bluuebunny/crossref_metadata_2025 huggingface dataset:
Robust path following control of 4WID autonomous vehicle with driving condition adaptive mechanism
Authors: Liang Yixiao , Li Yinong , Khajepour Amir , Zheng Ling
Published: December 2022

This paper proposes a novel integrated path following control scheme for a 4-Wheel Independent Drive (4WID) autonomous vehicle that can adaptively change its mechanism according to the driving conditions. The proposed integrated system handles the lateral steering controller, longitudinal speed, and yaw moment controls considering tire force capacity of each corner. For the lateral controller, the cornering stiffness uncertainties and the transient performance are considered and combined into an H∞ robust controller based on linear matrix inequality (LMI) theory. A super-twisting sliding mode controller (STSMC) based longitudinal controller is designed to deal with disturbances and suppress chattering. When encountering extreme conditions, the active yaw moment controller with hierarchical structure is adaptively activated to prevent large deviation from the reference path and maintain the stability of vehicle. For the tire force allocation, an optimization algorithm is proposed, which has flexible equality constraints to coordinate the longitudinal and lateral motions according to the driving conditions. Simulations based on Carsim-Simulink co-simulation platform show that the proposed method is effective and has excellent performance in both normal and extreme driving conditions.
Bivariate joint models for survival and change of cognitive function
Authors: Pan Shengning , van den Hout Ardo
Published: December 2022

Changes in cognitive function over time are of interest in ageing research. A joint model is constructed to investigate. Generally, cognitive function is measured through more than one test, and the test scores are integers. The aim is to investigate two test scores and use an extension of a bivariate binomial distribution to define a new joint model. This bivariate distribution model the correlation between the two test scores. To deal with attrition due to death, the Weibull hazard model and the Gompertz hazard model are used. A shared random-effects model is constructed, and the random effects are assumed to follow a bivariate normal distribution. It is shown how to incorporate random effects that link the bivariate longitudinal model and the survival model. The joint model is applied to the English Longitudinal Study of Ageing data.
Book review: Brian Black, In Dialogue with the Mahabharata
Authors: Basu Rohan
Published: December 2022

Brian Black, In Dialogue with the Mahabharata. New York: Routledge, 2021. 228 pp. £36.99 (paperback). ISBN: 9780367436001.
Culturally Acceptable Emotional Expressions Perceived by Non-U.S. Physicians Undergoing U.S.-Based Serious Illness Communication Skills Training: A Cross-Sectional Study
Authors: Onishi Eriko , Ishikawa Hirono , Ito Kaori , Nakagawa Shunichi , Shiozawa Youkie , Uemura Takeshi , Yuasa Misuzu , Ouchi Kei
Published: December 2022

Context

Responding to emotions is a key feature of U.S.-based serious illness communication skills training, VitalTalk®, of which trained actors portraying seriously ill patients is a component. The cultural appropriateness and perceived utility of the actors’ emotional expressions remain to be empirically evaluated outside of the U.S.

Objectives

To determine the cultural appropriateness and educational utility of VitalTalk® actors’ emotional expressions, as perceived by clinicians.

Methods

From January 2021-April 2022, we conducted a cross-sectional study of physicians in Japan attending virtual VitalTalk® training in Japanese, each session focusing on: responding to emotions (#1) and discussing goals of care (#2), respectively. We examined their perceived authenticity and utility of the actively and passively intense emotional expressions portrayed by actors in VitalTalk® role-plays.

Results

Physicians (N = 100, 94% response rate) from across Japan voluntarily attended two-session workshops and completed post-session surveys. Eighty-eight participants (88%) responded that both actively and passively intense emotions portrayed by the actors provided useful learning experiences. For session #1, the participants found actively intense emotional expressions to be more clinically authentic, compared to passively intense ones (4.21 vs 4.06 out of a 5-point Likert scale, P P= .02). For session #2, no such difference was observed (4.16 vs 4.08 of a 5-point Likert scale, P = .24).

Conclusions

Even in a culture where patients may express emotions passively, any intense and authentic emotional expressions by actors can be perceived as facilitating learning. Most participants perceived both the Name, Understand, Respect, Support, and Explore ‘(NURSE)' statements and Reframe, Expect emotion, Map out patient goals Align with goals and Propose a plan ‘(REMAP)' frameworks as useful in routine clinical practice in Japan.
Administration of ciprofloxacin through a nasogastric tube in pediatric oncology and stem cell transplantation patients
Authors: Bauters Tiene , Buyle Franky , Schelstraete Petra , Dhooge Catharina
Published: December 2022

