bluuebunny/crossref_metadata_2025 huggingface dataset:
Right Ventricular Function in Acute Respiratory Distress Syndrome: Impact on Outcome, Respiratory Strategy and Use of Veno-Venous Extracorporeal Membrane Oxygenation
Authors: Petit Matthieu , Jullien Edouard , Vieillard-Baron Antoine
Published: January 2022

Acute respiratory distress syndrome (ARDS) is characterized by protein-rich alveolar edema, reduced lung compliance and severe hypoxemia. Despite some evidence of improvements in mortality over recent decades, ARDS remains a major public health problem with 30% 28-day mortality in recent cohorts. Pulmonary vascular dysfunction is one of the pivot points of the pathophysiology of ARDS, resulting in a certain degree of pulmonary hypertension, higher levels of which are associated with morbidity and mortality. Pulmonary hypertension develops as a result of endothelial dysfunction, pulmonary vascular occlusion, increased vascular tone, extrinsic vessel occlusion, and vascular remodeling. This increase in right ventricular (RV) afterload causes uncoupling between the pulmonary circulation and RV function. Without any contractile reserve, the right ventricle has no adaptive reserve mechanism other than dilatation, which is responsible for left ventricular compression, leading to circulatory failure and worsening of oxygen delivery. This state, also called severe acute cor pulmonale (ACP), is responsible for excess mortality. Strategies designed to protect the pulmonary circulation and the right ventricle in ARDS should be the cornerstones of the care and support of patients with the severest disease, in order to improve prognosis, pending stronger evidence. Acute cor pulmonale is associated with higher driving pressure (≥18 cmH2O), hypercapnia (PaCO2 ≥ 48 mmHg), and hypoxemia (PaO2/FiO2 < 150 mmHg). RV protection should focus on these three preventable factors identified in the last decade. Prone positioning, the setting of positive end-expiratory pressure, and inhaled nitric oxide (INO) can also unload the right ventricle, restore better coupling between the right ventricle and the pulmonary circulation, and correct circulatory failure. When all these strategies are insufficient, extracorporeal membrane oxygenation (ECMO), which improves decarboxylation and oxygenation and enables ultra-protective ventilation by decreasing driving pressure, should be discussed in seeking better control of RV afterload. This review reports the pathophysiology of pulmonary hypertension in ARDS, describes right heart function, and proposes an RV protective approach, ranging from ventilatory settings and prone positioning to INO and selection of patients potentially eligible for veno-venous extracorporeal membrane oxygenation (VV ECMO).
Belowground Chemical Interactions: An Insight Into Host-Specific Behavior of Globodera spp. Hatched in Root Exudates From Potato and Its Wild Relative, Solanum sisymbriifolium
Authors: Kud Joanna , Pillai Syamkumar Sivasankara , Raber Gabriel , Caplan Allan , Kuhl Joseph C. , Xiao Fangming , Dandurand Louise-Marie
Published: January 2022

Understanding belowground chemical interactions between plant roots and plant-parasitic nematodes is immensely important for sustainable crop production and soilborne pest management. Due to metabolic diversity and ever-changing dynamics of root exudate composition, the impact of only certain molecules, such as nematode hatching factors, repellents, and attractants, has been examined in detail. Root exudates are a rich source of biologically active compounds, which plants use to shape their ecological interactions. However, the impact of these compounds on nematode parasitic behavior is poorly understood. In this study, we specifically address this knowledge gap in two cyst nematodes, Globodera pallida, a potato cyst nematode and the newly described species, Globodera ellingtonae. Globodera pallida is a devastating pest of potato (Solanum tuberosum) worldwide, whereas potato is a host for G. ellingtonae, but its pathogenicity remains to be determined. We compared the behavior of juveniles (J2s) hatched in response to root exudates from a susceptible potato cv. Desirée, a resistant potato cv. Innovator, and an immune trap crop Solanum sisymbriifolium (litchi tomato – a wild potato relative). Root secretions from S. sisymbriifolium greatly reduced the infection rate on a susceptible host for both Globodera spp. Juvenile motility was also significantly influenced in a host-dependent manner. However, reproduction on a susceptible host from juveniles hatched in S. sisymbriifolium root exudates was not affected, nor was the number of encysted eggs from progeny cysts. Transcriptome analysis by using RNA-sequencing (RNA-seq) revealed the molecular basis of root exudate-mediated modulation of nematode behavior. Differentially expressed genes are grouped into two major categories: genes showing characteristics of effectors and genes involved in stress responses and xenobiotic metabolism. To our knowledge, this is the first study that shows genome-wide root exudate-specific transcriptional changes in hatched preparasitic juveniles of plant-parasitic nematodes. This research provides a better understanding of the correlation between exudates from different plants and their impact on nematode behavior prior to the root invasion and supports the hypothesis that root exudates play an important role in plant-nematode interactions.
Cognition Without Neural Representation: Dynamics of a Complex System
Authors: Hipólito Inês
Published: January 2022

