bluuebunny/crossref_metadata_2025 huggingface dataset:
Effect of Compensatory Mechanisms on Postural Disturbances and Musculoskeletal Pain in Elite Sitting Volleyball Players: Preparation of a Compensatory Intervention
Authors: Gaweł Eliza , Zwierzchowska Anna
Published: September 2021

The aim of the study was to identify the effect of compensatory mechanisms on the prevalence of sagittal spinal curvature deformity and musculoskeletal pain and to assess the interrelationships between those components in sitting volleyball players. Twenty-one elite Polish sitting volleyball players (age = 34.1 ± 7.5, BM = 77.9 ± 16.0) participated in the study in which direct participatory systematic observation and a non-invasive method were used. Both objective (anthropometric, spinal curvature–Idiag M360) and subjective (musculoskeletal ailments–NMQ = 7) measurements were performed. The Statistica 13.3 software package was used for statistical analyses. The neck, lower back (43%), and upper back (38%) were the most frequently reported painful areas. Of all participants, 76% reported sagittal spinal deformities. In the habitual position, the results indicated moderate correlations (r = 0.5, p < 0.05) between the lumbar concavity of the back and low back pain (LBP) and between thoracic convexity and LBP (r = 0.4, p < 0.05). Internal and external compensation have an effect on the prevalence of spinal curvature deformities in the sagittal plane, with thoracic hyperkyphosis (38%) and lumbar hyperlordosis (33%) being the most common. More severe lower and upper back pain were correlated with greater angles of thoracic kyphosis and lumbar lordosis in the habitual position.
Prenatal Exposure to Acetaminophen and Childhood Asthmatic Symptoms in a Population-Based Cohort in Los Angeles, California
Authors: Liew Zeyan , Yuan Yuying , Meng Qi , von Ehrenstein Ondine S. , Cui Xin , Flores Marie E. S. , Ritz Beate
Published: September 2021

Acetaminophen is the most common over-the-counter pain and fever medication used by pregnant women. While European studies suggest acetaminophen exposure in pregnancy could affect childhood asthma development, findings are less consistent in other populations. We evaluated whether maternal prenatal acetaminophen use is associated with childhood asthmatic symptoms (asthma diagnosis, wheeze, dry cough) in a Los Angeles cohort of 1201 singleton births. We estimated risk ratio (RR) and 95% confidence interval (CI) for childhood asthmatic outcomes according to prenatal acetaminophen exposure. Effect modification by maternal race/ethnicity and psychosocial stress during pregnancy was evaluated. The risks for asthma diagnosis (RR = 1.39, 95% CI 0.96, 2.00), wheezing (RR = 1.25, 95% CI 1.01, 1.54) and dry cough (RR =1.35, 95% CI 1.06, 1.73) were higher in children born to mothers who ever used acetaminophen during pregnancy compared with non-users. Black/African American and Asian/Pacific Islander children showed a greater than two-fold risk for asthma diagnosis and wheezing associated with the exposure. High maternal psychosocial stress also modified the exposure-outcome relationships. Acetaminophen exposure during pregnancy was associated with childhood asthmatic symptoms among vulnerable subgroups in this cohort. A larger study that assessed prenatal acetaminophen exposure with other social/environmental stressors and clinically confirmed outcomes is needed.
Effects of a Specific Core Stability Program on the Sprint and Change-of-Direction Maneuverability Performance in Youth, Male Soccer Players
Authors: Brull-Muria Eric , Beltran-Garrido Jose Vicente
Published: September 2021

Although it is recommended to use sport-specific training programs to optimize performance, studies analyzing the effects of the core stability training with high levels of sport-specificity on athletic performance are insufficient and unclear. The objective of this study was to analyze the effects of the level of specificity of a CORE stability program on specific soccer actions. Fourteen youth players were randomly assigned to the specific core stability group (SCS; n = 7) or the general core stability group (GCS; n = 7). The eight-week intervention consisted of two weekly training sessions added to the usual soccer training. Both groups performed four CORE stability tasks. The SCS group followed the principle of sports specificity, while the GCS group performed CORE stability commons. Ten-meter linear sprinting (Sprint) and change-of-direction maneuverability (V-cut) were evaluated before and after the intervention programs. A statistically significant improvement was obtained in Sprint (d = 0.84 95% CI (0.22, 1.45), p = 0.008) and V-cut (d = 1.24 95% CI (0.52, 1.93), p < 0.001). At posttest, statistically nonsignificant differences were obtained between groups in Sprint (d = 1.03 95% CI (−0.25, 2.30), p = 0.082) and V-cut (d = −0.56 95% CI (−1.89, 0.78), p = 0.370). In conclusion, sprint and change-of-direction maneuverability were improved, but there was no superiority of any type of training.
Exposure Profile to Traffic Related Pollution in Pediatric Age: A Biomonitoring Study
Authors: Antonucci Arianna , Protano Carmela , Astolfi Maria , Mattei Vincenzo , Santilli Francesca , Martellucci Stefano , Vitali Matteo
Published: September 2021

