bluuebunny/crossref_metadata_2025 huggingface dataset:
GFPLAIN and Multi-Source Data Assimilation Modeling: Conceptualization of a Flood Forecasting Framework Supported by Hydrogeomorphic Floodplain Rapid Mapping
Authors: Annis Antonio , Nardi Fernando
Published: September 2021

Hydrologic/hydraulic models for flood risk assessment, forecasting and hindcasting have been greatly supported by the rising availability of increasingly accurate and high-resolution Earth Observation (EO) data. EO-based topographic and hydrologic open geo data are, nowadays, available on large scales. Data Assimilation (DA) models allow Early Warning Systems (EWS) to produce accurate and timely flood predictions. DA-based EWS generally use river flow real-time observations and 1D hydraulic models to identify potential inundation hot spots. Detailed high-resolution 2D hydraulic modeling is usually not used in EWS for the computational burden and the numerical complexity of injecting multiple spatially distributed sources of flow observations. In recent times, DEM-based hydrogeomorphic models demonstrated their ability in characterizing river basin hydrologic forcing and floodplain domains providing data-parsimonious opportunities for data-scarce regions. This work investigates the use of hydrogeomorphic floodplain terrain processing for optimizing the ability of DA-based EWSs in using diverse distributed flow observations. A flood forecasting framework with novel applications of hydrogeomorphic floodplain processing is conceptualized for empowering flood EWSs in preliminarily identifying the computational domain for hydraulic modeling, rapid flood detection using satellite images, and filtering geotagged crowdsourced data for flood monitoring. The proposed flood forecasting framework supports the development of an integrated geomorphic-hydrologic/hydraulic modeling chain for a DA that values multiple sources of observation. This work investigates the value of floodplain hydrogeomorphic models to tackle the major challenges of DA for EWS with specific regard to the computational efficiency issues and the lack of data in ungauged river basins towards an improved flood forecasting able to use advanced hydrodynamic modeling and to inject all available sources of observations including flood phenomena captures by citizens.
Relationships between Objectively Measured Sedentary Behavior during Pregnancy and Infant Birthweight
Authors: Benabid Abdelmoumene , Deslauriers Lara , Sinclair Isabelle , St-Pierre Myriane , Vaillancourt Cathy , Gagnon Sonia , Dancause Kelsey N.
Published: September 2021

Background: Although numerous studies have assessed physical activity during pregnancy and relationships with infant outcomes, such as birthweight, few have evaluated sedentary behavior. Our objective was to evaluate sedentary behavior across pregnancy and relationships with infant birthweight in a sociodemographically diverse sample. Methods: We measured device-assessed sedentary behavior and physical activity over three days at 16–18, 24–26, and 32–34 weeks gestation and infant birthweight from medical records among 71 participants. We used linear regression to assess relationships between sedentary behavior at each evaluation period with birthweight-for-gestational age Z-scores (BW-for-GA). Results: There were no linear relationships between sedentary behavior and BW-for-GA at any evaluation period. We observed a modest curvilinear relationship between sedentary behavior at 16–18 weeks and BW-for-GA (R2 = 0.073, p = 0.021). Low and high levels of sedentary behavior predicted lower BW-for-GA. Multivariate models suggested that this relationship was independent of physical activity levels. Conclusions: Considering the high levels of sedentary behavior during pregnancy observed in many studies, even modest associations with birthweight merit further consideration. Relationships might not be evident later in pregnancy or if only linear relationships are considered. More detailed studies could help guide recommendations on sedentary behavior during pregnancy and the development of more comprehensive interventions.
Using Systems Dynamics for Capturing the Multicausality of Factors Affecting Health System Capacity in Latin America while Responding to the COVID-19 Pandemic
Authors: Cordova-Pozo Kathya Lorena , Korzilius Hubert P. L. M. , Rouwette Etiënne A. J. A. , Píriz Gabriela , Herrera-Gutierrez Rolando , Cordova-Pozo Graciela , Orozco Miguel
Published: September 2021

Similar interventions to stop the spread of COVID-19 led to different outcomes in Latin American countries. This study aimed to capture the multicausality of factors affecting HS-capacity that could help plan a more effective response, considering health as well as social aspects. A facilitated GMB was constructed by experts and validated with a survey from a wider population. Statistical analyses estimated the impact of the main factors to the HS-capacity and revealed the differences in its mechanisms. The results show a similar four-factor structure in all countries that includes public administration, preparedness, information, and collective self-efficacy. The factors are correlated and have mediating effects with HS-capacity; this is the base for differences among countries. HS-capacity has a strong relation with public administration in Bolivia, while in Nicaragua and Uruguay it is related through preparedness. Nicaragua lacks information as a mediation effect with HS-capacity whereas Bolivia and Uruguay have, respectively, small and large mediation effects with it. These outcomes increase the understanding of the pandemic based on country-specific context and can aid policymaking in low-and middle-income countries by including these factors in future pandemic response models.
Inpatient Palliative Care Is Less Utilized in Rare, Fatal Extrahepatic Cholangiocarcinoma: A Ten-Year National Perspective
Authors: Mojtahedi Zahra , Yoo Ji Won , Callahan Karen , Bhandari Neeraj , Lou Donghui , Ghodsi Katayoon , Shen Jay J.
Published: September 2021

