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Aims: From 1 January 2018, the number of retail hours for the sale of alcohol was reduced from 14 to 5 hours on Sundays and from 14 to 10 hours on the other days of the week in Lithuania. The significant reduction of hours for the sale of alcohol on Sundays may have affected the distribution of alcohol-attributable deaths during the week. This study aimed to examine the change in the weekly pattern of alcohol-attributable male mortality before and after imposing limits on the hours when alcohol can be sold., Methods: Age-standardised male death rates by days of the week were calculated for four groups according to cause of death: alcohol poisoning (X45), all external causes of death (V01-Y98), diseases of the circulatory system (I00-I99) and all other causes of death. We compared age-standardised death rates for two periods: before (2015-2017) and after (2018-2019) the intervention. Mortality and population data were obtained from the Lithuanian Institute of Hygiene and Human Mortality Database., Results: We found that during 2018-2019, earlier observed peak in age-standardised death rates for external causes of death on Sunday diminished, and this day no longer differed from the weekly average. The same tendency was also observed for the Monday excess mortality due to circulatory diseases., Conclusions: The reduction of the hours when alcohol can be sold from the beginning of 2018 was associated with a change in a weekly pattern of alcohol-attributable male mortality. However, more studies are needed to examine the causes of the change in mortality pattern., Competing Interests: Declaration of conflicting interestsThe authors declared no potential conflicts of interest with respect to the research, authorship and/or publication of this article.

Urban green spaces benefit physical, mental health, and reduses the risk of cardiovascular disease. A study in Kaunas, Lithuania collected health data from 100 patients with symptomatic heart failure (HF) during 2006-2009. Residential greenness was measured by the normalized difference vegetation index (NDVI). We assessed the impact of greenness on health indicators and on changes in health markers after 6 months. Higher greenness levels based on the NDVI 1-km radius were related to higher mean values of heart rate (HR) and ejection fraction and lower left ventricular (LV) end-diastolic diameter index (LV EDDI), LV end-systolic volume (ESV), left atrium size (LAS), and right atrium size (RAS) at baseline. After 6 months, a decrease in DBP and HR and an improvement in spiroergometric parameters were associated with exposure to high levels of greenness.  The long-term rehabilitation group experienced significant changes in spiroergometric indicators. The results confirm that the greenness of the residential environment can improve health indicators in patients with HF.

The objective of the study was to investigate the association between employees' work addiction and perceived work addiction of their immediate managers and parents, separate in samples of men and women. A total of 964 Lithuanian employees took part in the study. The levels of work addiction were assessed using the Bergen Work Addiction Scale (Andreassen, Griffiths, Hetland & Pallesen, 2012). We used the same scale to measure work addiction of the employees and perceived work addiction of their parents and immediate managers. The results showed that perceived work addiction of both parents and managers was related to higher levels of work addiction in women. We further found that the positive relationship between perceived work addiction of mothers and men's work addiction was as strong as the association between perceived work addiction of managers and men's work addiction. The positive relationship between perceived work addiction of fathers and men's work addiction was weaker as compared to that between perceived work addiction of managers and men's work addiction. All independent variables accounted for a greater part of the variance in work addiction of men than that of women., (© 2023 Scandinavian Psychological Associations and John Wiley & Sons Ltd.)

Wild rodents are considered to be one of the most important TBEV-amplifying reservoir hosts; therefore, they may be suitable for foci detection studies. To investigate the effectiveness of viral RNA detection in wild rodents for suspected TBEV foci confirmation, we trapped small rodents ( n = 139) in various locations in Lithuania where TBEV was previously detected in questing ticks. Murine neuroblastoma Neuro-2a cells were inoculated with each rodent sample to maximize the chances of detecting viral RNA in rodent samples. TBEV RNA was detected in 74.8% (CI 95% 66.7-81.1) of the brain and/or internal organ mix suspensions, and the prevalence rate increased significantly following sample cultivation in Neuro-2a cells. Moreover, a strong correlation (r = 0.88; p < 0.05) was found between the average monthly air temperature of rodent trapping and the TBEV RNA prevalence rate in cell culture isolates of rodent suspensions, which were PCR-negative before cultivation in cell culture. This study shows that wild rodents are suitable sentinel animals to confirm TBEV foci. In addition, the study results demonstrate that sample cultivation in cell culture is a highly efficient method for increasing TBEV viral load to detectable quantities.

The Baltic states are the region in Europe where tick-borne encephalitis (TBE) is most endemic. The highest notification rate of TBE cases is reported in Lithuania, where the incidence of TBE has significantly increased since 1992. A recent study reported 0.4% prevalence of TBE virus (TBEV) in the two most common tick species distributed in Lithuania, Ixodes ricinus and Dermacentor reticulatus, with the existence of endemic foci confirmed in seven out of Lithuania's ten counties. However, until now, no comprehensive data on molecular characterisation and phylogenetic analysis have been available for the circulating TBEV strains. The aim of this study was to analyse TBEV strains derived from I. ricinus and D. reticulatus ticks collected from Lithuania and provide a genotypic characterisation of viruses based on sequence analysis of partial E protein and NS3 genes. The 54 nucleotide sequences obtained were compared with 81 TBEV strains selected from the NCBI database. Phylogenetic analysis of the partial E and NS3 gene sequences derived from 34 Lithuanian TBEV isolates revealed that these were specific to Lithuania, and all belonged to the European subtype, with a maximum identity to the Neudoerfl reference strain (GenBank accession no. U27495) of 98.7% and 97.4%, respectively. The TBEV strains showed significant regional genetic diversity. The detected TBEV genotypes were not specific to the tick species. However, genetic differences were observed between strains from different locations, while strains from the same location showed a high similarity., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Sidorenko et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Babesia vesperuginis is an intraerythrocytic protozoan parasite that circulates among bats and ticks in many countries worldwide. However, the distribution of B. vesperuginis in the Baltic region has not been studied. A total of 86 dead bats from eight different species were collected and screened for Babesia spp. using real-time PCR. Overall, 52.3% (45/86) of the bats were found positive for Babesia spp. The prevalence of Babesia spp. in different organs varied, with the highest prevalence observed in heart tissues (37.0%) and the lowest in liver tissues (22.2%). However, the observed differences in prevalence among organs were not statistically significant. Blood samples from 125 bats of nine different species were also analyzed for Babesia spp. prevalence using real-time PCR and nested PCR. The results showed a prevalence of 35.2% and 22.4%, respectively. Moreover, 28.3% (17/60) of the examined blood samples were confirmed positive for Babesia spp. through blood smear analysis. The total of 32 partial sequences of the 18S rRNA gene derived in this study were 100% identical to B. vesperuginis sequences from GenBank. In eight species of bats, Pipistrellus nathusii, Pipistrellus pipistrellus, Pipistrellus pygmaeus, Vespertilio murinus, Eptesicus nilssonii, Eptesicus serotinus, Myotis daubentonii and Nyctalus noctula, Babesia parasites were identified. In E. nilssonii, Babesia spp. was identified for the first time., (Copyright © 2023. Published by Elsevier GmbH.)

The increasing population of European bison (Bison bonasus) can contribute to the prevalence of zoonotic pathogens. The aim of the present study was to assess the presence of A. phagocytophilum infection in European bison tissues as well as ticks removed from European bison in Lithuania and Poland. A further objective of this work was to compare the detected A. phagocytophilum strains. A total of 85 tissue samples (spleen) of European bison and 560 ticks belonging to two species, Ixodes ricinus (n = 408) and Dermacentor reticulatus (n = 152) were tested. DNA of A. phagocytophilum was detected based on RT-PCR in 40% of the European bison samples, 8.8% of the I. ricinus and 5.9% of the D. reticulatus ticks. Analysis of the obtained partial 16S rRNA gene sequences of A. phagocytophilum revealed the presence of three variants with two polymorphic sites. Furthermore, phylogenetic analysis with partial msp4 gene sequences grouped A. phagocytophilum variants into three clusters. This study revealed that the groEL gene sequences of A. phagocytophilum from European bison and their ticks grouped into ecotype I and only one sequence from Lithuanian European bison belonged to ecotype II. The results of the present study indicated that European bison may play a role as a natural reservoir of A. phagocytophilum., Competing Interests: Declaration of Competing Interest The authors declare no conflict of interest., (Copyright © 2023 The Author(s). Published by Elsevier GmbH.. All rights reserved.)

