bluuebunny/crossref_metadata_2025 huggingface dataset:
Descriptive feedback with targeted education to improve telephonic escalation of care: a simulation-based study
Authors: Kuriakose Aster , Arachchige Subodhini Puhambugoda , Emeto Theophilus I , Hiskens Matthew I , Hariharan Gopakumar
Published: March 2024

Background

Awareness of communication failures in healthcare has necessitated the implementation of standardized, validated handover tools such as Identification, Situation, Background, Assessment, Recommendation (ISBAR). Although educational sessions improve communication, the effectiveness of individualized care escalation communication training is unknown. The primary aim was to conduct a simulation-based study to assess individualized one-on-one communication training for junior medical doctors for improving care escalation in pediatric emergencies. The secondary aim was to assess the evaluation of the training.

Methods

The prospective observational study assessed participants pre- and post-intervention. In Session One, participants presented a written case scenario telephonically to two senior pediatricians. Fifty participants were scored using an 18-item checklist based on the ISBAR tool and “free text” responses. Immediately following case presentations, participants completed individualized one-on-one 30-minute educational sessions regarding self-reflection, didactic teaching, and constructive feedback based on the ISBAR. Session Two included a second case presentation and reassessment. We conducted qualitative analysis of supervisor’s feedback on performance and trainee doctor’s evaluation of the training.

Results

There was significant improvement in 8 of the 18 components of the ISBAR checklist. All elements of care escalation were significantly improved, and overall communication was higher post-intervention (P < 0.001); however, no improvement was noted in participants’ explorations of differential diagnoses (P = 0.263). The qualitative analysis identified themes of improved urgency in seeking senior support and conversational clarity from supervisors, and improved intervention quality and self-confidence from participants.

Conclusions

Individualized communication training may improve pediatric emergency care escalation and communication among junior doctors.
Effect of morality or capitalist ideology in choosing dentistry as a career in Türkiye: a cross sectional study
Authors: Gökay Gonca Deste , Görürgöz Cansu , Kılınç Ahmet
Published: March 2024

Background

Previous studies have provided important findings on the profession of dentistry and the motivators for choosing dentistry. This study has attempted to contribute to this accumulation by using a sociocultural perspective and interpreting the relationships among motivators from this perspective in a large Turkish sample. The aim of this study was to investigate what motivates dental students to choose dentistry as a career in Türkiye.

Methods

First-year dental students from different dental schools were included in a descriptive cross-sectional study. The questionnaire included sections covering demographics, motivators and career satisfaction. A total of 919 students from 29 different state dental schools and four private dental schools participated. Descriptive statistics such as percentages, means and standard deviations were used to summarize the sociodemographic information and the distribution of the motivators. Factorial analysis was carried out for the structural status of the questionnaire items. The relationships between the motivators were analyzed using Pearson’s correlation.

Results

Among the 919 students, 64.2% were female, and 35.8% were male. Half of them chose dentistry after seeing their higher education institution’s examination results, while the other half had already considered it a career during their preuniversity years. Communicating with people, artistic skills, and helping others were the main motivators for students to choose dentistry as a career in Türkiye, and students’ overall career satisfaction was moderately high. The strongest correlations were between communication with people and benefits (r =.74), between communication with people and helping others (r =.71), between communication with people and artistic skills (r =.66), between artistic skills and benefits (r =.69), between artistic skills and helping others (r =.65), between dental experience and benefits (r =.51), between dental experience and helping others (r =.50), and between benefits and helping others (r =.71).

Conclusion

Helping others, artistic skills, communicating with people, and benefits were the most important factors motivating dental students to choose a career, and positive relationships were detected between these four factors. This information may help to develop more effective career guidance and mentorship strategies for dental students.
How to select and understand guidelines for patient-reported outcomes: a scoping review of existing guidance
Authors: Kaneyasu Takako , Hoshino Eri , Naito Mariko , Suzukamo Yoshimi , Miyazaki Kikuko , Kojima Satomi , Yamaguchi Takuhiro , Kawaguchi Takashi , Miyaji Tempei , Nakajima Takako Eguchi , Shimozuma Kojiro
Published: March 2024

Background

Over the past few decades, patient-reported outcomes (PROs) have been used to understand patient health conditions better. Therefore, numerous PRO measures (questionnaires) and guidelines or guidance have been developed. However, it is challenging to select target guidance from among the many available guidance and to understand the chosen guidance. This study comprehensively collected the existing PRO guidance for clinical trials or studies and practices to support novice PRO users in academia, industry, clinical practice, and regulatory and reimbursement decision-making.

Methods

For the scoping review, we searched the MEDLINE, Embase, Google Books, WorldCat, and the National Library of Medicine (NLM) Bookshelf databases from 2009 to 2023. The eligibility criteria were PRO guidance for clinical trials, clinical practice, or application such as health technology assessment. Those guidance cover aspects such as quality of life (QOL), PRO, health-related QOL, health state utilities, psychometric requirements, implementation methods, analysis and interpretation, or clinical practice applications. After the systematic search, three researchers individually reviewed the collected data, and the reviewed articles and books were scrutinized using the same criteria.