This paper proposes an account of neurocognitive activity without leveraging the notion of neural representation. Neural representation is a concept that results from assuming that the properties of the models used in computational cognitive neuroscience (e.g., information, representation, etc.) must literally exist the system being modelled (e.g., the brain). Computational models are important tools to test a theory about how the collected data (e.g., behavioural or neuroimaging) has been generated. While the usefulness of computational models is unquestionable, it does not follow that neurocognitive activity should literally entail the properties construed in the model (e.g., information, representation). While this is an assumption present in computationalist accounts, it is not held across the board in neuroscience. In the last section, the paper offers a dynamical account of neurocognitive activity with Dynamical Causal Modelling (DCM) that combines dynamical systems theory (DST) mathematical formalisms with the theoretical contextualisation provided by Embodied and Enactive Cognitive Science (EECS).
Do Flipped Learning and Adaptive Instruction Improve Student Learning Outcome? A Case Study of a Computer Programming Course in Taiwan
Authors: Chen Hong-Ren , Hsu Wen-Chiao
Published: January 2022

Flipped learning could improve the learning effectiveness of students. However, some studies have pointed out the limitations related to flipped classrooms because the content of the flipped course does not vary according to the needs of the students. On the other hand, adaptive teaching, which customizes the learning mode according to the individual needs of students, can make up for some of the shortcomings of flipped teaching. This study combines adaptive teaching with flipped teaching and applies it to face-to-face classroom activities. The purpose of this research is to explore whether the implementation of flipping and adaptive learning in a computer programming course can improve the learning effectiveness of students. The experimental subjects of this study are the sophomore students in the Department of Information Management. The flipped classroom with adaptive instruction has been realized in the limited course time. This study uses questionnaires to collect pre- and post-test data on the “learning motivation” of students. The learning effectiveness was evaluated based on the students' previous programming course (C language) and the semester scores of this course. Research results show that the post-test “learning motivation” has improved overall compared with the pre-test, and the learning effect is significant. The results of this research not only prove the effectiveness of modern teaching theories in programming courses but also lay the foundation for future teaching design.
German Laypeople’s Willingness to Donate Toward Insect Conservation: Application of an Extended Protection Motivation Theory
Authors: Dörge Lara , Büscher Milan , Drews Jasmin , Eylering Annike , Fiebelkorn Florian
Published: January 2022

It is essential to engage the public in conservation measures to conserve insects. We investigate the Protection Motivation Theory (PMT), as well as knowledge, attitudes, and sociodemographic variables (gender, age, education level, and income) as predictors of willingness to donate (WTD) and actual donations to insect conservation for a representative German sample (N = 515;MAge = 49.36,SD = 16.73; female = 50.1%). The PMT subcomponents severity, self-efficacy, and response efficacy, as well as attitudes toward insects, income, and education level, significantly predicted WTD. In contrast, severity, response barriers, age, gender, and the WTD significantly influenced actual donations. Overall, components of the PMT have high predictive power for both dependent variables. Our results suggest that an intention-behavior gap exists between the intention to donate and the actual donation toward insect conservation. Measures to increase WTD and actual donations for insect conservation are discussed.
The Five-Factor Perceived Shared Mental Model Scale: A Consolidation of Items Across the Contemporary Literature
Authors: van Rensburg Jandre J. , Santos Catarina M. , de Jong Simon B. , Uitdewilligen Sjir
Published: January 2022

Literature on Shared Mental Models (SMMs) has been burgeoning in recent years and this has provided increasingly detailed insight and evidence into the importance of SMMs within specific contexts. However, because past research predominantly focused on SMM structure as measured by diverse, context-dependent measures, a consolidated multi-dimensional measure of perceived SMMs that can be used across diverse team contexts is currently lacking. Furthermore, different conceptualizations of the dimensionality of SMMs exist, which further impedes the comparison between studies. These key limitations might hinder future development in the SMM literature. We argue that the field of SMMs has now matured enough that it is possible to take a deductive approach and evaluate the prior studies in order to refine the key SMMs dimensions, operationalizations, and measurement. Hence, we take a three-stage approach to consolidate existing literature scale-based measures of SMMs, using four samples. Ultimately, this leads to a 20-item five-dimensional scale (i.e., equipment, execution, interaction, composition, and temporal SMMs) – the Five Factor Perceived Shared Mental Model Scale (5-PSMMS). Our scale provides scholars with a tool which enables the measurement, and comparison, of SMMs across diverse team contexts. It offers practitioners the option to more straightforwardly assess perceived SMMs in their teams, allowing the identification of challenges in their teams and facilitating the design of appropriate interventions.
A Positive Psychology Perspective on Positive Emotion and Foreign Language Enjoyment Among Chinese as a Second Language Learners Attending Virtual Online Classes in the Emergency Remote Teaching Context Amid the COVID-19 Pandemic
Authors: Wang Qing , Jiang Yuhong
Published: January 2022

