bluuebunny/crossref_metadata_2025 huggingface dataset:
Asymptotic analysis for a second-order curved thin film
Authors: Zorgati Hamdi
Published: May 2023

We consider a second-order thin curved film whose behavior is governed by an energy made up of a first-order nonlinear part depending on the gradient of the deformation augmented by a quadratic second-order part depending on the tensor of second derivatives of the deformation. We carry out a 3D–2D analysis through an asymptotic expansion in powers of the thickness of the film as it tends to zero.
Is 911 The Answer? A Retrospective Review of Emergency Medical Services Use by Home Care Providers
Authors: McKay Sandra , Mohammed Emmelie , Roy Meghla , Hung Vivian , Wong Matthew , Lum Bonnie , King Emily C
Published: May 2023

With the Ontario healthcare system under strain the use of resources—particularly emergency medical services (EMS) is an increasing focus. Recent work has identified long-term care facilities as high users of EMS despite access to health-related support outside of the hospital. However, such insights are not available for home care. A retrospective review of administrative records of EMS calls drawn from over 6 million visits by home care providers found relatively low call rates: 8.4 calls per 100 000 personal support visits, 4.1 calls per 100 000 for rehabilitation providers, and 0.9 calls per 100 000 for nurses. The majority (85%) of calls resulted in transport to the hospital; the notable exception was fall-related events, and of these falls, a third (32%) were treated at home. Classification of reported physical symptoms suggests opportunities for leveraging in-home clinical specialists to avoid hospital transport where possible and preserve EMS capacity to respond to the most urgent and severe events.
Spontaneous iliac vein rupture and thrombosis in patients with May–Thurner syndrome: A narrative review
Authors: Skeik Nedaa , Adamek Andrew , Manunga Jesse
Published: May 2023

Spontaneous iliac vein rupture (SIVR) is extremely rare and can lead to serious complications, including death. Etiologies include inflammatory processes and hormonal and mechanical triggers, with concomitant May–Thurner syndrome (MTS) being a rare cause. Management can be challenging due to the difficult balance between reducing thrombotic burden and life-threatening hemorrhage that can result from aggressive anticoagulation. Furthermore, surgical interventions are associated with high mortality, making conservative management more desirable. We report a case of SIVR with retroperitoneal hematoma and concurrent MTS that was successfully managed using conservative measures. We further provide a narrative review of the current literature addressing the diagnosis, management, and outcome of SIVR focusing on cases with concurrent MTS.
The effect of autistic traits on prosocial behavior: The chain mediating role of received social support and perceived social support
Authors: Zhang Shuhua , Li Hong , Li Hai , Zhao Shuo
Published: May 2023

There is growing evidence that the defining characteristics of autism spectrum disorder are distributed across the general population; therefore, understanding the correlates of prosocial behavior in individuals with high levels of autistic traits could shed light on autism spectrum disorder and prosocial behavior. In this study, the mechanism underlying the influence of individuals’ autistic traits on their prosocial behavior was explored by conducting a questionnaire survey of 414 Chinese college students. The results showed that autistic traits can influence individuals’ prosocial behavior not only through the separate effects of received social support and perceived social support but also through the chain mediating effects of received social support and perceived social support; however, the direct effect of autistic traits on individuals’ prosocial behavior is not significant. This study is conducive to understanding the internal mechanism underlying the relationship between autistic traits and prosocial behavior. Future work is required to further investigate the clinical autism spectrum disorder samples and cross-cultural applicability of the model found in this study.

Lay abstract

Autistic traits are known to be associated with a set of core symptoms of autism spectrum disorder. The impact of autistic traits on prosocial behavior, including a consideration of the role of social support, has never been explored. We investigated whether and how social support mediates the autistic trait–prosocial behavior relationship. We found that autistic traits can influence prosocial behavior not only through received social support and perceived social support but also indirectly through the chain mediating effects of received social support and perceived social support. This study contributes to the understanding of how and to what extent prosocial behavior is influenced by autistic traits. Future work is required to further investigate the clinical autism spectrum disorder samples and cross-cultural applicability of the model found in this study.
The sharks and the fishermen: An exploratory content analysis of police officers who abused their positions for a sexual purpose
Authors: Sweeting Fay , Cole Terri
Published: May 2023

Abuse of position for a sexual purpose (APSP) in police officers is a serious form of corruption that often re-victimises highly vulnerable people such as victims of domestic abuse and rape. It is thought to be underreported by victims because they fear disbelief and negative repercussions. As a consequence, such behaviour may go undetected for a long time. Using a content analysis of 10 completed APSP investigations conducted by an English police force, the research explored the characteristics and behaviour of both the police officers and victims involved. The results suggest that there may be differences in behaviours and victim selection within APSP perpetrators. Two perpetrator types are tentatively suggested: the shark and the fisherman. The shark is characterised by those who make rapid sexual contact with a specifically targeted highly vulnerable victim, often causing lasting harm. The fisherman uses a more tentative approach, casting a wide net to many potential victims (with similarities to grooming) but often failing to make sexual contact. The behaviour of both offending styles, and the implications for internal police investigations, is discussed.
A mobilisation of motherhood, babyhood and childhood sensing pasts: Life diaries as creative and speculative force of experimentation
Authors: Michelle Schofield Lindsay
Published: May 2023

