bluuebunny/crossref_metadata_2025 huggingface dataset:
Understanding teacher emotional exhaustion: exploring the role of teaching motivation, perceived autonomy, and teacher–student relationships
Authors: Wang Xiaoyu , Yang Li , Chen Kun , Zheng Yanan
Published: January 2024

Introduction

This research investigates the complex interplay of factors influencing teacher emotional exhaustion within the educational environment. It draws upon a diverse sample of 680 teachers from 15 primary educational institutions in various districts of Shanghai, China.

Methods

The study examines the interrelationships among teacher-student relationships, perceived autonomy, teaching motivation, and emotional exhaustion. It employs validated scales to measure these constructs and utilizes Structural Equation Modeling (SEM) for analysis.

Results

The analyses using SEM reveal significant associations among the variables under study. The findings indicate robust correlations between positive teacher-student relationships, perceived autonomy, and higher teaching motivation. Concurrently, these factors exhibit a negative relationship with emotional exhaustion.

Discussion

Mediation analysis further unveils that teaching motivation plays a significant mediating role in the associations between teacher-student relationships, perceived autonomy, and emotional exhaustion. This emphasizes the intricate indirect effects of these constructs.

Conclusion

The study underscores the multifaceted nature of these factors and their collective impact on teacher well-being within educational settings. The implications derived highlight the importance for educational institutions to prioritize interventions fostering positive teacher-student relationships, autonomy-supportive environments, and intrinsic motivation among educators. These interventions aim to alleviate emotional exhaustion and enhance teacher well-being.
Optimizing methadone dose adjustment in patients with opioid use disorder
Authors: Liu Po-Shen , Kuo Teng-Yao , Chen I-Chun , Lee Shu-Wua , Chang Ting-Gang , Chen Hou-Liang , Chen Jun-Peng
Published: January 2024

Introduction

Opioid use disorder is a cause for concern globally. This study aimed to optimize methadone dose adjustments using mixed modeling and machine learning.

Methods

This retrospective study was conducted at Taichung Veterans General Hospital between January 1, 2019, and December 31, 2020. Overall, 40,530 daily dosing records and 1,508 urine opiate test results were collected from 96 patients with opioid use disorder. A two-stage approach was used to create a model of the optimized methadone dose. In Stage 1, mixed modeling was performed to analyze the association between methadone dose, age, sex, treatment duration, HIV positivity, referral source, urine opiate level, last methadone dose taken, treatment adherence, and likelihood of treatment discontinuation. In Stage 2, machine learning was performed to build a model for optimized methadone dose.

Results

Likelihood of discontinuation was associated with reduced methadone doses (β = 0.002, 95% CI = 0.000–0.081). Correlation analysis between the methadone dose determined by physicians and the optimized methadone dose showed a mean correlation coefficient of 0.995 ± 0.003, indicating that the difference between the methadone dose determined by physicians and that determined by the model was within the allowable range (p < 0.001).

Conclusion

We developed a model for methadone dose adjustment in patients with opioid use disorders. By integrating urine opiate levels, treatment adherence, and likelihood of treatment discontinuation, the model could suggest automatic adjustment of the methadone dose, particularly when face-to-face encounters are impractical.
Positive effect of Balint group on burnout and self-efficacy of head nurses in China: a randomized controlled trial
Authors: Shan Qu , Leonhart Rainer , Zhijuan Xie , Minjie Zheng , Xinxin Shi , Xinzhu Bai , Xiangyan Kong , Fritzsche Kurt
Published: January 2024

Background

Burnout is common among nurses and can lead to negative outcomes of medical care. This study aimed to explore the effectiveness of Balint groups to reduce burnout in head nurses in a Chinese hospital.

Methods

This was a randomized controlled trial with a pre- and post-test. A total of 80 head nurses were randomly assigned to either a Balint group (n = 40) or a control group (n = 40). Participants participated in Balint group for a period of 3 months. Participants in both groups completed the Maslach Burnout Inventory-Human Services Survey and the General Self-Efficacy Scale at the beginning and end of the study. Balint group members also completed the Group Climate Questionnaire-Short Form.

Results

In the Balint group, 33 participants attended all Balint groups, while the 40 participants in the control group had no intervention. Analysis of variance with repeated measures demonstrated a statistically significant difference on the Maslach Burnout Inventory subscale of sense of personal achievement (F = 9.598, p = 0.003) between the Balint and control groups. However, there were no significant differences between the groups on the subscales of emotional exhaustion (F = 0.110, p = 0.740) and depersonalization (F = 0.75, p = 0.387), and the General Self-Efficacy Scale (F = 0.709, p = 0.403).

