bluuebunny/crossref_metadata_2025 huggingface dataset:
Reproductive Autonomy in Appalachia: An Investigation into Perceived Contraceptive Pressure
Authors: Huslage Melody , Ely Gretchen E. , Nugent William R. , Auerbach Samantha , Agbemenu Kafuli
Published: December 2022

The reproductive autonomy of persons who can give birth can be impeded through forms of interpersonal violence and coercion. Moreover, macro-level factors (e.g., poverty, discrimination, community violence, legislative policies) may impede the reproductive autonomy of entire communities. This study investigates a form of violence we term perceived contraceptive pressure in Appalachia, an understudied region of the Eastern U.S., regarding reproductive health and decision-making. Through targeted Meta advertising, participants ( N = 632) residing in Appalachian zip codes completed an online survey on reproductive health. The focus of this study was to investigate the prevalence of perceived contraceptive pressure, who was at increased risk of experiencing pressure, and the source(s) of perceived pressure. Binomial regressions were conducted on three different dependent variables: perceived pressure to be sterilized, perceived pressure to use birth control, and perceived pressure not to use birth control. Approximately half of all respondents (49.5%) reported experiencing at least one type of pressure targeting contraceptive decision-making. The most prevalent source of perceived pressure to use birth control was from the healthcare provider (67.4%), and the most prevalent source of perceived pressure not to use birth control was the respondent’s partner (51.1%). Recommendations for providers serving clients in the Appalachian region include pursuing education regarding contraceptive pressure at the individual level and macro-level. In addition, Appalachian residents may benefit from educational programming on reproductive autonomy, healthy relationships, and how to navigate pressure in relationships.
The Impact of Information From Mental Health Care Providers on Decisions About State Compensation for Violent Crime Victimization
Authors: Kunst Maarten , Huibers Mara , van Wingerden Sigrid
Published: December 2022

In the Netherlands, as in many other countries, victims of intentionally committed violent crimes may apply for state compensation if the offender is unknown or unable to pay for the damages of the crime. This state compensation scheme is run by the Dutch Violent Offences Compensation Fund (VOCF). Lawyers who work for this fund need to evaluate applicants´ eligibility for state compensation on the basis of two criteria: (1) the plausibility of the applicant’s victimization story and (2) the severity of the injury sustained by the applicant. Whether these criteria are fulfilled is largely left to the discretion of the lawyer who evaluates the application. This discretionary power makes the decision-making process prone to biased outcomes. Inspired by previous research, this study investigated whether information from mental health care providers, such as psychiatrists or clinical psychologists, serves as a potential source of bias. Although this type of information may or should sometimes be used to evaluate an applicant’s eligibility for compensation, in most cases it should not affect the outcome of this evaluation because of its potential unreliability. A statistical association between availability of information from mental health care providers and adjudication of state compensation is therefore not to be expected. Analyzing 246 applications submitted to the Dutch VOCF between July 1st 2016 and July 1st 2017, this study tested the empirical validity of this expectation. Results indicated that the availability of information of mental health care providers was associated with adjudication of state compensation. This finding was discussed in view of the literature on heuristic thinking and biased decision making and the study’s limitations.
Convolutional autoencoder neural network for fault diagnosis with multi-sensor data
Authors: Wang Xin , Cui Lingli , Yang Na
Published: December 2022

With machines in manufacturing industry being automated, complex and intelligent, its monitoring systems are equipped with more and more smart sensors. How to extract useful features from great volume of multi-sensor data become a great challenge to the field of fault diagnosis. To overcome such challenge, an improved convolutional autoencoder neural network (CANN) is proposed to fuse and extract effective features of the color images formed by multi-sensor data in this paper. Firstly, the vibration signals of different channels are jointly transformed into color images. Secondly, an improved CANN is constructed by introducing special convolution kernels and residual connection for multi-sensor data fusion and feature extraction. Finally, the encoder part of CANN is connected with the softmax classifier for fault diagnosis. Two datasets collected from Wind Power Test-Bed and Industrial Blower Fan System are used to fully validate the effectiveness of proposed CANN. The results show that it can effectively fuse multi-sensor data and mine the discriminative features. Furthermore, compared with some related state-of-art methods, the CANN obtains higher diagnostic accuracy, especially for less labeled data.
Intelligent diagnosis method of bearing fault based on ICEEMDAN and Ghost-IRCNN
Authors: Zou Xueyan , He Deqiang , Jin Zhenzhen , Wei Zexian , Miao Jian
Published: December 2022

As a critical component of rotating machinery, the health status of bearings is of great significance to ensure the safety of machine operation. Since the vibration signals are interfered by noise during the machine operation, the traditional bearing fault diagnosis model has insufficient feature extraction ability, low diagnostic accuracy, and slow convergence speed. An intelligent bearing fault diagnosis method is proposed based on improved complete ensemble empirical mode decomposition with adaptive noise (ICEEMDAN) and inverted residual convolution neural network integrated with Ghost module (Ghost-IRCNN). Firstly, ICEEMDAN is used to decompose the signals, and the kurtosis-correlation coefficient-margin factor index is proposed to filter and reconstruct the important modal components. Then, the multi-scale sample entropy is used to construct the feature vectors. Finally, the Ghost module, convolution block attention module, and inverted residual bottleneck are combined to build Ghost-IRCNN to realize bearing fault classification and diagnosis. The experimental results show that the proposed method can extract bearing fault features effectively, and the diagnosis accuracy can reach more than 98.80% under complex conditions.
Classic Text No. 133: ‘Maxwell Jones and the Therapeutic Community’, by David Millard (1996)
Authors: Fees Craig , Kennard David
Published: December 2022

