bluuebunny/crossref_metadata_2025 huggingface dataset:
Key tips to providing a psychologically safe learning environment in the clinical setting
Authors: Hardie Philip , O’Donovan Roisin , Jarvis Suzi , Redmond Catherine
Published: November 2022

Having psychological safety embedded in preceptorship relationships facilitates positive interpersonal and educational experiences for students. Psychological safety refers to a student’s belief as to whether or not it is safe for them to take interpersonal risks, such as asking questions, sharing an idea for improvement or speaking up to maintain patient safety. Having psychological safety leads to collaboration, positive student learning experiences and effective patient care. This article presents key guidelines for preceptors to provide a psychologically safe learning environment for their students. Guidelines fall under four categories 1) before meeting students, 2) first meeting students, 3) continued relationship with students, and 4) general rules. These guidelines are informed by current literature on psychological safety and preceptorship and the author's clinical expertise in nursing preceptorship. We conceptualise psychological safety in a nursing preceptorship for preceptors to denote the experience of inclusivity, empowerment, and well-being of students within the social, cultural and physical clinical learning environment. A crucial attribute to cultivating a psychologically safe environment involves being an accessible and approachable preceptor.
Medication adherence prediction through temporal modelling in cardiovascular disease management
Authors: Hsu William , Warren James R. , Riddle Patricia J.
Published: November 2022

Background

Chronic conditions place a considerable burden on modern healthcare systems. Within New Zealand and worldwide cardiovascular disease (CVD) affects a significant proportion of the population and it is the leading cause of death. Like other chronic diseases, the course of cardiovascular disease is usually prolonged and its management necessarily long-term. Despite being highly effective in reducing CVD risk, non-adherence to long-term medication continues to be a longstanding challenge in healthcare delivery. The study investigates the benefits of integrating patient history and assesses the contribution of explicitly temporal models to medication adherence prediction in the context of lipid-lowering therapy.

Methods

Data from a CVD risk assessment tool is linked to routinely collected national and regional data sets including pharmaceutical dispensing, hospitalisation, lab test results and deaths. The study extracts a sub-cohort from 564,180 patients who had primary CVD risk assessment for analysis. Based on community pharmaceutical dispensing record, proportion of days covered (PDC)$$\ge$$≥ 80 is used as the threshold for adherence. Two years (8 quarters) of patient history before their CVD risk assessment is used as the observation window to predict patient adherence in the subsequent 5 years (20 quarters). The predictive performance of temporal deep learning models long short-term memory (LSTM) and simple recurrent neural networks (Simple RNN) are compared against non-temporal models multilayer perceptron (MLP), ridge classifier (RC) and logistic regression (LR). Further, the study investigates the effect of lengthening the observation window on the task of adherence prediction.

Results

Temporal models that use sequential data outperform non-temporal models, with LSTM producing the best predictive performance achieving a ROC AUC of 0.805. A performance gap is observed between models that can discover non-linear interactions between predictor variables and their linear counter parts, with neural network (NN) based models significantly outperforming linear models. Additionally, the predictive advantage of temporal models become more pronounced when the length of the observation window is increased.

Conclusion

The findings of the study provide evidence that using deep temporal models to integrate patient history in adherence prediction is advantageous. In particular, the RNN architecture LSTM significantly outperforms all other model comparators.
Patient safety culture in the operating room: a cross-sectional study using the Hospital Survey on Patient Safety Culture (HSOPSC) Instrument
Authors: Nwosu Arinze D.G. , Ossai Edmund , Ahaotu Francis , Onwuasoigwe Okechukwu , Amucheazi Adaobi , Akhideno Irene
Published: November 2022

Background

Credible evidence has established a link between the level of patient safety culture in healthcare environments and patient outcomes. Patient safety culture in the operating room has received scant attention despite the burden of adverse events among surgical patients. We aimed to evaluate the safety culture in our operating rooms and compare with existing data from other operating room settings.

Methods

We investigated the patient safety culture in the operating rooms of our hospital as perceived by the surgeons, nurse anaesthetists and perioperative nurses using the Hospital Survey on Patient Safety Culture (HSOPSC) instrument. IBM Statistical Package for Social Science software, version 25, was used for data entry and analysis. Differences were considered significant when p < 0.05.

Results

Only 122 completed surveys were returned out of a survey population of 132 frontline staff, yielding a response rate of 92.4%. The overall average composite score was 47%. The average composite scores ranged from 17–79.6% across the 12 dimensions of the HSOPSC, with teamwork within units being the only dimension with demonstrable strength. Non-punitive response to error, communication openness, feedback and communication about error”, frequency of events reported”, handoffs and transition and staffing need improvement. The perceived safety culture varied according to work areas and professional roles with nurse anaesthetists having the highest perception and the surgeons the least.

Conclusion

Patient safety culture in our operating rooms is adjudged to be weak, with only one of the twelve dimensions of HSOPSC demonstrating strength. This is notwithstanding its comparative strengths relative to other operating room settings.
Assessment of formats and completeness of paper-based referral letters among urban hospitals in Rwanda: a retrospective baseline study
Authors: Kalume Zamzam , Jansen Bart , Nyssen Marc , Cornelis Jan , Verbeke Frank , Niyoyita Jean Paul
Published: November 2022

Background

Patient referral is a process in which a healthcare provider decides to seek assistance due to the limitations of available skills, resources and services offered locally. Paper-based referrals predominantly used in low-income countries hardly follow any procedure. This causes a major gap in communication, coordination, and continuity of care between primary and specialized levels, leading to poor access, delay, duplication and unnecessary costs. The goal of this study is to assess the formats and completeness of existing paper-based referral letters in order to improve health information exchange, coordination, and continuity of care.