Background—Extrahepatic cholangiocarcinoma (ECC) is a rare, morbid, fatal cancer with distressing symptoms. Maintaining a high quality of life while reducing hospital charges and length of stay (LOS) for the end-of-life period remains a major challenge for the healthcare system. Palliative care utilization has been shown to address these challenges; moreover, its use has increased in recent years among cancer patients. However, the utilization of palliative care in rare cancers, such as ECC, has not yet been explored. Objectives—To investigate palliative care utilization among ECC patients admitted to US hospitals between 2007 and 2016 and its association with patient demographics, clinical characteristics, hospital charges, and LOS. Methods—De-identified patient data of each hospitalization were retrieved from the National Inpatient Sample (NIS) database. Codes V66.7 (ICD-9-CM) or Z51.5 (ICD-10-CM) were used to find palliative care utilization. Multivariate adjusted logistic regression analyses were conducted to assess factors associated with palliative care use, LOS, hospital charges, and in-hospital death. Results—Of 4426 hospitalizations, only 6.7% received palliative care services. Palliative care utilization did not significantly increase over time (p = 0.06); it reduced hospital charges by USD 25,937 (p < 0.0001) and LOS by 1.3 days (p = 0.0004) per hospitalization. Palliative care was positively associated with female gender, severe disease, and age group ≥80 (p ≤ 0.05). The average LOS was 8.5 days for each admission. Conclusions—Hospital admissions with palliative care utilization had lower hospital charges and LOS in ECC. However, ECC patients received less palliative care compared with more common cancers sharing similar symptoms (e.g., pancreatic cancer). ECC patients also had longer LOS compared with the national average. Further research is warranted to develop interventions to increase palliative care utilization among ECC hospital patients.
Assessing Performance of the Veterans Affairs Women Cardiovascular Risk Model in Predicting a Short-Term Risk of Cardiovascular Disease Incidence Using United States Veterans Affairs COVID-19 Shared Data
Authors: Jeon-Slaughter Haekyung , Chen Xiaofei , Ramanan Bala , Tsai Shirling
Published: September 2021

The current study assessed performance of the new Veterans Affairs (VA) women cardiovascular disease (CVD) risk score in predicting women veterans’ 60-day CVD event risk using VA COVID-19 shared cohort data. The study data included 17,264 women veterans—9658 White, 6088 African American, and 1518 Hispanic women veterans—ever treated at US VA hospitals and clinics between 24 February and 25 November 2020. The VA women CVD risk score discriminated patients with CVD events at 60 days from those without CVD events with accuracy (area under the curve) of 78%, 50%, and 83% for White, African American, and Hispanic women veterans, respectively. The VA women CVD risk score itself showed good accuracy in predicting CVD events at 60 days for White and Hispanic women veterans, while it performed poorly for African American women veterans. The future studies are needed to identify non-traditional factors and biomarkers associated with increased CVD risk specific to African American women and incorporate them to the CVD risk assessment.
When Movement Moves: Study Protocol for a Multi-Method Pre/Post Evaluation Study of Two Programmes; the Danish Team Twin and Cycling Without Age
Authors: Jørgensen Andreas , Petersen Christina Bjørk , Eghøj Martin , Toftager Mette
Published: September 2021

Physical activity (PA) can improve physical, mental, and social health, leading to quality of life (QoL). However, some are unable to participate independently due to age-related impairments or disabilities. This study protocol presents the design, methods, outcomes, strengths and limitations of the study “When Movement Moves” (WMM). WMM investigates whether indirect PA in a social context, where persons are unable to participate independently, can result in outcomes similar to those of independent PA, by evaluating the effects of disabled’s, elderly, volunteers’, relatives’ and nursing staff’s participation in either the running programme (Team Twin) or cycling programme (Cycling Without Age). Both programmes seek to enhance QoL through indirect PA in a social context, making PA possible for elderly and disabled persons through PA conducted by abled-bodied volunteers. WMM is a multi-method 12–16-week pre/post evaluation with quality of life, physical, mental and social health as main outcomes. Pre/post measurements consist of questionnaires, clinical examinations, and physical and cognitive appraisal. Throughout, interviews and participant observations will be conducted. Combined results will provide essential knowledge on the effects and experiences of indirect PA. Explorative data will pave the way for further research. Findings may inform policies, guidelines and health promotion among the elderly and disabled.
Changes in Physician Telemedicine Use during COVID-19: Effects of Practice Setting, Demographics, Training, and Organizational Policies
Authors: Pierce Bradford S. , Perrin Paul B. , Dow Alan W. , Dautovich Natalie D. , Rybarczyk Bruce D. , Mishra Vimal K.
Published: September 2021

