bluuebunny/crossref_metadata_2025 huggingface dataset:
Multilevel Toxicity Evaluations of Polyethylene Microplastics in Zebrafish (Danio rerio)
Authors: de Souza Freire Ingrid , Fascineli Maria Luiza , Piau Tathyana Benetis , Pereira Bruno Fiorelini , Grisolia Cesar Koppe
Published: February 2023

Microplastics in freshwater environments pose a serious threat to living beings. Polyethylene microplastics (PE-MP) are the type most used around the world as microbeads in personal care products, and they have been found in aquatic organisms. The behavior and toxicity of fluorescent PE-MP spheres with an average diameter of 58.9 μm were studied in adult, juvenile and embryo zebrafish (Danio rerio). The adults were studied for genotoxicity, cytotoxicity, histology and biochemical markers. Juveniles underwent a follow-up in the gastrointestinal (GI) tract with histologic observations, and embryos were studied for embryotoxicity with the FET-test. In adults, micronucleus test and comet assays found neither genotoxicity after acute exposure for 96 h at concentrations of 0.0, 12.5, 50 and 100 mg.L−1, nor cytotoxicity through the nuclear abnormalities test. Acetylcholinesterase (AChE), Glutathione-S-Transferase (GST) and Lactate Dehydrogenase (LDH) activities were measured in adults exposed for 96 h. The AChE and GST activities were significantly changed, while no changes occurred for LDH. In conclusion, these PE-MP spheres did not cause serious toxic effects in zebrafish because there was no internalization. The observed biochemical changes in AChE and GST may be associated with GI microbiological dysbiosis, previously reported. The PE-MP spheres in the intestine of juveniles remained present for 12–15 days on average after the post-exposure clearance study, showing a slow depuration. The histological analysis, in adults, found no internalization of these microbeads, with complete depuration. The PE-MP spheres did not cross the chorion barrier, showing no embryotoxic effects after exposures at 0.0, 6.25, 12.5, 50.0 or 100.0 mg.L−1 for 96 h.
Assessing the Turning Ability during Walking in People with Stroke Using L Test
Authors: Ng Shamay S. M. , Tse Mimi M. Y. , Chen Peiming , Lam Tony P. S. , Yeung Tony H. T. , Liu Tai-Wa , So Billy C. L.
Published: February 2023

Background: The L Test of Functional Mobility (L Test) was developed to assess the advanced mobility, which includes both turning and walking ability. This study aimed to evaluate (1) the intra-rater reliability of the L Test in four turning conditions, (2) the correlation with other stroke-specific impairment for community-dwelling older adults with stroke, and (3) the optimal cut-off completion time of the L Test to distinguish the difference of performance between healthy older adults and people with stroke. Methods: This is a cross-sectional design. Thirty older adults with stroke and healthy older adults were included. The subjects were assessed by L Test along with other stroke-specific outcomes. Results: The L Test showed excellent intra-rater reliability (ICC = 0.945–0.978) for the four turning conditions. There were significant correlations between L Test completion times and Fugl–Meyer Assessment–Lower Extremity (FMA-LE) scores, Fugl–Meyer Assessment–Upper Extremity (FMA-UE) scores, Berg Balance Scale (BBS) score, and Timed Up and Go (TUG) Test scores. The cut-off of the L Test was established as 23.41–24.13 s. Conclusion: The L Test is an easy-to-administer clinical test for assessing the turning ability of people with stroke.
A Machine Learning Approach to Finding the Fastest Race Course for Professional Athletes Competing in Ironman® 70.3 Races between 2004 and 2020
Authors: Thuany Mabliny , Valero David , Villiger Elias , Forte Pedro , Weiss Katja , Nikolaidis Pantelis T. , Andrade Marília Santos , Cuk Ivan , Sousa Caio Victor , Knechtle Beat
Published: February 2023

Our purpose was to find the fastest race courses for elite Ironman® 70.3 athletes, using machine learning (ML) algorithms. We collected the data of all professional triathletes competing between 2004 and 2020 in Ironman 70.3 races held worldwide. A sample of 16,611 professional athletes originating from 97 different countries and competing in 163 different races was thus obtained. Four different ML regression models were built, with gender, country of origin, and event location considered as independent variables to predict the final race time. For all the models, gender was the most important variable in predicting finish times. Attending to the single decision tree model, the fastest race times in the Ironman® 70.3 World Championship of around ~4 h 03 min would be achieved by men from Austria, Australia, Belgium, Brazil, Switzerland, Germany, France, the United Kingdom, South Africa, Canada, and New Zealand. Considering the World Championship is the target event for most professional athletes, it is expected that training is planned so that they attain their best performance in this event.
Development, Validation, and Measurement Invariance of the Body Image Bidimensional Assessment (BIBA) in Italian and Spanish Children and Early Adolescent Samples
Authors: Segura-Garcia Cristina , Aloi Matteo , Carbone Elvira Anna , Staltari Filippo Antonio , Rania Marianna , Papaianni Maria Cristina , Vaquero-Solís Mikel , Tapia-Serrano Miguel Ángel , Sánchez-Miguel Pedro Antonio , Liuzza Marco Tullio
Published: February 2023