In recent years, the theoretical lens of new materialism(s) and surge in feminist thinking has opened up new ways of understanding the complexities of motherhood, babyhood and early childhood. This surge in post-qualitative and feminist inquiry towards the troubling of dominant early childhood abstractions and norms, as well as resistance to human-centric perspectives offers new possibilities to engage both ethically and politically in an affirmative exploration of motherhoods, babyhoods and early childhoods. Through communicating the methodological nuances in two early childhood physical spaces this article is a (re)assembling of the fibrous, slippery and friable fragments of an earlier inquiry. The first of these spaces was a baby room in an Early Childhood Education and Care (ECEC) setting in the United Kingdom (UK), and the second was Higher Education (HE) Undergraduate (UG) Early Childhood Studies (ECS) teaching and learning environments, again in the UK. There were also a number of virtual, past and present, material, ephemeral and ethereal research sites that seem disparate, yet connected. The transversal methodology held bodies in the middle of the research, allowing things to creep in and creep out. A mobilisation of motherhood, babyhood and childhood sensing pasts produced neologisms, such as mothersick, Bowlb(arbar)ian and (gh)host(ile)(ly) which conjure transversality and spacetimemattering in all that I do in the HE ECS classroom and ECEC environments. Memories, histories and (her)stories – severed encounters shared and assembled. Cuts that brought pain to the surface(s) and bodies become ambiguous, unnerving, raw and exposed. Through the article, it is argued, powerful psychological developmental theories that reverberate through human and nonhuman bodies haunt student and pedagogue bodily knowledges and histories. It is suggested that ethically, HE pedagogues have a duty of care to think beyond the immediate teaching and learning classroom and consider how we touch the lives of UG ECS students, in unknown but often imperceptible and sensed ways.
Distinguishing Servant Leadership from Transactional and Transformational Leadership
Authors: Martinez Seth-Aaron , Leija Nahari
Published: May 2023

Problem

The scholarship of leadership abounds with the affordances, limitations, antecedents, and outcomes associated with the different theories in Human Resource Development (HRD) literature. However, a clear delineation between the host of individual leadership theories does not exist. Absent is a nuanced view of the similarities, differences, and any overlap between the various leadership theories. Without a clear understanding of the relationships between leadership theories, knowing when to apply which theories and when becomes difficult.

Solution

A systematic review of the literature surrounding servant leadership (SL) through 2022 was conducted to position SL among the more extensively researched transactional and transformational leadership theories. This article outlines the histories of the three theories, focusing on the characteristics, pervasiveness, antecedents, outcomes, and measurement of SL to distinguishing it from transactional and transformational leadership.; Stakeholders: Human resource development, human resource management, and organizational behavior scholars, practitioners, educators, and students. In addition, organizational leaders responsible for setting the organization’s vision and practitioners responsible for designing leadership development programs will benefit from this article.
Recent Advancements, Limitations, and Future Perspectives of the use of Personalized Medicine in Treatment of Colon Cancer
Authors: Dey Amit , Mitra Abhijit , Pathak Surajit , Prasad Suhanya , Zhang Alexander Sun , Zhang Hong , Sun Xiao-Feng , Banerjee Antara
Published: May 2023

Due to the heterogeneity of colon cancer, surgery, chemotherapy, and radiation are ineffective in all cases. The genomic profile and biomarkers associated with the process are considered in personalized medicine, along with the patient's personal history. It is based on the response of the targeted therapies to specific genetic variations. The patient's genetic transcriptomic and epigenetic features are evaluated, and the best therapeutic approach and diagnostic testing are identified through personalized medicine. This review aims to summarize all the necessary, updated information on colon cancer related to personalized medicine. Personalized medicine is gaining prominence as generalized treatments are finding it challenging to contain colon cancer cases which currently rank fourth among global cancer incidence while being the fifth largest in total death cases worldwide. In personalized therapy, patients are grouped into specific categories, and the best therapeutic approach is chosen based on evaluating their molecular features. Various personalized strategies are currently being explored in the treatment of colon cancer involving immunotherapy, phytochemicals, and other biomarker-specific targeted therapies. However, significant challenges must be overcome to integrate personalized medicine into healthcare systems completely. We look at the various signaling pathways and genetic and epigenetic alterations associated with colon cancer to understand and identify biomarkers useful in targeted therapy. The current personalized therapies available in colon cancer treatment and the strategies being explored to improve the existing methods are discussed. This review highlights the advantages and limitations of personalized medicine in colon cancer therapy. The current scenario of personalized medicine in developed countries and the challenges faced in middle- and low-income countries are also summarized. Finally, we discuss the future perspectives of personalized medicine in colon cancer and how it could be integrated into the healthcare systems.
Association of MTR A2756G and MTRR A66G Polymorphisms With Male Infertility: An Updated Meta-Analysis
Authors: Tariq Tamjeed , Arshad Adina , Bibi Ayesha , Aslam Shaista , Sohail Anam , Ishaq Bilal , Irfan Muhammad
Published: May 2023

