bluuebunny/crossref_metadata_2025 huggingface dataset:
Adverse childhood experiences do not moderate the association between aggressive antisocial behavior and general disinhibition in a forensic psychiatric inpatient sample
Authors: Meddeb Adam , Berlin Johan , Laporte Natalie , Wallinius Märta
Published: October 2022

Adverse childhood experiences (ACE) and high levels of disinhibition have been associated with a variety of negative outcomes such as aggressive antisocial behavior (AAB). However, forensic psychiatric populations remain an understudied group in this field of research. This study aimed to fill that gap by investigating associations between ACE, AAB, and disinhibition in a forensic psychiatric sample. Furthermore, we aimed to explore such findings by investigating whether ACE might have a moderating effect on the association between disinhibition and AAB. A sample of forensic psychiatric patients (n = 89) was recruited from a high-security forensic psychiatric facility in Sweden. All study variables were moderately to strongly related to each other, although we found no moderating effect of ACE. Post hoc analysis indicated that our ACE items had differential effects on AAB scores, with placement outside the family home, absent parents, and parental drug abuse producing the largest effect on AAB levels. Our findings are in line with previous research demonstrating a significant and robust relationship between ACE, AAB, and disinhibition. Forensic psychiatric populations are exposed to high levels of both self-reported and documented ACE. This calls for trauma-informed care and highlights the importance of considering ACE in risk assessment, preventive work, and policy making.
A multi-level study on whether ethical climate influences the affective well-being of millennial employees
Authors: Su Wei , Hahn Juhee
Published: October 2022

Millennial employees are increasingly paying more attention to well-being in the workplace and it has become an important issue for managers. Given that millennial employees are more sensitive to ethical issues, this study began by analyzing an ethical element in the organization—the ethical climate—and explored whether millennial employees have higher affective well-being in organizations with a good ethical climate. We verified our hypotheses based on 288 valid questionnaires collected from 40 teams. The results showed that: (1) ethical climate was a positive predictor of millennial employees’ organizational citizenship behavior (OCB) and affective well-being, (2) employees’ OCB partially mediated the relationship between ethical climate and affective well-being, and (3) an employee’s moral identity effectively moderated the relationship between ethical climate and affective well-being, although it did not play a significant moderating role between ethical climate and OCB. These findings provide empirical support for applying situational strength and social information processing theories and emphasize the importance of cultivating an ethical climate in organizations.
Influential children in middle childhood peer culture: Effects of temperament and community culture
Authors: Martin Roy P. , Lease Audra Michele
Published: October 2022

For children in middle childhood, the social world, particularly the behavior and attitudes of their school peers, has been shown to be an important factor in their educational and mental health outcomes. In the school environment, some children seem to influence the attitudes and behavior of their peers more than others. The behavior patterns of children, as reflected in temperamental traits, have been shown to drive peer perception in important ways and might play a role in identifying the individuals and social processes that operate in peer influence. It seems likely that temperamental traits will have different effects on school peers, dependent on characteristics of the school attended. Fourth and fifth grade children from four rural counties in the southeastern portion of the United States were studied. Temperamental characteristics were assessed based on teacher perception of six characteristics. Peer perceptions of the extent to which each child was perceived to influence others in five areas of school culture (e.g., academics, sports) was measured through a peer nomination procedure. Additional status-related perceptions and behaviors of participating children were also assessed by peer nominations. Teacher ratings of temperamental behaviors were submitted to latent profile analyses resulting in a seven-cluster model. Results indicated temperamental profiles were significantly and meaningfully associated with peer perceptions of influence as well as social status. Further, demographic differences between two groups of schools were found to moderate the effects that temperament profile had on peer influence.
Teachers’ acculturation in culturally diverse schools - How is the perceived diversity climate linked to intercultural self-efficacy?
Authors: Ulbricht Jolina , Schachner Maja K. , Civitillo Sauro , Noack Peter
Published: October 2022

While in the school context, acculturation is often studied in relation to students of immigrant descent, the current study applies an acculturation framework to teachers mostly representing the mainstream culture. Specifically, we investigated whether teachers’ acculturation attitudes towards their students mediate effects of the perceived cultural diversity climate at school on teachers’ intercultural self-efficacy in culturally diverse classrooms. Analyses were based on reports of 186 teachers (14% of immigrant descent; Mage = 40.8; SDage = 11.8, 73% female) in 22 culturally diverse secondary schools in Southwest Germany. Path analyses indicated that perceived norms of cultural pluralism, and perceived norms of equality and inclusion are directly and positively associated with facets of intercultural self-efficacy. Moreover, teachers’ support for cultural maintenance amongst their students was associated with intercultural self- efficacy, but no mediation was found between climate and intercultural self-efficacy via acculturation attitudes. Implications for teacher training, educational practice and future research on the acculturation and adjustment of teachers in culturally diverse classrooms are discussed.
Romantic relationship satisfaction and phubbing: The role of loneliness and empathy
Authors: Zhan Siqun , Shrestha Silu , Zhong Nian
Published: October 2022

