bluuebunny/crossref_metadata_2025 huggingface dataset:
Wading through Molasses: A qualitative examination of the experiences, perceptions, attitudes, and knowledge of Australian medical practitioners regarding medical billing
Authors: Faux Margaret , Adams Jon , Dahiya Simran , Wardle Jon
Published: January 2022

Background

Medical billing errors and fraud have been described as one of the last “great unreduced healthcare costs,” with some commentators suggesting measurable average losses from this phenomenon are 7% of total health expenditure. In Australia, it has been estimated that leakage from Medicare caused by non-compliant medical billing may be 10–15% of the scheme’s total cost. Despite a growing body of international research, mostly from the U.S, suggesting that rather than deliberately abusing the health financing systems they operate within, medical practitioners may be struggling to understand complex and highly interpretive medical billing rules, there is a lack of research in this area in Australia. The aim of this study was to address this research gap by examining the experiences of medical practitioners through the first qualitative study undertaken in Australia, which may have relevance in multiple jurisdictions.

Method

This study interviewed 27 specialist and general medical practitioners who claim Medicare reimbursements in their daily practice. Interviews were recorded, transcribed, and analysed using thematic analysis.

Results

The qualitative data revealed five themes including inadequate induction, poor legal literacy, absence of reliable advice and support, fear and deference, and unmet opportunities for improvement.

Conclusion

The qualitative data presented in this study suggest Australian medical practitioners are ill-equipped to manage their Medicare compliance obligations, have low levels of legal literacy and desire education, clarity and certainty around complex billing standards and rules. Non-compliant medical billing under Australia’s Medicare scheme is a nuanced phenomenon that may be far more complex than previously thought and learnings from this study may offer important insights for other countries seeking solutions to the phenomenon of health system leakage. Strategies to address the barriers and deficiencies identified by participants in this study will require a multi-pronged approach. The data suggest that the current punitive system of ensuring compliance by Australian medical practitioners is not fit for purpose.
Internet-based supply chain financing-oriented risk assessment using BP neural network and SVM
Authors: Fu Weiqiong , Zhang Hanxiao , Huang Fu
Published: January 2022

To better prevent the potential risks in Internet-based Supply Chain Financing (SCF) products, this paper optimizes and evaluates the Internet-based SCF-oriented Credit Risk Evaluation (CRE) method. Firstly, this paper summarizes 12 risk factors of SCF business, establishes a Risk Assessment Index System (RAIS) with good consistency and stability; then, the principles of Backpropagation (BP) Neural Network (NN) is expounded together with Support Vector Machines (SVM) and Genetic Algorithm (GA) model. Consequently, a CRE model is implemented by the NN tools in MATLAB based on the collection of multiple groups of SCF-oriented risk assessment samples. Subsequently, the assessment samples are trained and tested. Finally, the SCF-oriented CRE model is proposed and verified. The results show that the BP-GA model has presented high prediction consistency with the actual classification. According to the comparison of classification results of SVM, BP model, and BP-GA model, the classification accuracy of test samples of the proposed Internet-based SCF-oriented CRE system using BP-GA model reaches 97.19%; the Type I and Type II error rate of the CRE system based on BP-GA model is 7.2% and 14.21%, respectively. Therefore, a suitable SCF-oriented CRE method is put forward for China’s commercial banks along with scientific and feasible suggestions to manage SCF-oriented credit risks more reasonably and effectively.
Changes in self-reflective thinking level in writing and educational needs of medical students: A longitudinal study
Authors: Park Kwi Hwa , Kam Bee Sung , Yune So Jung , Lee Sang Yeoup , Im Sun Ju
Published: January 2022

Introduction

The purpose of this study was to longitudinally examine the change in understanding of the self-reflection method, reflective thinking, and writing attitude and perception. Moreover, we investigated students’ educational needs and methods regarding self-reflection.

Methods

The subjects were 117, who were in the pre-medical course in 2017 and were promoted to the medical course in 2019. Questions concerning students’ understanding of self-reflection methods, their attitude and perception of reflective writing, and educational needs and methods regarding self-reflection were self-developed. For students’ reflective thinking level in writing, we used the approach developed by Galvez-Martin, Bowman, and Morrison and adapted by Kwon. For dada analysis, χ2test, t-test, frequency analysis was used.

Results

We found that students’ level of understanding regarding self-reflection methods increases slightly, but not significant (χ2= 2.238, p>0.05). There was no significant change in the level of reflective thinking in writing (χ2= 8.003, p>0.05). The students’ attitude toward reflective writing decreased in the medical course than in the pre-medical course (t = 3.475, p<0.001). The perception that reflective writing was helpful for individual improvement decreased during the medical course (t = 4.931, p<0.001). The need for self-reflection education increased in the medical course (t = -2.659, p<0.001). They preferred implementation in the first year of the medical course as an instructor-led special lecture.