Pediatric oncology and hematopoietic stem cell transplantation patients are facing many gastrointestinal side effects of chemotherapy, including nausea, vomiting, mucositis, and diarrhea. International guidelines advise early enteral tube feeding as the first option of nutritional support in children undergoing myeloablative hematopoietic stem cell transplantation. When using enteral feeding tubes for nutritional purposes as well as drug administration, some pharmaceutical, nursing, and technical issues have to be taken into account. Ciprofloxacin is a fluoroquinolone, widely used because of its broad spectrum antimicrobial activity and favorable pharmacokinetic properties. However, its co-administration with polyvalent cations (as present in enteral feeding) makes the absorption of ciprofloxacin more difficult and may alter the pharmacokinetic parameters. Literature data are conflicting on how long the enteral feeding should be discontinued for patients receiving ciprofloxacin via an enteral feeding tube, ranging from 2 h before to 6 h after the administration of ciprofloxacin. Our research question was guided by challenges and concerns of nurses about the delay time between ciprofloxacin administration and restart of the enteral feeding without compromising the nutritional intake of the children. Our guideline was adapted, nurses were instructed accordingly, and patient leaflets with correct information were created.
Lumen diameter is associated with the patency after percutaneous angioplasty of arteriovenous fistulas
Authors: Li Dandan , Hao Ming , Sheng Haijun , Ge Hongwei , Zhu Yongbin
Published: December 2022

Aim:

To assess the value of lumen diameter after percutaneous angioplasty (PTA) to predict functional dialysis use (FDU) of arteriovenous fistulas (AVF).

Methods:

We performed a retrospective study of all patients who underwent first PTA because of AVF stenosis between March 2019 and March 2021. The outcome was FDU of AVF at 6 months follow up. Independent factors of FDU were identified using multivariate regression analyses. Receiver operating characteristic (ROC) curve was performed to investigate the predictive ability of lumen diameter for FDU.

Results:

A total 68 patients were included into this study and the AVF of 53 cases (77.9%) were good for FDU after 6 months. The AVF age was younger in failure group than that in success group (16.1 ± 9.1 months vs 28.3 ± 20.0 months, p = 0.026). Compared with failure group, the post-PTA minimum luminal diameter (MLD) was bigger in success group (4.5 [4.0–4.5 mm] vs 5.5 mm [4.5–5.5 mm], p < 0.001). Meanwhile, the gain of lumen diameter in success group was also bigger than that in failure group (2.5 mm [2.0–3.0 mm] in failure group vs 3.0 mm [2.75–3.5 mm] in success group, p = 0.012). The residual stenosis was higher in failure group than that in success group (30% [10%–40%] vs 10% [0%−20%], p = 0.003). Logistic regression showed that AVF age and post-PTA MLD were independent predictors of FDU. ROC analysis showed that the gain of lumen diameter, post-PTA MLD and improvement of stenosis were comparable to predict FDU. For post-PTA MLD, the area under ROC curve was 0.804 (95% CI, 0.681–0.927, p < 0.001). The best cutoff is 4.75 mm, with the sensitivity and specificity was 71.7% and 80.0%, respectively.

Conclusions:

AVF age and post-PTA MLD were independently predictors for FDU of AVF after PTA. To get the best performance, a minimum vein diameter of 4.75 mm should be obtained after angioplasty.
Association of daily physical activity with brain volumes and cervical spinal cord areas in multiple sclerosis
Authors: Block Valerie J , Cheng Shuiting , Juwono Jeremy , Cuneo Richard , Kirkish Gina , Alexander Amber M , Khan Mahir , Akula Amit , Caverzasi Eduardo , Papinutto Nico , Stern William A , Pletcher Mark J , Marcus Gregory M , Olgin Jeffrey E , Hauser Stephen L , Gelfand Jeffrey M , Bove Riley , Cree Bruce AC , Henry Roland G
Published: December 2022

Background:

Remote activity monitoring has the potential to evaluate real-world, motor function, and disability at home. The relationships of daily physical activity with spinal cord white matter and gray matter (GM) areas, multiple sclerosis (MS) disability and leg function, are unknown.

Objective:

Evaluate the association of structural central nervous system pathology with ambulatory disability.

Methods:

Fifty adults with progressive or relapsing MS with motor disability who could walk >2 minutes were assessed using clinician-evaluated, patient-reported outcomes, and quantitative brain and spinal cord magnetic resonance imaging (MRI) measures. Fitbit Flex2, worn on the non-dominant wrist, remotely assessed activity over 30 days. Univariate and multivariate analyses were performed to assess correlations between physical activity and other disability metrics.

Results:

Mean age was 53.3 years and median Expanded Disability Status Scale (EDSS) was 4.0. Average daily step counts (STEPS) were highly correlated with EDSS and walking measures. Greater STEPS were significantly correlated with greater C2-C3 spinal cord GM areas (ρ = 0.39, p = 0.04), total cord area (TCA; ρ = 0.35, p = 0.04), and cortical GM volume (ρ = 0.32, p = 0.04).