The objective of the present study was to find out the association of folate genes MTR A2756G and MTRR A66G polymorphisms with the risk of male infertility. The databases of Google Scholar, PubMed, and Science Direct were searched to find relevant studies. Data were extracted from the eligible studies and were analyzed for pooled up odds ratio (OR) with 95% confidence interval (CI). Review Manager 5.4 was used for statistical analysis. Nineteen case-control studies were included in this meta-analysis which comprised 3621 cases and 3327 controls. Pooled analysis revealed that there is a significant association between MTR A2756G polymorphism with male infertility except for the dominant model. The ORs and 95% CI for each genetic model were as follows: 1.21 [1.03–1.42] for the allele model (G vs. A), 2.31 [1.38–3.96] for the additive model (GG vs. AA), 1.17 [0.98–1.38] for the dominant model (GG+AG vs. AA) and 2.10 [1.55–2.86] for the recessive model (GG vs. AG+AA). MTRR A66G has no noticeable association with male infertility. The current meta-analysis suggests that MTR A2756G polymorphism might be a potential risk factor for male infertility. In the future, the sample size should be increased to confirm the present results.
A History of Heart Attack and Experiencing Frequent Mental Distress Among US Veterans and Adult Civilians: A 2019 National Level Cross-Sectional Study
Authors: Passini Jessica N. , Oancea S. Cristina
Published: May 2023

Introduction

Frequent mental distress (FMD) is poor mental health for ≥14 days in the past month. Prevalence and risk for depression and suicide are higher among US veterans (USV) than US civilians (USC). Limited research has been done among USV regarding FMD. Anyone can experience mental distress without being clinically depressed—examining FMD more broadly captures health burden of poor mental state. This study’s purpose was to examine the association between having a history of heart attack (HHHA) and FMD among USV vs USC.

Methods

This cross-sectional study used the 2019 Behavioral Risk Factor Surveillance System (n = 274 352) data. Weighted and adjusted logistic regression models were conducted overall and by USV/USC status.

Results

HHHA increases weighted adjusted odds (WAO) of FMD. Among insured not obese USV with HHHA, the WAO of FMD were 1.4x significantly greater ( P < .05) than among insured not obese USV without HHHA. Among uninsured obese USC with HHHA, the WAO of FMD were 3.2x significantly greater ( P < .0001) than among uninsured obese USC without HHHA, and significantly lower among USV.

Conclusions

Study findings suggest a distinction in FMD among USV/USC with HHHA. Understanding this association can inform policy for FMD screening post-heart attack as another potential intervention to prevent/reduce suicide among USV/USC.
The standardised Malay version of purdue pegboard test: Content validity and test-retest reliability testing
Authors: Poo Yin Sin , Chai Siaw Chui , Goh Poh Im , Kadar Masne , Razaob@Razab Nor Afifi
Published: May 2023

Introduction

Purdue Pegboard Test (PPT) is a valid and reliable instrument for measuring hand dexterity among individuals with or without medical conditions. In the Southeast Asia region where Malay is widely spoken, there is a need to have a Malay translation of Purdue Pegboard Test. This study aimed to translate the PPT into the Malay version (PPT-M) and to determine the content validity and test-retest reliability of this translated version.

Methods

This study involved: (1) four English teachers (translators) for forward and backward translation procedures; (2) 10 experts in the field of occupational therapy (expert reviewers) for content validity testing; and (3) 60 undergraduate students (participants) for test-retest reliability testing.

Results

PPT-M had excellent content validity with Item-Content Validity Index = 0.9–1.0, Scale-Content Validity Index/Average = 0.93–0.95, and a slightly lower Scale-Content Validity Index/Universal Agreement = 0.25–0.75. Test-retest reliability for 3-trial administration ( n = 30; Intraclass Correlation Coefficients, ICCs = 0.76–0.85; good) was higher compared to 1-trial administration ( n = 30; ICCs = 0.34–0.46; poor) for all subtests. Both trial administrations were mostly affected by systematic errors, especially practice effect as the retests gave higher scores. Random errors mostly affected Subtest 3 of 1-trial administration, evident by its Minimal Detectable Change Percent values = 30.84% that fell beyond the acceptable range.

