bluuebunny/crossref_metadata_2025 huggingface dataset:
Objective evidence for chronic back pain relief by Medical Yoga therapy
Authors: Arya Suvercha , Yadav Raj Kumar , Venkataraman Srikumar , Deepak Kishore Kumar , Bhatia Renu
Published: December 2022

Chronic low back pain (CLBP) is a musculoskeletal ailment that affects millions globally. The pain is disturbing associated with impaired motor activity, reduced flexibility, decreased productivity and strained interpersonal relationships leading to poor quality of life. Inflammatory mediators in vicinity of nociceptors and amplification of neural signals cause peripheral and central sensitization presented as hyperalgesia and/or allodynia. It could be attributed to either diminished descending pain inhibition or exaggerated ascending pain facilitation. Objective measurement of pain is crucial for diagnosis and management. Nociceptive flexion reflex is a reliable and objective tool for measurement of a subject's pain experience. Medical Yoga Therapy (MYT) has proven to relieve chronic pain, but objective evidence-based assessment of its effects is still lacking. We objectively assessed effect of MYT on pain and quality of life in CLBP patients. We recorded VAS (Visual analogue scale), McGill Pain questionnaire and WHOQOL BREF questionnaire scores, NFR response and Diffuse noxious inhibitory control tests. Medical yoga therapy consisted of an 8-week program (4 weeks supervised and 4 weeks at home practice). CLBP patients (42.5 ± 12.6 years) were randomly allocated to MYT (n = 58) and SCT groups (n = 50), and comparisons between the groups and within the groups were done at baseline and at end of 4 and 8 weeks of both interventions. (VAS) scores for patients in both the groups were comparable at baseline, subjective pain rating decreased significantly more after MYT compared to SCT (p = < 0.0001*, p = 0.005*). McGill Pain questionnaire scores revealed significant reduction in pain experience in MYT group compared to SCT. Nociceptive Flexion Reflex threshold increased significantly in MYT group at end of 4 weeks and 8 weeks, p < 0.0001#, p = < 0.0001∞ respectively) whereas for SCT we did not find any significant change in NFR thresholds. DNIC assessed by CPT also showed significant improvement in descending pain modulation after MYT compared to SCT both at end of 4 and 8 weeks. Quality of life also improved significantly more after MYT. Thus, we conclude with objective evidence that Medical Yoga Therapy relieves chronic low back pain, stress and improves quality of life better than standard care.
Improvement of the gait pattern after selective dorsal rhizotomy derives from changes of kinematic parameters in the sagittal plane
Authors: Jiang Wenbin , Jiang Shuyun , Yu Yan , Zhan Qijia , Wei Min , Mei Rong , Chen Fang , Guo Yao , Xiao Bo
Published: December 2022

Objective

Selective dorsal rhizotomy (SDR) can decrease spasticity in children suffering from spastic cerebral palsy (SCP) and thus improve their moving ability when supplemented with the post-operational rehabilitation program. In this case, the study aims to investigate the gait changes in children with mild SCP after SDR in short-term follow-up.

Methods

The information of ambulatory SCP cases who underwent SDR in our center was retrospectively reviewed, and comparisons of changes in spasticity, motor function and data of gait analysis before and after SDR were analyzed.

Results

In total, 32 cases were included in this study, with a mean age of 5.9 ± 2.1 years old. Noticeable decrease was found in the median value of the pre-operational MAS score after SDR at last follow-up in both sides of adductors, gastrocnemius, soleus, and left hamstrings. The Gross Motor Function Measure-66 score increased from 70.6 ± 9.2 to 73.4 ± 8.2, and the gait deviation index increased after SDR compared with the pre-operational data (right side: 65.8 ± 8.8 vs. 60.1 ± 10.7; left side: 63.5 ± 10.1 vs. 57.0 ± 9.9). Noticeable changes were found that the maximum angle of affected ankles in the sagittal plane (the dorsal-flexion angle) increased from 2.5° to 8.2°, the angles at initial contact (1% gait cycle) of affected knees in the sagittal plane decreased from 34.0° to 27.8°, and the angles at the end of swing phase (100% gait cycle) of affected knees in the sagittal plane decreased from 35.8° to 28.3°.

Conclusion

In short-term follow-up, SDR can lower spasticity in children with SCP. Post-operational gait analysis showed improvements in gross motor function and gait, which derived from the changes in the sagittal plane (ankle and knee). A longer follow-up duration is thus needed to clarify the long-term outcome.
The effects of qishen granules for patients with chronic heart failure: A multicenter randomized double-blind placebo-controlled trial
Authors: Du Kangjia , Liu Junjie , Tan Nannan , Huang Xinyi , Wang Juan , Zhao Huihui , Wang Wei
Published: December 2022

Background: Despite advancements in chronic heart failure (CHF) treatment, the effect often remains unsatisfactory and unstable. More effective therapies are needed. Qishen granules (QSG) are a novel Chinese botanical drug effective in treating CHF in animal models, but clinical evidence remains inadequate.

Objective: This study aims to evaluate the effects of QSG on patients with CHF.