This study investigates the effects of loneliness and empathy on romantic relationship satisfaction and phubbing. Loneliness plays a mediating role in romantic relationship satisfaction and phubbing. The level of empathy moderates these mediating effects. Five hundred and four Chinese adults completed tests of romantic relationship satisfaction, phubbing, loneliness, and empathy. The results show that romantic relationship satisfaction is negatively correlated with phubbing. Loneliness mediates this process. Specifically, lower romantic relationship satisfaction leads to more phubbing by increasing loneliness. Our study also shows that the mediating relationship is moderated by the level of empathy. To be more specific, the higher the level of empathy, the stronger the impact of romantic relationship satisfaction on loneliness, and the more phubbing individuals exhibit.
Promoting language development in physically disabled adults through sports: The content and language integrated learning method
Authors: Bekirogulları Hasan , Burgul Nazım , Yagcı Emete
Published: October 2022

This study reports on the outcomes of a qualitative study which explores the perceptions of ten wheelchair basketball players of the implementation of a content and language integrated learning (CLIL) program. The participants were all members of the official wheelchair basketball team of the Sports Federation for the Disabled in North Cyprus. They were all young adults (18–35 years old) and their level of English language proficiency ranged from elementary to beginner. After a 4-month CLIL intervention period, the data were elicited through individual interviews from the participants. A qualitative analysis of the textual data revealed the themes such as improved self-image, high motivation, developed social skills, and better speaking skills in the target language. The results have a few practical implications for English such as foreign language teachers, sports coaches, and local disability committees.
Strategic orientation, business model innovation and corporate performance—Evidence from construction industry
Authors: Han Wucheng , Zhou Yang , Lu Ruoyu
Published: October 2022

In the highly competitive Chinese construction market, developing a strategic orientation alone fails to maintain the sustainable competitive advantage of firms. In this paper, the mechanism of strategic orientation and business model innovation on corporate performance in a dynamic environment is investigated. Based on a sample of 356 Chinese construction firms, the partial least squares structural equation modelling (PLS-SEM) was adopted to test the hypotheses. It is found that entrepreneurial orientation and market orientation affect corporate performance differently. Unlike market orientation, which directly affects corporate performance, entrepreneurial orientation through business model innovation exerts influence instead of direct affection. Business model innovation plays a fully mediating role between entrepreneurial orientation and corporate performance and partially between market orientation and corporate performance. Meanwhile, environmental dynamism can positively moderate the relationship between business model innovation and corporate performance. This paper deepens the research on strategic orientation, business model innovation and corporate performance. The findings can provide a reference for construction firm managers to develop strategies and conduct business model innovation, which can finally help seek sustainable development in a dynamic environment.
Identification of potential Mitogen-Activated Protein Kinase-related key genes and regulation networks in molecular subtypes of major depressive disorder
Authors: Chen Youfang , Zhou Feng , Lu Weicheng , Zeng Weian , Wang Xudong , Xie Jingdun
Published: October 2022

Background

Major depressive disorder (MDD) is a heterogeneous and prevalent mental disorder associated with increased morbidity, disability, and mortality. However, its underlying mechanisms remain unclear.

Materials and methods

All analyses were conducted based on integrated samples from the GEO database. Differential expression analysis, unsupervised consensus clustering analysis, enrichment analysis, and regulation network analysis were performed.

Results

Mitogen-activated protein kinase (MAPK) signaling pathway was identified as an associated pathway in the development of MDD. From transcriptional signatures, we classified the MDD patients into two subgroups using unsupervised clustering and revealed 13 differential expression genes between subgroups, which indicates the probably relative complications. We further illustrated potential molecular mechanisms of MDD, including dysregulation in the neurotrophin signaling pathway, peptidyl-serine phosphorylation, and endocrine resistance. Moreover, we identified hub genes, including MAPK8, TP53, and HRAS in the maintenance of MDD. Furthermore, we demonstrated that the axis of miRNAs-TFs-HRAS/TP53/MAPK8 may play a critical role in MDD.

Conclusion

Taken together, we demonstrated an overview of MAPK-related key genes in MDD, determined two molecular subtypes, and identified the key genes and core network that may contribute to the procession of MDD.
Shame and guilt activations: Associations and sociodemographic differences among ploysubstance abusers
Authors: Abbasi Najam ul Hasan , Iqbal Mujahid , Yan Yu , Mubarik Sumaira , Nadeem Muhammad , Turan Mehmet Behzat , Younas Romana
Published: October 2022

Objectives

Shame and guilt in polysubstance abusers are still understudied despite their significance in substance use disorders (SUD). The goal of the current study is to develop a better understanding of how shame and guilt interact among polysubstance abusers who are receiving residential treatment.

Methods

The sample of two hundred four males with SUD admitted to five rehabilitation centers from two cities in Pakistan participated in this study. For comparison, 215 age-matched healthy individuals were recruited (control). All participants reported their scores on the state shame and guilt scale (SSGS) and demographic form. A cross-sectional study design was adopted.

