueline , Godman Brian , Seaton Ronald Andrew
Published: September 2021

Background: Although community-acquired pneumonia (CAP) severity assessment scores are widely used, their validity in low- and middle-income countries (LMICs) is not well defined. We aimed to investigate the validity and performance of the existing scores among adults in LMICs (Africa and South Asia). Methods: Medline, Embase, Cochrane Central Register of Controlled Trials, Scopus and Web of Science were searched to 21 May 2020. Studies evaluating a pneumonia severity score/tool among adults in these countries were included. A bivariate random-effects meta-analysis was performed to examine the scores’ performance in predicting mortality. Results: Of 9900 records, 11 studies were eligible, covering 12 tools. Only CURB-65 (Confusion, Urea, Respiratory Rate, Blood Pressure, Age ≥ 65 years) and CRB-65 (Confusion, Respiratory Rate, Blood Pressure, Age ≥ 65 years) were included in the meta-analysis. Both scores were effective in predicting mortality risk. Performance characteristics (with 95% Confidence Interval (CI)) at high (CURB-65 ≥ 3, CRB-65 ≥ 3) and intermediate-risk (CURB-65 ≥ 2, CRB-65 ≥ 1) cut-offs were as follows: pooled sensitivity, for CURB-65, 0.70 (95% CI = 0.25–0.94) and 0.96 (95% CI = 0.49–1.00), and for CRB-65, 0.09 (95% CI = 0.01–0.48) and 0.93 (95% CI = 0.50–0.99); pooled specificity, for CURB-65, 0.90 (95% CI = 0.73–0.96) and 0.64 (95% CI = 0.45–0.79), and for CRB-65, 0.99 (95% CI = 0.95–1.00) and 0.43 (95% CI = 0.24–0.64). Conclusions: CURB-65 and CRB-65 appear to be valid for predicting mortality in LMICs. CRB-65 may be employed where urea levels are unavailable. There is a lack of robust evidence regarding other scores, including the Pneumonia Severity Index (PSI).
Hydrological Modeling in Agricultural Intensive Watershed: The Case of Upper East Fork White River, USA
Authors: Bariamis George , Baltas Evangelos
Published: September 2021

Identifying the core hydrological processes of catchments is a critical step for operative hydrological modeling. This study attempts to assess the long-term alterations in streamflow in three adjacent catchments of Upper East Fork White River, Indiana USA, by employing the SWAT hydrological model. The model simulations are spanning from 1980 up to 2015 and distributed in three configurations periods to identify monthly alterations in streamflow. For this purpose, water abstraction, land use, tillage, and agricultural field drainage practices have been incorporated in the model to provide accurate data input. The model setup also integrates spatially disaggregated sectorial water use data from surface and groundwater resources integrating the significant increases of water abstractions mainly for agricultural and public water supply purposes. The land cover of the study area is governed by rotating crops, while agricultural practices and tile drainage are crucial model parameters affecting the regional hydrological balance. Streamflow prediction is based on the SUFI-2 algorithm and the SWAT-CUP interface has been used for the monthly calibration and validation phases of the model. The evaluation of model simulations indicate a progressively sufficient hydrological model setup for all configuration periods with NSE (0.87, 0.88, and 0.88) and PBIAS (14%, −7%, and −2.8%) model evaluation values at the Seymour outlet. Surface runoff/precipitation as well as percolation/precipitation ratios have been used as indicators to identify trends to wetter conditions. Model outputs for the upstream areas, are successful predictions for streamflow assessment studies to test future implications of land cover and climate change.
Evaluation of the HearWell Pilot Program: A Participatory Total Worker Health® Approach to Hearing Conservation
Authors: Cavallari Jennifer M. , Suleiman Adekemi O. , Garza Jennifer L. , Namazi Sara , Dugan Alicia G. , Henning Robert A. , Punnett Laura
Published: September 2021

Our objective was to pilot test HearWell, an intervention created to preserve hearing among highway maintainers, by using a participatory Total Worker Health® (TWH) approach to designing, implementing and evaluating interventions. Regional maintenance garages were randomized to control (n = 6); HearWell (n = 4) or HearWell Design Team (n = 2) arms. Maintainer representatives from the HearWell Design Team garages identified barriers to hearing health and collaborated to design interventions including a safety leadership training for managers, a noise hazard management scheme to identify noise levels and indicate the hearing protection device (HPD) needed, and a comprehensive HearWell training video and protocol. These worker-designed interventions, after manager input, were delivered to the HearWell Design Team and the HearWell garages. Control garages received standard industry hearing conservation training. Periodic surveys of workers in all 12 garages collected information on the frequency of HPD use and a new hearing climate measure to evaluate changes in behaviors and attitudes over the study period and following interventions. An intention-to-treat approach was utilized; differences and trends in group HPD use and hearing climate were analyzed using a mixed-effects model to account for repeated measures from individual participants. The HearWell Design Team maintainers reported the highest frequency of HPD use. Hearing climate improved in each group 6 months following intervention implementation, with the largest increase and highest value for the HearWell Design Team workers. The HearWell pilot intervention showed promising results in improving HPD use through a participatory TWH approach to hearing conservation. Furthermore, results suggest that employee participation in hearing conservation programs may be necessary for maximal effectiveness.
Towards Healthy Aging: Influence of the Built Environment on Elderly Pedestrian Safety at the Micro-Level
Authors: Lv Muhan , Wang Ningcheng , Yao Shenjun , Wu Jianping , Fang Lei
Published: September 2021

