bluuebunny/crossref_metadata_2025 huggingface dataset:
The question of access: Toward an equitable future of computational design
Authors: Noel Vernelle AA , Boeva Yana , Dortdivanlioglu Hayri
Published: November 2021

Digital fabrication and its cultivated spaces promise to break disciplinary boundaries and enable access to its technologies and computation for the broader public. This paper examines the trope of “access” in digital fabrication, design, and craft, and illustrates how it unfolds in these spaces and practices. An equitable future is one that builds on and creates space for multiple bodies, knowledges, and skills; allows perceptual interaction and corporeal engagement with people, materials, and tools; and employs technologies accessible to broad groups of society. By conducting comparative and transnational ethnographic studies at digital fabrication and crafting sites, and performing craft-centered computational design studies, we offer a critical description of what access looks like in an equitable future that includes digital fabrication. The study highlights the need to examine universal conceptions and study how they are operationalized in broader narratives and design pedagogy traditions.
Psychometric Properties of a Norwegian Version of the Social Emotional Assets and Resilience Scales–Child–Short Form
Authors: Strømgren Børge , Couto Kalliu Carvalho
Published: November 2021

Norwegian schools are obliged to develop students’ social competences. Programs used are School-Wide Positive Behavioral Interventions and Supports (PBIS) or classroom-based ones that aim to teach students social and emotional learning (SEL) skills in a broad sense. Some rating scales have been used to assess the effect of SEL programs on SEL skills. We explored the Norwegian version of the 12-item Social Emotional Assets and Resilience Scales–Child–Short Form (SEARS-C-SF). An exploratory factor analysis (EFA) was performed, proposing a one-factor solution that was verified by a confirmatory factor analysis (CFA). The scale reliability of .84 (λ2), means and standard deviations, as well as tier levels were compared with the original short form. Finally, concurrent, discriminant, and convergent validities for the SEARS-C-SF were compared with different Strengths and Difficulties Questionnaire (SDQ) subscales.
Media and Science Policy: Who Influences Whom Regarding Complementary and Alternative Medicines Regulation
Authors: Cano-Orón Lorena , Lopera-Pareja Emilia H.
Published: November 2021

This paper analyses the synergies between press and politics in the debate on the regulation of complementary and alternative medicines (CAM) in Spain between 1979 and 2018. We argue that longitudinal analysis and comparison of this interaction and synergy reveal how the mainstream discourse has shifted. We use a dataset of news ( N  =  2,059), a news sample ( n  =  325) and a dataset of parliamentary records ( N  =  86). Using both quantitative and qualitative approaches, the dynamics of the interaction between the different institutions and actors involved is assessed. Specifically, the study analyses the media and parliamentary attention to CAM issues (agenda setting), how CAM is addressed (framing), and the actors who have a voice in the discourse (costructuring of power relations). The results indicate that relevant changes in the public debate on CAM have only occurred over the last few years, corresponding to three overlapping dynamics of influence of the media on politics: amplification, framing, and costructuring of power relations. This recent period has seen convergence in the discussion and narratives/frames used, which also corresponds to more widespread skepticism regarding CAM.
Activin A and Follistatin Serum Concentrations in Breast Augmentation Patients
Authors: Zeplin Philip H.
Published: November 2021

Background: Capsular contracture is caused by an excessive fibrotic reaction similar as observed in other progressive fibrotic disorders. For their pathogenesis, several studies confirmed the importance of activins and follistatin. The aim of this study was to determine and analyze serum levels of Activin A and follistatin in patients with capsular contracture after aesthetic breast augmentation. Methods: The study included 361 female patients who underwent primary aesthetic breast augmentation, came for control examination after breast augmentation or for revision operation because of capsular contracture. Blood samples were taken and using a specific ELISA to determine the serum concentration levels of Activin A and Follistatin. Results: Ninety-six patients (n = 96), who developed a capsular contracture Baker ≥°III and underwent revision surgery were collected (capsular fibrosis group). One-hundred and fourteen patients (n = 114) were asymptomatic for capsular fibrosis Baker ≥°III after primary breast augmentation and 33 (n = 33) of them had developed no capsular fibrosis after more than 10 years (long-term group). For control group, blood samples were taken from 167 patients (n = 167) before primary aesthetic breast augmentation. Serum Activin A levels were significantly higher in the long-term Group compared with those in the capsular fibrosis- and the control groups. Follistatin levels were significantly lower in the capsular fibrosis group compared to the control- and the long-term groups. A small amount of control group patients (n = 16) developed a capsular fibrosis within 2 years after primary breast augmentation with significant lower follistatin levels. Retrospectively, they showed significantly lower serum follistatin levels than the control group even before the onset of capsular contracture. Conclusions: Capsular fibrosis has no effect on Activin A serum levels. In contrast, follistatin serum levels are lower in patients with capsular fibrosis. These results show that besides many other factors, a dysregulation of the Activin–follistatin axis may have importance on the pathogenesis of capsular contracture.
Anterior Glenoid Reconstruction With Distal Tibial Allograft: Biomechanical Impact of Fixation and Presence of a Retained Lateral Cortex
Authors: Parada Stephen A. , Shaw K. Aaron , McGee-Lawrence Meghan E. , Kyrkos Judith G. , Paré Daniel W. , Amero Jessica , Going James W. , Morpeth Brice , Shelley Robert , Eichinger Josef K. , Provencher Matthew T.
Published: November 2021

Background:

Glenoid reconstruction with distal tibial allograft (DTA) is a known surgical option for treating recurrent glenohumeral instability with anterior glenoid bone loss; however, biomechanical analysis has yet to determine how graft variability and fixation options alter the torque of screw insertion and load to failure.

