bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluating an implementation model of evidence-based therapy for eating disorders in non-specialist regional mental health settings
Authors: Johnson Catherine , Cook Lesley , Cadman Kath , Andersen Thu , Williamson Paul , Wade Tracey D.
Published: November 2022

Background

Many people with eating disorders (EDs) either do not access treatment, access it well after symptoms first start, or drop out of treatment. This study evaluated ways to improve early access to evidence-based interventions for those with EDs in a non-specialist community setting.

Methods

In an Australian regional community, links were formed between general medical practitioners and treatment providers (psychologists, mental health social workers and dietitians), who received ongoing training, feedback and support. Service users had access to 20–40 subsidised treatment sessions. Data were collected from 143 patients over 18 months. Our outcomes are reported according to the RE-AIM implementation framework: Reach (we measured uptake and treatment completion); Effectiveness (impact on disordered eating cognitions, body mass index, remission, and moderators of effectiveness including illness duration, previous treatment, presence of comorbidities, presence of a normative level of disordered eating, presence of any ED behaviours, weighing in treatment, multidisciplinary case conferencing, number of dietetic sessions); Adoption (drop-out and predictors); Implementation (barriers encountered); Maintenance (subsequent activity designed to embed new practices).

Results

Treatment was completed by 71%; significant large decreases in eating disorder cognitions were achieved; remission was obtained by 37% (intent-to-treat). Treatment completion was predicted by lower baseline levels of disordered eating, uptake of ≥ 3 dietetic sessions, and ≥ 2 team case conferences. Greater improvement over time was predicted by regular case conferencing and in-session weighing.

Conclusions

Implementation of this model in a regional community setting produced completion rates and outcomes comparable to those found in specialist clinical trials of ED treatments. Service providers identified care coordination as the most important factor to connect users to services and help navigate barriers to ongoing treatment.

Trial Registration:This research was an invited evaluation of a project implemented by the Australian Department of Health. The project did not introduce any new clinical practice but sought to improve access to evidence-based multidisciplinary treatment for people with EDs by removing four known systemic barriers: securing an accurate diagnosis, availability of multidisciplinary treatment, cost of treatment, and intensity of treatment. As such, the project did not require trial registration. Notwithstanding, this evaluation obtained ethics approval (Bellberry Human Research Ethics Committee, Application No: 2018-09-728-FR-1).
Using Artificial Intelligence for Optimization of the Processes and Resource Utilization in Radiotherapy
Authors: Krishnamurthy Revathy , Mummudi Naveen , Goda Jayant Sastri , Chopra Supriya , Heijmen Ben , Swamidas Jamema
Published: November 2022

The radiotherapy (RT) process from planning to treatment delivery is a multistep, complex operation involving numerous levels of human-machine interaction and requiring high precision. These steps are labor-intensive and time-consuming and require meticulous coordination between professionals with diverse expertise. We reviewed and summarized the current status and prospects of artificial intelligence and machine learning relevant to the various steps in RT treatment planning and delivery workflow specifically in low- and middle-income countries (LMICs). We also searched the PubMed database using the search terms (Artificial Intelligence OR Machine Learning OR Deep Learning OR Automation OR knowledge-based planning AND Radiotherapy) AND (list of Low- and Middle-Income Countries as defined by the World Bank at the time of writing this review). The search yielded a total of 90 results, of which results with first authors from the LMICs were chosen. The reference lists of retrieved articles were also reviewed to search for more studies. No language restrictions were imposed. A total of 20 research items with unique study objectives conducted with the aim of enhancing RT processes were examined in detail. Artificial intelligence and machine learning can improve the overall efficiency of RT processes by reducing human intervention, aiding decision making, and efficiently executing lengthy, repetitive tasks. This improvement could permit the radiation oncologist to redistribute resources and focus on responsibilities such as patient counseling, education, and research, especially in resource-constrained LMICs.
Saudi Arabian students in postgraduate dental programs: Investigating factors associated with burnout
Authors: Asiri Amal
Published: November 2022

Background: Burnout related to emotional and physical study or work demands affects an individual’s performance and wellbeing. This study focused on Saudi Arabian dental residents studying in the United States and the United Kingdom who are faced with many challenges in the pursuit of a higher education degree. 

Methods: A survey including demographic and Maslach Burnout inventory (MBI) questions was distributed to assess this population’s level of burnout. The MBI has been widely used in the literature to assess three components of burnout: emotional exhaustion (EE), depersonalization (DEP), and (diminished) personal accomplishment (PA). Potential predictors of burnout level, tested for statistical significance, included: (1) country (US vs UK), (2) hours of work, (3) sponsorship status, (4) marital status (5) gender, and (6) prior work experience. 

Results: The number of participants from the UK was 29 and from the US was 64 (n=93). The total number of participants who completed the survey was 87. Using multiple regression analyses, those found to predict EE included hours of work, sponsorship status, and gender. Only gender was found to predict PA. None of the variables were predictive of DEP. Moreover, after controlling for the demographic variables, the country where studying did not help account for the level of burnout. 

