bluuebunny/crossref_metadata_2025 huggingface dataset:
Efficiency Comparison of Public Hospitals under Different Administrative Affiliations in China: A Pilot City Case
Authors: Yin Gang , Chen Chaoyi , Zhuo Lijun , He Qingjing , Tao Hongbing
Published: April 2021

This study seeks to measure the efficiency disparity and productivity change of tertiary general public hospitals in Wuhan city, central China from the perspective of administrative affiliations by using panel data from 2013 to 2017. Sample hospitals were divided into three categories, namely provincial hospitals, municipal hospitals, and other levels of hospitals. Data envelopment analysis with bootstrapping technique was used to estimate efficiency scores, and a sensitive analysis was performed by varying the specification of model by considering undesirable outputs to test robustness of estimation, and efficiency evolution analysis was carried out by using the Malmquist index. The results indicated that the average values of provincial hospitals and municipal hospitals have experienced efficiency improvement over the period, especially after the initiation of Pilot Public Hospital Reform, but hospitals under other affiliations showed an opposite trend. Meanwhile, differences of administrative subordination in technical efficiency of public hospitals emerged, and the disparity was likely to grow over time. The higher efficiency of hospitals affiliated with municipality, as compared with those governed by province and under other administrative affiliations, may be attributed to better governance and organization structure.
Associations of Physician Characteristics with Sex Difference in Ischemic Heart Disease Incidence among Patients Living with Type 2 Diabetes in Taiwan
Authors: Lee Yung-Hsin , Chang Ya-Hui , Ku Li-Jung Elizabeth , Wu Jin-Shang , Isfandiari Muhammad Atoillah , Chou Li-Ping , Li Chung-Yi
Published: April 2021

(1) Background: Certain non-biological factors are suspected to explain the reduced sex difference in cardiovascular risk after diabetes. This study aimed to assess whether physician characteristics may account for such reduced sex difference. (2) Methods: Totally 10,105 type 2 diabetes patients (including 4962 men and 5143 women) were selected from Taiwan’s National Health Insurance claim data. The three-year period following the first day of clinical visit for type 2 diabetes in 2000 was set as the baseline period. The follow-up was made from the first day after baseline period to date of ischemic heart disease (IHD) incidence or censoring. Cox regression model was used to estimate hazard ratios (HRs) of IHD in relation to physician’s characteristics. (3) Results: The incidence of IHD for men and women was estimated at 17.47 and 15.96 per 1000 person-years, respectively. After controlling for socio-demographic variables and co-morbidity, male patients experienced a significantly higher HR than females for IHD (1.16, 95% Confidence Interval (CI) 1.04 to 1.29). Further adjustment for treatment adherence/continuity and physician characteristics resulted in essentially the same results. (4) Conclusions: Our study provides little support for the notation that physician characteristics may contribute to the reduced sex difference in IHD incidence in patients with type 2 diabetes.
Multiscale Temporal Irreversibility of Streamflow and Its Stochastic Modelling
Authors: Vavoulogiannis Stelios , Iliopoulou Theano , Dimitriadis Panayiotis , Koutsoyiannis Demetris
Published: April 2021

We investigate the impact of time’s arrow on the hourly streamflow process. Although time asymmetry, i.e., temporal irreversibility, has been previously implemented in stochastics, it has only recently attracted attention in the hydrological literature. Relevant studies have shown that the time asymmetry of the streamflow process is manifested at scales up to several days and vanishes at larger scales. The latter highlights the need to reproduce it in flood simulations of fine-scale resolution. To this aim, we develop an enhancement of a recently proposed simulation algorithm for irreversible processes, based on an asymmetric moving average (AMA) scheme that allows for the explicit preservation of time asymmetry at two or more time-scales. The method is successfully applied to a large hourly streamflow time series from the United States Geological Survey (USGS) database, with time asymmetry prominent at time scales up to four days.
Understanding How Relational Health Effects Intimate Partner Violence Perpetration among Low-Income, Black, Indigenous, Men of Color Exposed to Adverse Childhood Experiences: An Exploratory Study
Authors: Voith Laura A. , Lee Hyunjune , Russell Katie N. , Korsch-Williams Amy E.
Published: April 2021

Relational health has emerged as a consistent factor that can mitigate the effects of trauma among children; however, less is known about relational health with adults, particularly related to intimate partner violence (IPV) perpetration among racially and socioeconomically marginalized men. The Exploratory Sequential Design, Taxonomy Development Model was used. Semi-structured interviews (N = 11) and narrative analysis were conducted in Phase I. In Phase II, variables approximating the key themes that emerged in Phase I were selected from an existing dataset (N = 67), and relationships were examined using bivariate associations. The sample consisted of low-income Black, Indigenous, men of color (BIMOC) in a batterer intervention program (BIP). Adverse life experiences shaped participants’ world view via mistrust in others, stifling emotions and vulnerability, and a sense of personal guilt and shame. These orientations were then carried into adult relationships where men coped using social isolation to manage challenges, negatively affecting intimate relationships. For some men, mental health exacerbated these circumstances. Significant bivariate and multivariate associations supported this narrative. This study lays the foundation for future research to examine the potential effects of social support on IPV perpetration. BIPs should consider augmenting programming to enhance men’s social networks to support their use of nonviolence after program completion.
Provision of Assistive Technology for Students with Disabilities in South African Higher Education
Authors: Ndlovu Sibonokuhle
Published: April 2021

