bluuebunny/crossref_metadata_2025 huggingface dataset:
Renal Cell Carcinoma in Tuberous Sclerosis Complex
Authors: Henske Elizabeth P. , Cornejo Kristine M. , Wu Chin-Lee
Published: October 2021

Tuberous sclerosis complex (TSC) is an autosomal dominant disorder in which renal manifestations are prominent. There are three major renal lesions in TSC: angiomyolipomas, cysts, and renal cell carcinoma (RCC). Major recent advances have revolutionized our understanding of TSC-associated RCC, including two series that together include more than 100 TSC-RCC cases, demonstrating a mean age at onset of about 36 years, tumors in children as young as 7, and a striking 2:1 female predominance. These series also provide the first detailed understanding of the pathologic features of these distinctive tumors, which include chromophobe-like features and eosinophilia, with some of the tumors unclassified. This pathologic heterogeneity is distinctive and reminiscent of the pathologic heterogeneity in Birt–Hogg–Dube-associated RCC, which also includes chromophobe-like tumors. Additional advances include the identification of sporadic counterpart tumors that carry somatic TSC1/TSC2/mTOR mutations. These include unclassified eosinophilic tumors, eosinophilic solid cystic RCC (ESC-RCC), and RCC with leiomyomatous stroma (RCCLMS). A variety of epithelial renal neoplasms have been identified both in patients with tuberous sclerosis complex (TSC) and in the nonsyndromic setting associated with somatic mutations in the TSC1 and TSC2 genes. Interestingly, whether tumors are related to a germline or somatic TSC1/2 mutation, these tumors often display similar morphologic and immunophenotypic features. Finally, recent work has identified molecular links between TSC and BHD-associated tumors, involving the TFEB/TFE3 transcription factors.
Identification and Validation of a QTL for Bacterial Leaf Streak Resistance in Rice (Oryza sativa L.) against Thai Xoc Strains
Authors: Thianthavon Tripop , Aesomnuk Wanchana , Pitaloka Mutiara K. , Sattayachiti Wannapa , Sonsom Yupin , Nubankoh Phakchana , Malichan Srihunsa , Riangwong Kanamon , Ruanjaichon Vinitchan , Toojinda Theerayut , Wanchana Samart , Arikit Siwaret
Published: October 2021

Rice is one of the most important food crops in the world and is of vital importance to many countries. Various diseases caused by fungi, bacteria and viruses constantly threaten rice plants and cause yield losses. Bacterial leaf streak disease (BLS) caused by Xanthomonas oryzae pv. oryzicola (Xoc) is one of the most devastating rice diseases. However, most modern rice varieties are susceptible to BLS. In this study, we applied the QTL-seq approach using an F2 population derived from the cross between IR62266 and Homcholasit (HSC) to rapidly identify the quantitative trait loci (QTL) that confers resistance to BLS caused by a Thai Xoc isolate, SP7-5. The results showed that a single genomic region at the beginning of chromosome 5 was highly associated with resistance to BLS. The gene xa5 was considered a potential candidate gene in this region since most associated single nucleotide polymorphisms (SNPs) were within this gene. A Kompetitive Allele-Specific PCR (KASP) marker was developed based on two consecutive functional SNPs in xa5 and validated in six F2 populations inoculated with another Thai Xoc isolate, 2NY2-2. The phenotypic variance explained by this marker (PVE) ranged from 59.04% to 70.84% in the six populations. These findings indicate that xa5 is a viable candidate gene for BLS resistance and may help in breeding programs for BLS resistance.
Identification and Expression Profiling of Circulating MicroRNAs in Serum of Cysticercus pisiformis-Infected Rabbits
Authors: Chen Guoliang , Wang Liqun , Liu Tingli , Li Yanping , Zhang Shaohua , Li Hong , Luo Xuenong
Published: October 2021

Cysticercus pisiformis (C. pisiformis), the larval form of Taenia pisiformis, parasitize mainly the liver, omentum and mesentery of rabbits and cause huge economic losses in the rabbit breeding industry. MicroRNA (miRNA), a short non-coding RNA, is widely and stably distributed in the plasma and serum. Numerous data demonstrates that, after parasitic infection, miRNAs become the key regulatory factor for controlling host biological processes. However, the roles of serum miRNAs in C. pisiformis-infected rabbits have not been elucidated. In this study, we compared miRNA expression profiles between the C. pisiformis-infected and healthy rabbit serum using RNA-seq. A total of 192 miRNAs were differentially expressed (fold change ≥ 2 and p < 0.05), including 79 up- and 113 downregulated miRNAs. These data were verified by qRT-PCR (real time quantitative polymerase chain reaction) analysis. Additionally, GO analysis showed that the target genes of these dysregulated miRNAs were most enriched in cellular, single-organism and metabolic processes. KEGG pathway analysis showed that these miRNAs target genes were involved in PI3K-Akt, viral carcinogenesis and B cell receptor signaling pathways. Interestingly, after aligning clean reads to the T. pisiformis genome, four (miR-124-3p_3, miR-124-3p_4, miR-124a and novel-miR1) T. pisiformis-derived miRNAs were found. Of these, novel-miR1was upregulated in different periods after C. pisiformis infection, which was verified qRT-PCR, and pre- novel-miR-1 was amplified from the cysticerci by RT-PCR, implying novel-miR-1 was derived from C. pisiformis and has great potential for the diagnosis of Cysticercosis pisiformis infection. This is the first investigation of miRNA expression profile and function in the serum of rabbits infected by C. pisiformis, providing fundamental data for developing diagnostic targets for Cysticercosis pisiformis.
Development of New Cancer Treatment by Identifying and Focusing the Genetic Mutations or Altered Expression in Gynecologic Cancers
Authors: Tang Yun-Hsin , Lin Chiao-Yun , Lai Chyong-Huey
Published: October 2021