Conclusion

These results provide preliminary evidence that spinal cord GM area is a neuroanatomical substrate associated with STEPS. STEPS could serve as a proxy to alert clinicians and researchers to possible changes in structural nervous system pathology.
Concurrent and convergent validity of culture-specific psychopathology syndromes among Cambodian adolescents
Authors: Dao Anh , Khann Sareth , Seponski Desiree M. , Hoang-Minh Dang , Tran Cong V. , Weiss Bahr
Published: December 2022

Psychopathology is defined in part by its impacts on life functioning (e.g., fulfillment of daily responsibilities at work or school, in family relationships). Relations to life functioning are particularly important in the validation of culture-specific syndromes (patterns of mental health symptoms specific to a particular culture), to demonstrate that culture-specific symptom patterns do in fact represent pathology. The current study's goal was to assess the construct validity of the Cambodian Somatic Symptom and Syndrome Inventory (CSSI). The study focused on the statistically unique effects of the CSSI on life functioning (i.e., effects of the CSSI on life functioning, controlling for Western psychopathology syndromes), to determine whether the CSSI contributes information beyond standard Western measures, which would support CSSI culture-specific convergent validity. Because adolescence is a key period when psychopathology often develops, study participants were 391 high-school students in one urban and one rural area of Cambodia. Participants completed the CSSI, the Western psychopathology surveys Patient Health Questionnaire (PHQ-9) and Generalized Anxiety Disorder questionnaire (GAD-7), and life functioning measures assessing functional impairment, quality of life, and help-seeking. Results indicated strong CSSI concurrent validity (canonical correlation = 0.75) with the PHQ-9 and GAD-7, and CSSI total effects convergent validity on life functioning indicators. All CSSI statistically unique effects (controlling for the PHQ-9 and GAD-7) on life functioning measures were non-significant indicating that the CSSI, shown to be a valid assessment measure in the current study, does not add predictive information beyond standard Western measures. A key limitation that should be considered in interpretation of these results is that the life functioning measures, although reviewed by Khmer psychologists, were Western-based, thus potentially inflating relations with Western psychopathology measures.
Environing media and cultural techniques: From the history of agriculture to AI-driven smart farming
Authors: Wickberg Adam
Published: December 2022

This article presents the new theoretical concept of environing media, which is developed to offer critical insight into how processes of mediation affect how we perceive of, manage and use the environment. Building on the insight that the environment has been in a continuous slow process of change that is now escalating due to human impacts, the article sketches a history of how environmental change and mediation are intertwined. Taking the history of agriculture as a case for the theoretical development, it shows how the current digitization of farming and implementation of AI systems in precision agriculture is the last of a long series in which environmental mediation come to play a crucial role in the forging of human–Earth relations. The article thereby shows the complex interplay between knowing and changing the environment as media technologies produce new epistemologies that in turn produce new interventions.
Assessing technical vocational education and training institutions’ curriculum in Kenya: What strategies can position the youth for employment?
Authors: Muchira John M , Kiroro Francis , Mutisya Maurice , Ochieng Vollan O , Ngware Moses W
Published: December 2022

Africa could benefit from the demographic dividend by identifying strategies for investing in the massive youthful workforce. The current study employs the social cognitive career theory perspective to assess Technical Vocational Education and Training (TVET) institutions’ curriculum coverage of various skills in Kenya. We further examine the relevance of the curricula to the labour market and barriers affecting institutions' capacity to implement practical-oriented and demand-driven curricula. A cross-sectional research design was adopted using a mixed-method approach to gather and analyse data. Findings revealed different levels of coverage of soft and technical skills in the curriculum. Inadequate resources, lack of modern equipment and technology, and minimal adoption of practical components in the curriculum were identified as barriers to acquiring skills, consequently affecting TVET students' capacity to secure employment. To promote requisite skills acquisition and accelerate youth employability, we recommend a partnership between TVET institutions and the industry. Assessing how the competencies acquired align with labour market demands is also critical. Evidence gathered from this assessment will inform the improvement of existing on-the-job training, enable institutions to scale-up successful models and foster the development of human capital that is more adaptable to the dynamic world of work.
Facts in Context: Problem Perceptions, Numerical Information, and Policy Attitudes
Authors: Moniz Philip
Published: December 2022

How does policy-relevant information change citizens’ policy attitudes? Though giving numerical information about social conditions has been found, at times, to change policy attitudes, why it works (or doesn’t) is poorly understood. I argue new or corrective information may not translate into policy-attitude change in part because it fails to instill a sense of need for change. Perceived problem seriousness, an affect-laden judgment about the acceptability of the status quo, may therefore be an important psychological mechanism through which information changes people’s minds. To perceive a problem, conditions must seem worse than they ought to be. Previous research, however, presents numerical information without a point of reference from which citizens can base their judgments. By contextualizing facts with reference points from the past (time) as well as other countries (space), four survey experiments show that numerical information about a range of social problems can change policy attitudes by first changing their perceived seriousness.
FLAIR hyperintense vessels on MRI post brain arteriovenous malformation embolization: A novel finding associated with post-procedure intraparenchymal hemorrhage
Authors: White Timothy G , A Shah Kevin , Fraser Madison , Turpin Justin , Teron Ina , W Link Thomas , Dehdashti Amir R , Woo Henry H
Published: December 2022

Introduction

Brain arteriovenous malformations (BAVMs) are frequently managed by endovascular embolization with a growing number of centers embolizing with intent to cure. Hemorrhage post-embolization is a severe and poorly understood complication. We present a novel imaging finding associated with post-embolization hemorrhage that has significantly impacted the management of patients at our institution.