This paper used the Critical Disability Theory (CDT) to analyse the provision of assistive technology (AT) and assistive devices at an institution of higher education in South African. In this empirical study, data were collected through interviews with students with disabilities and Disability Rights Centre staff members. The paper sought to explore the effectiveness of the provision of AT and assistive devices, in terms of enabling students with disabilities’ learning. The provision was deemed inadequate, and a specific AT and assistive device was inaccessible to one category of disability, consequently limiting learning. The paper concludes that the provision of assistive devices at the institution enabled students with disabilities’ learning, however, there was a need for improvement by way of the Universal Design for Learning (UDL). The UDL will help all diverse students, including students with disabilities in all their categories of disability, to be assisted to learn through the provision of AT and assistive devices. It is hoped that the paper will contribute to contemporary debates on the provision of AT and assistive devices for people with disabilities in low-resource settings, from a South African context specifically, and in higher education broadly.
A Qualitative Study of the Health Perceptions in the Venezuelan Immigrant Population in Medellín (Colombia) and Its Conditioning Factors
Authors: Murillo-Pedrozo Andrés M. , Martínez-Herrera Eliana , Ronda-Pérez Elena , Agudelo-Suárez Andrés A.
Published: April 2021

This study explored the general and oral health perceptions in the Venezuelan immigrant population in Medellín (Colombia) and its conditioning factors. A qualitative study involving Venezuelan immigrants ≥18 years with a minimum stay of six months in Colombia was conducted. Dentists, dental students, and other health professionals also participated. Semi-structured interviews (n = 17), focus groups (n = 2), and key informants’ interviews (n = 4) were utilized. The interviews and focus groups were recorded and transcribed for later narrative content analysis. A high degree of vulnerability of participants was found due to the precarious living conditions from the premigratory moment and the lack of job placement possibilities at the time of settling in Colombia, where the migratory status played a fundamental role. Among the perceived needs, the mitigation of noncommunicable diseases stood out. Poor mental health symptoms (depression and anxiety) were perceived, and oral health was not a priority. Barriers to accessing health and dental care were found. The migrant condition was found to be a determinant that affected physical, mental, and oral health and the provision of health care. This situation is of interest to the construction of public health policies that guarantee access to fundamental rights.
Expression Profile of Stemness Markers CD138, Nestin and Alpha-SMA in Ameloblastic Tumours
Authors: Yiannis Callisthenis , Mascolo Massimo , Mignogna Michele Davide , Varricchio Silvia , Natella Valentina , De Rosa Gaetano , Lo Giudice Roberto , Galletti Cosimo , Paolini Rita , Celentano Antonio
Published: April 2021

Ameloblastic carcinoma is a rare malignant odontogenic neoplasm with a poor prognosis. It can arise de novo or from a pre-existing ameloblastoma. Research into stemness marker expression in ameloblastic tumours is lacking. This study aimed to explore the immunohistochemical expression of stemness markers nestin, CD138, and alpha-smooth muscle actin (alpha-SMA) for the characterisation of ameloblastic tumours. Six cases of ameloblastoma and four cases of ameloblastic carcinoma were assessed, including one case of ameloblastic carcinoma arising from desmoplastic ameloblastoma. In all tumour samples, CD138 was positive, whilst alpha-SMA was negative. Nestin was negative in all but one tumour sample. Conversely, the presence or absence of these markers varied in stroma samples. Nestin was observed in one ameloblastic carcinoma stroma sample, whilst CD138 was positive in one ameloblastoma case, one desmoplastic ameloblastoma case, and in two ameloblastic carcinoma stroma samples. Finally, alpha-SMA was found positive only in the desmoplastic ameloblastoma stroma sample. Our results suggest nestin expression to be an indicator for ameloblastic carcinoma, and CD138 and alpha-SMA to be promising biomarkers for the malignant transformation of ameloblastoma. Our data showed that nestin, CD138, and alpha-SMA are novel biomarkers for a better understanding of the origins and behaviour of ameloblastic tumours.
A Cross-Sectional Study on Disparities in Unmet Need among Refugees and Asylum Seekers in Thailand in 2019
Authors: Kunpeuk Watinee , Julchoo Sataporn , Phaiyarom Mathudara , Sinam Pigunkaew , Pudpong Nareerut , Suphanchaimat Rapeepong
Published: April 2021