Conclusion: In the literature, burnout was found to be prevalent among dental postgraduate students. This study suggests that Saudi Arabian dental residents experience high burnout due to emotional exhaustion when compared to other medical professionals. Moreover, Female residents are more likely to report experiencing burnout than their male counterparts. Limitations of the study, implications for practice and suggestions for further research are offered in the discussion.
Outward investment of Portuguese small and medium enterprises in the Central and Eastern European countries: motivations and challenges
Authors: Santos Eleonora , Moreira Jacinta
Published: November 2022

Background: This paper identifies the determinant factors of Portuguese investment in Poland, Hungary, and the Czech Republic. We assume that investment abroad is motivated by business opportunities, and the quality-price ratio of the workforce.

Methods: To this end, we used a qualitative methodology composed of 6 case studies, based on interviews and surveys with the managers of the Portuguese firms investing in those three economies.

Results: Despite the business opportunities, Portuguese investment directed towards these economies is negligible, due, in part, to the geographic and cultural distance. However, the economic and political stability, combined with market size and growth potential are undeniable attraction factors for Portuguese investors. Small and medium enterprises (SMEs), due to their flexible conditions that allow changes in the activity, and the strong trend towards outsourcing, to the detriment of the manufacturing industry, are the primary focus of international investment. This trend, although common to several sectors, has shown greater dynamism in the banking and financial sector.

Conclusions: The results suggest market-oriented investments aiming at growth and expansion.  The vast Polish market is the one that most attracted Portuguese investors. The hybrid feature of some strategies can align with the cautious attitude towards the investment translated into cooperation agreements with financial institutions for funding, the market learning process, and the training of the personnel. The anticipation of the installation over potential competitors, the experience in production and international markets, the price-quality ratio, the capacity of product adaptation and the design were considered important sources of competitive advantage that motivated the investment. The greatest difficulties during this process were language and the complexity of legislation.
Mathematics in professional education: fundamentals of the methodology of teaching engineering mathematics
Authors: Fedoseev Viktor , Rodionov Mihail , Shabanov Gennadiy , Pasin A. , Puchkov N.P.
Published: November 2022

The monograph discusses the issues of methods of mathematical education of a future engineer. The integration model of the educational process is taken as a basis. According to this model, the mathematics course should be integrated into the engineering education system. At the same time, both the content and the teaching methodology acquire specific features that allow us to consider the subject as a special engineering mathematics. The authors carry out a methodological analysis of the concept of "engineering mathematics", introduce the main integrating structures and on this basis develop learning technologies that meet the specifics of the engineering worldview and methodology of technical sciences.
It is addressed to researchers, specialists in the field of theory and methodology of vocational education, as well as teachers, graduate students and students of technical universities.
Destructive influence on minors: theory and practice of counteraction
Authors: Vorob'ev Sergey , Pestov Sergey , Bychkova Anna , Rep'ev Artem , Rep'eva Anna , Kuz'min Igor' , Kurilkin Konstantin , Shihanov Vladimir , Komarov Sergey , Semenova Svetlana
Published: November 2022

In the monograph, taking into account the scientific and legal analysis, the experience of practical and social activities, a systematic and comprehensive analysis of the problems associated with the destructive impact on the behavior of minors in the Russian Federation is carried out. The research was aimed at developing one of the first scientific definitions and signs of an information destructive psychological environment, which is the basis for committing crimes against life and health against minors, as well as scientific and practical proposals for improving state measures to counteract destructive effects in the youth environment.
It is addressed to students (cadets) studying in legal areas of training and specialties, graduate students (adjuncts), teaching staff, law enforcement officers.
Política exterior y de CTI en Colombia: la diplomacia científica como frontera
Authors: Pineros Ayala Rafael , Echeverría-King Luisa F. , Andrade-Sastoque Ernesto
Published: November 2022

La diplomacia científica (DC) se consolida como una propuesta ecléctica y de frontera entre la ciencia, la tecnología y la innovación (CTI), por un lado, y las Relaciones Internacionales y la política exterior, por el otro. ¿Cómo se articulan las políticas del sector ciencia y tecnología, y relaciones internacionales en Colombia en torno a la diplomacia científica? A partir de un análisis exploratorio y de naturaleza cualitativa-descriptiva de documentos de política pública en el período 2018-2022, se identifican las acciones de dc que Colombia ha implementado. Concluimos que se han dado pasos importantes y acelerados, pero persisten desafíos en materia de articulación y consolidación de la DC como una estrategia efectiva que facilite la consecución de objetivos tanto para el sector CTI, como de Relaciones Internacionales. Este artículo señala las bases conceptuales para comprender de manera situada la dc, algunas de sus críticas, y ubica la experiencia colombiana en perspectiva comparada con la de Brasil, México y Chile.
Preparations for enteral nutrition: an overview
Authors: Harris Gemma
Published: November 2022

