bluuebunny/crossref_metadata_2025 huggingface dataset:
Toward a systematic grading for the selection of patients to undergo awake surgery: identifying suitable predictor variables
Authors: Kram Leonie , Neu Beate , Schroeder Axel , Wiestler Benedikt , Meyer Bernhard , Krieg Sandro M. , Ille Sebastian
Published: May 2024

Background

Awake craniotomy is the standard of care for treating language eloquent gliomas. However, depending on preoperative functionality, it is not feasible in each patient and selection criteria are highly heterogeneous. Thus, this study aimed to identify broadly applicable predictor variables allowing for a more systematic and objective patient selection.

Methods

We performed post-hoc analyses of preoperative language status, patient and tumor characteristics including language eloquence of 96 glioma patients treated in a single neurosurgical center between 05/2018 and 01/2021. Multinomial logistic regression and stepwise variable selection were applied to identify significant predictors of awake surgery feasibility.

Results

Stepwise backward selection confirmed that a higher number of paraphasias, lower age, and high language eloquence level were suitable indicators for an awake surgery in our cohort. Subsequent descriptive and ROC-analyses indicated a cut-off at ≤54 years and a language eloquence level of at least 6 for awake surgeries, which require further validation. A high language eloquence, lower age, preexisting semantic and phonological aphasic symptoms have shown to be suitable predictors.

Conclusion

The combination of these factors may act as a basis for a systematic and standardized grading of patients’ suitability for an awake craniotomy which is easily integrable into the preoperative workflow across neurosurgical centers.
Heart-to-heart: infant heart rate at 3 months is linked to infant-directed speech, mother–infant interaction, and later language outcomes
Authors: Endevelt-Shapira Yaara , Bosseler Alexis N. , Zhao T. Christina , Mizrahi Julia C. , Meltzoff Andrew N. , Kuhl Patricia K.
Published: May 2024

Introduction

Previous studies underscore the importance of speech input, particularly infant-directed speech (IDS) during one-on-one (1:1) parent–infant interaction, for child language development. We hypothesize that infants’ attention to speech input, specifically IDS, supports language acquisition. In infants, attention and orienting responses are associated with heart rate deceleration. We examined whether individual differences in infants’ heart rate measured during 1:1 mother–infant interaction is related to speech input and later language development scores in a longitudinal study.

Methods

Using a sample of 31 3-month-olds, we assessed infant heart rate during mother–infant face-to-face interaction in a laboratory setting. Multiple measures of speech input were gathered at 3 months of age during naturally occurring interactions at home using the Language ENvironment Analysis (LENA) system. Language outcome measures were assessed in the same children at 30 months of age using the MacArthur-Bates Communicative Development Inventory (CDI).

Results

Two novel findings emerged. First, we found that higher maternal IDS in a 1:1 context at home, as well as more mother–infant conversational turns at home, are associated with a lower heart rate measured during mother–infant social interaction in the laboratory. Second, we found significant associations between infant heart rate during mother–infant interaction in the laboratory at 3 months and prospective language development (CDI scores) at 30 months of age.

Discussion

Considering the current results in conjunction with other converging theoretical and neuroscientific data, we argue that high IDS input in the context of 1:1 social interaction increases infants’ attention to speech and that infants’ attention to speech in early development fosters their prospective language growth.
Development and validation of a novel nomogram model for identifying risk of prolonged length of stay among patients receiving free vascularized flap reconstruction of head and neck cancer
Authors: Wang Chengli , Lin Liling , Wu Jiayao , Fu Ganglan , Liu Zhongqi , Cao Minghui
Published: May 2024

Background

The aim of the present study was to build and internally validate a nomogram model for predicting prolonged length of stay (PLOS) among patients receiving free vascularized flap reconstruction of head and neck cancer (HNC).

Methods

A retrospective clinical study was performed at a single center, examining patients receiving free vascularized flap reconstruction of HNC from January 2011 to January 2019. The variables were obtained from the electronic information system. The primary outcome measure was PLOS. Univariate and multivariate analyses were used to find risk factors for predicting PLOS. A model was then built according to multivariate results. Internal validation was implemented via 1000 bootstrap samples.

Results

The study included 1047 patients, and the median length of stay (LOS) was 13.00 (11.00, 16.00) days. Multivariate analysis showed that flap types ((radial forearm free flap (odds ratio [OR] = 2.238; 95% CI, 1.403-3.569; P = 0.001), free fibula flap (OR = 3.319; 95% CI, 2.019-4.882; P < 0.001)), duration of surgery (OR = 1.002; 95% CI, 1.001-1.003; P = 0.004), postoperative complications (OR = 0.205; 95% CI, 0.129-0.325; P = P < 0.001) and unplanned reoperation (OR = 0.303; 95% CI, 0.140-0.653; P = 0.002) were associated with PLOS. In addition to these variables, blood transfusion was comprised in the model. The AUC of the model was 0.78 (95% CI, 0.711–0.849) and 0.725 (95% CI, 0.605–0.845) in the primary and internal validation cohorts, respectively. The DCA revealed the clinical utility of the current model when making intervention decisions within the PLOS possibility threshold range of 0.2-0.8.

