bluuebunny/crossref_metadata_2025 huggingface dataset:
Risk factors for community-acquired pneumonia among inpatients with mental disorders in a tertiary general hospital
Authors: Han Jingjing , Shen Meiyu , Wan Qirong , Lv Zhihua , Xiao Ling , Wang Gaohua
Published: July 2022

Introduction

Community-acquired pneumonia (CAP) is an important cause of hospitalization and death in patients with mental disorders. It is critical to understand the risk factors of CAP and determine prevention strategies to reduce CAP. The aim of this study is to explore the characteristics of inpatients with mental disorders who have CAP and analyze the risk factors.

Methods

This retrospective study included 16,934 inpatients with mental disorders who were admitted for the first time to a tertiary general hospital between January 2017 and July 2021 (excluding January 2020–May 2020). Risk factors for CAP were identified by logistic regression analysis after propensity score matching (PSM, 1:4) for age, gender, and BMI.

Results

The CAP rate of inpatients with mental disorders was 1.78%. Inpatients who had CAP had a significantly prolonged hospital stay, and were more often admitted to a closed ward or the ICU. After PSM, the multivariable analysis revealed that clozapine use (OR = 3.212, 95% CI = 1.744–5.915, P < 0.001), schizophrenia spectrum disorder (OR = 2.785, 95% CI = 1.684–4.607, P < 0.001), alcohol consumption (OR = 2.549, 95% CI = 1.586–4.096, P < 0.001), cardiovascular disease (OR = 2.299, 95% CI = 1.362–3.879, P = 0.002), Charlson comorbidity index (CCI) ≥ 3 (OR = 2.092, 95% CI = 1.342–3.260, P = 0.001), organic mental disorder (OR = 1.941, 95% CI = 1.194–3.156, P = 0.007), antipsychotic drug use (OR = 1.886, 95% CI = 1.312–2.711, P = 0.001), unmarried status (OR = 1.720, 95% CI = 1.164–2.541, P = 0.006) and junior high school education (OR = 1.591, 95%CI = 1.010–2.508, P = 0.045) were independent risk factors for CAP in inpatients with mental disorders.

Conclusion

CAP was common in inpatients with mental disorders. Patients with mental disorders have unique risk factors for CAP. Further research is required to explore the relationship and mechanism between different mental disorders, antipsychotic drugs and CAP.
Psychographic segmentation to identify higher-risk teen peer crowds for health communications: Validation of Virginia's Mindset Lens Survey
Authors: Stalgaitis Carolyn A. , Jordan Jeffrey W. , Djakaria Mayo , Saggese Daniel J. , Bruce Hannah Robbins
Published: July 2022

Audience segmentation is necessary in health communications to ensure equitable resource distribution. Peer crowds, which are macro-level teen subcultures, are effective psychographic segments for health communications because each crowd has unique mindsets, values, norms, and health behavior profiles. These mindsets affect behaviors, and can be used to develop targeted health communication campaigns to reach those in greatest need. Though peer crowd research is plentiful, no existing peer crowd measurement tool has been formally validated. As such, we developed and validated Virginia's Mindset Lens Survey (V-MLS), a mindset-based teen peer crowd segmentation survey to support health communication efforts. Using an online convenience sample of teens (N = 1,113), we assessed convergent and discriminant validity by comparing the V-MLS against an existing, widely-used peer crowd survey (I-Base Survey®) utilizing a multi-trait multi-method matrix. We also examined the V-MLS's predictive ability through a series of regressions using peer crowd scores to predict behaviors, experiences, and traits relevant to health communication campaign planning. The V-MLS demonstrated reliability and convergent and discriminant validity. Additionally, the V-MLS effectively distinguished teen peer crowds with unique health behaviors, experiences, and personal traits. When combined with appropriate information processing and campaign development frameworks, this new tool can complement existing instruments to inform message framing, tone, and style for campaigns that target at-risk teens to increase campaign equity and reach.
Association Between Cancer Prevalence and Different Socioeconomic Strata in the US: The National Health and Nutrition Examination Survey, 1999–2018
Authors: Wang Mingsi , Liu Yang , Ma Yi , Li Yue , Sun Chengyao , Cheng Yi , Cheng Pengxin , Liu Guoxiang , Zhang Xin
Published: July 2022

Background

Inequality in health outcomes in relation to Americans' socioeconomic status (SES) is rising. American Cancer Society depicts that the most common cancers are diagnosed in men and women in 2021. We aim to study socioeconomic inequalities in related cancers to investigate whether the cancer prevalence differs within the family income to poverty ratio (PIR).