Methods

A retrospective exploratory research was conducted in eight public and three private healthcare facilities in the city of Kigali from May to October 2021. A purposive sampling method was used to select hospitals and referral letters from patients’ files. A data capture sheet was designed according to the contents of the referral letters and the resulting responses were analyzed descriptively.

Results

In public hospitals, five types of updated referral letters were available, in total agreement with World Health Organization (WHO) standards of which two (neonatal transfer form and patient monitoring transfer form) were not used. There was also one old format that was used by most hospitals and another format designed and used by a district hospital (DH) separately. Three formats were designed and used by private hospitals (PH) individually. A total of 2,304 referral letters were perused and the results show that “external transfer” forms were completed at 58.8%; “antenatal, delivery, and postnatal external transfer” forms at 47.5%; “internal transfer” forms at 46.6%; “Referral/counter referral” forms at 46.0%; district hospital referrals (DH2) at 73.4%. Referrals by private hospitals (PH1, PH2 and PH3) were completed at 97.7%, 70.7%, and 0.0% respectively. The major completeness deficit was observed in counter referral information for all hospitals.

Conclusion

We observed inconsistencies in the format of the available referral letters used by public hospitals, moreover some of them were incompatible with WHO standards. Additionally, there were deficits in the completeness of all types of paper-based referral letters in use. There is a need for standardization and to disseminate the national patient referral guideline in public hospitals with emphasis on referral feedback, referral registry, triage, archiving and a need for regular training in all organizations.
Gastrointestinal parasites of cats in Egypt: high prevalence high zoonotic risk
Authors: Abbas Ibrahim , Al-Araby Moustafa , Elmishmishy Bassem , El-Alfy El-Sayed
Published: November 2022

Background

Several gastrointestinal parasites that infect cats pose potential health threats for humans and animals. The present study is the first to report gastrointestinal (GIT) parasites in feces of stray cats from Gharbia governorate, Egypt. Findings were combined with those published in the earlier surveys from various Egyptian governorates, and various meta-analyses were conducted to underline the parasitic zoonoses from cats in Egypt.

Results

Out of 143 samples tested in Gharbia, 75 (52.4%) were found infected with 13 different parasites. Co-infections were observed in 49.3% of positives. Several parasites were detected, e.g., Toxocara cati (30.0%), Toxascaris leonina (22.4%), hookworms (8.4%), taeniids (4.2%), Strongyloides spp. (2.1%), Physaloptera spp. (2.1%), Alaria spp. (1.4%) and Dipylidium caninum (0.7%). Opisthorchis-like eggs were found in a single sample being the first report from cats in Africa. Oocysts of 4 coccidian parasites were identified, and a few Toxoplasma gondii-like oocysts were detected in 2 samples (1.4%). Results of the meta-analysis illustrated that occurrence of T. gondii oocysts in feces of cats from Egypt may have been overestimated in earlier studies; 1432 cats have been tested and displayed a 5 times higher pooled prevalence (11.9%) than the published global pooled prevalence for T. gondii oocysts in cats. This overestimation might have occurred because some small-sized oocysts that belong to other coccidian parasites were mis-identified as T. gondii. Toxocara cati had a high pooled prevalence (22.5%) in cats from Egypt, which is even greater than the published pooled prevalence in cats globally; however, several reports from Egypt have neglected the role of T. cati in human toxocarosis. Dipylidium caninum displayed also a high prevalence (26.7%).

Conclusion

Several zoonotic parasite species have been found in stray cats from Egypt, raising concerns about the risks to the Egyptian human population as well as environmental contamination. Prompt surveillance supervised by the government and accompanied by data dissemination will be helpful for developing effective control strategies.
Naturally acquired antibodies from Beninese infants promote Plasmodium falciparum merozoite-phagocytosis by human blood leukocytes: implications for control of asymptomatic malaria infections
Authors: Fall Abdou Khadre Dit Jadir , Kana Ikhlaq Hussain , Dechavanne Célia , Garcia-Senosiain Asier , Guitard Evelyne , Milet Jacqueline , Massougbodji Achille , Garcia André , Dugoujon Jean-Michel , Migot-Nabias Florence , Theisen Michael , Courtin David
Published: November 2022

Background

Immunoglobulin G (IgG) antibodies are thought to play important roles in the protection against Plasmodium falciparum (P. falciparum) malaria. A longitudinal cohort study performed in the Southern part of Benin, identified a group of infants who were able to control asymptomatic malaria infections (CAIG).

Methods

IgG antibodies against distinct merozoite antigens were quantified in plasma from Beninese infants. Functionality of these antibodies was assessed by the merozoite-phagocytosis assay using THP-1 cells and primary neutrophils as effector cells. Gm allotypes were determined by a serological method of haemagglutination inhibition.