Methods

A retrospective review of all patients undergoing embolization of BAVM at a single center was performed. Post-embolization magnetic resonance imaging (MRI) was reviewed for the presence of T2 fluid-attenuated inversion recovery (FLAIR) hyperintense vessels (FHVs). Bivariate analysis was performed to determine associations between patient characteristics and risk of hemorrhage.

Results

A total of 50 patients underwent 75 embolization procedures. Forty-six post-embolization MRIs were available for review. There were four hemorrhages and 100% of those presented with FHV. In contrast, only 11.9% of embolization procedures without post-procedural hemorrhage had FHVs on MRI. In total, 18.7% of embolizations led to some morbidity or mortality, with only 6.7% leading to permanent morbidity or mortality. In bivariate analysis, only the presence of FHVs was correlated with the risk of hemorrhage ( p < 0.05).

Conclusions

This is the first series to describe the finding of hyperintense blood vessels on FLAIR imaging after embolization of BAVMs and correlate it with hemorrhage post embolization. This finding can help guide practitioners and potentially identify patients at risk of delayed hemorrhage post embolization.
The impact of sleep behaviours, chronotype and time of match on the internal and external outcomes of a tennis match
Authors: Turner Mitchell , Beranek Philipp , Sahrom Sofyan , Lo Johnny , Ferrauti Alexander , Dunican Ian C , Cruickshank Travis
Published: December 2022

Tennis match performance is often evaluated by a player's internal (heart rate) and external (match analytics) outcomes. Numerous factors could influence these outcomes, including the time of day, which may be advantageous or not depending on a player's chronotype. This study aimed to determine the influence time of day, chronotype and sleep–wake behaviour (SWB) had on internal and external outcomes of tennis matches. Twelve state-level male tennis players, with a mean age of 28  ±  7, stature of 183  ±  7 and body mass of 86.6  ±  17.4 wore an actigraph device and completed a sleep diary for the study duration. Based on rankings, players were paired against the same opponent and completed three tennis matches at 8:00 am, 2:00 pm and 8:00 pm, separated by a minimum of 48 h. Fatigue and chronotype, measured by the Fatigue Severity Scale, Morningness Eveningness Questionnaire and midsleep time, were assessed before matches; motivation, measured by the Intrinsic Motivation Inventory, was assessed after matches. During matches, players wore global positioning systems and heart rate monitors; the match analytics and players’ rate of perceived exertion were recorded. Increased unforced errors and decreased winners and forced errors were observed in the evening matches. Decreased total distance and rate of perceived exertion during the second set were found for the evening compared to morning and afternoon matches. Chronotype and sleep–wake behaviour had trivial to weak associations with internal and external outcomes. These results indicate that players and coaches should consider the match times when training for future tournaments.
Investigating the relationship between authentic leadership and athletes' commitment, positive affect, and perceived teammate prosocial behaviour via trust and team culture
Authors: Malloy Ella , Yukhymenko-Lescroart Mariya A , Kavussanu Maria
Published: December 2022

Authentic leadership is a genuine form of leadership in which leaders demonstrate behaviours in line with their moral values. Research has started to examine this leadership style and its impact on a range of athlete outcomes. The aim of this study was to investigate whether coaches’ authentic leadership, as perceived by their athletes, is related to athletes’ commitment, positive affect and perceived teammate prosocial behaviour via trust and team culture. Participants were 366 (240 females, Mage = 21.07) athletes, participating mostly in team sports, who completed questionnaires assessing the aforementioned variables. Using multilevel path analysis, we found that authentic leadership was positively related to athletes' commitment and positive affect via trust and team culture, as well as to perceived teammate prosocial behaviour via trust. Our findings enhance our understanding of authentic leadership in sport and highlight its importance in predicting a range of outcomes. The findings suggest that authentic leadership in coaches could be key to creating more positive environments in sport.
Management of transgender patients in critical care
Authors: Flower Luke , Cheung Ada , Connal Stuart , Humphreys Alice , Kamaruddin Kamilla , Lennie Yasmin , Edwardson Stuart
Published: December 2022

As clinicians working in critical care, it is our duty to provide all of our patients with the high-quality care they deserve, regardless of their gender identity. The transgender community continues to suffer discrimination from the media, politicians and general public. As healthcare workers we often pride ourselves on our ability to safely care for all patients. However, there remains a distinct lack of understanding surrounding the care of critically ill transgender patients. This is likely in part because the specific care of transgender patients is not included in the Faculty of Intensive Care Medicine’s, Royal College of Anaesthetists’, Royal College of Physician’s, or Royal College of Emergency Medicine’s curriculum. There are several important considerations relevant for transgender patients in critical care including anatomical changes to the airway, alterations to respiratory and cardiovascular physiology and management of hormone therapy. Alongside this, there are simple but important social factors that exist, such as the use of patient pronouns and ensuring admittance to correctly gendered wards. In this review we will address the key points relevant to the care of transgender patients in critical care and provide suggestions on how education on the subject may be improved.
MRI hip morphology is abnormal in unilateral DDH and increased lateral limbus thickness is associated with residual DDH at minimum 10-year follow-up
Authors: Schmaranzer Florian , Justo Pedro , Kallini Jennifer R , Ferrer Marianna G , Miller Patricia E , Matheney Travis , Bixby Sarah D , Novais Eduardo N
Published: December 2022

Purpose:

The purpose of the study was to compare the post-reduction magnetic resonance imaging morphology for hips that developed residual acetabular dysplasia, hips without residual dysplasia, and uninvolved contralateral hips in patients with unilateral developmental dysplasia of the hip undergoing closed or open reduction and had a minimum 10-year follow-up.