The health of urban refugees and asylum seekers (URAS) in Thailand has been under-researched compared with other groups of non-Thai populations, especially on the topic of unmet need. The aim of this study is to examine the level of unmet need among URAS in Thailand, focusing on out-patient (OP) and in-patient (IP) care. A cross-sectional study was conducted between October and December 2019. Stratified random sampling was undertaken and a total of 181 participants were included. A bivariate analysis was used to explore the level of unmet need among different URAS groups. Multivariate logistic regression was undertaken to examine the association between potential correlations and unmet need of IP and OP care. The majority of participants were female and aged below 30 years, with a low educational background and poor economic status. Most of them had experienced an illness in the past month before the interview, and some suffered from chronic diseases. The prevalence of both OP and IP unmet needs was more frequent among URAS from Arab countries. Furthermore, being from Arab countries indicated a strong link with OP and IP unmet need. Additionally, having illness over the past six months and chronic diseases were found to be significant determinants of IP unmet need. Our analysis showed that nationality had a strong association with both IP and OP unmet need, especially among those from Arab countries. Therefore, culturally appropriate health services should be considered to promote healthcare access among diverse groups of URAS. Further qualitative studies on barriers to accessing OP and IP care, such as communication, interpretation, and social dimensions, are required.
Personality of Public Health Organizations’ Instagram Accounts and According Differences in Photos at Content and Pixel Levels
Authors: Kim Yunhwan , Lee Sunmi
Published: April 2021

Organizations maintain social media accounts and upload posts to show their activities and communicate with the public, as individual users do. Thus, organizations’ social media accounts can be examined from the same perspective of that of individual users’ accounts, with personality being one of the perspectives. In line with previous studies that analyzed the personality of non-human objects such as products, stores, brands, and websites, this study analyzed the personality of Instagram accounts of public health organizations. It also extracted features at content and pixel levels from the photos uploaded on the organizations’ accounts and examined how they were related to the personality traits of the accounts. The results suggested that the personality of public health organizations can be summarized as being high in openness and agreeableness but lower in extraversion and neuroticism. Openness and agreeableness were the personality traits associated the most with the content-level features, while extraversion and neuroticism were the ones associated the most with the pixel-level features. In addition, for each of the two traits associated the most with either the content- or pixel- level features, their associations tended to be in opposite directions with one another. The personality traits, except for neuroticism, were predicted from the photo features with an acceptable level of accuracy.
Toxic Metals (As, Cd, Ni, Pb) Impact in the Most Common Medicinal Plant (Mentha piperita)
Authors: Dinu Cristina , Gheorghe Stefania , Tenea Anda Gabriela , Stoica Catalina , Vasile Gabriela-Geanina , Popescu Roxana Luisa , Serban Ecaterina Anca , Pascu Luoana Florentina
Published: April 2021

This study aimed to evaluate the behavior of Mentha piperita under Cd, Pb, Ni, and As soil contamination and their transfer from soil in plants as well as translocation in the roots/stems/leaves system compared with a control without metal addition. The mint seedlings were exposed for a three-month period using two metal mixtures in the same concentrations such as AsCd and AsCdNiPb (23.7 mg/kg As, 5 mg/kg Cd, 136 mg/kg Ni, and 95 mg/kg Pb). The results of metal concentration in plants showed that Cd, Ni, and Pb were accumulated in different parts of the plant, except for As. In plants organs, the order of metal accumulation was roots > stems > leaves. No significant impact on the growth, development, and chlorophyll content compared to the control was observed in the first month of exposure. After three months of exposure, phytotoxic effects occurred. Generally, the transfer coefficients and translocation factors values were less than 1, indicating that Mentha piperita immobilized the metals in root. The laboratory experiments highlighted that for a short period of time, Mentha piperita has the capacity to stabilize the metals at the root level and was a metal-tolerant plant when using a garden rich-substrate.
Physical Activity Behaviors and Barriers in Multifetal Pregnancy: What to Expect When You’re Expecting More
Authors: Meah Victoria L. , Strynadka Morgan C. , Khurana Rshmi , Davenport Margie H.
Published: April 2021

The health benefits of prenatal physical activity (PA) are established for singleton pregnancies. In contrast, individuals with multifetal pregnancies (twins, triplets or more) are recommended to restrict or cease PA. The objectives of the current study were to determine behaviors and barriers to PA in multifetal pregnancies. Between 29 May and 24 July 2020, individuals with multifetal pregnancies participated in an online survey. Of the 415 respondents, there were 366 (88%) twin, 45 (11%) triplet and 4 (1%) quadruplet pregnancies. Twenty-seven percent (n = 104/388) of respondents completed no PA at all during pregnancy, 57% (n = 220/388) completed PA below current recommendations, and 16% (n = 64/388) achieved current recommendations (150-min per week of moderate-intensity activity). Most respondents (n = 314/363 [87%]) perceived barriers to PA during multifetal pregnancy. The most prominent were physical symptoms (n = 204/363 [56%]) and concerns about risks to fetal wellbeing (n = 128/363 [35%]). Sixty percent (n = 92/153) felt that these barriers could be overcome but expressed the need for evidence-based information regarding PA in multifetal pregnancy. Individuals with multifetal pregnancies have low engagement with current PA recommendations but remain physically active in some capacity. There are physical and psychosocial barriers to PA in multifetal pregnancy and future research should focus on how these can be removed.
Gender Differences in the COVID-19 Pandemic Risk Perception, Psychology, and Behaviors of Spanish University Students
Authors: Rodriguez-Besteiro Stephanie , Tornero-Aguilera José Francisco , Fernández-Lucas Jesús , Clemente-Suárez Vicente Javier
Published: April 2021

