bluuebunny/crossref_metadata_2025 huggingface dataset:
Development and validation of a prediction nomogram for a 6-month unfavorable prognosis in traumatic brain-injured patients undergoing primary decompressive craniectomy: An observational study
Authors: Tang Zhiji , Hu Kun , Yang Ruijin , Zou Mingang , Zhong Ming , Huang Qiangliang , Wei Wenjin , Jiang Qiuhua
Published: August 2022

Objective

This study was designed to develop and validate a risk-prediction nomogram to predict a 6-month unfavorable prognosis in patients with traumatic brain-injured (TBI) undergoing primary decompressive craniectomy (DC).

Methods

The clinical data of 391 TBI patients with primary DC who were admitted from 2012 to 2020 were reviewed, from which 274 patients were enrolled in the training group, while 117 were enrolled in the internal validation group, randomly. The external data sets containing 80 patients were obtained from another hospital. Independent predictors of the 6-month unfavorable prognosis were analyzed using multivariate logistic regression. Furthermore, a nomogram prediction model was constructed using R software. After evaluation of the model, internal and external validations were performed to verify the efficiency of the model using the area under the receiver operating characteristic curves and the calibration plots.

Results

In multivariate analysis, age(p = 0.001), Glasgow Score Scale (GCS) (p < 0.001), operative blood loss of >750 ml (p = 0.045), completely effaced basal cisterns (p < 0.001), intraoperative hypotension(p = 0.001), and activated partial thromboplastin time (APTT) of >36 (p = 0.012) were the early independent predictors for 6-month unfavorable prognosis in patients with TBI after primary DC. The AUC for the training, internal, and external validation cohorts was 0.93 (95%CI, 0.89–0.96, p < 0.0001), 0.89 (95%CI, 0.82–0.94, p < 0.0001), and 0.90 (95%CI, 0.84–0.97, p < 0.0001), respectively, which indicated that the prediction model had an excellent capability of discrimination. Calibration of the model was exhibited by the calibration plots, which showed an optimal concordance between the predicted 6-month unfavorable prognosis probability and actual probability in both training and validation cohorts.

Conclusion

This prediction model for a 6-month unfavorable prognosis in patients with TBI undergoing primary DC can evaluate the prognosis accurately and enhance the early identification of high-risk patients.
Altered cerebral blood flow patterns in ankylosing spondylitis: A three-dimensional pseudo-continuous arterial spin labeling study
Authors: Fang Jin , Hua Kelei , Chen Feng , Wan Zhifang , Yin Yi , Liu Ping , Wang Tianyue , Jiang Guihua
Published: August 2022

Objective

This study aimed to detect the cerebral blood flow (CBF) values changes in patients with ankylosing spondylitis (AS) and to evaluate the correlation between the CBF values and the specific clinical characteristics.

Materials and methods

Forty-eight patients with AS (43 male and 5 female) and 42 healthy controls (HCs) (38 male and 4 female) were recruited. Three-dimensional pseudo-continuous arterial spin labeling (3D-pCASL) was performed on a 3.0T magnetic resonance imaging (MRI). CBF values were obtained on the Philips post-processing workstation based on arterial spin labeling (ASL) data. The two-samplet-test was used to compare CBF differences. The correlation between CBF values and specific clinical characteristics of AS was evaluated.

Results

The AS group showed increased CBF values in the right precentral gyrus, the left inferior frontal gyrus, and the left temporal pole compared with HCs the AS group also showed decreased CBF values in the left precuneus and the left superior occipital gyrus compared with HCs. There were no significant correlations between the CBF values and the clinical characteristics including total back pain (TBP), erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP).

Conclusion

Patients with AS displayed CBF changes compared with HCs using 3D-PCASL. These results may enhance our understanding of the neural substrates of AS and provide evidence of AS-related neurological impairment.
What makes us act together? On the cognitive models supporting humans’ decisions for joint action
Authors: Curioni Arianna
Published: August 2022

We face tasks every day that we can solve alone but decide to solve together with others. When do we choose to act together vs. alone? How long do we persist in working together when doing so is difficult? Do we prefer to act together when times are uncertain? An open question in joint action research is under what conditions humans prefer to act together or alone to achieve a certain goal, and whether their preference is based on a utility calculus that takes into account the costs and benefits associated with individual and joint action alternatives. Research on cooperation reveals that frequent engagement in joint activities provides high survival benefits, as it allows individuals to achieve goals together that are otherwise unavailable. Yet, survival advantage does not wholly explain the reasons for human cooperative behavior. In fact, humans are motivated to cooperate even when it is not necessary to achieve an outcome. Research in cognitive science suggests that navigating the potential costs of joint actions is a challenge for humans, and that joint actions might provide individuals with rewards that go beyond the achievement of instrumental goals. We here address the influence of key factors on the decision to engage in joint action, such as the coordination costs arising when acting together compared to alone and the social and instrumental rewards expected when acting together compared to alone. Addressing these questions will provide critical insight for the design of cognitive models of human decisions for cooperation.
rTg(TauP301L)4510 mice exhibit increased VGlut1 in hippocampal presynaptic glutamatergic vesicles and increased extracellular glutamate release
Authors: Taipala Erika , Pfitzer Jeremiah C. , Hellums Morgan , Reed Miranda N. , Gramlich Michael W.
Published: August 2022