As vulnerable road users, elderly pedestrians are more likely to be injured in road crashes due to declining physical and perceptual capabilities. Most previous studies on the influence of the built environment on elderly pedestrian safety focused on intersections or areal units. Using a district of Shanghai as the study area, this research investigated the effects of the built environment at the road segment level with elderly pedestrian collision, taxi tracking point, point of interest, street view image, open street map, land use, housing price, and elderly population datasets. In particular, this research employed both Poisson and geographically weighted Poisson regression (GWPR) models to account for spatial nonstationarity. The Poisson model indicates that green space, sidewalks, and junctions on the roads significantly affected elderly pedestrian safety, and roads around nursing homes, schools, bus stops, metro stations, traditional markets, and supermarkets were hazardous for elderly pedestrians. The results of the GWPR model suggest that the influence of factors varied across the study area. Green space could decrease the risk of elderly pedestrian collisions only in areas without congested environments. Separations need to be installed between roadways and sidewalks to improve elderly road safety.
Mixed Exposure of Persistent Organic Pollutants Alters Oxidative Stress Markers and Mitochondrial Function in the Tail of Zebrafish Depending on Sex
Authors: Lee Songhee , Ko Eun , Lee Hyojin , Kim Ki-Tae , Choi Moonsung , Shin Sooim
Published: September 2021

Persistent organic pollutants (POPs) are lipid-soluble toxins that are not easily degraded; therefore, they accumulate in the environment and the human body. Several studies have indicated a correlation between POPs and metabolic diseases; however, their effects on mitochondria as a central organelle in cellular metabolism and the usage of mitochondria as functional markers for metabolic disease are barely understood. In this study, a zebrafish model system was exposed to two subclasses of POPs, organochlorine pesticides (OCPs) and polychlorinated biphenyls (PCBs), under two different conditions (solitary OCPs or OCPs with PCBs (Aroclor 1254)), and changes in the oxidative stress marker levels and mitochondrial enzyme activities in the electron transport chain of the tail were measured to observe the correlation between POPs and representative biomarkers for metabolic disease. The results indicated different responses upon exposure to OCPs and OCPs with Aroclor 1254, and accelerated toxicity was observed following exposure to mixed POPs (OCPs with Aroclor 1254). Males were more sensitive to changes in the levels of oxidative stress markers induced by POP exposure, whereas females were more susceptible to the toxic effects of POPs on the levels of mitochondrial activity markers. These results demonstrate that the study reflects real environmental conditions, with low-dose and multiple-toxin exposure for a long period, and that POPs alter major mitochondrial enzymes’ functions with an imbalance of redox homeostasis in a sex-dependent manner.
The Disappearance of Respiratory Viruses in Children during the COVID-19 Pandemic
Authors: Vittucci Anna Chiara , Piccioni Livia , Coltella Luana , Ciarlitto Claudia , Antilici Livia , Bozzola Elena , Midulla Fabio , Palma Paolo , Perno Carlo Federico , Villani Alberto
Published: September 2021

Background: Social distancing measures are used to reduce the spreading of COVID-19. The aim of this study was to assess the impact of local restrictions on the transmission of respiratory virus infections. Methods: we retrospectively analyzed the nasopharyngeal samples of all patients (0–18 years old) admitted with respiratory symptoms in a large Italian tertiary hospital during the last three seasons from 2018 to 2021. Results: A strong reduction in all viral respiratory infections was observed in the last season (2020–2021) compared to the two previous seasons (−79.69% and −80.66%, respectively). In particular, we found that during the epidemic period 2018–2019 and 2019–2020, the total number of Respiratory Syncytial Virus (RSV) cases was, respectively 726 and 689, while in the last season a total of five cases was detected. In the first months of 2018–2019 and 2019–2020, the total flu infections were 240 and 354, respectively, while in the last season we did not detect any influenza virus. As other viruses, the presence of Rhinovirus declined, but to a lesser extent: a total of 488 cases were assessed compared to the 1030 and 1165 cases of the two previous respective epidemic seasons. Conclusions: Public health interventions and distancing (including continuous use of face masks) settled to counter the pandemic spread of COVID-19 had a macroscopic impact on all respiratory virus transmission and related diseases, with a partial exception of Rhinovirus. The absence of viruses’ circulation could result in a lack of immunity and increased susceptibility to serious infections in the next seasons.
A Laissez-Faire Strategy Marked by Blinkers to Fulfill Established Pandemic Goals—The Case of Sweden
Authors: Svensson Göran , Rodriguez Rocio
Published: September 2021

