bluuebunny/crossref_metadata_2025 huggingface dataset:
Predictors of Nutritional Status, Depression, Internet Addiction, Facebook Addiction, and Tobacco Smoking Among Women With Eating Disorders in Spain
Authors: Ali Amira Mohammed , Hori Hiroaki , Kim Yoshiharu , Kunugi Hiroshi
Published: December 2021

Eating disorders (EDs) are a complex group of psychiatric conditions that involve dysfunctional eating patterns, nutritional alterations, and other comorbid psychopathologies. Some women with EDs may develop problematic internet use while they attempt to get information on dieting/weight control or get online support from people with similar problems. They may also drift toward tobacco smoking as a method to regulate their weight or to cope with their weight-related dysphoria. The occurrence of these conditions in EDs may prolong disease course and impede recovery. This study used structural equation modeling to investigate nutritional status (noted by body mass index, BMI), depression psychopathology, internet addiction (depicted by the Internet Addiction Test), Facebook addiction (depicted by the Bergen Facebook Addiction Scale), and smoking among 123 Spanish women diagnosed with EDs (mean age = 27.3 ± 10.6 years). History of hospitalization, marital status, age, and the level of education predicted BMI in certain ED groups. BMI did not predict depression, but it predicted internet addiction, Facebook addiction, and smoking in certain ED groups. Depression did not predict BMI, internet/Facebook addition, or smoking in any ED group. Some sociodemographic and clinical variables had indirect effects on depression, internet addiction, and Facebook addiction while age was the only variable expressing a direct effect on all outcome measures. Age, education, and history of prolonged treatment predicted smoking in certain ED patients. The findings signify that a considerable target for interventional strategies addressing nutritional and addictive problems in EDs would be women with high BMI, history of hospitalization, history of prolonged treatment, who are particularly young, single, and less educated. Replication studies in larger samples, which comprise various subtypes of EDs from both genders, are warranted to define the exact interaction among the addressed variables.
Changes in Brain Structure, Function, and Network Properties in Patients With First-Episode Schizophrenia Treated With Antipsychotics
Authors: Yin Ping , Zhao Chao , Li Yang , Liu Xiaoyi , Chen Lei , Hong Nan
Published: December 2021

Purpose: Comprehensive and longitudinal brain analysis is of great significance for understanding the pathological changes of antipsychotic drug treatment in patients with schizophrenia. This study aimed to investigate the changes of structure, function, and network properties in patients with first-episode schizophrenia (FES) after antipsychotic therapy and their relationship with clinical symptoms.

Materials and Methods: A total of 30 patients diagnosed with FES and 30 healthy subjects matched for sex and age were enrolled in our study. Patients at baseline were labeled as antipsychotic-naive first-episode schizophrenia (AN-FES), and patients after antipsychotic treatment were labeled as antipsychotic treatment first-episode schizophrenia (AT-FES). The severity of illness was measured by using the PANSS and CGI score. Structural and functional MRI data were also performed. Differences in GMV, ALFF, and ReHo between the FES group and healthy control group were tested using a voxel-wise two-sample t-test, and the comparison of AN-FES group and AT-FES group was evaluated by paired-sample t-test.

Results: After the 1-year follow-up, the FES patients showed increased GMV in the right cerebellum, right inferior temporal gyrus, left middle frontal gyrus, parahippocampal gyrus, bilateral inferior parietal lobule, and reduced GMV in the left occipital lobe, gyrus rectus, right orbital frontal cortex. The patients also showed increased ALFF in the medial superior frontal gyrus and right precentral gyrus. For network properties, the patients showed reduced characteristic path length and increased global efficiency. The GMV of the right inferior parietal lobule was negatively correlated with the clinical symptoms.

Conclusions: Our study showed that the antipsychotic treatment contributed to the structural alteration and functional improvement, and the GMV alteration may be associated with the improvement of clinical symptoms.
A Multimodal Fusion Analysis of Pretreatment Anatomical and Functional Cortical Abnormalities in Responsive and Non-responsive Schizophrenia
Authors: Yao Chenyang , Hu Na , Cao Hengyi , Tang Biqiu , Zhang Wenjing , Xiao Yuan , Zhao Youjin , Gong Qiyong , Lui Su
Published: December 2021

Background: Antipsychotic medications provide limited long-term benefit to ~30% of schizophrenia patients. Multimodal magnetic resonance imaging (MRI) data have been used to investigate brain features between responders and nonresponders to antipsychotic treatment; however, these analytical techniques are unable to weigh the interrelationships between modalities. Here, we used multiset canonical correlation and joint independent component analysis (mCCA + jICA) to fuse MRI data to examine the shared and specific multimodal features between the patients and healthy controls (HCs) and between the responders and non-responders.

Method: Resting-state functional and structural MRI data were collected from 55 patients with drug-naïve first-episode schizophrenia (FES) and demographically matched HCs. Based on the decrease in Positive and Negative Syndrome Scale scores from baseline to the 1-year follow-up, FES patients were divided into a responder group (RG) and a non-responder group (NRG). Gray matter volume (GMV), fractional amplitude of low-frequency fluctuation (fALFF), and regional homogeneity (ReHo) maps were used as features in mCCA + jICA.

