bluuebunny/crossref_metadata_2025 huggingface dataset:
Causal Structural Covariance Network Suggesting Structural Alterations Progression in Type 2 Diabetes Patients
Authors: Zhang Jiang , Liu Yuyan , Guo Xiaonan , Guo Jing , Du Zhengcong , He Muyuan , Liu Qihong , Xu Dundi , Liu Taiyuan , Zhang Junran , Yuan Huijuan , Wang Meiyun , Li Shasha
Published: July 2022

Background and Purpose

According to reports, type 2 diabetes (T2D) is a progressive disease. However, no known research has examined the progressive brain structural changes associated with T2D. The purpose of this study was to determine whether T2D patients exhibit progressive brain structural alterations and, if so, how the alterations progress.

Materials and Methods

Structural magnetic resonance imaging scans were collected for 81 T2D patients and 48 sex-and age-matched healthy controls (HCs). Voxel-based morphometry (VBM) and causal structural covariance network (CaSCN) analyses were applied to investigate gray matter volume (GMV) alterations and the likely chronological processes underlying them in T2D. Two sample t-tests were performed to compare group differences, and the differences were corrected using Gaussian random field (GRF) correction (voxel-level p < 0.001, cluster-level p < 0.01).

Results

Our findings demonstrated that GMV alterations progressed in T2D patients as disease duration increased. In the early stages of the disease, the right temporal pole of T2D patients had GMV atrophy. As the diseases duration prolonged, the limbic system, cerebellum, subcortical structures, parietal cortex, frontal cortex, and occipital cortex progressively exhibited GMV alterations. The patients also exhibited a GMV alterations sequence exerting from the right temporal pole to the limbic-cerebellum-striatal-cortical network areas.

Conclusion

Our results indicate that the progressive GMV alterations of T2D patients manifested a limbic-cerebellum-striatal-cortical sequence. These findings may contribute to a better understanding of the progression and an improvement of current diagnosis and intervention strategies for T2D.
Mechanisms of tunneling nanotube-based propagation of neurodegenerative disease proteins
Authors: Lagalwar Sarita
Published: July 2022

Tunneling nanotubes (TNTs), intercellular connections enriched with F-actin, were first identified as a viable means of cellular communication and organelle transport in animal cells at the early part of this century. Within the last 10 years, these microscopic and highly dynamic protrusions have been implicated in neurodegenerative disease propagation and pathogenesis. A host of aggregation-prone protein inclusions, including those containing alpha-synuclein, tau, prions and others, hijack this communication mechanism in both neurons and astrocytes. The exact cellular mechanisms underlying TNT-based propagation remain largely unknown, however, common practices can be identified. First, selective expression of the aggregation-prone form of proteins increases TNT density; next, endo-lysosomal pathways appear to support the loading and unloading of protein onto the TNT; and finally, TNT assembly results in the spontaneous formation of aggregation-prone protein inclusions in “acceptor” cells, indicating that TNTs are involved in not only the transport of inclusions but also in the seeding of new inclusions in naïve cells. These observations have implications for the spreading of neurodegenerative disease in the central nervous system and the consequent progression of symptoms. Here, I will summarize the empirical evidence of TNT-based aggregation-prone protein propagation to date, and propose an inclusive model of aggregate inclusion propagation along TNTs.
Case Report: Next-Generation Sequencing-Based Detection in A Patient with Three Synchronous Primary Tumors
Authors: Wu Tianqi , Wan Jian , Xia Kai , Yang Muqing , Feng Lijin , Yin Lu , Chen Chunqiu
Published: July 2022

Clinically rare, multiple primary tumors are a growth or development of two or more neoplasms in the same individual. A 57-year-old woman with two primary cancers, namely, breast and gastric cancers, and a gastrointestinal stromal tumor was admitted. Next-generation sequencing (NGS) of the three tumors and blood was performed to determine their clonal origin and identify genetic cancer susceptibility. NGS identified that germline genetic variants potentially correlated with an individual risk of developing multiple cancers and that additional mutations are required to drive the formation of different tumors.
Urethral Interfractional Geometric and Dosimetric Variations of Prostate Cancer Patients: A Study Using an Onboard MRI
Authors: Pham Jonathan , Savjani Ricky R. , Yoon Stephanie M. , Yang Tiffany , Gao Yu , Cao Minsong , Hu Peng , Sheng Ke , Low Daniel A. , Steinberg Michael , Kishan Amar U. , Yang Yingli
Published: July 2022

Purpose

For a cohort of prostate cancer patients treated on an MR-guided radiotherapy (MRgRT) system, we retrospectively analyzed urethral interfractional geometric and dosimetric variations based on onboard MRIs acquired at different timepoints and evaluated onboard prostatic urethra visualization for urethra-focused online adaptive RT.

