bluuebunny/crossref_metadata_2025 huggingface dataset:
A New Model for the Predicting the Risk of Preeclampsia in Twin Pregnancy
Authors: Han Qing , Zheng Shuisen , Chen Rongxin , Zhang Huale , Yan Jianying
Published: April 2022

Objective

We aimed to develop an effective nomogram model for predicting the risk of preeclampsia in twin pregnancies.

Methods

The study was a retrospective cohort study of women pregnant with twins who attended antenatal care and labored between January 2015 and December 2020 at the Fujian Maternity and Child Health Hospital, China. We extracted maternal demographic data and clinical characteristics. Then we performed the least absolute shrinkage and selection operator regression combined with clinical significance to screen variables. Thereafter, multivariate logistic regression was used to construct a nomogram that predicted the risk of preeclampsia in twin pregnancies. Finally, the nomogram was validated using C-statistics (C-index) and calibration curves.

Results

A total of 2,469 women with twin pregnancies were included, of whom 325 (13.16%) had preeclampsia. Multivariate logistic regression models revealed that serum creatinine, uric acid, mean platelet volume, high-density lipoprotein, lactate dehydrogenase, fibrinogen, primiparity, pre-pregnancy body mass index, and regular prenatal were independently associated with preeclampsia in twin pregnancies. The constructed predictive model exhibited a good discrimination and predictive ability for preeclampsia in twin pregnancies (concordance index 0.821).

Conclusion

The model for the prediction of preeclampsia in twin pregnancies has high accuracy and specificity. It can be used to assess the risk of preeclampsia in twin pregnancies.
Chick Hippocampal Formation Displays Subdivision- and Layer-Selective Expression Patterns of Serotonin Receptor Subfamily Genes
Authors: Fujita Toshiyuki , Aoki Naoya , Mori Chihiro , Fujita Eiko , Matsushima Toshiya , Homma Koichi J. , Yamaguchi Shinji
Published: April 2022

Hippocampal formation (HF) plays a key role in cognitive and emotional processing in mammals. In HF neural circuits, serotonin receptors (5-HTRs) modulate functions related to cognition and emotion. To understand the phylogenetic continuity of the neural basis for cognition and emotion, it is important to identify the neural circuits that regulate cognitive and emotional processing in animals. In birds, HF has been shown to be related to cognitive functions and emotion-related behaviors. However, details regarding the distribution of 5-HTRs in the avian brain are very sparse, and 5-HTRs, which are potentially involved in cognitive functions and emotion-related behaviors, are poorly understood. Previously, we showed that 5-HTR1B and 5-HTR3A were expressed in chick HF. To identify additional 5-HTRs that are potentially involved in cognitive and emotional functions in avian HF, we selected the chick orthologs of 5-HTR1D, 5-HTR1E, 5-HTR1F, 5-HTR2B, 5-HTR5A, and 5-HTR7 and performed in situ hybridization in the chick telencephalon. We found that 5-HTR1D, 5-HTR1E, 5-HTR5A, and 5-HTR7 were expressed in the chick HF, especially 5-HTR1D and 5-HTR1E, which showed subdivision- and layer-selective expression patterns, suggesting that the characteristic 5-HT regulation is involved in cognitive functions and emotion-related behaviors in these HF regions. These findings can facilitate the understanding of serotonin regulation in avian HF and the correspondence between the HF subdivisions of birds and mammals.
Responses of Soil Microbial Metabolic Activity and Community Structure to Different Degraded and Restored Grassland Gradients of the Tibetan Plateau
Authors: Wang Dangjun , Zhou Huakun , Zuo Juan , Chen Peng , She Yandi , Yao Buqing , Dong Shikui , Wu Jianshuang , Li Fan , Njoroge Denis Mburu , Shi Guoxi , Mao Xufeng , Ma Li , Zhang Zhonghua , Mao Zhun
Published: April 2022

Climate change and land-use disturbances are supposed to have severely affected the degraded alpine grasslands on the Tibetan Plateau. Artificial grassland establishment has been implemented as a restoration tool against grassland degradation. However, the impact of such degradation and restoration processes on soil microbial communities and soil quality is not clearly understood. Here, we aim to investigate how the dynamics of microbial community and soil quality of alpine grasslands respond to a gradient of degradation and that of restoration, respectively. We conducted a randomised experiment with four degradation stages (light, moderate, heavy, and extreme degradation) and three restoration stages (artificial restoration for 1, 5, and 10 years). We analysed the abundance and diversity of soil bacteria and fungi, and measured soil nutrients, enzymatic activity and microbial biomass. The concentration of soil nitrogen (TN), soil organic matter (OM) in heavy degraded grassland decreased significantly by 37.4 and 45.08% compared with that in light degraded grassland. TN and OM in 10-years restored grassland also increased significantly by 33.10 and 30.42% compared to that in 1-year restored grassland. Four soil enzymatic activity indicators related to microbial biomass decreased with degradation gradient and increased with recovery time (i.e., restoration gradient). Both bacterial and fungal community structure was significantly different among grassland degradation or restoration successional stages. The LEfSe analysis revealed that 29 fungal clades and 9 bacterial clades were susceptible to degraded succession, while16 fungal clades and 5 bacterial clades were susceptible to restoration succession. We conclude that soil quality (TN, OM, and enzymatic activity) deteriorated significantly in heavy degraded alpine grassland. Soil microbial community structure of alpine is profoundly impacted by both degradation and restoration processes, fungal communities are more sensitive to grassland succession than bacterial communities. Artificial grasslands can be used as an effective method of restoring degraded grassland, but the soil functions of artificial grassland, even after 10 years of recovery, cannot be restored to the original state of alpine grassland.
Evidence for Seed Transmission of Xylella fastidiosa in Pecan (Carya illinoinensis)
Authors: Cervantes Kimberly , Hilton Angelyn E. , Stamler Rio A. , Heerema Richard J. , Bock Clive , Wang Xinwang , Jo Young-Ki , Grauke L. J. , Randall Jennifer J.
Published: April 2022

