bluuebunny/crossref_metadata_2025 huggingface dataset:
Creating Spaces for Reconciliation and Healing
Authors: Borum Caty , Conrad-Pérez David
Published: February 2025

Chapter 7, “Creating Spaces for Reconciliation and Healing,” explores the role of documentaries in providing a space for community healing and interrogation, and for the recognition of underrepresented histories and communities in the governments, institutions, societies, and media systems that have historically exploited, traumatized, overlooked, and taken advantage of them. While these films might aim for reform related to specific outcome goals (like addressing institutional racism and mistreatment), many of their makers are primarily motivated to create safe spaces and to correct—not simply challenge—historical and dominant narratives for impacted communities. They are, in this way, educating external audiences as a secondary goal, choosing instead to center the lived experiences of oppressed communities and provide a space for healing and recognition and legitimacy to an underrepresented community or issue. Films profiled in this chapter include: Always in Season (United States), The Murder of Emmett Till (United States), In My Blood It Runs (Australia), Pray Away (United States), and Quipu Project (Peru).
Meandering between rational choice, realism, constructivism, and institutionalism
Authors: Steinbach Armin
Published: February 2025

This chapter establishes the methodological groundwork for the economic analysis of EU law undertaken in subsequent chapters. It briefly discusses the schools of thought native to economics and international relations that will inform the discussion, including game and rational choice theory as well as realism, constructivism, and institutionalism. It explains how these perspectives represent a valuable complement to doctrinal legal analysis, and presents the interrogatives why, how, who, and what as key parameters that will structure the subsequent discussion.
Leveraging economies of scale
Authors: Steinbach Armin
Published: February 2025

Economies of scales offer a normative benchmark to assess the benefits of allocating policy responsibilities at the centralized level. These benefits must be held against the costs of harmonization that accrue mainly where one-size-fits-all regulation is adopted despite heterogeneity of preferences across the regions. In the EU, economies of scale are the paradigmatic economic tool offered to assess the subsidiarity principle. Economies of scope can support or weaken the case of economies of scale. Scale and scope economies can productively shed light on EU internal market organization and its institutional architecture.
Gesture across cultures and languages
Authors: Gawne Lauren
Published: February 2025

This chapter explores some of the ways that gestures show variation in use between groups. There are three main themes to gesture variation in this chapter. The first is cultural influence. This includes examination of how people use the gestural space available to them, how gesture use is influenced by culture-specific understanding of politeness, and the spread of culture-specific emblem gestures. The second theme is cognitive influence on gestures. In this section we look at the literature on the way different groups conceptualize spatial relationships, and how this affects gesture use. We also look at how spatial metaphors for time influence gesture use. The third and final topic is the influence of language structure on gestural production. In this section we will look at the way the semantics and syntax of verb structures in different languages influence the shape of iconic gestures.
Postoperative mid-to-long-term adverse event prediction model for patients receiving non-cardiac surgery: An extension of Simple Postoperative AKI RisK (SPARK) model
Authors: Kwon Soie , Park Sehoon , Yang Sunah , Shin Chaiho , Lee Jeonghwan , Ryu Jiwon , Kim Sejoong , Cho Jeong Min , Yoon Hyung-Jin , Kim Dong Ki , Joo Kwon Wook , Kim Yon Su , Park Minsu , Kim Kwangsoo , Lee Hajeong
Published: February 2025

Background

Postoperative acute kidney injury (PO-AKI) is a critical complication of adverse kidney outcomes, both short and long-term. We aimed to expand our pre-existing PO-AKI prediction model to predict mid-to long-term adverse kidney outcomes.

Method

We included patients who underwent major non-cardiac surgeries from the original SPARK cohort, two external validation cohorts, and a temporal validation cohort. Mid-to-long-term adverse kidney outcomes were defined as ESKD progression or death within one or three years after surgery. We verified and tuned the original SPARK model to predict mid-to-long-term adverse kidney events.

Result

We included 33 636 patients in development, 71 232 patients in external validation, and 33 944 patients in temporal validation cohorts, respectively. One- and three-year adverse kidney events occurred in 5.5% and 13.2% in the development cohort, respectively. The original SPARK score demonstrated an acceptable discriminative power for 1-year and 3-year adverse outcome risks with C indices mostly above 0.7. However, the power was relatively poor when restricted to high-risk patients or those who actually developed PO-AKI. When we re-calculated the regression coefficients from Cox model, the discriminative performances were better, especially for those with high-risk characteristics (e.g. 1-year outcome, C-index 0.72 in developmental and 0.73‒0.77 in the validation datasets). Furthermore, when the model integrated the PO-AKI stage and history of malignancy with the SPARK variables, the performance was significantly enhanced (1-year, C-index 0.86 in development and 0.86‒0.88 in validation results). With the above findings, we constructed an online postoperative risk prediction system (https://snuhnephrology.github.io/postop/).