The actual COVID-19 pandemic scenario has generated a context of uncertainty, helplessness, and inequality. Yet, the perception of COVID-19 risk has influenced nutritional, psychological, and physical activity patterns depending on gender. We conducted the present research with the aim of studying gender differences of university students in the perceived risk of the COVID-19 pandemic, and in psychological, nutritional, oral health, and physical activity habits. To reach the study’s aim, 300 volunteer university students completed an online questionnaire which analyzed variables of perceived risk of the COVID-19 pandemic, psychological profiles, and nutritional, oral health, and physical activity habits. Results showed that females presented a higher perception of danger to the COVID-19 virus than males but showed no differences in how the pandemic has affected personal lives. Females showed higher values of anxiety, conscientiousness, neuroticism, and openness to experience, while males presented higher values of extraversion. Nutritionally, males presented greater consumption of soft drinks, meat, and pasta or rice, and lower buccal hygiene. Yet, no differences were found regarding physical activity patterns. Results from the present study could be used by various educational institutions to implement multidisciplinary interventions to reduce the stress and risk perception.
SARS-CoV-2 Seroprevalence among Health Care Workers—A Voluntary Screening Study in a Regional Medical Center in Southern Germany
Authors: Müller Katharina , Girl Philipp , Ruhnke Michaela , Spranger Mareike , Kaier Klaus , von Buttlar Heiner , Dobler Gerhard , Borde Johannes P.
Published: April 2021

Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is associated with a potentially severe clinical manifestation, coronavirus disease 2019 (COVID-19), and currently poses a worldwide challenge. Health care workers (HCWs) are at the forefront of any health care system and thus especially at risk for SARS-CoV-2 infection due to their potentially frequent and close contact with patients suffering from COVID-19. Serum samples from 198 HCWs with direct patient contact of a regional medical center and several outpatient facilities were collected during the early phase of the pandemic (April 2020) and tested for SARS-CoV-2-specific antibodies. Commercially available IgA- and IgG-specific ELISAs were used as screening technique, followed by an in-house neutralization assay for confirmation. Neutralizing SARS-CoV-2-specific antibodies were detected in seven of 198 (3.5%) tested HCWs. There was no significant difference in seroprevalence between the regional medical center (3.4%) and the outpatient institution (5%). The overall seroprevalence of neutralizing SARS-CoV-2-specific antibodies in HCWs in both a large regional medical center and a small outpatient institution was low (3.5%) at the beginning of April 2020. The findings may indicate that the timely implemented preventive measures (strict hygiene protocols, personal protective equipment) were effective to protect from transmission of an airborne virus when only limited information on the pathogen was available.
Aggressive Driving Behaviours in Cannabis Users. The Influence of Consumer Characteristics
Authors: Ortiz-Peregrina Sonia , Ortiz Carolina , Anera Rosario G.
Published: April 2021

This study analysed dangerous driving behaviours in twenty young occasional cannabis users through objective and self-reported data, studying the relationship between the two aspects. Visual function was assessed in a baseline session and after smoking cannabis, as well as speed-related behaviour in a driving simulator. The participants responded to questionnaires on sociodemographic factors, their consumption profile, and the incidence of dangerous behaviours (Dula Dangerous Driving Index; DDDI). After cannabis use, the results revealed a significant deterioration in visual function. In terms of speed management, they showed significantly greater acceleration force in the two different sections of the route, and they drove significantly faster. Our correlations indicate that males and heavier users display more risky speed management. Likewise, the heavier cannabis users admitted to increased dangerous driving behaviour, and an accident in the preceding year was associated with a trend towards aggressive driving behaviour according to the DDDI questionnaire. The findings of this study suggest that cannabis users adopt dangerous behaviours when driving, despite the effect this drug has on certain important functions, such as vision. The results suggest a need for awareness-raising and information campaigns.
Estimation of Excess Mortality and Years of Life Lost to COVID-19 in Norway and Sweden between March and November 2020
Authors: Rypdal Martin , Rypdal Kristoffer , Løvsletten Ola , Sørbye Sigrunn Holbek , Ytterstad Elinor , Bianchi Filippo Maria
Published: April 2021

