bluuebunny/crossref_metadata_2025 huggingface dataset:
Type O blood, the MCHC, and the reticulocyte count impact the early recurrence of primary warm-antibody autoimmune hemolytic anemia in children: A retrospective cohort analysis
Authors: Li Jiacheng , An Xizhou , Xu Ximing , Xiao Li , Wang Yang , Zhu Yao , Huang Lan , Zhang Kainan , Yao Xinyuan , Yi Weijia , Qin Jiebin , Yu Jie
Published: October 2022

Objective

Primary warm-antibody autoimmune hemolytic anemia (w-AIHA) is prone to recurrence in children. In this study, we aimed to identify risk indicators for the early recurrence of primary w-AIHA and construct an effective recurrence risk assessment model.

Methods

This was a retrospective cohort study. The clinical data of patients hospitalized with primary w-AIHA in the Department of Hematology and Oncology, Children's Hospital of Chongqing Medical University, between 1 January 2018 and 30 September 2021, were collected at the initial diagnosis. Univariate and multivariate logistic regression analyses were used to determine risk indicators for the early recurrence of primary w-AIHA in children, and ROC curve and Kaplan–Meier survival analyses were used for verification. Finally, a risk assessment model for early recurrence in children with primary w-AIHA was constructed using Cox regression and visualized using a nomogram. The model was also verified internally and externally.

Results

This study included 62 children with primary w-AIHA. Of which, 18 experienced recurrence 1 year after the initial diagnosis. The univariate and multivariate logistic regression analyses showed that type O blood and the reticulocyte count (Ret) were risk indicators for the early recurrence of pediatric primary w-AIHA (P = 0.009, 0.047, respectively). The mean corpuscular hemoglobin concentration (MCHC) is a protective factor (P = 0.040). According to the ROC curve and Kaplan–Meier survival analyses, children with primary w-AIHA whose blood type was O or had an MCHC of <313.5 pg/fL or a Ret of ≥0.161×1012/L had a higher risk of early recurrence (HR = 2.640, 4.430 and 4.450, respectively, and P = 0.040, 0.015 and 0.018, respectively). The blood types (O), MCHCs, and Rets of 56 patients were incorporated into the Cox regression model, and the recurrence risk assessment model for children with primary w-AIHA was successfully constructed and visualized using a nomogram. The calibration curves and decision-curve analysis (DCA) suggested that the risk model has clinical applicability and effectiveness.

Conclusion

Children with type O blood and an MCHC value of <313.5 pg/fL or a Ret value of ≥0.161×1012/L have a higher risk of early recurrence. The risk assessment model for the early recurrence of pediatric primary w-AIHA constructed in this study has good clinical applicability and effectiveness.
Psychosocial and psychological interventions' effectiveness among nurses in intensive care units caring for pediatric patients: A systematic review and meta-analysis
Authors: Choi Mi Hyang , Lee Misoon
Published: October 2022

Objective

This review aimed to evaluate the effectiveness of psychosocial and psychological interventions in nurses among intensive care units caring for pediatric patients.

Methods

A literature search was performed in PubMed, EMBASE, CINAHL databases, using preferred reporting items for systematic reviews and meta-analysis guidelines. Study design, population characteristics, contents of the programs, measured outcomes, and results were systematically reviewed from 8 selected studies. To estimate the effect size, a meta-analysis of the studies was performed using the RevMan 5.3 program. The effect size used was the standardized mean difference.

Results

Of 1,630 studies identified, 4 met the inclusion criteria, and 3 studies were used to estimate the effect size of psychosocial and psychological interventions. The primary outcome variable of these studies was stress. The effect of the intervention program on stress was also found to have no effect in individual studies, and the overall effect size was not statistically significant (standardized mean difference = −0.06; 95% confidence interval: −0.33, 0.20; Z = 0.48, p = 0.630). However, according to the individual literature included in this study, after the stress management program was applied as a group, a significant stress reduction was shown in the experimental group (p = 0.021).

Conclusions

These results show that psychosocial and psychological interventions were effective in stress management by a group approach. Therefore, it is necessary to develop psychosocial support interventions for stress management of nurses among intensive care units caring for pediatric patients more diversely.
An amino acid fertilizer improves the emergent accumulator plant Nasturtium officinale R. Br. phytoremediation capability for cadmium-contaminated paddy soils
Authors: Zhang Ran , Liu Qin , Xu Xiangting , Liao Ming’an , Lin Lijin , Hu Rongping , Luo Xian , Wang Zhihui , Wang Jin , Deng Qunxian , Liang Dong , Xia Hui , Lv Xiulan , Tang Yi , Wang Xun
Published: October 2022