Discussion

The addition of two clinical factors and recalibration of SPARK variables significantly improved mid-to-long-term postoperative risk prediction for mortality or dialysis after noncardiac surgery. Our calculator helps clinicians easily predict a mid-to-long-term risk and PO-AKI occurrence by entering a few variables.
Direct-to-Consumer Testing: Benefits and Concerns of Commercially Accessed Laboratory Tests
Authors: Orth Matthias , Sandberg Sverre , Shih Patti
Published: February 2025

Background

Promoting self-empowerment of patients and of healthy persons in contemporary health cultures shifts the imperative for initiating laboratory tests from the healthcare professionals (HCP) to the patients themselves.

Content

Laboratory testing requested directly by patients without interaction by HCP is called DTCT (direct-to-consumer testing). DTCT is not conducted within traditional healthcare systems, and the regulations that protect the patients in healthcare are not necessarily present in DTCT. Aggressive marketing of DTCT may mislead the consumer, resulting in psychological, physical, and financial harm. The benefit of laboratory testing is dependent on being used on selected persons, with samples collected and stored appropriately, measured with an adequate technique and the test results interpreted properly. DTCT can empower patients, but consumer knowledge varies and currently, there is a lack of reliable resources for consumers to consult. In the absence of healthcare protection rules for DTCT, the concept of informing consumers concurrently with marketing DTCT by the vendors is not in place.

DTCT might be advantageous over traditional testing settings in a few selected situations but has a substantial risk of medicalization of healthy persons and damaging the trust in the reliability of healthcare laboratory testing.
Prognostic Benefit of GLP-1 RA Addition to SGLT2i in Patients with ASCVD and Heart Failure: A Cohort Study
Authors: Chen Sih-Yao , Wu Jheng-Yan , Liao Kuang-Ming , Lin Yu-Min
Published: February 2025

Aims

Managing patients with atherosclerotic cardiovascular disease (ASCVD) and heart failure (HF) is challenging. While sodium-glucose cotransporter 2 inhibitors (SGLT2i) and glucagon-like peptide-1 receptor agonists (GLP-1 RA) show cardiovascular benefits, the impact of combining these agents is unclear. This study evaluated whether adding GLP-1 RA to SGLT2i provides additional benefits in patients with both ASCVD and HF.

Methods and Results

This retrospective observational study utilized the TriNetX database to analyze patients with ASCVD and HF who initiated GLP-1 RA with SGLT2i or SGLT2i alone from August 1, 2016, to September 30, 2024. A total of 2 797 317 patients were identified, with 96 051 patients meeting inclusion criteria. After propensity score matching (PSM), 5 272 patients in each group were analyzed. Primary outcomes included mortality or hospitalization within one year; secondary outcomes examined mortality, hospitalization, and heart failure exacerbation (HFE). Patients receiving GLP-1RA and SGLT2i therapies had significantly lower risk of mortality or hospitalization (HR 0.78; 95% CI 0.74–0.83), mortality (HR 0.72; 95% CI 0.62–0.84), hospitalization (HR 0.78; 95% CI 0.73–0.83), and HFE (HR 0.77; 95% CI 0.72–0.83) versus SGLT2i alone. Subgroup analyses showed consistent benefits in patients with HFpEF, HFrEF, patients with diabetes, obesity, chronic kidney disease, or those using semaglutide or dulaglutide, while liraglutide use showed a neutral effect. Drug-related side effects were monitored as safety outcomes, which showed no significant differences between groups.

Conclusions

In ASCVD and HF patients, adding GLP-1 RA to SGLT2i reduces one-year mortality and hospitalization, warranting further investigation in diverse settings.
Daily Stressor Appraisals and Subjective Age Predict Daily Affective Ratings
Authors: Graham Lyndsey N , O’Brien Erica L , Neupert Shevaun D
Published: February 2025

Objectives

Stressor appraisals are a transaction between the environment and the individual, such that individuals may appraise a situation as stressful when the problem is greater than the resources available to address it. Stressors appraised as threatening to the way one feels about themselves, their plans for the future, or their own physical health and safety are known to increase negative affect (Almeida et al., 2002). Appraisal theory (Lazarus, 1999) frames our predictions regarding the importance of daily contexts and aging processes to understand how stressor appraisals and feelings of aging may be associated with daily affective ratings. We investigated the potential interaction of daily stressors appraisals and daily subjective age on daily negative affect.

Methods

One hundred and one younger adults (aged 18-36, M = 19.4, SD = 2.05) and 73 older adults (aged 60-90, M = 65.2, SD = 4.66) participated in an online 8-day daily diary study.

Results

Our results indicated a significant two-way interaction between daily stressor appraisals and daily subjective age on daily negative affect, such that on days when participants reported low stress appraisals and younger subjective ages, participants also reported lower negative affect.