The molecular pathways that contribute to the onset of symptoms in tauopathy models, including Alzheimer’s disease (AD), are difficult to distinguish because multiple changes can happen simultaneously at different stages of disease progression. Understanding early synaptic alterations and their supporting molecular pathways is essential to develop better pharmacological targets to treat AD. Here, we focus on an early onset rTg(TauP301L)4510 tauopathy mouse model that exhibits hyperexcitability in hippocampal neurons of adult mice that is correlated with presynaptic changes and increased extracellular glutamate levels. However, it is not clear if increased extracellular glutamate is caused by presynaptic changes alone, or if presynaptic changes are a contributing factor among other factors. To determine whether pathogenic tau alters presynaptic function and glutamate release, we studied cultured hippocampal neurons at 14–18 days in vitro (DIV) from animals of both sexes to measure presynaptic changes in tauP301L positive mice. We observed that presynaptic vesicles exhibit increased vesicular glutamate transporter 1 (VGlut1) using immunohistochemistry of fixed cells and an established pH-sensitive green fluorescent protein approach. We show that tauP301L positive neurons exhibit a 40% increase in VGlut1 per vesicle compared to tauP301L negative littermates. Further, we use the extracellular glutamate reporter iGluSnFR to show that increased VGlut1 per vesicle directly translates into a 40% increase in extracellular glutamate. Together, these results show that increased extracellular glutamate levels observed in tauP301L mice are not caused by increased vesicle exocytosis probability but rather are directly related to increased VGlut1 transporters per synaptic vesicle.
Immunotherapy in non-small cell lung cancer: Past, present, and future directions
Authors: Punekar Salman R. , Shum Elaine , Grello Cassandra Mia , Lau Sally C. , Velcheti Vamsidhar
Published: August 2022

Many decades in the making, immunotherapy has demonstrated its ability to produce durable responses in several cancer types. In the last decade, immunotherapy has shown itself to be a viable therapeutic approach for non-small cell lung cancer (NSCLC). Several clinical trials have established the efficacy of immune checkpoint blockade (ICB), particularly in the form of anti-programmed death 1 (PD-1) antibodies, anti-cytotoxic T-lymphocyte-associated protein 4 (CTLA-4) antibodies and anti-programmed death 1 ligand (PD-L1) antibodies. Many trials have shown progression free survival (PFS) and overall survival (OS) benefit with either ICB alone or in combination with chemotherapy when compared to chemotherapy alone. The identification of biomarkers to predict response to immunotherapy continues to be evaluated. The future of immunotherapy in lung cancer continues to hold promise with the development of combination therapies, cytokine modulating therapies and cellular therapies. Lastly, we expect that innovative advances in technology, such as artificial intelligence (AI) and machine learning, will begin to play a role in the future care of patients with lung cancer.
The role of adjuvant chemotherapy in the management of acute promyelocytic leukemia differentiation syndrome
Authors: LaBella Dominic , Regan Samuel , Konig Heiko , Egan Daniel N. , Bailey Neil A. , Mawad Raya , Gilbert Morgan , Pagel John M. , Pu Jeffrey J.
Published: August 2022

Acute Promyelocytic Leukemia (APL) is characterized by the t(15;17) chromosomal translocation resulting in a PML-RARA fusion protein. The all-trans-retinoic acid (ATRA) and Arsenic Trioxide (ATO) only regimens have demonstrated success in treating low- and intermediate-risk patients. However, induction with ATRA/ATO only regimens have been showing increased incidence of differentiation syndrome (DS), a potentially lethal complication, traditionally treated with dexamethasone. We conducted a three-institution retrospective study, aiming to evaluate the role of short-term adjuvant chemotherapy in managing moderate DS for patients with low- or intermediate-risk APL initially treated with ATRA/ATO only protocols. We evaluated the difference in incidence and duration of moderate DS in APL patients who were treated with ATRA/ATO with or without adjuvant chemotherapy. 57 low- or intermediate-risk APL patients were retrospectively identified and included for this study; 36 patients received ATRA/ATO only induction treatment, and 21 patients received ATRA/ATO/adjuvant chemotherapy combination induction therapy. Similar proportions of patients experienced DS in both groups (66.7% vs. 81.0%, P = 0.246). The median duration of DS resolution in patients receiving ATRA/ATO only was 17 days (n = 23), and in patients receiving combination therapy was 8 days (n = 16) (P = 0.0001). The lengths of hospital stay in patients receiving ATRO/ATO only was 38 days (n = 7), and in patients receiving combination therapy was 14 days (n = 17) (P = 0.0007). In conclusion, adding adjuvant chemotherapy to ATRA/ATO only protocol may reduce the duration of DS and the length of hospital stay during APL induction treatment.
Research trends and hotspots of breast cancer management during the COVID-19 pandemic: A bibliometric analysis
Authors: Lyu Peng-fei , Li Jing-tai , Deng Tang , Lin Guang-Xun , Fan Ping-ming , Cao Xu-Chen
Published: August 2022

Background

The coronavirus disease 2019 (COVID-19) pandemic is disrupting routine medical care of cancer patients, including those who have cancer or are undergoing cancer screening. In this study, breast cancer management during the COVID-19 pandemic (BCMP) is reviewed, and the research trends of BCMP are evaluated by quantitative and qualitative evaluation.