Objectives: To examine (i.e., contextualize and visualize) the consequences of a laissez-faire strategy characterized by blinkers to fulfill established pandemic goals. The aim is to shed light on the implementation of pandemic measures based on post hoc (after-the-fact) reactions and actions instead of pre hoc ones (in advance). Study Design: This study is based on weekly updates of pandemic variables (i.e., cases, tests, percentage of positive tests, hospitalizations, Intensive Care Unit (ICU) admissions, deceased, and 7- and 14-day incidence) in Sweden from the start of the pandemic in March 2020 until March 2021. Method: This study reports the empirical findings based on Swedish pandemic variables during 52 consecutive weeks, related to the pandemic, all of which has been divided into three time periods to separate the 1st and 2nd waves of the pandemic, and considers them all together as one time period. Results: The findings illustrate the implementation of pandemic measures and the subsequent consequences of a laissez-faire strategy characterized by blinkers. People become diseased and then deceased. This reveals strong associations between the assessed pandemic variables and its subsequent consequences on morbidity and mortality, based on post hoc reactions and actions. Conclusions: The implementation of a pandemic strategy should react and act pre hoc, and to take the safe with the unsafe. Governments and public health agencies should take into account the inevitable associations between pandemic variables. Intertwined pre hoc measures of prevention, enforcement, and monitoring should be implemented in society to avoid the implementation of a laissez-faire strategy based on post hoc reactions and actions.
Deciphering the COVID-19 Health Economic Dilemma (HED): A Scoping Review
Authors: Kaim Arielle , Gering Tuvia , Moshaiov Amiram , Adini Bruria
Published: September 2021

Lessons learnt from the initial stages of the COVID-19 outbreak indicate the need for a more coordinated economic and public health response. While social distancing has been shown to be effective as a non-pharmaceutical intervention (NPI) measure to mitigate the spread of COVID-19, the economic costs have been substantial. Insights combining epidemiological and economic data provide new theoretical predictions that can be used to better understand the health economy tradeoffs. This literature review aims to elucidate perspectives to assist policy implementation related to the management of the ongoing and impending outbreaks regarding the Health Economic Dilemma (HED). This review unveiled the need for information-based decision-support systems which will combine pandemic spread modelling and control, with economic models. It is expected that the current review will not only support policy makers but will also provide researchers on the development of related decision-support-systems with comprehensive information on the various aspects of the HED.
ACTonFood. Acceptance and Commitment Therapy-Based Group Treatment Compared to Cognitive Behavioral Therapy-Based Group Treatment for Weight Loss Maintenance: An Individually Randomized Group Treatment Trial
Authors: Cattivelli Roberto , Guerrini Usubini Anna , Manzoni Gian Mauro , Vailati Riboni Francesco , Pietrabissa Giada , Musetti Alessandro , Franceschini Christian , Varallo Giorgia , Spatola Chiara A. M. , Giusti Emanuele , Castelnuovo Gianluca , Molinari Enrico
Published: September 2021

The purpose of this Individually Randomized Group Treatment Trial was to compare an Acceptance and Commitment Therapy-based (ACT) group intervention and a Cognitive Behavioral Therapy-based (CBT) group intervention for weight loss maintenance in a sample of adult patients with obesity seeking treatment for weight loss. One hundred and fifty-five adults (BMI: Kg/m2 = 43.8 [6.8]) attending a multidisciplinary rehabilitation program for weight loss were randomized into two conditions: ACT and CBT. Demographical, physical, and clinical data were assessed at the beginning of the program (t0), at discharge (t1), and at 6-month follow-up (t2). The following measures were administered: The Acceptance and Action Questionnaire-II (AAQ-II) and the Clinical Outcome in Routine Evaluation-Outcome Measure (CORE-OM). Generalized linear mixed models were performed to assess differences between groups. Moderation effects for gender and Eating Disorders (ED) have been considered. From baseline to discharge, no significant differences between interventions were found, with the only exception of an improvement in the CORE-OM total score and in the CORE-OM subjective wellbeing subscale for those in the CBT condition. From discharge to follow-up, ACT group participants showed significant results in terms of weight loss maintenance, CORE-OM total score, and CORE-OM and AAQ-II wellbeing, symptoms, and psychological problems subscales. Gender moderated the effects of time and intervention on the CORE-OM subscale reporting the risk for self-harm or harm of others. The presence of an eating disorder moderated the effect of time and intervention on the CORE-OM total score, on the CORE-OM symptoms and psychological problems subscales, and on the AAQ-II. Patients who received the ACT intervention were more likely to achieve a ≥5% weight loss from baseline to follow-up and to maintain the weight loss after discharge. The ACT intervention was thus effective in maintaining weight loss over time.
No Obvious Role for Suspicious Oral Pathogens in Arthritis Development
Authors: Rahajoe Poerwati S. , de Smit Menke J. , Raveling-Eelsing Elisabeth , du Teil Espina Marines , Stobernack Tim , Lisotto Paola , Harmsen Hermie J. M. , van Dijl Jan Maarten , Kertia Nyoman , Vissink Arjan , Westra Johanna
Published: September 2021