Enteral nutrition is the delivery of specially formulated nutrients, called enteral preparations, either orally or via tubes to meet patients' nutritional needs and avoid malnutrition. These feeds can be life-changing or lifesaving for patients. There are three broad enteral feed types: polymeric; pre-digested and disease-specific; and immune-enhancing. This article outlines the importance and involvement of nurses in the enteral feed process, including the selection and administration of enteral feeds, as well as presenting a summary of enteral preparations, their safety and evidence-based efficacy. Nurses should work within a well-coordinated multidisciplinary team, use existing knowledge and resources and refer to national guidelines, as well as practising in line with their professional roles and responsibilities to select and administer enteral preparations and continually monitor patients receiving enteral nutrition. Research has identified that enteral nutrition intolerance is an issue, particularly among critically ill patients. However, polymeric formula has been found to improve daily energy intake and tolerance and it is more cost-effective compared with semi-elemental formula in brain-injured critically ill patients. Immune-enhancing enteral nutrition could improve the immune function in patients with severe neurological diseases. While these findings are promising and can support enteral nutrition, there is a need for more research into the efficacy of specific formulas for certain conditions and for continuing to address enteral nutrition intolerance.
A global strategic direction
Authors: Harrison Penny
Published: November 2022

Penny Harrison revisits the World Health Organization's global strategic direction for nursing and midwifery up to 2025
When physical activity and surgery were thought to be incompatible: the patient's perspective
Authors: Kelly Michael P
Published: November 2022

This paper describes the experience of surgery (panproctocolectomy and ileostomy) and a programme of physical exercise undertaken prior to and after operation. The events took place in 1983, before the contemporary focus on the idea that physical activity might be an adjunct to prehabilitation and rehabilitation in surgery. Some of the implications of the experience are considered. Although there is a growing evidence base about the benefits of physical activity and exercise pre- and postoperatively, this is a relatively recent phenomenon. Carefully supervised exercise may have significant psychological, social and physiological benefits. Exercise may be a very useful aide to pre-operative preparation and postoperative recovery. The paper describes an early example of physical activity in panproctocolectomy and ileostomy formation.
Bowel dysfunction after anterior resection for rectal cancer
Authors: Burch Jennie , Taylor Claire , Wilson Ana , Norton Christine
Published: November 2022

Following bowel surgery for rectal cancer, which involves removal of part of the rectum in a procedure termed an anterior resection, bowel problems are often reported by patients. Collectively, symptoms are referred to as low anterior resection syndrome (LARS). A recently published definition of this phenomenon describes a range of bowel symptoms and the consequences and impacts they have on a person's lifestyle and quality of life. It is useful to understand what changes occur after an anterior resection and why, to be able to give appropriate information to patients preparing for an anterior resection about what to expect after surgery and to assist with symptom management after surgery.
The power of knowledge and cooperation
Authors: Kroboth Gabriele
Published: November 2022

Gabriele Kroboth celebrates past and future congresses held by the European Council of Enterostomal Therapy
Human Motion Capture Data Retrieval and Segmentation Technology for Professional Sports Training
Authors: Chen Hui
Published: November 2022

Human motion capturing is frequently used in sports research. The focus of this research is to help the user choose an appropriate motion capture system for their experimental setup for sports activities that addresses the challenges of linear size and acceptable fits with non-linear futures. In this paper, the eigenvalue combination was used to represent different motion postures, so as to construct an index space related to the motion sequence; and according to this index space, fast and accurate motion retrieval was done; at the same time, a motion data segmentation method based on MVU nonlinear dimensionality reduction was proposed. MVU can overcome the shortcomings that the linear size is reduced and difficult to deal with nonlinear features, and can better fit human motion data, and achieve higher accuracy.
Optimal Machine Learning Based Intrusion Detection System in Wireless Sensor Networks for Surveillance Applications
Authors: Amaran Sibi , Mohan Ramalingam Madhan , Jebakumar Rethnaraj
Published: November 2022

Security is considered as a major design issue in wireless sensor network (WSN) and can be solved by the use of intrusion detection systems (IDS). In this view, this paper devises a new k-means clustering with optimal support vector (KM-OSVM) based IDS for WSN. The KM-OSVM model incorporates preprocessing, clustering, classification, and parameter tuning. Primarily, data preprocessing and K-means clustering technique are applied to group the data instances into a set of clusters. Besides, SVM based classification technique is employed to allot class labels, and the parameters in SVM are optimally adjusted by the use of crow search optimization (CSO) algorithm, shows the novelty of the work. The experimental outcome of the KM-OSVM model is examined using UNSW-NB15 and CICIDS2017 datasets. The obtained outcomes demonstrated that the KM-OSVM model ensured better performance with the maximum accuracy of 95.12% and 98.98% respectively. Therefore, the KM-OSVM model can be employed as an effective tool to achieve security in the resource constrained WSN.
Impact of Cytomegalovirus DNAemia Below the Lower Limit of Quantification: Multistate Model in Lung Transplant Recipients
Authors:   Department of Pharmacy, Barnes-Jewish Hospital, Saint Louis, MO, USA, January Spenser , Britt Daniel , Pottebaum April , Krekel Tamara , Hachem Ramsey , Vazquez-Guillamet Rodrigo
Published: November 2022

