bluuebunny/crossref_metadata_2025 huggingface dataset:
Pharmacokinetics and Drug-Drug Interactions of Abacavir and Lamuvudine Co-administered With Antituberculosis Drugs in HIV-Positive Children Treated for Multidrug-Resistant Tuberculosis
Authors: van der Laan Louvina E. , Garcia-Prats Anthony J. , Schaaf H. Simon , Winckler Jana L. , Draper Heather , Norman Jennifer , Wiesner Lubbe , McIlleron Helen , Denti Paolo , Hesseling Anneke C.
Published: October 2021

Given the high prevalence of multidrug-resistant (MDR)-TB in high HIV burden settings, it is important to identify potential drug-drug interactions between MDR-TB treatment and widely used nucleoside reverse transcriptase inhibitors (NRTIs) in HIV-positive children. Population pharmacokinetic models were developed for lamivudine (n = 54) and abacavir (n = 50) in 54 HIV-positive children established on NRTIs; 27 with MDR-TB (combinations of high-dose isoniazid, pyrazinamide, ethambutol, ethionamide, terizidone, fluoroquinolones, and amikacin), and 27 controls without TB. Two-compartment models with first-order elimination and transit compartment absorption described both lamivudine and abacavir pharmacokinetics, respectively. Allometric scaling with body weight adjusted for the effect of body size. Clearance was predicted to reach half its mature value ∼2 (lamivudine) and ∼3 (abacavir) months after birth, with completion of maturation for both drugs at ∼2 years. No significant difference was found in key pharmacokinetic parameters of lamivudine and abacavir when co-administered with routine drugs used for MDR-TB in HIV-positive children.
Use of Herbal Medicines for the Treatment of Mild Mental Disorders and/or Symptoms During Pregnancy: A Cross-Sectional Survey
Authors: Gantner Giulia , Spiess Deborah , Randecker Eliane , Quack Lötscher Katharina C. , Simões-Wüst Ana Paula
Published: October 2021

Little is known about the treatment of mild mental disorders and/or symptoms (MDS) during pregnancy. Our main purpose was to compare the use of herbal medicines during pregnancy in women with and without MDS. A questionnaire consisting of 21 multiple-choice questions was distributed in the participating obstetrics clinics or birth centers in the Canton of Zurich, in Switzerland, from August 2018 to March 2019; 398 questionnaires were considered in the analysis. The use of any type of herbal medicines–including pharmaceutical herbal products as well as teas–during pregnancy was reported by 358 women (out of 398, 89.9%). Of these, 272 participants used pharmaceutical herbal products, whereby ginger (49.2%), raspberry leaf (42.7%), bryophyllum (37.8%), chamomile (27.2%), lavender (22%) and iron-rich herbs (12.3%) were the ones most commonly mentioned. More than half (207/398, 52.0%) of all participants reported suffering from MDS during pregnancy; only a few took (synthetic) psychoactive medications (5/398, 1.3%). The percentage of use of pharmaceutical herbal medicines was higher among women reporting MDS than among the remaining women (90.0 vs 75.9%; p < 0.001). At the same time, the prevalence of MDS was higher among users of pharmaceutical herbal products than among non-users (59.6 vs 34.0%; p = 0.001). Specific questions on candidate herbal medicines for the treatment of mild MDS revealed that bryophyllum (mentioned by 107 women), lavender (56 women) and valerian (20 women) were used to reduce stress, restlessness, sleep disorders and others, in part with perceived good to very good effectiveness and tolerability. The large majority of the pregnant women participating in the survey make use of herbal medicines. The particularly high prevalence of MDS among herbal medicine-users and the very rare use of synthetic psychoactive medications suggest that pregnant women rely on herbal medicines for treatment of mild MDS. The reported good effectiveness and tolerability of a few candidate herbal medicines deserve particular attention.
Chinese Herbal Medicine Therapy Reduces the Risks of Overall and Anemia-Related Mortalities in Patients With Aplastic Anemia: A Nationwide Retrospective Study in Taiwan
Authors: Chiu Mu-Lin , Hsu Yu-Lung , Chen Chao-Jung , Li Te-Mao , Chiou Jian-Shiun , Tsai Fuu-Jen , Lin Ting-Hsu , Liao Chiu-Chu , Huang Shao-Mei , Chou Chen-Hsing , Liang Wen-Miin , Lin Ying-Ju
Published: October 2021