Pecan bacterial leaf scorch, caused by Xylella fastidiosa subsp. multiplex, is an economically significant disease of pecan with known detrimental effects on the yield of susceptible cultivars. In this study, endosperm was harvested from developing pecan seeds, and direct qPCR and sequencing were used to detect and confirm the presence of X. fastidiosa. DNA was isolated from mature seeds originating from seven trees, revealing a positivity rate up to 90%, and transmission of X. fastidiosa from infected seed to the germinated seedlings was found to be over 80%. Further epidemiological analyses were performed to determine where X. fastidiosa localizes in mature seed and seedlings. The highest concentrations of X. fastidiosa DNA were found in the hilum and outer integument of the seeds and the petioles, respectively. High-, medium-, and low-density seeds were harvested to determine the impact of the bacterium on seed density and seedling growth rate. The growth rate of seedlings originating from low-density seeds was significantly reduced compared to the medium- and high-density seeds. Despite the increased growth and germination rates, the high-density seed group had a greater proportion of samples that tested positive for the presence of X. fastidiosa by qPCR. The results demonstrate the ability of X. fastidiosa to colonize developing seeds and be efficiently transmitted from well-developed seeds to germinated seedlings. Continued research is needed to understand the plant-microbe interactions involved in the colonization of pecan seeds by X. fastidiosa and to develop effective phytosanitary approaches to reduce the risks posed by seed transmission.
Phenotypic Trait Subdivision Provides New Sight Into the Directional Improvement of Eucommia ulmoides Oliver
Authors: Deng Peng , Wang Yiran , Hu Fengcheng , Yu Hang , Liang Yangling , Zhang Haolin , Wang Ting , Zhou Yuhao , Li Zhouqi
Published: April 2022

Eucommia ulmoides Oliver has been used extensively in many fields. To satisfy increasing demand, great efforts must be made to further improve its traits. However, limited information is available on these traits, which is a factor that restricts their improvement. To improve traits directionally, nine clones were assigned to six sites to analyze the effect of different variation sources (the genotype, site, and genotype × environment interaction) on the phenotypic trait. In addition, a mixed linear model was used to assess the contribution of variations. In general, for most traits, the site effect accounted for a larger proportion of the variance, followed by the genotype and genotype × environment interaction effects. All the studied genotypes and sites had a significant effect, indicating that they could be improved by selecting preferable genotypes or cultivation areas, respectively. Interestingly, growth traits or economic traits could be improved simultaneously. Trait performance and stability are necessary when selecting genotypes. Moreover, the discriminating ability of genotypes should be considered in selecting cultivation areas. Annual mean temperature and annual sunshine duration proved to be crucial factors that affected the traits. They were correlated positively with economic traits and leaf yield and correlated negatively with growth traits. These findings contributed to selecting a wider range of cultivation areas. Regarding the genotype × environment interaction effect, there were significant differences only in the gutta-percha content, the total number of leaves, and the chlorogenic acid content. These traits could also be improved by choosing appropriate genotypes for the local environment. The research has provided preliminary data on the main factors that affect the traits of E. ulmoides and offered solutions for trait improvement. This information could be a reference for the trait improvement of other plants.
Applications of a Hyperspectral Imaging System Used to Estimate Wheat Grain Protein: A Review
Authors: Ma Junjie , Zheng Bangyou , He Yong
Published: April 2022

Recent research advances in wheat have focused not only on increasing grain yields, but also on establishing higher grain quality. Wheat quality is primarily determined by the grain protein content (GPC) and composition, and both of these are affected by nitrogen (N) levels in the plant as it develops during the growing season. Hyperspectral remote sensing is gradually becoming recognized as an economical alternative to traditional destructive field sampling methods and laboratory testing as a means of determining the N status within wheat. Currently, hyperspectral vegetation indices (VIs) and linear nonparametric regression are the primary tools for monitoring the N status of wheat. Machine learning algorithms have been increasingly applied to model the nonlinear relationship between spectral data and wheat N status. This study is a comprehensive review of available N-related hyperspectral VIs and aims to inform the selection of VIs under field conditions. The combination of feature mining and machine learning algorithms is discussed as an application of hyperspectral imaging systems. We discuss the major challenges and future directions for evaluating and assessing wheat N status. Finally, we suggest that the underlying mechanism of protein formation in wheat grains as determined by using hyperspectral imaging systems needs to be further investigated. This overview provides theoretical and technical support to promote applications of hyperspectral imaging systems in wheat N status assessments; in addition, it can be applied to help monitor and evaluate food and nutrition security.
CRISPR/Cas9 and Nanotechnology Pertinence in Agricultural Crop Refinement
Authors: Naik Banavath Jayanna , Shimoga Ganesh , Kim Seong-Cheol , Manjulatha Mekapogu , Subramanyam Reddy Chinreddy , Palem Ramasubba Reddy , Kumar Manu , Kim Sang-Youn , Lee Soo-Hong
Published: April 2022