Background Cytomegalovirus (CMV) infections following transplantation lead to significant morbidity. Identification of CMV DNAemia continually improves and now viral loads below the lower limit of quantification (LLOQ) are detectable. However, the clinical course of positive CMV qPCR <LLOQ is unknown. Methods This retrospective study included lung transplant recipients experiencing their first episode of positive CMV qPCR <LLOQ with all qPCR assays conducted using COBAS® AmpliPrep/COBAS® TaqMan®. A Markov-like multistate model was utilized to describe the course of CMV DNAemia <LLOQ. A multivariable model was employed to identify predictors of transitioning to a positive, quantifiable state. Results 100 patients with a CMV <LLOQ result were included, encompassing 1,248 transitions in the six months following first episode of CMV qPCR <LLOQ. There was an 97.8% probability of remaining <LLOQ or undetectable and a 2.2% probability of transitioning to a positive, quantifiable qPCR state. The multivariable regression model identified treatment for rejection, increasing body mass index, valganciclovir therapy, and increasing CMV qPCR viral load as being predictive of transitioning from CMV qPCR undetectable or <LLOQ into a positive, quantifiable CMV qPCR state. Conclusions Most patients did not transition into a positive, quantifiable CMV qPCR state following a first episode of positive CMV qPCR <LLOQ in this cohort of lung transplant recipients.
Compressive and tensile strain effects on the ultrafast carrier dynamics and transport of gallium arsenide thin films on silicon and magnesium oxide substrates
Authors: Catindig Gerald Angelo R. , Bardolaza Hannah R. , Vasquez John Daniel E. , Jagus Rommel J. , Patrocenio Kerphy Liandro M. , Gonzales Karl Cedric P. , Prieto Elizabeth Ann P. , Somintac Armando S. , Estacio Elmer S. , De Los Reyes Alexander E. , Salvador Arnel A.
Published: November 2022

We investigate strain effects on the ultrafast carrier dynamics and transport of gallium arsenide films on silicon (GaAs/Si) and magnesium oxide (GaAs/MgO) substrates using temperature-dependent photoluminescence (PL) and terahertz time-domain spectroscopy (THz-TDS) from 11 K - 300 K. The PL shows that GaAs/Si and GaAs/MgO samples are under tensile and compressive strain at low temperature, respectively. The temperature-dependent THz emission from GaAs/Si does not show significant differences with the emission from bulk GaAs, while the THz emission from GaAs/MgO shows an order-of-magnitude decrease at low temperature. The THz emission from the samples exhibits an interplay between strain-induced effective mass changes and temperature-dependent electric field effects.
Ten simple rules for funding scientific open source software
Authors: Strasser Carly , Hertweck Kate , Greenberg Josh , Taraborelli Dario , Vu Elizabeth
Published: November 2022

Scientific research increasingly relies on open source software (OSS). Funding OSS development requires intentional focus on issues of scholarly credit, unique forms of labor, maintenance, governance, and inclusive community-building. Such issues cut across different scientific disciplines that make them of interest to a variety of funders and institutions but may present challenges in understanding generalized needs. Here we present 10 simple rules for investing in scientific OSS and the teams who build and maintain it.
The cure rate after different treatments for mucosal leishmaniasis in the Americas: A systematic review
Authors: Carvalho Janaína de Pina , Silva Sarah Nascimento , Freire Mariana Lourenço , Alves Líndicy Leidicy , Souza Carolina Senra Alves de , Cota Gláucia
Published: November 2022

Background

Mucosal or mucocutaneous leishmaniasis is the most severe form of tegumentary leishmaniasis due to its destructive character and potential damage to respiratory and digestive tracts. The current treatment recommendations are based on low or very low-quality evidence, and pentavalent antimonial derivatives remain strongly recommended. The aim of this review was to update the evidence and estimate the cure rate and safety profile of the therapeutic options available for mucosal leishmaniasis (ML) in the Americas.

Methodology

A systematic review was conducted in four different databases and by different reviewers, independently, to evaluate the therapeutic efficacy and toxicity associated with different treatments for ML. All original studies reporting cure rates in more than 10 patients from American regions were included, without restriction of design, language, or publication date. The risk of bias was assessed by two reviewers, using different tools according to the study design. The pooled cure rate based on the latest cure assessment reported in the original studies was calculated grouping all study arms addressing the same intervention. The protocol for this review was registered at the International Prospective Register of Systematic Reviews, PROSPERO: CRD42019130708.