Cadmium (Cd) contamination of paddy soil affects safe crop production. This study aimed to evaluate the effects of plant biostimulant amino acid fertilizer on the phytoremediation capability of an emergent accumulator plant Nasturtium officinale R. Br. for Cd-contaminated paddy soils. A pot study was carried out to study the effects of different concentrations of amino acid fertilizer on the Cd accumulation of N. officinale grown in Cd-contaminated paddy soil. The amino acid fertilizer increased the biomass of N. officinale. The amino acid fertilizer concentration exhibited a quadratic polynomial regression relationship with the root and shoot biomass. The fertilizer also increased the photosynthetic pigment (chlorophyll and carotenoid) contents, peroxidase (POD; EC 1.11.1.7) activity, and catalase (CAT; EC 1.11.1.6) activity of N. officinale, but decreased the soluble protein content and had no significant effect on the superoxide dismutase (SOD; EC 1.15.1.1) activity. Furthermore, the amino acid fertilizer increased the Cd content and Cd extraction of N. officinale. The shoot Cd extraction increased by 29.06%, 63.05%, 77.22%, and 17.40% at 1500-, 1200-, 900-, and 600-fold dilutions of the amino acid fertilizer, respectively, compared with the control. Moreover, the amino acid fertilizer promoted the Cd transport from the roots to shoots of N. officinale. The amino acid fertilizer concentration also exhibited a quadratic polynomial regression relationship with the root Cd content, shoot Cd content, root Cd extraction, and shoot Cd extraction, respectively. The correlation, grey relational, and path analyses revealed that the root biomass, shoot biomass, chlorophyll content, catalase activity, shoot Cd content, and root Cd extraction were closely associated with the shoot Cd extraction. Therefore, the amino acid fertilizer can promote Cd uptake and improve the phytoremediation capability of N. officinale to remediate Cd-contaminated paddy soils, and 900-fold dilution is the most suitable concentration.
The ÓMICAS alliance, an international research program on multi-omics for crop breeding optimization
Authors: Jaramillo-Botero Andres , Colorado Julian , Quimbaya Mauricio , Rebolledo Maria Camila , Lorieux Mathias , Ghneim-Herrera Thaura , Arango Carlos A. , Tobón Luis E. , Finke Jorge , Rocha Camilo , Muñoz Fernando , Riascos John J. , Silva Fernando , Chirinda Ngonidzashe , Caccamo Mario , Vandepoele Klaas , Goddard William A.
Published: October 2022

The OMICAS alliance is part of the Colombian government’s Scientific Ecosystem, established between 2017-2018 to promote world-class research, technological advancement and improved competency of higher education across the nation. Since the program’s kick-off, OMICAS has focused on consolidating and validating a multi-scale, multi-institutional, multi-disciplinary strategy and infrastructure to advance discoveries in plant science and the development of new technological solutions for improving agricultural productivity and sustainability. The strategy and methods described in this article, involve the characterization of different crop models, using high-throughput, real-time phenotyping technologies as well as experimental tissue characterization at different levels of the omics hierarchy and under contrasting conditions, to elucidate epigenome-, genome-, proteome- and metabolome-phenome relationships. The massive data sets are used to derive in-silico models, methods and tools to discover complex underlying structure-function associations, which are then carried over to the production of new germplasm with improved agricultural traits. Here, we describe OMICAS’ R&D trans-disciplinary multi-project architecture, explain the overall strategy and methods for crop-breeding, recent progress and results, and the overarching challenges that lay ahead in the field.
Psychophysiological restorative potential in cancer patients by virtual reality (VR)-based perception of natural environment
Authors: Song Rui , Chen Qujing , Zhang Ying , Jia Qing'an , He Hongyun , Gao Tian , Qiu Ling
Published: October 2022

The positive significance of nature to human’ self-reported well-being has been widely confirmed, but less attention has been paid to the study of cancer patients, as well as the role of time on the restorative effects. Therefore, using virtual reality (VR) and the inclusion of patients with esophageal and gastrointestinal cancer as participants, this study conducted indoor experiments to explore patients’ psychophysiological recovery through the perception of five different environmental types with three to five interventions per week. There were 63 participants selected from the People’s Hospital in Shaanxi Province. Depending on their psychophysiological state, they would participate in three to five interventions in a week to compare the number of interventions needed to achieve maximum restoration. The five environmental types utilized varied in land cover, vegetation structure, and landscape characteristics, and were identified as blue space (BS), open green space (OGS), semi-open green space (SOS), closed green space (CGS), and gray space (GrS). Before and after viewing landscapes, the changes of psychophysiological indicators were measured to explore the influence of different environmental types on participants. The results showed that the participants preferred and received the highest perceived restorative potentials in BS and lastly, GrS. The green and blue spaces measurably increased positive emotions and perceived restoration while a decreasing negative emotions and the heart rate (HR) compared with the GrS. Participants had the highest level of relaxation while their eyes were closed in the EEG baseline stage. Moreover, participants received the most relaxation when they contacted with nature three times a week, which indicated that excessive natural participation may not be conducive to the sustained development of cancer patients’ psychophysiological health. Instead of field appreciation, VR could be utilized to increase the access of cancer patients to nature and then be used as an approach to landscape interaction.
The role of employee psychological stress assessment in reducing human resource turnover in enterprises
Authors: Liu Cong , Miao Wenqing
Published: October 2022