The CRISPR/Cas9 (Clustered Regularly Interspaced Short Palindromic Repeats/CRISPR-associated protein 9) method is a versatile technique that can be applied in crop refinement. Currently, the main reasons for declining agricultural yield are global warming, low rainfall, biotic and abiotic stresses, in addition to soil fertility issues caused by the use of harmful chemicals as fertilizers/additives. The declining yields can lead to inadequate supply of nutritional food as per global demand. Grains and horticultural crops including fruits, vegetables, and ornamental plants are crucial in sustaining human life. Genomic editing using CRISPR/Cas9 and nanotechnology has numerous advantages in crop development. Improving crop production using transgenic-free CRISPR/Cas9 technology and produced fertilizers, pesticides, and boosters for plants by adopting nanotechnology-based protocols can essentially overcome the universal food scarcity. This review briefly gives an overview on the potential applications of CRISPR/Cas9 and nanotechnology-based methods in developing the cultivation of major agricultural crops. In addition, the limitations and major challenges of genome editing in grains, vegetables, and fruits have been discussed in detail by emphasizing its applications in crop refinement strategy.
In Search of Resistance Against Fusarium Ear Rot: Ferulic Acid Contents in Maize Pericarp Are Associated With Antifungal Activity and Inhibition of Fumonisin Production
Authors: Martínez-Fraca Javier , de la Torre-Hernández M. Eugenia , Meshoulam-Alamilla Max , Plasencia Javier
Published: April 2022

Fusarium verticillioides is a fungal pathogen of maize that causes seedling blight, stem rot, and Fusarium ear rot. Fungal infestation of maize kernels and ears affects grain quality from the ensuing mycotoxin buildup. Among the mycotoxins produced by F. verticillioides, fumonisins accumulate to high levels in Fusarium-infected maize kernels, fumonisin B1 (FB1) being the most abundant in naturally infected maize. Achieving resistance to Fusarium ear rot has been challenging, as various environmental factors facilitate fungal infection. Among the maize grain components that contribute to resistance to F. verticillioides infection, the pericarp is the first barrier faced by the fungus and thus plays a key role. Phenolic acids are major constituents of maize pericarp, of which ferulic acid (FA) is the predominant molecular species. In this work, we explored the relationship between FA levels, fungal infection, and FB1 production in 51 maize genotypes and whether the antioxidant activity of FA might play a role. We confirmed that FA is a major component of the seed pericarp, whose levels as bound FA varied between 4.5 and 26.3 mg/g across maize genotypes. We selected two pools of five maize varieties, with contrasting FA contents: low FA (LFA; 6.14 ± 0.40 mg/g) and high FA (HFA; 15.49 ± 1.31 mg/g). In vitro, HFA extracts inhibited fungal growth with effects comparable to FA concentrations in the 0.25–0.50 mM range. We also established a kernel assay to study F. verticillioides colonization and FB1 production in the LFA and HFA genotypes. Fungal colonization was significantly lower in HFA genotypes relative to LFA genotypes, based on ergosterol levels. Moreover, FB1 production was also inhibited in the HFA genotypes. Importantly, the antioxidant activity of maize pericarp extracts was associated with FA contents, with HFA extracts exhibiting a greater antioxidant activity than LFA extracts. Overall, our results highlight the role of FA and its antioxidant activity on resistance to Fusarium ear rot and provide the basis of a phenotypic trait that can be deployed for breeding selection.
Antioxidant Regulation and DNA Methylation Dynamics During Mikania micrantha Seed Germination Under Cold Stress
Authors: Cui Can , Wang Zhen , Su Yingjuan , Wang Ting
Published: April 2022

As a primary goal, adaptation to cold climate could expand an invasion range of exotic plants. Here, we aimed to explore the regulation strategy of M. micrantha seed development under cold stress through molecular physiology and multi-omics analysis. Significant increase of hydrogen peroxide, malondialdehyde, and electrolyte leakage observed under cold stress revealed that oxidative damage within M. micrantha seed cells was induced in the initial germination phase. Proteomic data underscored an activation of antioxidant activity to maintain redox homeostasis, with a cluster of antioxidant proteins identified. Genomic-wide transcriptome, in combination with time-series whole-genome bisulfite sequencing mining, elucidated that seven candidate genes, which were the target of DNA demethylation-dependent ROS scavenging, were possibly associated with an M. micrantha germ break. Progressive gain of CHH context DNA methylation identified in an early germination phrase suggested a role of a DNA methylation pathway, while an active DNA demethylation pathway was also initiated during late seed development, which was in line with the expression trend of methylation and demethylation-related genes verified through qRT-PCR. These data pointed out that cold-dependent DNA demethylation and an antioxidant regulatory were involved together in restoring seed germination. The expression level of total 441 genes presented an opposite trend to the methylation divergence, while the expression of total 395 genes was proved to be negatively associated with their methylation levels. These data provided new insights into molecular reprograming events during M. micrantha seed development.
Success of Process Innovations Through Active Works Council Participation
Authors: Breitling Kai , Scholl Wolfgang
Published: April 2022