This text was David Millard’s departing gift to a field to which he had contributed for 30 years, as practitioner and later as Lecturer in Applied Social Studies and editor of the International Journal of Therapeutic Communities. Charting the chronology of Maxwell Jones’s career as a world-renowned psychiatrist and therapeutic community pioneer, Millard contrasts Jones’s contribution at Mill Hill with Tom Main’s at Northfield. Jones’s most distinctive contribution was allowing patients to become auxiliary therapists and freeing nurses from the nursing hierarchy. Focusing on a subset of therapeutic communities in adult psychiatry, Millard’s paper is not an academic history of therapeutic communities as such. The roles of happenstance and positive deviance are demonstrated in the way change occurs in therapeutic communities. The ‘charisma question’ is briefly explored.
Effects of Design-Thinking Intergenerational Service-Learning Model on College Students: A Pilot Study in Taiwan
Authors: Hsiao Hsinyi , Tseng Jeffrey T. , Hsu Yu-Jung , Chen Tara , Wang Ying-Wei , Kuo Tsuann
Published: December 2022

Purpose: The design-thinking intergenerational service-learning model (DTISLM) has structured ageing-related trainings on strategies to improve empathy among college students for intergenerational program development and promote positive relationships and wellbeing between younger and older generations in community-based settings. The objective of this study was to examine the effects of DTISLM on college students’ ageism, intergenerational relationships, and health. Method: Mixed-methods data were collected via pre–post surveys and after-class reflection notes from 142 students from three universities in Taiwan. Results: DTISLM significantly improved college students’ level of empathy toward older adults, age stereotypes, intergenerational relationships, wellbeing (i.e., life satisfaction), and health behaviors (i.e., exercise). This intervention promoted health awareness among college students. Discussion: Via hands-on trainings for empathy improvement, DTISLM empowered college students to develop intergenerational programs that promoted positive intergenerational relationships and healthy habits. This sheds new light on university–community partnerships involving intergenerational service needs to create age-friendly societies globally.
The Assessment of Marriage, Couples, and Family Counseling Competencies: A Measure to Support Preparation Programs
Authors: Lambie Glenn W. , Frawley Caitlin , Haugen Jaimie Stickl , Grushka Jordan Kay
Published: December 2022

The Assessment of Marriage, Couples, and Family Counseling Competencies (AMCFCC) is an evaluation tool designed to measure marriage, couples, and family counseling trainees’ (MCF-CIT) learning outcomes in essential counseling and specialized competencies. The AMCFCC was developed to align with the Council for Accreditation of Counseling and Related Educational Programs (CACREP) standards, as well as the American Association for Marriage and Family Therapy Marriage and Family Therapy Core Competencies (MFT-CC). In this manuscript, we (a) present the need for the development of an AMCFCC; (b) introduce the AMCFCC; and (c) offer implications for preparation programs using the AMCFCC and areas for future research.
Traumatized Sexuality: Understanding and Predicting Profiles of Sexual Behaviors Using Childhood Abuse and Trauma Measures
Authors: Gewirtz-Meydan Ateret
Published: December 2022

In the current study we sought to identify sexual behavior profiles and examine the levels of childhood abuse history and trauma measures in each profile. The study was conducted among a large non-clinical sample of men and women ( n = 806). Latent profile analysis was employed to identify distinct profiles of sexual behaviors and then childhood abuse, posttraumatic stress disorder (PTSD), depression, and anxiety, and motives for engaging in sex were assessed in each profile. Four distinct profiles of sexual behavior were identified: hyposexual individuals, hypersexual porn users, porn users, and within usual ranges (WURs). Hypersexual porn users had significantly more childhood trauma (emotional, physical, and sexual) than WURs, significantly greater PTSD symptom than WURs and hyposexual individuals, and significantly greater anxiety and depression as compared with all other groups. The hyposexual individuals had significantly lower scores on all motives for engaging in sex than did porn users or hypersexual porn users. Hypersexual porn users and porn users reported coping and peer-pressure as motives for engaging in sex more than did WURs or hyposexual individuals. Clinicians working with survivors of childhood abuse should consider directly targeting these different maladaptive sexual behaviors by addressing PTSD symptoms, affective disorders, and motives for engaging in sex.
Psychiatric Nursing Workforce Survey: Results and Implications
Authors: Gerolamo Angela M. , Delaney Kathleen R. , Phoenix Bethany , Black Patricia , Rushton Amy , Stallings Janette
Published: December 2022

Objective:

The last national survey of psychiatric-mental health (PMH) nurses was conducted in 2016 and was limited to advanced practice registered nurses (APRNs). Data on the demographic and employment characteristics of the PMH workforce could inform how to optimize the PMH nursing workforce to address increasing demands for mental health services. The objective was to conduct a national survey of PMH registered nurses (RNs) and PMH-APRNs to gather data on their demographic, educational, and practice characteristics.