Hypothesis:

It was hypothesized that retention of the lateral cortex of the DTA graft and the presence of a washer with the screw will significantly increase the maximum screw placement torque as well as the load to failure.

Study Design:

Controlled laboratory study.

Methods:

Whole, fresh distal tibias were used to harvest 28 DTA grafts, half of which had the lateral cortex removed and half of which had the lateral cortex intact. The grafts were secured to polyurethane solid foam blocks with a 2-mm epoxy laminate to simulate a glenoid with an intact posterior glenoid cortex. Grafts underwent fixation with 4.0-mm cannulated drills, and screws and washers were used for half of each group of grafts while screws alone were used for the other half, creating 4 equal groups of 7 samples each. A digital torque-measuring screwdriver recorded peak torque for screw insertion. Constructs were then tested in compression with a uniaxial materials testing system and loaded in displacement control at 100 mm/min until at least 3 mm of displacement occurred. Ultimate load was defined as the load sustained at clinical failure.

Results:

The use of a washer significantly improved the ultimate torque that could be applied to the screws (+cortex and +washer = 12.42 N·m [SE, 0.82]; –cortex and +washer = 10.54 N·m [SE, 0.59]) ( P < .0001), whereas the presence of the native bone cortex did not have a significant effect (+cortex and –washer = 7.83 N·m [SE, 0.40]; –cortex and –washer = 8.03 N·m [SE, 0.56]) ( P = .181).

Conclusion:

In a hybrid construct of fresh cadaveric DTA grafts secured to a foam block glenoid model, the addition of washers was more effective than the retention of the lateral distal tibial cortex for both load to failure and peak torque during screw insertion.

Clinical Relevance:

This biomechanical study is relevant to the surgeon when choosing a graft and selecting fixation options during glenoid reconstruction with a DTA graft.
Serious Adverse Events and Fatal Outcomes Following COVID-19 Vaccination in the UK: Lessons for Other Countries
Authors: Bhatia Mrigesh , Putcha Venkata R. P. , Dwivedi Laxmi Kant , Singh D. P.
Published: November 2021

Vaccines have taken the centre stage in the fight against COVID-19 pandemic, and in reducing hospitalisation and associated mortality. Countries around the world are heavily dependent on the successful rollout of their vaccination programmes to open up the societies and re-start their economies. However, the success of any vaccine programme, to a large extent, depends upon the efficacy and safety of the vaccines. Given that UK has been way ahead in vaccinating its population, is considered a successful model compared to other countries in Europe and elsewhere and has a yellow card reporting system for adverse events, we use UK as an example to understand the side effects and fatal outcomes following vaccinations. Our results show that AstraZeneca seems to be underperforming in terms of overall reporting of minor adverse events, serious incidents and fatal outcomes following vaccination. The risk of serious anaphylactic reaction and fatal outcome was 1.36 and 1.17 times more in case of AstraZeneca vaccine when compared with Pfizer BioNTech vaccine. The analysis has implications for vaccine policies and programmes both at nation-state and global levels.
How I treat cardiovascular complications in patients with lymphoid malignancies
Authors: Herrmann Joerg , McCullough Kristen B. , Habermann Thomas M.
Published: November 2021

The prognosis of several lymphoid malignancies has improved through development of novel therapies, combination with traditional chemotherapies, and delineation of appropriate therapeutic sequencing. Toxicities that are arising because of prolonged or multiple sequential therapeutic interventions are becoming increasingly impactful. Among the broad spectrum of complications that patients with lymphoid malignancies may experience, cardiovascular toxicities are significant in terms of morbidity and mortality. The entire cardiovascular system can be affected, but cardiomyopathy, heart failure, and arrhythmias remain of greatest concerns with the use of anthracyclines, hematopoietic stem cell transplantation, and radiation therapy in patients with lymphoid malignancies. These aspects will be covered in this article within the framework of case-based discussions. Key to the management of cardiovascular complications in patients with lymphoid malignancies is awareness and preparedness across the cancer continuum. Baseline risk stratification helps to direct surveillance and early intervention efforts before, during, and after cancer therapy, which are paramount for the best possible outcomes. Along these lines, the overall goal is to enable the best possible therapies for lymphoid malignancies without the complications of clinically significant cardiovascular events.
Microlyse: a thrombolytic agent that targets VWF for clearance of microvascular thrombosis
Authors: de Maat Steven , Clark Chantal C. , Barendrecht Arjan D. , Smits Simone , van Kleef Nadine D. , El Otmani Hinde , Waning Manon , van Moorsel Marc , Szardenings Michael , Delaroque Nicolas , Vercruysse Kristof , Urbanus Rolf T. , Sebastian Silvie , Lenting Peter J. , Hagemeyer Christoph , Renné Thomas , Vanhoorelbeke Karen , Tersteeg Claudia , Maas Coen
Published: November 2021