Successful innovations are deemed to be necessary requisites for enterprise success. On the other hand, works council participation (“co-determination” in Germany) and employee participation are judged differently as either fostering employee and enterprise benefits or only the former or even none. Both forms of participation have found diverging theoretical and empirical argumentations regarding innovations. Here, we argue and show empirically that both forms of participation deliver positive contributions to innovation success, economically and employee-related, substantiated with qualitative reports from 36 process innovation cases and quantitative data from 44 cases. Qualitative case analyses reveal different profiles of works council participation depending on the innovation type. Independent of the innovation types, more successful innovations are marked by more intensive participation. Quantitative examinations of a causal model with path analysis specify how this is achieved: works council and employee participation further the growth of appropriate knowledge and the former also raises the coordination capability; both are essential preconditions for innovation success. A direct impact of works councils on innovation success complements the indirect effects. The slightly modified path analysis explains 53% of the innovation success variance.
Adverse Childhood Experiences Are Associated With Adult Dream Content: A Cross-Sectional Survey
Authors: Ma Yundong , Feng Xia , Wang Di , Zhao Xiaoxia , Yan Zejun , Bao Yanping , Zhu Ran , Sun Qiqing , Deng Jiahui , Lu Lin , Sun Hongqiang
Published: April 2022

Background

Dreams can be affected by recent life events and long-term life experiences. Previous evidence has shown that childhood adverse experiences are associated with sleep quality and dream experiences.

Objective

The aim of this study was to explore the relationship between childhood adverse experiences and dream content in adults.

Participants and Setting

A total of 163 participants without current or past physical or mental disorders aged between 18 and 35 were screened in the hospital. Among them, 120 subjects who completed a dream content record at home and whose anxiety and depression levels and sleep quality were within the normal range were included in the data analysis.

Methods

A cross-sectional survey was conducted from June 2017 to December 2019. Dream content for 10 consecutive days was recorded by the participants and coded by the Hall and Van de Castle coding system. Childhood adversity was assessed by the Childhood Trauma Questionnaire (CTQ). In the end, 719 dreams out of 626 nights for 120 participants (44 female) were included in the data analysis, gender differences between groups were analyzed usingt-tests orUtests, and Spearman’s partial correlation and multiple linear regression were used to investigate the relationship between childhood trauma and dream content.

Results

Childhood adversity was associated with characters, friendly interactions, and objects in dream content. Regression models of childhood adversity predicting characters and objects in dream content were constructed. There were no gender differences in general demographic data, sleep quality, emotional state, childhood adversity, dream recall frequency, or dream content.

Conclusion

Childhood adversity is associated with adult dream content.
Understanding Why Tourists Who Share Travel Photos Online Give More Positive Tourism Product Evaluation: Evidence From Chinese Tourists
Authors: Tang Xiuyuan , Gong Yanping , Chen Chunyan , Wang Suying , Chen Pengfei
Published: April 2022

This study tested a conceptual model in which photo-sharing behavior during travel elicits tourists’ emotional state, and in turn improves evaluation of the tourism product. The research results in the context of tourist attractions and restaurants provide support for the proposed model. Specifically, tourists’ photo-sharing behavior was significantly associated with more positive product evaluation, both directly and indirectly via the emotion of pleasure. These associations were stronger when the interdependent self-construers had good social experience. The results provide practical guidance for marketers to developing marketing strategy.
Extending Theory of Planned Behavior to Understand Service-Oriented Organizational Citizen Behavior
Authors: Tsai Kuang-Chung , Chou Tung-Hsiang , Kittikowit Santhaya , Hongsuchon Tanaporn , Lin Yu-Chun , Chen Shih-Chih
Published: April 2022