Methods:

An email survey was administered between October 2020 and February 2021 to all members of the American Psychiatric Nurses Association and to all PMH-APRNs certified by the American Nurses Credentialing Center. Separate surveys included 51 questions (RN) and 52 questions (APRN). Survey questions were informed by several sources including the Minimum Data Set for the Behavioral Health Workforce.

Results:

Surveys were completed by 4,088 PMH-RNs and 5,158 PMH-APRNs, with a combined response rate of 12.1%. Findings suggest that the workforce is aging but has increased slightly in diversity. In all, 62.4% of RNs reported a hospital as their primary employment setting, while the majority of APRNs (70.4%) practice in outpatient settings. Forty-four percent of the PMH-APRN respondents indicated that most of their patients receive federal insurance.

Conclusions:

Nursing must plan for significant retirements in the PMH workforce in next 5 years. Hospital-based practice continues to dominate PMH-RN roles but might be expanded to community-based settings teaming with PMH-APRNs in outpatient sites. Increasing the diversity of the workforce should be prioritized.
Riot in the party? Voter registrations in the aftermath of the January 6, 2021 capitol insurrection
Authors: Loving Sara , Smith Daniel A
Published: December 2022

Following the 6 January 2021 insurrection at the U.S. Capitol, news outlets reported that registered Republicans were leaving the party in droves. Drawing on millions of individual-level voter registration records in Florida, we place post-riot party-switching in broader context. We investigate whether Republicans were more likely to experience greater out-migration after the riot, detail to which parties’ individuals switched their allegiances, use a difference-in-difference strategy to determine if the 2021 exodus was greater than 4 years earlier, and examine whether those who decamped from the GOP returned to the fold a year later. We find that registered voters who switched parties after the January 6th uprising were more likely to be white, middle-aged, high-propensity voters, and that Republicans were nearly four times more likely than Democrats to defect following the insurrection. We also find that the GOP defection rate after January 6th was nine times higher than during the same time period in 2017. However, we find that Republican registrants who switched parties post-riot did not migrate to the Democratic Party, but rather became independents, and that a year later, almost no Republicans (only 4.6%) who had defected returned to their GOP roots.
Stress recovery behaviour of a large-diameter Fe-SMA stranded wire developed for structural prestressing loss compensation
Authors: Liu Ziqing , Dong Zhiqiang , Zhu Hong , Wu Gang , Wen Yuhua
Published: December 2022

A new type of large-diameter iron-based shape memory alloy (Fe-SMA) stranded wire was developed, and its stress recovery behaviour was experimentally investigated in this study. The produced Fe-SMA stranded wires had a diameter of 15.2 mm, which were the same as the most commonly used steel-stranded wires. This kind of large-diameter Fe-SMA stranded wire matched the existing prestressed anchorage system to reduce application cost and accelerate the field application of the Fe-SMA in civil engineering. The effects of prestrain levels (4%, 6%, 8%, 10%), activation temperatures (200°C, 300°C, 400°C, 500°C), and secondary activation effect on the recovery stress of Fe-SMA stranded wires were analysed. Test results showed that the recovery stresses of the Fe-SMA stranded wire were 223–357 MPa. The maximum recovery stress was measured for the specimen with a prestrain of 8% and an activation temperature of 500°C. With increasing activation temperature, the recovery stress increased, but the increment decreased gradually. An increased prestrain level resulted in a first increase and a second decrease in the recovery stress, which was highest at the 8% prestrain level. If the shape memory effect (SME) was not fully used during the first activation, then the remaining martensitic phase changed on the second activation. The recovery stress generated by the first activation was essentially the same as those generated by the second activation at the same activation temperature. Taking the Nanshao River concrete box girder bridge in China as an example, the effect of using Fe-SMA stranded wires to compensate the prestressing loss was calculated. The results showed that the Fe-SMA stranded wire developed was able to compensate the vertical prestress loss of the prestressed box girder bridge web well and maintain the main tensile stresses at a low level during the service life of the bridge.
Centering community building to facilitate transformative change for new teachers: An action research study
Authors: Gilbertson Erica , Nicolaides Aliki
Published: December 2022

In the context of increasingly complex challenges facing 21st century school systems, action research has incredible potential to help leaders address persistent problems and implement context-specific, sustainable solutions. Just as powerful, the action research process can be transformative for the individuals, groups, and organization involved. The authors, a doctoral candidate and associate professor, illustrate these concepts by sharing experiences leading an action research study that tackled the problem of high teacher turnover in a school-university partnership context. The article focuses primarily on the constructing phase of the action research cycle, in which the school-university partnership action research team becomes a learning community. The authors offer practical advice for building trusting relationships and share the story of how this team experienced individual and group transformation while designing innovative new teacher support through the action research process.
Anticancer Benefit of Metformin in Patients With Early-Stage Pancreatic Cancer: A Retrospective Cohort Study
Authors: Chen Yang , Qian Fang-jing , Ye Zhi-qiang , Xie Wen-xia , He You-di , Huang Jing-ren , Tian Ling , Gu Dian-na
Published: December 2022