Telemedicine use increased during the COVID-19 pandemic, but uptake was uneven and future use is uncertain. This study, then, examined the ability of personal and environmental variables to predict telemedicine adoption during the COVID-19 pandemic. A total of 230 physicians practicing in the U.S. completed questions concerning personal and environmental characteristics, as well as telemedicine use at three time points: pre-pandemic, during the pandemic, and anticipated future use. Associations between use and characteristics were determined to identify factors important for telemedicine use. Physicians reported that telemedicine accounted for 3.72% of clinical work prior to the pandemic, 46.03% during the pandemic, and predicted 25.44% after the pandemic ends. Physicians within hospitals reported less increase in telemedicine use during the pandemic than within group practice (p = 0.016) and less increase in use at hospitals compared to academic medical centers (p = 0.027) and group practice (p = 0.008). Greater telemedicine use was associated with more years in practice (p = 0.009), supportive organizational policies (p = 0.001), organizational encouragement (p = 0.003), expectations of greater patient volume (p = 0.003), and perceived higher quality of patient care (p = 0.032). Characteristics such as gender, number of physicians, and level of telemedicine training were not significant predictors. Organizations interested in supporting physicians to adopt telemedicine should encourage its use and create policies supporting its use. More senior physicians had a greater degree of telemedicine uptake, while training programs did not predict use, suggesting that efforts to develop telemedicine competency in younger physicians may be ineffective and should be re-examined.
Prevalence of Dental Caries and Periodontal Disease of High School Students Aged 15 to 18 Years in Taiwan
Authors: Chang Po-Sen , Huang Chun-Jui , Hsiang Chia-Lan , Lai Hongmin , Tsai Aileen I.
Published: September 2021

The purpose of this study was to assess the prevalence and distribution of dental caries and periodontal disease in Taiwanese high school students aged 15–18. A total of 1069 Taiwanese students participated in a cross-sectional nationwide dental survey. By using a stratified method based on the National Health Insurance administration regions, 24 high schools were randomly sampled in different areas of Taiwan. The participants were examined with dental mirrors and community periodontal index (CPI) probes without using radiographs, to measure dental caries and periodontal status. Demographic information and other relevant risk indicators for the two diseases were gathered via a self-report questionnaire. In this study population, the weighted mean decayed, missing and filled teeth (DMFT) scores for ages 15 to 18 were 5.2, 6.1, 6.1, and 5.7. The weighted mean decayed, missing and filled surfaces (DMFS) scores were 9.0, 12.0, 13.1, and 11.2 at ages 15, 16, 17, and 18, respectively. Additionally, 88.2% of the subjects had periodontal disease, with calculus as the most prevalent type. Moreover, 5.2% of these students showed loss of attachment. There was no significant association between dental caries and periodontal disease. Dental caries and periodontal disease were prevalent among Taiwanese high school students in this national dental survey.
Current State of COVID-19 Pandemic in Africa: Lessons for Today and the Future
Authors: Obande Godwin Attah , Bagudo Ahmad Ibrahim , Mohamad Suharni , Deris Zakuan Zainy , Harun Azian , Yean Chan Yean , Aziah Ismail , Banga Singh Kirnpal Kaur
Published: September 2021

This study is a cross-sectional, observational analysis of the COVID-19 pandemic in Africa, to understand the progression of the disease across the continent. Published data on COVID-19 from 20 January 2020 to 21 June 2021 were obtained and analyzed. Case fatality ratios, as well as case growth rates and other indices were computed. On 21 June 2021, a total of 178,210,532 confirmed cases and 3,865,978 deaths had been recorded worldwide. While the Americas recorded the highest number of cases, Southern Africa recorded the majority of African cases. Fatality rate since from 20 February 2020 to 21 June 2021 was highest in the Americas (2.63%) and low in the South Eastern Asia region (1.39%), globally increasing from 2.17% at the end of January to 6.36% in May 2020 and decreasing to a range between 2.14% to 2.30% since January 2021. In Africa, the infection rate per 100,000 persons was up to 3090.18, while deaths per 100,000 and case fatality ratio were as high as 119.64 and 5.72%, respectively, among the 20 most-affected countries. The testing rate per million population was highest in Botswana (512,547.08). Fatality appears to be increasing in some regions of Africa. The rate of infection and fatality in Africa could still likely take an upward turn. Strict control measures are required, considering the continent’s weak healthcare systems.
The First Random Observational Survey of Barrier Gestures against COVID-19
Authors: Renault Véronique , Humblet Marie-France , Parisi Gianni , Donneau Anne-Françoise , Bureau Fabrice , Gillet Laurent , Fontaine Sébastien , Saegerman Claude
Published: September 2021

In the context of COVID-19 in Belgium, face-to-face teaching activities were allowed in Belgian universities at the beginning of the 2020–2021 academic year. Nevertheless, several control measures were established to control COVID-19 transmission on the campuses. To ensure compliance with these measures, a random observational survey, based on five barrier gestures, was implemented at the University of Liege (greetings without contact, hand sanitisation, following a one-way traffic flow, wearing a mask and physical distancing). Each barrier gesture was weighted, based on experts’ elicitation, and a scoring system was developed. The results were presented as a diagram (to identify the margin of improvement for each barrier gesture) and a risk management barometer. In total, 526 h of observations were performed. The study revealed that some possible improvements could be made in the management of facilities, in terms of room allocation, the functionality of hydro-alcoholic gel dispensers, floor markings and one-way traffic flow. Compliance with the barrier gestures reached an overall weighted score of 68.2 (between 0 and 100). Three barrier gestures presented a lower implementation rate and should be addressed: the use of hydro-alcoholic gel (particularly when exiting buildings), compliance with the traffic flow and the maintenance of a 1.5 m physical distance outside of the auditoriums. The methodology and tool developed in the present study can easily be applied to other settings. They were proven to be useful in managing COVID-19, as the barometer that was developed and the outcomes of this survey enabled an improved risk assessment on campuses, and identified the critical points to be addressed in any further public health communication or education messages.
Relationship between Anthropometric, Physical and Hormonal Parameters among Pre-Pubertal Handball Players
Authors: Cselkó Alexandra , Szabó Edina Ivett , Váczi Mark , Kőszegi Tamas , Tékus Eva , Wilhelm Marta
Published: September 2021