Conclusions

Our study developed a nomogram that exhibits a commendable level of accuracy, thereby aiding clinicians in assessing the risk of PLOS among patients receiving free vascularized flap reconstruction for HNC.
Apriori prediction of chemotherapy response in locally advanced breast cancer patients using CT imaging and deep learning: transformer versus transfer learning
Authors: Moslemi Amir , Osapoetra Laurentius Oscar , Dasgupta Archya , Alberico David , Trudeau Maureen , Gandhi Sonal , Eisen Andrea , Wright Frances , Look-Hong Nicole , Curpen Belinda , Kolios Michael C. , Czarnota Gregory J.
Published: May 2024

Objective

Neoadjuvant chemotherapy (NAC) is a key element of treatment for locally advanced breast cancer (LABC). Predicting the response to NAC for patients with Locally Advanced Breast Cancer (LABC) before treatment initiation could be beneficial to optimize therapy, ensuring the administration of effective treatments. The objective of the work here was to develop a predictive model to predict tumor response to NAC for LABC using deep learning networks and computed tomography (CT).

Materials and methods

Several deep learning approaches were investigated including ViT transformer and VGG16, VGG19, ResNet-50, Res-Net-101, Res-Net-152, InceptionV3 and Xception transfer learning networks. These deep learning networks were applied on CT images to assess the response to NAC. Performance was evaluated based on balanced_accuracy, accuracy, sensitivity and specificity classification metrics. A ViT transformer was applied to utilize the attention mechanism in order to increase the weight of important part image which leads to better discrimination between classes.

Results

Amongst the 117 LABC patients studied, 82 (70%) had clinical-pathological response and 35 (30%) had no response to NAC. The ViT transformer obtained the best performance range (accuracy = 71 ± 3% to accuracy = 77 ± 4%, specificity = 86 ± 6% to specificity = 76 ± 3%, sensitivity = 56 ± 4% to sensitivity = 52 ± 4%, and balanced_accuracy=69 ± 3% to balanced_accuracy=69 ± 3%) depending on the split ratio of train-data and test-data. Xception network obtained the second best results (accuracy = 72 ± 4% to accuracy = 65 ± 4, specificity = 81 ± 6% to specificity = 73 ± 3%, sensitivity = 55 ± 4% to sensitivity = 52 ± 5%, and balanced_accuracy = 66 ± 5% to balanced_accuracy = 60 ± 4%). The worst results were obtained using VGG-16 transfer learning network.

Conclusion

Deep learning networks in conjunction with CT imaging are able to predict the tumor response to NAC for patients with LABC prior to start. A ViT transformer could obtain the best performance, which demonstrated the importance of attention mechanism.
Eosinophilic granulocytes as a potential prognostic marker for cancer progression and therapeutic response in malignant melanoma
Authors: Brand Corsin Linard , Hunger Robert Emil , Seyed Jafari Seyed Morteza
Published: May 2024

The importance of eosinophilic granulocytes in cancer has been widely discussed in recent years. The current study reviews the evidence on the role of eosinophilic granulocytes in melanoma as a prognostic marker for cancer progression and the efficacy of treatment with modern immune checkpoint inhibitors. A total of 33 human clinical studies were included in the review, with heterogeneous data due to differences in patients populations, study design and inclusion of small study groups. However, 28 of the 33 studies suggested that eosinophilic granulocytes could be used as a prognostic biomarker for outcome and/or potential response to systemic treatment and/or occurrence of adverse events in melanoma patients. Nevertheless, the exact role of eosinophils remains to be elucidated. Further prospective, larger and better controlled studies are warranted to clarify the significance of eosinophilic granulocytes in patients with melanoma, in more details.
Prospective study of AI-assisted prediction of breast malignancies in physical health examinations: role of off-the-shelf AI software and comparison to radiologist performance
Authors: Ma Sai , Li Yanfang , Yin Jun , Niu Qinghua , An Zichen , Du Lianfang , Li Fan , Gu Jiying
Published: May 2024

Objective

In physical health examinations, breast sonography is a commonly used imaging method, but it can lead to repeated exams and unnecessary biopsy due to discrepancies among radiologists and health centers. This study explores the role of off-the-shelf artificial intelligence (AI) software in assisting radiologists to classify incidentally found breast masses in two health centers.

Methods

Female patients undergoing breast ultrasound examinations with incidentally discovered breast masses were categorized according to the 5th edition of the Breast Imaging Reporting and Data System (BI-RADS), with categories 3 to 5 included in this study. The examinations were conducted at two municipal health centers from May 2021 to May 2023.The final pathological results from surgical resection or biopsy served as the gold standard for comparison. Ultrasonographic images were obtained in longitudinal and transverse sections, and two junior radiologists and one senior radiologist independently assessed the images without knowing the pathological findings. The BI-RADS classification was adjusted following AI assistance, and diagnostic performance was compared using receiver operating characteristic curves.