Conclusion

Self-reflective ability is not naturally developed as students’ progress through grade levels. Educational intervention is needed to help students understand approaches to self-reflection and its importance in enabling them to develop their abilities as well as to participate actively in reflective writing.
School anxiety profiles in Spanish adolescents and their differences in psychopathological symptoms
Authors: Fernández-Sogorb Aitana , Sanmartín Ricardo , Vicent María , Gonzálvez Carolina , Ruiz-Esteban Cecilia , García-Fernández José Manuel
Published: January 2022

School anxiety and psychopathological symptoms tend to co-occur across development and persist in adulthood. The present study aimed to determine school anxiety profiles based on Lang’s model of the triple response system (cognitive anxiety, psychophysiological anxiety, and behavioral anxiety) and to identify possible differences between these profiles in psychopathological symptoms (depression, hostility, interpersonal sensitivity, somatization, anxiety, psychoticism, obsessive-compulsive, phobic anxiety, and paranoid ideation). The School Anxiety Inventory (SAI) and the Symptom Assessment-45 Questionnaire (SA-45) were administered to 1525 Spanish students (49% girls) between 15 and 18 years old (M = 16.36, SD = 1.04). Latent Profile Analysis identified four school anxiety profiles: Low School Anxiety, Average School Anxiety, High School Anxiety, and Excessive School Anxiety. A multivariate analysis of variance revealed statistically significant differences among the school anxiety profiles in all the psychopathological symptoms examined. Specifically, adolescents with Excessive School Anxiety showed significantly higher levels of the nine psychopathological symptoms than their peers with Average School Anxiety and Low School Anxiety. In addition, the Excessive School Anxiety profile scored significantly higher in phobic anxiety than the High School Anxiety group. These findings allow to conclude that it is necessary enhance well-being and reduce psychopathology of those adolescents who manifest high and very high reactivity in cognitive, psychophysiological, and behavioral anxiety.
Prospective observational study investigating the effectiveness, safety, women’s experiences and quality of life at 3 months regarding cervical ripening methods for induction of labor at term—The MATUCOL study protocol
Authors: Ducarme Guillaume , Martin Stephanie , Chesnoy Veronique , Planche Lucie , Berte Marie-Pierre , Netier-Herault Elodie
Published: January 2022

Background

The purposes of successful induction of labor (IOL) are to shorten the time for IOL to delivery, increase the vaginal delivery rate, and reduce the rate of maternal and neonatal morbidity. In cases of unfavorable cervix (Bishop score <6), cervical ripening is advised to improve vaginal delivery rate. It may be initiated by mechanical (double balloon catheter (DBC), synthetic osmotic dilator) or pharmacologic (prostaglandins) methods, and the problem is complex due to the multitude of cervical ripening methods. We are constantly looking for the optimal protocol of cervical ripening for each woman. The present study aims to elucidate whether cervical ripening method is associated with increase rate of vaginal delivery, good women’s experience and unaltered long-term quality of life after cervical ripening at term regarding maternal and obstetric characteristics.

Methods and design

The MATUCOL study is a monocentric, prospective, observational study of all consecutive women who required cervical ripening (Bishop score <6) using different methods (DBC, vaginal dinoprostone, oral misoprostol) with a live fetus at term (≥37 weeks) between January 2020 and August 2021. The outcomes will be mode of delivery, maternal and neonatal morbidity, discomfort/pain assessments during cervical ripening, women’s experience and satisfaction, and the impact of cervical ripening on the health-related quality of life at 3 months. If it reports a significant efficacy/safety/perinatal morbidity/women’s satisfaction/quality of life at 3 months post-delivery associated with a method of cervical ripening in a specific situation (gestational and/or fetal disease) using a multivariate analysis, its use should be reconsidered in clinical practice.

Discussion

This study will reveal that some cervical ripening methods will be more effectiveness, safe, with good women’s experiences and QOL at 3 months compared to others regarding maternal and obstetric characteristics.

Trial registration

This study is being performed at La Roche sur Yon Hospital following registration as GNEDS on January 8, 2020.
Perceptions towards charcoal-burning suicide and the surge of this lethal method in Taiwan
Authors: Pan Yi-Ju , Loi Mei-Xian , Lan Yin-Hsiang , Chen Chun-Lin , Cheng I-Chih
Published: January 2022

Objective

Whether sociocultural perceptions of charcoal-burning suicide have influenced its rapid increase in prevalence is unclear. We aimed to explore perceptions of Taiwan’s general population regarding charcoal-burning suicide, their personal belief in life after death, and related feelings of thoughts associated with those who attempt charcoal-burning suicide.

Methods

An online web-based survey, focussing on sociocultural attitudes towards death, as well as perceptions towards charcoal-burning suicide, and those who attempt charcoal-burning suicide, was conducted from 14 January to 14 June 2016.

Results

In total, 1343 adults completed the online survey (mean age of 33.46; 66.6% women). Notably, 90.3% of participants considered charcoal burning to be an easily accessible suicide method. Multivariable analyses revealed that among the examined factors, the perceived ‘painlessness’ of charcoal-burning suicide was associated with an over seven-fold increased risk of choosing charcoal-burning suicide (OR = 7.394; p < 0.001; 95% CI: 2.614–20.912).

Conclusion

As reflected in this study, charcoal-burning suicide is perceived as easily accessible and painless. The perceived ‘painlessness’ may be the factor that distinguishes the choice of charcoal-burning suicide from that of other suicide methods. Future efforts to target these perceptions regarding charcoal-burning suicide may be warranted in both media reporting and suicide prevention programmes.
Cryptotanshinone inhibits proliferation and induces apoptosis of breast cancer MCF-7 cells via GPER mediated PI3K/AKT signaling pathway
Authors: Shi Danning , Li Hongbo , Zhang Zeye , He Yueshuang , Chen Meng , Sun Liping , Zhao Piwen
Published: January 2022