The aim of this study was to trace an exposure profile to traffic-derived pollution during pediatric age. For this purpose, two biomonitoring campaigns for the determination of urinary (u-) methyl tert-butyl ether (MTBE), ethyl tert-butyl ether (ETBE), tert-amyl methyl ether (TAME), and diisopropyl ether (DIPE) were carried out in two different periods of the year (summer 2017 and winter 2018), among a large sample of healthy children (n = 736; 5–11 years old) living in rural and urban areas in central Italy. The quantification of u-MTBE, u-ETBE, u-TAME, and u-DIPE was performed by HS-SPME-GC/MS technique and information on participants was collected by a questionnaire. u-DIPE concentrations resulted always under the LOQ. u-TAME mean levels were similar in both seasons (18.7 ng L−1 in summer vs. 18.9 ng L−1 in winter), while u-MTBE and u-ETBE levels were, respectively, 69.9 and 423.5 ng L−1 (summer) and 53.3 and 66.2 ng L−1 (winter). Main predictors of urinary excretion resulted the time spent in motor vehicles, being male and younger.
The Junior Students’ Internet Literacy Scale: Measure Development and Validation
Authors: Huang Yinghui , Liu Hui , Wang Weijun , Dong Rouchun , Tang Yun
Published: September 2021

Despite the great attention paid to Internet literacy research, little has been done to overcome the problems stemming from the heterogeneity of Internet literacy nomenclature and the use of non-standardized measurement tools, especially for adolescents in developing countries. Considering junior students are the high-risk groups of Internet addiction and have wide access to the Internet, the aim of this study is to develop a new scale to assess Chinese junior students’ Internet literacy (JIL). In the psychometric study (n = 1099 junior students), an 18-item scale was developed using the exploratory and confirmatory factor analyses, which includes five subscales: knowledge and skills for the Internet (KSI), Internet self-management (ISM), awareness and cognition of Internet (ACI), Internet interactions (II), and autonomous learning on the Internet (ALI). Evidence of internal reliability, test-retest reliability, and construct validity provided good psychometric support for the measure. Criterion-related validity of the measures was demonstrated by examining its anticipated theoretical relations to two hypotheses: (1) High JIL level alleviates the adverse effects of an individual’s Internet addiction degree, while pathological use for interacting with others on the Internet exacerbates the adverse effects; (2) an individual’s degree of Internet use self-efficacy is positively associated with JIL level. It is envisaged that the JIL Scale will help facilitate unified research in the field.
Sustainable Business Model in the Product-Service System: Analysis of Global Research and Associated EU Legislation
Authors: Batlles-delaFuente Ana , Belmonte-Ureña Luis Jesús , Plaza-Úbeda José Antonio , Abad-Segura Emilio
Published: September 2021

The business fabric is trying to resolve the many transformations that have occurred in recent decades. Companies are obliged to offer new ways to meet the needs of the market. This situation has led to the creation of new business models that combine both competitiveness and sustainability. Among the most consistent strategies, the product-service system (PSS) stands out. A bibliometric analysis was carried out on 1088 documents during the period 2000–2020, to synthesize the knowledge base on PSS in a global context and analyse future trends. The results obtained have made it possible to identify the evolution of scientific production, the main drivers of this issue, the lines of research developed and their link with EU legislation and reveal some critical gaps in knowledge. The main lines of research describe different aspects of PSS: servitisation, product design, manufacturing, life cycle, circular economy, and sustainable development. This study has identified how its analysis has developed to date and what terms allow us to glimpse new approaches; hence, it is a useful tool for PSS researchers and sponsors who provide financial resources that allow new directions in this research.
Spatial Coupling and Causal Effects between the Recreational Use of Ecological Land and Restoration: A Case Study of the Pearl River Delta Urban Agglomeration
Authors: Wang Fuyuan , Feng Rundong
Published: September 2021

As the urbanization and industrialization of China’s urban agglomerations reach increasingly high levels, residents are voicing a growing demand for improved green public sport and recreational space. The coordination of ecological land restoration (ELR) and recreational use at the regional level is therefore urgent. This study demonstrates the spatiotemporal evolution of coupled ELR and the recreational use of ecological land (RUoEL) in the Pearl River Delta urban agglomeration based on spatial interpretation, remote sensing mapping, and spatial statistical analysis. A geographical and temporally weighted regression is used to test the spatial effects of the RUoEL on the evolution of the ELR patterns. The results show that the RUoEL (mainly greenways and ecological recreational spaces) and ELR exert a certain degree of coupled spatial characteristics, and that the former significantly impacts the latter. These spatial differences are more notable in areas with high-level ecological recreational spaces, or which are located near densely populated built-up areas. Recreation-oriented ELR is therefore relatively easy to develop in these areas. The results provide important guidelines for the development of ecosystem service patterns in urban agglomerations that include the coexistence of ELR and recreational use, which will strengthen the academic support for regional ELR planning and improve public health.
Occupational Infections among Dental Health Workers in Germany—14-Year Time Trends
Authors: Malsam Rebecca , Nienhaus Albert
Published: September 2021