Methods

In this study, published studies relating to BCMP from 1 January 2020 to 1 April 2022 were searched from the Web of Science database (WoS). Bibliometric indicators consisted of publications, research hotspots, keywords, authors, journals, institutions, nations, and h-index.

Results

A total of 182 articles investigating BCMP were searched. The United States of America and the University of Rome Tor Vergata were the nation and the institution with the most publications on BCMP. The first three periodicals with leading published BCMP studies were Breast Cancer Research and Treatment, Breast, and In Vivo. Buonomo OC was the most prolific author in this field, publishing nine articles (9/182, 4.94%). The co-keywords analysis of BCMP suggests that the top hotspots and trends in research are screening, surgery, rehabilitation, emotion, diagnosis, treatment, and vaccine management of breast cancer during the pandemic. The hotspot words were divided into six clusters, namely, screening for breast cancer patients in the pandemic, breast cancer surgery in the pandemic, recovery of breast cancer patients in the pandemic, motion effect of the outbreak on breast cancer patients, diagnosis and treatment of breast cancer patients in the pandemic, and vaccination management for breast cancer patients during a pandemic.

Conclusion

BCMP has received attention from scholars in many nations over the last 3 years. This study revealed significant contributions to BCMP research by nations, institutions, scholars, and journals. The stratified clustering study provided the current status and future trends of BCMP to help physicians with the diagnosis and treatment of breast cancer through the pandemic, and provide a reference for in-depth clinical studies on BCMP.
pH-responsive graphene oxide loaded with targeted peptide and anticancer drug for OSCC therapy
Authors: Li Ran , Gao Ruifang , Zhao Yingjiao , Zhang Fang , Wang Xiangyu , Li Bing , Wang Lu , Ma Lixin , Du Jie
Published: August 2022

Oral squamous cell carcinoma (OSCC) is the most common type of cancer occurring in the oral and maxillofacial regions. Despite of the advances in the diagnosis and treatment, the overall 5-year survival rate has remained about 40%–50% in the past decades. Various nanotechnology-based carrier systems have been investigated for their potentials in the OSCC treatment. However, because of the lack of active targeting of tumors, their application is limited. Studies have shown that gastrin-releasing peptide receptors (GRPRs) are overexpressed on many human cancers, including head and neck squamous cell carcinoma. Herein, we aimed to develop a GRPR-targeted nano-graphene oxide (NGO) nanoprobe drug delivery system for OSCC therapy. DOX@NGO-BBN-AF750 was synthesized by the non-covalent bonding method to couple carboxylated NGO with BBN-AF750 (bombesin antagonist peptides conjugated to Alexa Fluor 750) and DOX (doxorubicin) through π-π and hydrogen bonding. Internalization and antitumor activities were carried out in human HSC-3 cancer cells. The tumor pH microenvironment was simulated to study the release of antitumor drug DOX from the DOX@NGO-ant BBN-AF750 complex under different pH conditions. DOX@NGO-BBN-AF750 showed internalization into HSC-3 cells. The IC50 (50% inhibitory concentration) was 5 µg/ml for DOX@NGO-BBN-AF750 in HSC-3 cells. Furthermore, DOX@NGO-BBN-AF750 showed a pH-sensitive drug release rate, and a dose-dependent and pH-responsive cytotoxicity in HSC-3 cells. DOX@NGO-BBN-AF750 presents the characteristics ensuring a slow release of DOX from the nanoprobe, thereby protecting the drug from degradation and prolonging the half-life of the drug. This report provides a versatile strategy to achieving targeted and imaging-guided therapy of OSCC.
External validation study of endometrial cancer preoperative risk stratification model (ENDORISK)
Authors: Vinklerová Petra , Ovesná Petra , Hausnerová Jitka , Pijnenborg Johanna M. A. , Lucas Peter J. F. , Reijnen Casper , Vrede Stephanie , Weinberger Vít
Published: August 2022

Introduction

Among industrialized countries, endometrial cancer is a common malignancy with generally an excellent outcome. To personalize medicine, we ideally compile as much information as possible concerning patient prognosis prior to effecting an appropriate treatment decision. Endometrial cancer preoperative risk stratification (ENDORISK) is a machine learning–based computational Bayesian networks model that predicts lymph node metastasis and 5-year disease-specific survival potential with percentual probability. Our objective included validating ENDORISK effectiveness in our patient cohort, assessing its application in the current use of sentinel node biopsy, and verifying its accuracy in advanced stages.

Methods

The ENDORISK model was evaluated with a retrospective cohort of 425 patients from the University Hospital Brno, Czech Republic. Two hundred ninety-nine patients were involved in our disease-specific survival analysis; 226 cases with known lymph node status were available for lymph node metastasis analysis. Patients were included undergoing either pelvic lymph node dissection (N = 84) or sentinel node biopsy (N =70) to explore the accuracy of both staging procedures.

Results

The area under the curve was 0.84 (95% confidence interval [CI], 0.77–0.9) for lymph node metastasis analysis and 0.86 (95% CI, 0.79–0.93) for 5-year disease-specific survival evaluation, indicating quite positive concordance between prediction and reality. Calibration plots to visualize results demonstrated an outstanding predictive value for low-risk cancers (grades 1–2), whereas outcomes were underestimated among high-risk patients (grade 3), especially in disease-specific survival. This phenomenon was even more obvious when patients were subclassified according to FIGO clinical stages.

