bluuebunny/crossref_metadata_2025 huggingface dataset:
The impact of an immersive digital therapeutic tool on experimental pain: a pilot randomized within-subject experiment with an active control condition
Authors: Diallo Sanoussy , Marchand Serge , Dumais Alexandre , Potvin Stéphane
Published: June 2024

Background

Pain is a complex and multifaced sensory and emotional experience. Virtual reality (VR) has shown promise in reducing experimental pain and chronic pain. This study examines an immersive VR environment initially designed for endometriosis patients, which demonstrated short-term analgesic effects. The research aims to determine the impact of the VR environment on experimental pain intensity and unpleasantness both during and after VR exposure (3D with binaural beats), while using an active control condition (2D with no binaural beats). Additionally, a secondary objective of the study was to identify the psychological and psychophysical factors that predict the analgesic effects of the immersive digital therapeutic tool.

Methods

The study involved twenty-one healthy individuals and used a within-subject design, comparing a VR treatment with an active control condition. Continuous heat stimulation was applied to the left forearm with a Peltier thermode. Pain ratings were collected for immediate and short-term effects.

Results

In both the VR and Control conditions, there were no significant differences in pain intensity before, during, and after exposure. However, during VR exposure, there was a significant decrease in pain unpleasantness as compared to before exposure (p < 0.001), with a 27.2% pain reduction. In the Control condition, there were no significant differences in pain unpleasantness during and after exposure. Furthermore, no psychological and psychophysical factors predicted the analgesic effects.

Discussion

The study investigated how a VR environment affected experimentally induced pain in healthy volunteers. It showed that VR reduced pain unpleasantness during exposure but had no lasting impact. The VR environment mainly influenced the emotional aspect of pain, possibly due to its inclusion of binaural beats and natural stimuli. The study suggests that the VR environment should be tested in chronic pain population with high distress levels.

Registration number (clinicaltrials.gov)

NCT06130267.
Evaluation of time to sputum smear conversion and its association with treatment outcomes among drug-resistant tuberculosis patients: a retrospective record-reviewing study
Authors: Alzarea Abdulaziz Ibrahim , Saifullah Amna , Khan Yusra Habib , Alanazi Adullah Salah , Alatawi Ahmed D. , Algarni Majed Ahmed , Almalki Ziyad Saeed , Alahmari Abdullah K. , Alhassan Hassan H. , Mallhi Tauqeer Hussain
Published: June 2024

Background: This study examined the time to sputum smear and culture conversion and determinants of conversion, as well as variables associated with treatment outcomes among drug-resistant pulmonary tuberculosis (DR-PTB) cases.

Methods: The electronic database and written medical records of patients were utilized to assess the sociodemographic, clinical, microbiological, and treatment characteristics and outcomes of study participants.

Results: Among 736 patients with pulmonary tuberculosis (PTB), the mean age was 36.5 ± 16.5 years, with males comprising 53.4% and a mean weight of 47.76 ± 11.97 kg. The median time period for sputum smear conversion and sputum culture conversion was a month. The first-month culture conversion (p < 0.001, aOR = 5.817, and 95% CI = 3.703–9.138) was the determinant of sputum smear conversion and receiver operating curve analysis with AUC = 0.881, 95% CI = 0.855–0.907, and p < 0.001, which showed a high level of predictive ability for the regression model for the initial sputum smear conversion. However, the first-month sputum conversion (p < 0.001, aOR = 7.446, and 95% CI = 4.869–11.388) was attributed to sputum culture conversion, and the model has shown excellent predictive ability for regression with ROC curve analysis demonstrating AUC = 0.862, 95% CI = 0.835–0.889, and p < 0.001. A total of 63.2% of patients showed favorable treatment outcomes, with 63.1% of cases achieving treatment-cured status. The previous use of SLD, history of smoking, duration of illness ≤ 1 year, extensively drug-resistant tuberculosis, and first-month sputum conversion were the variables attributed to favorable treatment outcomes observed in drug-resistant pulmonary tuberculosis cases. ROC curve analysis with AUC = 0.902, 95% CI = 0.877–0.927, and p < 0.001) has shown outstanding ability for regression model prediction for the variables influencing treatment outcomes.

Conclusions: Within 2 months of treatment, most patients had converted their sputum cultures and sputum smears. The determinants of early sputum smear and sputum culture conversion, as well as favorable treatment outcomes, were identified. These factors should be considered during the design and implementation of effective strategies for drug-resistant tuberculosis control programs.
Targeting pyruvate kinase M2 for the treatment of kidney disease
Authors: Chen Dan-Qian , Han Jin , Liu Hui , Feng Kai , Li Ping
Published: June 2024