Body dissatisfaction (BD) is an important public health issue as it negatively influences the physical and psychosocial wellbeing of children/early adolescents. Available measures of BD for this population are scarce, have a significant bias, or only evaluate weight-related dissatisfaction. This study, through the exploratory factor analysis (EFA), aims to develop and validate the Italian (Study 1) and Spanish (Study 2) versions of a new tool, the Body Image Bidimensional Assessment (BIBA), which is not subject to sex–age–race biases and is able to identify BD related to weight and height among children/early adolescents. Study 3 regards the confirmatory factor analysis (CFA), testing the measurement of invariance across sex and country. The BIBA has a two-factor structure (i.e., weight and height dissatisfaction) according to studies 1 and 2. McDonald’s ω ranged from 0.73 (weight) and 0.72 (height) with good reliability. CFA confirmed the two-factor model as a good fit for the Italian and Spanish samples. Finally, partial metric and scalar invariance of the BIBA dimensions across sexes and nations emerged. The BIBA has proven to be an easy-to-use tool that identifies two BD dimensions among children/early adolescents who could benefit from prompt educational interventions.
Occupational Risk Factors by Sectors: An Observational Study of 20,000 Workers
Authors: Dogbla Luther , Gouvenelle Cédric , Thorin Florence , Lesage François-Xavier , Zak Marek , Ugbolue Ukadike Chris , Charbotel Barbara , Baker Julien S. , Pereira Bruno , Dutheil Frédéric
Published: February 2023

Objective: We aimed to assess the prevalence of exposure by sector and the sectors of activity most exposed to each exposure, using routine occupational health data, and to quantify the risk of being exposed. Method: Occupational risk factors were assessed by workers followed by the Occupational Health Service of Cher, using self-reported questionnaires. The sectors of activity were grouped into seven sectors, and the risks were grouped into six occupational exposure groups. Comparisons were made using the Chi-squared test and Cramer’s V, and the odds ratios were calculated by using logistic regression. Results: We included 19,891 workers. The construction sector had the highest prevalence (p < 0.05 vs. all other sectors) of exposure to physical (76%) and biomechanical factors (82%), as well as chemical risks (75%). Human health and social work was the sector with the highest prevalence of exposure to biological factors (69%), psychosocial factors (90%), and atypical working hours (61%). With workers from administrative and support sectors as the reference, construction workers had more chance of declaring exposure to physical factors (OR = 3.28, 95%CI = 2.89 to 3.72), biomechanical factors (1.82, 1.58 to 2.09), and chemical agents (3.83, 3.38 to 4.33). Workers from the human health and social sectors had more chance of being exposed to biological agents (13.4, 11.9 to 15.2), atypical working hours (1.93, 1.75 to 2.14), and psychosocial factors (2.74, 2.38 to 3.16). Conclusion: Psychosocial risk factors were commonly reported in all sectors. Workers in the construction, human health, and social sectors seem to report more exposures than those in other sectors. The analysis of occupational exposures is a necessary basis to build an efficient preventive strategy for occupational health.
DNA-Methylation Signatures of Tobacco Smoking in a High Cardiovascular Risk Population: Modulation by the Mediterranean Diet
Authors: Fernández-Carrión Rebeca , Sorlí José V. , Asensio Eva M. , Pascual Eva C. , Portolés Olga , Alvarez-Sala Andrea , Francès Francesc , Ramírez-Sabio Judith B. , Pérez-Fidalgo Alejandro , Villamil Laura V. , Tinahones Francisco J. , Estruch Ramon , Ordovas Jose M. , Coltell Oscar , Corella Dolores
Published: February 2023

Biomarkers based on DNA methylation are relevant in the field of environmental health for precision health. Although tobacco smoking is one of the factors with a strong and consistent impact on DNA methylation, there are very few studies analyzing its methylation signature in southern European populations and none examining its modulation by the Mediterranean diet at the epigenome-wide level. We examined blood methylation smoking signatures on the EPIC 850 K array in this population (n = 414 high cardiovascular risk subjects). Epigenome-wide methylation studies (EWASs) were performed analyzing differential methylation CpG sites by smoking status (never, former, and current smokers) and the modulation by adherence to a Mediterranean diet score was explored. Gene-set enrichment analysis was performed for biological and functional interpretation. The predictive value of the top differentially methylated CpGs was analyzed using receiver operative curves. We characterized the DNA methylation signature of smoking in this Mediterranean population by identifying 46 differentially methylated CpGs at the EWAS level in the whole population. The strongest association was observed at the cg21566642 (p = 2.2 × 10−32) in the 2q37.1 region. We also detected other CpGs that have been consistently reported in prior research and discovered some novel differentially methylated CpG sites in subgroup analyses. In addition, we found distinct methylation profiles based on the adherence to the Mediterranean diet. Particularly, we obtained a significant interaction between smoking and diet modulating the cg5575921 methylation in the AHRR gene. In conclusion, we have characterized biomarkers of the methylation signature of tobacco smoking in this population, and suggest that the Mediterranean diet can increase methylation of certain hypomethylated sites.
Cognitive Effects of a Cognitive Stimulation Programme on Trained Domains in Older Adults with Subjective Memory Complaints: Randomised Controlled Trial
Authors: Gómez-Soria Isabel , Cuenca-Zaldívar Juan Nicolás , Rodriguez-Roca Beatriz , Subirón-Valera Ana Belén , Salavera Carlos , Marcén-Román Yolanda , Andrade-Gómez Elena , Calatayud Estela
Published: February 2023