Methods

Twenty-six prostate cancer patients were prospectively scanned on a 0.35-T MRgRT system using an optimized T2-weighted HASTE sequence at simulation and final fraction. Two radiation oncologists (RO1 and RO2) contoured the urethras on all HASTE images. The simulation and final fraction HASTE images were rigidly registered, and urethral interobserver and interfractional geometric variation was evaluated using the 95th percentile Hausdorff distance (HD95), mean distance to agreement (MDA), center-of-mass shift (COMS), and DICE coefficient. For dosimetric analysis, simulation and final fraction HASTE images were registered to the 3D bSSFP planning MRI and 3D bSSFP final setup MRI, respectively. Both ROs’ urethra contours were transferred from HASTE images for initial treatment plan optimization and final fraction dose estimation separately. Stereotactic body radiotherapy (SBRT) plans, 40 Gy in 5 fractions, were optimized to meet clinical constraints, including urethral V42Gy ≤0.03 cc, on the planning MRI. The initial plan was then forward calculated on the final setup MRI to estimate urethral dose on the final fraction and evaluate urethral dosimetric impact due to anatomy change.

Results

The average interobserver HD95, MDA, COMS, and DICE were 2.85 ± 1.34 mm, 1.02 ± 0.36 mm, 3.16 ± 1.61 mm, and 0.58 ± 0.15, respectively. The average interfractional HD95, MDA, COMS, and DICE were 3.26 ± 1.54 mm, 1.29 ± 0.54 mm, 3.34 ± 2.01 mm, and 0.49 ± 0.18, respectively. All patient simulation MRgRT plans met all clinical constraints. For RO1 and RO2, 23/26 (88%) and 21/26 (81%) patients’ final fraction estimated urethral dose did not meet the planned constraint. The average urethral V42Gy change was 0.48 ± 0.58 cc.

Conclusion

Urethral interfractional motion and anatomic change can result in daily treatment violating urethral constraints. Onboard MRI with good visualization of the prostatic urethra can be a valuable tool to help better protect the urethra through patient setup or online adaptive RT.
Immune Reconstitution of Patients Who Recovered From Steroid-Refractory Acute Graft-Versus-Host Disease After Basiliximab Treatment
Authors: Deng Dao-Xing , Fan Shuang , Zhang Xiao-Hui , Xu Lan-Ping , Wang Yu , Yan Chen-Hua , Chen Huan , Chen Yu-Hong , Han Wei , Wang Feng-Rong , Wang Jing-Zhi , Pei Xu-Ying , Chang Ying-Jun , Liu Kai-Yan , Huang Xiao-Jun , Mo Xiao-Dong
Published: July 2022

We aimed to identify the characteristics of immune reconstitution (IR) in patients who recovered from steroid-refractory acute graft-versus-host disease (SR-aGVHD) after basiliximab treatment. A total of 179, 124, 80, and 92 patients were included in the analysis for IR at 3, 6, 9, and 12 months, respectively, after haploidentical donor hematopoietic stem cell transplantation (HID HSCT). We observed that IR was fastest for monocytes and CD8+ T cells, followed by lymphocytes, CD3+ T cells, and CD19+ B cells and slowest for CD4+ T cells. Almost all immune cell subsets recovered comparably between patients receiving <5 doses and ≥5 doses of basiliximab. Most immune cell subsets recovered comparably between SR-aGVHD patients who recovered after basiliximab treatment and event-free HID HSCT recipients. Patients who recovered from SR-aGVHD after basiliximab treatment experienced satisfactory IR, which suggested that basiliximab may not have prolonged the negative impact on IR in these patients.
Ferroptosis: A Specific Vulnerability of RAS-Driven Cancers?
Authors: Andreani Cristina , Bartolacci Caterina , Scaglioni Pier Paolo
Published: July 2022

Ferroptosis has emerged as a new type of programmed cell death that can be harnessed for cancer therapy. The concept of ferroptosis was for the first time proposed in in the early 2000s, as an iron-dependent mode of regulated cell death caused by unrestricted lipid peroxidation (LPO) and subsequent plasma membrane rupture. Since the discovery and characterization of ferroptosis, a wealth of research has improved our understanding of the main pathways regulating this process, leading to both the repurposing and the development of small molecules.

However, ferroptosis is still little understood and several aspects remain to be investigated. For instance, it is unclear whether specific oncogenes, cells of origin or tumor niches impose specific susceptibility/resistance to ferroptosis or if there are some ferroptosis-related genes that may be used as bona fide pan-cancer targetable dependencies. In this context, even though RAS-driven cancer cell lines seemed to be selectively sensitive to ferroptosis inducers, subsequent studies have questioned these results, indicating that in some cases mutant RAS is necessary, but not sufficient to induce ferroptosis. In this perspective, based on publicly available genomic screening data and the literature, we discuss the relationship between RAS-mutation and ferroptosis susceptibility in cancer.
Skin Microbiome and Treatment-Related Skin Toxicities in Patients With Cancer: A Mini-Review
Authors: Richardson Brianna N. , Lin Jolinta , Buchwald Zachary S. , Bai Jinbing
Published: July 2022