Results: Between FES patients and HCs, there were three modality-specific discriminative independent components (ICs) showing the difference in mixing coefficients (GMV-IC7, GMV-IC8, and fALFF-IC5). The fusion analysis indicated one modality-shared IC (GMV-IC2 and ReHo-IC2) and three modality-specific ICs (GMV-IC1, GMV-IC3, and GMV-IC6) between the RG and NRG. The right postcentral gyrus showed a significant difference in GMV features between FES patients and HCs and modality-shared features (GMV and ReHo) between responders and nonresponders. The modality-shared component findings were highlighted by GMV, mainly in the bilateral temporal gyrus and the right cerebellum associated with ReHo in the right postcentral gyrus.

Conclusions: This study suggests that joint anatomical and functional features of the cortices may reflect an early pathophysiological mechanism that is related to a 1-year treatment response.
Factors Associated With Non-suicidal Self-Injury in Chinese Adolescents: A Meta-Analysis
Authors: Fan Yang-yang , Liu Jing , Zeng Yan-yan , Conrad Rachel , Tang Yi-lang
Published: December 2021

Non-suicidal self-injury (NSSI) in adolescents is an increasing public health problem in China. We conducted a meta-analysis of studies on NSSI in Chinese adolescents (between 10 and 19 years) to examine factors associated with NSSI. Twenty-five papers including 30 separate studies with 186,447 participants were included for analysis. The results from a random-effects model showed a weak, but significant overall prediction of NSSI (OR = 1.734). There were significant associations between the following seven factors and NSSI (ranking by the effect sizes, in descending order): adverse life events (OR = 2.284), negative coping style (OR = 2.040), problematic internet use (OR = 2.023), sleep disturbance (OR = 1.734), traumatic experiences (OR = 1.728), problematic parent-child relationship (OR = 1.585), mental health problems (OR = 1.578). Additionally, NSSI sample type moderated these effects. These findings highlight factors significantly associated with NSSI in Chinese adolescents. Parent-child relationship and mental health of the only children and left-behind children in China deserve more attention.

Systematic Review Registration:https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42019123508.
Consultation-Liaison Psychiatry Services in Ireland: A National Cross-Sectional Study
Authors: Doherty Anne M. , Plunkett Rosie , McEvoy Katherine , Kelleher Eric , Clancy Maurice , Barrett Elizabeth , Greene Elaine , Cassidy Eugene , Lee William , MacHale Siobhan
Published: December 2021

Objective: This study aimed to describe the provision of consultation-liaison psychiatry (CLP, also known as liaison psychiatry) services in acute hospitals in Ireland, and to measure it against recommended resourcing levels.

Methods: This is a survey of all acute hospitals in Ireland with Emergency Departments, via an electronic survey sent by email and followed up by telephone calls for missing data. Data were collected on service configuration, activity, and resourcing. Data were collected from CLP or proxy services at all acute hospitals with an Emergency Department in Ireland (n = 29). This study measured staffing and activity levels where available.

Results: None of the services met the minimum criteria set out by either national or international guidance per 500 bed general hospital.

Conclusions: CLP is a relatively new specialty in Ireland, but there are clear international guidelines about the staffing levels required to run these services safely and effectively. In Ireland, despite clear national guidance on staffing levels, no services are staffed to the levels suggested as the minimum. It is likely that patients in Ireland's acute hospitals have worse outcomes, and hospitals have unnecessary costs, due to this lack. This is the first study of CLP provision in Ireland and demonstrates the resource constraints under which most services work and the heterogeneity of services nationally.
Investigating the Outcomes of an Asthma Educational Program and Useful Influence in Public Policy
Authors: Ghaleb Dailah Hamad
Published: December 2021

The study was conducted to evaluate the effectiveness of an asthma educational program for asthma control, asthma self-management, asthma knowledge, and patient activation. The study analyzes different demographic variables with the purpose of investigating which asthma patients performed better than others. Based on these demographic characteristics, the study provides several recommendations for various stakeholders. The study is based on a positivist approach since its purpose is to investigate the consequences of an asthma educational program with a view to generalizing the results to a larger population. The study targets public and private hospitals which have applied the asthma educational program in collaboration with the Saudi Initiative for Asthma (SINA). Multiple questionnaires were deployed 263 valid responses were received from patients of public and private hospitals using online and offline data collection method. Several parametric and non-parametric tests were carried out in terms of data analysis. The results reveal that patients in the intervention group obtained high scores and were therefore more knowledgeable and able to control their asthma compared to the control group. Overall, patients in the intervention group performed better in terms of asthma control, asthma self-management and knowledge and awareness. There was a high level of patient activation in this group. In the context of demographic features, it was found that patients who are married and are undergraduate degree holders in employment scored high compared to patients who were young, single, post-graduate degree holders that were mainly self-employed. The results of this study can guide policy makers, SINA authorities, and hospitals as to which demographic category of asthma patients require immediate attention. The significance of asthma educational programmes has increased especially through social media platforms as the number of adult patients continues to increase day by day.
A Game Model for Medical Service Pricing Based on the Diagnosis Related Groups
Authors: Duan Jinli , Lin Zhibin , Jiao Feng
Published: December 2021

Background: Currently there are various issues that exist in the medical institutions in China as a result of the price-setting in DRGs, which include the fact that medical institutions tend to choose patients and that the payment standard for complex cases cannot reasonably compensate the cost.