This study adopted a positive psychology perspective to investigate positive emotion and foreign language enjoyment among Chinese as a second language (CSL) learners in an emergency remote teaching (ERT) context amid the COVID-19 pandemic. A set of 90 preparatory Chinese language students (40 males and 50 females) was assessed for their level of foreign language enjoyment using the Foreign Language Enjoyment Scale (FLES). Participles' scores on self-perceived language achievement and actual test scores were adopted as the measurement of their Chinese language proficiency. The results revealed that: (1) CSL learners experienced high level of FL enjoyment in an online learning context, (2) no significant correlation was found between FLE and leaners' actual language achievement nor between FLE and their self-perceived achievement, (3) female learners showed higher FLE than male learners and gender was found to have a significant effect on FLE-Private, (4) participants' geological location, i.e., whether in China or at home countries, significantly influenced their FLE, (5) participants' regional group was not a significant predictor of FLE, and (6) teacher-related variables and learner self-perceptions of achievement were strong predictors of FLE among CSL learners. The findings highlight the importance of teacher's role in an online learning environment and suggest that FLE may not boost performance in the short term for language beginners but is still conducive in the long run. Implications for both teachers and learners, and suggestions for future researches are provided.
Effect of Brand Experience on Customer Engagement Through Quality Services of Online Sellers to Students in Bekasi
Authors: Merdiaty Netty , Aldrin Neil
Published: January 2022

Customer engagement refers to the emotional attachment a student experiences as a customer during repeated and ongoing interactions. Engagement occurs through satisfaction, loyalty, and excitement about the brand experience. Organizations engage customers at the point of behavioral change by exploring opportunities for emotional connection through continuous and consistent positive experiences. When customers engage with a brand experience, they feel emotionally connected and excited about the product and the service quality. This study’s purpose is examining the effect of brand experience on customer engagement by using service quality as a mediator variable; this research was conducted by collecting data from 254 students of the iGeneration born in 1995. Overall, 254 students participated in this study. Of them, 172 people or 68% of the total respondents in this study were women, and 82 people or 32% were males. The results show no direct effect of brand experience on customer engagement, and there is a role for service quality mediators that mediate brand experience and customer engagement. The results are discussed, and the implications for the organization are mentioned.
Reducing Red Tape’s Negative Consequences for Leaders: The Buffering Role of Autonomous Motivation
Authors: Muylaert Jolien , Bauwens Robin , Audenaert Mieke , Decramer Adelien
Published: January 2022

In a context where the amount of red tape in healthcare organizations continues to rise, head nurses’ job satisfaction is constantly under pressure. By building on the Job Demands-Resources model, we developed a theoretical model investigating the relationship between red tape and job satisfaction. By investigating the mediating role of discretionary room and the moderating role of autonomous motivation in this relationship, this study does not only aim to provide additional knowledge regarding the underlying mechanisms in this relationship, but also to increase our understanding of how this suffering at work can be mitigated. Our conditional process analyses (N= 277 head nurses) indicate that red tape undermines head nurses’ job satisfaction and that discretionary room acts as an underlying mechanism in this process. By revealing the mediating role of discretionary room, this study advances our understanding of the risks originating from red tape for leaders. Furthermore, our findings also indicate that autonomous motivation mitigates the negative relation between red tape and discretionary room and between red tape and job satisfaction. As autonomous motivation turns out to be an important protection mechanism against the negative consequences of red tape, organizations should put extra effort into stimulating the autonomous motivation of their leaders. When organizations make sure that their leaders’ job designs and work environments meet the need for autonomy, competence, and relatedness, leaders will become more autonomously motivated, which will buffer the negative impact of red tape.
Factor Structure and Internal Consistency on a Reduced Version of the Revised Test of Need for Cognitive Closure
Authors: Jaume Luis Carlos , Schetsche Christian , Roca Marcelo Agustín , Quattrocchi Paula
Published: January 2022

The need for cognitive closure is a construct postulated by Kruglanski that explains the motivational aspects which influence decision-making and its impact on the social environment. Initially, it was assessed through a unidimensional scale, later criticized for its poor satisfactory reliability and validity. Regarding these criticisms, Pierro and Kruglanski developed a new 14-item scale to measure two dimensions, which were not previously evaluated: urgency tendency and permanence tendency. Although the Revised Test of Need for Cognitive Closure is more economical in terms of assessment time, it would be optimal to develop a reduced test that can assess faster while maintaining validity and reliability. The present research aims to reduce the Revised Test of Need for Cognitive Closure scale to the Argentinian context. To this end, we worked on a non-experimental design, assessing this scale within a sample of 690 Argentinian university students (Women = 81.16%, Men = 18.84%), and proceeded to perform reliability, as well as confirmatory factor analysis, convergent validity, and factorial invariance analysis. The results indicate a bi-factorial structure of a Need for Cognitive Closure instrument with eight items and two dimensions: urgency tendency (α = 0.76) and permanence tendency (α = 0.64), suggesting good reliability in both of them. In addition, well convergent validity was checked with other validated instruments, and finally, the factor loadings were shown to be invariant. In conclusion, it was demonstrated the reliability and validity of reducing the Revised Test of Need for Cognitive Closure in our social environment.
The Relationship Among Spirituality, Fear, and Mental Health on COVID-19 Among Adults: An Exploratory Research
Authors: Rathakrishnan Balan , Singh Soon Singh Bikar , Yahaya Azizi , Kamaluddin Mohammad Rahim , Aziz Siti Fardaniah Abdul
Published: January 2022