Discussion

The dynamic nature of stressor appraisals, in light of daily aging experiences and daily affective ratings, suggest potential benefits and boundaries associated with subjective aging experiences.
Deconer: An Evaluation Toolkit for Reference-based Deconvolution Methods Using Gene Expression Data
Authors: Zhang Wei , Zhang Xianglin , Liu Qiao , Wei Lei , Qiao Xu , Gao Rui , Liu Zhiping , Wang Xiaowo
Published: February 2025

In recent years, computational methods for quantifying cell type proportions from transcription data have gained significant attention, particularly those reference-based methods which have demonstrated high accuracy. However, there is currently a lack of comprehensive evaluation and guidance for available reference-based deconvolution methods in cell proportion deconvolution analysis. In this study, we introduce Deconvolution Evaluator (Deconer), a comprehensive toolkit for the evaluation of reference-based deconvolution methods. Deconer provides various simulated and real gene expression datasets, including both bulk and single-cell sequencing data, and offers multiple visualization interfaces. By utilizing Deconer, we conducted systematic comparisons of 16 reference-based deconvolution methods from different perspectives, including method robustness, accuracy in deconvolving rare components, signature gene selection, and building external reference. We also performed an in-depth analysis of the application scenarios and challenges in cell proportion deconvolution methods. Finally, we provided constructive suggestions for users in selecting and developing cell proportion deconvolution algorithms. This work presents novel insights to researchers, assisting them in choosing appropriate toolkits, applying solutions in clinical contexts, and advancing the development of deconvolution tools tailored to gene expression data. The tutorials, manual, source code, and demo data of Deconer are publicly available at https://honchkrow.github.io/Deconer/.
Factors Influencing the Establishment of Hospital Accreditation Programs in Low- and Middle-income Countries: A Scoping Review
Authors: Dharmagunawardene Dilantha , Bowman Paula , Avery Mark , Greenfield David , Hinchcliff Reece
Published: February 2025

Hospital accreditation programs are globally recognised as an important tool for enhancing quality and safety in healthcare; however, many programs in Low- and Middle-Income Countries (LMICs) are discontinued shortly after their establishment. This scoping review synthesised published evidence on factors influencing the establishment and sustainability of hospital accreditation programs in LMICs, to provide guidance to health stakeholders involved in these processes. Six databases were searched using the terms “accreditation,” “health,” “hospital,” and the country list of LMICs. Screening was undertaken collaboratively for validation. A framework to guide data extraction was developed by amalgamating eight existing classifications, theories, models, and frameworks concerning policy diffusion and implementation. The framework comprised the following domains: antecedent influences (A), contextual factors (C), establishment factors (E), standards, surveyors, stimulants (incentives) and survey related factors (S-4S), governance (G), legislation (L), execution (implementation; E), and assessment and monitoring (AM), forming the ACES-GLEAM framework. Thirty-two sources were identified, with an increasing publication trend over time. The included studies reported upon a broad range of patterns, innovations, influencers, enablers, and barriers concerning accreditation program establishment in LMICs. Key questions emerged, including the degree of government involvement, incorporation of international standards versus development of bespoke standards, the use of local versus external surveyors, the use of financial and other incentives to promote engagement, and mandatory versus voluntary approaches of program implementation. Resource constraints were recognised as the most important barriers to sustainable establishment, while the influence of global accreditation and donor agencies were viewed as presenting both positive and negative impacts. Health stakeholders are encouraged to reflect upon and apply the ACES-GLEAM framework, incorporating the guiding principles outlined in this paper, to help establish hospital accreditation programs in LMICs in a way that facilitates sustainability and effectiveness over time.
Antidepressants in the Treatment of Bipolar Depression: Commentary
Authors: Vázquez Gustavo H , Baldessarini Ross J
Published: February 2025

Background

Depression is a therapeutic challenge with bipolar disorder (BD) patients and remains a major contributor to disability, comorbidity, and premature mortality. Efficacy and safety of antidepressants for this indication remain particularly controversial and optimally safe and effective treatment of bipolar depression remains uncertain.

Method

We summarized selected research findings on treatment of depression in BD aimed at supporting practical guidelines for clinical treatment involving antidepressants.

Results

Growing research evidence indicates that antidepressants are probably effective in bipolar depression and possibly not less than in major depressive disorder (MDD). Tolerability of antidepressant treatment is greater with type II BD (BD-2) than with type I (BD-1), particularly when antidepressants are combined with a mood-stabilizer or antipsychotic. For bipolar depression preferred antidepressants are serotonin-reuptake inhibitors (SRIs) and bupropion given in moderate doses for limited times.

