bluuebunny/crossref_metadata_2025 huggingface dataset:
Burden Experienced by Primary Caregivers of Children With Psychotic Disorders and at Clinical High Risk for Psychosis
Authors: Carroll Devon , Wales Meghan , Rintell L. Sophia , Hojlo Margaret , Gonzalez-Heydrich Joseph , Berbert Laura , Fitzpatrick Molly , D’Angelo Eugene , Reed Mary P.
Published: December 2022

Background:

Despite the existing research exploring caregiver burden in adult psychosis, few studies have examined the experience of providing care to children diagnosed with psychotic disorders (PDs) and those identified as having clinical high risk for psychosis (CHR-P).

Aim:

This study measured the level of burden in caregivers of children with PD and CHR-P and examined associated risk factors, including social support, caregiver–child relationship, severity of illness, and frequency of psychiatric hospitalizations.

Methods:

A total of 56 caregivers completed validated measures and provided demographic information. Measures included the Zarit Burden Interview, the Multidimensional Scale of Perceived Social Support, the Behavior Assessment System for Children, Third Edition, Parenting Relationship Questionnaire–Child and Adolescent Form (BASC-3 PRQ-CA), and the Clinical Global Impression–Severity scale.

Results:

The majority of caregivers were women (86%), mothers (84%), White (63%), married (66%), working full-time (50%), college-educated (79%), and whose mean age was 45.7 years ( SD = 8.09). Nearly half of the caregivers (45%) reported a high level of caregiver burden, 39% rated their burden in the mild to moderate range, and 16% reported little to no burden. There was no significant difference in mean burden between PD and CHR-P groups. Higher caregiver burden was associated with lower levels of social support ( r = −.408, p = .002), lower levels of parenting confidence ( r = −.514, p < .001), higher levels of relational frustration ( r = .612, p < .001), and higher severity of illness ( r = .316 p = .025).

Conclusions:

These findings underscore the critical unmet need for support for caregivers of children with PD and CHR-P. Applications to clinical practice are discussed.
Effectiveness of an Uncertainty Management Psychoeducation Program for Schizophrenia Caregivers: A Randomized Controlled Trial
Authors: Bora Sultan Taş , Buldukoğlu Kadriye , Bailey Donald Etheridge
Published: December 2022

Background:

The inconsistent course of schizophrenia causes a long-term experience of uncertainty for individuals and their families. In Turkey, no studies yet exist that have attempted to address this constant uncertainty that is experienced by caregivers of schizophrenic patients.

Aims:

To evaluate the effects of the Uncertainty Management Psychoeducation Program on reducing uncertainty and intolerance to uncertainty, improving psychological well-being, and coping styles in caregivers of patients with schizophrenia.

Method:

Single-blinded randomized controlled trial. Caregivers of schizophrenia inpatients were recruited from the psychiatry clinic of a university-affiliated hospital. Data were collected between April 2019 and August 2020. Eligible individuals were randomly allocated to one of the two groups: intervention or control. The intervention group had five individual psychoeducation sessions: “Recognizing Uncertainty,” “Cognitively Reframing Uncertainty,” “Solving Uncertainty-Related Issues,” “Dealing with Uncertainty Using Communication Skills,” and the “Closing Session.” Participants in the control group received the usual care. Uncertainty, intolerance to uncertainty, psychological well-being, and stress coping strategies were measured at two points: at baseline and immediately following the intervention. Hypotheses were tested using the Mann–Whitney U and Wilcoxon tests.

Results:

A total of 54 participants were recruited. The intervention group’s ratings for “seeking social support” and “optimistic approach” were higher than the control group’s ratings. Significant within-group changes in terms of “uncertainty” and “optimistic approach” were reported for the intervention group in the post-intervention. In the control group, significant changes were seen in terms of “uncertainty” and “psychological well-being” over time.

Conclusion:

The Uncertainty Management Psychoeducation Program was found to be effective in reducing the level of uncertainty, increasing their optimistic approach, and seeking social support of caregivers of schizophrenic patients.
The adhesive contact problem for a piecewise-homogeneous orthotropic plate with an elastic patch
Authors: Shavlakadze Nugzar , Odishelidze Nana , Criado-Aldeanueva F
Published: December 2022

A piecewise-homogeneous elastic orthotropic plate, reinforced with a finite patch of the wedge-shaped, which meets the interface at a right angle and is loaded with tangential and normal forces is considered. Using methods of the theory of analytic functions, the problem is reduced to the system of singular integro-differential equations (SIDE) with fixed singularity. Under tension-compression of patch using an integral transformation a Riemann problem is obtained, the solution of which is presented in explicit form. The tangential contact stresses along the contact line are determined and their asymptotic behavior in the neighborhood of singular points is established.
How does repetition affect vocabulary learning through listening to the teacher’s explicit instruction? The moderating role of listening proficiency and preexisting vocabulary knowledge
Authors: Zhang Pengchong
Published: December 2022