Methods: We enrolled CHF patients in this 12-week, randomized, double-blind, placebo-controlled trial and randomly assigned them to the QSG (twice a day, 6.8 g granules at once) or placebo group. The primary endpoint was a change in the plasma N-terminal pro-B-type natriuretic peptide (NT-proBNP) level after treatment. The secondary outcome consists of the New York Heart Association (NYHA) functional classification, 6-min walking distance (6MWD), TCM syndrome integral scale, quality of life, and echocardiographic index.

Results: A total of 191 patients completed the 12-week follow-up period, with 94 in the QSG group and 97 in the placebo group. The Qishen granules group demonstrated a considerably greater reduction in NT-proBNP than the placebo group (50% vs 32% for QSG vs placebo, respectively; p = 0.011). Patients who received QSG performed better in the NYHA functional rank, 6MWD, TCM syndrome integral scale, and quality of life (p < 0.05). The QSG group performed better in HFrEF patients regarding the efficiency of NT-proBNP. There was no statistical significance in the change in evaluated safety parameters, such as blood routine and biochemistry.

Conclusion: Based on standard treatment, Qishen granules further reduced the levels of NT-proBNP when compared with placebo. Together with other outcomes, our findings suggest that QSG could be used in combination therapy for CHF.

Clinical Trial Registration: www.clinicaltrials.gov, identifier NCT03027375. Registered 9 October 2017
Emodin in cardiovascular disease: The role and therapeutic potential
Authors: Guo Yuanyuan , Zhang Rongzhen , Li Wenlan
Published: December 2022

Emodin is a natural anthraquinone derivative extracted from Chinese herbs, such as Rheum palmatum L, Polygonum cuspidatum, and Polygonum multiflorum. It is now also a commonly used clinical drug and is listed in the Chinese Pharmacopoeia. Emodin has a wide range of pharmacological properties, including anticancer, antiinflammatory, antioxidant, and antibacterial effects. Many in vivo and in vitro experiments have demonstrated that emodin has potent anticardiovascular activity. Emodin exerts different mechanisms of action in different types of cardiovascular diseases, including its involvement in pathological processes, such as inflammatory response, apoptosis, cardiac hypertrophy, myocardial fibrosis, oxidative damage, and smooth muscle cell proliferation. Therefore, emodin can be used as a therapeutic drug against cardiovascular disease and has broad application prospects. This paper summarized the main pharmacological effects and related mechanisms of emodin in cardiovascular diseases in recent years and discussed the limitations of emodin in terms of extraction preparation, toxicity, and bioavailability-related pharmacokinetics in clinical applications.
Ultrasonic optic nerve sheath diameter could improve the prognosis of acute ischemic stroke in the intensive care unit
Authors: Li Cong , Wang Cui-Cui , Meng Yan , Fan Jia-Yu , Zhang Jie , Wang Li-Juan
Published: December 2022

Objectives: Stroke patients with high intracranial pressure (ICP) may have poor prognosis. Non-invasive ultrasonic optic nerve sheath diameter (ONSD) could evaluate increased ICP. To investigate whether ONSD is valuable for prognosis of patients with acute ischemic stroke (AIS).

Methods: AIS receiving intensive care were recruited with the Glasgow Coma Scale (GCS) score. Patients in group A underwent ultrasonic ONSD to assess ICP voluntarily, whereas group B without ONSD. Patients were followed up at discharge and once a week for 3 months with Glasgow Outcome Scale (GOS) score (four to five scores indicated good prognosis and one to three scores indicated poor prognosis).

Results: Forty-nine patients were included. GCS scores did not differ significantly between groups A (26 patients) and B (8 ± 3 vs. 7 ± 3, p < 0.05). In group A, ONSD was 5.01 ± 0.48 mm, which correlated with GCS score (p < 0.05). At discharge, the GOS score was higher in group A than in group B (3.35 ± 1.35 vs. 2.57 ± 1.121, p = 0.034). The proportion of patients with a good prognosis was higher in group A than in group B (46.2% vs. 13.0%, p = 0.006). At discharge and after 3 months of follow-up, ONSD at admission was correlated with the GOS score in group A (r = -0.648 [p < 0.05] and -0.731 [p < 0.05], respectively). After 3 months of follow-up, the GOS score was higher in group A than group B (3.00 ± 1.673 vs. 2.04 ± 1.430, p < 0.05). The proportion of patients with a good prognosis was higher in group A than in group B (46.2% vs. 21.2%, p = 0.039). The Kaplan-Meier curve showed a higher rate of good prognosis in group A than in group B. ONSD (p < 0.05) was an independent predictor of poor prognosis.

Conclusion: Non-invasive ultrasonic ONSD could be useful in improving the prognosis of patients with AIS receiving intensive care.
A case report of severe pirimiphos-methyl intoxication: Clinical findings and cholinesterase status
Authors: Zellner Tobias , Rabe Christian , Wellen-Pawlowski Jens von der , Hansen Dagmar , John Harald , Worek Franz , Eyer Florian
Published: December 2022

