bluuebunny/crossref_metadata_2025 huggingface dataset:
Condylar Neck and Sub-Condylar Fractures: Surgical Consideration and Evolution of the Technique with Short Follow-Up on Five Cases
Authors: Cortese Antonio , Borri Antonio , Bergaminelli Marco , Bergaminelli Fabrizio , Claudio Pier Paolo
Published: November 2020

Condylar neck and sub-condylar fractures of the mandible are a frequent occurrence in maxillofacial surgery. The indication for surgical treatment of these fractures has changed over time, and several techniques have been developed with different results in the attempt to avoid the most worrisome adverse event, i.e., facial nerve injury. In this study, we present a new technique that combines an intraoral and a cutaneous pre-auricular access, which allows for easy and safe access to the surgical site, preventing facial nerve injury and avoiding surgical scars in high-impact aesthetic areas of the neck. Five consecutive patients affected by condylar neck or sub-condylar fractures were treated at a single institution using a combined intraoral and pre-auricular access. Results were evaluated after three months from surgery in terms of mandibular mobility, occurrence of complications, and patient’s satisfaction. All five patients had good outcome, with complete healing of the fracture and no occurrence of complications, including no facial nerve palsy. A key point of the technique is the safe reduction of the two mandibular fragments realized by a combined intraoral and a cutaneous pre-auricular surgical access. The periosteal plan of the ramus can be widely and safely elevated with the intraoral approach and connected to the condylar bone plane by the pre-auricular cutaneous approach without any need for soft tissue dissection at the fracture rim, thereby avoiding facial nerve injuries. Wide ramus periosteum elevation creates an “optical space”, allowing fragment reduction and fixation under direct oblique view without any endoscopic need. Our results strongly suggest that with our technique it is possible to treat sub-condylar and condylar neck fractures safely, avoiding facial nerve injury, which is an unacceptable complication due to its heavy impact on a patient’s life.
Chebyshev-Response Branch-Line Couplers with Enhanced Bandwidth and Arbitrary Coupling Level
Authors: Smolarz Robert , Wincza Krzysztof , Gruszczynski Slawomir
Published: November 2020

A new approach to the synthesis of broadband branch-line couplers with arbitrary coupling level was investigated in this paper. It was shown that the operational bandwidth of a classic branch-line coupler can be increased by utilizing N-section impedance transformers added to each of the coupler’s ports. Furthermore, the obtained response can be approximated by the Chebyshev polynomial. Moreover, it was proven that for such couplers a range of coupling coefficient values can be obtained by the modification of classic branch-line topology. The analysis of the electrical parameters of the proposed branch-line couplers was comprehensively investigated. To verify the correctness of the proposed design procedures, 3-dB, and 6-dB broadband branch-line couplers operating at the center frequency of 2 GHz having return losses greater than 20 dB were designed, fabricated, and measured.
For Preventative Automated Driving System (PADS): Traffic Accident Context Analysis Based on Deep Neural Networks
Authors: Kang Minhee , Song Jaein , Hwang Keeyeon
Published: November 2020

Automated Vehicles (AVs) are under development to reduce traffic accidents to a great extent. Therefore, safety will play a pivotal role to determine their social acceptability. Despite the fast development of AVs technologies, related accidents can occur even in an ideal environment. Therefore, measures to prevent traffic accidents in advance are essential. This study implemented a traffic accident context analysis based on the Deep Neural Network (DNNs) technique to design a Preventive Automated Driving System (PADS). The DNN-based analysis reveals that when a traffic accident occurs, the offender’s injury can be predicted with 85% accuracy and the victim’s case with 67%. In addition, to find out factors that decide the degree of injury to the offender and victim, a random forest analysis was implemented. The vehicle type and speed were identified as the most important factors to decide the degree of injury of the offender, while the importance for the victim is ordered by speed, time of day, vehicle type, and day of the week. The PADS proposed in this study is expected not only to contribute to improve the safety of AVs, but to prevent accidents in advance.
Analysis of Time and Frequency Response for Single/Multi-Tone Stimulus Harmonic Phase-Reference Based on Prime Number Algorithm
Authors: Yu He , Wang Cong , A. Humphreys David , Lin Maoliu , Ali Luqman , Meng Fanyi
Published: November 2020

We present a spectrally-dense phase-reference and its calibration for nonlinear vector network analyzers (NVNAs) using a step recovery diode (SRD) comb-generator with a multi-tone stimulus. Frequency selection for multi-tone stimulus based on prime number algorithms was used with the Digital Real-Time Oscilloscope (DRTO) to avoid the sub-Nyquist spurs components and to increase the effective sampling rate so that the waveform can be observed in greater detail. The measured results were calibrated to minimize drift and jitter and achieved excellent agreement between the prime number and the exact frequency strategies except at the sub-Nyquist frequencies. The analysis indicates that the prime number selected frequencies show significantly improved performance by avoiding the DRTO distortion components. We have verified the validity of the method described in this paper by experimental measurement results.
Direct Space Vector Modulation with Novel DC-Link Voltage Balancing Algorithm for Easy Software Implementation of Three-Phase Three-Level Converter
Authors: Kim Jun-Seok , Kwon Jung-Min
Published: November 2020

