bluuebunny/crossref_metadata_2025 huggingface dataset:
Psychological Stress as a Risk Factor for Accelerated Cellular Aging and Cognitive Decline: The Involvement of Microglia-Neuron Crosstalk
Authors: Carrier Micaël , Šimončičová Eva , St-Pierre Marie-Kim , McKee Chloe , Tremblay Marie-Ève
Published: November 2021

The relationship between the central nervous system (CNS) and microglia is lifelong. Microglia originate in the embryonic yolk sac during development and populate the CNS before the blood-brain barrier forms. In the CNS, they constitute a self-renewing population. Although they represent up to 10% of all brain cells, we are only beginning to understand how much brain homeostasis relies on their physiological functions. Often compared to a double-edged sword, microglia hold the potential to exert neuroprotective roles that can also exacerbate neurodegeneration once compromised. Microglia can promote synaptic growth in addition to eliminating synapses that are less active. Synaptic loss, which is considered one of the best pathological correlates of cognitive decline, is a distinctive feature of major depressive disorder (MDD) and cognitive aging. Long-term psychological stress accelerates cellular aging and predisposes to various diseases, including MDD, and cognitive decline. Among the underlying mechanisms, stress-induced neuroinflammation alters microglial interactions with the surrounding parenchymal cells and exacerbates oxidative burden and cellular damage, hence inducing changes in microglia and neurons typical of cognitive aging. Focusing on microglial interactions with neurons and their synapses, this review discusses the disrupted communication between these cells, notably involving fractalkine signaling and the triggering receptor expressed on myeloid cells (TREM). Overall, chronic stress emerges as a key player in cellular aging by altering the microglial sensome, notably via fractalkine signaling deficiency. To study cellular aging, novel positron emission tomography radiotracers for TREM and the purinergic family of receptors show interest for human study.
Inhibition of Advanced Glycation End Products in Yogurt by Lotus Seedpod Oligomeric Procyanidin
Authors: Feng Nianjie , Shen Yang , Hu Chuanqin , Tan Jiangying , Huang Zhao , Wang Chao , Guo Zhiqiang , Wu Qian , Xiao Juan
Published: November 2021

The basic ingredients of yogurt include lactose and protein. Yogurt undergoes the Maillard reaction easily, producing many advanced glycation end products (AGEs) that cause some chronic diseases. Lotus seedpod oligomeric procyanidin (LSOPC) have demonstrated a strong inhibitory effect on AGE formation in simulated models; however, the inhibition of procyanidin on AGE formation and the subsequent effects on yogurt quality remains unknown. Our study demonstrated that LSOPC had a good inhibitory effect on the formation of fluorescent AGEs and Nε-carboxymethyl lysine (P < 0.05). The inhibitory capacity on AGEs and antioxidant activity of yogurt were positively correlated with the concentration of LSOPC. The effect of LSOPC on the physicochemical properties of yogurt was also evaluated. Bound water content, viscosity, and flavor of yogurt were significantly increased after LSOPC addition (P < 0.05). Therefore, LSOPC may lead to significant benefits for controlling AGE formation and improving the quality of yogurt.
A Multi-Center, Real-World Study of Chidamide for Patients With Relapsed or Refractory Peripheral T-Cell Lymphomas in China
Authors: Liu Weiping , Zhao Donglu , Liu Ting , Niu Ting , Song Yongping , Xu Wei , Jin Jie , Cai Qingqing , Huang Huiqiang , Li Zhiming , Hou Ming , Zhang Huilai , Zhou Jianfeng , Hu Jianda , Shen Jianzhen , Shi Yuankai , Yang Yu , Zhang Liling , Zhao Weili , Ding Kaiyang , Qiu Lugui , Tan Huo , Zhang Zhihui , Liu Lihong , Wang Jinghua , Xu Bing , Zhou Hui , Gao Guangxun , Xue Hongwei , Bai Ou , Feng Ru , Huang Xiaobing , Yang Haiyan , Yan Xiaojing , Zeng Qingshu , Liu Peng , Li Wenyu , Mao Min , Su Hang , Wang Xin , Xu Jingyan , Zhou Daobin , Zhang Hongyu , Ma Jun , Shen Zhixiang , Zhu Jun
Published: November 2021

Chidamide has demonstrated significant clinical benefits for patients with relapsed/refractory (R/R) PTCL in previous studies. This multi-center observational study was aimed to evaluate the objective response rate (ORR), overall survival (OS), and safety of chidamide. From February 2015 to December 2017, 548 patients with R/R PTCL from 186 research centers in China were included in the study. Among the 261 patients treated with chidamide monotherapy, ORR was 58.6% and 55 patients (21.1%) achieved complete response (CR). Among the 287 patients receiving chidamide-containing combination therapies, ORR was 73.2% and 73 patients (25.4%) achieved CR. The median OS of all patients was 15.1 months. The median OS of patients receiving chidamide monotherapy and combination therapies was 433 and 463 days, respectively. These results demonstrate a significant survival advantage of chidamide treatments as compared with international historical records. Common adverse effects (AEs) were hematological toxicities. Most AEs in both monotherapy and combined treatments were grade 1–2. No unanticipated AEs occurred. In conclusion, chidamide-based therapy led to a favorable efficacy and survival benefit for R/R PTCL. Future studies should explore the potential advantage of chidamide treatment combined with chemotherapy.
A Concise Review on the Role of CircPVT1 in Tumorigenesis, Drug Sensitivity, and Cancer Prognosis
Authors: Ghafouri-Fard Soudeh , Khoshbakht Tayyebeh , Taheri Mohammad , Jamali Elena
Published: November 2021

