bluuebunny/crossref_metadata_2025 huggingface dataset:
De Novo Carcinoma after Solid Organ Transplantation to Give Insight into Carcinogenesis in General—A Systematic Review and Meta-Analysis
Authors: Zwart Eline S. , Yüksel Esen , Pannekoek Anne , de Vries Ralph , Mebius Reina E. , Kazemier Geert
Published: March 2021

Immunosuppressive therapy after solid organ transplantation leads to the development of cancer in many recipients. Analysis of the occurrence of different types of de novo carcinomas in relation to specific immunosuppressive drugs may give insight into their carcinogenic process and carcinogenesis in general. Therefore, a systematic search was performed in Embase and PubMed. Studies describing over five de novo carcinomas in patients using immunosuppressive drugs after solid organ transplantation were included. Incidence per 1000 person-years was calculated with DerSimonian–Laird random effects model and odds ratio for developing carcinomas with the Mantel–Haenszel test. Following review of 5606 papers by title and abstract, a meta-analysis was conducted of 82 studies. The incidence rate of de novo carcinomas was 8.41. Patients receiving cyclosporine developed more de novo carcinomas compared to tacrolimus (OR1.56, 95%CI 1.00–2.44) and mycophenolate (OR1.26, 95%CI 1.03–1.56). Patients receiving azathioprine had higher odds to develop de novo carcinomas compared to mycophenolate (OR3.34, 95%CI 1.29–8.65) and head and neck carcinoma compared to tacrolimus (OR3.78, 95%CI 1.11–12.83). To conclude, patients receiving immunosuppressive drugs after solid organ transplantation have almost a 20-fold increased likelihood of developing carcinomas, with the highest likelihood for patients receiving cyclosporine A and azathioprine. Looking into altered immune pathways affected by immunosuppressive drugs might lead to better understanding of carcinogenesis in general.
Cerebral Cavernous Malformation 1 Determines YAP/TAZ Signaling-Dependent Metastatic Hallmarks of Prostate Cancer Cells
Authors: Park Sangryong , Lee Ho-Young , Kim Jayoung , Park Hansol , Ju Young Seok , Kim Eung-Gook , Kim Jaehong
Published: March 2021

Enhanced Yes-associated protein (YAP)/transcriptional co-activator with PDZ-binding motif (TAZ) signaling is correlated with the extraprostatic extension of prostate cancer. However, the mechanism by which YAP/TAZ signaling becomes hyperactive and drives prostate cancer progression is currently unclear. In this study, we revealed that higher expression of CCM1, which is uniquely found in advanced prostate cancer, is inversely correlated with metastasis-free and overall survival in patients with prostate cancer. We also demonstrated that CCM1 induces the metastasis of multiple types of prostate cancer cells by regulating YAP/TAZ signaling. Mechanistically, CCM1, a gene mutated in cerebral cavernous malformation, suppresses DDX5, which regulates the suppression of YAP/TAZ signaling, indicating that CCM1 and DDX5 are novel upstream regulators of YAP/TAZ signaling. Our findings highlight the importance of CCM1-DDX5-YAP/TAZ signaling in the metastasis of prostate cancer cells.
Transformed Canine and Murine Mesenchymal Stem Cells as a Model for Sarcoma with Complex Genomics
Authors: Franceschini Natasja , Verbruggen Bas , Tryfonidou Marianna A. , Kruisselbrink Alwine B. , Baelde Hans , de Visser Karin E. , Szuhai Karoly , Cleton-Jansen Anne-Marie , Bovée Judith V. M. G.
Published: March 2021

Sarcomas are rare mesenchymal tumors with a broad histological spectrum, but they can be divided into two groups based on molecular pathology: sarcomas with simple or complex genomics. Tumors with complex genomics can have aneuploidy and copy number gains and losses, which hampers the detection of early, initiating events in tumorigenesis. Often, no benign precursors are known, which is why good models are essential. The mesenchymal stem cell (MSC) is the presumed cell of origin of sarcoma. In this study, MSCs of murine and canine origin are used as a model to identify driver events for sarcomas with complex genomic alterations as they transform spontaneously after long-term culture. All transformed murine but not canine MSCs formed sarcomas after subcutaneous injection in mice. Using whole genome sequencing, spontaneously transformed murine and canine MSCs displayed a complex karyotype with aneuploidy, point mutations, structural variants, inter-chromosomal translocations, and copy number gains and losses. Cross-species analysis revealed that point mutations in Tp53/Trp53 are common in transformed murine and canine MSCs. Murine MSCs with a cre-recombinase induced deletion of exon 2–10 of Trp53 transformed earlier compared to wild-type murine MSCs, confirming the contribution of loss of p53 to spontaneous transformation. Our comparative approach using transformed murine and canine MSCs points to a crucial role for p53 loss in the formation of sarcomas with complex genomics.
Invasive Cuban Treefrogs (Osteopilus septentrionalis) Have More Robust Locomotor Performance Than Two Native Treefrogs (Hyla spp.) in Florida, USA, in Response to Temperature and Parasitic Infections
Authors: Roznik Elizabeth A. , Cano Natalia , Surbaugh Kerri L. , Ramsay Chloe T. , Rohr Jason R.
Published: March 2021

