bluuebunny/crossref_metadata_2025 huggingface dataset:
Sleep–Wake Behaviour of 200-Mile Ultra-Marathon Competitors: A Case Study
Authors: Bianchi Darren , Miller Dean J. , Lastella Michele
Published: March 2022

The aim of this study was to examine the sleep–wake behaviour of 200-mile ultra-marathon runners before, during, and after a competition. A longitudinal, observational study was conducted to collect the sleep data of four (two females; mean age: 45.5 ± 3.1 years) runners competing in a 200-mile ultra-marathon (N = 4). Wrist-worn activity monitors, in conjunction with self-report sleep diaries, were used to measure sleep, beginning seven days prior to the race and concluding seven days following the race (2–19 June 2021). Descriptive analysis of runners’ subjective and objective sleep data was conducted. All runners completed the 200-mile event in an average of 82.5 ± 7.1 h. On average, runners obtained 4.7 ± 3.0 h of sleep from 4.8 ± 2.4 sleep episodes, averaging 59.9 ± 49.2 min of sleep per episode. Runners averaged 6.0 ± 1.3 h of sleep per night in the week before the competition and 6.3 ± 1.3 h per night in the week following the competition. Runners in the 200-mile (326 km) ultra-marathon drastically restricted their sleep. However, obtained sleep, the number of sleep episodes, and sleep episode length were greater than those previously reported with 100-mile (161 km) runners. In-race sleep data suggest an increased need for sleep as race duration increases. Interestingly, runners obtained less than the recommended ~8 h of sleep per night, in both pre-race and post-race phases of the competition.
Association of Breastfeeding Duration with 12-Month Postpartum Blood Lipids in a Predominately Lower-Income Hispanic Pregnancy Cohort in Los Angeles
Authors: Niu Zhongzheng , Naya Christine H. , Reynaga Lorena , Toledo-Corral Claudia M. , Johnson Mark , Yang Tingyu , Grubbs Brendan , Lurvey Nathana , Lerner Deborah , Dunton Genevieve F. , Habre Rima , Breton Carrie V. , Bastain Theresa M. , Farzan Shohreh F.
Published: March 2022

Breastfeeding may protect women’s long-term cardiovascular health; however, breastfeeding-related postpartum lipid changes remain unclear. We aim to examine associations of breastfeeding duration with maternal lipids at 12 months postpartum. In a subsample (n = 79) of the Maternal and Developmental Risks from Environmental and Social Stressors (MADRES) cohort, breastfeeding status and duration at 3, 6, and 12 months postpartum were self-reported. Serum levels of lipids, including total cholesterol, triglycerides (TG), high-, low-, and very low-density lipoprotein cholesterol (HDL-C, LDL-C, VLDL-C), were measured from blood samples collected at 12 months postpartum. We used linear regression models to compare lipids by breastfeeding duration, adjusting for potential confounders. Women who were breastfeeding at 12 months had higher HDL-C (mean: 41.74 mg/dL, 95% CI: 37.27–46.74 vs. 35.11 mg/dL, 95% CI: 31.42–39.24), lower TG (80.45 mg/dL, 95% CI: 66.20–97.77 vs. 119.11 mg/dL, 95% CI: 98.36–144.25), and lower VLDL-C (16.31 mg/dL, 95% CI: 13.23, 20.12 vs. 23.09 mg/dL, 95% CI: 18.61–28.65) compared to women who breastfed for <6 months. No lipids were significantly different between women who breastfed for 6–11 months and for <6 months. Each month’s increase in breastfeeding duration was significantly, inversely associated with TG and VLDL-C and positively with HDL-C. Adjusting for fasting status, demographics, pre-pregnancy body mass index, breastfeeding frequency, and pregnancy complications did not appreciably change effect estimates. Breastfeeding at 12 months postpartum and a longer duration of breastfeeding in the first year postpartum were both associated with increased HDL-C and decreased TG and VLDL-C at 12 months postpartum.
Academic Self-Concept Dramatically Declines in Secondary School: Personal and Contextual Determinants
Authors: Postigo Álvaro , Fernández-Alonso Rubén , Fonseca-Pedrero Eduardo , González-Nuevo Covadonga , Muñiz José
Published: March 2022

Academic self-concept is one of the most important non-cognitive variables in determining students’ attitudes towards school and their performance. The objective of this study was to use a longitudinal approach to analyze how academic self-concept changed between primary and secondary schools and to analyze the factors that affected that progression. The sample consisted of 7379 students (47.4% girls) evaluated at two time-points: fourth grade and eighth grade. Six schooling pathways were analyzed: repeating a year before fourth grade, repeating between fourth and eighth grade, and repeating eighth grade. Five two-level hierarchical linear models of intrasubject means were assessed. The results indicate that academic self-concept falls dramatically between primary school and secondary school, varying according to background variables. Nevertheless, the most influential factor was the students’ schooling pathway. This study reinforces the evidence that, at least in the Spanish context, educational policies need to address alternatives to repetition.
Role of Empathy and Lifelong Learning Abilities in Physicians and Nurses Who Work in Direct Contact with Patients in Adverse Working Conditions
Authors: Delgado Bolton Roberto C. , San-Martín Montserrat , Vivanco Luis
Published: March 2022

