bluuebunny/crossref_metadata_2025 huggingface dataset:
Sex comparisons in physiological and cognitive performance during hypoxic challenge
Authors: Vento Kaila A. , Borden Cammi K. , Blacker Kara J.
Published: November 2022

Within the tactical aviation community, human performance research lags in considering potential psychophysiological differences between male and female aviators due to little inclusion of females during the design and development of aircraft systems. A poor understanding of how male and female aviators differ with respect to human performance results in unknown potential sex differences on aeromedically relevant environmental stressors, perchance leading to suboptimal performance, safety, and health guidelines. For example, previous hypoxia studies have excluded female participants or lacked a sizeable sample to examine sex comparisons. As such, progress toward sensor development and improving hypoxia familiarization training are stunted due to limited knowledge of how individual differences, including sex, may or may not underlie hypoxia symptoms and performance impairment. Investigating sex differences bridges the gap between aerospace medicine and operational health, and addressing hypoxia is one of many facets yet to be studied. In the current study, we retrospectively examined N = 6 hypoxia studies with male-female participant samples (total, N = 189; male, n = 118; female, n = 71). We explored sex as a predictor of physiological response, sensory deficits, the severity of cognitive performance declines, and symptom manifestation via linear and binary logistic regression models. We found that the female sex predicted lower peripheral oxygen saturation and the likelihood of headache reporting in response to hypoxic challenge, yet explained little variance when combined with age and body mass index. The sensory and cognitive performance models did not converge, suggesting high intra-individual variability. Together, sex, age, and body mass index were not the most robust predictors in responses to hypoxic challenge; we cannot infer this for sensory deficits and cognitive performance within an experimentally induced hypoxic environment. The findings have implications for improving hypoxia familiarization training, monitoring sensor development, and emergency response and recovery protocols in case of a hypoxia occurrence suitable for all aircrew. We recommend continuing to elucidate the impact of sex and intrapersonal differences in hypoxia and other aeromedically relevant stressors in tactical aviation.
A symmetric prior knowledge based deep learning model for intracerebral hemorrhage lesion segmentation
Authors: Nijiati Mayidili , Tuersun Abudouresuli , Zhang Yue , Yuan Qing , Gong Ping , Abulizi Abudoukeyoumujiang , Tuoheti Awanisa , Abulaiti Adili , Zou Xiaoguang
Published: November 2022

Background: Accurate localization and classification of intracerebral hemorrhage (ICH) lesions are of great significance for the treatment and prognosis of patients with ICH. The purpose of this study is to develop a symmetric prior knowledge based deep learning model to segment ICH lesions in computed tomography (CT).

Methods: A novel symmetric Transformer network (Sym-TransNet) is designed to segment ICH lesions in CT images. A cohort of 1,157 patients diagnosed with ICH is established to train (n = 857), validate (n = 100), and test (n = 200) the Sym-TransNet. A healthy cohort of 200 subjects is added, establishing a test set with balanced positive and negative cases (n = 400), to further evaluate the accuracy, sensitivity, and specificity of the diagnosis of ICH. The segmentation results are obtained after data pre-processing and Sym-TransNet. The DICE coefficient is used to evaluate the similarity between the segmentation results and the segmentation gold standard. Furthermore, some recent deep learning methods are reproduced to compare with Sym-TransNet, and statistical analysis is performed to prove the statistical significance of the proposed method. Ablation experiments are conducted to prove that each component in Sym-TransNet could effectively improve the DICE coefficient of ICH lesions.

Results: For the segmentation of ICH lesions, the DICE coefficient of Sym-TransNet is 0.716 ± 0.031 in the test set which contains 200 CT images of ICH. The DICE coefficients of five subtypes of ICH, including intraparenchymal hemorrhage (IPH), intraventricular hemorrhage (IVH), extradural hemorrhage (EDH), subdural hemorrhage (SDH), and subarachnoid hemorrhage (SAH), are 0.784 ± 0.039, 0.680 ± 0.049, 0.359 ± 0.186, 0.534 ± 0.455, and 0.337 ± 0.044, respectively. Statistical results show that the proposed Sym-TransNet can significantly improve the DICE coefficient of ICH lesions in most cases. In addition, the accuracy, sensitivity, and specificity of Sym-TransNet in the diagnosis of ICH in 400 CT images are 91.25%, 98.50%, and 84.00%, respectively.