CircPVT1 (hsa_circ_0001821) is a cancer-related circular RNA (circRNA) that originated from a genomic locus on chromosome 8q24. This locus has been previously found to encode the oncogenic long non-coding RNA PVT1. Expression of this circRNA has been found to be upregulated in diverse neoplastic conditions. CircPVT1 acts as a sponge for miR-125a, miR-125b, miR-124-3p, miR-30a-5p, miR-205-5p, miR‐423‐5p, miR‐526b, miR-137, miR-145-5p, miR-497, miR-30d/e, miR-455-5p, miR-29a-3p, miR-204-5p, miR-149, miR-106a-5p, miR-377, miR-3666, miR-203, and miR-199a-5p. Moreover, it can regulate the activities of PI3K/AKT, Wnt5a/Ror2, E2F2, and HIF-1α. Upregulation of circPVT1 has been correlated with decreased survival of patients with different cancer types. In the current review, we explain the oncogenic impact of circPVT1 in different tissues based on evidence from in vitro, in vivo, and clinical investigations.
Successful Outcome After Intralesional Curettage for Spindle Cell Hemangioma of Fibula in an Infant: A Case Report
Authors: Han Tao , Wang Rufa , Zhou Xiaoguang
Published: November 2021

Spindle cell hemangioma (SCH), a non-neoplastic reactive vascular lesion, rarely locates in bones. We herein report a successful case of intralesional curettage for an infant with SCH of fibula. An 11-month-old boy was admitted to our center with a painless mass in the right proximal calf. Preoperative digital radiograph demonstrated a massive vascular lesion with an irregular bone destruction of proximal fibula. The lesion was removed via the intralesional curettage approach and pathologically diagnosed as SCH. The patient gained bone structure recovery of right proximal fibula. Two years after the surgery, he experienced no local recurrence. For the management of SCH of fibula with partial bone destruction, we suggest early-stage intralesional curettage as its safety and effectiveness.
Insight Into the Beneficial Role of Lactiplantibacillus plantarum Supernatant Against Bacterial Infections, Oxidative Stress, and Wound Healing in A549 Cells and BALB/c Mice
Authors: Dubey Ashish Kumar , Podia Mansi , Priyanka  , Raut Sachin , Singh Sanpreet , Pinnaka Anil Kumar , Khatri Neeraj
Published: November 2021

Lactiplantibacillus plantarum MTCC 2621 is a well-characterized probiotic strain and is reported to possess many health benefits. However, the wound healing potential of this probiotic is yet to be explored. Here, we have assessed the antibacterial, antioxidant, and wound healing activities of cell-free supernatant of Lactiplantibacillus plantarum MTCC 2621 (Lp2621). Lp2621 exhibited excellent antibacterial activity against the indicator bacteria in the agar well diffusion assay. Lp2621 did not show any hemolytic activity. The safety of Lp2621 gel was established using the skin irritation assay in BALB/c mice, and no dermal reactions were observed. The supernatant showed 60–100% protection of A549 cells against H2O2-induced stress. In the scratch assay, Lp2621 accelerated wound healing after 24 h of treatment. The percent wound healing was significantly higher in cells treated with Lp2621 at 18–24 h posttreatment. In an excision wound healing in mice, topical application of Lp2621 gel showed faster healing than the vehicle- and betadine-treated groups. Similar wound healing activity was observed in wounds infected with Staphylococcus aureus. Histological examination revealed better wound healing in Lp2621-treated mice. Topical treatment of the wounds with Lp2621 gel resulted in the upregulation of pro-inflammatory cytokine IL-6 in the early phase of wound healing and enhanced IL-10 expression in the later phase. These findings unveil a protective role of Lp2621 against bacterial infection, oxidative stress, and wound healing.
Intersegment Contacts of Potentially Damaging Variants of Cardiac Sodium Channel
Authors: Korkosh Vyacheslav S. , Zaytseva Anastasia K. , Kostareva Anna A. , Zhorov Boris S.
Published: November 2021