Methods

The study investigated data from adults aged 20–85 years participated in the 1999–2018 National Health and Nutrition Examination Survey (NHANES) who had complete data available on PIR and cancer or malignancy information (n = 49,720). Participants were stratified into 3 categories of PIR: high income (PIR ≥ 4), middle income (>1 and <4), or at or below the federal poverty level (≤1).

Results

The prevalence of prostate cancer was higher in the middle-income (3.61% [n = 464]) and high-income groups (3.36% [n = 227]) than in the low-income group (1.83% [n = 84], all p < 0.001). The prevalence of breast cancer was higher in middle-income (2.86% [n = 390]) and high-income participants (3.48% [n = 218]) than in low-income participants (2.00% [n = 117], all p < 0.001). Compared with the low-income group in men (0.48% [n = 22]), a higher prevalence of colon and rectum cancer occurs in the middle-income (0.87% [n = 112], p = 0.012) and high-income groups (0.89% [n = 58], p = 0.018). The prevalence of lung cancer in women was lower in high-income participants than middle-income participants (0.10% [n = 6] vs. 0.29% [n = 39], p = 0.014).

Conclusions

Increasing disparities in cancer prevalence were identified across all socioeconomic categories analyzed in this study. To ensure the sustainable development goals, it is a global health priority to understand inequalities in health and to target interventions accordingly.
Cigarettes' use and capabilities-opportunities-motivation-for-behavior model: a multi-country survey of adolescents and young adults
Authors: Sabbagh Heba Jafar , Abdelaziz Wafaa , Quritum Maryam , AlKhateeb Nada AbuBakr , Abourdan Joud , Qureshi Nafeesa , Qureshi Shabnum , Hamoud Ahmed H. N. , Mahmoud Nada , Odeh Ruba , Al-Khanati Nuraldeen Maher , Jaber Rawiah , Balkhoyor Abdulrahman Loaie , Shabi Mohammed , Folayan Morenike Oluwatoyin , Alade Omolola , Gomaa Noha , Alnahdi Raqiya , Mahmoud Nawal A. , El Wazziki Hanane , Alnaas Manal , Samodien Bahia , Mahmoud Rawa A. , Abu Assab Nour , Saad Sherin , Alhachim Sondos G. , El Tantawi Maha
Published: July 2022

The use of cigarettes among adolescents and young adults (AYA) is an important issue. This study assessed the association between regular and electronic-cigarettes use among AYA and factors of the Capability-Motivation-Opportunity-for-Behavior-change (COM-B) model. A multi-country survey was conducted between August-2020 and January-2021, Data was collected using the Global-Youth-Tobacco-Survey and Generalized-Anxiety-Disorder-7-item-scale. Multi-level logistic-regression-models were used. Use of regular and electronic-cigarettes were dependent variables. The explanatory variables were capability-factors (COVID-19 status, general anxiety), motivation-factors (attitude score) and opportunity-factors (country-level affordability scores, tobacco promotion-bans, and smoke free-zones) controlling for age and sex. Responses of 6,989-participants from 25-countries were used. Those who reported that they were infected with COVID-19 had significantly higher odds of electronic-cigarettes use (AOR = 1.81, P = 0.02). Normal or mild levels of general anxiety and negative attitudes toward smoking were associated with significantly lower odds of using regular-cigarettes (AOR = 0.34, 0.52, and 0.75, P < 0.001) and electronic-cigarettes (AOR = 0.28, 0.45, and 0.78, P < 0.001). Higher affordability-score was associated with lower odds of using electronic-cigarettes (AOR = 0.90, P = 0.004). Country-level-smoking-control policies and regulations need to focus on reducing cigarette affordability. Capability, motivation and opportunity factors of the COM-B model were associated with using regular or electronic cigarettes.
Beyond effectiveness evaluation: Contributing to the discussion on complexity of digital health interventions with examples from cancer care
Authors: Ventura Filipa , Brovall Maria , Smith Frida
Published: July 2022