Conclusions

Balint groups helped reduce burnout among head nurses in terms of personal achievement.
The impact of the pandemic on mothers and children, with a focus on syndemic effects on black families: the “Prenatal to Preschool” study protocol
Authors: Njoroge Wanjikũ F. M. , Tieu Tiffany , Eckardt Devlin , Himes Megan , Alexandre Christina , Hall Waynitra , Wisniewski Kate , Popoola Ayomide , Holloway Kayla , Rodriguez Yuheiry , Kornfield Sara , Momplaisir Florence , Wang Xi , Gur Raquel , Waller Rebecca
Published: January 2024

Introduction

Racism, a known social determinant of health, affects the mental health and well-being of pregnant and postpartum women and their children. Convincing evidence highlights the urgent need to better identify the mechanisms and the ways in which young children’s development and mental health are adversely impacted by their mothers’ experiences of racism. With the additional stressor of the COVID-19 pandemic, the criticality of improving knowledge of these domains has never been starker. The proposed project will address these questions and move the field forward to create targeted, culturally informed preventative interventions, thus achieving mental health equity for all children and families.

Methods

This prospective research is a cohort study that will longitudinally observe the outcomes of a cohort of mothers and their children recruited during the initial phase of the COVID-19 pandemic. Data will be parent/caregiver questionnaires assessing mental health, racism, support, and resilience at multiple time points with the first beginning at 24 months, clinical interviews with mothers, electronic medical records of mothers, and videotaped dyadic interactions at child age 24 and 48 months. A subset of Black participants will be asked to participate in qualitative interviews at child age 36 months.

Results

Analyze will be performed within and across Black and Non-Latino/a/e/x white (NLW) groups, and comparing mothers and fathers/secondary caregivers. Descriptive and multivariate analyzes will be run to better characterize how young children’s development and mental health may be adversely impacted by their caregiver’s experiences of racism.

Discussion

This prospective longitudinal mixed-methods study evaluates the simultaneous effects of the COVID-19 pandemic and racism on mothers and their developing children to characterize cross-racial differences, providing insight into risk and resilience factors in early development and the peripartum period.
Persistence of stigma and the cessation of substance use: comparing stigma domains between those who currently use and those who no longer use substances
Authors: Patel Krishna , Pokorski Emily , Norkoli Donna , Dunkel Emily , Wang Xinyue , Yang Lawrence H.
Published: January 2024

Introduction

Cessation of substance use, a facet of recovery, as well as mitigating stigma experienced by individuals with substance use disorder (SUD), are important to supporting health and well-being of those who use substances. But there is limited and mixed evidence on whether cessation of substance use has a positive impact on individuals’ stigma experiences. This study examined whether there were differences in stigma perceptions between those who self-report using substances and those who self-report not currently using substances associated with their SUD.

Materials and methods

A survey was conducted among individuals in 10 counties of Michigan with self-identified history with SUD. The survey aimed to understand five dimensions of stigma perceptions: enacted stigma, anticipated stigma, internalized stigma, social withdrawal, and treatment stigma. Survey items for each measure were adapted from prior literature. The mean was calculated for each stigma measure for analyses. Data analyses tested whether there were significant differences in each of the five stigma domains between the two groups using either regression or t-test, depending on the necessity to include covariates.

Results

Findings suggested that among the five stigma domains, only internalized stigma showed statistically significant differences between the two groups (b = 0.19, se = 0.08, p < 0.05) after adjusting for covariates (as needed). Those who were no longer using substances had lower internalized stigma compared to those who were currently using substances associated with their SUD. Analyses suggested that the other four stigma domains, enacted stigma, anticipated stigma, social withdrawal, and treatment stigma, did not show statistically significant differences between the two groups.

Discussion

While self-stigmatization (i.e., internalized stigma) was lower among those who report no longer using, our patterns suggest a persistence of stigma regardless of cessation of substances associated with SUD, particularly among stigma domains that are based on perceptions of how others may still perceive individuals who have used substances. Though more research is needed, results suggest that public health programmatic, policy, and campaign efforts that aim to eliminate stigma should account for and tailor to both people who report using and those who report no longer using substances to capture the breadth of needs in communities.
The efficacy and safety of acupoint catgut embedding therapy for depression: a protocol for systematic review and meta-analysis
Authors: Li Yadi , Zhou Jianlong , Wei Zheng , He Xia , Liang Lizhu , Sunzi Kejimu
Published: January 2024

Background

Depression is a common public health problem, characterized by persistent low mood, lack of pleasure and exhaustion. Conventional treatments such as antidepressants and psychotherapy have some limitations, including variable efficacy, adverse side effects and high costs. Acupoint catgut embedding (ACE) therapy, as a subtype of acupuncture, has gained increasing clinical application due to its long-term effects, higher patient compliance, and cost-effectiveness. This study aims to conduct a meta-analysis to evaluate the efficacy and safety of ACE for depression.

Methods

Electronic searches will be conducted in 12 databases (both in English and Chinese databases), encompassing from inception to April 2022, without language restrictions. Randomized controlled trials (RCTs) that involve ACE for treating depression will be included. The primary outcome measures will include the response rate, Hamilton Depression Rating Scale (HAMD), Beck Depression Inventory (BDI), and Traditional Chinese Medicine Symptom Scale (TCMSSS). The secondary outcome measure will include Quality of Life scale score (QoL) and the incidence of adverse events. Results will be presented as risk ratios for dichotomous data and mean differences for continuous data. Two reviewers will independently conduct study selection, data extraction, and quality assessment. The methodological quality of eligible studies will be evaluated according to the criteria specified by the Cochrane Handbook for Systematic Reviews of Interventions (Version 5.1.0). Meta-analysis will be performed by RevMan 5.3 software.