Empathy and lifelong learning are two professional competencies that depend on the four principles of professionalism: humanism, altruism, excellence, and accountability. In occupational health, there is evidence that empathy prevents work distress. However, in the case of lifelong learning, the evidence is still scarce. In addition, recent studies suggest that the development of lifelong learning varies in physicians and nurses and that it is sensitive to the influence of cultural stereotypes associated with professional roles. This study was performed with the purpose of determining the specific role that empathy and lifelong learning play in the reduction in occupational stress. This study included a sample composed by 40 physicians and 40 nurses with high dedication to clinical work in ambulatory consultations from a public healthcare institution in Paraguay. Somatization, exhaustion, and work alienation, described as indicators of occupational stress, were used as dependent variables, whereas empathy, lifelong learning, gender, discipline, professional experience, civil status, and family burden were used as potential predictors. Three multiple regression models explained 32% of the variability of somatization based on a linear relationship with empathy, lifelong learning, and civil status; 73% of the variability of exhaustion based on a linear relationship with empathy, somatization, work alienation, and discipline; and 62% of the variability of work alienation based on a linear relationship with lifelong learning, exhaustion, and discipline. These findings indicate that empathy and lifelong learning play important roles in the prevention of work distress in physicians and nurses. However, this role varies by discipline.
Influence of Particle Size and Zeta Potential in Treating Highly Coloured Old Landfill Leachate by Tin Tetrachloride and Rubber Seed
Authors: Ramli Siti Fatihah , Aziz Hamidi Abdul , Omar Fatehah Mohd , Yusoff Mohd Suffian , Halim Herni , Kamaruddin Mohamad Anuar , Ariffin Kamar Shah , Hung Yung-Tse
Published: March 2022

Old leachate normally has a low organic compound content, poor biodegradability and is hard to biologically treat. The efficacy of tetravalent metal salts as a coagulant and the application of a natural coagulant as a flocculant in landfill leachate treatment is still inconclusive. Hence, this study aimed to evaluate the potential application of tin tetrachloride (SnCl4) as the main coagulant and the rubber seed (Hevea brasiliensis) (RS) as the natural coagulant aid as the sole treatment in eradicating highly coloured and turbid stabilised landfill leachate present at one of the old local landfills in Malaysia. The standard jar test conducted revealed that SnCl4 was able to eliminate 99% and 97.3% of suspended solids (SS) and colour, respectively, at pH8, with 10,000 mg/L dosages, an average particle size of 2419 d·nm, and a zeta potential (ZP) of −0.4 mV. However, RS was found to be ineffective as the main coagulant and could only remove 46.7% of SS and 76.5% of colour at pH3 with 6000 mg/L dosages, and also exhibited smaller particles (933 d·nm) with ZP values of −6.3 mV. When used as a coagulant aid, the polymer bridging mechanism in RS helped in reducing the SnCl4 concentration from 10,000 mg/L to 8000 mg/L by maintaining the same performances. The presence of 1000 mg/L RS as a coagulant aid was able to remove 100% of SS and 97.6% of colour. The study concluded that RS has the potential to be used together with SnCl4 in treating concentrated leachate with SS and colour.
Digitally Fabricated Dentures for Full Mouth Rehabilitation with Zirconia, Polyetheretherketone and Selective Laser Melted Ti-6Al-4V Material
Authors: Lee Wei-Ting , Chen Yung-Chung
Published: March 2022

CAD/CAM technologies have been embedded into the fabrication of removable partial denture (RPD). Various materials such as zirconia and polyetheretherketone (PEEK) are developed for subtractive manufacturing. As for additive manufacturing, dental professionals have begun to use selective laser melting (SLM) techniques for fabricating metallic RPD frameworks. This report demonstrates a case rehabilitated with a maxillary telescopic crown-retained combining PEEK and zirconia material denture and a mandibular Kennedy Class I RPD fabricated with SLM techniques. First, a conventional impression was performed and the master cast was mounted with a centric relation record. Digital models were obtained using tabletop scanners and then the telescopic primary zirconia crowns were designed and milled. After transferring the intraoral distribution of primary crowns using pick-up impression, secondary PEEK crowns and framework were designed, milled, and veneered with composite resin. Mandibular framework was designed and constructed using SLM technique with Ti-6Al-4V. Definitive prostheses for both jaws were finished and delivered. Delivered prostheses functioned well for a one-year period. The was patient satisfied with the improvements in chewing function and esthetics. Both substrative and additive manufacturing techniques are suitable for framework fabrication. Further investigation is needed for improving the mechanical performance and long-term prognosis of digitally made prostheses.
Long-Term Mental Health Support after Natural Hazard Events: A Report from an Online Survey among Experts in Japan
Authors: Kayano Ryoma , Lin Mingming , Shinozaki Yasuko , Nomura Shuhei , Kim Yoshiharu
Published: March 2022

