bluuebunny/crossref_metadata_2025 huggingface dataset:
Spousal Violence and Contraceptive Use among Married Afghan Women in a Nationally Representative Sample
Authors: Ibrahimi Sahra , Steinberg Julia R.
Published: August 2022

Objective: Afghanistan is one of the countries with the highest prevalence of spousal violence (56%) and a low prevalence of contraceptive use (23%), yet there is no study assessing how spousal violence is related to contraceptive use, and what methods are most used by women. Therefore, this study examined the association between the number of types of spousal violence and contraceptive use. Method: Using data from 18,985 Afghan married women, aged 15 to 49, who responded to the 2015 Afghanistan Demographic and Health Survey, the current contraceptive method was grouped into five categories: male-involved methods, pills, injectables, long-acting reversible contraception, female sterilization, and Lactation Amenorrhea Method. The number of types of spousal violence in the past 12 months was categorized as none, one type, or two or more types, based on women’s experiences with verbal, physical, and sexual violence. For analysis, binary and multinomial logistic regression were used. Results: After adjusting for the covariates, the experience of any spousal violence was associated with contraception use (adjusted odds ratio (aOR) = 1.93, 95% CI: 1.64–2.27, p = 0.0001). Among those using contraception, experiencing two or three types of spousal violence was associated with using pills (adjusted risk ratio (aRRR) = 2.12, 95% CI: 1.63–2.77, p = 0.0001), injections (aRRR = 1.75, 95% CI: 1.26–2.41, p = 0.001), and LAM (aRRR = 3.27, 95% CI: 2.05–5.20, p = 0.0001), compared to male-involved methods. Conclusions: The findings of this study may inform policymakers and program implementers in designing interventions to address the pervasive problem of violence against women, and make pills and injectables more accessible to Afghan women, since these methods are under women’s control and more often used in Afghanistan.
Maternal Competence, Maternal Burnout and Personality Traits in Italian Mothers after the First COVID-19 Lockdown
Authors: Polizzi Concetta , Giordano Giulia , Burgio Sofia , Lavanco Gioacchino , Alesi Marianna
Published: August 2022

This study aimed to investigate the maternal sense of competence and maternal burnout in Italian mothers during the COVID-19 pandemic. The sample was composed of 278 mothers of children/adolescents aged 4 to 17 years old. Participants were recruited after the end of the first spring total Italian lockdown (June–October 2020) through online advertisements on websites and social media. We hypothesized a model in which a specific personality trait, such as neuroticism, affected maternal competence by the mediating role of maternal burnout. Results showed that neuroticism was directly and negatively predictive of perception of maternal competence, and it was negatively associated with maternal burnout, specifically specific antecedents that were strictly related to parental burnout. ANOVA results highlighted that the maternal level of education affected maternal competence in terms of satisfaction. In contrast, the working regimen during the first lockdown for COVID-19 affected maternal competence in terms of efficacy. Maternal burnout was affected by atypical child development in terms of both common (job burnout, stress management abilities) and specific (parental burnout) antecedents. COVID-19 strongly increased the risk of maternal burnout, resulting in mothers having a poor perception of their own competency. This is particularly the case in the presence of a neurotic personality.
EMPATIA: A Guide for Communicating the Diagnosis of Neuromuscular Diseases
Authors: Fernandes Isabella Araujo Mota , Menezes Renata Oliveira Almeida , Rego Guilhermina
Published: August 2022

Introduction: Neuromuscular diseases comprise a heterogeneous group of genetic syndromes that lead to progressive muscle weakness, resulting in functional limitation. There is a gap in the literature regarding the communication of the diagnosis of such diseases, compromising the autonomy of patients and families, besides causing stress on the assistant physician. Objectives: Developing a guide to reduce communication barriers in the diagnosis of neuromuscular diseases. Methodology: Systematic review, after searching the descriptors (“Muscular Diseases” OR “Neuromuscular Diseases”) AND (“Truth Disclosure” OR “Bad news communication” OR “Breaking bad News”) in the Pubmed, Bireme, and Scopus websites, and these results were analyzed through narrative textual synthesis. Results: 16 articles were submitted to the final analysis, giving rise to seven steps to support the communication process. These are Empathy, Message, Prognosis, Reception, Time, Individualization, and Autonomy. Discussion and conclusion: The empathic transmission of the message and the prognosis must accommodate the feelings of the interlocutors with different information needs. In this way, communication planning optimizes the time and individualizes each context, respecting the autonomy of those involved. EMPATIA reflects the bioethical and interdisciplinary analysis of the literature and comes to fill the gap related to the communication of bad news in neuromuscular diseases.
Understanding the Health and Health-Related Social Needs of Youth Experiencing Homelessness: A Photovoice Study
Authors: Damian April Joy , Ponce Delilah , Ortiz-Siberon Angel , Kokan Zeba , Curran Ryan , Azevedo Brandon , Gonzalez Melanie
Published: August 2022