Digital health interventions (DHIs) have become essential complementary solutions in health care to enhance support and communication at a distance, with evidence of improving patient outcomes. Improving clinical outcomes is a major determinant of success in any health intervention, influencing its funding, development, adoption and implementation in real-world practice. In this article we explore our experiences of developing and testing DHIs to identify and discuss complexity challenges along their intervention research lifecycle. Informed by the case study research approach, we selected three individual DHIs aimed at satisfying the supportive and educational needs of people living with cancer. The Care Expert, the Digi-Do and the Gatapp were underpinned on different complexity frameworks i.e., the Medical Research Council framework and the Non-adoption, Abandonment, Scale-up, Spread and Sustainability framework. This variance on the methodological underpinning was expected to prompt a multifaceted discussion on the complexity dimensions endorsed by each of the frameworks. Our discussion endorses the adoption of mixed-methods research designs, to gather the perspectives of stakeholders and end-users, as well as pragmatic evaluation approaches that value effectiveness outcomes as much as process outcomes. Furthermore, the dissemination and sustainability agenda of DHIs needs to be considered from early-stage development with the inclusion of a business model. This business plan should be worked in partnership with healthcare services, regulatory bodies and industry, aiming to assure the management of the DHI throughout time.
Relationship Between Weight Status and Self-Image Mediated by Pubertal Timing and Athletic Competence: A Cohort Study With Taiwanese Adolescents
Authors: Kuo Jen-Hao , Ubeda Herrera Josue Jaru , Liu Chia-Yi , Lee Ting-Hsuan , Strong Carol , Lin Chung-Ying , Chang Yun-Hsuan , Lin Yi-Ching , Hsieh Yi-Ping , Tsai Meng-Che
Published: July 2022

Background

Self-image reflects overall self-acceptance in developing adolescents. Using a representative cohort of Taiwanese youth, this study aims to explore the relationship between weight status, pubertal timing, athletic competence, and adolescent self-image.

Methods

Data come from the Taiwan Youth Project that comprised a longitudinal cohort of adolescents (N = 2690, 51% males, Mage = 13.3 ± 0.5 years) surveyed annually from seventh grade. Self-image was measured by perceived satisfaction with appearance and physique. Weight status was proxied by self-reported body mass index (BMI; kg/m2). Pubertal timing was defined using the Pubertal Developmental Scale, which mainly measured physical changes in puberty. Athletic competence was assessed by experiences with participation in competitive sports and self-perceived talent for sports. Linear regression analysis was applied to test for an association between BMI and self-image. In order to test for mediating roles of pubertal timing and athletic competence, Hayes' PROCESS macro on SPSS was conducted applying 5,000 bootstrap resamples with 95% confidence intervals of the indirect effect.

Results

BMI was inversely associated with self-image in both males (β = −0.074, [−0.095, −0.053]) and females (β = −0.095, [−0.122, −0.069]). The boot-strapped 95% confidence intervals indicated statistically significant mediating effects of pubertal timing (β = −0.008, [−0.015, −0.001]) and athletic competence (β = −0.006, [−0.011, −0.002]) in the link between BMI and self–image in females, whilst only athletic competence mediated this association (β = −0.006, [−0.009, −0.002]) in males. Moreover, BMI at baseline were also associated with long-term self-image in males (β = −0.037, [−0.057, −0.017]) and females (β = 0.132, [0.073, 0.190]).

Conclusions

Understanding the mediating factors may help enhance adolescents' self-image by providing guidance on healthy weight and physical activity behaviors according to different stages of pubertal progression.
An Analysis of Injury Trends and Disease Burden From Three Surveillance Hospitals in Urumqi From 2006 to 2018
Authors: Zhang Rong , Sun Jing-Xuan , Guo Ying-Zhen , Liu Lai-Xin , Wushouer Fuerhati , Dong Yan , Fang Ping , Muyiduli Xiamusiye , Gao Zhen-Guo , Dai Jiang-Hong , Ni Ming-Jian
Published: July 2022

Objective

To investigate injury trends, injury distribution, and disease burden from three surveillance hospitals in Urumqi from 2006 to 2018.

Method

Injury data from the National Injury Surveillance System (NISS) from three hospitals in Urumqi (2006 to 2018) were collected to analyze changes in the characteristics of outpatient injury cases. Years of potential life lost (YPLL) were calculated to determine the disease burden of the injury cases.

