bluuebunny/crossref_metadata_2025 huggingface dataset:
Gender Bias and the Lack of Equity in Pandemic Nursing in China: A Qualitative Study
Authors: Zhu Pingting , Wu Qiwei , Liu Xinyi , Waidley Ericka , Ji Qiaoying , Xu Ting
Published: September 2021

There has long been a gender bias in medicine. This qualitative study aims to identify the experience of sexism among frontline female nurses and further explore their expectations and possible strategies to get rid of gender bias. This is a descriptive phenomenological study of 23 female nurses with 11 ± 3.98 years of experience who spent 36 ± 6.50 days at the frontline during the initial COVID-19 outbreak. We employed Colaizzi’s phenomenological analysis method to understand the subjective experiences, revealing the following themes: (a) materialization of gender identity; (b) incoordinate relationships; (c) future voice of female nurses. The gender bias experienced by female frontline nurses further challenges their emotional identity and self-identity. Therefore, it is important to require extensive consciousness-raising and policy support to defend female nurses’ rights.
Australian Aboriginal and Torres Strait Islander Health Information: Progress, Pitfalls, and Prospects
Authors: Ring Ian , Griffiths Kalinda
Published: September 2021

Despite significant developments in Aboriginal and Torres Strait Islander Health information over the last 25 years, many challenges remain. There are still uncertainties about the accuracy of estimates of the summary measure of life expectancy, and methods to estimate changes in life expectancy over time are unreliable because of changing patterns of identification. Far too little use is made of the wealth of information that is available, and formal systems for systematically using that information are often vestigial to non-existent. Available information has focussed largely on traditional biomedical topics and too little on access to, expenditure on, and availability of services required to improve health outcomes, and on the underpinning issues of social and emotional wellbeing. It is of concern that statistical artefacts may have been misrepresented as indicating real progress in key health indices. Challenges and opportunities for the future include improving the accuracy of estimation of life expectancy, provision of community level data, information on the availability and effectiveness of health services, measurement of the underpinning issues of racism, culture and social and emotional wellbeing (SEWB), enhancing the interoperability of data systems, and capacity building and mechanisms for Indigenous data governance. There is little point in having information unless it is used, and formal mechanisms for making full use of information in a proper policy/planning cycle are urgently required.
The Relational Vulnerability of People Experiencing Multiple Exclusion Homelessness (MEH) in Spain
Authors: Valenzuela-Garcia Hugo , Molina José Luis , Lubbers Miranda J. , Grau Jorge
Published: September 2021

This paper draws on research analyzing the emotional and relational impacts of poverty and exclusion on charities’ clients in Spain since the 2008–2009 economic crisis, including people experiencing multiple exclusion homelessness (MEH). The study adopts a mixed-methods approach in which twenty in-depth cases were collected in different geographical locations, including twelve cases experiencing MEH. Unlike other disadvantaged groups, those affected by MEH suffer material shortages, traumatic experiences, psychological disorders, physical illnesses, and a high degree of relational vulnerability, as reflected in the structure and composition of their personal networks, which tend to be smaller in size, with just a few weak and temporary contacts, and with care professionals playing an important role. These charity users often need long-term socio-sanitary care, which challenges public and private health-care systems. Therefore, our contribution to this Special Issue is directed toward improving understanding of the relational characteristics of severely excluded people, how social support affects their personal networks, and the challenges this assistance poses to care services.
Prevalence of Obstructive Sleep Apnea Syndrome: A Single-Center Retrospective Study
Authors: Santilli Manlio , Manciocchi Eugenio , D’Addazio Gianmaria , Di Maria Erica , D’Attilio Michele , Femminella Beatrice , Sinjari Bruna
Published: September 2021

Obstructive sleep apnea syndrome (OSAS) is a sleep breathing disorder that often remains undiagnosed and untreated. OSAS prevalence is increasing exponentially. Starting on the dentist’s role as an epidemiological and diagnostic “sentinel”, the purpose of this study was to assess the prevalence of OSAS. The clinical diaries of 4659 patients were reviewed through a single-center retrospective analytic study. Descriptive statistical analysis was performed. Only 0.26% of patients reported to suffer from sleep apnea and were then diagnosed with OSAS. It was found that, out of 4487 patients, 678 suffered from hypertension (14.80%), 188 from gastro-esophageal-reflux-disease (GERD = 4.10%) and 484 from gastritis (10.78%). These results could be related to a difficult diagnosis of OSAS and to the absence of a dedicated section on sleep disorders in medical records. Therefore, the introduction of a question dedicated to sleep disorders, the administration of questionnaires (such as the STOP-BANG questionnaire) for early diagnosis, a multidisciplinary approach and pneumological examination could support the dentist in identifying patients at risk of OSAS.
Potential Use of Untreated Wastewater for Assessing COVID-19 Trends in Southern Italy
Authors: De Giglio Osvalda , Triggiano Francesco , Apollonio Francesca , Diella Giusy , Fasano Fabrizio , Stefanizzi Pasquale , Lopuzzo Marco , Brigida Silvia , Calia Carla , Pousis Chrysovalentinos , Marzella Angelo , La Rosa Giuseppina , Lucentini Luca , Suffredini Elisabetta , Barbuti Giovanna , Caggiano Giuseppina , Montagna Maria Teresa
Published: September 2021

