bluuebunny/crossref_metadata_2025 huggingface dataset:
The Use of the Adaptation Potential Reduction Model for Reproductive Toxicity Research In Vivo
Authors: Tyshko Nadezhda V. , Sadykova Elvira O. , Shestakova Svetlana I. , Nikitin Nikolay S. , Trebukh Marina D. , Loginova Maria S. , Pashorina Valentina A. , Zhminchenko Valentin M.
Published: November 2020

The modeling of adaptation potential decrease in rats due to modification of the diet’s vitamin–mineral composition allows to increase animals’ sensitivity to toxic load in reprotoxicological experiments. The threshold values of vitamins B1, B2, B3, and B6 and mineral substances Fe3+ and Mg2+ in the diet, which lead to a considerable reduction of laboratory animals’ adaptation potential, have been determined as 19% (from the basic level in the diet) for males and 18% for females. The efficiency of this model has been confirmed in a reprotoxicological experiment with glyphosate as a toxic factor: the action of the toxic factor against the background of reduced availability of B vitamins and salts Fe3+ and Mg2+ led to significant changes in such indicators of reproductive function as mating efficiency, postimplantation loss, and the total number of alive pups, while the toxic effect of glyphosate was not so pronounced against the normal level of essential substances. The obtained results prove that this adaptation potential reduction model can be recommended for the research of the low-toxicity objects reproductive toxicity in rats and for the safety assessment of novel food, in particular.
Energy Consumption Analysis of Lightweight Cryptographic Algorithms That Can Be Used in the Security of Internet of Things Applications
Authors: Aslan Bora , Yavuzer Aslan Füsun , Sakallı M. Tolga
Published: November 2020

The Internet of Things (IoT) has begun to acquire place in our lives quietly and gradually thanks to the presence of wireless communication systems. An increasing number of M2M applications, such as smart meters, healthcare monitoring, transportation and packaging, or asset tracking, make a significant contribution to the growth of devices and connections. Within such a large and uncontrollable ecosystem, IoT poses several new problems. Security and privacy are among the most important of these problems. Lightweight cryptography can be used more effectively for small size, low energy, and small footprint such as RFID tags, sensors, and contactless smart cards. Therefore, it can be used to ensure security and privacy in the IoT applications. In this study, PRESENT, CLEFIA, PICCOLO, PRINCE, and LBLOCK lightweight cryptographic algorithms, which can be used to secure data in IoT applications, were analyzed in a test environment. As a result of the tests, the energy consumption of the algorithms, current measurement, active mode working time, and active mode energy consumption were identified and based on this, some inferences have been made.
PredAmyl-MLP: Prediction of Amyloid Proteins Using Multilayer Perceptron
Authors: Li Yanjuan , Zhang Zitong , Teng Zhixia , Liu Xiaoyan
Published: November 2020

Amyloid is generally an aggregate of insoluble fibrin; its abnormal deposition is the pathogenic mechanism of various diseases, such as Alzheimer’s disease and type II diabetes. Therefore, accurately identifying amyloid is necessary to understand its role in pathology. We proposed a machine learning-based prediction model called PredAmyl-MLP, which consists of the following three steps: feature extraction, feature selection, and classification. In the step of feature extraction, seven feature extraction algorithms and different combinations of them are investigated, and the combination of SVMProt-188D and tripeptide composition (TPC) is selected according to the experimental results. In the step of feature selection, maximum relevant maximum distance (MRMD) and binomial distribution (BD) are, respectively, used to remove the redundant or noise features, and the appropriate features are selected according to the experimental results. In the step of classification, we employed multilayer perceptron (MLP) to train the prediction model. The 10-fold cross-validation results show that the overall accuracy of PredAmyl-MLP reached 91.59%, and the performance was better than the existing methods.
Cells of the Innate and Adaptive Immune Systems in Kaposi’s Sarcoma
Authors: Ngalamika Owen , Munsaka Sody
Published: November 2020

Kaposi’s sarcoma (KS) is an angioproliferative malignancy whose associated etiologic agent is the Kaposi’s sarcoma-associated herpesvirus (KSHV). KS is the most prevalent malignancy among HIV-infected individuals globally and is considered an AIDS-defining malignancy. The different forms of KS including HIV-associated KS, iatrogenic (immunosuppression-related) KS, and classical KS in elderly males suggest that immune cell dysregulation is among the key components in promoting KS development in KSHV-infected individuals. It is therefore expected that different cell types of the immune system likely play distinct roles in promoting or inhibiting KS development. This narrative review is focused on discussing cells of the innate and adaptive immune systems in KSHV infection and KS pathogenesis, including how these cells can be useful in the control of KSHV infection and treatment of KS.
Comparative Analysis of Reliable, Feasible, and Low-Cost Photovoltaic Microgrid for a Residential Load in Rwanda
Authors: Nsengimana Cyprien , Han Xin Tong , Li Ling-ling
Published: November 2020