Objective: The main objective is to prevent adverse selection problems in the operations of a diagnosis-related groups (DRGs) system with the game pricing model for scientific and reasonable pricing.

Methods: The study proposes an improved bargaining game model over three stages, with the government and patients forming an alliance. The first stage assumes the alliance is the price maker in the Stackelberg game to maximize social welfare. Medical institutions are a price taker and decide the level of quality of medical service to maximize their revenue. A Stackelberg equilibrium solution is obtained. The second stage assumes medical institutions dominate the Stackelberg game and set an optimal service quality for maximizing their revenues. The alliance as the price taker decides the price to maximize the social welfare. Another Stackelberg equilibrium solution is achieved. The final stage establishes a Rubinstein bargaining game model to combine the Stackelberg equilibrium solutions in the first and second stage. A new equilibrium between the alliance and medical institutions is established.

Results: The results show that if the price elasticity of demand increases, the ratio of cost compensation on medical institutions will increase, and the equilibrium price will increase. The equilibrium price is associated with the coefficient of patients' quality preference. The absolute risk aversion coefficient of patients affects government compensation and total social welfare.

Conclusion: In a DRGs system, considering the demand elasticity and the quality preference of patients, medical service pricing can prevent an adverse selection problem. In the future, we plan to generalize these models to DRGs pricing systems with the effects of competition of medical institutions. In addition, we suggest considering the differential compensation for general hospitals and community hospitals in a DRGs system, in order to promote the goal of hierarchical diagnosis and treatment.
Heterogeneity in the Effectiveness of Non-pharmaceutical Interventions During the First SARS-CoV2 Wave in the United States
Authors: Pan William K. , Fernández Daniel , Tyrovolas Stefanos , Iago Giné-Vázquez , Dasgupta Rishav Raj , Zaitchik Benjamin F. , Lantos Paul M. , Woods Christopher W.
Published: December 2021

Background: Attempts to quantify effect sizes of non-pharmaceutical interventions (NPI) to control COVID-19 in the US have not accounted for heterogeneity in social or environmental factors that may influence NPI effectiveness. This study quantifies national and sub-national effect sizes of NPIs during the early months of the pandemic in the US.

Methods: Daily county-level COVID-19 cases and deaths during the first wave (January 2020 through phased removal of interventions) were obtained. County-level cases, doubling times, and death rates were compared to four increasingly restrictive NPI levels. Socio-demographic, climate and mobility factors were analyzed to explain and evaluate NPI heterogeneity, with mobility used to approximate NPI compliance. Analyses were conducted separately for the US and for each Census regions (Pacific, Mountain, east/West North Central, East/West South Central, South Atlantic, Middle Atlantic and New England). A stepped-wedge cluster-randomized trial analysis was used, leveraging the phased implementation of policies.

Results: Aggressive (level 4) NPIs were associated with slower COVID-19 propagation, particularly in high compliance counties. Longer duration of level 4 NPIs was associated with lower case rates (log beta −0.028, 95% CI −0.04 to −0.02) and longer doubling times (log beta 0.02, 95% CI 0.01–0.03). Effects varied by Census region, for example, level 4 effects on doubling time in Pacific states were opposite to those in Middle Atlantic and New England states. NPI heterogeneity can be explained by differential timing of policy initiation and by variable socio-demographic county characteristics that predict compliance, particularly poverty and racial/ethnic population. Climate exhibits relatively consistent relationships across Census regions, for example, higher minimum temperature and specific humidity were associated with lower doubling times and higher death rates for this period of analysis in South Central, South Atlantic, Middle Atlantic, and New England states.

Conclusion and Relevance: Heterogeneity exists in both the effectiveness of NPIs across US Census regions and policy compliance. This county-level variability indicates that control strategies are best designed at community-levels where policies can be tuned based on knowledge of local disparities and compliance with public health ordinances.
The First Attempt to Reevaluate Radon and Thoron Exposure in Gansu Province Study Using Radon-Thoron Discriminating Measurement Technique
Authors: Kudo Hiromi , Yoshinaga Shinji , Li Xiaoliang , Lei Shujie , Zhang Shouzhi , Sun Quanfu , Koriyama Chihaya , Akiba Suminori , Tokonami Shinji
Published: December 2021

Although the epidemiological studies provide evidence for an increased risk of lung cancer risk associated with residential radon, an issue of radon-thoron discrimination remains to be solved. In this study, an updated evaluation of lung cancer risk among the residents in Gansu, China was performed where one of the major epidemiological studies on indoor radon demonstrated an increased risk of lung cancer. We analyzed data from a hospital-based case-control study that included 30 lung cancer cases and 39 controls with special attention to internal exposure assessment based on the discriminative measurement technique of radon isotopes. Results from the analyses showed non-significant increased lung cancer risks; odds ratios (ORs) adjusted for age, smoking, and total income were 0.35 (95% CI: 0.07–1.74) and 0.27 (95% CI: 0.04–1.74) for groups living in residences with indoor radon concentrations of 50–100 Bq m−3 and over 100 Bq m−3, respectively, compared with those with < 50 Bq m−3 indoor radon concentrations. Although the small sample size hampers the usefulness of present analyses, our study suggests that reevaluation of lung cancer risk associated with residential radon in the epidemiological studies will be required on the basis of precise exposure assessment.
Evaluating Rumor Debunking Effectiveness During the COVID-19 Pandemic Crisis: Utilizing User Stance in Comments on Sina Weibo
Authors: Wang Xin , Chao Fan , Yu Guang
Published: December 2021

Background: The spread of rumors related to COVID-19 on social media has posed substantial challenges to public health governance, and thus exposing rumors and curbing their spread quickly and effectively has become an urgent task. This study aimed to assist in formulating effective strategies to debunk rumors and curb their spread on social media.

