The purpose of this article is to empirically find the Environmental Kuznets Curve (EKC) relationship between income and carbon dioxide (CO₂) emissions and to analyze the influence of population aging on such emissions. We utilize Korean regional panel data of 16 provinces during the period from 1998 to 2016. To account for the nonstationary time series in the panel, we employ a fully modified ordinary least squares (FMOLS) and estimate long-run elasticity. From the empirical results, we can find the nonlinear relationship between income and CO₂ emissions. Additionally, we verify the fact that population aging reduces CO₂ emissions. A 1% increase in the proportion of the elderly results in a 0.4% decrease in CO₂ emissions. On the other hand, the younger population increases CO₂ emissions. These results were in line with those of additional analysis on residential and transportation CO₂ emissions, for the robustness check. Full article

The aim of this study was to analyse the effect of four types of re-warm-up (R-WU) activity, namely rest in normoxia (RN) at FiO₂ = 20.9%, rest in hypoxia (RH) at FiO₂ = 15%, activity (4 × 5 jumps/15 s) in normoxia (AN) and activity in hypoxia (AH) on physical performance. Ten elite male rugby players completed a 15-min warm-up followed by one of the 15-min randomized R-WU strategies. After R-WU, countermovement jump (CMJ), 20 m sprint and repeat sprint ability (RSA) tests were assessed. Compared to passive strategies (RN and RH), tympanic temperature was higher after active R-WU (AN and AH) (p = 0.016). Higher values of CMJ height (p = 0.037) and 20 m sprint (p = 0.02) were found in AH than in RN. In addition, mean RSA was lower (p = 0.008) in AH than in RN and RH. Blood lactate concentration was higher (p = 0.007) after RN and AN strategies than after AH. Muscle O₂ saturation (p = 0.021) and total Hb (p = 0.042) were higher after AH than after the other three conditions and after RN, respectively. Therefore, an active R-WU under hypoxia could be useful to elite rugby players, once it had attenuated the decline in tympanic temperature during a 15-min period after warm-up, improving jump, sprint and RSA performance. Full article

The chemical features of atmospheric dustfall and topsoil in the same region could reflect the processes of the migration, transport, and diffusion of pollutants in the atmospheric-soil system. Samples of atmospheric dustfall and topsoil were collected in Lanzhou City. The contents and correlation of water-soluble inorganic ions (WSIIs) and heavy metals in dustfall and topsoil were analyzed, the sources of heavy metals and WSIIs in dustfall were distinguished, and the potential ecological risks of heavy metals in dustfall and topsoil were evaluated. The highest contents of WSIIs are SO₄²⁻ (18,594 mg·kg⁻¹) and Ca²⁺ (10,070 mg·kg⁻¹) in dustfall, and for SO₄²⁻ (8271 mg·kg⁻¹) and Na⁺ (1994 mg·kg⁻¹) in topsoil. The concentrations of heavy metals (Pb, Cu, Zn, Cr, Cd, and Ni) in dustfall are considerably higher than those in topsoil. Combustion of biomass and coal, transportation and industrial activities are the major anthropogenic sources of WSIIs and heavy metals in Lanzhou. Pollution of heavy metals except Cr and Ni in dustfall, and Cu, Cr, and Ni in topsoil was up to different degrees, where the pollution of Cd was serious. The risk of Cd in dustfall is high while moderate in topsoil. This research could offer a reference for the atmospheric particle pollution prevention and control in Lanzhou. Full article