Results

A total of 196 patients with 202 breast masses were included in the study, with pathological results confirming 107 benign and 95 malignant masses. The receiver operating characteristic curve showed that experienced breast radiologists had higher diagnostic performance in BI-RADS classification than junior radiologists, similar to AI classification (AUC = 0.936, 0.806, 0.896, and 0.950, p < 0.05). The AI software improved the accuracy, sensitivity, and negative predictive value of the adjusted BI-RADS classification for the junior radiologists’ group (p< 0.05), while no difference was observed in the senior radiologist group. Furthermore, AI increased the negative predictive value for BI-RADS 4a masses and the positive predictive value for 4b masses among radiologists (p < 0.05). AI enhances the sensitivity of invasive breast cancer detection more effectively than ductal carcinoma in situ and rare subtypes of breast cancer.

Conclusions

The AI software enhances diagnostic efficiency for breast masses, reducing the performance gap between junior and senior radiologists, particularly for BI-RADS 4a and 4b masses. This improvement reduces unnecessary repeat examinations and biopsies, optimizing medical resource utilization and enhancing overall diagnostic effectiveness.
Should cancer pain still be considered a separate category alongside acute pain and chronic non-cancer pain? Reflections on ICD-11
Authors: Bäckryd Emmanuel
Published: May 2024

Introduction

Traditionally, cancer pain has often been viewed as an independent third major category in pain medicine alongside acute pain and chronic non-cancer pain. However, the new chronic pain category MG30 in the eleventh version of International Classification of Diseases (ICD-11) includes cancer-related pain as one of its seven subgroups. In light of this, the aim of the paper is to investigate whether the traditional trichotomy should be replaced by a dichotomy between acute pain and chronic pain, cancer-related pain being part of both groups depending on the duration of pain.

Methods

The rationale for viewing cancer pain as a separate category is reviewed.

Results

Cancer being a deadly disease, cancer pain has a life-and-death and existential dimension that is different from non-cancer pain. It seems sensible to believe that this is an additional dimension to the suffering caused by cancer pain, and that clinicians should therefore take this existential dimension into consideration when assessing pain.

Conclusion

Without challenging the place of chronic cancer-related pain under the MG30 heading, it is concluded that while using ICD-11 in the future, pain clinicians should continue being mindful of the fact that the reality of death shapes the experience of cancer pain. The traditional trichotomy is therefore still valid and mirrors the fact that human beings are vulnerable (acute pain), temporal (chronic pain) and mortal (cancer pain).
Kids+ Parent Infant Program (PIP): a community model for supporting partnerships in early developmental follow-up and support
Authors: Reynolds K. , Urbanowicz A. , Mayston M. , Foley S.
Published: May 2024

High-risk infants are discharged home from hospital with increased care needs and the potential for the emergence of developmental disabilities, contributing to high levels of parental stress and anxiety. To enable optimal outcomes for high-risk infants and their families, developmental follow-up programs need to continue following hospital discharge. However, current follow-up care for high-risk infants is variable in terms of type, access and equity, and there seems to be a gap in existing services such as supporting the transition home, parental support, and inclusion of all at-risk infants regardless of causality. Routine follow-up that identifies developmental delays or neuromotor concerns can facilitate timely referral and access to targeted intervention during critical periods of development. The Kids+ Parent Infant Program (PIP) is a unique model of developmental follow-up that shares some characteristics with established programs, but also includes additional key elements for a seamless, wrap-around service for all high-risk infants and their families living in a regional area of Australia. This community-based program provides integrated assessment and intervention of infants, alongside parent support and education, embracing a holistic model that accounts for the complexity and interrelatedness of infant, parent, medical and developmental factors. By prioritising the well-being of high-risk infants and their families, the Kids+ PIP paves the way for improved developmental outcomes and provides an innovative model for developmental follow-up, with the potential for reproduction in other healthcare settings.
High frequencies of nonviral colds and respiratory bacteria colonization among children in rural Western Uganda
Authors: Weary Taylor E. , Pappas Tressa , Tusiime Patrick , Tuhaise Shamilah , Ross Elizabeth , Gern James E. , Goldberg Tony L.
Published: May 2024

Introduction

Respiratory illness is the most common childhood disease globally, especially in developing countries. Previous studies have detected viruses in approximately 70-80% of respiratory illnesses.

Methods

In a prospective cohort study of 234 young children (ages 3-11 years) and 30 adults (ages 22-51 years) in rural Western Uganda sampled monthly from May 2019 to August 2021, only 24.2% of nasopharyngeal swabs collected during symptomatic disease had viruses detectable by multiplex PCR diagnostics and metagenomic sequencing. In the remaining 75.8% of swabs from symptomatic participants, we measured detection rates of respiratory bacteria Haemophilus influenzae, Moraxella catarrhalis, and Streptococcus pneumoniae by quantitative PCR.

Results

100% of children tested positive for at least one bacterial species. Detection rates were 87.2%, 96.8%, and 77.6% in children and 10.0%, 36.7%, and 13.3% for adults for H. influenzae, M. catarrhalis, and S. pneumoniae, respectively. In children, 20.8% and 70.4% were coinfected with two and three pathogens, respectively, and in adults 6.7% were coinfected with three pathogens but none were coinfected with two. Detection of any of the three pathogens was not associated with season or respiratory symptoms severity, although parsing detection status by symptoms was challenged by children experiencing symptoms in 80.3% of monthly samplings, whereas adults only reported symptoms 26.6% of the time. Pathobiont colonization in children in Western Uganda was significantly more frequent than in children living in high-income countries, including in a study of age-matched US children that utilized identical diagnostic methods. Detection rates were, however, comparable to rates in children living in other Sub-Saharan African countries.