Pyruvate kinase M2 (PKM2), a rate limiting enzyme in glycolysis, is a cellular regulator that has received extensive attention and regards as a metabolic regulator of cellular metabolism and energy. Kidney is a highly metabolically active organ, and glycolysis is the important energy resource for kidney. The accumulated evidences indicates that the enzymatic activity of PKM2 is disturbed in kidney disease progression and treatment, especially diabetic kidney disease and acute kidney injury. Modulating PKM2 post-translational modification determines its enzymatic activity and nuclear translocation that serves as an important interventional approach to regulate PKM2. Emerging evidences show that PKM2 and its post-translational modification participate in kidney disease progression and treatment through modulating metabolism regulation, podocyte injury, fibroblast activation and proliferation, macrophage polarization, and T cell regulation. Interestingly, PKM2 activators (TEPP-46, DASA-58, mitapivat, and TP-1454) and PKM2 inhibitors (shikonin, alkannin, compound 3k and compound 3h) have exhibited potential therapeutic property in kidney disease, which indicates the pleiotropic effects of PKM2 in kidney. In the future, the deep investigation of PKM2 pleiotropic effects in kidney is urgently needed to determine the therapeutic effect of PKM2 activator/inhibitor to benefit patients. The information in this review highlights that PKM2 functions as a potential biomarker and therapeutic target for kidney diseases.
Therapeutic potential of Erxian decoction and its special chemical markers in depression: a review of clinical and preclinical studies
Authors: Zeng Ning-Xi , Li Han , Su Meng-Yuan , Chen Xin , Yang Xiao-Yan , Shen Mei
Published: June 2024

The increasing prevalence of depression is a major societal burden. The etiology of depression involves multiple mechanisms. Thus, the outcomes of the currently used treatment for depression are suboptimal. The anti-depression effects of traditional Chinese medicine (TCM) formulations have piqued the interest of the scientific community owing to their multi-ingredient, multi-target, and multi-link characteristics. According to the TCM theory, the functioning of the kidney is intricately linked to that of the brain. Clinical observations have indicated the therapeutic potential of the kidney-tonifying formula Erxian Decoction (EXD) in depression. This review aimed to comprehensively search various databases to summarize the anti-depression effects of EXD, explore the underlying material basis and mechanisms, and offer new suggestions and methods for the clinical treatment of depression. The clinical and preclinical studies published before 31 August 2023, were searched in PubMed, Google Scholar, China National Knowledge Infrastructure, and Wanfang Database. This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Clinical studies have demonstrated that EXD exhibits therapeutic properties in patients with menopausal depression, postpartum depression, and maintenance hemodialysis-associated depression. Meanwhile, preclinical studies have reported that EXD and its special chemical markers exert anti-depression effects by modulating monoamine neurotransmitter levels, inhibiting neuroinflammation, augmenting synaptic plasticity, exerting neuroprotective effects, regulating the hypothalamic-pituitary-adrenal axis, promoting neurogenesis, and altering cerebrospinal fluid composition. Thus, the anti-depression effects of EXD are mediated through multiple ingredients, targets, and links. However, further clinical and animal studies are needed to investigate the anti-depression effects of EXD and the underlying mechanisms and offer additional evidence and recommendations for its clinical application. Moreover, strategies must be developed to improve the quality control of EXD. This review provides an overview of EXD and guidance for future research direction.
Danshen-Shanzha formula for the treatment of atherosclerosis: ethnopharmacological relevance, preparation methods, chemical constituents, pharmacokinetic properties, and pharmacological effects
Authors: Xu Qiong , Yu Zhe , Zhang Meng , Feng Tian , Song Fan , Tang Haifeng , Wang Siwang , Li Hua
Published: June 2024

Danshen-Shanzha Formula (DSF) is a well-known herbal combination comprising Radix Salvia Miltiorrhiza (known as Danshen in Chinese) and Fructus Crataegi (known as Shanzha in Chinese), It has been documented to exhibit considerable benefits for promoting blood circulation and removing blood stasis, and was used extensively in the treatment of atherosclerotic cardiac and cerebral vascular diseases over decades. Despite several breakthroughs achieved in the basic research and clinical applications of DSF over the past decades, there is a lack of comprehensive reviews summarizing its features and research, which hinders further exploration and exploitation of this promising formula. This review aims to provide a comprehensive interpretation of DSF in terms of its ethnopharmacological relevance, preparation methods, chemical constituents, pharmacokinetic properties and pharmacological effects. The related information on Danshen, Shanzha, and DSF was obtained from internationally recognized online scientific databases, including Web of Science, PubMed, Google Scholar, China National Knowledge Infrastructure, Baidu Scholar, ScienceDirect, ACS Publications, Online Library, Wan Fang Database as well as Flora of China. Data were also gathered from documentations, printed works and classics, such as the Chinese Pharmacopoeia, Chinese herbal classics, etc. Three essential avenues for future studies were put forward as follows: a) Develop and unify the standard preparation method of DSF as to achieve optimized pharmacological properties. b) Elucidate the functional mechanisms as well as the rationality and rule for the compatibility art of DSF by focusing on the clinic syndromes together with the subsequent development of preclinic study system in vitro and in vivo with consistent pathological features, pharmacokinetical behaviour and biomarkers. c) Perform more extensive clinical studies towards the advancement of mechanism-based on evidence-based medicine on the safety application of DSF. This review will provide substantial data support and broader perspective for further research on the renowned formula.
Enhancing target detection accuracy through cross-modal spatial perception and dual-modality fusion
Authors: Zhang Ning , Zhu Wenqing
Published: June 2024