Because of heavy workloads, non-transferable responsibilities, and shift systems, healthcare staff are prone to ill-health presenteeism. Based on social information processing theory, this study explored the influence of the psychosocial safety climate (PSC) on ill-health presenteeism. The mediating effects of perceived instrumental support and perceived emotional support and the moderating effect of organic structure in this process were observed. Using a time-lagged research design, data from 386 healthcare staff were gathered and multiple regression and bootstrapping were used to test each hypothesis. The results showed that: (1) PSC negatively relates to ill-health presenteeism. (2) Both perceived instrumental support and perceived emotional support mediate the relationship between PSC and ill-health presenteeism. The affective information processing path is more effective than the cognitive information processing path, but they do not convey a positive interaction effect on ill-health presenteeism. (3) The organic structure moderates the mediating effect of perceived emotional support but does not exert a significant moderating effect on the mediating process of perceived instrumental support. This study particularly identified PSC as a contextual antecedent of ill-health presenteeism. By combining organizational, work-related, and person-related factors, a more comprehensive theoretical framework for the understanding of ill-health presenteeism is developed, thus informing health promotion management. Full article

To date there have been no studies examining whether patients want emergency department (ED) therapy dog programs. This patient-oriented study examined the opinions of patients about whether they would want to be visited by a therapy dog in the Royal University Hospital ED. Cross-sectional survey data were collected over a six week period from a convenience sample of 100 adult patients who had not been visited by a therapy dog in the ED. Most (80%) indicated they would want a visit by a therapy dog as an ED patient. A higher proportion of individuals who currently have a pet dog (95%) or identify as having lots of experience with dogs (71%) were more likely to indicate this want compared to those without a dog (90%) or little to no experience with dogs (62%). The majority were also of the opinion that patients may want to visit a therapy dog in the ED to reduce anxiety (92%) and frustration (87%) as well as to increase comfort (90%) and satisfaction (90%) and to a lesser extent to reduce pain (59%). There was no significant difference in findings by gender or age, other than a higher proportion of older adults and females identifying cultural background and tradition as a possible reason that patients may not want to be visited by a therapy dog. The findings of this study can help guide considerations for future ED therapy dog programs. Full article

Multiple studies have investigated the positive effects of human–animal interactions and showed that animal-assisted activities can be successfully used to better human physical and mental health. Equine-assisted activities have also raised considerable attention within the field. Our research focuses on healthy students (aged 14–18) without deviations or special educational needs. We analyze the occurrence of behavior problems and prosocial behavior among adolescents who regularly have interactions with horses, and those who have no connection to horses at all. The subjects of our investigation completed the strengths and difficulties questionnaire (SDQ), and we use a ‘quasi’ 2 × 2 before-after control-impact design to analyze the data. Students studying equine-related vocations and students of other vocations are compared, at the beginning and at the end of their studies. Our results indicate that students of equine-related vocations are more helpful and empathetic, and have fewer behavior problems, than those studying other vocations. There is a negative correlation between prosocial behavior and behavior problems. The development of the prosocial behaviors of students with regular horse–human interactions is more remarkable than of those who have no connection to horses. With these results, we are going to confirm the hypothesis that equine-assisted activities correlate with positive behavioral traits among healthy adolescents. Full article

Although toxic Cd (cadmium) and Cr (chromium) in the aquatic environment are mainly from natural sources, human activities have increased their concentrations. Several studies have reported higher concentrations of Cd and Cr in the aquatic environment of Malaysia; however, the association between metal ingestion via drinking water and human health risk has not been established. This study collected water samples from four stages of the drinking water supply chain at Langat River Basin, Malaysia in 2015 to analyze the samples by inductivity coupled plasma mass spectrometry. Mean concentrations of Cd and Cr and the time-series river data (2004–2014) of these metals were significantly within the safe limit of drinking water quality standard proposed by the Ministry of Health Malaysia and the World Health Organization. Hazard quotient (HQ) and lifetime cancer risk (LCR) values of Cd and Cr in 2015 and 2020 also indicate no significant human health risk of its ingestion via drinking water. Additionally, management of pollution sources in the Langat Basin from 2004 to 2015 decreased Cr concentration in 2020 on the basis of autoregression moving average. Although Cd and Cr concentrations were found to be within the safe limits at Langat Basin, high concentrations of these metals have been found in household tap water, especially due to the contamination in the water distribution pipeline. Therefore, a two-layer water filtration system should be introduced in the basin to achieve the United Nations Sustainable Development Goals (SDGs) 2030 agenda of a better and more sustainable future for all, especially via SDG 6 of supplying safe drinking water at the household level. Full article