Discussion

Due to the limitations, a safer, high-efficacy and non-pharmacological intervention with minimal side effects is required for treating depression. ACE has the advantages of longer-lasting effects, improved patient compliance, and reduced treatment costs. This protocol represents a meta-analysis and systematic review, aiming to present the current evidence regarding the efficacy and safety of ACE for depression. It seeks to provide clinicians with a theoretical basis and valuable references for complementary and alternative medicine therapies in their treatment approaches.

Systematic review registration

https://www.crd.york.ac.uk/PROSPERO/#recordDetails, Identifier CRD42022325966.
A systematic review of approaches to improve medication adherence in homeless adults with psychiatric disorders
Authors: Hird Rachel , Radhakrishnan Rajiv , Tsai Jack
Published: January 2024

Introduction

Medication non-adherence is a significant problem among homeless individuals with psychiatric disorders in the United States. We conducted a systematic review to identify strategies to improve psychiatric medication adherence among homeless individuals with psychiatric disorders, including substance use disorders.

Methods

We searched seven databases (MEDLINE, Embase, PsychInfo, Scopus, Web of Science, CDSR, and CENTRAL) and screened 664 studies by title and abstract followed by full-text review. Our inclusion criteria were studies that: involved an intervention for homeless adults with psychiatric disorders, reported a quantitative outcome of medication adherence, and were published in English in a peer-reviewed journal. We rated the relative effectiveness of strategies described in each study using a self-designed scale.

Results

Eleven peer-reviewed studies met criteria for inclusion in this review. Within these studies, there were seven different approaches to improve medication adherence in this population. Three studies were randomized controlled trials (RCTs) and the remaining were observational studies. Outpatient interventions included Assertive Community Treatment, Cell Phone-Assisted Monitoring, Customized Adherence Enhancement plus Long-Acting Injectable Medications, and Homeless-Designated Pharmacy Clinics. Residential, shelter-based, and inpatient interventions included use of the Housing First model, Modified Therapeutic Communities, and Homeless-Designated Inpatient Care. The approaches described in four of the eleven studies were rated as scoring a 3 or higher on a 5-point scale of effectiveness in improving medication adherence; none received 5 points.

Discussion

The interventions with the strongest evidence for improving medication adherence in this population were Assertive Community Treatment, Customized Adherence Enhancement plus Long-Acting Injectable Medications, and Housing First. Overall, studies on this topic required more rigor and focus on medication adherence as an outcome in this population. This review highlights several promising strategies and the need for larger RCTs to determine effective and diverse ways to improve medication adherence among homeless adults with psychiatric disorders.
Assessment of knowledge and practice of nurses regarding infection prevention and associated factors at Debre Tabor Comprehensive Specialized Hospital, Northwest Ethiopia
Authors: Tafere Tesfahun Zemene , Belachew Tadele Biresaw , Feleke Dejen Getaneh , Adal Gashaw Mekete
Published: January 2024

Background

Healthcare-Acquired Infections have a major negative impact on the global healthcare delivery system, resulting in increased morbidity and mortality and excessive healthcare resource utilization. Infection prevention and control is the main healthcare agenda nationwide. However, it remains a challenge to achieving Sustainable Development Goals regarding healthcare issues. This study aims to assess nurses' knowledge and practice regarding infection prevention and associated factors at Debre Tabor Comprehensive Specialized Hospital, Northwest Ethiopia.

Methods

An institutional-based cross-sectional study was carried out from May 1 2021 to June 30 2021 at Debre Tabor Comprehensive Specialized Hospital, Ethiopia. A total of 219 nurses participated in this study. A stratified random sampling technique with a pre-tested structured self-administered questionnaire was used to collect data. A Multivariable logistic regression model was fitted to identify factors associated with the knowledge and practice of nurses regarding infection prevention.

Result

The current study shows that the overall knowledge and practice of nurses regarding infection prevention are 59.4% (95% CI: 53.0–65.8) and 53% (95% CI: 46.6–59.4), respectively. Educational level of diploma [AOR: 0.8, 95% CI: 0.67–0.83], years of work experience ≤ 10 [AOR: 1.7, 95% CI: 1.3–9.28], and being trained in infection prevention [AOR: 2.5 (2.3–8.0)] were found to be factors that affect the knowledge of nurses about infection prevention. Moreover, ≤ 10 years of work experience [AOR = 1.5, 95% CI: 1.2–10.1] and being trained in infection prevention [AOR = 2.2, 95% CI: 1.94–13.5] were found to be factors that affect the practice of nurses regarding infection prevention.