Results

We collected the PRO guidance published in articles and books between 2009 and 2023. From the database searches, 1,455 articles and 387 books were identified, of which one book and 33 articles were finally selected. The collected PRO guidance was categorized into the adoption of PRO measures, design and reporting of trials or studies using PROs, implementation of PRO evaluation in clinical trials or studies or clinical practice, analysis and interpretation of PROs, and application of PRO evaluation. Based on this categorization, we suggest the following for novices: When selecting guidance, novices should clarify the “place” and “purpose” where the guidance will be used. Additionally, they should know that the terminology related to PRO and the scope and expectations of PROs vary by “places” and “purposes”.

Conclusions

From this scoping review of existing PRO guidance, we provided summaries and caveats to assist novices in selecting guidance that fits their purpose and understanding it.
Investigating the nexus of metabolic syndrome, serum uric acid, and dementia risk: a prospective cohort study
Authors: Chen Tara SR , Mi Ning-Ning , Lao Hubert Yuenhei , Wang Chen-Yu , Lo Wai Leung Ambrose , Mao Yu-Rong , Tang Yan , Pei Zhong , Yuan Jin-Qiu , Huang Dong-Feng
Published: March 2024

Background

The global dementia prevalence is surging, necessitating research into contributing factors. We aimed to investigate the association between metabolic syndrome (MetS), its components, serum uric acid (SUA) levels, and dementia risk.

Methods

Our prospective study comprised 466,788 participants without pre-existing MetS from the UK Biobank. We confirmed dementia diagnoses based on the ICD-10 criteria (F00-03). To evaluate the dementia risk concerning MetS, its components, and SUA levels, we applied Cox proportional hazards models, while adjusting for demographic factors.

Results

Over a median follow-up of 12.7 years, we identified 6845 dementia cases. Individuals with MetS had a 25% higher risk of all-cause dementia (hazard ratio [HR] = 1.25, 95% confidence interval [CI] = 1.19–1.31). The risk increased with the number of MetS components including central obesity, dyslipidemia for high-density lipoprotein (HDL) cholesterol, hypertension, hyperglycemia, and dyslipidemia for triglycerides. Particularly for those with all five components (HR = 1.76, 95% CI = 1.51–2.04). Dyslipidemia for HDL cholesterol, hypertension, hyperglycemia, and dyslipidemia for triglycerides were independently associated with elevated dementia risk (p< 0.01). MetS was further linked to an increased risk of all-cause dementia (11%) and vascular dementia (VD, 50%) among individuals with SUA levels exceeding 400 μmol/L (all-cause dementia: HR = 1.11, 95% CI = 1.02–1.21; VD: HR = 1.50, 95% CI = 1.28–1.77).

Conclusions

Our study provides robust evidence supporting the association between MetS, its components, and dementia risk. These findings emphasize the importance of considering MetS and SUA levels in assessing dementia risk, offering valuable insights for prevention and management strategies.
Assessing the impact of type 2 diabetes on mortality and life expectancy according to the number of risk factor targets achieved: an observational study
Authors: Wang Bin , Fu Yanqi , Tan Xiao , Wang Ningjian , Qi Lu , Lu Yingli
Published: March 2024

Background

Type 2 diabetes (T2D) is associated with an increased risk of premature death. Whether multifactorial risk factor modification could attenuate T2D-related excess risk of death is unclear. We aimed to examine the association of risk factor target achievement with mortality and life expectancy among patients with T2D, compared with individuals without diabetes.

Methods

In this longitudinal cohort study, we included 316 995 participants (14 162 with T2D and 302 833 without T2D) free from cardiovascular disease (CVD) or cancer at baseline between 2006 and 2010 from the UK Biobank. Participants with T2D were categorised according to the number of risk factors within target range (non-smoking, being physically active, healthy diet, guideline-recommended levels of glycated haemoglobin, body mass index, blood pressure, and total cholesterol). Survival models were applied to calculate hazard ratios (HRs) for mortality and predict life expectancy differences.

Results

Over a median follow-up of 13.8 (IQR 13.1–14.4) years, deaths occurred among 2105 (14.9%) participants with T2D and 18 505 (6.1%) participants without T2D. Compared with participants without T2D (death rate per 1000 person-years 4.51 [95% CI 4.44 to 4.57]), the risk of all-cause mortality among those with T2D decreased stepwise with an increasing number of risk factors within target range (0–1 risk factor target achieved: absolute rate difference per 1000 person-years 7.34 [4.91 to 9.78], HR 2.70 [2.25 to 3.25]; 6–7 risk factors target achieved: absolute rate difference per 1000 person-years 0.68 [-0.62 to 1.99], HR 1.16 [0.93 to 1.43]). A similar pattern was observed for CVD and cancer mortality. The association between risk factors target achievement and all-cause mortality was more prominent among participants younger than 60 years than those 60 years or older (P for interaction = 0.012). At age 50 years, participants with T2D who had 0–1 and 6–7 risk factors within target range had an average 7.67 (95% CI 6.15 to 9.19) and 0.99 (-0.59 to 2.56) reduced years of life expectancy, respectively, compared with those without T2D.