The disparity between human and machine perception of spatial information presents a challenge for machines to accurately sense their surroundings and improve target detection performance. Cross-modal data fusion emerges as a potential solution to enhance the perceptual capabilities of systems. This article introduces a novel spatial perception method that integrates dual-modality feature fusion and coupled attention mechanisms to validate the improvement in detection performance through cross-modal information fusion. The proposed approach incorporates cross-modal feature extraction through a multi-scale feature extraction structure employing a dual-flow architecture. Additionally, a transformer is integrated for feature fusion, while the information perception of the detection system is optimized through the utilization of a linear combination of loss functions. Experimental results demonstrate the superiority of our algorithm over single-modality target detection using visible images, exhibiting an average accuracy improvement of 30.4%. Furthermore, our algorithm outperforms single-modality infrared image detection by 3.0% and comparative multimodal target detection algorithms by 3.5%. These results validate the effectiveness of our proposed algorithm in fusing dual-band features, significantly enhancing target detection accuracy. The adaptability and robustness of our approach are showcased through these results.
Effect of solution pH on root architecture of four apple rootstocks grown in an aeroponics nutrient misting system
Authors: Farqani Ali Al , Cheng Lailiang , Robinson Terence L. , Fazio Gennaro
Published: June 2024

The pH of the solution in the rhizosphere is an important factor that determines the availability and mobility of nutrients for plant uptake. Solution pH may also affect the root distribution and architecture of apple rootstocks. In this study, we evaluated the effect of solution pH on root system development of apple rootstocks using an aeroponics system designed and developed at Cornell AgriTech Geneva, USA. Four Geneva® apple rootstocks (G.210, G.214, G.41, and G.890) were grown in an aeroponic system under nutrient solution misting featuring continuously adjusted pH levels to three pH treatments (5.5, 6.5, and 8.0). Root development was monitored for 30 days and evaluated regularly for distribution and root mass. Images of the developed roots grown in the aeroponic system were collected at the end of the experiment using a high-resolution camera and analyzed using GiA Roots® software, which generates root architecture parameter values in a semi-automated fashion. The resulting root architecture analysis showed that the Geneva® rootstocks were significantly different for two architecture parameters. The length-to-width ratio analysis represented by two GiA Roots parameters (minor-to-major ellipse ratio and network width-to-depth ratio) showed that G.210 was flatter than G.890, which had a greater tendency to grow downward. Rootstocks G.214 and G.41 displayed similar growth values. The solution pH affected most root architecture parameter measurements where overall root growth was higher at pH 8 than at pH 5.5 and 6.5, which showed similar growth. In general, the average root width tended to decrease at higher pH values. While there were no significant differences in the leaf nutrient concentrations of P, K, Ca, Mg, S, B, Zn, Cu, and Fe within the four rootstocks, the pH level of the solution had a significant effect on P, Ca, and Mn. This study is the first of its kind to investigate the effect of pH on root architecture in a soil-free (aeroponic) environment and may have implications for apple root behavior under field conditions where pH levels are different.
Integration of molecular breeding and multi-resistance screening for developing a promising restorer line Guihui5501 with heavy grain, good grain quality, and endurance to biotic and abiotic stresses
Authors: Wei Minyi , Yan Qun , Huang Dahui , Ma Zengfeng , Chen Shen , Yin Xiaoting , Liu Chi , Qin Yuanyuan , Zhou Xiaolong , Wu Zishuai , Lu Yingping , Yan Liuhui , Qin Gang , Zhang Yuexiong
Published: June 2024

Rice, a critical staple on a global scale, faces escalating challenges in yield preservation due to the rising prevalence of abiotic and biotic stressors, exacerbated by frequent climatic fluctuations in recent years. Moreover, the scorching climate prevalent in the rice-growing regions of South China poses obstacles to the cultivation of good-quality, heavy-grain varieties. Addressing this dilemma requires the development of resilient varieties capable of withstanding multiple stress factors. To achieve this objective, our study employed the broad-spectrum blast-resistant line Digu, the brown planthopper (BPH)-resistant line ASD7, and the heavy-grain backbone restorer lines Fuhui838 (FH838) and Shuhui527 (SH527) as parental materials for hybridization and multiple crossings. The incorporation of molecular markers facilitated the rapid pyramiding of six target genes (Pi5, Pita, Pid2, Pid3, Bph2, and Wxb). Through a comprehensive evaluation encompassing blast resistance, BPH resistance, cold tolerance, grain appearance, and quality, alongside agronomic trait selection, a promising restorer line, Guihui5501 (GH5501), was successfully developed. It demonstrated broad-spectrum resistance to blast, exhibiting a resistance frequency of 77.33% against 75 artificially inoculated isolates, moderate resistance to BPH (3.78 grade), strong cold tolerance during the seedling stage (1.80 grade), and characteristics of heavy grains (1,000-grain weight reaching 35.64 g) with good grain quality. The primary rice quality parameters for GH5501, with the exception of alkali spreading value, either met or exceeded the second-grade national standard for premium edible rice varieties, signifying a significant advancement in the production of good-quality heavy-grain varieties in the southern rice-growing regions. Utilizing GH5501, a hybrid combination named Nayou5501, characterized by high yield, good quality, and resistance to multiple stresses, was bred and received approval as a rice variety in Guangxi in 2021. Furthermore, genomic analysis with gene chips revealed that GH5501 possessed an additional 20 exceptional alleles, such as NRT1.1B for efficient nitrogen utilization, SKC1 for salt tolerance, and STV11 for resistance to rice stripe virus. Consequently, the restorer line GH5501 could serve as a valuable resource for the subsequent breeding of high-yielding, good-quality, and stress-tolerant hybrid rice varieties.
Representing Scotland: Conservative narratives of nation, union, and Scottish independence
Authors: Brown Swan Coree , Anderson Paul
Published: June 2024

