bluuebunny/crossref_metadata_2025 huggingface dataset:
Being Pro-Active in Meeting the Needs of Suicide-Bereaved Survivors: results from an audit in Montreal
Authors: LIGIER Fabienne , Rassy Jessica , Fortin Gabrielle , Haaster Ian van , Doyon Claude , Brouillard Charlie , Séguin Monique , Lesage Alain
Published: August 2020

Background: Suicide is a major public health concern. In 2017, the suicide rate in Canada was 11 per 100 000 inhabitants. According to the literature, 1 in 5 people have experienced a death by suicide during their lifetime. The aim of this study was to describe the met and unmet needs of suicide-bereaved survivors and to formulate postvention recommendations. Methods: Further to an exploratory mixed-method audit of 39 suicides that occurred in Montreal (Canada) in 2016, suicide-bereaved survivors (n = 29) participated in semi-structured interviews and completed instruments to discuss and assess potential pathological grief, depression (PHQ-9), and anxiety (GAD-7), as well as health and social services utilization. A panel then reviewed each case and formulated recommendations. The mean age of participants was 57.7 years and 23 were women.Results: Although help was offered initially, in most cases by a health professional or service provider (16/29), 22 survivors would have liked to be contacted by telephone in the first two months post suicide. Four categories of individual unmet needs (medical/pharmacological, information, support, and outreach) and one collective unmet need (suicide pre/postvention training and delivery) emerged. Conclusions: Although provincial services have been developed and offered to suicide-bereaved survivors in the past decade, many dwindled over time and none has been applied systematically. Recommendations for different stakeholders (Ministry of Health and Social Services, coroners, NGOs, and representatives of suicide-bereaved survivors) outlined in this study could be an interesting first step to help develop a provincial suicide pre/postvention strategy.Trial registration: The research protocol was approved by the Scientific Committee of the Montreal Mental Health Institute (November 6, 2018) and the publication of results was approved by its Ethics Research Committee (February 1, 2019), project number 2019-1647.
A new 3D printing porous trabecular titanium metal acetabular cup for primary total hip arthroplasty: a minimum 2-year follow-up of 92 consecutive patients
Authors: Geng Xiao , Li Yang , Li Feng , Wang Xinguang , Zhang Ke , Liu Zhongjun , Tian Hua
Published: August 2020

Background Aseptic cup loosening is still one of the main reasons leading to acetabular cup failures. 3D printing porous trabecular titanium metal acetabular cup may provide good initial stability and secondary fixation because of its highly interconnected, porous structure. Few large sample studies have reported the clinical outcomes of Electron Beam Melting (EBM) porous titanium acetabular cup in Chinese population.Methods We retrospectively collected and analyzed the clinical data of a total of 92 consecutive patients between January 2013 and November 2017, with an average follow-up of 48.2±3.6 months. Clinical outcomes included Harris Hip Score (HHS), the Western Ontario and McMaster Universities (WOMAC) Osteoarthritis Index, satisfaction rate and cup survival rate were evaluated. Radiographic assessments were conducted to evaluate osteointegration. Results HHS scores improved significantly while the WOMAC score decreased significantly at the latest follow-up (p<0.001). The satisfaction rate (prevalence of satisfied or very satisfied) was 91.3%. No acetabular cup failures occurred. Radiolucent lines appeared in 15 cases (18 hips), and disappeared in six months. No cup loosening signs found until the last follow up. The overall survival rate of implantation is 99.1% (cup survival rate 100%).Conclusion The new EBM-produced 3D ACT™ cup demonstrated us its favorable short to mid-term clinical outcomes in Chinese THA patients. It can provide high acetabular cup survival rate, great clinical improvements and excellent biological fixation. Further investigations are needed to confirm its long-term outcomes.
Association between adipokines and thyroid carcinoma: a meta-analysis of case-control studies
Authors: Zhao Junyu , Wen Jing , Wang Shengnan , Yao Jinming , Liao Lin , Dong Jianjun
Published: August 2020

Background: The incidence of thyroid carcinoma is increasing all over the world. Some studies have suggested that the change of adipokines expression can induce thyroid carcinoma. However, other studies have come to the opposite conclusion. Therefore, we studied the relationship between adipokines and thyroid carcinoma. Methods: Databases—PubMed, Cochrane Library, SinoMed, CNKI, Wanfang, and clinical trial registries were searched. A meta-analysis was then performed through a fixed or random-effects model to calculate I values for heterogeneity analysis. Results: Twenty-nine articles were finally included for analysis. The level of serum tumor necrosis factor-alpha (TNF-α) [standardized mean difference (SMD) =1.31, 95% confidence interval (95% CI): 0.35 to 2.28, I2 = 98%, P = 0.008] and the ratio of TNF-α immunoreactivity in tissues [odds ratios (OR) =6.36, 95% CI: 1.92 to 21.05, I2 = 66%，P = 0.002] in thyroid carcinoma are significantly higher than those in control. The serum interleukin-6 (IL-6) in patients with thyroid carcinoma is higher than that in control (SMD = 1.04, 95% CI: 0.40 to 1.67, I2 = 96%, P = 0.001). There is no significant difference of the ratio of IL-6 immunoreactivity in tissues between carcinoma and control (OR = 1.23, 95% CI: 0.62 to 2.43, I2 = 86%, P = 0.55). The ratio of leptin immunoreactivity in tissues is significantly associated with the risk of thyroid carcinoma (OR = 12.21, 95% CI: 3.36 to 44.40, I2 = 85%, P < 0.00001). However, after analyzing the expression level of serum adiponectin in three studies, no significant difference is found between thyroid carcinoma and the control (P = 0.81).Conclusions: Adipokines ( TNF-α, IL-6 and leptin ) show a strong relationship between elevated concentrations (in serum and/or tissue) and thyroid carcinoma. However, the association between adiponectin and thyroid carcinoma needs further research.
Efficacy and Safety of Electro-Acupuncture (EA) on Insomnia in Patients with Lung Cancer: Study Protocol of a Randomized Controlled Trial
Authors: Yue Hongyu , Zhou Shuang , Wu Huangan , Yin Xuan , Li Shanshan , Liang Tingting , Li Yan , Fang Zhihong , Zhang Xufeng , Wang Linglin , Han Min , Chen Xiaolei , Zhang Ming , Zhang Wei , Zhang Zhangjin , Xu Shifen
Published: August 2020