With the advent of next-generation sequencing (NGS), The Cancer Genome Atlas (TCGA) research network has given gynecologic cancers molecular classifications, which impacts clinical practice more and more. New cancer treatments that identify and target pathogenic abnormalities of genes have been in rapid development. The most prominent progress in gynecologic cancers is the clinical efficacy of poly(ADP-ribose) polymerase (PARP) inhibitors, which have shown breakthrough benefits in reducing hazard ratios (HRs) (HRs between 0.2 and 0.4) of progression or death from BRCA1/2 mutated ovarian cancer. Immune checkpoint inhibition is also promising in cancers that harbor mismatch repair deficiency (dMMR)/microsatellite instability (MSI). In this review, we focus on the druggable genetic alterations in gynecologic cancers by summarizing literature findings and completed and ongoing clinical trials.
Heritability and De Novo Mutations in Oesophageal Atresia and Tracheoesophageal Fistula Aetiology
Authors: Brosens Erwin , Brouwer Rutger W. W. , Douben Hannie , van Bever Yolande , Brooks Alice S. , Wijnen Rene M. H. , van IJcken Wilfred F. J. , Tibboel Dick , Rottier Robbert J. , de Klein Annelies
Published: October 2021

Tracheoesophageal Fistula (TOF) is a congenital anomaly for which the cause is unknown in the majority of patients. OA/TOF is a variable feature in many (often mono-) genetic syndromes. Research using animal models targeting genes involved in candidate pathways often result in tracheoesophageal phenotypes. However, there is limited overlap in the genes implicated by animal models and those found in OA/TOF-related syndromic anomalies. Knowledge on affected pathways in animal models is accumulating, but our understanding on these pathways in patients lags behind. If an affected pathway is associated with both animals and patients, the mechanisms linking the genetic mutation, affected cell types or cellular defect, and the phenotype are often not well understood. The locus heterogeneity and the uncertainty of the exact heritability of OA/TOF results in a relative low diagnostic yield. OA/TOF is a sporadic finding with a low familial recurrence rate. As parents are usually unaffected, de novo dominant mutations seems to be a plausible explanation. The survival rates of patients born with OA/TOF have increased substantially and these patients start families; thus, the detection and a proper interpretation of these dominant inherited pathogenic variants are of great importance for these patients and for our understanding of OA/TOF aetiology.
The Expanding Constellation of Histone Post-Translational Modifications in the Epigenetic Landscape
Authors: Cavalieri Vincenzo
Published: October 2021

The emergence of a nucleosome-based chromatin structure accompanied the evolutionary transition from prokaryotes to eukaryotes. In this scenario, histones became the heart of the complex and precisely timed coordination between chromatin architecture and functions during adaptive responses to environmental influence by means of epigenetic mechanisms. Notably, such an epigenetic machinery involves an overwhelming number of post-translational modifications at multiple residues of core and linker histones. This review aims to comprehensively describe old and recent evidence in this exciting field of research. In particular, histone post-translational modification establishing/removal mechanisms, their genomic locations and implication in nucleosome dynamics and chromatin-based processes, as well as their harmonious combination and interdependence will be discussed.
How Does a Family Caregiver’s Sense of Role Loss Impact the Caregiving Experience?
Authors: Ribeiro Lisa , Ho Bach Q. , Senoo Dai
Published: October 2021

Family caregivers reportedly have a powerful sense of role loss, which is felt when one senses a change in role or responsibility, relationship distancing, or a changed asymmetry. Little is known about the impact it has on the caregiving experience, so the purpose of this study was to clarify this in three distinct settings: when an individual’s primary role changed to the caregiver role after the start of caregiving; when their primary role was other than the caregiver role after this start; and when their primary role was the caregiver role before caregiving started. Sixty-six individuals responded to an online survey, and a framework method was employed to organize the collected data and uncover themes for analysis. Our findings shed light on the sense of caregiver role loss and pointed to the possibility of generating it when family caregivers rotate through held roles and the use of it as a tool to maintain or regain a sense of personal choice in life and self-priority. Our study is probably the first to analyze this phenomenon in different caregiving settings based on an individual’s primary role and role transitions and brings to light a new perspective of the phenomenon by understanding how it arises, its nuances, and its impact on the caregiver’s experience.
Insecticidal Efficacy of Microbial-Mediated Synthesized Copper Nano-Pesticide against Insect Pests and Non-Target Organisms
Authors: Vivekanandhan Perumal , Swathy Kannan , Thomas Adelina , Kweka Eliningaya J. , Rahman Afroja , Pittarate Sarayut , Krutmuang Patcharin
Published: October 2021