The present paper proposes a direct space vector modulation and novel balance algorithm for easy software application of three-level converters which operate in three-phase. In the case of the conventional space vector modulation, to get the on-state times of the switches, the dwell times of the three nearest stationary vectors, which are obtained after sector and region selection algorithms, should be rearranged. These processes, therefore, contain diverse conditional statements and complicated calculations such as inverse trigonometric functions and square roots. However, the burden of the software application of the proposed algorithm is greatly reduced by not using the sector selection algorithm, the region selection algorithm, and the on-state time allocation process as the proposed modulation can directly control the switch on-state time. In a three-level topology, it is required to balance top and bottom capacitor voltages because the DC-link voltage is composed of two capacitor voltages; the unbalanced voltage of each DC-link capacitor causes the overvoltage of the switching devices. Thus, the DC-link voltage balancing algorithm is proposed, and it is also very simple and effective without additional circuits because it controls the switch on-state time directly as well. The 5-kW prototype proved the validity of the proposed algorithm with its feasibility.
Optimization of the Energy Consumption of Electric Motors through Metaheuristics and PID Controllers
Authors: Serradilla Francisco , Cañas Norberto , Naranjo José E.
Published: November 2020

The synthesis of electric motor control systems, seeking optimal performance, is a well-known and studied field of automation to date. However, the solutions often use very elaborate mathematical foundations and sometimes require considerable algorithmic complexity. Another approach to the same problem, which offers very interesting results, is the use of artificial intelligence methods to generate controllers. Intelligent methods allow the use of bio-inspired approaches to solve complex problems. This article presents a method to adjust the parameters of a controller for DC motors based on two components in the objective function: High productivity and efficiency. This can be achieved using well-known and low algorithmic complexity PID controllers, and metaheuristic artificial intelligence techniques to adjust a controller to obtain optimal behavior. To validate the benefits of the methodological proposal, a simulator of a DC motor has been rigorously constructed, respecting fundamental physical principles. The adjustment system based on metaheuristics (genetics algorithms) has been designed to work on the simulator and constitutes the central contribution of the paper. This system has been designed to establish the parameters of a PID controller, optimizing its behavior in relation to two variables of interest, such as performance and energy efficiency (a non-trivial problem). The results obtained confirm the benefits of the approach.
Functional Divergence between Várzea and Igapó Forests: A Study of Functional Trait Diversity in the Colombian Orinoco Basin
Authors: Bonilla Diana , Aldana Ana M. , Cárdenas Sasha , Sanchez Adriana
Published: November 2020

Research Highlights: Functional diversity studies help to better understand how organisms respond to different environmental conditions. Conditions in tropical flooded forests are highly variable, including levels of nutrient availability, pH, and flood depth, but few studies have explored the impact of variation in these factors on plant functional diversity. Background and Objectives: In the Orinoco basin, as in the Amazon, floodplain forests have been classified into várzea (white-water rivers, with nutrient-rich soils) and igapó (black-water rivers, associated with nutrient-poor soils). We evaluated the functional diversity of plant species in várzea and igapó, as well as the influence of external and internal filters on the plant community assembly of each forest type, and compared our results with studies in the Amazon basin. Materials and Methods: Six functional traits were recorded in the várzea and igapó forests of the Colombian Orinoco basin (one-hectare plot for each forest type, with no replicates). We evaluated plant species diversity (richness, Fisher’s α, Shannon and Simpson indices), as well as functional diversity (functional richness, functional evenness, functional divergence, and functional dispersion) and the influence of external and internal filters, based on a comparison of variance at different organizational levels. Results: A high functional differentiation between várzea and igapó was found, as well as a high functional divergence within each forest type. We also observed a greater influence of internal filters on the community assembly of both forest types, compared to external filters. Functional traits such as wood density and leaf dry matter content, showed the same patterns as the várzea and igapó forests in the Amazon. Conclusions: Despite the low taxonomic and functional richness, there is high functional divergence within flooded forests. We also show that in forests under stress (e.g., from flooding), internal filters can be key in assembling communities and promote high functional divergence. Given that the functional diversity of the várzea and igapó in the Orinoco is largely unexplored, we highlight the need for more research for the effective conservation of these flooded forests.
An Internet of Things (IoT) Acceptance Model. Assessing Consumer’s Behavior toward IoT Products and Applications
Authors: Tsourela Maria , Nerantzaki Dafni-Maria
Published: November 2020

