bluuebunny/crossref_metadata_2025 huggingface dataset:
Effects of Listening to Music During Blood Pressure Check in Primary Care Clinic Settings
Authors: Volkov Robert , Volkova Natalia
Published: June 2023

Background: Nearly half of adults in the United States (47% or 116 million) have hypertension and only 1 in 4 adults (24%) have their blood pressure under control. In 2020, more than 670, 000 death had hypertension as contributing cause. Listening to sounds of music can lead to reduction in blood pressure which was demonstrated in previous studies. To our knowledge it is the first study done in busy clinical practice with control group evaluating effects of 30 to 50 seconds of listening to music while blood pressure measurement was repeated. Methods:102 consecutive patients seen in primary care clinic from October 4, 2022, through December 14, 2022, were verbally consented to listening to the solo saxophone music while blood pressure measurement was repeated after initial blood pressure measurement revealed systolic blood above 139 millimeters of mercury (mmHg) and diastolic blood pressure above 89 mmHg. They were compared to 100 consecutive control patients, who were presented to clinic at the same time with the same blood pressure elevation parameters for medical assistant blood pressure check and no music intervention was done when blood pressure was repeated. Results:Systolic blood pressure drop in the study group with music intervention was 29.26 mmHg compared to 11.17 mmHg in control subjects ( P value .006) and diastolic blood pressure drop was from 5.99 mmHg to 3.98 mmHg ( P value .03). When separated by gender large systolic blood pressure drop was seen in control group in female patients 30.52 mmHg compared to controls 11.4 ( P value .002) but diastolic blood pressure did not drop significantly 5.43 mmHg to 4.41 mmHg decrease ( P value .184). Male subjects had significant drop in systolic and diastolic blood pressure in study group compared to control: 24.68 mmHg to 10.71 mmHg ( P value .001) and 8 mmHg to 3.71 mmHg ( P value .02), respectively. Conclusion: No significant extra time was required to implement recorded on smart phone music during repeat blood pressure check, which lead to significant improvement in blood pressure levels which could be lifesaving, taking into consideration harmful effects of the elevated blood pressure. This practice could be implemented in many busy primary care clinics and could lead to more relaxing patients’ experience and better blood pressure control. Patients may be advised to consider listening to music as a stress reduction in post pandemic time.
Qualitative Comparative Analysis: Search Target, Reflection on the Top-Down Approach, and Introduction of the Bottom-Up Approach
Authors: Ding Haien
Published: June 2023

Based on the INUS theory of causality, the search target of qualitative comparative analysis (QCA) is to find all the minimally sufficient conditions for the outcome’s occurrence in a data set, where the condition’s sufficiency, the necessity of the condition’s components, and the completeness of the solution are three core requirements. However, QCA’s current top-down approach, which relies on a truth table and Boolean minimization, cannot meet the main objective of QCA. Conditions generated by the top-down approach can be insufficient for the outcome or contain unnecessary components that can be removed. We found evidence supporting our arguments by examining the correctness of top-down QCA in Study 1. Then, we show that QCA can also proceed with a “bottom-up” search strategy in sufficiency analysis, similar to coincidence analysis (CNA). We contrast solutions of the top-down and bottom-up QCA approaches by analyzing a simulated crisp-set data set in Study 2 and a real-world fuzzy-set data set in Study 3. Both results show that only the bottom-up approach can produce all the minimally sufficient conditions. We contribute to the ongoing debate pertain QCA solution types and QCA algorithms by critically evaluating the limitations of QCA’s top-down approach and introducing a bottom-up approach for QCA.
Intrahepatic gallbladder duplication mimicking a hepatic cyst: A case report
Authors: Jagoda Sanjeewani , Subasinghe Duminda , Adhikari Yugantha , Pallewatte Aruna , Sivaganesh Sivasuriya
Published: June 2023

Gallbladder duplication is a rare anomaly of the biliary tree. Implications of misdiagnosis include unwarranted surgery and morbidity such as when liver resections are done suspecting cystic intraductal papillary neoplasm of the bile duct. The use of appropriate imaging, when suspected, facilitates diagnosis and avoids adverse surgical outcomes. We describe a case of an intrahepatic duplicate gallbladder containing calculi detected incidentally during a Focused Assessment Sonography for Trauma after a blunt trauma.
Italian psychedelic therapies of the past century: An historical overview
Authors: D’Arienzo Adriana , Samorini Giorgio
Published: June 2023