Conclusion: Compared with recent mainstream deep learning methods, the proposed Sym-TransNet can segment and identify different types of lesions from CT images of ICH patients more effectively. Moreover, the Sym-TransNet can diagnose ICH more stably and efficiently, which has clinical application prospects.
Symptomless turnip yellows virus infection causes grain yield loss in lentil and field pea: A three-year field study in south-eastern Australia
Authors: Nancarrow Narelle , Aftab Mohammad , Hollaway Grant , Rodoni Brendan , Trębicki Piotr
Published: November 2022

Turnip yellows virus (TuYV) is a damaging virus that is persistently transmitted by aphids and infects a wide range of grain hosts including lentil (Lens culinaris Medik), field pea (Pisum sativum L.) and canola (Brassica napus L., oilseed rape). Although information is available about the effects of TuYV infection on grain yield in canola, data about its impact on yield in pulses is lacking. In this study, field experiments quantifying the effects of TuYV infection on the grain yield of lentil and field pea were conducted over three consecutive years (2018-2020) with varying weather conditions. Plants artificially inoculated with TuYV using viruliferous green peach aphid (Myzus persicae, Sulzer) were grown under typical field conditions in south-eastern Australia. At maturity, grain yield, along with associated grain and plant growth parameters, were measured. Compared to the non-inoculated control treatment, early TuYV infection reduced grain yield by up to 36% in lentil and 45% in field pea, while late TuYV infection had no significant impact on yield. Despite a high incidence of TuYV infection and significant yield losses recorded in inoculated plots, no obvious symptoms of virus infection were observed in the inoculated plots in any of the six experiments; this lack of visible symptoms in lentil and field pea has significant implications for crop health assessments, demonstrating the importance of testing for virus instead of relying solely on the presence of visual symptoms, and may also be leading to an underestimation of the importance of TuYV in pulses in Australia.
Adaptability and stability for soybean yield by AMMI and GGE models in Ethiopia
Authors: Hailemariam Habtegebriel Mesfin
Published: November 2022

Genotype by environment interaction (GEI) is a phenomenon that occurs in heterogeneous environments that slows breeding progress by preventing the selection of superior cultivars for breeding and commercialization. Therefore, the objectives of this study were to find out how GEI impacts soybean output and to identify the most adapted and stable genotypes. Moreover, to look at the possibility of other mega environments for testing in the future. The experiments were grown for two years in a four-replicated randomized block design at each environment. Over the course of several harvests, yield components, days to flowering, days to maturity, plant height, the number of pods per plants, the number of seeds per plant, hundred seed weight and grain yield per hectare were evaluated in the main for 2018 and 2019.To analyze the stability performance of the genotypes, general linear method, GGE and Additive main effect and multiplicative interaction effects analysis (AMMI) and ASV rank analysis were applied. The GGE biplot revealed that the GGE biplots explained 74.29% of the total variation distributed as,56.69% and 17.62% of sum of squares between principal component PC1 and PC2, respectively whereas, AMMI model, the first two interaction principal component axes (IPCA1 and IPCA2) explained 47.74% and 26.62% of the variation due to GEI, respectively, exposed genotypes identified the five as best performer. The results from the four distinct stability statistics AMMI biplot (G8, G2, G1, G11), ASV (G1, G11; (GSI; G9, G1, G11) and (GGE: G2, G8, G9) are taken into account together with the genotypes` grand mean. The genotypes JM-CLK/CRFD-15-SD (G8) and 5002T (G1), which rank among the best and have the highest seed output, are suitable for hybridization as a parent and commercial production. Therefore, genotypes JM-CLK/CRFD-15-SD (G8) and 5002T(G1) have the highest seed output were among the best and thus could be recommended for release as a new soybean varieties cultivation across.
Silicon supplementation enhances productivity, water use efficiency and salinity tolerance in maize
Authors: Alayafi Abdullah H. , Al-Solaimani Samir G. M. , Abd El-Wahed Mohamed H. , Alghabari Fahad M. , Sabagh Ayman El
Published: November 2022

Drought and salinity stress severely inhibits the growth and productivity of crop plants by limiting their physiological processes. Silicon (Si) supplementation is considerd as one of the promising approaches to alleviate abiotic stresses such as drought and salinity. In the present study, a field experiment was conducted over two successive growth seasons (2019-20) to investigate the effect of foliar application of Si at two concentrations (1 and 2 kg Si ha-1) on the growth, yield and physiological parameters of three maize cultivars (ES81, ES83, and ES90) under three levels of irrigation salinity) [1000 (WS1), 2000 (WS2) and 3000 (WS3) mg L-1NaCl]. In this study, A trickle irrigation system was used. Si application significantly mitigated the harsh effects of salinity on growth and yield components of maize, which increased at all concentrations of Si. In irrigation with S3 salinity treatment, grain yield was decreased by 32.53%, however, this reduction was alleviated (36.19%) with the exogenous foliar application of Si at 2 kg Si ha-1. At salinity levels, Si application significantly increased maize grain yield (t ha-1) to its maximum level under WS of 1000 mg L-1, and its minimum level (Add value) under WS of 3000 mg L-1. Accordingly, the highest grain yield increased under Si application of 2 kg Si ha-1, regardless of salinity level and the cultivar ES81 achieved the highest level of tolerance against water salinity treatments. In conclusion, Application of Si at 2 kg Si ha-1 as foliar treatment worked best as a supplement for alleviating the adverse impacts of irrigation water salinity on the growth, physiological and yield parameters of maize.
Identifying risk factors for Jihadist terrorist offenders committing homicide: An explorative analysis using the European Database of Terrorist offenders
Authors: Alberda Daphne L. , Duits Nils , van den Bos Kees , Autsema Anneke , Kempes Maaike
Published: November 2022