Principal findings

Twenty-seven original studies from four databases fulfilled the selection criteria. A total of 1,666 patients with ML were treated predominantly with pentavalent antimonials in Brazil. Other interventions, such as pentamidine, miltefosine, imidazoles, aminosidine sulfate, deoxycholate and lipidic formulations of amphotericin B (liposomal, lipid complex, colloidal dispersion), in addition to combinations with pentoxifylline, allopurinol or sulfa were also considered. In general, at least one domain with a high risk of bias was identified in the included studies, suggesting low methodological quality. The pooled cure rate based on the latest cure assessment reported in the original studies was calculated grouping all study arms addressing the same intervention. It was confirmed that antimony is still the most used treatment for ML, with only moderate efficacy (possibly increased by combining with pentoxifylline). There is already evidence for the use of miltefosine for ML, with a cure rate similar to antimony, as observed in the only direct meta-analysis including 57 patients (OR: 1.2; 0.43–3.49, I2 = 0). It was possible to gather all descriptions available about adverse events reported during ML treatment, and the toxicity reflected the pattern informed in the manufacturers’ technical information.

Conclusions

This study provides an overview of the clinical experience in the Americas related to ML treatment and points out interventions and possible combinations that are eligible to be explored in future well-designed studies.
Summer decapod crustacean larval communities along the eastern Spanish Mediterranean coast
Authors: Carreton Marta , Rotllant Guiomar , Castejón Diego , Bahamón Nixon , Company Joan B.
Published: November 2022

Decapod crustaceans are a diverse group englobing several species of commercial and ecological interest. In the Mediterranean Sea, decapod crustacean fisheries are among the most profitable, although in many cases their early life stages are poorly known. In this study, we tackle the composition and diversity patterns of the decapod larval communities along the eastern Spanish Mediterranean coast. Zooplankton sampling was carried out in surface waters at 101 stations from July 20thto August 31st2016, over bottom depths between 90 and 1840 m. All shrimp larvae were identified to the lowest possible taxonomical level, and larvae from Anomura, Achelata and Brachyura were left at infraorder level. No larvae of Astacidea or Polychelida were found. The total zooplankton volume was estimated. A total of 20,022 decapod crustacean larvae were identified, focusing on shrimp taxa (suborder Dendrobranchiata and infraorder Caridea). Both zooplankton volume and decapod larval density values were higher in the northern part of the studied area, cut by deep submarine canyons. After assessing the diversity parameters of the decapod larval community, we present the summer mesoscale larval distribution of several species of commercial interest such as the caramote prawn (Penaeus kerathurus) or the deep-water rose shrimp (Parapenaeus longirostris). The northern submarine canyons are dominated by the presence of Penaeoidea, being the deep-sea shrimpAristeus antennatusthe dominant species in the community in this area, while the Sergestoidea are more abundant in the southern zone. This is the largest-scale study on decapod larvae mesoscale distribution in the Mediterranean Sea.
What factors contribute to the need for physical restraint in institutionalized residents in Taiwan?
Authors: Chien Ching-Fang , Huang Ling-Chun , Chang Yang-Pei , Lin Chung-Fen , Hsu Chih-Cheng , Yang Yuan-Han
Published: November 2022

Background

In Taiwan, physical restraint is commonly used in institutions to protect residents from falling or injury. However, physical restraint should be used cautiously to avoid side effects, such as worse cognition, mobility, depression, and even death.

Objectives

To identify the rate of physical restraint and the associated risk factors in institutionalized residents in Taiwan.

Methods

A community-based epidemiological survey was conducted from July 2019 to February 2020 across 266 residential institutions. Among the estimated 6,549 residents being surveyed, a total of 5,752 finished the study. The questionnaires were completed by residents, his/her family or social workers. The cognition tests were conducted by specialists and a multilevel analysis approach was used to identify cognition/disability/medical history/special nursing care/BPSD risk factors for physical restraints.

Results

Of the 5,752 included institutionalized residents, 30.2% (1,737) had been previously restrained. Older age, lower education level, lower cognitive function, higher dependence, residents with cerebrovascular disease, pulmonary disease, dementia, and intractable epilepsy, all contributed to a higher physical restraint rate, while orthopedic disease and spinal cord injury were associated with a lower physical restraint rate. Furthermore, residents with special nursing care had a higher restraint rate. Residents with most of the behavior and psychological symptoms were also associated with an increased restraint rate.

Conclusions

We studied the rate of physical restraint and associated risk factors in institutionalized residents in Taiwan. The benefits and risks of physical restraint should be evaluated before application, and adjusted according to different clinical situations.
Morphological awareness in developmental dyslexia: Playing with nonwords in a morphologically rich language
Authors: Melloni Chiara , Vender Maria
Published: November 2022