Dental health workers (DHW) are at increased risk of acquiring occupational infections. Due to various protective measures, it can be assumed that infections have decreased over the past 14 years. Secondary data from a German accident insurance company was analyzed in terms of reported and confirmed occupational diseases (OD) in DHW from 2006 to 2019. A total of 271 claims were reported, of which 112 were confirmed as OD, representing an average of eight per year. However, the number of claims and confirmed ODs has decreased by 65.6% and 85.7%, respectively. The decrease was most evident for hepatitis B (HBV) and C (HCV) infections, while tuberculosis (TB) infections were stable. A total of 44 HCV, 33 HBV, 6 TB and 24 latent TB infections were confirmed as ODs. For DHW, 0.05, and for hospital workers, 0.48 claims per 1000 full-time equivalents (FTE) were registered in 2019. In a separate documentation system, between March 2020 and February 2021, 155 COVID-19 claims were registered, and 47 cases were confirmed as ODs. For DHW, 0.7, and for hospital workers, 47.3 COVID-19 claims per 1000 FTE were registered since 2020. Occupational infectious diseases rarely occur among DHW. Nevertheless, new infectious diseases such as COVID-19 pose a major challenge for DHW. Continued attention should be paid to infectious disease prevention.
Estimation of the Impact of Foodborne Salmonellosis on Consumer Well-Being in Hungary
Authors: Vajda Ágnes , Ózsvári László , Szakos Dávid , Kasza Gyula
Published: September 2021

In Hungary, salmonellosis is one of the most frequent foodborne illnesses. According to our estimation, based on a representative consumer survey with 1001 respondents, the annual number of salmonellosis cases exceeded 90,000, which was 18 times higher than the officially reported data. Salmonellosis infections impose significant direct and indirect costs to the health care system, to companies (as employers) and to households. This study focused on the cost to households by analysing well-being losses due to Salmonella infections, for which the WTP (willingness-to-pay) method was used. WTP measures the cost that an individual would pay to avoid an undesirable harm or health outcome. For estimating WTP, 456 respondents gave quantifiable answers. The average WTP to avoid salmonellosis was 86.3 EUR. Based on this data, the total consumer well-being loss could be estimated to be about 7.87 million EUR per year in Hungary. These results indicate that consumers’ well-being losses alone would necessitate further interventions for Salmonella reduction.
Residents’ Insights on Their Local Food Environment and Dietary Behaviors: A Cross-City Comparison Using Photovoice in Spain
Authors: Gravina Leyre , Jauregi Amets , Fernández-Aedo Irrintzi , Díez Julia , Gittelsohn Joel , Colón-Ramos Uriyoan , Franco Manuel
Published: September 2021

Perceptions of local food environments and the ability of citizens to engage in participatory research may vary, even if participants share similar cultural and socioeconomic contexts. In this study, we aimed to describe participants’ narratives about their local food environment in two cities in Spain. We used the participatory methodology of Photovoice to engage participants in Madrid (n = 24) and Bilbao (n = 17) who took and discussed photographs about their local food environment (Madrid; n = 163 and Bilbao; n = 70). Common themes emerged across both cities (food insecurity, poverty, use of public spaces for eating and social gathering, cultural diversity and overconsumption of unhealthy foods); however, in Bilbao citizens perceived that there was sufficient availability of healthy foods despite that living in impoverished communities. Photovoice was a useful tool to engage participating citizens to improve their local food environments in both cities. This new approach allowed for a photovoice cross-city comparison that could be useful to fully understand the complexity and diversity of residents’ perceptions regardless of their place of residence.
Process of Posthospital Care Involving Telemedicine Solutions for Patients after Total Hip Arthroplasty
Authors: Kamecka Karolina , Rybarczyk-Szwajkowska Anna , Staszewska Anna , Engelseth Per , Kozlowski Remigiusz
Published: September 2021

The importance of telemedicine technologies around the world has been growing for many years, and it turned out to be a particularly important issue for conducting some medical procedures during the SARS-CoV-2 pandemic. It is necessary to create interdisciplinary teams to design and implement improved procedures using telemedicine tools. The aim of the article is to develop original, improved posthospital patient care process after total hip arthroplasty (THA) with the use of telemedicine technologies. In the study, a literature review and empirical research were used. The conducted research resulted in the designing an original posthospital patient care process after THA that uses telematics technologies. Due to the use of analyzed telemedicine technologies, the designed patient care process brings a possibility to increase the patient′s safety by monitoring life parameters, allowing for regular, remote contact with specialists and to be supervised remotely. All this may contribute to shortening the convalescence time, reducing the risk of complications, as well as reducing treatment costs. The designed model is ready for further clinical research with the participation of medical staff, patients after THA and patient caregivers.
Recruiting Cancer Survivors to a Mobile Mindfulness Intervention in the United States: Exploring Online and Face-to-Face Recruitment Strategies
Authors: Arnobit Celine Isabelle , Loo Kiana , Pagano Ian , Uchiyama Mai , Fukui Jami , Braun-Inglis Christa , Bantum Erin O’Carroll
Published: September 2021

Cancer survivorship research faces several recruitment challenges, such as accrual of a representative sample, as well as participant retention. Our study explores patterns in recruited demographics, patient-reported outcomes (PROs), and retention rates for a randomized controlled trial (RCT) utilizing a mobile mindfulness intervention for the well-being of cancer survivors. In total, 123 participants were recruited using traditional and online strategies. Using the chi-square test of independence, recruitment type was compared with demographic and clinical variables, PROs, and retention at Time 2 and Time 3. Online recruitment resulted in almost double the yield compared to traditional recruitment. Online-recruited participants were more often younger, from the continental U.S., Caucasian, diagnosed and treated less recently, at a later stage of diagnosis, diagnosed with blood cancer, without high blood pressure, and with less reported pain. The recruitment method was not significantly associated with retention. Online recruitment may capture a larger, broader survivor sample, but, similar to traditional recruitment, may also lead to selection biases depending on where efforts are focused. Future research should assess the reasons underlying the higher yield and retention rates of online recruitment and should evaluate how to apply a mix of traditional and online recruitment strategies to efficiently accrue samples that are representative of the survivor population.
The Effect of Hamstring Relaxation Program on Headache, Pressure Pain Threshold, and Range of Motion in Patients with Tension Headache: A Randomized Controlled Trial
Authors: Kwon Soon-Hyun , Chung Eun-Jung , Lee Jin , Kim Sang-Woo , Lee Byoung-Hee
Published: September 2021