The United Kingdom’s vote to exit the European Union reignited the debate about Scottish independence, requiring statewide political parties to rearticulate the case for the Union. The UK Conservative Party, as the party of government and one with a tumultuous history vis-à-vis Scotland and devolution, was at the fore in making this case. This article explores representations of Scotland, its position within the United Kingdom, and Scottish nationalism as a political force by the Conservative Party at a prolonged moment of significant political and constitutional tension. We focus, therefore, on 2019 to 2024, a parliamentary term and political period defined by protracted debates on Scotland’s place within the Union, playing out against the backdrop of the Brexit negotiations, the Covid-19 pandemic, and a worsening cost-of-living crisis. To this end, we draw upon parliamentary debates, two daily English newspapers (The Daily Telegraphandthe Sun) and two online right-leaning news sites (ConservativeHomeandThe Spectatoronline). Our analysis identifies three distinct but interrelated strands in Conservative representations of Scotland, each of which is centred on a contrast. First, a distinction between an inclusive unionism versus a narrow nationalism; second, a largely economic narrative, contrasting a prosperous union with the economic risks of independence; and finally, a contrast between governmental competence at Westminster and the SNP-led Scottish Government failing Scotland. These contrasting narratives elucidate the ways in which Conservatives construct representations of Scotland, particularly at moments of constitutional contestation.
Discovering the sensory, emotional, and interactive experiences of a place
Authors: de la Fuente Suárez Luis Alfonso
Published: June 2024

This article proposes a data collection technique for describing experiences of a built environment. Besides the experiences of the visual and physical aspects of the place, this technique helps describe the sensory, bodily, emotional, interactive, and social experiences occurring during the human-environment encounter. The enabling technique presented is called Reactions and Actions Description Survey (RADES). It employs 120 images depicting people going through different situations involving all the senses, showing expressions related to positive and negative emotions, and realizing varied activities. Forty-five participants visited the esplanade in the exterior of a historic building called Obispado. The case study is located on a hill and is a scenic viewpoint of Monterrey, Mexico. The participants answered the RADES and the Environmental Description Survey (ENVIDES), which focuses on describing the qualities of the place and the appraisals with which it is experienced. The comments about the experiences of the place obtained through both surveys were grouped into 133 categories. Qualitative and quantitative data about the experiences of the place were obtained through both techniques. A quantitative analysis of the data was realized since the participants not only described their experiences with words but also indicated numerically the intensity of such experiences. Spearman correlations between the experiences were calculated, and a general map of the experiences of the place was created through multidimensional scaling analysis (MDS). The study revealed the connections between the elements and qualities of the site and the views with specific positive and negative experiences occurring during the visit. Furthermore, MDS allowed the discovery of 10 dimensions of environmental experience—pleasure/displeasure, high/low arousal, dominance/submissiveness, knowing/inhabiting, environment/self, higher/lower cognition, spatiality/materiality, states/processes, natural/built, and visual/sensory. The presented techniques and the findings obtained through them can assist architects in recognizing valuable environmental features for the design of livable spaces.
The influence of parents’ education anxiety on children’s learning anxiety: the mediating role of parenting style and the moderating effect of extracurricular tutoring
Authors: Yin Xia , Zhang HePing , Chen Meng
Published: June 2024

Introduction

This study investigates the intricate relationship between parents’ education anxiety and children’s learning anxiety, examining the mediating role of parenting style and the moderating effect of extracurricular tutoring.

Methods

Utilizing data from the “Survey of Parents and Students in Primary and Secondary Schools,” the study employs stratified sampling (n = 3,298) and various psychological scales to measure education anxiety, parenting styles, and extracurricular tutoring.

Results

This study reveals that parents’ education anxiety significantly influences children’s learning anxiety, with a notable positive correlation (r = 0.301**). Parenting styles particularly rejection and overprotection style increase this anxiety, while emotional warmth style decreases it. Academic tutoring serves as a moderator, reducing the impact of parental anxiety on children’s learning anxiety (β = −0.033, p < 0.05).