Conclusions

Optimal treatment of depression requires further investigation, particularly for long-term maintenance. Nevertheless, treatment for acute depressive episodes can usefully and safely include some antidepressants in moderate doses for limited duration, best combined with lithium, some anticonvulsants or certain atypical antipsychotics, and more safely with BD-2 than BD-1 with close clinical supervision.
G6PD deficiency is associated with an increased risk of acute kidney injury independent of hemolytic complications in children with severe malaria
Authors: Namazzi Ruth , Kazinga Caroline , Lima-Cooper Giselle , Liepmann Claire , Goings Michael J , Bednarski Olivia , Abreu Marco , Schwantes-An Tae-Hwi , Batte Anthony , Opoka Robert O , John Chandy C , Conroy Andrea L
Published: February 2025

Acute kidney injury (AKI) is common and predicts mortality in severe malaria. Studies have reported an increased incidence of AKI in males with hemolytic features of SM. G6PD deficiency, an X-linked enzymopathy, can induce hemolysis. We evaluated whether the G6PD African allele (A-) was associated with AKI in children with severe malaria. The prevalence of G6PD deficiency was 16.7% among hemizygous males and 2.4% in females. G6PD deficiency was associated with 2.56-fold odds of AKI (95% CI, 1.33 to 4.93, p=0.005), adjusting for age, sex, site, nutritional status, and features of hemolysis.
Artificial intelligence in hepatology: a comparative analysis of ChatGPT-4, Bing, and Bard at answering clinical questions
Authors: Anvari Sama , Lee Yung , Jin David Shiqiang , Malone Sarah , Collins Matthew
Published: February 2025

Background and Aims

The role of artificial intelligence (AI) in hepatology is rapidly expanding. However, the ability of AI chat models such as ChatGPT to accurately answer clinical questions remains unclear. This study aims to determine the ability of large language models (LLMs) to answer questions in hepatology, as well as compare the accuracy and quality of responses provided by different LLMs.

Methods

Hepatology questions from the Digestive Diseases Self-Education Platform were entered into three LLMs (OpenAI’s ChatGPT-4, Microsoft’s Bing, and Google’s Bard) between September 7 and 13, 2023. Questions were posed with and without multiple-choice answers. Generated responses were assessed based on accuracy and number of correct answers. Statistical analysis was performed to determine the number of correct responses per LLM per category.

Results

A total of 144 questions were used to query the AI models. ChatGPT-4’s accuracy was 62.3%, Bing’s accuracy was 53.5%, and Bard’s accuracy was 38.2% (P < .001) for multiple-choice questions. For open-ended questions, ChatGPT-4’s accuracy was 44.4%, Bing’s was 28.5%, and Bard’s was 21.4% (P < .001). ChatGPT-4 and Bing attempted to answer 100% of the questions, whereas Bard was unable to answer 11.8% of the questions. All 3 LLMs provided a rationale in addition to an answer, as well as counselling where appropriate.

Conclusions

LLMs demonstrate variable accuracy when answering clinical questions related to hepatology, though show comparable efficacy when presented with questions in an open-ended versus multiple choice (MCQ) format. Further research is required to investigate the optimal use of LLMs in clinical and educational contexts.
The PARADIGM project – I. How early merger histories shape the present-day sizes of Milky-Way-mass galaxies
Authors: Joshi Gandhali D , Pontzen Andrew , Agertz Oscar , Rey Martin P , Read Justin , Pillepich Annalisa
Published: February 2025

How mergers affect galaxy formation depends on both feedback processes, and on the geometry and strength of the mergers themselves. We introduce the PARADIGM project, where we study the response of a simulated Milky-Way-mass galaxy ($M_{\rm 200c}\sim 10^{12}\,{\rm M}_{\odot }$ at $z=0$) forming in a cosmological setting to differing merger histories, using genetically modified initial conditions, each simulated with the VINTERGATAN and IllustrisTNG codes. While VINTERGATAN has been developed with an emphasis on resolving the cold interstellar medium, IllustrisTNG uses a subgrid two-phase model and consequently scales to large volume simulations, making them ideal to examine complementary views on how merger histories and feedback interact. Our genetic modifications alter the mass ratio of an important $z \approx 2$ merger while maintaining the halo’s $z=0$ mass. Whether simulated with VINTERGATAN or IllustrisTNG, smaller mass ratios for this early merger result in larger galaxies at $z=0$, due to a greater build-up of a kinematically cold disc. We conclude that such broad trends are robustly reproducible; however, the normalization of the resulting stellar sizes is substantially different in the two codes (ranging between $0.5\,{\rm and}\,1.7\ \rm {kpc}$ for VINTERGATAN but $1.3{\!-\!}7.0\ \rm {kpc}$ for IllustrisTNG). The VINTERGATAN galaxies systematically form stars earlier, leading to a larger bulge component. Despite the difference in size normalization, both simulation suites lie on the observed size−mass relation for their respective morphological types. In light of these results, we discuss the interplay between internal processes and large-scale gravitational interactions and gas accretion, and how the two galaxy models converge on similar emergent trends but along different evolutionary pathways.
Accessing pluripotent drones through reprogramming of dynamic soft self-healing chemical growth
Authors: Qin Kecheng , Tang Wei , Guo Xinyu , Xu Huxiu , Zhong Yiding , Wang Yonghao , Sheng Qincheng , Yang Huayong , Zou Jun
Published: February 2025