A particular role for Porphyromonas gingivalis (Pg) and Aggregatibacter actinomycetemcomitans (Aa) has been suggested in periodontitis and rheumatoid arthritis (RA), as these bacteria could initiate the formation of rheumatoid factor (RF) and anticitrullinated protein autoantibodies (ACPA). We assessed whether serum antibodies against Pg and Aa in RA patients and non-RA controls reflect the subgingival presence of Pg and Aa, and evaluated the relationship of these antibodies to the severity of periodontal inflammation and RA-specific serum autoantibodies. In 70 Indonesian RA patients and 70 non-RA controls, the subgingival presence of Pg and Aa was assessed by bacterial 16S rRNA gene sequencing, and serum IgG levels specific for Pg and Aa were determined. In parallel, serum levels of ACPA (ACPA:IgG,IgA) and RF (RF:IgM,IgA) were measured. The extent of periodontal inflammation was assessed by the periodontal inflamed surface area. In both RA patients and the controls, the presence of subgingival Pg and Aa was comparable, anti-Pg and anti-Aa antibody levels were associated with the subgingival presence of Pg and Aa, and anti-Pg did not correlate with ACPA or RF levels. The subgingival Pg and Aa were not related to RA. No noteworthy correlation was detected between the antibodies against Pg and Aa, and RA-specific autoantibodies.
Knowledge of and Intention to Participate in Physical Activity Programs and Their Associated Sociodemographic Factors in People with High Blood Pressure in a Rural Area of Bangladesh: Initial Investigation from a Cluster Randomized Controlled Trial
Authors: Islam Fakir M. Amirul , Hosen Mohammad Arzan , Islam Mohammad Ariful , Lambert Elisabeth A. , Thompson Bruce R. , Lambert Gavin W. , Maddison Ralph
Published: September 2021

This initial investigation aimed to investigate the knowledge of the health benefits of physical activity (PA) and attitudes towards participation in PA. The study recruited 307 people aged 30–75 years with hypertension as part of a cluster randomized controlled trial from a rural area in Bangladesh. Of the 307 participants, 135 participated less than 2.5 h of physical activity per week, from which we collected data on attitudes toward PA. Regression analysis and Rasch analysis were used. More than 85% of homemakers, employees or businesspersons were willing to take part in PA. Based on the combined score from the knowledge and attitude items, 46% of people endorsed PA programs; proportions were higher in men than women (53% vs. 41%). After adjusting for covariates, men (odds ratio, 95% confidence interval (CI) 3.50, 1.72–7.11) compared to women and people with at least primary levels of schooling (OR 3.06, 95% CI, 1.27–7.38) compared with those with no education were more likely to organize or take part in any PA programs. People have positive attitudes towards PA but do not feel obligated to participate in PA programs. Future programs are needed to promote awareness and motivational interventions for PA, especially targeting women and people with low education levels, should be developed and implemented.
Effective Ways to Encourage Health-Care Practices among Cultural Minorities in Israel during the COVID-19 Pandemic
Authors: Kalagy Tehila , Abu-Kaf Sarah , Braun-Lewensohn Orna
Published: September 2021

Following the worldwide outbreak of COVID-19, policymakers have been occupied with the questions of whether and how to specially address unique cultural groups coping with the pandemic. This study aimed to evaluate the potential for a culturally tailored approach to the transmission of health messages in a time of crisis among two minority populations within Israeli society: the Ultra-Orthodox population and the Arab population. To that end, 380 individuals from Israeli Ultra-Orthodox society and 360 individuals from Israeli Arab society completed a self-reported questionnaire in early April 2020, in the midst of the COVID-19 pandemic. The findings of this study reveal differences between these groups in terms of the effectiveness of different channels for conveying messages and the channels that were preferred, as well as significant relationships between community sense of coherence and the study variables. We found that advocacy and motivation based on values, on the one hand, and recognition of the effectiveness of a culturally tailored approach, on the other, may be the best approach for persuading members of minority populations, who belong to collectivist societies, to comply with epidemic-control instructions.
Internet Use, Electronic Health Literacy, and Hypertension Control among the Elderly at an Urban Primary Care Center in Thailand: A Cross-Sectional Study
Authors: Rojanasumapong Auswin , Jiraporncharoen Wichuda , Nantsupawat Nopakoon , Gilder Mary Ellen , Angkurawaranon Chaisiri , Pinyopornpanish Kanokporn
Published: September 2021