The study examines the effects of repetition on vocabulary learning within the context of three types of explicit aural vocabulary instruction – second language (L2) vs. codeswitching (CS) vs. contrastive focus-on-form (CFoF) – among 98 Chinese secondary school learners of English as a foreign language. It also explores how the effects of repetition on vocabulary learning were moderated by learners’ listening proficiency and preexisting levels of vocabulary knowledge. Within a 12-week pre–post test quasi-experimental design, learners listened to explicit vocabulary instruction for 20 target words, five of which were repeated four times, five repeated five times, five repeated seven times, and the remaining five repeated nine times. Findings suggested that regardless of the type of explicit instruction, vocabulary learning gains were positively correlated with repetitions but that at least seven repetitions were needed for significant gains to take place. In addition, the effects of repetition were moderated only by learners’ listening proficiency but not by their preexisting levels of vocabulary knowledge. Less proficient listeners benefited significantly more than more proficient listeners with every unit increase of the number of repetitions. The study illuminates important relationships between repetition and listening proficiency, factors useful to consider when designing pedagogical activities to enhance vocabulary learning through listening to explicit instruction.
Epistemic racism in the health professions: A qualitative study with Black women in Canada
Authors: Beagan Brenda L , Bizzeth Stephanie R , Sibbald Kaitlin R , Etowa Josephine B
Published: December 2022

Systemic racism within health care is increasingly garnering critical attention, but to date attention to the racism experienced by health professionals themselves has been scant. In Canada, anti-Black racism may be embodied in structures, policies, institutional practices and interpersonal interactions. Epistemic racism is an aspect of systemic racism wherein the knowledge claims, ways of knowing and ‘knowers’ themselves are constructed as invalid, or less credible. This critical interpretive qualitative study examined the experiences of epistemic racism among 13 healthcare professionals across Canada who self-identified as Black women. It explores the ways knowledge claims and expert authority are discredited and undermined, despite the attainment of professional credentials. Three themes were identified: 1. Not being perceived or portrayed as credible health professionals; 2. Requiring invisible labour to counter professional credibility ‘deficit’; and 3. Devaluing knowledge while imposing stereotypes. The Black women in our study faced routine epistemic racism. They were not afforded the position of legitimate knower, expert, authority, despite their professional credentials as physicians, nurses and occupational therapists. Their embodied cultural and community knowledges were disregarded in favour of stereotyped assumptions. Adopting the professional comportment of ‘Whiteness’ was one way these health care providers strived to be perceived as credible professionals. Their experiences are characteristic of ‘misogynoir’, a particular form of racism directed at Black women. Anti-Black epistemic racism constitutes one way Whiteness is perpetuated in health professions institutions.
Rape culture: sexual intimidation and partner rape among youth in sexually diverse relationships
Authors: Mayeza Emmanuel
Published: December 2022

South African studies on rape culture have examined this issue in relation to heterosexuality. They demonstrate how toxic masculinity exercises sexual power by victimizing women and girls. However, little is known about manifestations of rape culture in contexts where both victims and perpetrators are same-sex attracted young people within intimate relationships. Thus, this article extends the scope of the scholarly discussions on rape culture by exploring how rape culture manifests itself in the social and intimate lives of sexually diverse South African youth. It will also reflect on some of the ways that could be explored to address rape culture.
The persistence of the housewife ideology: Shifts in women’s roles in production of Sumbanese handwoven cloth
Authors: Gajjala Radhika , Faniyi Ololade Margaret , Ford Sarah , Untari Rustina , Al Makmun Muhammad Taufiq
Published: December 2022

This article examines women’s shifting roles in the production of handwoven cloth in Sumba, Indonesia. The main themes that emerge are the invisible labor of women and the production of a self-empowered entrepreneurial, gendered, laboring subjectivity that works in tandem with a housewife ideology firmly situated in a ‘new’ liberal patriarchy. The inequalities emerging from these shifts are parallel to inequalities produced through neoliberalization of global south craft communities in a context of global markets and tourist-oriented production. The discussion in this article is based on case studies drawn from over 50 interviews conducted during field visits and continued remotely when away from the field in Lambanapu and Praillu regions in Waingapu of Sumba, Indonesia. Overall, our analysis reveals how cultural work in this global south context reproduces a Westernized, neoliberal patriarchy even as it allows for individualized expressions of women’s agency.`
Simulation and experimental analysis of rotor-bearing system with rolling element bearing fault in axial piston pump under churning condition
Authors: Wu ZhuJin , Tang Hesheng , Li Yiming , Ren Yan , Chen Lei , Kumar Anil
Published: December 2022

Axial piston pumps have been widely studied and applied in engineering applications. Generally, traditional simulation models are established to analyze the vibration characteristics of the pump without the churning effect of the gap annular flow. A new vibration model of a rotor-bearing system considering the oil churning effect and time-varying excitation introduced by localized faults on the rolling element bearing is proposed in this work. External forces on rotor-bearing system are solved to obtain time-varying displacement and contact stiffness coefficient based on lump mass method. The dynamic model has constructed to analyze the dynamic characteristics of rotor-bearing system with bearing faults. The validity of the model is verified by comparing the simulation results with the analysis results and the experimental results. The findings reveal that rolling element bearing with localized faults alters the vibration characteristics of the rotor-bearing system. Both the simulation results and the experimental results show the fault characteristic frequency of the rotor-bearing system and the explicit component of its harmonics. The fault characteristic frequency of rotor-bearing system with bearing faults is consistent with the simulation result, and the error is less than 10%. The spectrum of the experimental and simulated signals is similar and indicates the validity of the dynamical model.
Understanding the effect of particle reinforcement on friction stir weldment: A review
Authors: G N ShivaKumar , G Rajamurugan
Published: December 2022