Conclusions

Individuals with T2D who achieved multiple risk factor targets had no significant excess mortality risk or reduction in life expectancy than those without diabetes. Early interventions aiming to promote risk factor modification could translate into improved long-term survival for patients with T2D.
Exploring the role of community pharmacies as a harm reduction environment for anabolic–androgenic steroid consumers: triangulating the perspectives of consumers and pharmacists
Authors: Piatkowski Timothy , Benn Sarah , Ayurzana Lkhagvadulam , King Michelle , McMillan Sara , Hattingh Laetitia
Published: March 2024

Background

While community pharmacies have been successful in providing harm reduction support for illicit substance consumers, little research has explored their role in addressing the needs of anabolic–androgenic steroid (AAS) consumers.

Objective

This study aimed to triangulate the attitudes and experiences of AAS consumers and community pharmacist’s regarding AAS harm reduction.

Methods

Semi-structured interviews were conducted with AAS consumers (n = 8) and community pharmacists (n = 15) between December 2022 and August 2023 in Australia. Interview data were analysed using reflexive thematic analysis.

Results

While consumers emphasised easy access to pharmacies, particularly in urban areas, challenges were noted in rural regions. AAS consumers expressed a preference for community pharmacies, perceiving them as less confronting and a feasible avenue for accessing professional advice, highlighting the potential role of pharmacists in nurturing therapeutic alliances with AAS consumers. Similarly, pharmacists expressed receptivity to providing harm reduction information but acknowledged knowledge gaps, suggesting a need for tailored education programs to support AAS consumers effectively.

Conclusions

Community pharmacies can be an important environment for AAS harm reduction. Strategies include utilising private spaces for open discussions with AAS consumers and enhancing pharmacists' understanding of AAS to foster trust and support. Further research is needed to address knowledge gaps and training needs for pharmacy staff, with the aim of creating a safer environment for AAS consumers.
CAR T cells and T cells phenotype and function are impacted by glucocorticoid exposure with different magnitude
Authors: Poiret Thomas , Vikberg Sara , Schoutrop Esther , Mattsson Jonas , Magalhaes Isabelle
Published: March 2024

Background

Chimeric antigen receptor (CAR) T cell therapy is associated with high risk of adverse events. Glucocorticoids (GCs) are cornerstone in the management of high-grade cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity syndrome (ICANS). Given the potentially deleterious effects of GCs on CAR T cells anti-tumor activity, increasing our understanding of GCs impact on CAR T cells is crucial.

Methods

Using several CAR T cells i.e., CD19, mesothelin (MSLN)-CD28 and MSLN-41BB CAR T cells (M28z and MBBz), we compared phenotypical, functional, changes and anti-tumor activity between i) transduced CD19 CAR T cells with untransduced T cells, ii) M28z with MBBz CAR T cells induced by Dexamethasone (Dx) or Methylprednisolone (MP) exposures.

Results

Higher levels of GC receptor were found in less differentiated CAR T cells. Overall, Dx and MP showed a similar impact on CAR T cells. Compared to untreated condition, GCs exposure increased the expression of PD-1 and TIM-3 and reduced the expression of LAG3 and function of T cells and CAR T cells. GC exposures induced more exhausted (LAG3 + PD1 + TIM3 +) and dysfunctional (CD107a-INFγ-TNF-IL2-) untransduced T cells in comparison to CD19 CAR T cells. GC exposure impaired more CD4 + than CD8 + CD19 CAR T cells. GC exposures increased more PD-1 expression associated with reduced proliferative capacity and function of M28z as compared to MBBz CAR T cells. CAR T cells anti-tumor activity was greatly affected by repeated GC exposure but partly recovered within 48h after GCs withdrawal.

Conclusions

In summary, GCs impacted phenotype and function of untransduced and CAR T cell with different magnitude. The nature of the CAR costimulatory domain influenced the magnitude of CAR T cell response to GCs.
Support, not blame: safe partner disclosure among women diagnosed with HIV late in pregnancy in South Africa and Uganda
Authors: Twimukye Adelline , Alhassan Yussif , Ringwald Beate , Malaba Thokozile , Myer Landon , Waitt Catriona , Lamorde Mohammed , Reynolds Helen , Khoo Saye , Taegtmeyer Miriam
Published: March 2024

Background

HIV partner disclosure rates remain low among pregnant women living with HIV in many African countries despite potential benefits for women and their families. Partner disclosure can trigger negative responses like blame, violence, and separation. Women diagnosed with HIV late in pregnancy have limited time to prepare for partner disclosure. We sought to understand challenges around partner disclosure and non-disclosure faced by women diagnosed with HIV late in pregnancy in South Africa and Uganda and to explore pathways to safe partner disclosure.

Methods

We conducted in-depth interviews and focus group discussions with pregnant women and lactating mothers living with HIV (n = 109), disaggregated by antenatal care (ANC) initiation before and after 20 weeks of gestation, male partners (n = 87), and health workers (n = 53). All participants were recruited from DolPHIN2 trial sites in Kampala (Uganda) and Gugulethu (South Africa). Topic guides explored barriers to partner disclosure, effects of non-disclosure, strategies for safe disclosure. Using the framework analysis approach, we coded and summarised data based on a socio-ecological model, topic guides, and emerging issues from the data. Data was analysed in NVivo software.