Conclusions

Our data confirmed ENDORISK model’s laudable predictive ability, particularly among patients with a low risk of lymph node metastasis and expected favorable survival. For high-risk and/or advanced stages, the ENDORISK network needs to be additionally trained/improved.
DDX5 and DDX17—multifaceted proteins in the regulation of tumorigenesis and tumor progression
Authors: Xu Kun , Sun Shenghui , Yan Mingjing , Cui Ju , Yang Yao , Li Wenlin , Huang Xiuqing , Dou Lin , Chen Beidong , Tang Weiqing , Lan Ming , Li Jian , Shen Tao
Published: August 2022

DEAD-box (DDX)5 and DDX17, which belong to the DEAD-box RNA helicase family, are nuclear and cytoplasmic shuttle proteins. These proteins are expressed in most tissues and cells and participate in the regulation of normal physiological functions; their abnormal expression is closely related to tumorigenesis and tumor progression. DDX5/DDX17 participate in almost all processes of RNA metabolism, such as the alternative splicing of mRNA, biogenesis of microRNAs (miRNAs) and ribosomes, degradation of mRNA, interaction with long noncoding RNAs (lncRNAs) and coregulation of transcriptional activity. Moreover, different posttranslational modifications, such as phosphorylation, acetylation, ubiquitination, and sumoylation, endow DDX5/DDX17 with different functions in tumorigenesis and tumor progression. Indeed, DDX5 and DDX17 also interact with multiple key tumor-promoting molecules and participate in tumorigenesis and tumor progression signaling pathways. When DDX5/DDX17 expression or their posttranslational modification is dysregulated, the normal cellular signaling network collapses, leading to many pathological states, including tumorigenesis and tumor development. This review mainly discusses the molecular structure features and biological functions of DDX5/DDX17 and their effects on tumorigenesis and tumor progression, as well as their potential clinical application for tumor treatment.
Augmenting antibody response to EGF-depleting immunotherapy: Findings from a phase I trial of CIMAvax-EGF in combination with nivolumab in advanced stage NSCLC
Authors: Evans Rachel , Lee Kelvin , Wallace Paul K. , Reid Mary , Muhitch Jason , Dozier Askia , Mesa Circe , Luaces Patricia L. , Santos-Morales Orestes , Groman Adrienne , Cedeno Carlos , Cinquino Aileen , Fisher Daniel T. , Puzanov Igor , Opyrchal Mateusz , Fountzilas Christos , Dai Tong , Ernstoff Marc , Attwood Kristopher , Hutson Alan , Johnson Candace , Mazorra Zaima , Saavedra Danay , Leon Kalet , Lage Agustin , Crombet Tania , Dy Grace K.
Published: August 2022

Background

CIMAvax-EGF is an epidermal growth factor (EGF)-depleting immunotherapy which has shown survival benefit as a switch maintenance treatment after platinum-based chemotherapy in advanced non-small cell lung cancer (NSCLC). The primary objective of this trial is to establish the safety and recommended phase II dose (RP2D) of CIMAvax-EGF in combination with nivolumab as second-line therapy for NSCLC.

Methods

Patients with immune checkpoint inhibitor-naive metastatic NSCLC were enrolled using a “3+3” dose-escalation design. Toxicities were graded according to CTCAE V4.03. Thirteen patients (one unevaluable), the majority with PD-L1 0%, were enrolled into two dose levels of CIMAvax-EGF.

Findings

The combination was determined to be safe and tolerable. The recommended phase 2 dose of CIMAvax-EGF was 2.4 mg. Humoral response to CIMAvax-EGF was achieved earlier and in a greater number of patients with the combination compared to historical control. Four out of 12 evaluable patients had an objective response.
In vitro models for head and neck cancer: Current status and future perspective
Authors: Moya-Garcia Christian R. , Okuyama Hideaki , Sadeghi Nader , Li Jianyu , Tabrizian Maryam , Li-Jessen Nicole Y. K.
Published: August 2022

The 5-year overall survival rate remains approximately 50% for head and neck (H&N) cancer patients, even though new cancer drugs have been approved for clinical use since 2016. Cancer drug studies are now moving toward the use of three-dimensional culture models for better emulating the unique tumor microenvironment (TME) and better predicting in vivo response to cancer treatments. Distinctive TME features, such as tumor geometry, heterogenous cellularity, and hypoxic cues, notably affect tissue aggressiveness and drug resistance. However, these features have not been fully incorporated into in vitro H&N cancer models. This review paper aims to provide a scholarly assessment of the designs, contributions, and limitations of in vitro models in H&N cancer drug research. We first review the TME features of H&N cancer that are most relevant to in vitro drug evaluation. We then evaluate a selection of advanced culture models, namely, spheroids, organotypic models, and microfluidic chips, in their applications for H&N cancer drug research. Lastly, we propose future opportunities of in vitro H&N cancer research in the prospects of high-throughput drug screening and patient-specific drug evaluation.
Case report: Important considerations for a renal mass on a solitary kidney in an adult with history of childhood wilms tumor
Authors: Schmeusser Benjamin N. , Palacios Arnold R. , Midenberg Eric , Nabavizadeh Reza , Master Viraj A. , Joshi Shreyas S.
Published: August 2022