Friction stir welding is a solid-state environment-friendly joining process with many advantages over all fusion welding processes. Many variants in friction stir welding are used for uplifting the process to its maximum possible extent. One such variant is particle reinforcement in the weldment, which is used for improving the mechanical properties by enhancing the metallurgical aspects in the weld region. Generally, micro- and nano-sized ceramic particles are used for reinforcing, which have a much higher melting point than the materials to be joined. From the literature studies, particle size plays a prominent role in attaining better mechanical properties in reinforcing techniques. In addition, an increase in particle size decreases the corresponding mechanical property. Higher heat input conditions like higher tool rotational speed and low welding speed are preferred as they better mix reinforced particles with the matrix material in the weld zone. However, the higher input conditions in the regular friction stir welding process coarsen the grains, thereby deteriorating the mechanical properties of the joint. Increasing the number of passes and switching the direction between the passes leads to uniform distribution of particles and enhance the mechanical properties. This review article's main aim is to understand better reinforcement particles in the weld line of a friction stir welding process. Also, the author emphasizes reinforcing the combination of nano and microparticles to reduce the cost of reinforcement without compromising the mechanical properties. The work mentioned above is missing in the open literature.
Developing methods of constrained groove pressing technique: A review
Authors: Kumar Sunil
Published: December 2022

Among various severe plastic deformation (SPD) techniques, constrained groove pressing (CGP) has arisen as a famous technique for fabricating ultrafine-grained sheet metals and alloys in recent times. The severe strain is applied to improve the mechanical performance and properties. However, inhomogeneous grain refinement, lower formability, surface unevenness, and microcracks are the common limitations of conventional CGP-processed samples. Therefore, this review inspects the latest progress through modifications of the CGP process and compares the process efficacy with the conventional process. Advanced CGP processing techniques, such as modification of die design, annealing of the processed sample, cross CGP, ring CGP, hybrid SPD, covered sheet casing CGP, and rubber pad CGP, are emerging techniques to up-scale the procedure and improve the grain refinement and thereby produce superior mechanical properties. In this review paper, the historic research of conventional CGP and its effect on grain refinement and mechanical properties is initially briefed and then recent progress through different advanced techniques is highlighted, especially in alloys. Albeit significant progress has been observed in CGP, the future scope and successful usage of CGP-processed samples in actual practice are discussed in the last stage.
Age and Five-Year Outcomes After Carotid Artery Stenting in Symptomatic Carotid Stenosis: A Retrospective Cohort Study
Authors: Liu Yun-e , Zhu Xianjin , Ma Yinghao , Tang Haiyan , Jin Min
Published: December 2022

Background

Several clinical trials have reported that periprocedural risk of carotid artery stenting (CAS) increase with age. China is experiencing one of the most rapid transitions to an aging society, while the clinical outcomes of CAS in real-world China are still limited. The study aimed to compare the periprocedural and an extending 5-year event rates between younger and older patients treated by CAS to testify the safety of CAS in older patients in China.

Methods

This is a single center, retrospective cohort study. Symptomatic patients who underwent CAS from Nov 2011 to June 2014 were retrospectively included in this study, The population was divided into two age groups: <70 and ≥70. The main primary endpoint was stroke, myocardial infarction or death occurring at 30 days, or ipsilateral stroke over 5-year after stenting.

Results

A total of 103 symptomatic patients (<70: 68%; ≥70: 32%) with CAS included in the study. During the 30-day period, the rate of primary outcome was 1.0% with only one stroke in patients younger than 70 years old ( P = 1.000). After five years, the rate of primary outcome was low (10.9%, 10/92) despite some of the patients had major stroke or underwent bilateral C1 stenting. There was no significant difference in the 5-year rates of the primary outcome between the young and old groups (12.3% vs 7.4%, P = .718). Kaplan-Meier estimates of the proportion of study participants with a primary endpoint showed that there was no significant age-dependent difference of the stroke and death outcome in symptomatic patients.

Conclusions

Age (<70 vs ≥ 70) had no influence on the risk of stroke or death in symptomatic patients either in the short or long term. CAS is an optimal treatment for older patients with cervical carotid artery stenosis, and CAS was safe for those with major stroke or bilateral C1 stenting.
Empirical support for the Al-Jazeera Effect notion: Al-Jazeera's Twitter following
Authors: Samuel-Azran Tal , Manor Ilan
Published: December 2022