Background: Epidemiologic studies have produced conflicting results on the effects of metformin on pancreatic cancer. This study aimed to observe and analyze whether metformin use is associated with better prognosis in pancreatic cancer. Materials and Methods: In this retrospective cohort study, all baseline data were retrieved from The Chinese Medicine Information Retrieval System ( https://dc.wzhospital.cn/vpn/index.html ) of The First Affiliated Hospital of Wenzhou Medical University. Survival data were collected by follow-up visits and medical records. Overall survival was the primary endpoint, while progression-free survival and disease-free survival were secondary endpoints. Progression or recurrence was assessed with radiologic images. Results: Seventy-six metformin users and 92 metformin nonusers diagnosed with pancreatic cancer from 2012 to 2020 in this hospital were enrolled. The adjusted hazard ratio for overall survival for metformin users was 0.50 (95% confidence interval = 0.33-0.76), where median overall survival was 16.0 months for metformin users versus 11.5 months for metformin nonusers. The protective effect was also found by analyzing progression-free survival (adjusted hazard ratio = 0.39, 95% confidence interval = 0.18-0.86) and disease-free survival (adjusted hazard ratio = 0.30, 95% confidence interval = 0.14-0.68). In the subgroup analysis, metformin use had a statistically significant association with prolongation of survival in stage I to II pancreatic cancer patients (hazard ratio = 0.47, 95% confidence interval = 0.25-0.91), but not for advanced tumor stage (hazard ratio for IV stage = 0.62, 95% confidence interval = 0.33-1.19), after adjustment for other risk factors. Conclusion: Metformin use is related to favorable survival outcomes of pancreatic cancer, especially in early tumor stage.
The off-label uses of pipeline embolization device for complex cerebral aneurysms: Mid-term follow-up in a single center
Authors: Zhang Huachen , Ren Jiyang , Wang Jiangdian , Lv Xianli
Published: December 2022

Objective

To describe the off-label uses of pipeline embolization device for a variety of types of aneurysms including ruptured aneurysms, posterior circulation aneurysms, small aneurysms, distal aneurysms, and recurrent aneurysms.

Methods

Clinical and angiographic data of patients who underwent pipeline embolization device treatment on off-label use at our center were retrospectively reviewed. For categorical variables, Fisher's exact test was used, and a two-sample Wilcoxon rank-sum test was used for patients’ age to analyze the correlation with outcomes.

Results

In this study, 121 aneurysms in 107 patients received off-label pipeline embolization device treatments. The overall rate of complete aneurysm occlusion was 77.8% (28/36 in 35 patients) for posterior circulation aneurysms and 95.3% (81/85 in 72 patients) for anterior circulation aneurysms. The posterior circulation aneurysms have a lower rate of aneurysm occlusion ( p = 0.0372). The small aneurysms have a higher rate of aneurysm occlusion ( p = 0.0104). The patient's sex, age, and aneurismal size were associated with ischemic stroke complications ( p = 0.0397, 0.0166, and 0.0178). In posterior circulation aneurysm patients, only two basilar apex aneurysms underwent pipeline embolization device treatment, both of whom died of thrombotic complications. There was no difference in mortality between posterior circulation aneurysm patients (8.6%, 3/35) and anterior circulation aneurysm patients (1.4%, 1/72) ( p = 0.1015). Patients of older age have a higher risk of death rate ( p = 0.0053).

Conclusions

The off-label use of pipeline embolization device is often performed in clinical practice and can achieve efficacy in complex aneurysms. The off-label use of pipeline embolization device was found to carry an increased rate of mortality in older patients. Excluding basilar apex aneurysms, the pipeline embolization device is as safe as anterior circulation aneurysms in the treatment of posterior circulation aneurysms elsewhere.
Can we accelerate rehabilitation following reverse shoulder arthroplasty? A systematic review
Authors: Sachinis Nikolaos Platon , Yiannakopoulos Christos K , Berthold Daniel P , Franz Alexander , Beitzel Knut
Published: December 2022

Background

There is no consensus concerning the rehabilitation protocol following reverse shoulder arthroplasty. Several patients are expecting to be able to use their arms for sports or recreation shortly after their operation.

Methods

This review was designed as an intervention systematic review with narrative analysis. Authors searched English literature in PubMed and Embase databases from 1/1/1989 until July 2022. Controlled studies comparing rehabilitation protocols for patients undergoing reverse shoulder arthroplasty were included. Data quality was examined with the Cochrane risk of a bias assessment tool for randomized trials, the Methodological Index for Non-Randomized studies (MINORS) tool, as well as the Grading of Recommendations Assessment Development and Evaluation (GRADE) approach.

Results

Three studies were finally analyzed. At 3 months post-op, forward flexion was found to be significantly higher in the early rehabilitation group (140.5, 95% confidence intervals (CIs): 135.10–145.89; the delayed rehabilitation group mean was 131.24, 95% CI: 125.73–136.74; p = 0.019). Twelve months post-op, no significant difference in any clinical or patient-reported outcome was shown. More complications were reported in the 6 weeks-delayed rehabilitation group.