Conclusions and recommendations

Most nurses were knowledgeable and had good practices. However, a substantial proportion of nurses had inadequate knowledge and practice regarding infection prevention. The nurses' knowledge and practice were associated with years of work experience and status of training on infection prevention. Moreover, the education level of nurses was another predictor variable of the knowledge of nurses. Therefore, healthcare workers in the hospital setting should adhere to the national infection prevention protocols. The policy designers should provide training for nurses on infection prevention to improve knowledge and practice in this area. Furthermore, to attain more detailed information, future research should involve a qualitative study.
Impact of leisure satisfaction on perceived risk of infectious disease during the COVID-19 pandemic: evidence from new worker classes
Authors: Kim Young-Jae , Ban Young-Min , Kang Seung-Woo
Published: January 2024

Introduction

This study examines how job market changes affect individuals’ leisure choices and satisfaction, focusing on worker classes that have undergone daily life changes (e.g., economic and social activities) due to the coronavirus disease-2019 (COVID-19) pandemic.

Methods

A population-based cross-sectional study design was employed. South Korean workers aged 20–59 years answered an online survey administered from September 14 to October 4, 2021. Ultimately, 764 responses were used in the analysis. The measures used in this study consisted of factors affecting infectious disease risk perception and leisure satisfaction among the six new worker classes that emerged during the pandemic, according to socio-demographic status.

Results

The results showed that among male participants, social, emotional, physical, environmental, and educational factors of leisure satisfaction were more strongly affected, with higher social, physical, and interpersonal relationships being factors in the perception of infectious disease risk. Among female participants, the interpersonal relationship factor of perceived risk was significantly affected by the social, emotional, and educational factors of leisure satisfaction. Interpersonal relationships, affected leisure satisfaction among members of Classes 1–3, who experienced no change in pay. However, for the members of Class6 who experienced a decrease in pay, the economic factor negatively affected leisure satisfaction and played a pivotal role in our findings.

Conclusion

This study verified the risk factors that inhibit leisure satisfaction among new worker classes that emerged during the COVID-19 pandemic. Furthermore, the psychological health of people suffering pandemic-related financial constraints was affected, as they experienced a lower quality of life owing to reduced leisure activities and satisfaction.
Thirty-two-year trends of cancer incidence by sex and cancer site in the Veneto Region from 1987 to 2019
Authors: Buja Alessandra , De Luca Giuseppe , Zorzi Manuel , Bovo Emanuela , Mocellin Simone , Trevisiol Chiara , Bronte Vincenzo , Guzzinati Stefano , Rugge Massimo
Published: January 2024

Background

This observational study considers the sex-specific incidence of the most incident cancers as recorded in the population-based Veneto Regional Cancer Registry over a period of more than 30 years (1987-2019).

Methods

The Veneto Regional Cancer Registry collected data for the time interval 1987–2019. Significant changes in incidence trends calculated on age-standardized incidence rates (Annual Percent Change—APC) were identified by join point regression analysis.

Results

Overall, the incidence trend for all cancers decreased in males and remained stable in females. In nine cancer sites, the incidence trends showed consistent differences by sex (oral cavity, esophagus, colon rectum and anus, liver, larynx, lung, cutaneous malignant melanoma, bladder, and thyroid gland). Other malignancies did not show significant sex-related differences (stomach, pancreas, biliary tract, kidney/urinary tract, central nervous system, multiple myeloma, non-Hodgkin lymphoma, and leukemia).

Conclusion

In the period 1987–2019, this study revealed sex-related differences in cancer incidence trends. Over time, cancer incidence remained higher in males, with a decreasing epidemiological impact, plausibly resulting from prevention campaigns against environmental cancer risk factors, as tobacco and alcohol. Conversely, a significant decrease was not observed in the incidence trend in females. These findings contribute essential insights for profiling the epidemiological map of cancer in a large Italian population, allowing comparison with other European cancer epidemiology studies and providing updated data supporting sex-related primary and secondary cancer prevention strategies.
Prevalence of depressive symptoms and correlates among individuals who self-reported SARS-CoV-2 infection after optimizing the COVID-19 response in China
Authors: Wei Liangjia , Qin Jiao , Lin Zhifeng , Huang Xinju , He Jinfeng , Yu Dee , Zhang Fei , Li Sisi , Cen Ping , Li Mu , Luo Tong , Zhang Rongjing , Zhong Shanmei , Qin Cai , Li Zeyu , Yang Yuan , Pan Huiqi , Zhao Mengdi , Wu Xiaoqiong , Jiang Junjun , Liang Hao , Ye Li , Liang Bingyu
Published: January 2024

Background

The burden of depression symptoms has increased among individuals infected with SARS-CoV-2 during COVID-19 pandemic. However, the prevalence and associated factors of depressive symptoms among individuals infected with SARS-CoV-2 remain uncertain after optimizing the COVID-19 response in China.

Methods

An online cross-sectional survey was conducted among the public from January 6 to 30, 2023, using a convenience sampling method. Sociodemographic and COVID-19 pandemic-related factors were collected. The depression symptoms were assessed using the Patient Health Questionnaire-9 (PHQ-9). Logistic regression analysis was performed to explore the associated factors with depressive symptoms.