Globalization scholars argue that the launch of Al-Jazeera has promoted a fairer horizontal news flow as a non-Western perspective entered the global public sphere leading to the Al-Jazeera Effect. In contrast, other scholars argue that Al-Jazeera outlets face biases and boycotts due to their Qatari origin, thus casting a shadow over the Al Jazeera Effect argument. This study employs an innovative approach to contribute to this debate by examining Al-Jazeera English (AJE) and AJ + 's Twitter following amongst four epistemic communities: ambassadors, foreign ministries, UN missions and journalists. The analysis found that AJE was consistently amongst the top five most followed new channels on Twitter, obtaining greater popularity than major Western news outlets such as Fox News and Sky News. This lends a unique empirical support for the Al-Jazeera Effect hypothesis. AJ + was found to be less popular, possibly due to its distinct nature as an online news platform.
From Author to Network: The Coming of Age of Civil Sphere Theory
Authors: Kivisto Peter , Sciortino Giuseppe
Published: December 2022

This article argues that Jeffrey Alexander’s The Civil Sphere constitutes the first sociological theory of civil society, a theory with its own developmental history. That history includes the trajectory of Alexander’s career prior to his simultaneous turn to cultural sociology and civil society. The former led him to develop what he calls a ‘strong program,’ while the use of the term ‘civil sphere’ serves to distinguish his approach to civil society from other articulations, past and present. This includes viewing the theory as offering a more realistic understanding of the prospects for and impediments to liberal democracy. Conceived at the outset as an ongoing project, rather than the last word on the topic, we review how that project has shifted from the work of one prominent theorist to a global network of scholars.
Age-Associated Changes in Proximal Femur Morphology Affect Femoral Component Sizing in Cementless Hip Arthroplasty
Authors: Veldman Hidde D. , Boymans Tim A. E. J. , van Steenbergen Liza N. , Heyligers Ide C.
Published: December 2022

Background

In cementless hip arthroplasty, the femoral component should obtain firm fixation within the endosteal bone and achieve adequate reconstruction of hip joint biomechanics simultaneously. Previous anatomical studies described age-related changes of the proximal femoral canal, such as canal widening, which theoretically necessitates the use of larger stem sizes in elderly patients. This study examines a potential association between patients’ age at surgery and the implant size of a cementless femoral component.

Material and methods

A total of 13,423 primary hip arthroplasties with a single cementless stem registered in the Dutch Arthroplasty Register (LROI) were included. Patient characteristics (ie patients’ age, sex, height and weight at time of surgery) and femoral component size were derived. A one-way ANCOVA was used to compare the mean stem size between age groups, and multivariable linear regression analysis was used in order to investigate to which extent ageing impacted stem size.

Results

Each subsequent age- group (ten-year intervals) had a significantly larger mean stem size than the prior age- group. Multivariable linear regression analysis revealed that age is positively correlated with stem size and that this correlation is more prominent in females than in males (beta = .046, P < .001 and beta = .028, P < .001 respectively).

Interpretation

Implant size is positively correlated with age, in particular in females and independently from investigated anthropometric characteristics. The present study endorses that the femoral canal morphology is related to patients’ characteristics such as age and sex. The morphology will subsequently influence implant sizing and therefore may have biomechanical and clinical implications.
Impact of a Medical Clinic Relocation on Travel Time: A Tale of 2 Modes of Transportation
Authors: Kahn Peter A , Ying Xiaohan , Li Sunnie , Mathis Walter S
Published: December 2022

The aim of this study was to quantify access disparities by examining the impact of a medical clinic relocation on travel time differences for patients using private cars versus public transit. Longitude and latitude of patient home addresses were extracted from electronic medical records for the 4 years before the clinic move. Using offline, open-source, and HIPAA-compliant routing software, roundtrip travel times were computed from each home address to the old and new clinic locations via car and bus. Mean roundtrip travel time by a car changed from 41.3 (IQR 16.1-80.7) to 45.4 (IQR 25.9-78.1) minutes, a 9.9% increase. Mean roundtrip travel time by public transit changed from 67.5 (IQR 51.5-100.2) to 120.8 (100.3-156.1) minutes, a 78.9% increase. Even clinic relocations that minimally impact car travel times can nevertheless yield substantial changes to those traveling by public transit. Clinics and health systems that wish to reduce barriers to accessing health care, especially among those already facing structural inequities, would benefit from utilizing the analytic approach described here.
Quality in stroke care during the early phases of the COVID-19 pandemic: A nationwide study
Authors: Blauenfeldt Rolf A , Hedegaard Jakob N , Kruuse Christina , Gaist David , Wienecke Troels , Modrau Boris , Damgaard Dorte , Johnsen Søren P , Andersen Grethe , Simonsen Claus Z
Published: December 2022

Introduction:

Evidence-based early stroke care as reflected by fulfillment of process performance measures, is strongly related to better patient outcomes after stroke and transient ischemic attack (TIA). Detailed data on the resilience of stroke care services during the COVID-19 pandemic are limited. We aimed to examine the quality of early stroke care at Danish hospitals during the early phases of the COVID-19 pandemic.

Materials and methods:

We extracted data from Danish national health registries in five time periods (11 March, 2020–27 January, 2021) and compared these to a baseline pre-pandemic period (13 March, 2019–10 March, 2020). Quality of early stroke care was assessed as fulfilment of individual process performance measures and as a composite measure (opportunity-based score).