Discussion

Overall, our results demonstrate that nonviral colds contribute significantly to respiratory disease burden among children in rural Uganda and that high rates of respiratory pathobiont colonization may play a role. These conclusions have implications for respiratory health interventions in the area, such as increasing childhood immunization rates and decreasing air pollutant exposure.
Serological responses to immunization during nephrosis in infants with congenital nephrotic syndrome of the Finnish type
Authors: Savonius Okko , Kaskinen Anu , Hölttä Tuula , Ylinen Elisa , Tainio Juuso , Nieminen Tea , Jahnukainen Timo
Published: May 2024

Background

Pretransplant vaccination is generally recommended to solid organ transplant recipients. In infants with congenital nephrotic syndrome (CNS), the immune response is hypothetically inferior to other patients due to young age and urinary loss of immunoglobulins, but data on the immunization response in severely nephrotic children remain scarce. If effective, however, early immunization of infants with CNS would clinically be advantageous.

Methods

We investigated serological vaccine responses in seven children with CNS who were immunized during nephrosis. Antibody responses to measles-mumps-rubella -vaccine (MMR), a pentavalent DTaP-IPV-Hib -vaccine (diphtheria, tetanus, acellular pertussis, inactivated poliovirus, Haemophilus influenzae type b), varicella vaccine, combined hepatitis A and B vaccine, and pneumococcal conjugate vaccine (PCV) were measured after nephrectomy either before or after kidney transplantation.

Results

Immunizations were started at a median age of 7 months [interquartile range (IQR) 7–8], with a concurrent median proteinuria of 36,500 mg/L (IQR 30,900–64,250). Bilateral nephrectomy was performed at a median age of 20 months (IQR 14–25), and kidney transplantation 10–88 days after the nephrectomy. Antibody levels were measured at median 18 months (IQR 6–23) after immunization. Protective antibody levels were detected in all examined children for hepatitis B (5/5), Clostridium tetani (7/7), rubella virus (2/2), and mumps virus (1/1); in 5/6 children for varicella; in 4/6 for poliovirus and vaccine-type pneumococcal serotypes; in 4/7 for Haemophilus influenzae type B and Corynebacterium diphtheriae; in 1/2 for measles virus; and in 2/5 for hepatitis A. None of the seven children had protective IgG levels against Bordetella pertussis.

Conclusion

Immunization during severe congenital proteinuria resulted in variable serological responses, with both vaccine- and patient-related differences. Nephrosis appears not to be a barrier to successful immunization.
Population pharmacokinetics of intravenous daptomycin in critically ill patients: implications for selection of dosage regimens
Authors: Wu Jianhua , Zheng Xiangyi , Zhang Liu , Wang Jiajun , Lv Yifei , Xi Yujie , Wu Dongfang
Published: May 2024

Daptomycin is gaining prominence for the treatment of methicillin-resistant Staphylococcus aureus infections. However, the dosage selection for daptomycin in critically ill patients remains uncertain, especially in Chinese patients. This study aimed to establish the population pharmacokinetics of daptomycin in critically ill patients, optimize clinical administration plans, and recommend appropriate dosage for critically ill patients in China. The study included 64 critically ill patients. Blood samples were collected at the designated times. The blood daptomycin concentration was determined using validated liquid chromatography-tandem mass spectrometry. A nonlinear mixed-effects model was applied for the population pharmacokinetic analysis and Monte Carlo simulations of daptomycin. The results showed a two-compartment population pharmacokinetic model of daptomycin in critically ill adult Han Chinese patients. Monte Carlo simulations revealed that a daily dose of 400 mg of daptomycin was insufficient for the majority of critically ill adult patients to achieve the anti-infective target. For critically ill adult patients with normal renal function (creatinine clearance rate >90 mL/min), the probability of achieving the target only reached 90% when the daily dose was increased to 700 mg. For patients undergoing continuous renal replacement therapy (CRRT), 24 h administration of 500 mg met the pharmacodynamic goals and did not exceed the safety threshold in most patients. Therefore, considering its efficacy and safety, intravenous daptomycin doses are best scaled according to creatinine clearance, and an increased dose is recommended for critically ill patients with hyperrenalism. For patients receiving CRRT, medication is recommended at 24 h intervals.
Poor sleep quality and associated factors among healthcare professionals at the University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia
Authors: Tesfaye Winta , Getu Ayechew Adera , Dagnew Baye , Lemma Alemu , Yeshaw Yigizie
Published: May 2024

Background

Poor sleep quality is linked to physiological dysfunction, which increases the risk of obesity, cardiovascular disease, cognitive impairment, and other medical conditions. Despite the known health risks of sleep disturbances, literature is still scant regarding sleep quality and its associated factors among healthcare professionals in Ethiopia. Therefore, this study aimed to determine the prevalence of poor sleep quality and its associated factors among healthcare professionals at the University of Gondar Comprehensive Specialized Hospital.