This paper aims to provide preliminary evidence on the degree of consensus on the approach to long-term mental health and psychosocial support after a natural hazard event. We conducted an online survey among mental health experts in Japan. The questionnaire was divided into five categories: (A) terminology setting definition of “long-term”, (B) priority in activity for long-term mental health support, (C) system and preparedness for better support, (D) transition from acute support to long-term support, and (E) actions to improve preparedness for future disasters. Invitations to participate in the survey were sent by e-mail in November 2017 to mental health experts in Japan, who had participated in workshops related to disaster mental health or trauma care organized by the National Institute of Mental Health over the last 15 years. Out of 1385 experts who received the invitation, a total of 305 participants responded to the survey. Participants were for the most part in agreement regarding focuses and required preparedness and actions for long-term support. There was still low consensus especially on defining the timeframe “long-term”. The acute phase and long-term phase were identified as being different in dimension rather than category. Although caution is necessary around the representativeness of these findings, they will provide important scientific evidence for the development of future plans for a qualitative improvement in long-term mental health support.
The Influence of Disease Status on Loneliness of the Elderly: Evidence from Rural China
Authors: Song Jiahao , Wu Haitao , Lan Hongxing , Xu Dingde , Wang Wei
Published: March 2022

At present, the dual pressure of rural labor outflow and population aging in China makes the problems of the rural elderly population increasingly prominent, and its health problem is particularly prominent. Based on the 2014 China elderly population health survey data (CLHLS), this paper finds that the physical health status of the rural elderly has a significant positive impact on their loneliness; that is, the rural elderly with poor health status are more likely to feel lonely. At the same time, the age of the elderly has a significant positive impact on their loneliness. On the contrary, gender, personality, family income and intergenerational support of the elderly have a negative impact on their loneliness. Chronic diseases such as hypertension and diabetes have no significant effect on the loneliness of the elderly in rural areas, but there is a “severe disease effect”; that is, when chronic diseases develop into serious diseases or acute serious diseases, it can negatively impact the elderly psychologically and produce or deepen their sense of loneliness. Based on the above conclusions, this paper further puts forward relevant policy suggestions from three aspects: constructing a disease prevention and control system for the rural elderly, improving the care and service system for the rural elderly, reshaping rural filial piety culture, and creating a good atmosphere of “respecting, loving and respecting parents” in rural areas.
Epidemiology, Distribution and Identification of Ticks on Livestock in Pakistan
Authors: Khan Sadia Salim , Ahmed Haroon , Afzal Muhammad Sohail , Khan Mobushir Riaz , Birtles Richard J. , Oliver Jonathan D.
Published: March 2022

Background: Ticks are ectoparasites that transmit a variety of pathogens that cause many diseases in livestock which can result in skin damage, weight loss, anemia, reduced production of meat and milk, and mortality. Aim: The aim of this study was to identify tick species and the distribution on livestock hosts (sheep, goat, dairy cattle, and buffalo) of Punjab, Khyber Pakhtunkhwa Province and Islamabad from October 2019 to November 2020. Materials and Methods: Surveillance was performed to calculate the prevalence of ticks on livestock. Tick prevalence data (area, host, breed, gender, age, and seasonal infestation rate) was recorded and analyzed. Results: A total of 2080 animals were examined from selected farms, and, of these, 1129 animals were tick-infested. A total of 1010 male tick samples were identified to species using published keys. Haemaphysalis punctata, Haemaphysalis sulcata, Hyalomma anatolicum, Hyalomma detritum, Hyalomma dromedarii, Hyalomma excavatum, Hyalomma marginatum, Hyalomma rufipes, Rhipicephalus decoloratus Rhipicephalus microplus, and Rhipicephalus sanguineus were collected from goats, sheep, buffalo, and cattle. The overall rates of tick infestation on livestock were 34.83% (buffalo), 57.11% (cattle), 51.97% (sheep) and 46.94% (goats). Within each species, different breeds demonstrated different proportions of infestation. For cattle breeds, infestation proportions were as follows: Dhanni (98.73%), Jersey (70.84%) and the Australian breed of cattle (81.81%). The Neeli Ravi breed (40%) of buffalo and the Beetal breed (57.35%) of goats were the most highly infested for these species. Seasonally, the highest prevalence of infestation (76.78%) was observed in summer followed by 70.76% in spring, 45.29% in autumn, and 20% in winter. The prevalence of tick infestation in animals also varied by animal age. In goats, animals aged 4–6 years showed the highest prevalence (90%), but in cattle, the prevalence of ticks was highest (68.75%) in 6 months–1-year-old animals. 1–3 years old buffalo (41.07%) and 6 months–1 year sheep (65.78%) had the highest prevalence rate. Females had significantly higher infestation rates (61.12%, 55.56% and 49.26%, respectively) in cattle, sheep, and goats. In buffalo, males showed a higher prevalence (38.46%) rate. Conclusions: This study showed tick diversity, infestation rate, and numerous factors (season, age, and gender of host) influencing tick infestation rate in different breeds of cattle, sheep, goats, and buffalo in Punjab Province, Khyber Pakhtunkhwa Province, and Islamabad, Pakistan. Higher tick burdens and rates of tick-borne disease reduce production and productivity in animals. Understanding tick species’ prevalence and distribution will help to develop informed control measures.
Drag Effect of Economic Growth and Its Spatial Differences under the Constraints of Resources and Environment: Empirical Findings from China’s Yellow River Basin
Authors: Zhou Yujiao , Li Ding , Li Weifeng , Mei Dong , Zhong Jianyi
Published: March 2022