Although phonological deficits are unanimously recognized as one of the key manifestations of developmental dyslexia, a growing body of research has reported impairments in morphological abilities. Our study aimed at casting further light on this domain by investigating the morphological awareness skills of 21 children with dyslexia (mean age 9.10 years old) and 24 children with typical development (mean age 10.3 years old). All children were monolingual speakers of Italian, which is a morphologically rich language characterized by complex inflectional and derivational paradigms. We developed an experimental protocol inspired by Berko’s Wug test and composed of 11 tasks addressing inflectional and derivational processes. Participants were asked to manipulate nonwords of various lexical categories, modeled after the phonotactic structure of Italian, and manipulation involved both word formation and base retrieval. Conditions of the experiments were based on verb conjugation classes differing in frequency, productivity, regularity, and formal transparency. Results confirmed that morphological skills are impaired in dyslexic children, who performed significantly more poorly than their age-matched peers in all tasks. Children with dyslexia were especially challenged by tasks and conditions requiring advanced morphological awareness skills, such as the retrieval of infinitives of infrequent and irregular conjugation classes. The educational and clinical implications of these findings are discussed.
Feasibility of flow-related enhancement brain perfusion MRI
Authors: Glandorf Julian , Klimeš Filip , Voskrebenzev Andreas , Gutberlet Marcel , Kern Agilo Luitger , Kornemann Norman , Mahmoudi Nima , Wattjes Mike P. , Wacker Frank , Vogel-Claussen Jens
Published: November 2022

Purpose

Brain perfusion imaging is of enormous importance for various neurological diseases. Fast gradient-echo sequences offering flow-related enhancement (FREE) could present a basis to generate perfusion-weighted maps. In this study, we obtained perfusion-weighted maps without contrast media by a previously described postprocessing algorithm from the field of functional lung MRI. At first, the perfusion signal was analyzed in fast low-angle shot (FLASH) and balanced steady-state free precession (bSSFP) sequences. Secondly, perfusion maps were compared to pseudo-continuous arterial spin labeling (pCASL) MRI in a healthy cohort. Thirdly, the feasibility of the new technique was demonstrated in a small selected group of patients with metastases and acute stroke.

Methods

One participant was examined with bSSFP and FLASH sequences at 1.5T and 3T, different flip angles and slice thicknesses. Twenty-five volunteers had bSSFP imaging and pCASL MRI. Three patients with cerebral metastases and one with acute ischemic stroke had bSSFP imaging and were compared to T1 post-contrast images and CT perfusion. Frequency analyses, SNR and perfusion contrast were compared at different flip angles and slice thicknesses. Regional correlations and Sorensen-Dice overlap were calculated in the healthy cohort. Dice overlap of the pathologies in the patient cohort were calculated.

Results

The bSSFP sequence presented detectable perfusion signal within brain vessel and parenchyma together with superior SNR compared to FLASH. Perfusion contrast and its corticomedullary differentiation increased with flip angle. Mean regional correlation was 0.36 and highly significant between FREE maps and pCASL and grey and white matter Dice match were 72% and 60% in the healthy cohort. Pathologies presented good overlap between FREE perfusion-weighted and T1 post-contrast images.

Conclusion

The feasibility of FREE brain perfusion imaging has been shown in a healthy cohort and selected patient cases with brain metastases and acute stroke. The study demonstrates a new approach for non-contrast brain perfusion imaging.
Five-year survival rate and prognostic factors in women with breast cancer treated at a reference hospital in the Brazilian Amazon
Authors: Cruz Soany de Jesus Valente , Ribeiro Andressa Karoline Pinto de Lima , Pinheiro Maria da Conceição Nascimento , Carneiro Vânia Cristina Campelo Barroso , Neves Laura Maria Tomazi , Carneiro Saul Rassy
Published: November 2022

Breast cancer is the most prevalent malignant neoplasm and the leading cause cancer of death among women globally. In Brazil, survival rates vary according to the region and few studies have been conducted on breast cancer survival in less developed areas, such as the Amazon region. The aim of this study was to analyze the five-year survival rate and prognostic factors in women treated for breast cancer in the city of Belém in northern Brazil. A retrospective hospital-based cohort study was conducted (2007–2013). Sociodemographic, clinical/tumor, and treatment variables were obtained from the records at the Ophir Loyola Hospital. Survival analysis involved the Kaplan-Meier statistical method and Cox regression analysis was performed. The significance level was 5% (p <0.05). A total of 1,430 cases were analyzed. Mean survival time was 51.71 (± 17.22) months, with an estimated overall survival of 79.4%. In the multivariate analysis, referral from the public health care system, advanced clinical stage, lymph node involvement and metastasis were associated with worse prognosis and lower survival rate. Radiotherapy and hormone therapy were associated with increased survival. These findings can contribute to the development of regional strategies for early detection of breast cancer, reducing the incidence and mortality rates and increasing survival time.
Psychological distress during the COVID-19 pandemic in Canada
Authors: Pongou Roland , Ahinkorah Bright Opoku , Maltais Stéphanie , Mabeu Marie Christelle , Agarwal Arunika , Yaya Sanni
Published: November 2022

Background

During major pandemics such as COVID-19, the fear of being infected, uncertain prognoses, and the imposition of restrictions may result in greater odds of emotional and psychological distress. Hence, the present study examines the predictors of psychological distress during the COVID-19 pandemic in Canada, and how they differ by gender.