Thrombotic microangiopathies are hallmarked by attacks of disseminated microvascular thrombosis. In thrombotic thrombocytopenic purpura (TTP), this is caused by a rise in thrombogenic ultra-large von Willebrand factor (VWF) multimers because of ADAMTS13 deficiency. We previously reported that systemic plasminogen activation is therapeutic in a TTP mouse model. In contrast to its natural activators (ie, tissue plasminogen activator and urokinase plasminogen activator [uPA]), plasminogen can directly bind to VWF. For optimal efficacy and safety, we aimed to focus and accelerate plasminogen activation at sites of microvascular occlusion. We here describe the development and characterization of Microlyse, a fusion protein consisting of a high-affinity VHH targeting the CT/CK domain of VWF and the protease domain of uPA, for localized plasminogen activation on microthrombi. Microlyse triggers targeted destruction of platelet-VWF complexes by plasmin on activated endothelial cells and in agglutination studies. At equal molar concentrations, Microlyse degrades microthrombi sevenfold more rapidly than blockade of platelet-VWF interactions with a bivalent humanized VHH (caplacizumab*). Finally, Microlyse attenuates thrombocytopenia and tissue damage (reflected by increased plasma lactate dehydrogenase activity, as well as PAI-1 and fibrinogen levels) more efficiently than caplacizumab* in an ADAMTS13−/− mouse model of TTP, without affecting hemostasis in a tail-clip bleeding model. These findings show that targeted thrombolysis of VWF by Microlyse is an effective strategy for the treatment of TTP and might hold value for other forms of VWF-driven thrombotic disease.
Identification of miRNAs and their target genes in genic male sterility lines in Brassica napus by small RNA sequencing
Authors: Jiang Jianxia , Xu Pengfei , Li Yajie , Li Yanli , Zhou Xirong , Jiang Meiyan , Zhang Junying , Zhu Jifeng , Wang Weirong , Yang Liyong
Published: November 2021

Background

Brassica napus is the third leading source of edible oil in the world. Genic male sterility (GMS) lines provide crucial material for harnessing heterosis for rapeseed. GMS lines have been used successfully for rapeseed hybrid production in China. MicroRNAs (miRNAs) play crucial regulatory roles in various plant growth, development, and stress response processes. However, reports on miRNAs that regulate the pollen development of GMS lines in B. napus are few.

Results

In this study, 12 small RNA and transcriptome libraries were constructed and sequenced for the flower buds from the fertile and sterile lines of two recessive GMS (RGMS) lines, namely, “6251AB” and “6284AB”. At the same time, 12 small RNA and transcriptome libraries were also constructed and sequenced for the flower buds from the fertile and sterile lines of two dominant GMS (DGMS) lines, namely, “4001AB” and “4006AB”. Based on the results, 46 known miRNAs, 27 novel miRNAs on the other arm of known pre-miRNAs, and 44 new conserved miRNAs were identified. Thirty-five pairs of novel miRNA-3p/miRNA-5p were found. Among all the identified miRNAs, fifteen differentially expressed miRNAs with over 1.5-fold change between flower buds of sterile and fertile lines were identified, including six differentially expressed miRNAs between “4001A” and “4001B”, two differentially expressed miRNAs between “4006A” and “4006B”, four differentially expressed miRNAs between “6251A” and “6251B”, and ten differentially expressed miRNAs between “6284A” and “6284B”. The correlation analysis of small RNA and transcriptome sequencing was conducted. And 257 candidate target genes were predicted for the 15 differentially expressed miRNAs. The results of 5′ modified RACE indicated that BnaA09g48720D, BnaA09g11120D, and BnaCnng51960D were cleaved by bna-miR398a-3p, bna-miR158-3p and bna-miR159a, respectively. Among the differentially expressed miRNAs, miR159 was chosen to analyze its function. Overexpression of bna-miR159 in Arabidopsis resulted in decreased seed setting rate, and shortened siliques, illustrating that miR159 may regulate the fertility and silique development in rapeseed.

Conclusions

Our findings provide an overview of miRNAs that are potentially involved in GMS and pollen development. New information on miRNAs and their related target genes are provided to exploit the GMS mechanism and reveal the miRNA networks in B. napus.
Item bias on the geriatric depression scale (GDS): investigating the quality and generalizability of GDS on Chinese and Korean community-dwelling elderly population
Authors: Park In Hye , Sya’bandari Yustika , Liu Yang
Published: November 2021

Background

Although some previous studies have reported the impact of cultural factors on individuals’ cognition and decision making, a shortage of research has led to this comparison study for Chinese and Korean elderly, a growing population with depression. This study aimed to explore depression levels in Chinese and South Korean elderly individuals by focusing on testing the generalizability of the Geriatric Depression Scale (GDS).

Methods

The data of 493 community-dwelling Chinese and Korean elderly individuals over the age of 60 years were used to examine GDS. To test the dimensionality, item quality, and reliability of the GDS, the item response theory, Rasch analysis was performed. The detection of differential item functioning (DIF) of the GDS between the two countries was determined by performing a hybrid ordinal logistic regression.