Discussion

Newer regimes permit immediate shoulder mobilization but may not be applied to every patient. The lack of strong evidence warrants the need for future controlled studies; subsequently, postoperative rehabilitation should be individualized.
The Impact of Body Mass Index on Recurrence Rates Following Laparoscopic Paraesophageal Hernia Repair
Authors: Parker Brett C. , Fletcher Reid , Bin Eisa Alsadiq , Reavis Kevin M. , Davila Bradley Daniel , Halpin Valerie J. , Swanström Lee L. , Dunst Christy M.
Published: December 2022

Introduction:

Laparoscopic paraesophageal hernia repair (LPEHR) has a reported recurrence rate of nearly 50%. While the etiology of these recurrences is multifactorial, obesity likely plays a role. The aim of this study is to determine the impact of Body Mass Index (BMI) on hiatal hernia recurrence following LPEHR.

Methods:

Retrospective review of a prospectively collected foregut surgical database identified patients who underwent a primary standard elective LPEHR between 2006 and 2012 and objective follow up >12 months after surgery. Hernia recurrence was defined as >2 cm axial displacement of fundoplication/stomach above the diaphragm on barium swallow/endoscopy. Data was analyzed based on BMI.

Results:

Of 236/350 (67%) who had long term-objective follow-up (mean 34 months), the overall recurrence rate was 24%. Recurrence rates were lower for patients with normal BMI (10.8% vs 26.1%, P < .05). Recurrence rates were similar across elevated BMI groups (overweight = 31%, class I = 24%, class II = 24%, class III = 18%, P = NS). The odds of recurrence was 2.92 (95% CI: 0.99-8.64) greater for patients with BMI > 25 than for normal weight individuals. There was no difference in recurrence rates based BMI 35.

Conclusions:

Patients with a normal BMI experience significantly lower recurrence rates following laparoscopic paraesophageal hernia repair. The increased risk appears to be similar across BMI categories, including individuals who do not meet criteria for formal weight loss surgery. Therefore, a BMI greater than 35 alone is not a reliable demarcation of recurrence risk. Efforts to achieve normal weight pre-operatively are recommended to minimize recurrences.
In vitro infection of human ocular tissues by SARS-CoV-2 lineage A isolates
Authors: Krishna Venkatramana D. , Roehrich Heidi , Schroeder Declan C. , Cheeran Maxim C.-J. , Yuan Ching , Hou Joshua H.
Published: December 2022

Background

The purpose of this study was: [1] to evaluate the infectivity of two SARS-CoV-2 lineage A variants on human ocular tissues in vitro, and [2] to evaluate the stability of SARS-CoV-2 lineage A variants in corneal preservation medium.

Methods

Primary cultures of donor corneal, conjunctival, and limbal epithelium were inoculated with two lineage A, GISAID clade S isolates of SARS-CoV-2 (Hong Kong/VM20001061/2020, USA-WA1/2020), to evaluate the susceptibility of the ocular tissue to infection. Flat-mounted Descemet’s Stripping Automated Endothelial Keratoplasty (DSAEK) grafts were inoculated with SARS-CoV-2 to evaluate the susceptibility of the endothelium to infection. All inoculated samples were immunostained for SARS-CoV-2 nucleocapsid (N)-protein expression to confirm positive infection. SARS-CoV-2 Hong Kong was then inoculated into cornea preservation media (Life4°C, Numedis, Inc.). Inoculated media was stored at 4oC for 14 days and assayed over time for changes in infectious viral titers.

Results

Corneal, conjunctival, and limbal epithelial cells all demonstrated susceptibility to infection by SARS-CoV-2 lineage A variants. Conjunctiva demonstrated the highest infection rate (78% of samples infected [14/18]); however, infection rates did not differ statistically between cell types and viral isolates. After inoculation, 40% (4/10) of DSAEK grafts had active infection in the endothelium. SARS-CoV-2 lineage A demonstrated < 1 log decline in viral titers out to 14 days in corneal preservation media.

Conclusions

SARS-CoV-2 lineage A variants can infect corneal, limbal, and conjunctival epithelium, as well as corneal endothelium. There was no statistical difference in infectivity between different lineage A variants. SARS-CoV-2 lineage A can survive and remain infectious in corneal preservation media out to 14 days in cold storage.
The prevalence of bronchodilator responsiveness of the small airway (using mid-maximal expiratory flow) in COPD - a retrospective study
Authors: Alobaidi Nowaf Y. , Almeshari Mohammed A. , Stockley James A. , Stockley Robert A. , Sapey Elizabeth
Published: December 2022

Background

Bronchodilator responsiveness (BDR) using FEV1 is often utilised to separate COPD patients from asthmatics, although it can be present in some COPD patients. With the advent of treatments with distal airway deposition, BDR in the small airways (SA) may be of value in the management of COPD. We aimed to identify the prevalence of BDR in the SA, utilizing maximal mid-expiratory flow (MMEF) as a measure of SA. We further evaluated the prevalence of BDR in MMEF with and without BDR in FEV1 and its association with baseline demographics, including conventional airflow obstruction severity and smoking history.