The novel coronavirus disease (COVID-19) is impactful on all aspects of individuals’ lives, particularly mental health due to the fear and spirituality associated with the pandemic. Thus, purpose of this study was to identify the relationship among fear, spirituality, and mental health on COVID-19 among adults in Malaysia. This study also examines spirituality as a mediator in relationship between fear and mental health. The study involved around 280 adults in Malaysia. This research is a quantitative study. Data analysis method (SEM-PLS) has been used for data analysis. Based on descriptive analysis, mental health questionnaire indicated that 60.0% of them are at a poor level of mental health whereas 57.5% of respondents showed a moderate level of COVID-19 fear, and 60.4% of respondents owned moderate level of spiritual well-being. The results also demonstrated that respondents that have a high level of fear would have a high level of mental health; interestingly, those with a high level of spirituality will have a lower level of mental health. Findings indicated that spirituality significantly mediated the relationship between fear and mental health. This research will help to demonstrate how important spirituality values to control mental health to be more positive among adults in Malaysia. The main contributions of this study are to help come out with new intervention method for those who are mentally ill and need help.
Post-Traumatic Growth of Nurses Who Faced the COVID-19 Epidemic and Its Correlation With Professional Self-Identity and Social Support
Authors: Mo Yuanyuan , Tao Pinyue , Liu Guiying , Chen Lin , Li Gaopeng , Lu Shuyu , Zhang Guining , Liang Rong , Huang Huiqiao
Published: January 2022

Objective:

To investigate post-traumatic growth (PTG) and analyze its correlation with professional self-identity and social support in Chinese nurses who faced the coronavirus disease 2019 (COVID-19) epidemic.

Methods:

A cross-sectional descriptive design was used in this study. An online questionnaire was completed by 266 nurses who faced the COVID-19 emergency in Hubei Province, China. The Post-traumatic Growth Inventory (PTGI), Professional Self-identity Scale, and Perceived Social Support Scale were used to assess the level of PTG, professional self-identity, and social support. Descriptive, univariate analysis and multiple regression analyses were used in exploring related influencing factors.

Results:

Participants' mean scores were 96.26 (SD = 21.57) for PTG, 115.30 (SD = 20.82) for professional self-identification, and 66.27 (SD = 12.90) for social support. Multiple regression analysis showed that nurses from other provinces moving to support Hubei Province, professional self-identity, and social support were the main factors affecting nurse stress (p = 0.014, < 0.001, and 0.017, respectively). Professional self-identity and social support were positively correlated with PTG (r = 0.720 and 0.620, respectively).

Conclusions:

There was a phenomenon of PTG when the nurses faced COVID-19 in Hubei Province. Providing an active coping style helps to improve the level of PTG.
Sexual Dysfunction in Chronically Medicated Male Inpatients With Schizophrenia: Prevalence, Risk Factors, Clinical Manifestations, and Response to Sexual Arousal
Authors: Liu Dianying , Liu Shaohua , Xiu Meihong , Deng Hongdong , Guo Huiyun , Liu Wanglin , Zhang Delong , Mao Zhongzhen , Huang Dan , Huang Donghua , Miao Qiumei , Qiu Lijuan , Zhao Ning Olivia , Wu Hanjing Emily , Zhang Xiangyang
Published: January 2022

Background

Sexual dysfunction is a common symptom in patients with schizophrenia, especially in chronically medicated patients. However, the relationship between sexual dysfunction and emotional response to sexual arousal in male patients with schizophrenia remains unclear. This study aimed to assess the incidence, risk factors of sexual dysfunction in males, and their clinical correlations to sexual arousal in male patients with schizophrenia in China.

Methods

A total of 162 male patients, aged 18–50 years, with schizophrenia were recruited from a psychiatric hospital in Ganzhou. The clinical symptoms were assessed by the Positive and Negative Syndrome Scale (PANSS). The Arizona Sexual Experience Scale was utilized to evaluate sexual dysfunction. Erotic images were selected from International Affective Picture System (IAPS). Sixty-eight out of the 162 subjects completed the erotic pictures reactivity task.

Results

Overall, 48 (29.6%) patients were measured as having global sexual dysfunction, 72 (44.4%) patients as having strength of sex drive dysfunction, 51 (31.5%) patients as having sexual arousal dysfunction, 55 (34.0%) patients as having penile erection dysfunction, 60 (37.0%) patients as having reached orgasm dysfunction, and 60 (37.0%) patients as having satisfaction with orgasm dysfunction. The sexual dysfunction patients had significantly higher scores on the negative symptoms of the PANSS. The only important predictor of sexual dysfunction was the severity of PANSS negative factor. The sense of pleasure and arousal post viewing erotic images in the sexual dysfunction group were lower compared to the non-sexual dysfunction group. The sense of pleasure and approach motivation were significantly negatively correlated with the severity of sexual dysfunction.