Age-related subjective memory complaints (SMC) are a common concern among older adults. However, little is known about the effects of cognitive stimulation (CS) interventions on subjective memory complaints. The aim of this study was to analyse the effectiveness of a CS programme on global cognition and cognitive functions of older adults with SMC. A randomised clinical trial was conducted on older adults with SMC, including 308 participants ≥65 years of age assessed 6 and 12 months after the intervention. The assessment instrument was the Spanish version of the Mini-Mental State Examination (MEC-35), and all domains of the instrument were assessed. For statistical analysis, the data were analysed using robust ANOVA with means truncated at 20% utilising a two-way repeated measures model, with between (groups) and within (measurements) factors. In post hoc tests, a Wilcoxon signed-rank test of exact permutations between groups and Bonferroni correction were applied. In post hoc between-group tests, significant differences were found: (1) post-treatment in MEC-35, temporal orientation, short-term memory (STM), global language and praxis, and language and praxis (p ≤ 0.005); (2) at 6 months in MEC-35, global orientation, temporal orientation, and STM (p = 0.005); (3) at 12 months in MEC-35, global orientation, temporal orientation, STM, global language and praxis, and language (p = 0.005). This study shows benefits in global cognition and orientation, temporal orientation, STM, and language in older adults with SMC.
Have Elbow Arthroscopy Hospitalizations Decreased over the Years? An Epidemiological Italian Study from 2001 to 2016
Authors: Longo Umile Giuseppe , Papalia Rocco , De Salvatore Sergio , Piccioni Valentina , Tancioni Alessandro , Piergentili Ilaria , Denaro Vincenzo
Published: February 2023

This study describes the trends of elbow arthroscopy in Italy and other countries in order to evaluate the yearly rates of EA. Its purpose is for future epidemiological studies to be able to compare their data between countries in order to understand the reasons for the increasing and decreasing trends. Data for this study were obtained from National Hospital Discharge records (SDO) at the Italian Ministry of Health (INHS). Data regarding sex, age, region of residence, region of surgery, length of hospitalization, and procedure codes were included. In total, 2414 elbow arthroscopies were performed in Italy from 2001 to 2016 in the adult population. The highest number of procedures was found in the 40–44 and 45–49 years age groups. Males represented the majority of patients undergoing EA both in total and over the years. An increase from 2001 to 2010 and a decrease from 2010 to 2016 were reported in the present analysis. According to other studies, males of 40–44 and 45–49 years age groups represent the most treated patients. Further epidemiological studies would provide data that could be compared between countries, reaching a general consensus on the best indications for this procedure.
Back to Locality? Demand Potential Analysis for Short Food Supply Chains
Authors: Solarz Krzysztof , Raftowicz Magdalena , Kachniarz Marian , Dradrach Agnieszka
Published: February 2023

The main purpose of the article is an attempt to estimate the demand for products traded within short food supply chains in Poland. The survey was conducted in autumn 2021 in the Kamienna Góra county, where the first business incubator in Poland, addressed to farmers and food producers, initiated and supported by the local government, is located. The Computer-Assisted Web Interview (CAWI) method constituted the basis for the process of collecting research material. The channel for reaching respondents was the LIBRUS application and local social media. Responses were mainly given by women, people with incomes in the range of PLN 1000–3000 per person, those aged 30–50, and those with a university education. The research results showed a high level of potential demand for local agri-food products, which should encourage farmers to switch from long to short supply chain models. The persisting low awareness regarding the existence of alternative distribution networks for local products, which primarily requires increased activities in the field of territorial marketing that promote local agri-food products among the residents of municipalities constitutes, from the perspective of consumers, a barrier to the development of short food supply chains.
ESG Investment Scale Allocation of China’s Power Grid Company Using System Dynamics Simulation Modeling
Authors: Huang Birong , Wang Zilong , Gu Yuan
Published: February 2023

In recent years, with the global recognition of the concept of sustainable development, the international market attaches great importance to the Environment, Society, and Governance (ESG) investment performance of enterprises. The “carbon peaking and carbon neutrality” goal puts forward requirements for Chinese enterprises to carry out ESG investment. As a large state-owned enterprise in China, power grid companies need to take the lead in ESG investment. Based on the System Dynamics (SD) theory, this paper establishes the simulation model of ESG-responsible investment of power grid companies, including the environmental investment sub-module, social investment sub-module, and governance investment sub-module. Taking a provincial Power Grid Company as an example, the numerical simulation of ESG investment of power grid companies is carried out. The actual input-output efficiency of ESG investment of power grid companies is reflected through the mapping relationship between key indicators and investment amount, and the ESG investment scale and investment weight of the Power Company in the coming years are predicted. Compared with the traditional static analysis method, this model can provide a theoretical basis for power grid companies to carry out ESG investment decisions.
Breast Cancer Beliefs and Screening Practices among Syrian Refugee Women and Jordanian Women
Authors: Atrooz Fatin , Aljararwah Sally Mohammad , Acquati Chiara , Khabour Omar F. , Salim Samina
Published: February 2023