A 63-year-old male was admitted to a district hospital after ingesting ethanol and pirimiphos-methyl (PM) with suicidal intentions. History included alcoholic cirrhosis with alcoholism, adiposity, diabetes with cerebral microangiopathy, chronic renal insufficiency, heparin-induced thrombocytopenia, and status post necrotizing fasciitis. Emergency medical service reported an alert patient without signs of cholinergic crisis; activated charcoal and atropine were administered. Upon hospital arrival, he received fluid resuscitation, activated charcoal, and atropine. He was transferred to a toxicology unit the next day. On admission, he had no cholinergic signs (dry mucous membranes, warm skin, and mydriatic pupils) requiring small atropine doses (0.5 mg per hour). Four hours after admission, he developed bradycardia and respiratory distress, necessitating intubation. He received atropine by continuous infusion for 7 days (248 mg total) and obidoxime (bolus and continuous infusion). PM, pirimiphos-methyl-oxon (PMO), and phosphorylated tyrosine (Tyr) adducts derived from human serum albumin were analyzed in vivo. Cholinesterase status (acetylcholinesterase (AChE), butyrylcholinesterase (BChE), inhibitory activity of patient plasma and reactivatability, and phosphorylated BChE-derived nonapeptides) was measured in vivo. Obidoxime and atropine were monitored. PM and PMO were detectable, PM with maximum concentration ∼24 h post admission (p.a.) and PMO at ∼18 h p.a. Tyr adducts were detectable. AChE in vivo was suppressed on admission, increased continuously after starting obidoxime, and reached maximum activity after ∼30 h. AChE in vivo and reactivatability remained at the same level until the end of monitoring. BChE was already suppressed on admission; termination of the antidote treatment was possible after BChE had recovered to 1/5th of its normal value and extubation was possible after BChE had recovered to 2/5th. While a substantial part of BChE was already aged on admission, aging continued peaking at ∼24 h p.a. After initiating obidoxime treatment, plasma levels increased until obidoxime plasma levels reached a steady state. On admission, plasma atropine level was low; it increased with the start of the continuous infusion. Afterward, the level dropped to a steady state. The clinical course was characterized by bouts of pneumonia, necessitating re-intubation and prolonged ventilation, sepsis, delirium, and a peripheral neuropathy. After psychiatric evaluation, the patient was discharged to a neurological rehabilitation facility after 77 days of hospital care.
A 10 bit 1 MS/s SAR ADC with one LSB common-mode shift energy-efficient switching scheme for image sensor
Authors: Hu Yunfeng , Hu Lexing , Tang Bin , Yi Zichuan
Published: December 2022

A 10 bit 1 MS/s SAR ADC with one LSB common-mode shift energy-efficient switching scheme for image sensor is presented. Based on the two sub-capacitor arrays architecture and the common-mode technique, the proposed switching scheme achieves 98.45% less switching energy over the conventional architecture with common-mode shift in one LSB. The comparator uses a low power dynamic comparator. The sampling switch adopts a bootstrap circuit with low sampling error. SAR logic is composed of Bit-Slice circuit with low power consumption and few transistors. Simulated in 180 nm CMOS process and 1 MS/s sampling rate, the ADC achieves the 60.06 dB SNDR, the 75.43 dB SFDR and the 10.45 μW power consumption.
Acute hypoxia induced dysregulation of clock-controlled ovary functions
Authors: Ding Mengnan , Lu Yarong , Huang Xin , Xing Chen , Hou Shaojun , Wang Dongxue , Zhang Yifan , Wang Wei , Zhang Chongchong , Zhang Min , Meng Fanfei , Liu Kun , Liu Guangchao , Zhao Jincheng , Song Lun
Published: December 2022

High altitudes or exposure to hypoxia leads to female reproductive disorders. Circadian clocks are intrinsic time-tracking systems that enable organisms to adapt to the Earth’s 24-h light/dark cycle, which can be entrained by other environmental stimuli to regulate physiological and pathological responses. In this study, we focused on whether ovarian circadian clock proteins were involved in regulating female reproductive dysfunction under hypoxic conditions. Hypobaric hypoxia was found to induce a significantly prolonged estrous cycle in female mice, accompanied by follicular atresia, pituitary/ovarian hormone synthesis disorder, and decreased LHCGR expression in the ovaries. Under the same conditions, the levels of the ovarian circadian clock proteins, CLOCK and BMAL1, were suppressed, whereas E4BP4 levels were upregulated. Results from granulosa cells (GCs) further demonstrated that CLOCK: BMAL1 and E4BP4 function as transcriptional activators and repressors of LHCGR in ovarian GCs, respectively, whose responses were mediated by HIF1ɑ-dependent (E4BP4 upregulation) and ɑ-independent (CLOCK and BMAL1 downregulation) manners. The LHCGR agonist was shown to efficiently recover the impairment of ovulation-related gene (EREG and PGR) expression in GCs induced by hypoxia. We conclude that hypoxia exposure causes dysregulation of ovarian circadian clock protein (CLOCK, BMAL1, and E4BP4) expression, which mediates female reproductive dysfunction by impairing LHCGR-dependent signaling events. Adjusting the timing system or recovering the LHCGR level in the ovaries may be helpful in overcoming female reproductive disorders occurring in the highlands.
Pulse respiration quotient as a measure sensitive to changes in dynamic behavior of cardiorespiratory coupling such as body posture and breathing regime
Authors: Matić Zoran , Kalauzi Aleksandar , Moser Maximilian , Platiša Mirjana M. , Lazarević Mihailo , Bojić Tijana
Published: December 2022

Objective: In this research we explored the (homeo)dynamic character of cardiorespiratory coupling (CRC) under the influence of different body posture and breathing regimes. Our tool for it was the pulse respiration quotient (PRQ), representing the number of heartbeat intervals per breathing cycle. We obtained non-integer PRQ values using our advanced Matlab® algorithm and applied it on the signals of 20 healthy subjects in four conditions: supine position with spontaneous breathing (Supin), standing with spontaneous breathing (Stand), supine position with slow (0.1 Hz) breathing (Supin01) and standing with slow (0.1 Hz) breathing (Stand01).