Background: The aims of our study were to investigate the changes in anthropometric and physical parameters and fasting hormonal levels among pre-pubertal female handball players (n = 14, age: 11.53 ± 0.58 yrs, height: 153.36 ± 5.12 cm, body mass: 43.59 ± 6.14 kg) in the pre-season period following 8 weeks of handball training, and to analyze the contribution of hormones, physical performance and anthropometric parameters. Methods: Prior to and immediately following the training period, several anthropometric, strength, and cardiorespiratory variables, including fasting hormonal concentrations (plasma cortisol, estradiol, testosterone and growth hormones) were measured. Athletes performed concurrent resistance and aerobic exercises, including game-based trainings during the 8-week training period. Results: Significant elevations were found in all strength parameters (maximal handgrip strength dominant (D): 16.40%, p < 0.01; non-dominant (ND): 25.15%, p < 0.05; maximal concentric (MVC) torque of quadriceps D: 13.82%, p < 0.05; ND: 12.61%, p < 0.05; MVC torque of hamstring D: 12.14%, p < 0.01; ND: 12.44%, p < 0.01), including plasma cortisol levels (C, 34.30%, p < 0.05) and peak respiratory quotient (5.24%, p < 0.05). Body composition and maximal oxygen uptake (VO2max) remained unchanged. Percentage changes in thigh (r = 0.316, p < 0.05), hand (r = 0.361, p < 0.05), and hip circumference (r = 0.297, p < 0.05) correlated with C changes. Percentage changes in plasma growth hormone levels (GH) contributed to the magnitude of gains in handgrip strength (r = 0.553, p < 0.05). Percentage changes in maximal exercise pulmonary ventilation (MVE) correlated with elevated C (r = −0.592, p < 0.05). Discussion: Changes in anthropometric variables and fasting hormone levels (estradiol, testosterone and cortisol) were poor indicators of developing VO2max and strength during pre-pubertal years. Physical adaptation may not be explained in consideration of the athletes’ hormonal or anthropometric characteristics. Conclusion: Gradually increased training volume followed by a summer break should be applied to youth handball, considering the anti-hypertrophic responses and the inhibitory effect of elevating C on pre-pubertal maturation.
Access to Daylight at Home Improves Circadian Alignment, Sleep, and Mental Health in Healthy Adults: A Crossover Study
Authors: Nagare Rohan , Woo May , MacNaughton Piers , Plitnick Barbara , Tinianov Brandon , Figueiro Mariana
Published: September 2021

As the primary environmental cue for the body’s master biological clock, light–dark patterns are key for circadian alignment and are ultimately fundamental to multiple dimensions of health including sleep and mental health. Although daylight provides the proper qualities of light for promoting circadian alignment, our modern indoor lifestyles offer fewer opportunities for adequate daylight exposure. This field study explores how increasing circadian-effective light in residences affects circadian phase, sleep, vitality, and mental health. In this crossover study, 20 residents spent one week in their apartments with electrochromic glass windows and another week with functionally standard windows with blinds. Calibrated light sensors revealed higher daytime circadian-effective light levels with the electrochromic glass windows, and participants exhibited consistent melatonin onset, a 22-min earlier sleep onset, and higher sleep regularity. In the blinds condition, participants exhibited a 15-min delay in dim light melatonin onset, a delay in subjective vitality throughout the day, and an overall lower positive affect. This study demonstrates the impact of daytime lighting on the physiological, behavioral, and subjective measures of circadian health in a real-world environment and stresses the importance of designing buildings that optimize daylight for human health and wellbeing.
An Integrative Behavioral Couple Therapy (IBCT)-Based Conflict Prevention Program: A Pre-Pilot Study with Non-Clinical Couples
Authors: Barraca Jorge , Nieto Elvira , Polanski Thomas
Published: September 2021

Integrative Behavioral Couple Therapy (IBCT) has demonstrated its efficacy treating severe couple conflict. Nevertheless, its capacity to prevent such conflicts before they appear has not been analyzed. The following empirical study examines the effectiveness of a conflict prevention program based on IBCT’s main therapeutic strategies (empathic joining, unified detachment). A sample of 12 individuals (six couples) from the Community of Madrid completed the DAS (Spanier, 1976; Martín-Lanas et al., 2017), IBCTQ (Barraca et al., 2017), and ASPA-A (Carrasco, 1996) pre-treatment, posttreatment, and at a three-year follow up. Three of these couples were randomly assigned to the experimental group, in which they received five, 120-minute sessions of an IBCT-based conflict prevention program. The three remaining couples were assigned to a control group and received no treatment. Results indicated that the experimental couples grew in their acceptance of differences and significantly improved their level of empathic joining and unified detachment; they also manifested greater satisfaction in their total DAS score. At the three-year follow up, neither group showed significant changes with regard to their posttreatment scores. Although the data are based on a small number of couples and should be replicated, the results suggest that a program based on IBCT strategies can help prevent couple conflict up to three years after its application.
Impact of the COVID-19 Pandemic on Loneliness and Social Isolation: A Multi-Country Study
Authors: O’Sullivan Roger , Burns Annette , Leavey Gerard , Leroi Iracema , Burholt Vanessa , Lubben James , Holt-Lunstad Julianne , Victor Christina , Lawlor Brian , Vilar-Compte Mireya , Perissinotto Carla M. , Tully Mark A. , Sullivan Mary Pat , Rosato Michael , Power Joanna McHugh , Tiilikainen Elisa , Prohaska Thomas R.
Published: September 2021

