bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparison of the Active Sitting Test and Head-Up Tilt Test for Diagnosis of Postural Tachycardia Syndrome in Children and Adolescents
Authors: Cai Hong , Wang Shuo , Zou Runmei , Liu Ping , Li Fang , Wang Yuwen , Wang Cheng
Published: September 2021

Objectives: We aimed to compare the hemodynamic responses to the active sitting test with the passive head-up tilt test (HUTT) in children and adolescents with postural tachycardia syndrome (POTS). We hypothesized that sitting tachycardia was also present in POTS patients during sitting.

Materials and methods: We tested 30 POTS patients and 31 control subjects (mean age = 12 years, range = 9–16 years) who underwent both active sitting test and HUTT successively. We measured the heart rate (HR) and blood pressure (BP) during each test.

Results: For both POTS patients and control subjects, the HUTT produced significantly larger HR and BP increases from 3 to 10 min of postural change than did the sitting test. Moreover, POTS patients with excessive orthostatic tachycardia during the HUTT also had significantly larger increases in HR at all test intervals during the sitting test than did the control subjects. A maximum increase in HR ≥ 22 bpm within 10 min of the sitting test was likely suggested to predict orthostatic tachycardia, yielding a sensitivity and specificity of 83.3 and 83.9%, respectively. Only six of 30 POTS patients (20%) reached the 40-bpm criterion during the sitting test, and no one complained of sitting intolerance symptoms.

Conclusions: We have shown that POTS patients also have sitting tachycardia when changing from a supine position to a sitting position. We believe that the active sitting test is a reasonable alternative maneuver in assessing POTS in population groups that cannot tolerate the standing test or HUTT.
Bridging Pediatric and Adult Rehabilitation Services for Young Adults With Childhood-Onset Disabilities: Evaluation of the LIFEspan Model of Transitional Care
Authors: Kingsnorth Shauna , Lindsay Sally , Maxwell Joanne , Hamdani Yani , Colantonio Angela , Zhu Jingqin , Bayley Mark Theodore , Macarthur Colin
Published: September 2021

Background: LIFEspan (“Living Independently and Fully Engaged”) is a linked transition service model for youth and young adults with childhood-onset disabilities offered via an inter-agency partnership between two rehabilitation hospitals (one pediatric and one adult) in Toronto, Canada.

Objective: The objective was to evaluate healthcare outcomes (continuity of care and healthcare utilization) for clients enrolled in LIFEspan.

Methods: A prospective, longitudinal, observational mixed-method study design was used. The intervention group comprised youth with Acquired Brain Injury (ABI) and Cerebral Palsy (CP) enrolled in LIFEspan. A prospective comparison group comprised youth with Spina Bifida (SB) who received standard care. A retrospective comparison group comprised historical, disability-matched clients (with ABI and CP) discharged prior to model introduction. Medical charts were audited to determine continuity of care, i.e., whether study participants had at least one visit to an adult provider within 1 year post-discharge from the pediatric hospital. Secondary outcomes related to healthcare utilization were obtained from population-based, health service administrative datasets. Data were collected over a 3-year period: 2 years pre and 1 year post pediatric discharge. Rates were estimated per person-year. Fisher's Exact Test was used to examine differences between groups on the primary outcome, while repeated measures GEE Poisson regression was used to estimate rate ratios (post vs. pre) with 95% confidence intervals for the secondary outcomes.

Results: Prospective enrolment comprised 30 ABI, 48 CP, and 21 SB participants. Retrospective enrolment comprised 15 ABI and 18 CP participants. LIFEspan participants demonstrated significantly greater continuity of care (45% had engagement with adult services in the year following discharge at 18 years), compared to the prospective SB group (14%). Healthcare utilization data were inconsistent with no significant changes in frequency of physician office visits, emergency department visits, or hospitalizations for clients enrolled in LIFEspan in the year following discharge, compared to the 2 years prior to discharge.

Conclusion: Introduction of the LIFEspan model increased continuity of care, with successful transfer from pediatric to adult services for clients enrolled. Data on longer-term follow-up are recommended for greater understanding of the degree of adult engagement and influence of LIFEspan on healthcare utilization following transfer.
Case Report: Acute Fulminant Cerebral Edema With Perivascular Abnormalities Related to Kawasaki Disease
Authors: Maeda Kenichi , Chong Pin Fee , Akamine Satoshi , Yamashita Fumiya , Morooka Yuya , Mori Harushi , Lee Sooyoung , Mizuno Yumi , Kira Ryutaro
Published: September 2021

Introduction: Kawasaki disease (KD) is an acute systemic vasculitis in children, but 0.4% of patients with KD exhibit central nervous system involvement. Acute encephalitis and encephalopathy accompanied with KD have been reported to be mostly self-limiting complications.

Case Presentation: A 2-year-old girl developed recurrent vomiting, a cluster of generalized seizures, and decreased consciousness on day 12 after the onset of KD. Magnetic resonance imaging (MRI) T2-weighted images on day 13 showed high signal intensities in bilaterally symmetrical and subcortical white matter and thalamus, and linear radial hyperintensities parallel to the cerebral vessels of the periventricular white matter. Diffuse white matter hyperintensity on the apparent diffusion coefficient map suggested vasogenic edema. Subsequently, lethal cerebral edema rapidly progressed in 8 hrs after the MRI examination.