In this paper, the model is constructed by measuring the psychological stress condition of employees; the psychological stress condition measurement model analyzes and tests the reasons for reducing human resource turnover in enterprises. In this paper, through the research related to the problem of talent loss in enterprises, we found that enterprises of other ownership often use the talent loss early warning model, to measure the possibility of talent loss in enterprises and issue an early warning, which enables enterprises to solve the talent loss crisis in time and minimize the negative impact of talent loss on enterprises. In this paper, we analyze the causes of human resource attrition risk from a theoretical point of view, construct a system of human resource attrition risk indicators for enterprises, and explain the content of each technical indicator and its measurement method. The PLS structural equation of the HR attrition risk evaluation model is established based on the constructed risk index system. In addition, the analysis of the causes of human resources turnover risk in the company also proposes strategies to avoid and prevent the threat. The PLS structural equation evaluation model of HR turnover risk is applied to various situations of human resource management to analyze the case of the comprehensive evaluation of HR turnover risk to guide the practical application of the model. Therefore, the research results of this paper have significant reference value for enterprises to solve similar human resource attrition problems. At the same time, it will provide a reference for enterprises to improve their human resource diagnostic capability and promote the development of human resource management.
Metaverse as a possible tool for reshaping schema modes in treating personality disorders
Authors: Yin Bin , Wang Ya-Xin , Fei Cheng-Yang , Jiang Ke
Published: October 2022

Personality disorders (PD) are usually treated with face-to-face sessions and/or digital mental health services. Among many schools of therapies, schema therapy stands out because rather than simply targeting the symptoms of PD, it cordially targets the cause of PD and heals the early maladaptive schema, thus is exceptionally good at soothing emotional disturbances before enacting cognitive restructuring, resulting in long-term efficacy. However, according to Piaget’s genetic epistemology, the unmet needs lie in the fact that the schemata that determine the adaptive behavior can only be formed in the interaction with the real world that the patient is living in and reconsolidated by the feedback from the object world upon the patient’s newly-formed behavior. Therefore, in order to reshape the patient’s schema modes to support adaptive behavior and regain emotional regulation capabilities of the healthy adult, one may have to reconstruct the object world surrounding the patient. Metaverse, the bestowed successor to the Internet with the cardinal feature of “the sense of full presence,” can become a powerful tool to reconstruct a new object world for the patient with the prescription of a psychotherapist, so as to transform the treatment techniques in schema therapy into the natural autobiographical experiences of patients in the new object world, thus gradually reshape the patient’s schema modes that can ultimately result in an adaptive, and more inclusive, interaction with the real world. This work describes the underlying theory, the mechanism, the process, and ethical considerations of such promising technology for the not-too-far future.
Ventral tegmental area dopaminergic action in music therapy for post-traumatic stress disorder: A literature review
Authors: Ning Meng , Wen Shizhe , Zhou Peiling , Zhang Changzheng
Published: October 2022

Post-traumatic stress disorder (PTSD) is a debilitating sequela of extraordinary traumatic sufferings that threaten personal health and dramatically attenuate the patient's quality of life. Accumulating lines of evidence suggest that functional disorders in the ventral tegmental area (VTA) dopaminergic system contribute substantially to PTSD symptomatology. Notably, music therapy has been shown to greatly ameliorate PTSD symptoms. In this literature review, we focused on whether music improved PTSD symptoms, based on VTA dopaminergic action, including the effects of music on dopamine (DA)-related gene expression, the promotion of DA release and metabolism, and the activation of VTA functional activities. In addition, the strengths and limitations of the studies concerning the results of music therapy on PTSD are discussed. Collectively, music therapy is an effective approach for PTSD intervention, in which the VTA dopaminergic system may hold an important position.
Has the COVID-19 pandemic strengthened confidence in managing the climate crisis? Transfer of efficacy beliefs after experiencing lockdowns in Switzerland and Austria
Authors: Moser Stephanie , Seebauer Sebastian
Published: October 2022

In the spring of 2020, countries introduced lockdowns as radical measures to deal with the first wave of the COVID-19 pandemic, which led to strong disruptions of people's everyday lives. Such drastic collective measures had previously seemed inconceivable in relation to other urgent crises, such as the climate crisis. In this paper, we ask how individual, participatory, and collective efficacy beliefs in dealing with the COVID-19 pandemic transferred to efficacy beliefs regarding the climate crisis. We present comparative results from two surveys: Study 1 assesses efficacy beliefs among German-speaking Swiss residents (n = 1,016), shortly after lockdown measures were relaxed. Study 2 compares changes in efficacy beliefs among Austrian high school students (n = 113) before and after the lockdown. In Study 1, climate-related self- and participatory efficacy are enhanced by the corresponding COVID-19-related beliefs. Climate-related efficacy beliefs mediate the effect of COVID-related counterparts on climate-friendly behavior and policy support. Study 2 shows that COVID-19-related efficacy beliefs are transferred to climate-related counterparts over time, and that the transfer of participatory efficacy is moderated by perceived similarity of the two crises. Experiencing successful individual and collective action during the COVID-19 pandemic seems to inspire confidence in dealing with climate change. Underlying processes (direct transfer, consistency, awareness-raising, learning) are discussed.
Competency-based pre-service education for clinical psychology training in low- and middle-income countries: Case study of Makerere University in Uganda
Authors: Alipanga Benjamin , Kohrt Brandon A.
Published: October 2022