The financial crisis of 2007–2008 and the COVID-19 pandemic have caused many enterprises to suffer great losses. Thus, companies have to take measures such as pays cut, furloughs, or layoffs, which caused dissatisfaction among employees and triggered labor disputes. Therefore, this study explores the service-oriented organizational citizenship behavior based on the decomposed theory of planned behavior in order to understand the behavioral intentions of employees through their mental states, job attitudes, subjective norms, and perceived behavioral control. This study conducted questionnaire surveys for employees in different industries, collected 281 valid questionnaires, and applied Structural Equation Model for the analysis. The results show: (1) employees believe organizational justice in the organization is important, and when they feel treated fairly, their job attitudes and beliefs are enhanced. (2) Employees’ job attitudes and beliefs support service-oriented organizational citizenship behavior, in other words, they have positive job attitudes and beliefs and will actively provide better service to customers. (3) When employees are treated reasonably and fairly by the organization and have positive job attitudes (job satisfaction and organizational commitment) and perceived behavior control, their spontaneous service-oriented organizational citizenship behavior is stimulated, thus increasing organizational development.
Effects of Stores’ Environmental Components on Chinese Consumers’ Emotions and Intentions to Purchase Luxury Brands: Integrating Partial Least Squares-Structural Equation Modeling and Fuzzy-Set Qualitative Comparative Analysis Approaches
Authors: Yang Shaohua , Isa Salmi Mohd , Wu Hongyan , Thurasamy Ramayah , Fang Xi , Fan Yedan , Liu Danping
Published: April 2022

Purpose

Drawing upon the stimulus-organism-response (S-O-R) model, this paper aims to investigate the effects of stores’ environmental components (i.e., lighting, cleanliness, scent, design, layout, music, and employee interaction) on Chinese consumers’ emotions and intentions to purchase luxury brands.

Design/Methodology/Approach

Data were collected from Chinese consumers who have purchased luxury brands from retail stores. Partial least squares-structural equation modeling (PLS-SEM) and fuzzy-set qualitative comparative analysis (fsQCA) were employed for data analysis.

Findings

The results of PLS-SEM indicated that three dimensions of the store environment (i.e., music, scent, and employee interaction) directly and significantly influenced Chinese consumers’ emotions. However, fsQCA revealed greater heterogeneity among respondents by highlighting stores’ environmental components and Chinese consumers’ emotions.

Originality/Value

This study makes significant contributions to the marketing literature by examining the S-O-R model alongside fsQCA approach to conditionally predict outcomes in a luxury brand context. The present study may be one of the first to examine the effects of stores’ environmental components on Chinese consumers’ emotions and purchase intentions, applying both symmetrical test (PLS-SEM) and asymmetrical test (fsQCA) approaches to determine significant components of the store environment as well as component combinations that predict Chinese consumers’ emotions and purchase intentions.
Inclusion of Refugee Peers – Differences Between Own Preferences and Expectations of the Peer Group
Authors: Beißert Hanna , Mulvey Kelly Lynn
Published: April 2022

Given the high numbers of refugees from Syria entering Germany in the recent years, the social integration of refugee youth has become an increasingly important issue in Germany. Thus, the current study examines adolescents’ decisions and reasoning around the inclusion of Syrian peers in Germany. Using a hypothetical scenario, we assessed adolescents’ (N = 100, M = 13.65 years, SD = 1.93, 51 females, 49 males) peer inclusion decisions and reasoning with attention to comparing inclusion of a Syrian refugee peer and a German peer. Given the importance of group norms for adolescents, we assessed not only adolescents’ own inclusion decisions, but also what they would expect their peer group to decide and what they think their peer group should do. Moreover, adolescents’ underlying reasoning was assessed. The analyses revealed that adolescents thought they would be more inclusive of a Syrian peer than a German peer and that their peer group should be more inclusive of a Syrian peer than a German peer. These tendencies toward including refugees were justified with references to morality as well as social-conventions. In contrast to their own decisions and to what they think their peer group should, participants expected their group would be more inclusive toward a German peer than a Syrian peer. This was mainly justified by referencing aspects of group functioning and psychological information about the peers, whereas moral and prosocial reasoning was very rarely used for the expected group decision. In sum, these findings document that adolescents in Germany wish to be inclusive regarding refugee peers and that they balance attention to morality and other domains of social reasoning when thinking about inclusion decisions while they expect that their peers will not consider morally relevant information when making these decisions. These findings have important practical implications as they indicate the importance of interventions that focus on promoting inclusive peer group norms.
The Impact of EFL Teachers’ Open-Mindedness and Immediacy on Their Social Intelligence: A Theoretical Review
Authors: Cui Zhan
Published: April 2022

The role of psycho-emotional and social factors in determining teachers’ pedagogical success has been largely endorsed in the literature. This highlights the necessity of improving EFL teachers’ awareness and knowledge of various factors related to classroom interaction and interpersonal communication. Despite the existence of some L2 studies on interpersonal communication skills after the popularity of positive psychology, the interplay of variables that directly reflect classroom interactions and their linkage to one’s intelligence(s) has been overlooked, to date. To fill this gap, the present mini review presented the theoretical and empirical foundations of three significant teacher-related variables, namely open-mindedness, immediacy, and social intelligence. In so doing, their relevant definitions, conceptualizations, models, and correlates were provided. Finally, the study offered some practical implications and suggestions for EFL stakeholders and researchers who can improve their knowledge and use of social-based variables in second/foreign language education.
Monitoring the Mental Health and Professional Overload of Health Workers in Brazil: A Longitudinal Study Considering the First Wave of the COVID-19 Pandemic
Authors: Osório Flávia L. , Zuardi Antonio Waldo , Silveira Isabella L. M. , Crippa José Alexandre S. , Hallak Jaime Eduardo Cecílio , Pereira-Lima Karina , Loureiro Sonia R.
Published: April 2022