Results

Purified IgG from infants in CAIG promoted higher levels of merozoite-phagocytosis than did IgG from children who were unable to control asymptomatic infections (Ologit multivariate regression model, Coef. = 0.06, 95% CI 0.02;0.10, P = 0.002). High level of merozoite-phagocytosis activity was significantly associated with high levels of IgG against AMA1 (Coef. = 1.76, 95% CI 0.39;3.14, P = 0.012) and GLURP-R2 (Coef. = 12.24, 95% CI 1.35;23.12, P = 0.028). Moreover, infants of the G3m5,6,10,11,13,14,24 phenotype showed higher merozoite-phagocytosis activity (Generalized linear model multivariate regression, Coef. = 7.46, 95% CI 0.31;14.61, P = 0.041) than those presenting other G3m phenotypes.

Conclusion

The results of the present study confirm the importance of antibodies to merozoite surface antigens in the control of asymptomatic malaria infection in Beninese infants. The study also demonstrated that G3m phenotypes impact the functional activity of IgG. This last point could have a considerable impact in the research of candidate vaccines against malaria parasites or other pathogens.
Preoperative administration of branched-chain amino acids reduces postoperative insulin resistance in rats by reducing liver gluconeogenesis
Authors: Zhang Jin , Chi Rui , Zhang Yunpeng , Xie Yi , Liu Yunxia , Bao Qun , Lv Hengyu , Han Bo , Sun Haipeng , Sun Peng
Published: November 2022

Background

Postoperative insulin resistance (PIR) represents an important characteristic of metabolic response following surgical injury. Clinical outcomes are negatively correlated to postoperative insulin resistance and hyperglycemia, indicating a novel treatment for reducing postoperative insulin resistance is urgently needed. The current work aimed to assess the protective effects of branched-chain amino acids (BCAA) on glucose metabolism disorders induced surgically in a rat model, and to explore the underpinning mechanism.

Methods and results

Rats were randomly assigned to 2 groups, including the control and BCAA groups. Rats were given a compulsory oral 3 mL load by gavage two hours before surgery. The results showed that BCAA remarkably reduced glycemia by suppressing liver gluconeogenesis via reduction of cAMP-response element-binding protein-regulated transcription coactivator 2 (CRTC2) and glucose-6-phosphatase (G6PC) gene and protein expression levels (all Ps < 0.05).

Conclusions

This study revealed that BCAA lower blood glucose levels by reducing liver gluconeogenesis without significant elevation of plasma insulin levels. We anticipate that preoperative BCAA supplementation may be a means for preventing postoperative insulin resistance.
A comprehensive understanding of ambient particulate matter and its components on the adverse health effects based from epidemiological and laboratory evidence
Authors: Li Tianyu , Yu Yang , Sun Zhiwei , Duan Junchao
Published: November 2022

The impacts of air pollution on public health have become a great concern worldwide. Ambient particulate matter (PM) is a major air pollution that comprises a heterogeneous mixture of different particle sizes and chemical components. The chemical composition and physicochemical properties of PM change with space and time, which may cause different impairments. However, the mechanisms of the adverse effects of PM on various systems have not been fully elucidated and systematically integrated. The Adverse Outcome Pathway (AOP) framework was used to comprehensively illustrate the molecular mechanism of adverse effects of PM and its components, so as to clarify the causal mechanistic relationships of PM-triggered toxicity on various systems. The main conclusions and new insights of the correlation between public health and PM were discussed, especially at low concentrations, which points out the direction for further research in the future. With the deepening of the study on its toxicity mechanism, it was found that PM can still induce adverse health effects with low-dose exposure. And the recommended Air Quality Guideline level of PM2.5 was adjusted to 5 μg/m3 by World Health Organization, which meant that deeper and more complex mechanisms needed to be explored. Traditionally, oxidative stress, inflammation, autophagy and apoptosis were considered the main mechanisms of harmful effects of PM. However, recent studies have identified several emerging mechanisms involved in the toxicity of PM, including pyroptosis, ferroptosis and epigenetic modifications. This review summarized the comprehensive evidence on the health effects of PM and the chemical components of it, as well as the combined toxicity of PM with other air pollutants. Based on the AOP Wiki and the mechanisms of PM-induced toxicity at different levels, we first constructed the PM-related AOP frameworks on various systems.

Graphical Abstract
Four emerging immune cellular blood phenotypes associated with disease duration and activity established in Psoriatic Arthritis
Authors: Skougaard Marie , Ditlev Sisse B. , Stisen Zara R. , Coates Laura C. , Ellegaard Karen , Kristensen Lars Erik
Published: November 2022

Background

Psoriatic Arthritis (PsA) is an immune-mediated disease with heterogenous symptoms indicating differences in the underlying immunopathogenesis. The primary objective of the study explored the dynamic mechanisms and interplay between immune cell subtypes constituting the immune response driving PsA to evaluate possible differences in immune cellular phenotypes, and secondary examined associations between emerging immune cellular phenotypes and disease outcomes.

Methods

Peripheral blood was collected from 70 PsA patients. Frequencies of nine immune cell subtypes were determined by multicolor flow cytometry. The interplay between immune cells were examined with principal component analysis (PCA) to establish immune cellular phenotypes. Disease characteristics, Disease Activity in Psoriatic Arthritis (DAPSA) and Psoriasis Area Severity Index (PASI) were retrieved to examine associations to individual cellular phenotypes.