Over 1,500 missense variants of sodium channel hNav1.5, which are reported in the ClinVar database, are associated with cardiac diseases. For most of the variants, the clinical significance is uncertain (VUS), not provided (NP), or has conflicting interpretations of pathogenicity (CIP). Reclassifying these variants as pathogenic/likely pathogenic (P/LP) variants is important for diagnosing genotyped patients. In our earlier work, several bioinformatics tools and paralogue annotation method consensually predicted that 74 VUS/NP/CIP variants of 54 wild type residues (set w54) are potentially damaging variants (PDVs). Atomic mechanisms underlying dysfunction of the PDVs are unknown. Here we employed a recent cryo-EM structure of the hNav1.5 channel with likely inactivated pore domain (PD) and activated voltage-sensing domains (VSDs), and ad hoc models of the closed and open PD and resting VSDs to explore intersegment contacts of w54 residues. We found that 44 residues from set w54 contact 84 residues with 118 disease missense variants. These include 104 VUS/NP/CIP variants, most of which are associated with the loss-of-function Brugada syndrome (BrS1) or gain-of-function long QT syndrome (LQT3). Matrix representation of the PDVs and their contact variants facilitated recognition of coupled mutations associated with the same disease. In particular, BrS1-associated coupled mutations, which disturb the P-loops region with the selectivity filter slow inactivation gate, would cause the channel dysfunction. Other likely causes of the channel dysfunction include coupled BrS1-associated variants within VSDs that would destabilize their activated states and coupled LQT3-associated variants, which would stabilize the open PD or activated VSDs. Our study proposes mechanisms of channel dysfunction for scores of BrS1- and LQT3-associated variants, confirms status for 82% of PDVs, and suggests damaging status for their contact variants, which are currently categorized as VUS/NP/CIP variants.
The R2R3 Transcription Factor CsMYB59 Regulates Polyphenol Oxidase Gene CsPPO1 in Tea Plants (Camellia sinensis)
Authors: Huang Xiangxiang , Ou Shuqiong , Li Qin , Luo Yong , Lin Haiyan , Li Juan , Zhu Mingzhi , Wang Kunbo
Published: November 2021

Polyphenol oxidase (PPO) plays a role in stress response, secondary metabolism, and other physiological processes during plant growth and development, and is also a critical enzyme in black tea production. However, the regulatory mechanisms of PPO genes and their activity in tea plants are still unclear. In this study, we measured PPO activity in two different tea cultivars, Taoyuandaye (TYDY) and Bixiangzao (BXZ), which are commonly used to produce black tea and green tea, respectively. The expression pattern of CsPPO1 was assessed and validated via transcriptomics and quantitative polymerase chain reaction in both tea varieties. In addition, we isolated and identified an R2R3-MYB transcription factor CsMYB59 that may regulate CsPPO1 expression. CsMYB59 was found to be a nuclear protein, and its expression in tea leaves was positively correlated with CsPPO1 expression and PPO activity. Transcriptional activity analysis showed that CsMYB59 was a transcriptional activator, and the dual-luciferase assay indicated that CsMYB59 could activate the expression of CsPPO1 in tobacco leaves. In summary, our study demonstrates that CsMYB59 represents a transcriptional activator in tea plants and may mediate the regulation of PPO activity by activating CsPPO1 expression. These findings provide novel insights into the regulatory mechanism of PPO gene in Camellia sinensis, which might help to breed tea cultivars with high PPO activity.
Creeping Bentgrass Yield Prediction With Machine Learning Models
Authors: Zhou Qiyu , Soldat Douglas J.
Published: November 2021

Nitrogen is the most limiting nutrient for turfgrass growth. Instead of pursuing the maximum yield, most turfgrass managers use nitrogen (N) to maintain a sub-maximal growth rate. Few tools or soil tests exist to help managers guide N fertilizer decisions. Turf growth prediction models have the potential to be useful, but the currently existing turf growth prediction model only takes temperature into account, limiting its accuracy. This study developed machine-learning-based turf growth models using the random forest (RF) algorithm to estimate short-term turfgrass clipping yield. To build the RF model, a large set of variables were extracted as predictors including the 7-day weather, traffic intensity, soil moisture content, N fertilization rate, and the normalized difference red edge (NDRE) vegetation index. In this study, the data were collected from two putting greens where the turfgrass received 0 to 1,800 round/week traffic rates, various irrigation rates to maintain the soil moisture content between 9 and 29%, and N fertilization rates of 0 to 17.5 kg ha–1applied biweekly. The RF model agreed with the actual clipping yield collected from the experimental results. The temperature and relative humidity were the most important weather factors. Including NDRE improved the prediction accuracy of the model. The highest coefficient of determination (R2) of the RF model was 0.64 for the training dataset and was 0.47 for the testing data set upon the evaluation of the model. This represented a large improvement over the existing growth prediction model (R2= 0.01). However, the machine-learning models created were not able to accurately predict the clipping production at other locations. Individual golf courses can create customized growth prediction models using clipping volume to eliminate the deviation caused by temporal and spatial variability. Overall, this study demonstrated the feasibility of creating machine-learning-based yield prediction models that may be able to guide N fertilization decisions on golf course putting greens and presumably other turfgrass areas.
The Mindset of Intelligence Is Not a Contributor of Placebo Effects in Working Memory Training
Authors: Liu Peibing , Zhang Xin , Zhou Renlai
Published: November 2021

Whether working memory training is effective in enhancing fluid intelligence remains in dispute. Several researchers, who doubt the training benefits, consider that placebo effects may be the reason for positive training gains. One of the vital variables that may induce the placebo effect is the mindset of intelligence. In this article, we provide a test of whether the mindset of intelligence leads to placebo effects in working memory training. Participants were overtly recruited and allocated to the growth mindset group or the fixed mindset group by Theories of Intelligence Scale scores. A single, 1 h session working memory training is the cue to introduce the placebo effects. During pre/post-testing, all participants completed tasks measuring working memory capacity (near transfer) and fluid intelligence (far transfer). Our findings show no significant difference between the two groups in both tasks. Therefore, these results suggest that the placebo effect does not exist in this study, which means individuals' mindset of intelligence may not be a contributor to the placebo effect in 1 h working memory training. This research will further help to clarify the mechanism of the placebo effect in working memory training.
The Relationship Between Preschool Teachers’ Proactive Personality and Innovative Behavior: The Chain-Mediated Role of Error Management Climate and Self-Efficacy
Authors: Pan Baocheng , Song Zhanmei , Wang Youli
Published: November 2021

Objective: This study, aims to explore the relationship of error management climate and self-efficacy between preschool teachers’ proactive personality and innovative behavior.