A common managerial and theoretical concern is to know how individuals perceive Internet of Things (IoT) products and applications and how to accelerate adoption of them. The purpose of the current study is to answer, “What are the factors that define behavioral intention to adopt IoT products and applications among individuals?” An IoT adoption model was developed and tested, incorporating pull factors from two different information impact sources: technical and psychological. This study employs statistical structural equation modeling (SEM) in order to examine the conceptual IoT acceptance model. It is demonstrated that facilitated appropriation, perceived usefulness and perceived ease of use, as mediators, significantly influence consumers’ attitude and behavioral intention towards IoT products and applications. User character, cyber resilience, cognitive instrumentals, social influence and trust, all with different significance rates, exhibited an indirect effect, through the three mediators. The IoT acceptance model (IoTAM) upgrades current knowledge on consumers’ behavioral intention and equips practitioners with the knowledge needed to create successful integrated marketing tactics and communication strategies. It provides a solid base for examining multirooted models for the acceptance of newly formed technologies, as it bridges the discontinuity in migrating from information and communication technologies (ICTs) to IoT adoption studies, causing distortions to societies’ abilities to make informed decisions about IoT adoption and use.
Biological and Pharmacological Potential of Xylitol: A Molecular Insight of Unique Metabolism
Authors: Ahuja Vishal , Macho Markéta , Ewe Daniela , Singh Manoj , Saha Subhasish , Saurav Kumar
Published: November 2020

Xylitol is a white crystalline, amorphous sugar alcohol and low-calorie sweetener. Xylitol prevents demineralization of teeth and bones, otitis media infection, respiratory tract infections, inflammation and cancer progression. NADPH generated in xylitol metabolism aid in the treatment of glucose-6-phosphate deficiency-associated hemolytic anemia. Moreover, it has a negligible effect on blood glucose and plasma insulin levels due to its unique metabolism. Its diverse applications in pharmaceuticals, cosmetics, food and polymer industries fueled its market growth and made it one of the top 12 bio-products. Recently, xylitol has also been used as a drug carrier due to its high permeability and non-toxic nature. However, it become a challenge to fulfil the rapidly increasing market demand of xylitol. Xylitol is present in fruit and vegetables, but at very low concentrations, which is not adequate to satisfy the consumer demand. With the passage of time, other methods including chemical catalysis, microbial and enzymatic biotransformation, have also been developed for its large-scale production. Nevertheless, large scale production still suffers from high cost of production. In this review, we summarize some alternative approaches and recent advancements that significantly improve the yield and lower the cost of production.
Work Potential and Work Performance during the First Try-Out of the Person-Centred Return to Work Rehabilitation Programme ReWork-Stroke: A Case Study
Authors: Nilsson Annika Öst , Johansson Ulla , Ekbladh Elin , Bernspång Birgitta , Hellman Therese , Eriksson Gunilla
Published: November 2020

Background: This case study explores changes in work potential and work performance for ten people who worked before their stroke while participating in the ReWork-Stroke programme. It describes measures performed by the occupational therapists to enhance work potential and work performance and the participants’ level of work re-entry nine months after the start of their work trial. Methods: Ten people who had experienced a mild or moderate stroke participated. Changes were assessed using the Worker Role Interview and the Assessment of Work Performance. Logbooks relating to work potential and work performance were analysed using content analysis. Results: The participants’ work potential was in general supportive to returning to work at baseline and remained so at the three-month follow-up. Most changes occurred in the environmental factors regarding the participants’ belief that adaptations at the workplace would make re-entry possible. Changes concerning work performance were predominately in a positive direction. Seven of the participants returned to paid work. Conclusion: The ReWork-Stroke programme seems promising for promoting changes in work potential, work performance, and return to paid work. However, further studies are needed to evaluate changes in work potential and work performance and the programme’s effectiveness for increasing work re-entry for people who have had stroke.
Predictors of Quality of Life among Parents of Children with Chronic Diseases: A Cross-Sectional Study
Authors: Toledano-Toledano Filiberto , Moral de la Rubia José , Nabors Laura A. , Domínguez-Guedea Miriam Teresa , Salinas Escudero Guillermo , Rocha Pérez Eduardo , Luna David , Leyva López Ahidée
Published: November 2020

Quality of life (QOL) is a key aspect of the health care process for children with chronic diseases and their families. Although clinical evidence regarding the impact of chronic disease on children exists, few studies have evaluated the effects of the interaction between sociodemographic and psychosocial factors on the family caregiver’s QOL, indicating a significant gap in the research literature. The present study aimed to identify the predictors of the QOL of parents of children with chronic diseases. Three parental sociodemographic predictors (age, schooling, and family income) and four psychosocial predictors (family functioning, social support, depression, and resilience) were examined. In this cross-sectional study, 416 parents of children with chronic diseases who were hospitalized at a National Institute of Health in Mexico City were interviewed. The participants completed a sociodemographic variables questionnaire (Q-SV) designed for research on family caregivers of children with chronic disease. The predicted variable was assessed through the World Health Organization Quality of Life Questionnaire. The four psychosocial predictors were assessed through the Family Functioning Scale, Social Support Networks Scale, Beck Depression Inventory, and Measurement Scale of Resilience. The regression model explained 42% of the variance in parents’ QOL. The predictors with positive weights included age, schooling, monthly family income, family functioning, social support networks, and parental resilience. The predictors with negative weights included depression. These findings suggest that strong social relationships, a positive family environment, family cohesion, personal resilience, low levels of depression, and a family income twice the minimum wage are variables associated with better parental QOL.
Case Series of Dengue Fever in Peripartum Period: Maternal and Foetal Outcome
Authors: Saroyo Yudianto Budi , Sungkar Ali , Irwinda Rima , Surya Raymond
Published: November 2020