Conclusion: To our knowledge, acute fulminant cerebral edema in patients with KD has not been previously reported. We should be aware of the possibility of severe encephalitis related to KD. Furthermore, diffuse white matter vasogenic edema with perivascular abnormalities on MRI may be an alerm, potentially leading to fatal cerebral edema.
Small-Molecule Inhibitors Overcome Epigenetic Reprogramming for Cancer Therapy
Authors: Xiao Wenjing , Zhou Qiaodan , Wen Xudong , Wang Rui , Liu Ruijie , Wang Tingting , Shi Jianyou , Hu Yonghe , Hou Jun
Published: September 2021

Cancer treatment is a significant challenge for the global health system, although various pharmacological and therapeutic discoveries have been made. It has been widely established that cancer is associated with epigenetic modification, which is reversible and becomes an attractive target for drug development. Adding chemical groups to the DNA backbone and modifying histone proteins impart distinct characteristics on chromatin architecture. This process is mediated by various enzymes modifying chromatin structures to achieve the diversity of epigenetic space and the intricacy in gene expression files. After decades of effort, epigenetic modification has represented the hallmarks of different cancer types, and the enzymes involved in this process have provided novel targets for antitumor therapy development. Epigenetic drugs show significant effects on both preclinical and clinical studies in which the target development and research offer a promising direction for cancer therapy. Here, we summarize the different types of epigenetic enzymes which target corresponding protein domains, emphasize DNA methylation, histone modifications, and microRNA-mediated cooperation with epigenetic modification, and highlight recent achievements in developing targets for epigenetic inhibitor therapy. This article reviews current anticancer small-molecule inhibitors targeting epigenetic modified enzymes and displays their performances in different stages of clinical trials. Future studies are further needed to address their off-target effects and cytotoxicity to improve their clinical translation.
Identification of Oleanolic Acid as Allosteric Agonist of Integrin αM by Combination of In Silico Modeling and In Vitro Analysis
Authors: Jin Lu , Han Xiaoyu , Zhang Xinlei , Zhao Zhimin , Ulrich Judith , Syrovets Tatiana , Simmet Thomas
Published: September 2021

Oleanolic acid is a widely distributed natural product, which possesses promising antitumor, antiviral, antihyperlipidemic, and anti-inflammatory activities. A heterodimeric complex formed by integrin αM (CD11b) and integrin β2 (CD18) is highly expressed on monocytes and macrophages. In the current study, we demonstrate that the I domain of αM (αM-I domain) might present a potential cellular target for oleanolic acid. In vitro data show that oleanolic acid induces clustering of αM on macrophages and reduces their non-directional migration. In accordance with experimental data, molecular docking revealed that oleanolic acid binds to the αM-I domain in its extended-open form, the dominant conformation found in αM clusters. Molecular dynamics simulation revealed that oleanolic acid can increase the flexibility of the α7 helix and promote its movement away from the N-terminus, indicating that oleanolic acid may facilitate the conversion of the αM-I domain from the extended-closed to the extended-open conformation. As demonstrated by metadynamics simulation, oleanolic acid can destabilize the local minimum of the αM-I domain in the open conformation partially through disturbance of the interactions between α1 and α7 helices. In summary, we demonstrate that oleanolic acid might function as an allosteric agonist inducing clustering of αM on macrophages by shifting the balance from the closed to the extended-open conformation. The molecular target identified in this study might hold potential for a purposeful use of oleanolic acid to modulate chronic inflammatory responses.
Melatonin Maintains Anabolic-Catabolic Equilibrium and Regulates Circadian Rhythm During Osteoarthritis Development in Animal Models: A Systematic Review and Meta-analysis
Authors: Sumsuzzman Dewan Md. , Choi Jeonghyun , Khan Zeeshan Ahmad , Kamenos George , Hong Yonggeun
Published: September 2021

Background: The driving force behind osteoarthritis (OA) pathogenesis is an anabolic-catabolic (a/c) imbalance. Melatonin (MT) is a key player in maintaining a/c stability and mitigates OA pathogenesis, but mechanisms underlying its effects remain poorly understood.

Objectives: We performed a systematic review analyzing the experimental data that support the clinical applicability of MT in the treatment of OA pathogenesis, placing particular emphasis on the regulation of circadian rhythms and a/c balance.

Methods: Major electronic databases and grey literature were used to identify related original articles. Methodological quality of all selected studies was evaluated using the SYRCLE risk of bias tool. Pooled mean differences (MDs)/standardized mean differences (SMDs) with 95% confidence intervals (CIs) were calculated to estimate the effect size.

Results: Eleven trials were included in this systematic review. Compared with the control group, MT significantly decreased the levels of interleukin-1β (IL-1β; SMD = −5.45; 95% CI [−6.78, −4.12]; p < 0.00001, and histological grading scale (SMD = −3.46; 95% CI, [−5.24, −1.68]; p < 0.0001). MT significantly increased the transforming growth factor-β1 (TGF-β1; SMD = 1.17; 95% CI [0.31, 2.03]; p < 0.0007). Furthermore, core circadian clock genes Per2 and Cry1 mRNA levels were regulated by MT treatment in OA progression.