Methods

An institution-based cross-sectional study was conducted at the University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia. A total of 418 healthcare professionals participated in the study. The study participants were chosen using the stratified random sampling method. Data were collected using a structured, self-administered questionnaire. The Pittsburgh Sleep Quality Index (PSQI) was used to assess the sleep quality of participants. Bi-variable and multivariable logistic regression models were used. p ≤ 0.05 was used to declare statistically significant variables.

Results

The mean age of the study participants was 30.7 years (SD ± 6.3). The overall prevalence of poor sleep quality was 58.9% [95% CI (54.2, 63.6%)]. Being female [adjusted odds ratio (AOR) = 1.9, 95% CI (1.2, 2.9)], being a shift worker [AOR = 5.7, 95% CI (2.3, 14.3), not performing regular exercise [AOR = 2.08 (1.2–3.6)], being a khat chewer [AOR = 3.1, 95% CI (1.2, 7.6)], and having depressive symptoms [AOR = 2.6, 95% CI (1.3, 6.8)] were significantly associated with higher odds of having poor sleep quality.

Conclusion

The prevalence of poor sleep quality among healthcare professionals was found to be high. As a result, we recommend that healthcare providers at the University of Gondar Comprehensive Specialized Hospital focus on early regular screening for sleep disturbances and pay special attention to shift work schedules and behaviors such as khat chewing, exercise, and depressive symptoms.
The efficacy of transcranial direct current stimulation in the treatment of anorexia nervosa: a randomized double-blind clinical trial
Authors: Rząd Zuzanna , Rog Joanna , Kajka Natalia , Szewczyk Paweł , Krukow Paweł , Karakuła-Juchnowicz Hanna
Published: May 2024

Background

Anorexia nervosa (AN) is a life-threatening disease with a low effectiveness of treatment. The high relapse and mortality rate indicate new treatment approaches are needed. Here, we represent the protocol for randomized clinical trial (RCT) of transcranial direct current stimulation (tDCS) efficiency in the AN treatment. The main purpose of the 3-week RCT is to determine the effect of tDCS on the mental state and advances in nutritional rehabilitation in patients with AN.

Methods

50 female inpatients (13-25 years old, body mass index (BMI) 17.5 kg/m2 or less) will be randomly allocated into groups: active (n=25) and sham (n=25) tDCS. Thirty 25-minute tDCS sessions (applied current at 2mA) will be given to DLPFC (F3 anode/F4 cathode) twice a day for 3 weeks on working days parallel to treatment as usual. The primary outcome measures include changes in symptoms related to eating disorders, as assessed by the Eating Attitudes Test (EAT-26), following tDCS sessions over a 3-week trial period. The secondary outcome measures include changes in: brain bioelectric activity, anthropometric measurements, mood, nutritional status, neurocognition, psychological symptoms, selected biological markers related to stress, food intake, inflammation and neurotrophins.

Discussion

This paper describes the evaluation of a 3-week tDCS-based intervention for AN patients. The study design was developed by a multidisciplinary research team to assess the treatment effect, taking into account various types of variables. This approach could help in better understanding the potential therapeutic tDCS strategy in AN.

Clinical trial registration

www.ClinicalTrials.gov, identifier NCT05814458.
Self-harm among inmates of the Berlin prison system
Authors: Blees Alexander , Jakobowitz Sharon , Hofer Jakob , Konrad Norbert , Krebs Julia , Opitz-Welke Annette
Published: May 2024

Introduction

Self-harming behavior in prisoners is a prevalent phenomenon, with international studies estimating a 4% prevalence rate. However, studies on self-injurious behavior in the German prison system are currently lacking. Therefore, our study aims to conduct an initial assessment.

Methods

The Criminological Service for the Berlin Prison System distributed questionnaires on incidents of self-harm to all Berlin prisons, except for juvenile detention centers. The questionnaires were supplemented with medical data, such as psychiatric diagnoses and medication.

Results

62 questionnaires were returned, which could be attributed to 52 inmates. Compared to the average population in the Berlin prison system, the study sample exhibited variations in age, gender distribution and nationality. 94% of the inmates received a psychiatric diagnosis. Two-thirds of the male inmates had substance use disorders, while 83% of the female inmates had emotionally unstable personality resp. borderline disorders. Prior to self-harm, 87% of the inmates were administered psychiatric medication.

Discussion

Our study found similarities between the study population and international studies in the distribution of certain characteristics. We assume that many of the postulated risk factors can also apply to Berlin prisoners. However, the study is limited by the small number of cases and the absence of a control group.
Loneliness predicts decreased physical activity in widowed but not married or unmarried individuals
Authors: Pollak Chava , Verghese Joe , Blumen Helena M.
Published: May 2024

Background

Physical activity is associated with improved health and function in older adults, yet most older adults are sedentary. Loneliness is associated with decreased physical activity at the cross-section, but longitudinal studies are scarce. We examined longitudinal associations between loneliness and physical activity—and whether they were modified by marital status and network size (the number of children, relatives, and friends a person interacts with at least once a month).