Adult survivors of childhood Wilms tumor are at an increased risk of secondary malignant neoplasms. The presence of a solitary kidney further complicates clinical management in this population. Herein, we present the case of a 37 year old female with a history of childhood Wilms tumor presenting with a secondary renal neoplasm. We highlight important clinical considerations for renal function preservation and present a finding of predisposition to kidney stone formation due to urinary stasis from distorted ureter architecture secondary to tumor mass effect.
Personality traits and complex problem solving: Personality disorders and their effects on complex problem-solving ability
Authors: Kipman Ulrike , Bartholdy Stephan , Weiss Marie , Aichhorn Wolfgang , Schiepek Günter
Published: August 2022

Complex problem solving (CPS) can be interpreted as the number of psychological mechanisms that allow us to reach our targets in difficult situations, that can be classified as complex, dynamic, non-transparent, interconnected, and multilayered, and also polytelic. The previous results demonstrated associations between the personality dimensions neuroticism, conscientiousness, and extraversion and problem-solving performance. However, there are no studies dealing with personality disorders in connection with CPS skills. Therefore, the current study examines a clinical sample consisting of people with personality and/or depressive disorders. As we have data for all the potential personality disorders and also data from each patient regarding to potential depression, we meet the whole range from healthy to impaired for each personality disorder and for depression. We make use of a unique operationalization: CPS was surveyed in a simulation game, making use of the microworld approach. This study was designed to investigate the hypothesis that personality traits are related to CPS performance. Results show that schizotypal, histrionic, dependent, and depressive persons are less likely to successfully solve problems, while persons having the additional behavioral characteristics of resilience, action orientation, and motivation for creation are more likely to successfully solve complex problems.
Effects of animated pedagogical agent-guided loving-kindness meditation on flight attendants’ spirituality, mindfulness, subjective wellbeing, and social presence
Authors: Liu Chao , Chen Hao , Zhou Fang , Chiang Chao-Hung , Chen Yi-Lang , Wu Kan , Huang Ding-Hau , Liu Chia-Yih , Chiou Wen-Ko
Published: August 2022

Loving-kindness meditation (LKM) was first practiced by Buddhists and then developed by clinical psychologist. Previous studies on LKM have mainly focused on the impact of real person-guided meditation on depression, anxiety, and other negative psychology. During the COVID-19 pandemic, this study explored the effect and mechanism of media-guided LKM on the improvement of social presence, mindfulness, spirituality, and subjective wellbeing (SWB). From the viewpoint of positive psychology, this study compared the different media effects of animated pedagogical agent (APA)-guided LKM and audio-guided LKM. A total of 82 flight attendants were recruited from airlines; then, they were randomly assigned to two groups: APA group (41 participants) and audio group (41 participants), which both underwent an 8-week LKM training intervention. The aforementioned four main variables were measured pre and post the meditation experiment. The results indicated that both APA-guided meditation and audio-guided meditation significantly improved subjects’ spirituality and SWB. Compared with audio-guided meditation, APA-guided meditation significantly improved the subjects’ spirituality, SWB, and social presence. Audio-guided meditation has no significant effect on social presence. This study highlights APA-guided meditation has a positive effect on spirituality, SWB, and social presence, which may provide individuals with a simple and easy method to improve their mental health.
Perceived parenting and identification with all humanity: Insights from England and Germany
Authors: Hagel Minne Luise , Trutzenberg Friedemann , Eid Michael
Published: August 2022

In the past decade, identification with all humanity (IWAH) has been found to predict several positive behavioral outcomes like volunteering, a willingness to contribute to humanitarian relief, and cooperative health behavior during the COVID-19 pandemic. However, to this day, little is known about how individual differences in IWAH emerge. Therefore, the present study aimed to explore whether there is a relationship between individuals’ upbringing and their IWAH. For this purpose, data on IWAH, remembered parenting behavior (RPB), and remembered parental attachment assessed by 3056 individuals (1517 from Germany and 1539 from England) were analyzed. Structural equation models were used to (A) analyze the correlations between RPB, attachment, and IWAH and to (B) test whether single facets of RPB and attachment could significantly predict IWAH when controlling for the other facets in a latent regression analysis. The facets of positive RPB correlated significantly positively with the two facets of IWAH (global self-definition and global self-investment) and explained between 4.1 and 7% of their variance. Surprisingly, in the English sample, two facets of negative RPB also correlated significantly positively with IWAH. The explained variance in IWAH being significant but small, it is argued that parents’ attitudes or behavior specifically related to IWAH could have a greater impact on IWAH than more unspecific parenting behavior. For instance, we discovered that the extent to which participants perceived their parents as global citizens explained about one third of the variance in their own identification as global citizens. Fostering IWAH could constitute an effective approach to tackle important global challenges. Therefore, more research is needed to test the generalizability of the results and to further analyze the roots of people’s IWAH.
Influencing factors of online products decision-making oriented to tourism economy under the guidance of consumer psychology
Authors: Jin Linlin , Hu Bin
Published: August 2022