Introduced species pose a threat to biodiversity, and ecological and physiological factors are important in determining whether an introduced species becomes successfully established in a new region. Locomotor performance is one such factor that can influence the abundance and distribution of an introduced species. We investigated the effects of temperature and parasitism by the intestinal nematode Aplectana hamatospicula on the maximum jump distance and endurance in one invasive and two native treefrogs in Florida, USA. We collected frogs from the wild, estimated their parasite loads, and tested their locomotor performance at three temperatures. Contrary to expectations, invasive Cuban treefrogs (Osteopilus septentrionalis), which are adapted to a warmer climate in the Caribbean, outperformed pinewoods treefrogs (Hyla femoralis) and squirrel treefrogs (H. squirella) at each temperature, even when controlling for body size differences. In all three species, maximum jump distance was positively related to temperature, and this relationship was stronger for larger frogs. Parasites influenced both the maximum jump distance and endurance of frogs. In all three species, larger frogs jumped farther maximum distances than smaller frogs, but this relationship was stronger when frogs had lower, rather than higher, parasite loads. Parasitism had little effect on endurance in invasive frogs, but it tended to decrease the endurance of native frogs at high temperatures. Furthermore, at low temperatures, the lengths of consecutive jumps of infected native frogs tended to increase, suggesting that parasites limited the distances of initial jumps. Effects of temperature and parasites on the locomotor performance of frogs could influence their abilities to forage, escape predators, and disperse. The tremendous locomotor performance of O. septentrionalis, which is maintained across temperatures and parasite loads, likely contributes to the invasion success of this species.
Effects of Longer Droughts on Holm Oak Quercus ilex L. Acorn Pests: Consequences for Infestation Rates, Seed Biomass and Embryo Survival
Authors: Canelo Tara , Gaytán Álvaro , Pérez-Izquierdo Carlos , Bonal Raúl
Published: March 2021

The effects of climate change on oaks Quercus spp. constitute a main environmental concern for the conservation of temperate forests. In this context, we assessed the consequences of longer droughts on the interactions between the holm oak Quercus ilex L. and its main acorn pests. Infested acorns were prematurely abscised before reaching their potential size. The volume of the acorns attacked by Cydia fagiglandana (Lepidoptera) was smaller than those attacked by Curculio elephas (Coleoptera); however, their weight did not differ because Curculio larvae consumed more cotyledon. For the same reason, embryo survival likelihood was not lower in Cydia acorns despite their smaller size. Delays of late summer rain reduced infestation by Curculio, as soil hardness hampers adult emergence from their underground cells. By contrast, late and scarce precipitations benefited Cydia; rainfall might hamper adult flight and eggs/L1 larvae survival. There was not a “zero-sum” effect, because the decrease of Curculio infestation rates was not fully compensated by an increase of Cydia. Under the longer droughts projected for the Mediterranean Basin, our results predict lower infestation rates and higher acorn survival likelihood. However, further studies including other environmental factors are needed to better forecast the net consequences for holm oak fitness.
Risk Assessment of Endometrial Hyperplasia or Endometrial Cancer with Simplified Ultrasound-Based Scoring Systems
Authors: Stachowicz Norbert , Smoleń Agata , Ciebiera Michał , Łoziński Tomasz , Poziemski Paweł , Borowski Dariusz , Czekierdowski Artur
Published: March 2021

Background: Abnormal uterine bleeding (AUB) represents a common diagnostic challenge, as it might be related to both benign and malignant conditions. Endometrial cancer may not be detected with blind uterine cavity sampling by dilatation and curettage or suction devices. Several scoring systems using different ultrasound image characteristics were recently proposed to estimate the risk of endometrial cancer (EC) in women with AUB. Aim: The aim of the present study was to externally validate the predictive value of the recently proposed scoring systems including the Risk of Endometrial Cancer scoring model (REC) for EC risk stratification. Material and methods: It was a retrospective cohort study of women with postmenopausal bleeding. From June 2012 to June 2020 we studied a group of 394 women who underwent standard transvaginal ultrasound examination followed by power Doppler intrauterine vascularity assessment. Selected ultrasound features of endometrial lesions were assessed in each patient. Results: The median age was 60.3 years (range ± 10.7). The median body mass index (BMI) was 30.4 (range ± 6.0). Histological examination revealed 158 cases of endometrial hyperplasia (EH) and 236 cases of EC. Of the studied ultrasound endometrial features, the highest areas under the curve (AUCs) were found for endometrial thickness (ET) (AUC = 0.76; 95% CI: 0.71–0.81) and for interrupted endomyometrial junction (AUC = 0.70, 95% CI: 0.65–0.75). Selected scoring systems presented moderate to good predictive performance in differentiating EC and EH. The highest AUC was found for REC model (AUC = 0.75, 95% CI: 0.70–0.79) and for the basic model that included ET, Doppler score and interrupted endometrial junction (AUC = 0.77, 95% CI: 0.73–0.82). REC model was more accurate than other scoring systems and selected single features for differentiating benign hyperplasia from EC at early stages, regardless of menopausal status. Conclusions: New scoring systems, including the REC model may be used in women with AUB for more efficient differentiation between benign and malignant conditions.
Diversity and Communities of Fungal Endophytes from Four Pinus Species in Korea
Authors: Rim Soon Ok , Roy Mehwish , Jeon Junhyun , Montecillo Jake Adolf V. , Park Soo-Chul , Bae Hanhong
Published: March 2021