Conclusion: MT may maintain a/c balance and regulate circadian rhythms during OA development. MT could be used in as adjunct with other interventions to manage pain and OA severity.
Adoption of Pharmacogenomic Testing: A Marketing Perspective
Authors: Koufaki Margarita-Ioanna , Karamperis Kariofyllis , Vitsa Polixeni , Vasileiou Konstantinos , Patrinos George P. , Mitropoulou Christina
Published: September 2021

Pharmacogenomics is becoming an important part of clinical practice and it is considered one of the basic pillars of personalised medicine. However, the rate of pharmacogenomics adoption is still low in many healthcare systems, especially in low- or middle-income countries. The low level of awareness of healthcare specialists could be a potential reason due to which pharmacogenomics application is still in a premature stage but there are several other barriers that impede the aforementioned process, including the lack of the proper promotion of pharmacogenomic testing among interested stakeholders, such as healthcare professionals and biomedical scientists. In this study, we outline the available marketing theories and innovation that are applied to personalized medicine interventions that would catalyze the adoption of pharmacogenomic testing services in clinical practice. We also present the current ethical and legal framework about genomic data and propose ways to tackle the main concerns mentioned in the literature and to improve the marketing perspective of PGx.
The Functional Roles of RNAs Cargoes Released by Neutrophil-Derived Exosomes in Dermatomyositis
Authors: Li Liya , Zuo Xiaoxia , Liu Di , Luo Hui , Zhu Honglin
Published: September 2021

Dermatomyositis (DM) is an idiopathic inflammatory myopathy characterized by cutaneous manifestations. We first identified the profiles of noncoding RNAs (lncRNAs and miRNAs) in peripheral neutrophil exosomes (EXOs) of DM patients and explored their potential functional roles. Bioinformatics analyses were performed with R packages. Real-time quantitative PCR was used to validate the altered RNAs in DM neutrophil EXO-stimulated human dermal microvascular endothelial cells (HDMECs) and human skeletal muscle myoblasts (HSkMCs). In DM neutrophil EXOs, 124 upregulated lncRNAs (with 1,392 target genes), 255 downregulated lncRNAs (with 1867 target genes), 17 upregulated miRNAs (with 2,908 target genes), and 15 downregulated miRNAs (with 2,176 target genes) were identified. GO analysis showed that the differentially expressed (DE) lncRNAs and DE miRNAs participated in interleukin-6 and interferon-beta production, skeletal muscle cell proliferation and development, and endothelial cell development and differentiation. KEGG analysis suggested that DE lncRNAs and DE miRNAs were enriched in the PI3K–Akt, MAPK, AMPK and FoxO signalling pathways. Many novel and valuable DE lncRNAs and DE miRNAs interacted and cotargeted in the PI3K–Akt, MAPK, AMPK and FoxO signalling pathways. Our study suggests that neutrophil EXOs participate in DM pathogenesis through lncRNAs and miRNAs in the PI3K–Akt, MAPK, AMPK and FoxO signalling pathways.
Multi-Omics Approach to Dissect the Mechanisms of Rexinoid Signaling in Myoblast Differentiation
Authors: Khilji Saadia , Li Yuan , Chen Jihong , Li Qiao
Published: September 2021

Stem cells represent a key resource in regenerative medicine, however, there is a critical need for pharmacological modulators to promote efficient conversion of stem cells into a myogenic lineage. We have previously shown that bexarotene, an agonist of retinoid X receptor (RXR) approved for cancer therapy, promotes the specification and differentiation of skeletal muscle progenitors. To decipher the molecular regulation of rexinoid signaling in myogenic differentiation, we have integrated RNA-seq transcription profiles with ChIP-seq of H4K8, H3K9, H3K18, H3K27 acetylation, and H3K27 methylation in addition to that of histone acetyl-transferase p300 in rexinoid-promoted myoblast differentiation. Here, we provide details regarding data collection, validation and omics integration analyses to offer strategies for future data application and replication. Our analyses also reveal molecular pathways underlying different patterns of gene expression and p300-associated histone acetylation at distinct chromatin states in rexinoid-enhanced myoblast differentiation. These datasets can be repurposed for future studies to examine the relationship between signaling molecules, chromatin modifiers and histone acetylation in myogenic regulation, providing a framework for discovery and functional characterization of muscle-specific loci.
Impaired Nicotinamide Adenine Dinucleotide Biosynthesis in the Kidney of Chronic Kidney Disease
Authors: Liu Xinhui , Luo Denggui , Huang Shiying , Liu Siqi , Zhang Bing , Wang Fochang , Lu Jiandong , Chen Jianping , Li Shunmin
Published: September 2021