Aplastic Anemia (AA) is a rare but fatal hematologic disease that may occur at any age and especially higher in Asia. We investigated whether Chinese herbal medicine (CHM) is beneficial to AA patients as a complementary therapy using a nationwide population-based database in Taiwan between 2000–2016. Patient survival was estimated by Kaplan‒Meier survival analyses and Cox proportional-hazard model. CHM-users presented lower risks of overall and anemia-related mortalities when compared to non-users. The risk of overall mortality for CHM-users in AA patients was 0.70-fold [adjusted hazard ratio (aHR): 0.70, 95% confidence interval (CI): 0.66-0.74, p < 0.001). The risk of anemia-related mortality was lower in CHM-users when compared to non-users (aHR: 0.46, 95% CI: 0.32-0.67, p < 0.001). The association rule analysis revealed that CHM pairs were Ban-Zhi-Lian (BZL; Scutellaria barbata D. Don)→Bai-Hua-She-She-Cao (BHSSC; Oldenlandia diffusa (Willd.) Roxb.), followed by Dang-Gui (DG; Angelica sinensis (Oliv.) Diels)→Huang-Qi (HQi; Astragalus membranaceus (Fisch.) Bunge), and Xian-He-Cao (XHC; Agrimonia pilosa f. borealis (Kitag.) Chu)→Gui-Pi-Tang (GPT). Network analysis showed that BZL, BHSSC, DG, HQi, XHC, GPT, and Dan-Shen (DanS; Salvia miltiorrhiza var. charbonnelii (H.Lév.) C.Y.Wu) were commonly used CHMs for AA patients. Therefore, further studies for these commonly prescribed herbs are needed in functional investigations in hematopoiesis-stimulating effect and large-scale randomized controlled trials (RCT) in bone marrow failure related diseases.
Potential Reduction of Peripheral Local SAR for a Birdcage Body Coil at 3 Tesla Using a Magnetic Shield
Authors: van Leeuwen C.C. , Steensma B.R. , Glybovski S.B. , Lunenburg M.F.J. , Simovski C. , Klomp D.W.J. , van den Berg C.A.T. , Raaijmakers A.J.E.
Published: October 2021

The birdcage body coil, the standard transmit coil in clinical MRI systems, is typically a shielded coil. The shield avoids interaction with other system components, but Eddy Currents induced in the shield have an opposite direction with respect to the currents in the birdcage coil. Therefore, the fields are partly counteracted by the Eddy currents, and large coil currents are required to reach the desired B1+level in the subject. These large currents can create SAR hotspots in body regions close to the coil. Complex periodic structures known as metamaterials enable the realization of a magnetic shield with magnetic rather than electric conductivity. A magnetic shield will have Eddy currents in the same direction as the coil currents. It will allow generating the same B1+with lower current amplitude, which is expected to reduce SAR hotspots and improve homogeneity. This work explores the feasibility of a birdcage body coil at 3 T with a magnetic shield. Initially, we investigate the feasibility by designing a scale model of a birdcage coil with an anisotropic implementation of a magnetic shield at 7 T using flattened split ring resonators. It is shown that the magnetic shield destroys the desired resonance mode because of increased coil loading. To enforce the right mode, a design is investigated where each birdcage rung is driven individually. This design is implemented in a custom built birdcage at 7 T, successfully demonstrating the feasibility of the proposed concept. Finally, we investigate the potential improvements of a 3 T birdcage body coil through simulations using an idealized magnetic shield consisting of a perfect magnetic conductor (PMC). The PMC shield is shown to eliminate the peripheral regions of high local SAR, increasing the B1+per unit maximum local SAR by 27% in a scenario where tissue is present close to the coil. However, the magnetic shield increases the longitudinal field of view, which reduces the transmit efficiency by 25%.
The Microbiome in Autoimmune Liver Diseases: Metagenomic and Metabolomic Changes
Authors: Zheng Yanping , Ran Ying , Zhang Hongxia , Wang Bangmao , Zhou Lu
Published: October 2021

Recent studies have identified the critical role of microbiota in the pathophysiology of autoimmune liver diseases (AILDs), including autoimmune hepatitis (AIH), primary biliary cholangitis (PBC), and primary sclerosing cholangitis (PSC). Metagenomic studies reveal significant decrease of gut bacterial diversity in AILDs. Although profiles of metagenomic vary widely, Veillonella is commonly enriched in AIH, PBC, and PSC. Apart from gut microbiome, the oral and bile microbiome seem to be associated with these diseases as well. The functional analysis of metagenomics suggests that metabolic pathways changed in the gut microbiome of the patients. Microbial metabolites, including short-chain fatty acids (SCFAs) and microbial bile acid metabolites, have been shown to modulate innate immunity, adaptive immunity, and inflammation. Taken together, the evidence of host–microbiome interactions and in-depth mechanistic studies needs further accumulation, which will offer more possibilities to clarify the mechanisms of AILDs and provide potential molecular targets for the prevention and treatment in the future.
RyR2 and Calcium Release in Heart Failure
Authors: Benitah Jean-Pierre , Perrier Romain , Mercadier Jean-Jacques , Pereira Laetitia , Gómez Ana M.
Published: October 2021

Heart Failure (HF) is defined as the inability of the heart to efficiently pump out enough blood to maintain the body's needs, first at exercise and then also at rest. Alterations in Ca2+ handling contributes to the diminished contraction and relaxation of the failing heart. While most Ca2+ handling protein expression and/or function has been shown to be altered in many models of experimental HF, in this review, we focus in the sarcoplasmic reticulum (SR) Ca2+ release channel, the type 2 ryanodine receptor (RyR2). Various modifications of this channel inducing alterations in its function have been reported. The first was the fact that RyR2 is less responsive to activation by Ca2+ entry through the L-Type calcium channel, which is the functional result of an ultrastructural remodeling of the ventricular cardiomyocyte, with fewer and disorganized transverse (T) tubules. HF is associated with an elevated sympathetic tone and in an oxidant environment. In this line, enhanced RyR2 phosphorylation and oxidation have been shown in human and experimental HF. After several controversies, it is now generally accepted that phosphorylation of RyR2 at the Calmodulin Kinase II site (S2814) is involved in both the depressed contractile function and the enhanced arrhythmic susceptibility of the failing heart. Diminished expression of the FK506 binding protein, FKBP12.6, may also contribute. While these alterations have been mostly studied in the left ventricle of HF with reduced ejection fraction, recent studies are looking at HF with preserved ejection fraction. Moreover, alterations in the RyR2 in HF may also contribute to supraventricular defects associated with HF such as sinus node dysfunction and atrial fibrillation.
Stimuli for Adaptations in Muscle Length and the Length Range of Active Force Exertion—A Narrative Review
Authors: Kruse Annika , Rivares Cintia , Weide Guido , Tilp Markus , Jaspers Richard T.
Published: October 2021