Main results: Linear features of CRC (in PRQ signals) were dynamically very sensitive to posture and breathing rhythm perturbations. There are obvious increases in PRQ mean level and variability under the separated and joined influence of orthostasis and slow (0.1 Hz) breathing. This increase was most pronounced in Stand01 as the state of joint influences. Importantly, PRQ dynamic modification showed greater sensitivity to body posture and breathing regime changes than mean value and standard deviation of heart rhythm and breathing rhythm. In addition, as a consequence of prolonged supine position, we noticed the tendency to integer quantization of PRQ (especially after 14 min), in which the most common quantization number was 4:1 (demonstrated in other research reports as well). In orthostasis and slow breathing, quantization can also be observed, but shifted to other values. We postulate that these results manifest resonance effects induced by coupling patterns from sympathetic and parasympathetic adjustments (with the second as dominant factor).

Significance: Our research confirms that cardiorespiratory coupling adaptability could be profoundly explored by precisely calculated PRQ parameter since cardiorespiratory regulation in healthy subjects is characterized by a high level of autonomic adaptability (responsiveness) to posture and breathing regime, although comparisons with pathological states has yet to be performed. We found Stand01 to be the most provoking state for the dynamic modification of PRQ (cardiorespiratory inducement). As such, Stand01 has the potential of using for PRQ tuning by conditioning the cardiorespiratory autonomic neural networks, e.g., in the cases where PRQ is disturbed by environmental (i.e., microgravity) or pathologic conditions.
How multisensory perception promotes purchase intent in the context of clothing e-customisation
Authors: Li Pei , Guo Xiangmei , Wu Chunmao , Spence Charles
Published: December 2022

With the continuing development of internet technologies, an increasing number of consumers want to customise the products they buy online. In order to explore the relationship between perception and purchase intent, a conceptual framework was developed that was based on the link between multisensory perception, positive emotions, and purchase intent in fashion e-customisation marketing. We discuss the outcomes derived from consumers’ experiences in fashion e-customisation and analyse the relationships between variables. Questionnaires were used to collect data for this quantitative study (n = 398 participants). The data was analysed using factor analysis, correlation analysis, and regression analysis. The findings contribute to the field of clothing e-customisation by identifying the effects of visual perception, haptic imagery, and auditory stimulation on arousal, and purchase intent. Visual perception and haptic imagery exerted a positive influence over dominance. We also identify the effects of arousal and dominance on purchase intent, and assess the mediating effects of these variables on visual perception, haptic mental imagery, and purchase intent. The results highlight how fashion e-customisation marketing strategies can be adopted by managers in order to increase positive emotions and how multisensory perception can potentially be used to influence consumers’ purchase behaviour.
Bright, but allergic and neurotic? A critical investigation of the “overexcitable genius” hypothesis
Authors: Fries Jonathan , Baudson Tanja Gabriele , Kovacs Kristof , Pietschnig Jakob
Published: December 2022

Introduction

Higher intelligence has been associated with improved health and longevity. However, recent findings have claimed that exceptional intelligence may come at a cost. Individuals at the upmost end of the intelligence distribution are reported to be disproportionately afflicted by a set of stress-related physical and mental health conditions: so-called overexcitabilities. Few accounts have investigated this issue and no studies are available for non-US samples yet. Here, we aimed to replicate and extend previous work by examining hitherto unaddressed overexcitabilities in a European high-IQ sample.

Methods

We carried out a preregistered survey among members of MENSA, the world’s largest high-IQ society. In total, 615 (307 male) members from Austria, Germany, Hungary, Switzerland, and the United Kingdom participated.

Results and Discussion

Compared to the general population, our sample exhibited considerably elevated prevalences in autism spectrum disorders (risk ratio/RR = 2.25), chronic fatigue syndrome (RR = 5.69), depression (RR = 4.38), generalized anxiety (RR = 3.82), and irritable bowel syndrome (RR = 3.76). Contrary to previous accounts, neither asthma, allergies, nor autoimmune diseases were elevated. We show that this subsample of intellectually gifted persons faces specific health challenges compared to the general population. The reasons for this remain speculative, as we find little evidence for previously proposed immunological explanations. However, it is possible that the effects are caused by sample selectiveness (i.e., membership in a high-IQ society) rather than high IQ itself.
Neural correlates of linguistic collocations during continuous speech perception
Authors: Garibyan Armine , Schilling Achim , Boehm Claudia , Zankl Alexandra , Krauss Patrick
Published: December 2022