The human skin hosts millions of bacteria, fungi, archaea, and viruses. These skin microbes play a crucial role in human immunological and physiological functions, as well as the development of skin diseases, including cancer when the balance between skin commensals and pathogens is interrupted. Due to the linkages between inflammation processes and skin microbes, and viral links to skin cancer, new theories have supported the role a dysbiotic skin microbiome plays in the development of cancer and cancer treatment-related skin toxicities. This review focuses on the skin microbiome and its role in cancer treatment-related skin toxicities, particularly from chemotherapy, radiation therapy, and immunotherapy. The current literature found changes in the diversity and abundance of the skin microbiome during cancer treatments such as radiation therapy, including lower diversity of the skin microbiome, an increased Proteobacteria/Firmicutes ratio, and a higher abundance of pathogenic Staphylococcus aureus. These changes may be associated with the development and severity of treatment-related skin toxicities, such as acute radiation dermatitis, hand-foot syndrome in chemotherapy, and immunotherapy-induced rash. Several clinical guidelines have issued potential interventions (e.g., use of topical corticosteroids, phototherapy, and non-pharmaceutical skin care products) to prevent and treat skin toxicities. The effectiveness of these promising interventions in alleviating treatment-related skin toxicities should be further tested among cancer patients.
Endoscopic-assisted transorbital surgery: Where do we stand on the scott’s parabola? personal considerations after a 10-year experience
Authors: Dallan Iacopo , Cristofani-Mencacci Lodovica , Fiacchini Giacomo , Turri-Zanoni Mario , van Furth Wouter , de Notaris Matteo , Picariello Miriana , Alexandre Enrico , Georgalas Christos , Bruschini Luca
Published: July 2022

Transorbital approaches are genuinely versatile surgical routes which show interesting potentials in skull base surgery. Given their “new” trajectory, they can be a very useful adjunct to traditional routes, even being a valid alternative to them in some cases, and add valuable opportunities in selected patients. Indications are constantly expanding, and currently include selected intraorbital, skull base and even intra-axial lesions, both benign and malignant. Given their relatively recent development and thus unfamiliarity among the skull base community, achieving adequate proficiency needs not only a personalized training and knowledge but also, above all, an adequate case volume and a dedicated setting. Current, but mostly future, applications should be selected by genetic, omics and biological features and applied in the context of a truly multidisciplinary environment.
What Is New in Classification, Diagnosis and Management of Chronic Musculoskeletal Pain: A Narrative Review
Authors: Zhuang Jiejie , Mei Houlian , Fang Fang , Ma Xiaqing
Published: July 2022

Chronic musculoskeletal pain (CMP) is the most common type of chronic pain, defined as persistent or recurrent pain condition deriving from musculoskeletal structures such as muscles, joints or bones that lasts for more than 3 months. CMP is multifactorial and severely affects people's quality of life. CMP may be influenced by a number of factors, including contextual factors, the presence of comorbidities, arthritis coping efficacy and access to CMP care. To deepen the comprehensive understanding of CMP, this narrative review provides the latest literature on disease classification, clinical diagnosis, treatment and basic research. In terms of the classification of the disease, here we introduce the 11th edition of the International Classification of Diseases (IDC-11), in which CMP is divided into chronic primary musculoskeletal pain and chronic secondary musculoskeletal pain. In the clinical diagnosis section, the progress of central sensitization in the diagnosis of CMP will also be summarized. In addition, we summarize some recent advances in clinical treatment and basic research.
Screening for an Underlying Tubulopathy in Children With Growth Failure, Simply Maths?
Authors: Becue Caroline , Ceuleers Britt , den Brinker Marieke , Somers Ines , Ledeganck Kristien J. , Dotremont Hilde , Trouet Dominique
Published: July 2022

Background

Involving pediatric nephrological input in the clinical diagnostic work-up of children with short stature, gave rise to the hypothesis that the presence of an underlying renal tubular disorder in children with short stature is possibly underestimated. This study focussed on the added value of calculated urinary fractional excretion (FE) in the early detection of tubular disorders in children with growth failure.

Methods

This trial was designed as an observational study analyzing the medical files of children between 5 and 16 years who had been referred for short stature to the pediatric endocrinology outpatient clinic at the University Hospital Antwerp between 25/01/2015 and 01/03/2019. Based on the laboratory results of the simultaneously taken blood and urine sample, the fractional excretions of Sodium, Chloride, Potassium, Calcium, Phosphate, and Magnesium were calculated.

Results

Of the 299 patients, 54 patients had at least one deviating fractional excretion value, requiring further investigation (control sample of blood and urine, kidney ultrasound or 24 h urine collection). Genetic screening for tubulopathies was performed in 19 patients. In 5 patients (1.7% of the total population) a tubulopathy was confirmed based on genetic analysis.

Conclusion

This study explored the possibility of using fractional excretions as a screening test to obtain an earlier diagnosis of tubular disorders in children with short stature. Of the 299 patients, 5 patients were diagnosed with a genetically confirmed tubulopathy. Based on these results, we propose a flowchart for an additional work-up in all children with a deviating fractional excretion.
Therapeutic and Prophylactic Effects of Amphotericin B Liposomes on Chronic Social Defeat Stress-Induced Behavioral Abnormalities in Mice
Authors: Lu Jiashu , Huang Chao , Lu Qun , Lu Xu
Published: July 2022