This study aimed to explore the internet usage and electronic health literacy (eHL) among adults aged 60 and older with hypertension and to explore the associations between eHL and blood pressure control. A cross-sectional survey was conducted at an out-patient primacy care clinic in the urban city center of Chiang Mai, Thailand. eHL was measured using the eHealth Literacy Scale (eHEALS). Logistic regression was used to identify the association between eHL and blood pressure, adjusting for age and sex as a priori confounders and key sociodemographic factors previously identified in univariable analysis. A total of 110 older adult patients with a history of diagnosed hypertension agreed to participate. The mean age of the participants was 67 years old. Fifty-six participants (50.9%) had used the internet in their lifetime. Among internet users, 37 out of 56 participants (66%) could be classified as having high eHL. However, there was insufficient evidence for associations among internet use, eHL and hypertension control. This result potentially creates new opportunities for eHealth education and interventions. Efforts to produce centralized clear, reliable health information targeting this demographic would be worthwhile to help manage chronic diseases such as hypertension in Thailand in the future.
From Burden to Depressive Symptoms in Informal Caregivers during the COVID-19 Pandemic: A Path Analysis
Authors: Rajovic Tatjana , Todorovic Natasa , Vracevic Milutin , Rajovic Nina , Pavlovic Andrija , Pavlovic Vedrana , Grbic Igor , Sapic Rosa , Krsmanovic Slavica , Vukmirovic Marijana , Stanisavljevic Tamara , Markovic Ksenija , Mostic Tanja , Stanisavljevic Dejana , Milic Natasa
Published: September 2021

Background: The objective of this study was to assess the complex relationship between the multiple determinants of the caregiving process, the caregiver burden, and depression during the COVID-19 pandemic in Serbia. Methods: A cross-sectional study was conducted on a nationally representative sample (n = 798) during the COVID-19 pandemic in Serbia from March to September 2020. A nine-section questionnaire designed for this study included the characteristics of caregivers, characteristics of care and care recipients, COVID-19 related questions, and the following standardized instruments: 12-Item Short-Form Health Survey, Fatigue Severity Scale, Activities of Daily Living Scale and Instrumental Activities of Daily Living Scale, Zarit Caregiver Burden Scale, and Beck Depression Inventory. Path analysis was used for the simultaneous assessment of the direct and indirect relationships of all determinants. Results: More than two thirds (71.9%) of informal caregivers experienced a burden, and more than one quarter (27.1%) had depression symptomatology. Self-rated physical health, need for psychosocial support, and caregiver burden were the main direct predictors of depression. Multiple determinants of the caregiving process had indirect effects on depressive symptomatology via the caregiver burden as a mediating factor. Conclusions: The subjective burden presented a significant risk factor for depressive symptoms in caregivers during the COVID-19 pandemic. The provision of psychosocial support was identified as an important opportunity to reduce depressive risk in informal caregivers.
The Relationship between Customers and Community Pharmacies during the COVID-19 (SARS-CoV-2) Pandemic: A Survey from Italy
Authors: Baratta Francesca , Ciccolella Michele , Brusa Paola
Published: September 2021

Community pharmacies are among the most easily accessible health services. Considering the major impact of COVID-19 in social terms, the purpose was to analyse the evolution of the relationship between community pharmacies and customers during the pandemic in 2020 and to understand which strategies should be implemented in the future. The data have been collected from May to December 2020. Pharmacists administered a questionnaire, also available online, to all customers that agreed to participate. The total number of respondents was 502. The results obtained confirm a generally high level of satisfaction with pharmacies among customers and appreciation for the role of community pharmacies. For the future, the priority is to monitor the situation to break down social inequalities. A task that can be entrusted to the branch of the healthcare service ideally suited to this end: local medicine, of which the community pharmacy is an essential element. The post-pandemic pharmacy will need to have the skills to provide accurate and reliable information on issues, including broad topics such as prevention and lifestyle to fight “syndemic” (two or more factors that work together to make a disease worse) and “infodemic” (too much information including false or misleading information during a disease outbreak).
Sexual Exposure to HIV Infection during the COVID-19 Pandemic in Men Who Have Sex with Men (MSM): A Multicentric Study
Authors: de Sousa Alvaro Francisco Lopes , Lima Shirley Verônica Melo Almeida , Rocha João Victor , de Carvalho Herica Emilia Félix , Queiroz Artur Acelino Francisco Luz Nunes , Schneider Guilherme , de Oliveira Layze Braz , Camargo Emerson Lucas Silva , Oliveira Adélia Dalva da Silva , Mendes Isabel Amélia Costa , Fronteira Inês
Published: September 2021