As a complement to clinical disease surveillance, the monitoring of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) in wastewater can be used as an early warning system for impending epidemics. This study investigated the dynamics of SARS-CoV-2 in untreated wastewater with respect to the trend of coronavirus disease 2019 (COVID-19) prevalence in Southern Italy. A total of 210 wastewater samples were collected between May and November 2020 from 15 Apulian wastewater treatment plants (WWTP). The samples were concentrated in accordance with the standard of World Health Organization (WHO, Geneva, Switzerland) procedure for Poliovirus sewage surveillance, and molecular analysis was undertaken with real-time reverse-transcription quantitative PCR (RT-(q) PCR). Viral ribonucleic acid (RNA) was found in 12.4% (26/210) of the samples. The virus concentration in the positive samples ranged from 8.8 × 102 to 6.5 × 104 genome copies/L. The receiver operating characteristic (ROC) curve modeling showed that at least 11 cases/100,000 inhabitants would occur after a wastewater sample was found to be positive for SARS-CoV-2 (sensitivity = 80%, specificity = 80.9%). To our knowledge, this is the first study in Italy that has applied wastewater-based epidemiology to predict COVID-19 prevalence. Further studies regarding methods that include all variables (meteorological phenomena, characteristics of the WWTP, etc.) affecting this type of wastewater surveillance data would be useful to improve data interpretation.
MacKillop Family Services’ Family Preservation and Reunification Response for Vulnerable Families—Protocol for an Effectiveness-Implementation Study
Authors: Morris Heather , Savaglio Melissa , Halfpenny Nick , O’Donnell Renee , Pileggi Alesia , Dunbar Andrea , Miller Robyn , Skouteris Helen
Published: September 2021

International evidence supports the effect of intensive family preservation and reunification services in preventing children’s placement in out-of-home care (OOHC). Evidence within Australia is scarce. This protocol paper describes a hybrid effectiveness-implementation evaluation of the Victorian Family Preservation and Reunification (FPR) Response implemented by MacKillop Family Services. Participants include families engaged in the program and staff involved in program delivery. A pre-post study design will be used to assess the effectiveness of the FPR in improving family outcomes from intake to closure, including: (i) parenting knowledge, skills, and capability; (ii) family safety and home environment; (iii) child development, adolescent behaviour, education attendance and attachment; (iv) connection to services; and (v) prevention of children from entering or re-entering OOHC. Interviews and focus groups will be conducted with staff to evaluate the program’s fidelity, reach, feasibility, acceptability, and enablers and barriers to implementation. Quantitative data will be analysed using descriptive statistics and a series of paired-samples t-tests and F tests to examine changes in outcomes over time; thematic analysis will be used for qualitative data. If the FPR can yield significant improvements in families’ outcomes, this would provide strong support for its scale-up across Australia, to better support vulnerable families.
Patients’ with Multimorbidity and Psychosocial Difficulties and Their Views on Important Professional Competence for Rehabilitation Coordinators in the Return-to-Work Process
Authors: Azad Azadé , Svärd Veronica
Published: September 2021

Coordinators may play a key role during the return-to-work (RTW) process for people on sickness absence. There are still few studies on the newly implemented rehabilitation coordinators (RECO) within Swedish healthcare, and none focus on their competence. The aim of this study was to explore how persons with multimorbidity and psychosocial difficulties describe the professional competence of the RECO they encountered during their RTW process. The study takes a relational and practical approach in defining professional competence, including both what professionals do and what they possess. Interviews with 12 people with multimorbidity and psychosocial difficulties who had encountered a RECO during their RTW process were analysed using thematic analysis. Six different themes were found: communicative and coordinating skills; advisory and guidance skills; engagement and advocacy skills; being persistent and flexible; being empathic and therapeutic; being professional and trustworthy. Most of these are found in research on RTW coordinators, but being persistent, and having advisory, guidance, advocacy and therapeutic skills have not been recognised as important competences previously. This study adds patients’ views on important professional competence that support the RTW process, which should be regarded in further developments of RECOs’ functions and their competence descriptions.
Synergistic Effect of History of Cardiovascular Disease and Mental Distress on Post-Traumatic Stress Disorder after the Great East Japan Earthquake: The Fukushima Health Management Survey
Authors: Tezuka Kazuhide , Kubota Yasuhiko , Ohira Tetsuya , Nakano Hironori , Maeda Masaharu , Yabe Hirooki , Yasumura Seiji , Harigane Mayumi , Shimizu Yuji , Okada Takeo , Kiyama Masahiko , Kamiya Kenji ,   on behalf of the Fukushima Health Management Survey Group
Published: September 2021