Results:

A total of 23,054 patients were admitted with stroke and 8153 with a TIA diagnosis in the entire period. On a national level, the opportunity-based score (95% confidence interval [CI]) at baseline for ischemic patients was 81.1% (80.8–81.4), for intracerebral hemorrhage (ICH) 85.5% (84.3–86.6), and for TIA 96.0% (95.3–96.1). An increase of 1.1% (0.1–2.2) and 1.5% (0.3–2.7) in the opportunity-based score was observed during the first national lockdown period for AIS and TIA followed by a decline of −1.3% (−2.2 to −0.4) in the gradual reopening phase for AIS indicators. We found a significant negative association between regional incidence rates and quality-of-care in ischemic stroke patients implying that quality decreases when admission rates increase.

Conclusion:

The quality of acute stroke/TIA care in Denmark remained high during the early phases of the pandemic and only minor fluctuations occurred.
What level of resistance to air pollution is justified? On violence and self-defense
Authors: Mohorčich J.
Published: December 2022

This article evaluates responses to air pollution that lie beyond the domain of state policy and nonviolent civil disobedience. I begin by presenting evidence that fine particulate matter pollution is more serious than commonly recognized. As a result, attempts to address it deserve more attention from those who are concerned about achieving a just and livable world. I argue that, in part because of its physical characteristics, air pollution pushes the limits of civil disobedience as moral communication. I evaluate one nonviolent and one unarmed violent strategy for collective self-defense against air pollution and make at least two concrete recommendations for engaging in collective self-defense against air pollution.
HLA-E–restricted immune responses are crucial for the control of EBV infections and the prevention of PTLD
Authors: Vietzen Hannes , Furlano Philippe L. , Cornelissen Jan J. , Böhmig Georg A. , Jaksch Peter , Puchhammer-Stöckl Elisabeth
Published: December 2022

Primary Epstein-Barr virus (EBV) infections may cause infectious mononucleosis (IM), whereas EBV reactivations in solid organ and hematopoietic stem cell transplant recipients are associated with posttransplantation lymphoproliferative disorders (PTLDs). It is still unclear why only a minority of primary EBV-infected individuals develop IM, and why only some patients progress to EBV+PTLD after transplantation. We now investigated whether nonclassic human leukocyte antigen E (HLA-E)–restricted immune responses have a significant impact on the development of EBV diseases in the individual host.

On the basis of a large study cohort of 1404 patients and controls as well as on functional natural killer (NK) and CD8+ T-cell analyses, we could demonstrate that the highly expressed HLA-E∗0103/0103 genotype is protective against IM, due to the induction of potent EBV BZLF1-specific HLA-E–restricted CD8+ T-cell responses, which efficiently prevent the in vitro viral dissemination.

Furthermore, we provide evidence that the risk of symptomatic EBV reactivations in immunocompetent individuals as well as in immunocompromised transplant recipients depends on variations in the inhibitory NKG2A/LMP-1/HLA-E axis. We show that EBV strains encoding for the specific LMP-1 peptide variants GGDPHLPTL or GGDPPLPTL, presented by HLA-E, elicit strong inhibitory NKG2A+ NK and CD8+ T-cell responses. The presence of EBV strains encoding for both peptides was highly associated with symptomatic EBV reactivations. The further progression to EBV+PTLD was highly associated with the presence of both peptide-encoding EBV strains and the expression of HLA-E∗0103/0103 in the host. Thus, HLA-E–restricted immune responses and the NKG2A/LMP-1/HLA-E axis are novel predictive markers for EBV+PTLD in transplant recipients and should be considered for future EBV vaccine design.
A systematic review of randomisation method use in RCTs and association of trial design characteristics with method selection
Authors: Bruce Cydney L. , Juszczak Edmund , Ogollah Reuben , Partlett Christopher , Montgomery Alan
Published: December 2022

Background

When conducting a randomised controlled trial, there exist many different methods to allocate participants, and a vast array of evidence-based opinions on which methods are the most effective at doing this, leading to differing use of these methods. There is also evidence that study characteristics affect the performance of these methods, but it is unknown whether the study design affects researchers’ decision when choosing a method.

Methods

We conducted a review of papers published in five journals in 2019 to assess which randomisation methods are most commonly being used, as well as identifying which aspects of study design, if any, are associated with the choice of randomisation method. Randomisation methodology use was compared with a similar review conducted in 2014.

Results

The most used randomisation method in this review is block stratification used in 162/330 trials. A combination of simple, randomisation, block randomisation, stratification and minimisation make up 318/330 trials, with only a small number of more novel methods being used, although this number has increased marginally since 2014. More complex methods such as stratification and minimisation seem to be used in larger multicentre studies.

Conclusions

Within this review, most methods used can be classified using a combination of simple, block stratification and minimisation, suggesting that there is not much if any increase in the uptake of newer more novel methods. There seems to be a noticeable polarisation of method use, with an increase in the use of simple methods, but an increase in the complexity of more complex methods, with greater numbers of variables included in the analysis, and a greater number of strata.
Challenges of middle-aged men in utilizing new health services from primary health care providers' perspective: a qualitative study
Authors: Fadaei Dehcheshmeh Nayeb , Emamian Fard Seyed Mehdi , Roghani Tayebeh , Mohammadi Parvin , Faraji-Khiavi Farzad
Published: December 2022

Background

Despite its special importance among different age groups, the middle-aged male group has often been neglected in the Iranian health system. The aim of this study was to examine, from the perspective of primary health care providers, the challenges of middle-aged men in utilizing health services.