Recently, innate immune system stimulants, such as lipopolysaccharide (LPS) and macrophage-colony stimulating factor (M-CSF), were reported to prevent and reverse chronic stress-induced behavioral abnormalities, suggesting that innate immune stimulation could be a potential strategy for the treatment and prevention of mental disorders. Amphotericin B liposome is a clinically available antifungal medication that can stimulate macrophages and microglia. We hypothesize that amphotericin B liposome may be used to prevent and reverse behavioral abnormalities triggered by chronic stress. As expected, our results showed that a single injection of amphotericin B liposome (1 mg/kg) immediately after stress cessation reversed the decrease in time spent in the interaction zone in the social interaction test (SIT) and the increase in immobility time in the tail suspension test (TST) and forced swimming test (FST) in mice caused by chronic social defeat stress (CSDS). In addition, a single injection of amphotericin B liposomes (1 mg/kg) 1 day before stress exposure was found to prevent the CSDS-induced decrease in time spent in the interaction zone in the SIT and the increase in immobility time in the TST and FST in mice. Pretreatment with minocycline to inhibit the innate immune response was able to abolish the reversal effect of post-stress injection of amphotericin B liposomes on CSDS-induced behavioral abnormalities and the prophylactic effect of pre-stress injection of amphotericin B liposomes on CSDS-induced behavioral abnormalities. These results demonstrate that amphotericin B liposomes have both therapeutic and prophylactic effects on chronic stress-induced behavioral abnormalities in mice by mobilizing the innate immune response.
Hyaluronic Acid–Stabilized Fe3O4 Nanoparticles for Promoting In Vivo Magnetic Resonance Imaging of Tumors
Authors: Zhang Weijie , Zhang Zhongyue , Lou Shitong , Chang Zhiwei , Wen Baohong , Zhang Tao
Published: July 2022

The use of iron oxide (Fe3O4) nanoparticles as novel contrast agents for magnetic resonance imaging (MRI) has attracted great interest due to their high r2 relaxivity. However, both poor colloidal stability and lack of effective targeting ability have impeded their further expansion in the clinics. Here, we reported the creation of hyaluronic acid (HA)-stabilized Fe3O4 nanoparticles prepared by a hydrothermal co-precipitation method and followed by electrostatic adsorption of HA onto the nanoparticle surface. The water-soluble HA functions not only as a stabilizer but also as a targeting ligand with high affinity for the CD44 receptor overexpressed in many tumors. The resulting HA-stabilized Fe3O4 nanoparticles have an estimated size of sub-20 nm as observed by transmission electron microscopy (TEM) imaging and exhibited long-term colloidal stability in aqueous solution. We found that the nanoparticles are hemocompatible and cytocompatible under certain concentrations. As verified by quantifying the cellular uptake, the Fe3O4@HA nanoparticles were able to target a model cell line (HeLa cells) overexpressing the CD44 receptor through an active pathway. In addition, we showed that the nanoparticles can be used as effective contrast agents for MRI both in vitro in HeLa cells and in vivo in a xenografted HeLa tumor model in rodents. We believe that our findings shed important light on the use of active targeting ligands to improve the contrast of lesion for tumor-specific MRI in the nano-based diagnosis systems.
Role of Traditional Chinese Medicine in Treating Severe or Critical COVID-19: A Systematic Review of Randomized Controlled Trials and Observational Studies
Authors: Li Mengting , Zhu Hongfei , Liu Yafei , Lu Yao , Sun Minyao , Zhang Yuqing , Shi Jiaheng , Shi Nannan , Li Ling , Yang Kehu , Sun Xin , Liu Jie , Ge Long , Huang Luqi
Published: July 2022

Background: The coronavirus disease 2019 (COVID-19) continues to spread globally. Due to the higher risk of mortality, the treatment of severe or critical patients is a top priority. Traditional Chinese medicine (TCM) treatment has played an extremely important role in the fight against COVID-19 in China; a timely evidence summary on TCM in managing COVID-19 is crucial to update the knowledge of healthcare for better clinical management of COVID-19. This study aimed to assess the effects and safety of TCM treatments for severe/critical COVID-19 patients by systematically collecting and synthesizing evidence from randomized controlled trials (RCTs) and observational studies (e.g., cohort).

Methods: We searched nine databases up to 19th March 2022 and the reference lists of relevant publications. Pairs of reviewers independently screened studies, extracted data of interest, and assessed risk of bias. We performed qualitative systematic analysis with visual presentation of results and compared the direction and distribution of effect estimates for each patient’s important outcome. We performed sensitivity analyses to observe the robustness of results by restricting analysis to studies with low risk of bias.

Results: The search yielded 217,761 records, and 21 studies (6 RCTs and 15 observational studies) proved eligible. A total of 21 studies enrolled 12,981 severe/critical COVID-19 patients with a mean age of 57.21 years and a mean proportion of men of 47.91%. Compared with usual supportive treatments, the effect estimates of TCM treatments were consistent in direction, illustrating that TCM treatments could reduce the risk of mortality, rate of conversion to critical cases, and mechanical ventilation, and showed significant advantages in shortening the length of hospital stay, time to viral clearance, and symptom resolution. The results were similar when we restricted analyses to low-risk-bias studies. No serious adverse events were reported with TCM treatments, and no significant differences were observed between groups.