Methods:

Retrospective study of patients with unilateral dysplasia of the hip who underwent open/closed hip reduction followed by post-reduction magnetic resonance imaging. Twenty-eight patients with a mean follow-up of 13 ± 3 years were included. In the treated hips, residual dysplasia was defined as subsequent surgery for residual acetabular dysplasia or for Severin grade > 2 at latest follow-up. On post-reduction, magnetic resonance imaging measurements were performed by two readers and compared between the hips with/without residual dysplasia and the contralateral uninvolved side. Magnetic resonance imaging measurements included acetabular version, coronal/ axial femoroacetabular distance, acetabular depth–width ratio, osseous/cartilaginous acetabular indices, and medial/lateral (limbus) cartilage thickness.

Results:

Fifteen (54%) and 13 (46%) hips were allocated to the “no residual dysplasia” group and to the “residual dysplasia” group, respectively. All eight magnetic resonance imaging parameters differed between hips with residual dysplasia and contralateral uninvolved hips (all p < 0.05). Six of eight parameters differed (all p < 0.05) between hips with and without residual dysplasia. Among these, increased limbus thickness had the largest effect (odds ratio = 12.5; p < 0.001) for increased likelihood of residual dysplasia.

Conclusions:

We identified acetabular morphology and reduction quality parameters that can be reliably measured on the post-reduction magnetic resonance imaging to facilitate the differentiation between hips that develop with/without residual acetabular dysplasia at 10 years postoperatively.

Level of evidence:

level III, prognostic case-control study.
“I choose fish”: Understanding informal civil society in Vietnam through environmental grievances and actions
Authors: Nguyen-Van-Quoc Thai , Trell Elen-Maarja
Published: December 2022

This paper focuses on informal civil society in an authoritarian context, particularly the unprecedented nation-wide protests and civic action in Vietnam, triggered by the industrial pollution and the resulting mass fish death on the central coast in 2016. We explore civil society actors' motivations and tactics to take action under political restrictions. Data was collected from semi-structured interviews with civil society actors. The findings illustrate how informal civil society in Vietnam is built on independent or partly NGO-affiliated individuals working together to promote non-violent change, although the process of doing so might involve challenging the government apparatus. The activists were motivated to take action by the dead fish’ symbolism of endangered livelihood, environmental protection, and to demand transparency from the government. Critical factors further contributing to the mobilisation of citizens included the combination of food symbolism and anti-China nationalism, the tactical use of Facebook by urban activists, and religious leadership in the rural areas. The protests resulting from the coastal pollution can be seen as boundary-spanning events through which Vietnamese civil society actors ‘invent’ spaces of (political) participation amidst limited ‘invited’ space.
Visualizing the pattern of origin of international visitors to Beijing and Shanghai based on mobile phone data
Authors: Wang Yao , Feng Yongheng , Meng Xiaodong , Xiao Yang
Published: December 2022

There is a long tradition of understanding globalization by measuring the “world city-ness”, and there are two distinctive frameworks concerning the interrelations of the “world city network”, one of which builds upon the notion of worldwide corporate organizations and the other on the infrastructure of transport. Despite that, more studies on a single city are still required, since most cities participated in the globalization process on their own terms. Thus, the aim of this study is to visualize the patterns of origins of foreign visitors using data from mobile phones in order to better understand how China's global cities contribute to globalization in a cartogram. It is found that the strength of Shanghai’s global connections are concentrated overtly in the countries of the Asia-Pacific region, but Beijing still has the dominant role in sustaining China’s global links.
Novel plasma protein biomarkers from critically ill sepsis patients
Authors: Van Nynatten Logan R. , Slessarev Marat , Martin Claudio M. , Leligdowicz Aleks , Miller Michael R. , Patel Maitray A. , Daley Mark , Patterson Eric K. , Cepinskas Gediminas , Fraser Douglas D.
Published: December 2022

Background

Despite the high morbidity and mortality associated with sepsis, the relationship between the plasma proteome and clinical outcome is poorly understood. In this study, we used targeted plasma proteomics to identify novel biomarkers of sepsis in critically ill patients.

Methods

Blood was obtained from 15 critically ill patients with suspected/confirmed sepsis (Sepsis-3.0 criteria) on intensive care unit (ICU) Day-1 and Day-3, as well as age- and sex-matched 15 healthy control subjects. A total of 1161 plasma proteins were measured with proximal extension assays. Promising sepsis biomarkers were narrowed with machine learning and then correlated with relevant clinical and laboratory variables.