Background: A set of evidence-based alcohol control policy measures was adopted in the period 2016-2020 in Lithuania. The present study fills a knowledge gap on how changes in alcohol control policy are associated with attitudes toward different alcohol policy measures. Objective: This study aims to explore whether support for key alcohol control policy measures in Lithuania declined following implementation of alcohol control measures. Methods: Data came from the Standard European Alcohol Survey. Two representative surveys with the same questionnaire, were conducted in Lithuania in 2015 ( N  = 1513, 51.7% female, response rate was 38.9%) and 2020 ( N  = 1015, 50.6% female, response rate was 38.0%). Multi-stage stratified probability sampling was applied. Surveys were carried out using computer-assisted face-to-face interviews, descriptive statistics and multiple logistic regression analyses was applied. We used a binomial logistic regression analysis and the Pearson chi-square test. Results: There was a significant decline in a proportion of respondents who agreed that the number of alcohol selling places should be kept low (OR: 0.84, p  = .032), alcohol prices should be kept high (OR: 0.83, p  = .027), and the police should be allowed to randomly check whether the driver is sober (OR: 0.65, p  < .001). The proportion of respondents who agree that individuals are responsible enough with their drinking significantly declined (OR: 0.76, p  = .003). Conclusion: Support for restrictions on alcohol-selling points, increase in alcohol price, and random alcohol testing of drivers declined following the adoption of new alcohol control policy measures. Our findings might be beneficial for policy-makers planning alcohol control policies and information campaigns.

Background: Despite an increased focus on cold-related mortality in recent years, there has been comparatively little research specifically on hypothermia mortality and its associated factors., Methods: Educational inequalities in hypothermia mortality among individuals aged 30-74 in the Baltic countries (Estonia, Latvia, Lithuania) and Finland in 2000-15 were examined using data from longitudinal mortality follow-up studies of population censuses (the Baltics) and from a longitudinal register-based population data file (Finland)., Results: Age-standardized mortality rates (ASMRs) were much higher in the Baltic countries than in Finland across the study period. From 2000-07 to 2008-15, overall ASMRs declined in all countries except among Finnish women. Although a strong educational gradient was observed in hypothermia mortality in all countries in 2000-07, inequalities were larger in the Baltic countries. Between 2000-07 and 2008-15, ASMRs declined in all educational groups except for high-educated women in Finland and low-educated women in Lithuania; the changes however were not always statistically significant. The absolute mortality decline was often larger among the low educated resulting in narrowing absolute inequalities (excepting Lithuania), whereas a larger relative decline among the high educated (excepting Finnish women) resulted in a considerable widening of relative inequalities in hypothermia mortality by 2008-15., Conclusion: Although some reduction was observed in absolute educational inequalities in hypothermia mortality in 2000-15, substantial and widening relative inequalities highlight the need for further action in combatting factors behind deaths from excessive cold in socioeconomically disadvantaged groups, including risky alcohol consumption and homelessness., (© The Author(s) 2023. Published by Oxford University Press on behalf of the European Public Health Association.)

This study aimed at evaluating the scale and costs of an environmentally and economically optimal set of Best Management Practices (BMPs) for agricultural pollution abatement in Lithuania in order to reach water protection goals in both inland and marine waters by distributing BMPs optimally in space, while taking climate change impacts into consideration. The assessment of BMPs impact involved the use of the SWAT model by applying two climate change representative concentration pathways (RCP4.5 and RCP8.5) and two time horizons (mid-century and end-century), as well as five BMPs (arable land conversion to grasslands, reduced fertilization, no-till farming, catch-crops, and stubble fields throughout winter). The optimization of the set of BMPs employed a genetic algorithm. The results suggest that the need for BMPs application will increase from 52% of agricultural areas in the historical period up to 65% by the end of century in the RCP8.5 scenario. This means less arable land could actually be used for crop production in the future if water protection targets are met. The high costs for reaching water targets would rise even more, i.e. by 173% for RCP4.5, and by 220% for the RCP8.5 scenario, reaching approximately 200 million euros/year. In such a context, the BMP optimization approach is essential for significant reduction of the costs. Winter cover crops and reduced fertilization show the best effectiveness and cost balance, and will therefore be essential in pursuing water protection targets., (© 2022. The Author(s).)

Background: Air pollution has a significant effect on human health and there is a broad body of evidence showing that exposure to air pollution is associated with an increased risk of adverse health effects. The main objective of this study was to assess the association of traffic-related air pollutants with fatal AMI during the ten-year period., Methods: The study was conducted in Kaunas city, where the WHO MONICA register included a total of 2273 adult cases of fatal AMI cases during the 10-year study period. We focused on the period between 2006 and 2015. The associations between exposure to traffic-related air pollution and the risk of fatal AMI were evaluated by using a multivariate Poisson regression model, RR presented per an increase in IQR., Results: It was found that the risk of fatal AMI was significantly higher in all subjects (RR 1.06; 95% CI 1.00-1.12) and women (RR 1.12; 95% CI 1.02-1.22) when the concentration of PM 10 in the ambient air was increased 5-11 days before the onset of AMI, adjusting for NO 2 concentration. The effect was stronger during spring in all subjects (RR 1.12; 95% CI 1.03-1.22), in men (RR 1.13; 95% CI 1.01-1.26), in younger-aged (RR 1.15; 95% CI 1.03-1.28), and in winter in women (RR 1.24; 95% CI 1.03-1.50)., Conclusions: Our findings show that ambient air pollution increases the risk of fatal AMI, and this pertains to PM 10 specifically.

Background: Taxation increases which reduce the affordability of alcohol are expected to reduce mortality inequalities. A recent taxation increase in Lithuania offers the unique possibility to test this hypothesis., Methods: Census-linked mortality data between 2011 and 2019 were used to calculate monthly sex- and education-stratified age-standardized mortality rates for the population aged 40 to 70 years. As primary outcome, we analysed the difference in age-standardized all-cause mortality rates between the population of lowest versus highest educational achievement. The impact of the 2017 taxation increase was evaluated using interrupted time series analyses. To identify whether changes in alcohol use can explain the observed effects on all-cause mortality, the education-based mortality differences were then decomposed into n = 16 cause-of-death groupings., Results: Between 2012 and 2019, education-based all-cause mortality inequalities in Lithuania declined by 18% among men and by 14% among women. Following the alcohol taxation increase, we found a pronounced yet temporary reduction of mortality inequalities among Lithuanian men (- 13%). Subsequent decomposition analyses suggest that the reduction in mortality inequalities between lower and higher educated men was mainly driven by narrowing mortality differences in injuries and infectious diseases., Conclusions: A marked increase in alcohol excise taxation was associated with a decrease in mortality inequalities among Lithuanian men. More pronounced reductions in deaths from injuries and infectious diseases among lower as compared to higher educated groups could be the result of differential changes in alcohol use in these populations., (© 2023. The Author(s).)

Background: No studies analysing out-of-hospital cardiac arrest (OHCA) epidemiology and outcomes in Lithuania were published in the last decade., Methods: We conducted a retrospective analysis of prospectively collected data. The incidence of OHCA and the demographics and outcomes of patients who were treated for OHCA between 1 and 2016 and 31 December 2018 at Kaunas Emergency Medical Service (EMS) were collected and are reported in accordance with the Utstein recommendations. Multivariable logistic regression analysis was used to identify predictors of survival to hospital discharge., Results: In total, 838 OHCA cases of EMS-treated cardiac arrest (CA) were reported (95.8 per 100.000 inhabitants). The median age was 71 (IQR 58-81) years of age, and 66.7% of patients were males. A total of 73.8% of OHCA cases occurred at home, 59.3% were witnessed by a bystander, and 54.5% received bystander cardiopulmonary resuscitation. The median EMS response time was 10 min. Cardiac aetiology was the leading cause of CA (78.8%). The initial rhythm was shockable in 27.6% of all cases. Return of spontaneous circulation at hospital transfer was evident in 24.9% of all cases. The survival to hospital discharge rate was 10.9%, and the 1-year survival rate was 6.9%. The survival to hospital discharge rate in the Utstein comparator group was 36.1%, and the 1-year survival rate was 27.2%. Five factors were associated with improved survival to hospital discharge: shockable rhythm, time from call to arrival at the patient less than 10 min, witnessed OHCA, age < 80 years, and male sex., Conclusion: This is the first OHCA study from Lithuania examining OHCA epidemiology and outcomes over a three year period. Routine OHCA data collection and analysis will allow us to track the efficacy of service improvements and should become a standard practice in all Lithuanian regions., Trial Registration: This research was registered in the clinicaltrials.gov database: Identifiers: NCT04784117, Unique Protocol ID: LITOHCA. Brief Title: Out-of-hospital Cardiac Arrest Epidemiology and Outcomes in Kaunas 2016-2021., (© 2022. The Author(s).)