Methods: A total of 2,053 original postings and 100,348 comments that replied to the postings of five false rumors related to COVID-19 (dated from January 20, 2020, to June 28, 2020) belonging to three categories, authoritative, social, and political, on Sina Weibo in China were randomly selected. To study the effectiveness of different debunking methods, a new annotation scheme was proposed that divides debunking methods into six categories: denial, further fact-checking, refutation, person response, organization response, and combination methods. Text classifiers using deep learning methods were built to automatically identify four user stances in comments that replied to debunking postings: supporting, denying, querying, and commenting stances. Then, based on stance responses, a debunking effectiveness index (DEI) was developed to measure the effectiveness of different debunking methods.

Results: The refutation method with cited evidence has the best debunking effect, whether used alone or in combination with other debunking methods. For the social category of Car rumor and political category of Russia rumor, using the refutation method alone can achieve the optimal debunking effect. For authoritative rumors, a combination method has the optimal debunking effect, but the most effective combination method requires avoiding the use of a combination of a debunking method where the person or organization defamed by the authoritative rumor responds personally and the refutation method.

Conclusion: The findings provide relevant insights into ways to debunk rumors effectively, support crisis management of false information, and take necessary actions in response to rumors amid public health emergencies.
The Disease Severity and Clinical Outcomes of the SARS-CoV-2 Variants of Concern
Authors: Lin Lixin , Liu Ying , Tang Xiujuan , He Daihai
Published: December 2021

With the continuation of the pandemic, many severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants have appeared around the world. Owing to a possible risk of increasing the transmissibility of the virus, severity of the infected individuals, and the ability to escape the antibody produced by the vaccines, the four SARS-CoV-2 variants of Alpha (B.1.1.7), Beta (B.1.351), Gamma (P.1), and Delta (B.1.617.2) have attracted the most widespread attention. At present, there is a unified conclusion that these four variants have increased the transmissibility of SARS-CoV-2, but the severity of the disease caused by them has not yet been determined. Studies from June 1, 2020 to October 15, 2021 were considered, and a meta-analysis was carried out to process the data. Alpha, Beta, Gamma, and Delta variants are all more serious than the wild-type virus in terms of hospitalization, ICU admission, and mortality, and the Beta and Delta variants have a higher risk than the Alpha and Gamma variants. Notably, the random effects of Beta variant to the wild-type virus with respect to hospitalization rate, severe illness rate, and mortality rate are 2.16 (95% CI: 1.19–3.14), 2.23 (95% CI: 1.31–3.15), and 1.50 (95% CI: 1.26–1.74), respectively, and the random effects of Delta variant to the wild-type virus are 2.08 (95% CI: 1.77–2.39), 3.35 (95% CI: 2.5–4.2), and 2.33 (95% CI: 1.45–3.21), respectively. Although, the emergence of vaccines may reduce the threat posed by SARS-CoV-2 variants, these are still very important, especially the Beta and Delta variants.
Forecasting Dengue Hotspots Associated With Variation in Meteorological Parameters Using Regression and Time Series Models
Authors: Patil Seema , Pandya Sharnil
Published: December 2021

For forecasting the spread of dengue, monitoring climate change and its effects specific to the disease is necessary. Dengue is one of the most rapidly spreading vector-borne infectious diseases. This paper proposes a forecasting model for predicting dengue incidences considering climatic variability across nine cities of Maharashtra state of India over 10 years. The work involves the collection of five climatic factors such as mean minimum temperature, mean maximum temperature, relative humidity, rainfall, and mean wind speed for 10 years. Monthly incidences of dengue for the same locations are also collected. Different regression models such as random forest regression, decision trees regression, support vector regress, multiple linear regression, elastic net regression, and polynomial regression are used. Time-series forecasting models such as holt's forecasting, autoregressive, Moving average, ARIMA, SARIMA, and Facebook prophet are implemented and compared to forecast the dengue outbreak accurately. The research shows that humidity and mean maximum temperature are the major climate factors and exhibit strong positive and negative correlation, respectively, with dengue incidences for all locations of Maharashtra state. Mean minimum temperature and rainfall are moderately positively correlated with dengue incidences. Mean wind speed is a less significant factor and is weakly negatively correlated with dengue incidences. Root mean square error (RMSE), mean absolute error (MAE), and R square error (R2) evaluation metrics are used to compare the performance of the prediction model. Random Forest Regression is the best-fit regression model for five out of nine cities, while Support Vector Regression is for two cities. Facebook Prophet Model is the best fit time series forecasting model for six out of nine cities. Based on the prediction, Mumbai, Thane, Nashik, and Pune are the high-risk regions, especially in August, September, and October. The findings exhibit an effective early warning system that would predict the outbreak of other infectious diseases. It will help the relevant authorities to take accurate preventive measures.
Relationship Between Cognition and Gait at 2- and 12-Months Post-Traumatic Brain Injury
Authors: Vuong Veronica , Patterson Kara K. , Cole Lauren Patricia , Henechowicz Tara Lynn , Sheridan Conor , Green Robin E. A. , Thaut Michael H.
Published: December 2021