Treatment strategies and training regimens, which induce longitudinal muscle growth and increase the muscles’ length range of active force exertion, are important to improve muscle function and to reduce muscle strain injuries in clinical populations and in athletes with limited muscle extensibility. Animal studies have shown several specific loading strategies resulting in longitudinal muscle fiber growth by addition of sarcomeres in series. Currently, such strategies are also applied to humans in order to induce similar adaptations. However, there is no clear scientific evidence that specific strategies result in longitudinal growth of human muscles. Therefore, the question remains what triggers longitudinal muscle growth in humans. The aim of this review was to identify strategies that induce longitudinal human muscle growth. For this purpose, literature was reviewed and summarized with regard to the following topics: (1) Key determinants of typical muscle length and the length range of active force exertion; (2) Information on typical muscle growth and the effects of mechanical loading on growth and adaptation of muscle and tendinous tissues in healthy animals and humans; (3) The current knowledge and research gaps on the regulation of longitudinal muscle growth; and (4) Potential strategies to induce longitudinal muscle growth. The following potential strategies and important aspects that may positively affect longitudinal muscle growth were deduced: (1) Muscle length at which the loading is performed seems to be decisive, i.e., greater elongations after active or passive mechanical loading at long muscle length are expected; (2) Concentric, isometric and eccentric exercises may induce longitudinal muscle growth by stimulating different muscular adaptations (i.e., increases in fiber cross-sectional area and/or fiber length). Mechanical loading intensity also plays an important role. All three training strategies may increase tendon stiffness, but whether and how these changes may influence muscle growth remains to be elucidated. (3) The approach to combine stretching with activation seems promising (e.g., static stretching and electrical stimulation, loaded inter-set stretching) and warrants further research. Finally, our work shows the need for detailed investigation of the mechanisms of growth of pennate muscles, as those may longitudinally grow by both trophy and addition of sarcomeres in series.
Activation of Astrocytes in the Persistence of Post-hypoxic Respiratory Augmentation
Authors: Fukushi Isato , Takeda Kotaro , Pokorski Mieczyslaw , Kono Yosuke , Yoshizawa Masashi , Hasebe Yohei , Nakao Akito , Mori Yasuo , Onimaru Hiroshi , Okada Yasumasa
Published: October 2021

Acute hypoxia increases ventilation. After cessation of hypoxia loading, ventilation decreases but remains above the pre-exposure baseline level for a time. However, the mechanism of this post-hypoxic persistent respiratory augmentation (PHRA), which is a short-term potentiation of breathing, has not been elucidated. We aimed to test the hypothesis that astrocytes are involved in PHRA. To this end, we investigated hypoxic ventilatory responses by whole-body plethysmography in unanesthetized adult mice. The animals breathed room air, hypoxic gas mixture (7% O2, 93% N2) for 2min, and again room air for 10min before and after i.p. administration of low (100mg/kg) and high (300mg/kg) doses of arundic acid (AA), an astrocyte inhibitor. AA suppressed PHRA, with the high dose decreasing ventilation below the pre-hypoxic level. Further, we investigated the role of the astrocytic TRPA1 channel, a putative ventilatory hypoxia sensor, in PHRA using astrocyte-specificTrpa1knockout (asTrpa1−/−) and floxedTrpa1(Trpa1f/f) mice. In bothTrpa1f/fand asTrpa1−/−mice, PHRA was noticeable, indicating that the astrocyte TRPA1 channel was not directly involved in PHRA. Taken together, these results indicate that astrocytes mediate the PHRA by mechanisms other than TRPA1 channels that are engaged in hypoxia sensing.
Sphingolipids in Lung Pathology in the Coronavirus Disease Era: A Review of Sphingolipid Involvement in the Pathogenesis of Lung Damage
Authors: Khan Saad A. , Goliwas Kayla F. , Deshane Jessy S.
Published: October 2021