The genus Bartonella contains facultative Gram-negative intracellular bacteria from the family Bartonellaceae that can cause diseases in humans and animals. Various Bartonella species have been detected in rodents' ectoparasites, such as fleas, ticks, mites, and lice. However, the role of laelapid mites (Mesostigmata: Laelapidae) as carriers of Bartonella spp. needs to be confirmed. We aimed to investigate the presence of Bartonella spp. in laelapid mites collected from small rodents in Lithuania using real-time PCR targeting the transfer-messenger RNA/tmRNA ( ssrA ) gene and to characterize Bartonella strains using nested PCR and sequence analysis of the 16S-23S rRNA intergenic transcribed spacer region (ITS). A total of 271 laelapid mites of five species ( Laelaps agilis, Haemogamasus nidi, Eulaelaps stabularis, Myonyssus gigas, and Hyperlaelaps microti ) were collected from five rodent species ( Apodemus flavicollis , Apodemus agrarius , Clethrionomys glareolus, Micromys minutus, and Microtus oeconomus ) during 2015-2016. Bartonella DNA was detected in three mite species L. agilis, M. gigas, and Hg. nidi with an overall prevalence of 11.4%. Sequence analysis of the 16S-23S rRNA ITS region revealed the presence of Bartonella taylorii in L. agilis , Hg. nidi, and M. gigas , and Bartonella grahamii in L. agilis . Our results suggest that laelapid mites are involved in the maintenance of rodent-associated Bartonella spp. in nature. To the best of the authors' knowledge, this is the first study to demonstrate the presence of Bartonella spp. DNA in laelapid mites from small rodents.

It is essential to understand how climate change and varieties affect crop phenology and yields to adapt to future climate change. The aim of this study was to analyse the phenological development trends of three winter wheat cultivars (1990-2020) to identify the most critical meteorological-climatic factors influencing the development and yield of the cultivars and to investigate the heat requirements for each phenological phase to reveal the potential of the different cultivars to adapt to the warming climate. The observed dates of green-up, the beginning of stem elongation, and the grain development advanced significantly, but the timing of maturity changed insignificantly during the period of 1990-2020. The most marked change was related to the shortening of the period from sowing to green-up. The green-up dates were related to the mean temperature of the period after sowing. The occurrence of stem elongation and grain development dates were negatively correlated with the mean temperature in May. Significant correlations were found between temperature and duration from sowing to green-up and positive from stem elongation to grain development. The change of cultivar led to earlier green-up and grain development dates, but cultivar choise had no influence on sowing, stem elongation, and maturity dates from 1990 to 2020. The newer cultivar Skagen was more successful in exploiting increased thermal resources. The heat requirements remained almost unchanged during the vegetative development period, while the heat amount required during the reproductive period increased by about 15%. These findings demonstrate that the choice of crop cultivars with higher thermal requirements may be an appropriate adaptation mean to achieve higher yields in response to climate change, at least in the middle latitudes., (© 2022. The Author(s) under exclusive licence to International Society of Biometeorology.)

Background: The problem of underestimating the burden of mental health-related mortality is widely discussed in the public health literature. Relevant scientific evidence from societies experiencing the largest burden of mental health mortality is important for better understanding global and national mental health challenges and improving policies. Three Baltic States - Estonia, Lithuania, and Latvia - are countries in the Central and Eastern European region that experienced post-soviet transition trauma and showed among the highest suicide and alcohol-related mortality rates in Europe. This study aimed to examine the change in the burden of mental health-related mortality in three Baltic States in the context of consistent growth in life expectancy in 2007-2018., Methods: We calculated age-standardized years of life lost due to specific mental health-related causes of death in three Baltic countries from 2007 to 2018. Four mental health-related causes of death groups were analyzed: (i) all mental and behavioural disorders; (ii) intentional self-harm; (iii) main substance use-related causes of death; and (iv) external causes of death. The number of deaths came from the WHO Mortality Database; population exposures were extracted from the Human Mortality Database., Results: We found that the proportion of age-standardized years of life lost due to mental disorders was relatively low in all three countries. It varied from 0.2% for females in Lithuania in 2009 to 2.4% for males in Estonia in 2007. However, the proportion of age-standardized years of life lost from self-harm and substance use remained high. In 2018, the proportion of age-standardized years of life lost due to self-harm was highest among males in Lithuania (4.1%) while the highest proportion due to substance use-related causes of death was among males in Estonia (7.3%)., Conclusions: Our findings indicate that the burden of mental health-related mortality remained high and showed divergent temporal changes across the three countries. In the context of the Baltic States and other post-soviet countries, fractions of various external causes of death and alcohol-related causes of death should be considered in assessing the total burden of mental health-related mortality., (© 2022. The Author(s).)

The emergence of African swine fever (ASF) in Lithuania and its subsequent persistence has led to a decline in the population of wild boar ( Sus scrofa ). ASF has been spreading in Lithuania since its introduction, therefore it is important to understand any genetic impact of ASF outbreaks on wild boar populations. The aim of this study was to assess how the propensity for an outbreak has shaped genetic variation in the wild boar population. A total of 491 wild boar samples were collected and genotyped using 16 STR markers. Allele richness varied between 15 and 51, and all SSR loci revealed a significant deviation from the Hardy-Weinberg equilibrium. Fixation indices indicated a significant reduction in heterozygosity within and between subpopulations. PCoA and STRUCTURE analysis demonstrated genetic differences between the western region which had had no outbreaks (restricted zone I) and the region with ASF infection (restricted zones II and III). It is concluded that environmental factors may play a particular role in shaping the regional gene flow and influence the genetic structure of the wild boar population in the region with ASF outbreaks.

Scholars suggest that improving hazard perception (HP) skills among different road users can lead to safer driving. To this end, a small number of countries have developed a national hazard perception test for their licensing procedures. The purpose of the current research is to develop and validate a new video-based hazard prediction test for the Lithuanian driving context. Eighty-eight drivers participated in the study. Initially, 25 naturalistic clips were included and edited into a hazard prediction test following the "what happens next?" paradigm. The overall score of the test was higher for experienced drivers when compared with novices. On further inspection the overall group difference was driven by 12 clips. The Lithuanian Hazard Perception test HPT-LIT featuring static images (Tūskė et al., 2019) and Hazard Perception Questionnaire developed by White et al. (2011) were used to validate the new test. This new version of the test (12 clips, LHP 12 ) showed acceptable psychometric properties. Drivers with less driving experience demonstrated poorer hazard prediction skills than experienced drivers. The results revealed a negative correlation between hazard prediction scores on LHP 12 and crash involvement in the novice driver group, as well as a positive correlation between prediction scores and self-reported hazard prediction skills. It was concluded that the new Lithuanian hazard test shows potential for future research., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

Most countries around the world use the penalties' system in order to increase compliance with road traffic rules. However, it can be argued that the most penalties' systems are ineffective, as drivers do not change offending behavior due to received penalty and repeatedly violate them. The perceived fairness of these penalties may be related to the level of adherence to these traffic rules. Therefore, this research explored the perceived justice of penalties for road traffic rules in a sample of Lithuanian drivers and investigated the differences between offenders and non-offenders. The sample consisted of 358 participants (63.4 percent females, aged 18-75, mean age 35.2 years) who completed an online survey. Participants were asked to report how fair they believed penalties were for road traffic rule offences in general and using a list of 23 specific penalties, including: drink driving, speeding, dangerous maneuverings, illegal overtaking, handheld phone use while driving, etc. The survey measured demographic data, as well as data regarding driving exposure, traffic offences and crashes during the last 12 months. The results revealed that in general drivers perceived the penalties as fair or adequate. The answer "adequate/fair" was chosen most frequently for almost all penalties (from 41.1 to 71.3 percent), with only the penalty for carrying a child without a car seat (€30-50) being perceived as too mild (55.5%). Gender differences were found in the evaluation of the penalty for driving under the influence of alcohol, while age and driving frequency differences were found in the perceived fairness of the penalties for not using a seatbelt, aberrant driving and using a handheld mobile phone while driving. Drivers who reported no offences during the last year, perceived the penalties for speeding as being too mild, when compared to drivers with at least one penalty over the previous year. Contrarily, offenders reported the penalties for speeding as being too severe. Offenders, who experienced driving license suspension, perceived the penalties as being too severe for drink driving and aberrant driving than offenders who received monetary fines. In summary, both Lithuanian offenders and non-offenders generally perceived the penalties for traffic rule offences as adequate and fair, but individual differences and the experience of traffic sanctions were related to the perceived justice of specific penalties., Competing Interests: The authors have declared that no competing interests exist.