Ambient particulate matter (PM), a major component of air pollution, aggravates ocular discomfort and inflammation, similarly to dry eye disease (DED) or allergies. However, the mechanism(s) by which PM induces the ocular inflammatory response is unknown. This study investigated the immunological response of traffic-related fine particulate matter (PM_2.5) on the ocular surface in a murine model. C57BL/6 mice were exposed by topical application to PM_2.5 or vehicle for 14 days to induce experimental environmental ocular disease. Corneal fluorescein staining and the number of ocular inflammatory cells were assessed in both groups. The expression of IL-1β, IL-6, tumor necrosis factor (TNF)-α, and mucin 5AC (MUC5AC) in the ocular surface were evaluated by real-time PCR. An immunohistochemical assay evaluated apoptosis and goblet cell density. ELISA was used to determine the levels of serum IgE and cytokines of Type 1 helper (Th1) and Type 2 helper (Th2) cells after in vitro stimulation of T cells in the draining lymph nodes (LNs). Exposure to traffic-related PM_2.5 significantly increased corneal fluorescein staining and cellular toxicity in the corneal epithelium compared with the vehicle control. A significant increase in the number of CD11b+ cells on the central cornea and mast cells in the conjunctiva was observed in the PM_2.5 group. Exposure to PM_2.5 was associated with a significant increase in the corneal or conjunctival expression of IL-1β, IL-6, TNF, and MUC5AC compared to the vehicle, and increased maturation of dendric cells (DCs) (MHC-II^highCD11c⁺) in draining LNs. In addition, PM_2.5 exposure increased the level of serum IgE and Th2 cytokine production in draining LNs on day 14. In conclusion, exposure to traffic-related PM_2.5 caused ocular surface damage and inflammation, which induced DC maturation and the Th2-cell-dominant allergic immune response in draining LNs. Full article

Background: Burnout is known to have detrimental effects on healthcare staff with regard to both personal and occupational matters. The association between burnout symptoms and work satisfaction in endoscopy nursing staff in Germany has not been studied previously. We aimed to investigate the association between work satisfaction and risk of burnout in endoscopy nursing staff in Germany and to extract predictors for burnout in the area of work satisfaction, which can inform the design of future interventions. Setting: All members of the German Association of Endoscopy Staff in Germany (Deutsche Gesellschaft für Endoskopiefachberufe e.V.—DEGEA) were invited to take part in an online survey. Methods: The total sample consisted of 674 endoscopy staff members. Of those, 579 were female (85.9%) and 95 were male (14.1%). The mean age of the participants was 44.3 years (SD 10.6), with a median age of 46 years, a minimum age of 20, and a maximum age of 64 years. We used confirmatory factor analyses to examine the Maslach burnout inventory (MBI) and, a questionnaire for assessing general and facet-specific job satisfaction (KAFA), regarding their postulated internal structure in our special sample. Canonical correlations were performed to examine the association between work satisfaction and burnout in endoscopy staff members. Results: We were able to replicate the factorial structures of the MBI and the KAFA, both showing an acceptable model fit. The canonical correlation analysis resulted in three canonical functions, with canonical correlations of 0.64 (p < 0.001), 0.32 (p < 0.001), and 0.17 (p < 0.001). The first canonical function revealed that KAFA scales for colleagues, professional development, payment, supervisor, and general job satisfaction were good predictors for less exhaustion, less depersonalization and lack of empathy, and higher personal accomplishment. Commonality analysis revealed that general job satisfaction was the most significant factor in explaining the squared canonical correlation. The second canonical function showed that occupational function and colleagues were good predictors for exhaustion and personal accomplishment. Conclusions: Interventions aimed at ameliorating symptoms of burnout in endoscopy staff should be tailored to address specific needs as experienced by the employees. Therefore, the results of this study could contribute to the design of various interventions, which could be employed to address the issue of work satisfaction and burnout in endoscopy staff most effectively. Full article