Results

The median age for critically ill sepsis patients was 56 (IQR 51–61) years. The median MODS and SOFA values were 7 (IQR 5.0–8.0) and 7 (IQR 5.0–9.0) on ICU Day-1, and 4 (IQR 3.5–7.0) and 6 (IQR 3.5–7.0) on ICU Day-3, respectively. Targeted proteomics, together with feature selection, identified the leading proteins that distinguished sepsis patients from healthy control subjects with ≥ 90% classification accuracy; 25 proteins on ICU Day-1 and 26 proteins on ICU Day-3 (6 proteins overlapped both ICU days; PRTN3, UPAR, GDF8, NTRK3, WFDC2 and CXCL13). Only 7 of the leading proteins changed significantly between ICU Day-1 and Day-3 (IL10, CCL23, TGFα1, ST2, VSIG4, CNTN5, and ITGAV; P < 0.01). Significant correlations were observed between a variety of patient clinical/laboratory variables and the expression of 15 proteins on ICU Day-1 and 14 proteins on ICU Day-3 (P < 0.05).

Conclusions

Targeted proteomics with feature selection identified proteins altered in critically ill sepsis patients relative to healthy control subjects. Correlations between protein expression and clinical/laboratory variables were identified, each providing pathophysiological insight. Our exploratory data provide a rationale for further hypothesis-driven sepsis research.
Afghan women’s empowerment and antenatal care utilization: a population-based cross-sectional study
Authors: Yeo Sarah , Bell Melanie , Kim Yu Ri , Alaofè Halimatou
Published: December 2022

Background

Although antenatal care (ANC) offers a unique opportunity to diagnose and prevent complications by mitigating modifiable risk, 38.2% of women did not complete any ANC visits in Afghanistan in 2015. Women empowerment is associated with increased use of ANC; however, there is no evidence of the effect of women empowerment on ANC in the country. Addressing this gap, we aimed to evaluate the association between women’s empowerment and ANC utilization based on the conceptual framework of women’s empowerment.

Methods

We analyzed data from the 2015 Afghanistan Demographic and Health Survey for 11,056 women. The association between four domains of women’s empowerment, including capability, access to resources, security, and decision-making and power, and at least four ANC visits was analyzed using a multivariable logistic regression.

Results

After adjusting for covariates, access to information (AOR 1.38, 95%CI 1.24, 1.54) and decision-making (AOR 1.16, 95%CI 1.08, 1.24) were positively associated with four or more ANC visits. Compared to those without any education, women with primary education (AOR 1.67, 95%CI 1.02, 2.72), secondary education (AOR 2.43, 95%CI 1.25, 4.70), and higher education (AOR 3.03, 95%CI 1.30, 7.07) had higher odds of least four ANC visits. However, asset ownership was negatively associated with ANC visits (AOR 0.72, 95%CI 0.56, 0.92). Variables related to security and literacy were not associated with the minimum ANC visits.

Conclusions

The mixed results of the study highlight the complex natures of women’s empowerment, warranting a more nuanced understanding of women’s empowerment in the context and future research that capture multidimensionality of women’s empowerment. Also, efforts to empower women, particularly those with no education and had less decision-making power and access to health information, could be an effective strategy to enhance ANC use in Afghanistan.
Mental health status of medical students during postgraduate entrance examination
Authors: Chen Fajiang , Chen Juanmei , Chen Baoxin , Mofatteh Mohammad , Wen Caijuan , Wellington Jack , Gong Dongchao , Yang Hailing , Zeng Zhiyi , Miao Xiaoyu , Wu Shaoyong , Chen Yimin
Published: December 2022

Background

The postgraduate entrance examination can be a milestone for many medical students to advance their careers. An increasing number of students are competing for limited postgraduate offers available, and failure to enter postgraduate studies can have adverse mental health consequences. In this paper, we aim to investigate the mental health status of medical students during the postgraduate application entrance examination and to provide a targeted basis for mental health education and psychological counselling.

Methods

Using the Symptom Checklist-90 scale (SCL-90) questionnaire, the mental health status of 613 students who passed two rounds of the Postgraduate Entrance Examination in 2019 to enroll in Guangzhou Medical University in China was evaluated and followed up for retesting 6 months later. We used SPSS 20.0 statistical software for comparative analysis, including One-Sample T-Test, Independent-Samples T-Test, Paired Samples T-Test and Chi-square Test.

Results

Our data showed that 12.10% of students had mental health problems during the postgraduate entrance examination, and it decreased significantly to 4.40% at the 6-month follow-up after the examination period finished (P < 0.01). Somatization was the most significant symptom of the students both during and after the postgraduate entrance examination stages. All SCL-90 factors were scored significantly lower both in and after the postgraduate entrance examination stages than the 2008 national college student norm score (P < 0.01). Excluding psychiatric factors, all other SCL-90 factors in the postgraduate entrance examination stage scored higher than the graduate stage (P < 0.05), and the total score of SCL-90 in female medical students was higher compared to male students (P < 0.05).