Chronic kidney disease (CKD) is a global public health problem with high morbidity and mortality. Decreased nicotinamide adenine dinucleotide (NAD+) levels were found to be associated with aging, cancer, and neurodegenerative and metabolic disorders. However, the alteration of renal NAD+ levels and biosynthesis pathways in CKD is less known. In the present study, we aimed to evaluate renal NAD+ levels and tested the expression of key enzymes in three NAD+ biosynthesis pathways in two different types of CKD rat model. CKD rat models were established by 5/6 nephrectomy (5/6 Nx) and feeding with adenine-containing feed, respectively. Renal function was assessed by serum creatinine (Scr) and blood urea nitrogen (BUN). Renal pathology was evaluated by periodic acid-Schiff (PAS) and Masson’s trichrome staining. The expression of key enzymes in three NAD+ biosynthesis pathways was determined and quantified by Western blot analysis. The results showed CKD rat models were successfully established as evidenced by increased Scr and BUN levels, upregulation of neutrophil gelatinase-associated lipocalin (NGAL), glomerular hypertrophy, and renal fibrosis. Renal NAD+ and NADH content were both declined in two CKD rat models, and NAD+ levels were negatively correlated with Scr and BUN levels in CKD rats. Three key enzymes involved in NAD+ biosynthesis were significantly downregulated in the kidney of both of the two CKD models. They were quinolinate phosphoribosyltransferase (QPRT) in the de novo pathway, nicotinamide mononucleotide adenylyltransferase 1 (NMNAT1), and NMNAT3 in the salvage pathway. Moreover, the expression of NAD+-consuming enzymes sirtuin 3 (SIRT3) and CD38 decreased significantly in CKD rats. In conclusion, NAD+ biosynthesis was significantly impaired in CKD, which may attribute to downregulation of QPRT and NMNAT 1/3.
Prediction of Cerebral Aneurysm Hemodynamics With Porous-Medium Models of Flow-Diverting Stents via Deep Learning
Authors: Li Gaoyang , Song Xiaorui , Wang Haoran , Liu Siwei , Ji Jiayuan , Guo Yuting , Qiao Aike , Liu Youjun , Wang Xuezheng
Published: September 2021

The interventional treatment of cerebral aneurysm requires hemodynamics to provide proper guidance. Computational fluid dynamics (CFD) is gradually used in calculating cerebral aneurysm hemodynamics before and after flow-diverting (FD) stent placement. However, the complex operation (such as the construction and placement simulation of fully resolved or porous-medium FD stent) and high computational cost of CFD hinder its application. To solve these problems, we applied aneurysm hemodynamics point cloud data sets and a deep learning network with double input and sampling channels. The flexible point cloud format can represent the geometry and flow distribution of different aneurysms before and after FD stent (represented by porous medium layer) placement with high resolution. The proposed network can directly analyze the relationship between aneurysm geometry and internal hemodynamics, to further realize the flow field prediction and avoid the complex operation of CFD. Statistical analysis shows that the prediction results of hemodynamics by our deep learning method are consistent with the CFD method (error function <13%), but the calculation time is significantly reduced 1,800 times. This study develops a novel deep learning method that can accurately predict the hemodynamics of different cerebral aneurysms before and after FD stent placement with low computational cost and simple operation processes.
A C-Terminally Truncated Variant of Neurospora crassa VDAC Assembles Into a Partially Functional Form in the Mitochondrial Outer Membrane and Forms Multimers in vitro
Authors: Ferens Fraser G. , Summers William A. T. , Bharaj Ameet , Stetefeld Jörg , Court Deborah A.
Published: September 2021

The voltage-dependent anion-selective channel (VDAC) is a porin in the mitochondrial outer membrane (MOM). Unlike bacterial porins, several mitochondrial β-barrels comprise an odd number of β-strands, as is the case for the 19-β-stranded VDAC. Previously, a variant of a VDAC from Neurospora crassa, VDAC-ΔC, lacking the predicted 19th β-strand, was found to form gated, anion-selective channels in artificial membranes. In vivo, the two C-terminal β-strands (β18 and β19) in VDAC form a β-hairpin necessary for import from the cytoplasm into mitochondria and the β-signal required for assembly in the mitochondrial outer membrane resides in β19. The current study demonstrated that the putative 18-stranded β-barrel formed by VDAC-ΔC can be imported and assembled in the MOM in vivo and can also partially rescue the phenotype associated with the deletion of VDAC from a strain of N. crassa. Furthermore, when expressed and purified from Escherichia coli, VDAC-ΔC can be folded into a β-strand-rich form in decyl-maltoside. Size exclusion chromatography (SEC) alone or combined with multi-angle light scattering (SEC-MALS) and analytical ultracentrifugation revealed that, unlike full-length VDACs, VDAC-ΔC can self-organize into dimers and higher order oligomers in the absence of sterol.
Effect of Psychological Capital of Volunteers on Volunteering Behavior: The Chained Mediation Role of Perceived Social Support and Volunteer Motivation
Authors: Xu Li ping , Liao Jin bao , Wu Yu shen , Kuang Hong da
Published: September 2021