Results

Our findings illustrate pregnant women who initiate ANC late experience many difficulties which are compounded by the late HIV diagnosis. Various individual, interpersonal, community, and health system factors complicate partner disclosure among these women. They postpone or decide against partner disclosure mainly for own and baby’s safety. Women experience stress and poor mental health because of non-disclosure while demonstrating agency and resilience. We found many similarities and some differences around preferred approaches to safe partner disclosure among female and male participants across countries. Women and male partners preferred healthcare workers to assist with disclosure by identifying the ‘right’ time to disclose, mentoring women to enhance their confidence and communication skills, and providing professional mediation for partner disclosure and couple testing. Increasing the number of counsellors and training them on safe partner disclosure was deemed necessary for strengthening local health services to improve safe partner disclosure.

Conclusion

HIV diagnosis late in pregnancy amplifies existing difficulties among pregnant women. Late ANC initiation is an indicator for the likelihood that a pregnant woman is highly vulnerable and needs safeguarding. Respective health programmes should be prepared to offer women initiating ANC late in pregnancy additional support and referral to complementary programmes to achieve safe partner disclosure and good health.
Duloxetine reduces opioid consumption and pain after total hip or knee arthroplasty: a meta-analysis of randomized controlled trials
Authors: Lin Yicai , Jiang Mingyang , Liao Chun , Wu Qingjian , Zhao Jinmin
Published: March 2024

Purpose

There is no consensus in the current literature on the analgesic role of duloxetine after total hip arthroplasty (THA) or total knee arthroplasty (TKA). Thus, we designed this meta-analysis to reveal the analgesic effectiveness and safety of duloxetine in TKA or THA.

Methods

As of October 2022, two authors (L.C. and W.Q.J.) independently searched five main databases (EMBASE, Web of Science, PubMed, Cochrane Library, and Google Scholar) to find relevant studies. Duloxetine vs. placebo in randomized controlled trials (RCTs) for THA or TKA were included. We set perioperative total opioid consumption as the primary outcome. Secondary outcomes included resting or dynamic pain scores over time, gastrointestinal adverse events, neurological adverse events, and other adverse reactions.

Results

Eight RCTs with 695 patients were incorporated in our study. This meta-analysis showed high evidence that duloxetine was effective in reducing perioperative opioid consumption (Standard mean difference [SMD] = − 0.50, 95% confidence intervals [CI]: −0.70 to − 0.31, P < 0.00001) and low to moderate evidence that duloxetine could reduce pain within three weeks after surgery. Low to high evidence showed no differences between the two groups for most adverse events. Substantial evidence suggests that duloxetine can reduce nausea and vomiting after surgery (Risk ratio [RR] = 0.69, 95% CI: 0.50 to 0.95, P = 0.02, I2 = 4%). However, moderate evidence suggested that duloxetine might be associated with increased postoperative drowsiness (RR = 1.83, 95% CI: 1.08 to 3.09, P = 0.02, I2 = 0%).

Conclusion

Duloxetine reduced overall opioid consumption in the perioperative period and relieved pain within three weeks after surgery without increasing the risk of adverse drug events. Duloxetine can be part of a multimodal management regimen in patients with THA and TKA.
Predictive value of preoperative platelet count and D-dimer levels for spinal cord injury following acute type a aortic dissection
Authors: Pei Fengbo , Wei Jinhua , Yao Yao , Wu Hui , Chen Zujun
Published: March 2024

Background

This study aims to identify the risk factors contributing to spinal cord injury (SCI) following a type A acute aortic dissection (TA-AAD).

Methods

This retrospective study was conducted at a single center and involved 481 patients who received frozen elephant trunk stent implantation for TA-AAD. Additionally, these patients underwent total arch replacement with deep hypothermic circulatory arrest. This study was performed at Fuwai Hospital between September 2016 and April 2020.

Results

The resulting data of the multivariate logistic regression analysis demonstrated that preoperative platelet count (odds ratio [OR] = 0.774) and D-dimer levels (OR = 2.247) could serve as independent predictors for postoperative SCI in patients with TA-AAD.

Conclusion

The findings indicate that preoperative platelet count and D-dimer levels are independent risk factors for postoperative SCI in patients with TA-AAD. This study holds significant clinical implications regarding the prognosis and therapeutic responses for patients with TA-AAD.
Axillary vein as an alternative venous access site for VV-ECMO cannulation: a case report
Authors: Pan Tao , Zhou Xiaoyang , Pan Jianneng , Chen Bixin , Xu Chang , Xu Zhaojun , Dong Pingping , Yu Tingting
Published: March 2024

Background

Ultrasound-guided percutaneous axillary vein cannulation can reduce cannulation failure and mechanical complications, is as safe and effective as internal jugular vein cannulation, and is superior to subclavian vein cannulation using landmark technique. As far, reports of venovenous extracorporeal membrane oxygenation (VV-ECMO) with percutaneous axillary vein cannulation are rare.