Reducing the global treatment gap for mental health conditions in low- and middle-income countries (LMICs) requires not only an expansion of clinical psychology training but also assuring that graduates of these programs have the competency to effectively and safely deliver psychological interventions. Clinical psychology training programs in LMICs require standardized tools and guidance to evaluate competency. The World Health Organization (WHO) and UNICEF developed the “Ensuring Quality in Psychological Support” (EQUIP) platform to facilitate competency-based training in psychosocial support, psychological treatments, and foundational helping skills, with an initial focus on in-service training for non-specialists. Our goal was to design the first application of EQUIP to implement competency-based training into pre-service education for clinical psychology trainees. With Makerere University in Uganda as a case study, we outline an approach to develop, implement, and evaluate a competency-based curriculum that includes seven steps: (1) Identify core clinical psychology competencies; (2) Identify evaluation methods appropriate to each competency; (3) Determine when competency evaluations will be integrated in the curriculum, who will evaluate competency, and how results will be used; (4) Train faculty in competency-based education including conducting competency assessments and giving competency-based feedback; (5) Pilot test and evaluate the competency-based education strategy with faculty and students; (6) Modify and implement the competency-based education strategy based on pilot results; and (7) Implement ongoing evaluation of the competency-based curriculum with continuous quality improvement. This approach will be formally evaluated and established as a foundation for pre-service training in other low-resource settings.
The factors that affect members’ use of a beauty industry matchmaking platform: Validation of the COM-B extended model
Authors: Chang Yang-Wen , Hsu Yen
Published: October 2022

The global impact of COVID-19 has seriously affected health and livelihood in every country or region, especially in terms of physical consumption behaviors. Hairdressing is an essential physical consumption behavior. To prevent infection, the consumption model for using the beauty industry matchmaking platform (BIMP) has been used during the pandemic. This study investigates the changes in the behavior of media app users in the beauty industry in the post-epidemic era of COVID-19. The COM-B model is the basis for a research framework to study the factors that affect changes in behavior in the areas of Capability, Motivation, and Opportunity of the theoretical framework. A new dimension of fashion sense has expanded the application and validation of the COM-B model to determine the causal relationship between the ability to pursue beauty, motivation, fashion sense, and opportunities by using the platform and the dimension of user behavior. The study finds that fashion sense in the BIMP has a positive and significant impact on beauty care ability, self-motivation to pursue beauty and future cooperation opportunities. The ability, motivation and opportunity to act are all positively significant, which is in agreement with the theoretical framework of the COM-B model. There is no mediating effect for motivation between fashion sense and behavior. The results of this study show that increasing the sense of fashion for members using the BIMP will increases active behavior for members using the platform. This study also proposes practical suggestions for the operation of the BIMP based on the results.
The impact of environmental information disclosure on enterprises’ green preference of outbound investment: Evidence from China
Authors: Peng Cheng , Fu Wenting , Jiang Hui , Zou Yu
Published: October 2022

China is accelerating green and low-carbon transformation and promoting high-quality economic development. To effectively contribute to the improvement of global environmental quality and enhance enterprises’ awareness of environmental responsibility in the process of outbound investment, China strongly advocates that enterprises should comply with the environmental protection laws and regulations of host countries and try to strengthen local environmental protection as investing abroad. However, inadequate attention has been paid to the factors influencing green preferences in corporate outbound investment. Therefore, using a sample of Chinese A-share listed companies from 2008 to 2019, this paper aims to empirically analyze whether the quality of environmental information disclosure (QEID) affects enterprises’ green preference of outbound investment (OIGP), and the influence mechanism of QEID on the enterprises’ OIGP by analyzing the mediating effects of green technology innovation and media attention. It is found that QEID significantly promotes corporate OIGP. In terms of influence mechanism, QEID promotes firms’ OIGP by restraining media attention, while the mediating role of green technology innovation in the effect of QEID on firms’ OIGP is manifested as the masking effect. In addition, it is found that these influence mechanisms are different among enterprises with different property rights and different life cycle stages.
Psychiatric genetic counseling for patients with schizophrenia and their families
Authors: Kotzé Carla , Zwide Gopolang
Published: October 2022