The purpose of this study was to determine if the severity of headache is reduced by decreasing hamstring tension in patients with tension headache. Thirty patients participated in this study. The participants were randomly allocated to two groups: hamstring relaxation program (HR) group (n = 15) and control group (n = 15). The participants in the HR group participated in a HR program for 25 min per day, three times per week, for a period of 4 weeks, and the control group participated in an electrotherapy for 25 min per day, three times per week, for a period of 4 weeks. Both groups participated in a self-myofacial release for 5 min per day, three times per week, for a period of 4 weeks. Headache was evaluated using the headache impact test (HIT-6) and visual analog scale (VAS). The pain pressure threshold (PPT) was evaluated using a digital pressure algometer. The range of motion (ROM) was evaluated using a goniometer and two special tests: straight leg raise test (SLRT) and popliteal angle test (PAT). The two groups showed no significant differences in terms of age, sex, height, and weight. The VAS and HIT-6 scores (p < 0.05) and neck and hamstring PPT showed significant improvements (p < 0.05). Neck flexion ROM and SLRT and PAT scores showed significant improvements (p < 0.05) in both groups, and the HR group showed significantly more improvements than the control group. This study confirmed that the HR program has positive effects on tension headache and is a good intervention for alleviating headaches in patients with tension headache.
Sex, Sleep Duration, and the Association of Cognition: Findings from the China Health and Retirement Longitudinal Study
Authors: Li Wei , Sun Ning , Kondracki Anthony , Sun Wenjie
Published: September 2021

Background: We aimed to examine the association between sleep duration and cognitive impairment among elderly Chinese people. Methods: generalized linear modeling was used to analyze the baseline data for adults aged 65 years and over (n = 4785) selected from the 2011 China Health and Retirement Longitudinal Study (CHARLS). The two aspects of cognitive impairment assessed in the study were mental status and memory. Sex-stratified logistic regression models were conducted to identify the effect of sleep duration in the different gender groups. Results: of all the participants, 49.8% were females and 32.5% aged 75 years and over. Of the participants, 59.7% had short sleep duration (<7 h/day), and 9.0% of them had long sleep duration (>8 h/day). Compared to normal sleep duration, long sleep duration was associated with lower mental status scores (β = −0.43, p = 0.001) and lower memory scores (β = −0.26, p = 0.006). Long sleep duration was associated with lower mental status in both men (β = −0.37, p = 0.033) and women (β = −0.46, p = 0.025), however, only in men was long sleep duration found to be associated with low memory scores (β = −0.26, p = 0.047). Conclusions: Our study showed that long sleep duration was significantly associated with poorer mental status and memory scores in elderly Chinese people. Paying greater attention to the effects of sleep patterns on the risk of cognitive decline may yield practical implications for dementia prevention and health promotion, especially among older women with lower educational attainment, living in rural areas, and those who have long sleep duration.
Is Medication-Related Osteonecrosis of the Jaws (MRONJ) Associated to Cyclin-Dependent Kinase (CDK) 4/6 Inhibitors? A Word of Cautiousness. Comment on Marcianò et al. Medication-Related Osteonecrosis of the Jaws and CDK4/6 Inhibitors: A Recent Association. Int. J. Environ. Res. Public Health 2020, 17, 9509
Authors: Fusco Vittorio , Alessio Manuela , Guglielmini Pamela Francesca , Vincenti Maura , Fasciolo Antonella , Rossi Maura
Published: September 2021

Marcianò et al. launched an alert in this journal about a possible association between medication-related osteonecrosis of the jaws (MRONJ) and cyclin-dependent kinase (CDK) 4/6 inhibitors in breast cancer patients [...]
Dual Tasking during Trip Recovery and Obstacle Clearance among Young, Healthy Adults in Human Factors Research
Authors: Kodithuwakku Arachchige Sachini N. K. , Chander Harish , Knight Adam C. , Burch V Reuben F. , Chen Chih-Chia , Reneker Jennifer C.
Published: September 2021