In recent years, the historical record of psychedelic therapy in Europe and the Americas has undergone considerable revision. In this article, we contribute to this re-interpretation by sharing documentation relating to psychedelic therapy carried out in Italy during the period 1927–1966. Our library research has uncovered one hundred publications, documenting at least 60 clinical studies in which psychedelics were administered. There is evidence of some primacy regarding this psychedelic research: Italy has the world record, for the twentieth century, for having carried out the largest number of clinical studies on patients with psilocybin and with lysergic acid amide (LSA); humans first received the high dose of 500 mcg of lysergic acid diethylamide (LSD) in Italy; and LSD plus LSA, and LSD plus psilocybin, were administered simultaneously for the first time. The most successful Italian clinical studies appear to have been those in which psilocybin was used in the treatment of depressive states, with the observed optimal dose being that of 3 mg administered intravenously every second or third day, alternated with placebo injections. Another therapeutic target that seems to have provided interesting results concerns the use of LSD and psilocybin for what was then called “neurosis.” Italian psychiatrists have also made useful contributions to theoretical aspects concerning psychedelic therapies, for example in the conflicting debate on the “psychotomimetic paradigm” and in the distinction between the “primary” and “secondary” effects of these substances.
Key Factors Affecting Efficiency of Private and Public Sector Bank: Analytical Study
Authors: Jagtap Manisha Vikas
Published: June 2023

The foundation of every nation’s economic structure is made up of financial institutions. It consists financial institutions such as banks, credit societies, asset management companies, insurance firms and mortgage lenders. They assist the economy expand by giving their clients financial support and services. One of the key factors in the growth of the national economy is seen as being banks. The current study examines the financial results of the nation’s public and private sector banks in order to comprehend how well the bank makes financial decisions. Moreover, to identify the various factors that affect the bank’s financial stability. The research instrument used is capital adequacy, asset quality, management capability, earnings capacity and liquidity model and t-test. It can be concluded that public sector banks need to focus on strategic decisions for sustaining in the competition with private sector banks. They require to be more professional as like private players in the banking business.
Preventing Hospital-Acquired Venous Thrombosis Embolism in Medical Patients Admitted to Acute Care Hospitals
Authors: Beam Alexandra , Bulka Sommer , Goodwin Jennifer Evans , Mauck Nicole , Alissa Malaz , Patrick Jonathan
Published: June 2023

Venous thrombosis embolism (VTE) is a leading cause of preventable death in the nation and has been identified as a high priority quality metric for clinical improvement at MedStar Health. Not only do VTEs impact several financial and reputational quality programs, but they also effect patient outcomes and patient safety. In an effort to reduce hospital acquired VTEs, MedStar Health developed a multi-disciplinary task force that identified four primary areas of opportunity that will provide awareness, improve compliance, and enhance clinical workflows that will contribute to the reduction of VTEs.
Let’s pause for a second: Neurodynamic evidence for rapid and coordinated team pauses during simulated patient encounters
Authors: Stevens Ronald , Galloway Trysha
Published: June 2023

In this study we explored neurodynamic candidates for coordinated periods of wakeful rest across team members while they performed healthcare simulations. Wakeful rest occurs sporadically when a person pauses task-related behavior at goal areas or choice points and is thought to be associated with memory replay. Analysis of the second-by-second EEG-derived neurodynamics of Emergency Medical Flight dyads identified periods of inter-brain coordination that surrounded periods of individual team member uncertainty but were negatively correlated with them ( r = -.3 to - .81). The brain region expression and inter-brain network connectivity of the shared information had properties consistent with the default mode network (DMN), an important effector of wakeful rest in animals and humans. This shared information was present in the 70-110 Hz electroencephalogram (EEG) spectrum which may represent bursts of memory replay. Going forward, our hypothesis is that these periods of wakeful rest (pauses) associated with increased inter-brain coordination may represent self-imposed or opportunistic ‘time-outs’ for team members to ‘gather their thoughts’ and mentally replay recent events before mentally projecting their plans forward.
Machine Learning Data Pipeline for the Democratization of AI
Authors: DiCostanzo Dominic J. , Ayan Ahmet S. , Jhawar Sachin R. , Allen Theodore T. , Patterson Emily S.
Published: June 2023

The use of artificial intelligence continues to increase. In healthcare, there has been a recent increase in AI applications to real-time individual patient clinical care, as opposed to population-based research or quality improvement efforts. However, the expertise to evaluate and implement these solutions is limited and often congregates in academic medical centers, creating barriers to adoption for smaller community and rural centers. Lowering the barrier to entry for innovative tools can help address disparities in patient outcomes due to access and other urban/rural contributors. We describe a strategy for evaluating commercially available machine learning models to disseminate lessons learned from developing, validating, and implementing machine learning-based models in clinical care in radiation therapy. In addition, we share an end-to-end data pipeline as open-source code with the tools necessary to identify, extract, organize, and process the data for use in machine-learning applications. We illustrate the application of this data pipeline to the use of brachytherapy to treat female cervical cancer patients. The example will show how we used the proposed pipeline to extract 708 potential participants and applied the developed methods and visualizations to clean the data providing 144 study participants for inclusion in our study. Finally, we discuss the anticipated challenges in implementing machine learning models in commercially available FDA-approved devices and suggest solutions using discrete tools built in different programming languages.
Aging and Visual Presentations in MRI Environments
Authors: Walker Jenny , Kumar Rachit , Hoo Marvin , Wheeler Mark E.
Published: June 2023