Sphingolipids are bioactive lipids involved in the regulation of cell survival, proliferation, and the inflammatory response. The SphK/S1P/S1PR pathway (S1P pathway) is a driver of many anti-apoptotic and proliferative processes. Pro-survival sphingolipid sphingosine-1-phosphate (S1P) initiates its signaling cascade by interacting with various sphingosine-1-phosphate receptors (S1PR) through which it is able to exert its pro-survival or inflammatory effects. Whereas sphingolipids, including ceramides and sphingosines are pro-apoptotic. The pro-apoptotic lipid, ceramide, can be produced de novo by ceramide synthases and converted to sphingosine by way of ceramidases. The balance of these antagonistic lipids and how this balance manifests is the essence of the sphingolipid rheostat. Recent studies on SARS-CoV-2 have implicated the S1P pathway in the pathogenesis of novel coronavirus disease COVID-19-related lung damage. Accumulating evidence indicates that an aberrant inflammatory process, known as “cytokine storm” causes lung injury in COVID-19, and studies have shown that the S1P pathway is involved in signaling this hyperinflammatory response. Beyond the influence of this pathway on cytokine storm, over the last decade the S1P pathway has been investigated for its role in a wide array of lung pathologies, including pulmonary fibrosis, pulmonary arterial hypertension (PAH), and lung cancer. Various studies have used S1P pathway modulators in models of lung disease; many of these efforts have yielded results that point to the potential efficacy of targeting this pathway for future treatment options. Additionally, they have emphasized S1P pathway’s significant role in inflammation, fibrosis, and a number of other endothelial and epithelial changes that contribute to lung damage. This review summarizes the S1P pathway’s involvement in COVID-19 and chronic lung diseases and discusses the potential for targeting S1P pathway as a therapeutic option for these diseases.
Climate Change and Coffee Quality: Systematic Review on the Effects of Environmental and Management Variation on Secondary Metabolites and Sensory Attributes of Coffea arabica and Coffea canephora
Authors: Ahmed Selena , Brinkley Sarah , Smith Erin , Sela Ariella , Theisen Mitchell , Thibodeau Cyrena , Warne Teresa , Anderson Evan , Van Dusen Natalie , Giuliano Peter , Ionescu Kim Elena , Cash Sean B.
Published: October 2021

Climate change is impacting crop performance and agricultural systems around the world with implications for farmers and consumers. We carried out a systematic review to synthesize evidence regarding the effects of environmental factors associated with climate change and management conditions associated with climate adaptation on the crop quality of a culturally-relevant perennial crop, coffee (Coffea arabica and Coffea canephora). Seventy-three articles were identified that addressed the study's research question including 42 articles on environmental factors, 20 articles on management conditions, and 11 articles on both. While variation was found between studies, findings highlight that coffee quality is vulnerable to changes in light exposure, altitude, water stress, temperature, carbon dioxide, and nutrient management. Both increases as well as decreases were found in secondary metabolites and sensory attributes that determine coffee quality in response to shifts in environmental and management conditions. The most consistent evidence identified through this systematic review includes the following two trends: (1) increased altitude is associated with improved sensory attributes of coffee and; (2) increased light exposure is associated with decreased sensory attributes of coffee. Research gaps were found regarding the effects of shifts in carbon dioxide, water stress, and temperature on the directionality (increase, decrease, or non-linear) of coffee quality and how this varies with location, elevation, and management conditions. This systematic review further identified the following research needs: (1) long-term studies that examine the interactive effects of multiple environmental factors and management conditions on coffee quality; (2) studies that examine the interaction between sensory attributes and secondary metabolites that determine coffee quality and; (3) studies on the feasibility of various climate-adaptation strategies for mitigating the effects of climate change on coffee quality. Evidence-based innovations are needed to mitigate climate impacts on coffee quality toward enhanced sustainability and resilience of the coffee sector from farm to cup.
Experimental and Theoretical Study of the Effects of Rare Earth Elements on Growth and Chlorophyll of Alfalfa (Medicago sativa L.) Seedling
Authors: Song Kexiao , Gao Jinzhu , Li Shuo , Sun Yunfu , Sun Haoyang , An Baiyu , Hu Tianming , He Xueqing
Published: October 2021

Rare earth elements (REEs) of low concentration are usually beneficial to plant growth, while they are toxic at high concentrations. The effects of treatment with lanthanum (La) (10 and 20 μM), cerium (Ce) (10 and 20 μM), and terbium (Tb) (10 and 20 μM) on seedling growth of alfalfa (Medicago sativa L.), which is one of the most important perennial leguminous forages in the world, were studied. The results showed that all three REE treatments quickened the germination of seeds. The length of shoot under La (20 μM) treatment was significantly shortened (P < 0.05). In addition, treatment with La, Ce, and Tb had a “hormesis effect” on root length. There was a significant decrease in chlorophyll content on treatment with the three REEs, and the degree of decline was in the order of La < Ce < Tb, under the same concentration. In vitro experiments and quantum chemical calculations were further performed to explain why the treatments with REEs reduced the chlorophyll content. In vitro experiments showed that La, Ce, and Tb treatments reduced the absorbance of chlorophyll, and the decrease followed in the order of La > Ce > Tb. Quantum chemical calculations predicted that the decrease in absorption intensity was caused by the reactions between La, Ce, Tb, and chlorophyll, which formed lanthanides-chlorophyll; and there were five types of stable lanthanides-chlorophyll. In conclusion, the decrease in chlorophyll content on treatment with REEs was caused by the change in chlorophyll structure.
The Implementation of Patient-Centered Humanistic Care for COVID-19 Closely Contacted Hemodialysis Patients Under the Hospital-Based Group Medical Quarantine: A Brief Research Report
Authors: Zhang He , Gan Liangying , Li Xiaodan , Shao Xiaofeng , Zuo Li , Gao Jie , Huang Xiaobo , Jia Xiaojun , Liang Junqing , Hou Zhihua , Wang Yanhua , Wang Lei , Gao Zhancheng , Wang Jianliu , Chen Hongsong
Published: October 2021