Results

The four-dimensional framework of the GDS, categorized into agitation, cognitive concerns, dysphoria, and vigor/withdrawal was fit for measuring depression levels in Chinese and Korean elderly individuals. In addition, good item quality and reliability of the GDS indicate that almost all items in this scale contribute to measuring the intended trait. Meanwhile, 18 out of 28 items of the GDS were detected as country-related DIF with five items having a large effect size.

Conclusions

Although China and Korea are close geographically and culturally, the item bias shown by severe country-related DIF implies that different cultural backgrounds impact how the elderly interpret GDS items. The cultural issues related to the specific DIF items, the implication to accuracy of individual scores estimation, and the optimal decision to treat individuals were discussed.
Revisiting left atrial volumetry by magnetic resonance imaging: the role of atrial shape and 3D angle between left ventricular and left atrial axis
Authors: Kuusisto Jouni K. , Pöyhönen Pauli A. K. , Pirinen Jani , Lehmonen Lauri J. , Räty Heli P. , Martinez-Majander Nicolas , Putaala Jukka , Sinisalo Juha , Järvinen Vesa
Published: November 2021

Background

Accurate measurement of left atrial (LA) volumes is needed in cardiac diagnostics and the follow up of heart and valvular diseases. Geometrical assumptions with 2D methods for LA volume estimation contribute to volume misestimation. In this study, we test agreement of 3D and 2D methods of LA volume detection and explore contribution of 3D LA axis orientation and LA shape in introducing error in 2D methods by cardiovascular magnetic resonance imaging.

Methods

30 patients with prior first-ever ischemic stroke and no known heart disease, and 30 healthy controls were enrolled (age 18–49) in a substudy of a prospective case–control study. All study subjects underwent cardiac magnetic resonance imaging and were pooled for this methodological study. LA volumes were calculated by biplane area-length method from both conventional long axis (LAVAL-LV) and LA long axis-oriented images (LAVAL-LA) and were compared to 3D segmented LA volume (LAVSAX) to assess accuracy of volume detection. 3D orientation of LA long axis to left ventricular (LV) long axis and to four-chamber plane were determined, and LA 3D sphericity indices were calculated to assess sources of error in LA volume calculation. Shapiro–Wilk test, Bland–Altman analysis, intraclass and Pearson correlation, and Spearman’s rho were used for statistical analysis.

Results

Biases were − 9.9 mL (− 12.5 to − 7.2) for LAVAL-LV and 13.4 (10.0–16.9) for LAVAL-LA [mean difference to LAVSAX (95% confidence interval)]. End-diastolic LA long axis 3D deviation angle to LV long axis was 28.3 ± 6.2° [mean ± SD] and LA long axis 3D rotation angle to four-chamber plane 20.5 ± 18.0°. 3D orientation of LA axis or 3D sphericity were not correlated to error in LA volume calculation.

Conclusions

Calculated LA volume accuracy did not improve by using LA long axis-oriented images for volume calculation in comparison to conventional method. We present novel data on LA axis orientation and a novel metric of LA sphericity and conclude that these measures cannot be utilized to assess error in LA volume calculation.

Trial registration

Main study Searching for Explanations for Cryptogenic Stroke in the Young: Revealing the Etiology, Triggers, and Outcome (SECRETO; NCT01934725) has been registered previously.
The ensemble learning model is not better than the Asian modified CKD-EPI equation for glomerular filtration rate estimation in Chinese CKD patients in the external validation study
Authors: Zhao Li , Zhang Jing-jing , Tian Xin , Huang Jian-min , Xie Peng , Li Xiang-zhou
Published: November 2021

Objective

To assess the clinical practicability of the ensemble learning model established by Liu et al. in estimating glomerular filtration rate (GFR) and validate whether it is a better model than the Asian modified Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation in a cohort of Chinese chronic kidney disease (CKD) patients in an external validation study.

Methods

According to the ensemble learning model and the Asian modified CKD-EPI equation, we calculated estimated GFRensemble and GFRCKD-EPI, separately. Diagnostic performance of the two models was assessed and compared by correlation coefficient, regression equation, Bland–Altman analysis, bias, precision and P30 under the premise of 99mTc-diethylenetriaminepentaacetic acid (99mTc-DTPA) dual plasma sample clearance method as reference method for GFR measurement (mGFR).

Results

A total of 158 Chinese CKD patients were included in our external validation study. The GFRensemble was highly related with mGFR, with the correlation coefficient of 0.94. However, regression equation of GFRensemble = 0.66*mGFR + 23.05, the regression coefficient was far away from one, and the intercept was wide. Compared with the Asian modified CKD-EPI equation, the diagnostic performance of the ensemble learning model also demonstrated a wider 95% limit of agreement in Bland-Altman analysis (52.6 vs 42.4 ml/min/1.73 m2), a poorer bias (8.0 vs 1.0 ml/min/1.73 m2, P = 0.02), an inferior precision (18.4 vs 12.7 ml/min/1.73 m2, P < 0.001) and a lower P30 (58.9% vs 74.1%, P < 0.001).