Although many studies have examined various aspects of terrorism, relatively little is known about risk indicators associated with specific types of terrorist offences. To partly fill this void, this study explores differences on risk indicators of the Violent Extremism Risk Assessment tool (VERA-2R) between 21 Jihadist offenders who were convicted for homicide and a comparison group of 30 Jihadist offenders convicted for other Jihadist terrorist offences. In doing so, we use judicial data from the European Database of Terrorist offenders (EDT). The results reveal that a number of risk and protective indicators differ between both groups. Both terrorist offender groups often expressed grievances about perceived injustice, but the homicide group more frequently expressed anger, moral outrage, or hatred in response to the perceived injustice than the comparison group. The homicide group also identified their attacks more often than the comparison group, and were more actively engaged in planning and preparation them. Additionally, the homicide group was less often motivated to commit their terrorist offences by group belonging compared with the non-homicide group. With respect to the protective indicators, persons in the comparison group more often reject violence as a means to achieve goals. Although further research is necessary, the results from this study indicate that a differentiated approach might be needed for risk assessment and risk management of the terrorist offender population.
Investigating high schoolers’ L2 writing anxiety, L2 writing self-efficacy, L2 writing self-regulated strategies, and L2 writing engagement: Relationships and mediator
Authors: Zhou Jie , Wang Shusheng , Wang Junju
Published: November 2022

This study used a structural equation modeling approach to investigate the relationships among L2 writing anxiety, L2 writing self-efficacy, L2 writing self-regulated strategies and L2 writing engagement, and possible mediators that regulate the effect of individual factors. A questionnaire was administered to 340 Chinese high school students from different parts of the country. The results of the study suggested a negative relationship between L2 writing anxiety and L2 writing self-efficacy, and a direct effect of both on L2 writing engagement. While a higher level of L2 writing self-efficacy indicated a lower level of L2 writing anxiety and more students’ L2 writing engagement, L2 writing efficacy had a much stronger direct effect on L2 writing engagement than L2 writing anxiety. In addition, L2 writing self-regulated strategies were found to play a mediating role between L2 writing self-efficacy and L2 writing engagement, but not between L2 writing anxiety and L2 writing engagement. This study helps to understand the interplay of individual factors related to L2 writing and sheds light on promoting English writing abilities of Chinese high school students.
School attendance problems in adolescent with attention deficit hyperactivity disorder
Authors: Niemi Sofia , Lagerström Martin , Alanko Katarina
Published: November 2022

Introduction: A link between having a neurodevelopmental disorder, such as attention deficit hyperactivity disorder (ADHD) and school absenteeism, has been found in previous studies. Why ADHD poses a risk for absenteeism remains unclear, and insight into the mechanisms of the association is needed. The aim of the present study was to investigate school attendance problems (SAP) and both the symptoms related and the perceived reasons for them, as reported by adolescents with ADHD (n = 95), compared with neurotypical adolescents (n = 1,474).

Method: The current study (N = 1,569) was part of the School absence in Finland-project. SAPs were measured with the Inventory of School Attendance Problems (ISAP). The ISAP questionnaire contains a symptom scale (ISAP S) and a function scale (ISAP F), which shows if and how the symptoms impacts school attendance. A linear mixed effects model was used to analyze outcomes on the ISAP factors, controlling for background variables living status, gender, other diagnoses, highest level of education for the parent and age.

Results: Results show that adolescents with ADHD had been more absent from school compared to neurotypical adolescents during the prior 12-weeks. Adolescents with ADHD showed significantly more symptoms of agoraphobia/panic, problems within the family and problems with parents than neurotypical peers. The symptoms separation anxiety, agoraphobia/panic, aggression, problems within the family and problems with parents more often were perceived as the reason for SAP (ISAP F).

Discussion: The results are in line with our initial hypotheses and previous studies. Because of the low response rate on the ISAP F scale, the results regarding reasons for SAPs should be interpreted with caution. Future research could examine specific preventive actions of SAPs for adolescents with ADHD, and different subtypes of ADHD.
Perceived corporate social responsibility, ethical leadership, and moral reflectiveness impact on pro-environmental behavior among employees of small and medium enterprises: A double-mediation model
Authors: Mansour Mourad , Aman Nida , Al-Ghazali Basheer M. , Shah Syed Haider Ali
Published: November 2022

Corporate social responsibility (CSR) is ever-evolving concept and gaining significance in the business world. This research proposes a research model that elucidates the mechanism by which Corporate social responsibility (CSR), ethical leadership, and moral reflectiveness promote pro-environmental behavior among employees of Small and Medium Enterprises (SMEs). In today’s ever-changing environment, small and medium companies (SMEs) are critical for any economy to thrive and prosper. SMEs account for more than 30% of the GDP in Pakistan. However, little is known about the processes by which type of leadership influence the pro-environmental behavior, or the circumstances under which such impacts are strengthened or mitigated. The current study attempted to fill the gap by investigating a dual process model in which ethical leadership and a moral reflectiveness acted as two explanatory mechanisms in the impact of Corporate social responsibility (CSR) on pro-environmental behavior among employees working in small and medium enterprises (SMEs). The structural equation modeling technique was used to test the research model’s hypothesized relationships. A survey was used to collect data from 390 employees. Results showed that perceived CSR directly impacted moral reflectiveness and ethical leadership. Moreover, the moral reflectiveness and ethical leadership mediated the relationship between the perceived CSR and pro-environmental behavior. These findings contributed significantly to perceived CSR, ethical leadership, moral reflectiveness, and pro-environmental behavior among employees by exploring and integrating the holistic research work into one framework to add to the body of knowledge. Practical implications and future research directions are also highlighted.
Knowledge mapping of students’ mental health status in the COVID-19 pandemic: A bibliometric study
Authors: Yang Yang , Cao Qingtai , Zhao Mingyi , Zhuang Quan
Published: November 2022