Conclusion

PPT-M has the potential to be a valuable instrument for measuring hand dexterity among Malay speaking individuals especially when the 3-trial administration is used.
Instructional leadership scale for high school principals: Development and validation
Authors: Lai Hsieh-Chih , Lien Hsin-Yi
Published: May 2023

Principal instructional leadership (PIL) refers to the management of school curriculum, instruction, and assessment by the principal of a school. It is essential to measure the extent of the instructional leadership provided by principals and to propose means of improving instructional leadership. The principal instructional leadership scale (PILS) has been put forward to achieve these goals. In the current study, we validated the PILS on a sample of Taiwanese teachers using a multilevel approach involving expert reviews and three studies. Following two stages in confirmation of content validity by 20 experts, the initial 30-item PILS with five core concepts was subjected to discrimination analysis, exploratory factor analysis, and internal consistency reliability analysis utilizing SPSS 13.0 for Windows and AMOS 22.0 ( n  =  339). This resulted in the deletion of nine items. In the second study, the individual item reliability of the remaining 21 items was examined, and the composite reliability, convergent validity, and discriminant validity confirmed the selection of the optimal model ( n  =  672). The results of the third study ( n  =  1438) supported metric invariance, scalar invariance, and factor variance-covariance invariance and confirmed scalar measurement invariance across genders. Finally, cross-validation analysis verified that the scale was stable and well-constructed.
Current state of mobile health apps in endourology: a review of mobile platforms in marketplaces and literature
Authors: Talyshinskii Ali , Bakhman Guliev , Hameed BM Zeeshan , Pietropaolo Amelia , Naik Nithesh , Somani Bhaskar K
Published: May 2023

Several mobile healthcare (mHealth) apps are available in various marketplaces, but there is still concern about their accuracy, data safety, and regulation. The goal of this review was to critically analyze the mobile apps created for education, diagnosis, and medical and surgical treatment of patients with kidney stone disease (KSD), as well as to assess the level of data security, the contribution of physicians in their development and adherence to the Food and Drug Administration (FDA) and Medical Device Regulation (MDR) guidance. A comprehensive literature search was performed using PubMed (September 2022), in the Apple App Store and Google Play store using relevant keywords and inclusion criteria. Information was extracted for the name of the app, primary and additional functionalities, release and last update, number of downloads, number of marks and average rating, Android/iOS compatibility, initial and in-app payments, data safety statement, physician involvement statement, and FDA/MDR guidance. A total of 986 apps and 222 articles were reviewed, of which based on the inclusion, 83 apps were finally analyzed. The apps were allocated to six categories about their primary purpose: education ( n = 8), fluid trackers ( n = 54), food content description and calculators ( n = 11), diagnosis ( n = 3), pre- and intra-operative application ( n = 4), and stent trackers ( n = 2). Of these apps, the number of apps supported for Android, iOS, and both of them were 36, 23, and 23, respectively. Despite a wide range of apps available for KSD, the participation of doctors in their development, data security, and functionality remains insufficient. Further development of mHealth should be carried out properly under the supervision of urological associations involving patient support groups, and these apps must be regularly updated for their content and data security.
The ripple effect: A critical analysis of the successful development of the material scope of Directive 2000/78/EC in the context of age
Authors: Dewhurst Elaine
Published: May 2023

This article analyses the material scope of Directive 2000/78 as it has been interpreted by the Court of Justice of the European Union (CJEU). From the outset, a very broad interpretation of the material scope provisions in Article 3 has been promulgated to ensure that the equality purposes of the Directive are met. The article analyses three particular areas of concern which have arisen in the age context, namely: access to employment, occupation and vocational training; employment conditions, including pay; and termination of employment and occupation. The article comes to three main conclusions in this regard. Firstly, when access is restricted, the CJEU will invariably find such a measure to fall within the scope of the Directive. Secondly, where conditions of employment, including in this context pay, are impacted in some way, the CJEU has been willing to stretch the boundaries of the scope of the Directive through the use of a contractual nexus approach. There are some red lines that the CJEU has been unwilling to cross, but these are rare. Finally, in the termination of employment, including dismissal and retirement, the CJEU has applied an access/exercise approach so as to adeptly include such measures within the scope of the Directive, despite textual challenges. The article then goes on to apply these principles set out by the CJEU in the context of some recent preliminary references. This application also provides support for the proposition that the material scope is a very broad one which can encompass a range of measures within its terms, and that the situations in which some measures fall outside the scope of the Directive are very limited.
Phase I/II results of ceralasertib as monotherapy or in combination with acalabrutinib in high-risk relapsed/refractory chronic lymphocytic leukemia
Authors: Jurczak Wojciech , Elmusharaf Nagah , Fox Christopher P. , Townsend William , Paulovich Amanda G. , Whiteaker Jeffrey R. , Krantz Fanny , Wun Chuan-Chuan , Parr Graeme , Sharma Shringi , Munugalavadla Veerendra , Manwani Richa , Dean Emma , Munir Talha
Published: May 2023

Background:

Patients with relapsed/refractory (R/R) chronic lymphocytic leukemia (CLL) have limited treatment options. Ceralasertib, a selective ataxia telangiectasia and Rad-3-related protein (ATR) inhibitor, demonstrated synergistic preclinical activity with a Bruton tyrosine kinase (BTK) inhibitor in TP53- and ATM-defective CLL cells. Acalabrutinib is a selective BTK inhibitor approved for treatment of CLL.

Objectives:

To evaluate ceralasertib ± acalabrutinib in R/R CLL.

Design:

Nonrandomized, open-label phase I/II study.