Results

Four components were identified using PCA resembling four immune cellular phenotypes. Component 1, explaining 25.6% of the variance with contribution from T-helper 17 cells (Th17), memory T regulatory cells (mTregs), dendritic cells and monocytes, was associated with longer disease duration and higher DAPSA. Component 2, driven by Th1, naïve Tregs and mTregs, was associated with shorter disease duration. Component 3 was driven by both Th1, Th17 and CD8+ T cells, while component 4 was characterized by a reverse correlation between CD8+ T cells and natural killer cells.

Conclusion

Four immune cellular phenotypes of PsA were suggested at baseline demonstrating complex immune cellular mechanisms in PsA implying the possibility of improving PsA patient stratification based on both clinical and immune cellular phenotypes.
Limb-girdle muscular dystrophy type 2B causes HDL-C abnormalities in patients and statin-resistant muscle wasting in dysferlin-deficient mice
Authors: White Zoe , Sun Zeren , Sauge Elodie , Cox Dan , Donen Graham , Pechkovsky Dmitri , Straub Volker , Francis Gordon A. , Bernatchez Pascal
Published: November 2022

Limb-girdle muscular dystrophy (MD) type 2B (LGMD2B) and Duchenne MD (DMD) are caused by mutations to the Dysferlin and Dystrophin genes, respectively. We have recently demonstrated in typically mild dysferlin- and dystrophin-deficient mouse models that increased plasma cholesterol levels severely exacerbate muscle wasting, and that DMD patients display primary dyslipidemia characterized by elevated plasma cholesterol and triglycerides. Herein, we investigate lipoprotein abnormalities in LGMD2B and if statin therapy protects dysferlin-deficient mice (Dysf) from muscle damage. Herein, lipoproteins and liver enzymes from LGMD2B patients and dysferlin-null (Dysf) mice were analyzed. Simvastatin, which exhibits anti-muscle wasting effects in mouse models of DMD and corrects aberrant expression of key markers of lipid metabolism and endogenous cholesterol synthesis, was tested in Dysf mice. Muscle damage and fibrosis were assessed by immunohistochemistry and cholesterol signalling pathways via Western blot. LGMD2B patients show reduced serum high-density lipoprotein cholesterol (HDL-C) levels compared to healthy controls and exhibit a greater prevalence of abnormal total cholesterol (CHOL)/HDL-C ratios despite an absence of liver dysfunction. While Dysf mice presented with reduced CHOL and associated HDL-C and LDL-C-associated fractions, simvastatin treatment did not prevent muscle wasting in quadriceps and triceps muscle groups or correct aberrant low-density lipoprotein receptor (LDLR) and 3-hydroxy-3-methylglutaryl coenzyme A reductase (HMGCR) protein expression. LGMD2B patients present with reduced serum concentrations of HDL-C, a major metabolic comorbidity, and as a result, statin therapy is unlikely to prevent muscle wasting in this population. We propose that like DMD, LGMD2B should be considered as a new type of genetic dyslipidemia.
Spatial–temporal heterogeneity and determinants of HIV prevalence in the Mano River Union countries
Authors: Laybohr Kamara Idrissa , Wang Liang , Guo Yaxin , Huo Shuting , Guo Yuanyuan , Xu Chengdong , Liao Yilan , Liu William J. , Ma Wei , Gao George F.
Published: November 2022

Background

Utilizing population-based survey data in epidemiological research with a spatial perspective can integrate valuable context into the dynamics of HIV prevalence in West Africa. However, the situation in the Mano River Union (MRU) countries is largely unknown. This research aims to perform an ecological study to determine the HIV prevalence patterns in MRU.

Methods

We analyzed Demographic and Health Survey (DHS) and AIDS Indicator Survey (AIS) data on HIV prevalence in MRU from 2005 to 2020. We examined the country-specific, regional-specific and sex-specific ratios of respondents to profile the spatial–temporal heterogeneity of HIV prevalence and determine HIV hot spots. We employed Geodetector to measure the spatial stratified heterogeneity (SSH) of HIV prevalence for adult women and men. We assessed the comprehensive correct knowledge (CCK) about HIV/AIDS and HIV testing uptake by employing the Least Absolute Shrinkage and Selection Operator (LASSO) regression to predict which combinations of CCKs can scale up the ratio of HIV testing uptake with sex-specific needs.

Results

In our analysis, we leveraged data for 158,408 respondents from 11 surveys in the MRU. From 2005–2015, Cote d'Ivoire was the hot spot for HIV prevalence with a Gi_Bin score of 3, Z-Score 8.0–10.1 and P < 0.001. From 2016 to 2020, Guinea and Sierra Leone were hot spots for HIV prevalence with a Gi_Bin score of 2, Z-Score of 3.17 and P < 0.01. The SSH confirmed the significant differences in HIV prevalence at the national level strata, with a higher level for Cote d'Ivoire compared to other countries in both sexes with q-values of 0.61 and 0.40, respectively. Our LASSO model predicted different combinations of CCKs with sex-specific needs to improve HIV testing uptake.

Conclusions

The spatial distribution of HIV prevalence in the MRU is skewed and the CCK about HIV/AIDS and HIV testing uptake are far below the threshold target set by UNAIDS for ending the epidemic in the sub-region. Geodetector detected statistically significant SSH within and between countries in the MRU. Our LASSO model predicted that different emphases should be implemented when popularizing the CCK about HIV/AIDS for adult women and men.
Investigation of the relationship between early maladaptive schemas, temperament and eating attitude in adults
Authors: Güler Kahraman , Özgörüş Zeynep
Published: November 2022

Background

Current research on eating attitude has focused primarily on female perspective (Kapoor et al. in J Educ Health Promot 11(80):1–7, 2022; Piko et al. in J Prev Med Hyg. 63(1):83–89, 2022). To extend cross-gender approaches, this study aimed to examine the relationship between early maladaptive schemas, temperament, and eating attitude and to see whether these three concepts differ between men and women.