Methods

This is a qualitative research that was conducted using semi-structured interviews in 2020 in Shoushtar Faculty of Medical Sciences, Iran. The research population included 60 managers and staff of the health sector. To collect the data, a group discussion method was used based on purposive sampling method. Data analysis was done manually using the conventional content analysis method with data reduction. Lincoln & Guba’s four criteria of credibility, dependability, confirmability, and transferability were used to assess the trustworthiness of the results.

Results

The challenges of middle-aged men to receive modern health services were identified in 35 codes, 9 categories and three main themes. These themes included Context, Content, and Process. The Context theme comprised the following three categories: personal, economic and sociocultural, and geographic factors. The Content theme contained two categories of staff and facilities. Finally, the Process theme included four categories of service quality, program management, system of information registration and follow-up, and health education and publicizing.

Conclusion

Promoting middle-aged men’s benefits from modern health services calls for overcoming three categories of challenges related to: context, content, and process. Time and place restrictions on access to services should be alleviated by empowering health care workers, improving their working conditions, and strengthening the facilities of comprehensive health service centers. In addition, with proper management of the family physician program and service provision at different levels, the coverage of services for middle-aged men can also be extended.
Trends in hepatitis B notification rates in Guangzhou, China, between 2009 and 2020: an epidemiological study
Authors: Liu Wei , Dong Zhiqiang , Hu Wensui , Li Ke , Sun Lili , Hou Jianrong , Jia Shijie , Liu Yuan
Published: December 2022

Background

Although the prevalence of hepatitis B in Guangzhou, China, is high, the epidemiological trends are not well-documented. We aimed to analyse newly reported hepatitis B cases in Guangzhou between 2009 and 2020 to explore the epidemiological trends and provide insights for the development of control measures.

Methods

Information on the population and new cases of hepatitis B in Guangzhou between 2009 and 2020 was obtained from the China Information System for Disease Control and Prevention, which was used to calculate the annual notification rates of hepatitis B by sex, age group (0–9; 10–19; 20–29; 30–39; 40–49; 50–59; ≥ 60 years), and location (urban or rural). Joinpoint regression analysis was used to analyse the temporal trends and calculate the average annual percentage change (AAPC) and annual percentage change (APC) for each identified trend line segment.

Results

Between 2009 and 2020, 287,034 new cases of hepatitis B were cumulatively reported. The average annual notification rate was 181.13/100,000, and the notification rate showed a long-term downward trend during the period 2009–2020, with an annual decrease of 6.30% (APC − 6.30%; 95% CI − 7.56 to − 5.02%). Men had a significantly higher notification rate than women; however, the sex ratio decreased from a maximum of 2.34 in 2010 to a minimum of 1.54 in 2020. A downward trend in the notification rate was observed in urban areas and an upward trend was observed in rural areas, with an increase in the rural/urban ratio from 0.46 in 2012 to 1.57 in 2020. The notification rate for all age groups showed a decreasing trend from 2009, with the exception of the 50–59 years and ≥ 60 years groups, whose notification rates began to decrease from 2014 and 2015, respectively.

Conclusions

Although the overall notification rate of hepatitis B in Guangzhou decreased annually, it remained high. Further, in rural areas, the notification rate has been increasing, and effective measures should be taken to control hepatitis B infection in Guangzhou.
Convolutional neural network -based phantom image scoring for mammography quality control
Authors: Sundell Veli-Matti , Mäkelä Teemu , Vitikainen Anne-Mari , Kaasalainen Touko
Published: December 2022

Background

Visual evaluation of phantom images is an important, but time-consuming part of mammography quality control (QC). Consistent scoring of phantom images over the device’s lifetime is highly desirable. Recently, convolutional neural networks (CNNs) have been applied to a wide range of image classification problems, performing with a high accuracy. The purpose of this study was to automate mammography QC phantom scoring task by training CNN models to mimic a human reviewer.

Methods

Eight CNN variations consisting of three to ten convolutional layers were trained for detecting targets (fibres, microcalcifications and masses) in American College of Radiology (ACR) accreditation phantom images and the results were compared with human scoring. Regular and artificially degraded/improved QC phantom images from eight mammography devices were visually evaluated by one reviewer. These images were used in training the CNN models. A separate test set consisted of daily QC images from the eight devices and separately acquired images with varying dose levels. These were scored by four reviewers and considered the ground truth for CNN performance testing.

Results

Although hyper-parameter search space was limited, an optimal network depth after which additional layers resulted in decreased accuracy was identified. The highest scoring accuracy (95%) was achieved with the CNN consisting of six convolutional layers. The highest deviation between the CNN and the reviewers was found at lowest dose levels. No significant difference emerged between the visual reviews and CNN results except in case of smallest masses.