Results

A total of 2,726 participants completed the survey. The prevalence of depression symptoms was 35.3%. About 58% of the participants reported experiencing insufficient drug supply. More than 40% of participants reported that they had missed healthcare appointments or delayed treatment. One-third of participants responded experiencing a shortage of healthcare staff and a long waiting time during medical treatment. Logistic regression analysis revealed several factors that were associated with depression symptoms, including sleep difficulties (OR, 2.84; 95% CI, 2.34–3.44), chronic diseases (OR, 2.15; 95% CI, 1.64–2.82), inpatient treatment for COVID-19 (OR, 3.24; 95% CI, 2.19–4.77), with COVID-19 symptoms more than 13 days (OR, 1.30, 95% CI 1.04–1.63), re-infection with SARS-CoV-2 (OR, 1.52; 95% CI, 1.07–2.15), and the increased in demand for healthcare services (OR, 1.32; 95% CI, 1.08–1.61).

Conclusion

This study reveals a moderate prevalence of depression symptoms among individuals infected with SARS-CoV-2. The findings underscore the importance of continued focus on depressive symptoms among vulnerable individuals, including those with sleeping difficulties, chronic diseases, and inpatient treatment for COVID-19. It is necessary to provide mental health services and psychological interventions for these vulnerable groups during the COVID-19 epidemic.
Is it time to switch to a formulation other than the live attenuated poliovirus vaccine to prevent poliomyelitis?
Authors: Devaux Christian Albert , Pontarotti Pierre , Levasseur Anthony , Colson Philippe , Raoult Didier
Published: January 2024

The polioviruses (PVs) are mainly transmitted by direct contact with an infected person through the fecal-oral route and respiratory secretions (or more rarely via contaminated water or food) and have a primary tropism for the gut. After their replication in the gut, in rare cases (far less than 1% of the infected individuals), PVs can spread to the central nervous system leading to flaccid paralysis, which can result in respiratory paralysis and death. By the middle of the 20th century, every year the wild polioviruses (WPVs) are supposed to have killed or paralyzed over half a million people. The introduction of the oral poliovirus vaccines (OPVs) through mass vaccination campaigns (combined with better application of hygiene measures), was a success story which enabled the World Health Organization (WHO) to set the global eradication of poliomyelitis as an objective. However this strategy of viral eradication has its limits as the majority of poliomyelitis cases today arise in individuals infected with circulating vaccine-derived polioviruses (cVDPVs) which regain pathogenicity following reversion or recombination. In recent years (between January 2018 and May 2023), the WHO recorded 8.8 times more cases of polio which were linked to the attenuated OPV vaccines (3,442 polio cases after reversion or recombination events) than cases linked to a WPV (390 cases). Recent knowledge of the evolution of RNA viruses and the exchange of genetic material among biological entities of the intestinal microbiota, call for a reassessment of the polio eradication vaccine strategies.
Study on the health risk of cyanuric acid in swimming pool water and its prevention and control measures
Authors: Chen Zhe , Su Yi , Chen Jian , Li Zhu , Wang Ting
Published: January 2024

Cyanuric acid is a widely used fine chemical intermediate that acts as a free chlorine buffer in swimming pool water, wherein it is often used as a stabilizer to maintain the germicidal efficacy of chlorinated disinfectants. However, it has also been associated with health risks. Herein, we introduced the sources and functions of cyanuric acid in swimming pool water, focusing on potential health risks associated with excessive concentration of the component and the current control standards worldwide. Also, the prevention and control measures were summarized in terms of physical chemistry, biodegradation, and ultraviolet radiation to provide a basis for the development of public health policies for swimming pool management.
Acute health symptoms related to perception and practice of pesticides use among farmers from all regions of Thailand
Authors: Sapbamrer Ratana , Sittitoon Nalin , Thongtip Sakesun , Chaipin Eakasit , Sutalangka Chatchada , Chaiut Wilawan , La-up Aroon , Thirarattanasunthon Phiman , Thammachai Ajchamon , Suwannakul Boonsita , Sangkarit Noppharath , Kitro Amornphat , Panumasvivat Jinjuta
Published: January 2024

Introduction

Occupational exposure to pesticides may cause acute health effects for farmers and agricultural workers. Therefore, this study aims to investigate the prevalence of poisoning symptoms related pesticide exposure among farmers from all regions of Thailand, as well as factors linked to poisoning symptoms of neurological and neuromuscular systems, the respiratory system, and eye and skin disorders.

Methods

A cross sectional study was conducted in 4,035 farmers who lived in four regions of Thailand. The samples were chosen using stratified random sampling, with 746 for the Central region, 2,065 for the North-East, 586 for the North, and 638 for the South.

Results

The results found that the highest prevalence of poisoning symptoms was found in association with neurological and neuromuscular systems (75%), followed by the respiratory system (60.4%), the eyes (41.2%), and skin (14.8%). The most prevalent symptoms were muscle pain (49%) for neurological and neuromuscular symptoms, burning nose (37.6%) for respiratory symptoms, itchy eyes (26.3%) for eye symptoms, and rashes (14.4%) for skin symptoms. The remarkable findings were that types of pesticide use, task on the farm, types of pesticide sprayers, and perception are the crucial factors affecting all poisoning symptoms.