Background: Cancer-related insomnia (CRI) is one of the most prevalent complaints among cancer survivors and severely impairs patients’ quality of life. As a popular non-pharmacological alternative treatment, acupuncture provides a good clinical curative effect on insomnia. The aim of this trial is to evaluate efficacy and safety of electro-acupuncture on insomnia in patients with lung cancer. Method: This is a protocol for a multicenter randomized single-blinded sham-controlled trial. We will randomly assign 252 eligible patients with lung cancer-related insomnia into two groups at a ratio of 1:1, the treatment group (EA) and the control group (sham EA). All treatment will be given 3 times per week for 8 weeks, and a 12-week follow-up will be conducted. The primary outcome will be measured by the Pittsburgh Sleep Quality Index (PSQI). The secondary outcomes will include sleep parameters recorded from the actigraphy, scores from Quality of Life Questionnaire Core-30 (QLQ-C30), and Patient Health Questionnaire-9 (PHQ-9). All adverse effects during the trial will be assessed by the Treatment Emergent Symptom Scale (TESS). All analyses will be based on ITT principle and performed with the statistical software SPSS (version 24.0) by t test, rank-sum test, chi-square and so on. A two-sided significance level will be set at 5%.Discussion: This large-sample trial protocol will evaluate the efficacy of electro-acupuncture on insomnia in patients with lung cancer. This protocol, if proven to be effective, will contribute to filling the gap in treatment options in the CRI field and provide a promising intervention for insomnia in lung cancer survivors. Trial registration: ChiCTR, ChiCTR1900026395, Registered 8 October 2019, http://www.chictr.org.cn/showproj.aspx?proj=44068
A tool to evaluate proportionality and necessity in the use of restrictive practices in forensic mental health settings: The DRILL tool (Dundrum Restriction, Intrusion and Liberty Ladders).
Authors: Kennedy Harry G , Mullaney Ronan , McKenna Paul , Thompson John , Timmons David , Gill Pauline , O'Sullivan Owen P , Braham Paul , Duffy Dearbhla , Kearns Anthony , Linehan Sally , Mohan Damian , Monks Stephen , McLoughlin Lisa , O'Connell Paul , O'Neill Conor , Wright Brenda , O'Reilly Ken , Davoren Mary
Published: August 2020

Background: Prevention of violence due to severe mental disorders in psychiatric hospitals may require intrusive, restrictive and coercive therapeutic practices. Research concerning appropriate use of such interventions is limited by lack of a system for description and measurement. We set out to devise and validate a tool for clinicians and secure hospitals to assess necessity and proportionality between imminent violence and restrictive practices including de-escalation, seclusion, restraint, forced medication and others.Methods: In this retrospective observational cohort study, 28 patients on a 12 bed male admissions unit in a secure psychiatric hospital were assessed daily for six months. Data on adverse incidents were collected from case notes, incident registers and legal registers. Using the functional assessment sequence of antecedents, behaviours and consequences (A, B, C) we devised and applied a multivariate framework of structured professional assessment tools, common adverse incidents and preventive clinical interventions to develop a tool to analyse clinical practice. We validated by testing assumptions regarding the use of restrictive and intrusive practices in the prevention of violence in hospital. We aimed to provide a system for measuring contextual and individual factors contributing to adverse events and to assess whether the measured seriousness of threating and violent behaviours is proportionate to the degree of restrictive interventions used. General Estimating Equations tested preliminary models of contexts, decisions and pathways to interventions. Results: A system for measuring adverse behaviours and restrictive, intrusive interventions for prevention had good internal consistency. Interventions were proportionate to seriousness of harmful behaviours. A ‘Pareto’ group of patients (5/28) were responsible for the majority (80%) of adverse events, outcomes and interventions. The seriousness of the precipitating events correlated with the degree of restrictions utilised to safely manage or treat such behaviours.Conclusion: Observational scales can be used for restrictive, intrusive or coercive practices in psychiatry even though these involve interrelated complex sequences of interactions. The DRILL tool has been validated to assess the necessity and demonstrate proportionality of restrictive practices. This tool will be of benefit to services when reviewing practices internally, for mandatory external reviewing bodies and for future clinical research paradigms.
Lifetime co-occurring psychiatric disorders in newly diagnosed adults with Attention Deficit Hyperactivity Disorder (ADHD) or/and Autism Spectrum Disorder (ASD)
Authors: Pehlivanidis Artemios , Papanikolaou Katerina , Mantas Vasilios , Kalantzi Eva , Korobili Kalliopi , Xenaki Lida- Alkistis , Vassiliou Georgia , Papageorgiou Charalambos
Published: August 2020