Conclusions

Our study showed that the ensemble learning model cannot replace the Asian modified CKD-EPI equation for the first choice for GFR estimation in overall Chinese CKD patients.
Opinions and clinical practice of functional movement disorders: a nationwide survey of clinicians in China
Authors: Xie Xin-Yi , Lin Guo-zhen , Huang Qiang , Li Chun-Bo , Hallett Mark , Voon Valerie , Ren Ru-jing , Chen Sheng-di , Wang Gang
Published: November 2021

Background

There is rare reports about opinions and clinical practice of functional movement disorders (FMD) in China. The present survey aimed to investigate the views of FMD in Chinese clinicians.

Methods

The Chinese version survey of FMD were conducted in nationwide practitioners by means of an online questionnaire.

Results

Four hundred and thirty-four Chinese clinicians completed a 21-item questionnaire probing diagnostic and management issues in FMD. More than 80% of respondents considered that atypical movement disorder, multiple somatizations, and emotional disturbance were essential or absolutely necessary for clinically definite diagnosis of FMD. About three quarters of respondents requested standard neurological investigations to rule out organic causes. Over half believed that prior diagnosis of an organic disorder (59.9%), lack of associated non-physiologic deficits (51.8%), and evidence of physical injury (50.0%) were ‘very influential’ or ‘extremely influential’ for a non-FMD diagnosis. The majority (77.4%) of the respondents may refer patients to a neuropsychiatrist or psychiatrist experienced in FMD, followed by psychologist or psychotherapist experienced in FMD (53.2%). However, lack of guidelines, physician knowledge, and training often limited clinicians’ ability in managing patients with FMD. Early diagnosis of FMD, identification and management of concurrent psychiatric disorder, and acceptance of the diagnosis by the patient were considered most important for predicting a favorable prognosis.

Conclusions

Opinions and clinical practice of Chinese practitioners not only varied among Chinese neurologists, but also differed from international peers. Combined efforts are needed to promote related research and establish practice guidelines in China in the future.
Effect of short-term psychological intervention on anxiety of pregnant women with positive screening results for chromosomal disorders: a randomized controlled trial
Authors: Bayat Arezoo , Amiri-Farahani Leila , Soleimani Mehdi , Eshraghi Nooshin , Haghani Shima
Published: November 2021

Background and aim

Prenatal diagnosis of fetal abnormalities is a critical and stressful event for women. Most pregnant women are concerned about fetal abnormalities and screening tests. Due to the importance of anxiety reduction in pregnant women, this study was conducted to determine the effect of short-term psychological intervention on the anxiety of pregnant women with positive screening results for chromosomal disorders.

Methods

A randomized clinical trial was performed on women referred to Akbarabadi Hospital in Tehran, Iran, who had positive screening results for chromosomal abnormalities. Participants were selected from eligible individuals by a continuous method and were assigned to two groups of cognitive-behavioral training (n = 46) and control (n = 46), using the block balanced randomization method. Participants in the cognitive-behavioral training group received 4 sessions of individual counseling. The control group received routine pregnancy visits. The Spielberger State-Trait Anxiety Inventory was completed before the intervention and immediately at the end of the intervention (before receiving the amniocentesis result). The analysis of intervention effects was performed as intention-to-treat and per-protocol analysis.

Results

There was a statistically significant difference in post-intervention state anxiety scores and trait anxiety scores (p <  0.001) between the intervention and control groups, when their means were adjusted for pre-intervention scores for both intention-to-treat and per-protocol analysis. Also, there was a large effect size between the groups in terms of state (ITT: ηp2 = 0.63, PP: ηp2 = 0.71) and trait (ITT: ηp2 = 0.72, PP: ηp2 = 0.75) anxiety scores clinically for both intention-to-treat and per-protocol analysis. The intervention group had a statistically significant and large decrease in state and trait anxiety scores from pretrial to post-trial. In contrast, the control group had a statistically significant and medium increase in state and trait anxiety scores from pretrial to post-trial.

Conclusion

The results showed that cognitive-behavioral training reduced the anxiety of pregnant women with positive screening results for chromosomal disorders. According to the results, it is recommended to hold cognitive-behavioral training classes to reduce the anxiety of pregnant women with a positive screening result for chromosomal disorders.

Trial registration

IRCT.ir:IRCT20180427039436N7; date of registration: 24/08/2020 2020-08-24.
Subjective cognitive complaints and relations to objective cognitive performance among Lebanese patients with schizophrenia
Authors: Haddad Chadia , Salameh Pascale , Sacre Hala , Polin Clément , Clément Jean-Pierre , Calvet Benjamin
Published: November 2021

Background

Patients with schizophrenia have a particularly low level of insight into their illness compared to people with other mental health disorders. The objectives of the study were to evaluate: 1) subjective cognitive complaints in individuals with schizophrenia in comparison with health controls, 2) the relation between subjective cognitive complaint (SCC) and objective cognitive performance in the patients group, and 3) factors related to cognitive complaint, such as depression, insight, autonomy, and psychological symptoms.