The practice of sex with casual partners without the use of adequate prevention in the period of social distancing due to the COVID-19 pandemic among men who have sex with men (MSM) can expose them to the risk of infection by the HIV virus. To assess this, we conducted an online survey in April and May 2020 in the entire national territory of Brazil and Portugal. We used the snowball technique for sampling, associated with circulation in social networks, totaling 2934 participants. Bivariate and multivariate logistic regression was used to produce the adjusted Odds Ratio (aOR). Eight-hundred-and-forty-two (28.7%) MSM presented at-risk sexual exposure in this period. In general, the types of sexual practices that most increased the chances of sexual exposure were having multiple partners (aOR:14.045); having practiced chemsex (aOR:2.246) and group sex (aOR:2.431), as well as presenting a history of at-risk sexual exposure (aOR:5.136). When we consider each country separately, the chances are increased in Brazil since the probability of the outcome was increased in those who practiced group sex (aOR:5.928), had multiple partners (aOR:19.132), and reported a sexual history of at-risk exposure (aOR:8.861). Our findings indicate that practices that are classically associated with greater chances of engaging in risky sexual exposure to HIV infection were the factors that most increased the chances of acquiring the virus in the pandemic context.
Victims and Perpetrators of Child Sexual Abuse: Abusive Contact and Penetration Experiences
Authors: Ferragut Marta , Ortiz-Tallo Margarita , Blanca Maria J.
Published: September 2021

Child sexual abuse (CSA) includes abusive contact experiences, which habitually impact the victim’s whole life. This study aims to analyze the characteristics of six CSA experiences with physical contact, including penetration, in a representative sample of the Spanish population. Participants were 1071 Spanish adults (53% males; Mage: 45.37) who completed the Child Sexual Abuse Experiences Questionnaire. The victim’s age at the first episode, the perpetrator’s characteristics, and the number of times that each experience occurred were analyzed, taking into account gender differences. Results were reported for every experience independently. The most prevalent age at the first experience was from 6 years old onwards, but with differences in some experiences. The abuses usually happened more than once, committed by the same person. The most prevalent perpetrator is a male, although a female perpetrator is more prevalent in male victims. Most of the abuses were committed by an adult acquaintance, a strange adult, and other minors, with some gender differences. The implications of the results concerning every CSA experience are discussed, highlighting their value for future research and practice, the design of preventive programs, and early detection of CSA.
Green-Extension Design—A New Strategy to Reduce the Environmental Pressure from the Existing Consumer Electronics
Authors: Yi Siliang , Wu Chih-Fu
Published: September 2021

Existing electronic devices will quickly become e-waste when encountering technological iterations, which results in serious environmental and public health problems. Previous circular economy research has mainly focused on the development of new products with long life or recycling discarded products. This study firstly proposes the Green-Extension Design (GED) strategy for developing adaptable accessories that provide existing products with the ability to continue to work in a different context. Competitiveness was selected to evaluate the performance of GED, and three competitiveness components were derived through principal component analysis (PCA). Moreover, AHP (Analytic Hierarchy Process) was applied to define the weights of the three competitiveness components, and a GED model was established on the basis of production function. Furthermore, the calculation method for each competitiveness component was defined. The GED strategy is aimed at extending the life of existing products, as well as reducing resource waste and environmental pollution. The GED model based on competitiveness components can enable enterprises to design products of high competitiveness and obtain market share as a result.
The Apathy Evaluation Scale (AES-C): Psychometric Properties and Invariance of Italian Version in Mild Cognitive Impairment and Alzheimer’s Disease
Authors: Furneri Giovanna , Platania Silvia , Privitera Alessandra , Martelli Federica , Smeriglio Rossana , Razza Grazia , Maci Tiziana , Castellano Sabrina , Drago Filippo , Santagati Mario , Caponnetto Pasquale , Caraci Filippo , Di Nuovo Santo
Published: September 2021