In February 2020, an inpatient in Peking University People's Hospital (PKUPH), China, was confirmed positive for the novel coronavirus. In this case, 143 hemodialysis patients were labeled as close contacts and required to be placed under the hospital-based group medical quarantine (HB-GMQ) for 2 weeks by the authorities. After the case was reported, false or misleading information about the case flourished on social media platforms, which led to infodemic. Under this context, PKUPH adopted patient-centered humanistic care to implement the HB-GMQ, through the synergy of administrative, healthcare, logistical, and other measures under the model of patient-centered care of the Massachusetts Medical Society (MMS). As a result, all the patients tided over the HB-GMQ with no COVID-19 infection and no unanticipated adverse events, and all met the criteria for lifting the HB-GMQ. According to the questionnaires taken during the HB-GMQ, a high level of satisfaction was found among the quarantined and no symptomatic increase of anxiety and depression in the patients before and during the HB-GMQ, by comparing the Zung self-rating anxiety scale (SAS) and self-rating depression scale (SDS) conducted in December 2019 and on the 12th day of the HB-GMQ. This article is to brief on PKUPH's experience in implementing patient-centered humanistic care tailored to hemodialysis patients under the HB-GMQ, and to validate the hypothesis that patient-centered humanistic care is effective and helpful to help them tide over the HB-GMQ, so as to shed light on how to implement the HB-GMQ and cope with the HB-GMQ-induced problems in other hospitals.
Inpatient Institutional Care: The Forced Social Environment
Authors: Joyes Emma C. , Jordan Melanie , Winship Gary , Crawford Paul
Published: October 2021

The landscape of mental health recovery is changing; there have been calls for a shift from the clinical expertise being the dominant voice within mental healthcare towards a more personalised and collaborative service that supports those in need of mental healthcare to define what recovery is for the individual. Within this new recovery movement, there has been a recognition of the importance of the social environment in which individuals are situated and the relationship of this to mental health and wellbeing. Included in this is the importance of an individual’s role within society and the ways in which knowledge, such as experts by experience, can hold an important value. The argument then, is that social connectedness forms part of the recovery journey and that relationships can help us develop or re-connect with who we are in powerful ways. Such a view has only been strengthened by the recent and ongoing global COVID-19 pandemic. Within the UK, discussions of the importance of our wellbeing have become commonplace within the context of restricted social contact. With this heightened awareness of how the social contributes to wellbeing, it is important to consider the environments in which those in receipt of mental healthcare are situated. One of which is institutionalised care, where it is commonplace to restrict social contact. For example, by virtue of being within a locked environment, individuals’ freedom of movement is often non-existent and thus contacts with those not residing or working within the institution is restricted. While such restrictions may be deemed necessary to protect the individual’s mental health, such environments can be unintentionally toxic. Data are presented from an ethnography that was conducted within an inpatient forensic mental health hospital in the UK to highlight the problematic social environment which some individuals experience. Key interpersonal issues are presented, such as, trust, racism, the threat of physical violence and bullying that was experienced by staff and residents at the hospital. Consideration is given to the coping strategies enacted by residents and the pathologising of such behaviour. The consequences on interpersonal wellbeing are explored.
Polish Emergency Dispatchers During a COVID-19 Pandemic – Burnout Syndrome, Perceived Stress, and Self-Efficacy. Effects of Multidimensional Path Analysis
Authors: Makara-Studzińska Marta , Załuski Maciej , Adamczyk Katarzyna
Published: October 2021

International research has demonstrated that emergency call operators face unique risks to their mental health, in particular job stress, and occupational burnout syndrome. There is already wide knowledge about the relationship between stress, burnout and employee personal resources, which has practical application in preventing mental health. However, more research into the subtle relationships between variables is needed. The aim of the study was to check the moderation effect of differences in the intensity of latent variables on the relationship between perceived stress, self-efficacy and professional burnout. The participants were 546 call-takers and dispatchers from 14 public-safety answering point in Poland aged between 19 and 65 years. The Link Burnout Questionnaire, the 10-item Perceived Stress Scale, the Generalized Self-Efficacy Scale, and an independent questionnaire were used to gather information. The method of path analysis was used. The study confirmed the existence of negative relationships between perceived stress (assessment of the current situation) and self-efficacy (a personal trait). Taking into account the moderating effect of latent variable: psychological comfort revealed a hidden relationship between stress and burnout. The stress-burnout relationship occurred only among participants with low level of psychological comfort, so it was not a proportional relationship. In the case of participants with a high level of second latent variable: power-to-affect, the hypothesis that a high level of this variable should weaken the relationship between stress and burnout was not confirmed. The level of latent variables did not affect the self-efficacy relationship with occupational burnout. Taking into account the differences in the intensity of latent variables showed their moderating effect, which often turned out to be different from the assumed one and obtained in the research of other authors. This allowed to discover the relationships that might otherwise have been overlooked and not included in burnout prevention. The results showed a high level of occupational burnout in the ECD’s group during the COVID-19 pandemic: 32% of the responders reported emotional exhaustion, 53% loss of professional effectiveness.
The Influence of Equipment and Environment on Children and Young Adults Learning Aquatic Skills
Authors: van Duijn Tina , Ng Jonathan Leo , Burnay Carolina , Anderson Neil , Uehara Luiz , Cocker Kane , Button Chris
Published: October 2021