Conclusion: Encouraging evidence suggests that TCM presents substantial advantages in treating severe/critical COVID-19 patients. TCM has a safety profile that is comparable to that of conventional treatment alone. TCMs have played an important role in China’s prevention and treatment of COVID-19, which sets an example of using traditional medicine in preventing and treating COVID-19 worldwide.
Probabilistic Inference and Dynamic Programming: A Unified Approach to Multi-Agent Autonomous Coordination in Complex and Uncertain Environments
Authors: Di Gennaro Giovanni , Buonanno Amedeo , Fioretti Giovanni , Verolla Francesco , Pattipati Krishna R. , Palmieri Francesco A. N.
Published: July 2022

We present a unified approach to multi-agent autonomous coordination in complex and uncertain environments, using path planning as a problem context. We start by posing the problem on a probabilistic factor graph, showing how various path planning algorithms can be translated into specific message composition rules. This unified approach provides a very general framework that, in addition to including standard algorithms (such as sum-product, max-product, dynamic programming and mixed Reward/Entropy criteria-based algorithms), expands the design options for smoother or sharper distributions (resulting in a generalized sum/max-product algorithm, a smooth dynamic programming algorithm and a modified versions of the reward/entropy recursions). The main purpose of this contribution is to extend this framework to a multi-agent system, which by its nature defines a totally different context. Indeed, when there are interdependencies among the key elements of a hybrid team (such as goals, changing mission environment, assets and threats/obstacles/constraints), interactive optimization algorithms should provide the tools for producing intelligent courses of action that are congruent with and overcome bounded rationality and cognitive biases inherent in human decision-making. Our work, using path planning as a domain of application, seeks to make progress towards this aim by providing a scientifically rigorous algorithmic framework for proactive agent autonomy.
Rice carotenoid biofortification and yield improvement conferred by endosperm-specific overexpression of OsGLK1
Authors: Li Zhenjun , Gao Jianjie , Wang Bo , Xu Jing , Fu Xiaoyan , Han Hongjuan , Wang Lijuan , Zhang Wenhui , Deng Yongdong , Wang Yu , Gong Zehao , Tian Yongsheng , Peng Rihe , Yao Quanhong
Published: July 2022

Carotenoids, indispensable isoprenoid phytonutrients, are synthesized in plastids and are known to be deficient in rice endosperm. Many studies, involving transgenic manipulations of carotenoid biosynthetic genes, have been performed to obtain carotenoid-enriched rice grains. Nuclear-encoded GOLDEN2-LIKE (GLK) transcription factors play important roles in the regulation of plastid and thylakoid grana development. Here, we show that endosperm-specific overexpression of rice GLK1 gene (OsGLK1) leads to enhanced carotenoid production, increased grain yield, but deteriorated grain quality in rice. Subsequently, we performed the bioengineering of carotenoids biosynthesis in rice endosperm by introducing other three carotenogenic genes, tHMG1, ZmPSY1, and PaCrtI, which encode the enzymes truncated 3-hydroxy-3-methylglutaryl-CoA reductase, phytoene synthase, and phytoene desaturase, respectively. Transgenic overexpression of all four genes (OsGLK1, tHMG1, ZmPSY1, and PaCrtI) driven by rice endosperm-specific promoter GluB-1 established a mini carotenoid biosynthetic pathway in the endosperm and exerted a roughly multiplicative effect on the carotenoid accumulation as compared with the overexpression of only three genes (tHMG1, ZmPSY1, and PaCrtI). In addition, the yield enhancement and quality reduction traits were also present in the transgenic rice overexpressing the selected four genes. Our results revealed that OsGLK1 confers favorable characters in rice endosperm and could help to refine strategies for the carotenoid and other plastid-synthesized micronutrient fortification in bioengineered plants.
Indigenization of Political Identity in Postcolonial Hong Kong
Authors: Tang Wenfang , Hung Jennifer Sin Yu , Ho Brian Ying Yeung
Published: July 2022

Drawing data collected in 2021 from a probability sample of Hong Kong residents, we examine their political identity with the former colonists and their post-colonial ruler in China. The data show an expected anti-China sentiment but an unexpectedly lukewarm attitude toward their former colonists. Instead, the survey respondents expressed strong feelings toward indigenization with traditional Chinese culture. For the sources of such sentiment, this paper finds that the anti-Mandarin language policy, the post-1997 anti-establishment education policy, and the anti-China media are particularly important reasons. This study attributes the trend of post-colonial indigenization to the political vacuum left by the departure of the old ruler and the new ruler's inability to indoctrinate the newly ruled under the postcolonial institutional design of One Country Two Systems. This trend of indigenization is likely to tilt toward identity with the Chinese state as China is stepping up its effort to make the territory more China-friendly.
Music students’ workload, stress, and coping in higher education: Evidence-based policymaking
Authors: Jääskeläinen Tuula
Published: July 2022

Evidence-based policies are needed to support students as they cope with their experiences of workload and stress in higher music education. This subject was explored in the Music Student Workload Project as a collaboration between Finland and the United Kingdom in seven studies: (1) a theoretical study scrutinizing diverse higher music education systems in connection with equality and cultural reproduction; (2) a systematic review mapping international research on music students’ workload; (3) a methodological study discussing the transcendental phenomenological approach as a method for obtaining a meaningful understanding of music students’ experiences in higher education; (4) a qualitative study exploring music students’ workload experiences in connection with their meaningful engagement in music; (5) a mixed-method study shedding light on music students’ proactive coping styles in connection with workload and stress; (6) a mixed-method study examining music students’ experienced workload, stress, and livelihoods; and (7) a qualitative study exploring teachers’ ways of supporting music students’ workload and stress. The meta-narrative synthesis was conducted by triangulating the key elements of these studies to generate four actionable policy and intervention recommendations to inform educational policies and practices for supporting students in coping with workload and stress in higher music education: (1) support music students’ proactive coping skills; (2) find solutions to the unequal workload and stress experiences between low-income and well-off students, different genders, and different study programs; (3) ensure teachers’ continuing professional development, particularly in the learner-centered pedagogical approaches; and (4) invest resources for providing more longitudinal, cross-cultural, and interventional research investigating music students’ discipline-specific experiences of workload and stress.
COVID-19 vaccine uptake among family caregivers of people with dementia: The role of attitudes toward vaccination, perceived social support and personality traits
Authors: Bruno Francesco , Malvaso Antonio , Chiesi Francesca , Laganà Valentina , Servidio Rocco , Isella Valeria , Ferrarese Carlo , Gottardi Federica , Stella Eloisa , Agosta Federica , Filippi Massimo , Lorenzo Raffaele Di , Martin Leslie R. , Bruni Amalia Cecilia , Maletta Raffaele
Published: July 2022