Methods:

In arm A, patients received ceralasertib monotherapy 160 mg twice daily (BID) continuously (cohort 1) or 2 weeks on/2 weeks off (cohort 2). In arm B, patients received acalabrutinib 100 mg BID continuously (cycle 1), followed by combination treatment with ceralasertib 160 mg BID 1 week on/3 weeks off from cycle 2. Co-primary objectives were safety and pharmacokinetics. Efficacy was a secondary objective.

Results:

Eleven patients were treated [arm A, n = 8 (cohort 1, n = 5; cohort 2, n = 3); arm B, n = 3 (acalabrutinib plus ceralasertib, n = 2; acalabrutinib only, n = 1)]. Median duration of exposure was 3.5 and 7.2 months for ceralasertib in arms A and B, respectively, and 15.9 months for acalabrutinib in arm B. Most common grade ⩾3 treatment-emergent adverse events (TEAEs) in arm A were anemia (75%) and thrombocytopenia (63%), with four dose-limiting toxicities (DLTs) of grade 4 thrombocytopenia. No grade ⩾3 TEAEs or DLTs occurred in arm B. Ceralasertib plasma concentrations were similar when administered as monotherapy or in combination. At median follow-up of 15.1 months in arm A, no responses were observed, median progression-free survival (PFS) was 3.8 months, and median overall survival (OS) was 16.9 months. At median follow-up of 17.2 months in arm B, overall response rate was 100%, and median PFS and OS were not reached.

Conclusion:

Ceralasertib alone showed limited clinical benefit. Acalabrutinib plus ceralasertib was tolerable with preliminary activity in patients with R/R CLL, though findings are inconclusive due to small sample size.

Registration:

NCT03328273
Maternal obesity: Perinatal implications
Authors: Reed Julie , Case Sarah , Rijhsinghani Asha
Published: May 2023

Over the previous three decades, the prevalence and growth of overweight and obese status has risen relentlessly in both the general population and pregnant women. This rise is seen in both higher pre-pregnancy body mass index measurements along with excessive weight gain during pregnancy. Maternal obesity has been shown to exacerbate co-morbidities such as insulin resistance, pregnancy induced hypertension, and infectious states in parturient mothers. These changes have been shown to subsequently increase rates of fetal anomalies and affect fetal growth, as well as various aspects of the delivery such as rates of instrumented vaginal deliveries and an increase in delivery by cesarean section. Maternal obesity increases fetal birth weight, influences the delivery room resuscitation of the neonate by increasing the need for respiratory support, and increases the risk of neonatal hypoxic ischemic encephalopathy. This review also looks at recent studies revealing the strong association between maternal and offspring obesity and other long-term neurodevelopmental outcomes of offspring.
A mixed-methods assessment of community-engaged learning in a Master of Public Health program
Authors: Thaivalappil Abhinand , Coghlin Rachel , Bell Courtney , Dougherty Brendan , Duench Stephanie , Janicki Rachelle , Papadopoulos Andrew
Published: May 2023

Objective:

Community-engaged learning is used in Master of Public Health programs to enhance student training, connect with communities, help solve societal issues, develop competencies, and build partnerships. However, it is unclear how much community-engaged learning components supplement existing Master of Public Health programs and prepare students in developing these competencies. Thus, the aim of this study was to apply an explanatory mixed-methods study design to evaluate a Canadian Master of Public Health program’s community-engaged learning activities and propose recommendations to strengthen public health training and course delivery.

Methods:

We conducted a questionnaire among Master of Public Health students ( n = 25), focus group discussion with a subset of these students ( n = 7), and one-on-one semi-structured telephone interviews with community partners who had previously hosted Master of Public Health students for practicum placements ( n = 11).

Results:

Community-engagement enhanced learning among Master of Public Health students, with the practicum placement, and program development capstone resulting in the largest self-reported development. Students in the focus group indicated community engagement provided skill and professional development, but also identified wanting additional curriculum coverage on various statistical software and qualitative research methods. Interviews with community partners revealed benefits of practicum placements such as mutual knowledge transfer, increased organizational capacity, and strengthened academic–community partnerships. Community partners also commented on challenges with recruitment, training, and aligning student–organization goals.

Conclusion:

The findings from this study suggest that an update to the Master of Public Health program curriculum, its core competencies, a combination of community-engagement activities, and future evaluations will be needed to advance education delivery.
Public campaign financing’s effects on judicial legitimacy: Evidence from a survey experiment
Authors: Bjornlund Tiger , Mark Alyx
Published: May 2023