Discussion

The findings are also beneficial to the Thai government and other relevant organizations for launching measures, campaigns, or interventions to lower modifiable risk factors, resulting in reducing health risks associated with pesticide exposure.
Anxiety and associated factors in Northwest Ethiopian pregnant women: a broad public health concern
Authors: Haile Tsion Tadesse , Kebede Azmeraw Ambachew , Gessesse Dereje Nibret , Tsega Nuhamin Tesfa , Aklil Mastewal Belayneh , Temesgan Wubedle Zelalem , Anteneh Tazeb Alemu , Tibebu Nebiyu Solomon , Alemu Haymanot Nigatu , Seyoum Asmra Tesfahun , Tiguh Agumas Eskezia , Yismaw Ayenew Engida , Mihret Muhabaw Shumye , Nenko Goshu , Wondie Kindu Yinges , Taye Birhan Tsegaw , Abegaz Marta Yimam
Published: January 2024

Introduction

Pregnancy-related anxiety is a prevalent mental health issue that mostly affects women in low-income countries such as Ethiopia. It has been linked to unfavorable pregnancy outcomes, such as miscarriage, prematurity, and low birth weight. However, it has often received less attention, and community-based evidence lacks its prevalence and associated factors. Thus, the purpose of this study was to assess the prevalence and associated factors of anxiety in Northwest Ethiopian pregnant women in Gondar city.

Methods

A community-based cross-sectional study was conducted from 1 July to 30 August 2021 in Gondar city. A cluster sampling technique was used to select a sample of 872 pregnant women, and in-person interviews were conducted to gather data. Descriptive and analytical statistical procedures were carried out.

Results

Of the participants, pregnancy-related anxiety was reported in 29.4% (95% CI: 26.3, 32.4) of women. The likelihood of having anxiety was higher among women who had known medical illness (AOR = 3.16; 95% CI: 1.8, 5.35), loneliness (AOR = 2.52; 95% CI: 1.34, 4.73), depression (AOR = 2.38; 95% CI: 1.48, 3.85), poor social support (AOR = 1.93; 95% CI: 1.21, 3.07), and intimate partner violence (AOR = 2.87; 95% CI: 2.04, 4.04).

Conclusion

In this study, three out of ten women have suffered from anxiety. It is strongly advised to identify and treat known medical illnesses early in pregnancy, enhance social support, diagnose and treat depression, and limit intimate partner violence through multimodal and integrative activities with concerned bodies.
Peer effects and health impacts of different body cognitive biases in children: micro evidence from China
Authors: Zhang Yun , Wang Xueying , Zhu Weiqiang
Published: January 2024

Background

In China, children commonly display body cognitive biases, which constitute a significant yet hidden public health issue. These biases potentially jeopardize children’s well-being, hinder the cultivation of human capital, and impede societal progress. However, limited research employs theoretical analysis and econometric testing to investigate the formation of different body cognitive biases among Chinese children and their health impacts.

Methods

Based on a local average network model for theoretical analysis, this study utilizes a sample of 4,289 children from four phases of the China Health and Nutrition Survey (CHNS) conducted from 2004 to 2011. Utilizing Logit and IV Probit models, systematically evaluate the peer effect, heterogeneity of effects, and health impacts of children’s different body cognitive biases.

Results

(1) The peer effect contributes to the development of light- and heavy-body cognitive biases in Chinese children. (2) The heterogeneity analysis shows that the peer effect of body cognitive biases is more significant in rural and female children. (3) The influence of heavy-body cognitive bias is more pronounced in adolescent children. (4) The “eating-activity balance” is disrupted by the two body cognitive biases in children, leading to deviations from normal body type. (5) Specifically, the light-body cognitive bias leads children to intake more and burn fewer calories, increasing their risk of obesity. (6) Conversely, the heavy-body cognitive bias prompts children to intake less and expend more calories, resulting in a higher prevalence of thinness.

Discussion

This study innovates by exploring peer effects on body cognitive biases in Chinese children, elucidating their direction and health implications. While overweight and obesity are recognized as overt health issues, the spread and impact of implicit issues like body cognitive biases should not be overlooked. Nevertheless, the issue is largely neglected in developing countries, such as China, where existing children’s health policies are inadequate in addressing it. Promoting accurate body image perception and understanding of health prevention strategies among children requires adequate attention to peer effects.
Regional geographies and public health lessons of the COVID-19 pandemic in the Arctic
Authors: Tiwari Sweta , Petrov Andrey N. , Golosov Nikolay , Devlin Michele , Welford Mark , DeGroote John , Degai Tatiana , Ksenofontov Stanislav
Published: January 2024

Objectives

This study examines the COVID-19 pandemic’s spatiotemporal dynamics in 52 sub-regions in eight Arctic states. This study further investigates the potential impact of early vaccination coverage on subsequent COVID-19 outcomes within these regions, potentially revealing public health insights of global significance.

Methods

We assessed the outcomes of the COVID-19 pandemic in Arctic sub-regions using three key epidemiological variables: confirmed cases, confirmed deaths, and case fatality ratio (CFR), along with vaccination rates to evaluate the effectiveness of the early vaccination campaign on the later dynamics of COVID-19 outcomes in these regions.