Methods: Four hundred thirty-nine preschool teachers were tested by proactive personality scale, error management climate scale, general self-efficacy scale, and employee innovation behavior scale.

Results: Preschool teachers’ proactive personality can directly predict their innovative behaviors, has a significant indirect effect on innovative behaviors through error management climate, and has a significant indirect effect on innovative behaviors through self-efficacy. Error management climate and self-efficacy play a chain-mediated role in the relationship between preschool teachers’ proactive personality and innovative behavior.

Conclusion: Error management climate and self-efficacy play a chain-mediated role in the relationship between preschool teachers’ proactive personality and innovative behavior.
Exploring Parental Responses to Pre-schoolers’ “Everyday” Pain Experiences Through Electronic Diary and Ecological Momentary Assessment Methodologies
Authors: O’Sullivan Grace , McGuire Brian , Roche Michelle , Caes Line
Published: November 2021

Objective: Parental influence during children’s “everyday” pain events is under-explored, compared to clinical or experimental pains. We trialed two digital reporting methods for parents to record the real-world context surrounding their child’s everyday pain events within the family home.

Methods: Parents (N = 21) completed a structured e-diary for 14 days, reporting on one pain event experienced by their child (aged 2.5–6 years) each day, and describing child pain responses, parental supervision, parental estimates of pain severity and intensity, and parental catastrophizing, distress, and behavioral responses. During the same 2-week period, a subsample of parent-child pairs (N = 9) completed digital ecological momentary assessments (EMA), immediately after any chosen pain event. Children reported their current pain while parents estimated the child’s pain and indicated their own distress.

Results: “Everyday” pain events frequently featured minor injuries to the child’s head, hands or knees, and child responses included crying and non-verbal comments (e.g., “Ouch!”). Pain events occurred less frequently when parents had been supervising their child, and supervising parents reported lower levels of worry and anxiety than non-supervising parents. Child sex was significantly associated with parental estimates of pain intensity, with parents of girls giving higher estimates than parents of boys. Child age was significantly associated with both the number of pain events and with parental estimates of pain intensity and child distress: the youngest children (2–3 years) experienced the fewest pain events but received higher pain and distress estimates from parents than older children. Hierarchal Linear Modeling revealed that parental estimates of pain severity were significant positive predictors of parental distress and catastrophizing in response to a specific pain event. Furthermore, higher levels of parental catastrophic thinking in response to a specific pain event resulted in increased distress, solicitousness, and coping-promoting behaviors in parents. The EMA data revealed that children reported significantly higher pain intensity than their parents.

Conclusion: The electronic pain diary provided a key insight into the nature of “everyday” pain experiences around the family home. Digital daily reporting of how the family copes with “everyday” events represents a viable means to explore a child’s everyday pains without disrupting their home environment.
Students’ Performance in Online Learning Environment: The Role of Task Technology Fit and Actual Usage of System During COVID-19
Authors: Butt Sameera , Mahmood Asif , Saleem Saima , Rashid Tayyiba , Ikram Amir
Published: November 2021

The 2019 Pandemic has forced students to take online classes, increasing their stress levels and negatively impacting their academic performance. This issue urges the development of a mechanism to make online learning more effective in this nerve-racking time. Therefore, the present study has integrated the task technology fit (TTF) model and the DeLone and McLean Model of Information Systems Success (DMISM) to address the stated issue. The data were collected from 330 and 326 students of top-ranked public and private universities of Punjab, respectively. The theoretical framework was analyzed with the help of structural equation modeling (SEM) using Analysis of Moment Structures (AMOS). The findings indicate that overall quality positively predicts performance through the mediating role of user satisfaction and TTF. The overall quality also positively elevates performance through the mediating role of user satisfaction and actual usage of the system. Moreover, perceived usefulness proved to be a moderator between overall quality and user satisfaction. Finally, the expected practical and theoretical implications have also been discussed.
How Live Streaming Features Impact Consumers’ Purchase Intention in the Context of Cross-Border E-Commerce? A Research Based on SOR Theory
Authors: Guo Jia , Li Yu , Xu Yujing , Zeng Kai
Published: November 2021