Results

The group with SUD reported greater activations on SGSS (r = 0.79, p < 0.001) as compared to healthy (control) individuals (r = 0.48, p < 0.001). Further, multivariate analysis indicated that people with SUD who were of older age, unemployed, living in a nuclear family system, with a higher level of education, and low income, experienced higher levels of shame and guilt. Multinomial logistic regression analysis revealed that people with SUD in the age group 41–60 years (OR 5.2, 95%CI 2.4–6.8), unemployed (OR 4.4, 95%CI 3.2–4.7), nuclear family system (OR 5.9, 95%CI 4.5–6.4) and low monthly income group (OR 5.4, 95%CI 3.5–5.8) had a significantly high risk of shame and guilt than the control group.

Conclusion

Findings of the current study indicate an association between shame and guilt activation and SUD. These results suggest that polysubstance users may benefit from therapeutic interventions to avoid a generalization of shame and guilt toward their substance use. Reducing shame and guilt should be considered a priority in treating adults with multiple SUD.
Evaluation of burnout among stay-behind healthcare workers during the current Omicron wave of COVID-19 in Taizhou, China
Authors: Pan Shuang-Jun , Qian Wei-Yan , Yang Yu-Pei , Zhang Mei-Xian , Hu Xiao-Ming , Chen Hai-Xiao , Tung Tao-Hsin
Published: October 2022

Background

Since February 2022, a new Omicron wave of COVID-19 emerged in Shanghai, China. Many healthcare workers came to Shanghai from hospitals of other parts of China as aid workers. Hospitals in areas with mild COVID-19 outbreaks will inevitably be understaffed, it is likely to cause job burnout of stay-behind healthcare workers. Stay-behind healthcare workers were those who had not been dispatched to support COVID-19 prevention and control in other regions. This study was designed to evaluate the burnout among stay-behind healthcare workers in the current COVID-19 Omicron wave in Taizhou, China.

Methods

A population-based, anonymous, cross-sectional online survey was designed in the Wen-Juan Xing platform. The survey was sent to all stay-behind healthcare workers of the hospital (n = 1739) from April 29 to May 3, 2022. The Maslach Burnout Inventory-General Survey (MBI-GS) was used for the burnout survey. For univariate analysis, the χ2 test and one way ANOVA were used to assess differences in categorical variables and continuous variables, respectively. The effect of independent associated risk factors on each type of burnout was examined using the multinomial logistic regression model.

Results

A total of 434 participants completed the survey invitation effectively. A total of 71.2% of stay-behind healthcare workers experienced burnout during COVID-19, including 54.8% experiencing mild to moderate burnout and 16.4% experiencing severe burnout. Night shift, depression, social support, positive coping and number of children appeared to be significantly related to mild to moderate burnout. Night shift, depression, social support, positive coping, number of children, professional title, and anxiety appeared to be significantly related to severe burnout.

Conclusion

Job burnout among stay-behind healthcare workers was an important problem during the current Omicron wave of COVID-19. Night shift, depression, social support, positive coping, and number of children were associated with mild to moderate and severe burnout. Anxiety and professional title were associated with severe burnout.
Associations of the serum kynurenine pathway metabolites with P50 auditory gating in non-smoking patients with first-episode schizophrenia
Authors: Yang Qingyan , Zhang Yong , Yang Kebing , Niu Yajuan , Fan Fengmei , Chen Song , Luo Xingguang , Tan Shuping , Wang Zhiren , Tong Jinghui , Yang Fude , Li Chiang-Shan R. , Tan Yunlong
Published: October 2022

Objective

Our study aimed to investigate the associations between the serum level of kynurenine pathway (KP) metabolites and P50 auditory gating in non-smoking patients with first-episode schizophrenia (FES).

Materials and methods

In this study, 82 non-smoking patients with FES and 73 healthy controls (HC). P50 auditory gating was measured using a fully functional digital 64-channel EEG system, and the components included S1 amplitude, S2 amplitude, gating ratio (S2/S1), and amplitude difference (S1–S2). Serum levels of kynurenine and kynurenine acid were assessed using a combination of liquid chromatography with tandem mass spectrometry. Psychopathology was assessed by the Positive and Negative Syndrome Scale (PANSS).

Results

The serum kynurenine (251.46 ± 65.93 ng/ml vs. 320.65 ± 65.89 ng/ml, t = –6.38, p < 0.001), and kynurenine acid levels (5.19 ± 2.22 ng/ml vs. 13.26 ± 4.23 ng/ml, t = –14.73, p < 0.001), S1 amplitude [2.88 (1.79, 3.78) μV vs. 3.08 (2.46, 4.56) μV, Z = –2.17, p = 0.030] and S1–S2 [1.60 (0.63, 2.49) μV vs. 1.92 (1.12, 2.93) μV, Z = –2.23, p = 0.026] in patients with FES were significantly lower than those in HC. The serum kynurenine and kynurenine acid levels were negatively associated with S1–S2 (r = –0.32, p = 0.004 and r = –0.42, p < 0.001; respectively) and positively correlated with S2/S1 ratio (r = 0.34, p = 0.002 and r = 0.35, p = 0.002; respectively) in patients.