Methods

Data of 2,756 adults aged 18 years and above from a cross-sectional online survey conducted between July and October 2020 was used for this study. A multivariable logistic regression analysis was carried out. The results were presented as adjusted odds ratio (aOR) with their respective confidence interval (CI).

Results

Lower odds of psychological distress were found among males compared to females and among individuals aged 45–64 or 65–84 years compared to those aged 18–44. The odds of psychological distress decreased with a rise in income, with individuals whose annual income was greater than or equal to $100,000 being less likely to experience psychological distress compared to those whose income was less than $20,000. The odds of psychological distress were higher among residents of Ontario compared to residents of Quebec. Similarly, the odds of psychological distress were higher among individuals who reported experiencing COVID-19 symptoms compared to those who did not report any COVID-19 symptoms. The disaggregated results by gender showed that age, province, and self-reported COVID-19 symptoms had significant associations with psychological distress in both males and females, but these effects were more pronounced among females compared to males. In addition, income was negatively associated with psychological distress for both males and females, with this effect being stronger among males.

Conclusion

Five exposure variables (gender, age, province, experiencing COVID-19 symptoms, and total annual income in 2019) significantly predicted the likelihood of reporting psychological distress during the COVID-19 pandemic in Canada. Clearly, there is an imminent need to provide mental health support services to vulnerable groups. Additionally, interventions and policies aimed at combating psychological distress during pandemics such as COVID-19 should be gender specific.
Selective immunoglobulin A deficiency in children with diabetes mellitus: Data from a medical center in Ukraine
Authors: Boyarchuk Oksana , Dobrovolska Lesya , Svystunovych Halyna
Published: November 2022

The aim of this study was to estimate the prevalence of selective immunoglobulin A deficiency (SIgAD) among children with type 1 diabetes mellitus (DM) in Ternopil region (western Ukraine). Serum IgA levels were measured in 240 patients aged 4–17 years with DM and in 324 children of a control group of the same age. Normal IgA level was observed in 210 (87.5%) patients, increased—in 18 (7.5%), decreased (lower than the age reference value)—in 12 (5.0%) patients with DM. The mean IgA level in patients with DM was 152.11±73.78 mg/dL. SIgAD criteria were met by 7 (2.9%) children with DM, but none of the children of the control group met the SIgAD criteria. Female / male ratio among the patients with SIgAD was 1/6. There was no history of recurrent infections in these patients. No correlation between IgA and HbA1c levels was detected. Autoimmune thyroiditis was observed in 42.9% of patients with DM and SIgAD, and in 3.5% of patients with DM and normal or increased IgA levels. Thus, the prevalence of selective IgA deficiency in children with DM in Ternopil region (Ukraine) is 2.9% (1:34). This study shows that patients with low IgA levels need further re-examination of IgA levels to exclude SIgAD. Children with SIgAD and DM should be monitored for autoimmune manifestations that may affect the course and consequences of the disease.
Factors associated with infants’ sunlight exposure among mothers attending the EPI unit of Wolkite University Specialized Hospital
Authors: Mengistu Girma Teferi , Terefe Ayana Benti , Gudeta Tolesa Gemeda , Mengistu Bizunesh Kefale
Published: November 2022

Background

Infant sunlight exposure in their early infancy is essential for the cutaneous synthesis of vitamin D. Vitamin D deficiency is highly prevalent due to inadequate exposure to sunlight. In Ethiopia, one in thirteen children had rickets, which could be prevented by sunlight exposure or supplementation. This study aimed to identify the practice of infants’ sunlight exposure and associated factors among mothers attending the Expanded program immunization unit of Wolkite University Specialized Hospital.

Method

This study employed an institutional-based cross-sectional study design to collect data. Data were collected from 220 mothers using an interviewer-administered questionnaire. The study employed a systematic random sampling technique to reach the study participants. The collected data were entered into a computer using the software Epidata 3.1 version and exported to SPSS version 23 for statistical analysis. Descriptive and inferential analysis was conducted. Logistic regression analysis was done, and a statistical association was declared at a p-value < 5% and a 95% confidence interval(CI). Then the results were presented using a frequency table, figures, and description.

Result

A total of 220 infant-coupled mothers who visited the Expanded program immunization unit were included in the study. According to the current study, 67.3% of mothers had good practice with infants’ sunlight exposure. Mothers’ practice of infant sunlight exposure was affected by age of mothers 30–34 years, [AOR = 3.10, 95%CI (1.13, 8.51)], and age ≥35 years, [AOR = 4.49, 95%CI (1.20, 16.86)], and living in urban, [AOR = 1.94, 95%CI (1.053, 3.57)].