Methods

Lung function data of ever-smoking COPD patients were retrospectively analysed. BDR was evaluated 20 min after administering 2.5 mg of salbutamol via jet nebulizer. Increase in percent change of ≥ 12% and absolute change of ≥ 200 ml was used to define a BDR in FEV1, whereas an increase percent change of MMEF ≥ 30% was used to define a BDR in MMEF. Patients were classified as one of three groups according to BDR levels: group 1 (BDR in MMEF and FEV1), group 2 (BDR in MMEF alone) and group 3 (no BDR in either measure).

Result

BDR in MMEF was present in 59.2% of the patients. Of note, BDR in MMEF was present in all patients with BDR in FEV1 (group 1) but also in 37.9% of the patients without BDR in FEV1 (group 2). Patients in group 1 were younger than in groups 2 and 3. BMI was higher in group 1 than in group 3. Baseline FEV1% predicted and FVC % predicted were also higher in groups 1 and 2 than in group 3.

Conclusion

BDR in the SA (evaluated by MMEF) is common in COPD, and it is also feature seen in all patients with BDR in FEV1. Even in the absence of BDR in FEV1, BDR in MMEF is detected in some patients with COPD, potentially identifying a subgroup of patients who may benefit from different treatment strategies.
What is the agreement between intraoperative fluoroscopy and postoperative radiographs in Bernese periacetabular osteotomy?
Authors: Peng Jianping , Xiao Fei , Zhu Junfeng , Shen Chao , Li Yang , Han Xiuguo , Cui Yimin , Chen Xiaodong
Published: December 2022

Background

It is important to reorient the acetabular fragment into an optimal position and version to ensure a good long-term outcome after Bernese periacetabular osteotomy (PAO). Unfortunately, the intraoperative balance between overcorrection and undercorrection remains challenging for the surgeon. The purpose of this study was to answer two questions: (1) Does the femoral head coverage measured on intraoperative fluoroscopy agree with that measured on postoperative radiography? (2) What is the reliability of intraoperative fluoroscopy in identifying hip center correction in PAO?

Methods

A total of 173 patients (173 hips) who underwent PAO for developmental dysplasia of the hip (DDH) at our center from July 01, 2020, to December 31, 2020, were retrospectively reviewed. Imaging data from 111 patients (female/male, 98/13; right/left, 72/39; mean age, 28.93 years) were included in this study. The analysis included measurement of the lateral center-edge angle (LCEA), acetabular index (AI), anterior wall index (AWI), posterior wall index (PWI), extrusion index (EI), and medial offset distance (MO). These measurements were acquired from intraoperative fluoroscopic images and postoperative radiographs and compared by paired t test using SPSS (version 24.0). Significance was determined at a p value of < 0.05. Bland–Altman analysis, conducted using GraphPad Software (version 9), was used to quantify the agreement between intraoperative fluoroscopic images and postoperative radiographs.

Results

The means (standard deviations, SDs) of the LCEA, AI, AWI, PWI, EI, and MO obtained on intraoperative fluoroscopy were 32.86° (5.73°), 0.66° (5.55), 0.29 (0.10), 0.75 (0.17), 11.15% (6.50%), and 8.49 mm (3.68 mm), respectively. On postoperative radiography, the corresponding values were 32.91° (6.31°), 1.63° (5.22°), 0.29 (0.15), 0.85 (0.14), 11.27% (7.36%), and 9.60 mm (3.79 mm). The differences in the LCEA, AWI, and EI acquired from intraoperative fluoroscopic images and postoperative radiographs were not significant (p = 0.90, 0.95, and 0.83, respectively), but those in the AI, PWI, and MO were significant (p < 0.05). The mean biases (95% limits of agreement) of the LCEA, AI, AWI, PWI, EI, and MO were − 0.04 (− 6.85), − 0.97 (− 7.78), 0 (− 0.30), − 0.11 (− 0.36), − 0.12 (− 11.92), and − 1.11 (− 5.51), respectively.

Conclusion

The LCEA, EI, and AWI can be used to reliably predict postoperative femoral head coverage at the level of 2D graphics. Acetabular inclination can be cautiously assessed using AI on intraoperative fluoroscopy. In the absence of intraoperative 3D image evaluation, the AWI and PWI demonstrate acceptable agreement between fluoroscopy and radiography in assessing the acetabular version. Although the MO shows slight bias, it can be helpful in properly positioning the acetabulum during PAO.
Factors influencing the accuracy of multimodal image fusion for oral and maxillofacial tumors: a retrospective study
Authors: Hu Lei-Hao , Zhang Wen-Bo , Yu Yao , Sun Zhi-Peng , Yu Guang-Yan , Peng Xin
Published: December 2022

Background

Ensuring high accuracy in multimodal image fusion for oral and maxillofacial tumors is crucial before further application. The aim of this study was to explore the factors influencing the accuracy of multimodal image fusion for oral and maxillofacial tumors.