Conclusion

Our findings suggested that neuroactive metabolites of the KP might play an important role in sensory gating deficit in first episode patients with schizophrenia. Furthermore, metabolites of the KP may be a new target for the treatment of cognitive impairments in schizophrenia.
Synthetic cannabinoid JWH-073 alters both acute behavior and in vivo/vitro electrophysiological responses in mice
Authors: Barbieri Mario , Tirri Micaela , Bilel Sabrine , Arfè Raffaella , Corli Giorgia , Marchetti Beatrice , Caruso Lorenzo , Soukupova Marie , Cristofori Virginia , Serpelloni Giovanni , Marti Matteo
Published: October 2022

JWH-073 is a synthetic cannabinoid (SCB) that is illegally marketed within an “herbal blend”, causing psychoactive effects more intense than those produced by Cannabis. Users report that JWH-073 causes less harmful effects than other SCBs, misrepresenting it as a “safe JWH-018 alternative”, which in turn prompts its recreational use. The present study is aimed to investigate the in vivo pharmacological activity on physiological and neurobehavioral parameters in male CD-1 mice after acute 1 mg/kg JWH-073 administration. To this aim we investigate its effect on sensorimotor (visual, acoustic, and tactile), motor (spontaneous motor activity and catalepsy), and memory functions (novel object recognition; NOR) in mice coupling behavioral and EEG data. Moreover, to clarify how memory function is affected by JWH-073, we performed in vitro electrophysiological studies in hippocampal preparations using a Long-Term Potentiation (LTP) stimulation paradigm. We demonstrated that acute administration of JWH-073 transiently decreased motor activity for up to 25 min and visual sensorimotor responses for up to 105 min, with the highest effects at 25 min (~48 and ~38%, respectively), while the memory function was altered up to 24 h (~33%) in treated-mice as compared to the vehicle. EEG in the somatosensory cortex showed a maximal decrease of α (~23%) and γ (~26%) bands at 15 min, β (~26%) band at 25 min, a maximal increase of θ (~14%) band at 25 min and δ (~35%) band at 2 h, and a significant decrease of θ (~18%), α (~26%), and β (~10%) bands during 24 h. On the other hand, EEG in the hippocampus showed a significant decrease of all bands from 10 min to 2 h, with the maximal effect at 30 min for θ (~34%) and γ (~26%) bands and 2 h for α (~36%), β (~29%), and δ (~15%) bands. Notably, the δ band significant increase both at 5 min (~12%) and 24 h (~19%). Moreover, in vitro results support cognitive function impairment (~60% of decrease) by interfering with hippocampal synaptic transmission and LTP generation. Our results suggest that JWH-073 deeply alters brain electrical responsiveness with minor behavioral symptoms. Thus, it poses a subtle threat to consumers who mistakenly consider it safer than other SCBs.
A comparison of rural–urban differences in out-of-pocket expenses among older Mexicans with diabetes
Authors: Rojas Alvarez Alfonso , Vazquez Christian E. , Lopez-Ortega Mariana , Angel Jacqueline L.
Published: October 2022

Objective

To compare total out-of-pocket expenses for physician visits and medications among older adults living with diabetes in Mexico from urban, semi-urban, and rural areas.

Methods

The sample included 2,398 Mexicans aged 65 years and older with self-reported diabetes from the 2018 Mexican Health and Aging Study. Out-of-pocket expenses for physician visits and medications were regressed on locality, controlling for several factors.

Results

The profile of those with higher out-of-pocket medication expenditures included rural localities, higher education, unmarried, depressive symptoms, participation in Seguro Popular, and lacking insurance. In the multivariate analysis, rural older adults with diabetes paid a higher amount in medication expenditures compared with other localities.

Conclusion

Differences in locality are closely tied to the effective implementation of Seguro Popular. Although this program has improved access to care, participants have higher out-of-pocket expenditures for medications than those on employer-based plans across all localities. Among all groups, the uninsured bare the highest burden of expenditures, highlighting a continued need to address health inequities for the most underserved populations.
Measuring spatial accessibility and supply-demand deviation of urban green space: A mobile phone signaling data perspective
Authors: Chen Jingyuan , Wang Cheng , Zhang Yunbin , Li Dan
Published: October 2022

The reasonable distribution of urban green space (UGS) is a topic that urban researchers have been exploring for a long time. Solving the imbalance between the supply and demand of UGS plays an important role in improving the health level of a city. This study examines the central urban area of Hefei as an example. We developed a modified Gaussian two-step floating catchment area method and used the path planning model of Gaode Map to evaluate the accessibility of UGS under different transportation modes and different time thresholds while integrating mobile phone signaling data. Additionally, a fine-scale analysis of the actual supply and demand relationship of UGS was conducted by integrating the accessibility evaluation results with the recreational situation of UGS to analyze the deviation of supply and demand to further discuss the spatial distribution equilibrium of UGS. The main conclusions are as follows. (1) The spatial distribution of UGSs in the central urban area of Hefei is uneven. Different time thresholds and different transportation modes have a significant impact on the UGS accessibility evaluation results. (2) With the increase in the time threshold or travel distance, the number of grids above the moderate accessibility level generally increases. The spatial distribution of the grids with moderate, high and highest accessibility level present different patterns of contiguous, clusters, and spots distribution. (3) After combining these results with the actual recreational situation of UGS, we found that the overall demand in the central urban area exceeds the supply at the 15-min threshold, while the overall supply exceeds the demand at the 30-min threshold. The grids with balanced supply and demand or more supply than demand have comprehensive parks with a moderate population density and strong road connectivity in the neighborhood. This study strengthens the data granularity and improves the accuracy of accessibility evaluation by integrating mobile phone signaling data with the path planning model of Gaode Map. Also, we evaluate the accessibility with multi-transport modes and different time thresholds, which can bring more practical guidance for optimizing the distribution of UGS.
Perspectives on exercise intensity, volume, step characteristics and health outcomes in walking for transport
Authors: Schantz Peter , Olsson Karin Sofia Elisabeth , Salier Eriksson Jane , Rosdahl Hans
Published: October 2022