As individuals age, their vision tends to decline. These changes are natural, but often neglected when designing tasks for both older and younger adults. For instance, many MRI machine set-ups include in-bore displays. Ongoing work in our lab suggests that some older adults have issues seeing stimuli on these displays if there is a visual noise component. This is a problem that did not occur with younger adult samples. Therefore, this work provides an example of how this concern was addressed using a psychophysical thresholding technique. We hope that our experience will inform others who are facing similar issues and/or seeking suggestions for improving their patient and participants’ scanning experiences.
Human Factors and User Experience in At-Home Dialysis Treatment Technology and Patient Procedures
Authors: Pavlov Kathren , Montalvo Fernando , Sasser Jordan A. , Jones Luciana , DiBello Alexis , McConnell Daniel S. , Smither Janan A.
Published: June 2023

At-home dialysis treatments are becoming increasingly common as suitable options for renal disease treatment. However, the nature of self-administered, at-home dialysis presents specific medical risks and unsupervised patient experiences that require unique attention by health professionals. This study utilized Arhippainen’s ten user experience heuristics to evaluate and identify strengths and weaknesses of at-home dialysis treatments while suggesting methods to improve the at-home patient experience. Results of our heuristic assessment showed that some at-home dialysis providers consider patient needs and consider human factor design aspects. However, patient experience can still be improved by implementing UX principles aimed at providing a satisfying and positive interaction with products and services.
Spray-Dried Oregano Oil and Lavender Oil Microcapsules for Antibacterial Sports and Leisurewear
Authors: Türkoğlu Gizem Ceylan , Erkan Gökhan , Karavana Sinem Yaprak , Sarıışık Ayşe Merih , Çetmeli Bakadur Ayşegül , Ütebay Burçin , Popescu Alina
Published: June 2023

In this research, an industrially adaptable method is designed for antibacterial clothing. The essential oils of oregano and lavender were extracted using water vapor distillation, then they were spray-dried to form microcapsules. Comprehensive morphological analysis revealed the round shape of the microcapsules with smooth surfaces. The mean size of the optimum oregano and lavender microcapsules were 5.2 µm and 2.2 µm. The essential oils were detected in the polymeric matrix as peaks of microcapsules’ infrared spectra resembled both oils and polymer. Thermal analyses showed that encapsulation delays the degradation of the essential oil. The microcapsules were applied to six different fabrics used in sports and leisurewear by exhaustion. Scanning electron microscopy images indicated the existence of capsules after 10 washes. The antibacterial properties of cotton fabrics were assessed against Escherichia coli and Staphylococcus aureus in terms of the oil and washings. The developed products can serve as a long-lasting, natural antibacterial alternative to other products on the market.
Five Recent Trials That Are Changing Cardiology Practice Across the World
Authors: Madivada S.S. Mukharjee , Patnaik AN
Published: June 2023

There are several recent trials that are burgeoning at a rapid pace in the field of cardiology. We picked up 5 trials that impacted our practice: CLEAR OUTCOMES trial, REVIVED BCIS2 trial, DELIVER trial, ADVOR trial, and EBC MAIN trial. After a brief description of the results of these trials, we gave our perspective of their impact on our practice.
Displacement beyond dislocation: Aversive racism in gentrification studies
Authors: Bloch Stefano , Meyer Dugan
Published: June 2023

In this article, we argue for a critical gentrification studies that includes a more expansive and nuanced understanding of how displacement works, beyond the mapping and counting of dislocated bodies. As part of our argument, we introduce the concept of aversive racism to the geographical literature on displacement, pointing to this insidious mode of spatial practice that we argue is widely constitutive of place-making and place-taking processes in gentrifying areas. We do this by first providing a review and analysis of how displacement has been conceptualized and measured in existing geographical scholarship on gentrification, followed by a critical examination of the gentrification literature's engagement with race and racism, and a final argument for an affective approach within a Black geographies framing that encourages more analyses based on experiential encounters with more-than-physical displacement-by-gentrification.
The role of diet and nutrition in the management of COPD
Authors: Beijers Rosanne J.H.C.G. , Steiner Michael C. , Schols Annemie M.W.J.
Published: June 2023

In 2014, the European Respiratory Society published a statement on nutritional assessment and therapy in COPD. Since then, increasing research has been performed on the role of diet and nutrition in the prevention and management of COPD. Here, we provide an overview of recent scientific advances and clinical implications. Evidence for a potential role of diet and nutrition as a risk factor in the development of COPD has been accumulating and is reflected in the dietary patterns of patients with COPD. Consuming a healthy diet should, therefore, be promoted in patients with COPD. Distinct COPD phenotypes have been identified incorporating nutritional status, ranging from cachexia and frailty to obesity. The importance of body composition assessment and the need for tailored nutritional screening instruments is further highlighted. Dietary interventions and targeted single or multi-nutrient supplementation can be beneficial when optimal timing is considered. The therapeutic window of opportunity for nutritional interventions during and recovering from an acute exacerbation and hospitalisation is underexplored.
An exploratory study on students’ denominations, personal religious faith, knowledge about, and acceptance of evolution
Authors: Gutowski Roxanne , Aptyka Helena , Großschedl Jörg
Published: June 2023

Background

The theory of evolution serves as an overarching scientific principle for all areas of biology. Hence, knowledge about and acceptance of evolution are indispensable for holistic education. However, the levels of knowledge about and acceptance of evolution vary greatly. It is supposed that insufficient knowledge and lack of acceptance are associated with high personal religious faith and affiliated denominations. Therefore, it is fundamental to examine knowledge about and acceptance of evolution, personal religious faith, and denomination.