Steady progress in the field of psychiatric genetics, generating new and fascinating insight into the genetic and phenotypic complexity of schizophrenia and other serious mental illnesses, have created an increased need of psychiatric genetic counseling. It is a crucial aspect of psychiatric clinical practice to ensure a balanced approach that takes into consideration genetic and environmental risk factors and ongoing education in this rapidly developing field is essential. Genetic counseling will be increasingly important to assist patients with schizophrenia and their families to make a meaningful informed decision about genetic testing. It will preempt unrealistic expectations, discrimination and stigma related to incomplete understanding of genetic test results in the psychiatric context.
MDMA-assisted psychotherapy; Inclusion of transgender and gender diverse people in the frontiers of PTSD treatment trials
Authors: Stauffer Christopher S. , Brown Melanie R. , Adams Dee , Cassity Marca , Sevelius Jae
Published: October 2022

Introduction

Transgender and gender diverse (TGD) people experience stigma, discrimination, trauma, and post-traumatic stress disorder (PTSD) at higher rates compared to the general population; however, TGD people have been underrepresented in PTSD research. Clinical trials of 3,4-methylenedioxymethamphetamine (MDMA)-assisted psychotherapy demonstrate promising safety and efficacy for the treatment of PTSD. Issues related to equitable access, power imbalances in the therapeutic relationship, and vulnerable states of consciousness occasioned by MDMA are magnified when working with people affected by structural vulnerabilities and health disparities, and community engagement in research planning and implementation is essential. To inform the inclusion and safety of TGD people in future MDMA-assisted psychotherapy research, the aims of the current study were to: characterize TGD experiences with trauma-related mental health care, assess openness of TGD people to participate in experimental PTSD research, and to gather specific feedback on protocol design for conducting MDMA-assisted psychotherapy with TGD people.

Materials and methods

We conducted three virtual focus group discussions (FGDs) with 5–6 participants each (N = 17). Eligible TGD participants had a history of receiving trauma-related mental health care. Each FGD was facilitated by two licensed clinicians who identified as TGD. Qualitative data analysis was conducted via an iterative process of identification of recurrent patterns and themes.

Results

We have identified several key issues TGD people face when seeking and engaging in trauma-related mental health care, including barriers to receiving adequate gender-affirming and trauma-informed mental health care and frustration with providers lacking cultural humility. Suggested amendments to MDMA-assisted psychotherapy protocols include: routine collection of trans-inclusive gender identity data, implementing an explicit gender-affirming treatment approach, ensuring a culturally safe setting, and diversifying co-therapy dyads.

Discussion

The inclusion of TGD voices in early conversations about emerging experimental PTSD interventions promotes equitable access, in the context of health and healthcare disparities, and helps researchers understand the needs of the community and tailor research to meet those needs. Through an ongoing conversation with the TGD community, we aim to incorporate a gender-affirming approach into existing research protocols and inform future applications of MDMA-assisted psychotherapy in addressing the effects of minority stress and boosting resilience.
Cognitive behavioral therapy with adaptive virtual reality exposure vs. cognitive behavioral therapy with in vivo exposure in the treatment of social anxiety disorder: A study protocol for a randomized controlled trial
Authors: Ørskov Per Trads , Lichtenstein Mia Beck , Ernst Mathias Torp , Fasterholdt Iben , Matthiesen Asge Frederik , Scirea Marco , Bouchard Stephane , Andersen Tonny Elmose
Published: October 2022

Background

Social anxiety disorder (SAD) has a high prevalence and an early onset with recovery taking decades to occur. Current evidence supports the efficacy of cognitive behavioral therapy (CBT) with virtual reality (VR) exposure. However, the evidence is based on a sparse number of studies with predominantly small sample sizes. There is a need for more trials investigating the optimal way of applying VR based exposure for SAD. In this trial, we will test the efficacy of CBT with adaptive VR exposure allowing adjustment of the exposure based on real-time monitoring of the participants's anxiety level.

Methods

The trial is a randomized controlled, assessor-blinded, parallel-group superiority trail. The study has two arms: (1) CBT including exposure in vivo (CBT-Exp), (2) CBT including exposure therapy using individually tailored VR-content and a system to track anxiety levels (CBT-ExpVR). Treatment is individual, manual-based and consists of 10 weekly sessions with a duration of 60 min. The study includes 90 participants diagnosed with SAD. Assessments are carried out pre-treatment, mid-treatment and at follow-up (6 and 12 months). The primary outcome is the mean score on the Social Interaction Anxiety Scale (SIAS) with the primary endpoint being post-treatment.

Discussion

The study adds to the existing knowledge by assessing the efficacy of CBT with adaptive VR exposure. The study has high methodological rigor using a randomized controlled trial with a large sample size that includes follow-up data and validated measures for social anxiety outcomes.

Clinical trial registration

ClinicalTrials.gov, identifier: NCT05302518.
Group-based trajectory and predictors of anxiety and depression among Chinese breast cancer patients
Authors: Li Wengao , Zhang Qiongxiao , Xu Yining , Sun Hengwen , Wen Youlu , Xu Wenjing , Tong Yiling , Garg Samradhvi , Chen Yu , Yang Yuan
Published: October 2022

Background

The aim of the current study is to investigate the change in anxiety and depression amongst Chinese breast cancer patients and to identify causal associations between baseline variables and the trajectory of anxiety and depression within this identified group.