Purpose: Homelessness is a major public health problem facing millions of youths across the United States (U.S.), with lesbian gay, bisexual, transgender, questioning (LGBTQ+) youths and youths of color being disproportionately at higher risk. This study obtains an understanding of the health and health-related social needs of youths experiencing homelessness during the coronavirus disease (COVID-19) pandemic. Methods: A total of 14 youths between the ages of 14 and 24 who (a) lived, worked, or attended school in New Britain, Connecticut (CT) and (b) had at least one experience of homelessness or housing insecurity worked with the research team to conduct a needs assessment regarding youth homelessness. Using photovoice, a community-based participatory research method, participants created photo narratives to share their stories and recommendations for community change. The main goals of photovoice are to enable participants to (1) record and represent their everyday realities; (2) promote critical dialogue and knowledge about person and community strengths and concerns; and (3) reach policy makers. Results: Most of the participants identified as youths of color, and half of the participants identified as members of the LGBTQ+ community. Three major themes that appeared in the youths’ narratives include the following: mental health and substance use challenges, trouble accessing basic human needs, and lack of a social support system. Conclusion: This study uplifts and empowers a vulnerable population to increase visibility around a major public health challenge from their own lived experiences. Despite the challenges that were voiced, many participants shared a sense of hope and resiliency. The major themes endorsed by the youths has the potential of informing practitioners and policy makers of how to better address the needs of youths experiencing homelessness, particularly those most at risk.
The Double Mediating Effect of Family Support and Family Relationship Satisfaction on Self-Compassion and Meaning in Life among Korean Baby Boomers
Authors: Jeong Yu-soo , Lee Young-soon
Published: August 2022

This study identified the relationship between self-compassion and meaning in life among Korean baby boomers and examined the double mediating effect of family support and family relationship satisfaction on this relationship. For this purpose, data were collected from 400 baby boomers (born between 1955–1963) using the self-compassion, meaning in life, family support, and family relationship satisfaction scales. PROCESS Macro 3.5 Model 6 was used to analyze the double mediating effects. The results revealed that first, there was a significant correlation between the self-compassion, meaning in life, family support, and family relationship satisfaction of this study. Second, in the relationship between self-compassion and the meaning in life, family support, and family relationship satisfaction were found to have a partial mediating effect and a double mediating effect. The implications and limitations of these findings are also discussed.
Prevalence, Causes, and Adverse Clinical Impact of Delayed Presentation of Non-COVID-19-Related Emergencies during the COVID-19 Pandemic: Findings from a Multicenter Observational Study
Authors: Alshahrani Mohammed S. , Alfaraj Dunya , AlHumaid Jehan , Alshahrani Khalid , Alsubaie Aisha , Almulhim Nasser , Althawadi Dana , Alam Salah , Alzahrani Malak , Alwosibai Hassan , Alshahrani Abdullah , Makhdom Rawan , Alkhadra Faisal , Al-faraj Sukayna , Al-Qahtani Saad , AlSulaibikh Amal , Jumaan Mohammed Al , Asonto Laila Perlas , Alahmadi Sarah , Alghamdi Mohannad , Al-Mulhim Mohammed
Published: August 2022

Objective: The coronavirus disease (COVID-19) pandemic has disrupted healthcare systems worldwide, resulting in decreased and delayed hospital visits of patients with non-COVID-19-related acute emergencies. We evaluated the impact of the COVID-19 pandemic on the presentation and outcomes of patients with non-COVID-19-related medical and surgical emergencies. Method: All non-COVID-19-related patients hospitalized through emergency departments in three tertiary care hospitals in Saudi Arabia and Bahrain in June and July 2020 were enrolled and categorized into delayed and non-delayed groups (presentation ≥/=24 or <24 h after onset of symptom). Primary outcome was the prevalence and cause of delayed presentation; secondary outcomes included comparative 28-day clinical outcomes (i.e., 28-day mortality, intensive care unit (ICU) admission, invasive mechanical ventilation, and acute surgical interventions). Mean, median, and IQR were used to calculate the primary outcomes and inferential statistics including chi-square/Fisher exact test, t-test where appropriate were used for comparisons. Stepwise multivariate regression analysis was performed to identify the factors associated with delay in seeking medical attention. Results: In total, 24,129 patients visited emergency departments during the study period, compared to 48,734 patients in the year 2019. Of the 256 hospitalized patients with non-COVID-19-related diagnoses, 134 (52%) had delayed presentation. Fear of COVID-19 and curfew-related restrictions represented 46 (34%) and 25 (19%) of the reasons for delay. The 28-day mortality rates were significantly higher among delayed patients vs. non-delayed patients (n = 14, 10.4% vs. n = 3, 2.5%, OR: 4.628 (CI: 1.296–16.520), p = 0.038). Conclusion: More than half of hospitalized patients with non-COVID-19-related diagnoses had delayed presentation to the ED where mortality was found to be significantly higher in this group. Fear of COVID-19 and curfew restrictions were the main reasons for delaying hospital visit.
Reversible Splenial Lesion Syndrome as a Challenging Casuistry
Authors: Tatar Dominika , Bocian Bogusława , Świerzy Krzysztof , Badura Brzoza Karina
Published: August 2022