Photovoltaic microgrids provide free renewable energy solutions for Rwandans. Although solar technology keeps on its advancement, hydropower remains the principal power source in Rwanda. Other renewable power sources include wind and geothermal energies that are not yet fully exploited. Nonrenewable sources in Rwanda including methane, peat, thermal, and fuels are also used for providing energy solutions for the citizens. Rwanda Energy Group (REG) sets the energy strategic plan since 2015 for achieving the minimum of 512 MW of energy production in 2024/2025 to meet the total energy demand. The plan predicted 52% for grid-connected and 48% for off-grid (standalone) connections. The literature survey and data analysis collected on site were used to evaluate and determine the best cheaper microgrid model from the three comparison case studies for the household in Rwanda. The study focused on the economic power generation model mainly based on solar resources to minimize the electricity cost and provide income for the excess energy produced. Moreover, the study resulted in a low-cost (four times cheaper), reliable, and affordable grid-connected PV and battery microgrid model for a residential home with a minimum daily load of 5.467 kWh. The simulation results based on economic comparison analysis found the levelized cost of energy (LCOE) and net present cost (NPC) for each power-generated model by using Hybrid Optimization Model for Electric Renewable (Homer) pro software. The results show that the LCOE for electricity production by each of the Grid connected-PV-Battery system, Diesel GenSet-PV-Batteries, and PV-Batteries systems was 0.0645 US$/1 kWh, 1.38 US$/1 kWh and 1.82 US$/1 kWh, respectively, compared with 0.2621 US$/1 kWh, the current residential electricity price (2020) for Rwanda.
Advantage of Combining OBIA and Classifier Ensemble Method for Very High-Resolution Satellite Imagery Classification
Authors: Han Ruimei , Liu Pei , Wang Guangyan , Zhang Hanwei , Wu Xilong
Published: November 2020

Accurate and timely collection of urban land use and land cover information is crucial for many aspects of urban development and environment protection. Very high-resolution (VHR) remote sensing images have made it possible to detect and distinguish detailed information on the ground. While abundant texture information and limited spectral channels of VHR images will lead to the increase of intraclass variance and the decrease of the interclass variance. Substantial studies on pixel-based classification algorithms revealed that there were some limitations on land cover information extraction with VHR remote sensing imagery when applying the conventional pixel-based classifiers. Aiming at evaluating the advantages of classifier ensemble strategies and object-based image analysis (OBIA) method for VHR satellite data classification under complex urban area, we present an approach-integrated multiscale segmentation OBIA and a mature classifier ensemble method named random forest. The framework was tested on Chinese GaoFen-1 (GF-1), and GF-2 VHR remotely sensed data over the central business district (CBD) of Zhengzhou metropolitan. Process flow of the proposed framework including data fusion, multiscale image segmentation, best optimal segmentation scale evaluation, multivariance texture feature extraction, random forest ensemble learning classifier construction, accuracy assessment, and time consumption. Advantages of the proposed framework were compared and discussed with several mature state-of-art machine learning algorithms such as the

k

-nearest neighbor (KNN), support vector machine (SVM), and decision tree classifier (DTC). Experimental results showed that the OA of the proposed method is up to 99.29% and 98.98% for the GF-1 dataset and GF-2 dataset, respectively. And the OA is increased by 26.89%, 11.79%, 11.89%, and 4.26% compared with the traditional machine learning algorithms such as the decision tree classifier (DTC), support vector machine (SVM),

k

-nearest neighbor (KNN), and random forest (RF) on the test of the GF-1 dataset; OA increased by 32.31%, 13.48%, 9.77%, and 7.72% for the GF-2 dataset. In terms of time consuming, by rough statistic, OBIA-RF spends 223.55 s, SVM spends 403.57 s, KNN spends 86.93 s, and DT spends 0.61 s on average of the GF-1 and GF-2 datasets. Taking the account classification accuracy and running time, the proposed method has good ability of generalization and robustness for complex urban surface classification with high-resolution remotely sensed data.
A Hybrid Neural Network BERT-Cap Based on Pre-Trained Language Model and Capsule Network for User Intent Classification
Authors: Liu Hai , Liu Yuanxia , Wong Leung-Pun , Lee Lap-Kei , Hao Tianyong
Published: November 2020

User intent classification is a vital component of a question-answering system or a task-based dialogue system. In order to understand the goals of users’ questions or discourses, the system categorizes user text into a set of pre-defined user intent categories. User questions or discourses are usually short in length and lack sufficient context; thus, it is difficult to extract deep semantic information from these types of text and the accuracy of user intent classification may be affected. To better identify user intents, this paper proposes a BERT-Cap hybrid neural network model with focal loss for user intent classification to capture user intents in dialogue. The model uses multiple transformer encoder blocks to encode user utterances and initializes encoder parameters with a pre-trained BERT. Then, it extracts essential features using a capsule network with dynamic routing after utterances encoding. Experiment results on four publicly available datasets show that our model BERT-Cap achieves a F1 score of 0.967 and an accuracy of 0.967, outperforming a number of baseline methods, indicating its effectiveness in user intent classification.
Neonatal Hypoglycemia Related to Glycine Levels in Uncontrolled Gestational Diabetes Mellitus during Mid-Late Pregnancy: Multicenter, Prospective Case-Cohort Observational Study
Authors: Long Yuhang , Chen Le , Yang Yaochao , Liu Wei , Zhang Hanxi , Bao Xin , Liu Meijun , Chen WuJuan , Jiang Fangfang , Hong Ting , Wang Jianying , Chen Yao , Cao Jianyong , Xie Dan , Su Zhaojuan
Published: November 2020