Despite significant declines in breast cancer (BC) incidence in the West, this disease is widespread in Jordan, where cancer detection occurs at much advanced stages. This is particularly concerning for Syrian refugee women resettled in Jordan, who are less likely to undergo cancer preventative procedures because of poor health literacy and lack of health services access. The present work assesses and compares breast cancer awareness and breast cancer screening behaviors among Syrian refugee women and Jordanian women residing close to the Syrian–Jordanian border city of Ar-Ramtha. A cross-sectional survey was conducted using a validated Arabic version of the Breast Cancer Screening Beliefs Questionnaire (BCSBQ). A total of 138 Syrian refugee women and 160 Jordanian women participated in the study. Results indicate that 93.6% of Syrian refugee women and Jordanian women ≥ 40 years of age reported never having undergone a mammogram. Syrian refugee women and Jordanian women reported low attitudes toward general health checkup (mean score for Syrian refugees 45.6 vs. 42.04 among Jordan women; p = 0.150). Barriers for BC screening were higher among Syrian refugees (mean score = 56.43) than Jordanian women (mean score = 61.99, p = 0.006). Women with higher education were more likely to report fewer barriers to screening (p = 0.027). The study documents a significant lack of BC screening awareness among Syrian refugee women and Jordanian women, indicating that future work is needed to alter current attitudes towards mammograms and early detection measures especially for Syrian refugee women and Jordanian women residing in rural areas of Jordan.
Adsorption of Phenanthrene on Multi-Walled Carbon Nanotubes in the Presence of Nonionic Surfactants
Authors: Cao Huimin , Zhou Zhenyang , Wang Cuiping , Sun Hongwen
Published: February 2023

The bioavailability and mobility of phenanthrene (Phe) adsorbed by multi-walled carbon nanotubes (MWCNTs) may be substantially influenced by nonionic surfactants used both in the synthesis and dispersion of MWCNTs. The adsorption mechanisms of Phe adsorbed onto MWCNTs under the different nonionic surfactants Tween 80 (TW-80) and Triton X-100 (TX-100) in the aqueous phase were investigated in terms of changes in the MWCNTs’ compositions and structures. The results showed that TW-80 and TX-100 were easily adsorbed onto MWCNTs. Phe adsorption data onto MWCNTs were better suited to the Langmuir equation than the Freundlich equation. Both TW-80 and TX-100 reduced the adsorption capacity of Phe onto MWCNTs. When TW-80 and TX-100 were added in the adsorption system, the saturated adsorption mass of Phe decreased from 35.97 mg/g to 27.10 and 29.79 mg/g, respectively, which can be attributed to the following three reasons. Firstly, the hydrophobic interactions between MWCNTs and Phe became weakened in the presence of nonionic surfactants. Secondly, the nonionic surfactants covered the adsorption sites of MWCNTs, which caused Phe adsorption to be reduced. Finally, nonionic surfactants can also promote the desorption of Phe from MWCNTs.
Threat Appraisal, Resilience, and Health Behaviors in Recovered COVID-19 Patients: The Serial Mediation of Coping and Meaning-Making
Authors: Krok Dariusz , Telka Ewa , Szcześniak Małgorzata , Falewicz Adam
Published: February 2023

Research indicates that both cognitive appraisal and personal resources can noticeably influence health behaviors, as individuals modify their health convictions and practices on the basis of threat appraisal, personality, and meaning. The aim of the current study was to investigate whether coping strategies and meaning-making can serially mediate the relationship of threat appraisal and resilience with health behaviors in recovered COVID-19 patients. Self-report measures of threat appraisal, resilience, coping, meaning-making, and health behaviors were completed by 266 participants (aged 17 to 78, 51.5% female) who had recovered from COVID-19. The serial mediation analysis showed that the relationship of threat appraisal and resilience with health behaviors was mediated by problem-focused coping, meaning-focused coping, and meaning-making, but not by emotion-focused coping. These results suggest that associations among threat perception, resilience, and health behavior depend to some extent on the interplay of coping and meaning-making, which reveals their unique role in the process of recovery from COVID-19, with potential implications for health interventions.
Characteristics of the Thermal Environment and its Guidance to Ecological Restoration in a Resource-Based Area in the Loess Area
Authors: Liu Shihan , Wang Dandan , Cao Yingui
Published: February 2023