Methods

Pairs of single-modality images were obtained from oral and maxillofacial tumor patients, and were fused using a proprietary navigation system by using three algorithms (automatic fusion, manual fusion, and registration point-based fusion). Fusion accuracy was evaluated including two aspects—overall fusion accuracy and tumor volume fusion accuracy—and were indicated by mean deviation and fusion index, respectively. Image modality, fusion algorithm, and other characteristics of multimodal images that may have potential influence on fusion accuracy were recorded. Univariate and multivariate analysis were used to identify relevant affecting factors.

Results

Ninety-three multimodal images were generated by fusing 31 pairs of single-modality images. The interaction effect of image modality and fusion algorithm (P = 0.02, P = 0.003) and thinner slice thickness (P = 0.006) were shown to significantly influence the overall fusion accuracy. The tumor volume (P < 0.001), tumor location (P = 0.007), and image modality (P = 0.01) were significant influencing factors for tumor volume fusion accuracy.

Conclusions

To ensure high overall fusion accuracy, manual fusion was not preferred in CT/MRI image fusion, and neither was automatic fusion in image fusion containing PET modality. Using image sets with thinner slice thickness could increase overall fusion accuracy. CT/MRI fusion yielded higher tumor volume fusion accuracy than fusion containing PET modality. The tumor volume fusion accuracy should be taken into consideration during image fusion when the tumor volume is small and the tumor is located in the mandible.
Investigation on prevalence and risk factors associated with genitourinary syndrome of menopause in middle-aged and older women in Beijing community: a cross sectional study
Authors: Zhu Ye , Wei Junxiu , Yang Xin , Zhu Wei , Zhang Weiting
Published: December 2022

Background

Genitourinary syndrome of menopause (GSM) comprises genital symptoms (dryness, burning, itching, irritation, bleeding), sexual symptoms (dyspareunia and other sexual dysfunctions) and urinary symptoms (dysuria, frequency, urgency, recurrent urinary infections) associated with menopause. To avoid invasive testing and painful physical examinations, validated questionaries, which can assess the prevalence and risk factors associated with symptoms of GSM. We aimed to investigate the prevalence and risk factors associated with GSM in middle-aged and older women in the communities of Beijing, China.

Methods

A cross-sectional, questionnaire study was performed among 35–70 years old Chinese woman. Vaginal health index score and urinary distress inventory (UDI-6) was used to evaluate vulvovaginal atrophy (VVA) and urinary incontinence (UI). Stages of pelvic organ prolapse (POP) was measured during gynecological examination with POP-Q system. Mean ± standard deviation (SD) and proportion/percentages were used to summarize continuous and categorial variables respectively. The Bonferroni method was used to adjust for multiple comparisons.

Results

A total of 2702/3000 participants completed the questionnaire survey. The mean ± SD age of participants was 53.7 ± 7.0 years and prevalence of VVA among participants was 34.8% (941/2702). In UDI-6 questionnaires total 47.5% (1284/2702) participants reported experiencing urinary incontinence (UI). Further, POP was highly prevalent in anterior vaginal wall 38.9% (1050/2702) followed by posterior vaginal wall 25.3% (683/2702) and uterine 22.2% (599/2702). Besides, multiple logistic regression analysis inferred older age (45–54 years [OR (95% CI): 3.38 (2.03, 5.64)]; 55–64 years [OR (95% CI): 8.63 (5.09, 14.64)]), menopause [OR (95% CI): 2.20 (1.71, 2.85)] and Faecal Inconsistence (FI) [OR (95% CI): 1.31(1.00, 1.72)] as independent risk factors for VVA.

Conclusions

Our study evidenced that GSM is prevalent in old age Chinese women. GSM is related with UI, POP and VVA. Further older age, menopause and FI were risk factors associated with VVA. Our findings could help health care personnel to get a comprehensive overview of factors associated with VVA and urinal distress, which may facilitate early detection and prevention of GSM.
Engaging patients in patient safety: a qualitative study examining healthcare managers and providers’ perspectives
Authors: Sarkhosh Samaneh , Abdi Zhaleh , Ravaghi Hamid
Published: December 2022

Background

Patients can play an essential role in improving patient safety by becoming actively involved in their health care. The present study aimed to qualitatively explore healthcare providers’ (HCPs) and managers’ perceptions on patient participation in patient safety processes.

Methods

This qualitative study carried out in three teaching hospitals in Tehran, Iran. The data were collected through semi-structured interviews with 31 HCPs and managers working at public teaching hospitals, medical universities and the Ministry of Health. The data were analyzed using thematic analysis.

Results

Three main themes and 21 sub-themes emerged from the interviews. Participants believed that patients and their families can play an effective role in maintaining and improving patient safety through different roles. However, a variety of barriers were identified at patients, providers, and system levels hindering patient participation in delivering safe care.

Conclusion

The participants identified facilitators and barriers to patient engagement in safety-orientated activities at multiple patients, providers, and system levels, indicating that complex, multifaceted initiatives must be designed to address the issue. This study encourages further research to enhance the understating of the problems and solutions to patient involvement in safety initiatives in the Iranian healthcare setting.
Sequence analysis of the combinations of work shifts and absences in health care – comparison of two years of administrative data
Authors: Krutova Oxana , Peutere Laura , Ervasti Jenni , Härmä Mikko , Virtanen Marianna , Ropponen Annina
Published: December 2022

Background

In health care, the shift work is arranged as irregular work shifts to provide operational hours for 24/7 care. We aimed to investigate working hour trends and turnover in health care via identification of time-related sequences of work shifts and absences among health care employees. The transitions between the work shifts (i.e., morning, day, evening, and night shifts), and absences (days off and other leaves) over time were analyzed and the predictors of change in irregular shift work were quantified.