Although judicial elections are considered a method of keeping state courts—otherwise insulated from public pressure—accountable, the private financing of judicial campaigns has been met with significant criticism. In particular, the perception that campaign contributions can buy favorable case outcomes for contributors to judicial candidates may pose problems for judicial legitimacy. While some scholars and advocacy groups have advanced proposals which seek to eliminate private financing from judicial elections, research has yet to demonstrate a link between the public’s evaluations of a court’s legitimacy and the campaign financing system the state employs. In this paper, we present the results of a survey experiment that examines the public’s evaluations of judicial legitimacy under different campaign financing schemes. We find evidence supportive of our core hypothesis: respondents viewed courts with publicly financed elections as more legitimate than those with privately financed elections. This study helps to reinforce the viability of public financing by empirically demonstrating that the public views a state supreme court elected using the public financing model as more legitimate and less susceptible to donor pressure than one selected using privately financed models.
Determinants of the implementation of artificial intelligence-based screening for diabetic retinopathy—a cross-sectional study with general practitioners in Germany
Authors: Wewetzer Larisa , Held Linda A. , Goetz Katja , Steinhäuser Jost
Published: May 2023

Objective

Diabetic retinopathy (DR) may lead to irreversible damage to the eye and cause blindness if diagnosed in its advanced stages. Artificial intelligence (AI) may support screening and contribute to a timely diagnosis. The aim of this study was to evaluate factors that might influence the success of implementing AI-supported devices for DR screenings in general practice.

Methods

A questionnaire with modules on attitudes toward digital solutions, technical factors, perceived patient perspectives, and sociodemographic data was constructed and 2100 general practitioners (GPs) in Germany were invited to participate via a personal letter.

Results

Two hundred nine physicians participated in the survey (10% response rate, mean age = 54 years, 46% women). Acquisition costs (mean = 1.37), remuneration (mean = 1.46), and running costs (mean = 1.40) were considered particularly relevant in the context of AI-based screening tools. GPs indicated that a mean of €27.00 (SD = 19) was considered to be an appropriate reimbursement for an AI-based screening for DR in their practice. Less relevant factors were availability of a smartphone used in the practice (mean = 2.53) and time until the examination result was available (mean = 2.29). Important technical factors were practicability of the device (mean = 1.27), unproblematic installation of any necessary software (mean = 1.34), and the integrability into the practice information system (mean = 1.44). Considering the patient welfare, physicians rated the accuracy of the examination, omission of pupil dilation, and the duration of the examination as the most important factors. Participants ranked the factors broadening the scope of care, strengthening the primary care (PC) range, and signs of modern medical practice as the most important factors for making an AI-based screening tool attractive for their practice.

Conclusions

These findings serve as a basis for a successful implementation of AI-assisted screening devices in PC and might facilitate early screenings for ophthalmological diseases in general practice. The most relevant barriers that need to be overcome for a successful implementation of such tools include clarification of the costs and reimbursement policies.
Subjective well-being, happiness, and environmental health factors related to women planning a pregnancy or pregnant, using mobile health intervention
Authors: Ortega-García Juan Antonio , Sánchez-Sauco Miguel Felipe , Zafra-Rodríguez José Alberto , Cabrera-Rivera Laura Teresa , Díaz-Martínez Francisco , Llegus-Santiago Eduardo Manuel , Delgado-Marín Juan Luis , Orenes-Piñero Esteban , Kloosterman Nicole , Bach Albert , Ojeda-Sánchez Carlos , Ramis Rebeca
Published: May 2023

Objectives

To compare the environmental health results in women trying to get pregnant or pregnant using a mobile health application (Green Page) through healthcare professionals or self-completed by women, and to explore the relationship between the subjective well-being of these women with their lifestyles and environmental factors.

Methods

A descriptive study with mixed methods was conducted in 2018. A mobile health survey was used in two phases. Phase 1 was a cross-sectional study through professionals ( n  =  1100) followed by phase 2, a convenience sampling through women's self-reporting ( n  =  3425). A personalized report was downloadable with health recommendations for the well-being of the mother and child.

Results

Of the 3205 participants (mean age  =  33 years, SD  =  0.2 years), 1840 were planning a pregnancy and 1365 were pregnant. One in five pregnant women had a low level of happiness. Globally, subjective well-being and happiness were found to be negatively associated with lack of contact with nature, sedentary lifestyle, excess weight, environmental exposure, and older age in pregnancy. Precisely 45%, 60%, and 14% of women were exposed to tobacco, alcohol, and illegal drugs, respectively. The women self-reported levels of risk factors higher than when the tool was used by or through professionals.

Conclusions

The use of mobile health interventions focused on environmental health during planning or pregnancy periods could help improve the quality of healthcare and foster greater involvement of women in their self-care process, thus promoting empowerment, healthier environments, and lifestyles. Ensuring equity of access and data protection are global challenges to be addressed.
Hospital length of stay prediction for general surgery and total knee arthroplasty admissions: Systematic review and meta-analysis of published prediction models
Authors: Gokhale Swapna , Taylor David , Gill Jaskirath , Hu Yanan , Zeps Nikolajs , Lequertier Vincent , Teede Helena , Enticott Joanne
Published: May 2023

Objective

Systematic review of length of stay (LOS) prediction models to assess the study methods (including prediction variables), study quality, and performance of predictive models (using area under receiver operating curve (AUROC)) for general surgery populations and total knee arthroplasty (TKA).

Method

LOS prediction models published since 2010 were identified in five major research databases. The main outcomes were model performance metrics including AUROC, prediction variables, and level of validation. Risk of bias was assessed using the PROBAST checklist.