The thermal environment is a crucial part of ecological environments. It is vital to study the distribution and generation of thermal environments for regional sustainable development. Mining area, agricultural area and urban area were taken as the research object, and remote sensing data were used to study the spatiotemporal distribution characteristics of the thermal environment. The relationship between the thermal environment and land use types was analyzed, and the effect of mining and reclamation on the thermal environment was emphasized. The main findings were: (1) the thermal effect zone in the study area was dispersed. The area ratio of the thermal effect zone accounted for 69.70%, 68.52%, 65.85%, 74.20% and 74.66% in the year 2000, 2003, 2009, 2013 and 2018, respectively. The contribution to the overall thermal effect was in the order of agricultural area > mining area > urban area. (2) The proportion of forest and the average grid temperature always showed a significant negative correlation in different scales and had the highest correlation and the greatest influence. (3) The land surface temperature (LST) of opencast areas was higher than the surrounding temperature, and the temperature difference was 3–5 °C. The LST of reclaimed sites was lower than the surrounding temperature, and the temperature difference was −7 to 0 °C. The quantitative study found that reclamation mode, shape and spatial location could affect the cooling effect of the reclaimed site. This study can provide a reference for the mitigation of thermal effects and the identification of influences of mining and reclamation on the thermal environment in the coordinated development of similar regions.
Factors Affecting Access to Public Healthcare Facilities in the City of Tshwane, South Africa
Authors: Moeti Thabiso , Mokhele Tholang , Weir-Smith Gina , Dlamini Simangele , Tesfamicheal Solomon
Published: February 2023

Access to healthcare services is largely determined by socioeconomic factors, with economically well-off individuals obtaining healthcare services more efficiently than those who are disadvantaged. This paper aims to assess the effects of socioeconomic and other related factors on access to healthcare facilities in the City of Tshwane, South Africa, during the COVID-19 pandemic. Data were sourced from the Gauteng City-Region Observatory (GCRO) quality of life survey (2020/2021). Multivariate logistic regression was applied. Results showed that 66.3% of the respondents reported that they had access to public healthcare facilities within their area. Furthermore, results showed that those who lived in informal houses were significantly (OR = 0.55, 95% CI [0.37–0.80], p < 0.01) less likely to report that they had access to public healthcare facilities in their area compared to those who lived in formal houses. More efforts need to be undertaken to ensure that all citizens have access to public healthcare facilities, especially among those who are disadvantaged, such as informal dwellers. In addition, future research should encompass locality in relation to the factors that affect access to public healthcare facilities, especially during pandemics such as the COVID-19 pandemic, in order to have geographically targeted interventions.
Connectedness among Urban Parks from the Users’ Perspective: A Systematic Literature Review
Authors: Li Jun , Md. Dali Melasutra , Nordin Nikmatul Adha
Published: February 2023

Although many benefits of urban green space networks have been consistently demonstrated, most of the discussion on space connectivity has concentrated on ecological aspects, such as patch–corridor–matrix connectivity. There are limited systematic studies that have investigated the connectedness between urban parks and people. This study aimed to explore the connectedness among urban parks from the users’ perspective by using a systematic literature review. By following the PRISMA protocol and analyzing 54 studies from Scopus and Web of Science between 2017 and 2022, we proposed the concepts of physical connectedness and perceived connectedness. The “physical connectedness” contained the dimensions of road attributes and park attributes, as well as six categories including physical accessibility, street connectivity, the street environment, spatial scale, facilities and amenities, and natural elements. The “perceived connectedness” mainly referred to people’s perception of the physical environment. The four categories were perceived accessibility, perceived safety, aesthetics, and Kaplan’s perceptual model. Finally, in terms of individual attributes, the impact of sociodemographic factors (age, gender, income, education, and occupation) and the motivation for activity on park connectedness were also taken into account. On the basis of our findings, this study suggested that park connectedness should not only focus on physical connectedness but also perceived connectedness.
Developing and Applying an Urban Resilience Index for the Evaluation of Declining Areas: A Case Study of South Korea’s Urban Regeneration Sites
Authors: Kim Byungsuk , Lee Gil-Sang , Kim Minjun , Lee Who-Seung , Choi Hee-Sun
Published: February 2023

This study attempts to identify the direction of urban regeneration projects in declining areas by using the concept of urban resilience to cope with climate change and disaster. To this end, urban resilience was classified into a Green Resilient Infrastructure (GRI) and an Interactive Safety System (ISS), through a review of previous studies, and categorized into vulnerability, adaptability, and transformability. A total of 12 detailed indicators were derived and indexed using Euclidean distance. Using the indicators, three Korean urban regeneration targets, in Daegu, Mokpo, and Seosan, were selected to evaluate resilience before and after the urban regeneration plan. Consequently, the postplanning resilience index improved in all three target sites, compared to before the regeneration plan. Additionally, previously the regeneration plan showed lower index values in comparison to places not designated as urban regeneration areas. These results suggest that urban resilience needs to be considered in future urban regeneration projects, and that resilience indicators can be used as a means to set the direction of urban regeneration projects. To improve the overall resilience of a region, these indices can help local government establish a reference point for urban resilience in its region.
Analgesic Use in Patients during Cardio-Pulmonary Resuscitation
Authors: Dąbrowski Sebastian , Lange Sandra , Basiński Andrzej
Published: February 2023