This work involves a comprehensive chemical composition analysis of leaf and cone samples of Lithuanian hop varieties. This study aimed to determine the chemometric properties of the leaves and cones of five Lithuanian hop varieties. Determined properties were the following: (a) xanthohumol content, (b) phenolic compounds, (c) flavonoids, (d) radical scavenging activity, and (e) the qualitative composition of volatile compounds. The total content of phenolic compounds in aqueous 75% methanolic extracts varied between 31.4-78.2 mg of rutin equivalents (RE)/g, and the concentration of flavonoids was between 11.0-23.3 mg RE/g. Radical scavenging activity varied between 34.4-87.2 mg RE/g. A QUENCHER analysis procedure showed 91.7-168.5 mg RE/g of the total phenolic compound content, 12.7-21.4 mg RE/g of flavonoids, and 48.4-121.0 mg RE/g of radical scavenging activity. 'Fredos taurieji' and 'Fredos derlingieji' varieties have shown maximum values of phenolic compounds and radical scavenging activity both in leaf and cone suspensions. These varieties accumulated a higher amount of xanthohumol in leaves. The concentration of xanthohumol in the samples varied between 0.0014-0.2136% of dry mass, with the highest concentration in the cones of 'Kauno gražieji'. We identified 19 volatile compounds in leaves, and in cones, we identified 32. In both of them, α-humulene and β caryophyllene dominated. 'Raudoniai' leaves were exceptional in their aroma due to dominating compound nagina ketone (Kovats index 1306). The QUENCHER procedure has shown a great potential for the unextractable residue of hop raw material. Further investigation and valorization of different hop biomass components, not only cones, are essential.

Mood can be considered as a diffuse and global emotional state, with both valence and arousal characteristics, that is not directed towards a specific object. Investigation of moods in specific language and cultural contexts relies on the availability of appropriately validated measures. The current study involved the translation and validation of the Brunel Mood Scale (BRUMS) from English into Lithuanian. The 24-item, 6-factor scale, referred to as the BRUMS-LTU, was administered to 746 participants who were fluent in Lithuanian ( n men = 199 (26.7%), n women = 11.4 years). Confirmatory factor analysis showed an adequate fit of the hypothesized measurement model to the data (CFI  =  0.954, TLI  = 0 .944, RMSEA  = 0 .060 [CI 0.056, 0.064], SRMR = 0.070) and multi-sample analysis supported configural, metric, scalar, and residual invariance across genders. Concurrent measures (i.e., Perceived Stress Scale, Big Five Personality Test) correlated with subscale scores in line with theoretical predictions, supporting both convergent and divergent validity. Internal consistency coefficients of the six subscales were satisfactory. Mood scores varied significantly by gender, with men generally reporting more positive moods than women. Findings support the adequacy of the psychometric properties of the BRUMS-LTU. Thus, the scale can be recommended for use in further psychological studies of mood in Lithuania and may also be useful for applied practitioners.M = 41.8 years, SD = 11.4 years). Confirmatory factor analysis showed an adequate fit of the hypothesized measurement model to the data (CFI  =  0.954, TLI  = 0 .944, RMSEA  = 0 .060 [CI 0.056, 0.064], SRMR = 0.070) and multi-sample analysis supported configural, metric, scalar, and residual invariance across genders. Concurrent measures (i.e., Perceived Stress Scale, Big Five Personality Test) correlated with subscale scores in line with theoretical predictions, supporting both convergent and divergent validity. Internal consistency coefficients of the six subscales were satisfactory. Mood scores varied significantly by gender, with men generally reporting more positive moods than women. Findings support the adequacy of the psychometric properties of the BRUMS-LTU. Thus, the scale can be recommended for use in further psychological studies of mood in Lithuania and may also be useful for applied practitioners.

The aim of this study was to determine the association between the daily number of cases of ischemic stroke (IS) and hemorrhagic stroke (HS) in patients aged 25-64 years and the El Niño-Southern Oscillation (ENSO) events during 2000-2015. As an indicator of the effect of the ENSO, the monthly NIÑO 3.4 index (Equatorial Pacific Sea Surface Temperature) was used. During the 5844-day study period, 5600 cases of stroke (3170 (56.61%) in men and 2430 (43.39%) in women) were analyzed. Of these, 4354 (77.8%) cases were IS, and 1041 (18.6%) cases were HS. In 3496 (62.2%) cases, stroke occurred in the age group of 55-64 years. In the analysis, we used the following categories of the ENSO events: strong La Niña, moderate La Niña, moderate El Niño, and strong El Niño. The effect of the ENSO was examined by using the multivariate Poisson regression adjusting for weather variables. The highest risk of both strokes (BS) was observed on days of strong and moderate La Niña (rate ratio (RR) 1.27, 95% CI 1.13-1.42) and RR = 1.15 (1.07-1.23), respectively), while the risk for IS was the highest on days of moderate El Niño (RR = 1.11(1.02-1.20)). A lower risk for BS was found on days of strong El Niño (RR = 0.77(0.62-0.97)). We found that ENSO events affected the occurrence of BS and IS in all age groups, and the strongest effect was observed among females. The results of this study provide new evidence that ENSO events may affect the risk of stroke, especially the risk of IS., (© 2021. The Author(s).)

The aim of the present study is to present the composition of the leech fauna from Lithuania. Based on morphology, 12 species of leeches belonging to 10 genera and 5 families (Haemopidae, Hirudinidae, Glossiphoniidae, Erpodellidae and Piscicolidae) were identified in the country. Comparison of the data generated in current study with historical records, we extend the list of species to 21. Additional localities of Hirudo medicinalis and Erpobdella monostriata, two uncommon leeches, were established in Lithuania.

Introduction: The increase in the suicide mortality rate among middle-aged adults in the United States (US) has been well documented. Aside from a few studies from the United Kingdom, it is unclear whether the suicide mortality rate trend in the US is also occurring in other developed countries. Accordingly, we aimed to compare the suicide mortality rate trends over the past 30 years in the US to a country in the European Union-Lithuania., Methods: Joinpoint regression analyses were performed to identify secular trends in the gender-specific age-standardized suicide mortality rate among individuals 15 + years of age, as well as middle-aged adults (45-54 years of age), and suicide mortality rate ratio for men-to-women., Results: Age-standardized suicide mortality rates among middle-aged adults in the US increased annually, on average, by 0.89% (95% CI: 0.66%, 1.12%) among men and 1.21% (95% CI: 0.75%, 1.66%) among women between 1990 and 2019. In contrast to the US, there was an overall downward trend in the suicide mortality rates among middle-aged adults in Lithuania across the study period. The average annual percent change in the suicide mortality rate ratio for men-to-women were not statistically significant for either country., Conclusion: The suicide mortality rate trend in the US does not appear to be an indicator of an upcoming global trend, but rather should be regarded as a cautionary example of what other countries should strive to avoid., (© 2022. The Author(s).)

Background: The Patient Health Questionnaire-9 (PHQ-9) and the Generalized Anxiety Disorder Questionnaire- 7 (GAD-7) are short screening instruments used for detection of depression and anxiety symptoms in various settings, including general and mental health care as well as the general population. The aim of this study is to evaluate psychometric properties and factorial structure of the PHQ-9 and the GAD-7 in a sample of Lithuanian university students., Methods: 1368 students (mean age 22.5±4.8) completed the PHQ-9 and the GAD-7 questionnaires online; after the completion of the survey, students were asked to provide phone contact for an additional interview. Eligible students were approached later by trained interviewers and completed The Clinical Interview Schedule-Revised for assessment of depressive and anxiety disorders., Results: Results showed that the PHQ-9 and the GAD-7 are reliable screening tools for depression and anxiety (Cronbach alpha 0.86 and 0.91, respectively). The one-factor structure of the PHQ-9 and the GAD-7 was confirmed by the Confirmatory Factor Analysis. A cut-off of ≥10 for the PHQ-9 resulted in 71% sensitivity and 66% specificity recognizing students with increased risk for mood or anxiety disorder. For the GAD-7, a cut-off ≥9 resulted in 73% sensitivity and 70% specificity recognizing students at risk. The PHQ-9 was sensitive but not specific in recognizing students with depressive disorders. The sensitivity and specificity of the GAD-7 in differentiating students with generalized anxiety disorders were low., Conclusions: The PHQ-9 and the GAD-7 have sufficient formal psychometric properties, but their clinical utility as diagnostic tools for recognition of depressive and anxiety disorders in students is limited. Due to low specificity and high false positive rates, both scales are recommended only as an initial screening tool for recognition of subjects with increased risk of mental disorders, however positive cases should be later assessed using more comprehensive instruments., Competing Interests: JGS served as a consultant at FACITtrans from 2017 to 2020. In the past several years JB has been serving as a consultant to Cogstate, Ltd. The rest of the authors declare no commercial or financial relationships that could be construed as a potential conflict of interest. This does not alter our adherence to PLOS ONE policies on sharing data and materials.”