With the development and deepening of the process of global integration, global health is gaining increasing attention. An increasing number of studies have examined global health from diverse perspectives to promote the realization of global public health. The purpose of this research is to systematically and comprehensively evaluate the knowledge structure, knowledge domain, and evolution trend in the field of global health research. Based on the 14,692 document data retrieved from Web of Science Core Collection from 1996 to 2019, this article carried out a visual analysis of global health research from the perspective of scientific output characteristics, scientific research cooperation networks, keywords, and highly cited literature. The results show that scholars’ interest in global health research is increasing, especially after the outbreak of SARS. USA, England, Canada, Australia, and China have the most prominent contributions to global health research. Significant authors, high impact journals and core institutions also identified. The study found that “global health governance”, “global health diplomacy”, “medical education”, “global health education” and “antimicrobial resistance” are the research frontiers and hot spots. This study provides an overview and valuable guidance for researchers and related personnel to find the research direction and practice of global health. Full article

Deficiencies in iron and vitamin D are frequently observed in athletes. Therefore, we examined whether different baseline vitamin D₃ levels have any impact on post-exercise serum hepcidin, IL-6 and iron responses in ultra-marathon runners. In this randomized control trial, the subjects (20 male, amateur runners, mean age 40.75 ± 7.15 years) were divided into two groups: experimental (VD) and control (CON). The VD group received vitamin D₃ (10,000 UI/day) and the CON group received a placebo for two weeks before the run. Venous blood samples were collected on three occasions—before the run, after the 100 km ultra-marathon and 12 h after the run—to measure iron metabolism indicators, hepcidin, and IL-6 concentration. After two weeks of supplementation, the intervention group demonstrated a higher level of serum 25(OH)D than the CON group (27.82 ± 5.8 ng/mL vs. 20.41 ± 4.67 ng/mL; p < 0.05). There were no differences between the groups before and after the run in the circulating hepcidin and IL-6 levels. The decrease in iron concentration immediately after the 100-km ultra-marathon was smaller in the VD group than CON (p < 0.05). These data show that various vitamin D₃ status can affect the post-exercise metabolism of serum iron. Full article

Health is increasingly subject to the complex interplay between the built environment, population composition, and the structured inequity in access to health-related resources across communities. The primary objective of this paper was to examine cardiometabolic disease (diabetes, cardiovascular diseases, stroke) markers and their prevalence across relatively small geographic units in the 500 largest cities in the United States. Using data from the American Community Survey and the 500 Cities Project, the current study examined cardiometabolic diseases across 27,000+ census tracts in the 500 largest cities in the United States. Earlier works clearly show cardiometabolic diseases are not randomly distributed across the geography of the U.S., but rather concentrated primarily in Southern and Eastern regions of the U.S. Our results confirm that chronic disease is correlated with social and built environment factors. Specifically, racial concentration (%, Black), age concentration (% 65+), housing stock age, median home value, structural inequality (Gini index), and weight status (% overweight/obese) were consistent correlates (p < 0.01) of cardiometabolic diseases in the sample of census tracts. The paper examines policy-related features of the built and social environment and how they might play a role in shaping the health and well-being of America’s metropolises. Full article

In this study, the Nordic Musculoskeletal Questionnaire (NMQ) was administered to a valid sample of 81 Taiwanese bakery workers to explore their discomfort or symptoms of work-related musculoskeletal disorders and identify the risk factors. Wrist postures were also examined during 3 typical dough operations (kneading, rolling, and rounding) by using an electrogoniometer. The prevalence of musculoskeletal discomfort in any part of the body in the past year among the respondents was 93.0%, with the highest prevalence of 66.3% and 51.8% in the hands/wrists (right and left), followed by the prevalence of 50.6% and 45.8% in the shoulders (right and left) and the lower back (48.2%), respectively. The results also revealed that during the 3 dough processing operations, the workers’ wrist movements in specific operations were close to the recommended limits suggested in previous studies, especially the ulnar deviation and palm flexion of the right wrist during dough kneading and the radial deviation of the left wrist during dough rolling and rounding. The study findings can be used to explain why the bakers self-report a high proportion of wrist and shoulder disorders and can also serve as a reference for task rearrangement and redesign. Full article