The corpus callosum plays a vital role in brain function. In particular, in the trunk of the corpus callosum, in the course of various diseases, there may be temporary, reversible changes (reversible splenial lesion syndrome (RESLES)), as well as partially reversible and irreversible changes. This article discusses the differentiation of RESLES and other conditions with changes in the corpus callosum lobe, as well as the accompanying clinical symptoms. Moreover, a case report of a patient in whom the above changes appeared in the nuclear magnetic resonance (NMR) image is presented. A 20-year-old patient with the diagnosis of Ehlers–Danlos syndrome type VI was admitted to the psychiatric ward in an emergency because of psychomotor agitation, refusal to take food and fluids, delusional statements with a message, grandeur, and auditory hallucinations. In the performed magnetic resonance imaging (MRI) of the brain, the corpus callosum non-characteristic in T2-weighted images revealed a hyperintensive area, which was significantly hyperintensive in diffusion magnetic resonance (DWI) sequences and in apparent diffusion coefficient (ADC) sequences with reduced signal intensity and no signs of bleeding. The hypothesis of subacute ischemic stroke of the corpus callosum was presented. In the control MRI of the brain, changes in the corpus callosum completely regressed, thus excluding an ischemic etiology and favoring the diagnosis of RESLES. During hospitalization, the patient experienced significant fluctuations in mental status, with the dominant symptoms typical of the paranoid syndrome in the form of disturbances in the course and structure of thinking and perception, and a clear and stable improvement was obtained after the administration of long-acting intramuscular olanzapine. Taking into account the clinical and radiological picture, the age of the episode, the rapidity of the disease development, the persistence of its clinical symptoms after the withdrawal of radiological changes in the brain NMR image, as well as the significant improvement in the clinical condition after the introduction of antipsychotic drugs, the final diagnosis was made of schizophrenia.
Factors Relating to a Safety Culture in the University Perinatal Center: The Nurses’ and Midwives’ Perspective
Authors: Ribelienė Janina , Macijauskienė Jūratė , Tamelienė Rasa , Kudrevičienė Aušrelė , Nedzelskienė Irena , Blaževičienė Aurelija
Published: August 2022

Background: According to The Joint Commission, a culture of safety is a key component for achieving sustainable and safe health care services, and hospitals must measure and monitor this achievement. Promoting a patient safety culture in health services optimally includes midwifery and nursing. The first aim of this study is to assess the University Perinatal Center’s staff members’ perceptions of safety culture. A second aim is to identify how the perceptions of safety culture actors are related to the socio-demographic characteristic of the respondents. Methods: A descriptive, cross-sectional, correlational design was applied in this study. Registered nurses and midwives were recruited from the University Perinatal Center in Lithuania (N = 233). Safety culture was measured by the Safety Attitudes Questionnaire (SAQ). Results: The mean scores of the responses on the 6 factors of the SAQ ranged from 3.18 (0.46) (teamwork climate) to 3.79 (0.55) (job satisfaction) points. The percentage of positive responses to the SAQ (4 or 5 points on the Likert scale) ranged from 43.2% to 69.0%. The lowest percentage of the respondents provided positive responses to the questions on perception of management and teamwork climate, while the highest percentage of the respondents provided positive responses to the questions on job satisfaction. Perception of management positively correlated with safety climate (r = 0.45, p < 0.01) and working conditions (r = 0.307, p < 0.01). Safety climate positively correlated with job satisfaction (r = 0.397, p < 0.01) and working conditions (r = 0.307, p < 0.01). Job satisfaction positively correlated with working conditions (r = 0.439, p < 0.01). Conclusion: Evaluating the opinions of the safety climate among nurses and midwives who work at the University Perinatal Center showed that teamwork climate and perception of management are weak factors. Therefore, stakeholders should organize more training about patient safety and factors that affect patient safety.
Systematic Bias in Self-Reported Social Media Use in the Age of Platform Swinging: Implications for Studying Social Media Use in Relation to Adolescent Health Behavior
Authors: Boyle Sarah C. , Baez Sebastian , Trager Bradley M. , LaBrie Joseph W.
Published: August 2022

Public health researchers are increasingly interested in the potential relationships between social media (SM) use, well-being, and health behavior among adolescents. However, most research has assessed daily SM time via self-report survey questions, despite a lack of clarity around the accuracy of such reports given the current tendency of youth to access SM on multiple electronic devices and cycle between multiple SM platforms on a daily basis (i.e., platform swinging). The current study investigates the potential for systematic reporting biases to skew findings. Three hundred and twenty incoming college students downloaded software on their computers, tablets, and smartphones to track their active use of Facebook, Twitter, Instagram, and Snapchat over a 2-week surveillance period and then self-reported their average daily minutes on each platform immediately after. Larger proportions of students over-estimated than under-estimated their use, with the largest overestimations found on the most heavily used platforms. Females logged significantly more SM time and were less accurate in reporting than were males and, independently, the likelihood of substantial inaccuracies in reporting total SM time and time on most individual platforms increased with each additional SM platform participants reported using. Findings demonstrate that self-reported estimates of SM time among adolescents in the age of SM platform swinging are prone to substantial error and may lead to biased conclusions about relationships between variables. Alternative measurement approaches are suggested to improve the validity of future research in this area.
Can Economic Growth and Environmental Protection Achieve a “Win–Win” Situation? Empirical Evidence from China
Authors: Yang Zhen , Gao Weijun , Li Jiawei
Published: August 2022