Case presentation

A 64-year-old man presenting with dyspnea and chest tightness after aspirating sewage was admitted to the emergency department. Computed tomography (CT) showed diffuse exudation of both lungs and arterial blood gas analysis showed an oxygenation index of 86. He was diagnosed with aspiration pneumonia-induced acute respiratory distress syndrome (ARDS) and intubated for deteriorated oxygenation. Despite the combination therapy of protective mechanical ventilation and prone position, the patient’s oxygenation deteriorated further, accompanied with multiple organ dysfunction syndrome, which indicated the requirement of support with VV-ECMO. However, vascular ultrasound detected multiple thrombus within bilateral internal jugular veins. As an alternative, right axillary vein was chosen as the access site of return cannula. Subsequently, femoral-axillary VV-ECMO was successfully implemented under the ultrasound guidance, and the patient’s oxygenation was significantly improved. Unfortunately, the patient died of hyperkalemia-induced ventricular fibrillation after 36 h of VV-ECMO running. Despite the poor prognosis, the blood flow during ECMO run was stable, and we observed no bleeding complication, vascular injury, or venous return disorder.

Conclusions

Axillary vein is a feasible alternative access site of return cannula for VV-ECMO if internal jugular vein access were unavailable.
Analysis of disease characteristics of a large patient cohort with congenital generalized lipodystrophy from the Middle East and North Africa
Authors: Al Yaarubi Saif , Alsagheir Afaf , Al Shidhani Azza , Alzelaye Somaya , Alghazir Nadia , Brema Imad , Alsaffar Hussain , Al Dubayee Mohammed , Alshahrani Awad , Abdelmeguid Yasmine , Omar Omneya M. , Attia Najya , Al Amiri Elham , Al Jubeh Jamal , Algethami Albandari , Alkhayyat Haya , Haleem Azad , Al Yahyaei Mouza , Khochtali Ines , Babli Saleha , Nugud Ahmed , Thalange Nandu , Albalushi Sarah , Hergli Nadia , Deeb Asma , Alfadhel Majid
Published: March 2024

Background

Congenital generalized lipodystrophy (CGL) is a rare inherited disease characterized by a near-total absence of adipose tissue and is associated with organ system abnormalities and severe metabolic complications. Here, we have analyzed the disease characteristics of the largest CGL cohort from the Middle East and North Africa (MENA) who have not received lipodystrophy-specific treatment.

Methods

CGL was diagnosed clinically by treating physicians through physical assessment and supported by genetic analysis, fat loss patterns, family history, and the presence of parental consanguinity. Data were obtained at the time of patient diagnosis and during leptin-replacement naïve follow-up visits as permitted by available medical records.

Results

Data from 43 patients with CGL (37 females, 86%) were collected from centers located in eight countries. The mean (median, range) age at diagnosis was 5.1 (1.0, at birth–37) years. Genetic analysis of the overall cohort showed that CGL1 (n = 14, 33%) and CGL2 (n = 18, 42%) were the predominant CGL subtypes followed by CGL4 (n = 10, 23%); a genetic diagnosis was unavailable for one patient (2%). There was a high prevalence of parental consanguinity (93%) and family history (67%) of lipodystrophy, with 64% (n = 25/39) and 51% (n = 20/39) of patients presenting with acromegaloid features and acanthosis nigricans, respectively. Eighty-one percent (n = 35/43) of patients had at least one organ abnormality; the most frequently affected organs were the liver (70%, n = 30/43), the cardiovascular system (37%, n = 16/43) and the spleen (33%, n = 14/43). Thirteen out of 28 (46%) patients had HbA1c > 5.7% and 20/33 (61%) had triglyceride levels > 2.26 mmol/L (200 mg/dl). Generally, patients diagnosed in adolescence or later had a greater severity of metabolic disease versus those diagnosed during childhood; however, metabolic and organ system abnormalities were observed in a subset of patients diagnosed before or at 1 year of age.

Conclusions

This analysis suggests that in addition to the early onset of fat loss, family history and high consanguinity enable the identification of young patients with CGL in the MENA region. In patients with CGL who have not received lipodystrophy-specific treatment, severe metabolic disease and organ abnormalities can develop by late childhood and worsen with age.
The clinical effectiveness of a self-management intervention for patients with persistent depressive disorder and their partners/caregivers: results from a multicenter, pragmatic randomized controlled trial
Authors: Solis Ericka C. , Carlier Ingrid V. E. , Kamminga Noëlle G. A. , Giltay Erik J. , van Hemert Albert M.
Published: March 2024

Background

Persistent depressive disorder (PDD) is prevalent and debilitating. For patients with PDD, psychiatric rehabilitation using self-management interventions is advised as the next therapeutic step after multiple unsuccessful treatment attempts. The “Patient and Partner Education Program for All Chronic Diseases” (PPEP4All) is a brief, structured self-management program that focuses on functional recovery for patients and their partners/caregivers. In chronic somatic disorder populations, PPEP4All has already been shown to be clinically effective. We examined whether PPEP4All adapted for PDD (PPEP4All-PDD, nine weekly group or individual sessions) is also clinically effective for adults/elderly with PDD and their partners/caregivers compared to care-as-usual (CAU) in specialized mental healthcare.