Methods

We analyzed data from 1,931 older adults without dementia at baseline from the Rush Memory and Aging Project with a mean follow-up of 4.8 years (mean age 79.6 ± 7.7, 74.9% women). Loneliness was assessed using the de Jong Gierveld Loneliness Scale. Physical activity was assessed as the frequency with which participants engaged in five categories of activities (e.g., walking, gardening, calisthenics, bicycling, and swimming). Linear mixed effects models examined associations between baseline loneliness and change in physical activity over time after adjusting for demographics, depressive symptoms, global cognition, disability, network size, marital status, social support, and social and cognitive activities. We assessed for effect modification by marital status and network size.

Results

Associations between loneliness and physical activity differed by marital status. In widowed individuals, baseline loneliness was associated with a 0.06 h/week greater decrease in physical activity per year compared to those who were not lonely (p = 0.005, CI -0.1, 0.02)—which equaled a 150% decrease in physical activity per year. Loneliness did not predict a statistically significant decrease in physical activity in married or unmarried individuals.

Discussion

Loneliness is associated with decreased physical activity in widowed older adults and should be considered in the design of interventions to prevent or slow the decline in physical activity and promote healthy aging.
How medical insurance payment systems affect the physicians’ provision behavior in China—based on experimental economics
Authors: Lin Shuyan , Sun Qiang , Zhou Hezeng , Yin Jia , Zheng Chao
Published: May 2024

Background

It introduced an artefactual field experiment to analyze the influence of incentives from fee-for-service (FFS) and diagnosis-intervention package (DIP) payments on physicians’ provision of medical services.

Methods

This study recruited 32 physicians from a national pilot city in China and utilized an artefactual field experiment to examine medical services provided to patients with different health status.

Results

In general, the average quantities of medical services provided by physicians under the FFS payment were higher than the optimal quantities, the difference was statistically significant. While the average quantities of medical services provided by physicians under the DIP payment were very close to the optimal quantities, the difference was not statistically significant. Physicians provided 24.49, 14.31 and 5.68% more medical services to patients with good, moderate and bad health status under the FFS payment than under the DIP payment. Patients with good, moderate and bad health status experienced corresponding losses of 5.70, 8.10 and 9.42% in benefits respectively under the DIP payment, the corresponding reductions in profits for physicians were 10.85, 20.85 and 35.51%.

Conclusion

It found patients are overserved under the FFS payment, but patients in bad health status can receive more adequate treatment. Physicians’ provision behavior can be regulated to a certain extent under the DIP payment and the DIP payment is suitable for the treatment of patients in relatively good health status. Doctors sometimes have violations under DIP payment, such as inadequate service and so on. Therefore, it is necessary to innovate the supervision of physicians’ provision behavior under the DIP payment. It showed both medical insurance payment systems and patients with difference health status can influence physicians’ provision behavior.
Demographic determinants of happiness in Andalusia: insights from the 2022 social survey data
Authors: Matas-Terrón Antonio , Sánchez Barroso Carmen , Matas-Terrón José M.
Published: May 2024

The Social Survey of Andalusia is an instrument for monitoring the Andalusian reality developed by the regional government of Andalusia, whose dataset is open access to the citizens. The 2022 edition included questions related to happiness, social relations as well as socio-demographic factors. Based on this dataset, the present study aimed to analyse the relationship between socio-demographic factors and people’s experiences of happiness. It also set out to explore which factors might be indispensable for experiencing moments of happiness as measured in the survey. A sample of 4,968 cases was gotten, conducting a descriptive analysis, a logit regression in complex samples, and a Necessary Conditions Analysis. The results found two very different social profiles in terms of the experience of happiness, determined by age, sex, educational level and economic status. However, neither factor proved to be a necessary condition for happiness. Both conclusions should be taken into consideration in any socio-community intervention.
Polygenic risk-stratified screening for nasopharyngeal carcinoma in high-risk endemic areas of China: a cost-effectiveness study
Authors: Yang Da-Wei , Miller Jacob A. , Xue Wen-Qiong , Tang Minzhong , Lei Lin , Zheng Yuming , Diao Hua , Wang Tong-Min , Liao Ying , Wu Yan-Xia , Zheng Xiao-Hui , Zhou Ting , Li Xi-Zhao , Zhang Pei-Fen , Chen Xue-Yin , Yu Xia , Li Fugui , Ji Mingfang , Sun Ying , He Yong-Qiao , Jia Wei-Hua
Published: May 2024

Background

Nasopharyngeal carcinoma (NPC) has an extremely high incidence rate in Southern China, resulting in a severe disease burden for the local population. Current EBV serologic screening is limited by false positives, and there is opportunity to integrate polygenic risk scores for personalized screening which may enhance cost-effectiveness and resource utilization.

Methods

A Markov model was developed based on epidemiological and genetic data specific to endemic areas of China, and further compared polygenic risk-stratified screening [subjects with a 10-year absolute risk (AR) greater than a threshold risk underwent EBV serological screening] to age-based screening (EBV serological screening for all subjects). For each initial screening age (30–34, 35–39, 40–44, 45–49, 50–54, 55–59, 60–64, and 65–69 years), a modeled cohort of 100,000 participants was screened until age 69, and then followed until age 79.