Introduction: Dengue fever is a major public health problem in tropical and subtropical areas. There are not many studies concerning the complications of dengue fever in pregnancy. We present four serial cases of dengue fever in pregnancy. Case illustration: Three of four cases were delivered by caesarean section; two of them died during post-caesarean care. All cases had the lowest platelet level below 50,000/µL and were given platelet transfusion during and after delivery; they also showed abnormal liver function tests. For foetal outcome, none tested positive for dengue. Discussion: Complication of dengue infection depends on a combination of host and viral virulence. Regardless of prophylactic platelet transfusion, some studies revealed clinical bleeding in patients with dengue infection due to an intricate effect on the haemostatic system. The adverse foetal outcome may contribute because of placental circulation caused by endothelial damage with increased vascular permeability leading to plasma leakage. There is no national guideline for dengue fever in pregnancy. Conclusions: The management of dengue fever in pregnancy at the tertiary hospital is still suboptimal. Dengue fever around peripartum presents a higher risk of morbidity and mortality for the mother and therefore needs a multidiscipline team approach.
Associations between Household-Level Exposures and All-Cause Diarrhea and Pathogen-Specific Enteric Infections in Children Enrolled in Five Sentinel Surveillance Studies
Authors: Colston Josh M. , Faruque Abu S. G. , Hossain M. Jahangir , Saha Debasish , Kanungo Suman , Mandomando Inácio , Nisar M. Imran , Zaidi Anita K. M. , Omore Richard , Breiman Robert F. , Sow Samba O. , Roose Anna , Levine Myron M. , Kotloff Karen L. , Ahmed Tahmeed , Bessong Pascal , Bhutta Zulfiqar , Mduma Estomih , Penatero Yori Pablo , Sunder Shrestha Prakash , Olortegui Maribel P. , Kang Gagandeep , Lima Aldo A. M. , Humphrey Jean , Prendergast Andrew , Schiaffino Francesca , Zaitchik Benjamin F. , Kosek Margaret N.
Published: November 2020

Diarrheal disease remains a major cause of childhood mortality and morbidity causing poor health and economic outcomes. In low-resource settings, young children are exposed to numerous risk factors for enteric pathogen transmission within their dwellings, though the relative importance of different transmission pathways varies by pathogen species. The objective of this analysis was to model associations between five household-level risk factors—water, sanitation, flooring, caregiver education, and crowding—and infection status for endemic enteric pathogens in children in five surveillance studies. Data were combined from 22 sites in which a total of 58,000 stool samples were tested for 16 specific enteropathogens using qPCR. Risk ratios for pathogen- and taxon-specific infection status were modeled using generalized linear models along with hazard ratios for all-cause diarrhea in proportional hazard models, with the five household-level variables as primary exposures adjusting for covariates. Improved drinking water sources conferred a 17% reduction in diarrhea risk; however, the direction of its association with particular pathogens was inconsistent. Improved sanitation was associated with a 9% reduction in diarrhea risk with protective effects across pathogen species and taxa of around 10–20% risk reduction. A 9% reduction in diarrhea risk was observed in subjects with covered floors, which were also associated with decreases in risk for zoonotic enteropathogens. Caregiver education and household crowding showed more modest, inconclusive results. Combining data from diverse sites, this analysis quantified associations between five household-level exposures on risk of specific enteric infections, effects which differed by pathogen species but were broadly consistent with hypothesized transmission mechanisms. Such estimates may be used within expanded water, sanitation, and hygiene (WASH) programs to target interventions to the particular pathogen profiles of individual communities and prioritize resources.
Analysis of the Risk Factors Associated with Hearing Loss of Infants Admitted to a Neonatal Intensive Care Unit: A 13-Year Experience in a University Hospital in Korea
Authors: Choi Kyu Young , Lee Bum Sang , Choi Hyo Geun , Park Su-Kyoung
Published: November 2020

Early detection of hearing loss in neonates is important for normal language development, especially for infants admitted to the neonatal intensive care unit (NICU) because the infants in NICU have a higher incidence of hearing loss than healthy infants. However, the risk factors of hearing loss in infants admitted to the NICU have not been fully acknowledged, especially in Korea, although they may vary according to the circumstances of each country and hospital. In this study, the risk factors of hearing loss in NICU infants were analyzed by using the newborn hearing screening (NHS) and the diagnostic auditory brainstem response (ABR) test results from a 13-year period. A retrospective chart review was performed using a list of NICU infants who had performed NHS from 2004 to 2017 (n = 2404) in a university hospital in Korea. For the hearing loss group, the hearing threshold was defined as 35 dB nHL or more in the ABR test performed in infants with a ‘refer’ result in the NHS. A four multiple number of infants who had passed the NHS test and matched the age and gender of the hearing loss group were taken as the control group. Various patient factors and treatment factors were taken as hearing loss related variables and were analyzed and compared. From the 2404 infants involved, the prevalence of hearing loss was 1.8% (n = 43). A comparison between the hearing loss group (n = 43) and the control group (n = 172) revealed that history of sepsis, peak total bilirubin, duration of vancomycin use, days of phototherapy, and exposure to loop-inhibiting diuretics were significantly different, and can be verified as significant risk factors for hearing loss in NICU infants.
Costing of Cesarean Sections in a Government and a Non-Governmental Hospital in Cambodia—A Prerequisite for Efficient and Fair Comprehensive Obstetric Care
Authors: Glaeser Eva , Jacobs Bart , Appelt Bernd , Engelking Elias , Por Ir , Yem Kunthea , Flessa Steffen
Published: November 2020