The COVID-19 global pandemic and subsequent public health social measures have challenged our social and economic life, with increasing concerns around potentially rising levels of social isolation and loneliness. This paper is based on cross-sectional online survey data (available in 10 languages, from 2 June to 16 November 2020) with 20,398 respondents from 101 different countries. It aims to help increase our understanding of the global risk factors that are associated with social isolation and loneliness, irrespective of culture or country, to support evidence-based policy, services and public health interventions. We found the prevalence of severe loneliness was 21% during COVID-19 with 6% retrospectively reporting severe loneliness prior to the pandemic. A fifth were defined as isolated based on their usual connections, with 13% reporting a substantial increase in isolation during COVID-19. Personal finances and mental health were overarching and consistently cross-cutting predictors of loneliness and social isolation, both before and during the pandemic. With the likelihood of future waves of COVID-19 and related restrictions, it must be a public health priority to address the root causes of loneliness and social isolation and, in particular, address the needs of specific groups such as carers or those living alone.
Measuring Quality of Public Hospitals in Croatia Using a Multi-Criteria Approach
Authors: Kadoić Nikola , Šimić Diana , Mesarić Jasna , Begičević Ređep Nina
Published: September 2021

Quality of public hospital services presents one of the most important aspects of public health in general. A significant number of health services are delivered due to public hospitals. Under the World Bank program “Improving Quality and Efficiency of Health Services: Program for Results”, the competent bodies in Croatia aimed to identify the top 40% best-performing public acute hospitals in Croatia, based on a clinical audit in the preceding 12 months. This paper presents how this goal was achieved, using a multi-criteria decision-making (MCDM) approach. A MCDM approach was selected due to the multidimensionality and complexity of healthcare performance and service quality. We aimed to develop a methodology for ranking top-performing hospitals at the national level. We chose the composite indicator methodology, combined with the analytic hierarchy process (AHP) as a tool for determining weights for aggregation of individual indicators. The study looked at three clinical entities: acute myocardial infarction, cerebrovascular insult, and antimicrobial prophylaxis in colorectal surgery. Indicators for each entity were evidence-based, following the national guidelines, but limited by availability of data. The clinical audit and databases of competent administrative bodies were used as sources of data. The problem investigated in this paper has a significant impact at the strategic (national) level. Even though the AHP has already been applied in the public health domain, to the best of our knowledge, this is the first application of the AHP in combination with composite indicators for hospital ranking at a national level. The AHP enabled participation of experts from the audited hospitals in the assessment of indicator weights. Results show that composite indicators can be successfully implemented for acute hospital evaluation using the AHP methodology: (1) the AHP supported a flexible structuring of the problem; (2) the resulting complexity of pairwise comparisons was appropriate for the experts (consistency ratios were under 0.1); (3) using the AHP approach enabled a successful aggregation of different opinions into group priorities; (4) the developed methodology was robust and enabled identifying the top 40% ranking best-performing public acute hospitals in Croatia combining 20 criteria within three entities, based on input from 36 clinical experts. The proposed methodology can be useful to other researchers for assessment of healthcare quality at the strategic level.
Improving Community Health Workers’ Attitudes toward Collaborative Practice in the Care of Older Adults: An In-Service Training Intervention Trial in the Philippines
Authors: Siongco Kathryn Lizbeth L. , Nakamura Keiko , Seino Kaoruko , Moncatar TJ Robinson T. , Tejero Lourdes Marie S. , De La Vega Shelley Ann F. , Bonito Sheila R. , Javier Richard , Tsutsui Takako , Tashiro Yuri , Al-Sobaihi Saber , Lorenzo Fely Marilyn E. , Canila Carmelita C.
Published: September 2021

The objective of this study was to evaluate the efficacy of an in-service, short-term training program in improving the attitudes toward, and readiness and activities for collaboration among community health workers (CHWs) in a primary care setting in the Philippines. A randomized controlled trial was adopted dividing participants into an intervention (n = 42) and a control group (n = 39). Attitudes toward, and readiness and activities for collaboration were measured using three standardized scales before and at 6 months after the training. A significant difference (p < 0.001) was observed in the Attitudes Toward Health Care Teams Scale (ATHCTS) scores between pre- and post-test in the intervention (6.3 ± 8.3 [Mean ± SD]) and control groups (0.7 ± 8.2). Multivariate linear regression analysis showed an independent positive association between the intervention and greater improvement in the ATHCTS score (Coefficient β = 6.17; 95% CI = 0.82, 11.53; p = 0.03) at follow-up, after adjustment for age, years in current occupation, and social support role of participants. The results demonstrated the efficacy of the intervention for improving the attitudes of CHWs toward collaborative practice in the care of older adults.
The Intentions to Wear Face Masks and the Differences in Preventive Behaviors between Urban and Rural Areas during COVID-19: An Analysis Based on the Technology Acceptance Model
Authors: Zhang Bo , Li Zhongjie , Jiang Lei
Published: September 2021