Aims. To explore the relationship between gestational diabetes mellitus (GDM) and neonatal cord blood amino acid and carnitine levels after GDM was diagnosed among pregnant women monitoring glycosylated haemoglobin levels of 5.5%-6.4% during mid-late gestation. Methods. In all, 7289 qualified participants were recruited and divided into two groups (GDM and control groups) between 1 July 2015 and 1 July 2020, and all maternal-neonatal data were collected and analyzed at three centers. Results. Interestingly, glycine in cord blood was not only significantly different between groups (15.52 vs. 6.67,

P
<
0.001

) but also associated with neonatal hypoglycemia (

r
=
0.132

,

P
<
0.001

). Although glycine was an independent positive factor with neonatal hypoglycemia, it had lacked effective size to predict the risk of neonatal hypoglycemia (

b
=
0.002

,

P
<
0.001

). Conclusion. The study identifies some differences and relationships in maternal-neonatal data when the GDM group has fluctuating glycosylated haemoglobin levels of 5.5%-6.4% without hypoglycemic drug intervention, compared with the control group. Although umbilical cord blood of glycine levels has a lack of effective power to predict the risk of neonatal hypoglycemia, it is probably an independent factor involved in the maternal-neonatal glucolipid metabolism.
Optimal New Sliding Mode Controller Combined with Modified Supertwisting Algorithm for a Perturbed Quadrotor UAV
Authors: El Houm Yassine , Abbou Ahmed , Labbadi Moussa , Cherkaoui Mohamed
Published: November 2020

This paper deals with the design of a novel modified supertwisting fast nonlinear sliding mode controller (MSTFNSMC) to stabilize a quadrotor system under time-varying disturbances. The suggested control strategy is based on a modified supertwisting controller with a fast nonlinear sliding surface to improve the tracking performance. The paper suggests a simple optimization tool built-in MATLAB/Simulink to tune the proposed controller parameters. Fast convergence of state variables is established by using a nonlinear sliding surface for rotational and translational subsystems. The modified supertwisting controller is developed to suppress the effect of chattering, reject disturbances, and ensure robustness against external disturbance effect. The stability of the proposed controller (MSTFNSMC) is proved using the Lyapunov theory. The performance of the proposed MSTFNSMC approach is compared with the supertwisting sliding mode controller (STSMC) by numerical simulations to verify its effectiveness.
Politics, Economy, and Çiftliks: The History of Four Çiftliks in Larissa (Yenişehir-i Fener)
Authors: Yildiz Aysel
Published: November 2020

The Ottoman state authorities tried to prevent çiftlik formation in all parts of the empire. Yet, they also tried to keep this valuable and cash/kind-producing economic commodity under strict surveillance. The tax-farming and confiscation systems served as two important mechanisms of state control and ensured the state’s redistributive/reallocative role. Having the right to confiscate and redistribute estates, as well as being the ultimate decision maker in the tax-farming system, the Ottoman authorities acted as the chief regulator of the çiftlik market. Therefore, the central state was always a crucial party to be taken into consideration in the triangle of the çiftlik economy together with the peasantry and the çiftlik holders. This article provides a survey of four çiftliks in Larissa (Yenişehir-i Fener), namely Yeğenli, Göçeri, Köleler, and Zaim, in order to understand the redistributive and reallocative role of the Ottoman imperial center and its impact on the history of the region.
The Newly Found Oldest Patriarchal Berat
Authors: Kotzageorgis Phokion
Published: November 2020

This article discusses a newly found Ottoman document. It concerns the oldest—to date—patriarchal diploma of investiture (berat), which was issued for Patriarch Raphael i (1475–76). This and the other two known berats from that epoch constitute a successive set of such documents, and give scholars the opportunity to study the mechanisms of production of patriarchal diplomas of investiture that were so important for the Orthodox Church in the Ottoman period. Furthermore, these documents date from the formative period of the Orthodox Church under Ottoman rule, providing first-hand evidence on how the Church institution became stabilised under the Ottomans.
An annotated and illustrated catalogue of the Osmylidae collection (Neuroptera) at the Natural History Museum, London
Authors: MARTINS CALEB CALIFRE , PRICE BENJAMIN W.
Published: November 2020

The Natural History Museum, London, houses of one of the largest insect collections in the world including several hundred specimens of the small lacewing family Osmylidae. Herein we provide the complete label information, specimen condition, locality and habitus pictures of the Osmylidae primary types of the Natural History Museum, with some historical information about the specimens.
A New Detection Scheme of Wave-Breaking Events with Blocking Flow Configurations
Authors: Shi Ning , Nakamura Hisashi
Published: November 2020