Cardiovascular disease (CVD) and mental distress have been suggested to be associated with post-traumatic stress disorder (PTSD), but the effect of their combination on PTSD is unknown. We reviewed the synergistic effects of the history of CVD and mental distress on the possibility of PTSD among residents in Fukushima after the Great East Japan Earthquake. This cross-sectional study was conducted among 38,392 participants aged 40–74 years in the evacuation area who applied for the Fukushima Health Management Study in Fiscal Year 2011. Relative excess risk due to interaction (RERI), attributable proportion (AP), odds ratio (OR), and 95% confidence interval (CI) were calculated to investigate the combined effect of history of CVD and mental distress on PTSD. We identified 8104 probable cases of PTSD (21.1%). History of CVD, mental distress, and their combination were positively associated with probable PTSD: the multivariable ORs (95% CIs) were 1.44 (1.04, 2.01), 20.08 (18.14, 22.22), and 26.60 (23.07, 30.67), respectively. There was a significant increase in RERI: the corresponding RERI (95% CI) and AP were 6.08 (3.16, 9.00) and 22.9%. Gender-specific analyses showed similar associations. Thus, we found a supra-additive association of history of CVD and mental distress with probable PTSD after the disaster.
Analysis of Factors Affecting Employment Status of Kidney Transplant Recipients in Selected European Union Member States
Authors: Wlodarczyk Elzbieta , Viklický Ondřej , Budde Klemens , Kolářová Marie , Bergfeld Leon , Paczek Leszek , Mucha Krzysztof , Glyda Maciej , Wlodarczyk Zbigniew
Published: September 2021

Despite an increasing quality of life after renal transplantation, the number of recipients undertaking paid professional work remains relatively low. Employment after kidney transplantation became a new important marker of clinically significant health recovery. Furthermore, for social and economic reasons, returning to work and participation in social life may be considered as an objective parameter that demonstrate the effectiveness of transplantation. The objectives of the following study were to evaluate the factors that determine resuming paid work after renal transplantation, to assess a patient’s decision about returning to professional activity by comparative analysis of renal transplant recipients from Poland, Czech Republic and Germany, and to identify groups of patients exposed to professional exclusion in those EU countries. Five hundred renal transplant recipients from three EU countries were included into the study. The two main research methods used in the study were the SF-36 questionnaire, constructed and validated to assess the quality of life after kidney transplantation and a questionnaire constructed for the purposes of this study. Multifactorial analysis identified several risk factors associated with professional exclusions after kidney transplantation, namely young or advanced age, female gender, lack of education, place of residence in rural areas, long period of illness, and lack of occupational activity before transplantation. Despite the high standards of social care and rehabilitation support, patients in Germany failed to take up professional activity after kidney transplantation in more cases than those in Poland and Czech Republic. Surprisingly, the objective function of the kidney (creatinine level) and the multidimensional assessment of quality of life (SF-36 survey) did not have a significant association with the employment status after renal transplantation.
Recycling Potential of Plastic Resources from End-of-Life Passenger Vehicles in China
Authors: Li Yang , Huang Shiyu , Liu Yanhui , Ju Yiyi
Published: September 2021

A rapid increase in the number of end-of-life (EoL) passenger vehicles has led to a large amount of waste plastics in China. However, the scale and efficiency of recycling resources from EoL vehicles still restricts the sustainable and healthy development of the automotive industry. The current behavior of automotive/recycling industry entities, as well as the strategy of waste management policymakers, may depend on the potential of total recyclable resources. To reveal such recycling potential of various plastic materials in EoL passenger vehicles, we predicted total EoL passenger vehicles in China from 2021 to 2030 (used the Weibull distribution) considering passenger vehicle ownership (estimated by the Gompertz model), quantified the demand for new passenger vehicles (estimated using its non-linear relationship with income level and passenger vehicle ownership), and assessed the recyclable plastics by categories and by provinces. The results show that (i) the annual average recycled plastic resources from EoL vehicles would exceed 2400 thousand t in 2030, more than 2.5 times in 2021, showing a great recycling potential; (ii) the differences among the three scenarios are relatively small, indicating that no matter the saturation level of passenger vehicles in China would be high or low, a rapid increase of recyclable plastic resources can be expected from 2021 to 2030; (iii) at the provincial level, a considerable gap between the potential of recycling plastic from EoL passenger vehicles and the regional processing capacity. Given such great potential and regional differences, the recycling policies should be applied in stages and consider the development level and recovery pressure in each region.
Determinants of Perceived Accessibility of Maternity Leave and Childcare Leave in South Korea
Authors: Kim Eun Jung , Hwang Won Ju , Kim Mi Jeong
Published: September 2021

This study examined the determinants of perceived accessibility of maternity leave and childcare leave in South Korea. Although maternity leave and childcare leave are mandated in Korea, many employees are hesitant to use the policies. The purpose of this study was to empirically examine why some women are more likely than others to perceive the policies as inaccessible and to identify what those women’s characteristics are. The results revealed that nonregular workers were significantly less likely than regular workers with secure contracts to perceive the policies as accessible even though they were eligible for them. In addition, workers who worked in the private sector, did not belong to a labor union, worked in small firms, or worked long hours were significantly less likely to perceive the policies as accessible than those who worked in the public sector, belonged to a labor union, worked in large firms, or worked short hours. Further, workers with low salaries were significantly less likely than workers with high salaries to perceive the policies as accessible. The study underscores that accessibility of leave policies in Korea is significantly correlated with women’s employment status and wage level in the labor market.
Integrating eHealth within a Transforming Mental Healthcare Setting: A Qualitative Study into Values, Challenges, and Prerequisites
Authors: Lorenz-Artz Karin , Bierbooms Joyce , Bongers Inge
Published: September 2021