Conclusion

A CNN-based automatic mammography QC phantom scoring system can score phantom images in a good agreement with human reviewers, and can therefore be of benefit in mammography QC.
Prostate-specific membrane antigen expression predicts recurrence of papillary thyroid carcinoma after total thyroidectomy
Authors: Ryu Young Jae , Lim Soo Young , Na Yong Min , Park Min Ho , Kwon Seong Young , Lee Ji Shin
Published: December 2022

Background

Prostate-specific membrane antigen (PSMA) overexpression has been observed in the endothelial neovasculature of several solid malignancies. This study aimed to identify PSMA expression in the primary tumor of classical papillary thyroid carcinoma (PTC) and assess the correlation between the degree of PSMA expression and recurrence.

Methods

We reviewed the electronic medical records of patients who underwent total thyroidectomy and central neck dissection, with or without lateral neck dissection, for classical PTC between 2009 and 2014 at our institution. Recurrence was defined as a structural disease based on histological confirmation on follow-up. Fifty-one patients with the recurrent structural disease were matched, using a propensity score matching method, to patients with no disease evidence during follow-up. Clinicopathological and follow-up data were collected for 102 patients. The monoclonal mouse anti-human PSMA/FOLH1/NAALADase I antibody was used for staining the primary tumor. The score of PSMA expression was classified as negative (< 5% positivity), weak (5–10 % positivity), moderate (11–49% positivity), and strong (more than 50% positivity). Clinicopathological factors were compared between patients with low and high PSMA expression. Moreover, whether the degree of PSMA expression and clinicopathological factors could predict recurrence was investigated. Cox proportional hazard regression models were used to evaluate the risk of recurrence.

Results

There was no significant difference in clinicopathological factors between low (negative or weak) and high (moderate or strong) PSMA expression. Gross extrathyroidal extension (ETE), absence of chronic lymphocytic thyroiditis, and high PSMA expression were all associated with lower recurrence-free survival (RFS) rate in a univariate analysis. In multivariate analysis, gross ETE (hazard ratio [HR], 2.279; 95% confidence interval [CI], 1.257−4.132; p = 0.007) and high PSMA expression (HR, 1.895; 95% CI, 1.073−3.348; p = 0.028) were associated with poor RFS.

Conclusions

High PSMA expression in the primary tumor was a significant factor in predicting recurrence in classic PTC. PSMA could be a potential biomarker for personalized management for PTC.
Socio-temporal contextual and community factors associated with daily exclusive ENDS use and dual use with tobacco cigarettes among adolescent vapers: an ecological momentary assessment study
Authors: Abadi Melissa H. , Shamblen Stephen R. , Thompson Kirsten , Lipperman-Kreda Sharon , Grube Joel , Richard Bonnie O. , Aramburu Camila
Published: December 2022

Background

Adolescents who dual use ENDS with tobacco cigarettes are more likely to have an increased risk of developing dependence. Yet, little is understood about the factors driving dual use among adolescents. The current study sought to reveal the day-to-day socio-temporal contextual and community factors associated with adolescents’ use of electronic nicotine delivery systems (ENDS), and how these factors predict dual use with tobacco cigarettes.

Methods

We collected ecological momentary assessments (EMA) from a sample of 50 adolescent past two-week vapers (ages 14–17 years old) over 14 days. Daily EMA data were collected on ENDS and tobacco cigarette use, as well as a range of contextual (i.e., motivations to vape, location of vaping, who with when vaping) and community factors (i.e., exposure to peers vaping, to adults vaping, to ENDS advertising, to ENDS warning messages). Our primary analyses were multilevel regressions, accounting for daily observations nested within individuals (N = 700 observations).

Results

Participants used ENDS exclusively on 44% of days and dual used ENDS and tobacco cigarettes on 8% of the days. Dual use days (versus exclusive ENDS use days) were associated with “vaping because tobacco use was prohibited” (OR = 34.65,p < .05). Also, dual use days (versus no use days) were associated with greater exposure to adults vaping (OR = 5.59,p < .05), peers vaping (OR = 7.48,p < .05), and (c) ENDS advertisements or promotions (OR = 2.12,p < .01), whereas exclusive use days (versus no use days) were only associated with greater exposure to peers vaping (OR = 2.58,p < .01).

Conclusions

Results showed that exposure to peers and adults vaping and exposure to ENDS marketing were associated with same day dual use behaviors. And, that adolescents who dual used were motivated to use ENDS because they were easy to conceal. Findings support stricter regulation of ENDS marketing and for smoke-free air laws that include ENDS. In addition, these findings support prioritizing family- and school-based prevention programming that effectively communicates risk associated with ENDS use, including heightened risk of dual use and dependence. Such efforts can reduce the number of adolescents who use ENDS as well as the number who transition to tobacco cigarette use.
The short-term outcomes of cementless stem for hip arthroplasty in the elderly patients: comparison with patients < 65 years
Authors: Wang Jun , Deng Zhibo , Huang Bin , Zhao ZhengMing , Wan HaiMing , Ding Hong
Published: December 2022

Objective

The use of cement or cementless femoral stem prosthesis for hip arthroplasty in elderly patients has been controversial. This study investigated the efficacy and safety of cementless femoral stem in elderly patients (age ≥ 65 years).