Fungal endophytes are ubiquitous in nature. They are known as potential sources of natural products, and possible agents for biocontrol attributing to their ability to produce a repertoire of bioactive compounds. In this study, we isolated fungal endophytes from three different tissues (needle, stem and root) of four Pinus species (Pinus densiflora, Pinus koraiensis, Pnus rigida, and Pinus thunbergii) across 18 sampling sites in Korea. A total number of 5872 culturable fungal endophytes were isolated using standard culturing techniques. Molecular identification based on the sequence analyses of the internal transcribed spacer (ITS) or 28S ribosomal DNA revealed a total of 234 different fungal species. The isolated fungal endophytes belonged to Ascomycota (91.06%), Basidiomycota (5.95%) and Mucoromycota (2.97%), with 144 operational taxonomic units (OTUs) and 88 different genera. In all sampling sites, the highest species richness (S) was observed in site 1T (51 OTUs) while the lowest was observed in site 4T (27 OTUs). In terms of diversity, as measured by Shannon diversity index (H’), the sampling site 2D (H′ = 3.216) showed the highest while the lowest H’ was observed in site 2K (H’ = 2.232). Species richness (S) in three different tissues revealed that root and needle tissues are highly colonized with fungal endophytes compared to stem tissue. No significant difference was observed in the diversity of endophytes in three different tissues. Among the four Pinus species, P. thunbergii exhibited the highest species richness and diversity of fungal endophytes. Our findings also revealed that the environmental factors have no significant impact in shaping the composition of the fungal endophytes. Furthermore, FUNGuild analysis revealed three major classifications of fungal endophytes based on trophic modes namely saprotrophs, symbiotrophs, and pathotrophs in four Pinus species, with high proportions of saprotrophs and pathothrops.
Pharmaceuticals Market, Consumption Trends and Disease Incidence Are Not Driving the Pharmaceutical Research on Water and Wastewater
Authors: González Peña Omar Israel , López Zavala Miguel Ángel , Cabral Ruelas Héctor
Published: March 2021

Pharmaceuticals enhance our quality of life; consequently, their consumption is growing as a result of the need to treat ageing-related and chronic diseases and changes in the clinical practice. The market revenues also show an historic growth worldwide motivated by the increase on the drug demand. However, this positivism on the market is fogged because the discharge of pharmaceuticals and their metabolites into the environment, including water, also increases due to their inappropriate management, treatment and disposal; now, worldwide, this fact is recognized as an environmental concern and human health risk. Intriguingly, researchers have studied the most effective methods for pharmaceutical removal in wastewater; however, the types of pharmaceuticals investigated in most of these studies do not reflect the most produced and consumed pharmaceuticals on the market. Hence, an attempt was done to analyze the pharmaceutical market, drugs consumption trends and the pharmaceutical research interests worldwide. Notwithstanding, the intensive research work done in different pharmaceutical research fronts such as disposal and fate, environmental impacts and concerns, human health risks, removal, degradation and development of treatment technologies, found that such research is not totally aligned with the market trends and consumption patterns. There are other drivers and interests that promote the pharmaceutical research. Thus, this review is an important contribution to those that are interested not only on the pharmaceutical market and drugs consumption, but also on the links, the drivers and interests that motivate and determine the research work on certain groups of pharmaceuticals on water and wastewater.
The Effect of a Voice-Centered Psycho-Educational Program on Maternal Self-Efficacy: A Feasibility Study
Authors: Shoemark Helen , Dahlstrøm Marie , Bedford Oscar , Stewart Lauren
Published: March 2021

This study examined the effect of a brief psycho-educational program, Time Together, on maternal self-efficacy, mother-infant bonding, and mood/anxiety for community-based mothers. This program centered on maternal voice, timing of interplay, and recognition of infant cues. A convergent parallel mixed-methods design included quantitative measures: the Karitane Parenting Confidence Scale, the Mother-Infant Bonding Scale, Edinburgh Postnatal Depression Scale and State & Trait Anxiety Inventory, and a sequential qualitative analysis to elaborate on the quantitative findings. Significant changes on the Karitane Parenting Confidence Scale were found. Qualitative analysis of the participant interviews and reflective diaries from the two weeks following the psycho-educational program confirmed that participation enhanced mothers’ ability to understand their infant, to soothe their infant when distressed, to play and to establish an effective bedtime routine. This feasibility study indicated that this is a promising approach to improve early mother-infant interaction and maternal self-efficacy.
University Students’ Self-Rated Health in Relation to Perceived Acoustic Environment during the COVID-19 Home Quarantine
Authors: Dzhambov Angel M. , Lercher Peter , Stoyanov Drozdstoy , Petrova Nadezhda , Novakov Stoyan , Dimitrova Donka D.
Published: March 2021