People with dementia have an increased risk of contracting severe forms of COVID-19. Although in worldwide vaccination programs priority has been given to older people, having taken the vaccine does not totally eliminate the risk of contracting COVID-19 when one is in close contact with unvaccinated people. Thus, family caregivers’ choices to remain unvaccinated against COVID-19 could have potentially lethal consequences for their relatives. To our knowledge, this study represents the first attempt within the international literature to analyze COVID-19 vaccine uptake among family caregivers of people with dementia and to identify some of the psychological factors, related to COVID-19 and vaccination behavior, that could facilitate or hinder vaccine uptake. Contact information for family caregivers was obtained from five different centers and associations throughout the Italian territory. Data were collected from 179 respondents during July-September 2021 using a cross-sectional web-based survey design. More than 75% of the respondents indicated that had been vaccinated against COVID-19 and reported receiving vaccine information mainly from print or electronic newspapers (86%), followed by TV (81%) and families (64.2%). In multivariable logistic regression analyses, worries about unforeseen future effects was significantly related to COVID-19 vaccine uptake, indicating that family caregivers concerned about potential side effects of vaccines were less likely to have been vaccinated against COVID-19 (OR = 0.60, CI = 0.40-0.89). Openness to experience was also related to COVID-19 vaccine uptake, with family caregivers higher on this trait being less likely to have been vaccinated against COVID-19 (OR = 0.83, CI = 0.71-0.98). Implications for targeting of vaccine-related messages are discussed.
Free will and the desire for suicide in mental illness
Authors: Zürcher Tobias
Published: July 2022

The desire to die brings about the most radical consequences that can occur in a human life. It therefore requires a high degree of justification. Questions have been raised as to whether this justification can be given in the case of a suicide desire in mental illness. Landmark court decisions and the practice of assisted suicide organizations make the justification of a mentally ill person’s suicide desire dependent on the desire not being an expression of the illness. This view is explained in detail and finally rejected as misleading. That argument is based on a conceptual analysis of the self, the nature of reasons for action, and the meaning of necessity with respect to personal autonomy. Against this background, it is shown that it is irrelevant for the assessment of the desire to die whether it has been causally brought about by the mental illness. On the other hand, what matters is whether the person has an internal reason that gives importance to his or her desire. This is to be distinguished from external, normative expectations of a person’s “normal” desires. An internal reason that justifies the person’s concern must give expression to who the person essentially is and what the person fundamentally cares about. Three objections to this view are formulated, critically evaluated, and rejected. From these considerations it follows that a professional assessment of the desire to die of mentally ill persons must consist primarily in clarifying whether the desire to die fulfills the stated conditions for freedom, irrespective of the mental illness.
Investigating Global Spatial Patterns of Diarrhea-Related Mortality in Children Under Five
Authors: Almasi Ali , Zangeneh Alireza , Ziapour Arash , Saeidi Shahram , Teimouri Raziyeh , Ahmadi Tohid , Khezeli Mehdi , Moradi Ghobad , Soofi Moslem , Salimi Yahya , Rajabi-Gilan Nader , Ramin Ghasemi Seyed , Heydarpour Fatemeh , Moghadam Shahrzad , Yigitcanlar Tan
Published: July 2022

Objective

Investigating the trends of child diarrhea-related mortality (DRM) is crucial to tracking and monitoring the progress of its prevention and control efforts worldwide. This study explores the spatial patterns of diarrhea-related mortality in children under five for monitoring and designing effective intervention programs.

Methods

The data used in this study was obtained from the World Health Organization (WHO) public dataset that contained data from 195 countries from the year 2000 to 2017. This dataset contained 13,541,989 DRM cases. The worldwide spatial pattern of DRM was analyzed at the country level utilizing geographic information system (GIS) software. Moran's I, Getis-Ord Gi, Mean center, and Standard Deviational Ellipse (SDE) techniques were used to conduct the spatial analysis.

Results

The spatial pattern of DRM was clustered all across the world during the study period from 2000 to 2017. The results revealed that Asian and African countries had the highest incidence of DRM worldwide. The findings from the spatial modeling also revealed that the focal point of death from diarrhea was mainly in Asian countries until 2010, and this focus shifted to Africa in 2011.