Methods

In this mixed-method multicenter pragmatic randomized controlled trial, 70 patients with PDD and 14 partners/caregivers were allocated to either PPEP4All-PDD (patients, n = 37; partners/caregivers, n = 14) or CAU (patients, n = 33; partners/caregivers, not included) and completed questionnaires at 0, 3, 6, and 12 months regarding depressive symptoms, psychopathology, psychosocial burden, mental resilience, and happiness/well-being. Qualitative data were collected regarding treatment satisfaction. Data were analyzed using mixed model analyses and an intention-to-treat (ITT) approach.

Results

There was no statistically significant difference in any outcome regarding clinical effectiveness between PPEP4All-PDD and CAU. Subgroup analysis for depressive symptoms did not show any interaction effect for any subgroup. Although 78% of participants recommended PPEP4All-PDD, there was no difference in treatment satisfaction between PPEP4All-PDD (score = 6.6; SD = 1.7) and CAU (score = 7.6; SD = 1.2), p = 0.06.

Conclusion

Although depressive symptoms did not improve relative to CAU, this only confirmed that treatment for patients with treatment-resistant PDD should move from symptom reduction to functional recovery. Also, functional recovery may be reflected in other outcomes than psychosocial burden, such as self-empowerment, in patients with treatment-resistant PDD. Future research on PPEP4All-PDD could focus on a longer-term program and/or online program that may also be offered earlier in the treatment process as an empowerment intervention. 

Trial registration

Netherlands Trial Register Identifier NL5818. Registered on 20 July 2016 https://clinicaltrialregister.nl/nl/trial/20302
FLM-ICR: a federated learning model for classification of internet of vehicle terminals using connection records
Authors: Yang Kai , Du Jiawei , Liu Jingchao , Xu Feng , Tang Ye , Liu Ming , Li Zhibin
Published: March 2024

With the rapid growth of Internet of Vehicles (IoV) technology, the performance and privacy of IoV terminals (IoVT) have become increasingly important. This paper proposes a federated learning model for IoVT classification using connection records (FLM-ICR) to address privacy concerns and poor computational performance in analyzing users' private data in IoV. FLM-ICR, in the horizontally federated learning client-server architecture, utilizes an improved multi-layer perceptron and logistic regression network as the model backbone, employs the federated momentum gradient algorithm as the local model training optimizer, and uses the federated Gaussian differential privacy algorithm to protect the security of the computation process. The experiment evaluates the model's classification performance using the confusion matrix, explores the impact of client collaboration on model performance, demonstrates the model's suitability for imbalanced data distribution, and confirms the effectiveness of federated learning for model training. FLM-ICR achieves the accuracy, precision, recall, specificity, and F1 score of 0.795, 0.735, 0.835, 0.75, and 0.782, respectively, outperforming existing research methods and balancing classification performance and privacy security, making it suitable for IoV computation and analysis of private data.
Structural modeling of Chinese students’ academic achievement identity and basic psychological needs: do academic self-efficacy, and mindfulness play a mediating role?
Authors: Chen Shuya
Published: March 2024

Background

Mindfulness and academic self-efficacy were proposed as mediating variables, with successful academic identity as an exogenous variable. The backdrop for this research centers on the significance of psychological factors in shaping academic identity among college students.

Objectives

The primary aim of the research was to investigate the relationship between fundamental psychological needs, mindfulness, academic self-efficacy, and successful academic identity. Specifically, the study explored the direct and indirect impacts of basic psychological needs on successful academic identity mediated by mindfulness and academic self-efficacy.

Method

The research employed a descriptive method, utilizing correlational studies and structural equation modeling. A sample of 355 college students at Henan Judicial Police Vocational College, Henan, China, was randomly selected through multistage cluster sampling. Data were collected using established scales, including the Basic Psychological Needs Scale, Baer Mindfulness Scale, Jenkins and Morgan Academic Self-Efficacy Scale, and Vas and Isakson Successful Academic Identity Scale. The data analysis was conducted using AMOS 22 software.

Findings

The research findings revealed that fundamental psychological needs directly and indirectly significantly impact successful academic identity. Mindfulness played a mediating role in this relationship. However, academic self-efficacy did not considerably mediate the influence of fundamental psychological needs on successful academic identity (p > 0.05). These results highlight the complex dynamics between psychological needs, mindfulness, academic self-efficacy, and successful academic identity among college students in the specified academic year.

Conclusions

The findings suggest targeted interventions, such as workshops for families and teachers to address basic needs and psychologist and school counselor interventions to increase mindfulness. Additionally, organizing educational classes is imperative for fostering a supportive environment conducive to successful academic identity among college students.
Understanding the role of digital immersive technology in educating the students of english language: does it promote critical thinking and self-directed learning for achieving sustainability in education with the help of teamwork?
Authors: Tang Fenghua
Published: March 2024

Purpose

Universities are constantly searching for best practices to promote sustainability when it comes to educating students of the English language. Although this area of study has recently gained the attention of scholars around the world there is still a need to explore it from various perspectives.