Conclusions

This study shows that nearly one-third of young and middle-aged chronically medicated male inpatients with schizophrenia suffer from sexual dysfunction. The negative factor of the PANSS can be regarded as the risk factor of sexual dysfunction. Schizophrenia patients with sexual dysfunction experienced lower pleasure and higher avoidance motivation than non-sexual dysfunction patients when exposed to erotic stimuli.
The Significance of Toll-Like Receptors in the Neuroimmunologic Background of Alcohol Dependence
Authors: Czerwińska-Błaszczyk Agnieszka , Pawlak Edyta , Pawłowski Tomasz
Published: January 2022

Toll-like receptors (TLR) are a group of protein belonging to the family of Pattern Recognition Receptors (PRR) which have the ability to distinguish between an organism's own antigens and foreign ones and to induce immunological response. TLR play a significant part in non-specific immunity but at the same time they are also a vital element linking non-specific response to the specific one. A growing number of data seems to indicate that the non-specific immunity mechanisms affect the development and sustenance of alcohol addiction. Alcohol damages the organism's cells not only directly but also through an increase inintestinal permeability which induces innate immune response of peripheral blood cells. The signaling pathway of Toll-like receptors located on the surface of brain immune cells intensifies the inflammatory reaction and, through modifying gene expression of proinflammatory factors, unnaturally supports it. This overly protracted “sterile inflammatory reaction” positively correlates with alcohol craving affecting also the functioning of the reward system structures and increasing the risk of relapse of alcoholism. Recurrent alcoholic binges sensitize the microglia and cause an escalation in inflammatory reaction which also leads to neurodegeneration. The induction of innate immunity signaling pathways exposes clinical symptoms of alcohol addiction such as increased impulsivity, loss of behavioral control, depressive-anxiety symptoms and cognitive dysfunctions. Traditional methods of treating alcohol addiction have tended to focus predominantly on reducing symptoms which—given the frequency of relapses—seems insufficient. The aim of the present paper is to discuss the role of toll-like receptors as elements of the immunity system which, together with the nervous system, plays a crucial part in the pathogenesis of alcohol addiction. We also wish to present pharmacotherapeutic perspectives targeted at the neuroimmunological mechanisms of alcohol addiction.
Family Conflict Associated With Intrinsic Hippocampal-OFC Connectivity in Adolescent Depressive Disorder
Authors: Feng Ruohan , Bao Weijie , Zhuo Lihua , Gao Yingxue , Yao Hongchao , Li Yang , Liang Lijun , Liang Kaili , Zhou Ming , Zhang Lianqing , Huang Guoping , Huang Xiaoqi
Published: January 2022

Background

Family environment and life events have long been suggested to be associated with adolescent depression. The hippocampus plays a crucial role in the neural mechanism of major depressive disorder (MDD) through memory during stressful events. However, few studies have explored the exact neural mechanisms underlying these associations. Thus, the current study aimed to explore alterations in hippocampal functional connectivity (FC) in adolescent MDD based on resting-state functional magnetic resonance imaging and further investigate the relationship between hippocampal FC, environmental factors, and clinical symptom severity.

Methods

Hippocampal FC was calculated using the seed-based approach with the bilateral hippocampus as the seed for 111 adolescents with and without MDD; comparisons were made between participants with MDD and controls. We applied the Chinese version of the Family Environment Scale (FES-CV) and Adolescents Self-Rating Life Events Checklist (ASLEC) to evaluate family environment and life stress. Their relationship with hippocampal FC alterations was also investigated.

Results

We found that compared to controls, adolescents with MDD showed decreased connectivity between the left hippocampus and bilateral orbital frontal cortex (OFC) and right inferior temporal gyrus. In addition, the hippocampal-OFC connectivity was negatively correlated with conflict scores of the FES-CV in the MDD group and mediated the association between family conflict and depressive and anxiety symptoms.

Conclusion

Our findings are novel in the field and demonstrate how family conflict contributes to MDD symptomatology through hippocampal-OFC connectivity; these findings may provide potential targets for personalized treatment strategies.
Avoiding Routine Oxygen Therapy in Patients With Myocardial Infarction Saves Significant Expenditure for the Health Care System—Insights From the Randomized DETO2X-AMI Trial
Authors: Hofmann Robin , Abebe Tamrat Befekadu , Herlitz Johan , James Stefan K. , Erlinge David , Alfredsson Joakim , Jernberg Tomas , Kellerth Thomas , Ravn-Fischer Annica , Lindahl Bertil , Langenskiöld Sophie ,   DETO2X-SWEDEHEART Investigators
Published: January 2022

Background: Myocardial infarction (MI) occurs frequently and requires considerable health care resources. It is important to ensure that the treatments which are provided are both clinically effective and economically justifiable. Based on recent new evidence, routine oxygen therapy is no longer recommended in MI patients without hypoxemia. By using data from a nationwide randomized clinical trial, we estimated oxygen therapy related cost savings in this important clinical setting.

Methods: The DETermination of the role of Oxygen in suspected Acute Myocardial Infarction (DETO2X-AMI) trial randomized 6,629 patients from 35 hospitals across Sweden to oxygen at 6 L/min for 6–12 h or ambient air. Costs for drug and medical supplies, and labor were calculated per patient, for the whole study population, and for the total annual care episodes for MI in Sweden (N = 16,100) with 10 million inhabitants.