As the global economic development intensifies the plunder of resources and the environment, the constraints are becoming more and more obvious. Based on the background of the strategy for ecological conservation and high-quality development of the Yellow River Basin, this paper intends to construct a resource-environment-constrained economic growth drag effect model and a spatial Dubin model, and explore the economic growth drag effect and its spatial differences in the Yellow River Basin under the constraints of resources and environment. The study found that the total drag effects of the overall economic growth of the Yellow River Basin that were obtained by the classic panel model without spatial effects is significantly negative. This is consistent with the conclusion that the average total drag effects of 80 prefecture-level cities is negative. The total drag effects of the overall economic growth of the Yellow River Basin changes from unconstrained to medium-constrained after adding spatial constraints, indicating that the spatial correlation of factors will restrict economic growth. From the level of the Yellow River sub-catchment, the total drag effect of the direct effects of the upper, middle, and lower reaches of the Yellow River is consistent with the total drag effect of the total effect. It shows that the upper economic growth is strongly constrained by the local resources and environment, while the downstream is strongly constrained by the adjacent resources and the environment. The research results provide references for resolving the resources and environment constraints in the Yellow River Basin. It provides useful inspiration for promoting ecological protection and high-quality development strategies in the Yellow River Basin.
Still Lost in Transition? Perspectives of Ongoing Cancer Survivorship Care Needs from Comprehensive Cancer Control Programs, Survivors, and Health Care Providers
Authors: Ross Leslie W. , Townsend Julie S. , Rohan Elizabeth A.
Published: March 2022

Public health agencies have played a critical role in addressing the complex health and mental health needs of cancer survivors. We conducted a mixed-methods evaluation via a Web-based survey (n = 51) and focus groups (n = 11) with National Comprehensive Cancer Control Program (NCCCP) recipients and interviews (n = 9) with survivors, health care providers (HCPs), and patient navigators to explore these audiences’ cancer survivorship information needs and strategies to improve resource dissemination. Participants revealed a need for tailored resources and support for survivors on healthy lifestyle, post-treatment survivorship concerns, psychosocial health, and navigating the health system. HCP needs included education on survivorship care plans and care coordination to facilitate the transition between oncology and primary care. HCPs were survivors’ most trusted source for information; however, participants noted difficulties engaging HCPs in survivorship care. These findings can help public health practitioners focus their efforts to better meet the needs of cancer survivors and their HCPs.
A Fire Revealing Coastal Norway’s Wildland–Urban Interface Challenges and Possible Low-Cost Sustainable Solutions
Authors: Log Torgrim , Gjedrem Anna Marie
Published: March 2022

The Calluna vulgaris L. that dominated coastal heathlands of Western Europe were for millennia managed by regular burning cycles for improved grazing. Most places in Norway this practice has, however, been neglected over the last 5–7 decades, resulting in accumulation of above ground biomass including degenerated Calluna and successional fire-prone species, e.g., native juniper (Juniperus communis) and exotic blacklisted Sitka spruce (Picea sitchensis). Today, in dry periods, the heathland represents a fire threat to the increasing number of homes in the wildland–urban interface (WUI), as exemplified by the June 2021 Sotra Island WUI fire. The fire burned 700 ha of encroached heathlands, destroyed three buildings, and threatened settlements. In the present study, the Sotra fire was investigated to understand the fire development and analyse possible risk reducing measures. Photographic material obtained during the fire, weather conditions prior to and during the fire, involved fire fuel, fire spread mechanisms, firefighting response, and possible consequences under slightly changed circumstances were analysed. Compared to previous fires in coastal Norway, the Sotra fire represents a step change in fire development including, e.g., pyrocumulus-like clouds, fire whirls, and fire spread 270 m across a fjord. Preventive measures based on the local context are analysed, including engaging voluntary communities to remove fire-prone fuel, e.g., juniper and Sitka, to create defensible space. Moreover, strategic fire breaks in the terrain, e.g., well-managed heathland strengthening existing fuel breaks, e.g., lakes, cultivated fields, naked rock, and roads, are recommended. Mechanical cutting is suggested as a short-term measure while fenceless grazing may represent a long-term solution to prevent regrowth. During a period of record high energy prices, this may provide free of charge firewood and make way for future local food production, in line with the UN Sustainable Development Goals, while reducing the fire risk.
The Energy Transition between Desideratum and Challenge: Are Cogeneration and Trigeneration the Best Solution?
Authors: Neacșa Adrian , Panait Mirela , Mureșan Jianu Daniel , Voica Marian Catalin , Manta Otilia
Published: March 2022

Climate change has brought to the attention of politicians, researchers, and other stakeholders the need to protect the environment. The concerns at the international level are more and more intense, and the solutions found are multiple. One of the directions to follow is a new energy transition, which involves the use of renewable energy, but also techniques of cogeneration and trigeneration. This study presents the main research on increasing energy efficiency in the use of a primary energy source and the impact on the environment. Compared to the classical methods of obtaining heat and electricity from burning fossil fuels through separate technologies, the study brings to the fore two methods (cogeneration and trigeneration) that have much higher yields by obtaining two or even three forms of energy from the use of a single source of combustion. The impact on the environment is also significantly reduced by eliminating additional sources of pollution (reducing greenhouse gas emissions). Taking into account the evolutions of the energy market during this period, this article aims to analyze, from the point of view of the two most important influencing factors, the economic efficiency of processes and the reduction of greenhouse gas emissions by overlapping their effect, in case of the use of modern technologies (cogeneration and trigeneration), for the combined production of various forms of energy.
Gestational Sympathetic Stress Programs the Fertility of Offspring: A Rat Multi-Generation Study
Authors: Piquer Beatriz , Ruz Freddy , Barra Rafael , Lara Hernan E.
Published: March 2022