Blocking flow configurations, which tend to accompany strong circulation anomalies and therefore can cause extreme weather conditions, have recently been studied in relation to large-scale wave breaking (WB). Although WB events have been detected often from an instantaneous morphology perspective, the present study proposes a new approach for the detection from a wave-activity perspective in focusing on its accumulation, saturation, and release. This evolution of wave activity is theoretically equivalent to anomalous potential vorticity (PV) flux with its sign changing from negative to positive, which is utilized in this study to detect WB events that accompany high-amplitude height anomalies and blocking flow configurations. As in previous studies, a given WB event is classified into a high pressure type or low pressure type depending upon the sign of the primary PV anomaly center and further into an eastward or westward type depending upon the longitudinal movement of that center. The new method applied to the wintertime Northern Hemisphere shows that a WB event with a blocking anticyclone is likely to accompany an eastward-moving PV anomaly center, occurring mostly under anticyclonic westerly shear. By contrast, a WB event with a strong cyclonic anomaly mostly accompanies the eastward-moving PV anomaly center under cyclonic westerly shear. Composite analysis confirms the consistency between the sign-changing anomalous PV flux and convergence/divergence of wave-activity flux of quasi-stationary Rossby wave trains around the WB region.
The Wechsel Gneiss Complex of Eastern Alps: an Ediacaran to Cambrian continental arc and its Early Proterozoic hinterland
Authors: Neubauer Franz , Liu Yongjiang , Chang Ruihong , Yuan Sihua , Yu Shengyao , Genser Johann , Liu Boran , Guan Qingbin
Published: November 2020

Many metamorphosed basement complexes in the Alps are polymetamorphic and their origin and geological history may only be deciphered by detailed geochronology on the different members including oceanic elements like ophiolites, arc successions, and continental passive margin successions. Here we present a case study on the Lower Austroalpine Variegated Wechsel Gneiss Complex and the overlying low-grade metamorphosed Wechsel Phyllite Unit at the eastern margin of Alps. The Wechsel Gneiss Complexes are known to have been overprinted by Devonian metamorphism, and both units were affected by Late Cretaceous greenschist facies metamorphism. New U–Pb zircon ages reveal evidence for two stages of continental arc-like magmatism at 500–520 Ma and 550–570 Ma in the Variegated Wechsel Gneiss Complex. An age of ca. 510 Ma of detrital zircons in metasedimentary rocks also constrain the maximum age of metasedimentary rocks, which is younger than Middle Cambrian. The overlying Wechsel Phyllite Unit is younger than 450 Ma (Late Ordovician) and seems to have formed by denudation of the underlying Variegated Wechsel Gneiss Complex. We speculate on potential relationships of the continental arc-type magmatism of the Variegated Wechsel Gneiss Complex and potential oceanic lithosphere (Speik complex) of Prototethyan affinity, which is also preserved in the Austroalpine nappe complex. The abundant, nearly uniform 2.1 Ga- and ca. 2.5 Ma-age signature of detrital zircons in metasediments (paragneiss, quartzite) of the Variegated Wechsel Gneiss Complex calls for Lower Proterozoic continental crust in the nearby source showing the close relationship to northern Gondwana prominent in West Africa and Amazonia.
Frequency of Leishmania spp. infection among HIV-infected patients living in an urban area in Brazil: a cross-sectional study
Authors: Cunha M. A. , Celeste B. J. , Kesper N. , Fugimori M. , Lago M. M. , Ibanes A. S. , Ouki L. M. , Neto E. A. Simões , Fonseca F. F. , Silva M. A. L. , Júnior W. L. Barbosa , Lindoso J. A. L.
Published: November 2020

Background

There is little information about the frequency ofLeishmaniainfection in asymptomatic people living with HIV (PLWH) and about the performance of laboratory diagnostic methods in coinfected patients in Latin America. The main objective of this study is to evaluate the frequency ofLeishmaniaspp. infection in HIV-infected patients living in an urban area in Brazil.

Methods

To detectLeishmaniainfection, diagnostic tests were performed to detect anti-Leishmaniaantibodies (ELISA usingLeptomonas seymouriantigens; ELISA using rK39 antigens; ELISA using rK28 antigens; indirect fluorescent-antibody test (IFAT); direct agglutination test (DAT)) andLeishmaniaDNA (polymerase chain reaction (PCR) with the target genes kDNA and ITS-1).

Results

The frequency of at least one positive test was 15%. For ELISA usingLeptomonasantigens and IFAT, there was an association between CD4+ T lymphocyte counts and test positivity, with a higher positivity of these tests in more immunosuppressed patients (CD4+ T cell count < 200/mm3).

Conclusions

According to our data, there was a high prevalence ofLeishmaniaspp. infections in this population living with HIV. Although there is the possibility of cross-reaction, some tests that are considered highly specific for the diagnosis ofLeishmaniainfection were positive. There was also an association between the positivity of some tests studied and lower values of CD4+ T lymphocytes.
Retrospective single center cohort study: effect of intensive home hemodialysis on right ventricular systolic pressure and clinical outcomes
Authors: Girsberger Michael , Chan Christopher T.
Published: November 2020

Background

Increased right ventricular systolic pressure (RVSP), a surrogate marker for pulmonary hypertension, is common in patients with end-stage kidney disease. Limited data suggest improvement of RVSP with intensive dialysis, but it is unknown whether these improvements translate to better clinical outcomes.

Methods

We conducted a retrospective single center cohort study at the Toronto General Hospital. All patients who performed intensive home hemodialysis (IHHD) for at least a year between 1999 and 2017, and who had a baseline as well as a follow-up echocardiogram more than a year after IHHD, were included. Patients were categorized into two groups based on the RVSP at follow-up: elevated (≥ 35 mmHg) and normal RVSP. Multivariate and cox regression analyses were done to identify risk factors for elevated RVSP at follow-up and reaching the composite endpoint (death, cardiovascular hospitalization, treatment failure), respectively.