Achieving a “win–win” situation regarding economic growth and environmental protection has become a common goal for sustainable development in all countries around the world. As the world’s largest developing country and the second largest economy, China has been striving to maintain economic growth while improving environmental quality to achieve its sustainable development goals. Applying the decoupling approach, a model widely used to quantify the relationship between the environment and the economy, this study analyzed the relationship between the economy and the environment, examining the decoupling performance of economic growth and environmental impacts in 30 Chinese provinces, autonomous regions, and municipalities to investigate whether economic growth and environmental protection have achieved a “win–win” situation. Nighttime light (NTL) data were used to measure the performance of economic growth. In addition, an environmental pressure index (EPI) assessment framework covering 6 primary and 11 secondary indicators was constructed to measure the environmental quality of China over time. First, NTL data proved to be a valid data source for assessing decoupling performance; second, environmental pressure at both the national and provincial levels significantly decreased during the study period; third, the relationship between the economy and the environment has been further improved, and economic growth and environmental protection have achieved a “win–win” situation. These findings offer an in-depth analysis of the decoupling of the economy and the environment in China and serve as a guide for future implementation strategies for sustainable development in various regions.
Risk Factors for Cancer Mortality in Spain: Population-Based Cohort Study
Authors: Lázaro-Sánchez Antonio D. , Juárez Marroquí Asunción , Quesada Rico Jose Antonio , Orozco-Beltrán Domingo
Published: August 2022

Background: Cancer is considered a major public health problem due to its increasing incidence and high mortality. This study aims to identify risk factors for cancer mortality in Spain. Methods: Retrospective population-based cohort study in 20,397 participants of the 2011/2012 National Health Survey in Spain. Risk factors associated with mortality due to neoplasm from 2011 to 2017 were analyzed, and hazard ratios were calculated with a multivariate Cox model with competing risks for mortality from other causes. Results: Myocardial infarction, chronic obstructive pulmonary disease, cirrhosis, and mental disorders were associated with an increased risk of mortality due to neoplasm. Male sex, age over 50 years, history or current smoking habit, negligible intake of legumes, and poorer self-perceived health were also associated with increased cancer mortality. Conclusions: Comorbidities, tobacco use, poor diet, and worse self-perceived health were the main risk factors for cancer mortality in Spain.
Rationalism or Intuitionism: How Does Internet Use Affect the Perceptions of Social Fairness among Middle-Aged Groups in China?
Authors: Xie Yong , Wu Lin , Liu Bo
Published: August 2022

Background: In the digital age, the Internet has profoundly affected our production and life, which in turn has affected our mental health. However, little research has been conducted on when and how Internet use (IU) affects social fairness perception (SFP). Methods: Using the data of Chinese General Social Survey (CGSS) 2015, this paper identifies the causal effect of IU on Chinese middle-aged people’s SFP through Ordinary Least Square (OLS) regression and the instrumental variable (IV) method, and uses the Sobel and Bootstrap Test for mediation analysis. Results: IU not only directly reduces Chinese people’s SFP by channeling their social emotions, but also indirectly decreases SFP through the inspiration of government trust. However, inconsistent with some previous studies, social comparison mainly has a partial masking effect on the causality between IU and SFP. Conclusions: The significant negative impact of IU on SFP is the result of the combination of rationalism and intuitionism.
Attitudes toward Grandparental Involvement in Hong Kong: A Trend Analysis
Authors: Chen Mengtong , Chen Qiqi , Lo Camilla Kin Ming , Kelley Susan J. , Chan Ko Ling , Ip Patrick
Published: August 2022

This article examines individuals’ attitudes toward the involvement of grandparents in family issues in Hong Kong. While existing studies have largely focused on the nature and types of grandparents’ involvement in childcare, it is worth conducting a quantitative investigation of the attitudes in the general population about grandparental involvement. Drawing on the 2011, 2013, 2015, and 2017 waves of the Family Surveys, the study examined the trend in attitudes toward grandparental involvement with 8932 HK residents. Multivariate linear regression analyses were performed to assess individual and family relationship factors associated with the attitudes toward grandparental involvement. Results show that although most people held positive attitudes toward grandparental involvement, there was a significant drop in the agreement with grandparental involvement in 2017 across all age groups. The findings imply that intergenerational support tends to be weakened in HK in recent years. Involving grandparents in family issues in HK was more likely to be need-driven rather than value-driven, as parent respondents had relatively more positive attitudes toward grandparental involvement compared with non-parents. Positive family and intergenerational relationships were significantly associated with the positive attitudes toward grandparental involvement. Policymakers and service providers should recognize the changes in people’s attitudes toward family lives and provide appropriate support such as family counselling, (grand)parenting programs and childcare support to promote the wellbeing of families and older adults.
An Exploratory Investigation of the Effect of a Sports Vision Program on Grade 4 and 5 Female Netball Players’ Visual Skills
Authors: Coetzee Dané , de Waal Elna
Published: August 2022