Introduction: Cardiopulmonary resuscitation-induced consciousness is a newly recognized phenomenon with an increasing incidence. A return of consciousness during cardiopulmonary resuscitation affects up to 0.9% of cases. Patients may also experience physical pain associated with chest compressions, as most victims of cardiac arrest who are subjected to resuscitative efforts sustain ribs or sternum fractures. Methods: A rapid review was carried out from August 2021 to December 2022. Results: Thirty-two articles were included in the rapid review. Of these, eleven studies focused on the return of consciousness during CPR, and twenty-one on CPR-induced chest injuries. Conclusion: A small number of studies that have dealt with the return of consciousness associated with cardiopulmonary resuscitation made it hard to clearly determine how often this occurs. There were more studies that dealt with chest trauma during resuscitation, but no study considered the use of analgesics. Of note, there was no standardized therapeutic approach as far as the use of analgesics and/or sedatives was considered. This is probably due to the lack of guidelines for analgesic management during cardiopulmonary resuscitation and peri-resuscitative period.
Associations between Gendered Family Structures and Adolescent Stress, Loneliness, and Sadness in South Korea
Authors: Dufur Mikaela J. , Woo Hyeyoung
Published: February 2023

While a large literature connects family environments characterized by access to two married biological parents to better child mental health outcomes, we know less about the mechanisms linking family structure to mental health outcomes for children living in other family structures. While essentialist theory suggests that access to both male and female parents will be an important determinant of child mental health, some research directly comparing single-mother and single-father families found no difference in child outcomes by parent gender, suggesting evidence for more structural theories of gender. However, most of this research uses data from Western countries and seldom extends to examining mental health outcomes. In this paper, we used data from a large, generalizable survey of Korean adolescents (the 2021 Korea Youth Risk Behavior Survey) to compare the mental health of children living in families with two married biological parents, single mothers, and single fathers. Our findings underscore the importance of examining family environments in different contexts.
Indian Healthcare Workers’ Issues, Challenges, and Coping Strategies during the COVID-19 Pandemic: A Cross-Sectional Study
Authors: Ali Anahita , Kumar Santosh
Published: February 2023

India faced the maximum number of mortalities and morbidities during the second wave of COVID-19. Healthcare workers (HCWs) worked in high-pressure and stressful environments. Therefore, this study aimed to assess the common issues, challenges, and coping strategies of HCWs, as well as the statistical association between demographical characteristics and coping strategies. A cross-sectional study was conducted with 759 HCWs, involving simple, random sampling in Rajasthan, India, between August 2022 and October 2022. Participants responded to a self-administered questionnaire that included a Brief–COPE inventory. The statistical association between commonly adopted coping strategies and demographic characteristics was tested using the chi-square test and Fisher’s exact test. A total of 669 (88%) respondents agreed that they faced issues during the COVID-19 pandemic: 721 (95%) participants experienced challenges at the personal level, 716 (94%) at the organizational level, and 557 (74%) at the societal level. Problem-focused coping strategies were frequently adopted by the participants. Gender, marital status, education, hours of work per day, and residential area were significantly associated with a problem-focused coping strategy (p < 0.05). The findings of this study reported a limited use of coping strategies by the participants during the public health crisis, despite facing issues and challenges at work. These findings highlight the need to assist HCWs in developing coping mechanisms to maintain good mental health at work.
A Scalable Program for Improving Physical Activity in Older People with Dementia Including Culturally and Linguistically Diverse (CALD) Groups Who Receive Home Support: A Feasibility Study
Authors: Lee Den-Ching A. , Haines Terry P. , Callisaya Michele L. , Hill Keith D.
Published: February 2023

Home care clients with dementia/cognitive impairment are typically functionally dependent and physically inactive. We pilot-tested a co-designed physical exercise program for its feasibility, safety, adherence and potential for benefits on physical activity, physical function, healthcare use and falls. Trained community care support workers delivered a 12-week home exercise program to clients with dementia/cognitive impairment, once weekly for 15 min during care shifts, supplemented by carers’ supervision of exercises for 30 min, three times weekly. A physiotherapist provided fortnightly phone support to ensure safety and exercise progression. Baseline and Week 12 assessments using validated scales for physical activity, physical function, daily living independence, falls efficacy, quality of life, self-reported healthcare use, falls and sleep quality were undertaken. Differences were examined with regression analyses. Care support workers (n = 26) and client/carer dyads (n = 26 and 80.8% culturally and linguistically diverse) participated. Participants recorded adverse events/falls and exercises in dairies. Fifteen dyads completed the program. No falls/adverse events occurred with the exercises. The adherence rates against targets for exercise time completed and days in which exercise were undertaken for support workers were 137%/79.6%, and for client/carer dyads were 82%/104.8%, respectively. Physical activity participation, physical function and falls efficacy significantly improved at Week 12 compared to baseline. The feasibility, safety and adherence of the co-designed physical exercise program were demonstrated. Strategies to minimise dropouts in future effectiveness studies are required.
Development of a Physical Therapy-Based Exercise Program for Adults with Down Syndrome
Authors: Mann Sarah , Spiric Jennifer , Mitchell Cailin , Hilgenkamp Thessa Irena Maria
Published: February 2023