Objective

The purpose of this study was to investigate the international scientific output on mental health of students during COVID-19 from 2020 to 2022 through a bibliometric analysis and to explore trend and research hotspots in this field.

Methods

We searched the Web of Science Core Collection for publications and used a variety of software to analyze and visualize the data such as R, CiteSpace, VOSviewer and Scimago.

Results

A total of 2,734 publications were retrieved as of June 4, 2022, published by 3,894 institutions from 120 countries/regions. China and the United States lead in the quantity and quality of publications in this field. According to Bradford’s Law, 16 journals are considered core journals in the field. Co-cited references indicate the main psychological problems of students under the epidemic revolve around anxiety, poor sleep and financial difficulty. Their behavior might also be influenced by increased internet and alcohol use.

Conclusion

Mental health of students during COVID-19 is attracting increasing attention. It is identified that the research hotspots in this field continue to revolve around emotional anxiety and unhealthy behaviors. Due to the different troubles faced by different groups under COVID-19, further exploration of the relevant factors specific for students are needed, with a hopeful view to providing ideas for intervention measures.
Evaluating the impact of a new educational tool on understanding of polygenic risk scores for alcohol use disorder
Authors: Driver Morgan N. , Kuo Sally I-Chun , Petronio Lia , Brockman Deanna , Dron Jacqueline S. , Austin Jehannine , Dick Danielle M.
Published: November 2022

Introduction

As gene identification efforts have advanced in psychiatry, so have aspirations to use genome-wide polygenic information for prevention and intervention. Although polygenic risk scores (PRS) for substance use and psychiatric outcomes are not yet available in clinical settings, individuals can access their PRS through online direct-to-consumer resources. One of these widely used websites reports that alcohol use disorder is the third most requested PRS out of >1,000 conditions. However, data indicate that there are misunderstandings about complex genetic concepts, with a lower understanding of PRS being associated with a more negative impact of receiving polygenic risk information. There is a need to develop and evaluate educational tools to increase understanding of PRS.

Methods

We conducted a randomized controlled trial to evaluate the impact of web-based educational information on understanding of PRS for alcohol use disorder. A total of 325 college students (70.4% female; 43.6% White; mean age = 18.9 years) from an urban, diverse university completed the study.

Results

Overall, participants were highly satisfied with the educational information. Results from a one-way ANOVA indicated that there was a significant increase in overall understanding of PRS for alcohol use disorder (p-value < 0.001), among individuals who received educational information about PRS and alcohol use disorder, as compared to receiving no accompanying information (adj. p-value < 0.001), or educational information about alcohol use disorder only (adj. p-value < 0.001).

Discussion

These findings suggest that the web-based educational tool could be provided alongside polygenic risk information in order to enhance understanding and interpretation of the information.

Clinical trial registration

[ClinicalTrials.gov], identifier [NCT05143073].
Suubi4StrongerFamilies: A study protocol for a clustered randomized clinical trial addressing child behavioral health by strengthening financial stability and parenting among families in Uganda
Authors: Ssewamala Fred M. , McKay Mary M. , Sensoy Bahar Ozge , Nabunya Proscovia , Neilands Torsten , Kiyingi Joshua , Namatovu Phionah , Guo Shenyang , Nakasujja Noeline , Mwebembezi Abel
Published: November 2022

Background

Children in Sub-Saharan Africa are burdened by significant unmet mental health needs. Across the region, high rates of poverty, HIV/AIDS, food insecurity, stigma, and an inadequate health safety net system exacerbate serious child behavioral health needs and impede an effective response. Disruptive behavioral disorders are particularly concerning as they persist through adolescence and adulthood. Hence, addressing the context-specific social influences on child behavioral health is critical given that children in the region comprise more than half of the total regional population. Against this backdrop, this study protocol describes a randomized clinical trial that will examine the mechanisms by which economic empowerment and family strengthening interventions targeting social, familial, and context-specific drivers affect the mental health of children in Uganda.

Methods

The study uses an experimental, longitudinal design across 30 cluster-randomized primary schools to compare single and combination intervention options; influences of economic empowerment and family strengthening on economic, perceptual, and functioning mediators; and context-specific moderators. The study will be conducted with 900 Ugandan children in mid-upper primary school (10–14 years). The three study conditions (n= 300 each) are: (1) economic empowerment only (EE only), (2) multiple family group-based family strengthening only (MFG-based FS only), and (3) combined EE + MFG-based FS. The interventions will be provided for 12 months; and assessments will occur at baseline, 12, 24, and 36 months.