Vision is one of the most complex and dominant sensory systems necessary for information feedback from the environment. Few studies have already reported a positive effect of a sport vision program on elite sport teams’ visual skills; however, few studies have focused on the effect of sport vision programs on children’s visual skills. Therefore, the aim of this study was to determine the effect of a sports vision program on Grade 4 and 5 female netball players’ visual skills. Girls (N = 25) with a mean age of 10.08 years (SD = 0.65) formed part of this study. A pre-test–post-test design was followed with a retention test. The eight-week sports vision program was executed twice a week for 60 min on the experimental group (n = 13). The Developmental Test of Visual–Motor Integration (VMI-4), the Wayne Saccadic Fixator (WSF) and the Developmental Eye Movement (DEM) test were used to evaluate the girls’ visual skills, hand–eye coordination, visual reaction time, peripheral vision and saccadic eye movements. No statistical differences were found between the two groups before starting with the sports vision program. After intervention, significant differences between the two groups were reported, with the experimental group performing better in hand–eye coordination (p = 0.001) and reaction time (p = 0.001). Results further indicated that the experimental group experienced significant improvements (p ≤ 0.05) in motor coordination, hand–eye coordination, reaction speed and visual tracking after intervention with significant lasting effects (p ≤ 0.05). The control group performed significantly worse in reaction time (p = 0.01). A sports vision program can be recommended for Grade 4 and 5 female netball players to improve certain visual skills.
Health and Well-Being of Church Musicians during the COVID-19 Pandemic—Experiences of Health and Work-Related Distress from Musicians of the Evangelical Lutheran Church in Finland
Authors: Kuusi Tuire , Viertiö Satu , Helenius Anna , Tervo-Niemelä Kati
Published: August 2022

Earlier research has revealed contrasting gender results in standardized mortality ratios (SMR) for cancers and cardiovascular diseases of Finnish church musicians compared with the general population. In order to better understand the SMRs, our study examined gender differences in health and work-related experiences of church musicians with special focus on experienced stress and burnout on the one hand, and work engagement and mental well-being on the other. The data were collected by a questionnaire including both standardized measures and open-ended questions. Statistical methods (mostly χ2 tests) were used for examining gender differences in the measures, and the open-ended questions were analyzed using theory-driven content analysis. The two sets of data complemented each other. Analyses of the standardized measures showed that church musicians have more burnout and distress than the general population but the results were not gendered. However, the open-ended questions revealed clearly higher distress in females than in males. Based on the contrast between the measures and the open-ended questions, we raise the question about how well females who have distressing work can recognize the stress factors and change them, especially if distress becomes a “normal state”.
The Role of Polygenic Susceptibility on Air Pollution-Associated Asthma between German and Japanese Elderly Women
Authors: Kress Sara , Hara Akinori , Wigmann Claudia , Sato Takehiro , Suzuki Keita , Pham Kim-Oanh , Zhao Qi , Areal Ashtyn , Tajima Atsushi , Schwender Holger , Nakamura Hiroyuki , Schikowski Tamara
Published: August 2022

Polygenic susceptibility likely influences individual responses to air pollutants and the risk of asthma. We compared the role of polygenic susceptibility on air pollution-associated asthma between German and Japanese women. We investigated women that were enrolled in the German SALIA cohort (n = 771, mean age = 73 years) and the Japanese Shika cohort (n = 847, mean age = 67 years) with known asthma status. Adjusted logistic regression models were used to assess the associations between (1) particulate matter with a median aerodynamic diameter ≤ 2.5μm (PM2.5) and nitrogen dioxide (NO2), (2) polygenic risk scores (PRS), and (3) gene-environment interactions (G × E) with asthma. We found an increased risk of asthma in Japanese women after exposure to low pollutant levels (PM2.5: median = 12.7µg/m3, p-value < 0.001, NO2: median = 8.5µg/m3, p-value < 0.001) and in German women protective polygenic effects (p-value = 0.008). While we found no significant G × E effects, the direction in both groups was that the PRS increased the effect of PM2.5 and decreased the effect of NO2 on asthma. Our study confirms that exposure to low air pollution levels increases the risk of asthma in Japanese women and indicates polygenic effects in German women; however, there was no evidence of G × E effects. Future genome-wide G × E studies should further explore the role of ethnic-specific polygenic susceptibility to asthma.
Youth Psychiatric Hospitalization in Israel during COVID-19: A Multi-Center Study
Authors: Dror Chen , Hertz-Palmor Nimrod , Barzilai Yael , Gila Schoen , Tali Bretler-Zager , Alex Gizunterman , Tal Lahav , Maya Kritchmann-Lupo , Talia Saker , Doron Gothelf , Bloch Yuval
Published: August 2022

During the COVID-19 pandemic there have been numerous reports of increases in psychiatric morbidity and a deterioration of status among existing patients. There is little information about how this increase has affected youth and rates of adolescent psychiatric hospitalization. Our study was aimed at examining trends in youth psychiatric hospitalization during the first year of the COVID-19 pandemic. Method: We used medical records to compare trends in hospitalization rates from 2019 to 2020, among psychiatric youth wards from five different centers in Israel. Results: The number of patients that were hospitalized in youth psychiatric wards decreased significantly from 2019 (Mean ± SD=52.2 ± 28.6 per month) to 2020 (M ± SD = 40.8 ± 22.0; unstandardized B = −11.4, 95% CI = −14.4 to −8.3, p < 0.0001). There was a significant decrease in the number of patients that were hospitalized due to internalizing disorders from 2019 (M ± SD = 22.3 ± 9.3 per month) to 2020 (M ± SD = 16.8 ± 7.7; B = −5.5, 95% CI = −8.0 to −3.0, p = 0.0002) and a marginally significant increase in the number of restraints per month (2019: M ± SD = 2.8 ± 6.8, 2020: M ± SD = 9.0 ± 14.5; Z = −1.96, Rosenthal’s r = 0.36, p = 0.07). Conclusions: There was a significant decline in psychiatric hospitalizations during the pandemic, specifically among patients suffering from internalizing disorders. The reasons for this decline, and the future impact these changes had on hospitalizations during the pandemic demand further research. Study limitations: This is a retrospective multicenter study from five medical centers in Israel, therefore generalizability of our findings is limited.
The Agricultural Green Production following the Technological Progress: Evidence from China
Authors: Xiao Shuxing , He Zuxin , Zhang Weikun , Qin Xiaoming
Published: August 2022