The exposure to sympathetic stress during the entire period of gestation (4 °C/3 h/day) strongly affects the postnatal reproductive performance of the first generation of female offspring and their fertility capacity. The aim of this work was to determine whether this exposure to sympathetic stress affects the reproductive capacity of the next three generations of female offspring as adults. Adult female Sprague–Dawley rats were mated with males of proven fertility. We studied the reproductive capacity of the second, third, and fourth generations of female offspring (the percentage of pregnancy and the number and weight of female offspring). The estrus cycle activity of the progenies was studied, and a morphological analysis of the ovaries was carried out to study the follicular population. The second generation had a lower number of pups per litter and a 20% decrease in fertile capacity. The estrus cycle activity of the third generation decreased even more, and they had a 50% decrease in their fertile capacity, and their ovaries presented polycystic morphology. The fourth generation however, recovered their reproductive capacity but not the amount of newborns pups. Most probably, the chronic intrauterine exposure to the sympathetic stress programs the female gonads to be stressed in a stressful environment; since the fourth generation was the first born with no direct exposure to stress during development, it opens studies on intrauterine factors affecting early follicular development.
Anthropometric Parameters, Physical Activity, Physical Fitness, and Executive Functions among Primary School Children
Authors: Contreras-Osorio Falonn , Guzmán-Guzmán Iris Paola , Cerda-Vega Enrique , Chirosa-Ríos Luis , Ramírez-Campillo Rodrigo , Campos-Jara Christian
Published: March 2022

Physical activity during childhood and adolescence favors brain development and cognitive functioning, particularly the executive functions. This study aimed to assess potential associations between anthropometric parameters, physical activity, physical fitness, and executive functions among elementary school children returning to school after the COVID-19 lockdown in Chile. School-age male and female participants (n = 90; age, 10–12 years) participated in the study. To determine the association between variables, a multivariable linear regression analysis was performed. Higher fat-related anthropometric indexes were associated with lower working memory, cognitive flexibility, planning, and attention (r = −0.55 to −0.22; p = 0.031 to <0.001). In contrast, higher physical activity levels, better sprint performance, higher lower-body muscular power, and greater upper-body muscular strength were associated with better working memory, cognitive flexibility, inhibition, planning, and/or attention (r = 0.19 to −0.54; p = 0.04 to <0.001). Current results consistently suggest the need for adequate levels of physical activity, physical fitness, and anthropometric parameters among the school-age population to promote healthy and adequate executive functions.
Comparison between Single and Multi-LED Emitters for Photodynamic Therapy: An In Vitro Study on Enterococcus faecalis and Human Gingival Fibroblasts
Authors: Petrini Morena , Pierfelice Tania Vanessa , D’Amico Emira , Carlesi Teocrito , Iezzi Giovanna , D’Arcangelo Camillo , Di Lodovico Silvia , Piattelli Adriano , D’Ercole Simonetta
Published: March 2022

Aim of the study: The aim was to evaluate the effects of two LED devices, TL-01 and TL-03 in photodynamic therapy (PDT), on Enterococcus faecalis and on human gingival fibroblasts (HGFs). TL-01, characterized by a single emitter, irradiates one periodontal site at a time, whereas the multi-led device (TL-03) irradiates all vestibular sites of a single arch at a time. Methods: E. faecalis bacterial suspensions and HGFs were incubated for 45 min with Aladent gel (ALAD) containing 5-aminolevulinic acid and then exposed to LED devices (ALAD-PDT), having different distance and timing of irradiation (TL-01 N (0.5 mm, for 7 min), TL-03 N (0.5 mm, 15 min) and TL-03 F (30.0 mm, 15 min)). For bacterial suspension, the colony forming units and the live/dead staining were evaluated after 24 h, while the protoporphyrin IX (PpIX) content was monitored in all phases of the experimentation. For HGFs, the cell viability, proliferation, cell morphology, and adhesion were evaluated at 24 h. Results: Both TL-01 and TL-03 showed a significant reduction of bacterial load. The photoinactivation was inversely proportional to the PpIX accumulation. TL-01 and TL-03 promoted proliferation and adhesion of HGFs. Conclusions: Both tested devices for ALAD-PDT were equally effective in significantly reducing Enterococcus faecalis growth and in promoting HGFs proliferation and adhesion, in vitro.
Sex and Economic Disparity Related to Reperfusion Therapies for Patients with Acute Ischemic Stroke in South Korea across a 10-Year Period: A Nationwide Population-Based Study Using the National Health Insurance Database
Authors: Moon Jusun , Shin Jinyoung , Lee Jeehye , Jeong Ho Jin , Kim Hyeongsu , An Jaehyeong , Jo Sung Hyun , Ko Kwang-Pil , Choi Jeoungbin
Published: March 2022