Discussion

The study underscores the importance of addressing internal family dynamics to alleviate education anxiety. It advocates for a balanced approach to tutoring, emphasizing the benefits of arts and sports activities in reducing learning anxiety. Parents should be encouraged to adopt emotionally warm parenting styles and to engage their children in a variety of extracurricular activities.
The influence of music performance anxiety on career expectations of early musical career students: self-efficacy as a moderator
Authors: Wang Qi-ran , Yang Rong
Published: June 2024

Music performance anxiety (MPA) is recognized as a distinct emotional behavior rather than merely a motor control disorder and is influenced by specific conditioning experiences. This study investigates the interrelationships between MPA, self-efficacy, and future career expectations among music students within the Chinese context. The participants of this study were 340 high school students majoring in music education and performance, drawn from three music schools in China. Data were collected using several questionnaires: the MPA Inventory for Adolescents (MPAI-A), the Self-Efficacy Formative Questionnaire, and the Career Futures Inventory (CFI). The findings indicate that MPA is negatively associated with self-efficacy and future career expectations. Additionally, self-efficacy acts as a partial moderator between MPA and career expectations, suggesting that enhancing the self-efficacy of music students can boost their future career aspirations and mitigate the adverse effects of MPA. This research explores the complex relationships among MPA, self-efficacy, and future career expectations, emphasizing the importance of curriculum and pedagogical strategies in music schools. Music students with high levels of self-efficacy may exhibit more confidence and stable performances before audiences. According to the panel regression analysis, self-efficacy significantly positively influences career expectations. An appropriate educational environment and supportive pedagogical approaches to MPA can foster the early career development of musicians.
Postpartum acute stress disorder symptoms, social support, and quality of couple’s relationship associations with childbirth PTSD
Authors: Handelzalts Jonathan E. , Kalfon-Hakhmigari Maor , Raichin Adi , Peled Yoav
Published: June 2024

Background

We aimed to examine the hypothesized negative associations between childbirth post-traumatic stress disorder (PTSD) symptoms (using the two-factor model of birth-related and general symptoms), social support, and a couple’s relationship quality at 8–12 weeks postpartum. This analysis considered the longitudinal positive shared variance with acute stress disorder (ASD) symptoms measured shortly after birth, while accounting for obstetric and demographic variables.

Methods

Participants included 246 mothers who gave birth at the maternity ward of a tertiary healthcare center. Self-report questionnaires were used 1–4 days postpartum (T1): Demographic information, the Birth Satisfaction Scale-Revised (BSS-R), and the National Stressful Events Survey Acute Stress Disorder Short Scale (NSESSS). At T2 (8–12 weeks postpartum), the Multidimensional Scale of Perceived Social Support (MSPSS), the Dyadic Adjustment Scale (DAS-7), and the City Birth Trauma Scale (BiTS).

Results

In partial support of our hypotheses, three hierarchical regression analyses revealed a significant positive contribution of ASD symptoms to childbirth PTSD general symptoms (β = .33, p <.001) and the total score (β = .29, p <.001), but not to birth-related symptoms. Social support (β = -.21, p = .003) and the quality of the couple’s relationship (β=-.20, p = .003) showed negative associations with the BiTS general symptoms.

Conclusion

Our study enhances understanding of the shared variance between childbirth ASD and PTSD, supporting the factor structure of general and birth-related symptoms as different aspects of childbirth PTSD and highlighting the negative association of social support and the quality of a couple’s relationship with PTSD general symptoms, suggesting potential avenues for targeted interventions.
The effect of the stress autism mate app on perceived stress, coping, and resilience in adults with autism: a single-case experimental design
Authors: Hoeberichts Kirsten , Roke Yvette , Niks Irene , van Harten Peter N.
Published: June 2024

Introduction

The mobile health application “Stress Autism Mate” (SAM) was designed to support adults with autism in identifying and managing daily stress. SAM measures stress four times daily, provides a daily and weekly stress overview, and provides personalised stress reduction advice. This study aimed to assess the effectiveness of SAM over four weeks in reducing perceived stress and internalised stigma, and enhancing coping self-efficacy, quality of life, and resilience among adults with autism.

Methods

Using an A1-B-A2 single-case experimental design, the effect of using SAM on adults with autism was assessed. The phases consisted of A1; treatment as usual (TAU), B; introducing SAM, and finally A2; follow-up with TAU and without the use of SAM. Each phase lasted four weeks, and data were collected via questionnaires before and after each phase. Linear mixed models were used for data analysis.

Results

Results show significant reductions in perceived stress levels, increased coping self-efficacy, and improved perceived health and psychological well-being after using SAM. Furthermore, increased resilience, and decreased internalised stigma were reported after follow-up.

Discussion

In conclusion, this study highlights SAM as a valuable tool for empowering adults with autism to reduce stress and internalised stigmaand to improve coping self-efficacy, psychological well-being, and resilience.
“Some distance between us”: a UK mixed methods study exploring experiences of remote care for eating disorders during COVID-19
Authors: Murphy-Morgan Claire , Brown Richard , Love Charlotte , Branley-Bell Dawn
Published: June 2024

Introduction

COVID-19 necessitated a rapid move from face-to-face services to remote care for eating disorders/eating distress (EDs). This study explores the advantages and challenges of remote care, identifying future implications for service provision. Remote care has been considered in the broadest of terms, including therapeutic care (e.g., Cognitive Behavioural Therapy, peer support, forums, one-to-one and group care options).