This study explored the role of perceived social support and voluntary motivation in the effect of psychological capital of volunteers on volunteering behavior. A sample of 1,165 volunteers who were registered in the China Voluntary Service Information System was investigated using a self-reported questionnaire, showing that the psychological capital, perceived social support, voluntary motivation, and volunteering behavior of the volunteers were significantly and positively related to each other. The psychological capital of the volunteers affected volunteering behavior not only directly, but also indirectly through the mediating role of voluntary motivation. Moreover, perceived social support and voluntary motivation also played a chain role in the relationship between the psychological capital and volunteering behavior of the volunteers. Therefore, increasing the psychological capital of the volunteers should promote their perceived social support and inspire voluntary motivation, in turn affecting their volunteering behavior.
Multidimensional and Intersectional Gender Identity and Sexual Attraction Patterns of Adolescents for Quantitative Research
Authors: Kassis Wassilis , Aksoy Dilan , Favre Céline A. , Artz Sibylle T.-G.
Published: September 2021

To identify and compare gender identity and sexual attraction (GISA) patterns using a latent class analysis (LCA), questionnaire data from a cross-sectional study on social resilience in adolescence was conducted in 2020, using a sample of 785 Swiss seventh grade high school students. Following McCall’s complex intersectionality approach, we applied an intracategorical and intersectional approach to reshape, differentiate, and critique the existing binary, heteronormative GISA categorization. To empirically validate the detected classes according to content, we measured the participants’ psychological characteristics with measures of self-esteem, social competence, symptoms of anxiety and depression, dissociation, social desirability, and emotional styles, and related these measures to the respective GISA patterns the LCA detected. The results of our multistep LCA endorsed that heteronormatively binary gender identities are far too simplistic to fully illustrate adolescents’ differences and similarities where gender is concerned. Out of the subsample ofn= 785 adolescents (375 identified as “assigned females” and 410 “assigned males”), three significant subgroups of multidimensional GISA patterns emerged for both assigned females and males where differences within the identified GISA groups were larger than those between traditional “boys” and “girls” overall. The LCA demonstrated that the six classes with GISA indicators could be described as low GISA diverse (cis/heterosexual), intermediate GISA diverse (gender identity diverse and/or sexual diverse), high GISA diverse (gender diverse/sexual diverse) for both assigned males and females thus showing that GISA and the psychological state according to gender variance is greater within groups of assigned females and assigned males than between these groups.
Motivational Processes Influencing Mental Health Among Winter Sports Athletes in China
Authors: Wu Xinran , Zainal Abidin Nor Eeza , Aga Mohd Jaladin Rafidah
Published: September 2021

This study examined the association between motivational processes, psychological distress (depression, anxiety, and stress), and burnout among winter sports athletes within the Hierarchical Model of Intrinsic and Extrinsic Motivation (HMIEM). A total of 685 winter sport athletes participated in this study (377 males, 308 females, age range 18–25 years), from three sport universities across nine winter sports. They completed five psychometric inventories related to motivational factors and mental disorders. Overall, a task-oriented climate showed a positive association with basic psychological needs, eliciting a positive pathway to autonomous and controlled motivation. In contrast, an ego-oriented climate showed a negative association with basic psychological needs, eliciting a negative pathway to amotivation. Autonomous and controlled motivation were negatively associated with symptoms of psychological distress and burnout, while amotivation was positively associated with symptoms of psychological distress and burnout. These findings highlight the complex relationships between various motivational factors and mental health disorders among winter sport athletes, and support the essential requirement for adding mental health factors to the outcomes of the HMIEM sequence.
The Inhibitory Effect of Perceived Organizational Politics on Employee Voice Behavior: A Moderated Mediation Model
Authors: Liu Qin , Zhou Hao , Sheng Xinyi
Published: September 2021

Research on the mediating mechanisms and boundary conditions of perceived organizational politics’ (POP) effect on employee voice is underdeveloped. Based on conservation of resources theory, we proposed a moderated mediation model in which organizational embeddedness acts as a mediator to explain why POP inhibits promotive and prohibitive voice. Additionally, we posited sense of impact as a boundary condition affecting this relationship. A time-lagged survey of 227 employed MBA students from a university in southwestern China revealed that organizational embeddedness mediates the relationship between POP and promotive and prohibitive voice, and sense of impact moderates the relationship between POP and promotive voice, such that the relationship is stronger when sense of impact is weaker. The moderating effect was not significant for prohibitive voice. These findings have implications for theory, practice, and further organizational research.
Self-Handicapping in Chinese Medical Students During the COVID-19 Pandemic: The Role of Academic Anxiety, Procrastination and Hardiness
Authors: Jia Jun , Wang Lin-lin , Xu Jia-bin , Lin Xian-hao , Zhang Bin , Jiang Qin
Published: September 2021

Background: In the face of the 2019 Coronavirus Disease (COVID-19) outbreak, Chinese medical students worried about their future studies which might make them more susceptible to academic anxiety. Previous studies have shown that academic anxiety is an important risk factor for self-handicapping, but there are few studies to explore the relationship between the two which may be mediated or moderated by other variables. Therefore, this study investigated how Chinese medical students' academic anxiety is correlated to their self-handicapping in time of COVID-19 epidemic, and explored the moderating and mediating effects of hardiness and procrastination.

Methods: In this study, 320 Chinese medical students' psychological traits were measured with Academic Anxiety Questionnaire, Self-Handicapping Scale, General Procrastination Scale and Hardiness Scale to explore the potential associations between these variables.