Currently, medical and stored grain pests are major concerns of public health and economies worldwide. The synthetic pesticides cause several side effects to human and non-target organisms. Copper nanoparticles (CuNPs) were synthesized from an aqueous extract of Metarhizium robertsii and screened for insecticidal activity against Anopheles stephensi, Aedes aegypti, Culex quinquefasciatus, Tenebrio molitor and other non-target organisms such as Artemia salina, Artemia nauplii, Eudrilus eugeniae and Eudrilus andrei. The synthesized copper nano-particles were characterized using, UV-vis spectrophotometer, Fourier Transform Infrared Spectroscopy (FTIR), X-Ray Diffraction (XRD), Energy Dispersive X-Ray analysis (EDaX), High Resolution Scanning Electron Microscope (HR-SEM) and Atomic Force Microscope (AFM) analysis. Insects were exposed to 25 μg/mL concentration produced significant mortality against larvae of A. stephensi, A. aegypti, C. quinquefasciatus and T. molitor. The lower toxicity was observed on non-target organisms. Results showed that, M. robertsii mediated synthesized CuNPs is highly toxic to targeted pests while they had lower toxicity were observed on non-target organisms.
Dementia in Media Coverage: A Comparative Analysis of Two Online Newspapers across Time
Authors: sm-Rahman Atiqur , Lo Chih Hung , Jahan Yasmin
Published: October 2021

The news media, specifically online newspapers, is one of the powerful transmitters of discourse due to its rapid accessibility that contributes to social beliefs and attitudes that often shape our perceptions on dementia and Alzheimer’s disease. The media portrayal of dementia is largely heterogeneous, but there is certainly an association between the influence of online news coverage and the social perceptions of dementia that need to be understood more broadly. In this study, we examined the portrayal of dementia in two online newspapers (The New York Times and The Guardian) that might have an influence on dementia discourse by comparing the content and form of the news coverage on dementia across time. This study was guided by three interconnected theoretical understandings: cultivation theory, agenda-setting theory, and spiral of silence theory. A total of 291 published articles featuring dementia from 2014 to 2019 were included in this study and a content analysis of the articles provided insight into the dementia-related news coverage. Our results showed that both newspapers have a decreasing trend in publishing articles related to dementia over time. In addition, dementia-related (modifiable) risk factors as principal news content was significantly associated with the year of publication. Despite a weak association between story categories and newspapers, the majority of articles reported preventive measures as the main story category. Although both newspapers featured more articles with a less negative tone across time when reporting on dementia, derogative wording, as discourse, was commonly used to address the illness. We have provided some insight into understanding how online newspapers potentially affect subjective representations of dementia as well as perpetuate dementia discourse. Finally, we suggest that future study may benefit from establishing a linkage between the depiction of dementia in online newspapers and the contextualization of dementia within cultures.
Mortality-Risk Prediction Model from Road-Traffic Injury in Drunk Drivers: Machine Learning Approach
Authors: Sirikul Wachiranun , Buawangpong Nida , Sapbamrer Ratana , Siviroj Penprapa
Published: October 2021

Background: Alcohol-related road-traffic injury is the leading cause of premature death in middle- and lower-income countries, including Thailand. Applying machine-learning algorithms can improve the effectiveness of driver-impairment screening strategies by legal limits. Methods: Using 4794 RTI drivers from secondary cross-sectional data from the Thai Governmental Road Safety Evaluation project in 2002–2004, the machine-learning models (Gradient Boosting Classifier: GBC, Multi-Layers Perceptrons: MLP, Random Forest: RF, K-Nearest Neighbor: KNN) and a parsimonious logistic regression (Logit) were developed for predicting the mortality risk from road-traffic injury in drunk drivers. The predictors included alcohol concentration level in blood or breath, driver characteristics and environmental factors. Results: Of 4974 drivers in the derived dataset, 4365 (92%) were surviving drivers and 429 (8%) were dead drivers. The class imbalance was rebalanced by the Synthetic Minority Oversampling Technique (SMOTE) into a 1:1 ratio. All models obtained good-to-excellent discrimination performance. The AUC of GBC, RF, KNN, MLP, and Logit models were 0.95 (95% CI 0.90 to 1.00), 0.92 (95% CI 0.87 to 0.97), 0.86 (95% CI 0.83 to 0.89), 0.83 (95% CI 0.78 to 0.88), and 0.81 (95% CI 0.75 to 0.87), respectively. MLP and GBC also had a good model calibration, visualized by the calibration plot. Conclusions: Our machine-learning models can predict road-traffic mortality risk with good model discrimination and calibration. External validation using current data is recommended for future implementation.
Communicating Air Quality Index Information: Effects of Different Styles on Individuals’ Risk Perception and Precaution Intention
Authors: Wu Yuheng , Zhang Lin , Wang Jilong , Mou Yi
Published: October 2021

Air Quality Index (AQI) is information about atmospheric pollutants, which is essential for governments to inform the public about the current air quality and potential health risks. By analyzing the AQIs from 11 countries (regions), we discovered considerable variations in the design of AQI information, which may open up room for unintended interpretation from the public. Therefore, as an attempt to address the inefficiency of some common styles of AQI information in promoting the public’s precaution against bad air and better design such information, an online experiment with a 2 (descriptor: neutral vs. negatively valenced) × 2 (target groups in AQI warning messages: vague vs. specific) factorial design was conducted to test the effects of such information on individuals’ risk perception and precaution intention. The results indicated that AQI information with a neutral descriptor was associated with lower self-risk perception and precaution intention levels than with a negatively valenced one. Among the individuals not included in the at-risk groups, those who read the warning messages with vague target groups had a higher third-person perception toward smog risk than those targeting specific population groups. Practical and theoretical implications are discussed.
Three-Year Intervention Effects on Food and Beverage Intake—Results from the Quasi-Experimental Copenhagen School Child Intervention Study (CoSCIS)
Authors: Ren Xuan , Jensen Britt Wang , Larsen Sofus Christian , Rohde Jeanett Friis , Specht Ina Olmer , Nielsen Birgit Marie , Husby Ida , Bugge Anna , Andersen Lars Bo , Trolle Ellen , Heitmann Berit Lilienthal
Published: October 2021