Results

One hundred eight patients were included in the study. At baseline, 63% (68/108) of patients had normal RVSP and 37% (40/108) having elevated RVSP. After a follow-up of 4 years, 70% (76/108) patient had normal RVSP while 30% (32/108) had elevated RVSP. 8 (10%) out of the 76 patients with normal RVSP and 15 (47%) out of the 32 patients with elevated RVSP reached the composite endpoint of death, cardiovascular hospitalization or technique failure. In a multivariate analysis, age, diabetes and smoking were not associated with elevated RVSP at follow-up. Elevated RVSP at baseline was not associated with a higher likelihood in reaching the composite endpoint or mortality.

Conclusion

Mean RVSP did not increase in patients on IHHD over time, and maintenance of normal RVSP was associated with better clinical outcomes.
How do parents deal with their children’s chronic kidney disease? A qualitative study for identifying factors related to parent’s adaptation
Authors: Khorsandi Fatemeh , Parizad Naser , Feizi Aram , Hemmati MaslakPak Masumeh
Published: November 2020

Background

Parents’ adaptation affects the health outcomes of children with chronic kidney diseases (CKD). Identifying factors that affect parents’ adaptation is necessary to understand their adaptation status. This study aims to explore factors related to the adaptation of parents who have children with CKD.

Methods

This was a qualitative study with a content analysis approach. Seventeen parents of children with CKD were selected by using purposive sampling. The leading researcher performed semi-structured, in-depth, face-to-face interviews to collect data. Conventional content analysis was used to analyze data.

Results

Two main categories extracted from the data were “adaptation facilitators” and “adaptation barriers.” Adaptation facilitators were supported by three sub-categories: “social support”, “family capability” and “spiritual beliefs”. Four sub-categories of “adaptation barriers” were revealed as: “family-related barriers,” “mental stress by others,” “the chronic nature of the disease,” and “unfavorable treatment conditions.”

Conclusions

Identifying the factors influencing parental adaptation helps the medical staff to make the necessary interventions to support the parents. According to this study, increasing parent access to the required information, supporting them financially and emotionally, and helping them identify support resources can facilitate their adaptation to their child’s chronic illness. Also, identifying and eliminating adaptation barriers can help parents deal better with their child’s chronic disease.
Maternal HBsAg carriers and pregnancy outcomes: a retrospective cohort analysis of 85,190 pregnancies
Authors: Zhang Yulong , Chen Jiacheng , Liao Tingting , Chen Siwen , Yan Jianying , Lin Xiaoqian
Published: November 2020

Background

Nowadays, a positive HBV carrier status is common among pregnant women, especially in endemic areas (such as China), little is known about the impact of maternal HBV infection on the risk of adverse pregnancy outcomes. Pregnant women with HBV infection often develop obstetric complications, such as pregnancy-induced hypertension (PIH) syndrome, postpartum hemorrhage, and gestational diabetes mellitus (GDM), and their infants often exhibit neonatal complications.

Methods

This study undertook a retrospective cohort analysis to explore the association of HBV carrier status with adverse pregnancy outcomes. A cohort of 85,190 women including 9699 HBsAg-positive and 73,076 HBsAg-negative pregnancies was retrospectively analyzed.

Results

It’s found that HBsAg-positive pregnancies may result in higher risk of various maternal outcomes such as ICP (OR 3.4,95%CI 2.80 to 4.13), postpartum hemorrhage (OR 1.16,95%CI 1.00 to 1.34). Interestingly, there was a decreased risk of Preeclampsia (OR 0.91,95%CI 0.87 to 0.96), premature rupture of membrane (OR 0.91,95%CI 0.87 to 0.96) and gestational hypertension (OR 0.828,95%CI 0.701 to 0.978). And in vaginal delivery subgroup analysis, It’s found that the HBsAg-positive group had a higher risk of placental abruption (OR, 1.44; 95% CI, 1.16–1.79).

Conclusions

The present results suggest that compared with HBV positive pregnancies were more likely to be ICP and postpartum hemorrhage. HBV-positive pregnant women underwent vaginal delivery were more likely to have placental abruption and premature birth compared with HBV-negative women. Obstetricians should be aware of ICP, postpartum hemorrhage, placental abruption and premature birth in HBV-positive pregnant women.
Should we increase the focus on diet when considering associations between lifestyle habits and deliberate self-harm?
Authors: Berg Elizabeth , Wilhelm Kay , Handley Tonelle
Published: November 2020

Background

Despite increasing awareness of high rates of physical illness and poor lifestyle behaviours among patients with a history of repeated deliberate self-harm (DSH), there is little research on specific lifestyle factors that are potentially problematic for this group. This paper aims to explore the relationship between lifetime repeated DSH and certain lifestyle factors, including balanced meals, eating breakfast, consumption of ‘junk’ food, weight, exercise, substance/alcohol use, smoking and social support, in a cohort of patients who presented to the Emergency Department (ED) with suicidal ideation or DSH.