The functions of drones implemented by existing design paradigms are usually fixed and do not have the possibility of further “development”. In biology and stem cells, pluripotency is defined as a system that is not fixed in its developmental potential. Inspired by this concept, we report a single pluripotent drone that can further “develop” into a series of drones that exhibit different functions to perform a variety of challenging tasks. To realize this concept, we propose a method of reprogramming of dynamic soft self-healing chemical growth (R-growth), which can differentiate specific “organs” through growth to achieve corresponding functions, and after completing the corresponding tasks, these “organs” can disappear and return to the initial drone state, and can respond to possible damage through rapid self-healing (∼3.2 s, more than 1000 times the self-healing speed of existing similar membranes). R-growth is large-scale (>1.5 m), fast (0.15 m/s), lightweight (∼5 g, 1/20 the weight of traditional micro air pumps), self-contained, and free-wheeling, matching various existing drones, thereby differentiating their functions to enable an unprecedented range of tasks. Our work can realize the differentiation, disappearance, and switching of any functional “organ” of a drone, while such macro robots or humans, to date, only exist in science fiction movies.
9 THE CLINICAL INTERVENTION EFFECT OF MINDFULNESS PAINTING ART THERAPY ON ADOLESCENT DEPRESSION PATIENTS
Authors: Zhai Yujia
Published: February 2025

Background

With the arrival of the new era, teenagers face enormous academic and life pressures, which are accompanied by various psychological and physiological problems, and in severe cases, even depression. Depression can affect various aspects of people’s lives and is gradually becoming younger, with teenagers experiencing more severe depression problems. Therefore, it is necessary to focus on how to improve depression. Related studies have shown that mandala painting, as an art form, can induce mindfulness or flow, and may have a certain effect on intervening in depression. Therefore, the study mainly explored the clinical intervention effect of mandala painting on adolescent depression patients.

Methods

The study selected 50 adolescent patients diagnosed with depression from a certain middle school, aged between 15-18 years old. The study used a randomized controlled experimental design to randomly divide patients into an experimental group and a control group, with 25 people in each group. The experimental group participated in mindfulness painting art therapy intervention, using mandala painting as part of mindfulness art therapy. The control group did not receive mindfulness painting intervention, but received conventional cognitive-behavioral therapy treatment. The course of treatment for both therapy groups is 8 weeks, twice a week for 1 hour each time. Before and after intervention, scores were obtained using the Self Rating Depression Scale (SDS) and Hamilton Depression Rating Scale (HAMD) for adolescents.

Results

The SDS and HAMD scores of patients in the experimental and control groups before and after the 8-week intervention are shown in Table 1. According to Table 1, the SDS and HAMD scores of the experimental group undergoing mindfulness painting art therapy were significantly improved, and the improvement effect was significantly better than that of the control group. Among them, the SDS score of the experimental group was as high as 46.89 ± 4.01 points before intervention, and decreased to 36.91 ± 2.17 points after intervention, with a statistical difference between the two (P<0.05). Meanwhile, there was a statistically significant difference (P<0.05) in the HAMD scores of the experimental group before and after intervention. In addition, in the inter group comparison, the experimental group had significantly lower scores on various scales after intervention compared to the control group.

Discussion

The research results indicate that mindfulness painting art therapy using mandala painting has a significant clinical intervention effect on adolescent depression patients. Compared to traditional cognitive-behavioral therapy, mandala painting can effectively alleviate depressive symptoms in adolescent depression patients and significantly improve mindfulness levels, with strong clinical application prospects for mental illness. Future research can further explore the mechanism by which mandala painting alleviates depressive symptoms.
11 DESIGN AND IMPLEMENTATION OF SPEECH EMOTION INTERACTION SYSTEM FOR PATIENTS WITH MENTAL ILLNESS
Authors: Zhang* Ying , Huang Bo
Published: February 2025

Background

In recent years, with the development of voice emotion technology, its application in the treatment of psychiatric patients has become increasingly widespread. Speech emotion recognition technology is a technique that uses speech signal analysis and pattern recognition technology to classify human speech signals into emotions and determine the emotional state of the speaker. The research aims to explore the impact of voice emotion interaction system on the symptoms of schizophrenia patients, in order to provide more convenient and efficient treatment services for more schizophrenia patients.

Methods

Combining support vector machine and long short-term memory network, a speech emotion interaction system is designed. The system is divided into recording module and analysis module. A total of 62 patients diagnosed with schizophrenia between January 2024 and September 2024 were selected from a top-three hospital in a certain city, and randomly divided into voice-emotion interaction system group (31 patients) and conventional group (31 patients). The conventional group was treated with traditional psychotherapy and conventional drug therapy, and the voice-emotion interaction system group was treated with voice-emotion interaction system on the basis of the conventional group. The intervention duration was 2 months. SPSS 23.0 was used for data analysis, and the Symptoms of patients were evaluated using the Scale for the Assessment of Negative Symptoms (SANS).