Conclusion

Children in Sub-Saharan Africa are burdened by significant unmet mental health needs, including disruptive behavior disorders that persist through adolescence and adulthood if left untreated. The proposed study will examine the mechanisms by which economic empowerment and family strengthening interventions targeting social, familial and context-specific drivers affect the mental health of children in mid-upper primary schools in Uganda. Findings from this study can inform group, community, and population approaches that are needed for scalable solutions to address the social drivers negatively impacting child behavioral health in low-resource settings, including in Sub-Saharan Africa.

Clinical trial registration

[https://clinicaltrials.gov/], identifier [NCT053 68714].
Prevalence status and associated factors of wrist postural injury in the Chinese occupational population
Authors: Chen Nengzhou , Li Guanlin , Sun Xin , Zhang Meibian , Zhang Huadong , Ling Ruijie , Liu Yiming , Li Gang , Ren Zaoliang , Yin Yan , Shao Hua , Zhang Hengdong , Li Jiajie , Qiu Bing , Wang Dayu , Zeng Qiang , Liang Zhanhui , Wang Rugang , Chen Jianchao , Zhang Danying , Mei Liangying , Liu Yongquan , Liu Jixiang , Zhang Chengyun , Li Tianlai , Wang Zhongxu , Chen Qingsong , Jia Ning
Published: November 2022

Objective

This study investigated the prevalence of wrist injuries in 15 industries and different types of work in China. Study on the associated factors of wrist injuries provides a scientific basis for prevention and treatment of wrist diseases in occupational workers.

Methods

A cross-sectional study of musculoskeletal symptoms of related practitioners in 15 industries, including automobile manufacturing, was conducted to retrieve worker demographic information, working wrist posture, and pain conditions. Multivariable binary logistic regression analyses were performed to identify factors associated with work-related musculoskeletal disorders (WMSDs).

Results

The prevalence of wrist injuries among the study population was 13.2%. Toy manufacturing, animal husbandry, automobile manufacturing, shoe manufacturing, and biopharmaceutical manufacturing had the highest wrist injury rates at 29.1, 19.1, 14.9, 14.9, and 14.0%, respectively. Among the types of jobs, enamel workers (63.0%), butchers (43.6%), combers (32.5%), welders (31.3%), and scaffolders (26.5%) had the highest prevalence rates. Based on the final multivariate logistic regression analysis: female [odds ratios (OR) = 1.24; 95% confidence interval (CI), 1.15–1.35], 6–10 years of service (OR = 1.11; 95% CI, 1.03–1.18), >10 years of service (OR = 1.15; 95% CI, 1.06–1.25), frequent upward and downward flexion in wrist posture at work (OR = 1.81; 95% CI, 1.84–2.11), and frequent wrist placement on the edge of angular objects increased the OR of injury (OR = 1.52; 95% CI, 1.44–1.61). Need to squeeze objects tightly while working (OR = 1.72; 95% CI, 1.57–1.89), prolonged wrist flexion (OR = 1.86; 95% CI, 1.75–1.97), and work hand position above the shoulder for prolonged periods (OR = 1.11; 95% CI, 1.04–1.19) also suggested the relationship between these factors and the higher prevalence of wrist injury in the workers. The associated factor was physical activity (OR = 0.86; 95% CI, 0.80–0.94).

Conclusion

This study suggested the relationship between these factors and the higher prevalence of wrist injury in the toy manufacturing, animal husbandry, automobile manufacturing, and shoe-making industries, enamel workers, butchers, and combers. And are work types that require special attention. Females, working age, physical activity, and abnormal posture of the wrist were factors significantly associated with WMSDs.
Mathematical modeling in the health risk assessment of air pollution-related disease burden in China: A review
Authors: Chung Chee Yap , Yang Jie , Yang Xiaogang , He Jun
Published: November 2022

This review paper covers an overview of air pollution-related disease burden in China and a literature review on the previous studies which have recently adopted a mathematical modeling approach to demonstrate the relative risk (RR) of air pollution-related disease burden. The associations between air pollution and disease burden have been explored in the previous studies. Therefore, it is necessary to quantify the impact of long-term exposure to ambient air pollution by using a suitable mathematical model. The most common way of estimating the health risk attributable to air pollution exposure in a population is by employing a concentration-response function, which is often based on the estimation of a RR model. As most of the regions in China are experiencing rapid urbanization and industrialization, the resulting high ambient air pollution is influencing more residents, which also increases the disease burden in the population. The existing RR models, including the integrated exposure-response (IER) model and the global exposure mortality model (GEMM), are critically reviewed to provide an understanding of the current status of mathematical modeling in the air pollution-related health risk assessment. The performances of different RR models in the mortality estimation of disease are also studied and compared in this paper. Furthermore, the limitations of the existing RR models are pointed out and discussed. Consequently, there is a need to develop a more suitable RR model to accurately estimate the disease burden attributable to air pollution in China, which contributes to one of the key steps in the health risk assessment. By using an updated RR model in the health risk assessment, the estimated mortality risk due to the impacts of environment such as air pollution and seasonal temperature variation could provide a more realistic and reliable information regarding the mortality data of the region, which would help the regional and national policymakers for intensifying their efforts on the improvement of air quality and the management of air pollution-related disease burden.
Family experiences and attitudes toward care of ICU patients with delirium: A scoping review
Authors: Lange Sandra , Mȩdrzycka-Da̧browska Wioletta , Friganović Adriano , Religa Dorota , Krupa Sabina
Published: November 2022