Results

We conducted an exploratory study with German upper secondary school students (N = 172). Firstly, the results showed a weak to moderate correlation between knowledge about and acceptance of evolution. Secondly, students of different denominations differed in their knowledge about evolution, use of key concepts, acceptance of evolution, and personal religious faith but not in their use of misconceptions. Thirdly, the findings revealed that a student’s denomination predicts knowledge level, whereas personal religious faith predicts acceptance.

Conclusions

Our exploratory study indicates that, in addition to the strength of personal religious faith, the denomination may be critical to knowledge about and acceptance of evolution.
Effects of alcohol use on sperm chromatin structure, a retrospective analysis
Authors: Trautman Ariadne , Gurumoorthy Aarabhi , Hansen Keith A.
Published: June 2023

Background

The evaluation of the infertile couple is often complex as multiple factors in both the male and female can contribute, including social history. Previous studies have displayed that male ethanol consumption can disturb sperm motility, nuclear maturity, and deoxyribonucleic acid (DNA) integrity. The main purpose of this study is to evaluate the effects of male alcohol use on sperm chromatin structure analysis (SCSA®).

This study was a retrospective chart review of 209 couples that presented to a midsize infertility clinic in the Midwest and had a semen analysis and SCSA® performed. Data extracted from the electronic medical record included demographics, tobacco use, alcohol use, occupational exposures, semen analysis results, and SCSA® results (DNA Fragmentation index (DFI) and High DNA stainability (HDS)). Statistical analysis was performed on this data set to determine significance with a p-level of 0.05, with the primary input being level of alcohol use and primary outcome being the SCSA® parameters.

Results

Overall, 11% of the cohort had heavy alcohol use (> 10 drinks/week), 27% moderate (3–10/week), 34% rare (0.5- < 3/week), and 28% none. 36% of the cohort had HDS > 10% (a marker of immature sperm chromatin). Level of alcohol use was not significantly associated with HDS > 10% or DFI. Heavier alcohol use was significantly associated with lower sperm count (p = 0.042). Increasing age was significantly associated with increasing DNA Fragmentation Index (p = 0.006), increased sperm count (p = 0.002), and lower semen volume (p = 0.022). Exposure to heat at work was significantly associated with lower semen volume (p = 0.042). Tobacco use was associated with lower sperm motility (p < 0.0001) and lower sperm count (p = 0.002).

Conclusions

There was not a significant association between the level of alcohol use and the High DNA Stainability or DNA Fragmentation Index of sperm. Increasing age was associated with semen parameters as expected, heat exposure was associated with lower semen volume, and tobacco use was associated with lower sperm motility and density. Further studies could investigate alcohol use and reactive oxidative species in sperm.
Evaluating the mouse neural precursor line, SN4741, as a suitable proxy for midbrain dopaminergic neurons
Authors: Boyd Rachel J. , McClymont Sarah A. , Barrientos Nelson B. , Hook Paul W. , Law William D. , Rose Rebecca J. , Waite Eric L. , Rathinavelu Jay , Avramopoulos Dimitrios , McCallion Andrew S.
Published: June 2023

To overcome the ethical and technical limitations of in vivo human disease models, the broader scientific community frequently employs model organism-derived cell lines to investigate disease mechanisms, pathways, and therapeutic strategies. Despite the widespread use of certain in vitro models, many still lack contemporary genomic analysis supporting their use as a proxy for the affected human cells and tissues. Consequently, it is imperative to determine how accurately and effectively any proposed biological surrogate may reflect the biological processes it is assumed to model. One such cellular surrogate of human disease is the established mouse neural precursor cell line, SN4741, which has been used to elucidate mechanisms of neurotoxicity in Parkinson disease for over 25 years. Here, we are using a combination of classic and contemporary genomic techniques – karyotyping, RT-qPCR, single cell RNA-seq, bulk RNA-seq, and ATAC-seq – to characterize the transcriptional landscape, chromatin landscape, and genomic architecture of this cell line, and evaluate its suitability as a proxy for midbrain dopaminergic neurons in the study of Parkinson disease. We find that SN4741 cells possess an unstable triploidy and consistently exhibits low expression of dopaminergic neuron markers across assays, even when the cell line is shifted to the non-permissive temperature that drives differentiation. The transcriptional signatures of SN4741 cells suggest that they are maintained in an undifferentiated state at the permissive temperature and differentiate into immature neurons at the non-permissive temperature; however, they may not be dopaminergic neuron precursors, as previously suggested. Additionally, the chromatin landscapes of SN4741 cells, in both the differentiated and undifferentiated states, are not concordant with the open chromatin profiles of ex vivo, mouse E15.5 forebrain- or midbrain-derived dopaminergic neurons. Overall, our data suggest that SN4741 cells may reflect early aspects of neuronal differentiation but are likely not a suitable proxy for dopaminergic neurons as previously thought. The implications of this study extend broadly, illuminating the need for robust biological and genomic rationale underpinning the use of in vitro models of molecular processes.
Cytosine base editors (CBEs) for inducing targeted DNA base editing in Nicotiana benthamiana
Authors: Luo Juan , Abid Muhammad , Tu Jing , Cai Xinxia , Zhang Yi , Gao Puxin , Huang Hongwen
Published: June 2023