Background: Online education became mandatory for many students during the Coronavirus disease 2019 (COVID-19) pandemic and blurred the distinction between settings where processes of stress and restoration used to take place. The lockdown also likely changed perceptions of the indoor acoustic environment (i.e., soundscape) and raised its importance. In the present study, we seek to understand how indoor soundscape related to university students’ self-rated health in Bulgaria around the time that the country was under a state of emergency declaration caused by the COVID-19 pandemic. Methods: Between 17 May and 10 June 2020, we conducted a cross-sectional online survey among 323 students (median age 21 years; 31% male) from two universities in the city of Plovdiv, Bulgaria. Self-rated health (SRH) was measured with a single-item. Participants were asked how frequently they heard different types of sounds while at home and how pleasant they considered each of those sounds to be. Restorative quality of the home (the “being away” dimension of the Perceived Restorativeness Scale) was measured with a single-item. A priori confounders and effect modifiers included sociodemographics, house-related characteristics, general sensitivity to environmental influences, and mental health. Our analysis strategy involved sequential exploratory factor analysis (EFA), multivariate linear and ordinal regressions, effect modification tests, and structural equation modeling (SEM). Results: EFA supported grouping perceived sounds into three distinct factors—mechanical, human, and nature sounds. Regression analyses revealed that greater exposure to mechanical sounds was consistently associated with worse SRH, whereas no significant associations were found for human and nature sounds. In SEM, exposure to mechanical sounds related to lower restorative quality of the home, and then to poorer SRH, whereas nature sounds correlated with higher restorative quality, and in turn with better SRH. Conclusions: These findings suggest a role of positive indoor soundscape and restorative quality for promoting self-rated health in times of social distancing.
Concerns or Desires Post-Pandemic: An Extended MGB Model for Understanding South Korean Residents’ Perceptions and Intentions to Travel to China
Authors: Qiao Guanghui , Zhao Xiao-li , Xin Luqi , Kim Seokchool
Published: March 2021

In this study, we examined South Korean residents’ travel-related behavioural intention for mainland China post-COVID-19 using an extended model of goal-directed behaviour. To do so, we integrated South Korean residents’ perceptions of country image (PCI), mass media, and concerns about travel into the framework of the original model of goal-directed behaviour (MGB). Structural equation modelling was used to identify the structural relationships among the latent variables. The results show that mass media had a positive influence on South Korean residents’ perception of China’s image, a negative influence on residents’ concerns, and a positive influence on residents’ behavioural intentions for travel overseas. Meanwhile, PCI had a positive influence on residents’ attitude towards travel overseas. The theoretical and practical implications of the study are discussed.
The Teaching Digital Competence of Health Sciences Teachers. A Study at Andalusian Universities (Spain)
Authors: Cabero-Almenara Julio , Barroso-Osuna Julio , Gutiérrez-Castillo Juan-Jesús , Palacios-Rodríguez Antonio
Published: March 2021

The impact and benefit that information and communication technologies (ICT) have in the educational field require new teaching skills. This fact has been increased by the recent crisis caused by COVID-19. This study tries to investigate the level of digital teaching competence (DTC) of Higher Education teachers of Health Sciences, and its relationship with several variables. For this, it has the participation of 300 teachers from the 9 universities of Andalusia (Spain). The research is structured through a descriptive (RQ1) and inferential (RQ2) design. The answers given to the DigCompEdu Check-In questionnaire adapted to the Spanish context are analyzed. The results, which show high levels of reliability of the questionnaire (Cronbach and McDonald) and validity (CFA), indicate that the level of competence is basic-intermediate. In addition, the area in which teachers excel is digital resources. For this reason, it is proposed to structure personalized training plans and continue expanding the characteristics of this study at an international level.
Economic Feasibility of Floating Offshore Wind Farms Considering Near Future Wind Resources: Case Study of Iberian Coast and Bay of Biscay
Authors: Castro-Santos Laura , deCastro Maite , Costoya Xurxo , Filgueira-Vizoso Almudena , Lamas-Galdo Isabel , Ribeiro Americo , Dias João M. , Gómez-Gesteira Moncho
Published: March 2021

Wind energy resources are subject to changes in climate, so the use of wind energy density projections in the near future is essential to determine the viability and profitability of wind farms at particular locations. Thus, a step forward in determining the economic assessment of floating offshore wind farms was taken by considering current and near-future wind energy resources in assessing the main parameters that determine the economic viability (net present value, internal rate of return, and levelized cost of energy) of wind farms. This study was carried out along the Atlantic coast from Brest to Cape St. Vincent. Results show that the future reduction in wind energy density (2%–6%) mainly affects the net present value (NPV) of the farm and has little influence on the levelized cost of energy (LCOE). This study provides a good estimate of the economic viability of OWFs (Offshore Wind Farms) by taking into account how wind resources can vary due to climate change over the lifetime of the farm.
A New Perspective for Improving the Human Resource Development of Primary Medical and Health Care Institutions: A Structural Equation Model Study
Authors: Jia Huanhuan , Cao Peng , Yu Jianxing , Zhang Jingru , Jiang Hairui , Zhao Qize , Yu Xihe
Published: March 2021