Results

The comparison of SANS scores between the voice emotion interaction system group and the conventional group is shown in Table 1. After intervention, the scores of emotion indifference or dullness, poor thinking, impaired will, attention disorder, interest or social disorder were 11.46 ± 2.57, 11.08 ± 2.30, 8.34 ± 1.48, 7.08 ± 1.25 and 10.62 ± 2.54, respectively, which were significantly lower than before intervention. Before intervention, there was no significant difference between the two groups (P > 0.05), and after intervention, there was a significant difference between the two groups (P < 0.05).

Discussion

The voice emotion interaction system can effectively improve the symptoms of schizophrenia patients. Through this system, patients can improve their emotional state through voice communication with the system. Doctors can better understand the psychological needs of patients based on their voice emotional changes, and provide more suitable psychological treatment plans for patients.
20 THE INTERVENTION EFFECT OF TOURISM ACTIVITIES ON THE SOCIAL FUNCTION RECOVERY OF PATIENTS WITH SCHIZOPHRENIA
Authors: Gao Fang , Huang* Peng , Chen Chi
Published: February 2025

Background

Schizophrenia is a serious mental disorder, and although drug therapy and psychological intervention have made some progress, the recovery of patients’ social function remains one of the difficulties in treatment. In recent years, an increasing number of studies have shown that tourism activities may become a novel and effective intervention method due to their multidimensional social interactions, emotional experiences, and environmental stimuli. Research and explore the intervention effect of tourism activities on the social function recovery of patients with schizophrenia, in order to provide scientific basis for intervention strategies in this field.

Methods

The study adopted a randomized controlled design and selected 100 patients with schizophrenia in the recovery period with a disease course of more than 2 years. They were randomly divided into an experimental group (n=50) and a control group (n=50). Both groups received conventional drug therapy and psychological intervention for 12 weeks, and the experimental group received an additional group travel activity once every two weeks for two days, a total of six times. Tourism activities include natural landscape viewing, cultural site visits and team work activities. Social functional impairment screening scale, positive and negative symptom scale and subjective well-being scale were used to evaluate the patients before and after the activity. SPSS 25.0 was used for statistical analysis.

Results

The effect of social function recovery in patients with schizophrenia is shown in Table 1. As can be seen from Table 1, after the intervention, the social functional impairment screening score of the experimental group decreased significantly, from 8.7±2.4 before the intervention to 5.3±1.6, while that of the control group changed little, from 8.6±2.2 to 6.8±1.9, with statistical significance between groups (P<0.01). The positive and negative symptom scores showed that the negative symptoms of the experimental group improved more significantly, from 46.2±7.5 to 31.5±5.8, and from 45.8±7.8 to 38.7±6.5 in the control group, the difference was significant (P<0.01). In addition, the patients’ subjective well-being score showed a significant improvement in the experimental group, from 14.5±3.2 to 21.7±3.6 before the intervention, while the control group only increased from 14.3±3.1 to 17.8±3.4.

Discussion

The results show that tourism activities have significant intervention effects in improving the social function, relieving negative symptoms and enhancing subjective well-being of patients with schizophrenia. In addition, tourism activities can effectively improve patients’ participation enthusiasm and make them more willing to communicate with others, forming a virtuous circle. The research brings a new therapeutic idea for the treatment of schizophrenia patients.

Funding

No. BXLBX0932.
24 THE IMPROVEMENT OF STUDENTS’ ANXIETY AND DEPRESSIVE SYMPTOMS THROUGH THE COMBINATION OF ANTIDEPRESSANT MEDICATION AND ART COLOR TEACHING
Authors: Zhou* Bojie , Qin Fuqiang
Published: February 2025

Background

The incidence of anxiety and depression symptoms in adolescents is constantly increasing. Although antidepressants can alleviate symptoms to some extent, they also come with side effects and dependency issues. Art color teaching, as an art therapy, provides individuals with a way to express emotions and stress through color and creative activities. Therefore, the study aims to explore the intervention effect of combining antidepressant drugs with art color teaching on improving students’ anxiety and depression symptoms.

Methods

The study selected 60 students from a certain middle school with anxiety and depression as the research subjects, aged between 15-19 years old. The study randomly divided patients into an experimental group and a control group, with 30 people in each group. The experimental group adopted a fusion intervention method of antidepressant medication combined with art color teaching, while the control group received conventional antidepressant medication treatment intervention. The intervention treatment period for the two groups was 5 months. Before and after the intervention, the Self Rating Depression Scale (SDS) and Self Rating Anxiety Scale (SAS) were used as evaluation tools for adolescents.

Results

During the treatment period, the SDS and SAS scores of patients in the experimental and control groups are shown in Table 1. According to Table 1, it can be seen that the experimental group showed significant improvement in SDS and SAS scale scores compared to the control group. The SDS score of the experiment before intervention was 56.13 ± 2.326 points, and after intervention, the score decreased to 51.13 ± 2.167 points, with a statistically significant difference between the two (P<0.05). In addition, the SAS score of the experimental group was 52.40 ± 1.352 points before intervention, and the score value decreased to 49.00 ± 1.512 points after intervention, indicating that there was also a statistical difference in SAS score before and after intervention (P<0.05). Based on the comprehensive comparison of the data in Table 1, it can be concluded that the scores of various scales in the experimental group were lower than those in the control group.