Conclusion

DRM is common among children who live in Asia and Africa. These concentrations may also be due to differences in knowledge, attitude, and practices regarding diarrhea. Through GIS analysis, the study was able to map the distribution of DRM in temporal and spatial dimensions and identify the hotspots of DRM across the globe.
Examining the Mental Health, Wellbeing, Work Participation and Engagement of Medical Laboratory Professionals in Ontario, Canada: An Exploratory Study
Authors: Nowrouzi-Kia Behdin , Dong Jingwen , Gohar Basem , Hoad Michelle
Published: July 2022

Objectives

The overall objective of this proposed project is to examine the impact of the COVID-19 pandemic on the mental health, functioning and wellbeing of medical laboratory technologists (MLT) and medical laboratory technicians/assistants (MLT/A) in Ontario, Canada.

Methods

A cross-sectional study included a self-reported questionnaire for MLT and MLT/A in Ontario. The questionnaire included questions about demographics and occupational characteristics. Questions about mental health, functioning, well-being and psychosocial work environments were also included using validated questionnaires.

Results

There were 551 MLT and 401 MLT/A in the analytic sample. Most of the respondents were women. The mean age and standard deviation of the overall sample were 42.0 ± 11.8. MLT demonstrated higher quantitative demands, possibilities for development, and organizational justice compared to MLT/A. The scores of work pace, emotional demands, role conflicts, job insecurity, insecurity over working conditions and negative acts were higher for MLT/A than MLT. The WHODAS 2.0 scores of the respondents were 20.80 ± 6.68, higher than approximately 92% average people. For both groups, most respondents scored the COPSOQ-III domains as worse since COVID-19.

Conclusion

The study provides preliminary evidence regarding the workplace mental health outcomes of medical laboratory professionals in Ontario, Canada. The findings suggest that MLT and MLT/A experience psychosocial work conditions that impact mental health, functioning and disability. Accordingly, additional research is necessary to understand the experiences of medical laboratory professionals.
Association of Sleep Duration With All-Cause and Cardiovascular Mortality: A Prospective Cohort Study
Authors: Jin Qiman , Yang Niannian , Dai Juan , Zhao Yuanyuan , Zhang Xiaoxia , Yin Jiawei , Yan Yaqiong
Published: July 2022

To clarify the association of sleep duration with all-cause and cardiovascular mortality, and further estimate the population attributable fraction (PAF) for the 10-year risk of cardiovascular disease (CVD) due to inappropriate sleep duration among US adults, we included data of the National Health and Nutrition Examination Survey (NHANES) from 2005 to 2014 by linkage to the National Death Index until December 31, 2015 in a prospective design. Cox proportional hazards models were used for multivariate longitudinal analyses. The Pooled Cohort Equations methods was adopted to calculate the predicted 10-year CVD risk. In the current study, sleep <5 h or longer than 9 h per day were significantly associated with elevated risks of all-cause mortality, and the multivariable-adjusted HRs across categories were 1.40 (95% CI, 1.14–1.71), 1.12 (95% CI, 0.91–1.38), 1 (reference), 1.35 (95% CI, 1.12–1.63), and 1.74 (95% CI, 1.42–2.12). Similarly, the HRs of cardiovascular mortality across categories were 1.66 (95% CI, 1.02–2.72), 1.15 (95% CI, 0.77–1.73), 1 (reference), 1.55 (95% CI, 1.05–2.29), and 1.81 (95% CI, 1.09–3.02). Under a causal–effect assumption, we estimated that 187 000 CVD events (PAF 1.8%, 0.9% to 2.3%) were attributable to short sleep duration and 947 000 CVD events (PAF 9.2%, 6.4% to 11.6%) were attributable to long sleep duration from 2018 to 2028. This study informed the potential benefit of optimizing the sleep duration for the primary prevention of CVD in a contemporary population.
Epidemiology and Economic Burden of an Outbreak of Cyclopeptide-Containing Mushroom Poisoning in the West of Iran
Authors: Karami Matin Behzad , Amrollahi-Sharifabadi Mohammad , Rezaei Satar , Heidari Afshar , Kazemi-Karyani Ali
Published: July 2022

Little evidence is available on the epidemiological and economical dimensions of certain foodborne diseases such as wild mushroom poisoning. This study aimed to investigate the epidemiology and estimate the costs of poisoning with cyclopeptide-containing mushrooms in Kermanshah province in 2018. In this study, poisoning was investigated in different subgroups. The cost of illness method with a bottom-up approach was used to estimate the poisoning costs. Both direct and indirect costs of the poisoning were included in the analysis. The perspective of the study was society. Required data were obtained from the medical records of Imam Khomeini hospital and completed through a line survey with the patients. Two hundred eighty-three patients were poisoned in Kermanshah due to poisoning with cyclopeptide-containing mushrooms. Of 283 patients, 143 (50.53%) were men and 59.01% of patients were rural residents. About 43% of admissions were out-patient cases and ~40% of patients were hospitalized within 1–3 days. Also, eight patients were pronounced dead in the area. The total cost of poisoning with cyclopeptide-containing mushrooms in Kermanshah province was $ 1,259,349.26. Of that, $ 69,281.65 was related to direct medical costs and $ 10,727.23 was direct non-medical costs. The indirect costs of death were estimated to be $ 1,125,829.7. The current study revealed that there is a significant financial burden due to cyclopeptide-containing mushrooms on patients, the health system, and society as a whole. Further studies are recommended to clarify the epidemiological and economic burden of foodborne illnesses related to wild mushroom poisonings. Sharing the outputs with health authorities, and informing the general public are warranted to reduce the burden of such diseases.
Experiences of Game-Based Learning and Reviewing History of the Experience Using Player's Emotions
Authors: Sumi Kaoru , Sato Shusuke
Published: July 2022