This study performs the spatial Durbin model (SDM) and threshold model to analyze the efficiency of agricultural green production following technological progress from 1998 through 2019. The SDM supports a nonlinear contribution of technological progress spillover to agricultural green total factor productivity (GTFP), exacerbated by upgrading agricultural structure. Moreover, the threshold model confirms that technological progress has a single threshold effect on agricultural GTFP with the rationalization of the agrarian system as a threshold variable; meanwhile, the contribution of technological progress to agricultural GTFP is less than that of agricultural total factor productivity. Out of the expanded application of dissipative structure theory in agricultural GTFP systems innovatively, this study reveals the urgency to strengthen the innovation of independent technology, lower the threshold for introducing technology, and optimize the agrarian structure in the long-term sustainable agriculture for the economies that are undergoing a similar development stage as China.
Valproate Targets Mammalian Gastrulation Impairing Neural Tissue Differentiation and Development of the Placental Source In Vitro
Authors: Katušić-Bojanac Ana , Plazibat Milvija , Himelreich-Perić Marta , Eck-Raković Katarina , Krasić Jure , Sinčić Nino , Jurić-Lekić Gordana , Ježek Davor , Bulić-Jakuš Floriana
Published: August 2022

The teratogenic activity of valproate (VPA), an antiepileptic and an inhibitor of histone deacetylase (HDACi), is dose-dependent in humans. Previous results showed that VPA impairs in vitro development and neural differentiation of the gastrulating embryo proper. We aimed to investigate the impact of a lower VPA dose in vitro and whether this effect is retained in transplants in vivo. Rat embryos proper (E9.5) and ectoplacental cones were separately cultivated at the air-liquid interface with or without 1 mM VPA. Embryos were additionally cultivated with HDACi Trichostatin A (TSA), while some cultures were syngeneically transplanted under the kidney capsule for 14 days. Embryos were subjected to routine histology, immunohistochemistry, Western blotting and pyrosequencing. The overall growth of VPA-treated embryos in vitro was significantly impaired. However, no differences in the apoptosis or proliferation index were found. Incidence of the neural tissue was lower in VPA-treated embryos than in controls. TSA also impaired growth and neural differentiation in vitro. VPA-treated embryos and their subsequent transplants expressed a marker of undifferentiated neural cells compared to controls where neural differentiation markers were expressed. VPA increased the acetylation of histones. Our results point to gastrulation as a sensitive period for neurodevelopmental impairment caused by VPA.
Anti-Angiogenic Therapy in ALK Rearranged Non-Small Cell Lung Cancer (NSCLC)
Authors: Tan Aaron C. , Pavlakis Nick
Published: August 2022

The management of advanced lung cancer has been transformed with the identification of targetable oncogenic driver alterations. This includes anaplastic lymphoma kinase (ALK) gene rearrangements. ALK tyrosine kinase inhibitors (TKI) are established first-line treatment options in advanced ALK rearranged non-small cell lung cancer (NSCLC), with several next-generation ALK TKIs (alectinib, brigatinib, ensartinib and lorlatinib) demonstrating survival benefit compared with the first-generation ALK TKI crizotinib. Still, despite high objective response rates and durable progression-free survival, drug resistance inevitably ensues, and treatment options beyond ALK TKI are predominantly limited to cytotoxic chemotherapy. Anti-angiogenic therapy targeting the vascular endothelial growth factor (VEGF) signaling pathway has shown efficacy in combination with platinum-doublet chemotherapy in advanced NSCLC without a driver alteration, and with EGFR TKI in advanced EGFR mutated NSCLC. The role for anti-angiogenic therapy in ALK rearranged NSCLC, however, remains to be elucidated. This review will discuss the pre-clinical rationale, clinical trial evidence to date, and future directions to evaluate anti-angiogenic therapy in ALK rearranged NSCLC.
Expanded Newborn Screening in Italy Using Tandem Mass Spectrometry: Two Years of National Experience
Authors: Ruoppolo Margherita , Malvagia Sabrina , Boenzi Sara , Carducci Carla , Dionisi-Vici Carlo , Teofoli Francesca , Burlina Alberto , Angeloni Antonio , Aronica Tommaso , Bordugo Andrea , Bucci Ines , Camilot Marta , Carbone Maria Teresa , Cardinali Roberta , Carducci Claudia , Cassanello Michela , Castana Cinzia , Cazzorla Chiara , Ciatti Renzo , Ferrari Simona , Frisso Giulia , Funghini Silvia , Furlan Francesca , Gasperini Serena , Gragnaniello Vincenza , Guzzetti Chiara , La Marca Giancarlo , La Spina Luisa , Lorè Tania , Meli Concetta , Messina MariaAnna , Morrone Amelia , Nardecchia Francesca , Ortolano Rita , Parenti Giancarlo , Pavanello Enza , Pieragostino Damiana , Pillai Sara , Porta Francesco , Righetti Francesca , Rossi Claudia , Rovelli Valentina , Salina Alessandro , Santoro Laura , Sauro Pina , Schiaffino Maria Cristina , Simonetti Simonetta , Vincenzi Monica , Tarsi Elisabetta , Uccheddu Anna Paola
Published: August 2022