Results

Among subjects aged 30 to 54 years, polygenic risk-stratified screening strategies were more cost-effective than age-based screening strategies, and almost comprised the cost-effectiveness efficiency frontier. For men, screening strategies with a 1-year frequency and a 10-year absolute risk (AR) threshold of 0.7% or higher were cost-effective, with an incremental cost-effectiveness ratio (ICER) below the willingness to pay (¥203,810, twice the local per capita GDP). Specifically, the strategies with a 10-year AR threshold of 0.7% or 0.8% are the most cost-effective strategies, with an ICER ranging from ¥159,752 to ¥201,738 compared to lower-cost non-dominated strategies on the cost-effectiveness frontiers. The optimal strategies have a higher probability (29.4–35.8%) of being cost-effective compared to other strategies on the frontier. Additionally, they reduce the need for nasopharyngoscopies by 5.1–27.7% compared to optimal age-based strategies. Likewise, for women aged 30–54 years, the optimal strategy with a 0.3% threshold showed similar results. Among subjects aged 55 to 69 years, age-based screening strategies were more cost-effective for men, while no screening may be preferred for women.

Conclusion

Our economic evaluation found that the polygenic risk-stratified screening could improve the cost-effectiveness among individuals aged 30–54, providing valuable guidance for NPC prevention and control policies in endemic areas of China.
“Let’s get back to normal”: emotions mediate the effects of persuasive messages on willingness to vaccinate for COVID-19
Authors: Muis Krista R. , Kendeou Panayiota , Kohatsu Martina , Wang Shuting
Published: May 2024

Objective

We examined the effectiveness of three different messages for persuading individuals to get vaccinated against COVID-19, and the role that emotions play in persuasion.

Methods

Four hundred-thirty-six participants reported their concern about the COVID-19 pandemic and confidence/hesitancy toward vaccines. Participants were randomly assigned to one of three text conditions: (1) self-interest: a persuasive message that focused on how much of a “serious threat COVID-19 is to you,” and to get vaccinated to “protect yourself”; (2) self-interest + altruistic: a persuasive message that focused on the “threat to you and your community” and to get vaccinated to “protect you and your loved ones”; (3) self-interest + altruistic + normal: a persuasive message that included (2) but added “This is the only way we can get back to a normal life.”; and, (4) a baseline control: no text. After reading, participants reported their emotions toward COVID-19 vaccines and their willingness to get vaccinated.

Results

Individuals in the self-interest + altruistic + normal condition were more willing to get vaccinated compared to the control condition and self-interest + altruistic condition. However, there were no differences in willingness between the self-interest + altruistic + normal condition and the self-interest condition. Moreover, emotions mediated relations between vaccine confidence/hesitancy and willingness.

Conclusion

A message that focuses on “getting back to normal” can achieve important public health action by increasing vaccine uptake to protect the population. Future work is needed across multiple countries and contexts (i.e., non-pandemic) to assess message effectiveness.
Equity in oncology care: addressing disparities in cancer treatment in Georgia
Authors: Keruakous Amany R. , Akpan Inemesit , Chahin Michael , Kirolos Aghapy , Keruakous Mai
Published: May 2024

This research delves into the disparities in access to oncology care among cancer patients in Georgia, with a specific focus on the distinct challenges faced by African American (AA) individuals compared to non-African American (Non-AA) counterparts. Leveraging data from the 2020 Behavioral Risk Factor Surveillance System (BRFSS) survey and supplementary online resources, the study meticulously examines socioeconomic factors, including income, education, and insurance coverage, which significantly influence the quality of cancer care received. The analysis reveals substantial income gaps between AA and Non-AA patients, underscoring the critical implications for healthcare access. Moreover, AA patients exhibit lower rates of full insurance coverage for cancer-related treatments, posing additional barriers to comprehensive care. By investigating the intersections of race, income, and education, the research aims to pinpoint the root causes of these disparities and proposes evidence-based solutions to address the identified challenges. The ultimate objective is to contribute valuable insights that inform targeted policy recommendations and community-based interventions, fostering a more equitable landscape for oncology care in Georgia. This study seeks to amplify awareness and advocate for tangible measures, striving toward healthcare equity for all cancer patients, irrespective of their racial or socioeconomic backgrounds.
Role of self-control, financial attitude, depression, anxiety, and stress in predicting consumers’ online shopping addiction
Authors: Erzincanlı Yıldız , Akbulut Gönül , Çubukcu Betül Buladi , Taş Halil Gökhan
Published: May 2024