Results: Per patient, costs were estimated to 36 USD, summing up to a total cost of 119,832 USD for the whole study population allocated to oxygen treatment. Applied to the annual care episodes for MI in Sweden, costs sum up to between 514,060 and 604,777 USD. In the trial, 62 (2%) patients assigned to oxygen and 254 (8%) patients assigned to ambient air developed hypoxemia. A threshold analysis suggested that up to a cut-off of 624 USD spent for hypoxemia treatment related costs per patient, avoiding routine oxygen therapy remains cost saving.

Conclusions: Avoiding routine oxygen therapy in patients with suspected or confirmed MI without hypoxemia at baseline saves significant expenditure for the health care system both with regards to medical and human resources.

Clinical Trial Registration:ClinicalTrials.gov, identifier: NCT01787110.
Evaluation of Rapid Antigen Tests Using Nasal Samples to Diagnose SARS-CoV-2 in Symptomatic Patients
Authors: Alqahtani Manaf , Abdulrahman Abdulkarim , Mustafa Fathi , Alawadhi Abdulla I. , Alalawi Batool , Mallah Saad I.
Published: January 2022

Introduction

The best way to mitigate an outbreak besides mass vaccination is via early detection and isolation of infected cases. As such, a rapid, cost-effective test for the early detection of COVID-19 is required.

Methods

The study included 4,183 mildly symptomatic patients. A nasal and nasopharyngeal sample obtained from each patient was analyzed to determine the diagnostic ability of the rapid antigen detection test (RADT, nasal swab) in comparison with the current gold-standard (RT-PCR, nasopharyngeal swab).

Results

The calculated sensitivity and specificity of the RADT was 82.1 and 99.1%, respectively. Kappa's coefficient of agreement between the RADT and RT-PCR was 0.859 (p < 0.001). Stratified analysis showed that the sensitivity of the RADT improved significantly when lowering the cut-off RT-PCR Ct value to 24.

Conclusion

Our study's results support the potential use of nasal swab RADT as a screening tool in mildly symptomatic patients, especially in patients with higher viral loads.
Assessment of Financial Toxicity Among Patients With Advanced Lung Cancer in Western China
Authors: Xu Tianqi , Xu Leidi , Xi Hangtian , Zhang Yong , Zhou Ying , Chang Ning , Yang Wenhui , Zhang Yan , Wang Ming , Ju Qing , Yang Xuemin , Chen Xiangxiang , Che Yinggang , Chen Fulin , Qu Shuoyao , Zhang Jian
Published: January 2022

Background: Lung cancer is the leading source of cancer-caused disability-adjusted life years. Medical cost burden impacts the well-being of patients through reducing income, cutting daily expenses, curtailing leisure activities, and depleting exhausting savings. The COmprehensive Score for Financial Toxicity (COST) was created and validated by De Souza and colleagues. Our study intends to measure the financial burdens of cancer therapy and investigate the link between financial toxicity and health-related quality of life (HRQoL) in an advanced lung cancer population.

Methods: Patients aged ≥ 18 years with confirmed stage III to IV lung cancer were eligible. The COST questionnaire verified by de Souza et al. was used to identify financial toxicity. Multivariable linear regression analysis with log transformation univariate analysis and Pearson correlations were used to perform the analysis.

Results: The majority of the patients (90.8%, n = 138/152) had an annual income of $50,000 ($7,775). The cohort's insurance situation was as follows: 64.5% of the cohort had social insurance, 20.4% had commercial insurance, and 22.0% had both. Patients who were younger age (50–59, P < 0.001), employed but on sick leave, and had lower income reported increased levels of financial toxicity (P < 0.05). The risk factors for high financial toxicity: (i) younger age (50–59), (ii) <1 month of savings, and (iii) being employed but on sick leave. Increased financial toxicity is moderately correlated with a decrease in QoL.

Conclusion: Poorer psychological status and specific demographics are linked to increased financial toxicity (lower COST). Financial toxicity has a modest relationship with HRQoL and may have a clear link with HRQoL measurements.
A Hybrid Framework for Intrusion Detection in Healthcare Systems Using Deep Learning
Authors: Akshay Kumaar M. , Samiayya Duraimurugan , Vincent P. M. Durai Raj , Srinivasan Kathiravan , Chang Chuan-Yu , Ganesh Harish
Published: January 2022