Objective

This study aims to comprehensively investigate the impact of digital immersive technology on the education of English language students, specifically focusing on its potential to promote critical thinking and self-directed learning for achieving sustainability in education through teamwork. The research will assess the influence of digital immersive experiences on enhancing learning outcomes, examining their role in fostering critical thinking skills and encouraging self-directed learning practices. Additionally, the study explores the collaborative aspects of digital immersive technology, evaluating its contribution to teamwork among students.

Methodology

The objective was achieved by using a survey questionnaire to collect data from 304 registered students in various universities in Beijing. Data analysis was conducted by applying Mplus 7.0 software.

Findings

The findings revealed that the use of digital immersive technology was pivotal for achieving sustainable education both directly and indirectly to an extent. In addition, team working moderated all the respective paths except the path involving the use of digital immersive technology and critical thinking.

Implications

These results generated implications for teachers and policymakers to promote and facilitate the use of digital technology for teaching the English language to students, encouraging them to develop critical skills and self-directed learning strategies. The study also offered guidance and deeper understanding for researchers to address the concerns linked to the use of digital technology and sustainable education particularly in their future endeavors.
The effect of planning time on vocabulary acquisition in a task-based environment: the mediating roles of working memory and field (in)dependence
Authors: Gui Jingjing , Ismail Sayed M.
Published: March 2024

This research investigated the impact of planning time, working memory (WM), and cognitive styles on language learning outcomes within the framework of Task-Based Language Teaching (TBLT). Drawing on a diverse sample of language learners, the study employed a pretest-posttest control group quasi-experiment to examine the effects of providing pre-task planning time on language performance. Participants engaged in communicative tasks, with a focus on vocabulary acquisition and task complexity, while their cognitive processes were assessed through measures of WM and cognitive styles. The findings revealed significant interactions between planning time and cognitive styles, particularly field dependence, influencing language production and proficiency such that learners with planning time outperformed learners without planning time; high-WM learners outperformed their low-WM peers, and field independent learners outstripped their field-dependent counterparts. Moreover, the study contributes to the broader understanding of the nuanced relationship between planning time, WM, and cognitive styles in the context of TBLT. The implications of these findings for language teachers, materials developers, syllabus designers, curriculum developers, and policymakers are discussed, offering insights into the design of effective language learning environments. Despite certain limitations, the study provides a foundation for further research exploring cross-cultural variations, longitudinal effects, and the integration of technology in language education, with the aim of advancing pedagogical practices tailored to diverse learner profiles.
Arabic translation, content validity and reliability of the Multiple Sclerosis Intimacy and Sexuality Questionnaire-19 (MSISQ-19)
Authors: Abou El-Maaty Ali Ahmed , El Sherifi Saad Shawki , El-Gilany Abdel-Hady , Zehry Hamada Ibrahim , Salim Almaza Ali , Rohiem Mahmoud F. , Ismael Ahmed Fawzi
Published: March 2024

Background

The prevalence of sexual dysfunction (SD) in multiple sclerosis (MS) patients is accounted to affect nearly 75% of them with higher rate in men than women. Though most of the patients may desire to discuss confidentially the SD with their physician, but both the physician and the patient usually hesitate to break into this presumed taboo. Assuming that MS affects about 35.9 per 100,000 population, it is clearly a problem of paramount significance not to find, to the best of our knowledge, a specific scale for assessing SD in MS patients who speak Arabic. We aimed to translate the Multiple Sclerosis Intimacy and Sexuality Questionnaire-19 (MSISQ-19) from English into Arabic and then to Validate the Arabic version as a tool to evaluate the SD in MS patients.

Results

We included 40 (21 males and 19 females) sexually active married MS patients. Every patient completed the Arabic translation of the MSISQ-19. Validity construction was explored by the Cronbach's alpha coefficient and the exploratory factor analysis. The Arabic version of the scale was evaluated for clarity, relevance, and translation of the content. The SD represents 45.5% in our study (47.6% in males, 43.4% in females).

Conclusion

Through screening and diagnosis of SD in MS patients, MSISQ-19 would help both patients and physicians to invade the mystery of this hectic issue. In Arabic populations, Arabic version of MSISQ-19 could be a reliable, reproducible and validated tool for the targeting SD in MS patients.
The unweighed factor during assessment of systemic lupus erythematosus arthritis
Authors: Abdel-Moniem Omneya Mohamed-Ayman , Hassouna Sally S.
Published: March 2024

Background

Systemic lupus erythematosus (SLE) is a known multisystemic autoimmune disorder. Active disease causes diverse morbidities. Arthritis is one of disease features present in most of patients, so it is important to study risk factors for such a complaint. Obesity appeared in some studies to increase SLE activity, here in this study, and for the first time, the effect of body weight on arthritis associating the disease was assessed.

Methods

SLE patients were asked about their joint manifestations and were asked to weigh up joint pain severity which was translated into values of patient self-report joint count (PTJT) present in Multidimensional Health Assessment Questionnaire (MDHAQ), which was then compared to joint examination in the form of 28 tender joint count (28 TJC) and 28 swollen joint count (28 SJC). All previous items were correlated to body mass index (BMI).

Results

BMI has a significant positive correlation with PTJT p = 0.013, and when PTJT of upper limbs and lower limbs were assessed separately, BMI was also positively corelated with p = 0.008 and 0.049, respectively.