Introduction

The family has an important role in the care of the ICU patient. Research shows that the implementation of non-pharmacological interventions to prevent delirium, including interventions with the family, can reduce the incidence of delirium. The aim of this review was to search the available literature about the experiences and attitudes of family/carers of ICU patients diagnosed with delirium during hospitalization.

Methods

A scoping review method was used to map terms relevant to the involvement of relatives in the care of critically ill patients with delirium. To identify studies, the following databases were searched: PubMed, Scopus, EBSCO, Web of Science, and Cochrane Library. The database search was ongoing from 15 July 2022, with a final search on 4 August 2022.

Results

Thirteen articles reporting on the experiences and attitudes of family/carers of ICU patients who developed delirium during hospitalization were included in the scoping review. Of the included studies, eight were qualitative studies, three were quantitative studies and two were reviews (systematic review and integrative review). The studies were conducted in North America, Europe, South Africa, and Asia. Our findings show that carers experienced adverse effects associated with delirium in ICU patients such as stress, anxiety, embarrassment, uncertainty, anger, shock. Families/relatives need both emotional and informational support from medical staff.

Conclusion

Relatives want to be involved in the care of the delirium patient, although this needs improvement in some aspects of care such as: lack of awareness, family/relatives knowledge of delirium, improved education, and communication with medical staff. Recognition of delirium by families is acceptable and feasible. Family involvement may induce an increased anxiety, but this aspect needs further research.
Health system strengthening using a Maximizing Engagement for Readiness and Impact (MERI) Approach: A community case study
Authors: Kyomuhangi Teddy , Manalili Kimberly , Kabakyenga Jerome , Turyakira Eleanor , Matovelo Dismas , Khan Sobia , Kyokushaba Clare , MacIntosh Heather , Brenner Jennifer L.
Published: November 2022

Introduction

Health system strengthening initiatives in low and middle-income countries are commonly hampered by limited implementation readiness. The Maximizing Engagement for Readiness and Impact (MERI) Approach uses a system “readiness” theory of change to address implementation obstacles. MERI is documented based on field experiences, incorporating best practices, and lessons learned from two decades of maternal, newborn, and child health (MNCH) programming in East Africa.

Context

The MERI Approach is informed by four sequential and progressively larger MNCH interventions in Uganda and Tanzania. Intervention evaluations incorporating qualitative and quantitative data sources assessed health and process outcomes. Implementer, technical leader, stakeholder, and policymaker reflections on sequential experiences have enabled MERI Approach adaptation and documentation, using an implementation lens and an implementation science readiness theory of change.

Key programmatic elements

The MERI Approach comprises three core components. MERIChange Strategies (meetings, equipping, training, mentoring) describe key activity types that build general and intervention-specific capacity to maximize and sustain intervention effectiveness. The SOPETAR ProcessModel (Scan, Orient, Plan, Equip, Train, Act, Reflect) is a series of purposeful steps that, in sequence, drive each implementation level (district, health facility, community). A MERIMotivational Framework identifies foundational factors (self-reliance, collective-action, embeddedness, comprehensiveness, transparency) that motivate participants and enhance intervention adoption. Components aim to enhance implementer and system readiness while engaging broad stakeholders in capacity building activities toward health outcome goals. Activities align with government policy and programming and are embedded within existing district, health facility, and community structures.

Discussion

This case study demonstrates feasibility of the MERI Approach to support district wide MNCH programming in two low-income countries, supportive of health outcome and health system improvements. The MERI Approach has potential to engage districts, health facilities, and communities toward sustainable health outcomes, addressing intervention implementation gaps for current and emerging health needs within and beyond East Africa.
Strategies of socio-ecological transition for a sustainable urban metabolism
Authors: Padovan Dario , Cristiano Silvio , Gonella Francesco
Published: November 2022

Urbanization plays a key role in the human activities causing and feeding climate change. At present, climate change and other environmental issues are directly or indirectly related to the metabolism of cities. However, cities may also play a central role in the fight against climate change. This is the reason why Urban Metabolism (UM) has become a powerful concept to account for and understand the way in which complex systems such as cities use and dispose of material resources, also suggesting measures to change their operational regimes. The rightsizing and optimization of UM is basically a matter of social innovation. It implies changes in the way a city collectively produces and reproduces its physical stocks and provides services to its inhabitants. This article aims at identifying strategies, scenarios, and pathways to slow down urban metabolic processes while improving their efficiency, thus managing a successful transition to an urban (more) circular economy, as well as decreasing the material intensity of the urban economy. The main objectives of the article are the following:

1. The development of a renewed approach for studying Urban Metabolism based on transdisciplinary approaches and methods aimed to model metabolic agents' patterns of practices.