Background: Health impact assessment (HIA) has scarcely been developed in Spain, in comparison with other European countries. Moreover, little is known about the effectiveness of HIA, taking into account direct impacts—changes on the decision-making process—as well as indirect impacts or those related to the process outcomes. From this broad perspective of HIA usefulness, the purpose was to assess the effectiveness of five HIAs carried out in Spain at the local level, and the role played by context and process factors on these impacts. Methods: We carried out a qualitative study based on 14 interviews to HIAs participants from different sectors. A documentary review and nonparticipant observation techniques were implemented for an in depth understanding. Results: The direct effectiveness of the HIAs was partial, but they had indirect effectiveness in all cases. The institutional and socio-political context, however, was not favorable to effectiveness. The elements of the process were largely determined by the context, although their influence, mediated by the role of proactive individuals, favored the effectiveness of the HIAs. Conclusions: When assessing HIA effectiveness, it is important to take into account a broad perspective on the nature of impacts and those factors influencing direct and indirect effectiveness. In Spain, the institutional and sociopolitical context was less favorable to HIA effectiveness than process-related factors. In order to implement the Health in All Policies strategy, will be necessary to improve context-related factors, such as institutional facilitators for HIA and democratic quality. Full article

The aim of this paper is to analyze the primary stress factors female professors at online universities are exposed to. The technique used for the prospective and exploratory analysis was the Delphi method. Two rounds of consultations were done with fourteen judges with broad experience in health and safety at work and university teaching who reached a consensus of opinion regarding a list of nine psychosocial risk factors. Among the most important risk factors, mental overload, time pressure, the lack of a schedule, and emotional exhaustion were highlighted. These risk factors are related to the usage and expansion of information and communication technology (ICT) and to the university system itself, which requires initiating more research in the future in order to develop the intervention programs needed to fortify the health of the affected teachers and protect them from stress and other psychosocial risks. Full article

The widespread dissemination of policy information is necessary for the success of the public policy, but the distribution of information among vulnerable groups has received little attention. We examined a public policy that focuses on the poorest people in China, the anti-poverty relocation and settlement program (ARSP). The infrastructure in the region where the policy is implemented is weak, and the information literacy of resettlers is low. This study analyses the impact of the policy information gap on the subjective well-being of resettlers. We found that the distribution of policy information among the poor is uneven, and the resettlers compare the policy information they obtain with a reference group (working-age people and less-educated people in the same village/community) to generate a policy information gap. The policy information gap indirectly affects subjective well-being by affecting the probability that people will be exposed to risks due to policy. As the policy information gap increases, the subjective well-being of resettlers changes in an inverted U-shape. This impact varies significantly among different groups, policy implementation stages, and resettlement methods. Attention should be paid to the information acquisition ability of the vulnerable groups and the welfare effects of social comparison, and to improve the method of publicizing policy information, which helps to improve the well-being of resettlers. Full article