Language is fundamentally predictable, both on a higher schematic level as well as low-level lexical items. Regarding predictability on a lexical level, collocations are frequent co-occurrences of words that are often characterized by high strength of association. So far, psycho- and neurolinguistic studies have mostly employed highly artificial experimental paradigms in the investigation of collocations by focusing on the processing of single words or isolated sentences. In contrast, here we analyze EEG brain responses recorded during stimulation with continuous speech, i.e., audio books. We find that the N400 response to collocations is significantly different from that of non-collocations, whereas the effect varies with respect to cortical region (anterior/posterior) and laterality (left/right). Our results are in line with studies using continuous speech, and they mostly contradict those using artificial paradigms and stimuli. To the best of our knowledge, this is the first neurolinguistic study on collocations using continuous speech stimulation.
Classroom management problems faced by education administrators in distance education during the pandemic period
Authors: Ece Özlem , Bastas Mert
Published: December 2022

Distance education contributes to the development of teamwork skills that may be needed in business life and builds effective collaborative communication skills that allow individuals to learn on their own. Students are able to take online classes, interact with their teachers and become a member of interactive groups. During the pandemic, countries faced different constraints that changed the general perception of education. The use of distance education programs, especially during the recent global COVID-19 epidemic, has had a positive or negative impact on students and had similar impacts on teachers as well. The education sector has also been affected by the various measures taken by countries to minimize the risk of transmission during the pandemic period. In this period, the traditional understanding of education has been interrupted and teachers carried out their education and training activities in technological environments. Distance education has also brought some difficulties as well as provided certain advantages to teachers. Quantitative analysis was preferred as the research method to describe the difficulties teachers faced when implementing open and distance education in Turkey. Within the scope of this study, problems of distance education faced by educators in classroom management are tried to be examined during the pandemic period.
Acupuncture and related therapies for the anxiety and depression in irritable bowel syndrome with diarrhea (IBS-D): A network meta-analysis of randomized controlled trials
Authors: Wang Xuesong , Shi Xuliang , Lv Jing , Zhang Juncha , Huo Yongli , Zuo Guang , Lu Guangtong , Liu Cunzhi , She Yanfen
Published: December 2022

Objective

A growing number of clinical studies have suggested the value of acupuncture-related therapies for patients with irritable bowel syndrome with diarrhea (IBS-D), and the patient’s mental state plays an important role, but there are many types of acupuncture-related therapies involved. This study aimed to evaluate the mental status, efficacy and safety of the different acupuncture-related therapies for IBS-D patients.

Methods

We searched seven databases to collect randomized controlled trials of acupuncture-related therapies for IBS-D. After independent literature screening and data extraction, the quality of the final included literature was evaluated. Hamilton anxiety rating scale (HAMA), hamilton depression rating scale (HAMD), self-rating anxiety scale (SAS), and self-rating depression scale (SDS) was used as the primary outcome indicator. And the network meta-analysis (NMA) was performed by using Revman 5.4, Stata 15.0 and WinBUGS 1.4.3 software, and the surface under the cumulative ranking curve was conducted to rank the included interventions.

Results

We analyzed 24 eligible studies with 1,885 patients, involving eight types of acupuncture and related therapies along with comprehensive therapies. The NMA result shows that: for SAS scores, combined therapies were more efficacious than anti-diarrheal or antispasmodic (western medicine, WM) (SMD: −8.92; 95% CI: −15.30, −2.47); for SDS scores, combined therapies were more efficacious than WM (SMD: −8.45; 95% CI: −15.50, −1.41). For HAMA scores, moxibustion (MOX) was more efficacious than placebo (SMD: −8.66; 95% CI: −16.64, −0.38). For HAMD scores, MOX was more efficacious than all other included interventions. For response rate, MOX was more efficacious than the following interventions: acupuncture (ACU) (SMD:0.29; 95% CI:0.08,0.93), Chinese herb medicine (CH) (SMD:0.09; 95% CI:0.02,0.36), combined therapies (SMD:0.23; 95% CI:0.06, 0.85), electroacupuncture (EA) (SMD:0.06; 95% CI:0.01,0.33), warm acupuncture (WA) (SMD:22.16; 95% CI:3.53,148.10), WM (SMD:15.59; 95% CI:4.68,61.21), and placebo (SMD:9.80; 95% CI:2.90,45.51). Combined therapies were more efficacious than the following interventions: CH (SMD:0.39; 95% CI:0.19,0.80), WA (SMD:4.96; 95% CI:1.30,21.62), and WM (SMD:3.62; 95% CI:2.35,5.66). The comprehensive ranking results show that MOX, ACU, combined therapies, and EA had high SUCRA rankings involving different outcome indicators.

Conclusion

MOX, ACU, combined therapies, and EA better alleviate anxiety and depression among IBS-D patients, and with a higher safety level, may be the optimal therapies. In addition, combining acupuncture-related treatments and other therapies also delivers a higher global benefit level.