2. The definition of urban patterns of resource use of different agents shaping urban metabolism (households, corporate agents, communities, and public authorities).

3. The exploration of the main policies and administrative tools that cities use to manage environmental problems leading to different urban regulation regimes.

4. A tool for generating future scenarios and roadmaps to reach a low-carbon future. This tool is crucial for engaging experts, stakeholders and the public looking for new solutions.
Space weather observations, modeling, and alerts in support of human exploration of Mars
Authors: Green James L. , Dong Chuanfei , Hesse Michael , Young C. Alex , Airapetian Vladimir
Published: November 2022

Space weather observations and modeling at Mars have begun but they must be significantly increased to support the future of Human Exploration on the Red Planet. A comprehensive space weather understanding of a planet without a global magnetosphere and a thin atmosphere is very different from our situation at Earth so there is substantial fundamental research remaining. It is expected that the development of suitable models will lead to a comprehensive operational Mars space weather alert (MSWA) system that would provide rapid dissemination of information to Earth controllers, astronauts in transit, and those in the exploration zone (EZ) on the surface by producing alerts that are delivered rapidly and are actionable. To illustrate the importance of such a system, we use a magnetohydrodynamic code to model an extreme Carrington-type coronal mass ejection (CME) event at Mars. The results show a significant induced surface field of nearly 3,000 nT on the dayside that could radically affect unprotected electrical systems that would dramatically impact human survival on Mars. Other associated problems include coronal mass ejection (CME) shock-driven acceleration of solar energetic particles producing large doses of ionizing radiation at the Martian surface. In summary, along with working more closely with international partners, the next Heliophysics Decadal Survey must include a new initiative to meet expected demands for space weather forecasting in support of humans living and working on the surface of Mars. It will require significant effort to coordinate NASA and the international community contributions.
A survey of organizational structure and operational practices of elite youth football academies and national federations from around the world: A performance and medical perspective
Authors: Gregson Warren , Carling Christopher , Gualtieri Antonio , O'Brien James , Reilly Patrick , Tavares Francisco , Bonanno Daniele , Lopez Emmanuel , Marques Joao , Lolli Lorenzo , Salvo Valter Di
Published: November 2022

Aim

Medical and performance units are integral components of player development programmes in elite football academies. Nevertheless, the nature of the operational processes implemented by practitioners within clubs and national federations remains unexplored. The aim of the present study, therefore, was to survey elite youth professional football academies from around the world regarding the operational processes adopted by their medical and performance units.

Methods

Of the 50 organizations invited, 10 national federations and 25 clubs took part in the survey resulting in a response rate of 70% (95% confidence interval, 56%−81%). The respondents represented three groups: senior club and academy management, performance, and medical staff.

Results

The majority (60%−90%) of clubs and national federations reported strategic alignment between senior and academy medical and performance units as well as between academy medical and performance units. Survey responses indicated substantial heterogeneity in the composition and number of medical and performance professionals employed in academies. The majority of respondents agreed their medical and performance departments were effective in utilizing staff knowledge and external sources of knowledge to inform their practice (56%−80%). Performance staff (40%−50%) and physiotherapists (30%−32%) were deemed most influential in injury prevention programmes. During the return-to-play process, the influence of specific practitioners in the medical and performance units was dependent upon the phase of return-to-play. Shared decision-making was common practice amongst performance and medical staff in injury prevention and return-to-play processes. Medical and performance data were generally centralized across the first team and academy in majority (50%−72%) of clubs and national federations. Data were integrated within the same data management system to a higher degree in clubs (68%) vs. national federations (40%). Research and development activity were reported for most academies (50%−72%), and generally led by the head of performance (37%) or team doctor (21%). Research activities were largely undertaken via internal staff (~100%), academic collaborations (50%−88%) and/or external consultants and industry partnerships (77%−83%) in the national federation and clubs.

Conclusion

Collectively, these findings provide a detailed overview regarding key operational processes delivered by medical and performance practitioners working in elite football academies.
Fastball pitching performance only slightly decreases after mobility impediment of the pelvis and trunk—Do (catch-up) compensation strategies come into play?
Authors: Leenen A. J. R. , Trigt Bart van , Hoozemans M. J. M. , Veeger H. E. J.
Published: November 2022

Background

Baseball pitching performance can be mechanically explained by the summation of speed principle and the principle of optimal coordination of partial momenta. Impeding optimal energy generation or transfer by or between the pelvis and trunk segments could provide valuable insight into possible compensation or catch-up mechanisms that may manifest themselves based on these principles.

Aim

The aim of the present study was to explore the effects of experimentally impeding the mobility of and between the pelvis and trunk segments (1) on ball speed and mechanical peak joint power, and (2) on mechanical peak load of the elbow and shoulder joints at maximal external rotation (MER) during fastball pitching.