Results

Five general surgery studies (15 models) and 10 TKA studies (24 models) were identified. All general surgery and 20 TKA models used statistical approaches; 4 TKA models used machine learning approaches. Risk scores, diagnosis, and procedure types were predominant predictors used. Risk of bias was ranked as moderate in 3/15 and high in 12/15 studies. Discrimination measures were reported in 14/15 and calibration measures in 3/15 studies, with only 4/39 externally validated models (3 general surgery and 1 TKA). Meta-analysis of externally validated models (3 general surgery) suggested the AUROC 95% prediction interval is excellent and ranges between 0.803 and 0.970.

Conclusion

This is the first systematic review assessing quality of risk prediction models for prolonged LOS in general surgery and TKA groups. We showed that these risk prediction models were infrequently externally validated with poor study quality, typically related to poor reporting. Both machine learning and statistical modelling methods, plus the meta-analysis, showed acceptable to good predictive performance, which are encouraging. Moving forward, a focus on quality methods and external validation is needed before clinical application.
Examining Factors That Influence Learner Retention in MOOCs During the COVID-19 Pandemic Time
Authors: Yu Zhonggen , Yu Liheng
Published: May 2023

Massive Open Online Courses have become a frequent platform for learners to acquire knowledge. This study aims to explore multiple factors influencing learner retention in MOOCs during the COVID-19 pandemic. To address this, we collected quantitative and qualitative data from questionnaires and qualitative data from interviews and then analyzed them through the Partial Least Square–Structural Equation Modeling to test 14 research hypotheses. The proposed research model and research hypotheses are empirically tested with 243 participants across the world. According to the results, support is found for all of the 14 research hypotheses. We confirmed 14 factors influencing learner retention in MOOCs. The result is beneficial for designers and manufacturers of MOOCs to improve the quality of the products and facilitate online or blended learning during this special time. It could also help students improve their learning experiences. Future research could examine influencing factors of learner retention in MOOCs with interdisciplinary cooperation.
Love Sick: Attachment Anxiety and COVID-Era Romantic Encounters Among College Students
Authors: Peterson Julie Longua , Hamilton Hannah R. , DeHart Tracy , Kellogg Danielle , Morgan Mia
Published: May 2023

The current research explored how attachment anxiety influences attitudes and behaviors in romantic contexts among single emerging adults during COVID-19. Study 1 ( n = 242) revealed that, despite increased risk perceptions, emerging adults high in attachment anxiety report decreased cautiousness and a greater percentage of hook-ups outside their pod/bubble. Attitudes about masking with a romantic partner mirrored those of low anxiety emerging adults. In study 2 ( n = 186), we used a quasi-experimental design to explore whether romantic (vs. control) contexts differentially impact attitudes toward masking. High anxiety emerging adults reported somewhat increased risk perceptions across condition, but more negative attitudes toward masking and less confidence in helping a partner mask in the romantic (vs. control) condition. Low anxiety emerging adults’ attitudes and confidence were unaffected by condition. Results suggest that emerging adults high in anxiety, while generally more concerned about COVID, appeared to reduce cautiousness in romantic contexts.
Systematic Review and Meta-analyses of Randomized Controlled Trials Comparing Exercise Loading Protocols With Passive Treatment Modalities or Other Loading Protocols for the Management of Midportion Achilles Tendinopathy
Authors: Maetz Renaud , Dubé Marc-Olivier , Tougas Arielle , Prudhomme Félix , Dubois Blaise , Roy Jean-Sébastien
Published: May 2023

Background:

There is no clear consensus as to which intervention to prioritize for midportion Achilles tendinopathy (AT), although recent clinical practice guidelines have recommended eccentric exercises.

Purpose/Hypothesis:

The purpose of this study was to (1) compare exercise loading protocols with passive treatment modalities for the management of midportion AT and (2) compare different exercise loading protocols. We hypothesized that loading exercises would be associated with a greater decrease in pain and symptoms compared with passive treatment modalities but that no loading protocols would be associated with improved results.

Study Design:

Systematic review; Level of evidence, 1.

Methods:

Following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, we searched the MEDLINE, EMBASE, CINHAL, and Web of Science databases for randomized controlled trials (RCTs) and compared eccentric loading protocols with passive treatment modalities or different eccentric loading protocols as an intervention for midportion AT. A total of 5126 articles were identified after the initial search. After selection, the risk of bias (RoB) and the Grading of Recommendations, Assessment, Development and Evaluation approach were applied to pooled studies for quantitative analysis. The outcomes of interest were pain and function, which were measured using the visual analog scale and the Victorian Institute of Sport Assessment–Achilles scale. Mean differences (MDs) and 95% CIs were calculated using random effects (significant heterogeneity) or fixed effects (nonsignificant heterogeneity) inverse variance models.