Methods

The sample group consists of a total of 308 participants, 206 (66.9%) women and 102 (33.1%) men, living in Bursa and participating in the research voluntarily. In the study, Sociodemographic Data Form was used to obtain personal information of the participants, Young Schema Questionnaire—Short Form 3 was used to evaluate early maladaptive schemas, Temperament Evaluation of Memphis, Pisa, Paris and San-Diego Autoquestionnaire was used to evaluate temperament characteristics and Eating Attitude Test was used to evaluate eating attitudes.

Results

As a result of the study, a moderate and positive relationship was found between the Defectiveness, Emotional Inhibition, Enmeshment/Dependence, Failure, Abandonment, Vulnerability to Harm or Illness, Negativity/Pessimism schemas and eating attitude. Among these schemas, Defectiveness was found to be the best predictor of deterioration in eating attitude. A weak and positive relationship was found between the scores obtained from the Eating Attitude Test and Cyclothymic and Irritable temperaments, and a moderate positive relationship with Anxious temperament. Among these temperaments, Anxious temperament was found to be the best predictor of deterioration in eating attitude.

Conclusions

When the results were examined, a relationship was observed between early maladaptive schemas and temperament types, and this relationship was examined in detail. The results obtained at the end of the study were discussed and suggestions were made for future studies.
Psychometric evaluation of an Adverse Childhood Experiences (ACEs) measurement tool: an equitable assessment or reinforcing biases?
Authors: Mei Xiaohan , Li Jiayu , Li Zhi-Shu , Huang Shun , Li Li-Li , Huang Yang-Hong , Liu Jianhong
Published: November 2022

Background

Utilizing Adverse Childhood Experiences (ACEs) measurement scales to assess youths’ adversities has expanded exponentially in health and justice studies. However, most of the ACEs assessment scales have yet to meet critical psychometric standards, especially for key demographic and minority groups. It is critical that any assessment or screening tool is not reinforcing bias, warranting the need for validating ACEs tools that are equitable, reliable and accurate. The current study aimed to examine the structural validity of an ACEs scale. Using data from the 2019 Behavioral Risk Factor Surveillance System (BRFSS), which collected of 97,314 responses collected from adults across sixteen states. This study assessed the psychometric properties and measurement invariance of the ACEs tool under the structural equation modeling framework.

Results

We found the 11-item ACEs screening tool as a second-order factor with three subscales, all of which passed the measurement invariance tests at metric and scalar levels across age, race, sex, socioeconomic status, gender identity, and sexual orientation. We also found that minority groups experienced more childhood adversity with small effect size, with the exception of the gender identity.

Conclusion

The ACEs measurement scale from the BRFSS is equitable and free from measurement bias regardless of one’s age, race, sex, socioeconomic status, gender identity, and sexual orientation, and thus is valid to be used to compare group mean differences within these groups. The scale is a potentially valid, viable, and predictive risk assessment in health and justice and research settings to identify high-risk groups or individuals for treatments.
The process of stigma experience in the families of people living with bipolar disorder: a grounded theory study
Authors: Latifian Maryam , Raheb Ghoncheh , Uddin Riaz , Abdi Kianoush , Alikhani Rosa
Published: November 2022

Background

One of the most challenging issues faced by families of people living with bipolar disorder is stigma. This study was conducted to explain the process of stigma experience in the families of people living with bipolar disorder using the grounded theory method.

Methods

Data for this study were collected through semi-structured interviews with participants in Razi Psychiatric Hospital in Tehran, Iran, via purposive sampling and field notetaking. The dependability, conformability, and transferability measures were included to support the data accuracy and robustness, and MAXQDA 2020 software was used to facilitate data coding. The Strauss–Corbin method was used to analyse the data.

Results

A total of 20 family members of people living with bipolar disorder, four people living with bipolar disorder, and three mental health professionals participated in this study. The analysis of participants’ experiences led to identifying 64 subcategories, 21 categories, and six main concepts, including social deprivation, being labelled, cultural deficiency and lack of awareness, economic challenges, forced acceptance of the existing situation, and social isolation.

Conclusion

Families of people living with bipolar disorder experience social deprivation, social isolation, and social rejection, which have irreparable consequences for them. Overcoming stigma in these families should be a priority of policymakers and planners in the field of psychosocial health.
The quantification of physico-mechanical properties and durability of onyx-travertines from Santa Ana de los Ríos de Cuenca, Ecuador
Authors: Romero Bastidas Martha , Aguirre Ullauri María del Cisne , Ramírez Bustamante Johanna , Vargas Vallejo Michel , Castillo Carchipulla Edison
Published: November 2022