The SARS-CoV-2 virus first emerged in late 2019 and has since spread quickly throughout China and become a global pandemic. As the situation with COVID-19 has evolved, wearing a face mask in public has grown commonplace. Using the technology acceptance model (TAM) as a foundation, this study introduces three new variables, namely, perceived risk, social pressure, and social image, to establish an extended model for investigating the factors that influence if residents wear masks. A total of 1200 questionnaires were distributed in China, from 1 February to 30 May 2020, through China’s largest online platform. The results indicate the following: 1. Residents’ positive attitude towards mask wearing promotes their behavioral intention to wear masks. 2. Perceived risk, social pressure, and social image have a positive impact on attitude towards mask wearing. 3. The intention to wear masks and attitude were both positively influenced by perceived usefulness. 4. The perceived usefulness is more influential in rural than urban groups, in terms of behavioral intention. This article proposes that public education on the facts related to the coronavirus, the threats posed by the COVID-19 pandemic to health, and the usefulness of face masks in preventing the transmission of COVID-19 could increase residents’ intention to wear a mask.
Attitudes and Behaviors That Impact Skin Cancer Risk among Men
Authors: Adams Gabrielle J. , Goldstein Elianna K. , Goldstein Beth G. , Jarman Kristen L. , Goldstein Adam O.
Published: September 2021

Despite substantially higher skin cancer risks, little research has investigated men’s attitudes about skin cancer and how those attitudes relate to their risks of developing skin cancer. This study aims to close the gap in research, regarding men’s perceptions and behaviors about skin cancer, sun exposure, and tanning. This study utilized a cross-sectional survey of 705 men recruited from Amazon Mechanical Turk (MTurk), reporting attitudes and behaviors towards sun exposure, tanning, and sun protection. While the majority of men reported large daily outdoor activities, that their skin frequently burns with sun exposure, and riskier perceptions of tanning, only a minority reported daily use of sunscreen or most other sun protective behaviors. More sun protection methods were associated with more frequent use of sunscreen and less positive tanning perceptions. Men consistently engaged in high-risk behaviors for developing skin cancer, but they did not engage highly in protective behaviors to mitigate their risk. The findings can help improve clinical and public health interventions to lower men’s risk of skin cancer with strong messages about sunscreen use and sun protective methods.
A Comparative Study of 2-Hour Interface Pressure in Different Angles of Laterally Inclined, Supine, and Fowler’s Position
Authors: Kim Soo-Yeon , Shin Yong-Soon
Published: September 2021

Insufficient research exists for position change intervals to eradicate pressure ulcers. We tried to provide evidence for the position change interval by comparing peak pressure, risk area ratio, and the time to reach 30 mmHg and 60 mmHg, and presented this in detail, according to the angle in the three positions. The study conducted RCTs on a total of 64 healthy adults. For two hours, interface pressure measurements were compared with 30° and 90° tilting at the inclined, 0° and 45° head-of-bed (HOB) elevation at the supine, and 30° and 45° HOB elevation at the Fowler’s position. The peak pressure on 30° tilting remained less than 60 mmHg for 2 h, unlike 90° tilting. To reach 60 mmHg took 78.18 min at 30° tilting, within 30 min at the 30° supine, 30° and 45° at the Fowler’s position, and 39.55 min at 0° supine. The pressure difference according to the angles was only significant at 30° and 90° tilting, with no difference in the other groups. To prevent pressure ulcers, position changes are required every 2 h in the 30° tilting position, every 1.5 to 2 h at 0° supine, and at least every 1.5 h for all the other positions.
Prior Social Contact and Mental Health Trajectories during COVID-19: Neighborhood Friendship Protects Vulnerable Older Adults
Authors: Gan Daniel R. Y. , Best John R.
Published: September 2021

Social networking protects mental health during a crisis. Prior contact with social organizations, friends, and non-friend neighbors may be associated with better trajectories of loneliness, depression and subjective memory during COVID-19. Regression analysis was conducted using longitudinal data from a representative sample of n = 3105 US adults aged ≥55 in April–October 2020. Latent profile analysis was also conducted. Prior contact with friends (B = −0.075, p < 0.001), neighbors (B = −0.048, p = 0.007), and social organizations (B = −0.073, p < 0.001) predicted for better mental health during COVID-19. Three profiles were identified: Profile 1 had the best outcomes, with prior contact with social organizations (B = −0.052, p = 0.044) predicting decreasing loneliness. For Profile 2, prior ‘meeting’ contact with friends predicted decreasing loneliness (B = −0.075, p < 0.001) and better subjective memory (B = −0.130, p = 0.011). Conversely, prior contact with neighbors (B = −0.165, p = 0.010) predicted worsening loneliness among Profile 3. The COVID-19 pandemic has had a differential impact on the mental health trajectories of aging adults with social ties of different strengths. Stronger neighborhood networks are important to mitigate poor mental health outcomes among vulnerable older adults during a crisis. Older adults who are living alone and had relied on non-friend neighbors for social connectedness require additional community supports. Policy interventions are required to mitigate the mental health impact of future pandemics.
A Novel Ultra-Wideband Double Difference Indoor Positioning Method with Additional Baseline Constraint
Authors: Zhao Yinzhi , Zou Jingui , Guo Jiming , Huang Gege , Cai Lixian
Published: September 2021