Results

From February 2020 to February 2023, the Arctic experienced five distinct waves of COVID-19 infections and fatalities. However, most Arctic regions consistently maintained Case Fatality Ratios (CFRs) below their respective national levels throughout these waves. Further, the regression analysis indicated that the impact of initial vaccination coverage on subsequent cumulative mortality rates and Case Fatality Ratio (CFR) was inverse and statistically significant. A common trend was the delayed onset of the pandemic in the Arctic due to its remoteness. A few regions, including Greenland, Iceland, the Faroe Islands, Northern Canada, Finland, and Norway, experienced isolated spikes in cases at the beginning of the pandemic with minimal or no fatalities. In contrast, Alaska, Northern Sweden, and Russia had generally high death rates, with surges in cases and fatalities.

Conclusion

Analyzing COVID-19 data from 52 Arctic subregions shows significant spatial and temporal variations in the pandemic’s severity. Greenland, Iceland, the Faroe Islands, Northern Canada, Finland, and Norway exemplify successful pandemic management models characterized by low cases and deaths. These outcomes can be attributed to successful vaccination campaigns, and proactive public health initiatives along the delayed onset of the pandemic, which reduced the impact of COVID-19, given structural and population vulnerabilities. Thus, the Arctic experience of COVID-19 informs preparedness for future pandemic-like public health emergencies in remote regions and marginalized communities worldwide that share similar contexts.
Enhancing pedestrian perceived safety through walking environment modification considering traffic and walking infrastructure
Authors: Kim Yeonjoo , Choi Byungjoo , Choi Minji , Ahn Seunghui , Hwang Sungjoo
Published: January 2024

Urban policies have recently been formulated, following the increasing interest in pedestrian-friendly cities, people-centered safety, and accessibility. Despite the research efforts on physical walking safety, safety evaluations centered on pedestrian perception have been under-reported. Investigating the factors affecting pedestrian subjective safety perception is critical to promoting walking intention because pedestrians forgo walking if they feel unsafe. This study explored the relationship between various walking environmental factors and pedestrians’ psychological perception of safety by surveying 99 pedestrians’ perceptions at nine study sites and conducting a field investigation. Because of the multifaceted nature of pedestrian perception, mediation effect analyses were also conducted to understand the relationship between walking environment factors and perceived safety in depth, considering the role of the perception of traffic characteristics and walking infrastructure. This study found that walking environmental factors closely related to physical safety (e.g., traffic safety facilities and crosswalks) may not greatly contribute to perceived safety and demonstrated that maintaining infrastructure quality is essential for enhancing perceived safety, considering the mediating effect of the perception of infrastructure on perceived safety. The results imply that to improve the walking environment, it is necessary to consider both the physical safety and the perceived safety of pedestrians. This requires comprehensive planning for enhancing traffic safety facilities as well as ensuring user comfort and pleasure through quality infrastructure. This study can provide a basis for enhancing pedestrian-centered safety and promoting residents’ walking intention for public health while increasing their perceptions of safety.
Determinants of physical activity behavior among older adults with subjective cognitive decline based on the capability, opportunity, motivation, and behavior model: mediating and moderating effects
Authors: Chen Yiping , Li Wei , Yang Hui
Published: January 2024

Background

PA is vital for secondary prevention in older adults with subjective cognitive decline (SCD), but their physical activity (PA) levels are low, and the underlying interaction pathways among associated factors are poorly understood. This study aims to identify mediating and moderating effects of determinants on PA behavior in older adults with SCD using the capability, opportunity, motivation, and behavior model.

Methods

Following the STROBE checklist, we conducted a cross-sectional survey among 289 older adults with SCD. Path regression, mediation effects, and moderation effects were used to explore the associated factors of PA behavior and the associations among these variables.

Results

The prevalence of physical inactivity among older adults with SCD was high (40.3%). The path model fit indices were χ2/df = 1.145, GFI = 0.968, CFI = 0.988, and RMSEA = 0.022. Path regression revealed that frailty, physical and social support, PA motivation, and fall history had significant direct association with PA behavior. PA motivation not only partially mediates between frailty and PA behavior but also partially mediates between physical and social support and PA behavior. Additionally, fall history moderated the relationship between frailty and PA behavior.

Conclusion

PA behavior in older adults with SCD requires improvement. Healthcare professionals should devise more effective interventions to boost PA behavior by enhancing motivation. Screening for frailty and addressing fall history, while providing sufficient physical and social support, is crucial.
Argument-based inductive logics, with coverage of compromised perception
Authors: Bringsjord Selmer , Giancola Michael , Govindarajulu Naveen Sundar , Slowik John , Oswald James , Bello Paul , Clark Micah
Published: January 2024