The diet of Danish children is often not in accordance with dietary guidelines. We aimed to evaluate changes in the intake of selected foods and beverages during a multi-component school-based physical activity intervention, and to investigate if changes were modified by socioeconomic status (SES). The study included 307 children (intervention group: 184; comparison group: 123) with information on dietary intake pre- and post-intervention as well as on SES. Linear regression models were conducted to assess the effect of the intervention on changes in dietary factors. Children from the intervention group increased their intake of whole-grain bread during the intervention (group means: 6.1 g/d (95% CI: 2.2 to 10.0) vs. 0.3 g/d (95% CI: −3.1 to 3.7) in the comparison group, p = 0.04). A significant interaction between SES and group allocation was observed to change in fruit intake (p = 0.01). Among children from low SES families, only those from the comparison group decreased their fruit intake (group means: −40.0 g/d (95% CI: −56.0 to −23.9) vs. 9.3 g/d (95% CI: −16.1 to 94) in the intervention group, p = 0.006). The present study found no convincing effect of introducing a multi-component intervention on dietary intake except a small beneficial effect on whole-grain bread consumption. However, beneficial intervention effects in fruit intake were found particularly among children from low SES families.
Risk Factors of Right Ventricular Dysfunction and Adverse Cardiac Events in Patients with Repaired Tetralogy of Fallot
Authors: Leonardi Benedetta , Calvieri Camilla , Perrone Marco Alfonso , Di Rocco Arianna , Carotti Adriano , Caputo Massimo , Secinaro Aurelio , Curione Davide , Gagliardi Maria Giulia , Guccione Paolo , Albanese Sonia , Galletti Lorenzo , Drago Fabrizio
Published: October 2021

Aim: This study evaluates the risk factors associated with right ventricular (RV) dilation and dysfunction leading to pulmonary valve replacement (PVR) or adverse cardiac events in repaired Tetralogy of Fallot (rToF) patients. Methods: Data from all rToF patients who underwent magnetic resonance imaging (MRI) evaluation at our hospital between February 2007 and September 2020 were collected. Results: Three hundred and forty-two patients (60% males, 42% older than 18 years), with a median age of 16 years (IQR 13–24) at the time of MRI, were included. All patients underwent complete repair at a median age of 8 months (IQR 5–16), while palliation was performed in 56 patients (16%). One hundred and forty-four patients (42%) subsequently received pulmonary valve replacement (PVR). At the multivariate analysis, male gender was an independent predictor for significant RV dilation, RV and left ventricular (LV) dysfunction. Transventricular ventricular septal defect (VSD) closure and previous palliation significantly affected LV function and RV size, respectively. Male gender and the transventricular VSD closure were independent predictors for PVR. Conclusions: Male gender and surgical history (palliation, VSD closure approach) significantly affected the long-term outcomes in rToF patients and should be taken into consideration in the follow-up management and in PVR timing in this patient population.
IQOS Marketing in the US: The Need to Study the Impact of FDA Modified Exposure Authorization, Marketing Distribution Channels, and Potential Targeting of Consumers
Authors: Berg Carla J. , Abroms Lorien C. , Levine Hagai , Romm Katelyn F. , Khayat Amal , Wysota Christina N. , Duan Zongshuan , Bar-Zeev Yael
Published: October 2021

IQOS, the leading heated tobacco product globally, recently received ‘reduced exposure’ authorization from the US Food and Drug Administration. Independent research focusing on IQOS marketing and potential impact on consumers’ perceptions and behavior, and ultimately public health, is critical. The literature to date has underscored several concerns. First, Philip Morris’s (PM’s) marketing distribution requires scrutiny, particularly given its innovative promotional strategies. For example, IQOS is distributed via unique points-of-sale (POS; e.g., specialty and pop-up stores, “corners” in convenience stores) and uses various other opportunities (e.g., social media, sponsored events, direct-to-consumer). Second, although PM claims that IQOS’ target market is current combustible tobacco users and not young people, the literature indicates that in some populations, IQOS use is equally prominent among smokers and nonsmokers, and that specific subgroups (e.g., young adults, women) are targeted. Third, the impact of IQOS’ use of ad content promoting IQOS health benefits must be studied (e.g., how consumers interpret modified exposure messages). In conclusion, surveillance of IQOS marketing, particularly following reduced exposure authorization, is critical for obtaining valuable data to estimate population impact, particularly among population subgroups (e.g., young adults), and inform future tobacco regulation. These considerations have implications beyond IQOS—to other products and companies.
Teaching and Practicing Cognitive-Behavioral and Mindfulness Skills in a Web-Based Platform among Older Adults through the COVID-19 Pandemic: A Pilot Randomized Controlled Trial
Authors: Shapira Stav , Cohn-Schwartz Ella , Yeshua-Katz Daphna , Aharonson-Daniel Limor , Clarfield Avram Mark , Sarid Orly
Published: October 2021