We estimate the weekly excess all-cause mortality in Norway and Sweden, the years of life lost (YLL) attributed to COVID-19 in Sweden, and the significance of mortality displacement. We computed the expected mortality by taking into account the declining trend and the seasonality in mortality in the two countries over the past 20 years. From the excess mortality in Sweden in 2019/20, we estimated the YLL attributed to COVID-19 using the life expectancy in different age groups. We adjusted this estimate for possible displacement using an auto-regressive model for the year-to-year variations in excess mortality. We found that excess all-cause mortality over the epidemic year, July 2019 to July 2020, was 517 (95%CI = (12, 1074)) in Norway and 4329 [3331, 5325] in Sweden. There were 255 COVID-19 related deaths reported in Norway, and 5741 in Sweden, that year. During the epidemic period of 11 March–11 November, there were 6247 reported COVID-19 deaths and 5517 (4701, 6330) excess deaths in Sweden. We estimated that the number of YLL attributed to COVID-19 in Sweden was 45,850 [13,915, 80,276] without adjusting for mortality displacement and 43,073 (12,160, 85,451) after adjusting for the displacement accounted for by the auto-regressive model. In conclusion, we find good agreement between officially recorded COVID-19 related deaths and all-cause excess deaths in both countries during the first epidemic wave and no significant mortality displacement that can explain those deaths.
What Explains the Association between Usage of Social Networking Sites (SNS) and Depression Symptoms? The Mediating Roles of Self-Esteem and Fear of Missing Out
Authors: Leung Angel Nga Man , Law Wilbert , Liang Yvonne Yiqing , Au Antony Chun Lam , Li Cheng , Ng Henry Kin Shing
Published: April 2021

The goal of the study was to understand the mechanisms of how social networking sites (SNS) usage is related to depression symptoms, as measured by the Center for Epidemiological Studies-Depression Scale (CESD). Three studies were conducted to examine the mediation roles of self-esteem and Fear of Missing Out (FoMO). In Study 1, among 347 Chinese college students, time spent on SNS was negatively associated with self-esteem; while self-esteem then negatively associated with depression symptoms. In Study 2, among 180 Chinese college students, time spent on SNS was positively related to FoMO; while FoMO then positively related to depression symptoms. In Study 3, among 233 Chinese university students, both self-esteem and FoMO were simultaneously included in the mediation model to test their respective roles in explaining depression symptoms. Results showed that more time spent on SNS was related to lower self-esteem, and higher FoMO, respectively; while self-esteem then negatively, and FoMO then positively, explained depression symptoms, respectively. In addition, when participants spent 3.5 h (Study 1), 2.5 h (Study 2), and 2.54 h (Study 3) on SNS, they reached the cutoff for subthreshold depression, as measured by CESD. Combining results from three studies, both self-esteem and FoMO mediated the relation between SNS usage and depression symptoms. This study provides implications to understand the mechanism of SNS-related depression.
The Influence of the Urban Environment on Mental Health during the COVID-19 Pandemic: Focus on Air Pollution and Migration—A Narrative Review
Authors: Menculini Giulia , Bernardini Francesco , Attademo Luigi , Balducci Pierfrancesco Maria , Sciarma Tiziana , Moretti Patrizia , Tortorella Alfonso
Published: April 2021

The coronavirus disease 2019 (COVID-19) pandemic caused a crisis worldwide, due to both its public health impact and socio-economic consequences. Mental health was consistently affected by the pandemic, with the emergence of newly diagnosed psychiatric disorders and the exacerbation of pre-existing ones. Urban areas were particularly affected by the virus spread. In this review, we analyze how the urban environment may influence mental health during the COVID-19 pandemic, considering two factors that profoundly characterize urbanization: air pollution and migration. Air pollution serves as a possibly risk factor for higher viral spread and infection severity in the context of urban areas and it has also been demonstrated to play a role in the development of serious mental illnesses and their relapses. The urban environment also represents a complex social context where minorities such as migrants may live in poor hygienic conditions and lack access to adequate mental health care. A global rethinking of the urban environment is thus required to reduce the impact of these factors on mental health. This should include actions aimed at reducing air pollution and combating climate change, promoting at the same time a more inclusive society in a sustainable development perspective.
Time Granularity Impact on Propagation of Disruptions in a System-of-Systems Simulation of Infrastructure and Business Networks
Authors: Dubaniowski Mateusz Iwo , Heinimann Hans Rudolf
Published: April 2021

A system-of-systems (SoS) approach is often used for simulating disruptions to business and infrastructure system networks allowing for integration of several models into one simulation. However, the integration is frequently challenging as each system is designed individually with different characteristics, such as time granularity. Understanding the impact of time granularity on propagation of disruptions between businesses and infrastructure systems and finding the appropriate granularity for the SoS simulation remain as major challenges. To tackle these, we explore how time granularity, recovery time, and disruption size affect the propagation of disruptions between constituent systems of an SoS simulation. To address this issue, we developed a high level architecture (HLA) simulation of three networks and performed a series of simulation experiments. Our results revealed that time granularity and especially recovery time have huge impact on propagation of disruptions. Consequently, we developed a model for selecting an appropriate time granularity for an SoS simulation based on expected recovery time. Our simulation experiments show that time granularity should be less than 1.13 of expected recovery time. We identified some areas for future research centered around extending the experimental factors space.
The Relationship between HIV Duration, Insulin Resistance and Diabetes Risk
Authors: Tiozzo Eduard , Rodriguez Allan , Konefal Janet , Farkas Gary J. , Maher Jennifer L. , Lewis John E.
Published: April 2021