Superblocks are currently being introduced in Barcelona to respond to the city’s scarcity of green spaces and high levels of air pollution, traffic injuries, and sedentariness. The aim is to calm the streets by reducing the number of square meters dedicated to private vehicles and to reclaim part of this public space for people. Salut als Carrers (Health in the Streets) is a project to evaluate the potential environmental and health effects of the superblock model with an equity perspective in Barcelona. This study aims to explain the various interventions implemented in different neighborhoods in Barcelona and the methods that will be used to evaluate them in a quasi-experimental and health impact assessment (HIA) approaches. Given the complexity of the intervention evaluated, the project employs mixed methodologies. Quantitative methods include: (a) a pre–post health survey of 1200 people randomly selected from the municipal register asked about self-perceived health and quality of life, social support, mental health, mobility, physical activity, neighborhood characteristics, and housing; (b) pre–post environmental measurements, mainly of nitrogen dioxide (NO₂), particulate matter of less than 10 µm (PM₁₀), and particulate matter of less than 2.5 µm (PM_2.5) and black carbon; (c) pre–post environmental walkability measures using the Microscale Audit of Pedestrian Streetscapes (MAPS) tool; (d) use of public space and physical activity levels using the System for Observing Play and Recreation in Communities (SOPARC), a validated observation tool; (e) pre–post traffic injury measures with a comparison group; and (f) the comparison and integration of pre–post assessment with previous HIAs and the improvement of future HIAs. Qualitative studies will be performed to analyze residents’ perception of these effects by using: (a) various focus groups according to different participant characteristics who are more or less likely to use the superblocks; and (b) a guerrilla ethnography, which is a method that combines ethnographic observation and semi-structured interviews. This study, which evaluates the impact of an ambitious urban-renewal program on health, will help to assess the effectiveness of public policy in terms of health and health inequalities. Full article

Background: High Intensity Interval Training (HIIT) is a sustainable and effective method for improving Cardiorespiratory Fitness (CRF) in adolescents. HIIT is proven to produce equal or greater improvements in CRF when compared to moderate intensity continuous exercise (MICE) in adolescents. Methods: The studies included were considered eligible if: (1) Participants were adolescents (11–18 years old); (2) Examined changes in CRF measured either directly or indirectly; (3) Included a non-exercising control group or MICE comparison group; (4) Participants were matched at enrolment; (5) Reported HIIT protocol information; (6) Provided HIIT intensity. A meta-analysis was conducted to determine the effect of HIIT on CRF. Meta-regression and moderator analyses were performed out to quantitatively examine moderators of protocol design on CRF improvements. Results: HIIT displays a moderate effect to improve CRF (g = 0.86, 95% CI 0.518–1.106, p < 0.001). Neither study duration (weeks), nor total or weekly accumulated HIIT volume (min) displayed any significant moderation effect on pooled improvement on CRF (p > 0.05). Conclusions: HIIT is an effective method to improve CRF in adolescents, irrespective of body composition. Notably, meta regression analysis identified that prolonged high volume HIIT programs are similarly effective to short term low volume HIIT programs. This becomes of particular interest for those involved in school curricula, where short HIIT exercise may provide a pragmatic adjunct to the health benefits of Physical Education (PE) lessons. Full article

Although social presence plays an essential role under general conditions, its role becomes significant for societal protection during the quarantine period in epidemic outbreak. In this study, we attempted to identify the role of E-government and COVID-19 word of mouth in terms of their direct impact on online social presence during the outbreak as well as their impacts mediated by epidemic protection and attitudes toward epidemic outbreaks. For this purpose, a unique multi-mediation model is proposed to provide a new direction for research in the field of epidemic outbreaks and their control. Through random sampling, an online survey was conducted and data from 683participants were analyzed. Partial least squares structural equation modeling was used to test the relationships between the variables of interest. The study results revealed that the roles of E-government and COVID-19 word of mouth are positively related to online social presence during the outbreak. Epidemic protection and attitude toward epidemic outbreak were found to positively moderate the impact of the role of E-government and COVID-19 word of mouth on online social presence during the outbreak. The key findings of this study have both practical and academic implications. Full article