In some countries, including China, primary health care is rarely utilized because of medical personnel shortages at primary medical and health care institutions (PMHCIs). Several studies suggest that the most effective solution is to guide qualified doctors and medical graduates to work in PMHCIs, but the studies and measures have been formulated only from the perspective of the government and PMHCIs; few have considered the subjective willingness of medical personnel. Therefore, it is necessary to explore the measures to develop human resources of PMHCIs from the guiding object. This research was divided into two parts based on implicit theory and a lexical approach. The first part collected the factors affecting their choosing PMHCIs for employment, and the second part used exploratory factor analysis (EFA), confirmatory factor analysis (CFA), and structural equation modeling (SEM) to explore the dimensions and paths of the influencing factors. At last, seven factors were obtained from the EFA, and the SEM hypothesis fit the data well. Internal Organization Development, Patient Factor, Remuneration and Development, and Family Support had a significantly positive effect on the Sense of Gain of medical personnel seeking employment at PMHCIs, whereas both Job Responsibilities and Condition of the City Where the PMHCI Is Located had no significant effect. In addition, the indirect effects of Internal Organization Development and Condition of the City Where the PMHCI Is Located on the Sense of Gain were significant. The Patient Factor, Family Support, and Remuneration and Development significantly mediated the relationship between the internal and external environment of the institution and the Sense of Gain, whereas the mediating effect of Job Responsibilities was not significant. The improvement of family support, remuneration and development, and patient factors increase the willingness of medical personnel to seek employment at PMHCIs. In addition, the internal and external environments of a PMHCI play a vital role in guiding medical personnel to PMHCIs for employment. This research provides theoretical support for improving the development of human resources, guiding medical personnel to work in PMHCIs, and promoting the use of primary care services.
Nurses’ Experiences in Managing Cardiovascular Disease in Selected Rural and Peri-Urban Clinics in Limpopo Province, South Africa
Authors: Kgatla Mamoeng Nancy , Mothiba Tebogo M. , Sodi Tholene , Makgahlela Mpsanyana
Published: March 2021

Deaths caused by cardiovascular diseases (CVDs) account for 60% of all deaths that occur in rural and remote areas. Disease management programs are increasingly used to improve the effectiveness of chronic care. Nurses are a key component of the health workforce and have an important role to play in CVD prevention, treatment, and the care of sick people in remote areas. Due to the nature of their work, nurses are prone to working hard, and to experience burnout, sleep, or eating disorders. This is often exacerbated by a shortage of staff and equipment. The objectives of the study were to explore and describe the experiences of professional nurses in managing CVDs in South African rural and peri-urban clinics. A qualitative, explorative-descriptive design and a contextual research approach were adopted for the present study. Purposive sampling was employed to recruit nurses who were managing patients with CVD from 11 primary health care facilities. Data were collected through semi-structured individual interviews and analyzed using Tesch’s open coding method. Interview transcripts were coded and analyzed for common themes. The following two major themes emerged from the data: perceived institutional challenges affecting the management of CVDs and nurses’ perceptions of patient challenges that impede the effective management of CVD. The study concludes by highlighting that apart from a resource challenge, the shortage of nurses in rural clinics is the biggest reason behind overcrowding, waiting long hours for consultations, and an increase in the workload, resulting in medical errors and poor quality care. It is, therefore, recommended that, for improved care and management of CVD in rural populations, local governments need to employ more skilled nurses whilst availing the necessary material resources.
Organically Linking Green Development and Ecological Environment Protection in Poyang Lake, China Using a Social-Ecological System (SES) Framework
Authors: Feng Ji , Zhao Zheng , Wen Yali , Hou Yilei
Published: March 2021

Wetlands are unique ecosystems formed by the interaction between land and water on Earth. Poyang Lake, which is a part of China’s largest freshwater lake wetland, is well known for its ecological and economic importance. This study uses a social-ecological system (SES) framework that integrates watershed and human activities; we used action scenarios to analyse the influencing factors, solutions, and feedback mechanisms involved in the SES framework. We chose Nanchang, Jiujiang, and Shangrao in the Poyang Lake wetlands of the Jiangxi province as the study areas to provide a problem-oriented analytical strategy for the organic interface between ecological conservation and green development. The key issues indicate that the Poyang Lake region faces multiple problems, such as ecosystem structural changes and environmental pollution, caused by anthropological activities, inefficient implementation of conservation policies, and insufficient funding for pollution prevention and control. Our findings provide a systematic solution for major conservation and development issues in the Poyang Lake region and are adapted to the characteristics of the lake. We also provide a theoretical reference and direction for the implementation of green development and modernisation of ecological governance in the Great Lakes basin in China.
Altitude and SARS-CoV-2 Infection in the First Pandemic Wave in Spain
Authors: Castilla Jesús , Fresán Ujué , Trobajo-Sanmartín Camino , Guevara Marcela
Published: March 2021

After the first pandemic wave, a nationwide survey assessed the seroprevalence of SARS-CoV-2 antibodies in Spain and found notable differences among provinces whose causes remained unclear. This ecological study aimed to analyze the association between environmental and demographic factors and SARS-CoV-2 infection by province. The seroprevalence of SARS-CoV-2 antibodies by province was obtained from a nationwide representative survey performed in June 2020, after the first pandemic wave in Spain. Linear regression was used in the analysis. The seroprevalence of SARS-CoV-2 antibodies of the 50 provinces ranged from 0.2% to 13.6%. The altitude, which ranged from 5 to 1131 m, explained nearly half of differences in seroprevalence (R2 = 0.47, p < 0.001). The seroprevalence in people residing in provinces above the median altitude (215 m) was three-fold higher (6.5% vs. 2.1%, p < 0.001). In the multivariate linear regression, the addition of population density significantly improved the predictive value of the altitude (R2 = 0.55, p < 0.001). Every 100 m of altitude increase and 100 inhabitants/km2 of increase in population density, the seroprevalence rose 0.84 and 0.63 percentage points, respectively. Environmental conditions related to higher altitude in winter–spring, such as lower temperatures and absolute humidity, may be relevant to SARS-CoV-2 transmission. Places with such adverse conditions may require additional efforts for pandemic control.
Characterization of the Skin Cultivable Microbiota Composition of the Frog Pelophylax perezi Inhabiting Different Environments
Authors: Proença Diogo Neves , Fasola Emanuele , Lopes Isabel , Morais Paula V.
Published: March 2021