Methods

Cross-sectional study was conducted between July 2019 and March 2020 enrolled 120 patients with schizophrenia disorders, selected from the Psychiatric Hospital of the Cross (HPC) – Lebanon and 60 healthy controls. The Self-Assessment Scale of Cognitive Complaints in Schizophrenia (SASCCS) was used to measure people living with schizophrenia perception of their cognitive impairment, while the Brief Assessment of Cognition in Schizophrenia (BACS) was used to evaluate their cognitive functioning.

Results

A significant difference was found between schizophrenia patients and healthy controls in all neurocognition and SASCCS tests. The hierarchical regression analysis showed that the BACS total score (Beta = −.06,p = .04), the PANSS general psychopathology (Beta = .29,p = .003), higher depression (Beta = .75,p = .003) were significantly associated with higher SCC. However, higher autonomy (Beta = − 6.35,p = .001) was significantly associated with lower SCC. A Structural equation model showed that the two most contributing variables were general psychopathology (Standardized Beta (SB): .33,p < 0.001) and autonomy (SB: −.29,p < 0.001).

Conclusion

A significant proportion of patients with schizophrenia could estimate their cognitive impairment. It also showed a positive correlation between depression and activity of daily living with SCC, suggesting that this aspect should be investigated alongside the clinical symptoms when a patient with schizophrenia presents with SCC.
Sustaining success: a qualitative study of gay and bisexual men’s experiences and perceptions of HIV self-testing in a randomized controlled trial
Authors: Zhang Ye , Guy Rebecca J. , Smith Kirsty S. , Jamil Muhammad S. , Prestage Garrett , Applegate Tanya L. , Conway Damian P. , Holt Martin , Keen Phillip , Bavinton Benjamin , McNulty Anna M. , Batrouney Colin , Russell Darren , Vaughan Matthew , Chen Marcus , Fairley Christopher K. , Grulich Andrew E. , Kaldor John M. , Callander Denton
Published: November 2021

Background

HIV self-testing was proved as an effective tool for increasing testing frequency in gay and bisexual men at high risk of infection. Questions remain about understanding why HIVST encouraged testing and how such success can be translated to programmatic implementation.

Methods

We conducted a qualitative investigation of how FORTH participants experienced and perceived HIVST. Stratified sampling was used to recruit gay and bisexual men participating in the FORTH HIVST intervention to take part in interviews, focusing on infrequent testers and those who had received inaccurate HIVST results.

Results

Our analysis identified several prominent themes organized into two overarching domains from the 15 interviews: (i) aspects of HIVST contributing to HIV testing frequency, and (ii) sustaining HIVST into the future. Participants also believed that their use of HIVST in the future would depend on the test kit’s reliability, particularly when compared with highly reliable clinic-based testing.

Conclusion

HIVST increases the frequency of HIV testing among gay and bisexual men due, in part, to the practical, psychological, and social benefits it offers. To capitalize fully on these benefits, however, strategies to ensure the availability of highly reliable HIVST are required to sustain benefits beyond the confines of a structured research study.
Perceived social support and self-efficacy beliefs for healthy eating and physical activity among Arabic-speaking university students: adaptation and implementation of health beliefs survey questionnaire
Authors: Ali Habiba I. , Alhebshi Salma , Elmi Fadima , Bataineh Mo’ath F.
Published: November 2021

Background

Few assessment tools exist for investigating perceived social support and self-efficacy behaviors in Arabic-speaking populations. Moreover, literature on the levels of social support and self-efficacy for adopting healthy eating and engaging in regular physical activity among Arabic-speaking young adults is currently lacking. This study aimed to adapt the Health Beliefs Survey Questionnaire (HBSQ) for Arabic-speaking populations and assess perceived social support and self-efficacy for adopting healthy eating and increased physical activity among university students.

Methods

In the first stage of the study, forward and backward translation and pretesting of the social support and self-efficacy scales of the HBSQ were conducted. The adapted questionnaire was administered to female university students (n = 258), and a subsample of 195 participants retook the questionnaire after 1 month. Construct validity was assessed with confirmatory factor analysis. The internal consistency of each subscale item was assessed by Cronbach’s alpha coefficient, and reproducibility was tested with intraclass correlation coefficients (ICCs) and Bland-Altman plots. In the second stage, the adapted questionnaire was used to assess the perceived social support and self-efficacy levels in a different sample of Arabic-speaking female university students (n = 283).

Results

Based on the results from confirmatory factor analysis, 6 items were selected for the social support scale and 19 items for the self-efficacy scale. The adapted questionnaire showed moderate to high internal reliability (Cronbach alpha coefficient = 0.681 to 0.900). The ICCs of the various subscales ranged from 0.666 to 0.997, indicating moderate to excellent reproducibility of the culturally adapted questionnaire. This was confirmed by Bland-Altman analysis. Participants in the second stage of the study reported significantly higher (P < 0.001) perceived support from family compared to friends in reducing sugar intake and increasing fiber consumption.