Mental health care is shifting towards more person-centered and community-based health care. Although integrating eHealth within a transforming healthcare setting may help accomplishing the shift, research studying this is lacking. This study aims to improve our understanding of the value of eHealth within a transforming mental healthcare setting and to define the challenges and prerequisites for implementing eHealth in particular within this transforming context. In this article, we present the results of 29 interviews with clients, social network members, and professionals of an ambulatory team in transition within a Dutch mental health care institute. The main finding is that eHealth can support a transforming practice shifting towards more recovery-oriented, person-centered, and community-based service in which shared-decision making is self-evident. The main challenge revealed is how to deal with clients’ voices, when professionals see the value of eHealth but clients do not want to start using eHealth. The shift towards client-centered and network-oriented care models and towards blended care models are both high-impact changes in themselves. Acknowledging the complexity of combining these high-impact changes might be the first step towards creating blended client-centered and network-oriented care. Future research should examine whether and how these substantial shifts could be mutually supportive.
Effect of Smartphone App’s Intervention on Consumers’ Knowledge, Attitude, Practice, and Perception of Food Poisoning Prevention When Dining Out at Selected Rural Areas in Terengganu
Authors: Zaujan Nur Afifah Mursyida , Ali Asma’ , Osman Malina , Chee Hui Yee , Ithnin Nur Raihana , Misni Norashiqin , Sukeri Surianti , Chin Christie Pei-Yee
Published: September 2021

(1) Background: Lack of food safety awareness and preventive behaviour when dining out increases the risk of food poisoning. Furthermore, food poisoning cases among rural communities have been rising in recent years. However, the health-related mobile application is a promising tool in improving food poisoning prevention knowledge, attitude, practice, and perception (KAP2) among consumers. Therefore, the current study developed a novel smartphone app, MyWarung©, and determined its efficacy in increasing awareness, attitude, practice, and perception of food poisoning and its prevention when dining out, especially among rural consumers. (2) Methods: A quasi-experimental pre-and post-intervention study with a control and intervention group were performed on 100 consumers in Terengganu. (3) Results: The intervention’s inter-group outcomes were analysed using the Mann–Whitney test, while the within-group effects were ascertained using the Wilcoxon sign rank test via the SPSS software. It was found that the control group had higher median scores in knowledge (30.0, IQR 7.0), attitude (46.0, IQR 5.0), and practice (34.0, IQR 3.0) than the intervention group before intervention. After the intervention programme, the intervention group showed significant improvement in food poisoning knowledge (p = 0.000), attitude (p = 0.001), and practice (p = 0.000). However, the intervention group’s perceived barriers (p = 0.129) and susceptibility (p = 0.069) and the control group’s perceived barriers (p = 0.422) did not show any significant improvement. (4) Conclusion: The findings indicated that the MyWarung© mobile app usage enhanced the food poisoning knowledge, preventive attitude, and practice among consumers when dining out.
Qualitative Investigation into Therapists’ Experiences of Online Therapy: Implications for Working Clients
Authors: Kotera Yasuhiro , Kaluzeviciute Greta , Lloyd Christopher , Edwards Ann-Marie , Ozaki Akihiko
Published: September 2021

Online therapy has increasingly been utilised during the COVID-19 pandemic by many, including working populations. However, few qualitative studies have explored how online therapy is experienced in practice and discussed its implications for those working clients. Semi-structured interviews attended by nine integrative psychotherapists practising in California, the United States, were conducted. Thematic analysis of the transcripts identified three themes: (i) ‘Positive experiences of online therapy’, (ii) ‘Challenges experienced by therapists and clients in online therapy’, and (iii) ‘Preparation and training for online therapy’. Online therapy was assessed as being helpful, particularly in terms of mitigating against previous geographical and temporal barriers to uptake. However, due to technological disruptions and potential blurring of professional boundaries, online therapy may detract from the emotional salience of therapy, negatively impacting the therapeutic relationship and containment. Considering these positive experiences, participants expected that the demand for online therapy would continue to increase. Particularly in the occupational context, online therapy can offer interventions without fostering shame regarding mental health. The findings provide preliminary qualitative evidence that online therapy can be a useful adjunct to traditional forms of face-to-face therapy. However, therapists require more explicit training in implementing online therapy. Results are discussed in particular regarding the utility of this therapy for working clients.
Heart Rate Variability-Guided Training for Enhancing Cardiac-Vagal Modulation, Aerobic Fitness, and Endurance Performance: A Methodological Systematic Review with Meta-Analysis
Authors: Manresa-Rocamora Agustín , Sarabia José Manuel , Javaloyes Alejandro , Flatt Andrew A. , Moya-Ramón Manuel
Published: September 2021