Microorganisms that live in association with amphibian skin can play important roles in protecting their host. Within the scenarios of global change, it is important to understand how environmental disturbances, namely, metal pollution, can affect this microbiota. The aim of this study is to recognize core bacteria in the skin cultivable microbiota of the Perez frog (Pelophylax perezi) that are preserved regardless of the environmental conditions in which the frogs live. The characterization of these isolates revealed characteristics that can support their contributions to the ability of frogs to use metal impacted environments. Frog’s skin swabs were collected from P. perezi populations that inhabit a metal-polluted site and three reference (non-metal polluted) sites. Bacterial strains were isolated, identified, and subjected to an acid mine drainage tolerance (AMD) test, collected upstream from a site heavily contaminated with metals, and tested to produce extracellular polymeric substances (exopolysaccharide, EPS). All frog populations had Acinetobacter in their cutaneous cultivable microbiota. Significant growth inhibition was observed in all bacterial isolates exposed to 75% of AMD. EPS production was considered a characteristic of several isolates. The data obtained is a preliminary step but crucial to sustain that the cultivable microbiota is a mechanism for protecting frogs against environmental contamination.
Kinematic Analysis of Water Polo Player in the Vertical Thrust Performance to Determine the Force-Velocity and Power-Velocity Relationships in Water: A Preliminary Study
Authors: Annino Giuseppe , Romagnoli Cristian , Zanela Andrea , Melchiorri Giovanni , Viero Valerio , Padua Elvira , Bonaiuto Vincenzo
Published: March 2021

Background: To date, studies on muscle force and power-velocity (F-v and P-v) relationships performed in water are absent. Aim: The goal of this study is to derive the F-v and P-v regression models of water polo players in water vertical thrust performance at increasing load. Methods: After use of a control object for direct linear transformation, displacement over the water and elapsed time was measured, by using a high-speed 2D-videoanalysis system, on 14 players involved in the study. Results: Intra-operator and player’s performance interclass correlation coefficient (ICC) reliability showed an excellent level of reproducibility for all kinematic and dynamic measurements considered in this study with a coefficient of variation (CV) of less than 4.5%. Results of this study have shown that an exponential force-velocity relationship seems to explain better the propulsive force exerted in the water in lifting increasing loads compared to the linear one, while the power and velocity have been shown to follow a second-order polynomial regression model. Conclusion: Given the accuracy of the video analysis, the high reliability and the specificity of the results, it is pointed out that video analysis can be a valid method to determine force-velocity and power-velocity curves in a specific environment to evaluate the neuromuscular profile of each water polo player.
An Eventual Sars-CoV-2 Infection Prevention Protocol in the Medical Setting and Dental Office
Authors: Fiorillo Luca , Meto Aida , Cicciù Francesca , De Stefano Rosa
Published: March 2021

The current Coronavirus disease 2019 (COVID-19) pandemic has affected the entire world population, and in particular the medical-health field, especially dentistry [...]
The Effects of Childhood Maltreatment on Non-Suicidal Self-Injury in Male Adolescents: The Moderating Roles of the Monoamine Oxidase A (MAOA) Gene and the Catechol-O-Methyltransferase (COMT) Gene
Authors: Gao Yemiao , Xiong Yuke , Liu Xia , Wang Hui
Published: March 2021

(1) Background: Numerous studies suggest strong associations between childhood maltreatment and nonsuicidal self-injury (NSSI); this is also true for the roles of dopaminergic genes in the etiology of some psychopathologies related to NSSI. Investigating the interactions of environments and genes is important in order to better understand the etiology of NSSI. (2) Methods: Within a sample of 269 Chinese male adolescents (Mage = 14.72, SD = 0.92), childhood maltreatment and NSSI were evaluated, and saliva samples were collected for MAOA T941G and COMT Val158Met polymorphism analyses. (3) Results: The results revealed no primary effects attributable to MAOA T941G and COMT Val158Met polymorphism on NSSI. However, there was a significant three-way interaction between MAOA, COMT, and child abuse (β = −0.34, p < 0.01) in adolescent NSSI. Except for carriers of the T allele of MAOA and the Met allele of COMT, all studied male adolescents displayed higher NSSI scores when exposed to a higher level of child abuse. A similar three-way interaction was not observed in the case of child neglect. (4) Conclusions: The results indicate that the MAOA gene and COMT gene play moderating roles in the association between child abuse and NSSI of male adolescents and suggest the polygenic underpinnings of NSSI.
Improving Our Understanding and Practice of Antibiotic Prescribing: A Study on the Use of Social Norms Feedback Letters in Primary Care
Authors: Steels Stephanie , Gold Natalie , Palin Victoria , Chadborn Tim , van Staa Tjeerd Pieter
Published: March 2021