Few longitudinal studies assessed the less immediate consequences of the COVID-19 pandemic on health workers' mental health, especially in less developed countries. The objective was to assess the evolution of mental health indicators of Brazilian health workers providing care to COVID-19 patients, considering the beginning and first wave of the pandemic, identifying risk and protective factors. A non-probabilistic sample of health professionals was assessed for 6 months at seven different points in time using standardized instruments to measure anxiety, depression, insomnia, posttraumatic stress, and burnout symptoms. Risk and protective factors were assessed using a questionnaire addressing socio-demographic, clinical, occupational variables, and COVID-19 risk perception. The results indicate high rates for all the indicators (>30%) throughout the follow-up; only anxiety symptoms decreased in the different phases compared to the baseline. Depression and insomnia symptoms showed a significant drop in isolated points of the assessment, which were not maintained at the final follow-up. Burnout indicators concerning emotional exhaustion and depersonalization remained stable (40 and 20%), while professional achievement decreased by approximately 19%. Occupational and personal characteristics (profession and work setting), perceptions regarding protective measures imposed by the institutions, and future professional prospects stood out as risk/protective factors in mental health. Unlike European and Asian countries, where mental distress symptoms tended to decrease over the pandemic, this study's results suggest alarming indicators of mental health problems remaining stable with burnout symptoms on the rise. Hence, the different contexts across countries, with different management resources and investments in health actions, seem to influence workers' mental health differently, demanding constant attention and monitoring and measures to minimize the impacts on individuals and collectives, especially in less developed countries like Brazil.
Strategies for the Prevention of Violence in Institutional Care: A Qualitative Interview Study With Ward Managers
Authors: Lindow Martin , Kjellin Lars , Engström Ingemar , Pelto-Piri Veikko
Published: April 2022

Background

The presence of violence within psychiatric and residential settings remains a challenge. Research on this problem has often focused on describing violence prevention strategies from either staffs' or service users' perspectives, and the views of ward managers has been largely overlooked. The aim of the present study was therefore to identify ward managers' strategies to prevent violence in institutional care, focusing on safety and values.

Methods

Data were collected using semi-structured interviews with 12 ward managers who headed four different types of psychiatric wards and two special residential homes for adolescents. Qualitative content analysis was applied, first using a deductive approach, in which quotes were selected within a frame of primary, secondary, and tertiary prevention, then by coding using an inductive approach to create themes and subthemes.

Results

Ward managers' strategies were divided into the four following themes: (1)Balancing being an active manager with relying on staff's abilitiesto carry out their work properly while staying mostly in the background; (2)Promoting value awareness and non-coercive practices in encounters with service usersby promoting key values and adopting de-escalation techniques, as well as focusing on staff-service user relationships; (3)Acknowledging and strengthening staff's abilities and competenceby viewing and treating staff as a critical resource for good care; and (4)Providing information and support to staffby exchanging information and debriefing them after violent incidents.

Conclusions

Ward managers described ethical challenges surrounding violence and coercive measures. These were often described as practical problems, so there seems to be a need for a development of higher ethical awareness based on a common understanding regarding central ethical values to be respected in coercive care. The ward managers seem to have a high awareness of de-escalation and the work with secondary prevention, however, there is a need to develop the work with primary and tertiary prevention. The service user group or user organizations were not considered as resources in violence prevention, so there is a need to ensure that all stakeholders are active in the process of creating violence prevention strategies.
EEG Biomarkers in Children and Adolescents With Feeding and Eating Disorders: Current Evidence and Future Directions
Authors: Berchio Cristina , Cambi Susanne , Pappaianni Edoardo , Micali Nadia
Published: April 2022

Introduction

Electroencephalography (EEG) represents a powerful tool to detect abnormal neural dynamics in child and adolescent psychiatry. Feeding and Eating Disorders (FEDs), such as anorexia nervosa (AN), bulimia nervosa (BN), binge eating disorder (BED), and avoidant restrictive food intake disorder (ARFID) onset in childhood and adolescence. EEG has rarely been used to examine cortical brain activity in children and adolescents with FEDs. This review aims to summarize EEG findings in FEDs amongst children and adolescents, and to highlight areas deserving further research.

Methods

We searched the literature for EEG studies on children and adolescents with FEDs using Google Scholar, PsycINFO, Medline, and PubMed.

Results

Twelve studies were identified, the majority focusing on AN (N = 10). The identified studies suggest reduced action monitoring control (preparatory waves, N200, P300), specific perceptual-cognitive styles to body/face perception (late positive potentials/early posterior negativity), as well as fundamental changes in posterior theta oscillations in AN. Behavioral traits of BN/BED (i.e., loss of control eating, emotional eating), and AN seem to be associated with an increased attentional reactivity (P300) to visual food stimuli.