Background

Quantification of movement intensity and energy utilization, together with frequency of trips, duration, distance, step counts and cadence, is essential for interpreting the character of habitual walking for transport, and its potential support of health. The purpose of the study is to illuminate this with valid methods and novel perspectives, and to thereby provide a new basis for characterizing and interpreting walking in relation to health outcomes.

Methods

Habitual middle-aged commuting pedestrians (males = 10, females = 10) were investigated in the laboratory at rest and with maximal treadmill and cycle ergometer tests. Thereafter, levels of oxygen uptake, energy expenditure, ventilation, heart rate, blood lactate, rated perceived exertion, cadence, number of steps, duration, distance, and speed were recorded during the normal walking commute of each participant in Greater Stockholm, Sweden. The number of commutes per week over the year was self-reported.

Results

Walking in the field demanded about 30% more energy per km compared to level treadmill walking. For both sexes, the walking intensity in field was about 46% of maximal oxygen uptake, and energy expenditure amounted to 0.96 kcal · kg−1 · km−1. The MET values (males: 6.2; females: 6.5) mirrored similar levels of walking speed (males: 5.7; females: 5.9 km · h−1) and levels of oxygen uptake (males: 18.6; females: 19.5 mL · kg−1 · min−1). The average number of MET-hours per week in a typical month was 22 for males and 20 for females. This resulted in a total weekly energy expenditure of ~1,570 and 1,040 kcal for males and females, respectively. Over the year, the number of walking commutes and their accumulated distance was ~385 trips and 800 km for both sexes.

Conclusion

Walking in naturalistic field settings demands its own studies. When males and females walk to work, their relative aerobic intensities and absolute energy demands for a given distance are similar. It is equivalent to the lower part of the moderate relative intensity domain. The combination of oxygen uptake, trip duration and frequency leads to high and sustained levels of MET-hours as well as energy expenditure per week over the year, with a clear health enhancing potential. Based on this study we recommend 6000 transport steps per day, or equivalent, during five weekdays, over the year, in order to reach optimal health gains.
Digital interventions to promote physical activity among inactive adults: A study protocol for a hybrid type I effectiveness-implementation randomized controlled trial
Authors: Zanaboni Paolo , Manskow Unn Sollid , Sagelv Edvard Hamnvik , Morseth Bente , Edvardsen Alf Egil , Aamot Inger-Lise , Nes Bjarne Martens , Hastings Bryce , Gagnon Marie-Pierre , Antypas Konstantinos
Published: October 2022

Introduction

Physical inactivity is the fourth leading risk factor for global mortality, and inactive adults have a higher risk to develop lifestyle diseases. To date, there is preliminary evidence of the efficacy of fitness technologies and other digital interventions for physical activity (PA) promotion. Intervention studies are needed to test the effectiveness and implementation of innovative PA promotion strategies.

Methods and analysis

The ONWARDS study is a hybrid type I effectiveness-implementation randomized control trial aiming at an inactive and presumably high-risk population living in Northern Norway. One hundred and eighty participants will be assigned to 3 groups in a 1:1:1 ratio and participate for 18 months. Participants in group A will be provided an activity tracker with the personalized metric Personal Activity Intelligence (PAI). Participants in group B will be provided with both an activity tracker with the personalized metric PAI and access to online training videos (Les Mills+) to perform home-based training. Participants in group C will be provided an activity tracker with the personalized metric PAI, home-based online training and additional peer support via social media. The primary objective is to test which combination of interventions is more effective in increasing PA levels and sustaining long-term exercise adherence. Secondary objectives include: proportion of participants reaching PA recommendations; exercise adherence; physical fitness; cardiovascular risk; quality of life; perceived competence for exercise; self-efficacy; social support; usability; users' perspectives on implementation outcomes (adoption, acceptability, adherence, sustainability). The study design will allow testing the effectiveness of the interventions while gathering information on implementation in a real-world situation.

Discussion

This study can contribute to reduce disparities in PA levels among inactive adults by promoting PA and long-term adherence. Increased PA might, in turn, result in better prevention of lifestyle diseases. Digital interventions delivered at home can become an alternative to training facilities, making PA accessible and feasible for inactive populations and overcoming known barriers to PA. If effective, such interventions could potentially be offered through national health portals to citizens who do not meet the minimum recommendations on PA or prescribed by general practitioners or specialists.