Methods

This is a longitudinal prospective study. Three hundred women with breast cancer were recruited. Patient's depression and anxiety were repeatedly measured by PHQ-9 and GAD-7 at baseline, 6, 12, and 18 months after discharge. The SAS 9.4 PROC Traj procedure was used to examine the group-based trajectory of these recruited patients. Linear mixed models (LMM) were utilized to examine anxiety/depression changes over time, accounting for relevant baseline demographic and clinical factors.

Results

About 26.3% of the participants reported none or very mild anxiety over time, 60.7% reported stable low-level anxiety, and the remaining 13.0% showed significantly decreasing trend in GAD total scores. Meanwhile, 10.7% of the participants reported none or very mild depressive symptoms over time, 66.0% reported stable PHQ total scores throughout the research period, and 23.3% were classified as the “high level-decreasing group”. Patients reported significantly higher anxiety and depression scores in the first three assessments. Participants with no or mild life stress along with a positive personality tended to report lower anxiety and depression scores over time.

Conclusion

Most of the breast cancer patients reported stable low-level anxiety and depression 18 months after discharge. Early assessment of optimism and stress levels among cancer patients might help identify people at risk of experiencing long-term anxiety and depression.
Associations between external beam radiotherapy and overall survival in patients with gallbladder cancer: A population-based study
Authors: Song Jiazhao , Kang Xiaoli , Di Yupeng , Ren Gang , Wang Yingjie
Published: October 2022

Background

There is a lack of studies regarding radiotherapy (RT) in patients with gallbladder cancer (GBC) on the survival benefit after surgery and nonsurgical treatment. Therefore, this study evaluated the impact of external beam RT on the overall survival (OS) of patients with GBC in a real-world setting.

Methods

Patients with GBC enrolled from the Surveillance, Epidemiology, and End Results (SEER) database were examined through Kaplan–Meier survival curves and multivariable Cox regression analyses.

Results

A total of 7,866 patients with GBC were screened for the current analysis, of whom 2,130 (27.1%) did not undergo RT or surgery, 209 (2.7%) underwent RT, 4,511 (57.3%) underwent surgery, and 1,016 (12.9%) underwent both RT and surgery. The median OS times were 4 months, 8 months, 16 months, and 22 months (p < 0.0001). OS was significantly different between adjuvant RT (p = 0.0002) and palliative RT (p < 0.0001). Multifactorial analysis (controlling for age, sex, year of diagnosis, marital status, race, grade, and stage) showed that both adjuvant RT (surgery and adjuvant RT vs. surgery alone; HR, 0.75; 95% CI, 0.69–0.82, p < 0.001) and palliative RT (RT alone vs. no treatment; HR, 0.80; 95% CI, 0.69–0.92, p = 0.003) had a significant impact on patient OS. The results remained stable following sensitivity analyses.

Conclusion

The study results indicate that adjuvant and palliative radiation treatment was associated with a survival benefit. GBC patients can derive a survival benefit from external beam RT.
Repeat infections with chlamydia in women may be more transcriptionally active with lower responses from some immune genes
Authors: Huston Wilhelmina M. , Lawrence Amba , Wee Bryan A. , Thomas Mark , Timms Peter , Vodstrcil Lenka A. , McNulty Anna , McIvor Ruthy , Worthington Karen , Donovan Basil , Phillips Samuel , Chen Marcus Y. , Fairley Christopher K. , Hocking Jane S.
Published: October 2022

Chlamydia trachomatis, the most common bacterial sexually transmitted infection worldwide, is responsible for considerable health burden due to its significant sequelae. There are growing concerns about chlamydial treatment and management due to widely documented increasing burden of repeat infections. In the current study, a cohort study design of 305 women with urogenital chlamydial infections demonstrated that 11.8% of women experienced repeat infections after treatment with azithromycin. The chlamydial DNA load measured by quantitative PCR was higher in women who experienced a repeat infection (p = 0.0097) and repeat infection was associated with sexual contact. There was no genomic or phenotypic evidence of azithromycin resistance within the chlamydial isolates. During repeat infection, or repeat positive tests during follow up, vaginal chlamydial gene expression (ompA, euo, omcB, htrA, trpAB) was markedly higher compared to baseline, and two of the selected immune genes analyzed had significantly lower expression at the time of repeat infection. Overall, there are two implications of these results. The results could be generalized to all recent infections, or repeat positive events, and indicate that chlamydial infections are have higher transcriptional activity of select genes early in the infection in women. Alternatively, after azithromycin treatment, repeat infections of Chlamydia may be more transcriptionally active at certain genes, and there may be post-treatment immunological alterations that interplay into repeat exposures establishing an active infection. The potential that recent infections may involve a higher level of activity from the organism may have implications for management by more regular testing of the most at risk women to reduce the risk of sequelae.
Measuring Asian hate: Discordant reporting of race-based hate incidents and unfair treatment and association with measures of wellbeing
Authors: Ponce Ninez A. , Adia Alexander C. , Banawa Rachel A. , Tan Sean , Sabado-Liwag Melanie D.
Published: October 2022

Background

During COVID-19, anti-Asian discrimination increased in attention. Hate and unfair treatment are related but do not completely overlap. We expect those who report a hate incident would also report race-based unfair treatment, yet feelings of social desirability or self-blame may lead to under-reporting of unfair treatment.