Background: Co-occurring psychiatric disorders in adults with Attention Deficit Hyperactivity Disorder (ADHD) and/or Autism Spectrum Disorder (ASD) contribute to the burden of the healthcare and possibly to the delay of diagnosis. Aim of the study was to clinically assess the prevalence and compare lifetime co-occurring psychopathology in a sample of newly diagnosed ADHD and/or ASD adults and discuss the diagnostic challenges they pose.Methods: The lifetime prevalence rates of ten of the most frequently co-occurring psychiatric diagnoses was registered in 336 adults of normal intelligence who underwent a thorough clinical evaluation for the diagnosis of ADHD and/or ASD for the first time in their lives. Four study groups were formed: the ADHD (n=151), the ASD (n=58), the ADHD+ASD (n=28) and the nonADHD/nonASD (NN) (n=88) group. Results: At least one co-occurring psychopathology was found in 72.8% of the ADHD group, in 50% of the ASD group, in 72.4% of the ADHD+ASD group and in 76.1% of the NN group (p=0.004). In all groups the most frequent psychiatric disorder was depressive disorder. The only significant difference regarding the patterns of psychiatric co-occurrence between the ADHD and the nonADHD groups (ASD and NN groups) was found for SUD (p=0.001). Also, the proportion of subjects with Bipolar Disorder was significantly greater in the NN group as compared to those with ASD (p=0.025). Conclusions: Our results support the high prevalence of co-occurring psychiatric disorders in adults with ADHD and/or ASD with the ASD group presenting the lowest rate. The most marked difference between the ADHD and the nonADHD groups was found for SUD. Moreover, our findings highlight the need for a thorough clinical assessment of all referred patients both in the presence and absence of ADHD and/or ASD.
Knowledge and Attitudes about Transcranial Magnetic Stimulation Among Psychiatrists in China
Authors: Deng Jiahui , Gong Yimiao , Lin Xiao , Bao Yanping , Sun Hongqiang , Lu Lin
Published: August 2020

Background: Repetitive transcranial magnetic stimulation (rTMS) is a noninvasive form of brain stimulation. It has been used in many mental health institutions to treat mental disorders worldwide. However, comprehensive knowledge about rTMS is not yet widespread among psychiatrists. The present study assessed psychiatrists’ knowledge and attitudes about rTMS in China and investigated related factors.Methods: A quantitative observational cross-sectional study was conducted using an online survey. The sample consisted of 522 psychiatrists. Multinomial logistic regression and multiple linear regression analyses were used to explore factors that contributed to psychiatrists’ knowledge about rTMS. We also ascertained psychiatrists’ attitudes about rTMS and provide recommendations for the more widespread use of rTMS.Results: The majority of respondents (86.4%) reported having access to rTMS at their institution. A total of 379 psychiatrists (72.6%) knew that rTMS was approved by the United States Food and Drug Administration for treatment-resistant depression. Univariate logistic regression indicated that psychiatrists who were older, had a senior professional title, worked more years, had an onsite clinical rTMS program in their hospital, and received formal training in theory and application (all p < 0.05) were more likely to know that rTMS was approved by the Food and Drug Administration for the treatment of depression. The percentages of respondents who knew most or all indications, the mechanism of action, parameter settings, adverse reactions were 51.9%, 40.2%, 27.4%, and 41.4%. Linear regression showed that formal training in rTMS theory and practice were associated with higher knowledge scores (all p < 0.05). Most of the subjects had negative attitudes about using rTMS to treat mental disorders. When asked about their attitudes about continuing rTMS education, nearly all of the respondents indicated that they were willing to pursue continuing training in rTMS in the future. Conclusions: Many psychiatrists had an insufficient level of knowledge about rTMS and negative attitudes about rTMS. Psychiatrists who had formal rTMS training experience had higher levels of rTMS knowledge. rTMS training and relevant policy making should be strengthened.
Multisensory cueing facilitates naming in aphasia
Authors: Grechuta Klaudia , Ballester Belén Rubio , Munné Rosa Espín , Bernal Teresa Usabiaga , Hervás Begoña Molina , Mohr Bettina , Pulvermüller Friedemann , Segundo Rosa San , Verschure Paul FMJ
Published: August 2020

Background: Impaired naming is a ubiquitous symptom in all types of aphasia, which often adversely impacts independence, quality of life, and recovery of affected individuals. Previous research has demonstrated that naming can be facilitated by phonological and semantic cueing strategies that are largely incorporated into the treatment of anomic disturbances. Beneficial effects of cueing, whereby naming becomes faster and more accurate, are often attributed to the priming mechanisms occurring within the distributed language network. Objective: We proposed and explored two novel cueing techniques: (1) Silent Visuomotor Cues (SVC), which provided articulatory information of target words presented in the form of silent videos, and (2) Semantic Auditory Cues (SAC), which consisted of acoustic information semantically relevant to target words (ringing for “telephone”). Grounded in neurophysiological evidence, we hypothesized that both SVC and SAC might aid communicative effectiveness possibly by triggering activity in perceptual and semantic language regions, respectively.Methods: Ten participants with chronic non-fluent aphasia were recruited for a longitudinal clinical intervention. Participants were split into dyads (i.e., five pairs of two participants) and required to engage in a turn-based peer-to-peer language game using the Rehabilitation Gaming System for aphasia (RGSa). The objective of the RGSa sessions was to practice communicative acts, such as making a request. We administered SVCs and SACs in a pseudorandomized manner at the moment when the active player selected the object to be requested from the interlocutor. For the analysis, we compared the times from selection to the reception of the desired object between cued and non-cued trials.Results: Naming accuracy, as measured by a standard clinical scale, significantly improved for all stimuli at each evaluation point, including the follow-up. Moreover, the results yielded beneficial effects of both SVC and SAC cues on word naming, especially at the early intervention sessions when the exposure to the target lexicon was infrequent. Conclusions. This study supports the efficacy of the proposed cueing strategies which could be integrated into the clinic or mobile technology to aid naming even at the chronic stages of aphasia. These findings are consistent with sensorimotor accounts of language processing, suggesting a coupling between language, motor, and semantic brain regions. Trial registration: NCT02928822. Registered 30 May 2016
Changes in treatment strategy over time for arteriovenous malformation in a Japanese high-volume center
Authors: Komatsu Katsuya , Takagi Yasushi , Ishii Akira , Kikuchi Takayuki , Yamao Yukihiro , Yoshida Kazumichi , Miyamoto Susumu
Published: August 2020