This work aims to increase the consumption of online tourism products and promote the development of the tourism economy. Based on this, it first analyses the Internet market under the guidance of consumer psychology. Then, the influencing factors of online product decision-making for the tourism economy are discussed. Finally, based on the above analysis, it discusses and evaluates the main factors affecting the consumption of online travel products. The research method of this work is set based on psychology so that it can analyze the psychological state of consumers more deeply and promote the development of the consumer market. The results show that the main factors affecting the consumption of online travel products include online travel platforms and user characteristics. Specifically, approximately 80% of users consume online travel products based on platform reviews, approximately 10% of users consume online travel products based on platform recommended content, and approximately 5% of users consume online travel products based on platform search content. Users vary mainly by age, gender, and region and have different preferences for different platforms. Among the four major platforms, Ctrip occupies the most consumers. The conclusion is that the main way to develop the tourism economy is to build a better online travel platform. At the same time, it is necessary to promote online tourism according to the characteristics of users and increase the marketing of online tourism products. This work not only provides a reference for promoting online tourism product marketing but also helps to promote the development of the tourism economy.
Factor Structures of Patient Health Questionnaire-9 Instruments in Exploring Depressive Symptoms of Suburban Population
Authors: Vu Linh Gia , Le Linh Khanh , Dam Anh Vu Trong , Nguyen Son Hoang , Vu Thuc Thi Minh , Trinh Trang Thu Hong , Do Anh Linh , Do Ngoc Minh , Le Trang Huyen , Latkin Carl , Ho Roger C. M. , Ho Cyrus S. H.
Published: August 2022

Background

This study aims to examine the psychometric properties of the nine-item Patient Health Questionnaire (PHQ-9) and assess the relationship between the PHQ-9 domain and demographics and health behaviors in Vietnamese people.

Materials and Methods

The PHQ9 was administered to 899 participants. Exploratory factor and reliability analyses were performed. Tobit regression and Ordered logistic regression were further performed to determine factors associated with the PHQ-9 score and characteristics of depression.

Results

The 2-factor model of PHQ-9, including factor 1 “Somatic” and factor 2 “Cognitive/Affective,” showed good psychometric properties. The Cronbach’s alpha value showed high internal consistency in two factors (0.84 and 0.80, respectively). Gender, health behavior exercising, drinking, and health status had associations with both factors of the PHQ-9 model.

Conclusion

The PHQ-9 scale is a valid and reliable instrument to assess depression in the Vietnam population. This scale can be a useful screening tool for depression; however, further validation studies in other populations are required.
Factors influencing hospital anxiety and depression among emergency department nurses during the COVID-19 pandemic: A multi-center cross-sectional study
Authors: Alzahrani Naif S. , Almarwani Abdulaziz Mofdy , Asiri Saeed A. , Alharbi Hanan F. , Alhowaymel Fahad M.
Published: August 2022

Introduction

The emergency department (ED) is a highly stressful environment, which exposes nurses to infection. ED nurses handle life-threatening conditions, endure long working hours, and deal with anxious patients and their families.

Aim

This study aimed to examine factors, which may influence anxiety and depression levels among ED nurses during the coronavirus disease 2019 (COVID-19) pandemic.

Methods

A cross-sectional design was used with 251 participants from six hospitals in Saudi Arabia (mean age = 32.7 ± 6.59, range = 21–54 years, 70.5% females). Data were collected using the Hospital Anxiety and Depression Scale (HADS), and the analysis was conducted using structural equation modeling (SEM).

Results

Based on the HADS scores, 29.1 and 25.5% of ED nurses were identified as doubtful cases for depression and anxiety, respectively. Additionally, 34.7 and 43.3% of ED nurses were identified as definite cases for depression and anxiety, respectively. Higher anxiety levels were observed among female nurses, nurses with lower physical activity levels, and nurses who worked in urban areas. Low physical activity levels and more than 6 years of work experience correlated with a higher level of depression. None of the hypothesized paths in the anxiety and depression models were significant, except for two observed variables—namely, work location and physical exercise in the anxiety model and physical exercise in the depression model.

Conclusion

Emergency department nurses expressed high levels of anxiety and depression during the COVID-19 pandemic, which may negatively affect their performance and reduce care quality. Therefore, health care leaders should implement specialized mental health education programs focused on nursing occupational safety and support to improve ED nurses’ psychological well-being. Specific attention should be paid to ED female nurses who work in urban areas, especially those with more than 6 years of experience.
Seeking bridge symptoms of anxiety, depression, and sleep disturbance among the elderly during the lockdown of the COVID-19 pandemic—A network approach
Authors: Zhang Liang , Tao Yanqiang , Hou Wenxin , Niu Haiqun , Ma Zijuan , Zheng Zeqing , Wang Shujian , Zhang Shuang , Lv Yichao , Li Qiubai , Liu Xiangping
Published: August 2022

Background

Besides physical changes, elderly adults are prone to have mental disorders such as anxiety, depression, and sleep disturbance, and the pandemic of COVID-19 worsened the situation. However, internal relationships and co-occurrence of psychopathologies were scarcely examined. Therefore, in the current study, through network analysis, we inspected relationships among symptoms of depression, anxiety, and sleep disturbance and identified key symptoms that espoused the disease.