Discussion

The research results indicate that the integrated intervention method of using antidepressants combined with art color teaching has significant intervention and treatment effects on middle school students with depression and anxiety disorders. Compared to traditional drug therapy, combining art color teaching provides a supplementary method of non-drug therapy. This integrated intervention approach can not only improve treatment effectiveness, but also promote the recovery of patients’ social functions, which has important practical significance for improving patients’ quality of life.
58 EFFECT OF PSYCHOLOGICAL EDUCATION ON COGNITIVE FUNCTION IMPROVEMENT IN PATIENTS WITH SCHIZOPHRENIA
Authors: Qi Meiqi , Yao Xichang , Jin* Ge
Published: February 2025

Background

Patients with schizophrenia often show significant cognitive deficits in the course of the disease, including impairment of attention, memory, executive function and language ability, which significantly affect the quality of life and social function of patients. In recent years, psychological education has been widely used as an auxiliary intervention to improve the cognitive function of patients with schizophrenia. In order to better treat schizophrenic patients, the study analyzed the effect of psychological education on improving cognitive function of schizophrenic patients

Methods

Randomized controlled trial design was used in this study, and two experimental stages were set up: baseline assessment and intervention experiment. An intervention group and a control group with 40 participants were randomly divided. The control group received only conventional medication and regular psychiatric outpatient visits. The intervention group received a 12-week psycho-educational course and was divided into three intervention phases. The first stage is 1-4 weeks and includes cognitive education and functional assessment feedback. The second phase is five to eight weeks and involves training in specific cognitive skills, including attention, memory and language skills. The third stage is 9-12 weeks and involves emotion management and social function enhancement. SPSS 24.0 software was used for statistical analysis of the data, independent sample T-test was used to compare the differences between the two groups, and paired sample T-test was used to evaluate the changes before and after intervention in the group, and the significance level was set at P<0.05.

Results

There was no significant difference in baseline cognitive function between the intervention group and the control group (P>0.05). The effect of intervention is shown in Table 1. As can be seen from Table 1, the total score of Wexler Adult Intelligence Scale increased by 15.8% (from 78.4±6.5 to 90.7±7.2, P<0.001) in the intervention group and only 3.5% (from 77.9±6.8 to 80.6±6.7, P>0.05) in the control group. In the Wisconsin card classification test, the intervention group increased from 12.6±4.2 to 19.3±4.5 (P<0.001), and the control group only increased from 12.3±4.1 to 13.1±4.3 (P>0.05).

Discussion

Our findings suggest that psychoeducational interventions can significantly improve cognitive function, especially attention, memory and executive function, in patients with schizophrenia. Compared with drug therapy alone, psychoeducation provides a more comprehensive functional recovery program through the combination of cognitive skill training and emotional management. This study provides a feasible scheme for the comprehensive management of schizophrenia.

Funding

No. 242400410379.
103 EFFECT OF EARLY INTERVENTION FOR SCHIZOPHRENIA MODERN LITERATURE RESEARCH
Authors: Pan Gonglingzi
Published: February 2025

Background

Schizophrenia, as a common mental illness, usually shows relatively hidden symptoms in the early stage, which makes timely intervention particularly important. As an art form rich in emotional expression and cognitive inspiration, modern literature has gradually attracted attention in mental health intervention. The study aims to explore the effect of modern literature on early intervention of schizophrenia, especially its potential in alleviating symptoms, improving cognitive function and emotional expression.

Methods

The study selected 80 early schizophrenia patients and randomly divided them into an experimental group and a control group, with 40 people in each group. The experimental group received a 12-week modern literature intervention, which included reading, analyzing and discussing literary works, focusing on emotional resonance, cognitive inspiration and self-expression. The control group continued to receive conventional drug treatment and psychological intervention. The study used the Emotional Disorder Scale (EDS) and the Cognitive Function Scale (CFS) to evaluate the patients before and after, and the Clinical Symptoms Scale (CSS) was used to evaluate the improvement of symptoms.

Results

The results showed that modern literature intervention significantly improved the emotional cognition, positive symptoms, negative symptoms and thought disorder of the patients in the experimental group. Specific data are shown in Table 1.

As can be seen from Table 1, the experimental group showed significant improvement in all aspects. The positive symptom score dropped from 31.3 to 22.1, an improvement of 9.2 points (P < 0.05). The negative symptom score dropped from 30.2 to 19.6, an improvement of 10.6 points (P < 0.05). The cognitive function score increased from 56.9 to 72.4, with an improvement of 15.5 points (P < 0.05). The emotional cognition score dropped from 38.5 to 26.1, an improvement of 12.4 points (P < 0.05). In the control group, the improvements in various indicators were smaller. The improvements in positive symptoms, negative symptoms, cognitive function scores, and emotional cognition were only 2.2 points, 0.5 points, 0.8 points, and 1.2 points respectively, none of which reached statistical significance.