Background
Despite rapid developments in devices used to treat arteriovenous malformation (AVM), a randomised trial of Unruptured Brain Arteriovenous malformations published in 2014, recommended conservative treatment for nonhemorrhagic AVM.
Objective
The purpose of the current retrospective study was to confirm how AVM treatment in Japan has changed and to assess the safety of treatment for hemorrhagic and nonhemorrhagic AVMs.
Methods
We enrolled 242 consecutive patients with AVM; each patient's treatment was selected and performed at our hospital. The type of onset, Spetzler–Martin (S–M) grade, age, sex, selected treatment, mortality, and morbidity were compared between the first and second periods of our study.
Results
In patients with grade I–III AVM, the selected treatment changed between the first and second periods; however, in grade IV and V patients, the selected treatment did not change. Overall, interventions by microsurgery alone decreased (p < 0.001), the proportion of total treatments including microsurgery decreased (p = 0.005), interventions using stereotactic radiosurgery (SRS) alone increased (p = 0.009), and interventions including SRS increased (p = 0.002). Morbidity associated with intervention was 0.92% in the first period and 0% in the second period, and mortality was 0.92% in the first period and 1.67% in the second.
Conclusions
With the development of new devices, the selected treatment was changed in patients with S–M grade I–III AVM, but was not changed in patients with grade VI and V. The complication rate was low and did not change throughout the periods. These findings suggest that the safety of treatment depends on a full understanding of device development and the selection of proper treatment, not on hemorrhagic onset. Further treatment innovations are expected to change the treatment for grade IV and V AVMs.
The Endogenous Capacity to Produce Proinflammatory Mediators by the Ex Vivo Perfused Human Lung 
Authors: Leligdowicz Aleksandra , Ross James T. , Nesseler Nicolas , Matthay Michael A.
Published: August 2020

Background: The ex vivo human perfused lung model has enabled optimizing donor lungs for transplantation and delineating mechanisms of lung injury. Perfusate and airspace biomarkers are a proxy of the lung response to experimental conditions. However, there is a lack of studies evaluating biomarker kinetics during perfusion and after exposure to stimuli. In this study we analyzed the ex vivo perfused lung response to three key perturbations: exposure to the perfusion circuit, exogenous fresh whole blood, and bacteria.Results: 99 lungs rejected for transplantation underwent ex vivo perfusion. One hour after reaching experimental conditions, fresh whole blood was added to the perfusate (n=55). Two hours after reaching target temperature, Streptococcus pneumoniae was added to the perfusate (n=42) or to the airspaces (n=17). Perfusate and airspace samples were collected at baseline (once lungs were equilibrated for 1 hour, but before blood or bacteria were added) and 4 hours later. Interleukin (IL)-6, IL-8, Angiopoietin (Ang)-2, and soluble tumor necrosis factor receptor (sTNFR)-1 were quantified. Baseline perfusate and airspace biomarker levels varied significantly, and this was not related to pre-procurement PaO2:FiO2 ratio, cold ischemia time, and baseline alveolar fluid clearance (AFC). After 4 hours of ex vivo perfusion, the lung demonstrated a sustained production of proinflammatory mediators. The change in biomarker levels was not influenced by baseline donor lung characteristics (cold ischemia time, baseline AFC) nor was it associated with measures of experimental epithelial (final AFC) or endothelial (percent weight gain) injury. In the presence of exogenous blood, the rise in biomarkers was attenuated. Lungs exposed to intravenous (IV) bacteria relative to control lungs demonstrated a significantly higher rise in perfusate IL-6.Conclusions: The ex vivo perfused lung has a marked endogenous capacity to produce inflammatory mediators over the course of short-term perfusion that is not significantly influenced by donor lung characteristics or the presence of exogenous blood, and only minimally affected by the introduction of systemic bacteremia. The lack of association between biomarker change and donor lung cold ischemia time, final alveolar fluid clearance, and experimental percent weight gain suggest that the maintained ability of the human lung to produce biomarkers is not merely a marker of lung epithelial or endothelial injury, but may support the function of the lung as an immune cell reservoir.
Differences and similarities of high-resolution computed tomography features between Pneumocystis pneumonia and Cytomegalovirus pneumonia in AIDS patients
Authors: Du Chunjing , Liu Jingyuan , Chen Hui , Yan Shuo , Pu Lin , Xiong Haofeng , Xiang Pan , Li Chuansheng , Zhang Ming , Chen Budong , Li Ang
Published: August 2020