In the UK, 81% of all antibiotics are prescribed in primary care. Previous research has shown that a letter from the Chief Medical Officer (CMO) giving social norms feedback to General Practitioners (GPs) whose practices are high prescribers of antibiotics can decrease antibiotic prescribing. The aim of this study was to understand the best way for engaging with GPs to deliver feedback on prescribing behaviour that could be replicated at scale; and explore GP information requirements that would be needed to support prescribing behaviour change. Two workshops were devised utilising a participatory approach. Discussion points were noted and agreed with each group of participants. Minutes of the workshops and observation notes were taken. Data were analysed thematically. Four key themes emerged through the data analysis: (1) Our day-to-day reality, (2) GPs are competitive, (3) Face-to-face support, and (4) Empowerment and engagement. Our findings suggest there is potential for using behavioural science in the form of social norms as part of a range of engagement strategies in reducing antibiotic prescribing within primary care. This should include tailored and localised data with peer-to-peer comparisons.
Exposure to Occupational Hazards among Health Care Workers in Low- and Middle-Income Countries: A Scoping Review
Authors: Rai Rajni , El-Zaemey Sonia , Dorji Nidup , Rai Bir Doj , Fritschi Lin
Published: March 2021

Health care workers are exposed to numerous workplace hazards. The implementation of safety measures in high-income countries has largely mitigated these risks. However, in many low- and middle- income countries (LMICs), resources to institute safety measures are lacking, increasing the risk of occupational exposures to these hazards. The aim of this scoping review is to map and synthesize the available research on occupational hazards among health care workers in LMICs, identify research gaps and inform policy. Searches for relevant articles were conducted in five electronic databases using a broad range of search terms. The inclusion criteria were: quantitative observational or experimental studies which examined exposure to one or more occupational hazards among health care workers in a LMCI; and the article was published in English in a peer-reviewed journal. A total of 99 studies met the inclusion criteria, and data were extracted from these studies. Large proportions of health care workers in LMICs were exposed to biological hazards (bloodborne pathogens, tuberculosis), psychosocial hazards (workplace violence, burnout, job dissatisfaction), ergonomic hazards (musculoskeletal complaints), and chemical hazards (exposure to latex and antineoplastic drugs). The implementation of risk reduction strategies was suboptimal. The majority of the literature was on biological hazards (48%), and research on other hazards was limited in comparison. Occupational safety needs to become a priority public health issue to protect health care workers in LMICs. More research is needed to understand the magnitude of the problem in these countries.
Influence of Teacher and Family Support on University Student Motivation and Engagement
Authors: Descals-Tomás Adela , Rocabert-Beut Esperanza , Abellán-Roselló Laura , Gómez-Artiga Amparo , Doménech-Betoret Fernando
Published: March 2021

Although many studies endorse the notion that the way students perceive support influences their engagement, very few have explored the possible mediator role of intention to learn between these variables. The present work provides new evidence to the existing literature because it analyses the work of intention to learn (measured with expectancy–value beliefs and achievement goals) as a mediating motivational variable in the relation between university students’ external support (teacher and family) and their engagement. The Educational Situation Quality Model (MOCSE, its acronym in Spanish) has employed as a theoretical framework to perform this analysis. A sample of 267 Spanish university students completed the questionnaires employed to measure the considered variables at three times. They answered teacher and family support scales when the course began (time 1), intention to learn scales halfway through the course (time 2), and engagement scales when the course ended (time 3). The obtained structural equation models showed a positive and significant effect for teacher and family support on the considered motivational variables (expectancy–value beliefs and achievement goals) and these, in turn, on student behavioral engagement. These results allow us to point out a series of recommendations for university teachers to improve their students’ involvement in their learning process.
Correction: Wachs, S., et al. Associations between Witnessing and Perpetrating Online Hate in Eight Countries: The Buffering Effects of Problem-Focused Coping. Int. J. Environ. Res. Public Health 2019, 16, 3992
Authors: Wachs Sebastian , Wright Michelle F. , Sittichai Ruthaychonnee , Singh Ritu , Biswal Ramakrishna , Kim Eun-mee , Yang Soeun , Gámez-Guadix Manuel , Almendros Carmen , Flora Katerina , Daskalou Vassiliki , Maziridou Evdoxia
Published: March 2021

The authors wish to add the following corrections to their paper published in the International Journal of Environmental Research and Public Health [...]
Hazardous Heavy Metals Accumulation and Health Risk Assessment of Different Vegetable Species in Contaminated Soils from a Typical Mining City, Central China
Authors: Wang Zhen , Bao Jianguo , Wang Tong , Moryani Haseeb Tufail , Kang Wei , Zheng Jin , Zhan Changlin , Xiao Wensheng
Published: March 2021