Discussion

Studies have shown that modern literary intervention improves emotional cognition, positive symptoms, negative symptoms, and thought disorders in patients with schizophrenia, and effectively enhances cognitive function. This intervention method can help patients better express emotions, understand others, and improve their thinking and cognitive abilities. Future research can further explore the differences in the intervention effects of different types of literary works on patients with schizophrenia, and provide a more personalized and diversified treatment model for the early intervention of schizophrenia.

Funding

No. 20BZW003.
An external design on performance improvement of the transition windbreak wall between an embankment and a hill cut along the high-speed railway
Authors: Zhang Jie , Huang Fengyi , Liu Tianchen , Xu Ao , Li Yichao , Ji Peng , Liu Tanghong
Published: February 2025

The embankment and hill cut are conventional infrastructure scenarios along the railway line in windy regions. The windbreak walls with the same height are separately installed on them to guarantee the safety of train operation. However, due to the realistic terrain, the distances of windbreak walls on embankment and hill cut from the railway centerline are not the same, generating a windbreak wall transition and causing a sudden change of the windproof performance, which contributes to the called “yawing” phenomenon when the train passing through the specified windbreak transition. The current study aims to predict the flow characteristics around the existing right-angled windbreak wall, three preliminary designs and four local improvement designs at the transition connecting the embankment and the hill cut along the high-speed railway. The detached-eddy simulation (DES) method with the realizable k−ε turbulence model was used, while the contour lines were applied to generate the realistic terrain. The velocity distributions in the existing windbreak wall transition present a fast change from the large negative value (i.e., −0.16U on windward line (WWL) and −0.20U on leeward line (LWL)) to the positive value (i.e., 0.47U on windward line and 0.42U on leeward line) within the distance of 10h. The different locations of windbreak walls on the embankment and hill cut create a rectangular discontinuous transition. The consistency of the windproof performance is destroyed at the windbreak wall transition, resulting in a sudden gust on the railway lines. A preliminary design idea coming from the hypotenuse in a right triangle was proposed to smooth the transition from the windbreak on the cut to that on the embankment. Three included angles were discussed, and the 30° scheme shows the best shielding performance, achieving about 46% reduction on the peak-to-peak value on the WWL and 32% on the LWL at the middle height of the train. However, the positive peaks are still observed. On this 30° scheme, four local improvement designs are attempted to further smooth the velocity distributions. The best design that meets three wind directions can achieve about 80% reduction of peak-to-peak values. All achievements can provide a reference for the design of windbreak walls at different transitions and improve the safety of train operation under strong winds.
Levosimendan improves central haemodynamic status and gas exchange in a model of ischaemic cardiac arrest
Authors: Rysz Susanne , Al-Saadi Jonathan , Campoccia Jalde Francesca , Nyman Jesper , Lundberg Johan , Jonsson Fagerlund Malin , Djärv Therese
Published: February 2025

BACKGROUND

Ischaemic cardiac arrest has poor survival. In an earlier animal study, we have shown that levosimendan increases the return of spontaneous circulation and survival compared with placebo. However, the impact of levosimendan on central cardiovascular variables and gas exchange during resuscitation in ischaemic cardiac arrest is unknown.

OBJECTIVE

To evaluate levosimendan's dose–response effect on central cardiovascular variables and gas exchange in an established swine cardiac arrest model.

DESIGN

A large animal study.

SETTING

Animal study with Swedish landrace pigs at Karolinska Institutet, Sweden.

INTERVENTION

Ten swine underwent induced acute myocardial infarction and ventricular fibrillation. Levosimendan (62.5 μg kg−1) was administered during resuscitation, and immediate outcomes were compared with low dose levosimendan (12 μg kg−1, n 
= 12) or placebo (n 
= 12) from earlier experiments using the same model.

MAIN OUTCOME MEASURES

Haemodynamic and gas exchange variables during resuscitation. Time to and proportion of return to spontaneous circulation.

RESULTS

High-dose levosimendan improved gas exchange, with better arterial O2 and CO2 levels (P < 0.01), reduced systolic pulmonary arterial pressure, central venous pressure and vasopressor support with adrenaline after return to spontaneous circulation compared with low dose and placebo (P = 0.01). All animals in both levosimendan groups achieved return to spontaneous circulation compared with 67% in the placebo group (P = 0.02). Median [IQR] time to return of spontaneous circulation was 15 min [12 to 18] for high dose 17 min [15 to 26] for low dose compared with 23 min [15 to 60] for placebo (P = 0.08).

CONCLUSIONS

Levosimendan enhances key resuscitation outcomes in the immediate period of ischaemic cardiac arrest, promoting its potential as an effective pharmacological intervention. With an apparent dose-dependent reduction in right ventricular afterload and subsequent improvement in gas exchange, we cautiously propose that levosimendan-induced pulmonary vasodilation alleviates right heart strain and improves interventricular dependency, thereby enhancing the likelihood of return of spontaneous circulation.