Trial registration

https://clinicaltrials.gov/ct2/show/NCT04526444, Registered 23 April 2021, identifier: NCT04526444.
A qualitative study of nursing practitioners' experiences with COVID-19 patients dying alone in Greece
Authors: Voultsos Polychronis , Tsompanian Anna , Deligianni Maria , Tsamadou Eftychia , Tsaroucha Alexandra K.
Published: October 2022

Background

In Greece, there is still limited research on death in isolation due to COVID-19. This deserves attention because of the recent financial crisis, which profoundly impacted public health, and the high relevance of the Hippocratic tradition to the moral values of clinical practice.

Methods

A prospective qualitative study using in-depth interviews with 15 frontline nursing practitioners working in a COVID-19 ward or intensive care unit (ICU) was conducted from July 2021 to December 2021.

Results

The inability of family members to say a final goodbye before, during, or after death by performing proper mourning rituals is extremely inhuman and profoundly impacts the mental health status of patients, family members, and nursing practitioners. Patients and their family members strongly desire to see each other. Epidemiology, liability, and proper nursing performance emerged as reasons for the enforced strict visitation restrictions. Participants emphasized that visitations should be allowed on an individual basis and highlighted the need for the effective use of remote communication technology, which, however, does not substitute for in-person contact. Importantly, physicians allowed “clandestine” visits on an individual basis. Nursing practitioners had a strong empathic attitude toward both patients and their families, and a strong willingness to provide holistic care and pay respect to dead bodies. However, they also experienced moral distress. Witnessing heartbreaking scenes with patients and/or their families causes nursing practitioners to experience intense psychological distress, which affects their family life rather than nursing performance. Ultimately, there was a shift from a patient-centered care model to a population-centered care model. Furthermore, we identified a range of policy- and culture-related factors that exaggerate the negative consequences of dying alone of COVID-19.

Conclusion

These results reinforce the existing literature on several fronts. However, we identified some nuances related to political decisions and, most importantly, convictions that are deeply rooted in Greek culture. These findings are of great importance in planning tailored interventions to mitigate the problem of interest and have implications for other similar national contexts.
25-OH vitamin D threshold for optimal bone mineral density in elderly patients with chronic kidney disease
Authors: Roy Debajyoti , Ng Chee Yong , Kog Zheng Xi , Yeon Wenxiang , Poh Cheng Boon , Koduri Sreekanth , Chionh Chang Yin , Sultana Rehena , Hai Kiat Puar Troy
Published: October 2022

Introduction: Vitamin D deficiency is common in chronic kidney disease (CKD) and is associated with lower bone mineral density (BMD), decreased muscle strength, and increased hip fracture risk. Guidelines have suggested targeting 25-OH vitamin D (25(OH)D) levels between 20 and 30 ng/ml. However, vitamin D metabolism is altered in CKD, and threshold levels for optimal BMD are unknown.

Methods: We included 1097 patients with hip fractures. CKD was defined as estimated glomerular filtration rate <60 ml/min/1.73 m (Mucsi et al., Clin. Nephrol., 2005, 64(4), 288–294) and low BMD defined as T score ≤ −2.5 at femoral neck. We assessed the association of 25(OH)D with low BMD in patients with and without CKD: using the conventional threshold 25(OH)D < 30 ng/dl, as well as a new threshold.

Results: CKD was present in 479 (44%) patients. Using a threshold of 25(OH)D < 30 ng/ml, there were no significant differences in patients with CKD and low BMD when compared to the other groups. We identified 27 ng/ml as a better threshold with the Youden index. Using 25(OH)D < 27 ng/ml as a threshold, 360 of 482 patients (74.7%) with low 25(OH)D had low BMD, compared to only 185/276 (67%) of patients with adequate vitamin D, p = 0.02, which was irrespective of the presence or absence of CKD. Furthermore, patients with CKD and 25(OH)D < 27 ng/ml had a higher odds ratio of mortality upon follow-up, 1.61, 95% CI: 1.08–2.39, compared to those with CKD and 25(OH)D ≥ 27 ng/ml.

Conclusion: We find that 25(OH)D < 27 ng/ml is associated with low BMD in patients with and without CKD. Further prospective studies targeting vitamin D repletion to at least 27 ng/ml and the outcome of hip fractures will be useful to validate these findings.
Deep learning prediction of two-dimensional ocean dynamics with wavelet-compressed data
Authors: Muhamed Ali Ali , Zhuang Hanqi , Ibrahim Ali K. , Wang Justin L. , Chérubin Laurent M.
Published: October 2022