Given that “cross-border e-commerce + live streaming” has become an important driver of global trade but limited attention has been paid to this area, this study examines the impacts of live streaming features on the consumers’ cross-border purchase intention from the perspectives of consumers’ overall perceived value and overall perceived uncertainty based on the SOR theory. In addition, through investigating the moderating effects of saving money, this study reveals the impacts of amazing bargains in live streaming commerce. A total of 272 samples were collected by a questionnaire survey to test the proposed research model. The results show that live streaming features significantly increase consumers’ overall perceived value and purchase intention, and significantly reduce consumers’ overall perceived uncertainty; in addition, saving money further increases the impact of live streaming features on consumers’ overall perceived value. This study provides a theoretical basis and reference for cross-border e-commerce platforms and merchants to effectively leverage live streaming to influence consumers’ perception and purchase intention.
Chinese English as a Foreign Language Teachers’ Self-Efficacy and Psychological Well-Being as Predictors of Their Work Engagement
Authors: Kong Xiansui
Published: November 2021

Work engagement is widely acknowledged as an influential element in teachers’ professional success; thus, remarkable attention has been paid to the physical and psychological predictors of this construct. Yet, the antecedents of English as a foreign language (EFL) teachers’ work engagement have rarely been studied. To narrow the existing gap, the current inquiry aimed to delve into the psychological determinants of teacher work engagement by scrutinizing the role of psychological well-being and self-efficacy in Chinese EFL teachers’ engagement. To this end, three close-ended questionnaires were given to 304 Chinese EFL teachers via WeChat messenger. Conducting correlational analyses, positive and substantial relationships were discovered between psychological well-being, self-efficacy, and teaching engagement. The function that psychological well-being and self-efficacy may serve in Chinese EFL teachers’ engagement was also assessed using path analysis. Chinese EFL teachers’ work engagement was found to be considerably affected by their sense of efficacy and well-being. Some pedagogical implications that might be noteworthy for teachers and institutional administrators are finally discussed.
Evaluation of the E-Mental Health Mindfulness-Based and Skills-Based “CoPE It” Intervention to Reduce Psychological Distress in Times of COVID-19: Results of a Bicentre Longitudinal Study
Authors: Bäuerle Alexander , Jahre Lisa , Teufel Martin , Jansen Christoph , Musche Venja , Schweda Adam , Fink Madeleine , Dinse Hannah , Weismüller Benjamin , Dörrie Nora , Junne Florian , Graf Johanna , Skoda Eva-Maria
Published: November 2021

Background: The SARS-CoV-2 pandemic poses immense challenges for health care systems and population-wide mental health. The e-mental health intervention “CoPE It” has been developed to offer standardized and manualized support to overcome psychological distress caused by the pandemic. The aim of this study was to assess the effectiveness of “CoPE It” in terms of reducing distress (primary outcome), depression and anxiety symptoms, and improving self-efficacy, and mindfulness (secondary outcomes). Furthermore, the intervention's usability, feasibility, and participants' satisfaction with “CoPE It” was evaluated (tertiary outcome). The study protocol has been published previously.

Methods: A bicentre longitudinal study was conducted from April 27th 2020 to May 3rd 2021. N = 110 participants were included in the analyses. The intervention consisted of four modules featuring different media promoting evidence-based methods of cognitive behavioral therapy and mindfulness-based stress reduction. Difference in psychological distress between baseline (T0) and post-intervention (T1) were analyzed by repeated measure analysis of covariance. Mixed linear models were applied to assess moderating effects. Depressive symptoms, generalized anxiety symptoms, self-efficacy, and mindfulness were compared between baseline (T0) and post-intervention (T1) via t-tests. Usability of the “CoPE It” intervention and participants' satisfaction was evaluated by calculation means and frequencies.

Results:Primary outcome: A significant effect of time on psychological distress at post-intervention (T1) after controlling for age, gender, education, mental illness and attitudes toward online interventions was found. Depressive and anxiety symptoms, and mindfulness were a significant moderators of the relationship between time and psychological distress for consistent wording. Secondary outcomes: There was a significant decrease in depressive symptoms and generalized anxiety, and a significant increase in self-efficacy and mindfulness between baseline (T0) and post-intervention (T1). Tertiary outcomes: 95.83% of the participants thought the “CoPE It” intervention was easy to use and 87.50% were satisfied with the “CoPE It” intervention in an overall, general sense.

Conclusion: The e-mental health “CoPE It” intervention seems to be an effective approach in reducing psychological distress, anxiety and depressive symptoms, and in enhancing self-efficacy and mindfulness during the COVID-19 pandemic. Participants' satisfaction and the program‘s feasibility, and usability were proven to be high.

Clinical Trial Registration:www.ClinicalTrials.gov, identifier: DRKS00021301.
Front-Line Emergency Department Clinician Acceptability and Use of a Prototype Real-Time Cloud-Based Influenza Surveillance System
Authors: Rothman Richard E. , Hsieh Yu-Hsiang , DuVal Anna , Talan David A. , Moran Gregory J. , Krishnadasan Anusha , Shaw-Saliba Katy , Dugas Andrea F.
Published: November 2021

Objectives: To assess emergency department (ED) clinicians' perceptions of a novel real-time influenza surveillance system using a pre- and post-implementation structured survey.