Background Accurately differentiating pneumocystis from cytomegalovirus pneumonia is crucial for correct therapy selection in AIDS patients. Hence, the goal of this study was to compare the CT features of pneumocystis pneumonia and cytomegalovirus pneumonia in AIDS patients and identify clinical hallmarks to accurately distinguish these two pathologies.Methods A total of 112 AIDS patients (78 with pneumocystis pneumonia and 34 were cytomegalovirus pneumonia) were included in this study. Two experienced chest radiologists retrospectively reviewed CT images for 17 features including ground-glass opacity, consolidation, nodules, and halo sign. Significance was calculated by the chi-square (χ2) test.Results The presence of consolidation (61.77% in cytomegalovirus pneumonia, 35.9% in pneumocystis pneumonia, p=0.011), halo signs (32.35% in cytomegalovirus pneumonia, 11.54% in pneumocystis pneumonia, p＜0.001), and nodules (47.06% in cytomegalovirus pneumonia, 8.97% in pneumocystis pneumonia, p＜0.001), especially small nodules (32.5% in cytomegalovirus pneumonia, 6.41% in pneumocystis pneumonia, p＜0.001) without perilymphatic distribution, were significantly more frequent in patients with cytomegalovirus pneumonia than in those with pneumocystis pneumonia. Large nodules were not found in any of patients with cytomegalovirus pneumonia. The presence of ground-glass opacity (100% in pneumocystis pneumonia and cytomegalovirus pneumonia), reticulation (57.69% in pneumocystis pneumonia, 52.94% in cytomegalovirus pneumonia, p=0.782) and bronchial wall thickening (34.62% in pneumocystis pneumonia, 47.06% in cytomegalovirus pneumonia, p=0.213) were common in both groups. Conclusions Analysis of consolidation, nodules, and halo signs may contribute to the differential diagnosis of pneumocystis pneumonia or cytomegalovirus pneumonia. However, some CT features considered typical in one or other diseases appear with similar frequency in both cohorts of AIDS patients.
Association between post-traumatic stress disorder symptoms and bone fractures after the Great East Japan Earthquake in older adults: a prospective cohort study from the Fukushima Health Management Survey
Authors: Hayashi Fumikazu , Ohira Tetsuya , Nakano Hironori , Nagao Masanori , Okazaki Kanako , Harigane Mayumi , Yasumura Seiji , Maeda Masaharu , Takahashi Atsushi , Yabe Hirooki , Suzuki Yuriko , Kamiya Kenji
Published: August 2020

Background Psychological stress has been known to affect bone metabolism and increase fracture risk. However, the association between post-traumatic stress disorder (PTSD) and bone fractures remains unclear. The current study aimed to clarify the effects of disaster-induced PTSD symptoms on fracture risk in older adults.Methods This study analyzed responses from 17,459 individuals aged ≥65 without a history of fractures at the time of the Great East Japan Earthquake who answered the Mental Health and Lifestyle Survey component of the Fukushima Health Management Survey conducted in 2011. Obtained data were able to determine the presence or absence of fractures until 2016. Age, sex, physical factors, social factors, psychological factors, and lifestyle factors were subsequently analyzed. Survival analysis was then performed to determine the relationship between each factor and fractures. Thereafter, univariate and multivariate Cox proportional hazard models were constructed to identify fracture risk factors.Results A total of 2,097 (12.0%) fractures occurred during the follow-up period. Accordingly, univariate and multivariate Cox proportional hazard models showed that PTSD symptoms (total PTSD checklists scoring ≥ 44) [hazard ratio (HR): 1.26; 95% confidence interval (CI): 1.10–1.44; P = 0.001], history of cancer (HR: 1.48; 95% CI: 1.23–1.79; P < 0.001), history of stroke (HR: 1.26; 95% CI: 1.04–1.52; P = 0.021), history of heart disease (HR: 1.30; 95% CI: 1.13–1.49; P < 0.001), history of diabetes (HR: 1.23; 95% CI: 1.09–1.39; P = 0.001), current smoking (HR: 1.27; 95% CI: 1.01–1.61; P = 0.045), and high dissatisfaction with sleep or no sleep at all (HR: 1.36; 95% CI: 1.04–1.77; P = 0.024) promoted a significant increase in fracture risk independent of age and sex.Conclusions The present study indicate that disaster-induced PTSD symptoms and insomnia could contribute to increased fracture risk among older adults residing in evacuation areas within Fukushima prefecture.
Older age and frailty are the chief predictors of mortality in COVID-19 patients admitted to an acute medical unit in a secondary care setting- A cohort study
Authors: Chinnadurai Rajkumar , Ogedengbe Onesi , Agarwal Priya , Money-Coomes Sally , Abdurrahman Ahmad Z , Mohammed Sajeel , Kalra Philip A , Rothwell Nicola , Pradhan Sweta
Published: August 2020

Background There is a need for more observational studies across different clinical settings to better understand the epidemiology of the novel COVID-19 infection. Evidence on clinical characteristics of COVID-19 infection is scarce in secondary care settings in Western populations.MethodsWe describe the clinical characteristics of all consecutive COVID-19 positive patients (n=215) admitted to the acute medical unit at Fairfield General Hospital (secondary care setting) between 23 March 2020 and 30 April 2020 based on the outcome at discharge (group 1: alive or group 2: deceased). We investigated the risk factors that were associated with mortality using binary logistic regression analysis. Kaplan-Meir (KM) curves were generated by following the outcome in all patients until 12 May 2020. ResultsThe median age of our cohort was 74 years with a predominance of Caucasians (87.4%) and males (62%). Of the 215 patients, 86 (40%) died. A higher proportion of patients who died were frail (group 2: 63 vs group 1: 37%, p<0.001), with a higher prevalence of cardiovascular disease (group 2: 58 vs group 1: 33%, p<0.001) and respiratory diseases (group 2: 38 vs group 1: 25 %, p=0.03). In the multivariate logistic regression models, older age (odds ratio (OR) 1.03; p=0.03), frailty (OR 5.1; p<0.001) and lower estimated glomerular filtration rate (eGFR) on admission (OR 0.98; p=0.01) were strong and independent predictors of inpatient mortality. KM curves showed a clear significantly shorter survival time in the frail older patients. ConclusionOlder age and frailty are strong and independent risk factors associated with mortality in COVID-19 patients hospitalised to an acute medical unit at secondary care level. A holistic approach by incorporating these factors is warranted in the management of patients with COVID-19 infection.
The Role of Postprandial Very-Low-Density Lipoprotein ­in the Development of Atrial Remodeling in Metabolic Syndrome 
Authors: Lee Hsiang-Chun , Shin Shyi-Jang , Huang Jih-Kai , Lin Ming-Yen , Lin Yu-Hsun , Ke Liang-Yin , Jiang He-Jiun , Tsai Wei-Chung , Chao Min-Fang , Lin Yi-Hsiung
Published: August 2020