Conclusions

The results of the psychometric testing indicate the shortened Arabic HBSQ is a reliable tool for assessing perceived social support from family and close friends as well as for evaluating self-efficacy for choosing healthy foods and increasing physical activity among female university students.
Alcohol consumption in relation to cardiovascular and non-cardiovascular mortality in an elderly male Chinese population
Authors: Ye Xiao-Fei , Miao Chao-Ying , Zhang Wei , Sheng Chang-Sheng , Huang Qi-Fang , Wang Ji-Guang
Published: November 2021

Background

We investigated the association of alcohol consumption with cardiovascular and non-cardiovascular mortality in elderly Chinese men.

Methods

Our participants were recruited from residents living in a suburban town of Shanghai (≥60 years of age, n = 1702). Alcohol intake was classified as non-drinkers, past drinkers (stopped drinking for ≥12 months), and current light-to-moderate (1 to 299 g/week) and heavy drinkers (≥300 g/week). Alcoholic beverages were classified as beer/wine, rice aperitif and liquor/mix drinking.

Results

During 5.9 years (median) of follow-up, all-cause, cardiovascular and non-cardiovascular deaths occurred in 211, 98 and 113 participants, respectively. The corresponding incidence rates were 23.6/1000, 10.9/1000 and 12.6/1000 person-years, respectively. Both before and after adjustment for confounding factors, compared with non-drinkers (n = 843), past drinkers (n = 241), but not the current light-to-moderate (n = 241) or heavy drinkers (n = 377), had a higher risk of all-cause (adjusted hazard ratio [HR] 1.90, 95% confidence interval [CI] 1.35–2.68, P = 0.0003) and non-cardiovascular mortality (HR 2.46, 95% CI 1.55–3.91, P = 0.0001). Similar trends were observed for cardiovascular mortality (HR 1.44, 95% CI 0.85–2.44, P = 0.18). In similar unadjusted and adjusted analyses, compared with the current beer/wine drinkers (n = 203), liquor/mix drinkers (n = 142), but not aperitif drinkers (n = 273), had a significantly higher risk of all-cause (HR 3.07, 95% CI 1.39–6.79, P = 0.006), and cardiovascular mortality (HR 10.49, 95% CI 2.00–55.22, P = 0.006). Similar trends were observed for non-cardiovascular mortality (HR 1.94, 95% CI 0.73–5.16, P = 0.18).

Conclusions

Our study showed risks of mortality associated with past drinking and liquor drinking in the elderly Chinese men.
Resilience mediates the association between self-harm and suicidal ideation in Chinese left-behind children
Authors: Xiao Yuanyuan , Liu Fang , Ran Hailiang , Deng Wenhang , Che Yusan , Fang Die , Donald Ahouanse Roland
Published: November 2021

Background

A significant association between self-harm (SH) and suicide ideation (SI) has been found in Chinese left-behind children (LBC). Existing literature suggests that resilience might be a mediator in this association. However, this hypothesis has not been effectively discussed. The major aim of our study is to analyze the possible mediation of resilience in SH-SI association in Chinese LBC.

Methods

A population-based clustering sampling survey of 2619 LBC was conducted in southwestern China Yunnan province. Self-developed structured questionnaire was used to collect relevant information. Univariate and multivariate Logistic regression models were applied to estimate the associations between SH and SI, resilience and SI, and SH and resilience. Path analysis was adopted to measure the mediation of resilience, as well as its 5 dimensions, in the association between SH and SI. A subgroup analysis was further done to explore the mediation of resilience in the associations between SH severity and SI, SH repetition and SI, among self-harmed LBC.

Results

Compared with LBC who reported no SH behaviors, the odds ratio (OR) for SI was 3.37 (95% CI: 2.63–4.31) among self-harmed LBC. Based on the path model, resilience significantly mediated a quarter of the total association between SH and SI. Among the 5 dimensions of resilience, emotion regulation, interpersonal assistance, and family support were the strongest mediators. Subgroup analysis revealed that, the mediation of resilience was only significant for SH severity and SI.

Conclusions

Resilience played as a prominent mediator in SH-SI association among Chinese LBC. Resilience-centered intervention measures could be considered to reduce suicidal risk of this disadvantageous group.
Audiobooks from terminally ill parent for their children – a qualitative evaluation
Authors: Cuhls Henning , Hesse Michaela , Ates Gülay , Radbruch Lukas
Published: November 2021

Background

Improving the quality of life is one of the main objectives of palliative care. Biographical approaches are often used in combination with leaving a legacy in a range of different interventions such as Dignity Therapy or Life Review. This study presents an evaluation of audiobook biographies for palliative care patients with young children.

Methods

Young parents diagnosed with a life-limiting disease could participate and create an audiobook for their young children. The audiobook itself was recorded over several days and edited by qualified radio journalists. After providing informed consent participants were interviewed twice over the course of the intervention regarding expectations, concerns, motivation, and experiences. Interviews and notes were transcribed verbatim and were analyzed using content analysis. The contents of the audiobooks are not part of the evaluation.

Results

The data were collected from February 2017 till September 2020. Fifty-four patients with ninety-six children at a mean age of 7 years were included and created an audiobook. The main theme of all interviews were the children. Within this field identified main topics were legacy, motivation, usage, benefit, aims, difficulties and worries in descending order. All patients would recommend the intervention.