Methods

A longitudinal cohort study was conducted using employer-owned payroll-based register data of objective and day-to-day working hours and absences of one hospital district in Finland from 2014 to 2019 (n = 4931 employees). The working hour data included start and end of work shifts, any kind of absence from work (days off, sickness absence, parental leave), and employee’s age, and sex. Daily work shifts and absences in 2014 and 2019 were used in sequence analysis. Generalized linear model was used to estimate how each identified sequence cluster was associated with sex and age.

Results

We identified four sequence clusters: “Morning” (60% in 2014 and 56% in 2019), “Varying shift types” (22% both in 2014 and 2019), “Employee turnover” (13% in 2014 and 3% in 2019), and “Unstable employment (5% in 2014 and 19% in 2019). The analysis of transitions from one cluster to another between 2014 and 2019 indicated that most employees stayed in the same clusters, and most often in the “Varying shift types” (60%) and “Morning” (72%) clusters. The majority of those who moved, moved to the cluster “Morning” in 2019 from “Employee turnover” (43%), “Unstable employment” (46%) or “Varying shift types” (21%). Women were more often than men in the clusters “Employee turnover” and “Unstable employment”, whereas older employees were more often in “Morning” and less often in the other cluster groups.

Conclusion

Four clusters with different combinations of work shifts and absences were identified. The transition rates between work shifts and absences with five years in between indicated that most employees stayed in the same clusters. The likelihood of a working hour pattern characterized by “Morning” seems to increase with age.
Compliance with standard precautions and associated factors among undergraduate nursing students at governmental universities of Amhara region, Northwest Ethiopia
Authors: Ayele Desalegn Getachew , Baye Tezera Zewdu , Demissie Negesu Gizaw , Woretaw Ashenafi Worku
Published: December 2022

Background

Standard precautions are minimum infection control practices used to prevent the transmission of diseases and applied to all patient care. Nursing students are at high risk of exposure to occupational biologic hazards because they are obligated to provide care to patients admitted with unknown infection statuses. Compliance with standard precautions is an effective and efficient means of infection prevention. However, their compliance with standard precautions among nursing students is not known in Ethiopia. Therefore, this study aimed to assess compliance with standard precautions and associated factors among undergraduate BSc nursing students at governmental universities located in the Amhara Region, northwest Ethiopia.

Methods

An institutional-based cross-sectional study was conducted among undergraduate BSc nursing students at the governmental universities located in Amhara Region, northwest Ethiopia, from April 15 to May 15, 2021. A simple random sampling technique was used to select 423 samples. Descriptive statistics were presented in text, tables, and charts. Multicollinearity and model fitness were checked. All variables were entered into multivariable logistic regression and aP-value of < 0.05 was considered to identify statistically significant factors.

Result

Around 221 (53.4%) of the study participants were males. Good compliance of nursing students towards standard precautions was 56.3% (95% CI = 51.4–60.9), which is significantly associated with good knowledge (AOR = 2.52, 95% CI = 1.61–3.94), a perceived safe workplace climate (AOR = 2.15, 95% CI = 1.24–3.71), and training or seminars related to standard precautions in the last six months (AOR = 1.52, 95% CI = 1.01–2.29).

Conclusion

The overall compliance of nursing students with standard precautions was low, with nearly half of the nursing students failing to comply with standard precautions. The major factors associated with good compliance were good knowledge, a perceived safe workplace, and having seminars or training in the last six months. Training, enhancing knowledge, and creating a safe hospital environment are recommended to improve nursing students’ compliance with standard precautions.
Interventions for adults with deafblindness - an integrative review
Authors: Warnicke Camilla , Wahlqvist Moa , Anderzén-Carlsson Agneta , Sundqvist Ann-Sofie
Published: December 2022

Purpose

To compile the current research on interventions for rehabilitation aimed at adults (aged 18-65 years) with deafblindness.

Materials and methods

A comprehensive search was conducted in eight databases. An additional manual search was also carried out. A total of 7049 unique references were initially identified, and after screening, 28 original scientific articles were included. The results from these articles were categorized based on limiting consequences of deafblindness: communication, orientation and to move around freely and safely and access to information, as well as to psychological adaptation to deafblindness.

Results

Fourteen of the included articles had their main focus on access to communication, ten on orientation and the ability to move around feely and safely, three on the opportunity to gain access to information, and one related to psychological adaptation to deafblindness. Most articles focused on technical devices, of which one-third were single case studies.

Conclusion

There is a limited number of evaluated interventions for people with deafblindness. Most of the existing studies involved one to five participants with deafblindness, and only few studies involved a larger number of participants. More research with a larger number of participants are needed, which could be facilitated by international cooperation between practitioners and researchers.