Purpose: This systematic review with meta-analysis was conducted to establish whether heart rate variability (HRV)-guided training enhances cardiac-vagal modulation, aerobic fitness, or endurance performance to a greater extent than predefined training while accounting for methodological factors. Methods: We searched Web of Science Core Collection, Pubmed, and Embase databases up to October 2020. A random-effects model of standardized mean difference (SMD) was estimated for each outcome measure. Chi-square and the I2 index were used to evaluate the degree of homogeneity. Results: Accounting for methodological factors, HRV-guided training was superior for enhancing vagal-related HRV indices (SMD+ = 0.50 (95% confidence interval (CI) = 0.09, 0.91)), but not resting HR (SMD+ = 0.04 (95% CI = −0.34, 0.43)). Consistently small but non-significant (p > 0.05) SMDs in favor of HRV-guided training were observed for enhancing maximal aerobic capacity (SMD+ = 0.20 (95% CI = −0.07, 0.47)), aerobic capacity at second ventilatory threshold (SMD+ = 0.26 (95% CI = −0.05, 0.57)), and endurance performance (SMD+ = 0.20 (95% CI = −0.09, 0.48)), versus predefined training. No heterogeneity was found for any of the analyzed aerobic fitness and endurance performance outcomes. Conclusion: Best methodological practices pertaining to HRV index selection, recording position, and approaches for establishing baseline reference values and daily changes (i.e., fixed or rolling HRV averages) require further study. HRV-guided training may be more effective than predefined training for maintaining and improving vagal-mediated HRV, with less likelihood of negative responses. However, if HRV-guided training is superior to predefined training for producing group-level improvements in fitness and performance, current data suggest it is only by a small margin.
A Study on the Reliability and Validity of the Korean Health Literacy Instrument for Late School-Aged Children
Authors: Park Sook-Kyoung , Kim Eun-Gyeong
Published: September 2021

This study aimed to develop and validate the Korean Health Literacy Instrument, which measures Korean late school-aged children’s understanding capacity. The construct’s concepts were drawn from the literature review and interviews with school nurses and teachers. A survey was then conducted in 552 fifth and sixth graders in nine elementary schools, from 1 to 9 May 2014. The KR-20 coefficient for reliability, difficulty index, discrimination index, item-total correlation, and known group technique for validity were performed. An exploratory factor analysis was performed to test the construct validity of the instrument and its unidimensionality. The results reveal that a two-factor structure was appropriate for the Korean school-age health literacy tool (root mean square error of approximation = 0.06, Comparative Fit Index = 0.96, and Tucker–Lewis Index = 0.95). From the remaining 16 items, the internal consistency reliability coefficient of this instrument was 0.85, and the criterion-related validity was 0.62 (p < 0.001). The Korean health literacy instrument for late school-aged children was suitable for screening individuals who have limited health literacy. Based on the findings of this study, future studies must continue to conduct empirical investigations on the Korean health literacy instrument for late school-aged children
Impact of Synchronous Online Physical Education Classes Using Tabata Training on Adolescents during COVID-19: A Randomized Controlled Study
Authors: Lee Kwang-Jin , Noh Byungjoo , An Keun-Ok
Published: September 2021

This study aimed to investigate the effects of online physical education classes, using Tabata training, on middle school students’ physical fitness. Fifty-four adolescents were randomly assigned to either the asynchronous online class group (AOCG, n = 24, age: 15.8 ± 0.4 years) or the synchronous online class group (SOCG, n = 24 age: 15.9 ± 0.3 years). The online physical education class lasted two days per week for 10 weeks. Recorded video lectures were conducted for the AOCG, and Tabata training for the SOCG, as real-time lecture methods. Baseline and post-online physical education class measures included muscular strength, muscular endurance, flexibility, balance, and cardiorespiratory fitness tests. The results showed that the synchronous online physical education class had a positive effect on the improvement of muscle mass, ankle strength (dorsiflexion), hip strength (abduction, flexion, extension, and external rotation), knee strength (extension and flexion), and balance (Y-balance test) in adolescents. These findings suggest that the physical fitness of adolescents can be sufficiently improved through appropriate online physical education class methods. Further research should focus on developing and evaluating different types of exercises for synchronous online physical education classes as a precautionary measure for the second wave of COVID-19.
Are the Effects of DES Over? A Tragic Lesson from the Past
Authors: Zamora-León Pilar
Published: September 2021

Diethylstilbestrol (DES), a transplacental endocrine-disrupting chemical, was prescribed to pregnant women for several decades. The number of women who took DES is hard to know precisely, but it has been estimated that over 10 million people have been exposed around the world. DES was classified in the year 2000 as carcinogenic to humans. The deleterious effects induced by DES are very extensive, such as abnormalities or cancers of the genital tract and breast, neurodevelopmental alterations, problems associated with socio-sexual behavior, and immune, pancreatic and cardiovascular disorders. Not only pregnant women but also their children and grandchildren have been affected. Epigenetic alterations have been detected, and intergenerational effects have been observed. More cohort follow-up studies are needed to establish if DES effects are transgenerational. Even though DES is not currently in use, its effects are still present, and families previously exposed and their later generations deserve the continuity of the research studies.
Interventions to Increase Leukocyte Testing during Treatment with Dimethyl Fumarate
Authors: Heidenreich Paul A. , Lin Shoutzu , Gholami Parisa , Moore Von R. , Burk Muriel L. , Glassman Peter A. , Cunningham Francesca E. , Sahay Anju
Published: September 2021