Background: Negatively charged very-low-density lipoprotein (VLDL-χ) in metabolic syndrome (MetS) patients exerts cytotoxic effects on endothelial cells and atrial myocytes. Atrial cardiomyopathy, manifested by atrial remodeling with a dilated diameter, contributes to atrial fibrillation pathogenesis and predicts atrial fibrillation development. The correlation of VLDL-χ with atrial remodeling is unknown. This study investigated the association between VLDL-χ and left atrial dilatation. Methods: Consecutively, 87 MetS and 80 non-MetS individuals between 23 and 74 years old (50.6% men) without overt cardiovascular diseases were included in the prospective cohort study. Blood samples were collected while fasting and postprandially (at 0.5, 1, 2, and 4 hours after a unified meal). VLDL was isolated by ultracentrifugation; the percentile concentration of VLDL-χ (%) was determined by ultra-performance liquid chromatography. The correlations of left atrial diameter (LAD) with variables including VLDL-χ, LDL-C, HDL-C, triglycerides, glucose, and blood pressure, were analyzed by multiple linear regression models. A hierarchical linear model was conducted to test the independencies of each variable’s correlation with LAD. Results: The mean LAD was 3.4 ± 0.5 cm in non-MetS subjects and 3.9 ± 0.5 cm in MetS patients (P< 0.01). None of the fasting lipid profiles were associated with LAD. VLDL-χ, BMI, waist circumference, hip circumference, and blood pressure were positively correlated with LAD (all P<0.05) after adjustment for age and sex. Significant interactions between VLDL-χ and blood pressure, waist circumference, and hip circumference were observed. When adjusted for obesity- and blood pressure-related variables, 2-hour postprandial VLDL-χ (mean 1.30 ± 0.61%) showed a positive correlation with LAD in MetS patients. Each 1% VLDL-χ increase was estimated to increase LAD by 0.23 cm. Conclusions: Postprandial VLDL-χ is associated with atrial remodeling. VLDL-χ is a novel biomarker and may be a therapeutic target for atrial cardiomyopathy in MetS patients. Trial registration: ISRCTN 69295295. Retrospectively registered 9 June 2020.
Seeking healthcare at their 'right' time; the iterative decision process for women with breast cancer
Authors: AGBEKO ANITA ESEENAM , Arthur Joshua , Bayuo Jonathan , Kaburi Basil Benduri , Kyei Ishmael
Published: August 2020

BACKGROUND: About 85% of breast cancer patients attending Komfo Anokye Teaching Hospital (KATH), Ghana, present with stage III/IV disease. In spite of great investments into the early diagnosis and management of breast cancer, late presentation persists and poses a barrier to realising the possible benefits of the gains made in breast cancer management. This study assessed the symptom appraisal and medical health seeking behaviour of women with either locally advanced or metastatic breast cancer attending breast clinic at KATH METHOD: In-depth interviews of women presenting with clinical stage III/IV breast cancer were conducted to explore the women’s care seeking pathways after symptom identification until arrival at KATH from May 2015 to March 2016. Thematic data analysis was conducted using the Andersen behavioural model for health service use. RESULTS: Fifteen women aged 24 – 79 years were interviewed. The time from symptom identification to reporting to KATH was 4 - 24 months. The initial symptom was a breast lump or breast swelling which all the women identified themselves. These were initially appraised as not serious because most importantly, they did not interfere with their daily function. Symptom progression such as prevented them from undertaking their usual economic, social and family function triggered seeking care from health facilities. The availability of money to pay for care and diagnostic investigations influenced the time taken to navigate the referral pathway. While the women initially deferred healthcare for reasons related to their ability to perform economic, family and social roles, ultimately, aggressively pursuing healthcare was also for the same economic, family and social reasons or goals.CONCLUSION: Deciding to seek care and pursue treatment for breast cancer symptoms may be much more complicated than it appears. Economic, family and social function significantly drive the health seeking process both at the personal and health facility phases of health seeking. Breast cancer education messages must be adapted to incorporate these functional goals and their influence on symptom appraisal and decision making to seek help and not just focus on the breast symptom as an isolated entity.
Common and distinct neural representations of aversive somatic and visceral stimulation in healthy individuals
Authors: Wager Tor , Oudenhove Lukas Van , Kragel Philip , Dupont Patrick , Ly Huynh Giao , Pazmany Els , Enzlin Paul , Rubio Amandine , Delon-Martin Chantal , Bonaz Bruno , Aziz Qasim , Tack Jan , Fukudo Shin , Kano Michiko
Published: August 2020

Pain is a primary driver of motivated behavior and learning. Different varieties of pain may be encoded in different brain circuits, but the neural similarities and differences across different types of pain are not well understood. Here, we examine the similarites and differences in brain processing of visceral and somatic pain, one of the most fundamental distinctions in the pain field. We analyze data from 7 fMRI studies (N = 165) and 5 types of pain and discomfort—esophageal, gastric, and rectal distension, cutaneous thermal stimulation, and vulvar pressure—to establish and validate generalizable pain representations. We first evaluate an established multivariate brain measure, the Neurologic Pain Signature (NPS), as a potential common nociceptive pain system across all pain types. Then, we develop a multivariate classifier for visceral vs. somatic pain. The NPS (1) responded robustly in 98% of participants across all types, (2) correlated with perceived intensity of visceral pain/discomfort, and (3) showed specificity to pain when compared with non-painful cognitive and affective conditions drawn from 12 additional studies (total N = 180, AUROC 0.93). Pre-defined signatures for other types of negative affect did not respond to visceral pain. The novel visceral vs. somatic classifier reliably distinguished somatic (thermal) from visceral (rectal) stimulation in both cross-validation and independent cohorts (AUROC 0.84). Other types reflected mixtures of somatic and visceral patterns. These results validate the NPS as measuring a common core nociceptive pain system across pain types, and lay a foundation for new brain-based biomarkers for particular types of pain.
A Cross-Sectional Study on the Practice of Wet Nursing Among Muslim Mothers
Authors: Rahim Norsyamlina Che Abdul , Hamjah Salasiah Hanin , Majid Latifah Abdul , Kusrin Zuliza , Hashim Nurhidayah Muhammad , Saidon Rafeah , Bahari Nora’inan , Ilias Muhamad Zariff , Ahmad Noor Ani
Published: August 2020