The outbreak of the COVID-19 pandemic has led to an acceleration in the development of web-based interventions to alleviate related mental health impacts. The current study explored the effects of a short-term digital group intervention aimed at providing cognitive behavioral and mindfulness tools and skills to reduce loneliness and depression and to increase social support among older adults in Israel. This pilot randomized controlled trial included community-dwelling older adults (n = 82; aged between 65–90 years; 80% female) who were randomized either to an intervention group (n = 64) or a wait-list control group (n = 18). The intervention included seven online sessions, over 3.5 weeks. Depression, loneliness, and social support measures were administered at baseline, immediately post-intervention, and at 1-month follow-up. Repeated measures ANOVA revealed statistically and clinically significant reductions in depression in the intervention group, with results maintained at one-month follow-up. Loneliness levels also significantly decreased post-intervention; however, this benefit was not maintained at one-month follow-up. Social support slightly increased both post-intervention and 1-month follow-up—but these changes were not statistically significant. There were no overall changes for the wait-list control group. Our intervention provided promising evidence regarding the effectiveness of an online group intervention to alleviate mental health effects and to promote the coping of older adults during the COVID-19 pandemic. This relatively simple model can be effectively utilized by communities globally to help connect lonely and isolated older inhabitants, both during the pandemic and in more routine times.
Dimensions of Service Quality in Health-Fitness Clubs in China
Authors: Xu Karen Kaijuan , Chen Kenny Kuanchou , Kim Euisoo , García-Fernández Jerónimo , Nauright John , Zhang James J.
Published: October 2021

The purpose of this study was to explore the dimensions of service quality in fitness clubs in China and examine their impact on customer satisfaction. In Phase I of the study, we collected qualitative data from online comments related to service quality in 30 Tera Wellness clubs in Shanghai (k = 6252). Conducting content analysis, we synthesized the information and identified preliminary themes and formulated measurement statements. Phase II implemented a series of quantitative research procedures to examine the measurement properties of statements developed in Phase I. Conducting exploratory factor analysis, confirmatory factor analysis, and structural equation modeling analyses based on responses of club members (N = 533), we identified a total of 27 items in six dimensions: service recovery, service assurance, facility function, program operation, instructor quality, and staff performance. These factors significantly (p < 0.05) predicted customer satisfaction with fitness clubs in China. The findings highlight the importance of high-quality service delivery, service recovery, and service assurance and pinpoint specific areas for improvement.
Environmental and Occupational Short-Term Exposure to Airborne Particles and FEV1 and FVC in Healthy Adults: A Systematic Review and Meta-Analysis
Authors: da Silveira Fleck Alan , Sadoine Margaux L. , Buteau Stéphane , Suarthana Eva , Debia Maximilien , Smargiassi Audrey
Published: October 2021

Background: No study has compared the respiratory effects of environmental and occupational particulate exposure in healthy adults. Methods: We estimated, by a systematic review and meta-analysis, the associations between short term exposures to fine particles (PM2.5 and PM4) and certain parameters of lung function (FEV1 and FVC) in healthy adults. Results: In total, 33 and 14 studies were included in the qualitative synthesis and meta-analyses, respectively. In environmental studies, a 10 µg/m3 increase in PM2.5 was associated with an FEV1 reduction of 7.63 mL (95% CI: −10.62 to −4.63 mL). In occupational studies, an increase of 10 µg/m3 in PM4 was associated with an FEV1 reduction of 0.87 mL (95% CI: −1.36 to −0.37 mL). Similar results were observed with FVC. Conclusions: Both occupational and environmental short-term exposures to fine particles are associated with reductions in FEV1 and FVC in healthy adults.
What Sets Physically Active Rural Communities Apart from Less Active Ones? A Comparative Case Study of Three US Counties
Authors: Abildso Christiaan G. , Perry Cynthia K. , Jacobs Lauren , Umstattd Meyer M. Renée , McClendon Megan , Edwards Michael B. , Roemmich James N. , Ramsey Zachary , Stout Margaret
Published: October 2021

Background: Rural US communities experience health disparities, including a lower prevalence of physical activity (PA). However, “Positive Deviants”—rural communities with greater PA than their peers—exist. The purpose of this study was to identify the factors that help create physically active rural US communities. Methods: Stakeholder interviews, on-site intercept interviews, and in-person observations were used to form a comparative case study of two rural counties with high PA prevalence (HPAs) and one with low PA prevalence (LPA) from a southern US state, selected based on rurality and adult PA prevalence. Interview transcripts were inductively coded by three readers, resulting in a thematic structure that aligned with a Community Capital Framework, which was then used for deductive coding and analysis. Results: Fifteen stakeholder interviews, nine intercept interviews, and on-site observations were conducted. Human and Organizational Capital differed between the HPAs and LPA, manifesting as Social, Built, Financial, and Political Capital differences and a possible “spiraling-up” or cyclical effect through increasing PA and health (Human Capital), highlighting a potential causal model for future study. Conclusions: Multi-organizational PA coalitions may hold promise for rural PA by directly influencing Human and Organizational Capital in the short term and the other forms of capital in the long term.
Risk and Resilience: How Is the Health of Older Adults and Immigrant People Living in Canada Impacted by Climate- and Air Pollution-Related Exposures?
Authors: Tilstra McKenzie , Tiwari Ishwar , Niwa Leigh , Campbell Sandra , Nielsen Charlene , Jones C. , Osornio Vargas Alvaro , Bulut Okan , Quemerais Bernadette , Salma Jordana , Whitfield Kyle , Yamamoto Shelby
Published: October 2021