The risk of developing Type 2 Diabetes Mellitus in people living with HIV (PLWH) can be four times greater and can occur at an earlier age and even without the presence of obesity compared to those without HIV. Therefore, the purpose of this analytical cross-sectional study was to determine the relationship between HIV duration and glucose metabolism among PLWH. Eighty-two PLWH were categorized into shorter (≤15 years) or longer HIV duration (≥16 years) and then compared for differences in demographics, physical and clinical characteristics, biomarkers, and dietary intake. Compared to those with shorter HIV duration (n = 34), those with longer HIV duration (n = 48) were on average older (p = 0.02), reported lower consumption of alcohol (p = 0.05), had higher levels of homeostasis model assessment of insulin resistance (HOMA-IR, p = 0.02), were also more likely to be a woman (p = 0.06), and have higher levels of fasting insulin (p = 0.06). When adjusted for age and body weight, the levels of HOMA-IR and fasting insulin were higher (p = 0.02 and p = 0.04) with longer compared to shorter HIV duration, respectively. Longer exposure to HIV infection is associated with impaired insulin sensitivity. Continuing research aimed at the long-term effects of HIV infection and (antiretroviral therapy) is required.
A Survey on Stretching Practices in Women and Men from Various Sports or Physical Activity Programs
Authors: Babault Nicolas , Rodot Gaelyann , Champelovier Marrain , Cometti Carole
Published: April 2021

Recommendations for prescribing stretching exercises are regularly updated. It appears that coaches progressively follow the published guidelines, but the real stretching practices of athletes are unknown. The present study aimed to investigate stretching practices in individuals from various sports or physical activity programs. A survey was completed online to determine some general aspects of stretching practices. The survey consisted of 32 multiple-choice or open-ended questions to illustrate the general practices of stretching, experiences and reasons for stretching. In total, 3546 questionnaires were analyzed (47.3% women and 52.7% men). Respondents practiced at the national/international level (25.2%), regional level (29.8%), or recreationally (44.9%). Most respondents (89.3%) used stretching for recovery (74.9%) or gains of flexibility (57.2%). Stretching was generally performed after training (72.4%). The respondents also indicated they performed stretching as a pre-exercise routine (for warm-up: 49.9%). Static stretching was primarily used (88.2%) but when applied for warm-up reasons, respondents mostly indicated performing dynamic stretching (86.2%). Only 37.1% of the respondents indicated being supervised. Finally, some gender and practice level differences were noticed. The present survey revealed that the stretching practices were only partly in agreement with recent evidence-based recommendations. The present survey also pointed out the need to improve the supervision of stretching exercises.
Examining the Driving Factors of Urban Residential Carbon Intensity Using the LMDI Method: Evidence from China’s County-Level Cities
Authors: Zhao Jincai , Liu Qianqian
Published: April 2021

Improving carbon efficiency and reducing carbon intensity are effective means of mitigating climate change. Carbon emissions due to urban residential energy consumption have increased significantly; however, there is a lack of research on urban residential carbon intensity. This paper examines the spatiotemporal variation of carbon intensity in the residential sector during 2001–2015, and then identifies the causes of the variation by utilizing the logarithmic mean Divisia index (LMDI) with the help of Microsoft Excel 2016 for 620 county-level cities in 30 Chinese provinces. The results show that high carbon intensity is mainly found in large cities, such as Beijing, Tianjin, and Shanghai. However, these cities showed a downward trend in carbon intensity. In terms of influencing factors, the energy consumption per capita, urban sprawl, and land demand are the three most influential factors in determining the changes in carbon intensity. The effect of energy consumption per capita mainly increases the carbon intensity, and its impact is higher in the municipal districts of provincial capital cities than in other types of cities. Similarly, the urban sprawl effect also promotes increases in carbon intensity, and a higher degree of influence appears in large cities. However, as urban expansion plateaus, the effect of urban sprawl decreases. The land-demand effect reduces the carbon intensity, and the degree of influence of the land-demand effect on carbon intensity is also clearly stronger in big cities. Our findings show that lowering the energy consumption per capita and optimizing the land-use structure are a reasonable direction of efforts, and the effects of differences in influencing factors should be paid more attention to reduce carbon intensity.
Dissatisfaction with Local Medical Services for Middle-Aged and Elderly in China: What Is Relevant?
Authors: Fan Xiaojing , Su Min , Zhao Yaxin , Wang Duolao
Published: April 2021