A complete enumeration study was conducted to evaluate trends related to reperfusion therapies (intravenous thrombolysis (IVT) and endovascular treatment (EVT)) in acute ischemic stroke (AIS) in South Korea, according to sex, economic status, and age, over a 10-year period retrospectively, using the National Health Information Database (NHIS-2020-1-481). This study included AIS patients aged ≥20 years who were hospitalized in a general hospital or tertiary hospital for ≥4 days and underwent brain imaging during the same period. Study participants were classified by sex, economic status (Medical Aid beneficiaries and National Health Insurance beneficiaries) and age (20–44, 45–64, 65–79, and ≥80 years). Women showed a significantly lower OR (Odds ratio) than men in IVT (OR: 0.75; 95% CI: 0.73–0.77), EVT (OR: 0.96; 95% CI: 0.93–0.99), and any therapy (OR: 0.82; 95% CI: 0.80–0.84). The Medical Aid beneficiaries showed significantly lower OR in IVT (OR 0.91, 95% CI 0.88–0.95), EVT (OR 0.93, 95% CI 0.89–0.98), and either therapy (OR 0.92, 95% CI 0.90–0.95) than the National Health Insurance beneficiaries. This study showed sex and economic disparity related to reperfusion therapies in patients with AIS in Korea.
Investigating the Daytime Visibility Requirements of Pavement Marking Considering the Influence of CCT and Illuminance of Natural Light
Authors: Hu Jiangbi , Guan Yanyan , Wang Ronghua , Cao Qingyun , Guo Yunpeng , Hu Qingxin
Published: March 2022

Pavement marking in daylight with poor quality cannot provide a reference for drivers to specify their own position relative to nearby vehicles. Luminance and Correlated color temperature (CCT) of sunlight is of importance for daytime visibility of in-service pavement markings, which lacks detailed consideration. This paper aims to explore the daytime visibility requirements of in-service pavement markings considering the influence of natural light characteristics. Based on analyzing the mechanism and impact factors of daytime visibility of pavement markings, a subjective scale of pavement markings state in the drivers’ field of view was proposed and a short and bold line was recommended as the standard state. Thirty-six tested drivers were randomly selected to detect white and yellow markings of both 15 cm and 20 cm width under 2000 to 23,000 lx and 5500 to 8500 K for outdoor natural light environment. The luminance contrast of the pavement marking to the surrounding road surface ranged from 0 to 10. The result indicated that the natural light with 2000 to 3000 lx and 7500 to 8500 K is the most unfavorable light environment for drivers to recognize pavement markings during daytime. The detection distance is becoming longer with the increase of luminance contrast. The detection distance does not increase with the increase of luminance contrast when the luminance contrast of white markings is greater than 4 and that of yellow markings is greater than 3. The model was established expressing the relationship between luminance contrast and Qd contrast. The preview time 3.65 s was selected to calculate the minimum requirements of Qd at speeds of 60, 80, 100 km/h, respectively, for different types of markings. The results can provide scientific evidence for quality evaluation and maintenance management of pavement markings in service for daytime visibility.
Tobacco Industry Efforts to Respond to Smoke-Free Policies in Multi-Unit Housing: An Evaluation of Tobacco Industry Documents
Authors: Miller Joshua , Vijayaraghavan Maya
Published: March 2022

The tobacco industry’s efforts to undermine clean indoor air policies in the hospitality industry, public spaces and workspaces is well documented, but less is known about their efforts to respond to the implementation of smoke-free policies in multi-unit housing (MUH). From 1988 to 2018, public and private multi-unit housing properties voluntarily implemented smoke-free polices in their buildings. We searched the UCSF’s Truth Tobacco Industry Documents Library to examine whether the tobacco industry responded to the implementation of these smoke-free policies in MUH using the same strategies they deployed to respond to smoke-free policies in other industries. We found that the tobacco industry used two primary strategies to respond to smoke-free policies in multi-unit housing: (1) distortion, which included funding studies that downplayed the link between SHS and asthma among low-income, inner-city MUH residents; and (2) deflection, which included engaging in corporate responsibility for youth living in low-income MUH. Despite these efforts, local jurisdictions continued to voluntarily implement smoke-free policies in MUH, pointing to a potential counter strategy to the tobacco industry influence.
Role Value, Occupational Balance, and Quality of Life: A Cross-Sectional Study on Exploring the Urban Older People Perspective in South Korea
Authors: Park Myoung-Ok , Lee Ji-Hyun
Published: March 2022

The purpose of this study was to investigate the role value, occupational balance, and quality of life among urban older adults in South Korea. We recruited 90 urban older adults in Seoul, Gyeonggi-do and Chungcheong-do. Assessments used (1) Role Checklist, (2) Life Balance Inventory (LBI), and (3) WHO Quality of Life Scale abbreviated version (WHOQOL-BREF). Our results showed that the roles that were perceived as very valuable were as family members, housekeepers, and guardians (in descending order). The roles that were perceived as less valuable were students, volunteers, and organizational members (in descending order). The activities that individuals were actively pursuing were hygiene management, rest, and healthy eating (in descending order). By contrast, the activities that were not being actively pursued were composing (music, poetry), preparing for event planning, dancing, yoga, and taekwondo. The total score of the Role Checklist and WHOQOL-BREF total (r = 0.343, p < 0.01), K-LBI total and WHOQOL-BREF total (r = 0.386, p < 0.01), and role value total and K-LBI (r = 323, p < 0.01) showed a statistically significant correlation. As a result of the regression analysis, the sub-item of work balance that affected the quality of life was managing appearance (R2 = 51.7, p < 0.001). These data showed that the role of urban older adults in Korea was mainly played within the family. The level of participation was low in the areas of instrumental daily life activities, work, leisure, and social participation. We propose that this population needs to be provided with opportunities for active aging through broader professional participation.
What Is So Special about Wingsuit BASE Jumpers? A Comparative Study of Their Psychological Characteristics
Authors: Bouchat Pierre , Feletti Francesco , Monasterio Erik , Brymer Eric
Published: March 2022