Methods: We created and implemented a laboratory-based real-time influenza surveillance system at two EDs at the beginning of the 2013-2014 influenza season. Patients with acute respiratory illness were tested for influenza using rapid PCR-based Cepheid Xpert Flu assay. Results were instantaneously uploaded to a cloud-based data aggregation system made available to clinicians via a web-based dashboard. Clinicians received bimonthly email updates summating year-to-date results. Clinicians were surveyed prior to, and after the influenza season, to assess their views regarding acceptability and utility of the surveillance system data which were shared via dashboard and email updates.

Results: The pre-implementation survey revealed that the majority (82%) of the 151 ED clinicians responded that they “sporadically” or “don't,” actively seek influenza-related information during the season. However, most (75%) reported that they would find additional information regarding influenza prevalence useful. Following implementation, there was an overall increase in the frequency of clinician self-reporting increased access to surveillance information from 50 to 63%, with the majority (75%) indicating that the surveillance emails impacted their general awareness of influenza. Clinicians reported that the additional real-time surveillance data impacted their testing (65%) and treatment (51%) practices.

Conclusions: The majority of ED clinicians found surveillance data useful and indicated the additional information impacted their clinical practice. Accurate and timely surveillance information, distributed in a provider-friendly format could impact ED clinician management of patients with suspected influenza.
Health Inequality Analysis in Europe: Exploring the Potential of the EQ-5D as Outcome
Authors: Spronk Inge , Haagsma Juanita A. , Lubetkin Erica I. , Polinder Suzanne , Janssen M. F. , Bonsel G. J.
Published: November 2021

Objective: This study explored the additive value of the multi-item EuroQol 5-Dimension 5-Level (EQ-5D-5L) as an outcome measure in health inequality analyses, relative to the single-item EuroQol visual analog scale (EQ VAS).

Methods: A sample comprising the general population from Italy, the Netherlands, and United Kingdom (UK) completed the EQ-5D-5L and the EQ VAS. The level of education was selected as a proxy for socio-economic status (SES). EQ-5D-5L level sum scores (LSS) were compared against EQ VAS scores. Stratified and multivariable analyses were used to study the associations between SES and the LSS/EQ VAS relative to the presence of chronic health conditions.

Results: A total of 10,172 people participated in this study. In the UK and Netherlands, the LSS was worst for respondents with a low educational level and better for respondents with middle and high educational levels. For Italy, the LSS was best for respondents with a middle educational level compared to respondents with low and high educational levels. The same patterns were observed for the EQ VAS, but differences were slightly smaller. Multivariable analyses showed generally stronger predictive relations in the UK, and with the LSS. The presence of chronic health conditions and being unable to work were independent strong predictors, canceling out the effects of education.

Conclusions: In three different European countries, the EQ-5D measures show the presence of education-dependent health inequalities, which are universally explained in regression analysis by independently the presence of chronic health conditions and the inability to work. In stratified analysis, the EQ-5D-5L LSS discriminates slightly better between participants with different levels of SES compared to the EQ VAS.
Experience and Discussion: Safeguards for People With Disabilities During the COVID-19 Pandemic in China
Authors: Qi Fei , Wu Yuqi , Wang Qi
Published: November 2021

The special vulnerability of people with disability (PWD) in the COIVD-19 pandemic has been confirmed by many studies, but data shows that the infection rate of PWD in China is lower than for non-disabled people. We believe that this difference can be attributed to the Chinese government's targeted safeguards for the disabled community during the pandemic, including support for disability empowerment, the establishment of a remote interactive decision-making system, fair vaccine distribution and economic protection for PWD. The professionalism of decision-makers and the maintenance of channels of interaction with PWD are also important. All of these changes have benefitted China's public health policy and legal framework. This system, which has six components (governance, prevention, response, knowledge, coordination, and people), enables the country to quickly formulate a series of safeguards for PWD that have a sufficient legal basis. We believe that China's rapidly improving public health policy and legal framework will make a hugely significant impact by alleviating the impact of the COVID-19 pandemic on the PWD community. Countries should pay more attention to discovering the special needs and obstacles of PWD in the COIVD-19 pandemic: in referring to China's experience, they should explore the protection framework for persons with disabilities and adjust it to their own needs on the basis of national conditions.
Is It Time We Stop Discouraging Evening Physical Activity? New Real-World Evidence From 150,000 Nights
Authors: Kahn Michal , Korhonen Topi , Leinonen Leena , Martinmaki Kaisu , Kuula Liisa , Pesonen Anu-Katriina , Gradisar Michael
Published: November 2021

Professional and colloquial sleep hygiene guidelines advise against evening physical activity, despite meta-analyses of laboratory studies concluding that evening exercise does not impair sleep. This study is the first to investigate the association between objectively measured evening physical activity and sleep within a real-world big-data sample. A total of 153,154 nights from 12,638 individuals aged 18–60 years (M = 40.1 SD = 10.1; 44.5% female) were analyzed. Nighttime sleep and minutes of physical activity were assessed using Polar wearable devices for 14 consecutive days. Thirty minutes or more of moderate-to-near maximal physical activity during the 3 h before sleep onset were recorded in 12.4% of evenings, and were more frequent on weekdays than weekends (13.3 vs. 10.2% respectively, p < 0.001). Linear mixed modeling revealed that sleep efficiency was not significantly associated with evening physical activity, and that sleep duration was 3.4 min longer on average on nights following evenings in which participants engaged in 30 min or more of moderate-intense physical activity. Effects were found for sleep timing metrics, as evening physical activity was linked with earlier sleep onset and offset times (−13.7 and −9.3 min, respectively). Overall, these effects were greater– but still very small– on weekdays compared to weekends. The present study provides further evidence for the lack of meaningful links between sleep duration or quality and physical activity in the hours preceding sleep. Taken together with recent meta-analytic findings, these findings suggest that changes in public health recommendations are warranted regarding evening physical activity and its relation to sleep.
Phenotyping Adopters of Mobile Applications Among Patients With COPD: A Cross-Sectional Study
Authors: Flora Sofia , Hipólito Nádia , Brooks Dina , Marques Alda , Morais Nuno , Silva Cândida G. , Silva Fernando , Ribeiro José , Caceiro Rúben , Carreira Bruno P. , Burtin Chris , Pimenta Sara , Cruz Joana , Oliveira Ana
Published: November 2021