Apathy is a neuropsychiatric symptom observed in different neurological and psychiatric disorders. Although apathy is considered a symptom, it has been recently reconsidered as a syndrome characterised by three dimensions: cognitive symptoms, affective symptoms and behavioural symptoms. Recent studies have shown that apathy can be considered as a prodromal symptom of Alzheimer’s disease (AD), but also an indicator of the transition from mild cognitive impairment to AD. According to this scenario, an early detection of apathy in subjects with Mild Cognitive Impairment (MCI) and Mild AD can be a valid psychometric strategy to improve an early diagnosis and promote a prompt intervention. The Apathy Evaluation Scale is a validated tool composed of 18 items that assess and quantify emotional, behavioural and cognitive aspects of apathy. The aim of this study is to assess the specific reliability and validity of the Italian version of the Apathy Evaluation Scale—Clinician Version (AES-C) to detect apathy both in amnestic MCI and mild AD patients. In the present paper, we therefore examined the psychometric properties and the invariance of the Italian Version of the AES-C conducted on a sample composed of an experimental group of amnestic MCI and AD patients (N = 107) and a control group (N = 107) constituted by Age- and Sex-matched healthy controls. Results confirm the goodness of the scale. Confirmatory factory analysis confirmed that the AES-C Italian Version presents the same stability of one second-order factor and three first-order factors identified in the original version, and all items are predicted by a single general factor. Moreover, the scale was found to be invariant across both populations. Moreover, reliability and discriminant analysis showed good values. We found in the experimental group a negative correlation between the AES-C and Frontal Assessment Battery (FAB) (rs = −0.21, p < 0.001) and Mini Mental State Examination (MMSE) (rs = −0.04, p < 0.001), while a positive correlation was found between the AES-C and Hamilton psychiatric Rating scale for Depression (HAM-D) scores (rs = 0.58, p < 0.001) Overall, our data demonstrated the validity of the Italian version of the AES-C for the assessment of apathy both in MCI and in AD patients.
Policy Inertia on Regulating Food Marketing to Children: A Case Study of Malaysia
Authors: Ng SeeHoe , Kelly Bridget , Yeatman Heather , Swinburn Boyd , Karupaiah Tilakavati
Published: September 2021

Unhealthy food marketing shapes children’s preference towards obesogenic foods. In Malaysia, policies regulating this food marketing were rated as poor compared to global standards, justifying the need to explore barriers and facilitators during policy development and implementation processes. The case study incorporated qualitative methods, including historical mapping, semi-structured interviews with key informants and a search of cited documents. Nine participants were interviewed, representing the Federal government (n = 5), food industry (n = 2) and civil society (n = 2). Even though the mandatory approach to government-led regulation of food marketing to children was the benchmark, more barriers than facilitators in the policy process led to industry self-regulations in Malaysia. Cited barriers were the lack of political will, industry resistance, complexity of legislation, technical challenges, and lack of resources, particularly professional skills. The adoption of industry self-regulation created further barriers to subsequent policy advancement. These included implementer indifference (industry), lack of monitoring, poor stakeholder relations, and policy characteristics linked to weak criteria and voluntary uptake. These underlying barriers, together with a lack of sustained public health advocacy, exacerbated policy inertia. Key recommendations include strengthening pro-public health stakeholder partnerships, applying sustained efforts in policy advocacy to overcome policy inertia, and conducting monitoring for policy compliance and accountability. These form the key lessons for advocating policy reforms.
A Comparative Study of Frequency Ratio, Shannon’s Entropy and Analytic Hierarchy Process (AHP) Models for Landslide Susceptibility Assessment
Authors: Panchal Sandeep , Shrivastava Amit K.
Published: September 2021

Landslide susceptibility maps are very important tools in the planning and management of landslide prone areas. Qualitative and quantitative methods each have their own advantages and dis-advantages in landslide susceptibility mapping. The aim of this study is to compare three models, i.e., frequency ratio (FR), Shannon’s entropy and analytic hierarchy process (AHP) by implementing them for the preparation of landslide susceptibility maps. Shimla, a district in Himachal Pradesh (H.P.), India was chosen for the study. A landslide inventory containing more than 1500 landslide events was prepared using previous literature, available historical data and a field survey. Out of the total number of landslide events, 30% data was used for training and 70% data was used for testing purpose. The frequency ratio, Shannon’s entropy and AHP models were implemented and three landslide susceptibility maps were prepared for the study area. The final landslide susceptibility maps were validated using a receiver operating characteristic (ROC) curve. The frequency ratio (FR) model yielded the highest accuracy, with 0.925 fitted ROC area, while the accuracy achieved by Shannon’s entropy model was 0.883. Analytic hierarchy process (AHP) yielded the lowest accuracy, with 0.732 fitted ROC area. The results of this study can be used by engineers and planners for better management and mitigation of landslides in the study area.
Industrially Compatible Transfusable iPSC-Derived RBCs: Progress, Challenges and Prospective Solutions
Authors: Lim Zhong Ri , Vassilev Svetlan , Leong Yew Wai , Hang Jing Wen , Rénia Laurent , Malleret Benoit , Oh Steve Kah-Weng
Published: September 2021