As violent clashes between doctors and patients in China intensify, patient dissatisfaction has been identified as a major concern in the current healthcare reform in China. This study aims to investigate the main determinants of dissatisfaction with local medical services attributable to middle-aged and elderly characteristics and identify areas for improvement. A total of 14,263 rural participants and 4898 urban participants were drawn from the China Health and Retirement Longitudinal Study in 2018. Dissatisfaction was measured by two methods: binary outcome (1 = Dissatisfaction; 0 = No) demonstrated the risk of occurring dissatisfaction among various characteristics, and continuous outcome (ranges from score 1 to 5) showed the degree. The mean score of dissatisfaction was 2.73 ± 1.08. Sixteen percent of rural participants and 19% of urban participants reported dissatisfaction with local medical services, respectively. The multilevel analyses demonstrated that participants’ utilization of paid family doctor services decreased the risk of occurring dissatisfaction; dissatisfaction was less focused on females; having chronic diseases increased the risk of dissatisfaction. This study suggests promotion of family doctor services can effectively reduce middle-aged and elderly dissatisfaction with the local medical services. In addition, more attention should be focused on males and middle-aged and elderly with chronic diseases in order to decrease dissatisfaction.
Interventions Preventing Vaginitis, Vaginal Atrophy after Brachytherapy or Radiotherapy Due to Malignant Tumors of the Female Reproductive Organs—A Systematic Review
Authors: Wierzbicka Adrianna , Mańkowska-Wierzbicka Dorota , Cieślewicz Stanisław , Stelmach-Mardas Marta , Mardas Marcin
Published: April 2021

Background: Radiotherapy, as a method of treatment of cervical and uterine cancers, may induce severe late-onset vaginal side effects. Unfortunately, little evidence on the management of adverse effects has been presented. This study aimed to evaluate the available interventions which reduce symptoms of vaginitis and vaginal atrophy by improving dyspareunia, mucosal inflammation, vaginal pH and vaginal dryness in women who have undergone brachytherapy or radiotherapy due to uterine or cervical malignancies. Materials and methods: A comprehensive literature search was performed following PRISMA guidelines. The systematic search was conducted using electronic databases, namely Scopus, Web of Science and PubMed, between October and November 2020 to identify randomized controlled trials (RCT) and, prospective randomized studies (PRS). Results: The analyzed population consists of 376 patients with uterine or cervical cancer, treated with hyaluronic acid, vitamin A, vitamin E, alpha-tocopherol acetate and dienestrol. Intervention with HA along with vitamin A and vitamin E revealed advantage in endpoints such as reduced dyspareunia, vaginal mucosal inflammation, vaginal dryness, bleeding, fibrosis and cellular atypia. Administration of alpha-tocopherol acetate reduced vaginal mucosal inflammation and improved vaginal acanthosis, whereas dienestrol resulted in reduced dyspareunia, vaginal caliber and bleeding. Conclusions: Vaginal suppositories were found to be clinically effective at the management of late-onset vulvovaginal side effects after radiotherapy.
Revisiting Banking Stability Using a New Panel Cointegration Test
Authors: Ghassan Hassan B. , Boulanouar Zakaria , Hassan Kabir M.
Published: April 2021

Using a new panel cointegration test that considers serial correlation and cross-section dependence on a mixed and heterogenous sample of Saudi banks, we revisit the cointegrating equation of the z-score index of banking stability. Our results show that even when we consider the cross-section dependency and serial correlation of the errors, there is a possibility of a long-run relationship, which holds in our sample of banks. Furthermore, in the medium term, we found some banks to be integrated, whereas others were non-cointegrated. We interpret this to suggest that some banks contribute to banking stability, whereas others do not. In other words, there exists at least one bank that acts as a destabilizer and the challenge for financial regulators is to identify which banks these are. However, the current version of the Hadri et al. test does not allow for the identification of the non-cointegrated banks. If the test was able to do that, the regulatory authorities would be able to develop corrective policies/measures specifically tailored to the non-cointegrated units.
A Geomorphic Approach for Identifying Flash Flood Potential Areas in the East Rapti River Basin of Nepal
Authors: Pangali Sharma Til Prasad , Zhang Jiahua , Khanal Narendra Raj , Prodhan Foyez Ahmed , Nanzad Lkhagvadorj , Zhang Da , Nepal Pashupati
Published: April 2021

Basin geomorphology is a complete system of landforms and topographic features that play a crucial role in the basin-scale flood risk evaluation. Nepal is a country characterized by several rivers and under the influence of frequent floods. Therefore, identifying flood risk areas is of paramount importance. The East Rapti River, a tributary of the Ganga River, is one of the flood-affected basins, where two major cities are located, making it crucial to assess and mitigate flood risk in this river basin. A morphometric calculation was made based on the Shuttle Radar Topographic Mission (SRTM) 30-m Digital Elevation Model (DEM) in the Geographic Information System (GIS) environment. The watershed, covering 3037.29 km2 of the area has 14 sub-basins (named as basin A up to N), where twenty morphometric parameters were used to identify flash flood potential sub-basins. The resulting flash flood potential maps were categorized into five classes ranging from very low to very high-risk. The result shows that the drainage density, topographic relief, and rainfall intensity have mainly contributed to flash floods in the study area. Hence, flood risk was analyzed pixel-wise based on slope, drainage density, and precipitation. Existing landcover types extracted from the potential risk area indicated that flash flood is more frequent along the major Tribhuvan Rajpath highway. The landcover data shows that human activities are highly concentrated along the west (Eastern part of Bharatpur) and the east (Hetauda) sections. The study concludes that the high human concentrated sub-basin “B” has been categorized as a high flood risk sub-basin; hence, a flood-resilient city planning should be prioritized in the basin.
Toward Improving Image Retrieval via Global Saliency Weighted Feature
Authors: Zhao Hongwei , Wu Jiaxin , Zhang Danyang , Liu Pingping
Published: April 2021