Systematic review registration

[https://www.crd.york.ac.uk/], identifier [CRD42022364560].
Caught between is and ought: The Moral Dissonance Model
Authors: Te Brake Hans , Nauta Bart
Published: December 2022

Considerable academic effort has been invested in explaining the causes of, and processes behind moral injury. These efforts are mostly focused on assessment and treatment within a clinical setting. Collective and social factors contributing to moral injury are often overlooked in current literature. This perspective article considers the role of contextual factors associated with moral injury and proposes a framework that describes their relation to individual aspects. The resulting Moral Dissonance Model (MDM) draws on existing theories and frameworks. The MDM explains how dissonance can occur when the actual behavior–the response to a morally challenging situation–contradicts with morally desirable behavior. Individual and collective factors, which change over time, contribute to the experience of dissonance. The inability to sufficiently solve dissonance can lead to moral injury, but not as a matter of course. The MDM can help to understand the underlying processes of moral distress. It raises awareness of the influence of public debate and controversy, and the resulting changing societal attitudes over time. Its implications and future use are discussed.
Well-being and well-becoming through the life-course in public health economics research and policy: A new infographic
Authors: Edwards Rhiannon Tudor
Published: December 2022

Background

The term “well-becoming” is not new, but is not routinely used in our everyday language or in research in public health economics. It has been applied in early years research. Well-becoming can be thought of as our multitude of life-journeys toward meaning and purposefulness.

Objective

To develop a new infographic in the spirit of the Dahlgren and Whitehead rainbow infographic of social determinants of health. The purpose being to redefine well-being as a process of growth through life, articulated as well-becoming.

Methods

A rapid review of life-course stage appropriate models of well-being was undertaken with stages of the life-course as defined as: preconception and birth; early years; adolescence; working, parenting and caring; older age, and death. Infographics in this area were identified and the information above was used to design a new infographic with the concept of well-being and well-becoming at its center.

Results

A new infographic reflecting an underlying concept of “the wheel of life” is presented. It shows movement through the life-course at its center, with concentric rings summarizing personal, local, and national and global factors that have an impact on well-being and well-becoming of individuals through the life-course. Of note, is the inclusion of death, which is a topic often avoided. Prepared during 2021–22, the infographic reflects the role of pandemic and war within the national and global ring of influential factors. I reflect on three ways in which health economists are currently using a life-course approach and the concept of well-becoming in the economic evaluation of individual programs and at a population level of government policy.

Conclusion

Moving from solely focusing on a concept of well-being to a concept of well-being and well-becoming acknowledges the influence that socioeconomic and other conditions in a particular life-course stage have on subsequent life-course stages, and the cost-effectiveness of intervening across the life-course.
The association between problematic smartphone use and the severity of temporomandibular disorders: A cross-sectional study
Authors: Pei Ya-Peng , Li Han-Chao , Zhong Jia-Wei , Gao Xin-Lin , Xiao Chu-Qiao , Yue Yuan , Xiong Xin
Published: December 2022

Objective

To evaluate the prevalence of different types of temporomandibular disorders (TMD) symptoms in young adults and determine their associations with problematic smartphone use (PSU).

Methods

The data of the study were collected from local university students through an online questionnaire survey. Demographic information, Fonseca Anamnestic Index (FAI), Smartphone Addiction Scale-Short Version (SAS-SV), and Patient Health Questionnaire-4 (PHQ-4) responses were gathered electronically and analyzed using multiple logistic regression analysis.

Results

There were 163 male and 307 female respondents were participated in this study. The prevalence of PSU and TMD were 83.6% and 66.4%, respectively. There was a moderate statistical correlation between PSU and TMD among young adults (r = 0.31, p < 0.01). The logistic regression model revealed that the risk of TMD was 1.77 times higher in people with PSU than in those without PSU (OR = 1.77; 95% CI 1.04–3.06). PSU is a risk factor for pain-related TMD (OR = 1.81; 95% CI 1.08–3.04) but not intra-articular TMD.

Conclusion

Subjects showed high prevalence of both TMD and PSU. People with PSU experienced more severe and frequent pain-related rather than intra-articular TMD symptoms than those without PSU. By reducing the problematic smartphone use, the risk factor of TMD might be avoided.
Patient safety and staff psychological safety: A mixed methods study on aspects of teamwork in the operating room
Authors: Arad Dana , Finkelstein Adi , Rozenblum Ronen , Magnezi Racheli
Published: December 2022

Objectives

To predict the amount of teamwork that takes place throughout a surgery, based on performing a preoperative safety standards (surgical safety checklist and surgical count) and to explore factors affecting patient safety and staff psychological safety during a surgery, based on interprofessional teamwork.

Methods

This mixed methods study included quantitative and qualitative analyses. Quantitative data included 2,184 direct observations of surgical cases with regard to the performance of safety standards during surgeries in 29 hospitals, analyzed using multivariate binary logistic regressions. Qualitative data were obtained from an analysis of 25 semi-structured interviews with operating room (OR) clinicians and risk managers, using an inductive thematic analysis approach.

Results

Analysis of the OR observations revealed that a lack of teamwork in the preoperative “sign-in” phase doubled the chances of there being a lack of teamwork during surgery [odds ratio = 1.972, 95% confidence interval (CI) 1.741, 2.233, p < 0.001] and during the “time-out” phase (odds ratio = 2.142, 95% CI 1.879, 2.441, p < 0.001). Consistent presence of staff during surgery significantly increased teamwork, by 21% for physicians and 24% for nurses (p < 0.05), but staff turnover significantly decreased teamwork, by 73% for physicians (p < 0.05). Interview data indicated that patient safety and staff psychological safety are related to a perception of a collaborative team role among OR staff, with mutual commitment and effective interprofessional communication.