For the general public, BASE jumping is considered the ultimate extreme activity. Among BASE jumpers, those using wingsuits are generally perceived as the most experienced but also as the most risk-taking. Starting from this observation, we wanted to know whether wingsuit users differed in their psychological characteristics from other BASE jumpers. More specifically, we hypothesized that wingsuit users would be characterized by higher levels of mental toughness and by lower levels of harm avoidance. We also expected them to use more mental training techniques than the other jumpers. To this end, we conducted a vast survey on a sample of 183 BASE jumpers. Contrary to our hypotheses, the results did not reveal any significant difference in psychological characteristics between wingsuit users and other BASE jumpers. This absence of significant differences is discussed and recommendations for the use of mixed or multi-methods in the study of extreme sports are proposed.
Negative Correlation of Serum Adiponectin Level with Aortic Stiffness in Elderly Diabetic Persons
Authors: Hung Jui-Jung , Wu Du-An , Chen Ming-Chun , Hsu Bang-Gee
Published: March 2022

Adiponectin has anti-inflammatory activity against atherosclerosis. Aortic stiffness is a common manifestation of atherosclerosis in diabetes mellitus and elderly persons. This study aimed to evaluate whether low serum adiponectin levels were associated with aortic stiffness in geriatric diabetic patients. Blood samples were obtained from 130 diabetic participants aged ≥ 65 years. We defined high aortic stiffness based on a carotid–femoral pulse wave velocity (cfPWV) of >10 m/s. Circulating adiponectin concentrations were examined using enzyme-linked immunosorbent assays. Sixty-six participants (50.8%) had aortic stiffness. Patients with aortic stiffness had lower serum adiponectin concentrations than those in the control group (p < 0.001). Multivariate logistic regression analysis showed that the adiponectin level (odds ratio: 0.939, 95% confidence interval: 0.898–0.981, p = 0.005) was an independent predictor of aortic stiffness in elderly diabetic persons. Multivariate forward stepwise linear regression analysis also demonstrated that the adiponectin level (β = −0.256, adjusted R2 change = 0.100, p = 0.003) was negatively associated with cfPWV values in older diabetic patients. In conclusion, serum adiponectin is negatively correlated with cfPWV and is an independent predictor of aortic stiffness in elderly diabetic persons.
Physical Activity and BMI before and after the Situation Caused by COVID-19 in Upper Primary School Pupils in the Czech Republic
Authors: Pyšná Jana , Pyšný Ladislav , Cihlář David , Petrů Dominika , Müllerová Lenka Hajerová , Čtvrtečka Luděk , Čechová Anna , Suchý Jiří
Published: March 2022

Regular physical activity is a very important factor in the healthy development of an individual and an essential part of a healthy lifestyle. However, today’s population still suffers from an insufficient amount of exercise caused mainly by technological progress and often inappropriate conditions for practising sports. In relation to this, we are grappling with a steady increase in obesity. During the COVID-19 pandemic, conditions for regular physical activity became even more unfavourable, with the declaration of a state of emergency and antipandemic measures leading to the closure of sports grounds and sporting competitions. Using a questionnaire survey of a sample of children (n = 1456), we found that, already before the pandemic, 69% of the observed sample had not met the recommended amount of physical activity, and only 67% of the sample was of normal weight. By comparing both groups after the end of pandemic restrictions, we found statistically significant differences at examined indicators of the children’s Body Mass Index (BMI), their physical activity, and free time spending habits. We noticed the significant differences in BMI indicators in two different categories, normal weight (7.5%) and stage 1 obesity (1.66%). Simultaneously, we noticed differences in the children’s physical activities, especially with children who attend sports playgroups connected to athletic development (8.74%). More differences were noticed in free time spending habits indicators; the most significant ones were with the children who spend their free time behind the personal computer for more than 14 h a week (5.4%) and with the children who spend their free time on social media for 8–14 h a week (18.56%).
Comparison of Early and Late Intubation in COVID-19 and Its Effect on Mortality
Authors: McKay Benjamin , Meyers Matthew , Rivard Leah , Stankewicz Holly , Stoltzfus Jill C. , Rammohan Guhan
Published: March 2022

Background: Best practices for management of COVID-19 patients with acute respiratory failure continue to evolve. Initial debate existed over whether patients should be intubated in the emergency department or trialed on noninvasive methods prior to intubation outside the emergency department. Objectives: To determine whether emergency department intubations in COVID-19 affect mortality. Methods: We conducted a retrospective observational chart review of patients who had a confirmed positive COVID-19 test and required endotracheal intubation during their hospital course between 1 March 2020 and 1 June 2020. Patients were divided into two groups based on location of intubation: early intubation in the emergency department or late intubation performed outside the emergency department. Clinical and demographic information was collected including comorbid medical conditions, qSOFA score, and patient mortality. Results: Of the 131 COVID-19-positive patients requiring intubation, 30 (22.9%) patients were intubated in the emergency department. No statistically significant difference existed in age, gender, ethnicity, or smoking status between the two groups at baseline. Patients in the early intubation cohort had a greater number of existing comorbidities (2.5, p = 0.06) and a higher median qSOFA score (3, p ≤ 0.001). Patients managed with early intubation had a statistically significant higher mortality rate (19/30, 63.3%) compared to the late intubation group (42/101, 41.6%). Conclusion: COVID-19 patients intubated in the emergency department had a higher qSOFA score and a greater number of pre-existing comorbidities. All-cause mortality in COVID-19 was greater in patients intubated in the emergency department compared to patients intubated outside the emergency department.
The Provider Role and Perspective in the Denial of Family Planning Services to Women in Malawi: A Mixed-Methods Study
Authors: Peterson Jill M. , Bendabenda Jaden , Mboma Alexander , Chen Mario , Stanback John , Gunnlaugsson Geir
Published: March 2022