Conclusions

Increased BMI may be a risk factor for arthritis associated with SLE, regardless its effect on weight-bearing joints. Management of body weight may help in preventing progression of joint affection in SLE.
Health Disparities in Young Adults: A Direct Comparison of Distress and Unmet Needs Across Cancer Centers
Authors: Markwardt Haley S. , Taghavi Sarah E. , Shear Deborah Z. , McDuffee Peyton R. , Smith Emily J. , Dunker Alexandra M. , Wilson Mary M. , Russell Janae A. , Shi Molin , Hall Brittany C.
Published: March 2024

PURPOSE

Information on concerns that young adults (YAs) with cancer face when receiving care outside of specialized treatment centers is needed to increase equitable care to YAs at greater risk of marginalization by the health care system. The current study compared distress and unmet needs at the time of clinic visit between YAs receiving care from three different cancer clinics: (1) a National Cancer Institute–designated center, (2) a community-based clinic, and (3) a county hospital outpatient clinic.

METHODS

The Adolescent and Young Adult Psycho-Oncology Screening Tool (AYA-POST) was administered to measure distress and cancer-related concerns of YAs in active treatment. A one-way analysis of variance (ANOVA) compared distress scores by treatment site. A Fisher's exact test compared the number of participants endorsing each item on the Needs Assessment Checklist from each site. A simple linear regression determined the association between distress and number of items endorsed on the Needs Assessment Checklist.

RESULTS

Ninety-seven participants completed the AYA-POST, endorsing, on average, 11 concerns. Fisher's exact test showed significant differences between sites in the proportion of participants endorsing eight items: boredom ( P < .001), eating/appetite ( P < .001), nausea/vomiting ( P < .001), financial concern ( P = .002), hopelessness/helplessness ( P = .03), confidentiality ( P = .04), sibling concern ( P = .04), and insurance ( P = .05). The simple linear regression model was significant (F(1, 94) = 39.772, P < .001, R2 = 0.297), indicating the number of unmet needs accounted for almost 30% of the variance in distress. The one-way ANOVA was not significant (F(2, 93) = 1.34, P = .267).

CONCLUSION

Social determinants of health can influence the number and type of unmet needs experienced, affecting distress and other outcomes and underscoring the importance of timely, effective, age-appropriate screening and intervention for distress and unmet needs in YAs with cancer.
Reversing the Oedipal Reading Practice: Interpellation, Enigmas of Reading, and John Barth's The Floating Opera
Authors: Edelsburg Chen
Published: March 2024

This article examines the author-reader relationship as it is shaped by an “enigma of reading.” Evident in texts that directly address their readers, this enigma attempts to interpellate those readers into a specific role. Using two different models of interpellation created by Slavoj Žižek and Eyal Dotan, this article describes the shift from modern to postmodern texts in terms of reading enigmas. The author's particular case study focuses on the narrator's addresses in John Barth's Floating Opera. These addresses reveal how the narrative oscillates between interpellations that encourage a paranoid reading stance, stemming from an “enigma of desire” (as in Žižek's model) and interpellations that discourage this position, derived from an “enigma of addresser” (as in Dotan's model). Ultimately, readers are left feeling confused, without a stable reading position, and are forced to apply a “flickering” reading practice. This kind of practice rejects the oedipal role of the author as a father, in the Lacanian sense, who is the absolute subject responsible for constructing meaning and forming the law of the text.
En Colombia, virulencia de toxoplasmosis amenaza la visión
Authors: López María Alejandra
Published: March 2024

En nuestro territorio existe una tormenta perfecta para esta enfermedad: circulación de variedades más agresivas del microorganismo y población con factores genéticos que pueden propiciar una respuesta más negativa hacen parte de la fórmula. Un estudio del Rosario revisa cómo la relación entre el parásito y los colombianos hace que su infección sea más violenta.
Mobile Push vs. Pull Targeting and Geo-Conquesting
Authors: Molitor Dominik , Spann Martin , Ghose Anindya , Reichhart Philipp
Published: March 2024

Firms have two distinct options when delivering content to consumers’ mobile devices: mobile push and mobile pull. Mobile push delivers firm-initiated (ad) content directly to consumers, while mobile pull requires consumers to initiate requests for (ad) content. This study tests the impact of mobile push and mobile pull on consumers’ coupon redemption behavior in a large-scale randomized field experiment in a geo-conquesting setting, targeting customers located around competitor retail stores with mobile coupons to drive them to stores of the focal retailer. The results show that mobile push increases coupon redemption rates by 6.0%, with substantial heterogeneity based on app-specific use experience and store density: App-specific use experience negatively moderates the effect of mobile push delivery on redemptions, likely because both usage experience and push notifications reduce app-specific search costs, thereby acting as substitutes for one another. In areas with higher store density, the positive effect of mobile push delivery on the redemption likelihood is greater, suggesting that push notifications can highlight the focal coupon among alternative store choices, thereby reducing consumer switching costs. These findings have important implications for retailers and brands in creating competitive mobile targeting campaigns that effectively leverage both mobile push and pull delivery mechanisms.