Methods

From 2007 to 2016, data from lifestyle and mental health measures were collected from 448 attenders at an outpatient clinic for DSH or suicidal ideation following ED presentation. Lifestyle behaviours (Fantastic Lifestyle Checklist) and mental health (Depression and Anxiety Stress Scale), clinical diagnosis and number of previous DSH episodes were measured on arrival. The associations between lifestyle variables and the number of lifetime DSH episodes were examined.

Results

Sex, age, depression symptoms, poor diet, and smoking were all associated with a higher average number of deliberate self-harm episodes across the lifespan. There were non-significant positive trends for the other poor lifestyle behaviours. There was no association between DSH episodes and diagnosis of depression or anxiety disorder. In a multiple linear regression model, the only factors that remained significant were age, smoking and eating balanced meals, however, the relationship between smoking and lifetime DSH was moderated by more immediate DSH behaviours.

Conclusion

In this sample of patients referred to a service following presentation to the ED with acute mental health concerns, balanced meals and smoking were the lifestyle behaviours that were found to have the strongest independent association with repeated DSH across the lifespan.
Psychometric properties of the moral injury symptom scale among Chinese health professionals during the COVID-19 pandemic
Authors: Zhizhong Wang , Koenig Harold G. , Yan Tong , Jing Wen , Mu Sui , Hongyu Liu , Guangtian Liu
Published: November 2020

Background

Moral injury among physicians and other health professionals has attracted attention in the mainstream literature, this study aim to assess the psychometric properties of the 10-item Moral Injury Symptoms Scale-Health Professional (MISS-HP) among healthcare professionals in China.

Methods

A total of 583 nurses and 2423 physicians were recruited from across mainland China. An online survey was conducted from March 27 to April 26, 2020 (during the middle of the COVID-19 pandemic) using the Chinese version of the MISS-HP. Reliability was assessed by internal consistency reliability and test-retest reliability. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were performed to determine scale structure.

Results

Cronbach’s α of the scale for both samples was acceptable (0.71 for nurses and 0.70 for physicians), as was test-retest reliability (ICCs for the individual items ranged from 0.41 to 0.74, with 0.77 for the overall scale in physicians). EFA suggested three factors, and the CFA indicated good fit to the data. Convergent validity was demonstrated with the 4-item Expressions of Moral Injury Scale (r = 0.45 for physicians, r = 0.43 for nurses). Discriminant validity was demonstrated by correlations with burnout and well-being (r = 0.34–0.47), and concurrent validity was suggested by correlations with depression and anxiety symptoms (r = 0.37–0.45). Known groups validity was indicated by a higher score in those exposed to workplace violence (B = 4.16, 95%CI: 3.21–5.10, p < 0.001).

Conclusions

The MISS-HP demonstrated acceptable reliability and validity in a large sample of physicians and nurses in mainland China, supporting its use as a screening measure for moral injury symptoms among increasingly stressed health professionals in this country during the COVID-19 pandemic.
The potential impact of an anti-stigma intervention on mental health help-seeking attitudes among university students
Authors: Shahwan Shazana , Lau Jue Hua , Goh Chong Min Janrius , Ong Wei Jie , Tan Gregory Tee Hng , Kwok Kian Woon , Samari Ellaisha , Lee Ying Ying , Teh Wen Lin , Seet Vanessa , Chang Sherilyn , Chong Siow Ann , Subramaniam Mythily
Published: November 2020

Background

The reluctance of young adults to seek mental health treatment has been attributed to poor mental health literacy, stigma, preference for self-reliance and concerns about confidentiality. The purpose of this study was to examine the potential impact of an anti-stigma intervention that includes education about depression, information about help-seeking as well as contact with a person with lived experience, on help seeking attitudes.

Methods

A pre-post study design was employed. Changes in help-seeking attitudes were measured using the Inventory of Attitudes towards Seeking Mental Health Services (IASMHS) immediately post-intervention and after 3 months. Sociodemographic data, information on past experiences in the mental health field and contact with people with mental illness were collated. Three hundred ninety university students enrolled in the study. Linear mixed models were used to examine the effects of the intervention.

Results

Scores on all subscales of the IASMHS, Psychological Openness (PO), Help-seeking Propensity (HP) and Indifference to Stigma improved significantly post-intervention and at 3-month follow-up compared to pre-intervention, with HP demonstrating the highest effect size. However, a significant decline was observed on all three scales at 3-month follow-up compared to post-intervention. Gender, having friends/family with mental illness, and previous experience in the mental health field moderated the intervention effects for the PO and HP subscales.

Conclusion

The study showed that the brief anti-stigma intervention was associated with improvements in help-seeking attitudes among university students with differential effects among certain sub-groups. As the beneficial outcomes appeared to decrease over time, booster sessions or opportunities to participate in mental health-related activities post-intervention may be required to maintain the desired changes in help-seeking attitudes.
Development and validation of dust exposure prevention questionnaire for cardiovascular patients based on the health belief model
Authors: Noroozi Farzaneh , Eisapareh Kumars , Bahadori Alireza , Ghahremani Leila , Cousins Rosanna , Mokarami Hamidreza
Published: November 2020

Background

Many cardiovascular patients suffer from respiratory failure. Environmental conditions can exacerbate symptomatology. It is necessary to prevent exposure to dust by taking educational steps to identify and modify patient behavior. This study aimed to develop and validate a dust exposure behavior questionnaire based on the Health Belief Model.