Conclusion

The current study showed that two-thirds (67.3%) of mothers had good practice of sunlight exposure to their infants. Factors that affect mothers’ practice of infants’ sunlight exposure are age and place of residence. Health professionals should provide health education for mothers on the benefits of infants’ sunlight exposure.
Rates of cardiovascular events among patients with moderate-to-severe atopic dermatitis in an integrated health care system: A retrospective cohort study
Authors: Hedderson Monique M. , Asgari Maryam M. , Xu Fei , Quesenberry Charles P. , Sridhar Sneha , Geier Jamie , Lemeshow Adina R.
Published: November 2022

Patients with versus without atopic dermatitis may have a greater risk of cardiovascular events, and the risk increases with severity of atopic dermatitis. The incidence of cardiovascular events in the population of patients with moderate-to-severe atopic dermatitis is largely unknown. This retrospective study evaluates incidence rates of cardiovascular events in patients aged ≥12 years with moderate-to-severe atopic dermatitis in a cohort of Kaiser Permanente Northern California health care system members without recognized risk factors for adverse events. Patients with moderate-to-severe atopic dermatitis, as defined by dermatologist-rendered code and prescription history between 2007 and 2018, were included. Major adverse cardiovascular events, venous thrombotic events, deep vein thrombosis, and pulmonary embolisms were identified via International Classification of Diseases codes. Stratification variables included age, sex, race, smoking history, and diabetes. Incidence rates per 1000 person-years were calculated by the number of patients with an incident event divided by the total person-years of observation. Among 8197 patients with moderate-to-severe atopic dermatitis, incidence rates per 1000 person-years (95% confidence interval) for major adverse cardiovascular events, venous thrombotic events, deep vein thrombosis, and pulmonary embolism were: 2.6 (2.1–3.2), 2.0 (1.5–2.5), 1.6 (1.2–2.1), and 0.7 (0.5–1.0), respectively. Incidence rates for all events were higher for older versus younger patients, patients with versus without diabetes, former smokers versus patients who had never smoked, and men versus women, except for pulmonary embolisms, which were higher in women. This study estimated the incidence of cardiovascular events in patients with moderate-to-severe atopic dermatitis and provides valuable information for clinicians.
Census of Twitter users: Scraping and describing the national network of South Korea
Authors: Guan Lu , Liu Xiao Fan , Sun Wujiu , Liang Hai , Zhu Jonathan J. H.
Published: November 2022

Population-level national networks on social media are precious and essential for network science and behavioural science. This study collected a population-level Twitter network, based on both language and geolocation tags. We proposed a set of validation approaches to evaluate the validity of our datasets. Finally, we re-examined classical network and communication propositions (e.g., 80/20 rule, six degrees of separation) on the national network. Our dataset and strategy would flourish the data collection pool of population-level social networks and further develop the research of network analysis in digital media environment.
Age, race, insurance type, and digital divide index are associated with video visit completion for patients seen for oncologic care in a large hospital system during the COVID-19 pandemic
Authors: Cousins Matthew M. , Van Til Monica , Steppe Emma , Ng Sophia , Ellimoottil Chandy , Sun Yilun , Schipper Matthew , Evans Joseph R.
Published: November 2022

Introduction

The COVID-19 pandemic drove rapid adoption of telehealth across oncologic specialties. This revealed barriers to telehealth access and telehealth-related disparities. We explored disparities in telehealth access in patients with cancer accessing oncologic care.

Materials/Methods

Data for all unique patient visits at a large academic medical center were acquired pre- and intra-pandemic (7/1/2019-12/31/2020), including visit type (in-person, video, audio only), age, race, ethnicity, rural/urban (per zip code by Federal Office of Rural Health Policy), distance from medical facility, insurance, and Digital Divide Index (DDI; incorporates technology/internet access, age, disability, and educational attainment metrics by geographic area). Pandemic phases were identified based on visit dynamics. Multivariable logistic regression models were used to examine associations of these variables with successful video visit completion.

Results

Data were available for 2,398,633 visits for 516,428 patients across all specialties. Among these, there were 253,880 visits from 62,172 patients seen in any oncology clinic. Dramatic increases in telehealth usage were seen during the pandemic (after 3/16/2020). In multivariable analyses, patient age [OR: 0.964, (95% CI 0.961, 0.966) P<0.0001], rural zip code [OR: 0.814 (95% CI 0.733, 0.904) P = 0.0001], Medicaid enrollment [OR: 0.464 (95% CI 0.410, 0.525) P<0.0001], Medicare enrollment [OR: 0.822 (95% CI 0.761, 0.888) P = 0.0053], higher DDI [OR: 0.903 (95% CI 0.877, 0.930) P<0.0001], distance from the facility [OR: 1.028 (95% CI 1.021, 1.035) P<0.0001], black race [OR: 0.663 (95% CI 0.584, 0.753) P<0.0001], and Asian race [OR: 1.229 (95% CI 1.022, 1.479) P<0.0001] were associated with video visit completion early in the pandemic. Factors related to video visit completion later in the pandemic and within sub-specialties of oncology were also explored.

Conclusions

Patients from older age groups, those with minority backgrounds, and individuals from areas with less access to technology (high DDI) as well as those with Medicare or Medicaid insurance were less likely to use video visits. With greater experience through the pandemic, disparities were not mitigated. Further efforts are required to optimize telehealth to benefit all patients and avoid increasing disparities in care delivery.