Effectiveness of technology-based interventions to improve physical activity (PA) in people with COPD is controversial. Mixed results may be due to participants' characteristics influencing their use of and engagement with mobile health apps. This study compared demographic, clinical, physical and PA characteristics of patients with COPD using and not using mobile apps in daily life. Patients with COPD who used smartphones were asked about their sociodemographic and clinic characteristics, PA habits and use of mobile apps (general and PA-related). Participants performed a six-minute walk test (6MWT), gait speed test and wore an accelerometer for 7 days. Data were compared between participants using (App Users) and not using (Non-App Users) mobile apps. A sub-analysis was conducted comparing characteristics of PA–App Users and Non-Users. 59 participants were enrolled (73% Male; 66.3 ± 8.3 yrs; FEV1 48.7 ± 18.4% predicted): 59% were App Users and 25% were PA-App Users. Significant differences between App Users and Non-App Users were found for age (64.2 ± 8.9 vs. 69.2 ± 6.3yrs), 6MWT (462.9 ± 91.7 vs. 414.9 ± 82.3 m), Gait Speed (Median 1.5 [Q1–Q3: 1.4–1.8] vs. 2.0 [1.0–1.5]m/s), Time in Vigorous PA (0.6 [0.2–2.8] vs. 0.14 [0.1–0.7]min) and Self-Reported PA (4.0 [1.0–4.0] vs. 1.0 [0.0–4.0] Points). Differences between PA–App Users and Non-Users were found in time in sedentary behavior (764.1 [641.8–819.8] vs. 672.2 [581.2–749.4] min) and self-reported PA (4.0 [2.0–6.0] vs. 2.0 [0.0–4.0] points). People with COPD using mobile apps were younger and had higher physical capacity than their peers not using mobile apps. PA-App Users spent more time in sedentary behaviors than Non-Users although self-reporting more time in PA.
Experiences With Safer Conception Services for HIV-Serodiscordant Couples at a Referral Hospital in Nairobi, Kenya
Authors: Kaggiah Anne , Kimemia Grace , Moraa Hellen , Muiruri Peter , Kinuthia John , Roxby Alison C.
Published: November 2021

Human immunodeficiency virus-serodiscordant couples are an important source of new HIV infections in Africa. When trying to conceive, uninfected partners may be at high risk of infection if the infected partner is not virally suppressed. Multiple strategies targeting safer conception exist, but these services are limited. However, when services are available and used, serodiscordant couples can be protected from HIV transmission, and safe to have children if desired. To successfully introduce, integrate, promote, and optimize the service delivery of safer conception with HIV care, it is crucial to understand how HIV-serodiscordant couples perceive and experience these services. Further, viral load monitoring can be critical to safer conception, but there is limited literature on how it informs the decision of the partners about conception. This qualitative study describes the knowledge, perceptions, and experiences of both safer conception services and viral load monitoring among 26 HIV-serodiscordant couples seeking safer conception care at a referral hospital in Nairobi, Kenya. In-depth interviews of HIV-serodiscordant couples were conducted from April to July 2017, and transcripts were analyzed to identify the themes central to the experience of safer conception services of couples and viral load monitoring. Serodiscordant couples reported success in using some of the safer conception methods and had positive experiences with healthcare providers. However, despite using the services, some were concerned about HIV transmission to the seronegative partner and baby, while others faced challenges when using pre-exposure prophylaxis (PrEP) and vaginal insemination. Overall, their motivation to have children overcame their concern about HIV transmission, and they welcomed discussions on risk reduction. Moreover, supportive clinic staff was identified as key to facilitating trust in safer conception methods. Furthermore, viral load monitoring was identified as integral to safer conception methods, an emerging theme that requires further evaluation, especially where routine viral load monitoring is not performed. In conclusion, healthcare providers offering safer conception services should build trust with couples, and recognize the need for continual couple counseling to encourage the adoption of safer conception services.
Using Qualitative Indicators in Infrastructure Assessment Using the Functionality–Resiliency–Sustainability Framework
Authors: Upadhyaya Jyoti Kumari , Biswas Nihar , Tam Edwin K. L.
Published: November 2021