In this study, physico-mechanical properties and durability of 4 onyx-travertines from Sinincay (Ecuador) were investigated. These onyx-travertines are commonly used for decorative purposes in buildings in the Historic Center of Santa Ana de los Ríos de Cuenca. The aim of this work was to characterize these stones and determine the variation of their physico-mechanical properties, such as mass loss and water absorption, after being subjected to four durability tests: salt crystallization (S-C), freeze–thaw (F-T), thermal shock (T-S) and acid attack (A-A). In addition, Scanning Electron Microscopic (SEM) analyses were carried out to record weathering patterns and understand the deterioration mechanism. Results show that these stones’ sedimentary structure is stratified. Two specimens exhibit geometrical features consistent with porous laminated facies and the remaining two have slightly porous cryptolaminated ones. Facies’ structure orientation is also found to determine mechanical strength, exhibiting the normal to lamination orientation the lowest value. As for durability, the statistical interpretation of the results suggests that the level of severity of each test follows S-C > F–T > A-A > T-S. In addition, laminated facies are more vulnerable to accelerated aging tests. Impact of S-C, F–T and T-S tests is mainly explained by differences in porosity and damage produced by A-A is related to the available effective area for the reaction to take place. Thus, the onyx-travertine is more than a wonderful material, it represents an interesting case study for development of future research on heritage stone in Ecuador and the world by employing normalized tests that are rarely used or published.
Force profile assessment of direct-printed aligners versus thermoformed aligners and the effects of non-engaged surface patterns
Authors: Hertan Evan , McCray Julie , Bankhead Brent , Kim Ki Beom
Published: November 2022

Background

The purpose of the study was to measure the forces delivered by direct-printed aligners (DPA) in the vertical dimension and compare the force profile with traditional thermoformed aligners (TFA) and to investigate the impact of non-engaged surface patterns to the properties of DPA and TFA.

Methods

A force-measuring appliance was fabricated capable of displacing the aligner in 0.10 mm increments and measuring the resultant force. Polyethylene terephthalate glycol (ATMOS 0.030″ American Orthodontics) and TC-85DAC resin (Graphy Inc) were used to create TFA and DPA, respectively. Aligners were temperature-controlled prior to and during testing to simulate the oral environment. The resultant forces from displacements ranging from 0.10 to 0.30 mm were measured.

Results

At intraoral temperatures, DPA demonstrated significantly less force than TFA. TFA demonstrated a substantial statistically significant increase in force with each 0.10 mm increase in vertical displacement. DPA demonstrated a much more consistent force profile across the range of displacements. The effects of surface patterns in both DPA and TFA were generally a decrease in force. Statistical significance of surface patterns was detected for TFA at displacements of 0.30 mm and greater and significant for DPA only at a displacement of 0.10 mm. Surface patterns in both DPA and the TFA did not show any statistical difference when assessing force proprieties.

Conclusions

Forces delivered by aligners in the vertical dimension by DPA are more consistent and of lower magnitude than those of TFA aligners. Surface patterns were not capable of altering the force properties of both DPA and TFA.
Adherence to low carbohydrate diets and non-alcoholic fatty liver disease: a case control study
Authors: Yaghoubi Fatemeh , Darand Mina , Vasmehjani Aazam Ahmadi , Darabi Zahra , Talenezhad Nasir , Mirzavandi Farhang , Hosseinzadeh Mahdieh
Published: November 2022

Background

Non-alcoholic fatty liver disease (NAFLD) is defined as the excessive accumulation of fat in the liver cells of people who do not drink alcohol. The aim of study is investigated the association between low carbohydrate diets (LCDs) and NAFLD.

Methods

This age and gender-matched case–control study was conducted on 120 patients newly diagnosed with NAFLD and 120 adults without NAFLD. Diagnosis of NAFLD based on laboratory tests and abdominal ultrasound. Low carbohydrate diets score calculated on the percentage of energy as carbohydrate, fat, and protein. Participants in the highest rank intake of fat and protein and lowest intake of carbohydrate received 10 points. Multivariable logistic odds ratio was used for examine the relation between LCDs and NAFLD.

Results

This study showed subjects in the highest tertile of LCD has more intake of zinc and vitamin B12 compare to lowest. Also, intake of protein (p = 0.02) carbohydrate (p < 0.02) and cholesterol (p = 0.02) were significantly higher in patient with NAFLD compare to control subjects. There was no significant association between LCD and risk of NAFLD (OR: 1.36; 95% CI: 0.97–1.92; P-trend = 0.13) in crude and adjusted (OR: 1.31; 95% CI: 0.84–2.04; P-trend = 0.23) model.

Conclusion

However, we showed that intake of protein, carbohydrate and cholesterol are higher in NAFLD, but our results of study showed that LCDs with higher proportion intakes of protein and fat was not associated with NAFLD. Further prospective studies are required for confirm these associations.
Incidence and predictors of attrition rate after children started inpatient treatments for complicated severe acute malnutrition in North West Ethiopia
Authors: Kebede Fassikaw , Kebede Tsehay
Published: November 2022

Background

Retaining children for inpatient treatment of complicated severe acute malnutrition (SAM) is a growing challenge until achieved the reference weight of a child. In Ethiopia, there is limited information regarding the time to be lost from the stabilizing centers after initiation of treatment. Thus, this study aimed to identify incidence and predictors of attrition for children suffering from SAM after started inpatient treatment in North West Ethiopia.

Methods

A retrospective cohort study was conducted among under-five children admitted and started inpatient treatment for complicated SAM from 2015/2016 to 2020/2021. Data were entered using Epi-data version 4.2 and then exported to STATA (SE) version R-14 software for further analysis. The analysis was computed using Cox proportional hazard regression model after checking all proportional hazard assumptions. Covariates having < 0.2 of P values in the bi-variable analysis were candidates transferred to the multivariable Cox proportional hazard regression model. Finally, a statistical significance was declared at a P value of < 0.05.