Background

The base editors can introduce point mutations accurately without causing double-stranded DNA breaks or requiring donor DNA templates. Previously, cytosine base editors (CBEs) containing different deaminases are reported for precise and accurate base editing in plants. However, the knowledge of CBEs in polyploid plants is inadequate and needs further exploration.

Results

In the present study, we constructed three polycistronic tRNA-gRNA expression cassettes CBEs containing A3A, A3A (Y130F), and rAPOBEC1(R33A) to compare their base editing efficiency in allotetraploid N. benthamiana (n = 4x). We used 14 target sites to compare their editing efficiency using transient transformation in tobacco plants. The sanger sequencing and deep sequencing results showed that A3A-CBE was the most efficient base editor. In addition, the results showed that A3A-CBE provided most comprehensive editing window (C1 ~ C17 could be edited) and had a better editing efficiency under the base background of TC. The target sites (T2 and T6) analysis in transformed N. benthamiana showed that only A3A-CBE can have C-to-T editing events and the editing efficiency of T2 was higher than T6. Additionally, no off-target events were found in transformed N. benthamiana.

Conclusions

All in all, we conclude that A3A-CBE is the most suitable vector for specific C to T conversion in N. benthamiana. Current findings will provide valuable insights into selecting an appropriate base editor for breeding polyploid plants.
Does the feedback of blood results in observational studies influence response and consent? A randomised study of the Understanding Society Innovation Panel
Authors: Benzeval Michaela , Andrayas Alexandria , Mazza Jan , Al Baghal Tarek , Burton Jonathan , Crossley Thomas F. , Kumari Meena
Published: June 2023

Background

While medical studies generally provide health feedback to participants, in observational studies this is not always the case due to logistical and financial difficulties, or concerns about changing observed behaviours. However, evidence suggests that lack of feedback may deter participants from providing biological samples. This paper investigates the effect of offering feedback of blood results on participation in biomeasure sample collection.

Methods

Participants aged 16 and over from a longitudinal study – the Understanding Society Innovation Panel—were randomised to three arms – nurse interviewer, interviewer, web survey – and invited to participate in biomeasures data collection. Within each arm they were randomised to receive feedback of their blood results or not. For those interviewed by a nurse both venous and dried blood samples (DBS) were taken in the interview. For the other two arms, they were asked if they would be willing to take a sample, and if they agreed a DBS kit was left or sent to them so the participant could take their own sample and return it. Blood samples were analysed and, if in the feedback arms, participants were sent their total cholesterol and HbA1c results.

Response rates for feedback and non-feedback groups were compared: overall; in each arm of the study; by socio-demographic and health characteristics; and by previous study participation. Logistic regression models of providing a blood sample by feedback group and data collection approach controlling for confounders were calculated.

Results

Overall 2162 (80.3% of individuals in responding households) took part in the survey; of those 1053 (48.7%) consented to provide a blood sample. Being offered feedback had little effect on overall participation but did increase consent to provide a blood sample (unadjusted OR 1.38; CI: 1.16–1.64). Controlling for participant characteristics, the effect of feedback was highest among web participants (1.55; 1.11–2.17), followed by interview participants (1.35; 0.99 –1.84) and then nurse interview participants (1.30; 0.89–1.92).

Conclusions

Offering feedback of blood results increased willingness to give samples, especially for those taking part in a web survey.
Symptoms of depression and anxiety in Chinese adolescents: heterogeneity and associations with executive function
Authors: Sun Jing , Wang Shaoxia , Mu Guoxia , Liu Jingru , Su Rina , Zhang Xiang , Fang Jianqun , Wang Yanrong
Published: June 2023

Background

Depression and anxiety are common symptoms associated with significant morbidity in adolescents. Few studies have explored the relationship between latent profiles of adolescent depression-anxiety symptoms and executive function (EF), which is also a major pediatric public health concern.

Methods

The sample included 1,306 participants who were recruited from two schools in Ningxia. The Depression Self-Rating Scale for Children (DSRSC) and the Screen for Child Anxiety Related Emotional Disorders (SCARED) were used to assess the level of depression-anxiety symptoms in adolescents, and their executive function state was assessed using the Behavior Rating Inventory of Executive Function-Self-Report version (BRIEF-SR). Latent profile analysis (LPA) was carried out using Mplus 7.0 to explore the most likely number of profiles based on the subscales of DSRSC and SCARED. The relationship between adolescents’ executive function and depression-anxiety symptoms were analyzed by multivariable logistic regression, and the odds ratio were used to test the impact of this relationship.