Knowing the cost of health care services is a prerequisite for evidence-based management and decision making. However, only limited costing data is available in many low- and middle-income countries. With a substantially increasing number of facility-based births in Cambodia, costing data for efficient and fair resource allocation is required. This paper evaluates the costs for cesarean section (CS) at a public and a Non-Governmental (NGO) hospital in Cambodia in the year 2018. We performed a full and a marginal cost analysis, i.e., we developed a cost function and calculated the respective unit costs from the provider’s perspective. We distinguished fixed, step-fixed, and variable costs and followed an activity-based costing approach. The processes were determined by personal observation of CS-patients and all procedures; the resource consumption was calculated based on the existing accounting documentation, observations, and time-studies. Afterwards, we did a comparative analysis between the two hospitals and performed a sensitivity analysis, i.e., parameters were changed to cater for uncertainty. The public hospital performed 54 monthly CS with an average length of stay (ALOS) of 7.4 days, compared to 18 monthly CS with an ALOS of 3.4 days at the NGO hospital. Staff members at the NGO hospital invest more time per patient. The cost per CS at the current patient numbers is US$470.03 at the public and US$683.23 at the NGO hospital. However, the unit cost at the NGO hospital would be less than at the public hospital if the patient numbers were the same. The study provides detailed costing data to inform decisionmakers and can be seen as a steppingstone for further costing exercises.
Impact of Gene–Environment Interactions on Cancer Development
Authors: Mbemi Ariane , Khanna Sunali , Njiki Sylvianne , Yedjou Clement G. , Tchounwou Paul B.
Published: November 2020

Several epidemiological and experimental studies have demonstrated that many human diseases are not only caused by specific genetic and environmental factors but also by gene–environment interactions. Although it has been widely reported that genetic polymorphisms play a critical role in human susceptibility to cancer and other chronic disease conditions, many single nucleotide polymorphisms (SNPs) are caused by somatic mutations resulting from human exposure to environmental stressors. Scientific evidence suggests that the etiology of many chronic illnesses is caused by the joint effect between genetics and the environment. Research has also pointed out that the interactions of environmental factors with specific allelic variants highly modulate the susceptibility to diseases. Hence, many scientific discoveries on gene–environment interactions have elucidated the impact of their combined effect on the incidence and/or prevalence rate of human diseases. In this review, we provide an overview of the nature of gene–environment interactions, and discuss their role in human cancers, with special emphases on lung, colorectal, bladder, breast, ovarian, and prostate cancers.
The Dual Function Model of Attachment Security Priming: Theoretical Framework and Empirical Evidence
Authors: Ai Ting , Gillath Omri , Karantzas Gery C.
Published: November 2020

According to attachment theory, security providing attachment figures fulfill two main functions: (1) safe haven—providing safety and comfort and reducing stress—helping people regain a sense of security; and (2) secure base—providing resources and a base from which people can spring into action. According to the Dual Function of Security Priming Model, security priming can result in one of two outcomes paralleling these two functions. Which outcome is likely to present itself depends on the level of stress imposed by the context. Here we describe the Dual Function Model of Security Priming (DFSP) Model and provide evidence from a study examining the effects of attachment security priming on hypothalamic-pituitary-adrenal activity. In the study, participants were exposed to security-related cues under high or low/no-stress conditions, while their salivary cortisol concentrations were measured. Cortisol is a suitable index as it is released not only in response to stress, but also more generally when energy needs to be mobilized. We found that while security priming led to significant decreases in salivary cortisol concentrations when presented after a stressor (stress reduction), it led to a significant increase in salivary cortisol concentrations when presented before the stressor (energy mobilization).
Consideration of the Psychological and Mental Health of the Elderly during COVID-19: A Theoretical Review
Authors: Lee Kunho , Jeong Goo-Churl , Yim JongEun
Published: November 2020