Trip-induced falls are extremely common in ergonomic settings. Such situations can lead to fatal or non-fatal injuries, affecting the workers’ quality of life and earning capacity. Dual tasking (DT) is a leading cause of trips and ineffective obstacle clearance among workers. DT increases their attentional demand, challenging both postural control and concurrent secondary tasks. As the human brain has limited attentional processing capacity, even young, healthy adults need to prioritize duties during DT. This article aimed to analyze these secondary task types and their applications in recent trip-related studies conducted on young, healthy adults. An extensive review of the recent trip-related literature was performed to provide a condensed summary of the dual tasks used. In previous trip-related literature, distinct types of secondary tasks were used. The choice of the concurrent task must be made vigilantly depending on the occupation, environmental context, available resources, and feasibility. DT can be used as a tool to train workers on selective attention, which is a lifesaving skill in ergonomic settings, especially in the occupations of roofers, construction workers, or truck drivers. Such training can result in successful obstacle clearance and trip recovery skills, which eventually minimizes the number of falls at the workplace.
Reply to Fusco et al. Is Medication-Related Osteonecrosis of the Jaws (MRONJ) Associated to Cyclin-Dependent Kinase (CDK) 4/6 Inhibitors? A Word of Cautiousness. Comment on “Marcianò et al. Medication-Related Osteonecrosis of the Jaws and CDK4/6 Inhibitors: A Recent Association. Int. J. Environ. Res. Public Health 2020, 17, 9509”
Authors: Marcianò Antonia , Guzzo Gian Marco , Peditto Matteo , Picone Antonio , Oteri Giacomo
Published: September 2021

We read the letter from Dr. Fusco and colleagues with great interest, and we would like to thank them for the stimulating comments regarding our paper “Medication-Related Osteonecrosis of the Jaws and CDK4/6 Inhibitors: A Recent Association” [...]
Telepsychiatry to Provide Mental Health Support to Healthcare Professionals during the COVID-19 Crisis: A Cross-Sectional Survey among 321 Healthcare Professionals in France
Authors: Cormi Clément , Sanchez Stéphane , de l’Estoile Valentine , Ollivier Laura , Letty Aude , Berrut Gilles , Mulin Emmanuel
Published: September 2021

Pandemics are difficult times for the mental health of healthcare professionals, who are more likely to present with PTSD-like symptoms. In the context of a highly contagious communicable disease, telemedicine is a useful alternative to usual care, and should be considered as a means to support healthcare professionals’ mental health. This is a multicenter (n = 19), cross-sectional study, based on a 27-item questionnaire, aiming to investigate the acceptability to healthcare workers of a telepsychiatry service as a means of providing mental health support during the COVID-19 pandemic. Between October and December 2020, 321 responses were received, showing that women, caregiving staff, and those directly involved in the care of COVID-19 patients are less favorable to the idea of receiving remote support. In our population, barriers were related to the clinical setting or ethics, and most of the respondents would not accept a drug prescription by telepsychiatry. Although telepsychiatry should be a part of the armamentarium of mental health management, it is not suitable as a stand-alone approach, and should be combined with conventional face-to-face consultations.
The Role of Physical Activity-Related Health Competence and Leisure-Time Physical Activity for Physical Health and Metabolic Syndrome: A Structural Equation Modeling Approach for German Office Workers
Authors: Blaschke Simon , Carl Johannes , Ellinger Jan , Birner Ulrich , Mess Filip
Published: September 2021

Office workers (OWs) are prone to insufficient physical activity (PA), which increases their risk of metabolic syndrome (MetS) and impaired physical health. The Physical Activity-related Health Competence (PAHCO) model holds the potential to facilitate a healthy physically active lifestyle. Therefore, in this study, we investigate the interplay between PAHCO, leisure-time PA, physical health, and MetS in OWs in Germany. In a cross-sectional study, OWs (N = 316, 25% female) completed self-report questionnaires along with an occupational health checkup to examine their Metabolic Syndrome Severity Score (MetSSS) values. Structural equation modeling indicated a strong positive association between PAHCO and leisure-time PA and a small positive association with physical health. PAHCO showed a considerable negative association with the MetSSS. Leisure-time PA was a positive mediator for the PAHCO–physical health association but was not a significant mediator for the association between PAHCO and the MetSSS. These findings underscore the importance of PAHCO in the context of leisure-time PA, physical health, and MetS in OWs. Furthermore, our findings highlight the health-enhancing value of the qualitative aspects of PA, such as motivational and volitional components in PA participation, with respect to physical health and MetS.
Agonist Treatment for Opioid Dependence Syndrome: The Impact of Current Understanding upon Recommendations for Policy Initiatives
Authors: Dickson Cheryl , Junod Valérie , Stamm René , Jeannot Emilien , Hämmig Robert , Scholten Willem , Simon Olivier
Published: September 2021

The provision of opioid agonist treatments (OATs), as a standard approach towards opioid dependence syndrome, differs widely between countries. In response to access disparities, in 2014, the Council of Europe’s Pompidou Group first brought together an expert group on framework conditions for the treatment of opioid dependence. The group used a Delphi approach to structure their discussions and develop guiding principles for the modernisation of OAT regulations and legislation. The expert group identified some 60 guiding principles, which were then the subject of wide public consultation. Endorsed by Pompidou Group member states, the final report identified four key recommendations: (1) Prescription and delivery without prior authorisation schemes; (2) Effective removal of financial barriers to access to care; (3) Coordination and follow-up by a national consultative body; and (4) Neutral, precise and respectful terminology. During meetings, the expert group hypothesised that inequalities in OAT access are likely to be linked to underlying rationales which in theory are contradictory, but in practice co-exist within the different political frameworks. The present article considers the perceived influence upon different regulatory frameworks. Discussion is centred around the potential impact of underlying rationales upon the effective implementation of a modernised framework.
Work-Related Health Literacy: A Scoping Review to Clarify the Concept
Authors: Ehmann Anna T. , Ög Eylem , Rieger Monika A. , Siegel Achim
Published: September 2021