Result

Overall, 760 files of under-five children were analyzed with a mean (± SD) age of participants 27.8 (± 16.5) months. About 6944 child-days of treatment observation were recorded with the crude incidence of attrition rate of 9.7% (95% CI 7.9–12.6). The overall median time of attrition and half-life time S(t1/2) of survival rates was determined as 14 (IQR =  ± 7) days and 91.6% (95% CI 88.2–93.1), respectively. The attrition rate was significantly associated with cases living in rural residents (AHR = 6.03; 95% CI 2.2; 25.2), being re-admitted SAM cases (AHR = 2.99; 95% CI 1.62; 5.5), and caregivers did not have formal education (AHR = :5.6, 95% CI 2.7; 11.7) were all independent predictors for attrition from inpatient treatment.

Conclusions

Nearly one in every ten severely acute malnourished under-five children defaulted at the end of treatment observation with a median time of 14 (IQR =  ± 7) days. Living in a rural residence, being re-admitted cases, caregivers who did not have a formal education were significantly associated with the attrition rate. Hence, it is crucial to detect and control the identified causes of defaulting from treatment observation promptly. Furthermore, serious counseling during admission and nutritional provision strategies are essential for virtuous treatment outcomes.
Current understanding of T cell immunity against SARS-CoV-2
Authors: Lu Xiuyuan , Yamasaki Sho
Published: November 2022

As an important part of adaptive immunity, T cells are indispensable in the defense against pathogens including viruses. SARS-CoV-2 is a new human coronavirus that occurred at the end of 2019 and has caused the COVID-19 pandemic. Nevertheless, most of the infected patients recovered without any antiviral therapies, suggesting an effective immunity developed in the bodies. T cell immunity responds upon SARS-CoV-2 infection or vaccination and plays crucial roles in eliminating the viruses and generating T cell memory. Specifically, a subpopulation of CD4+ T cells could support the production of anti-SARS-CoV-2 antibodies, and cytotoxic CD8+ T cells are also protective against the infection. SARS-CoV-2–recognizing T cells could be detected in SARS-CoV-2–unexposed donors, but the role of these cross-reactive T cells is still in debate. T cell responses could be diverse across individuals, mainly due to the polymorphism of HLAs. Thus, compared to antibodies, T cell responses are generally less affected by the mutations of SARS-CoV-2 variants. Up to now, a huge number of studies on SARS-CoV-2–responsive T cells have been published. In this review, we introduced some major findings addressing the questions in the main aspects about T cell responses elicited by SARS-CoV-2, to summarize the current understanding of COVID-19.
Transient sinus bradycardia caused by hepatitis A virus: a case report
Authors: Kilicaslan Onder , Isancli Didem Kizmaz , Fil Esmanur , Irdem Ahmet , Karbuz Adem
Published: November 2022

Background

The most common cause of acute viral hepatitis is the hepatitis A virus (HAV). Millions of people are thought to be infected each year. It is transmitted either by the fecal-oral route or by consuming contaminated food. Extrahepatic complications, notably cardiologic ones, are infrequent. This case report was presented due to the development of HAV-related bradycardia without hypotension in an unvaccinated refugee patient.

Case presentation

A 9-year-old male presented with the complaint of jaundice and vomiting. There was no history of fever, diarrhea, or abdominal pain. A precise knowledge of suspected food intake is lacking. There was no pathological examination finding except jaundice. Total bilirubin, direct bilirubin, aspartate aminotransferase, and alanine aminotransferase levels were high. The coagulation test was normal. Anti-HAV-IgM/IgG was positive in the patient with suspicious viral hepatitis. In the follow-up, the heart rate decreased to 43 beats/min during sleep and 46 beats/min when awake. Cardiological examination and tests were within normal limits. Hypotension was not accompanied. In the follow-up, bradycardia and impaired liver function tests regressed. The patient was discharged on the 10th day.

Conclusions

Cardiologic complications are rare, and patients diagnosed with acute hepatitis A should be monitored. The most effective way of protection from the hepatitis A virus is vaccination.
Laser pulmonary metastasectomy preserves parenchyma: a single-centre retrospective study from the United Kingdom
Authors: Chandarana Karishma , Caruana Edward J. , Weaver Helen , Rathinam Sridhar , Nakas Apostolos
Published: November 2022

Background

Pulmonary metastasectomy (PME) is a modality increasingly employed to control oligometastatic disease from a variety of solid tumours.

We present data from a single UK centre, following the introduction of laser-assisted surgery (LAS) using the Limax® 120 Nd:Yag laser (Gebrüder Martin GmbH & Co. KG, Tuttlingen, Germany).

Methods

All patients undergoing PME between September 2015 and August 2018 were included in our study. Those undergoing LAS were compared to a control of conventional stapled wedge metastasectomy (SWM). Data was analysed retrospectively from a prospective kept database. Statistical analysis was performed using JASP (Version 0.14.1).