Background: A common and debilitating challenge experienced by people with TBI is gait-associated mobility impairment and persisting cognitive impairments. Cognitive and physical impairments are often addressed independently during rehabilitation, however, increasing evidence links cognitive and motor processes more closely.

Objectives: (1) To determine if correlations exist between measures of cognitive and gait recovery, post-TBI. (2) To investigate the predictive power of cognition at 2-months on gait outcomes at 12-months post-TBI.

Methods: In this secondary, longitudinal study of cognitive and neural recovery, data from 93 participants admitted to an inpatient neurorehabilitation program were analyzed. Spatiotemporal gait variables [velocity, step time variability (STV), step length variability (SLV)] were collected along with cognitive variables [Trail Making Test-B (TMT-B), Digit Span-Forward (DS-F)]. Spearman's correlation coefficients were calculated between gait and cognitive variables. Multilinear and step wise regression analyses were calculated to determine predictive value of cognitive variables at 2-months on gait performance at 12-months-post TBI.

Results: At 2-months post-injury, TMT-B was significantly correlated with gait velocity and STV; and DS-F was significantly correlated with velocity. At 12-months post-injury, TMT-B and DS-F was still significant correlated with velocity. TMT-B at 2-months was correlated with SLV and STV at 12-months; and DS-F correlated significantly with velocity. Regression models showed TMT-B at 2-months predicting STV, SLV, and velocity at 12-months.

Conclusions: Significant associations and predictions between physical and cognitive recovery post-TBI were observed in this study. Future directions may consider a “neural internetwork” model as a salient rehabilitation approach in TBI that integrates physical and cognitive functions.
Application of Causal Inference to the Analysis of Occupant Thermal State and Energy Behavioral Intentions in Immersive Virtual Environments
Authors: Rentala Girish , Zhu Yimin , Mukhopadhyay Supratik
Published: December 2021

Identification and quantitative understanding of factors that influence occupant energy behavior and thermal state during the design phase are critical in supporting effective energy-efficient design. To achieve this, immersive virtual environments (IVEs) have recently shown potential as a tool to simulate occupant energy behaviors and collect context-dependent behavior data for buildings under design. On the other hand, prior models of occupant energy behaviors and thermal states used correlation-based approaches, which failed to capture the underlying causal interactions between the influencing factors and hence were unable to uncover the true causing factors. Therefore, in this study, the authors investigate the applicability of causal inference for identifying the causing factors of occupant/participant energy behavioral intentions and their thermal states in IVE condition and compare those results with the baseline in-situ condition. The energy behavioral intentions here are a proximal antecedent of actual energy behaviors. A set of experiments involving 72 human subjects were performed through the use of a head-mounted device (HMD) in a climate chamber. The subjects were exposed to three different step temperatures (cool, neutral, warm) under an IVE and a baseline in-situ condition. Participants' individual factors, behavioral factors, skin temperatures, virtual experience factors, thermal states (sensation, acceptability, comfort), and energy behavioral intentions were collected during the experiments. Structural causal models were learnt from data using the elicitation method in conjunction with the PC-Stable algorithm. The findings show that the causal inference framework is a potentially effective method for identifying causing factors of thermal states and energy behavioral intentions as well as quantifying their causal effects. In addition, the study shows that in IVE experiments, the participants' virtual experience factors such as their immersion, presence, and cybersickness were not the causing factors of thermal states and energy behavioral intentions. Furthermore, the study suggests that participants' behavioral factors such as their attitudes toward energy conservation and perceived behavioral control to conserve energy were the causing factors of their energy behavioral intentions. Also, the indoor temperature was a causing factor of general thermal sensation and overall skin temperature. The paper also discusses other findings, including discrepancies, limitations of the study, and recommendations for future studies.
Future Anxiety Among Young People Affected by War and Armed Conflict: Indicators for Social Work Practice
Authors: Alotaibi Nouf M.
Published: December 2021

Strengthening the evidence base for professional social work intervention that contributes to providing psychosocial support to international students affected by war and conflict is a major priority as this vulnerable group of youth increases. Therefore, this study aimed to determine the level of future anxiety among international students coming from areas experiencing war and conflict. This study used the descriptive correlative approach, where the future anxiety scale was applied to a sample of 287 international students affected by war and conflicts. Findings showed that there are statistically significant differences between males and females (in favor of females) in the level of the social dimension of future anxiety. The current study results showed a statistically significant relationship between future anxiety and some variables related to war and conflict (living in a war environment - direct and indirect exposure to damage). There are statistically significant differences between those who lived in Yemen at the time of wars and those who did not live (in favor of those who lived in Yemen at the time of wars) in the level of future anxiety. There are also statistically significant differences between those exposed to harm or their family because of the war and those who were not exposed (in favor of those who were exposed) in the level of future anxiety as a whole. The study recommends developing psychosocial support services for this vulnerable group, considering the cultural context to promote women and protect them from discrimination in the services they deserve on an equal basis with men.
A Direct Assessment of the External Domain of Food Environments in the National Capital Region of India
Authors: Chaudhry Monica , Jaacks Lindsay M. , Bansal Monu , Mahajan Palak , Singh Ayushi , Khandelwal Shweta
Published: December 2021