Conclusion

Creating an audiobook as a legacy to their children seemed to help the diseased parents to cope with their limited life span.
The perceived impact of the Covid-19 pandemic on medical student education and training – an international survey
Authors:   TMS Collaborative, Wanigasooriya Kasun , Beedham William , Laloo Ryan , Karri Rama Santhosh , Darr Adnan , Layton Georgia R. , Logan Peter , Tan Yanyu , Mittapalli Devender , Patel Tapan , Mishra Vivaswan Dutt , Odeh Osama , Prakash Swathi , Elnoamany Salma , Peddinti Sri Ramya , Daketsey Elorm Adzoa , Gadgil Shardool , Bouhuwaish Ahmad Elmabri Mohammad , Ozair Ahmad , Bansal Sanchit , Elhadi Muhammed , Godbole Aditya Amit , Axiaq Ariana , Rauf Faateh Ahmad , Ashpak Ashna
Published: November 2021

Background

The Covid-19 pandemic led to significant changes and disruptions to medical education worldwide. We evaluated medical student perceived views on training, their experiences and changes to teaching methods during the pandemic.

Methods

An online survey of medical students was conducted in the Autumn of 2020. An international network of collaborators facilitated participant recruitment. Students were surveyed on their perceived overall impact of Covid-19 on their training and several exposure variables. Univariate analyses and adjusted multivariable analysis were performed to determine strengths in associations.

Results

A total of 1604 eligible participants from 45 countries took part in this survey and 56.3% (n = 860) of these were female. The median age was 21 (Inter Quartile Range:21–23). Nearly half (49.6%, n = 796) of medical students were in their clinical years. The majority (n = 1356, 84.5%) were residents of a low or middle income country. A total of 1305 (81.4%) participants reported that the Covid-19 pandemic had an overall negative impact on their training. On adjusted analysis, being 21 or younger, females, those reporting a decline in conventional lectures and ward based teaching were more likely to report an overall negative impact on their training (p ≤ 0.001). However, an increase in clinical responsibilities was associated with lower odds of participants reporting a negative impact on training (p < 0.001). The participant’s resident nation economy and stage of training were associated with some of the participant training experiences surveyed (p < 0.05).

Conclusion

An international cohort of medical students reported an overall significant negative impact of the Covid-19 pandemic on their undergraduate training. The efficacy of novel virtual methods of teaching to supplement traditional teaching methods warrants further research.
Determinants of research productivity during postgraduate medical education: a structured review
Authors: Laupland Kevin B. , Edwards Felicity , Dhanani Jayesh
Published: November 2021

Background

Although formal participation in research is an integral and often mandatory component of clinical training programs, resulting productivity is highly variable. The objective of this review was to identify determinants of successful research performance among graduate medical education trainees.

Methods

A structured review of the published literature was performed by searching PubMed, CINAHL, and EMBASE from inception through to 7 April, 2021. Articles examining graduate medical education trainee research productivity evidenced by publications in peer-reviewed journals were included.

Results

Eighty-five articles were included of which most (66; 78%) were reported from the USA or Canada (10; 12%). A wide range of disciplines were represented with the most common being general surgery, internal medicine, orthopedic surgery, and pediatrics. Themes (number of reports) included trainee characteristics (n = 24), project characteristics (n = 8), mentoring/supervision (n = 11), and programmatic aspects (n = 57). Although variable results were observed, research productivity tended to be higher with prior research experience, later years of training, male gender, and pursuit of a postgraduate degree. Few project related aspects of success were identified. Trainee publication was associated with mentors with higher rank, publication productivity, and supportive academic environments. Training programs with organised programs/curricula including protection of time for research were associated with increased productivity as were provision of incentives or rewards but not mandatory requirements.

Conclusion

This review identifies several trainee characteristics, project and mentor aspects, and programmatic aspects associated with increased productivity that may serve as a useful resource for trainees and graduate medical education training programs.
Examining gender differentials and determinants of private health insurance coverage in Zambia
Authors: Mulenga James , Mulenga Mulenga C. , Musonda Katongo M. C. , Phiri Chilizani
Published: November 2021

Background

Health insurance is an essential aspect of healthcare. This is because it enables the insured to acquire timely and essential healthcare services, besides offering financial protection from catastrophic treatment costs. This paper seeks to establish gender differentials and determinants of health insurance coverage in Zambia.

Methods

The data used in this study was obtained from the 2018 Zambia Demographic and Health Survey. Data were analyzed using STATA 13.0 software and focused on descriptive and Probit regression analyses.

Results

The study reveals that for women and men, age, wealth category, education, and professional occupation are positively associated with health insurance while being self-employed in the agricultural sector negatively influences health insurance coverage for both sexes. Other variables have gender-specific effects. For instance, being in marital union and having a clerical occupation increases the probability of having health insurance for women while being in the services, skilled, and unskilled manual occupations increases the probability of having health insurance for men. Further, residing in rural areas reduces the probability of having health insurance for men.

Conclusion

The study concludes that there are differences in factors that influence health insurance between women and men. Hence, this study highlights the need to enhance health insurance coverage by addressing the different factors that influence health insurance coverage among men and women. These factors include enhancing education, job creation, diversifying insurance schemes, and gender consideration in the design of National Health Insurance Scheme.