COVID-19 has spread worldwide causing an unprecedented public health crisis. After the World Health Organization declared a pandemic in March 2020, the number of confirmed cases and deaths has continued to increase. This situation may be prolonged until an effective, tested, and safe treatment is available. COVID-19 can occur at any age. However, the maximum confirmed cases and deaths have occurred among the elderly. Particularly, the mental and physical health of the elderly aged above 60 and classified as high-risk groups is more vulnerable than other age groups, requiring more attention. Strong social restraint, social distancing, and quarantine measures to prevent the COVID-19 spread have raised concerns about their mental health. Therefore, it is crucial to analyze and identify the psychological concepts and protective factors that support and constitute these guidelines and strategies and prepare practical suggestions and guidelines to protect the mental health of the elderly during COVID-19. These discussions will facilitate a deeper understanding and expansion of these guidelines and strategies. Therefore, this study explores factors—including pandemic-induced stress, self-integration, self-efficacy, and resilience—in order to prepare practical and detailed suggestions and guidelines using studies that considered these factors, including coping with COVID-19-induced stress, social support, and physical activity.
The Effects of Increasing Penalties in Drunk Driving Laws—Evidence from Chile
Authors: García-Echalar Andrés , Rau Tomás
Published: November 2020

This paper analyzes Chile’s drunk driving laws and their effects on car crashes, injuries, and deaths. There were two policy changes. While the 2012 law increased license suspension penalties and decreased the legal blood alcohol limits for drivers, the 2014 law only increased sanctions, including at least one year of actual imprisonment for drunk driving implicated in car crashes with severe injury or death. We use a rich data set of countrywide administrative records that permit us to identify direct measures of alcohol-related accidents, including fatalities and injuries. We also have access to blood alcohol tests to assess whether the laws affected drivers’ alcohol consumption. Using count data models and a rich set of covariates, including police stops and gasoline sales, we find a short-run decrease in accidents and injuries for the 2012 law and a sustained decline in these outcomes for the 2014 law. Neither intervention has an effect on deaths. There is a marginal decline in alcohol consumption after the enactment of both legal changes. However, while the 2012 law only affects male drivers, the 2014 law affects both males and females. No reductions in alcohol intake are found for heavy drinkers.
Intersectionality: Social Marginalisation and Self-Reported Health Status in Young People
Authors: Robards Fiona , Kang Melissa , Luscombe Georgina , Hawke Catherine , Sanci Lena , Steinbeck Katharine , Zwi Karen , Towns Susan , Usherwood Tim
Published: November 2020

Background: The aim of this study was to measure young people’s health status and explore associations between health status and belonging to one or more socio-culturally marginalised group. Methods: part of the Access 3 project, this cross-sectional survey of young people aged 12–24 years living in New South Wales, Australia, oversampled young people from one or more of the following groups: Aboriginal and or Torres Strait Islander; living in rural and remote areas; homeless; refugee; and/or, sexuality and/or gender diverse. This paper reports on findings pertaining to health status, presence of chronic health conditions, psychological distress, and wellbeing measures. Results: 1416 participants completed the survey; 897 (63.3%) belonged to at least one marginalised group; 574 (40.5%) to one, 281 (19.8%) to two and 42 (3.0%) to three or four groups. Belonging to more marginalised groups was significantly associated with having more chronic health conditions (p = 0.001), a greater likelihood of high psychological distress (p = 0.001) and of illness or injury related absence from school or work (p < 0.05). Conclusions: increasing marginalisation is associated with decreasing health status. Using an intersectional lens can to be a useful way to understand disadvantage for young people belonging to multiple marginalised groups.
Solar UV Radiation in the Tropics: Human Exposure at Reunion Island (21° S, 55° E) during Summer Outdoor Activities
Authors: Cadet Jean-Maurice , Bencherif Hassan , Cadet Nicolas , Lamy Kévin , Portafaix Thierry , Belus Matthias , Brogniez Colette , Auriol Frédérique , Metzger Jean-Marc , Wright Caradee Y.
Published: November 2020

Reunion Island is a popular tourist destination with sandy beaches, an active volcano (Piton de la Fournaise), and Piton des Neiges, the highest and most dominant geological feature on the island. Reunion is known to have high levels of solar ultraviolet radiation (UVR) with an ultraviolet index (UVI) which can reach 8 in winter and 16 in summer (climatological conditions). UVR has been linked to skin cancer, melanoma, and eye disease such as cataracts. The World Health Organization (WHO) devised the UVI as a tool for expressing UVR intensity. Thresholds ranging from low (UVI 1–2) to extreme (UVI > 11) were defined depending on the risk to human health. The purpose of the study was to assess UVR exposure levels over three of the busiest tourist sites on the island. UVR was measured over several hours along popular hiking trails around Piton de la Fournaise (PDF), Piton des Neiges (PDN), and St-Leu Beach (LEU). The results were compared with those recorded by the local UV station at Saint-Denis. In addition, cumulative standard erythemal dose (SED) was calculated. Results showed that UVI exposure at PDF, PDN, and LEU were extreme (>11) and reached maximum UVI levels of 21.1, 22.5, and 14.5, respectively. Cumulative SEDs were multiple times higher than the thresholds established by the Fitzpatrick skin phototype classification. UVI measurements at the three study sites showed that Reunion Island is exposed to extreme UVR conditions. Public awareness campaigns are needed to inform the population of the health risks related to UVR exposure.
Adolescents’ Sexy Self-Presentation on Instagram: An Investigation of Their Posting Behavior Using a Prototype Willingness Model Perspective
Authors: Van Ouytsel Joris , Walrave Michel , Ojeda Mónica , Del Rey Rosario , Ponnet Koen
Published: November 2020