Learning aquatic skills is an important component of developing physical literacy in children. Aquatic skills such as floating, swimming and safe entry/exit promote engagement in different water environments and may help preserve lives in an emergency. This scoping review was conducted to evaluate the influence of task constraints (i.e., equipment) and environmental constraints (i.e., physical and social) on how children learn foundational aquatic skills. In developed countries, children are typically taught in swimming pools under direct supervision. It is also not uncommon to see children and infants learning to swim with assistive equipment (e.g., buoyancy aids). However, perhaps surprisingly, the evidence on how and where children learn aquatic skills does not uniformly promote such practices. For example, the use of flotation devices has not been proven to aid skill learning. Some researchers have advocated that children should learn aquatic skills whilst wearing outdoor clothing. One benefit of children wearing clothing is an increased capacity to practice in colder water (such as the ocean, rivers, or lakes). Overall, whilst practitioners often use equipment for various reasons it seems that not all equipment is equally useful in promoting the acquisition of aquatic skills. In less developed countries, with limited access to swimming pools and fewer resources for private instruction, a range of different open water aquatic environments and practices, such as swimming in temporarily flooded areas, have been reported. Such strategies are in urgent demand of further research given that drowning rates in less developed countries around the world exceed those in developed nations. It can be argued that learning in pools does not afford the opportunities to develop the whole range of adaptive skills that may be required in different open water environments such as navigating currents and waves, floating whilst clothed, or making life-saving decisions. Consequently, a shift toward teaching in open water environments has occurred in several countries. This review provides an evidence-base upon which practitioners can design more effective aquatic education programs for children.
Maternal Executive Functioning, Emotional Availability and Psychological Distress During Toddlerhood: A FinnBrain Birth Cohort Study
Authors: Nordenswan Elisabeth , Deater-Deckard Kirby , Karrasch Mira , Laine Matti , Kataja Eeva-Leena , Holmberg Eeva , Eskola Eeva , Hakanen Hetti , Karlsson Hasse , Karlsson Linnea , Korja Riikka
Published: October 2021

Executive functioning (EF) is one of the building blocks in parental caregiving behavior, and contextual variables have been reported to moderate the link between EF and caregiving behavior. Although psychological distress due to various factors is prevalent during early parenthood and is negatively associated with adult EF, it is not known whether psychological distress influences the maternal EF/caregiving link. This study explored the association between maternal EF and caregiving behavior (more specifically, Emotional Availability/EA), and whether single and cumulative maternal psychological distress domains moderated the EF/EA association in a general population sample of 137 Finnish birth cohort mothers with 2.5-year-old children. EF was measured with a composite of five computerized Cogstate tasks, EA with the Emotional Availability Scales, and three psychological distress domains with self-report questionnaires (depression: EPDS, anxiety: SCL-90, insomnia: AIS). Better EF was significantly associated with more positive, sensitive caregiving, but this association was no longer significant when controlling for education level. Neither individual nor cumulative distress domains moderated the EF/EA association significantly, although the observed moderation effects were in the expected direction. These findings suggest that EF should be recognized alongside socioemotional factors as variables that are associated with parental caregiving behavior during toddlerhood. Furthermore, if the non-significant moderation results are replicated, they indicate that mothers in community samples are not at great risk for psychological distress that would compromise their capacity to utilize their EF while caring for their child. Further studies are needed to confirm these findings, as well as to examine these associations among fathers and in samples that have higher levels of chronic stressors. Studies with more diverse samples in terms of distress levels and EF performance would provide further insight into early childhood parenting and its risk factors.
What Makes People Hide Knowledge? Influence of Passive Leadership and Creative Self-Efficacy
Authors: Mubarak Namra , Osmadi Atasya , Khan Jabran , Mahdiyar Amir , Riaz Asim
Published: October 2021

Although numerous studies have been conducted in the field of knowledge sharing with a focus given to its importance, very little attention has been given to knowledge hiding practices. A very few studies have been found to make an attempt to figure out its impact and antecedents. Likewise, the negative role of passive leadership in the project management literature has not been evidenced enough despite its existence in project-based organizations. Both knowledge hiding and passive leadership are the highly neglected areas in the project management literature. Therefore, this study not only attempts to investigate the influence of passive leadership on knowledge hiding but also aims to explore the role of creative self-efficacy between them. IT project organizations were chosen to collect data because of their high failure rate due to an insufficient knowledge transfer. The findings of this study revealed that the neglected passive leadership greatly influences the knowledge hiding practices among individuals. However, according to the results, knowledge hiding practices are found to reduce the presence of creative self-efficacy. Thus, the antecedents of knowledge hiding should be considered to create an innovative and successful business environment. The results are highly significant not only for the field of project management but also for other practitioners.
Norms According to Age and Gender for the Spanish Version of the Inventory of Depression and Anxiety Symptoms (IDAS-II)
Authors: Sanchez-Garcia Manuel , De la Rosa-Cáceres Ana , Stasik-O'Brien Sara , Mancheño-Barba Juan José , Lozano Óscar M. , Diaz-Batanero Carmen
Published: October 2021