Dimethyl fumarate (DMF), a treatment for multiple sclerosis, may cause leukopenia and infection. Accordingly, periodic white blood cell (WBC) monitoring is recommended. We sought to evaluate the US Department of Veteran Affairs’ safety program which provides facilities with a list of patients prescribed DMF therapy without a documented white blood cell count (WBC). We identified 118 sites with patients treated with DMF from 1 January 2016 through 30 September 2016. Each site was asked if any of seven interventions were used to improve WBC monitoring (academic detailing, provider education without academic detailing, electronic clinical reminders, request for provider action plan, draft orders for WBC monitoring, patient mailings, and patient calls). The survey response rate was 78%. For the 92 responding sites (78%) included sites (1115 patients) the mean rate of WBC monitoring was 54%. In multivariate analysis, academic detailing increased the rate by 17% (95% CI 4 to 30%, p = 0.011) and provider education increased the rate by 9% (95% CI 0.6 to 18%, p = 0.037). The WBC monitoring rate increased by 3.8% for each additional intervention used (95% CI 1.2–6.4%, p = 0.005). Interventions focused on the physician, including academic detailing, were associated with improved WBC monitoring for patients at risk for leukopenia from DMF treatment.
Indigenous and Tribal Peoples Data Governance in Health Research: A Systematic Review
Authors: Griffiths Kalinda E. , Blain Jessica , Vajdic Claire M. , Jorm Louisa
Published: September 2021

There is increasing potential to improve the research and reporting on the health and wellbeing of Indigenous and Tribal peoples through the collection and (re)use of population-level data. As the data economy grows and the value of data increases, the optimization of data pertaining to Indigenous peoples requires governance that defines who makes decisions on behalf of whom and how these data can and should be used. An international a priori PROSPERO (#CRD42020170033) systematic review was undertaken to examine the health research literature to (1) identify, describe, and synthesize definitions and principles; (2) identify and describe data governance frameworks; and (3) identify, describe, and synthesize processes, policies and practices used in Indigenous Data Governance (ID-GOV). Sixty-eight articles were included in the review that found five components that require consideration in the governance of health research data pertaining to Indigenous people. This included (1) Indigenous governance; (2) institutional ethics; (3) socio-political dynamics; (4) data management and data stewardship; and (5) overarching influences. This review provides the first systematic international review of ID-GOV that could potentially be used in a range of governance strategies moving forward in health research.
BiLSTM-I: A Deep Learning-Based Long Interval Gap-Filling Method for Meteorological Observation Data
Authors: Xie Chuanjie , Huang Chong , Zhang Deqiang , He Wei
Published: September 2021

Complete and high-resolution temperature observation data are important input parameters for agrometeorological disaster monitoring and ecosystem modelling. Due to the limitation of field meteorological observation conditions, observation data are commonly missing, and an appropriate data imputation method is necessary in meteorological data applications. In this paper, we focus on filling long gaps in meteorological observation data at field sites. A deep learning-based model, BiLSTM-I, is proposed to impute missing half-hourly temperature observations with high accuracy by considering temperature observations obtained manually at a low frequency. An encoder-decoder structure is adopted by BiLSTM-I, which is conducive to fully learning the potential distribution pattern of data. In addition, the BiLSTM-I model error function incorporates the difference between the final estimates and true observations. Therefore, the error function evaluates the imputation results more directly, and the model convergence error and the imputation accuracy are directly related, thus ensuring that the imputation error can be minimized at the time the model converges. The experimental analysis results show that the BiLSTM-I model designed in this paper is superior to other methods. For a test set with a time interval gap of 30 days, or a time interval gap of 60 days, the root mean square errors (RMSEs) remain stable, indicating the model’s excellent generalization ability for different missing value gaps. Although the model is only applied to temperature data imputation in this study, it also has the potential to be applied to other meteorological dataset-filling scenarios.
Fidelity of a Motivational Interviewing Intervention for Improving Return to Work for People with Musculoskeletal Disorders
Authors: Løchting Ida , Hagen Roger , Monsen Christine K. , Grotle Margreth , Storheim Kjersti , Aanesen Fiona , Øiestad Britt Elin , Eik Hedda , Bagøien Gunnhild
Published: September 2021

The objective of this study was to conduct a fidelity evaluation of a motivational interviewing (MI) intervention delivered by social insurance caseworkers, in a three-arm randomized controlled trial (RCT) for improving return to work for people on sick leave with musculoskeletal disorders. The caseworkers received six days of MI training, including an intervention manual prior to the trial onset, as well as supervision throughout the trial. The caseworkers recorded 21 MI sessions at regular intervals during the trial. An independent MI analysis center scored the recordings using the MI treatment integrity code (MITI 4). In addition, three experienced MI trainers assessed the adherence to the MI intervention manual on a 1–4 Likert scale and MI competence. Total MITI 4 mean scores were at beginning proficiency levels for two components (global technical, mean 3.0; SD 0.6 and the reflections/questions ratio, mean 1.1; SD 0.2) and under beginning proficiency for two components (global relational, mean 3.2; SD 0.7 and complex question, mean 34.0; SD 21.2). The MI trainers’ assessment showed similar results. The mean adherence score for the MI sessions was 2.96 (SD 0.9). Despite delivering a thorough course and supervision package, most of the caseworkers did not reach proficiency levels of good MI competence during the study. The fidelity evaluation showed that a large amount of training, supervision and practice is needed for caseworkers to become competent MI providers. When planning to implement MI, it is important that thorough consideration is given regarding the resources and the time needed to train caseworkers to provide MI in a social insurance setting.
Earlier Flowering of Betula pendula Roth in Augsburg, Germany, Due to Higher Temperature, NO2 and Urbanity, and Relationship with Betula spp. Pollen Season
Authors: Kolek Franziska , Plaza Maria Del Pilar , Leier-Wirtz Vivien , Friedmann Arne , Traidl-Hoffmann Claudia , Damialis Athanasios
Published: September 2021