Results

The LPA results show that the three-profile model was the best-fitting model for adolescent depression and anxiety symptoms. The proportions of Profile-1 (“Healthy Group”), Profile-2 (“Anxiety Disorder Group”), and Profile-3 (“Depression-Anxiety Disorder Group”) were 61.4%, 23.9%, and 14.7%, respectively. Additional analyses using multivariable logistic regression suggested that poor shifting capacity and emotional control were significantly more likely to be classified into the depression and/or anxiety groups, and worse working memory, task completion, and better inhibition were significantly more likely to be classified into the anxiety group.

Conclusions

The findings contribute to our understanding of the heterogeneity of adolescents’ depression-anxiety symptoms and highlight the important role of executive function in influencing mental health outcomes. These findings will guide the improvement and delivery of interventions for the treatment of anxiety and depression in adolescents, mitigating functional impairments in patients and reducing disease risk.
Internet addiction and mental health disorders in high school students in a Peruvian region: a cross-sectional study
Authors: Perez-Oyola Jean C. , Walter-Chavez Dionela M. , Zila-Velasque J. Pierre , Pereira-Victorio César Johan , Failoc-Rojas Virgilio E. , Vera-Ponce Víctor J. , Valladares-Garrido Danai , Valladares-Garrido Mario J.
Published: June 2023

Objectives

To determine the association between internet addiction disorder (IAD) and anxiety and depressive symptomatology in high school students in two private schools in Chiclayo, Peru, during the COVID-19 pandemic.

Materials and methods

Analytical cross-sectional investigation of 505 adolescents from two private schools. The dependent variables were anxiety and depressive symptomatology, measured with the Beck Adapted Depression Questionnaire (BDI-IIA) and the Beck Anxiety Inventory (BAI), respectively. The main independent variable was IAD, measured with the Internet Addiction Test instrument(IATI). Prevalence ratios (PR) and 95% confidence intervals (95%CI) were estimated.

Results

The average age was 14.16 years and 54.9% were women. 22.2% and 3.2% presented mild and moderate IAD; respectively. 9.3% presented severe anxiety and 34.3% severe depressive symptomatology. In the simple regression, adolescents with mild, moderate and severe IAD presented 19% (PR = 1.19; 95%CI: 1.05–1.35), 25% (PR = 1.25; 95%CI: 1.02–1.53) and 53% (PR = 1.47; 95% CI: 1.47–1.60) higher prevalence of depressive symptomatology; however, this association was not maintained in the multiple model. Anxiety increased 196% in adolescents with severe IAD (PR = 2.96; 95%CI: 1.86–4.71).

Conclusion

 We found that 2, 1, and 3 out of 10 students presented IAD, depressive symptomatology, and anxiety, respectively. We did not find an association between IAD and depressive symptomatology, but we did find an association with anxiety. Among the factors associated with the development of depressive symptomatology were the male sex, the presence of eating disorders, subclinical insomnia, using devices for more than 2 h, and using the Internet for academic activities. About anxiety, the associated factors are the female sex, the presence of eating disorders, subclinical insomnia, and the use of the Internet as social interaction. We recommend implementing counseling programs in view of the imminent introduction of the Internet as a pillar in education.
Experiences of distress and gaps in government safety net supports among parents of young children during the COVID-19 pandemic: a qualitative study
Authors: Mooney Alyssa C. , Jackson Kaitlyn E. , Hamad Rita , Fernald Lia C. H. , Hoskote Mekhala , Gosliner Wendi
Published: June 2023

Background

The COVID-19 pandemic prompted rapid federal, state, and local government policymaking to buffer families from the health and economic harms of the pandemic. However, there has been little attention to families’ perceptions of whether the pandemic safety net policy response was adequate, and what is needed to alleviate lasting effects on family well-being. This study examines the experiences and challenges of families with low incomes caring for young children during the pandemic.

Methods

Semi-structured qualitative interviews conducted from August 2020 to January 2021 with 34 parents of young children in California were analyzed using thematic analysis.

Results

We identified three key themes related to parents’ experiences during the pandemic: (1) positive experiences with government support programs, (2) challenging experiences with government support programs, and (3) distress resulting from insufficient support for childcare disruptions. Participants reported that program expansions helped alleviate food insecurity, and those attending community colleges reported accessing a range of supports through supportive counselors. However, many reported gaps in support for childcare and distance learning, pre-existing housing instability, and parenting stressors. With insufficient supports, additional childcare and education workloads resulted in stress and exhaustion, guilt about competing demands, and stagnation of longer-term goals for economic and educational advancement.