Introduction: Alcohol use is a major risk factor for mortality. Previous studies suggest that the alcohol-attributable mortality burden is higher in lower socioeconomic strata. This project will test the hypothesis that the 2017 increase of alcohol excise taxes linked to lower all-cause mortality rates in previous analyses will reduce socioeconomic mortality inequalities., Methods and Analysis: Data on all causes of deaths will be obtained from Statistics Lithuania. Record linkage will be implemented using personal identifiers combining data from (1) the 2011 whole-population census, (2) death records between 1 March 2011 (census date) and 31 December 2019, and (3) emigration records, for individuals aged 40-70 years. The analyses will be performed separately for all-cause and for alcohol-attributable deaths. Monthly age-standardised mortality rates will be calculated by sex, education and three measures of socioeconomic status (SES). Inequalities in mortality will be assessed using absolute and relative indicators between low and high SES groups. We will perform interrupted time series analyses, and test the impact of the 2017 rise in alcohol excise taxation using generalised additive mixed models. In these models, we will control for secular trends for economic development., Ethics and Dissemination: This work is part of project grant 1R01AA028224-01 by the National Institute on Alcohol Abuse and Alcoholism. It has been granted research ethics approval 050/2020 by Centre for Addiction and Mental Health Research Ethics Board on 17 April 2020, renewed on 30 March 2021. The time series of mortality inequalities as well as the statistical code will be made publicly available, allowing other researchers to adapt the proposed method to other jurisdictions., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Background: Wild boar (Sus scrofa) is a widely distributed ungulate whose success can be attributed to a variety of ecological features. The genetic variation and population structure of Lithuania's wild boar population have not yet been thoroughly studied. The purposes of this study were to investigate the genetic diversity of S. scrofa and assess the effects of habitat fragmentation on the population structure of wild boar in Lithuania. A total of 96 S. scrofa individuals collected from different regions of Lithuania were genotyped using fifteen microsatellite loci., Results: The microsatellite analysis of the wild boars indicated high levels of genetic diversity within the population. Microsatellite markers showed evidence of a single panmictic wild boar population in Lithuania according to STRUCTURE's highest average likelihood, which was K = 1. This was supported by pairwise F st values and AMOVA, which indicated no differentiation between the four sampling areas. The results of the Mantel test revealed a weak isolation by distance and geographic diversity gradients that persisted between locations. Motorway fencing and heavy traffic were not an effective barrier to wild boar movement., Conclusions: There was limited evidence of population genetic structure among the wild boar, supporting the presence of a single population across the study area and indicating that there may be no barriers hindering wild boar dispersal across the landscape. The widespread wild boar population in Lithuania, the high level of genetic variation observed within subpopulations, and the low level of variation identified between subpopulations suggest migration and gene flow between locations. The results of this study should provide valuable information in future for understanding and comparing the detailed structure of wild boar population in Lithuania following the outbreak of African swine fever., (© 2021. The Author(s).)

Introduction: Employee alcohol consumption is a major challenge to both the health of the employee and productivity of the company. Our study investigates the overall alcohol intoxication rates of employees at companies in Lithuania, alcohol intoxication incidence rates during the work week and associations between company variables and employee alcohol intoxication at work., Methods: Data for our study were collected at 153 different companies in Lithuania during the year 2018. Overall 2 455 997 alcohol breath tests were analysed. Data were analysed using descriptive statistics and Poisson regression analysis., Results: Descriptive statistics showed that the alcohol intoxication (blood alcohol concentration ≥ 0.01%) incidence rate was 0.31% (n = 7535). Average alcohol intoxication was 0.04%. Furthermore, higher alcohol intoxication incidence rates were found on Mondays and in the morning than at any other day or time. The results of Poisson regression analysis showed that the alcohol intoxication incidence rate ratios were highest among small companies, companies from the farming sector and companies from rural areas., Discussion and Conclusions: We found a relationship between company variables, testing time and incidence rates of alcohol intoxication. The increased alcohol intoxication at work throughout the weekend and on Monday is consistent with the alcohol consumption patterns in the Lithuanian population. Relatively low alcohol intoxication rate for the majority of the positively tested cases may indicate consumption of small amounts of alcohol just before starting work or excessive alcohol consumption the day before. Our findings could be an indicator of an underlying problem and have implications for alcohol prevention strategies., (© 2021 Australasian Professional Society on Alcohol and other Drugs.)

A reliable surveillance strategy of tick-borne encephalitis virus (TBEV) is necessary to ensure adequate disease control measures. However, current approaches assessing geographical TBEV circulation are ineffective or have significant limitations. In this study we investigated a total of 1363 goat and 312 sheep bulk tank milk samples for the presence of TBEV. Samples were collected from systematically selected farms in Lithuania every 4-5 days from April to November in 2018 and 2019. To validate results, we additionally tested 2685 questing ticks collected in the vicinity of milk collection sites. We found 4.25% (95% CI 3.25-5.47) and 4.48% (95% CI 2.47-7.41) goat and sheep milk samples to be positive for TBEV, respectively. Furthermore, geographical distribution of TBEV in milk samples coincided with the known TBE endemic zone and was correlated with incidence of TBE in humans in 2019. When sampling time coincides, TBEV detection in milk samples is as good a method as via flagged ticks, however bulk milk samples can be easier to obtain more frequently and regularly than tick samples. The minimal infectious rate (MIR) in ticks was 0.34% (CI 95% 0.15-0.64). Therefore, our results confirm that testing milk serves as a valuable tool to investigate the spatial distribution of TBEV at higher resolution and lower cost.

Few studies have examined the relation between urban built environment and the prevalence of hypertension. This cross-sectional study aimed at assessing the relationship between the environmental quality, physical activity, and stress on hypertension among citizens of Kaunas city, Lithuania. We conducted a survey of 1086 citizens residing in 11 districts to determine their perceptions of environmental quality, health behavior, and health indices. The independent variables included residential traffic flows, access to public transportation and green spaces. Dependent variables included physician-diagnosed hypertension, systolic and diastolic blood pressure, and stress level. We used multivariable logistic regression to assess the associations as odds ratios (OR). The environmental factors beneficially associated with meeting the physical activity recommendations were opportunities for walking to reach the city's green spaces and available relaxation areas. Residents of high noise level districts aged 45-64 years had a significantly higher OR of stress and a higher prevalence of hypertension when age, sex, education status, family status, and smoking were accounted for. However, meeting the physical activity recommendations had a beneficial effect on the risk of hypertension. This study provided evidence that improvement of the district-level built environment supporting citizens' physical activity might reduce the risk of hypertension.

Sustainable mobility is becoming a key factor in improving the quality of life of the residents and increasing physical activity (PA) levels. The current situation of sustainable mobility and its analysis is a first step in understanding the factors that would encourage residents to discover and choose alternative modes of travel. The present study examined the factors that encourage the choice of active modes of travel among urban adult population. Walking and cycling were analyzed as the most sustainable forms of urban mobility from the perspective of car and public transport (PT) users. Total of 902 subjects aged 18 years or older were analyzed in the study to assess commuting habits in Kaunas city, Lithuania. The majority (61.1%) of the respondents used a passenger vehicle, 28.2% used PT, and only 13.5% used active modes of travel. The results showed that safer pedestrian crossings, and comfortable paths were the most significant factors that encourage walking. A wider cycling network, and bicycle safety were the most important incentives for the promotion of cycling. Our findings show that the main factors encouraging walking and cycling among car and PT users are similar, however, the individual characteristics that determine the choice of these factors vary significantly.