Methods

We asked 1,302 elderly adults to fill in Patient Health Questionnaire-2 (depressive symptoms), the Generalized Anxiety Disorder-2 (anxiety symptoms), and the Youth Self-rating Insomnia Scale (sleep disturbance) and then constructed three networks for elderly adults, male elderly, and female elderly. Via network analysis, we accomplished four goals. First, we identified symptom with the highest centrality (i.e., strength) index for each network; then, we found the strongest correlation (i.e., edges) in each network; thirdly, we confirmed specific nodes that could bridge anxiety, depression, and sleep disturbance; the last was to compare networks based on genders. Network stability and accuracy tests were performed.

Results

Networks of elderly adults, male elderly, and female elderly were stable, accurate, and intelligible. Among all networks, “Nervousness”- “Excessive worry” (GAD-1- GAD-2) had the strongest correlation, and “Nervousness” (GAD-1) had the highest strength and bridge strength value. When we made a comparison between female elderly's and male elderly's networks, except for the significant difference in the mean value of “Difficulty initiating sleep” (YSIS-3), the findings showed that the two networks were similar. Network stability and accuracy proved to be reliable.

Conclusions

In networks of anxiety, depression, and sleep disturbance, anxiety played a conspicuous role in comorbidity, which could be a target for practical intervention and prevention.
Actigraphy monitoring in anxiety disorders: A mini-review of the literature
Authors: Pastre Martin , Lopez-Castroman Jorge
Published: August 2022

Sleep disturbances and changes of activity patterns are not uncommon in anxiety disorders, but they are rarely the object of attention. Actigraphic monitoring of day and night activity patterns could provide useful data to detect symptom worsening, prevent risk periods, and evaluate treatment efficacy in those disorders. Thus, we have conducted a systematic search of the scientific literature to find any original study using actigraphic monitoring to investigate activity and sleep patterns in patients affected by any type of anxiety disorder according to the definition of the DSM-5. We found only six studies fulfilling these criteria. Three studies report significant findings in patients suffering from anxiety disorders. Overall, the samples and methods are heterogeneous. Although the authors support the interest of actigraphic monitoring in anxiety disorders, the evidence to date is very limited.
The impact of social media on risk perceptions during COVID-19 in Saudi Arabia
Authors: Angawi Khadijah , Albugmi Mutlaq
Published: August 2022

Background

Social media is considered a critical source for seeking health information, especially during outbreaks. During the Coronavirus disease 2019 (COVID-19) pandemic, social media played an important role in disseminating information. However, it has been a source of misinformation in many communities throughout the pandemic. Whether this disseminated information has a positive or negative impact, individuals' risk perceptions of disease are influenced. It is important to explore factors that build public behaviors and their adaptation of risk reduction measures during the COVID-19 pandemic. Therefore, the aim of this study is to determine the role of social media and its impact on the risk perceptions of the COVID-19 in Saudi Arabia.

Methods

This was a cross-sectional study, and participants were recruited using different social media outlets between August to October 2020. The survey was delivered through Qualtrics platform targeting Saudi Arabian residents over the age of 18 years old. The questionnaire was delivered in English and Arabic. A convenience sampling was used to recruit participants to the study. The survey link was posted on several social media platforms.

Results

A total of 2,680 respondents completed the online survey. The results showed that male gender, individuals earning 4,000–12,000 SAR, and employed had positive and significant relationships with risk perception compared to their counterparts (β: 0.044, p-value: 0.035 and β: 0.051, p-value: 0.041, β: 0.108 p-value: < 0.001, β: 0.119 p-value: < 0.001), respectively. In second block, individuals exposed to social media had higher risk perception (β: 0.096, p-value < 0.001). In third block, self-efficacy was significantly but negatively associated with risk perception, indicating individuals who were self-efficient were less likely to perceive risk for the COVID-19 (β: −0.096, p-value < 0.001). There was no interactive effect of social media and self-efficacy on risk perception.

Conclusion

The current study results show that social media exposure to the COVID-19 information has a positive impact in shaping an individuals' risk perception. The study also suggests that there is a need for public officials and policymakers to develop effective communication strategies through risk communication campaigns targeted at women, individuals with lower socioeconomic status, and those who are single as they showed a negative relationship with risk perception.
Heterogeneity of symptoms and functions among women receiving chemotherapy for breast cancer in China: A multicentre, cross-sectional study
Authors: Cai Tingting , Zhou Tingting , Yuan Changrong , Yu Chunfang , Ni Feixia , Sheng Zhiren
Published: August 2022

Background

Currently, few studies have explored the heterogeneity of symptoms and functions in patients with breast cancer. This study aimed to identify the subgroups of symptoms and functions in women receiving chemotherapy for breast cancer and determine whether the subgroups differed in demographic and clinical characteristics.

Methods

A cross-sectional multicenter survey involving five hospitals in Zhejiang, Shanghai, Shandong, and Guangxi provinces of Mainland China was implemented between August 2020 to December 2021. Participants completed questionnaires that included the PROMIS-57, PROMIS cognitive function short form, and demographic and clinical characteristics. Latent class analysis was performed, followed by chi-square test and analysis of variance. Subsequently, significant variables were included in multinomial logistic regression.