Results: The most obvious finding to emerge from this study was that self- handicapping had a positive correlation with academic anxiety and procrastination, but had a negative correlation with hardiness; hardiness had a negative association with academic anxiety and procrastination; and academic anxiety and procrastination were positively correlated. In addition, the relationship between academic anxiety and self-handicapping of Chinese medical students was not only partially mediated by procrastination, but also moderated by hardiness. Furthermore, medical students who had lower hardiness had stronger direct effect, while the indirect effect was strong at high and low conditions of hardiness.

Conclusion: In time of the COVID-19 epidemic, the academic anxiety and self-handicapping of medical students are influenced by procrastination and hardiness to a great extent. Thus, in addition to suggesting that more attention should be paid to the academic anxiety and procrastination of medical students, in the future, more attention should be paid to cultivating the hardiness of medical students and exerting its interventional role in self-handicapping.
Well-Being as Human Development, Equality, Happiness and the Role of Freedom, Activism, Decentralization, Volunteerism and Voter Participation: A Global Country-Level Study
Authors: Perkins Douglas D. , Ozgurer Mehmet Reha , Lupton Andrew , Omidvar-Tehrani Shadi
Published: September 2021

We propose and test a new model for predicting multiple quantitative measures of well-being globally at the country level based on the United Nations Human Development Index (HDI), income inequality (Net Gini), and National Happiness Index (NHI; U.N. Sustainable Development Solutions Network world survey of life satisfaction). HDI consists of per-capita Gross National Income (economic well-being), average life expectancy (proxy for health well-being), and educational attainment (capabilities well-being). Using data on 105 countries representing 95% of the world’s population, a history of grassroots activism (Global Non-violent Action Database), civil liberties and political rights (Freedom Score), political and fiscal decentralization, and voter participation (Institute for Democracy and Electoral Assistance) correlate with HDI and NHI. Citizen volunteering (Gallup Civic Engagement Index) predicts only NHI. In multivariate analyses, Freedom Score is the most robust predictor of all well-being measures, including income equality. Fiscal decentralization and voter turnout also predict HDI and NHI, controlling for other influences. Based on prior analyses in the Global Development of Applied Community Studies project, implications and recommendations are discussed for developing community human research and professional resources across 12 disciplines in countries where they are needed based on social justice, citizenship, well-being, inequality, human rights, and other development challenges. We recommend individual and community-level and qualitative analyses of the above predictors’ relationships with these same conceptualizations of well-being, as well as consideration of other social, cultural and political variables and their effect on well-being.
A Research Domain Criteria Approach to Gambling Disorder and Behavioral Addictions: Decision-Making, Response Inhibition, and the Role of Cannabidiol
Authors: Pallanti Stefano , Marras Anna , Makris Nikolaos
Published: September 2021

Gambling Disorder (GD) has been recently re-classified in the DSM-5 under the “substance-related and addictive disorders,” in light of its genetic, endophenotypic, and phenotypic resemblances to substance dependence. Diminished control is a core defining concept of psychoactive substance dependence or addiction and has given rise to the concept of “behavioral” addictions, which are syndromes analogous to substance addiction, but with a behavioral focus other than ingestion of a psychoactive substance. The main symptom clusters are represented by loss of control, craving/withdrawal, and neglect of other areas of life, whereas in a Research Domain Criteria (RDoC) perspective, GD patients exhibit deficits in the domain of “Positive valence systems,” particularly in the “Approach motivation” and “Reward learning” constructs, as well as in the “Cognitive systems,” primarily in the “Cognitive control” construct. In the Addictions Neuroclinical Assessment (ANA), three relevant domains for addictions emerge: “Incentive salience,” “Negative Emotionality,” and “Executive Function.” The endocannabinoid system (ECS) may largely modulate these circuits, presenting a promising pharmaceutical avenue for treating addictions. Up to now, research on cannabidiol has shown some efficacy in Attention Deficit/Hyperactivity Disorder (ADHD), whereas in behavioral addictions its role has not been fully elucidated, as well as its precise action on RDoC domains. Herein, we review available evidence on RDoC domains affected in GD and behavioral addictions and summarize insights on the use of cannabidiol in those disorders and its potential mechanisms of action on reward, decisional, and sensorimotor processes.
A Systematic Review on Sex- and Gender-Sensitive Research in Public Mental Health During the First Wave of the COVID-19 Crisis
Authors: Tibubos Ana N. , Otten Daniëlle , Ernst Mareike , Beutel Manfred E.
Published: September 2021

Background:Sex and gender are important modifiers of mental health and behavior in normal times and during crises. We investigated whether they were addressed by empirical, international research that explored the mental health and health behavior ramifications after the onset of the COVID-19 pandemic.

Methods:We systematically searched the databases PsyArXiv, PubMed, PsycInfo, Psyndex, PubPsych, Cochrane Library, and Web of Science for studies assessing mental health outcomes (main outcomes) as well as potential risk and protective health behavior (additional outcomes) up to July 2, 2020.

Findings:Most of the 80 publications fulfilling the selection criteria reflected the static difference perspective treating sex and gender as dichotomous variables. The focus was on internalizing disorders (especially anxiety and depression) burdening women in particular, while externalizing disorders were neglected. Sex- and gender-specific evaluation of mental healthcare use has also been lacking. With respect to unfavorable health behavior in terms of adherence to prescribed protective measures, men constitute a risk group.