Methods

The short-term efficacy of primary hip arthroplasty with cementless femoral stem in our hospital from January 2014 to June 2021 was retrospectively analyzed. Patients were divided into two groups according to age: young group (< 65 years) and the elder group (≥ 65 years). The evaluation index was the Harris Hip score (Harris), postoperative femoral stem prosthesis sinking distance and femoral plant-related complications (periprosthetic fracture, prosthesis loosening, infection, dislocation, etc.).

Results

There were 72 cases of 86 hips in the young group and 83 cases of 92 hips in the elder group. The recovery trend of functional score in the elder group was similar to that in the young group, and the Harris score increased from (38.35 ± 18.21) before surgery to (86.91 ± 12.55) at last follow-up (p < 0.01). Compared with the two groups at the same time of 3 months, 6 months and 12 months after operation, the sinking distance of the elder group was significantly greater (P < 0.05). Even in the elder group, there was a significant difference in sinking distance between 6 and 3 months after surgery (2.44 ± 0.49 mm vs 2.10 ± 0.65 mm, P = 0.004). However, there was no significant difference between 12 and 6 months (2.53 ± 0.53 mm vs 2.44 ± 0.49 mm, P = 0.40). A total of 10 patients in the elder group and 6 patients in the young group had a complication event (P = 0.36).

Conclusions

Elderly patients with cementless femoral stems can achieve metal-bone integration slightly longer than young patients, but short-term clinical outcomes can be restored to a satisfactory level with adequate safety. However, the long-term efficacy still needs to be verified by multicenter, large sample size and prospective clinical follow-up results.
Adopting transfer learning for neuroimaging: a comparative analysis with a custom 3D convolution neural network model
Authors: Soliman Amira , Chang Jose R. , Etminani Kobra , Byttner Stefan , Davidsson Anette , Martínez-Sanchis Begoña , Camacho Valle , Bauckneht Matteo , Stegeran Roxana , Ressner Marcus , Agudelo-Cifuentes Marc , Chincarini Andrea , Brendel Matthias , Rominger Axel , Bruffaerts Rose , Vandenberghe Rik , Kramberger Milica G. , Trost Maja , Nicastro Nicolas , Frisoni Giovanni B. , Lemstra Afina W. , Berckel Bart N. M. van , Pilotto Andrea , Padovani Alessandro , Morbelli Silvia , Aarsland Dag , Nobili Flavio , Garibotto Valentina ,   the Alzheimer’s Disease Neuroimaging Initiative, Ochoa-Figueroa Miguel
Published: December 2022

Background

In recent years, neuroimaging with deep learning (DL) algorithms have made remarkable advances in the diagnosis of neurodegenerative disorders. However, applying DL in different medical domains is usually challenged by lack of labeled data. To address this challenge, transfer learning (TL) has been applied to use state-of-the-art convolution neural networks pre-trained on natural images. Yet, there are differences in characteristics between medical and natural images, also image classification and targeted medical diagnosis tasks. The purpose of this study is to investigate the performance of specialized and TL in the classification of neurodegenerative disorders using 3D volumes of 18F-FDG-PET brain scans.

Results

Results show that TL models are suboptimal for classification of neurodegenerative disorders, especially when the objective is to separate more than two disorders. Additionally, specialized CNN model provides better interpretations of predicted diagnosis.

Conclusions

TL can indeed lead to superior performance on binary classification in timely and data efficient manner, yet for detecting more than a single disorder, TL models do not perform well. Additionally, custom 3D model performs comparably to TL models for binary classification, and interestingly perform better for diagnosis of multiple disorders. The results confirm the superiority of the custom 3D-CNN in providing better explainable model compared to TL adopted ones.
Effects of a multidisciplinary management program on symptom burden and medication adherence in heart failure patients with comorbidities: A randomized controlled trial
Authors: Ghobadi Parvin , Gholami Mohammad , Hasanvand Shirin , Toulabi Tahereh , Moradifar Nasrolah , Birjandi Mehdi
Published: December 2022

Background

Comorbidities in heart failure (HF) are a complex clinical challenge. There is little data on the benefits of multidisciplinary postdischarge management programs in such patients. This study aimed to examine the effects of a multidisciplinary management program (MMP) on symptom burden and medication adherence in HF patients with comorbidities.

Methods

In this clinical trial study, 94 HF patients with comorbidities were assigned to intervention (n = 47) and control (n = 47) groups by the stratified-random method. The intervention group underwent MMP supervised by a nurse for two months after discharge, including multi-professional visits, telephone follow-ups, and an educational booklet. Medication adherence and symptom burden were assessed using Morisky Medication Adherence Scale (MMAS) and Edmonton Symptom Assessment Scale (ESAS), respectively, on three occasions: Before discharge, six weeks, and eight weeks after discharge.

Results

Both groups almost matched at the baseline, and the most frequent comorbidities included myocardial infarction (MI), hypertension, peptic ulcer, and depression, respectively. The interactive effect of time in groups showed that mean changes in total scores of symptom burden and medication adherence were significantly different (P < 0.001) at other time points. A significant increase in medication adherence (P < 0.001) and a significant reduction in the burden of all symptoms were observed in the intervention group compared to the control group from Time 1 to Time 3.

Conclusions

The MMP (targeting comorbidity) is a promising strategy for managing symptoms and medication adherence in HF patients with comorbidities.