Flowering and pollen seasons are sensitive to environmental variability and are considered climate change indicators. However, it has not been concluded to what extent flowering phenology is indeed reflected in airborne pollen season locally. The aim of this study was to investigate, for the commonly represented in temperate climates and with highly allergenic pollen Betula pendula Roth, the responsiveness of flowering to different environmental regimes and also to check for commensurate changes in the respective pollen seasons. The region of Augsburg, Bavaria, Germany, was initially screened for birch trees, which were geolocated at a radius of 25 km. Random trees across the city were then investigated during three full flowering years, 2015–2017. Flowering observations were made 3–7 times a week, from flower differentiation to flower desiccation, in a total of 43 plant individuals. Data were regressed against meteorological parameters and air pollutant levels in an attempt to identify the driving factors of flowering onset and offset. Flowering dates were compared with dates of the related airborne pollen seasons per taxon; airborne pollen monitoring took place daily using a Hirst-type volumetric sampler. The salient finding was that flowering occurred earlier during warmer years; it also started earlier at locations with higher urbanity, and peaked and ended earlier at sites with higher NO2 concentrations. Airborne pollen season of Betula spp. frequently did not coincide locally with the flowering period of Betula pendula: while flowering and pollen season were synchronized particularly in their onset, local flowering phenology alone could explain only 57.3% of the pollen season variability. This raises questions about the relationship between flowering times and airborne pollen seasons and on the rather underestimated role of the long-distance transport of pollen.
Effects of the Resilience of Nurses in Long-Term Care Hospitals during on Job Stress COVID-19 Pandemic: Mediating Effects of Nursing Professionalism
Authors: Park Bom-Mi , Jung Jiyeon
Published: September 2021

Purpose: To investigate nursing professionalism as a mediating factor in the relationship between resilience and job stress levels for nurses working in long-term care hospitals during the COVID-19 pandemic. Methods: A cross-sectional survey was conducted from January to March 2021 in seven long-term care hospitals in the Seoul metropolitan area to measure resilience, nursing professionalism, and job stress among nurses. Simple and multiple regression analyses along with the Sobel test were performed to verify the mediating effect of nursing professionalism. Results: Data from 200 nurses were included in the final analysis. Results showed that individual and occupational characteristics could lead to differences in nurses’ resilience, job stress levels, and nursing professionalism. Nursing professionalism had a significant mediating effect on the relationship between resilience and job stress levels. The effect of resilience on job stress levels was significant (β = −0.16, p = 0.024). After controlling for nursing professionalism, the effect declined and was not statistically significant (β = −0.09, p = 0.251). Conclusion: There is a need to increase individual resilience and nursing professionalism through intervention programs and policy proposals to manage job stress among long-term care hospital nurses during the COVID-19 pandemic.
Cyclodextrins Allow the Combination of Incompatible Vancomycin and Ceftazidime into an Ophthalmic Formulation for the Treatment of Bacterial Keratitis
Authors: Bouattour Yassine , Neflot-Bissuel Florent , Traïkia Mounir , Biesse-Martin Anne-Sophie , Frederic Robin , Yessaad Mouloud , Jouannet Mireille , Wasiak Mathieu , Chennell Philip , Sautou Valerie
Published: September 2021

Ceftazidime (CZ) and vancomycin (VA) are two antibiotics used to treat bacterial keratitis. Due to their physical incompatibility (formation of a precipitate), it is not currently possible to associate both molecules in a single container for ophthalmic administration. We firstly characterized the incompatibility then investigated if 2-hydroxypropyl-beta (HPβCD) and 2-hydroxypropyl-gamma cyclodextrins (HPγCD) could prevent this incompatibility. The impact of pH on the precipitation phenomena was investigated by analysing the supernatant solution of the mixture using high performance liquid chromatography. A characterization of the inclusion of CZ with HPγCD using 1H nuclear magnetic resonance (NMR), and VA with HPβCD using 1H-NMR and a solubility diagram was performed. A design of experiment was built to determine the optimal conditions to obtain a formulation that had the lowest turbidity and particle count. Our results showed that VA and CZ form an equimolar precipitate below pH 7.3. The best formulation obtained underwent an in-vitro evaluation of its antibacterial activity. The impact of HPCDs on incompatibility has been demonstrated through the inclusion of antibiotics and especially VA. The formulation has been shown to be able to inhibit the incompatibility for pH higher than 7.3 and to possess unaltered antibacterial activity.
DNA Demethylation in the Processes of Repair and Epigenetic Regulation Performed by 2-Ketoglutarate-Dependent DNA Dioxygenases
Authors: Kuznetsov Nikita A. , Kanazhevskaya Lyubov Yu. , Fedorova Olga S.
Published: September 2021