Background and objectives: Lyme disease is the most common tick-borne infectious disease in Europe, caused by the spirocheta bacteria of Borrelia burgdorferi. Several genospecies of B. burgdorferi are pathogenic to humans. B. burgdorferi sensu stricto, which is prevalent in North America, causes reactive arthritis, whereas B. garinii and B. afzelii, common in Europe, can affect the skin, heart, or nervous system; it has been shown that the clinical symptoms of the disease may be very different. The objective of this study was to identify the baseline characteristics of Lyme disease and to elucidate the frequency of different Lyme disease syndromes in Lithuania. Materials and Methods: Patients who were diagnosed with Lyme disease during an ambulatory visit to the Center of Infectious Diseases, Vilnius University Santaros clinics, from 2014 to 2016, were enrolled in this study. A retrospective material analysis was conducted. Results: In total, 1005 patients were enrolled with the following prevalence of clinical syndromes: erythema migrans (EM), 945 (94.02%); Lyme arthritis, 32 (3.18%); neuroborreliosis, 23 (2.28%); Lyme carditis, 4 (0.39%); and acrodermatitis, 1 (0.09%). Erythema migrans was dominant among middle-aged women, with a rash appearing mainly on the lower extremities. Lyme arthritis mainly manifested among middle-aged women as an oligoarthritis, mostly affecting the knee joint. Neuroborreliosis was seen more often in middle-aged women than men and the main symptom was nervus facialis neuropathy. Lyme carditis, manifested as an atrioventricular block, with a male/female ratio of 3:1, and the median age was 51. Acrodermatitis was diagnosed in a 61-year-old woman, as a painful, red rash on the hand. Conclusions: According to the prevalence of B. garinii and B. afzelii in Europe, previously it was thought that Lyme disease presented as erythema migrans, and less frequently as neuroborreliosis; however, this study revealed that other syndromes may also be seen. In addition, we revealed that the longer it takes for erythema migrans to appear, the greater the likelihood of Lyme arthritis developing.

Aim: The Lithuanian population has outstanding rates of alcohol consumption and alcohol related mortality. Alteration of brain dopaminergic system play a role in the risk for addiction disorders. We evaluated the association of one single nucleotide polymorphism rs1800497 in the Ankyrin Repeat and Kinase Domain Containing 1 - Dopamine Receptor D2 complex (ANKK1-DRD2) and a catechol-o-methyltransferase (COMT) rs4680 single nucleotide polymorphism with the risk for alcohol use disorder and impulsiveness in Lithuanian population. Both genetic polymorphisms are known to alter brain dopaminergic activity, thus we also investigated the possible interaction effect of these polymorphisms., Methods: The study included 329 participants recruited from the local community. Hazardous alcohol use was evaluated using the Alcohol Use Disorder Identification Test (AUDIT). Impulsiveness was measured using the Barratt Impulsiveness Scale - 11 (BIS-11). Between group differences of AUDIT and BIS-11 scores were examined stratified by genetic polymorphisms and their combinations. The independent effect of each polymorphism and their interaction for hazardous alcohol use were evaluated using adjusted logistic regression analyses., Results: The ANKK1-DRD2 rs1800497 polymorphism was associated with total AUDIT score, but not with the hazardous use of alcohol, as indicated by the AUDIT test cut-off of 8. The COMT rs4680 GG genotype was associated with the hazardous use of alcohol (adjusted OR = 2.094, p = 0.029), but this association was not statistically significant after adjustment for multiple comparisons. Presence of both COMT rs4680 and ANKK1-DRD2 rs1800497 GGxCT/TT polymorphisms was associated with significantly increased risk for hazardous use of alcohol (adjusted OR = 5.016, p = 0.005). The COMT rs4680 and ANKK1-DRD2 rs1800497 genetic polymorphisms, and their combination were not associated with impulsiveness., Conclusions: Our study demonstrated that the interaction of COMT rs4680 and ANKK1-DRD2 rs1800497 genetic polymorphisms is associated with a hazardous use of alcohol., (Copyright © 2020 Elsevier B.V. All rights reserved.)

Background: The impact of weather on morbidity from stroke has been analysed in previous studies. As the risk of stroke was mostly associated with changing weather, the changes in the daily stroke occurrence may be associated with changes in atmospheric circulation. The aim of our study was to detect and evaluate the association between daily numbers of ischaemic strokes (ISs) and haemorrhagic strokes (HSs) and the teleconnection pattern., Methods: The study was performed in Kaunas, Lithuania, from 2000 to 2010. The daily numbers of ISs, subarachnoid haemorrhages (SAHs), and intracerebral haemorrhages (ICHs) were obtained from the Kaunas Stroke Register. We evaluated the association between these types of stroke and the teleconnection pattern by applying Poisson regression and adjusting for the linear trend, month, and other weather variables., Results: During the study period, we analysed 4038 cases (2226 men and 1812 women) of stroke. Of these, 3245 (80.4%) cases were ISs, 533 (13.2%) cases were ICHs, and 260 (6.4%) cases were SAHs. An increased risk of SAH was associated with a change in mean daily atmospheric pressure over 3.9 hPa (RR = 1.49, 95% CI 1.14-1.96), and a stronger El Niño event had a protective effect against SAHs (RR = 0.34, 95% CI 0.16-0.69). The risk of HS was positively associated with East Atlantic/West Russia indices (RR = 1.13, 95% CI 1.04-1.23). The risk of IS was negatively associated with the Arctic Oscillation index on the same day and on the previous day (RR = 0.97, p < 0.033). During November-March, the risk of HS was associated with a positive North Atlantic Oscillation (NAO) (RR = 1.29, 95% CI 1.03-1.62), and the risk of IS was negatively associated with the NAO index (RR = 0.92, 95% CI 0.85-0.99)., Conclusions: The results of our study provide new evidence that the North Atlantic Oscillation, Arctic Oscillation, East Atlantic/West Russia, and El Niño-Southern Oscillation pattern may affect the risk of stroke. The impact of these teleconnections is not identical for various types of stroke. Emergency services should be aware that specific weather conditions are more likely to prompt calls for more severe strokes.

The Baltic States are the region in Europe where tick-borne encephalitis (TBE) is most endemic, with one-third of the European TBE cases detected in Lithuania, Latvia and Estonia. With the Czech Republic and Germany, Lithuania has among the highest population incidences of TBE. Ticks from the Ixodidae family are the main vectors of the TBE virus (TBEV) in Europe. However, there is still a lack of data on the prevalence of TBEV in ticks in different parts of Lithuania. This study analysed the current prevalence of TBEV in the two most common tick species distributed in Lithuania: Ixodes ricinus and Dermacentor reticulatus. Questing I. ricinus (n = 7170) and D. reticulatus (n = 1676) ticks were collected from 81 locations in all ten counties of Lithuania between 2017 and 2019. The presence of TBEV was analysed using a real-time reverse transcription polymerase chain reaction (RT-PCR) and TBEV prevalence in ticks was calculated as the minimum infection rate (MIR). TBEV was detected in the three developmental stages (adults, nymphs and larvae) of I. ricinus and in D. reticulatus adults. The MIR of TBEV in the total sample of I. ricinus was 0.4 % (28/7170) and for D. reticulatus was also estimated to be 0.4 % (6/1676). TBEV-infected ticks were found in 16 locations in seven counties, with MIR ranging from 0.1 % to 1.0 %. The TBEV strains detected belong to the European subtype. To the best of the authors' knowledge, this is the first report on the prevalence of TBEV in unfed D. reticulatus ticks and in I. ricinus unfed larvae in Lithuania., (Copyright © 2020 Elsevier GmbH. All rights reserved.)

The objectives of this study were to investigate the prevalence and abundance of deer keds on various cervids in Lithuania, to molecularly characterize the deer ked species based on mitochondrial COI and 16S rRNA genes, and to compare them with Lipoptena species found in other countries. A total of 11,939 deer keds (Lipoptena cervi and Lipoptena fortisetosa) was collected from the fur of 30 cervids in Lithuania between 2015 and 2019. The values of infestation with deer keds differed among the species of the hosts. Moose and red deer were more frequently infested with L. cervi than with L. fortisetosa, while L. fortisetosa was found more often on roe deer. Phylogenetic analysis of the COI and 16S rRNA genes of five Lipoptena species revealed 110 and 55 variable nucleotide positions, respectively. Among Lithuanian samples, three COI haplotypes of L. cervi and three haplotypes of L. fortisetosa were detected, while there was no variation observed in the 16S rRNA sequences analyzed with one haplotype of L. cervi and one haplotype of L. fortisetosa. This is the first study on L. cervi and L. fortisetosa parasitizing cervids and the first molecular characterization of these deer ked species in Lithuania., (© 2020 The Society for Vector Ecology.)