G protein-coupled estrogen receptor (GPER) was reported to be a potential target in the breast cancer therapy. This study aimed to illuminate the function of GPER and its mediated PI3K/AKT pathway in cryptotanshinone (CPT) inducing cell apoptosis and antiproliferation effect on GPER positive breast cancer MCF-7 cells. Cell proliferation was tested by MTT assay. Apoptosis rates were tested by Annexin V-FITC/PI double staining and the cell cycle was researched by flow cytometry. Autodock vina was applied to make molecular docking between CPT or estradiol and GPER. siRNA technique and GPER specific agonist G-1 or antagonist G-15 were applied to verify the mediated function of GPER. Apoptosis and cell cycle related proteins, as well as the key proteins on PI3K/AKT signaling pathway were detected by western blot. The results indicated that CPT could exert antiproliferation effects by arresting cell cycle in G2/M phase and downregulating the expression of cyclin D, cyclin B and cyclin A. Besides, apoptosis induced by CPT was observed. CPT might be a novel GPER binding compounds. Significantly, suppression of PI3K/AKT signal transduction by CPT was further increased by G-1 and decreased by G-15. The study revealed that the effect of antiproliferation and apoptosis treating with CPT on MCF-7 cells might be through the downregulation of PI3K/AKT pathway mediated by activated GPER.
Serotype-specific effectiveness against pneumococcal carriage and serotype replacement after ten-valent Pneumococcal Conjugate Vaccine (PCV10) introduction in Pakistan
Authors: Nisar Muhammad Imran , Jehan Fyezah , Shahid Shahira , Ahmed Sheraz , Shakoor Sadia , Kabir Furqan , Hotwani Aneeta , Muneer Sahrish , Khalid Farah , Muhammad Sajid , Althouse Benjamin M. , Hu Hao , Whitney Cynthia G. , Ali Asad , Zaidi Anita K. M. , Omer Saad B. , Iqbal Najeeha
Published: January 2022

Objective

Pakistan was one of the first South-Asian countries to introduce the ten-valent pneumococcal conjugate vaccine (PCV10) at the national level, using a 3+0 schedule without catchup, in 2013.

Methods

From 2014–18, fifteen children <2 years old were recruited every week in Matiari, Sindh, and nasopharyngeal swabs were collected. The samples were cultured, and pneumococcus was further serotyped through multiplex PCR at the Aga Khan University Hospital as per the method described by the Centers for Disease Control and Prevention, USA.

Results

Pneumococcus was detected in 2370/3140 (75%) children. Vaccine type (VT) and non-vaccine type (NVT) serotypes were carried by 379 and 1990 children. There was a significant decline in VT carriage (by 40.3%, p-value <0.001), whereas overall NVT carriage remained the same. The prevalence of VT serotypes 6B, 9V/9A, and 19F showed a significant decline by 58.8%, 79.3%, and 56%, respectively. The prevalence of NVT serotypes 19A, 21, and 10A increased by 70%, 33.3%, and 65.6%, respectively, whereas serotypes 13 and 9N/9L decreased by 53.4% and 51.8%, respectively. Serotype-specific vaccine effectiveness estimates that reached statistical significance were for 9V/9A (VE = 65.0, 95% CI 26.0–83.5%), 19F (VE = 55.3, 95% CI 15.5–76.4%) and for the vaccine related serotype 6A (VE = 28.4, 95% CI 0.9–48.2%).

Conclusion

The emergence of NVT serotypes, primarily 19A replacing VT serotypes in this rural community, necessitates continuous monitoring of serotypes in the carriage and invasive disease to evaluate the utility of existing vaccine formulations.
Automated analysis of facial emotions in subjects with cognitive impairment
Authors: Jiang Zifan , Seyedi Salman , Haque Rafi U. , Pongos Alvince L. , Vickers Kayci L. , Manzanares Cecelia M. , Lah James J. , Levey Allan I. , Clifford Gari D.
Published: January 2022

Differences in expressing facial emotions are broadly observed in people with cognitive impairment. However, these differences have been difficult to objectively quantify and systematically evaluate among people with cognitive impairment across disease etiologies and severity. Therefore, a computer vision-based deep learning model for facial emotion recognition trained on 400.000 faces was utilized to analyze facial emotions expressed during a passive viewing memory test. In addition, this study was conducted on a large number of individuals (n = 493), including healthy controls and individuals with cognitive impairment due to diverse underlying etiologies and across different disease stages. Diagnoses included subjective cognitive impairment, Mild Cognitive Impairment (MCI) due to AD, MCI due to other etiologies, dementia due to Alzheimer’s diseases (AD), and dementia due to other etiologies (e.g., Vascular Dementia, Frontotemporal Dementia, Lewy Body Dementia, etc.). The Montreal Cognitive Assessment (MoCA) was used to evaluate cognitive performance across all participants. A participant with a score of less than or equal to 24 was considered cognitively impaired (CI). Compared to cognitively unimpaired (CU) participants, CI participants expressed significantly less positive emotions, more negative emotions, and higher facial expressiveness during the test. In addition, classification analysis revealed that facial emotions expressed during the test allowed effective differentiation of CI from CU participants, largely independent of sex, race, age, education level, mood, and eye movements (derived from an eye-tracking-based digital biomarker for cognitive impairment). No screening methods reliably differentiated the underlying etiology of the cognitive impairment. The findings provide quantitative and comprehensive evidence that the expression of facial emotions is significantly different in people with cognitive impairment, and suggests this may be a useful tool for passive screening of cognitive impairment.
Time to breastfeeding cessation and its predictors among mothers who have children aged two to three years in Gozamin district, Northwest Ethiopia: A retrospective follow-up study
Authors: Tsega Tilahun Degu , Tafere Yilkal , Ashebir Wassachew , Asmare Biachew
Published: January 2022

Introduction

Globally, breastfeeding duration is below the recommended level. In Ethiopia, more than 24% of mothers ceased breastfeeding before 24 months of age of a child which caused 14,000 preventable childhood deaths annually. To tackle this problem, current and up-to-date information regarding the time to breastfeeding cessation and its predictors is essential. Therefore, this study aims to determine the time to breastfeeding cessation and its predictors among mothers who have children aged two to three years in Gozamin district, Northwest Ethiopia.