Site-specific DNA methylation plays an important role in epigenetic regulation of gene expression. Chemical methylation of DNA, including the formation of various methylated nitrogenous bases, leads to the formation of genotoxic modifications that impair DNA functions. Despite the fact that different pathways give rise to methyl groups in DNA, the main pathway for their removal is oxidative demethylation, which is catalyzed by nonheme Fe(II)/α-ketoglutarate–dependent DNA dioxygenases. DNA dioxygenases share a common catalytic mechanism of the oxidation of the alkyl groups on nitrogenous bases in nucleic acids. This review presents generalized data on the catalytic mechanism of action of DNA dioxygenases and on the participation of typical representatives of this superfamily, such as prokaryotic enzyme AlkB and eukaryotic enzymes ALKBH1–8 and TET1–3, in both processes of direct repair of alkylated DNA adducts and in the removal of an epigenetic mark (5-methylcytosine).
Endometriosis: Epidemiology, Classification, Pathogenesis, Treatment and Genetics (Review of Literature)
Authors: Smolarz Beata , Szyłło Krzysztof , Romanowicz Hanna
Published: September 2021

Endometriosis is a “mysterious” disease and its exact cause has not yet been established. Among the etiological factors, congenital, environmental, epigenetic, autoimmune and allergic factors are listed. It is believed that the primary mechanism of the formation of endometriosis foci is retrograde menstruation, i.e., the passage of menstrual blood through the fallopian tubes into the peritoneal cavity and implantation of exfoliated endometrial cells. However, since this mechanism is also observed in healthy women, other factors must also be involved in the formation of endometriosis foci. Endometriosis is in many women the cause of infertility, chronic pain and the deterioration of the quality of life. It also represents a significant financial burden on health systems. The article presents a review of the literature on endometriosis—a disease affecting women throughout the world.
Metformin Affects Olaparib Sensitivity through Induction of Apoptosis in Epithelial Ovarian Cancer Cell Lines
Authors: Gralewska Patrycja , Gajek Arkadiusz , Marczak Agnieszka , Rogalska Aneta
Published: September 2021

This study examined the effect of combination treatment with the poly (ADP-ribose) polymerase inhibitor olaparib and metformin on homologous recombination (HR)-proficient epithelial ovarian cancer (EOC). Ovarian cancer cell lines (OV-90 and SKOV-3) were treated with olaparib, metformin, or a combination of both. Cell viability was assessed by MTT and colony formation assays. The production of reactive oxygen species (ROS) and changes in mitochondrial membrane potential were examined using the specific fluorescence probes, DCFH2-DA (2′,7′-dichloro-dihydrofluorescein diacetate) and JC-1 (5,5′,6,6′-tetrachloro-1,1′,3,3′-tetraethylbenzimidazolcarbocyanine). Apoptotic and necrotic changes were measured by double staining with Hoechst 33258 and propidium iodide, orange acridine and ethidium bromide staining, phosphatidylserine externalization, TUNEL assay, caspase 3/7 activity, and cytochrome c and p53 expression. Compared with single-drug treatment, the combination of olaparib and metformin significantly inhibited cell proliferation and colony formation in HR-proficient ovarian cancer cells. ROS production preceded a decrease in mitochondrial membrane potential. The changes in ROS levels suggested their involvement in inducing apoptosis in response to combination treatment. The present results indicate a shift towards synergism in cells with mutant or null p53, treated with olaparib combined with metformin, providing a new approach to the treatment of gynecologic cancers. Taken together, the results support the use of metformin to sensitize EOC to olaparib therapy.
Age-Related Changes in the Matrisome of the Mouse Skeletal Muscle
Authors: Lofaro Francesco Demetrio , Cisterna Barbara , Lacavalla Maria Assunta , Boschi Federico , Malatesta Manuela , Quaglino Daniela , Zancanaro Carlo , Boraldi Federica
Published: September 2021

Aging is characterized by a progressive decline of skeletal muscle (SM) mass and strength which may lead to sarcopenia in older persons. To date, a limited number of studies have been performed in the old SM looking at the whole, complex network of the extracellular matrix (i.e., matrisome) and its aging-associated changes. In this study, skeletal muscle proteins were isolated from whole gastrocnemius muscles of adult (12 mo.) and old (24 mo.) mice using three sequential extractions, each one analyzed by liquid chromatography with tandem mass spectrometry. Muscle sections were investigated using fluorescence- and transmission electron microscopy. This study provided the first characterization of the matrisome in the old SM demonstrating several statistically significantly increased matrisome proteins in the old vs. adult SM. Several proteomic findings were confirmed and expanded by morphological data. The current findings shed new light on the mutually cooperative interplay between cells and the extracellular environment in the aging SM. These data open the door for a better understanding of the mechanisms modulating myocellular behavior in aging (e.g., by altering mechano-sensing stimuli as well as signaling pathways) and their contribution to age-dependent muscle dysfunction.