Conclusion

The postgraduate entrance examination event has a significant negative influence on students’ mental health. The mental health of college and graduate students as an important part of their higher education experience should be systematically studied, and psychological counselling or help should be provided to them throughout their studies, specifically during the examination period. Educating applicants about mental health should be implemented during the postgraduate entrance examination curriculum.
A repeated cross-sectional and longitudinal study of mental health and wellbeing during COVID-19 lockdowns in Victoria, Australia
Authors: Wright Annemarie , De Livera Alysha , Lee Keun Hee , Higgs Carl , Nicholson Matthew , Gibbs Lisa , Jorm Anthony
Published: December 2022

Background

Population surveys across the world have examined the impact of the COVID-19 pandemic on mental health. However, few have simultaneously examined independent cross-sectional data with longitudinal data, each of which have different strengths and weaknesses and facilitate the investigation of distinct research questions. This study aimed to investigate psychological distress and life satisfaction during the first and second lockdowns in the state of Victoria, Australia, and the social factors that may be affected by lockdowns and could affect mental health.

Methods

The VicHealth Victorian Coronavirus Wellbeing Impact Study included two 20-min opt-in online panel surveys conducted in May and September 2020 in Victoria, each with a sample of 2000 adults aged 18 + . A two-part study design was used: a repeated cross-sectional study of respondents who participated in Survey One and Survey Two, followed by a longitudinal nested cohort study. The primary exposures were social solidarity, social connectedness and staying connected with family and friends. Using logistic regression modelling, we explored the associations between our exposures and primary outcomes of psychological distress and life satisfaction with and without adjustment for covariates, both cross-sectionally and longitudinally. The results from the multivariable models were summarised using adjusted Odds Ratios (aOR), 95% Confidence Intervals (CI).

Results

Cross-sectional results indicated that the percentage of participants with low life satisfaction was significantly higher in the second survey sample (53%) compared to the first (47%). The percentage of participants with high psychological distress was higher but not significantly different between the two survey samples (14% first survey vs 16% second survey). Longitudinal study results indicated that lower social connectedness was significantly associated with higher psychological distress (aOR:3.3; 95% CI: 1.3–8.4) and lower life satisfaction (aOR:0.2; 95% CI: 0.1–0.4). Younger adults had higher psychological distress compared to older adults (aOR:6.8; 95% CI:1.5–31.1). Unemployment at the time of the first survey was significantly associated with lower life satisfaction at the second survey (aOR:0.5; 95% CI: 0.3–0.9).

Conclusion

This study supports the findings of other international studies. It also highlights the need to promote increased social connection and maintain it at times of isolation and separation, particularly amongst younger adults.
Investigating different dimensions of infertile women’s quality of life: a descriptive cross-sectional study
Authors: Kiani Zahra , Simbar Masoumeh , Hajian Sepideh , Zayeri Farid , RashidiFakari Farzaneh , Chimeh Fatemeh Jalali
Published: December 2022

Background

Infertility is a major challenge in the life of women which affects their quality of life. Infertile women's quality of life is a relatively new field of research that has recently been considered by health researchers. However, there has been no standard tool for measuring different aspects of infertile women's quality of life with female factors, and general and specific tools of infertile couples have been used to assess their quality of life. This study, thus, aimed to analyze different aspects of the quality of life of infertile women.

Methods

This descriptive cross-sectional study was conducted on 320 infertile women referred to a teaching hospital affiliated with Mazandaran University of Medical Sciences and private infertility treatment centers in Sari, Iran. Demographic and fertility characteristics and the quality of life questionnaire for infertile women questionnaire (a 25-item tool was designed which measured 7 factors of psychological effects, sexual life with infertility family and social effects, infertility-related concerns, physical effects, adaptive approaches and factors preventing infertility adaptation), were recruited for data gathering. Data were analyzed using SPSS version 22. Descriptive statistics (percentage, mean, standard deviation), correlation coefficient, independent sample t-test, and multiple linear regression were used. P-values less than 0.05 were considered statistically significant.

Results

The total mean score of infertile women's quality of life was 65.68 ± 8.91%. Findings were indicative of infertile women's quality of life in the dimensions of adaptive approach (70.48 ± 15.02%), psychological (67.88 ± 12.06%), family and social (64.63 ± 10.76%), physical, 63.42 ± 11.36%), inhibitory factors/ factors preventing adaptation (60.98 ± 8.24%), related concerns (51.52 ± 10.21%) and sexual life (40.12 ± 14.28%). According to the final multiple linear regression model, women's education (B = 2.57, p < 0.001), spouse's education (B = 1.56, p = 0.046), economic status (B = 1.64, p < 0.001), age of women (B = -0.62, p < 0.001), age of spouse (B = -0.65, p < 0.001), duration of infertility (B = -0.36, p = 0.024) and duration of marriage (B = -0.39, p = 0.022) were the final predictors of the quality of life score in infertile women of the study.