Results:

In this study, 12 RCTs (N = 543 participants) were included, of which 2 had a high RoB and 10 showed some concerns of bias. Passive interventions resulted in greater pain reduction in the short term compared with eccentric loading protocols (n = 4 studies; n = 212 participants; pooled MD, 10.22 [95% CI, 2.18 to 18.25]; P = .01). For function, there was a nonsignificant trend in favor of eccentric loading in the short- (n = 3 studies; n = 144 participants; pooled MD, –7.91 [95% CI, –16 to 0.19]; P = .06) and midterm follow-up (n = 5 studies; n = 258 participants; pooled MD, –6.78 [95% CI, –14.23 to 0.68]; P = .07). Meta-analyses of RCTs comparing different types of exercise loading protocols showed no significant differences in the short, mid-, and long term with regard to pain and function.

Conclusion:

Our meta-analyses did not highlight the superiority of one treatment over another for midportion AT.
A Recurrent De Novo Variant in EIF2AK2 Causes a Hypomyelinating Leukodystrophy
Authors: Macintosh Julia , Thiffault Isabelle , Pastinen Tomi , Sztriha László , Bernard Geneviève
Published: May 2023

De novo pathogenic variants in EIF2AK2 have recently been reported as a novel genetic cause of leukoencephalopathy. Here, we describe a male individual who presented in the first year of life with clinical features resembling Pelizaeus-Merzbacher disease (PMD), including nystagmus, hypotonia, and global developmental delay, and which later progressed to include ataxia and spasticity. Brain MRI at the age of two revealed diffuse hypomyelination. This report adds to the limited number of individuals published and further reinforces de novo variants in EIF2AK2 as a molecular cause of a leukodystrophy that clinically and radiologically resembles PMD.
Synergistic influence of MWCNTs/RGO on low-velocity impact response and mechanical properties of carbon fiber/epoxy composite
Authors: Bahrami Mohammad Amin , Feli Saeed
Published: May 2023

Nanoparticles can be used to enhance and improve the mechanical properties and low-velocity impact response of carbon fiber-reinforced polymer (CFRP) composites both simultaneously and individually. Also, the synergistic influence of two nanoparticles can be improved the mechanical properties and low-velocity impact response of CFRP composites. In this paper, the effects of reduced graphene oxide (RGO) and multi-walled carbon nanotubes (MWCNTs) on the mechanical properties, low-velocity impact response and damage area of epoxy/fiber carbon composites are investigated both simultaneously and individually. Composite specimens are fabricated with 0.4 weight percentages (wt.%) of RGO, 0.06 wt.% of MWCNTs individually, and a combination of RGO and MWCNTs with 0.6 and 0.06 wt.%, respectively. For comparison of the results, the neat epoxy specimens are fabricated and also tested. Direct homogenization technique is applied for preparation of nanocomposite mixture and then each layer of carbon fiber reinforced nanocomposite is fabricated using a hand lay-up process. Tensile modulus, tensile strength, variations of load, displacement, velocity, and absorbed energy of specimens versus time are obtained. For specimens with MWCNTs/RGO tensile modulus and tensile strength increased by about 21.30% and 17.12%, respectively, and the load peak increased by 15.15% at 1 J, 13.35% at 2 J, 39.62% at 3 J, and 39.62% at 3 J. It is concluded that the synergistic influence of MWCNTs and RGO on the results is more significant and has a higher effect on the impact responses. After the impact tests, Optical microscopy and SEM method are used to analyze fracture surfaces.
CircSSNN: circRNA-binding site prediction via sequence self-attention neural networks with pre-normalization
Authors: Cao Chao , Yang Shuhong , Li Mengli , Li Chungui
Published: May 2023

Background

Circular RNAs (circRNAs) play a significant role in some diseases by acting as transcription templates. Therefore, analyzing the interaction mechanism between circRNA and RNA-binding proteins (RBPs) has far-reaching implications for the prevention and treatment of diseases. Existing models for circRNA-RBP identification usually adopt convolution neural network (CNN), recurrent neural network (RNN), or their variants as feature extractors. Most of them have drawbacks such as poor parallelism, insufficient stability, and inability to capture long-term dependencies.

Methods

In this paper, we propose a new method completely using the self-attention mechanism to capture deep semantic features of RNA sequences. On this basis, we construct a CircSSNN model for the cirRNA-RBP identification. The proposed model constructs a feature scheme by fusing circRNA sequence representations with statistical distributions, static local contexts, and dynamic global contexts. With a stable and efficient network architecture, the distance between any two positions in a sequence is reduced to a constant, so CircSSNN can quickly capture the long-term dependencies and extract the deep semantic features.

Results

Experiments on 37 circRNA datasets show that the proposed model has overall advantages in stability, parallelism, and prediction performance. Keeping the network structure and hyperparameters unchanged, we directly apply the CircSSNN to linRNA datasets. The favorable results show that CircSSNN can be transformed simply and efficiently without task-oriented tuning.

Conclusions

In conclusion, CircSSNN can serve as an appealing circRNA-RBP identification tool with good identification performance, excellent scalability, and wide application scope without the need for task-oriented fine-tuning of parameters, which is expected to reduce the professional threshold required for hyperparameter tuning in bioinformatics analysis.