Background: In the rapidly shifting Canadian climate, an ageing population, and increased migration, a greater understanding of how local climate and air pollution hazards impact older adults and immigrant populations will be necessary for mitigating and adapting to adverse health impacts. Objectives: To explore the reported health impacts of climate change and air pollution exposures in older adults and immigrant people living in Canada, identify known factors influencing risk and resilience in these populations and gaps in the literature. Methods: We searched for research focused on older adults and immigrants living in Canada, published from 2010 onward, where the primary exposures were related to climate or air pollution. We extracted data on setting, exposures, health outcomes, and other relevant contextual factors. Results and Discussion: We identified 52 eligible studies, most focused in Ontario and Quebec. Older people in Canada experience health risks due to climate and air pollution exposures. The extent of the risk depends on multiple factors. We found little information about the climate- and air pollution-related health impacts experienced by immigrant communities. Conclusions: Further research about climate- and air pollution-related exposures, health, and which factors promote or reduce resiliency in Canada’s older adults and immigrant communities is necessary.
Work Task Association with Lead Urine and Blood Concentrations in Informal Electronic Waste Recyclers in Thailand and Chile
Authors: Shkembi Abas , Nambunmee Kowit , Jindaphong Siripond , Parra-Giordano Denisse , Yohannessen Karla , Ruiz-Rudolph Pablo , Neitzel Richard L. , Arain Aubrey
Published: October 2021

The informal recycling of electronic waste (“e-waste”) is a lucrative business for workers in low- and middle-income countries across the globe. Workers dismantle e-waste to recover valuable materials that can be sold for income. However, workers expose themselves and the surrounding environment to hazardous agents during the process, including toxic metals like lead (Pb). To assess which tools, tasks, and job characteristics result in higher concentrations of urine and blood lead levels among workers, ten random samples of 2 min video clips were analyzed per participant from video recordings of workers at e-waste recycling sites in Thailand and Chile to enumerate potential predictors of lead burden. Blood and urine samples were collected from participants to measure lead concentration. Boosted regression trees (BRTs) were run to determine the relative importance of video-derived work variables and demographics, and their relationship with the urine and blood concentrations. Of 45 variables considered, five job characteristics consisting of close-toed shoes (relative importance of 43.9%), the use of blunt striking instruments (14%), bending the back (5.7%), dismantling random parts (4.4%), and bending the neck (3.5%) were observed to be the most important predictors of urinary Pb levels. A further five job characteristics, including lifting objects <20 lbs. (6.2%), the use of screwdrivers (4.2%), the use of pliers/scissors (4.2%), repetitive arm motion (3.3%), and lifting objects >20 pounds (3.2%) were observed to be among the most important factors of blood Pb levels. Overall, our findings indicate ten job characteristics that may strongly influence Pb levels in e-waste recycling workers’ urine and blood.
An Updated Meta-Analysis of Remote Blood Pressure Monitoring in Urban-Dwelling Patients with Hypertension
Authors: Park Sang-Hyun , Shin Jong-Ho , Park Joowoong , Choi Woo-Seok
Published: October 2021

Following the coronavirus disease-2019 pandemic, this study aimed to evaluate the overall effects of remote blood pressure monitoring (RBPM) for urban-dwelling patients with hypertension and high accessibility to healthcare and provide updated quantitative summary data. Of 2721 database-searched articles from RBPM’s inception to November 2020, 32 high-quality studies (48 comparisons) were selected as primary data for synthesis. A meta-analysis was undertaken using a random effects model. Primary outcomes were changes in office systolic blood pressure (SBP) and diastolic blood pressure (DBP) following RBPM. The secondary outcome was the BP control rate. Compared with a usual care group, there was a decrease in SBP and DBP in the RBPM group (standardized mean difference 0.507 (95% confidence interval [CI] 0.339–0.675, p < 0.001; weighted mean difference [WMD] 4.464 mmHg, p < 0.001) and 0.315 (CI 0.209–0.422, p < 0.001; WMD 2.075 mmHg, p < 0.001), respectively). The RBPM group had a higher BP control rate based on a relative ratio (RR) of 1.226 (1.107–1.358, p < 0.001). RBPM effects increased with increases in city size and frequent monitoring, with decreases in intervention duration, and in cities without medically underserved areas. RBPM is effective in reducing BP and in achieving target BP levels for urban-dwelling patients with hypertension.
Evaluation of an Ozone Chamber as a Routine Method to Decontaminate Firefighters’ PPE
Authors: Lucena Marcella A. de Melo , Zapata Félix , Mauricio Filipe Gabriel M. , Ortega-Ojeda Fernando E. , Quintanilla-López M. Gloria , Weber Ingrid Távora , Montalvo Gemma
Published: October 2021