In adults with Down syndrome, the combination of low physical activity and fitness levels and the high prevalence of musculoskeletal co-morbidities stresses the need for specialized exercise programs. The goal of this research study was to develop a specialized exercise program for individuals with Down syndrome using the physical therapy approach of a systems review as the foundation. We first conducted an overview of the literature on co-morbidities in adults with Down syndrome using the systems review method to categorize these findings. We extracted recommendations for content and delivery of an exercise program based on the literature review, and finally composed a specialized exercise program for individuals with Down syndrome adhering to these recommendations.
Formative Development of ClockWork for the Postpartum Period: A Theory-Based Intervention to Harness the Circadian Timing System to Address Cardiometabolic Health-Related Behaviors
Authors: Conlon Rachel P. Kolko , Hu Haomin , Saptono Andi , Hawkins Marquis S. , Parmanto Bambang , Levine Michele D. , Buysse Daniel J.
Published: February 2023

Individuals with body mass index (BMI) ≥ 25 kg/m2 before pregnancy have greater difficulty losing the weight gained during pregnancy, and this postpartum weight retention predicts higher risk for cardiometabolic disease. The postpartum period involves substantial disruptions in circadian rhythms, including rhythms related to eating, physical activity, sleep, and light/dark exposure, each of which are linked to obesity and cardiometabolic disease in non-pregnant adult humans and animals. We posit that a multi-component, circadian timing system-based behavioral intervention that uses digital tools—ClockWork—will be feasible and acceptable to postpartum individuals and help promote weight- and cardiometabolic health-related behaviors. We provide data from stakeholder interviews with postpartum individuals (pre-pregnancy BMI ≥ 25; n = 7), which were conducted to obtain feedback on and improve the relevance and utility of digital self-monitoring tools for health behaviors and weight during the postpartum period. Participants perceived the ClockWork intervention and digital monitoring app to be helpful for management of postpartum weight-related health behaviors. They provided specific recommendations for increasing the feasibility intervention goals and improving app features for monitoring behaviors. Personalized, easily accessible interventions are needed to promote gestational weight loss after delivery; addressing circadian behaviors is an essential component of such interventions. Future studies will evaluate the efficacy of the ClockWork intervention and associated digital tools for improving cardiometabolic health-related behaviors linked to the circadian timing system during the postpartum period.
Coconut Sugar: Chemical Analysis and Nutritional Profile; Health Impacts; Safety and Quality Control; Food Industry Applications
Authors: Saraiva Ariana , Carrascosa Conrado , Ramos Fernando , Raheem Dele , Lopes Maria , Raposo António
Published: February 2023

Consumers often wish to substitute refined sugar with alternative sweeteners, such as coconut sugar, given growing interest in healthy eating and the public’s negative perception of excess sugar intake. Coconut sugar is a healthier, sweetener option than the majority of other sugars that are commercially available. Sap is collected from trees to be transported, stored, and evaporated during processing, which are labor- and resource-intensive operations. Consequently, the cost of production is higher than it is for cane sugar. Given its high nutritional value and low glycemic index, people are willing to pay higher prices for it. However, one barrier is ignorance of its health benefits. This review examines and deals in-depth with the most significant features of coconut sugar chemical analyses to focus on several analytical methodologies given the increasing demand for naturally derived sweeteners in the last 10 years. A deeper understanding of the quality control, safety, health effects, nutritional profile, and sustainability issues corresponding to coconut sugar is necessary to effectively implement them in the food industry.
Effectiveness of Epidural Steroid Injection Depending on Discoradicular Contact: A Prospective Randomized Trial
Authors: Budrovac Dino , Radoš Ivan , Hnatešen Dijana , Haršanji-Drenjančević Ivana , Tot Ozana Katarina , Katić Franjo , Lukić Iva , Škiljić Sonja , Nešković Nenad , Dimitrijević Iva
Published: February 2023

Lumbar radicular pain is a major public health and economic problem. It is among the most common reasons for professional disability. The most common cause of lumbar radicular pain is intervertebral disc herniation, which results from degenerative disc changes. The dominant pain mechanisms are direct pressure of the hernia on the nerve root and the local inflammatory process triggered by intervertebral disc herniation. Treatment of lumbar radicular pain includes conservative, minimally invasive, and surgical treatment. The number of minimally invasive procedures is constantly increasing, and among these methods is epidural administration of steroids and local anesthetic through a transforaminal approach (ESI TF). The aim of this research was to examine the effectiveness of ESI TF as measured by a visual analog scale (VAS) and the Oswestry Disability Index (ODI), depending on whether there is contact between the herniated intervertebral disc and the nerve root. In both groups of participants, there was a significant reduction in pain intensity, but there was no significant difference between the groups. In the group with disc herniation and nerve root contact, the only significant reduction was in pain intensity (p < 0.001). There were no significant differences in measurements in other domains of the ODI. In the group without disc herniation and nerve contact, there was a significant difference in all domains except weight lifting. In the group without contact, there was significant improvement after 1 month (p = 0.001) and 3 months (p < 0.001) according to the ODI, while there was no significant improvement in the group with contact. In addition, there were no significant differences in the distribution of participants based on the ODI and whether disc herniation and nerve contact was present. The results suggest that transforaminal epidural administration of steroids is a clinically effective method for treating lumbar radicular pain caused by intervertebral disc herniation in people with and without nerve root contact, without significant differences.
Differences between Rural and Urban Practices in the Response to the COVID-19 Pandemic: Outcomes from the PRICOV-19 Study in 38 Countries
Authors: Petrazzuoli Ferdinando , Collins Claire , Van Poel Esther , Tatsioni Athina , Streit Sven , Bojaj Gazmend , Asenova Radost , Hoffmann Kathryn , Gabrani Jonila , Klemenc-Ketis Zalika , Rochfort Andrée , Adler Limor , Windak Adam , Nessler Katarzyna , Willems Sara
Published: February 2023