Conclusion

Given that infertility causes extensive changes in individuals, families, and social dimensions of infertile women, it can affect their quality of life. We can take steps to improve the health of infertile women by promoting various dimensions of their quality of life.
Effect of highly concentrated bleaching gels on enamel microhardness and superficial morphology, and the recovery action of four remineralizing agents
Authors: Melo María , Fioresta Rossella , Sanz José Luís , Pecci-Lloret María Pilar , Llena Carmen
Published: December 2022

Background

Dental bleaching is a common clinical practice. The aim of this study is to investigate the effect of 35% hydrogen peroxide (HP) bleaching gel on the morphology and microhardness of enamel, and to analyze the effect of four remineralizing agents.

Methods

One hundred blocks were prepared. The enamel surfaces were bleached with 35% HP in one session. The specimens were divided into four remineralization treatment groups (n = 25). G1: Tooth Mousse, G2: Remin-Pro, G3: Colgate Pro-Relif, G4: Mirafluor. The remineralizing protocol was applied 3 min per day for one week. Vickers microhardness (HV) measurements and SEM observations were performed at baseline, after bleaching, and after remineralizing treatment in all groups. Statistical analyses were performed using the paired t-test and ANOVA.

Results

After bleaching, SEM showed an increase of irregularities on the surface of the samples. Enamel microhardness decreased a mean of 47.7 HV, equivalent to a mean decrease of 18.3% (p < 0.05). After remineralization, the HV increased in all groups between 16 and 33% (p < 0.01), recovering the initial microhardness of enamel samples. SEM images revealed a higher quantity of superficial mineral deposits in groups 1 and 2 compared to the rest of the groups.

Conclusions

The application of remineralizing products generates a significant increase in enamel microhardness. Tooth Mousse-treated samples showed a greater microhardness recovery, followed by Remin Pro. The superficial morphology of the samples reflects the results obtained in the HV tests.
Acquisition of a single grid-based phase-contrast X-ray image using instantaneous frequency and noise filtering
Authors: Yang Jae-Suk , Jeon Sun-Young , Choi Jang-Hwan
Published: December 2022

Background

To obtain phase-contrast X-ray images, single-grid imaging systems are effective, but Moire artifacts remain a significant issue. The solution for removing Moire artifacts from an image is grid rotation, which can distinguish between these artifacts and sample information within the Fourier space. However, the mechanical movement of grid rotation is slower than the real-time change in Moire artifacts. Thus, Moire artifacts generated during real-time imaging cannot be removed using grid rotation. To overcome this problem, we propose an effective method to obtain phase-contrast X-ray images using instantaneous frequency and noise filtering.

Result

The proposed phase-contrast X-ray image using instantaneous frequency and noise filtering effectively suppressed noise with Moire patterns. The proposed method also preserved the clear edge of the inner and outer boundaries and internal anatomical information from the biological sample, outperforming conventional Fourier analysis-based methods, including absorption, scattering, and phase-contrast X-ray images. In particular, when comparing the phase information for the proposed method with the x-axis gradient image from the absorption image, the proposed method correctly distinguished two different types of soft tissue and the detailed information, while the latter method did not.

Conclusion

This study successfully achieved a significant improvement in image quality for phase-contrast X-ray images using instantaneous frequency and noise filtering. This study can provide a foundation for real-time bio-imaging research using three-dimensional computed tomography.
Pre-service medical education course completion and drop-out rates
Authors: Enabulele Osahon , Enabulele Joan Emien
Published: December 2022

Introduction

The “Global strategy on human resources for health: Workforce 2030” was adopted by the 69th World Health Assembly. Among its objectives is the strengthening of data on human resources for health, to inform evidence-based policy decisions. These data include the course completion and drop-out rates, to inform mechanisms that support recruitment and retention.

Objective

This paper sought to evaluate trends in course completion and drop-out rates of health workforce students. However, original data were only obtained for pre-service medical students, but no other health worker occupational groups.

Methods

A mixed method approach was employed to obtain data presented in this paper. A structured questionnaire was sent out to targeted medical training institutions, regulatory bodies, and National Medical Associations, supplemented by a web and literature search for existing studies or data reports. Data were analyzed using IBM SPSS Statistics version 21.0 (Chicago, IL, USA) and Microsoft Excel 2010.

Results

Eight previously published studies were identified originating from six countries, with course completion rates ranging from 84% in Pakistan to 98.6% in the United States of America, while the drop-out rates ranged from 1.4% in the United States of America to 16% in Pakistan. An analysis of pre-service medical students in Australia and New Zealand, revealed average course completion rates of 93.3% and 96.9%, respectively, and average drop-out rates of 6.7% and 3.1%, respectively. An analysis of pre-service medical students from Nigeria, revealed an average course completion rate of 88.3%, and an average drop-out rate of 11.7%. Data were not readily available for most countries targeted during the research, either because of lack of existing mechanisms for collation of required data or restrictions making such data publicly unavailable and inaccessible.

Conclusions

Drop-out rate for pre-service medical students varies across countries with some countries recording higher drop-out rates, which raise significant concerns about the capacity of such countries to scale up production of human resources for health. Data that monitor both course completion and drop-out rates, and seek to provide insight into reasons for observed numbers, can inform mechanisms to address the causes of course drop-out and support student retention.