Conclusions

Families of young children, already facing housing and economic insecurity prior to the pandemic, experienced parental burnout. To support family well-being, participants endorsed policies to remove housing barriers, and expand childcare options to mitigate job loss and competing demands on parents. Policy responses that either alleviate stressors or bolster supports have the potential to prevent distress catalyzed by future disasters or the more common destabilizing experiences of economic insecurity.
Work-related musculoskeletal symptoms among Saudi radiologists: a cross-sectional multi-centre study
Authors: Alelyani Magbool , Gameraddin Moawia , Khushayl Abdullah Mohammed A. , Altowaijri Aljoharah M. , Qashqari Maryam Ibrahim , Alzahrani Fahad Ali Ahmed , Gareeballah Awadia
Published: June 2023

Background

Musculoskeletal disorders are common health problems worldwide. Several factors cause these symptoms, including ergonomics and other individual considerations. Computer users are prone to repetitive strain injuries that increase the risk of developing musculoskeletal symptoms (MSS). Radiologists are susceptible to developing MSS because they work long hours analysing medical images on computers in an increasingly digitalised field. This study aimed to identify the prevalence of MSS among Saudi radiologists and the associated risk factors.

Methods

This study was a cross-sectional, non-interventional, self-administered online survey. The study was conducted on 814 Saudi radiologists from various regions in Saudi Arabia. The study's outcome was the presence of MSS in any body region that limited participation in routine activities over the previous 12 months. The results were descriptively examined using binary logistic regression analysis to estimate the odds ratio (OR) of participants who had disabling MSS in the previous 12 months. All university, public, and private radiologists received an online survey containing questions about work surroundings, workload (e.g., spent at a computer workstation), and demographic characteristics.

Results

The prevalence of MSS among the radiologists was 87.7%. Most of the participants (82%) were younger than 40 years of age. Radiography and computed tomography were the most common imaging modalities that caused MSS (53.4% and 26.8%, respectively). The most common symptoms were neck pain (59.3%) and lower back pain (57.1%). After adjustment, age, years of experience, and part-time employment were significantly associated with increased MSS (OR = .219, 95% CI = .057–.836; OR = .235, 95% CI = 087–.634; and OR = 2.673, 95% CI = 1.434–4.981, respectively). Women were more likely to report MSS than males (OR = 2.12, 95% CI = 1.327–3.377).

Conclusions

MSS are common among Saudi radiologists, with neck pain and lower back pain being the most frequently reported symptoms. Gender, age, years of experience, type of imaging modality, and employment status were the most common associated risk factors for developing MSS. These findings are vital for the development of interventional plans to reduce the prevalence of musculoskeletal complaints in clinical radiologists.
Absence of detrusor muscle in TUR-BT specimen – can we predict who is at highest risk?
Authors: Volz Yannic , Trappmann Rabea , Ebner Benedikt , Eismann Lennert , Pyrgidis Nikolaos , Pfitzinger Paulo , Bischoff Robert , Schlenker Boris , Stief Christian , Schulz Gerald Bastian
Published: June 2023

Introduction

As a high-quality TUR-BT is important to ensure adequate treatment for bladder cancer patients, the aim of the current study is to investigate the impact of patient-related, surgical and tumor-specific parameters on detrusor muscle (DM) absence (primary objective) and to assess the impact of DM on the prognosis after a TUR-BT (secondary objective).

Patients and methods

Transurethral resection of bladder tumors (TUR-BTs) between 2009 and 2021 were retrospectively screened (n = 3237). We included 2058 cases (1472 patients) for the primary and 472 patients for secondary objective. Clinicopathological variables including tumor size, localization, multifocality, configuration, operation time and skill-level of the urologist were assessed. We analyzed predictors for missing DM and prognostic factors for recurrence-free survival (RFS) for the complete cohort and subgroups.

Results

DM was present in 67.6% (n = 1371/2058). Surgery duration (continuous, minutes) was an independent predictor for absence of DM in the complete cohort (OR:0.98, r:0.012, 95%CI:0.98–0.99, p = 0.001). Other significant risk factors for missing DM were papillary tumors (OR:1.99, r:0.251, 95%CI:1.22–3.27, p = 0.006) in the complete cohort and bladder-roof and posterior-bladder-wall localization for re-resections. Absence of DM in high-grade BC correlated with reduced RFS (HR:1.96, 95%CI:1.0–3.79, p = 0.045).

Conclusion

Sufficient time for a TUR-BT is mandatory to assure DM in the TUR-BT specimen. Also, cases with more difficult locations of bladder tumors should be performed with utmost surgical diligence and endourological training should incorporate how to perform such operations. Of note, DM correlates with improved oncological prognosis in high-grade BC.
Effect of immersion and thermocycling in different beverages on the surface roughness of single- and multi-shade resin composites
Authors: El-Rashidy Aiah A. , Shaalan Omar , Abdelraouf Rasha M. , Habib Nour A.
Published: June 2023

Background

Resin composite restorations are highly esthetic restorations, which should have and maintain high surface polish. However, esthetic restorations are subjected to different beverages at variable temperatures, which may affect their surface roughness. This study aimed to evaluate the surface roughness of single-shade (Omnichroma) and multi-shade (Filtek Z350XT) composite materials, following aging by immersion and thermocycling in different beverages, simulating one year of clinical service.