Introduction and Aims: Eastern Europe is known to suffer from a large burden of alcohol-related mortality. However, persisting unfavourable conditions at the national level mask variation at the sub-national level. We aim to explore spatial patterns of cause-specific mortality across four post-communist countries: Belarus, Lithuania, Poland and Russia (European part)., Design and Methods: We use official mortality data routinely collected over 1179 districts and cities. The analysis refers to males aged 20-64 years and covers the period 2006-2014. Mortality variation is mainly assessed by means of the standardised mortality ratio. Getis-Ord Gi* statistic is employed to detect hot and cold spots of alcohol-related mortality., Results: Alcohol-related mortality exhibits a gradient from very high levels in northwestern Russia to low levels in southern Poland. Spatial transitions from higher to lower mortality are not explicitly demarcated by national boundaries. Within these countries, hot spots of alcohol-related mortality dominate the territories of northwestern and western Russia, eastern and northwestern Belarus, southeastern Lithuania, and eastern and central Poland., Discussion and Conclusions: The observed mortality gradient is likely associated with the spread of alcohol epidemics from the European part of Russia to the other countries, which appears to have started more than a century ago. Contemporary socioeconomic and demographic factors should be taken into account when developing anti-alcohol policies. The same is true for the peculiarities of culture, norms, traditions and behavioural patterns observed in specific geographical areas of the four countries. Reducing alcohol-related harm in the areas identified as hot spots should be prioritised., (© 2020 The Authors. Drug and Alcohol Review published by John Wiley & Sons Australia, Ltd on behalf of Australasian Professional Society on Alcohol and other Drugs.)

Introduction and Aims: Globally, Czechia and Lithuania are among the top-ranking countries in terms of high alcohol consumption. This study highlights notable contrasts in temporal trends in alcohol-related mortality and identifies country-specific patterns in educational differences., Design and Methods: The study uses harmonised cause-of-death series from the Human Cause of Death Database. Mortality disparities by education were assessed using census-linked mortality data. Directly standardised death rates were used to estimate levels of national and group-specific mortality. Relative and absolute mortality differences by education were assessed by range-type measures (Poisson regression mortality ratios and rate differences) and Gini-type measures., Results: Between 1994-1995 and 2016, the absolute difference between Czechia and Lithuania in terms of alcohol-related age-standardised death rates (per 1 000 000) decreased from 450 for males and 130 for females to 76 in males and 11 in females. In both countries, alcohol-related mortality was markedly higher among persons of lower education levels. Lithuanian males experienced the highest absolute inequalities measured by rate difference between the low and high educated (740 per million), while Lithuanian females showed the most pronounced relative inequalities (6.70-fold difference between low and high educated). The corresponding figures were less than half for Czechia., Discussion and Conclusions: Reducing educational disparities in alcohol-related mortality within both countries would have a substantial impact on overall levels. Policies aimed at targeting the lowest priced and illegal alcohols and reducing levels of harmful drinking should be a priority, especially in Lithuania., (© 2020 The Authors. Drug and Alcohol Review published by John Wiley & Sons Australia, Ltd on behalf of Australasian Professional Society on Alcohol and other Drugs.)

Introduction and Aims: Over the recent decades, Lithuania has reported very high alcohol-related harm and mortality indicators when compared to other countries. This, among other reasons, led to an adoption of comprehensive evidence-based alcohol control policy measures back in 2007 and 2016. The aim of this study is to examine alcohol-related male mortality in the context of changing alcohol control policies over the period 2000-2017., Design and Methods: The life table decomposition method was applied to estimate to what extent the age groups and causes of death are responsible for changes in male life expectancy in the period 2000-2017. Furthermore, a time series intervention model was used to study the impact of alcohol control measures on alcohol-related mortality. A seasonal autoregressive integrated moving average model was fitted., Results: Male life expectancy increased by 6.23 years in the period 2007-2017, mainly due to a decrease in mortality from external causes of death (2.12 years), cardiovascular diseases (1.84 years) and alcohol-related disorders (0.86 years). Reduced male mortality in the 30-64 years age group also contributed to a large increase in male life expectancy during the same period., Discussion and Conclusions: The greatest positive effect of reduced alcohol-related mortality to male life expectancy was observed during the period 2007-2009. It overlaps with the start of implementation of the comprehensive alcohol control measures. However, further research on the impact of different alcohol policy interventions on various outcomes is needed., (© 2020 Australasian Professional Society on Alcohol and other Drugs.)

Citizens' participation in urban environmental quality assessment is important when identifying local problems in the sustainable development and environmental planning policy. The principal aim of this study was to analyze whether any social differences exist between the joint effect of built neighborhood quality and exposure to urban green spaces and the risk of hypertension. The study sample consisted of 580 participants residing in 11 districts in Kaunas city, Lithuania. Using geographic information systems (GIS), individual data on the socioeconomic status (SES) and health were linked to the participants' perceptions of the environmental quality and exposure to green spaces (NDVI). We used multivariate logistic regression to estimate associations as odds ratios (OR). Those study participants with lower education and those study participants with higher education on low incomes rated their health significantly worse. Low SES persons residing in areas with low exposure to green spaces had a significantly higher risk of hypertension when sex, age, family status, smoking, and income were accounted for (OR 1.83, 95% CI 1.01-3.36). This citizen science study provided evidence that the social environment and the quality of the built environment had a complex effect on disparities in the risk of hypertension.

Objective: Researchers continue to seek reasons for novice drivers' over-representation in crashes. Evidence on how early interventions might mitigate this global phenomenon remains inconclusive. This study explores changes in novice drivers' beliefs during pre-licensure training and within their first one-year independent provisional license period, and how these changes might help to predict subsequent risky driving., Method: A sample of novice drivers (N = 175) from Lithuania participated in a three-wave longitudinal study. They completed questionnaires when beginning driver training (T1), at the end of their training (T2), and after one year of independent driving (T3). The Attitudes towards Risky Driving Questionnaire, the Adelaide Driving Self Efficacy Scale, the Driving Cognitions Questionnaire, the Driver Behaviour Questionnaire, and the Social Desirability Scale were used., Results: Reported driving self-efficacy increased and fear of driving decreased from the beginning to the end of driver training and after one-year follow-up in both men and women. Road safety attitudes changed in the risk-unfavourable direction from T1 to T2. However, at T3 these attitudes returned to the initial level for men. Female novice drivers reported the same level of safety attitudes at T2 and T3. Risky attitudes, driving self-efficacy, and fear of driving predicted reported driving errors and violations., Conclusions: Reported psychological changes occurred during the driver training period and in the first year of independent driving. It is recommended that special attention should be paid to a group of novices who experienced safety compromising changes in attitudes, driving self-efficacy, and fear of driving during training and in the first year of their driving career., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

The relict tick Haemaphysalis concinna Koch, 1844 (Acari: Ixodidae) has high medical and veterinary importance as it is known as a vector or a carrier of various pathogens causing human and animal diseases. Haemaphysalis concinna is a widely distributed species in forests of temperate Eurasia. In Europe, it is found mainly in deciduous or mixed forests near shores of lakes or rivers. However, there is still a lack of knowledge about current distribution, relative density, and other ecological parameters of H. concinna. On June 30th, 2019, one specimen of H. concinna was found on the fur of a hunted roe deer in Lithuania. This is the first record of H. concinna in Lithuania and, to the best of our knowledge, it represents the northernmost distribution point of H. concinna in Europe (22°55'26.5"E/ 55°27'50.7"N)., (Copyright © 2020 Elsevier GmbH. All rights reserved.)

Background: Personality traits are related with risk of hazardous alcohol use and alcohol dependence. The Substance Use Risk Profile Scale (SURPS) measures personality traits associated with addictive substance abuse. We examined psychometric properties of the SURPS in Lithuanian population., Materials and Methods: Two hundred forty-seven participants (mean age 37.22 ± 0.78 years), were recruited from the local community and from an inpatient addiction treatment centre. Internal consistency, stability, factor structure, content validity, and external validity of the SURPS were examined. Hazardous alcohol use was evaluated by Alcohol Use Disorder Identification Test (AUDIT). Alcohol dependence diagnosis was established by International Classification of Diseases - 10 (ICD - 10). We also performed gender analyses for associations of personality traits with alcohol dependence and hazardous use of alcohol., Results: The SURPS scale demonstrated appropriate internal validity, good temporal stability, and adequate criterion validity and construct validity. The SURPS scores of hopelessness, anxiety sensitivity and impulsivity were higher in the alcohol dependence group than in the control group for both males and females. Impulsivity and sensation seeking were associated with hazardous alcohol use and these associations were more prevalent in females., Conclusions: Lithuanian translation of the SURPS scale was appropriate. The SURPS demonstrated good sensitivity for discriminating on alcohol dependence and was more sensitive for discriminating on hazardous alcohol use for females.