Methods

Using a mixed methods approach, data were collected from 211 people with lived experience of EDs (PWLE), with and without formal diagnosis. 27 participants took part in semi-structured interviews/workshops and a further 184 participants took part via an online survey. Participants reported on their ED status, the impact of the pandemic on symptoms, the benefits, and challenges of remote care (and type of support accessed), and any reasons for not accessing support. Participants were invited to make future care recommendations.

Results

ED symptoms were reported as worsening during the pandemic with contributing factors including isolation, lack of routine, negative emotions, and feeling like the external situation was outside of one’s control. Remote care was positively attributed to increased flexibility and facilitation of social connection. Identified barriers to access included lack of awareness about support availability, digital access/literacy, and competing commitments. Further challenges included approaches being perceived as too clinical (e.g., ED information and support presented using clinical language and/or limited to support within medical care settings, without acknowledging the broader context of disordered eating), uncertainty around remote care quality, and concerns that remote platforms may facilitate masking of symptoms. Participants reported distress caused by online platforms where self-view is the default during video calls. They expressed a need for more holistic approaches to remote care, including: “real stories” of recovery, and hybrid (online and offline) options for greater flexibility and widening of access and choice. Participants also expressed a need for appropriate digital literacy training.

Discussion

Future recommendations emphasise user-centred holistic and hybrid approaches to ED remote support, with training to address digital literacy barriers and facilitate user control of platform functionalities (e.g., self-view). This study underscores the need for continued remote care with a focus on inclusivity and user empowerment.
The prevalence of PTSD and coping strategies among Palestinian mental health professionals during political violence and wartime
Authors: Ahmead Muna , Abu Turki Mariam , Fawadleh Louy
Published: June 2024

Background

In times of war, mental health professionals are at an increased risk of developing psychological problems, including posttraumatic stress disorder (PTSD). The effects of conflicts or wars on mental health professionals in Palestine and their coping methods of dealing with these challenges remain unknown. This study aimed to assess the prevalence of PTSD symptoms and strategies for coping among mental health professionals in Palestine, in light of the ongoing Gaza war and political violence.

Methods

The study utilized a cross-sectional research design. Self-reported questionnaires, including the PCL-5 and Brief COPE scales, were used to gather data. The relationship between the research variables and PTSD symptoms was investigated using frequencies, percentages, bivariate analysis, Pearson correlation, and Pearson’s chi-square test.

Results

A total of 514 participants were recruited, with an estimated prevalence of PTSD of 38.7%. Furthermore, the multivariate analysis revealed that having a prior history of trauma and feeling disabled or unable to deal with your patients during the current Gaza war and Israeli–Palestinian political violence increases the likelihood of developing PTSD symptoms. In addition, using venting, self-blame, and behavioral disengagement as coping strategies increases the likelihood of developing symptoms of PTSD. Moreover, using acceptance and substance use as coping strategies reduces the risk of developing PTSD symptoms.

Conclusion

The findings revealed a high prevalence of PTSD symptoms among mental health professionals during wartime and political violence. As a result, mental health professionals need immediate assistance in enhancing their mental wellbeing through supervision, psychotherapy, and comprehensive and continuous training.
Provider perspectives on the impact of COVID-19 on treatment of substance use and opioid use disorders among American Indian and Alaska Native adults
Authors: Richardson Meenakshi , Hirchak Katherine , Bajet Kelsey , Brigman Mariah , Shaffer Racquel , Keyes Beverly , Oliver Karen Anderson , Kropp Frankie , McDonell Michael G. , Venner Kamilla L. , Campbell Aimee N. C.
Published: June 2024

Introduction

American Indian/Alaska Native (AI/AN) communities are more likely to suffer negative consequences related to substance misuse. The COVID-19 pandemic exacerbated the opioid poisoning crisis, in combination with ongoing treatment barriers resulting from settler-colonialism, systemic oppression and racial discrimination. AI/AN adults are at greatest risk of COVID-19 related serious illness and death. In collaboration with an Indigenous community advisory board and Tribal leadership, this study explored AI/AN treatment provider perceptions of client-relatives’ (i.e., SUD treatment recipients) experiences during the pandemic from 2020 to 2022.

Methods

Providers who underwent screening and were eligible to participate (N = 25) represented 6 programs and organizations serving rural and urban areas in Washington, Utah, and Minnesota. Participants engaged in audio-recorded 60–90 min semi-structured individual interviews conducted virtually via Zoom. The interview guide included 15 questions covering regulatory changes, guidance for telemedicine, policy and procedures, staff communication, and client-relatives’ reactions to implemented changes, service utilization, changes in treatment modality, and perceptions of impact on their roles and practice. Interview recordings were transcribed and de-identified. Members of the research team independently reviewed transcripts before reaching consensus. Coding was completed in Dedoose, followed by analyses informed by a qualitative descriptive approach.