Objectives

To describe reporting of an experience of race-based hate but not an experience of race-based unfair treatment among Asians in California and explore the association between this reporting discordance with (1) serious psychological distress, (2) forgoing needed medical care, (3) increased household interpersonal conflict, and (4) feeling unsafe in their neighborhood.

Methods

We used the 2020 California Health Interview Survey's AANHPI COVID Module, conducted weighted descriptive and multivariate analyses, and computed adjusted relative risks (RR). The multivariate models controlled for Asian subgroup, age, gender, immigrant status, education level, poverty, and English proficiency.

Results

Among Asians who reported race-based hate (6.9% overall), 62.4% reported not experiencing race-based unfair treatment. Compared to Asians not reporting a hate incident, this “discordant” group was more likely to experience serious psychological distress (RR = 6.9), forgo necessary medical care (RR = 2.4), increased household interpersonal conflicts (RR = 2.7), and feel unsafe in their neighborhoods (RR = 3.0). The “concordant” group did not post significant effects for severe psychological distress nor forgoing necessary medical care.

Discussion

Most Asians reporting hate did not report race-based unfair treatment, and this group is most affected by the consequences of a hate incident. We indicate future directions for research and policy.
Personal assistants in England and the factors associated with absenteeism
Authors: Roland Daniel , Allan Stephen , Chambers Eleni , Smith Debs , Gousia Katerina
Published: October 2022

Personal assistants (PAs) have become an increasingly important element of long-term care (LTC) in England since the introduction of Direct Payments in 1996 and the Care Act 2014 legislation. The PAs, who are directly employed by social care users, can perform a number of support tasks including vital assistance in activities of daily living (ADL). Internationally these roles would be classed as domestic care work, including the employment of migrant care workers, e.g. in Germany and Austria. High turnover rates and work absenteeism in this market can cause disruption of these important daily activities, causing LTC users to potentially suffer neglect and poorer quality of life. Although there is research on turnover and absenteeism in nursing workforce in hospitals and LTC workers in nursing homes, little attention has been given to reasons for turnover of PAs and even less for absenteeism, which often precedes turnover, in a workforce of over 100,000 people in England. This research aims to fill this gap in knowledge by analyzing the reasons behind the absenteeism of PAs using quantitative methods. We used survey data of PAs in England, exploring the factors associated to one form of absenteeism—sick leave from work. After controlling for a number of factors ranging from job characteristics such as number of hours worked and type of contract, socio-economic characteristics from the PA and their employer, and supply and demand factors at local government region, the findings suggest a number of factors that significantly influenced sick leave, including distances traveled to work and number of PAs employed. Following the analysis, two people with life experience of LTC discuss the findings of the study and how they compare to their experiences of the market for PAs, providing a unique perspective from the people who could benefit the most from improving PA retention and reducing absenteeism.
Intended and unintended impacts of the comprehensive reform of urban public hospitals: A mixed-method study in Hangzhou, China
Authors: Zhang Tao , Liu Jing , Lu Beiyin , Yan Zhongheng , Huang Xiaojun , Lu Wei
Published: October 2022

Objectives

Public hospital reform is a key area in the Chinese healthcare system reform with the aim of controlling excessive growth of medical expenditures. This study aims to evaluate the impacts of two rounds of urban public hospital reforms respectively starting in 2018 and 2019.

Method

A mixed-method method was conducted in Hangzhou. In the quantitative phase, monthly data covering 7 provincial, 12 municipal, and 35 district hospitals from March 2017 to June 2020 was analyzed using a panel-interrupted time-series. Thematic content analysis was conducted using qualitative data collected from 32 in-depth interviews.

Results

Quantitative data showed a considerable reduction in the proportion of drug revenue (provincial hospitals: −4.937%; municipal hospitals: −2.765%; district hospitals: −2.189%) and an increase in the proportion of consumable (provincial hospitals: β2 = 2.025; municipal hospitals: β3 = 0.206) and examinations (provincial hospitals: β2 = 1.354, β3=0.159; municipal hospitals: β2 = 1.179) revenue after the first reform. In post-reform 2, The respective instant decrease and increase in the proportion of consumable (provincial hospitals: −2.395%; municipal hospitals: −0.898%) and medical services (provincial hospitals: 2.115%; municipal hospitals: −2.604%) revenue were observed. Additionally, quantitative and qualitative data indicated inpatient expenditures dropped considerably after the reform. However, insufficient compensation for medical services and increased financial pressure on hospitals were repeatedly mentioned as unintended consequences in qualitative interviews.