Online shopping addiction is a behavior that creates serious problems and has become increasingly prevalent in modern society. When addressing online shopping addiction, the direct or indirect causes of individuals’ shopping actions must be taken into consideration. The present study aims to examine the effects of self-control, financial attitude, depression, anxiety, and stress on online shopping addiction by determining online shopping addiction, self-control, and financial attitude levels of consumers. The sample of this study consists of 694 voluntarily participating consumers selected through convenience sampling methods from a city in Türkiye. Data were collected through Google Forms and uploaded to the SPSS 25.0 package program. During the research process, the relationship patterns between self-control, financial attitude, depression, anxiety, and stress on online shopping addiction were examined by using structural equation modeling. It was determined in this study that consumers have moderate levels of financial attitude and self-control, and low levels of online shopping addiction. Given the results related to the relationships and hypotheses between variables, anxiety, depression, and financial attitude were found to have statistically significant effects on online shopping addiction, whereas stress and self-control were found to not have a significant effect. Within the scope of this study, it was identified that anxiety and depression positively affect online shopping addiction, whereas financial attitude has a negative effect.
Surface-modified PVDF membranes for separation of dye by forward osmosis
Authors: Muratow Marta , Yalcinkaya Fatma , Bryjak Marek , Siekierka Anna
Published: May 2024

Modification of membranes is widely used for altering their separation properties. In this study, the modification of PVDF nanofiber mat by deposition of polyamide layers was evaluated to improve dye recovery by means of forward osmosis process. The polyamide active layer was prepared by a reaction of cyclic aromatic amines, m-phenylenediamine, or piperazine, and trimesoylchloride. The modification progress was monitored by FTIR analysis, water uptake, nitrogen content, and grafting yields. Investigated membranes showed an excellent dye separation features with water flux and dye fluxes strongly related to type of applied amines and reaction time. The best obtained membrane demonstrated outstanding performance in forward osmosis; their water flux was 3.3 LMH and rejection rate of 97% for bromocresol green dye. The membrane allowed increase dye concentration by 50% after 24 h of the process.
Development of a large animal orthotopic intestinal transplantation model with long-term survival for study of immunologic outcomes
Authors: Merl Sarah , Chen Bryan , Gunes M. Esad , Atta Hussein , Yang Kryscilla , Ekanayake-Alper Dilrukshi , Hajosi Dominik , Huang Fei , Bhola Brittany , Patwardhan Satyajit , Jordache Philip , Nowak Greg , Martinez Mercedes , Kato Tomoaki , Sykes Megan , Yamada Kazuhiko , Weiner Joshua
Published: May 2024

Introduction

Intestinal transplantation (ITx) is the last remaining therapy for patients with intestinal failure once parenteral nutrition is no longer an option, however its use is limited by immunological complications, including high rates of rejection and morbidity associated with immunosuppression, such as infection and malignancy. We aimed to develop a large animal model of ITx with which to study the immune response to ITx and to design and test tolerance induction regimens.

Methods

Learning from prior complications, we developed and progressively improved both surgical methods for the donor and recipient as well as postoperative management strategies. Methods of stoma generation, bowel positioning, vessel preparation, and fluid management were optimized. The immunosuppression strategy mirrored our clinical regimen.

Results

As a result of our modifications, results improved from survival less than 1 month to consistent long-term survival with good graft function. We review several techniques that were developed to avoid pitfalls that were encountered, which can be used to optimize outcomes in this model.

Discussion

Achieving long-term survival after swine orthotopic ITx permits immunological analysis and pre-clinical trials in a large animal model of ITx.
Basic psychological need satisfaction of collegiate athletes: the unique and interactive effects of team identification and LMX quality
Authors: Leduc Joé G. , Boucher Frédéric , Marques Dominic L. , Brunelle Eric
Published: May 2024

Purpose

The present study sought to understand the relationships between team identification, leader-member exchange (LMX) quality, and the basic psychological need satisfaction of collegiate athletes, as well as the moderating role of coach-athlete LMX quality.

Methods

Self-reported data from 319 collegiate athletes were analyzed using SPSS version 29. The relationships between the study variables were tested by moderation analysis using PROCESS macro model 1.

Results

Regression analyses showed team identification to be positively related to the satisfaction of the needs for competence and relatedness, while LMX quality was positively related to the satisfaction of the needs for competence and autonomy. Furthermore, moderation analyses showed that LMX quality positively moderated the relationship between team identification and the satisfaction of the needs for competence and relatedness.

Conclusion

The results of this study highlight the important role that team identification and LMX quality play in the satisfaction of the basic psychological needs of collegiate athletes. The implications of these results for the optimal functioning of collegiate athletes are discussed.
Baseline socioeconomic characterization and resource use of the community in the Mefakiya watershed
Authors: Mohammed Mekin , Bekele Demsew , Bazie Melkamu
Published: May 2024

Baseline characterization is used during the project to show progress toward the goal and objectives and after the project to measure the amount of change. The main objective of the study was to investigate the socio-economic characterization and natural resource use in the Mefakiya learning watershed. Both qualitative and quantitative data were collected. Quantitative data were collected using a structured questionnaire through face-to-face interviews with households at the intervention site. Sixty representative households were selected randomly and interviewed. Constraints and potentials were identified via focus group discussions. Descriptive statistics were used to analyze the quantitative data. The majority of the sample households (90%) were male-headed. Agriculture (crop and livestock production) is the principal (98.3%) occupation of the sample households in the Mefakiya watershed. Maize, finger millet, and teff, the major crops cultivated in the watershed, are produced by 98, 92, and 68% of the households, respectively. The study area is characterized by high natural resource degradation that is interconnected in nature. Therefore, an integrated approach is more important and necessary for the sustainable use of watershed resources and further development in all aspects of the watershed in the study area.