Results

Fifty-seven procedures in 46 patients, were included in the final analysis. Demographic data was similar at baseline between the LAS and SWM group, with colorectal cancer being the most common primary, 44/57 (77%). LAS was favoured in patients who had previously undergone pulmonary metastasectomy, 9/12 (75%). Patients in the LAS group had a smaller parenchymal volume resected (MD 30.6 cm3, p = 0.0084), with a lower incidence of clear histological marginal resection (11/27 vs 29/30, p < 0.0001); but no difference in operative time, morbidity, patient-reported outcome measures, or local recurrence between the two groups at 2 years. LAS was associated with a lower procedural cost (MD £452.92, p < 0.0001).

Conclusions

Laser-assisted pulmonary metastasectomy presents a safe and acceptable alternative to traditional stapled wedge resection, with notable parenchymal-sparing, no discernible learning curve, and lower direct costs.
Planar metasurface-based concentrators for solar energy harvest: from theory to engineering
Authors: Zhang Cheng , Zhan Yujie , Qiu Yongxue , Xu Leilei , Guan Jianguo
Published: November 2022

Solar energy is an inexhaustible renewable energy resource, which is a potential solution to global warming and aids sustainable development. The use of solar-thermal collectors to harness solar energy facilitates low-cost heat storage and can improve the stability of power grids based on renewable energy. In solar-thermal collectors, traditional concentrators, such as parabolic troughs and dishes, are typically used but inevitably require high-precise supports and complex tracking sun systems, which increase the cost of solar-thermal power stations and hinder their further applications. In contrast, planar meta-lenses (so-called metasurface-based concentrators) consisting of two-dimensional nanostructured arrays are allowed to engineer the frequency dispersion and angular dispersion of the incident light through delicately arranging the aperture phase distribution, thereby correcting their inherent aberrations. Accordingly, the novel meta-lenses offer tremendous potentials to effectively capture broadband, wide-angle sunlight without the extra tracking system. This review summarizes the research motivation, design principles, building materials, and large-area fabrication methods of meta-lens for solar energy harvesting in terms of focusing efficiency, operation bandwidth, and angular dependence. In addition, the main challenges and future goals are examined.
Ultracompact multifunctional metalens visor for augmented reality displays
Authors: Li Yan , Chen Shuyi , Liang Haowen , Ren Xiuying , Luo Lingcong , Ling Yuye , Liu Shuxin , Su Yikai , Wu Shin-Tson
Published: November 2022

Virtual reality (VR) and augmented reality (AR) have found widespread applications in education, engineering, healthcare, and entertainment. However, these near-eye displays are often bulky and heavy, and thus are not suitable for long-term wearing. Metalenses, with an ultra-thin formfactor, subwavelength modulation scale, and high modulation flexibility, are promising candidates to replace the conventional optics in AR display systems. In this work, we proposed and fabricated a novel reflective dielectric metalens-visor based on Pancharatnam-Berry phase with see-through capability. It achieves diffraction-limited focusing behavior for the reflected red light, while keeping a good transmission spectrum in the visible region. Hence, this single piece metalens-visor can perform the function of two integrated elements simultaneously: an eyepiece and an optical combiner, which in turn greatly reduces the weight and the size of an AR display. We have implemented a proof-of-concept AR display system employing the metalens-visor, and experimentally demonstrated color AR images with good image quality. This work reveals the great potential of multi-functional metasurface devices which enables optical integration in interdisciplinary applications including wearable displays, biological imaging, and aeronautic optical instruments.
Attitudes and beliefs towards low back pain (LBP) among physiotherapists in Spain
Authors: Pérez Sebastián Eustaquio Martín , González Lucía Llanos , Acevedo Irene Acosta , Barrera Raúl Bilbao , Pérez José Luis Alonso , Romero Eleuterio Atanasio Sánchez , Reina María Dolores Sosa , Pérez Isidro Miguel Martín , Villafañe Jorge Hugo
Published: November 2022

Background

The aim of this study is to investigate the attitudes and beliefs of Spanish physiotherapists towards the diagnosis and management of low back pain (LBP). A descriptive, cross-sectional study was conducted according to STROBE guidelines from December 18, 2021, to May 2022. An online survey was developed based on Pain Attitudes and Beliefs Scale for Physiotherapists (PABS-PT), a reliable and validated self-administered instrument developed to assess the strength of two possible treatment orientations of physiotherapists towards the diagnosis and management of LBP. Respondents were selected through a non-probabilistic convenience sampling technique, and the selection criteria were (1) active physiotherapists with no restrictions on gender and length of service, (2) physical therapists who have worked in both public and private environments, and (3) physiotherapists who have been officially registered with no restriction on the place of practice in Spain. Survey data was obtained and analyzed using the SPSS Statistic 28 (IBM®) statistical software.

Results

Three hundred eighty-one questionnaires were finally included (F;n=151, M;n=230). In relation to the diagnosis, the respondents indicated that the tissue damage was sufficient to explain widespread and lasting pain, but rather that it was due to psychological factors. In addition, for those surveyed, the diagnosis should not focus exclusively on imaging tests but on clinical symptoms and signs. However, the weak relationship between objective damage and perceived pain intensity, as well as the weak relationship between posture and the development or worsening of LBP, did not seem to be clear to physiotherapists. From the point of view of treatment, we can indicate that professionals are committed to maintaining adequate and individualized physical activity as a first-line treatment in pain management.

Conclusions

Most physiotherapists in Spain have up-to-date knowledge of the biopsychosocial model of pain care. However, regarding attitudes and beliefs towards LBP, there are still contents and behaviors based on spine protective paradigms that are not conducive to active pain management.