Conclusions

Overall, the urban public hospital reforms in China created positive effects in adjusting hospital revenue structure and constraining soaring medical expenditures. Unintended consequences remind policymakers to establish rational and dynamic compensation mechanisms for public hospitals.
Epidemiological characteristics of traumatic spinal cord injuries in a multicenter retrospective study in northwest China, 2017–2020
Authors: Wang Xiaohui , Du Jinpeng , Jiang Chao , Zhang Yong-yuan , Tian Fang , Chen Zhe , Zhang Yuyang , Zhang Ying , Yan Liang , Hao Dingjun
Published: October 2022

Background

Traumatic spinal cord injuries (TSCIs) are worldwide public health problems that are difficult to cure and impose a substantial economic burden on society. There has been a lack of extensive multicenter review of TSCI epidemiology in northwest China during the Corona Virus Disease 2019 (COVID-19) pandemic.

Method

A multicenter retrospective study of 14 selected hospitals in two provinces in northwest China was conducted on patients admitted for TSCI between 2017 and 2020. Variables assessed included patient demographics, etiology, segmental distribution, treatment, waiting time for treatment, and outcomes.

Results

The number of patients with TSCI showed an increasing trend from 2017 to 2019, while there were 12.8% fewer patients in 2020 than in 2019. The male-to-female ratio was 3.67:1, and the mean age was 48 ± 14.9 years. The primary cause of TSCI was high falls (38.8%), slip falls/low falls (27.7%), traffic accidents (23.9%), sports (2.6%), and other factors (7.0%). The segmental distribution showed a bimodal pattern, peak segments were C6 and L1 vertebra, L1 (14.7%), T12 (8.2%), and C6 (8.2%) were the most frequently injured segments. In terms of severity, incomplete injury (72.8%) occurred more often than complete injury (27.2%). The American Spinal Injury Association impairment scale of most patients did not convert before and after treatment in the operational group (71.6%) or the conservative group (80.6%). A total of 975 patients (37.2%) from urban and 1,646 patients (62.8%) from rural areas were included; almost all urban residents could rush to get treatment after being injured immediately (<1 h), whereas most rural patients get the treatment needed 4–7 h after injury. The rough annual incidence from 2017 to 2020 is 112.4, 143.4, 152.2, and 132.6 per million people, calculated by the coverage rate of the population of the sampling hospital.

Conclusion

The incidence of TSCI in northwest China is high and on the rise. However, due to pandemic policy reasons, the incidence of urban residents decreased in 2020. The promotion of online work may be an effective primary prevention measure for traumatic diseases. Also, because of the further distance from the good conditional hospital, rural patients need to spend more time there, and the timely treatment of patients from remote areas should be paid attention to.
Dilated perivascular spaces can present incidental CSF-isointense foci within the ventral forebrain of dogs and cats in transverse MR images
Authors: Fischer Carolin , Schaub Sebastian , Büttner Kathrin , Hartmann Katinka , Schmidt Martin Jürgen
Published: October 2022

Objective

Virchow-Robin-Spaces (VRS) are cerebrospinal fluid (CSF)-containing perivascular spaces encompassing brain vessels while coursing through the parenchyma. VRS can enlarge and become visible in magnetic resonance imaging (MRI). While dilatated VRS are mostly incidental findings, they were associated with degenerative brain disease in humans. This study aimed to evaluate their occurrence and MRI morphology within the ventral forebrain of structurally normal canine and feline brains and physiological cerebrospinal fluid analysis.

Sample

Retro- and prospective, observational study reviewing medical records of client-owned dogs and cats which underwent MRI brain scans for unrelated reasons between 2011 and 2021. We comprised studies with various magnetic field strengths (1 Tesla/3 Tesla). Out of 2500 brain scans, three hundred thirty-five patients (293 dogs, 42 cats) presented with absent intracranial pathology and physiological CSF analysis and were included.

Procedure

The ventral forebrain of the included animals was assessed for bi- or unilateral CSF-isointense foci in the transverse plane. Statistical correlations were evaluated between dilated VRS presence, field strength, age, gender, weight, and cranium conformation. Additionally, a post-mortem histopathologic analysis of one dog and one cat showing dilated VRS on MRI was performed to confirm perforating arteries in the gray matter of the ventral forebrain.

Results

57% of patients presented dilated VRS (N = 191: 170 dogs, 21 cats). 43% did not display dilated VRS (control group; N = 144: 123 dogs, 21 cats). A significant relation between increased magnetic field strength and detection of dilated VRS was observed in dogs; there was a 2.4 increase (p = 0.0001) in detection using 3 Tesla vs. 1 Tesla. There was a 2.4-fold increase in dilated VRS occurrence in male dogs compared to female dogs. Detection also increased with the rise of body weight. We detected no statistically significant difference between dilated VRS and the control group in age, species or cranium conformation.

Conclusion and Clinical Relevance

Dilated VRS can be seen within the ventral forebrain at the level of the rostral commissure on transverse MR images as symmetrical or unilateral, dot-like, CSF-isointense areas. Understanding their signal intensity features and localization prevents misinterpretation and helps differentiate them from various pathological conditions.