Methods

A community-based retrospective follow-up study was used among 502 mothers who have children aged two to three years in the Gozamin district from October 1, 2017, up to September 30, 2020. Interviewer-administered structured questionnaires were used. Cox proportional hazard model was applied after its assumptions and model fitness were checked, to identify predictors for time to breastfeeding cessation.

Results

The overall mean time to breastfeeding cessation was 22.56 (95%CI: 22.21, 22.91) months, and the cumulative survival probability on breastfeeding up to 24 months was 82.5% (95%CI:78.85, 85.53). The overall incidence of early breastfeeding cessation was 7.77 (95%CI:6.31, 9.58) per 1000 person-month observations. Having no antenatal care follow up (AHR:2.15, 95%CI:1.19, 3.89), having ≥4 number of children (AHR:1.76, 95%CI:1.10, 2.80), < 24 months breastfeeding experience (AHR:1.77, 95%CI:1.14, 2.75), and presence of cow milk in the household (AHR:3.01, 95%CI:1.89, 4.78) were significant predictors for time to breastfeeding cessation.

Conclusion

The time to breastfeeding cessation is below the recommendation and therefore, strengthening breastfeeding education and related counseling at the community level is better.
Fate of sloughed biomass in integrated fixed-film systems
Authors: Aqeel Hussain , Liss Steven N.
Published: January 2022

Fate of biofilm sloughing was assessed in a laboratory-scale (LS) integrated fixed-film sequencing batch reactor (IF-SBR) treating synthetic wastewater and in a full-scale (FS) integrated fixed-film activated sludge (IFAS) system treating municipal wastewater. It was observed that the properties of biofilms and flocs, including sludge volume index (SVI), mixed liquor suspended solids (MLSS), effluent suspended solids (ESS), relative hydrophobicity, and composition of extracellular polymeric substance (EPS) were associated with biofilm sloughing and formation of large granular flocs in the LS IF–SBR. In the FS IFAS system, the changes were studied at the molecular level. For example, the extracted EPS content results (the protein to polysaccharide ratio decreased in the flocs and increased in the biofilms, with biofilm sloughing) were complemented with the confocal laser scanning microscopy (CLSM) coupled with molecular specific staining. CLSM analyses revealed that micro-colonies rich in polysaccharides readily sloughed from the carriers. Live-dead staining revealed areas of the biofilm where the viability of biomass was a contributing factor associated with areas of the biofilm susceptible to sloughing. 16S rRNA gene sequencing (Illumina) of FS IFAS samples revealed greater diversity (α-diversity) in biofilms compared to flocs. Biofilm sloughing resulted in a decrease in diversity in biofilms and a corresponding increase in the flocs during sloughing. Microbial population dynamics revealed that bacteria known for denitrification (for example, Comamonadaceae) detached from the biofilms during sloughing, readily associated with the suspended biomass, and were retained in the bioreactors.
A data flow process for confidential data and its application in a health research project
Authors: Crossfield Samantha S. R. , Zucker Kieran , Baxter Paul , Wright Penny , Fistein Jon , Markham Alex F. , Birkin Mark , Glaser Adam W. , Hall Geoff
Published: January 2022

Background

The use of linked healthcare data in research has the potential to make major contributions to knowledge generation and service improvement. However, using healthcare data for secondary purposes raises legal and ethical concerns relating to confidentiality, privacy and data protection rights. Using a linkage and anonymisation approach that processes data lawfully and in line with ethical best practice to create an anonymous (non-personal) dataset can address these concerns, yet there is no set approach for defining all of the steps involved in such data flow end-to-end. We aimed to define such an approach with clear steps for dataset creation, and to describe its utilisation in a case study linking healthcare data.

Methods

We developed a data flow protocol that generates pseudonymous datasets that can be reversibly linked, or irreversibly linked to form an anonymous research dataset. It was designed and implemented by the Comprehensive Patient Records (CPR) study in Leeds, UK.

Results

We defined a clear approach that received ethico-legal approval for use in creating an anonymous research dataset. Our approach used individual-level linkage through a mechanism that is not computer-intensive and was rendered irreversible to both data providers and processors. We successfully applied it in the CPR study to hospital and general practice and community electronic health record data from two providers, along with patient reported outcomes, for 365,193 patients. The resultant anonymous research dataset is available via DATA-CAN, the Health Data Research Hub for Cancer in the UK.

Conclusions

Through ethical, legal and academic review, we believe that we contribute a defined approach that represents a framework that exceeds current minimum standards for effective pseudonymisation and anonymisation. This paper describes our methods and provides supporting information to facilitate the use of this approach in research.
A longitudinal linkage study of occupation and ischaemic heart disease in the general and Māori populations of New Zealand
Authors: Barnes Lucy A. , Eng Amanda , Corbin Marine , Denison Hayley J. , t’ Mannetje Andrea , Haslett Stephen , McLean Dave , Ellison-Loschmann Lis , Jackson Rod , Douwes Jeroen
Published: January 2022

Objectives

Occupation is a poorly characterised risk factor for cardiovascular disease (CVD) with females and indigenous populations under-represented in most research. This study assessed associations between occupation and ischaemic heart disease (IHD) in males and females of the general and Māori (indigenous people of NZ) populations of New Zealand (NZ).