Some adolescents use social media platforms, such as Instagram, for sexualized self-presentation, which includes posting images in which someone is scarcely dressed, has a sexy gaze or in which sexual willingness is suggested. These behaviors could be a first step towards sexting. Given that adolescents are highly influenced by peer perceptions, this study uses the prototype willingness model to assess how teenagers’ perceptions of others could influence their posting behaviors. The study was conducted among 2626 students (n = 1530; 58.4% girls) between the ages of 14 and 21 (M = 16.14; SD = 1.02) in 10 secondary schools in the Dutch-speaking community in Belgium. The results show that older adolescents and girls were more likely to post images of themselves on Instagram. The models showed that peer norms and willingness and attitudes were significantly associated with posting intention. The perceived norms of adolescents’ parents were not significantly related to the behaviors. There were also significant associations between perceived similarity, prototype favorability and the willingness to engage in sexualized self-presentation on Instagram. The implications for education and practice are discussed.
Relationship between the Normative Need for Orthodontic Treatment and Oral Health in Mexican Adolescents Aged 13–15 Years Old
Authors: González-Aragón Pineda Álvaro Edgar , García Pérez Alvaro , Rosales-Ibáñez Raúl , Stein-Gemora Eduardo
Published: November 2020

This cross-sectional study aimed to establish a relationship between the Normative Need for Orthodontic Treatment (NNOT) and oral health among Mexican adolescents aged 13–15 years old. A convenience sample of 424 subjects in Mexico City participated in the study. The dependent variable used was NNOT, which was determined via the dental health component (grades 4 and 5) of the Index of Orthodontic Treatment Need (IOTN). The variables for oral health were as follows: caries experience, oral hygiene, self-reported temporomandibular joint pain, and self-reported bruxism. Logistic regression models were fitted to determine the association between NNOT and oral health. The prevalence of NNOT was 66.0% (280/424), and the crowding was the most prevalent occlusal anomaly with 36.1% (n = 135). Multivariate models showed that subjects with NNOT were more than twice as likely to present poor hygiene (OR = 2.56; p = 0.001) as subjects presenting crowding (>4 mm) (OR = 1.99; p = 0.004) and increased overjet (>6 mm) (OR = 1.74; p = 0.046). Those schoolchildren who presented anterior guidance were 72% less likely to present NNOT (OR = 0.28; p < 0.001). In conclusion, the risk of presenting NNOT in Mexican adolescents is high, with a prevalence of over 50% of which the most prevalent occlusal anomaly was crowding. On the other hand, poor oral hygiene was associated with crowding and increased overjet.
Investigating the Associations among Drug Dependents’ Family Function and Exercise Attitudes: Marital Status Differences
Authors: Liu Jianing , McDonough Daniel J. , Wang Yingying , Zhou Yu , Gao Zan , Zhou Chenglin
Published: November 2020

This paper examines: (1) The demographic characteristics of different marital statuses of drug dependents; (2) differences in exercise attitudes and family function by marital status; and (3) if family function factors correlated with exercise attitudes and if exercise attitude factors correlated with family function. Multivariate analyses of variance (MANOVAs) revealed significant differences in drug dependents’ exercise attitudes between married and single groups (p < 0.05) and the married and “other” groups (p < 0.01). Furthermore, we observed significant differences in drug dependents’ family function between married and single groups (p < 0.01) and married and other groups (p < 0.05). Regression analyses indicated that communication [Fchange(1,1791) = 137.819; p < 0.001] was a significant positive predictor for drug dependents’ exercise attitude, accounting for 7.1% of the observed variance. Moreover, 50% of the variance was explained by willingness [Fchange(1,1791) = 850.49, p < 0.001] and control [Fchange(1,1790) = 141.415, p < 0.001], which were two significant predictors of drug dependents’ family function. Findings of this study were: (1) Exercise attitude and family function of married drug dependents were better than single drug dependents and other marital status addicts; (2) communication was observed as a factor of family function that correlated with exercise attitude; and (3) willingness was related with family function.
Harvest Programs in First Nations of Subarctic Canada: The Benefits Go Beyond Addressing Food Security and Environmental Sustainability Issues
Authors: Tsuji Leonard J. S. , Tsuji Stephen R. J. , Zuk Aleksandra M. , Davey Roger , Liberda Eric N.
Published: November 2020