Ultra-wideband (UWB) technology is suitable for indoor positioning owing to its high resolution and penetration. However, the current UWB positioning methods not only fail to fully analyze errors, but do not have the ability to eliminate gross and large random errors. In this article, the errors of UWB indoor positioning are analyzed comprehensively, and the basic function model is given. An indoor positioning method based on a double difference UWB with ranging observations is proposed and realized. In the proposed method, two UWB rover stations and a common base station are introduced, and the known baseline length between two rovers is used as the constraint condition for quality control. The observations and coordinate estimations are constrained by the prior and posteriori, respectively, and the weight of ranging observations with large residuals is reduced. Two groups of static experiments are designed. After adopting the proposed method, the plane error of one rover is 3.4 cm and 2.1 cm, and plane error of another rover is 3.3 cm and 2.0 cm, respectively. The positioning precision is improved by more than 80% compared with the traditional method. In the dynamic experiment, the coordinates of the starting and ending point obtained by the proposed method are basically consistent with the truth value, and the positioning results are close to the reference trajectory. The experimental results show that the proposed method can eliminate systematic and large random errors and improve the positioning precision effectively.
Lectin from Triticum vulgaris (WGA) Inhibits Infection with SARS-CoV-2 and Its Variants of Concern Alpha and Beta
Authors: Auth Janina , Fröba Maria , Große Maximilian , Rauch Pia , Ruetalo Natalia , Schindler Michael , Morokutti-Kurz Martina , Graf Philipp , Dolischka Andrea , Prieschl-Grassauer Eva , Setz Christian , Schubert Ulrich
Published: September 2021

Even in the face of global vaccination campaigns, there is still an urgent need for effective antivirals against SARS-CoV-2 and its rapidly spreading variants. Several natural compounds show potential as antiviral substances and have the advantages of broad availabilities and large therapeutic windows. Here, we report that lectin from Triticum vulgaris (Wheat Germ Agglutinin) displays antiviral activity against SARS-CoV-2 and its major Variants of Concern (VoC), Alpha and Beta. In Vero B4 cells, WGA potently inhibits SARS-CoV-2 infection with an IC50 of <10 ng/mL. WGA is effective upon preincubation with the virus or when added during infection. Pull-down assays demonstrate direct binding of WGA to SARS-CoV-2, further strengthening the hypothesis that inhibition of viral entry by neutralizing free virions might be the mode of action behind its antiviral effect. Furthermore, WGA exhibits antiviral activity against human coronavirus OC43, but not against other non-coronaviruses causing respiratory tract infections. Finally, WGA inhibits infection of the lung cell line Calu-3 with wild type and VoC viruses with comparable IC50 values. Altogether, our data indicate that topical administration of WGA might be effective for prophylaxis or treatment of SARS-CoV-2 infections.
The Bul1/2 Alpha-Arrestins Promote Ubiquitylation and Endocytosis of the Can1 Permease upon Cycloheximide-Induced TORC1-Hyperactivation
Authors: Megarioti Amalia H. , Primo Cecilia , Kapetanakis George C. , Athanasopoulos Alexandros , Sophianopoulou Vicky , André Bruno , Gournas Christos
Published: September 2021

Selective endocytosis followed by degradation is a major mechanism for downregulating plasma membrane transporters in response to specific environmental cues. In Saccharomyces cerevisiae, this endocytosis is promoted by ubiquitylation catalyzed by the Rsp5 ubiquitin-ligase, targeted to transporters via adaptors of the alpha-arrestin family. However, the molecular mechanisms of this targeting and their control according to conditions remain incompletely understood. In this work, we dissect the molecular mechanisms eliciting the endocytosis of Can1, the arginine permease, in response to cycloheximide-induced TORC1 hyperactivation. We show that cycloheximide promotes Rsp5-dependent Can1 ubiquitylation and endocytosis in a manner dependent on the Bul1/2 alpha-arrestins. Also crucial for this downregulation is a short acidic patch sequence in the N-terminus of Can1 likely acting as a binding site for Bul1/2. The previously reported inhibition by cycloheximide of transporter recycling, from the trans-Golgi network to the plasma membrane, seems to additionally contribute to efficient Can1 downregulation. Our results also indicate that, contrary to the previously described substrate-transport elicited Can1 endocytosis mediated by the Art1 alpha-arrestin, Bul1/2-mediated Can1 ubiquitylation occurs independently of the conformation of the transporter. This study provides further insights into how distinct alpha-arrestins control the ubiquitin-dependent downregulation of a specific amino acid transporter under different conditions.
Self-Assembly Nanoparticles of Natural Bioactive Abietane Diterpenes
Authors: Ntungwe Epole , Domínguez-Martín Eva María , Bangay Gabrielle , Garcia Catarina , Guerreiro Iris , Colombo Eleonora , Saraiva Lucilia , Díaz-Lanza Ana María , Rosatella Andreia , Alves Marta M. , Reis Catarina Pinto , Passarella Daniele , Rijo Patricia
Published: September 2021