This paper explores the differences between rural and urban practices in the response to the COVID-19 pandemic, emphasizing aspects such as management of patient flow, infection prevention and control, information processing, communication and collaboration. Using a cross-sectional design, data were collected through the online PRICOV-19 questionnaire sent to general practices in 38 countries. Rural practices in our sample were smaller than urban-based practices. They reported an above-average number of old and multimorbid patients and a below-average number of patients with a migrant background or financial problems. Rural practices were less likely to provide leaflets and information, but were more likely to have ceased using the waiting room or to have made structural changes to their waiting room and to have changed their prescribing practices in terms of patients attending the practices. They were less likely to perform video consultations or use electronic prescription methods. Our findings show the existence of certain issues that could impact patient safety in rural areas more than in urban areas due to the underlying differences in population profile and supports. These could be used to plan the organization of care for similar future pandemic situations.
Workplace Violence against Health Care Providers in Emergency Departments of Public Hospitals in Jordan: A Cross-Sectional Study
Authors: Al Khatib Osama , Taha Hana , Al Omari Lujain , Al-Sabbagh Mohammed Qussay , Al-Ani Abdallah , Massad Faysal , Berggren Vanja
Published: February 2023

Workplace violence (WPV) against healthcare providers is a serious problem that carries health, safety, and legal consequences. Healthcare providers working in emergency departments (ED) are more susceptible to WPV compared to other healthcare settings. This study aimed to assess the prevalence of physical and verbal violence against ED physicians and nurses in public hospitals in Amman, Jordan, and to explore the relationship between WPV and the socio-demographic characteristics of the participants. A quantitative descriptive cross-sectional study design was used to assess physical and verbal violence against ED physicians and nurses. A self-administered questionnaire was completed by 67 physicians and 96 nurses from three public hospitals in Amman. In the past year, 33% and 53% of the participants experienced physical and verbal violence, respectively. Compared to their female counterparts, males were more frequently physically (43.7% vs. 2.3%, p-value < 0.001) and verbally (61.3% vs. 29.5%, p-value < 0.001) abused. The main perpetrators of physical and verbal violence were the patients’ relatives. Out of 53 physical and 86 verbal abuse incidents, only 15 cases (10.8%) were followed up with legal persecution. In conclusion, there is a widespread occurrence of physical and verbal violence against ED physicians and nurses in the public sector hospitals in Jordan. A collaborative effort by all stakeholders should be instituted to ensure the safety of the physicians and nurses and to improve the quality of the healthcare provided.
Organic Carbon Controls Mercury Distribution and Storage in the Surface Soils of the Water-Level-Fluctuation Zone in the Three Gorges Reservoir Region, China
Authors: Zhu Sihua , Yang Caiyun , Chen Hong , Wang Yongmin , Li Jieqin , Zhang Ruixi , Yang Yu , Zhang Cheng , Wang Dingyong
Published: February 2023

The particular condition of the water-level-fluctuation zone (WLFZ) in the Three Gorges Reservoir (TGR), the largest hydroelectric reservoir in China, raises great concerns about mercury (Hg) contamination and ecological risk. In addition, previous research found that soil organic carbon (SOC) plays an essential role in controlling Hg distribution and speciation. However, there is minimal information on the Hg storage distribution and their relationships with SOC in the WLFZ in TGR. This study investigated Hg distribution, storage, and their relationships with SOC in the surface soils in WLFZ. The results showed that the total Hg (THg) content in the surface soils ranged from 18.40 to 218.50 ng g−1, with an average value of 78.17 ± 41.92 ng g−1. About 89% of samples had THg content above the background value in Chongqing, showing specific enrichment of Hg in WLFZ due to contamination in the TGR. The surface soils have low SOC, with an average value of 8.10 ± 3.90 g kg−1. Moreover, THg content showed consistent distribution with the SOC in WLFZ, with a significantly positive correlation (R = 0.52, p < 0.01, n = 242). THg storage (201.82 ± 103.46 g ha−1) in the surface soils was also significantly positively correlated with the SOC storage (R = 0.47, p < 0.01, n = 242). The reduced SOC sequestration, due to the periodical alternative “flooding–draining” and frequent reclamation and utilization of WLFZ, decreased the Hg adsorption in soil. Those might result in the re-release of Hg into waters when WLFZ is flooded. Therefore, more attention should be directed towards Hg cycling and the consequent environmental risks in the TGR region.