By breaking down barriers that impacted the ability of subarctic First Nations people to harvest waterfowl, the Sharing-the-Harvest program provided a safe, nutritious, and culturally appropriate food (i.e., geese) to James Bay Cree communities while also helping to protect the environment by harvesting overabundant geese. However, the impacts extend beyond those described above. Thus, the objectives of the present paper are twofold: to document the food sharing networks of the Sharing-the-Harvest program; and to examine the benefits associated with the harvest program beyond food security and environmental sustainability issues, as revealed through semi-directed interviews. In the regional initiative, harvested geese were shared with all James Bay communities; sharing is an important part of Cree culture. Where detailed information was collected, the goose-sharing network reached 76% of the homes in one of the communities. Likewise, in the local initiative, the goose-sharing network had a 76% coverage rate of the homes in the community. Although decreasing food insecurity was an important focus of the harvest-sharing programs, there were other benefits, from an Indigenous perspective, of being on the land, as identified by the Cree harvesters through semi-directed interviews (e.g., the transmission of Indigenous knowledge, the strengthening of social networks, and the feeling of wellness while out on-the-land). Thus, by participating in the on-the-land harvest programs, the Cree gained benefits beyond those solely related to strengthening food security and contributing in part to environmental sustainability. The Sharing-the-Harvest protocol has the potential to be adapted and employed by other Indigenous (or marginalized) groups worldwide, to help improve health and wellness, while, also protecting the environment from overabundant and/or invasive species.
Adverse Birth Outcomes Related to NO2 and PM Exposure: European Systematic Review and Meta-Analysis
Authors: Simoncic Valentin , Enaux Christophe , Deguen Séverine , Kihal-Talantikite Wahida
Published: November 2020

There is a growing number of international studies on the association between ambient air pollution and adverse pregnancy outcomes, and this systematic review and meta-analysis has been conducted focusing on European countries, to assess the crucial public health issue of this suspected association on this geographical area. A systematic literature search (based on Preferred Reporting Items for Systematic reviews and Meta-Analyses, PRISMA, guidelines) has been performed on all European epidemiological studies published up until 1 April 2020, on the association between maternal exposure during pregnancy to nitrogen dioxide (NO2) or particular matter (PM) and the risk of adverse birth outcomes, including: low birth weight (LBW) and preterm birth (PTB). Fourteen articles were included in the systematic review and nine of them were included in the meta-analysis. Our meta-analysis was conducted for 2 combinations of NO2 exposure related to birth weight and PTB. Our systematic review revealed that risk of LBW increases with the increase of air pollution exposure (including PM10, PM2.5 and NO2) during the whole pregnancy. Our meta-analysis found that birth weight decreases with NO2 increase (pooled beta = −13.63, 95% confidence interval (CI) (−28.03, 0.77)) and the risk of PTB increase for 10 µg/m3 increase in NO2 (pooled odds ratio (OR) = 1.07, 95% CI (0.90, 1.28)). However, the results were not statistically significant. Our finding support the main international results, suggesting that increased air pollution exposure during pregnancy might contribute to adverse birth outcomes, especially LBW. This body of evidence has limitations that impede the formulation of firm conclusions. Further studies, well-focused on European countries, are called to resolve the limitations which could affect the strength of association such as: the exposure assessment, the critical windows of exposure during pregnancy, and the definition of adverse birth outcomes. This analysis of limitations of the current body of research could be used as a baseline for further studies and may serve as basis for reflection for research agenda improvements.
The Gender Difference in Association between Home-Based Environment and Different Physical Behaviors of Chinese Adolescents
Authors: Hou Xiao , Liu Jing-Min , Tang Zheng-Yan , Ruan Bing , Cao Xu-Yao
Published: November 2020

Purpose: The aim of this study was to evaluate the home-based physical activity (PA) environmental characteristics, and different types of physical behavior level of adolescents in different genders, and explore the impact of different domains of home-based PA environmental factors on different physical behaviors of adolescents in different genders. Methods: Five hundred forty-four adolescents aged from 12 to 18 years old (males: n = 358, females: n = 186) and their parents were analyzed in this cross-sectional survey. The volume of various physical behaviors of all adolescent subjects were measured by the ActiGraph wGT3X-BT accelerometer, and the level in different domains of home-based environmental characteristics were assessed by the Gattshall’s home-based PA environment questionnaire, which was answered by adolescents’ parents. The difference in the volume of different physical behaviors was examined using Kruskal–Wallis analysis. The difference in home physical environment and home social environment for adolescents was examined using one-way analysis of variance (ANOVA). Multiple linear regression analysis in the adjusted model was used to evaluate the influence of different home-based PA environmental domains (PA availability, PA accessibility, Parental role-modeling of PA, and Parental policies around PA) on different physical behaviors (sedentary behavior, SB; light-intensity physical activity, LPA; and moderate-vigorous physical activity, MVPA) of adolescents (boys and girls). Results: The volume of LPA and MVPA, the score of PA accessibility in the home physical environment, and the score of home social environment of boys are significantly higher than those of girls, while the SB volume of boys is significantly lower than that of girls. The PA availability, the parents’ role-modeling of PA in same-sex parent–child dyads, and the parents’ policies around PA in opposite-sex parent–child dyads are significantly associated with adolescents’ decreased SB and increased LPA and MVPA. Conclusion: There is significant gender difference in adolescents’ physical behaviors and home-based environmental characteristics, as well as in the association between adolescents’ physical behaviors and their home-based environment. The PA availability, the parents’ role-modeling of PA in same-sex parent–child dyads, and the parents’ policies around PA in opposite-sex parent–child dyads can significantly promote adolescents’ healthy physical behaviors.