Amidst the global shortfalls in blood supply, storage limitations of donor blood and the availability of potential blood substitutes for transfusion applications, society has pivoted towards in vitro generation of red blood cells (RBCs) as a means to solve these issues. Many conventional research studies over the past few decades have found success in differentiating hematopoietic stem and progenitor cells (HSPCs) from cord blood, adult bone marrow and peripheral blood sources. More recently, techniques that involve immortalization of erythroblast sources have also gained traction in tackling this problem. However, the RBCs generated from human induced pluripotent stem cells (hiPSCs) still remain as the most favorable solution due to many of its added advantages. In this review, we focus on the breakthroughs for high-density cultures of hiPSC-derived RBCs, and highlight the major challenges and prospective solutions throughout the whole process of erythropoiesis for hiPSC-derived RBCs. Furthermore, we elaborate on the recent advances and techniques used to achieve cost-effective, high-density cultures of GMP-compliant RBCs, and on their relevant novel applications after downstream processing and purification.
NPA-Cu2+ Complex as a Fluorescent Sensing Platform for the Selective and Sensitive Detection of Glyphosate
Authors: Sun Fang , Ye Xin-Lu , Wang Yu-Bo , Yue Ming-Li , Li Ping , Yang Liu , Liu Yu-Long , Fu Ying
Published: September 2021

Glyphosate is a highly effective, low-toxicity, broad-spectrum herbicide, which is extensively used in global agriculture to control weeds and vegetation. However, glyphosate has become a potential threat to human and ecosystem because of its excessive usage and its bio-concentration in soil and water. Herein, a novel turn-on fluorescent probe, N-n-butyl-4-(3-pyridin)ylmethylidenehydrazine-1,8-naphthalimide (NPA), is proposed. It efficiently detected Cu2+ within the limit of detection (LOD) of 0.21 μM and displayed a dramatic turn-off fluorescence response in CH3CN. NPA-Cu2+ complex was employed to selectively and sensitively monitor glyphosate concentrations in real samples accompanied by a fluorescence turn-on mode. A good linear relationship between NPA and Cu2+ of glyphosate was found in the range of 10–100 μM with an LOD of 1.87 μM. Glyphosate exhibited a stronger chelation with Cu2+ than NPA and the system released free NPA through competitive coordination. The proposed method demonstrates great potential in quantitatively detecting glyphosate in tap water, local water from Songhua River, soil, rice, millet, maize, soybean, mung bean, and milk with mild conditions, and is a simple procedure with obvious consequences and no need for large instruments or pretreatment.
Targeted Therapy in the Treatment of Pediatric Acute Lymphoblastic Leukemia—Therapy and Toxicity Mechanisms
Authors: Lejman Monika , Kuśmierczuk Kinga , Bednarz Kinga , Ostapińska Katarzyna , Zawitkowska Joanna
Published: September 2021

Targeted therapy has revolutionized the treatment of poor-prognosis pediatric acute lymphoblastic leukemia (ALL) with specific genetic abnormalities. It is still being described as a new landmark therapeutic approach. The main purpose of the use of molecularly targeted drugs and immunotherapy in the treatment of ALL is to improve the treatment outcomes and reduce the doses of conventional chemotherapy, while maintaining the effectiveness of the therapy. Despite promising treatment results, there is limited clinical research on the effect of target cell therapy on the potential toxic events in children and adolescents. The recent development of highly specific molecular methods has led to an improvement in the identification of numerous unique expression profiles of acute lymphoblastic leukemia. The detection of specific genetic mutations determines patients’ risk groups, which allows for patient stratification and for an adjustment of the directed and personalized target therapies that are focused on particular molecular alteration. This review summarizes the knowledge concerning the toxicity of molecular-targeted drugs and immunotherapies applied in childhood ALL.
Current Concepts on Genetic Aspects of Mitochondrial Dysfunction in Amyotrophic Lateral Sclerosis
Authors: Jankovic Milena , Novakovic Ivana , Gamil Anwar Dawod Phepy , Gamil Anwar Dawod Ayman , Drinic Aleksandra , Abdel Motaleb Fayda I. , Ducic Sinisa , Nikolic Dejan
Published: September 2021

Amyotrophic Lateral Sclerosis (ALS), neurodegenerative motor neuron disorder is characterized as multisystem disease with important contribution of genetic factors. The etiopahogenesis of ALS is not fully elucidate, but the dominant theory at present relates to RNA processing, as well as protein aggregation and miss-folding, oxidative stress, glutamate excitotoxicity, inflammation and epigenetic dysregulation. Additionally, as mitochondria plays a leading role in cellular homeostasis maintenance, a rising amount of evidence indicates mitochondrial dysfunction as a substantial contributor to disease onset and progression. The aim of this review is to summarize most relevant findings that link genetic factors in ALS pathogenesis with different mechanisms with mitochondrial involvement (respiratory chain, OXPHOS control, calcium buffering, axonal transport, inflammation, mitophagy, etc.). We highlight the importance of a widening perspective for better understanding overlapping pathophysiological pathways in ALS and neurodegeneration in general. Finally, current and potentially novel therapies, especially gene specific therapies, targeting mitochondrial dysfunction are discussed briefly.