Methods

Thirty specimens of each material were prepared and divided into 6 subgroups (n = 5). In each material, the grouping of the specimens was as follows: the first subgroup was the as-prepared specimens stored dry without immersion or thermocycling. The second, third, and fourth subgroups were immersed in saliva, tea, and red wine, respectively, for 12 days at 37 °C. The fifth and sixth subgroups were thermocycled for 10,000 cycles, in tea (the fifth between 37 and 57 °C) and in red wine (the sixth between 37 °C and12°C). The resultant surface roughness was measured by two different methods, stylus profilometer and atomic force microscopy (AFM). Intergroup comparison was performed using independent t test, while intragroup comparison was performed using one-way analysis of variance (ANOVA) followed by Tukey’s post-hoc test.

Results

Intergroup comparison between both composites showed no statistically significant differences in all groups using the stylus profilometer roughness measurements (P>0.05), while the AFM measurements showed significant difference (P ≤ 0.05) within all storage media except the as-prepared control (P = 0.0645), where nanofilled Filtek Z350 XT showed lower nano-roughness. Intragroup comparison data were variable, depending on the material, aging conditions, and roughness assessment tool. However, the resultant average surface roughness (Ra) values in all groups did not exceed the threshold value of Ra 0.2 μm.

Conclusions

Both resin composites attained and retained a clinically acceptable surface finish after immersion and thermocycling in different beverages.
Twine virtual patient games as an online resource for undergraduate diabetes acute care education
Authors: Quail Nathaniel Patrick Andrew , Boyle James Graham
Published: June 2023

Background

Virtual patients provide a safe way to simulate authentic clinical practice. Twine is an open-source software that can be used to create intricate virtual patient games, including elements like non-linear free text history taking and time-related changes to the game’s narrative. We evaluated the incorporation of Twine virtual patient games into a diabetes acute care online learning package for undergraduate medical students at the University of Glassgow, Scotland.

Methods

Three games were developed using Twine, Wacom Intuous Pro, Autodesk SketchBook, Camtasia Studio, and simulated patients. Online material included three VP games, eight microlectures, and a single best answer multiple choice question quiz. The games were evaluated at Kirkpatrick Level 1 with an acceptability and usability questionnaire. The entire online package was evaluated at Kirkpatrick Level 2 with pre- and post-course multiple choice and confidence questions, with statistical analysis performed using paired t-tests.

Results

122 of approximately 270 eligible students provided information on resource utilisation, with 96% of these students using at least one online resource. 68% of students who returned surveys used at least one VP game. 73 students provided feedback on the VP games they had played, with the majority of median responses being “agree” on positive usability and acceptability statements. The online resources were associated with a mean multiple choice score increase from 4.37 out of 10 to 7.96 out of 10 (p < 0.0001, 95% CI + 2.99 to + 4.20, n = 52) and a mean total confidence score increase from 4.86 out of 10 to 6.70 out of 10 (p < 0.0001, 95% CI + 1.37 to + 2.30, n = 48).

Conclusions

Our VP games were well-received by students and promoted engagement with online material. The package of online material led to statistically significant increases in confidence and knowledge in diabetes acute care outcomes. A blueprint with supporting instructions has now been created to facilitate rapid creation of further games using Twine software.
Medical student intentions to practice internal medicine in underserved areas associated with debt, identity and extracurricular participation
Authors: Lapidus Aaron , Shah Sapan , Mekonnen Meheret , Araj Joseph , Nguyen Mytien , Mason Hyacinth , Eggan Branden , Genao Inginia
Published: June 2023

Background

Currently, Internal Medicine (IM) physicians do not reflect the ethno-racial diversity of the US population. Moreover, there is a shortage of IM physicians in Medically Underserved Areas (MUAs) in the US. The purpose of this study was to determine factors that influence medical students’ intent to practice IM in MUAs. We hypothesized students with intentions to pursue a career in IM and work in MUAs were more likely than their peers to identify as underrepresented in medicine (URiM), report greater student debt loads, and report medical school experiences in cultural competencies.

Methods

We analyzed de-identified data of 67,050 graduating allopathic medical students who completed the Association of American Medical Colleges’ (AAMC) Medical School annual Graduation Questionnaire (GQ) between 2012–2017 by multivariate logistic regression models, examining intent to practice IM in MUAs based on respondent characteristics.

Results

Of 8,363 students indicating an intent to pursue IM, 1,969 (23.54%) students also expressed an intent to practice in MUAs. Students awarded scholarships, (aOR: 1.23, [1.03–1.46]), with debt greater than $300,000 (aOR: 1.54, [1.21–1.95], and self-identified non-Hispanic Black/African American (aOR: 3.79 [2.95–4.87]) or Hispanic (aOR: 2.53, [2.05–3.11]) students were more likely than non-Hispanic White students to indicate intent to practice in MUAs. This pattern also existed for students who participated in a community-based research project (aOR: 1.55, [1.19–2.01]), had experiences related to health disparities (aOR: 2.13, [1.44–3.15]), or had experiences related to global health (aOR: 1.75, [1.34–2.28]).

Conclusions

We identified experiences and characteristics that associate with intention to practice IM in MUAs, which can aid future curricular redesign by medical schools to expand and deepen comprehension of health disparities, access to community-based research, and global health experiences. Loan forgiveness programs and other initiatives to increase recruitment and retention of future physicians should also be developed.