Heavy metal poisoning has caused serious and widespread human tragedies via the food chain. To alleviate heavy metal pollution, particular attention should be paid to low accumulating vegetables and crops. In this study, the concentrations of five hazardous heavy metals (HMs), including copper (Cu), chromium (Cr), lead (Pb), cadmium (Cd), and arsenic (As) were determined from soils, vegetables, and crops near four typical mining and smelting zones. Nemerow’s synthetical pollution index (Pn), Potential ecological risk index (RI), and Geo-accumulation index (Igeo) were used to characterize the pollution degrees. The results showed that soils near mining and metal smelting zones were heavily polluted by Cu, Cd, As, and Pb. The total excessive rate followed a decreasing order of Cd (80.00%) > Cu (61.11%) > As (45.56%) > Pb (32.22%) > Cr (0.00%). Moreover, sources identification indicated that Cu, Pb, Cd, and As may originate from anthropogenic activities, while Cr may originate from parent materials. The exceeding rates of Cu, Cr, Pb, Cd, and As were 6.7%, 6.7%, 66.7%, 80.0%, and 26.7% among the vegetable and crop species, respectively. Particularly, vegetables like tomatoes, bell peppers, white radishes, and asparagus, revealed low accumulation characteristics. In addition, the hazard index (HI) for vegetables and crops of four zones was greater than 1, revealing a higher risk to the health of local children near the mine and smelter. However, the solanaceous fruit has a low-risk index (HI), indicating that it is a potentially safe vegetable type.
Defining Post-COVID Symptoms (Post-Acute COVID, Long COVID, Persistent Post-COVID): An Integrative Classification
Authors: Fernández-de-las-Peñas César , Palacios-Ceña Domingo , Gómez-Mayordomo Víctor , Cuadrado María L. , Florencio Lidiane L.
Published: March 2021

The pandemic of the coronavirus disease 2019 (COVID-19) has provoked a second pandemic, the “long-haulers”, i.e., individuals presenting with post-COVID symptoms. We propose that to determine the presence of post-COVID symptoms, symptoms should appear after the diagnosis of SARS-CoV-2 infection; however, this situation has some problems due to the fact that not all people infected by SARS-CoV-2 receive such diagnosis. Based on relapsing/remitting nature of post-COVID symptoms, the following integrative classification is proposed: potentially infection related-symptoms (up to 4–5 weeks), acute post-COVID symptoms (from week 5 to week 12), long post-COVID symptoms (from week 12 to week 24), and persistent post-COVID symptoms (lasting more than 24 weeks). The most important topic is to establish the time reference points. The classification also integrates predisposing intrinsic and extrinsic factors and hospitalization data which could promote post-COVID symptoms. The plethora of symptoms affecting multiple systems exhibited by “long-haulers” suggests the presence of different underlying mechanisms.
Health Promoting Schools in Germany. Mapping the Implementation of Holistic Strategies to Tackle NCDs and Promote Health
Authors: Dadaczynski Kevin , Hering Thomas
Published: March 2021

Noncommunicable diseases (NCDs) and their underlying risk factors are seen as major public health problems that threaten health and welfare systems worldwide. The holistic and resource oriented Health Promoting School (HPS) approach can serve as an appropriate framework for the prevention and control of NCDs. The paper aimed to map the implementation of HPS activities in German schools and to examine associations with potential influencing factors. A series of cross-sectional online studies including five federal states and 5006 school principals (40.2% males, 50.8% females) from primary and secondary public schools was conducted from 2013 to 2018. Principal component analysis (PCA) resulted in two factors of HPS implementation (F1: concrete HPS action, F2: capacity building for HPS). Comparing both factors, a lower implementation level could be identified for HPS capacity building with lowest mean values found for regular teacher training and intersectoral collaboration. Multiple binary regression analyses revealed significant associations between low HPS implementation and male gender (OR: 1.36 to 1.42), younger age (OR: 1.47 to 1.90), secondary school (OR: 1.78 to 3.13) and federal state (Lower Saxony = OR: 1.27 to 1.45; Schleswig-Holstein = OR: 1.95 to 2.46). Moreover, low access to resources, decision-latitude and perceived educational benefits were independently associated with both factors of HPS implementation. Based on the results of this study, there is a need to support schools in their capacity building for health (e.g., regular teacher training, cooperation with local health services). Moreover, considering the core mission of schools, more evidence of the educational impact of health promotion and its translation into the language of education is needed for secondary schools in particular.
Factors Associated with Health-Related Quality of Life among Government Employees in Putrajaya, Malaysia
Authors: Ashri Muhamad Hasrol Mohd , Saad Hazizi Abu , Adznam Siti Nur’Asyura
Published: March 2021

The current rapid growth of the economy has necessitated an assessment of health-related quality of life (HRQOL) and its associated factors among employees. Unfortunately, there are still limited data available in this area among the Malaysian working population in government sectors. The aim of this study was to evaluate the factors associated with HRQOL among government employees in Putrajaya, Malaysia. This cross-sectional study recruited 460 eligible government employees who worked in the area of Putrajaya through simple random sampling. The self-administered questionnaire was distributed to these participants to collect information on the SF-36 profile of scores, sociodemographic factors, lifestyle factors, and medical history. The results of this study signify that most of the participants were identified as having good HRQOL with the mean score of overall HRQOL was 72.42 ± 14.99. Multivariate analysis showed that being younger, receiving a better monthly personal income, a smaller household number, performing more physical activity, not having any chronic disease, and not using any long-term medication were significantly positively associated with overall HRQOL. The participants who did not have a family history of chronic disease were reported to be significantly associated with better mental component summary (MCS). Further, males were significantly positively associated with bodily pain (BP) and general health (GH) only, whereas better occupational status was limited to social functioning (SF). In conclusion, the results of this study provide motivation for future research and initiatives for improving the physical, emotional, and social well-being of government employees.