Methods

A mixture of qualitative and quantitative methods was employed to design and develop the desired tool. Qualitative methods were used to identify the preventive behaviors needed by cardiovascular patients at risk of dust exposure using the opinions of two expert panels and a literature review. The quantitative phase of the research was performed to evaluate the psychometric properties of the research tool. The research population comprised 417 people with cardiovascular disease referred to a heart hospital in Bushehr, Iran in 2018. Consenting participants entered the study through consecutive sampling.

Results

The final version of the questionnaire included 27 items across six domains, namely perceived susceptibility, perceived barriers, perceived severity, perceived benefits, cues to action, and self-efficacy. The mean values of the content validity ratio and content validity index were 0.93 and 0.9, respectively. In addition, all items had a good correlation with the total score of their parent domain (P < 0.01). The model fit was initially unsuitable, according to the related indices. Hence, to achieve a better model fit, the model was improved by releasing some parameters based on the modifications suggested by the AMOS software. The modified model featured an acceptable fit (χ2/df = 2.2,P < 0.001). Cronbach’s alpha coefficients also confirmed appropriate reliability for all six domains.

Conclusion

The Dust Exposure Prevention questionnaire has desirable psychometric properties and appropriate validity to determine the behavioral factors involved in harm from dust exposure among cardiovascular disease patients. This marks an effective step toward evaluating the factors effective in preventing complications related to dust exposure among such patients.
Can counter-advertising diminish persuasive effects of conventional and pseudo-healthy unhealthy food product advertising on parents?: an experimental study
Authors: Dixon Helen , Scully Maree , Gascoyne Claudia , Wakefield Melanie
Published: November 2020

Background

To help address rising rates of obesity in children, evidence is needed concerning impacts of common forms of marketing for unhealthy child-oriented food products and the efficacy of educational interventions in counteracting any detrimental impacts of such marketing. This study aims to explore parents’ responses to advertising for unhealthy children’s food products that employ different types of persuasive appeals and test whether a counter-advertising intervention exposing industry motives and marketing strategies can bolster parents’ resistance to influence by unhealthy product advertising.

Methods

N = 1613 Australian parents were randomly assigned to view online either a: (A) non-food ad (control); (B) conventional confectionery ad (highlighting sensory benefits of the product); (C) pseudo-healthy confectionery ad (promoting sensory benefits and health attributes of the product); (D) conventional confectionery ad + counter-ad (employing inoculation-style messaging and narrative communication elements); (E) pseudo-healthy confectionery ad + counter-ad. Parents then viewed various snacks, including those promoted in the food ads and counter-ad. Parents nominated their preferred product, then rated the products.

Results

Exposure to the conventional confectionery ad increased parents’ preference for the advertised product, enhanced perceptions of the product’s healthiness and reduced sugar content and boosted brand attitude. Exposure to the pseudo-healthy confectionery ad increased parents’ preference for the advertised product, and enhanced perceptions of healthiness, fibre content and lower sugar content. The counter-ad diminished, but did not eliminate, product ad effects on parents’ purchasing preference, product perceptions and brand attitudes. The counter-ad also prompted parents to perceive processed foods as less healthy, higher in sugar and lower in fibre and may have increased support for advertising regulation.

Conclusions

Exposure to unhealthy product advertising promoted favourable perceptions of products and increased preferences for advertised products among parents. Counter-advertising interventions may bolster parents’ resistance to persuasion by unhealthy product advertising and empower parents to more accurately evaluate advertised food products.
Employment changes among Chinese family caregivers of long-term cancer survivors
Authors: Liu Siqi , Su Mingzhu , Yao Nengliang , Zhang Nan , Wang Jialin , Anderson Roger T. , Sun Xiaojie
Published: November 2020

Background

Family caregivers (FCGs) play a key role in the plan of care provision for long-term cancer survivors, yet few studies have been conducted on the impact of long-term caregiving on FCGs and their employment patterns. This study aims to further our understanding of the effect that caregiving role has on FCGs by identifying what cancer-related characteristics influence reduction of employment hours among FCGs in the post-treatment phase in China.

Methods

A total of 1155 cancer survivors participated in this study. Patients reported changes in the employment patterns of their FCGs. Descriptive analysis looked at demographic and cancer-related characteristics of cancer survivors and types of FCGs’ employment changes in both primary- and post-treatment phases. Chi-square test was used to statistically test the association between survivors’ characteristics and changes in FCGs’ hours of labor force work in post-treatment phase. Separate multivariable logistic regression models were used to examine the relationship between cancer-related characteristics of participants and employment reduction patterns among FCGs in post-treatment phase while controlling for demographic factors.

Results

In the primary-treatment phase, 45.6% of all FCGs reduced their working hours and 17.4% stopped working altogether. In the post-treatment phase, 25.2% of FCGs worked fewer hours and 6.6% left the workforce completely. The results show that a higher probability of change in employment hours among FCGs is associated with the following patient characteristics: having comorbidities, receiving chemotherapy treatment, limited ability to perform physical tasks, limited ability to perform mental tasks, and diagnosis of stage II of cancer.