Methods

Eleven elite baseball pitchers (mean age 17.4, SD 2.2 years; mean pitching experience 8.9, SD 3.0 years) were instructed to throw at least 15 fastballs as fast and accurately as possible under two conditions. One condition involved impeding the mobility of the pelvis and trunk segments to hamper their ability to rotate independently, which consequently should affect the separation time, defined as the time interval between the pelvis and trunk peak angular velocities. In the other condition, pitchers threw unimpeded. Ball speed, mechanical peak joint power and peak net moment of the elbow and shoulder at MER were compared between conditions using Generalized Estimating Equations (GEE).

Results

In the impeded pitching condition, the mean difference of the separation time was 12.4 milliseconds [95% CI (4.0, 20.7)] and for ball speed 0.6 mph [95% CI (0.2, 0.9)] lower compared to the unimpeded condition. Only the peak pelvic angular velocity, in addition to the trunk, upper arm and forearm, was 45 deg/s [95% CI (24, 66)] higher impeded condition. The mean differences of the joint power and net moments at the shoulder and elbow did not reach statistical significance.

Conclusion

In elite adolescent baseball, the observed pitching performance after experimentally impeding pelvic and trunk mobility undermines a potential distal catch-up strategy based on the summation of speed principle. The increased peak pelvic angular velocity may indicate a compensation strategy following the optimal coordination of partial momenta principle to practically maintain pitching performance.
Understanding long-term continence rates after robot-assisted laparoscopic prostatectomy – one-year follow-up on “Cognitive ability as a non-modifiable risk factor for post-prostatectomy urinary incontinence”
Authors: Reichert Mathias , Ploeger Hannah Maria , Uhlig Annemarie , Strauss Arne , Henniges Philipp , Trojan Lutz , Mohr Mirjam Naomi
Published: November 2022

Purpose

To evaluate long-term continence rates (12 months) in patients after robot-assisted laparoscopic prostatectomy (RALP) in relation to their cognitive ability (CoAb), which proved to be a predictor for early post-prostatectomy incontinence.

Material & Methods

This is the 12-month follow-up evaluation of our previously published observational single-center, prospective evaluation of 84 patients who underwent RALP as treatment of their localized prostate cancer between 07/2020 and 03/2021. Post-prostatectomy incontinence (PPI) was measured by asking patients about their 24 h pad usage, whereby 0 pads were considered continent and ≥1 pad was considered incontinent. CoAb was evaluated by performing the Mini-Mental State Examination prior to surgery. Possible predictors for PPI were evaluated using univariate and multivariable logistic regression models.

Results

Multivariable logistic regression analyses identified early incontinence status and nerve sparing (NS) as independent predictors for PPI after 12 months, resulting in a 5.69 times higher risk for PPI when the loss of urine was between 10 and 50 ml during the early performed pad test (one day after catheter removal) compared to 0–1 ml loss of urine [95% confidence interval (CI): 1.33–28.30, p = 0.024] and a 6.77 times higher risk for PPI, respectively, when only unilateral NS was performed compared to bilateral NS (95% CI: 1.79–30.89, p = 0.007). CoAb lost its predictive value for long-term PPI (p = 0.44).

Conclusion

The results of this study suggest that PPI is a dynamic, rather than a static condition with a dynamically changing pathophysiology within the first 12 months after RALP. Coping methods and therapies should adapt to this circumstance.
Establishment of minimally invasive ventral hernia repair with extraperitoneal mesh placement in a primary care hospital using the robotic platform
Authors: Bauer Katrin , Heinzelmann Frank , Vogel Robert , Büchler Peter , Mück Björn
Published: November 2022

Background

The progressive availability of robotic surgical systems opens new perspectives in abdominal wall surgery due to excellent visibility and dexterity of instruments. While complex hernias until today were treated primarily through an open access, we evaluated if this promising technology is suitable for treating the entire spectrum of a hernia center, including complex hernias.

Material/methods

In 2017, minimally invasive hernia surgery with extraperitoneal mesh placement was started in Kempten hospital. Since 2019, a Da Vinci X system has been available for this purpose. In order to observe the process of transition we retrospectively analyzed all patients who underwent ventral hernia repair in the department of general and visceral surgery at our hospital between January 2016 and December 2020 and were indicated for mesh implantation.

Results

In 2016, the percentage of minimally invasive procedures was 37.3%. In all of these cases an intraperitoneal mesh was implanted into the abdominal cavity. Open surgery was performed in 62.7%, of which an a retromuscular mesh was implanted in 75.7%, an intraperitoneal mesh in 21.6%, and an onlay mesh in 2.7%. In 2020, minimally invasive surgery accounted for 87.5%, of which 85.7% were performed robotically and 14.3 laparoscopically. In 94.3% of these minimally invasively treated patients the mesh was implanted in extraperitoneal position (75.8% in retromuscular and 24.2% in preperitoneal position). The percentage of complex hernias increased from 20.3% to 35.0% during the same period.

Conclusion

The majority of ventral hernia procedures can be performed safely using the robot in a minimally invasive technique with extraperitoneal mesh placement without leading to an increase in complications. Robotically-assisted hernia repair is a promising new technique that is also practical for complex hernias.