The overall aim of this scoping review is to outline the current state of research on health literacy (HL) in the workplace: the primary objective is to clarify the concept of individual work-related HL; the secondary aims are to report on interventions that promote individual work-related HL and to present respective measurement instruments validated to date. A high level of work-related HL could support work ability and in the longer run employability. These topics are becoming increasingly important in current circumstances and in view of ongoing developments (e.g., digitalization and “new” work). A basic understanding and measurement of HL as an individual competence in the context of working life is necessary to develop future interventions to promote HL among people of working age. According to the participants, concept, and context (PCC) framework, we included articles on health literacy (concept) in the target group of people of working age in the workplace (population and context). Key information sources were the databases PubMed, CINAHL, PsycInfo, and PSYNDEX. A total of 30 articles were included. There are several terms for “health literacy in the workplace” (including individual work-related or occupational HL). The conceptualizations of the individual employee’s competence covered all aspects of HL (“access”, “understand”, “appraise”, and “apply” health information). The conceptualizations differed, among others, in the covered time horizon (referring either only to employees’ current work situation or additionally to their employability in the lifespan) or whether they referred also to the viability of the respective company. Published interventions attempting to promote individual work-related HL seem mostly to be targeted at the promotion of mental HL. A variety of outcomes have been measured in intervention studies, while specific measurement instruments for individual work-related HL seem to be scarce. We recommend the development of country-specific instruments for the assessment of individual work-related health literacy and to measure mental and physical work-related health literacy.
Validation of the Generative Acts Scale-Chinese Version (GAS-C) among Middle-Aged and Older Adults as Grandparents in Mainland China
Authors: Guo Haoyi , Ngai Steven Sek-yum
Published: September 2021

The current study examined the psychometric properties of the 20-item Generative Acts Scale-Chinese version (GAS-C) among middle-aged and older adults as grandparents in mainland China. A total of 1013 grandparents (mean age = 58.32 years; 71.9% female) of children from 12 kindergartens were recruited using multistage cluster random sampling. A four-factor pattern of domestic, agentic, communal, and civic generative acts were identified by exploratory factor analysis and further verified by confirmatory factor analysis (CFA). Subsequently, multigroup CFA was performed to test the measurement invariance across gender, age group and hukou status at the configural, metric, and scalar levels. The Cronbach’s alpha value of the total (0.923) and subscales (range from 0.897 to 0.953) was satisfactory, indicating high internal consistency. Additionally, the significant gender differences in the domestic (male = 3.565, female = 3.718, p < 0.05), communal (male = 2.786, female = 2.591, p < 0.01), and civic subscales (male = 2.112, female = 1.864, p < 0.001) and the significant correlations between the GAS-C total scale and subscales with caregiving intensity (r = 0.433, p < 0.01), positive affect (r = 0.397, p < 0.01) and life satisfaction (r = 0.328, p < 0.01), supported concurrent validity. Overall, this study addressed the knowledge gap by validating a reliable and valid instrument to measure grandparents’ generative acts in mainland China, contributing to generativity studies cross-culturally in research and practice.
Relationship between Quality of Nursing Work Life and Uniformed Nurses’ Attitudes and Practices Related to COVID-19 in the Philippines: A Cross-Sectional Study
Authors: Navales Juneffer Villamen , Jallow Amadou Wurry , Lai Chien Yu , Liu Chieh Yu , Chen Shu Wen
Published: September 2021

(1) Background: Coronavirus disease 2019 (COVID-19) has spread rapidly worldwide. Uniformed nurses have played a critical role during the COVID-19 pandemic in the Philippines; however, uptake of literature is limited. This study assessed the relationship between quality of nursing work life (QNWL) and nurses’ attitudes and practices during the COVID-19 pandemic. (2) Methods: A descriptive cross-sectional design was used. Participants were recruited from four government hospitals in the Manila metropolitan area of the Philippines. Participants completed three questionnaires in an online survey: a demographic questionnaire, a QNWL questionnaire, and the attitude and practices toward COVID-19 questionnaire. Descriptive statistics, an independent t-test, a one-way analysis of variance, the Pearson correlation coefficient, and hierarchical linear regression were applied for data analysis. (3) Results: The mean age of the participants was 29 years. Most of the participants were single women who were not certified in their specialties. A total of QNWL scores were high, indicating that the participants displayed favorable attitudes and practices in relation to COVID-19. A statistically significant relationship was observed between QNWL, specialty certification, and practices related to COVID-19. Practices related to COVID-19 were a significant predictor of QNWL and one of its subscales, work design. (4) Conclusion: Young adult uniformed nurses in the Philippines have assumed numerous responsibilities during the COVID-19 pandemic. Providing these frontline nurses with comprehensive specialized education and training is crucial.
Civil Liability of Regional Health Services: The Case of the Piedmont Region
Authors: Rizzi Alessandro , Sorano Enrico , Cerrato Stefano A. , Riganti Federico , Stiari Alessandro , Macrì Ernesto , Sardi Alberto
Published: September 2021