For full description of images’ semantic information, image retrieval tasks are increasingly using deep convolution features trained by neural networks. However, to form a compact feature representation, the obtained convolutional features must be further aggregated in image retrieval. The quality of aggregation affects retrieval performance. In order to obtain better image descriptors for image retrieval, we propose two modules in our method. The first module is named generalized regional maximum activation of convolutions (GR-MAC), which pays more attention to global information at multiple scales. The second module is called saliency joint weighting, which uses nonparametric saliency weighting and channel weighting to focus feature maps more on the salient region without discarding overall information. Finally, we fuse the two modules to obtain more representative image feature descriptors that not only consider the global information of the feature map but also highlight the salient region. We conducted experiments on multiple widely used retrieval data sets such as roxford5k to verify the effectiveness of our method. The experimental results prove that our method is more accurate than the state-of-the-art methods.
A Deep Learning Streaming Methodology for Trajectory Classification
Authors: Kontopoulos Ioannis , Makris Antonios , Tserpes Konstantinos
Published: April 2021

Due to the vast amount of available tracking sensors in recent years, high-frequency and high-volume streams of data are generated every day. The maritime domain is no different as all larger vessels are obliged to be equipped with a vessel tracking system that transmits their location periodically. Consequently, automated methodologies able to extract meaningful information from high-frequency, large volumes of vessel tracking data need to be developed. The automatic identification of vessel mobility patterns from such data in real time is of utmost importance since it can reveal abnormal or illegal vessel activities in due time. Therefore, in this work, we present a novel approach that transforms streaming vessel trajectory patterns into images and employs deep learning algorithms to accurately classify vessel activities in near real time tackling the Big Data challenges of volume and velocity. Two real-world data sets collected from terrestrial, vessel-tracking receivers were used to evaluate the proposed methodology in terms of both classification and streaming execution performance. Experimental results demonstrated that the vessel activity classification performance can reach an accuracy of over 96% while achieving sub-second latencies in streaming execution performance.
Prevention of Bone Destruction by Mechanical Loading Is Not Enhanced by the Bruton’s Tyrosine Kinase Inhibitor CC-292 in Myeloma Bone Disease
Authors: Ziouti Fani , Rummler Maximilian , Steyn Beatrice , Thiele Tobias , Seliger Anne , Duda Georg N. , Bogen Bjarne , Willie Bettina M. , Jundt Franziska
Published: April 2021

Limiting bone resorption and regenerating bone tissue are treatment goals in myeloma bone disease (MMBD). Physical stimuli such as mechanical loading prevent bone destruction and enhance bone mass in the MOPC315.BM.Luc model of MMBD. It is unknown whether treatment with the Bruton’s tyrosine kinase inhibitor CC-292 (spebrutinib), which regulates osteoclast differentiation and function, augments the anabolic effect of mechanical loading. CC-292 was administered alone and in combination with axial compressive tibial loading in the MOPC315.BM.Luc model for three weeks. However, neither CC-292 alone nor its use in combination with mechanical loading was more effective in reducing osteolytic bone disease or rescuing bone mass than mechanical stimuli alone, as evidenced by microcomputed tomography (microCT) and histomorphometric analysis. Further studies are needed to investigate novel anti-myeloma and anti-resorptive strategies in combination with physical stimuli to improve treatment of MMBD.
Role of Scaffolds, Subchondral, Intra-Articular Injections of Fresh Autologous Bone Marrow Concentrate Regenerative Cells in Treating Human Knee Cartilage Lesions: Different Approaches and Different Results
Authors: Hernigou Jacques , Vertongen Pascale , Rasschaert Joanne , Hernigou Philippe
Published: April 2021

The value of bone marrow aspirate concentrates for treatment of human knee cartilage lesions is unclear. Most of the studies were performed with intra-articular injections. However, subchondral bone plays an important role in the progression of osteoarthritis. We investigated by a literature review whether joint, subchondral bone, or/and scaffolds implantation of fresh autologous bone marrow aspirate concentrated (BMAC) containing mesenchymal stem cells (MSCs) would improve osteoarthritis (OA). There is in vivo evidence that suggests that all these different approaches (intra-articular injections, subchondral implantation, scaffolds loaded with BMAC) can improve the patient. This review analyzes the evidence for each different approach to treat OA. We found that the use of intra-articular injections resulted in a significant relief of pain symptoms in the short term and was maintained in 12 months. However, the clinical trials indicate that the application of autologous bone marrow concentrates in combination with scaffolds or in injection in the subchondral bone was superior to intra-articular injection for long-term results. The tendency of MSCs to differentiate into fibrocartilage affecting the outcome was a common issue faced by all the studies when biopsies were performed, except for scaffolds implantation in which some hyaline cartilage was found. The review suggests also that both implantation of subchondral BMAC and scaffolds loaded with BMAC could reduce the need for further surgery.