Methods

Two surveys of the NZ adult population (NZ Workforce Survey (NZWS); 2004–2006; n = 3003) and of the Māori population (NZWS Māori; 2009–2010; n = 2107) with detailed occupational histories were linked with routinely collected health data and followed-up until December 2018. Cox regression was used to calculate hazard ratios (HR) for IHD and “ever-worked” in any of the nine major occupational groups or 17 industries. Analyses were controlled for age, deprivation and smoking, and stratified by sex and survey.

Results

‘Plant/machine operators and assemblers’ and ‘elementary occupations’ were positively associated with IHD in female Māori (HR 2.2, 95%CI 1.2–4.1 and HR 2.0, 1.1–3.8, respectively) and among NZWS males who had been employed as ‘plant/machine operators and assemblers’ for 10+ years (HR 1.7, 1.2–2.8). Working in the ‘manufacturing’ industry was also associated with IHD in NZWS females (HR 1.9, 1.1–3.7), whilst inverse associations were observed for ‘technicians and associate professionals’ (HR 0.5, 0.3–0.8) in NZWS males. For ‘clerks’, a positive association was found for NZWS males (HR 1.8, 1.2–2.7), whilst an inverse association was observed for Māori females (HR 0.4, 0.2–0.8).

Conclusion

Associations with IHD differed significantly across occupational groups and were not consistent across males and females or for Māori and the general population, even within the same occupational groups, suggesting that current knowledge regarding the association between occupation and IHD may not be generalisable across different population groups.
Physical activity and active transportation behaviour among rural, peri-urban and urban children in Kenya, Mozambique and Nigeria: The PAAT Study
Authors: Wachira Lucy-Joy , Hayker Sylvester O. , Larouche Richard , Oyeyemi Adewale L. , Prista Antonio , Owino George E. , Tremblay Mark S. , Onywera Vincent O.
Published: January 2022

Background

Physical activity (PA) is associated with numerous health benefits among children and youth. However, few studies have examined how active transportation (AT) and device-based measures of PA vary within and between countries in sub-Saharan Africa.

Purpose

This cross-sectional study sought to investigate the prevalence and correlates of AT and device-measured PA among children living in urban, peri-urban and rural areas in three African countries representing Eastern, Western and Southern regions of Africa.

Methods

3,205 participants (53.3% girls; 46.7% boys) aged 10–12 years were recruited in Kenya, Nigeria and Mozambique. Data were collected using a child questionnaire, a parent/guardian questionnaire and PiezoRx® pedometers. ANCOVA and binary logistic regression analyses were used to examine the correlates of AT and PA while controlling for gender, age, parent education and vehicle ownership.

Results

Participants accumulated an average of 45.6±23.5 min/day of moderate-to-vigorous physical activity (MVPA) and 11,215±4,273 steps/day. Kenyan and Mozambican children were significantly more active than their Nigerian counterparts (p<0.001). Only 23% met the MVPA guidelines of 60 min/day. 65.1% of participants engaged in AT to school (and 67.8% for the trip back home) with no gender differences. Living in a rural area, lower parent education, lower vehicle ownership and higher motorcycle ownership were associated with higher odds of AT. Other correlates of AT were country-specific. Girls accumulated less daily MVPA than boys in all countries. MVPA was positively associated with living in less urbanized areas in Nigeria and Mozambique. In Kenya, lower parental education and AT were associated with higher MVPA. Nigerian children’s daily MVPA decreased with age and the number of parent-perceived barriers to AT.

Conclusions

Majority of children engaged in AT, but still failed to meet MVPA recommendations. Most correlates of AT and PA were country-specific, suggesting that strategies to encourage both behaviours should be informed by local evidence.
Multi-parametric analysis of speech timing in inter-talker identical twin pairs and cross-pair comparisons: Some forensic implications
Authors: Cavalcanti Julio Cesar , Eriksson Anders , Barbosa Plinio A.
Published: January 2022

The purpose of this study was to assess the speaker-discriminatory potential of a set of speech timing parameters while probing their suitability for forensic speaker comparison applications. The recordings comprised of spontaneous dialogues between twin pairs through mobile phones while being directly recorded with professional headset microphones. Speaker comparisons were performed with twins speakers engaged in a dialogue (i.e., intra-twin pairs) and among all subjects (i.e., cross-twin pairs). The participants were 20 Brazilian Portuguese speakers, ten male identical twin pairs from the same dialectal area. A set of 11 speech timing parameters was extracted and analyzed, including speech rate, articulation rate, syllable duration (V-V unit), vowel duration, and pause duration. Three system performance estimates were considered for assessing the suitability of the parameters for speaker comparison purposes, namely global Cllr, EER, and AUC values. These were interpreted while also taking into consideration the analysis of effect sizes. Overall, speech rate and articulation rate were found the most reliable parameters, displaying the largest effect sizes for the factor “speaker” and the best system performance outcomes, namely lowest Cllr, EER, and highest AUC values. Conversely, smaller effect sizes were found for the other parameters, which is compatible with a lower explanatory potential of the speaker identity on the duration of such units and a possibly higher linguistic control regarding their temporal variation. In addition, there was a tendency for speech timing estimates based on larger temporal intervals to present larger effect sizes and better speaker-discriminatory performance. Finally, identical twin pairs were found remarkably similar in their speech temporal patterns at the macro and micro levels while engaging in a dialogue, resulting in poor system discriminatory performance. Possible underlying factors for such a striking convergence in identical twins’ speech timing patterns are presented and discussed.
Knowledge, attitude, and practice related to the COVID-19 pandemic among undergraduate medical students in Indonesia: A nationwide cross-sectional study
Authors: Adli Imam , Widyahening Indah Suci , Lazarus Gilbert , Phowira Jason , Baihaqi Lyanna Azzahra , Ariffandi Bagas , Putera Azis Muhammad , Nugraha David , Gamalliel Nico , Findyartini Ardi
Published: January 2022