This paper presents the implementation of decision criteria template to incorporate qualitative indicators in functionality, resiliency and sustainability assessments of stormwater infrastructure using the Functionality–Resiliency–Sustainability Framework. Qualitative attributes, even though deemed important, are usually not included, or adequately considered because of their inherent subjectivity associated with assessing them. Whenever qualitative indicators are used in practice, an ordinal scale such as poor, fair, good, very good is frequently applied. However, depending on the understanding and priorities of the evaluator, the meaning of poor, fair, good and very good score can differ significantly. Such indicators were generally not intended to facilitate engineering solutions but rather management related concerns. However, understanding the issues behind using qualitative measures is critical for stormwater infrastructure because many non-conventional indicators—which are frequently non-technical measures—can be used to assess the resiliency and sustainability of stormwater system. Moreover, there are few resources to adapt specific qualitative factors to quantitative equivalents. To address this gap, a decision criteria template is developed to score qualitative indicators within a multi-criteria assessment approach so that consistency, transparency, and subjectivity in the assessment can be addressed. The indicator scoring template is illustrated in an example stormwater system in city of Windsor, Ontario, Canada. Based on the analysis done using the decision criteria matrix, it was found that city of Windsor's stormwater infrastructure resiliency is relatively better than its assessed functionality and sustainability.
MMS Observations of Double Mid-Latitude Reconnection Ion Beams in the Early Non-Linear Phase of the Kelvin-Helmholtz Instability
Authors: Eriksson Stefan , Ma Xuanye , Burch James L. , Otto Antonius , Elkington Scot , Delamere Peter A.
Published: November 2021

The MMS satellites encountered a Kelvin-Helmholtz instability (KHI) period in the early non-linear phase at the post-noon flank magnetopause on 8 Sep 2015. The adjacent magnetosheath was characterized by a pre-dominantly northward Bz > 0 magnetic field with weakly positive in-plane components in a GSM coordinate system. Ion velocity distribution functions indicate at least 17 KH vortex intervals with two typically D-shaped ion beam distributions, commonly associated with reconnection exhausts, that stream in both directions along a mostly northward magnetic field at 350–775 km/s with a median 525 km/s ion beam speed. The counter-streaming ion beams are superposed on a core population of slowly drifting magnetosheath ions with a field-aligned 50–200 km/s speed. Each interval lasted no more than 5.25 s with a median duration of 1.95 s corresponding to in-plane spatial scales 3 < ΔS < 22 di assuming a constant 1 di = 61 km ion inertial scale and a tailward VKH∼258 km/s KH vortex propagation speed along the MMS trajectory. The counter-streaming ions are predominantly observed in the warm KH vortex region between the cold magnetosheath proper and the hot isotropic ion temperature of a low-latitude boundary layer as the MMS constellation traverses a KH vortex. The in-plane spatial scales and the locations of the observed counter-streaming ion beams generally agree with the predictions of twice-reconnected magnetic fields at two mid-latitude reconnection (MLR) regions in a two-fluid three-dimensional numerical simulation previously reported for this KH event. MMS typically recorded a higher phase space density of the fast parallel ion beam that we associate with a tailward reconnection exhaust from the southern MLR (SMLR) and a lower phase space density of the fast anti-parallel ion beam that we associate with a tailward reconnection exhaust from the northern MLR (NMLR) of similar speed. This is either consistent with MMS being closer to the SMLR region than the NMLR region, or that the KHI conditions may have favored reconnection in the SMLR region for the observed in-plane magnetosheath magnetic field as predicted by a two-fluid three-dimensional numerical simulation.
A Method for Conducting Preliminary Analysis of the Nature and Context of Sport for Development and Peace Projects in Fieldwork Research: An Illustration With a Malagasy Non-Governmental Organization
Authors: Gadais Tegwen , Décarpentrie Laurie , Webb Andrew , Ayoub Marie-Belle , Bardocz-Bencsik Mariann , Bélanger Claude
Published: November 2021

More research on sport for development and peace (SDP) organizations is needed to better understand their actual contributions to the United Nations (UN) Sustainable Development Goals (SDGs). Yet, the unstable, restricted, or even risky contexts in which many non-governmental organizations (NGOs) and SDP agencies sometimes operate often leave researchers to face important challenges to develop effective or feasible methods to work with such organizations. This study aimed to address the ontological and epistemological questions about what should be known about a given context in an organization before setting off on fieldwork. We propose a methodology, based on an actantial model (AM), as a method to analyze the nature and context of a project, to assess the actors involved in the project, and to establish if the global cost (i.e., material, temporal, financial, and physical) for conducting fieldwork is realistic and feasible of all the parties involved in the potential project. To illustrate this process, we analyzed the nature and context of an SDP project in Madagascar as the first step for potential collaborative research. As researchers, we do not want to invest time and energy to build up a fully developed field research project with an NGO in a context where it would not be realistic or feasible to conduct such research. Actually in this context, developing a research protocol without an implementation strategy might not only be detrimental to the researchers, but also to the NGO itself, where resources are often limited. Accordingly, the results from this preliminary field research demonstrate that an AM is a relevant analytical tool for obtaining insights about the context, the actors, and their relationships within an NGO. In conclusion, this model might be a useful instrument for conducting an initial analysis for the preliminary identification of the necessary conditions for the construction of a sustainable empirical research partnership with a given SDP project.