Results

Five main domains were identified related to client-relative experiences during the COVID-19 pandemic, as observed by providers: (1) accessibility, (2) co-occurring mental health, (3) social determinants of health, (4) substance use, coping, and harm reduction strategies, and (5) community strengths. Providers reported the distinctive experiences of AI/AN communities, highlighting the impact on client-relatives, who faced challenges such as reduced income, heightened grief and loss, and elevated rates of substance use and opioid-related poisonings. Community and culturally informed programming promoting resilience and healing are outlined.

Conclusion

Findings underscore the impact on SUD among AI/AN communities during the COVID-19 pandemic. Identifying treatment barriers and mental health impacts on client-relatives during a global pandemic can inform ongoing and future culturally responsive SUD prevention and treatment strategies. Elevating collective voice to strengthen Indigenous informed systems of care to address the gap in culturally-and community-based services, can bolster holistic approaches and long-term service needs to promote SUD prevention efforts beyond emergency response efforts.
The mortality burden related to COVID-19 in 2020 and 2021 - years of life lost and excess mortality in 13 countries and sub-national regions in Southern and Eastern Europe, and Central Asia
Authors: Cawley Caoimhe , Barsbay Mehtap Çakmak , Djamangulova Tolkun , Erdenebat Batmanduul , Cilović-Lagarija Šeila , Fedorchenko Vladyslav , Gabrani Jonila , Glushkova Natalya , Kalaveshi Arijana , Kandelaki Levan , Kazanjan Konstantine , Lkhagvasuren Khorolsuren , Santric Milicevic Milena , Sadikkhodjayeva Diloram , Skočibušić Siniša , Stojisavljevic Stela , Tecirli Gülcan , Terzic Natasa , Rommel Alexander , Wengler Annelene ,   for the BoCO-19-Study Group
Published: June 2024

Introduction

Between 2021 and 2023, a project was funded in order to explore the mortality burden (YLL–Years of Life Lost, excess mortality) of COVID-19 in Southern and Eastern Europe, and Central Asia.

Methods

For each national or sub-national region, data on COVID-19 deaths and population data were collected for the period March 2020 to December 2021. Unstandardized and age-standardised YLL rates were calculated according to standard burden of disease methodology. In addition, all-cause mortality data for the period 2015–2019 were collected and used as a baseline to estimate excess mortality in each national or sub-national region in the years 2020 and 2021.

Results

On average, 15–30 years of life were lost per death in the various countries and regions. Generally, YLL rates per 100,000 were higher in countries and regions in Southern and Eastern Europe compared to Central Asia. However, there were differences in how countries and regions defined and counted COVID-19 deaths. In most countries and sub-national regions, YLL rates per 100,000 (both age-standardised and unstandardized) were higher in 2021 compared to 2020, and higher amongst men compared to women. Some countries showed high excess mortality rates, suggesting under-diagnosis or under-reporting of COVID-19 deaths, and/or relatively large numbers of deaths due to indirect effects of the pandemic.

Conclusion

Our results suggest that the COVID-19 mortality burden was greater in many countries and regions in Southern and Eastern Europe compared to Central Asia. However, heterogeneity in the data (differences in the definitions and counting of COVID-19 deaths) may have influenced our results. Understanding possible reasons for the differences was difficult, as many factors are likely to play a role (e.g., differences in the extent of public health and social measures to control the spread of COVID-19, differences in testing strategies and/or vaccination rates). Future cross-country analyses should try to develop structured approaches in an attempt to understand the relative importance of such factors. Furthermore, in order to improve the robustness and comparability of burden of disease indicators, efforts should be made to harmonise case definitions and reporting for COVID-19 deaths across countries.
Exploring personal aptitudes and personality traits that, together with social determinants, shape health behaviors and conduct: a thematic analysis based on the Capability, Opportunity, Motivation and Behavior (COM-B) change system
Authors: Young-Silva Yudy , Berenguera Anna , Juvinyà-Canal Dolors , Martí-Lluch Ruth , Arroyo-Uriarte Paula , Tamayo-Morales Olaya , Marcilla-Toribio Irene , Elizondo-Alzola Usue , Méndez-López Fátima , Chela-Àlvarez Xènia , Motrico Emma
Published: June 2024

Introduction

Effective implementation of strategies to promote health and prevent noncommunicable illnesses requires a profound understanding of the interaction between the individual and society. This study brings to health research the consideration of psychosocial factors that influence the maintenance and change of health behaviors and conduct. From a primary care perspective, it is crucial to propose a biopsychosocial approach for the development of health promotion and self-care programs that embrace personal aptitudes as a relevant individual aspect.

Objectives

To explore experiences related to personal aptitudes and personality traits that influence health behaviors and conduct, taking into account the social determinants of health, through a thematic analysis based on the capability-opportunity-motivation and behavior (COM-B) system.

Methods and analysis

This qualitative research is carried out from a descriptive phenomenological perspective, based on 17 focus groups in which 156 people participated. Inductive and deductive analysis techniques were used following Lincoln and Guba’s criteria of methodological rigor. In addition to 7 different triangulations of analysts, 6 main categories were identified based on the COM-B system: psychological capacity, physical capacity, physical opportunity, social opportunity, reflective motivation, and automatic motivation. The importance of considering these factors to promote healthy behaviors was stressed.