Data on food environments in India and other low- and middle-income countries are scarce. The objective of this study was to assess the four dimensions of the external domain of food environments (availability, price, vendor and product properties, and marketing) in food establishments in the National Capital Region of India. The assessment focused on fruits, vegetables, and ultra-processed foods. The 60 food establishments surveyed were categorized as stores, restaurants, or mobile food vendors. Only 13.3% of food establishments sold fruits and vegetables. Stores were more likely to sell vegetables than mobile food vendors (14.8 vs. 6.2%, respectively) and sold a greater variety of both fruits and vegetables as compared to mobile food vendors [mean (SD) of 8.6 (3.2) fruits and 18.6 (9.2) vegetables available at stores vs. 5.5 (5.7) fruits and 25 vegetables available at the one mobile food vendor who sold vegetables]. However, these healthy food items were more expensive at stores. The availability (100% of stores, 12.5% of mobile food vendors, and 12.5% of restaurants) and variety (156 types) of ultra-processed foods across food establishments were higher than fruits and vegetables. A greater percentage of food establishments displayed advertisements for ultra-processed foods as compared to unprocessed or minimally processed foods such as fruits and vegetables. The National Capital Region of India has an unhealthy food environment. Regulations that limit the availability of ultra-processed foods and improve the availability and affordability of fruits and vegetables are needed to reverse the rising tide of chronic non-communicable diseases in this setting.
Clinical and Patient-Related Outcome After Stabilization of Dorsal Pelvic Ring Fractures: A Retrospective Study Comparing Transiliac Fixator (TIFI) and Spinopelvic Fixation (SPF)
Authors: Seemann Ricarda Johanna , Hempel Erik , Rußow Gabriele , Tsitsilonis Serafeim , Stöckle Ulrich , Märdian Sven
Published: December 2021

Purpose:Aim of this retrospective cohort study was the comparison of the transiliac fixator (TIFI) and spinopelvic fixation (SPF) for fixation of dorsal pelvic ring fractures in terms of clinical outcome, complications, and quality of life.

Methods:Thirty-eight patients (23 men, 15 women; mean age 47 ± 19 years) with dorsal pelvic ring fractures (type-C-injuries after AO/OTA) that have been stabilized by either TIFI (group TIFI,n= 22) or SPF (group SPF,n= 16) between May 2015 and December 2018 were retrospectively reviewed. Outcome measurements included demographic data, perioperative parameters, and complications and were obtained from the medical information system. Quality of life was assessed using the German version of the short form 36 (SF-36) and short muskuloskeletal function assessment (SMFA-D). Clinical results were assessed using Merle d'Aubigné-Score, Iowa Pelvic Score, and Majeed Pelvic Score.

Results:Both groups show relatively good post-operative results, which has previously been reported. Quality of life was comparable in both groups. Group TIFI was slightly superior regarding complication rates, cutting/suture time, and fluoroscopy time. Group SPF seemed to be superior regarding pain and pelvic scores.

Conclusion:None of the methods could demonstrate significant superiority over the other. Management of pelvic injuries remains a highly individual challenge adapted to the individual patients' condition. Nevertheless, if fractures allow for stabilization with TIFI, the use of this method should be taken into consideration as a less invasive and more tissue-conserving approach.
Parallel Loop Binding Compression Suture, a Modified Procedure for Pernicious Placenta Previa Complicated With Placenta Increta
Authors: Fu Mengdi , Bu Hualei , Fang Yan , Wang Chunling , Zhang Li , Zhang Yang , Sun Xiao , Li Mingbao , Jin Chengjuan , Xu Yintao , Chen Lijun
Published: December 2021

Objective: To evaluate the efficacy and safety of parallel loop binding compression suture of the lower uterus during cesarean section in pernicious placenta previa complicated with placenta increta.

Methods: This retrospective study was performed in patients with pernicious placenta previa complicated with placenta increta or percreta between November 2014 and December 2020 at the Qilu Hospital of Shandong University. Patients underwent parallel loop binding compression suture surgery were defined as study group, and patients underwent traditional surgery with figure-of-eight sutures as the main hemostatic method were defined as control group. Postpartum hemorrhage was evaluated as the primary outcome. The secondary outcomes included age, gestational weeks, operative time, fetal childbirth time, prevention of hysterectomy, blood transfusion, duration of postoperative catheterization, duration of antibiotic treatment, and postoperative hospitalization (days). Additionally, neonatal outcomes were evaluated.