Formal deductive logic, used to express and reason over declarative, axiomatizable content, captures, we now know, essentially all of what is known in mathematics and physics, and captures as well the details of the proofs by which such knowledge has been secured. This is certainly impressive, but deductive logic alone cannot enable rational adjudication of arguments that are at variance (however much additional information is added). After affirming a fundamental directive, according to which argumentation should be the basis for human-centric AI, we introduce and employ both a deductive and—crucially—an inductive cognitive calculus. The former cognitive calculus, DCEC, is the deductive one and is used with our automated deductive reasoner ShadowProver; the latter, IDCEC, is inductive, is used with the automated inductive reasoner ShadowAdjudicator, and is based on human-used concepts of likelihood (and in some dialects of IDCEC, probability). We explain that ShadowAdjudicator centers around the concept of competing and nuanced arguments adjudicated non-monotonically through time. We make things clearer and more concrete by way of three case studies, in which our two automated reasoners are employed. Case Study 1 involves the famous Monty Hall Problem. Case Study 2 makes vivid the efficacy of our calculi and automated reasoners in simulations that involve a cognitive robot (PERI.2). In Case Study 3, as we explain, the simulation employs the cognitive architecture ARCADIA, which is designed to computationally model human-level cognition in ways that take perception and attention seriously. We also discuss a type of argument rarely analyzed in logic-based AI; arguments intended to persuade by leveraging human deficiencies. We end by sharing thoughts about the future of research and associated engineering of the type that we have displayed.
Predicting disease onset from electronic health records for population health management: a scalable and explainable Deep Learning approach
Authors: Grout Robert , Gupta Rishab , Bryant Ruby , Elmahgoub Mawada A. , Li Yijie , Irfanullah Khushbakht , Patel Rahul F. , Fawkes Jake , Inness Catherine
Published: January 2024

Introduction

The move from a reactive model of care which treats conditions when they arise to a proactive model which intervenes early to prevent adverse healthcare events will benefit from advances in the predictive capabilities of Artificial Intelligence and Machine Learning. This paper investigates the ability of a Deep Learning (DL) approach to predict future disease diagnosis from Electronic Health Records (EHR) for the purposes of Population Health Management.

Methods

In this study, embeddings were created using a Word2Vec algorithm from structured vocabulary commonly used in EHRs e.g., Systematized Nomenclature of Medicine Clinical Terms (SNOMED CT) codes. This study is based on longitudinal medical data from ~50 m patients in the USA. We introduced a novel method of including binned observation values into an embeddings model. We also included novel features associated with wider determinants of health. Patient records comprising these embeddings were then fed to a Bidirectional Gated Recurrent Unit (GRU) model to predict the likelihood of patients developing Type 2 Diabetes Mellitus, Chronic Obstructive Pulmonary Disorder (COPD), Hypertension or experiencing an Acute Myocardial Infarction (MI) in the next 3 years. SHapley Additive exPlanations (SHAP) values were calculated to achieve model explainability.

Results

Increasing the data scope to include binned observations and wider determinants of health was found to improve predictive performance. We achieved an area under the Receiver Operating Characteristic curve value of 0.92 for Diabetes prediction, 0.94 for COPD, 0.92 for Hypertension and 0.94 for MI. The SHAP values showed that the models had learned features known to be associated with these outcomes.

Discussion

The DL approach outlined in this study can identify clinically-relevant features from large-scale EHR data and use these to predict future disease outcomes. This study highlights the promise of DL solutions for identifying patients at future risk of disease and providing clinicians with the means to understand and evaluate the drivers of those predictions.
Expression, purification and folding of native like mitochondrial carrier proteins in lipid membranes
Authors: Tabefam Marzieh , Smith Matthew D. , Jelokhani-Niaraki Masoud
Published: January 2024

Mitochondrial Carrier Family proteins (MCFs) are located in the mitochondrial inner membrane and play essential roles in various cellular processes. Due to the relatively low abundance of many members of the family, in vitro structure and function determination of most MCFs require over-expression and purification of recombinant versions of these proteins. In this study, we report on a new method for overexpression of MCFs in Escherichia coli (E. coli) membranes, efficient purification of native-like proteins, and their reconstitution in mitochondrial inner membrane lipid mimics. cDNAs of Uncoupling Protein 4 (UCP4), Adenine Nucleotide Translocase (ANT) and Phosphate Translocase (PiT) were subcloned into the pET26b (+) expression vector such that fusion proteins with a short N-terminal pelB leader sequence and a six-histidine tag were produced to target the proteins toward the inner membrane of E. coli and facilitate affinity purification, respectively. Utilizing a modified autoinduction method, these proteins were overexpressed and extracted from the membrane of E. coli BL21 (DE3) and two modified strains, E. coli BL21 C43 (DE3) and E. coli BL21 Lobstr (DE3), in high yields. The proteins were then purified by immobilized metal affinity chromatography as monomers. Purity, identity, and concentration of the eluted monomers were determined by semi-native SDS-PAGE, Western blotting and mass spectrometry, and a modified Lowry assay, respectively. Cleavage of the pelB leader sequence from proteins was verified by mass spectrometric analysis. The purified proteins, surrounded by a shell of bacterial membrane lipids, were then reconstituted from the mild non-denaturing octyl glucoside (OG) detergent into phospholipid liposomes. Monomeric UCP4 spontaneously self-associated to form stable tetramers in lipid membranes, which is consistent with our previous studies. However, PiT and ANT remained dominantly monomeric in both detergent and liposome milieus, as detected by a combination of spectroscopic and electrophoretic methods. Native-like helical conformations of proteins were then confirmed by circular dichroism spectroscopy. Overall, this study demonstrates that targeting mitochondrial carrier family proteins to E. coli membranes provides an effective expression system for producing this family of proteins for biophysical studies.