The unbounded increase in network traffic and user data has made it difficult for network intrusion detection systems to be abreast and perform well. Intrusion Systems are crucial in e-healthcare since the patients' medical records should be kept highly secure, confidential, and accurate. Any change in the actual patient data can lead to errors in the diagnosis and treatment. Most of the existing artificial intelligence-based systems are trained on outdated intrusion detection repositories, which can produce more false positives and require retraining the algorithm from scratch to support new attacks. These processes also make it challenging to secure patient records in medical systems as the intrusion detection mechanisms can become frequently obsolete. This paper proposes a hybrid framework using Deep Learning named “ImmuneNet” to recognize the latest intrusion attacks and defend healthcare data. The proposed framework uses multiple feature engineering processes, oversampling methods to improve class balance, and hyper-parameter optimization techniques to achieve high accuracy and performance. The architecture contains <1 million parameters, making it lightweight, fast, and IoT-friendly, suitable for deploying the IDS on medical devices and healthcare systems. The performance of ImmuneNet was benchmarked against several other machine learning algorithms on the Canadian Institute for Cybersecurity's Intrusion Detection System 2017, 2018, and Bell DNS 2021 datasets which contain extensive real-time and latest cyber attack data. Out of all the experiments, ImmuneNet performed the best on the CIC Bell DNS 2021 dataset with about 99.19% accuracy, 99.22% precision, 99.19% recall, and 99.2% ROC-AUC scores, which are comparatively better and up-to-date than other existing approaches in classifying between requests that are normal, intrusion, and other cyber attacks.
A Social-Ecological Approach to Studying Variation in Urban Trees and Ecosystem Services in the National Municipal District of Santo Domingo, Dominican Republic
Authors: Meléndez-Ackerman Elvia J. , Pérez Mervin E. , Espinal Ana B. Pou , Caballero Claudia , Cortés Leonardo , Bonilla-Duarte Solhanlle , Bauer Gerald , Martínez Guridy José M. , Arendt Wayne J. , Nowak David J.
Published: January 2022

Maintaining a diverse urban forest that provides ecosystem services can promote urban sustainability and resilience to environmental change. Around the world, cities have taken to inventorying their urban trees and quantifying their ecosystem services but more so in industrialized counties than in Latin America. Here we describe the results of an i-Tree inventory that established 206 survey plots in the National Municipal District of Santo Domingo (NMDSD). We used social-ecological theory to evaluate potential factors that may influence urban forest structure, composition, and ecosystem services diversity across three wards with distinct social and urban characteristics. Rarefaction curves showed a diverse urban forest dominated by non-native trees that have ornamental and medicinal uses. Wards differed in species composition with palms being particularly dominant in Wards 1 and 2 where the proportion of low-income houses is smaller. Ward 1 supports high-income residential areas and Ward 3 is the area with higher population and housing densities and lower income residents. On average, we found no significant differences among wards in tree species richness, average dbh, leaf area, and percent tree cover per plot. Trees in Ward 2 were taller, on average, than those in Ward 1 but were comparable to those in Ward 3. Likewise, tree density per plot was highest in Ward 2, followed by Ward 1 and Ward 3. Despite these significant differences in stem densities, average values in four ecosystem services involving measures of carbon, rainfall, and contaminants (C-sequestration, C-storage, avoided runoff, and removal of air pollutants) were non-significant across wards. We found disproportionately more street trees in Ward 1 relative to Wards 2 and 3 and more trees in public spaces in Wards 1 and 2 relative to Ward 3. Evidence for the luxury effect on tree distribution in the NMDSD was subtle and manifested mostly through differences in species composition and tree distribution across public and private domains as well as the amount of planting space. Overall results point to inequalities in the potential of reforestation among NMDS wards and an overabundance of non-native species, which should guide urban forest management with ecosystem services and conservation goals.
Circular Business Model Innovation and Its Relationship With Business Performance in Brazilian Industrial Chemical Companies
Authors: Motke Francies Diego , Gomes Clandia Maffini , Kneipp Jordana Marques , Perlin Ana Paula , Damke Luana Inês , Lamberti Tatiane Balbinot
Published: January 2022

This study aimed to analyze the relationship between circular business model innovation and business performance in Brazilian industrial chemical companies. This is a quantitative study carried out through a survey with Brazilian industrial companies. Based on a homogeneity analysis (Homals), the results showed that the high degree of innovation in business models from the adoption of circular economy (CE) strategies in the analyzed companies confirms that a significant change leads to superior performance, especially in market, production, economic and financial, and social.
Deafness And Music: Can Vibration Be Used When Playing Music Together?
Authors: Hopkins Carl , Maté-Cid Saúl , Fulford Robert , Seiffert Gary , Ginsborg Jane , Barker Natalie
Published: January 2022

Performing music or singing together provides people with great pleasure. But if you are deaf (or hard of hearing) it is not always possible to listen to other musicians while trying to sing or play an instrument. It can be particularly difficult to perceive different musical pitches with a hearing aid or other hearing-assistance device. However, the human body can transmit musical sounds to the brain when vibrations are applied to the skin. In other words, we can feel music. Our research has identified a safe way for deaf people to hear musical notes through the skin of their hands and feet. We have shown that vibration allows people to safely feel music on the skin. This approach allows people to identify a musical note as being higher or lower in pitch than other notes, and it helps musicians to play music together.
Women’s Empowerment as It Relates to Attitudes Towards and Practice of Female Genital Mutilation/Cutting of Daughters: An Ecological Analysis of Demographic and Health Surveys From 12 African Countries
Authors: Coll Carolina V. N. , Santos Thiago M. , Wendt Andrea , Hellwig Franciele , Ewerling Fernanda , Barros Aluisio J. D.
Published: January 2022

Background: Women’s empowerment may play a role in shaping attitudes towards female genital mutilation/cutting (FGM/C) practices. We aimed to investigate how empowerment may affect women’s intention to perpetuate FGM/C and the practice of FGM/C on their daughters in African countries.