Results: A total of 124 patients were enrolled in the study, including 38 patients receiving parallel loop binding compression suture surgery in the study group, and 86 patients in the control group. With parallel loop binding compression suture, the average operation time was significantly reduced (109.0 ± 33.5 vs. 134.4 ± 54.2 min, p = 0.00), and the volume of blood lost were also decreased (2152.6 ± 1169.4 vs. 2960.5 ± 1963.6 ml, p = 0.02), which correspondingly reduced RBC transfusion (7.2 ± 3.5 vs. 10.3 ± 8.7 units, p = 0.03) and FFP transfusion (552.6 ± 350.3 vs. 968.0 ± 799.8 ml, p = 0.00). The fetal childbirth time was extended (14.1 ± 5.6 vs. 11.0 ± 8.0 min, p = 0.03), however, there was no increase in NICU admission rates (36.9 vs. 34.9%, p = 0.83). Except for one premature infant (32 weeks) death in the control group, all infants at our hospital were safely discharged after treatment.

Conclusion: Parallel loop binding compression suture is an effective, swift, practical, and safe method to reduce postpartum bleeding in women with pernicious placenta previa, complicated with placenta increta. Besides, it has no adverse effects on newborns.
Robotic Pelvic Exenteration for Gynecologic Malignancies, Anatomic Landmarks, and Surgical Steps: A Systematic Review
Authors: Cianci Stefano , Arcieri Martina , Vizzielli Giuseppe , Martinelli Canio , Granese Roberta , La Verde Marco , Fagotti Anna , Fanfani Francesco , Scambia Giovanni , Ercoli Alfredo
Published: December 2021

Pelvic exenteration represents the last resort procedure for patients with advanced primary or recurrent gynecological malignancy. Pelvic exenteration can be divided into different subgroup based on anatomical extension of the procedures. The growing application of the minimally invasive surgical approach unlocked new perspectives for gynecologic oncology surgery. Minimally invasive surgery may offer significant advantages in terms of perioperative outcomes. Since 2009, several Robotic Assisted Laparoscopic Pelvic Exenteration experiences have been described in literature. The advent of robotic surgery resulted in a new spur to the worldwide spread of minimally invasive pelvic exenteration. We present a review of the literature on robotic-assisted pelvic exenteration. The search was conducted using electronic databases from inception of each database through June 2021. 13 articles including 53 patients were included in this review. Anterior exenteration was pursued in 42 patients (79.2%), 2 patients underwent posterior exenteration (3.8%), while 9 patients (17%) were subjected to total exenteration. The most common urinary reconstruction was non-continent urinary diversion (90.2%). Among the 11 women who underwent to total or posterior exenteration, 8 (72.7%) received a terminal colostomy. Conversion to laparotomy was required in two cases due to intraoperative vascular injury. Complications' report was available for 51 patients. Fifteen Dindo Grade 2 complications occurred in 11 patients (21.6%), and 14 grade 3 complications were registered in 13 patients (25.5%). Only grade 4 complications were reported (2%). In 88% of women, the resection margins were negative. Pelvic exenteration represents a salvage procedure in patients with recurrent or persistent gynecological cancers often after radiotherapy. A careful patient selection remains the milestone of such a mutilating surgery. The introduction of the minimally invasive approach has led to advantages in terms of perioperative outcomes compared to classic open surgery. This review shows the feasibility of robotic pelvic exenteration. An important step forward should be to investigate the potential equivalence between robotic approaches and the laparotomic one, in terms of long-term oncological outcomes.
Using Live Imaging and FUCCI Embryonic Stem Cells to Rank DevTox Risks: Adverse Growth Effects of PFOA Compared With DEP Are 26 Times Faster, 1,000 Times More Sensitive, and 13 Times Greater in Magnitude
Authors: Abdulhasan Mohammed , Ruden Ximena , You Yuan , Harris Sean M. , Ruden Douglas M. , Awonuga Awoniyi O. , Alvero Ayesha , Puscheck Elizabeth E. , Rappolee Daniel A.
Published: December 2021

Fluorescent ubiquitination-based cell cycle indicator (FUCCI) embryonic stem cells (ESCs), which fluoresce green during the S-G2-M phases, generate an S-shaped curve for the accumulation of cells during normal stemness (NS) culture with leukemia-inhibitory factor (LIF). Since it was hypothesized that a culture of ESCs was heterogeneous in the cell cycle, it was expected that increased S-G2-M-phases of the cell cycle would make an S-shaped curve parallel to the accumulation curve. Unexpectedly, it was observed that the fraction of FUCCI ESCs in green decreases over time to a nadir at ∼24 h after previous feeding and then rapidly enters S-G2-M-phases after medium change. G1 delay by infrequent medium change is a mild stress, as it does not affect growth significantly when frequency is increased to 12 h. Perfluoro-octanoic acid (PFOA) and diethyl phthalate (DEP) were used as examples of members of the per- and polyfluoroalkyl substances (PFAS) and phthalate families of chemicals, respectively. Two adverse outcomes were used to compare dose- and time-dependent effects of PFOA and DEP. The first was cell accumulation assay by time-lapse confluence measurements, largely at Tfinal/T74 h. The second was by quantifying dominant toxicant stress shown by the suppression of mild stress that creates a green fed/unfed peak. In terms of speed, PFOA is 26 times faster than DEP for producing a time-dependent LOAEL dose at 100 uM (that is, 2 h for PFOA and 52 h for DEP). PFOA has 1000-fold more sensitive LOAEL doses than DEP for suppressing ESC accumulation (confluence) at day 3 and day 2. There were two means to compare the magnitude of the growth suppression of PFOA and DEP. For the suppression of the accumulation of cells measured by confluence at Tfinal/T74h, there was a 13-fold suppression at the highest dose of PFOA > the highest dose of DEP. For the suppression of entry into the cell cycle after the G1 phase by stress on day 1 and 2, there is 10-fold more suppression by PFOA than DEP. The data presented here suggest that FUCCI ESCs can assay the suppression of accumulated growth or predict the suppression of future growth by the suppression of fed/unfed green fluorescence peaks and that PFOA’s adverse effects are faster and larger and can occur at more sensitive lower doses than DEP.
Social Behavior, Community Composition, Pathogen Strain, and Host Symbionts Influence Fungal Disease Dynamics in Salamanders
Authors: Cowgill Mae , Zink Andrew G. , Sparagon Wesley , Yap Tiffany A. , Sulaeman Hasan , Koo Michelle S. , Vredenburg Vance T.
Published: December 2021