Introduction

The potential role of medical students in raising awareness during public health emergencies has been acknowledged. To further explore their potentials as public educators and role models for the communities during the coronavirus disease 2019 (COVID-19) pandemic, this study aims to assess the knowledge, attitude, and practice of these students toward COVID-19.

Methods

An online cross-sectional survey was conducted among undergraduate medical students in Indonesia. Socio-demographics characteristics, social interaction history, information-seeking behavior, as well as knowledge, attitude, and practice toward COVID-19 were collected through a self-reported questionnaire. A p-value of <0.05 indicated statistical significance.

Results

Out of 4870 respondents, 64.9% had positive attitude and 51.5% had positive practice toward COVID-19, while only 29.8% had adequate knowledge. Knowledge was slightly positively correlated with attitude and practice (ρ = 0.074 and ρ = 0.054, respectively; both p<0.001), while attitude was weakly correlated with practice (ρ = 0.234, p<0.001). Several factors including age, sex, place of residence, institution type, academic level, family income, history of chronic illness, prior volunteering experience, and perceptual awareness on COVID-19 were significantly associated with either knowledge, attitude, and/or practice toward COVID-19. Furthermore, health institution’s and the government’s press releases, as well as health expert opinions were deemed as the most reliable sources of COVID-19-related information–yet trivially none of these sources were associated with knowledge, attitude, and practice in the study population.

Conclusion

Many undergraduate medical students in Indonesia had positive attitude and practice against COVID-19, yet only a few had adequate knowledge. This warrants further interventions to keep them updated with COVID-19 evidence to maximize their potentials in raising public awareness on COVID-19.
Clinical application of intraoperative somatic tissue oxygen saturation for detecting postoperative early kidney dysfunction patients undergoing living donor liver transplantation: A propensity score matching analysis
Authors: Park Jaesik , Jung Sangmin , Na Sanghoon , Choi Ho Joong , Shim Jung-Woo , Lee Hyung Mook , Hong Sang Hyun , Chae Min Suk
Published: January 2022

Background

Somatic tissue oxygen saturation (SstO2) is associated with systemic hypoperfusion. Kidney dysfunction may lead to increased mortality and morbidity in patients who undergo living donor liver transplantation (LDLT). We investigated the clinical utility of SstO2 during LDLT for identifying postoperative kidney dysfunction.

Patients and methods

Data from 304 adults undergoing elective LDLT between January 2015 and February 2020 at Seoul St. Mary’s Hospital were retrospectively collected. Thirty-six patients were excluded based on the exclusion criteria. In total, 268 adults were analyzed, and 200 patients were 1:1 propensity score (PS)-matched.

Results

Patients with early kidney dysfunction had significantly lower intraoperative SstO2 values than those with normal kidney function. Low SstO2 (< 66%) 1 h after graft reperfusion was more highly predictive of early kidney dysfunction than the values measured in other intraoperative phases. A decline in the SstO2 was also related to kidney dysfunction.

Conclusions

Kidney dysfunction after LDLT is associated with patient morbidity and mortality. Our results may assist in the detection of early kidney dysfunction by providing a basis for analyzing SstO2 in patients undergoing LDLT. A low SstO2 (< 66%), particularly 1 h after graft reperfusion, was significantly associated with early kidney dysfunction after surgery. SstO2 monitoring may facilitate the identification of early kidney dysfunction and enable early management of patients.
Development of a quantitative COVID-19 multiplex assay and its use for serological surveillance in a low SARS-CoV-2 incidence community
Authors: Guarino Cassandra , Larson Elisabeth , Babasyan Susanna , Rollins Alicia , Joshi Lok R. , Laverack Melissa , Parrilla Lara , Plocharczyk Elizabeth , Diel Diego G. , Wagner Bettina
Published: January 2022