Newborn screening (NBS) for inborn errors of metabolism is one of the most advanced tools for secondary prevention in medicine, as it allows early diagnosis and prompt treatment initiation. The expanded newborn screening was introduced in Italy between 2016 and 2017 (Law 167/2016; DM 13 October 2016; DPCM 12-1-2017). A total of 1,586,578 infants born in Italy were screened between January 2017 and December 2020. For this survey, we collected data from 15 Italian screening laboratories, focusing on the metabolic disorders identified by tandem mass spectrometry (MS/MS) based analysis between January 2019 and December 2020. Aminoacidemias were the most common inborn errors in Italy, and an equal percentage was observed in detecting organic acidemias and mitochondrial fatty acids beta-oxidation defects. Second-tier tests are widely used in most laboratories to reduce false positives. For example, second-tier tests for methylmalonic acid and homocysteine considerably improved the screening of CblC without increasing unnecessary recalls. Finally, the newborn screening allowed us to identify conditions that are mainly secondary to a maternal deficiency. We describe the goals reached since the introduction of the screening in Italy by exchanging knowledge and experiences among the laboratories.
Vasospasm-Related Death after Aneurysmal Subarachnoid Hemorrhage: A Retrospective Case–Control Study
Authors: Khanafer Ali , Bhogal Pervinder , Hellstern Victoria , Harmening Christoph , Bäzner Hansjörg , Ganslandt Oliver , Henkes Hans
Published: August 2022

Background: Vasospasm after the rupture of an intracranial aneurysm is a frequent phenomenon and is the main cause of morbidity and mortality in patients who have survived intracranial hemorrhage and aneurysm treatment. We analyzed the diagnosis and management of patients with aneurysmal subarachnoid hemorrhage who eventually died from ischemic brain damage due to vasospasm. Methods: Between January 2007 and December 2021 (15 years), a total of 1064 patients were diagnosed with an aneurysmal intracranial hemorrhage in a single comprehensive neurovascular center. Vasospasm was diagnosed in 408 patients (38.4%). A total of 187 patients (17.6%) died within 90 days of the aneurysm rupture. In 64 of these 187 patients (33.7%), vasospasm was considered to be the cause of death. In a retrospective analysis, demographic and clinical data for patients without, with non-fatal, and with fatal vasospasm were compared. The patients with fatal vasospasm were categorized into the following subgroups: “no diagnosis and treatment” (Group a), “delayed diagnosis” (Group b), “cardiovascular complications” (Group c), and “vasospasm-treatment complications” (Group d). Results: Among the patients with fatal vasospasm, 31 (48.4%) were assigned to group a, 26 (40.6%) to group b, seven (10.9%) to group c, and none (0%) to group d. Conclusion: The early recognition of severe posthemorrhagic vasospasm is a prerequisite for any treatment and requires routine diagnostic imaging in all unconscious patients. Aggressive endovascular vasospasm treatment may fail to prevent death but is infrequently the cause of a fatal outcome.
Dermoscopic Features of Different Forms of Cutaneous Mastocytosis: A Systematic Review
Authors: Sławińska Martyna , Kaszuba Agnieszka , Lange Magdalena , Nowicki Roman J. , Sobjanek Michał , Errichetti Enzo
Published: August 2022

The term mastocytosis refers to a heterogeneous group of disorders characterised by accumulation of clonal mast cells in different organs, most commonly in the skin. Little is known about the role of dermoscopy in the diagnostics of mastocytosis. To date, no systematic review on the dermoscopic features of cutaneous mastocytosis has been performed. The aim of this study was to summarise the current knowledge in the field as well as to identify the knowledge gaps to show possible directions for further studies, based on a systematic search of PubMed, Scopus, and Web of Science databases and related references published before 3 January 2022. Dermoscopic features, type of dermoscope, polarisation mode, magnification, and number of cases were analysed. In total, 16 articles were included in this review (3 case series and 13 case reports), analysing 148 patients with different variants of cutaneous mastocytosis; all of the studies analysed had a low level of evidence (V). The main dermoscopic features of urticaria pigmentosa included brown structureless areas, brown lines arranged in a network, and linear vessels distributed in a reticular pattern, with this last finding also being typical of telangiectasia macularis eruptiva perstans. The presence of either circumscribed yellow structureless areas or diffuse yellowish background was a constant pattern of mastocytoma, while nodular, pseudoangiomatous xanthelasmoid, and plaque-type mastocytosis were typified by light-brown structureless areas and/or pigment network, though the first two variants also showed yellow/yellow-orange structureless areas. Finally, pigmented streaks of radial distribution surrounding hair follicles were described to be a pathognomonic dermoscopic feature of pseudoxanthomatous mastocytosis. Although this review shows that the various clinical forms of cutaneous mastocytosis may feature diagnostic dermoscopic clues, it also underlines the need for further investigation as several relevant data are missing, including evaluation of dermoscopic pattern according to anatomical locations or “lesion age”, studies on rare mastocytosis variants, evaluation of the prognostic role of dermoscopy in the context of systemic involvement, and comparative analyses with common clinical mimickers.
A Proliferation-Inducing Ligand and B-Cell Activating Factor Are Upregulated in Patients with Essential Thrombocythemia
Authors: Bolkun Lukasz , Tynecka Marlena , Wasiluk Tomasz , Piszcz Jaroslaw , Starosz Aleksandra , Grubczak Kamil , Moniuszko Marcin , Eljaszewicz Andrzej
Published: August 2022