Civil liability represents one of the main responsibilities for healthcare facilities; it is the legal responsibility of paying money for damage to a person’s health. Even though this responsibility plays a key role in the economic sustainability of healthcare facilities, the literature does not enough investigate this responsibility in regional health services. The paper aims to define the evolution of compensation models for health civil liability adopted by regional health services. Through a longitudinal case study, the paper investigates the compensation model by a leading regional health service. The finding highlights the evolution of the compensation model for health civil liability adopted by a leading Regional Health Service from 1990 to 2021. It describes a transition from an insurance model to a mixed model based on self-coverage up to a set economic level, an insurance policy with self-insurance retention and deductible for all claims. The research contributes to the literature and practice throughout the definition of a compensation model for damages based on self-insurance of regional health service and insurance policies. The research promotes a compensation model used by a leading regional health service.
The Relationship between Weight Stigma, Physical Appearance Concerns, and Enjoyment and Tendency to Avoid Physical Activity and Sport
Authors: Bevan Nadia , O’Brien Kerry S. , Lin Chung-Ying , Latner Janet D. , Vandenberg Brian , Jeanes Ruth , Puhl Rebecca M. , Chen I-Hua , Moss Simon , Rush Georgia
Published: September 2021

Participation in physical activity and sport is on the decline and there is a poor understanding of the psychosocial factors that contribute to people’s reluctance to participate. We examined whether there were relationships between factors such as weight stigma, weight bias internalization, appearance evaluation, and fears of negative appearance evaluations, and enjoyment and avoidance of physical activity and sport. Undergraduate students (N = 579) completed a survey assessing demographics, and the variables described above. In hierarchal multivariate regression models, weight stigma (β = −0.16, p < 0.001), appearance evaluation (β = 0.19, p = 0.001), and weight bias internalization (β = −0.19, p = 0.003) were associated with lower enjoyment of physical activity and sport. Weight stigma (β = 0.46, p = 0.001), weight bias internalization (β = 0.42, p = 0.001), and fear of negative appearance evaluations (β = 0.16, p = 0.000) were also significantly associated with the tendency to avoid physical activity and sport. Serial mediation analysis showed the relationship between weight stigma and enjoyment of physical activity and sport was through appearance evaluation and weight bias internalization (indirect effect = −0.007, SE = 0.002, 95% CI = −0.01, −0.02). Similarly, the relationship between weight stigma and avoidance of physical activity and sport was through weight bias internalization and fear of negative appearance evaluations (indirect effect = 0.11, SE = 0.03, 95% CI = 0.05, 0.16). These results suggest that weight stigma and concerns about one’s physical appearance influence people’s enjoyment and reasoning for avoiding physical activity and sport. Research is needed to identify ways to reduce body-related stigma and increase enjoyment and participation in physical activity and sport.
Efficient Visualization of Large-Scale Oblique Photogrammetry Models in Unreal Engine
Authors: Huo Yuhao , Yang Anran , Jia Qingren , Chen Yebin , He Biao , Li Jun
Published: September 2021

Oblique photogrammetry models are indispensable for implementing digital twins of cities. Geographic information system researchers have proposed plenty of methods to load and visualize these city-scaled scenes. However, when the area viewed changes quickly in real-time rendering, current methods still require excessive GPU calculation and memory occupation. In this study, we propose a data organization method in which we merged all quadtrees and used a binary encoding method to encode nodes in a merged tree so that the parent–child relationship between the tree nodes could be calculated using rapid binary operations. After that, we developed a strategy to cancel the loading of redundant nodes based on the parent–child relationship, which helped to reduce the hard disk loading time and the amount of memory occupied in visualization. Moreover, we introduced a parameter to measure the area of the triangle mesh per pixel to achieve unified data scheduling under different production standards. We implemented our method based on Unreal Engine (UE), and three experiments were designed to illustrate the advantages of our methods in index acceleration, frame time, and memory reduction. The results show that our methods can significantly improve visualization fluency and reduce memory usage.
Good Cholesterol Gone Bad? HDL and COVID-19
Authors: Kluck George E. G. , Yoo Jeong-Ah , Sakarya Emmanuel H. , Trigatti Bernardo L.
Published: September 2021

The transmissible respiratory disease COVID-19, caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has affected millions of people worldwide since its first reported outbreak in December of 2019 in Wuhan, China. Since then, multiple studies have shown an inverse correlation between the levels of high-density lipoprotein (HDL) particles and the severity of COVID-19, with low HDL levels being associated with an increased risk of severe outcomes. Some studies revealed that HDL binds to SARS-CoV-2 particles via the virus’s spike protein and, under certain conditions, such as low HDL particle concentrations, it facilitates SARS-CoV-2 binding to angiotensin-converting enzyme 2 (ACE2) and infection of host cells. Other studies, however, reported that HDL suppressed SARS-CoV-2 infection. In both cases, the ability of HDL to enhance or suppress virus infection appears to be dependent on the expression of the HDL receptor, namely, the Scavenger Receptor Class B type 1 (SR-B1), in the target cells. SR-B1 and HDL represent crucial mediators of cholesterol metabolism. Herein, we review the complex role of HDL and SR-B1 in SARS-CoV-2-induced disease. We also review recent advances in our understanding of HDL structure, properties, and function during SARS-CoV-2 infection and the resulting COVID-19 disease.
Metastatic Prostate Cancer Cells Secrete Methylglyoxal-Derived MG-H1 to Reprogram Human Osteoblasts into a Dedifferentiated, Malignant-like Phenotype: A Possible Novel Player in Prostate Cancer Bone Metastases
Authors: Antognelli Cinzia , Marinucci Lorella , Frosini Roberta , Macchioni Lara , Talesa Vincenzo Nicola
Published: September 2021