Materials and methods: We used data from Demographic and Health Surveys carried out from 2010 to 2018. The countries included in our study were Benin, Burkina Faso, Chad, Côte d´Ivoire, Ethiopia, Guinea, Kenya, Mali, Nigeria, Senegal, Tanzania, and Togo. This study included 77,191 women aged 15–49 years with at least one daughter between zero and 14 years of age. The proportion of women who reported having at least one daughter who had undergone FGM/C as well as the mother’s opinion towards FGM/C continuation were stratified by empowerment levels in three different domains (decision-making, attitude to violence, and social independence) for each country. We also performed double stratification to investigate how the interaction between both indicators would affect daughter’s FGM/C.

Results: The prevalence of women who had at least one daughter who had undergone FGM/C was consistently higher among low empowered women. Tanzania, Benin, and Togo were exceptions for which no differences in having at least one daughter subjected to FGM/C was found for any of the three domains of women’s empowerment. In most countries, the double stratification pointed to a lower proportion of daughters’ FGM/C among women who reported being opposed to the continuation of FGM/C and had a high empowerment level while a higher proportion was observed among women who reported being in favor of the continuation of FGM/C and had a low empowerment level. This pattern was particularly evident for the social independence domain of empowerment. In a few countries, however, a higher empowerment level coupled to a favorable opinion towards FGM/C was related to a higher proportion of daughters’ FGM/C.

Conclusion: Women’s empowerment and opinion towards FGM/C seems to be important factors related to the practice of FGM/C in daughters. Strategies to improve women’s empowerment combined with shifts in the wider norms that support FGM/C may be important for achieving significant reductions in the practice.
How End-of-Life Blogs Re-Affirm the “Power to be Oneself”
Authors: Green Gill
Published: January 2022

Powerlessness generally denotes loss of control and may be experienced among those with a terminal diagnosis and, as such, empowerment is a dominant discourse in end-of-life policy in the western Anglo-Saxon world. This paper analyzes thematically blogs authored by three people with a terminal diagnosis to examine the “power to be oneself,” a concept which was identified in the “Ethics of Powerlessness” project conducted in the UK. The analysis demonstrates that the bloggers assert the “power to be themselves” which is expressed in three principal ways. Firstly, through assertion of agency to promote self-affirmation and control. Secondly, through claiming a “moral authority” expressed by providing advice not just on illness and death but also on how life should be lived. Thirdly, through discussing ideas about the future and creating a legacy. The blogs are a mechanism used to express and reinforce self-identity and to carve out a “sacred space” between life and death to nurture personal change and to project this onto a public arena. This analysis demonstrates the key role patient empowerment plays in constructing an identity with a terminal diagnosis, an element that is often overlooked in end-of-life policy.
Review: Insects—A Source of Safe and Sustainable Food?— “Jein” (Yes and No)
Authors: Grabowski Nils Th. , Abdulmawjood Amir , Acheuk Fatma , Barragán Fonseca Karol , Chhay Ty , Costa Neto Eraldo Medeiros , Ferri Maurizio , Franco Olivas Jonathan , González Aguilar Delia Guillermina , Keo Sath , Lertpatarakomol Rachakris , Miech Phalla , Piofczyk Thomas , Proscia Francesco , Mitchaothai Jamlong , Guerfali Meriem M'Saad , Sayed Waheed , Tchibozo Séverin , Plötz Madeleine
Published: January 2022

For almost a decade, edible insects have become promoted on a wider basis as one way to combat world hunger and malnourishment, although attempts to do so have a longer history. Contemporary researchers and consumers, particularly those without an entomophagous background, have been rising safety and sustainability concerns. The present contribution seeks a substantiated answer to the question posed above. The possible answer consists of different factors that have been taken into consideration. First, the species and its life cycle. It is mandatory to realize that what is labeled as “edible insects” stands for more than 2,140 animal species, not counting other edible, non-crustacean arthropods. Their life cycles are as diverse as the ecological niches these animals can fill and last between some days to several years and many of them may—or may not—be reproduced in the different farming systems. Second, the level of knowledge concerning the food use of a given species is important, be it traditional, newly created by research, or a combination of both. Third, the existence of a traditional method of making the use of the insect safe and sustainable, ideally from both the traditional and the modern points of view. Fourth, the degree of effectiveness of these measures despite globalization changes in the food-supplying network. Fifth, farming conditions, particularly housing, feeding (type, composition, and contaminants), animal health and animal welfare. Sixth, processing, transport, and storage conditions of both traditional and novel insect-based foodstuffs, and seventh, consumer awareness and acceptance of these products. These main variables create a complex web of possibilities, just as with other foodstuffs that are either harvested from the wild or farmed. In this way, food safety may be reached when proper hygiene protocols are observed (which usually include heating steps) and the animals do not contain chemical residues or environment contaminants. A varying degree of sustainability can be achieved if the aforementioned variables are heeded. Hence, the question if insects can be safe and sustainable can be answered with “jein,” a German portmanteau word joining “yes” (“ja”) and “no” (“nein”).