Discussion

This study examined how personal experiences related personal aptitudes and personality traits influence health behaviors and conduct in Spain. It was found that personality traits such as health literacy, self-efficacy, activation, and self-determination can influence the adoption of healthy behaviors. Likewise, the need for control, overthinking, and ambivalence made it impossible. Furthermore, social determinants of health and interpersonal relationships also play an important role.

Trial registration

ClinicalTrials.gov, NCT04386135. Registered on April 30, 2020
Leveraging community Wi-Fi and spaces for digital health use
Authors: Spaulding Erin M. , Miller Hailey N. , Metlock Faith E. , Chepkorir Joyline , Benjasirisan Chitchanok , Hladek Melissa D. , Han Hae-Ra
Published: June 2024

Digital health disparities continue to affect marginalized populations, especially older adults, individuals with low-income, and racial/ethnic minorities, intensifying the challenges these populations face in accessing healthcare. Bridging this digital divide is essential, as digital access and literacy are social determinants of health that can impact digital health use and access to care. This article discusses the potential of leveraging community Wi-Fi and spaces to improve digital access and digital health use, as well as the challenges and opportunities associated with this strategy. The existing limited evidence has shown the possibility of using community Wi-Fi and spaces, such as public libraries, to facilitate telehealth services. However, privacy and security issues from using public Wi-Fi and spaces remain a concern for librarians and healthcare professionals. To advance digital equity, efforts from multilevel stakeholders to improve users’ digital access and literacy and offer tailored technology support in the community are required. Ultimately, leveraging community Wi-Fi and spaces offers a promising avenue to expand digital health accessibility and use, highlighting the critical role of collaborative efforts in overcoming digital health disparities.
Exploring ChatGPT’s potential in the clinical stream of neurorehabilitation
Authors: Maggio Maria Grazia , Tartarisco Gennaro , Cardile Davide , Bonanno Mirjam , Bruschetta Roberta , Pignolo Loris , Pioggia Giovanni , Calabrò Rocco Salvatore , Cerasa Antonio
Published: June 2024

In several medical fields, generative AI tools such as ChatGPT have achieved optimal performance in identifying correct diagnoses only by evaluating narrative clinical descriptions of cases. The most active fields of application include oncology and COVID-19-related symptoms, with preliminary relevant results also in psychiatric and neurological domains. This scoping review aims to introduce the arrival of ChatGPT applications in neurorehabilitation practice, where such AI-driven solutions have the potential to revolutionize patient care and assistance. First, a comprehensive overview of ChatGPT, including its design, and potential applications in medicine is provided. Second, the remarkable natural language processing skills and limitations of these models are examined with a focus on their use in neurorehabilitation. In this context, we present two case scenarios to evaluate ChatGPT ability to resolve higher-order clinical reasoning. Overall, we provide support to the first evidence that generative AI can meaningfully integrate as a facilitator into neurorehabilitation practice, aiding physicians in defining increasingly efficacious diagnostic and personalized prognostic plans.
Health of Things Melanoma Detection System—detection and segmentation of melanoma in dermoscopic images applied to edge computing using deep learning and fine-tuning models
Authors: Da Costa Nascimento José Jerovane , Marques Adriell Gomes , Adelino Rodrigues Yasmim Osório , Brilhante Severiano Guilherme Freire , Rodrigues Icaro de Sousa , Dourado Carlos , De Freitas Souza Luís Fabrício
Published: June 2024

According to the World Health Organization (WHO), melanoma is a type of cancer that affects people globally in different parts of the human body, leading to deaths of thousands of people every year worldwide. Intelligent diagnostic tools through automatic detection in medical images are extremely effective in aiding medical diagnosis. Computer-aided diagnosis (CAD) systems are of utmost importance for image-based pre-diagnosis, and the use of artificial intelligence–based tools for monitoring, detection, and segmentation of the pathological region are increasingly used in integrated smart solutions within smart city systems through cloud data processing with the use of edge computing. This study proposes a new approach capable of integrating into computational monitoring and medical diagnostic assistance systems called Health of Things Melanoma Detection System (HTMDS). The method presents a deep learning–based approach using the YOLOv8 network for melanoma detection in dermatoscopic images. The study proposes a workflow through communication between the mobile device, which extracts captured images from the dermatoscopic device and uploads them to the cloud API, and a new approach using deep learning and different fine-tuning models for melanoma detection and segmentation of the region of interest, along with the cloud communication structure and comparison with methods found in the state of the art, addressing local processing. The new approach achieved satisfactory results with over 98% accuracy for detection and over 99% accuracy for skin cancer segmentation, surpassing various state-of-the-art works in different methods, such as manual, semi-automatic, and automatic approaches. The new approach demonstrates effective results in the performance of different intelligent automatic models with real-time processing, which can be used in affiliated institutions or offices in smart cities for population use and medical diagnosis purposes.