The traditional structure of families is undergoing profound changes, causing the so-called “crisis of family care.” This study describes the experiences and emotions of the family member who hires migrant caregivers for the older people. This is a qualitative study using a phenomenological design with nine women participants between 53 and 72 years of age. The data collection was carried out through two in-depth interviews and a focus group. There were three major topics: (1) the women in this study recognized that they were not able to take care of the family member directly, due to their responsibilities as female workers and mothers. The fact that migrant caregivers were chosen was conjunctural, where economic reasons were more important. (2) The family members supported the caregivers by teaching them about care and also resolving conflicts produced by culture shock. (3) Trusting the caregiver was a gradual process; the family members felt a complex set of emotions (insecurity, gratitude for the help, moral obligation). In conclusion, they wanted a caregiver who would provide the elder dependent with the love and compassion that they, as daughters, would provide if they had time to do so. The family became the caregiver’s managers and assumed the responsibility of training and helping them. Full article

The current systematic review evaluated the effects of different pre-cooling techniques on sports performance in highly-trained athletes under high temperature conditions. PubMed/MEDLINE, EMBASE, Web of Science, CENTRAL, Scopus, and SPORTDiscus databases were searched from inception to December 2019. Studies performing pre-cooling interventions in non-acclimatized highly-trained athletes (>55 mL/kg/min of maximal oxygen consumption) under heat conditions (≥30 °C) were included. The searched reported 26 articles. Pre-cooling techniques can be external (exposure to ice water, cold packs, or cooling clothes), internal (intake of cold water or ice), or mixed. Cooling prior to exercise concluded increases in distance covered (1.5–13.1%), mean power output (0.9–6.9%), time to exhaustion (19–31.9%), work (0.1–8.5%), and mean peak torque (10.4–22.6%), as well as reductions in completion time (0.6–6.5%). Mixed strategies followed by cold water immersion seem to be the most effective techniques, being directly related with the duration of cooling and showing the major effects in prolonged exercise protocols. The present review showed that pre-cooling methods are an effective strategy to increase sports performance in hot environments. This improvement is associated with the body surface exposed and its sensibility, as well as the time of application, obtaining the best results in prolonged physical exercise protocols. Full article

The severity of obstructive sleep apnoea (OSA) is diagnosed with polysomnography (PSG), during which patients are monitored by over 20 physiological sensors overnight. These sensors often bother patients and may affect patients’ sleep and OSA. This study aimed to investigate a method for analyzing patient snore sounds to detect the severity of OSA. Using a microphone placed at the patient’s bedside, the snoring and breathing sounds of 22 participants were recorded while they simultaneously underwent PSG. We examined some features from the snoring and breathing sounds and examined the correlation between these features and the snore-specific apnoea-hypopnea index (ssAHI), defined as the number of apnoea and hypopnea events during the hour before a snore episode. Statistical analyses revealed that the ssAHI was positively correlated with the Mel frequency cepstral coefficients (MFCC) and volume information (VI). Based on clustering results, mild snore sound episodes and snore sound episodes from mild OSA patients were mainly classified into cluster 1. The results of clustering severe snore sound episodes and snore sound episodes from severe OSA patients were mainly classified into cluster 2. The features of snoring sounds that we identified have the potential to detect the severity of OSA. Full article

Breast cancer survivors need to undergo adjuvant endocrine therapy after completion of curative treatments to prevent disease recurrence. These individuals often experience symptoms which are detrimental to their quality of life (QOL). Implementation of interventions for effective symptom management among these survivors is warranted. This review provides an overview of studies on the effectiveness of the previously developed interventions for breast cancer survivors undergoing adjuvant endocrine therapy on symptom alleviation and enhancement of QOL or health-related QOL (HRQOL). Five electronic databases were employed in the literature search. Study selection, data extraction and critical appraisal of the included studies were conducted by three authors independently. Twenty-four studies were included. Both pharmacological and non-pharmacological interventions are effective in addressing the symptoms associated with adjuvant endocrine therapy among the breast cancer survivors, and in improving their QOL, although discrepancies were noted between the studies in terms of the significance of these effects. Pharmacological and non-pharmacological interventions can be effective for symptom management among breast cancer survivors. Their implementation is recommended for effective survivorship care for these individuals. Further research on intervention development for breast cancer survivors is recommended to provide further evidence for the utility of the explored interventions in survivorship care for these patients. Full article