Results

A total of 1,180 patients were investigated, with an average age of 48.9 years. Three classes were identified: low symptom burdens and functions group (26.2%, Class 1), moderate symptom burdens and functions group (16.9%, Class 2), and low symptom burdens and high functions group (56.9%, Class 3). Compared with patients in Class 1 and 3, those in Class 2 consistently showed a higher tendency of having urban employee health insurance (odds ratio = 2.506, P < 0.05) and rural health insurance (odds ratio = 2.207, P < 0.05). Additionally, patients in Class 2 tended to be in their fourth cycle of chemotherapy. However, receiving chemotherapy and surgery increased the likelihood of belonging to Class 1.

Conclusions

A high proportion of patients experienced varying degrees of symptom and function issues, suggesting that attention is warranted for women with breast cancer undergoing chemotherapy. Patients with the urban employee basic medical system, the new rural cooperative medical system and in the early stage of chemotherapy cycles were more likely to have symptom burdens. Middle-aged postmenopausal women reported varying degrees of cognitive issues. Additionally, surgery increased the presence of potential long-term effects in functional levels.
Effect of a tailored upper extremity strength training intervention combined with direct current stimulation in chronic stroke survivors: A Randomized Controlled Trial
Authors: Palimeris Stephania , Ansari Yekta , Remaud Anthony , Tremblay François , Corriveau Hélène , Boudrias Marie Hélène , Milot Marie Hélène
Published: August 2022

Strengthening exercises are recommended for managing persisting upper limb (UL) weakness following a stroke. Yet, strengthening exercises often lead to variable gains because of their generic nature. For this randomized controlled trial (RCT), we aimed to determine whether tailoring strengthening exercises using a biomarker of corticospinal integrity, as reflected in the amplitude of motor evoked potentials (MEPs) elicited by transcranial magnetic stimulation (TMS), could optimize training effects in the affected UL. A secondary aim was to determine whether applying anodal transcranial direct current stimulation (tDCS) could enhance exercise-induced training effects. For this multisite RCT, 90 adults at the chronic stage after stroke (>6 months) were recruited. Before training, participants underwent TMS to detect the presence of MEPs in the affected hand. The MEP amplitude was used to stratify participants into three training groups: (1) low-intensity, MEP <50 μV, (2) moderate-intensity, 50 μV < MEP < 120 μV, and (3) high-intensity, MEP>120 μV. Each group trained at a specific intensity based on the one-repetition maximum (1 RM): low-intensity, 35–50% 1RM; moderate-intensity, 50–65% 1RM; high-intensity, 70–85% 1RM. The strength training targeted the affected UL and was delivered 3X/week for four consecutive weeks. In each training group, participants were randomly assigned to receive either real or sham anodal tDCS (2 mA, 20 min) over the primary motor area of the affected hemisphere. Pre-/post-intervention, participants underwent a clinical evaluation of their UL to evaluate motor impairments (Fugl-Meyer Assessment), manual dexterity (Box and Blocks test) and grip strength. Post-intervention, all groups exhibited similar gains in terms of reduced impairments, improved dexterity, and grip strength, which was confirmed by multivariate and univariate analyses. However, no effect of interaction was found for tDCS or training group, indicating that tDCS had no significant impact on outcomes post-intervention. Collectively, these results indicate that adjusting training intensity based on the size of MEPs in the affected extremity provides a useful approach to optimize responses to strengthening exercises in chronic stroke survivors. Also, the lack of add-on effects of tDCS applied to the lesioned hemisphere on exercise-induced improvements in the affected UL raises questions about the relevance of combining such interventions in stroke.

Clinical trial registry number

NCT02915185.https://www.clinicaltrials.gov/ct2/show/NCT02915185.
Experimenting with automated driving for technology or for the city? A matter of governance cultures
Authors: Servou Eriketti , Mögele Michael , Torrens Jonas
Published: August 2022

Urban experiments have been promoted as means to enable innovation for sustainability, particularly in urban mobility. Yet, they have been criticized for struggling to stimulate broader transformations, as they often are detached from public-value principles, lack embeddedness in the cities' everyday realities and are industry-oriented. How cultural changes on different governance levels intersect to produce urban experiments with transformative potential has received little attention. This paper focuses on how urban experiments are co-created with broader governance cultures in multiple governance levels, and what the implications of this co-creation are for urban transformation. We provide a theoretical background on the interrelations between governance cultures and urban experimentation, and the debate on urban experimentation within Science and Technology Studies, transition/innovation studies and urban studies to identify the main barriers for urban transformation. We, then, present our methodology consisting of the case study selection of the multi-level governance nexus State-Region-City in Stuttgart and Karlsruhe, our data collection with interviews and documents, and the analytical tool of storylines to capture the co-production of governance cultures and urban experiments. We continue with the analysis of the case study of automated driving experimentation with the concept of storylines. Our findings show that urban experiments are more likely to lead to urban transformation when the local public sector has a strong role in governance processes, and when experiments emerge through deliberation on daily urban problems and policy agendas. When governance processes are mainly led by state and industry actors who prioritize testing technologies as universal and scalable byproducts, it is less likely for urban experiments to lead to urban transformation. Finally, we discuss when urban experimentation advances technologyper seand when it adds public value and advances sustainability, arguing for a co-existence of different kinds of urban experiments. We conclude with future research and policy implications.