A serological COVID-19 Multiplex Assay was developed and validated using serum samples from convalescent patients and those collected prior to the 2020 pandemic. After initial testing of multiple potential antigens, the SARS-CoV-2 nucleocapsid protein (NP) and receptor-binding domain (RBD) of the spike protein were selected for the human COVID-19 Multiplex Assay. A comparison of synthesized and mammalian expressed RBD proteins revealed clear advantages of mammalian expression. Antibodies directed against NP strongly correlated with SARS-CoV-2 virus neutralization assay titers (rsp = 0.726), while anti-RBD correlation was moderate (rsp = 0.436). Pan-Ig, IgG, IgA, and IgM against NP and RBD antigens were evaluated on the validation sample sets. Detection of NP and RBD specific IgG and IgA had outstanding performance (AUC > 0.90) for distinguishing patients from controls, but the dynamic range of the IgG assay was substantially greater. The COVID-19 Multiplex Assay was utilized to identify seroprevalence to SARS-CoV-2 in people living in a low-incidence community in Ithaca, NY. Samples were taken from a cohort of healthy volunteers (n = 332) in early June 2020. Only two volunteers had a positive result on a COVID-19 PCR test performed prior to serum sampling. Serological testing revealed an exposure rate of at least 1.2% (NP) or as high as 5.7% (RBD), higher than the measured incidence rate of 0.16% in the county at that time. This highly sensitive and quantitative assay can be used for monitoring community exposure rates and duration of immune response following both infection and vaccination.
Risk factors and genotype distribution of hepatitis C virus in Georgia: A nationwide population-based survey
Authors: Baliashvili Davit , Averhoff Francisco , Kasradze Ana , Salyer Stephanie J. , Kuchukhidze Giorgi , Gamkrelidze Amiran , Imnadze Paata , Alkhazashvili Maia , Chanturia Gvantsa , Chitadze Nazibrola , Sukhiashvili Roena , Blanton Curtis , Drobeniuc Jan , Morgan Juliette , Hagan Liesl M.
Published: January 2022

In preparation for the National Hepatitis C Elimination Program in the country of Georgia, a nationwide household-based hepatitis C virus (HCV) seroprevalence survey was conducted in 2015. Data were used to estimate HCV genotype distribution and better understand potential sex-specific risk factors that contribute to HCV transmission. HCV genotype distribution by sex and reported risk factors were calculated. We used explanatory logistic regression models stratified by sex to identify behavioral and healthcare-related risk factors for HCV seropositivity, and predictive logistic regression models to identify additional variables that could help predict the presence of infection. Factors associated with HCV seropositivity in explanatory models included, among males, history of injection drug use (IDU) (aOR = 22.4, 95% CI = 12.7, 39.8) and receiving a blood transfusion (aOR = 3.6, 95% CI = 1.4, 8.8), and among females, history of receiving a blood transfusion (aOR = 4.0, 95% CI 2.1, 7.7), kidney dialysis (aOR = 7.3 95% CI 1.5, 35.3) and surgery (aOR = 1.9, 95% CI 1.1, 3.2). The male-specific predictive model additionally identified age, urban residence, and history of incarceration as factors predictive of seropositivity and were used to create a male-specific exposure index (Area under the curve [AUC] = 0.84). The female-specific predictive model had insufficient discriminatory performance to support creating an exposure index (AUC = 0.61). The most prevalent HCV genotype (GT) nationally was GT1b (40.5%), followed by GT3 (34.7%) and GT2 (23.6%). Risk factors for HCV seropositivity and distribution of HCV genotypes in Georgia vary substantially by sex. The HCV exposure index developed for males could be used to inform targeted testing programs.
Climate change impact on wheat and maize growth in Ethiopia: A multi-model uncertainty analysis
Authors: Rettie Fasil Mequanint , Gayler Sebastian , K. D. Weber Tobias , Tesfaye Kindie , Streck Thilo
Published: January 2022

Ethiopia’s economy is dominated by agriculture which is mainly rain-fed and subsistence. Climate change is expected to have an adverse impact particularly on crop production. Previous studies have shown large discrepancies in the magnitude and sometimes in the direction of the impact on crop production. We assessed the impact of climate change on growth and yield of maize and wheat in Ethiopia using a multi-crop model ensemble. The multi-model ensemble (n = 48) was set up using the agroecosystem modelling framework Expert-N. The framework is modular which facilitates combining different submodels for plant growth and soil processes. The multi-model ensemble was driven by climate change projections representing the mid of the century (2021–2050) from ten contrasting climate models downscaled to finer resolution. The contributions of different sources of uncertainty in crop yield prediction were quantified. The sensitivity of crop yield to elevated CO2, increased temperature, changes in precipitations and N fertilizer were also assessed. Our results indicate that grain yields were very sensitive to changes in [CO2], temperature and N fertilizer amounts where the responses were higher for wheat than maize. The response to change in precipitation was weak, which we attribute to the high water holding capacity of the soils due to high organic carbon contents at the study sites. This may provide the sufficient buffering capacity for extended time periods with low amounts of precipitation. Under the changing climate, wheat productivity will be a major challenge with a 36 to 40% reduction in grain yield by 2050 while the impact on maize was modest. A major part of the uncertainty in the projected impact could be attributed to differences in the crop growth models. A considerable fraction of the uncertainty could also be traced back to different soil water dynamics modeling approaches in the model ensemble, which is often ignored. Uncertainties varied among the studied crop species and cultivars as well. The study highlights significant impacts of climate change on wheat yield in Ethiopia whereby differences in crop growth models causes the large part of the uncertainties.
Psychometric properties of the Chinese version of the Perinatal Bereavement Care Confidence Scale (C-PBCCS) in nursing practice
Authors: Qian Jialu , Wu Honghe , Sun Shiwen , Wang Man , Yu Xiaoyan
Published: January 2022

Background

The Perinatal Bereavement Care Confidence Scale (PBCCS) was designed to evaluate midwives’ and nurses’ confidence and its psychosocial factors to provide bereavement care in Ireland. However, it is unknown whether this scale is valid and reliable for use with midwives and nurses in China. The aim of this study was to translate the English version into Chinese (C-PBCCS) and determine its validity and reliability in a population of Chinese midwives and nurses.