Conclusions

Healthcare organizations should consider the key finding of this study when trying to identify factors that affect teamwork during a surgery. Effective preoperative teamwork positively affects intraoperative teamwork, as does the presence of more clinicians participating in a surgery, with no turnover. Other factors include working in a fixed, designated team, led by a surgeon, which functions with effective interprofessional communication that promotes patient safety and staff psychological safety.
Consistency between 3 days' dietary records and 24-h urine in estimating salt intake in children and adolescents
Authors: Dong Jie , Yu Xiaoran , Li Xun , Xiang Shiting , Qin Yongquan , Zhu Shaolun , Zheng Jie , Yan Yinkun
Published: December 2022

Purpose

This study aimed to evaluate the salt intake in boarding school students and the consistency between salt intake measurements based on 24-h urine and weighed dietary records over 3 consecutive days in this population.

Methods

This was a school-based cross-sectional study. Overweight (including obesity) or hypertensive students aged 6–14 years and their normal counterparts were recruited for this study at three boarding schools in China. Three consecutive 24-h urine samples were collected from all participants. During the collection period of 24-h urine, the weighed diet records were collected in children who had all three meals at the school canteens on weekdays. Incomplete 24-h urine or dietary records were excluded from the analysis.

Results

The median salt excretion was 6,218 [4,636, 8,290] mg by 24-h urine and 120 (82.2%) consumed excess salt among the participants. The median salt intake was 8,132 [6,348, 9,370] mg by dietary records and 112 (97.4%) participants consumed excess salt than recommended in participants who have all three meals in the school canteens. In children with complete dietary records and 24-h urine, the level of salt intake estimated by 24-h urine accounted for 79.6% of the dietary records.

Conclusion

Our study showed that boarding school students consumed excessive salt from school canteens. Thus, policies or strategies targeting school canteens are urgently needed. Weighed dietary records are recommended if feasible.
Revisiting cloud overlap with a merged dataset of liquid and ice cloud extinction from CloudSat and CALIPSO
Authors: Oreopoulos Lazaros , Cho Nayeong , Lee Dongmin
Published: December 2022

We update the parameterization capturing the variation of parameters that describe how cloud occurrence (layer cloud fraction) and layer cloud optical depth (COD) distributions overlap vertically. Our updated analysis is motivated by the availability of a new dataset constructed by combining two products describing the two-dimensional extinction properties of liquid and ice phase clouds (and their mixtures) according to active cloud observations by the CloudSat and CALIPSO satellites. As before, cloud occurrence overlap is modeled with the decorrelation length of an inverse exponential function describing the decay with separation distance of the relative likelihood that two cloudy layers are overlapped maximally versus randomly. Similarly, cloud optical depth distribution vertical overlap is described again with a decorrelation length that describes the assumed inverse exponential decay with separation distance of the rank correlation between cloud optical depth distribution members in two cloudy layers. We derive the climatological zonal variability of these two decorrelation lengths using 4 years of observations for scenes of ∼100 km scale length, a typical grid size of numerical models used for climate simulations. As previously, we find a strong latitudinal dependence reflecting systematic differences in dominant cloud types with latitude, but substantially different magnitudes of decorrelation length compared to the previous work. The previously used parameterization form is therefore updated with new parameters to describe the latitudinal dependence of decorrelation lengths and its seasonal shift. Similar zonal patterns of decorrelation length are found when the analysis is broken down by different cloud classes. When the revised parameterization is implemented in a cloud subcolumn generator, simulated column cloud properties compare to observations quite well, and so do their associated cloud radiative effects, but improvements over the earlier version of the parameterization are marginal.
Do All People With Obesity Have Increased Risk of Disease?
Authors: Telle-Hansen Vibeke H. , Christensen Jacob J. , Formo Gulla Aa. , Holven Kirsten B. , Ulven Stine M.
Published: December 2022

Our cells use the food we eat to produce the energy needed to do work. This amazing process is called metabolism and it is necessary for survival. If we eat more than we need, we will gain weight and may become obese. Obesity affects how cells and organs perform work and also increases the risk of metabolic diseases, which include type 2 diabetes and cardiovascular diseases. Metabolic diseases are the most common diseases of our time. National and global health authorities are working hard to prevent and treat obesity and obesity-related diseases. However, some people with obesity appear to have normal metabolism. Why do some obese people develop metabolic diseases while others do not? In this article, we discuss how metabolism may differ in people with obesity. We also describe some key reasons why some people with obesity may be healthier than others.
Effects of organic cultivation on soil fertility and soil environment quality in greenhouses
Authors: Tong Lihong , Li Jie , Zhu Ling , Zhang Shuo , Zhou Hu , Lv Yizhong , Zhu Kun
Published: December 2022