Interpretations:Women remain a vulnerable group burdened by multiple stresses and mental health symptoms. The neglect of sex- and gender-specific evaluation of aggression-related disorders, substance addiction, and mental healthcare use in the early stage represents a potentially dangerous oversight.

Systematic Review Registration:https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020192026, PROSPERO 2020 CRD42020192026.
Time of Day-Dependent Alterations in Hippocampal Kynurenic Acid, Glutamate, and GABA in Adult Rats Exposed to Elevated Kynurenic Acid During Neurodevelopment
Authors: Wright Courtney J. , Rentschler Katherine M. , Wagner Nathan T. J. , Lewis Ashley M. , Beggiato Sarah , Pocivavsek Ana
Published: September 2021

Hypofunction of glutamatergic signaling is causally linked to neurodevelopmental disorders, including psychotic disorders like schizophrenia and bipolar disorder. Kynurenic acid (KYNA) has been found to be elevated in postmortem brain tissue and cerebrospinal fluid of patients with psychotic illnesses and may be involved in the hypoglutamatergia and cognitive dysfunction experienced by these patients. As insults during the prenatal period are hypothesized to be linked to the pathophysiology of psychotic disorders, we presently utilized the embryonic kynurenine (EKyn) paradigm to induce a prenatal hit. Pregnant Wistar dams were fed chow laced with kynurenine to stimulate fetal brain KYNA elevation from embryonic day 15 to embryonic day 22. Control dams (ECon) were fed unlaced chow. Plasma and hippocampal tissue from young adult (postnatal day 56) ECon and EKyn male and female offspring were collected at the beginning of the light (Zeitgeber time, ZT 0) and dark (ZT 12) phases to assess kynurenine pathway metabolites. Hippocampal tissue was also collected at ZT 6 and ZT 18. In separate animals, in vivo microdialysis was conducted in the dorsal hippocampus to assess extracellular KYNA, glutamate, and γ-aminobutyric acid (GABA). Biochemical analyses revealed no changes in peripheral metabolites, yet hippocampal tissue KYNA levels were significantly impacted by EKyn treatment, and increased in male EKyn offspring at ZT 6. Interestingly, extracellular hippocampal KYNA levels were only elevated in male EKyn offspring during the light phase. Decreases in extracellular glutamate levels were found in the dorsal hippocampus of EKyn male and female offspring, while decreased GABA levels were present only in males during the dark phase. The current findings suggest that the EKyn paradigm may be a useful tool for investigation of sex- and time-dependent changes in hippocampal neuromodulation elicited by prenatal KYNA elevation, which may influence behavioral phenotypes and have translational relevance to psychotic disorders.
Hypertension Prevalence Rates Among Urban and Rural Older Adults of China, 1991–2015: A Standardization and Decomposition Analysis
Authors: Yu Qi , Lin Shiqi , Wu Jilei
Published: September 2021

Objectives: The prevalence of hypertension (HTN) among older adults is becoming an important issue in public health in China as it is now stepping into the super-aged society with high pressure of a chronic disease burden. With urban–rural differences in population composition and health facilities, this study aimed to assess the gaps in the prevalence trends of HTN among older adults by considering demographic factors such as age, gender, education level, and regional differences during 1991–2015 in China.

Methods: We adopted the consistent sampling design and measure of HTN of the cross-longitudinal surveys of the China Health and Nutrition survey, and we compared the HTN prevalence rates between urban and rural older adults by taking each wave of the survey as a cross-sectional sample of the Chinese population by the following and supplementary samples. The classic standardization and decomposition analysis method was utilized with four factor-specific rates, and contributions were calculated, i.e., age, gender, education, and region, which reflects the aspect of demographic and social development differences between urban and rural areas of China.

Results: The prevalence rates of HTN of the whole of older adults were increasing in 1991–2015. However, the gaps of prevalence rates of HTN between urban and rural areas show different trends accompanied by the health policies launched by the government. Namely, the gap was narrowed during 1993–1997 and then enlarged during 1997–2011 and narrowing again. Those trends reflect the policy effects with the health resource allocation and utilization of health services for urban and rural older adults.

Conclusions: With the four factors of decomposition analysis, the differences reflect the results of health policy effects, considering the urban–rural discrepancy on older adults with different demographic characteristics. Hence, the differentiated policies should be considered with the urban–rural population, such as HTN prevention and the population health promotion.
The COVID-19 Pandemic and Economic Growth: Theory and Simulation
Authors: Xiang Lijin , Tang Mingli , Yin Zhichao , Zheng Mengmeng , Lu Shuang
Published: September 2021