Conclusions

Care for cancer patients in both primary- and post- treatment phases may have substantial impacts on hours of formal employment of Chinese FCGs. Interventions helping FCGs balance caregiving duties with labor force work are warranted.
Clinical application of pedicled thoracoacromial artery perforator flaps for tracheal reconstruction
Authors: Deng Di , Xu Feng , Liu Jifeng , Li Bo , Li Linke , Liu Jun , Chen Fei
Published: November 2020

Background

Large or complex trachea defects often require some tissue to reconstruct, various flaps have been reported for reconstructing this defect. However, pedicled thoracoacromial artery perforator flap have not been reported in tracheal reconstruction. Therefore, this study is to assess the efficacy and clinical application of pedicled thoracoacromial artery perforator flaps for tracheal reconstruction.

Methods

Eight patients who underwent tracheal reconstructions with pedicled TAAP flaps between December 2017 and October 2019 were retrospectively reviewed.

Results

All of the pedicled TAAP flaps in our study survived. The flap size ranged from 2 cm × 5 cm to 4 cm × 10 cm, and the size of each island of one double-island flap was 2 cm × 2.5 cm. The mean thickness was 0.6 cm, and the pedicle length varied between 6 and 9 cm (mean 7.9 cm). The mean time of flap harvest was 17 min. The mean age of the patients was 62.4 years and five elderly patients had comorbidities, such as diabetes, hypertension and asthma. One patient received a double-island flap for tracheal and esophageal reconstruction, and the other patient received simple tracheal reconstruction. One patient died due to cancer metastasis. Six patients obtained functional recovery of breathing, except one patients who did not experience closure of the tracheostomy opening due to uncompleted I131 treatment.

Conclusion

Pedicled TAAP flaps provide a short harvesting time, thin thickness and stable blood supply, and they do not require microsurgical skills. This flap is a good choice for the reconstruction of tracheal defects, especially in the aged or patients with comorbidities who are not able to tolerate prolonged surgery.
Medical students’ attitudes towards careers in primary care in Singapore
Authors: Zainal Humairah , Smith Helen Elizabeth
Published: November 2020

Background

Singapore needs more family doctors to care for its ageing population and their chronic conditions. While there is a shifting of care from acute care settings to more community care, this has not been reflected in the primary care training in local medical schools. Furthermore, no research has explored how different aspects of the medical school curricula in Singapore influence students’ perceptions of careers in General Practice and Family Medicine- a gap that is filled by this study.

Methods

Six focus groups involving 54 students from all three medical schools in Singapore were conducted. Discussions focused on their primary care experience, their professional and career aspirations, and perceptions towards the opportunities and challenges of primary care careers. Qualitative content analysis was used to interpret the data.

Results

The respondents shared eight key concerns of pursuing primary care careers including limited professional opportunities, emphasis on lifestyle benefits rather than professional characteristics, need for business acumen, conflicts created by business in clinical care, mundane case mix, lack of continuity of care, limited consultation time, and specialists’ negative attitudes towards family doctors. The positive views articulated included the opportunities for entrepreneurialism and a portfolio career, breadth of clinical problems presented, and an improved future for primary care.

Conclusions

Improving students’ perceptions of careers in primary care in Singapore would benefit from a concerted effort from multiple stakeholders; medical schools, healthcare providers, professional and regulatory bodies, and government.
An effective frequency-domain feature of atrial fibrillation based on time–frequency analysis
Authors: Hu Yusong , Zhao Yantao , Liu Jihong , Pang Jin , Zhang Chen , Li Peizhe
Published: November 2020

Background

Atrial fibrillation is a type of persistent arrhythmia that can lead to serious complications. Therefore, accurate and quick detection of atrial fibrillation by surface electrocardiogram has great importance on further treatment. The practical electrocardiogram signals contain various interferences in different frequencies, such as myoelectricity interference, power interference and so on. Detection speed and accuracy largely depend on the atrial fibrillation signal features extracted by the algorithm. But some of the discovered atrial fibrillation features are not well distinguishable, resulting in poor classification effect.

Methods

This paper proposed a high distinguishable frequency feature—the frequency corresponding to the maximum amplitude in the frequency spectrum. We used the R–R interval detection method optimized with the mathematical morphology method and combined with the wavelet transform method for analysis. According to the two features—the maximum amplitude in the frequency spectrum and R–R interval irregular, we could recognize atrial fibrillation signals in electrocardiogram signals by decision tree classification algorithm.

Results

The data used in the experiment come from the MIT-BIH database, which is publicly accessible via the web and with ethical approval and consent. Based on the input of time-domain and frequency-domain features, we classified sinus rhythm signals and AF signals using the decision tree generated by classification and regression tree (CART) algorithm. From the confusion matrix, we got the accuracy was 98.9%, sensitivity was 97.93% and specificity was 99.63%.

Conclusions

The experimental results can prove the validity of the maximum amplitude in the frequency spectrum and the practicability and accuracy of the detection method, which applied this frequency-domain feature. Through the detection method, we obtained good accuracy of classifying sinus rhythm signals and atrial fibrillation signals. And the sensitivity and specificity of our method were pretty good by comparison with other studies.