Organic cultivation has been considered as an important cultivation approach for sustainable agriculture in the world. Whether organic cultivation can mitigate the negative impact of agriculture on the environment especially in greenhouses is still unclear. The purpose of this study is to investigate the long-term impacts in soil fertility and environment quality through organic cultivation (OC), low-input cultivation (LC) and conventional cultivation (CC) in greenhouses after 15 years of cultivation. We found that the soil organic carbon (SOC) content in the OC treatment was 1.7 times of that in CC, 1.2 times of that in the LC treatments. Vegetable yield and the content of alkali nitrogen, available phosphorus and available potassium in the OC treatment was significantly higher than those in the LC and CC treatments. Due to the high input of organic fertilizers, increased content of heavy metals (Cu, Zn, Pb, Cd, Cr and As) were observed in the OC treatment. In addition, organic cultivation resulted in considerable residue accumulation of tetracycline antibiotics (TCs) and pesticides in the soil. Ecological risk assessment of soil pollutants showed that organic cultivation has the highest ecological risk index. At present, organic partial substitution or low-input cultivation could be a promising approach for the development of sustainable agriculture.
The surgical strategy for multilevel massive ossification of the posterior longitudinal ligaments
Authors: Li Ying-Ching , Liu Zhuo-Hao , Li Ying-Sheng , Yeap Mun-Chun , Liu Yu-Tse , Huang Yin-Cheng , Chen Ching-Chang , Tu Po-Hsun
Published: December 2022

Purpose

Creating enough decompression, favorable outcome, less complication, and maintain adequate lordosis and stability in the patients with cervical myelopathy due to multilevel massive ossification of the posterior longitudinal ligament (OPLL) still poses a challenge for surgeons. The aim of our study is to retrospectively evaluate our patients and try to seek a better surgical strategy.

Methods

Between 2015 and 2019, 55 consecutive patients with multilevel massive OPLL underwent surgical treatment. Among these, 40 patients were treated with cervical laminectomy and then anterior decompression, fusion, and fixation (ADF), which was defined as group 1, and 15 patients were treated with cervical laminectomy and fixation simultaneously, which was defined as group 2. The patient's radiographic characteristics and postoperative outcomes were evaluated.

Results

Better postoperative cervical sagittal lordosis and less long-term axial pain was achieved in group 1 (p < 0.001), though the functional outcome had no significant difference. In the multivariable analysis, anterior fixation accounts for independent factors for better cervical sagittal alignment (p < 0.001). No complications directly associated with cervical laminectomy were observed.

Conclusion

In patients with cervical multilevel massive OPLL, laminectomy at compression level and then ADF depended on the severity and range of compression, but corpectomy of not more than two vertebral bodies is suggested, except K-line (+) and long-segment massive OPLL majorly involving the C2 and posterior laminectomy above and below the OPLL-affected levels with posterior fixation simultaneously.
Residual stress and microstructure in IN718-René41 graded superalloy fabricated by laser blown directed energy deposition
Authors: Huang Shenyan , Shen Chen , An Ke , Zhang Yuxuan , Spinelli Ian , Brennan Marissa , Yu Dunji
Published: December 2022

Additively printed Ni-based superalloy with a compositionally graded transition from IN718 to René41 was fabricated by laser blown-powder directed energy deposition (DED/LB-M), with the goals of meeting location-specific temperature capability and reducing component cost for hot gas path turbine components. Residual stress distribution in thin wall specimens with three sets of DED build parameters in the as-built and stress-relieved states was measured by neutron diffraction. For calculating residual stress, the calculated d0 method was found to be more appropriate as stress-free reference than using the lattice spacing measured from the stress-relief heat treated specimens. Longer dwell time (lower interpass temperature), higher energy input, smaller layer thickness resulted in a higher magnitude of tensile residual stresses at edges and compressive residual stresses at center of the specimens. The residual stress results did not show a strong dependence on graded compositions, indicating that the residual stress build-up was more geometry and process dependent. Non-destructive neutron imaging based on the attenuation coefficient qualitatively visualized the compositional variation in the bulk and showed good agreement with quantitative Electron Probe Micro-Analysis (EPMA) measurement. Grain structure, texture, and residual plastic strain along the build direction were characterized by Electron Backscatter Diffraction (EBSD). Long columnar grains with (001) preferred grain orientation were dominant along the build direction. Compositional change did not show an obvious effect on the epitaxial growth of dendrites and the continuation of the columnar grains. Residual plastic strain was relatively low in the as-built specimens.
A Non-Permanent Magnet DC-Biased Vernier Reluctance Linear Machine with Non-Uniform Air Gap Structure for Ripple Reduction
Authors: Qiao Zhenyang , Zhang Yunpeng , Luo Jian , Fu Weinong , Shao Dingguo , Cao Haidong
Published: December 2022

Thrust ripple and density greatly impact the performance of the linear machine and other linear actuators, causing positioning control precision, dynamic performance, and efficiency issues. Generalized pole-pair combinations are difficult to satisfy both the thrust and ripple for double salient reluctance linear machines. In this paper, a DC-Biased vernier reluctance linear machine (DCB-VRLM) is proposed to solve the abovementioned issues. The key to the proposed design is to reduce the ripple and enhance the thrust density with non-uniform teeth by utilizing and optimizing the modulated flux in the air gap. To effectively verify the proposed design, the DCB-VRLMs with different winding pole pairs and secondary poles are compared. The 12-slot/10-pole combination is chosen to adopt a non-uniform air gap structure. Moreover, the energy distribution of AC/DC winding is studied and optimized to further enhance the performance of the proposed DCB-VRLM. The results indicate that the DCB-VRLM with the non-uniform air gap has a lower thrust ripple, better overload capability, and higher thrust density, which confirms its superiority in long-stroke linear rail transit and vertical elevator applications.