In this paper, we discuss whether the history of a learning experience, containing action and emotion information, is useful for review of the experience in game-based learning using virtual space. We developed a game-based story generation system that automatically generates scripts in real time by using a player's emotions and actions. The system has two functions: a game-based experiential learning environment and automatic story generation. The system provides the player with a virtual world and a virtual tool operated by using a hand controller and a display. The system recognizes the player's real-time emotions through facial expressions, and it outputs reactions based on these emotions and actions via a knowledge-based system when the player operates the tool. Then, it outputs scripts based on the emotions and the history of actions. We evaluated the system by conducting experiments with university students as subjects. As a result, subjects found the stories generated by this system interesting because they were based on the player's experience in the game and used the player's behavioral history and emotions. If we consider this as a record of the learning experience, the learning history is an impressive record accompanied by emotions. Thus, historical information that records the actions and emotions of the learner in real time is considered effective because it allows the learner to recall his or her own experiences after the game experience. The results suggest that the historical information, including the learner's real-time actions and emotions, is helpful for review in learning. There is a possibility that experiential learning through games using virtual spaces, such as the one used in this study, will become widespread in the future. In such cases, it will be necessary to examine the learning effects of using historical information with emotions. Therefore, we believe that the results and discussions in this study will be useful for experiential learning using virtual spaces.
African researchers do not think differently about Open Data
Authors: Skelly Lara , Chiware Elisha R. T.
Published: July 2022

A key motivation for Open Science is accessibility. For researchers in resource-poor economies, this translates into access to the methods, data and publications that will foster scientific research and discovery in such communities and environments. Attitudes toward Open Science are in flux, and there is a growing awareness of the roles and responsibilities that researchers have to one another in this regard. This paper explores how African researchers approach issues relating to Open Data by reporting on the State of Open Data Report data. Focusing on the attitudes toward Open Data, this paper reports on how African researchers view (i) data sharing, (ii) the use of shared data, and (iii) the Open Data ecosystem. The findings show that, although the attitudes of African researchers have changed over time, they are not very different from those held by their international counterparts. These findings will aid policymakers, as well as academic and research institutions, in highlighting the areas of future growth for Open Data in Africa.
Physical Therapist Impressions of Telehealth and Virtual Reality Needs Amidst a Pandemic
Authors: Elor Aviv , Conde Samantha , Powell Michael , Robbins Ash , Chen Nancy N. , Kurniawan Sri
Published: July 2022

Most physical therapists would agree that physical rehabilitation is difficult to perform remotely. Consequently, the global COVID-19 pandemic has forced many physical therapists and their clients to adapt to telehealth, especially with video conferencing. In this article, we ask: How has telehealth for physical rehabilitation evolved with the global pandemic and what are the largest technological needs, treatment methodologies, and patient barriers? With the increased widespread use of telehealth for physical therapy, we present a qualitative study towards examining the shortcomings of current physical therapy mediums and how to steer future virtual reality technologies to promote remote patient evaluation and rehabilitation. We interviewed 130 physical rehabilitation professionals across the United States through video conferencing during the COVID19 pandemic from July—August 2020. Interviews lasted 30–45 min using a semi-structured template developed from an initial pilot of 20 interviews to examine potential barriers, facilitators, and technological needs. Our findings suggest that physical therapists utilizing existing telehealth solutions have lost their ability to feel their patients’ injuries, easily assess range of motion and strength, and freely move about to examine their movements when using telehealth. This makes it difficult to fully evaluate a patient and many feel that they are more of a “life coach” giving advice to a patient rather than a traditional in-person rehabilitation session. The most common solutions that emerged during the interviews include: immersive technologies which allow physical therapists and clients 1) to remotely walk around each other in 3D, 2) enable evidence-based measures, 3) automate documentation, and 4) provider clinical practice operation through the cloud. We conclude with a discussion on opportunities for immersive virtual reality towards telehealth for physical rehabilitation.
Trans-Spinal Direct Current Stimulation in Spasticity: A Literature Mini-Review
Authors: Estudillo-Guerra Maria A. , Mesia-Toledo Ines , Rogel Noga , Yaghoubi Nader , Ahmed Zaghloul , Black-Schaffer Randie , Morales-Quezada Leon
Published: July 2022

Spasticity is common after a stroke and has a negative impact on functional and quality-of-life measures. There is an unmet medical need to provide safe and effective treatment using non-pharmacological approaches. Trans-spinal direct current stimulation (tsDCS) is an emerging modality for non-invasive neuromodulation that induces reduction of spinal excitability leading to a decrease in spasticity. We describe current treatment options for spasticity, including a literature review about the use of tsDCS in patients with spasticity. We found four clinical studies that used tsDCS to treat spasticity for different neurological conditions including hereditary spastic paraplegia, upper extremity spasticity following stroke, multiple sclerosis, and incomplete chronic spinal cord injury. Spasticity was the primary outcome in three of the studies and a secondary outcome in the final study. The three studies that addressed spasticity as the primary outcome found that active tsDCS decreased spasticity compared to sham. These studies suggest that tsDCS can modulate spinal motor and sensory spinal pathways through the use of specific electrode montages and stimulation parameters. This therapy can improve motor functions and may represent a viable treatment option for spasticity.