The outbreak of COVID-19 pandemic has caused profound consequences on world economy. In order to explore the long-term impact of the pandemic on economic growth and the effects of different policy responses, this paper combines economic theory with epidemiological model to construct an interdisciplinary model, in which labor supply is dynamically constrained by pandemic conditions. Analysis of model equilibrium suggests that outbreaks of infectious disease reduce labor supply and negatively affect economic output. The accumulation of health capital can suppress the spread of disease and improve the recovery rate of infected individuals, which will alleviate the labor supply constraint caused by the pandemic and lead to an increase in output and consumption. The model is then calibrated to Chinese economy. The simulation results imply that government's public health policy can enhance the role of health capital in promoting economic growth. But the marginal effect of certain policies is diminishing. Therefore, the government needs to balance pandemic prevention and control costs and marginal benefits when formulating public health policies. When the pandemic is under control, the resumption of production is feasible and the economic stimulus package could lead to economic recovery.
Economic Analysis of Inequality in Preventive Health Check-Ups Uptake in Saudi Arabia
Authors: Al-Hanawi Mohammed Khaled , Chirwa Gowokani Chijere
Published: September 2021

Background: Undertaking preventive health check-ups has proven to be an important strategy in the fight against several diseases. However, various socioeconomic circumstances may hinder participating in such an important health exercise for many people. With the growth in the burden of non-communicable diseases in Saudi Arabia, it is thus essential that people take an active role in undertaking preventive health check-ups. However, the extent to which this behavior is determined by inequalities in socioeconomic circumstances remains not well-documented. The aim of this study was to examine the socioeconomic inequalities in undertaking preventive health check-ups in Saudi Arabia, using a national survey with a sample of 11,528 respondents.

Methods: Data from the Saudi Family Health Survey conducted in 2018 by the General Authority for Statistics were used for the analysis of this study. Univariate, bivariate, and multivariate logistic regression analyses were employed to examine the socioeconomic factors associated with undertaking preventive health check-ups. Concentration indices were calculated, and associated concentration curves were used to assess the socioeconomic inequalities in preventive health check-ups uptake. Moreover, decomposition analysis was performed to examine the extent to which the socioeconomic variables affect uptake of preventive health check-ups.

Results: The results reveal that being older adults, more educated, insured, and married increase the probability of undertaking preventive health check-ups. Regarding socioeconomic inequalities, preventive health check-ups uptake was concentrated among the wealthier (concentration index: 0.0831; P < 0.001). However, some differences were observed in terms of socioeconomic inequality across the regions. Decomposition of the Erreygers index supported the analysis of the determinants and suggested that income, and education were the primary drivers of the associated inequality.

Conclusions: These results suggest that the government of Saudi Arabia should develop intervention programs and strategies that promote the uptake of health check-ups among the vulnerable group to reduce inequalities. Of particular importance is the need for more health-related education among the poor and those with lower education in order to raise their awareness on the benefits and advantages of conducting health examinations.
Energy Exchange Between Electromagnetic Ion Cyclotron (EMIC) Waves and Thermal Plasma: From Theory to Observations
Authors: Usanova M. E.
Published: September 2021

The cold plasmaspheric plasma, the ring current and the radiation belts constitute three important populations of the inner magnetosphere. The overlap region between these populations gives rise to wave-particle interactions between different plasma species and wave modes observed in the magnetosphere, in particular, electromagnetic ion cyclotron (EMIC) waves. These waves can resonantly interact with multiple particle species, being an important loss process for both ring current ions and radiation belt electrons, as well as a cold plasma heating mechanism. This mini-review will focus on the interaction between EMIC waves and cold and thermal plasma, specifically the role of EMIC waves in cold and thermal electron and ion heating. It will discuss early theoretical results in conjunction with numerical modelling and recent satellite observations, and address outstanding problems and controversies in this field.
Pain Distraction During Awake Major Colorectal Surgery: Supporting Patients Beyond the COVID-19 Era. Preliminary Findings
Authors: Romanzi Andrea , Gallo Gaetano , De Rango Sabrina , Vignati Barbara , Vannelli Alberto
Published: September 2021

Introduction: During the coronavirus disease 2019 (COVID-19) pandemic, hospitals rapidly ran out of intensive care beds. Because minimally invasive surgery and general anaesthesia are both aerosol-generating procedures, their use has become controversial. We report a case series of awake undelayable colorectal surgeries which, innovatively, took advantage of intraoperative pain distraction. Moreover, we describe our frugal solution to social distancing in psychological support of inpatients.

Methods: Between October 2020 and February 2021, five patients underwent acute-care colorectal surgery under locoregional anaesthesia in our department. A 3D mobile theatre (3DMT) was used during the operation to distract the patients from pain. Vital signs, pain intensity, ergonomic comfort/discomfort, sense of presence and distress were intraoperatively monitored. A postoperative “cuddle delivery” service was instituted: video messages from relatives and close friends were delivered daily to the patient through the 3DMT. Emotional effects were investigated through clinical interviews conducted by a psychologist at our hospital.

Results: Both intraoperative and postoperative pain were always well controlled. Conversion to general anaesthesia and postoperative intensive support/monitoring were never necessary. The “cuddle delivery” initiative helped patients fill the emotional gap created by the strict containment measures implemented inside the hospital, distracting them from emotional anxiety and physical pain.

Conclusions: During the next phase of the COVID-19 pandemic and even after the COVID-19 era, awake laparotomy under locoregional anaesthesia may be a crucial option for delivering acute-care surgery to selected patients when intensive care beds are unavailable and postponing surgery is unacceptable. We also introduce a new modality for the provision of emotional support during postoperative inpatient care as a countermeasure to the restrictions imposed by social distancing measures.