Inventory of Depression and Anxiety Symptoms-II (IDAS-II) constitutes a useful measurement tool with demonstrated psychometric properties that is contributing to the advancement of knowledge of emotional disorders within transdiagnostic models. To implement its use in clinical settings it is important that the scores can be interpreted in order to guide clinical decisions. This study aims to develops normative data for the Spanish version of the IDAS-II. An anonymous online survey was applied to 1,072 subjects, recruited through a stratified random sampling procedure taking into account population gender, age, and geographical region of Spain. Results show that women tend to score higher than men, particularly on the Dysphoria, General Depression, Appetite Gain, and Lassitude scales. Largest effect sizes for differences in the scores according to age were found for Lassitude, Dysphoria, and General Depression. Therefore, normative data according to gender and age group for each IDAS-II scale is provided. The norms provided in this work complement those already available, facilitating the decision-making of clinical professionals. Evidence of unidimensionality is provided for the 19 IDAS-II scales that allows researchers and clinicians to use specific IDAS-II scales independently.
Impact of Comorbid Alcohol Use Disorder on Health-Related Quality of Life Among Patients With Depressive Symptoms
Authors: Luoto Kaisa E. , Lindholm Lars H. , Koivukangas Antti , Lassila Antero , Sintonen Harri , Leinonen Esa , Kampman Olli
Published: October 2021

Background and Aim: In psychiatric clinical practice, comorbidity of depression and alcohol use disorder (AUD) is common. Both disorders have a negative impact on health-related quality of life (HRQoL) in general population. However, research on the impact of comorbid AUD on HRQoL among clinically depressed patients is limited. The purpose of this study was to explore the impact of a psychosocial treatment intervention on HRQoL for depressive patients in specialized psychiatric care with a special focus on the impact of AUD on HRQoL.

Material and Methods: Subjects were 242 patients of the Ostrobothnia Depression Study (ClinicalTrials.gov Identifier NCT02520271). Patients referred to specialized psychiatric care who scored at least 17 points on the Beck Depression Inventory at baseline and who had no psychotic disorders were included in the ODS. The treatment intervention in ODS comprised behavioral activation for all but began with motivational interviewing for those with AUD. HRQoL was assessed regularly during 24-month follow-up by the 15D instrument. In the present study, HRQoL of ODS patients with or without AUD was compared and the factors explaining 15D score analyzed with a linear mixed model. In order to specify the impact of clinical depression on HRQoL during the early phase of treatment intervention, a general population sample of the Finnish Health 2011 Survey was used as an additional reference group.

Results: HRQoL improved among all ODS study sample patients regardless of comorbid AUD during the first year of follow-up. During 12–24 months of follow-up the difference between groups was seen as HRQoL continued to improve only among the non-AUD patients. A combination of male gender, anxiety disorder, and AUD was associated with the poorest HRQoL in this sample. In combined sample analyses with the reference group, clinical depression had an impact on HRQoL in short-term follow-up regardless of the treatment intervention.

Conclusions: This study suggests that, in terms of improvement in HRQoL, the heterogenous group of depressive patients in specialized psychiatric care can be successfully treated with behavioral activation in combination with motivational interviewing for those with AUD.

Clinical Trial Registration:ClinicalTrials.gov Identifier: NCT02520271. Ostrobothnia Depression Study (ODS). A Naturalistic Follow-up Study on Depression and Related Substance Use Disorders. (2015). Available online at: https://clinicaltrials.gov/ct2/show/NCT02520271.
Psychosocial Pre-Transplant Screening With the Transplant Evaluation Rating Scale Contributes to Prediction of Survival After Hematopoietic Stem Cell Transplantation
Authors: Scherer Simon , Scheid Christoph , Bergwelt Michael von , Hellmich Martin , Albus Christian , Vitinius Frank
Published: October 2021

There is no standard in hematopoietic stem cell transplantations (HSCT) for pre-transplant screening of psychosocial risk factors, e.g., regarding immunosuppressant non-adherence. The aim of this prospective study is to explore the predictive value of the pretransplant psychosocial screening instrument Transplant Evaluation Rating Scale (TERS) for mortality in a 3-year follow-up. Between 2012 and 2017 61 patients were included and classified as low (TERS = 26.5–29) and increased-risk group (TERS = 29.5–79.5). Both groups were compared regarding mortality until 36 months after transplantation and secondary outcomes [Medication Experience Scale for Immunosuppressants (MESI); incidence/grade of GvHD]. The increased-risk group (n = 28) showed significantly worse cumulative survival in the outpatient setting (from 3 months to 3 years after HSCT) [Log Rank (Mantel Cox) P = 0.029] compared to low-risk group (n = 29) but there was no significant result for the interval immediately after HSCT until 3 years afterwards. Pre-transplant screening with TERS contributes to prediction of survival after HSCT. The reason remains unclear, since TERS did not correlate with GvHD or MESI. The negative result regarding the interval immediately after HSCT until 3 years could be caused by the intensive in-patient setting with mortality which is explained rather by biological reasons than by non-adherence.
Connect 2 Care, a Novel Community Outreach Program for Vulnerably Housed Patients With High Acute Care Use: A Mixed-Methods Study Protocol
Authors: McBrien Kerry A. , Nguyen Van , Garcia-Jorda Dailys , Rondeau Kimberly , Polachek Alicia , Kamran Hasham , Lang Eddy , Ghali William , Barnabe Cheryl , Braun Ted , McLane Patrick , Milaney Katrina , Ronksley Paul E. , Salvalaggio Ginetta , Spackman Eldon , Tang Karen L. , Williamson Tyler , Fabreau Gabriel
Published: October 2021

Introduction: Vulnerably housed individuals, especially those experiencing homelessness, have higher acute care use compared with the general population. Despite available primary care and social services, many face significant challenges accessing needed services. Connect 2 Care (C2C) is a novel transitional case management program that includes registered nurses and health navigators with complementary expertise in chronic disease management, mental health and addictions, social programs, community health, and housing, financial, transportation and legal resources. C2C bridges acute care and community services to improve care coordination.