This study addresses the challenge represented by the application of deep learning models to the prediction of ocean dynamics using datasets over a large region or with high spatial or temporal resolution In a previous study by the authors of this article, they showed that such a challenge could be met by using a divide and conquer approach. The domain was in fact split into multiple sub-regions, which were small enough to be predicted individually and in parallel with each other by a deep learning model. At each time step of the prediction process, the sub-model solutions would be merged at the boundary of each sub-region to remove discontinuities between consecutive domains in order to predict the evolution of the full domain. This approach led to the growth of non-dynamical errors that decreased the prediction skill of our model. In the study herein, we show that wavelets can be used to compress the data and reduce its dimension. Each compression level reduces by a factor of two the horizontal resolution of the dataset. We show that despite the loss of information, a level 3 compression produces an improved prediction of the ocean two-dimensional data in comparison to the divide and conquer approach. Our method is evaluated on the prediction of the sea surface height of the most energetic feature of the Gulf of Mexico, namely the Loop Current.
QUaRTM: A Quadcopter with Unactuated Rotor Tilting Mechanism capable of faster, more agile, and more efficient flight
Authors: Tang Jerry , Jain Karan P. , Mueller Mark W.
Published: October 2022

We present QUaRTM – a novel quadcopter design capable of tilting the propellers into the forward flight direction, which reduces the drag area and therefore allows for faster, more agile, and more efficient flight. The vehicle can morph between two configurations in mid-air, including the untilted configuration and the tilted configuration. The vehicle in the untilted configuration has a higher pitch torque capacity and a smaller vertical dimension. The vehicle in the tilted configuration has a lower drag area, leading to a higher top speed, higher agility at high speed, and better flight efficiency. The morphing is accomplished without any additional actuators beyond the four motors of a quadcopter. The rigid connections between the quadcopter frame and the quadcopter arms are replaced with sprung hinges. This allows the propellers to be tilted when high thrusts are produced, and recover to the untilted configuration when the thrusts are brought low. The effectiveness of such a vehicle is demonstrated by running experiments on a prototype vehicle with a shape similar to a regular quadcopter. Through the use of tilting, the vehicle is shown to have a 12.5% higher maximum speed, better high-speed agility as the maximum crash-free cruise speed increased by 7.5%, and a better flight efficiency as the power consumption has dropped by more than 20% in the speed range of 15–20 m s−1.
Oral infections in oral cancer survivors: A mini-review
Authors: Pispero Alberto , Lombardi Niccolò , Manfredi Maddalena , Varoni Elena Maria , Sardella Andrea , Lodi Giovanni
Published: October 2022

The oral cancer survivors are a group of special individuals whose disease affect anatomical structures with a key role in identity and communication and a fundamental role in basic human functions such as speaking, eating, swallowing and breathing. Thus, quality of life of these individuals can be impaired by the consequences of disease and treatments, in particular surgery and radiotherapy. Among others, infectious conditions of any nature, bacterial, viral, fungal, are a frequent finding among oral cancer survivors. In fact, the peculiar systemic and local conditions of these subjects are known to significantly modify the microbiota, which, besides facilitating opportunistic infections, can affect the cancer microenvironment, as well as alter the effects of the anti-cancer therapies. Similarly, mouth infections can also affect the prognosis of oral cancer survivors. Among the opportunistic infections, fungal are the most common infections affecting these subjects, since neutropenia resulting from cancer, as well as chemotherapy and/or radiotherapy treatments, promote the shift from the carrier state of Candida species, to pathogen state. Treatment of oral candidiasis can be difficult in oral cancer survivors, and good evidence supports clotrimazole as the most effective for prevention, and fluconazole as the one with the best risk-benefit profile. Probiotics, although promising, need better evidence to be considered an effective treatment or preventive measure.
Integration of life cycle assessment and life cycle costing within a BIM-based environment
Authors: Viscuso Salvatore , Monticelli Carol , Ahmadnia Amirhossein , Zanelli Alessandra
Published: October 2022

A building information modeling (BIM)-integrated workflow for quantifying and assessing the environmental and economic impacts during the life cycle of buildings is presented and deepened in this essay. With the support of digital methods and informative building models, these impacts can be scored through the analysis of variants and their weighted comparison. Through an optimized computational code, the semiautomatic calculation can directly link the results with the visualization tools (dashboards and colored 3D models), thus accelerating—and making it more accessible—the optioneering of multiple design alternatives during the project development.
Numerical and experimental investigations of uniform fluid distribution for droplet formation in parallelized microfluidics
Authors: Aladese Adedamola D. , Jeong Heon-Ho
Published: October 2022

Droplet microfluidics, which is the manipulation and handling of fluid in microscale channels, has excellent applications in material science, chemical synthesis, genetic analysis, drug discovery and delivery, organ on chips, and tissue engineering. Consequently, this field has attracted significant attention from both academic institutions and industries. However, one of the major constraints is increasing the droplet production rate from a single generator to thousands of generators in order to move from a laboratory scale to industrial standards. Although the scale-up method (in this case, parallelization) of droplet production using theoretical calculations has been extensively investigated, it has been discovered to be occasionally unreliable during experiments. The use of computational fluid dynamics (CFD) simulation, which has recently been applied to droplet microfluidics, has helped to determine the exact factors and conditions required for uniform droplet formation in flow-focusing devices. Thus far, there has been limited study on the simulation of distribution structures that effectively supply fluids to microfluidic devices in parallel orientation. In this study, CFD is used to provide detailed insights into the conditions required to achieve uniform fluid distribution in the delivery and/or distribution channel of microfluidic devices, and experimental analysis is used to further validate the findings.
Research advances in prevention and treatment of burn wound deepening in early stage
Authors: Lu Meiqi , Zhao Jie , Wang Xiaochuan , Zhang Jingjuan , Shan Fei , Jiang Duyin
Published: October 2022