Different approaches have been reported to enhance penetration of small drugs through physiological barriers; among them is the self-assembly drug conjugates preparation that shows to be a promising approach to improve activity and penetration, as well as to reduce side effects. In recent years, the use of drug-conjugates, usually obtained by covalent coupling of a drug with biocompatible lipid moieties to form nanoparticles, has gained considerable attention. Natural products isolated from plants have been a successful source of potential drug leads with unique structural diversity. In the present work three molecules derived from natural products were employed as lead molecules for the synthesis of self-assembled nanoparticles. The first molecule is the cytotoxic royleanone 7α-acetoxy-6β-hydroxyroyleanone (Roy, 1) that has been isolated from hairy coleus (Plectranthus hadiensis (Forssk.) Schweinf). ex Sprenger leaves in a large amount. This royleanone, its hemisynthetic derivative 7α-acetoxy-6β-hydroxy-12-benzoyloxyroyleanone (12BzRoy, 2) and 6,7-dehydroroyleanone (DHR, 3), isolated from the essential oil of thicket coleus (P. madagascariensis (Pers.) Benth.) were employed in this study. The royleanones were conjugated with squalene (sq), oleic acid (OA), and/or 1-bromododecane (BD) self-assembly inducers. Roy-OA, DHR-sq, and 12BzRoy-sq conjugates were successfully synthesized and characterized. The cytotoxic effect of DHR-sq was previously assessed on three human cell lines: NCI-H460 (IC50 74.0 ± 2.2 µM), NCI-H460/R (IC50 147.3 ± 3.7 µM), and MRC-5 (IC50 127.3 ± 7.3 µM), and in this work Roy-OA NPs was assayed against Vero-E6 cells at different concentrations (0.05, 0.1, and 0.2 mg/mL). The cytotoxicity of DHR-sq NPs was lower when compared with DHR alone in these cell lines: NCI-H460 (IC50 10.3 ± 0.5 µM), NCI-H460/R (IC50 10.6 ± 0.4 µM), and MRC-5 (IC5016.9 ± 0.5 µM). The same results were observed with Roy-OA NPs against Vero-E6 cells as was found to be less cytotoxic than Roy alone in all the concentrations tested. From the obtained DLS results, 12BzRoy-sq assemblies were not in the nano range, although Roy-OA NP assemblies show a promising size (509.33 nm), Pdl (0.249), zeta potential (−46.2 mV), and spherical morphology from SEM. In addition, these NPs had a low release of Roy at physiological pH 7.4 after 24 h. These results suggest the nano assemblies can act as prodrugs for the release of cytotoxic lead molecules.
Cellular Models for Primary CoQ Deficiency Pathogenesis Study
Authors: Santos-Ocaña Carlos , Cascajo María V. , Alcázar-Fabra María , Staiano Carmine , López-Lluch Guillermo , Brea-Calvo Gloria , Navas Plácido
Published: September 2021

Primary coenzyme Q10 (CoQ) deficiency includes a heterogeneous group of mitochondrial diseases characterized by low mitochondrial levels of CoQ due to decreased endogenous biosynthesis rate. These diseases respond to CoQ treatment mainly at the early stages of the disease. The advances in the next generation sequencing (NGS) as whole-exome sequencing (WES) and whole-genome sequencing (WGS) have increased the discoveries of mutations in either gene already described to participate in CoQ biosynthesis or new genes also involved in this pathway. However, these technologies usually provide many mutations in genes whose pathogenic effect must be validated. To functionally validate the impact of gene variations in the disease’s onset and progression, different cell models are commonly used. We review here the use of yeast strains for functional complementation of human genes, dermal skin fibroblasts from patients as an excellent tool to demonstrate the biochemical and genetic mechanisms of these diseases and the development of human-induced pluripotent stem cells (hiPSCs) and iPSC-derived organoids for the study of the pathogenesis and treatment approaches.
Activation of the NLRP3 Inflammasome Increases the IL-1β Level and Decreases GLUT4 Translocation in Skeletal Muscle during Insulin Resistance
Authors: Américo-Da-Silva Luan , Aguilera Javiera , Quinteros-Waltemath Oscar , Sánchez-Aguilera Pablo , Russell Javier , Cadagan Cynthia , Meneses-Valdés Roberto , Sánchez Gina , Estrada Manuel , Jorquera Gonzalo , Barrientos Genaro , Llanos Paola
Published: September 2021

Low-grade chronic inflammation plays a pivotal role in the pathogenesis of insulin resistance (IR), and skeletal muscle has a central role in this condition. NLRP3 inflammasome activation pathways promote low-grade chronic inflammation in several tissues. However, a direct link between IR and NLRP3 inflammasome activation in skeletal muscle has not been reported. Here, we evaluated the NLRP3 inflammasome components and their role in GLUT4 translocation impairment in skeletal muscle during IR. Male C57BL/6J mice were fed with a normal control diet (NCD) or high-fat diet (HFD) for 8 weeks. The protein levels of NLRP3, ASC, caspase-1, gasdermin-D (GSDMD), and interleukin (IL)-1β were measured in both homogenized and isolated fibers from the flexor digitorum brevis (FDB) or soleus muscle. GLUT4 translocation was determined through GLUT4myc-eGFP electroporation of the FBD muscle. Our results, obtained using immunofluorescence, showed that adult skeletal muscle expresses the inflammasome components. In the FDB and soleus muscles, homogenates from HFD-fed mice, we found increased protein levels of NLRP3 and ASC, higher activation of caspase-1, and elevated IL-1β in its mature form, compared to NCD-fed mice. Moreover, GSDMD, a protein that mediates IL-1β secretion, was found to be increased in HFD-fed-mice muscles. Interestingly, MCC950, a specific pharmacological NLRP3 inflammasome inhibitor, promoted GLUT4 translocation in fibers isolated from the FDB muscle of NCD- and HFD-fed mice. In conclusion, we found increased NLRP3 inflammasome components in adult skeletal muscle of obese insulin-resistant animals, which might contribute to the low-grade chronic metabolic inflammation of skeletal muscle and IR development.