Family planning (FP) has been a global health priority for decades, yet barriers persist, including women being turned away from facilities without receiving services. This study assessed the provider role and perspective in client turnaway in three districts of Malawi. In 2019, data collectors surveyed 57 FP providers from 30 health facilities. All reported being comfortable providing FP to married women with children and married adolescents under 18 years old with children, whereas 12% of the providers expressed discomfort providing such services to married adolescents under 18 without children. Sixty percent of the providers required clients desiring FP and wishing to initiate oral contraceptives or injectables to be currently menstruating. Data collectors later conducted in-depth interviews (IDIs) with 8 of the 57 providers about client turnaway. During IDIs, providers’ most frequently mentioned reasons for turnaway was client pregnancy or suspicion of pregnancy. Providers expressed fears that initiating FP with a pregnant woman could cause community mistrust in the efficacy of modern contraception. Provider support for FP waned for nulliparous clients, regardless of age or marital status. To improve FP services in Malawi, providers need continuous education on all available methods of FP, a reduction in stockouts and programs to further sensitize the community to how contraception works. Understanding how Malawi has helped providers overcome social and cultural norms regarding provision of FP to adolescents might help other countries to make improvements.
The Workplace and Psychosocial Experiences of Australian Senior Doctors during the COVID-19 Pandemic: A Qualitative Study
Authors: Tran Jonathan , Willis Karen , Kay Margaret , Hutt Kathryn , Smallwood Natasha
Published: March 2022

The coronavirus disease 2019 (COVID-19) pandemic has had significant mental health impacts among healthcare workers (HCWs), related to resource scarcity, risky work environments, and poor supports. Understanding the unique challenges experienced by senior doctors and identifying strategies for support will assist doctors facing such crises into the future. A cross-sectional, national, online survey was conducted during the second wave of the Australian COVID-19 pandemic. Inductive content analysis was used to examine data reporting workplace and psychosocial impacts of the pandemic. Of 9518 responses, 1083 senior doctors responded to one or more free-text questions. Of the senior doctors, 752 were women and 973 resided in Victoria. Four themes were identified: (1) work-life challenges; (2) poor workplace safety, support, and culture; (3) poor political leadership, planning and support; and (4) media and community responses. Key issues impacting mental health included supporting staff wellbeing, moral injury related to poorer quality patient care, feeling unheard and undervalued within the workplace, and pandemic ill-preparedness. Senior doctors desired better crisis preparedness, HCW representation, greater leadership, and accessible, authentic psychological wellbeing support services from workplace organisations and government. The pandemic has had significant impacts on senior doctors. The sustainability of the healthcare system requires interventions designed to protect workforce wellbeing.
Access to Healthcare and Social Protection among Migrant Workers in Thailand before and during COVID-19 Era: A Qualitative Study
Authors: Kunpeuk Watinee , Julchoo Sataporn , Phaiyarom Mathudara , Sinam Pigunkaew , Pudpong Nareerut , Loganathan Tharani , Yi Huso , Suphanchaimat Rapeepong
Published: March 2022

Thailand is a popular host nation for international migrant workers, particularly those from Cambodia, Lao PDR, and Myanmar. Thailand has introduced approaches to protect their rights for health and social welfare, using various mechanisms over many years. However, the implementation of these policies is dynamic and has been influenced by national security, economic necessity, and public health concerns. The aim of this study was to explore how Thailand designs and implements health and social welfare policies for migrants in Thailand, both before and during COVID-19. A qualitative analysis was used alongside interviews with 18 key informants in various sectors in this field. Thematic coding was applied. Results show that there were seven key themes emerging from the analysis, including: (i) sustainability of the HICS; (ii) people dropping out from the Social Security Scheme (SSS); (iii) quality of health screening in the Memorandum of Understanding (MOU) migrants; (iv) health screening problems and state quarantine management in response to COVID-19; (v) managing the migration quota and dependency on migrant workers; (vi) influx of migrants in the backdrop of COVID-19; and (vii) poor living conditions of migrants and the impact of COVID-19. The majority of interviewees agreed that undocumented migrants is a critical concern that impedes access to migrants’ health and social welfare. This situation was especially pronounced during the second wave of COVID-19 in Thailand, which took hold in migrant communities. In the short term, the poor living conditions of migrants urgently need to be addressed in order to contain and mitigate this crisis. In the long term, there needs to be an improved health system design that includes migrants, regardless of their immigration status. This requires intersectoral policy coherence, including the hastening of nationality verification to sustainably mitigate undocumented migrants.