The emerging fungal pathogen, Batrachochytrium dendrobatidis (Bd), which can cause a fatal disease called chytridiomycosis, is implicated in the collapse of hundreds of host amphibian species. We describe chytridiomycosis dynamics in two co-occurring terrestrial salamander species, the Santa Lucia Mountains slender salamander, Batrachoseps luciae, and the arboreal salamander, Aneides lugubris. We (1) conduct a retrospective Bd-infection survey of specimens collected over the last century, (2) estimate present-day Bd infections in wild populations, (3) use generalized linear models (GLM) to identify biotic and abiotic correlates of infection risk, (4) investigate susceptibility of hosts exposed to Bd in laboratory trials, and (5) examine the ability of host skin bacteria to inhibit Bd in culture. Our historical survey of 2,866 specimens revealed that for most of the early 20th century (~1920–1969), Bd was not detected in either species. By the 1990s the proportion of infected specimens was 29 and 17% (B. luciae and A. lugubris, respectively), and in the 2010s it was 10 and 17%. This was similar to the number of infected samples from contemporary populations (2014–2015) at 10 and 18%. We found that both hosts experience signs of chytridiomycosis and suffered high Bd-caused mortality (88 and 71% for B. luciae and A. lugubris, respectively). Our GLM revealed that Bd-infection probability was positively correlated with intraspecific group size and proximity to heterospecifics but not to abiotic factors such as precipitation, minimum temperature, maximum temperature, mean temperature, and elevation, or to the size of the hosts. Finally, we found that both host species contain symbiotic skin-bacteria that inhibit growth of Bd in laboratory trials. Our results provide new evidence consistent with other studies showing a relatively recent Bd invasion of amphibian host populations in western North America and suggest that the spread of the pathogen may be enabled both through conspecific and heterospecific host interactions. Our results suggest that wildlife disease studies should assess host-pathogen dynamics that consider the interactions and effects of multiple hosts, as well as the historical context of pathogen invasion, establishment, and epizootic to enzootic transitions to better understand and predict disease dynamics.
Preparation and Characterization of a New Monoclonal Antibody Specific Against Lawsonia intracellularis and Its Application in Indirect Immunofluorescence and Immunocytochemistry Assay
Authors: Xiao Ning , Li Jiannan , Li Minxue , Hu Yuting , Lin Huixing , Fan Hongjie
Published: December 2021

Proliferative enteropathy (PE) is an infectious enteric disease caused by Lawsonia intracellularis (L. intracellularis) and is endemic in pig herds worldwide. However, a L. intracellularis-specific monoclonal antibody plays an important role in the evaluation of L. intracellularis infection in vitro. Therefore, the objective of this study was to produce and identify the characteristics of a new monoclonal antibody against the outer membrane protein (Omp2) of L. intracellularis and apply it in an indirect immunofluorescence assay (IFA) and immunocytochemistry (IHC). The results indicated that three highly specific monoclonal antibodies against the Omp2 protein (4D9, 3G2, and 7G5) of L. intracellularis were obtained by using purified Omp2 as an immunogen, the titers of ascitic fluids of 4D9, 3G2, and 7G5 cells were 1:2,048,000, 1:512,000, and 1:256,000, respectively. IFA analysis showed that the 4D9, 3G2, and 7G5 have no cross-reactivity with other enteric bacteria commonly found in the ilea of pigs or closely related to L. intracellularis, such as Desulfovibrio, Bilophila wadsworthia (B. wadsworthia), Salmonella choleraesuis (S. choleraesuis), Salmonella typhimurium (S. typhimurium), Escherichia coli (E. coli), and Brachyspira hyodysenteriae (B. hyodysenteriae). IFA and IHC results indicated that the monoclonal antibodies can be successfully used as primary antibodies to detect L. intracellularis in infected cells and in the crypt of the ileum from infected tissues of PE. Our findings suggested that the new monoclonal antibody specific against L. intracellularis will be useful for the evaluation of L. intracellularis infection in vivo and in vitro.