Bone metastases from prostate cancer (PCa) result from a complex cross-talk between PCa cells and osteoblasts (OB). Thus, targeting this interplay has become an attractive strategy to interfere with PCa bone dissemination. The agents currently used in clinical trials have proved ineffective, boosting research to identify additional mechanisms that may be involved in this two-directional talk. Here, we investigated whether and how 5-hydro-5-methylimidazolone (MG-H1), a specific methylglyoxal (MG)-derived advanced glycation end product (AGE), was a novel player in the dialogue between PCa and OB to drive PCa bone metastases. Conditioned medium from osteotropic PC3 PCa cells, pre-treated or not with a specific MG scavenger, was administrated to human primary OB and cell morphology, mesenchymal trans-differentiation, pro-osteogenic determinants, PCa-specific molecules, and migration/invasion were studied by phase-contrast microscopy, real-time PCR, western blot and specific assays, respectively. We found that PC3 cells were able to release MG-H1 that, by binding to the receptor for AGEs (RAGE) on OB, reprogrammed them into a less-differentiate phenotype, endowed with some PCa-specific molecular features and malignant properties, in a mechanism involving reactive oxidative species (ROS) production and NF-kB pathway activation. These findings provide novel insights into the mechanisms of PCa osteoblastic metastases and foster in vivo research toward new therapeutic strategies interfering with PCa/OB cross-talk.
LncRNA MALAT1 Facilitates Ovarian Cancer Progression through Promoting Chemoresistance and Invasiveness in the Tumor Microenvironment
Authors: Mao Tsui-Lien , Fan Ming-Huei , Dlamini Nhlanhla , Liu Chao-Lien
Published: September 2021

Upregulation of metastasis-associated lung adenocarcinoma transcript 1 (MALAT1, also known as nuclear-enriched abundant transcript 2 (NEAT2) or LINC00047) was found in various solid tumors, including epithelial ovarian cancer (EOC). MALAT1 is a long noncoding (lnc)RNA that regulates many functional signaling pathways, including tumorigenesis. Herein, we observed the consistent upregulation of MALAT1 in MYST4-overexpressing cell lines, while MALAT1 was frequently found to be upregulated in various types of clinical carcinoma tissues, especially EOC. To further investigate the lncRNA MALAT1 in EOC progression, the transduced overexpression of MALAT1 in EOC cell lines and cancer-associated fibroblasts (CAFs) was employed. We found that MALAT1 overexpression in EOC cell lines significantly increased drug resistance, cell migration, and invasion. Furthermore, the concomitant overexpression of MALAT1 in EOC cells and CAFs dramatically increased EOC cell invasion. Accordingly, a mechanistic investigation of MALAT1 overexpression in EOC cells showed that expressions of the cytokines interleukin (IL)-1β and p-P38/p-NFκB/Cox2/prostaglandin E2 (PGE2) signaling were significantly increased, which stimulated inflammatory responses, whereas cell apoptosis was inhibited due to increased Bcl-2 levels and reduced Caspase3 levels. After MALAT1 was overexpressed in EOC cells, and the cyclin D1, p-PI3K, and p-Akt expressions increased, suggesting the promotion of tumor cell proliferation, while increased zinc finger E-box-binding homeobox-2 (ZEB2), yes-associated protein (YAP), and vimentin expression with E-cadherin downregulation indicated the enhancement of the epithelial-to-mesenchymal transition (EMT) in terms of metastasis, thereby triggering EOC progression. Together, our findings demonstrate how MALAT1 overexpression facilitates an oncogenic function through inhibiting tumor cell apoptosis, combined with increasing tumor cell inflammation, proliferation, and invasion in the EOC tumor microenvironment. MALAT1 is thus a potential diagnostic marker and therapeutic for this malignancy.
Wnt Modulation Enhances Otic Differentiation by Facilitating the Enucleation Process but Develops Unnecessary Cardiac Structures
Authors: Carpena Nathaniel T. , Chang So-Young , Choi Ji-Eun , Jung Jae Yun , Lee Min Young
Published: September 2021

Otic organoids have the potential to resolve current challenges in hearing loss research. The reproduction of the delicate and complex structure of the mammalian cochlea using organoids requires high efficiency and specificity. Recent attempts to strengthen otic organoids have focused on the effects of the Wnt signaling pathway on stem cell differentiation. One important aspect of this is the evaluation of undesirable effects of differentiation after Wnt activation. In the present study, we differentiated mouse embryonic stem cell embryoid bodies (EB) into otic organoids and observed two morphologies with different cell fates. EBs that underwent a core ejection process, or ‘enucleation,’ were similar to previously reported inner ear organoids. Meanwhile, EBs that retained their core demonstrated features characteristic of neural organoids. The application of a Wnt agonist during the maturation phase increased enucleation, as well as otic organoid formation, in turn leading to sensory hair cell-like cell generation. However, with a longer incubation period, Wnt activation also led to EBs with ‘beating’ organoids that exhibited spontaneous movement. This observation emphasizes the necessity of optimizing Wnt enhancement for the differentiation of specific cells, such as those found in the inner ear.