Ozone chambers have emerged as an alternative method to decontaminate firefighters’ Personal Protective Equipment (PPE) from toxic fire residues. This work evaluated the efficiency of using an ozone chamber to clean firefighters’ PPE. This was achieved by studying the degradation of pyrene and 9-methylanthracene polycyclic aromatic hydrocarbons (PAHs). The following experiments were performed: (i) insufflating ozone into PAH solutions (homogeneous setup), and (ii) exposing pieces of PPE impregnated with the PAHs to an ozone atmosphere for up to one hour (heterogeneous setup). The ozonolysis products were assessed by Fourier Transform Infrared Spectroscopy (FTIR), Thin-Layer Chromatography (TLC), and Mass Spectrometry (MS) analysis. In the homogeneous experiments, compounds of a higher molecular weight were produced due to the incorporation of oxygen into the PAH structures. Some of these new compounds included 4-oxapyren-5-one (m/z 220) and phenanthrene-4,5-dicarboxaldehyde (m/z 234) from pyrene; or 9-anthracenecarboxaldehyde (m/z 207) and hydroxy-9,10-anthracenedione (m/z 225) from 9-methylanthracene. In the heterogeneous experiments, a lower oxidation was revealed, since no byproducts were detected using FTIR and TLC, but only using MS. However, in both experiments, significant amounts of the original PAHs were still present even after one hour of ozone treatment. Thus, although some partial chemical degradation was observed, the remaining PAH and the new oxygenated-PAH compounds (equally or more toxic than the initial molecules) alerted us of the risks to firefighters’ health when using an ozone chamber as a unique decontamination method. These results do not prove the ozone-advertised efficiency of the ozone chambers for decontaminating (degrading the toxic combustion residues into innocuous compounds) firefighters’ PPE.
The Muscle Strength of the Knee Joint after ACL Reconstruction Depends on the Number and Frequency of Supervised Physiotherapy Visits
Authors: Czamara Andrzej , Krzemińska Katarzyna , Widuchowski Wojciech , Dragan Szymon Lukasz
Published: October 2021

The aim of this study in anterior cruciate ligament reconstruction (ACLR) patients was to assess the effect of six months of supervised physiotherapy with a higher number of visits (SPHNV) compared to supervised physiotherapy with a lower number of visits (SPLNV) on the maximal peak torque (PT) and isometric torque (IT) of values obtained for hamstring (H) and quadriceps (Q) muscles of the knee joints under isokinetic and isometric conditions. Hypothesis: SPHNV improves IT and PT more than SPLNV. Group I had ACLR with a higher number of visits (n = 20), Group II had ACLR with a lower number of visits (n = 20), and Group III served as the control (n = 20). In Groups I and II, IT values were measured for quadriceps and hamstring muscles of the knee joints in the 13th and 24th weeks and for PT in the 18th and 24th weeks after ACLR (60 and 180 °/s). In group III, the measurements were taken once. The isometric torque and isokinetic peak torque values were measured in N*m and they were normalized to body mass as relative IT (RIT) and relative PT (RPT) were expressed in N*m/kg. Results: In both ACLR groups, the RIT and RPT values obtained from the operated knee joints significantly increased in the 24 weeks following ACLR compared to the uninvolved side. Group II had significantly lower RIT and RPT values for quadriceps and hamstring muscles of the operated limbs compared with the uninvolved limbs (p = 0.008, p = 0.001). In group I, the larger number of visits positively correlated with the higher PT for quadriceps and hamstring muscles of the operated and uninvolved knees (from r = 0.506; p = 0.023 too r = 0.566; p = 0.009), respectively. Six months of SPHNV positively correlated with and improved the IT and PT values in patients after ACLR much more significantly than six months of SPLNV.
Profiles of Resilience among Children Exposed to Non-Maltreatment Adverse Childhood Experiences
Authors: Yoon Susan , Helsabeck Nathan , Wang Xiafei , Logan Jessica , Pei Fei , Hamby Sherry , Slesnick Natasha
Published: October 2021

Considering the high prevalence and negative consequences of non-maltreatment adverse childhood experiences (NM-ACEs), it is critical to understand their impacts on the resilient functioning of young children. This study sought to examine heterogeneity in resilience among first-grade children who were exposed to NM-ACEs during kindergarten and explore demographic and adversity characteristics that distinguish between resilience profiles. Latent profile analysis (LPA) was conducted on 4929 children drawn from the Early Childhood Longitudinal Study—Kindergarten (ECLS-K). The results of the LPA revealed four distinct resilience profiles: (1) low cognitive and executive functioning (4%); (2) low social and behavioral functioning (14%); (3) low average functioning (31%); and (4) multi-domain resilience (51%). Female children and those in families characterized by older maternal age, higher parental education level, household income above 200% federal poverty level, not receiving welfare benefits, and races other than Black were more likely to be in the multi-domain resilience profile. The findings highlight heterogeneity in resilience among children exposed to NM-ACEs and point to the need for a comprehensive, multi-domain assessment of child functioning to support optimal resilience development in this population.
Effects of Breastfeeding on Endometriosis-Related Pain: A Prospective Observational Study
Authors: Prosperi Porta Romana , Sangiuliano Chiara , Cavalli Alessandra , Hirose Marques Pereira Laila Cristine , Masciullo Luisa , Piacenti Ilaria , Scaramuzzino Sara , Viscardi Maria Federica , Porpora Maria Grazia
Published: October 2021

Endometriosis is a gynecological estrogen-dependent disease whose commonest pain symptoms are dysmenorrhea, dyspareunia, and acyclic chronic pelvic pain (CPP). Hormonal changes occurring during breastfeeding seem to reduce pain and disease recurrence. The aim of this observational prospective study was to assess the effect of breastfeeding on pain and endometriotic lesions in patients with endometriosis and to evaluate a possible correlation between the duration of breastfeeding, postpartum amenorrhea, and pain. Out of 156 pregnant women with endometriosis enrolled, 123 who breastfed were included in the study and were monitored for 2 years after delivery; 96/123 exclusively breastfed for at least 1 month. Mode of delivery, type and duration of breastfeeding, intensity of pain symptoms, and lesion size before pregnancy and during the 24-month follow-up were analyzed. All patients experienced a significant reduction in dysmenorrhea proportional to the duration of breastfeeding. CPP was significantly reduced only in women who exclusively breastfed. No significant improvement in dyspareunia was observed. Ovarian endometriomas were significantly reduced. Therefore, breastfeeding, particularly if exclusive, may cause improvement in dysmenorrhea and CPP proportional to the duration of breastfeeding, as well as a reduction in the size of ovarian endometriomas.
Integration of Consumer-Based Activity Monitors into Clinical Practice for Children with Type 1 Diabetes: A Feasibility Study
Authors: Jaggers Jason R. , McKay Timothy , King Kristi M. , Thrasher Bradly J. , Wintergerst Kupper A.
Published: October 2021