A proliferation-inducing ligand (APRIL) and B-cell activating factor (BAFF) are cytokines belonging to the tumor necrosis factor family which play an essential role in B-cell maturation, differentiation, and survival. Recent evidence indicates their importance in hematological disorders; however, their function in essential thrombocytosis (ET) pathogenesis remains elusive. Therefore, we aimed to analyze the role of APRIL and BAFF in megakaryocytopoiesis in ET patients. We observed elevated levels of APRIL and BAFF in the plasma of ET patients compared with healthy controls, while no differences were found among patients with different JAK2(V617F) statuses. In addition, APRIL levels were positively associated with the number of platelets and WBC count. In the bone marrow, APRIL but not BAFF levels were higher in ET patients with the JAK2(V617F) mutation; however, JAK2(V617F)-negative patients showed slightly reduced levels of BAFF. In ET patients, we showed that the differentiation of CD34+ progenitor cells towards megakaryocytes induces the expression of both APRIL and BAFF. More importantly, APRIL neutralization significantly reduced platelet production. In conclusion, our data provide evidence that blocking APRIL signaling, which acts as an autocrine growth factor for terminal megakaryocytopoiesis, inhibits platelet production in ET patients, regardless of the status of JAK2(V617F) mutation.
High-Speed and Energy-Efficient Carry Look-Ahead Adder
Authors: Balasubramanian Padmanabhan , Mastorakis Nikos E.
Published: August 2022

The carry look-ahead adder (CLA) is well known among the family of high-speed adders. However, a conventional CLA is not faster than other high-speed adders such as a conditional sum adder (CSA), a carry-select adder (CSLA), and the Kogge–Stone adder (KSA), which is the fastest parallel-prefix adder. Further, in terms of power-delay product (PDP) that characterizes the energy of digital circuits, the conventional CLA is not efficient compared to CSLA and KSA. In this context, this paper presents a high-speed and energy-efficient architecture for the CLA. Many adders ranging from ripple carry to parallel-prefix adders were implemented using a 32-28 nm CMOS standard digital cell library by considering a 32-bit addition. The adders were structurally described in Verilog and synthesized using Synopsys Design Compiler. From the results obtained, it is observed that the proposed CLA achieves a reduction in critical path delay by 55.3% and a reduction in PDP by 45% compared to the conventional CLA. Compared to the CSA, the proposed CLA achieves a reduction in critical path delay by 33.9%, a reduction in power by 26.1%, and a reduction in PDP by 51.1%. Compared to an optimized CSLA, the proposed CLA achieves a reduction in power by 35.4%, a reduction in area by 37.3%, and a reduction in PDP by 37.1% without sacrificing the speed. Although the KSA is faster, the proposed CLA achieves a reduction in power by 39.6%, a reduction in PDP by 6.5%, and a reduction in area by 55.6% in comparison.
Escaping the Reality of the Pandemic: The Role of Hopelessness and Dissociation in COVID-19 Denialism
Authors: Ciacchella Chiara , Veneziani Giorgio , Bagni Claudio , Campedelli Virginia , Del Casale Antonio , Lai Carlo
Published: August 2022

Background: Denialism of coronavirus disease 2019 (COVID-19) severely affected governments’ attempts to contain the spread of the virus. Indeed, groups of deniers showed scepticism and misinformation toward the causes of the virus, leading to less adherence to official guidelines and vaccination campaigns. The present study aimed to investigate the sociodemographic and psychological factors associated with COVID-19 denialism, expressed in the forms of scepticism, nonadherence to guidelines, and negative attitudes toward vaccination. Methods: Four hundred and sixty-one volunteers completed an online survey composed of the Beck Hopelessness Scale, the Dissociative Experiences Scale-II, the Sense of Community Index, and a questionnaire about COVID-19 denialism. Results: The multiple regression analyses showed that higher age and a lower level of education were positive predictors of COVID-19 denialism. Furthermore, the structural equation model showed that hopelessness positively predicted dissociation and negatively predicted the sense of community. In turn, only dissociation was found to positively predict COVID-19 denialism. Conclusions: The findings of the present study suggested that hopelessness could exacerbate a defensive dissociative response that could be associated with greater COVID-19 denialism. Moreover, older and less educated people showed a greater propensity to engage in COVID-19 denialism.