Background: The practice of wet nursing or the breastfeeding of another woman’s child in Malaysia is on the rise due to the emergence of awareness among the public about the importance and advantages contained in breast milk. This can be further explored by examining the benefits of breastfeeding, and society is acting by making breastfeeding a complement to breastfeeding in a variety of ways and circumstances. This study aims to investigate and determine the practice of wet nursing among Muslim mothers in Selangor.Methods: This cross-sectional study was conducted on 100 women who had breastfed another child in Selangor. Data were obtained using a validated questionnaire (Cronbach alpha = 0.8) and processed using the SPSS software.Results: Results showed 43.0% of respondents had at least breastfed one someone else’s child. Meanwhile, there were 3.0% of the respondents who were nursing seven to ten other children. A total of 237 children has been nourished by the respondents (n = 100). Of these, 21.5% were breastfed less than five times, while 78.5% were ever breastfed less than five times. Most mothers recorded milk child background data were breastfed, and this shows that the community aware of the importance of data documenting the suckler and indirectly proves that the authorities should act on these current needs.Conclusions: This study obtained a lot of useful information that indicated there is a wet-nursing practice in society. We hope the authorities take appropriate measures so that wet-nursing practices can be officially recorded and monitored to maintain the sustainability and welfare of the Muslims in the state and Malaysia in general.
Cultural adaptation and feasibility of trauma-focused cognitive behavioural therapy in China
Authors: Li Jia , Li Jina , Yuan Lin , Zhou Ying , Qu Zhiyong
Published: August 2020

Background: The contradiction between the burden of post-traumatic stress disorder (PTSD) and the lack of evidence-based treatments (EBTs) is common in low- and middle-income countries of Asia. The adaptation of trauma-focused cognitive behavioural therapy (TF-CBT) is helpful for meeting the needs of children in these countries. The objectives of this study were to describe the cultural adaptation process of TF-CBT and to explore the feasibility and acceptability of adapted interventions in China.Method: Based on the Map of the Adaptation Process (MAP), this study adapted the types of participants, form, content elements, length and language of TF-CBT. A total of 58 children and 8 facilitators participated in a feasibility study. Feasibility was measured by the retention of children. Acceptability was assessed by the client satisfaction questionnaire (CSQ-8) and interviews with the children and facilitators.Result: An intervention based on TF-CBT that included 7 group sessions and 3 individual sessions was developed. The results of the feasibility study showed that children had a high average retention rate (above 97%) and satisfaction (78.95%) with the intervention. Qualitative interviews showed that children and facilitators had high acceptance of the adapted intervention.Conclusion: The adapted group-based TF-CBT had good participant retention and satisfaction. It could be smoothly implemented in the Chinese school environment.Trial registration: Chinese Clinical Trial Registry, ChiCTR1800019837. Registered 2 December 2018, http://www.chictr.org.cn/showproj.aspx?proj=33479.
Der Wert der Medien in medienpädagogischen Biografien
Authors: Swertz Christian
Published: August 2020

In biografischen Erzählungen weisen sich Menschen selbst einen Wert zu. Das ist bei Wissenschaftlerinnen und Wissenschaftlern nicht anders. Eine Form solcher Erzählungen sind Erzählungen der Geschichte der Wissenschaft, in denen Wissenschaftlerinnen und Wissenschaftler der Wissenschaft und damit sich selbst einen Wert zuweisen. Es wird gezeigt, dass Medien in solchen Erzählungen ein Wert für die Medienpädagogik gegeben wird und die Medienpädagogik gleichzeitig an der Erzeugung des Werts beteiligt ist. Die Produktion des Werts von Medien und der Medienpädagogik durch Medienpädagoginnen und Medienpädagogen wird abschliessend werttheoretisch reflektiert.
Medienkritik und Medienpädagogik
Authors: Niesyto Horst
Published: August 2020

Medienkritik ist ein Grundbegriff der Medienpädagogik. Die Förderung von Medienkritik ist eine wesentliche Aufgabe der Medienpädagogik in allen pädagogischen Handlungsfeldern. Seit Bestehen der Medienpädagogik als wissenschaftliche Teildisziplin der Erziehungswissenschaft gibt es Definitionsangebote zum Begriff Medienkritik und Vorschläge zur Weiterentwicklung und Ausdifferenzierung des Begriffs. Im Unterschied hierzu entstanden nur relativ wenige empirische Studien, die die Untersuchung von Prozessen zur Förderung von Medienkritik in medienpädagogischen Handlungsfeldern zum Gegenstand hatten. Auch in der Theoriebildung gibt es Desiderata, insbesondere im Kontext der Digitalisierung und damit verbundenen Veränderungen in der gesellschaftlichen Kommunikation, der Sozialisation, der Bildung und Erziehung. Der folgende Beitrag bietet im ersten Teil einen Überblick zu bisherigen begrifflich-theoretischen Überlegungen, zu Praxisbeispielen und zu forschungsbezogenen Studien einer pädagogisch motivierten Medienkritik. Der zweite Teil greift ausgewählte Themen aus der aktuellen Fachdiskussion auf: die Notwendigkeit einer kritischen Medien- und Gesellschaftsanalyse, die Auseinandersetzung mit normativen Fragen und dem Subjektverständnis in der Medienpädagogik. Der Beitrag plädiert dafür, Medienkritik vor allem im Kontext einer politisch-kulturellen Medienbildung alltags- und praxisnah zu entwickeln.
Medienpädagogische Praxisarbeit als Pionierin für die Verbreitung von OER
Authors: Echterhoff Charlotte , Kröger Sonja
Published: August 2020