The burn wound is a dynamic living environment that is affected by many factors. It may present a progressive expansion of necrosis into the initially viable zone of stasis within a short time postburn. Therefore, how to salvage of the zone of stasis is of crucial importance in prevention and treatment strategies of burn wound progressive deepening. This review focuses on the cellular basis of tissue injury and the current progress of prevention and treatment strategies of burn wound progressive deepening, in order to provide references for the treatment of burn wounds in the early phase.
Standard opioid-containing versus opioid-sparing anesthesia on early postoperative recovery after video-assisted thoracic surgery: A propensity-weighted analysis
Authors: Jiang Yan-yu , Li Zhen-ping , Yao Ming , Zhou Qing-he
Published: October 2022

Purpose

Opioids have several adverse effects. At present, there are no large clinical studies on the effects of opioid-sparing anesthesia on early postoperative recovery after thoracoscopic surgery. This study was to investigate the effects of opioid-sparing anesthesia on early postoperative recovery after thoracoscopic surgery.

Methods

Adult patients who underwent video-assisted thoracic surgery from 1 January 2019 to 28 February 2021 were enrolled by reviewing the electronic medical records. Participants were divided into opioid-sparing anesthesia (OSA group) and opioid-containing anesthesia (STD group) based on intraoperative opioid usage. The propensity-score analysis was to compare the early postoperative recovery of two groups. The outcome measurements included the incidence of postoperative nausea and vomiting (PONV) during an entire hospital stay, need for rescue antiemetic medication, postoperative-pain episodes within 48 h after surgery, need for rescue analgesia 48 h postoperatively, duration of postoperative hospital stay, length of PACU stay, postoperative fever, postoperative shivering, postoperative atrial fibrillation, postoperative pulmonary infection, postoperative hypoalbuminemia, postoperative hypoxemia, intraoperative blood loss, and intraoperative urine output.

Results

A total of 1,975 patients were identified. No significant difference was observed in patient characteristics between the OSA and STD groups after adjusting for propensity score-based inverse probability treatment weighting. The incidence of postoperative nausea and vomiting was significantly lower in the OSA group than in the STD group (14.7% vs. 18.9%, p = 0.041). The rescue antiemetic use rate was lower in the OSA group than in the STD group (7.5% vs.12.2%; p = 0.002). PACU duration was longer in the OSA group than in the STD group (70.8 ± 29.0 min vs. 67.3 ± 22.7 min; p = 0.016). The incidence of postoperative fever was higher in the STD group than that in the OSA group (11.0% vs.7.7%; p = 0.032). There were no differences between the groups in terms of other outcomes.

Conclusions

Our results suggest that opioid-sparing anesthesia has a lower incidence of postoperative complications than opioid-based anesthetic techniques.
Comparison of 5-year outcomes and quality of life between endovenous laser (980 nm) and microwave ablation combined with high ligation for varicose veins
Authors: Fan Pengcheng , Cong Longlong , Dong Jian , Han Yang , Yang Lin
Published: October 2022

Our study aims to evaluateand compare the long-term results of endovenous laser (EVLA) and microwave ablation (EMA) combined with high ligation in treating varicose veins (VVs). A total of 122 patients (150 legs) underwent EMA combined with high ligation, and 127 patients (167 legs) underwent EVLA procedures (980 nm) combined with high ligation in this retrospective study. Outcomes included the Aberdeen Varicose Vein Questionnaire (AVVQ) score, the Venous Clinical Severity Score (VCSS), clinical recurrence of VVs and patient satisfaction duringthe 5-year follow-up.During the 5-year follow-up, patients who underwent the EVLA procedure showed a higher recurrence of VVs than those who underwent the EMA procedure (22.75% vs. 13.33%, P = 0.03, odds ratio (OR): 1.91, 95% confidence interval (CI): 1.06–3.45), especially at the primary site (6% vs. 14.37%, P = 0.01; OR: 2.63; 95% CI: 1.21–5.72). VV recurrence within 3 years was higher in patients who underwent EVLA than in those who underwent the EMA procedure (73.68% vs. 40%, P = 0.01; OR: 4.2; 95% CI: 1.37–12.86). Compared with those at baseline, the AVVQ score, VCSS and EQ-5D score improved significantly at 5 years for patients who underwent either procedure (P < 0.01); however, the VCSS and AVVQ score were higher for patients who underwent the EVLA procedure (P = 0.05). The patient reintervention rate was higher for EVLA than for EMA (14.79% vs. 7.33%, P = 0.033; OR: 2.19; 95% CI: 2.06–5.34). Our results confirmed that EMA and EVLA improve the QoL of patients and that EMA combined with high ligation demonstrates lower 5-year recurrence, especially at primary sites.