An increase in the daily rate of acute myocardial infarction (AMI) has been observed during days of geomagnetic storm (GS). However, the analysis of associations between the daily number of AMI and geomagnetic activity (GMA) over longer periods sometimes yields controversial results. The study aimed to detect the complex association between the daily numbers of AMI and weather, the Quasi-biennial Oscillation (QBO) phase, GMA, and solar wind variables. We used data of Kaunas population-based Ischemic Heart Disease Register of residents of Kaunas city (Lithuania) for 2000-2012. The associations between weather and space weather variables and the daily number of AMI were evaluated by applying the multivariate Poisson regression. A higher risk of AMI was positively associated with active-stormy local GMA (rate ratio (RR) = 1.06 (95% CI 1.01-1.10)), solar wind dynamic pressure with a lag of 4 days (RR = 1.02 (1.01-1.04) per 1 nPa increase), and solar wind speed with a lag of 3-7 days (RR = 1.03 (1.01-1.05) per 100 km/s increase). A positive association was found between the west QBO phase and the risk of AMI during winter (RR = 1.08 (1.01-1.16)), and a negative association was observed between them during March-November (RR = 0.93 (0.90-0.97)). The risk of AMI positively associated with the GS due to stream interaction regions with a lag of 0-2 days during the east QBO phase (RR = 1.10, p = 0.046) and was negatively associated with them during the west QBO phase (RR = 0.82, p = 0.024). These results may help understand the population's sensitivity under different weather and space weather conditions. The QBO phase may modify the effect of GS.

The perception of urban environmental quality is an important contributor when identifying local problems in sustainable development and environmental planning policy. This study examined the associations between environmental and social residential characteristics, physical activity, obesity, and hypertension in Kaunas city, Lithuania. This cross-sectional study analyzed 580 citizens' demographic-, socioeconomic-, health-, and lifestyle-related factors, environmental health concerns, and environmental quality perceptions. Using Geographic Information Systems and the multivariate logistic regression, we found that the less physically active group more often presented lower than mean ratings of the quality of pathways and cycling routes (32.9% and 45.6%, p = 0.042) and only irregularly visited the natural environment. Obese participants presented poorer ratings of air pollution, the quality of pathways and cycling routes, their possibility to reach green spaces by walking, and the available relaxing areas. The environmental issues associated with hypertension were poor possibilities to reach green spaces by walking (OR 1.94, 95% CI 1.14-3.32) and the availability of relaxation areas (OR 2.30, 95% 1.34-3.95). The quality of the neighborhood and individual-level characteristics were the factors that influenced a higher prevalence of health problems at the district level. Our findings suggest that a public health policy to improve the physical and social environment of the neighborhood would have a potential to increase citizens' physical activity and health.

Associations between species of Laelapidae (Mesostigmata: Dermanyssoidea) mites and small rodents have been studied insufficiently. The aim of this study was to investigate infestation patterns of small rodent species by laelapid mites at six locations in Lithuania. A total of 728 rodents were snap- and live-trapped in various locations during 2013-2016. Eight rodent species were identified, namely Apodemus flavicollis, Apodemus agrarius, Myodes glareolus, Micromys minutus, Mus musculus, Microtus oeconomus, Microtus arvalis and Microtus agrestis. A total of 343 (47.1%) rodents were found to be infested with up to eight species of parasitic mites from the Laelapidae family (n = 1363): Laelaps agilis, Laelaps hilaris, Hyperlaelaps microti, Haemogamasus nidi, Haemogamasus hirsutus, Eulaelaps stabularis, Hirstionyssus sunci and Myonyssus gigas. The dominant species of mite found on rodents was L. agilis (89.1%), found on 43.4% of all hosts. Abundance and mean intensity of infestation with mites varied among species of hosts and were highest for A. flavicollis. We document new geographical and host records for gamasid mites of eight rodent species in Lithuania.

It is shown the statistical associations between space weather pattern and humans' cardiovascular system. We investigated the association between space weather events and cardiovascular characteristics of 4076 randomly selected patients with acute coronary syndrome (ACS) who were admitted for inpatient treatment in Kaunas city, Lithuania during 2000-2005. We hypothesized that days of the space weather events, 1-3 days after, and the period between two events, named as intersection days (1-3 days after the event, which coincided with 1-3 days before the event), might be associated with patients' cardiovascular characteristics. The multivariate logistic regression was applied, and the patients' risk was evaluated by odds ratio (OR), adjusting for age, sex, smoking status, the day of the week, and seasonality. During the intersection days of geomagnetic storms (GS), the risk of ACS increases in obese patients (OR=1.72, p = 0.008). The risk of ventricular fibrillation during admission was associated with stream interaction region (SIR) with a lag of 0-3 days (OR=1.44, p = 0.049) The risk of ACS in patients with chronic atrial fibrillation was associated with fast solar wind (FSW) (≥600 km/s) (lag 0-3 days, OR=1.39, p = 0.030) and with days of solar proton event (lag 0-3) going in conjunction with SIR (lag 0-3) (OR=2.06, p = 0.021). During days which were not assigned as GS with a lag of (-3 to 3) days, FSW (lag 0-3) was associated with the risk of ACS in patients with renal disease (OR=1.71, p = 0.008) and days of SIR - with the risk in patients with pulmonary disease (OR=1.53, p = 0.021). A SIR event, days between two space weather events, and FSW without GS may be associated with a risk to human health., Competing Interests: Declaration of Competing Interest There are no conflicts of interest., (Copyright © 2020 The Committee on Space Research (COSPAR). Published by Elsevier Ltd. All rights reserved.)

Ixodes lividus Koch, 1844 (Ixodida: Ixodidae) ticks are parasites specific to the sand martin (Riparia riparia). The distribution range of I. lividus covers Europe and Asia and they are found wherever sand martins nest. Borrelia burgdorferi sensu stricto, Borrelia garinii and Rickettsia vini have recently been detected in I. lividus ticks in Central Europe. The aim of this study was to investigate the presence of Rickettsia spp. (Rickettsiales: Rickettsiaceae) and Borrelia spp. (Spirochaetales: Spirochaetaceae) in I. lividus ticks in Lithuania. A total of 2622 non-engorged I. lividus from two different colonies comprising 40 sand martin nests were collected in Lithuania in 2013 and 2015. Rickettsial DNA was detected in 106 of the 117 pooled larvae samples, in all examined seven nymphs, four females and one male specimen. Sequence analysis of partial gltA, ompA and htrA genes showed 99-100 % identity with the corresponding R. vini sequences deposited in GenBank. None of I. lividus tested was infected with Borrelia burgdorferi sensu lato. This is the first time that the presence of R. vini has been reported in Lithuania., (Copyright © 2020 Elsevier GmbH. All rights reserved.)

Background and objective: Lyme disease, also known as Lyme borreliosis (LB), is a tick-borne infectious disease caused by the spirochete bacteria Borrelia. The risk of infection depends on the geographical area, ecological factors, and human behavior. Clinical manifestations of Lyme borreliosis have a wide range, but the most frequent clinical symptom, which is also a diagnostic symptom, is a skin rash called erythema migrans (EM). The disease is very common worldwide. In Lithuania, the disease frequency is 99.9 cases per 100,000 population (Centre for Communicable Diseases and AIDS, Lithuania, 2017). The main aim of this study was to obtain the baseline characteristics of the disease regarding the infected Lithuanian population. Materials and Methods: We analyzed data from the Centre for Communicable Diseases and AIDS about all Lyme disease (A69.2) diagnosed patients over a three-year period (from 2014 to 2016) in Lithuania. Results: In 2014-2016, 7424 (crude incidence rate 85.4) cases with LB were diagnosed in Lithuania. Most of them (4633 (62.4%)) were identified in women. Older people were more likely to suffer from LB. Urban residents were 2.6 times more often affected that those living in villages. Tick bites were primarily observed in high season months, from May to September (90%), with the highest peak in July. There was a higher number of observed tick bites ( p = 0.003) in the urban residents. Erythema migrans occurred in 75.6% LB cases, while other symptoms did not exceed a quarter of all LB cases. There were 7353 (99.6%) cases where LB was confirmed via clinical symptoms and/or laboratory tests. Also, 1720 (23.2%) patients were tested for LB immunoglobulins. Conclusions: This study found a high incidence of Lyme disease in Lithuania. We elucidated the baseline characteristics regarding the infected Lithuanian population which may ease medical clinicians' work on new Lyme diagnoses., Competing Interests: The authors declare no conflict of interest.