In dem Beitrag plädieren die Autorinnen dafür, dass eine Medienpädagogik, die sich als Schlüsseldisziplin in einer digitalisierten Welt versteht, Vorbildfunktion übernehmen kann: Um den Kulturwandel in der Bildungslandschaft stärker zu fördern, kann die Medienpädagogik die Idee offener Bildung und die Verbreitung von Open Educational Resources (OER) noch nachhaltiger in Praxis und Forschung etablieren. Es wird zunächst der bildungspolitische Hintergrund von Offenen Bildungsmaterialien dargestellt und international verordnet. Darüber hinaus werden die Potenziale von OER für die medienpädagogische Praxisarbeit aufgezeigt. Die Relevanz von OER zeigt sich in traditionellen Schulpraktiken, die noch nicht primär Kreativität und Kooperation lehren – obwohl dies relevante Kompetenzen für die Zukunft sind. Die Autorinnen zeigen, dass neue Formen des Lehrens und Lernens aufgrund fortschreitender Digitalisierung im Bildungsbereich dringender denn je sind. OER werden vor dem Hintergrund als ein Vehikel für den notwendigen Kulturwandel beschrieben. Die aktuellen bildungspolitischen Entwicklungen legen nahe, dass jetzt der richtige Zeitpunkt ist, um den OER-Gedanken noch nachhaltiger in der medienpädagogischen Praxisarbeit zu verankern und somit verstärkt innerhalb der Medienpädagogik und anderen Disziplinen zu verbreiten.
Schulische Medienbildung im Spannungsfeld von Medienpädagogik und Fachdidaktik
Authors: Herzig Bardo , Martin Alexander
Published: August 2020

Die zunehmende Digitalisierung und Mediatisierung der Lebenswelt sind auf gesellschaftlicher und individueller Ebene mit grundlegenden und unausweichlichen Wandlungsprozessen verbunden. Somit stellt sich die Frage, welche Aufgaben Erziehung und Bildung unter diesen Rahmenbedingungen zukommen. Bildungspolitisch besteht Konsens darüber, dass Schulen bei der Vermittlung von Medienkompetenz eine wichtige Rolle spielen (müssen). Die konkrete Umsetzung soll dabei nicht in einem isolierten Lernbereich, sondern in der Verantwortung aller (Unterrichts-)Fächer liegen. Setzt man bildungspolitisch auf eine integrative Realisierung von Medienbildung, d.h. ohne einen eigenen Lernbereich oder ein eigenes Fach, so bedeutet dies, dass entsprechend abgestimmte schulische Lerngelegenheiten geschaffen werden müssen, die in der Summe der Beiträge aller Unterrichtsfächer einen umfassenden Kompetenzerwerb ermöglichen. Rahmenbedingungen, Vorgaben und Voraussetzungen für eine erfolgreiche Bewältigung dieser Aufgabe werden im Beitrag sowohl aus medienpädagogischer als auch aus fachdidaktischer Perspektive aufgegriffen und mit Blick auf Chancen und Herausforderungen beleuchtet.
Medienkompetenzförderung im Lehramtsstudium der Goethe-Universität
Authors: Kiesler Natalie
Published: August 2020

In einer digital geprägten Welt stehen Lehrkräfte vor zahllosen Herausforderungen bezüglich der Mediennutzung in ihrem Unterricht. Kinder und Jugendliche konsumieren Medien durch soziale Netzwerke, Messenger und vor allem in Form von Videos, Filmen und Serien. An der Goethe-Universität werden die aktuellen bildungspolitischen und gesellschaftlichen Forderungen nach medienkompetenten Lehrkräften u.a. in der ersten Phase der Ausbildung aufgegriffen. Im hier vorgestellten bildungswissenschaftlichen Seminar «Mediendidaktik im Kontext Schule» werden Studierende daher unter Anwendung der Methode «Lernen durch Lehren» zur Produktion eigener Erklärvideos in Kleingruppen angeleitet. Dadurch werden die Studierenden zu Expertinnen und Experten, während sie den Videoerstellungsprozess kennenlernen und Mediennutzungskompetenzen ausbilden. Durch die Verzahnung mit Feedbackschleifen und Reflexionsaufgaben als Teil des studentischen Portfolios wurde der bewusste und reflektierte Umgang mit Medien in der späteren Berufspraxis angestrebt. Die Lehrveranstaltung wurde prozessbegleitend und anhand eines Online-Fragebogens summativ evaluiert. Die Ergebnisse zeigen zwar den anhaltenden Bedarf zur Instruktion während der Medienproduktion, aber vor allem das Interesse an digitalen Medien. Die Studierenden erlebten den Lernprozess als leistungsmotivierend, produktiv und betonten die Relevanz der Themen und Ziele des Seminars für die spätere Berufspraxis. Zukünftige Lehrkräfte können in jeder Ausbildungsphase von Praxiserfahrung im Umgang mit digitalen Medien profitieren und sollten dahingehend weitere Angebote während des Studiums und darüber hinaus erhalten.