Methods

In this cross-sectional observational study, after translating the English version of the PBCCS into Chinese and ensuring the linguistic adequacy and clarity of the language, we evaluated the validity and reliability of the C-PBCCS with Chinese midwives and nurses (n = 608). Participants were recruited using convenience sampling from 10 maternity hospitals in Zhejiang and Jiangsu Provinces. Exploratory factor analysis (EFA) was conducted to determine the construct validity (n = 304). Another sample of 304 midwives and nurses was used for confirmatory factor analysis (CFA) to verify the quality of the factor structures. Cronbach’s alpha coefficient and Guttman split-half coefficient were adopted for the evaluation of internal consistency. The STROBE was followed in reporting the results.

Results

The 43-item PBCCS was reduced to 40 items. Bereavement support knowledge (13 items, three factors), Bereavement support skills (eight items, two factors), Self-awareness (eight items, two factors), and Organizational support (11 items, two factors). The CFA suggested that the four scales in the C-PBCCS had acceptable fit indices. The Cronbach’s alpha ranged from 0.835–0.901. The Guttman split-half coefficient was between 0.868–0.933.

Conclusion

The C-PBCCS was found to be a psychometrically sound measurement tool to evaluate Chinese-speaking midwives’ and nurses’ confidence and the psychosocial factors that affect their confidence in providing perinatal bereavement care.
Development of β-cyclodextrin/polyvinypyrrolidone-co-poly (2-acrylamide-2-methylpropane sulphonic acid) hybrid nanogels as nano-drug delivery carriers to enhance the solubility of Rosuvastatin: An in vitro and in vivo evaluation
Authors: Shoukat Hina , Pervaiz Fahad , Khan Mehran , Rehman Sadia , Akram Faizan , Abid Usman , Noreen Sobia , Nadeem Muhammad , Qaiser Rubina , Ahmad Rizwan , Farooq Irshad
Published: January 2022

The present study is aimed at enhancing the solubility of rosuvastatin (RST) by designing betacyclodextrin/polyvinypyrrolidone-co-poly (2-acrylamide-2-methylpropane sulphonic acid) crosslinked hydrophilic nanogels in the presence of crosslinker methylene bisacrylamide through free-radical polymerization method. Various formulations were fabricated by blending different amounts of betacyclodextrin, polyvinylpyrrolidone, 2-acrylamide-2-methylpropane sulphonic acid, and methylene bisacrylamide. The developed chemically crosslinked nanogels were characterized by FTIR, SEM, PXRD, TGA, DSC, sol-gel analysis, zeta size, micromeritics properties, drug loading percentage, swelling, solubility, and release studies. The FTIR spectrum depicts the leading peaks of resultant functional groups of blended constituents while a fluffy and porous structure was observed through SEM images. Remarkable reduction in crystallinity of RST in developed nanogels revealed by PXRD. TGA and DSC demonstrate the good thermal stability of nanogels. The size analysis depicts the particle size of the developed nanogels in the range of 178.5 ±3.14 nm. Drug loading percentage, swelling, solubility, and release studies revealed high drug loading, solubilization, swelling, and drug release patterns at 6.8 pH paralleled to 1.2 pH. In vivo experiments on developed nanogels in comparison to marketed brands were examined and better results regarding pharmacokinetic parameters were observed. The compatibility and non-toxicity of fabricated nanogels to biological systems was supported by a toxicity study that was conducted on rabbits. Efficient fabrication, excellent physicochemical properties, improved dissolution, high solubilization, and nontoxic nanogels might be a capable approach for the oral administration of poorly water-soluble drugs.
Pre-vaccination frequency of circulatory Tfh is associated with robust immune response to TV003 dengue vaccine
Authors: Izmirly Abdullah M. , Pelletier Adam-Nicolas , Connors Jennifer , Taramangalam Bhavani , Alturki Sawsan O. , Gordon Emma A. , Alturki Sana O. , Mell Joshua C. , Swaminathan Gokul , Karthik Vivin , Kutzler Michele A. , Kallas Esper G. , Sekaly Rafick-Pierre , Haddad Elias K.
Published: January 2022

It has been estimated that more than 390 million people are infected with Dengue virus every year; around 96 millions of these infections result in clinical pathologies. To date, there is only one licensed viral vector-based Dengue virus vaccine CYD-TDV approved for use in dengue endemic areas. While initially approved for administration independent of serostatus, the current guidance only recommends the use of this vaccine for seropositive individuals. Therefore, there is a critical need for investigating the influence of Dengue virus serostatus and immunological mechanisms that influence vaccine outcome. Here, we provide comprehensive evaluation of sero-status and host immune factors that correlate with robust immune responses to a Dengue virus vector based tetravalent vaccine (TV003) in a Phase II clinical cohort of human participants. We observed that sero-positive individuals demonstrate a much stronger immune response to the TV003 vaccine. Our multi-layered immune profiling revealed that sero-positive subjects have increased baseline/pre-vaccination frequencies of circulating T follicular helper (cTfh) cells and the Tfh related chemokine CXCL13/BLC. Importantly, this baseline/pre-vaccination cTfh profile correlated with the vaccinees’ ability to launch neutralizing antibody response against all four sero-types of Dengue virus, an important endpoint for Dengue vaccine clinical trials. Overall, we provide novel insights into the favorable cTfh related immune status that persists in Dengue virus sero-positive individuals that correlate with their ability to mount robust vaccine specific immune responses. Such detailed interrogation of cTfh cell biology in the context of clinical vaccinology will help uncover mechanisms and targets for favorable immuno-modulatory agents.