Conclusion

Electroencephalography research in children and adolescents with FEDs is limited and mostly focused on AN. While EEG abnormalities seem consistent with a reduced top-down control and attentional allocation deficits in AN, altered attention specific to food cues emerges across FEDs. Overcoming conventional EEG analyses, and investigating spatial properties (i.e., electrical neuroimaging), will enhance our understanding of FEDs neurobiology.
The Reimbursement Rate of New Rural Cooperative Medical Scheme and Self-Rated Health Among Rural Middle-Aged and Elderly
Authors: Xie Xingquan , Hu Ying
Published: April 2022

Objectives

The ultimate goal of the New Rural Cooperative Medical Scheme (NRCMS) is to improve physical and psychological health and aim to provide equitable, affordable, cost-effective healthcare services for all rural people. One of our major concerns from the perspective of policy outcome is whether middle-aged and elderly can benefit from the insurance to improve self-rated health. The main objectives of this study are to answer the questions that the reimbursement rate of the NRCMS is a possible explanation of why and how rural middle-aged and elderly shift from non-medical service inputs to medical service to produce health based on a family production theory.

Methods

Data were obtained from the China Health and Retirement Longitudinal Study (CHARLS) conducted in 2018, which involved 1,030 rural adults aged 45 years and older, and ordinal logistic regression estimator and two-step regression were used to examine these assumptions. Our approach controlled for the health status of those people at the same administrative level of the hospital.

Results

Our study shows some interesting results. First, the reimbursement rate of NRCMS predicted a higher level of SRH among rural middle-aged and elderly, but that all of the indirect effect of it on SRH could be explained in total by satisfaction of local medical services utilization (ab = 0.0492). Second, the results further showed that the odds ratio of satisfaction from affordable, convenient, high-quality medical services is 2.402 times (p < 0.01) greater for those with higher reimbursement levels than for their counterparts with lower reimbursement. Third, the odds ratios of inpatient care visit, outpatient care visit, and physical examination among policyholders of NRCMS are also 1.116, 1.628, and 1.08 times greater, respectively, than their counterparts who are not satisfied with these local medical services.

Conclusions

Our results concluded that generous insurance reimbursement can reduce the price of healthcare and costs of utilization that both had a dramatic effect on SRH among middle-aged and elderly when their demand for medical treatment is incurred. The government should focus on the healthcare cost, utilization, and health benefit calculations of health insurance policy options at the stage of rapid aging in rural China.
Guiding Principles for Surgical Pathways: A Tool for Improving Outcomes and Patient Safety
Authors: Bolcato Matteo , Rodriguez Daniele , Aprile Anna
Published: April 2022

Surgical activity is an important aspect for the management of health and safety processes and from an organizational perspective is one of the most complex activities performed in hospitals. It is often a defining and high value feature for any healthcare facility while being one of the most high-risk procedures for patients with the highest number of avoidable adverse events. To ensure effective management of surgical pathways, they need to be considered from the perspective of clinical governance which takes a global approach to planning and management with the goal of improving safety and quality for patients. This paper contains the main features of this objective outlined within the document issued subsequent to the State-Regional Italian Government conference. This regulatory effort includes effective recommendations to make surgical pathways safer and more efficient with particular reference to lean management, patient blood management and patient safety.
The Awareness of Rare Diseases Among Medical Students and Practicing Physicians in the Republic of Kazakhstan. An Exploratory Study
Authors: Walkowiak Dariusz , Bokayeva Kamila , Miraleyeva Alua , Domaradzki Jan
Published: April 2022

Although national plans or strategies for rare diseases (RDs) have been implemented in many jurisdictions research show that one of the main barriers RD patients face during medical encounter is medical professionals' low level of knowledge and experience on the diagnosis, treatment and rehabilitation of RD patients. Consequently, there is a need to increase the standards of medical education in the field of RDs and to revise the undergraduate and postgraduate training programs. However, while studies on medical education in the field of RDs has been conducted in various countries across the both Americas, Asia or the European Union, still little is known about the awareness of RDs among healthcare professionals in the Republic of Kazakhstan. Thus, we conducted a survey among 207 medical students and 101 medical doctors from the West Kazakhstan Marat Ospanov Medical University, Aktobe, Kazakhstan. The study was conducted between March and May 2021. The questionnaire assessed their knowledge about the number, examples, etiology and estimated frequency of RDs. It also evaluated respondents self-assessment of competence in RDs. Although the majority of respondents agreed that RDs constitute a serious public health issue both medical students and medical doctors showed insufficient knowledge on the etiology, epidemiology and prevalence of RDs, and many had problems with separating RDs from more common disorders. Moreover, they also lacked knowledge about and the central register of RD patients and reimbursement of orphan drugs in Kazakhstan. Finally, while almost half respondents declared having had classes about RDs during their studies most perceived their knowledge about RDs as insufficient or poor and felt unprepared for caring for RD patients. Additionally, although majority of respondents in both groups believed that all physicians, regardless of their specialization, should possess knowledge on RDs many respondents did not look for such information at all.
GANterfactual—Counterfactual Explanations for Medical Non-experts Using Generative Adversarial Learning
Authors: Mertes Silvan , Huber Tobias , Weitz Katharina , Heimerl Alexander , André Elisabeth
Published: April 2022