Methods and Analysis: We will perform a mixed-methods evaluation of the C2C program according to the Donabedian framework of structure, process and outcome, to understand how program structure and process, coupled with contextual factors, influence outcomes in a novel intervention. Eligible patients are homeless or unstably housed adults with complex health conditions and high acute care use. Change in emergency department visit rate 12-months after program enrolment is the primary outcome. Secondary outcomes include 12-month post-enrolment hospital admissions, cumulative hospital days, health-related quality of life, housing status, primary care attachment and substance use. Qualitative methods will explore experiences with the C2C program from multiple perspectives and an economic evaluation will assess cost-effectiveness.

Discussion: Academic researchers partnered with community service providers to evaluate a novel transitional case management intervention for vulnerably housed patients with high acute-care use. The study uses mixed-methods to evaluate the Connect 2 Care program according to the Donabedian framework of structure, process and outcome, including an assessment of contextual factors that influence program success. Insights gained through this comprehensive evaluation will help refine the C2C program and inform decisions about sustainability and transferability to other settings in Canada.
Sociodemographic Analysis of Suicide Rates Among Older Adults Living in Ecuador: 1997–2019
Authors: Troya M. Isabela , Gerstner Rebekka M. , Narvaez Freddy , Arensman Ella
Published: October 2021

Background: Despite most suicides occurring in low-and-middle-income countries (LAMICs), limited reports on suicide rates in older adults among LAMICs are available. In Ecuador, high suicide rates have been reported among adolescents. Little is known about the epidemiology of suicides among older adults in Ecuador.

Aim: To examine the sociodemographic characteristics of suicides among older adults living in Ecuador from 1997 to 2019.

Methods: An observational study was conducted using Ecuador's National Institute of Census and Statistics database from 1997 to 2019 in Ecuadorians aged 60 and older. International Classification of Diseases 10th Revision (ICD-10) (X60-X84)-reported suicide deaths were included in addition to deaths of events of undetermined intent (Y21-Y33). Sex, age, ethnicity, educational level, and method of suicide were analyzed. Annual suicide rates were calculated per 100,000 by age, sex, and method. To examine the trends in rates of suicide, Joinpoint analysis using Poisson log-linear regression was used.

Results: Suicide rates of female older adults remained relatively stable between 1997 and 2019 with an average annual percentage increase of 2.4%, while the male rates increased between 2002 and 2009, 2014 and 2016, and maintained relatively stable within the past 3 years (2017–2019). The annual age-adjusted male suicide rate was 29.8 per 100,000, while the female suicide rate was 5.26 per 100,000 during the study period. When adding deaths of undetermined intent, the annual male rate was 60.5 per 100,000, while the same rate was 14.3 for women. The most common suicide method was hanging (55.7%) followed by self-poisoning (26.0%). The highest suicide numbers were reported in urban districts, men, and those with lower education status.

Conclusion: This study contributes to building the baseline for further studies on suicide rates of older adults in Ecuador. Results highlight priority areas of suicide prevention. By examining suicide trends over 23 years, findings can help inform policy and future interventions targeting suicide prevention.
Attitudes of Healthcare Professionals and General Population Toward Vaccines and the Intention to Be Vaccinated Against COVID-19 in Spain
Authors: Iguacel Isabel , Luna Maldonado Aurelio , Luna Ruiz-Cabello Aurelio , Samatán Eva , Alarcón Judith , Ángeles Orte María , Santodomingo Mateos Silvia , Martínez-Jarreta Begoña
Published: October 2021

Background: To achieve herd immunity, the acceptance of the COVID-19 vaccine by the population, especially healthcare professionals, plays a key role. The objective of the present paper is to address the differences in attitudes among Spanish healthcare professionals compared with the general population regarding COVID-19 vaccination.

Methods: This cross-sectional study included data from 2,136 adults (n = 664 healthcare professionals) from an online survey conducted from May 6 to June 9, 2021. The Vaccination attitudes examination scale was used to measure the negative attitudes toward vaccines. Four subscales: mistrust of vaccine benefit, worries about the unforeseen future effect, concerns about commercial profiteering, and preference for natural immunity were calculated. Generalized linear mixed models were conducted to study these associations.

Results: Between 10.2 and 22.6% of the subjects showed high levels of negative attitudes toward vaccines. However, only 1.5% of our sample (2.1% among healthcare professionals) refused to get the COVID-19 vaccine when it was offered because they chose otherwise. Retired people showed the lowest concerns and the highest trust in vaccines. No statistically significant effects were found between working in a healthcare field and having higher positive attitudes toward vaccines.

Conclusion: Low levels of rejection against the COVID-19 vaccine were identified in the present sample. However, despite being at a higher risk, health care professionals did not show higher positive attitudes toward vaccines. Furthermore, refusal percentage to vaccination was higher among healthcare professionals compared with non-healthcare professionals. Developing a strategy to increase positive attitudes against the COVID-19 vaccine should be an objective for public health policy.