Current technology commonly utilized in diabetes care includes continuous glucose monitors (CGMs) and insulin pumps. One often overlooked critical component to the human glucose response is daily physical activity habits. Consumer-based activity monitors may be a valid way for clinics to collect physical activity data, but whether or not children with type 1 diabetes (T1D) would wear them or use the associated mobile application is unknown. Therefore, the purpose of this study was to test the feasibility of implementing a consumer-based accelerometer directly into ongoing care for adolescents managing T1D. Methods: Adolescents with T1D were invited to participate in this study and instructed to wear a mobile physical activity monitor while also completing a diet log for a minimum of 3 days. Clinical compliance was defined as the number of participants who were compliant with all measures while also having adequate glucose recordings using either a CGM, insulin pump, or on the diet log. Feasibility was defined as >50% of the total sample reaching clinical compliance. Results: A total of 57 children and teenagers between the ages of 7 and 19 agreed to participate in this study and were included in the final analysis. Chi-square results indicated significant compliance for activity tracking (p < 0.001), diet logs (p = 0.04), and overall clinical compliance (p = 0.04). Conclusion: More than half the children in this study were compliant for both activity monitoring and diet logs. This indicates that it is feasible for children with T1D to wear a consumer-based activity monitor while also recording their diet for a minimum of three days.
How to Address Consumers’ Concerns and Information Needs about Emerging Chemical and Microbial Contaminants in Drinking Water; The Case of GenX in The Netherlands
Authors: Claassen Liesbeth , Hartmann Julia , Wuijts Susanne
Published: October 2021

The perceived safety of tap water is an important condition for consumers to drink it. Therefore, addressing consumers’ concerns should be included in the roadmap towards the UN SDG 6 on safe drinking water for all. This paper studies consumers’ information needs regarding emerging contaminants in drinking water using a mental model approach for the development of targeted risk communication. As most consumers expect safe drinking water, free of contamination, communication on emerging contaminants may increase concerns. Here, we showed that communication strategies better tailored to consumers’ information needs result in smaller increases in risk perception compared with existing strategies.
Measuring Risk Perception in Pregnant Women in Heavily Polluted Areas: A New Methodological Approach from the NEHO Birth Cohort
Authors: Ruggieri Silvia , Maltese Sabina , Drago Gaspare , Panunzi Simona , Cibella Fabio , Bianchi Fabrizio , Minichilli Fabrizio , Cori Liliana
Published: October 2021

Risk perception (RP) evaluation during pregnancy and its relationship with lifestyles are considered useful tools for understanding communities living in high-risk areas and preventing dangerous exposure. It is well known that exposure to pollutants and less-healthy lifestyles may result in increased disease occurrence during life. Our work investigated environmental RP through ad hoc questionnaires administered to 611 mothers within the NEHO birth cohort, recruited in three heavily contaminated areas of Southern Italy. Four different RP indices, an exploratory factorial analysis (EFA), and a latent class analysis were evaluated from questionnaires. The highest values of risk perception index were observed in the Milazzo site (0.64 ± 0.16) and the lowest in the Crotone site (0.5 ± 0.18). EFA revealed four latent factors, including different items describing environmental pollution, and subjects were classified into four latent classes with different RP indices. Significant RP profiles were different among the sites (p < 0.001). Our results did not demonstrate any association between RP and lifestyles during pregnancy. Improving healthy lifestyle behaviours, particularly in polluted areas, would generate co-benefits by preventing further risk factors. As remediation interventions can take a long time, it needs to improve healthy lifestyles in residents until remediation is completed.
Spatial Correlation of Air Pollution and Its Causes in Northeast China
Authors: Du Mingze , Liu Weijiang , Hao Yizhe
Published: October 2021

To understand the status of air pollution in northeastern China, we explore the structure of air pollution transmission networks and propose targeted policy recommendations. Using air pollution data from 35 cities in northeastern China for a total of 879 periods from 6 January 2015 to 3 June 2017, this paper used social network analysis (SNA) to construct a spatial association network of air pollution in the region, and analyzed the spatial association of air pollution among cities and its causes in an attempt to reveal the transmission path of air pollution in the region. The results show that inter-city air pollution in northeast China forms a complex and stable correlation network with obvious seasonal differences of “high in winter and low in summer”. Different cities in the region play the roles of “spillover”, “intermediary” and “receiver” of air pollution in the network. Small respirable particulate (PM2.5) pollution constitutes a significant component of air pollution in northeast China, which spreads from Liaoning province to Heilongjiang province via Jilin province. Therefore, regional joint pollution prevention and control measures should be adopted to combat the air pollution problem, and different treatment measures should be developed for different city “roles” in the pollution network, in order to fundamentally solve the air pollution problem in the region.