With the ongoing rise of machine learning, the need for methods for explaining decisions made by artificial intelligence systems is becoming a more and more important topic. Especially for image classification tasks, many state-of-the-art tools to explain such classifiers rely on visual highlighting of important areas of the input data. Contrary, counterfactual explanation systems try to enable a counterfactual reasoning by modifying the input image in a way such that the classifier would have made a different prediction. By doing so, the users of counterfactual explanation systems are equipped with a completely different kind of explanatory information. However, methods for generating realistic counterfactual explanations for image classifiers are still rare. Especially in medical contexts, where relevant information often consists of textural and structural information, high-quality counterfactual images have the potential to give meaningful insights into decision processes. In this work, we present GANterfactual, an approach to generate such counterfactual image explanations based on adversarial image-to-image translation techniques. Additionally, we conduct a user study to evaluate our approach in an exemplary medical use case. Our results show that, in the chosen medical use-case, counterfactual explanations lead to significantly better results regarding mental models, explanation satisfaction, trust, emotions, and self-efficacy than two state-of-the art systems that work with saliency maps, namely LIME and LRP.
Perception of Green Spaces Preparedness and Accessibility During COVID-19: An Exploratory Survey in Two Mid-Sized Chilean Cities
Authors: Rojas Quezada Carolina , Aguilera Sáez Felipe , Vecchio Giovanni , Steiniger Stefan
Published: April 2022

Urban green spaces have shown to be beneficial for the physical and mental wellbeing of the general population—which particularly holds true during an unprecedented, stressful situation such as the COVID-19 pandemic. In urban settings characterized by structural inequality, scarce access to green spaces in a neighborhood can affect the wellbeing of its inhabitants and lower overall resilience of a community. Assuming that the effects of confinement and working from home produce an increased demand for recreational and sports activities, this paper looks to assess the level of preparedness and accessibility of green spaces during the COVID-19 pandemic, considering individual and public measures to avoid contagion. The assessment is carried out through an online exploratory survey and accessibility calculations that are applied to two Chilean cities with a Mediterranean climate, Talca and Chillán. The study considers the quality of green spaces based on (i) official statistics and (ii) a questionnaire directed toward residents. We found that high-quality urban green spaces are accessible to residents of both cities, but rather limited in December 2020 due to low levels of preparedness. Considering the qualities of existing urban green spaces allows for a more precise estimate of their contribution to the wellbeing of neighborhoods, and consequently facilitates better recommendations for urban plans and policies.
Deriving Snow Depth From ICESat-2 Lidar Multiple Scattering Measurements
Authors: Hu Yongxiang , Lu Xiaomei , Zeng Xubin , Stamnes Snorre A , Neuman Thomas A. , Kurtz Nathan T. , Zhai Pengwang , Gao Meng , Sun Wenbo , Xu Kuanman , Liu Zhaoyan , Omar Ali H. , Baize Rosemary R. , Rogers Laura J. , Mitchell Brandon O. , Stamnes Knut , Huang Yuping , Chen Nan , Weimer Carl , Lee Jennifer , Fair Zachary
Published: April 2022

Snow is a crucial element in the Earth’s system, but snow depth and mass are very challenging to be measured globally. Here, we provide the theoretical foundation for deriving snow depth directly from space-borne lidar (ICESat-2) snow multiple scattering measurements for the first time. First, based on the Monte Carlo lidar radiative transfer simulations of ICESat-2 measurements of 532-nm laser light propagation in snow, we find that the lidar backscattering path length follows Gamma distribution. Next, we derive three simple analytical equations to compute snow depth from the average, second-, and third-order moments of the distribution. As a preliminary application, these relations are then used to retrieve snow depth over the Antarctic ice sheet and the Arctic sea ice using the ICESat-2 lidar multiple scattering measurements. The robustness of this snow depth technique is demonstrated by the agreement of snow depth computed from the three derived relations using both modeled data and ICESat-2 observations.
Updates on Management of Avascular Necrosis Using Hip Arthroscopy for Core Decompression
Authors: Kunze Kyle N. , Sullivan Spencer W. , Nwachukwu Benedict U.
Published: April 2022

Osteonecrosis of the femoral head (ONFH) is caused when circulation within the femoral head is disrupted. Etiology of this disease is characterized by either traumatic events or atraumatic risk factors, such as chronic alcohol consumption or glucocorticoid use. ONFH commonly presents as pain in the groin, gluteus muscles, and/or knee with reductions in internal rotation range of motion of the hip. ONFH pathology can be confirmed with radiographic or advanced imaging and characterized by stage, size and location of the lesion. Treatment for ONFH consists of conservative and therapeutic methods as well as surgical intervention. Historically, ONFH has been treated using total hip arthroplasty (THA), but with increasing incidence in a younger, active population, measures to preserve the native hip joint have been explored. Recent advancements in hip arthroscopy and arthroscopy-assisted core decompression have led to improved outcomes, reduced pain and higher hip survival rate for early onset ONFH compared with more invasive approaches such as THA. Biologic treatments combined with arthroscopic core decompression have also shown improved outcomes and quality of life in few reports, suggesting a potential role for biologic adjuncts. The current study provides a comprehensive review and update on the literature surrounding arthroscopy-assisted core decompression for patients with ONFH.