Results

A total of 161,400 injury cases were recorded over 13 years, and the average age of the patient seeking medical attention was 32.4 years old. Male patients outnumbered female patients with a ratio of 1.6:1, but the proportion of female patients was greater after 45 years of age. The highest number of cases occurred in patients 15–29 years of age, accounting for 26.8% of all injury cases. Injury in females occurred most frequently in the home. A total of 41.4% of injury cases occurred while doing housework. The top three causes of injury were falls (49.7%), blunt force of an object, (13.7%), and motor vehicle accidents (MVA) (13.5%). Years of potential life lost from injury accounted for 7.39% of the total YPLL in the three hospitals.

Conclusion

Males should be targeted for injury prevention and intervention in Urumqi. The prevention of falls, blunt force of objects, and MVA should be made a priority. Injury prevention strategies and targeted projects should be developed to reduce the disease burden of injury.
Vaccine Refusal: A Preliminary Interdisciplinary Investigation
Authors: Brakel Linda A. W. , Foxall Gordon R.
Published: July 2022

Many people who generally receive standard recommended inoculations refuse to partake of COVID-19 vaccines, preventatives that are effective, safe, and life-saving amidst the current pandemic. Our quest is to understand this puzzling and dangerous phenomenon, as it exists among US and UK citizens, whom in other respects would be regarded as quite regular. We will discuss Vaccine Refusal compared with two better understood phenomena: addiction, and akrasia, along with the related matters of human action, intention, agency, will, and identity. Vaccine Refusal, we will argue, appears to be rewarded by “informational reinforcement” leading to heightened arousal, along with increases in self-esteem resulting from “bucking the trend,” asserting one's “superior” understanding, and “tribal identity” in acting against social norms. These factors provide an overall reward amounting to satisfaction that outweighs the well-known consequences of COVID-19 infections. Our investigations will also lead us to a pair of epistemological hypotheses about two subtypes of the Vaccine Refusers under consideration here.
Influence of Social Workers' Empathy Ability on Suicidal Ideation of Cancer Patients
Authors: Yang Ningxi , Zhang Yuting , Liu Zhibo , Wang Fang , Yang Guoqing , Hu Xiuying
Published: July 2022

Background

The nursing goal of patients with cancer is to provide them with holistic care, including physical, psychological, and social adaptation, and spirituality. This research aimed to explore the influence of the social workers' empathy ability on suicidal ideation of patients with cancer and its path.

Methods

There was a sum of 358 patients with cancer and the 45 social workers serving them participated in the survey. Data of their self-efficacy, depression symptom, stigma, and suicidal ideation were measured before the social work provided (T1) and 3 months after the social work finished (T2) were collected and compared. Pearson correlation analysis was used to assess the relationships between social workers' empathy ability and patient indicators at T2. The influence path of social workers' empathy ability on cancer patients' suicidal ideation was explored by path analysis at T2.

Results

At T2, patients reported higher self-efficacy and lower depression symptoms, stigma, and suicidal ideation than at T1. At T2, social workers' empathy ability was positively related to patients' self-efficacy and was negatively related to depression symptoms, stigma, and suicidal ideation. Social workers' empathy ability affected patients' suicidal ideation directly. In addition, patients' self-efficacy, depression symptoms, and stigma played mediating roles in the influence of social workers' empathy abilities on their suicidal ideation.

Conclusion

Social workers' empathy ability not only directly affected cancer patients' suicide ideation but also affected suicide ideation through the mediating roles of self-efficacy, depression symptoms, and stigma. Therefore, the improvement of the empathy ability of medical social workers needs to be paid attention to.
Job satisfaction and its related factors among emergency department physicians in China
Authors: Li Kang , Chen Hongmei , Tan Zhen , Yin Xiaoxv , Gong Yanhong , Jiang Nan , Yang Fengjie
Published: July 2022

Background

Job satisfaction is recognized as an important factor affecting the performance and quality of medical services of emergency department physicians. However, little is known about the status of job satisfaction among emergency department physicians in China. This study aimed to explore the current level of job satisfaction and its associated factors among emergency department physicians in China.

Methods

A nationwide cross-sectional survey was conducted in China from July to August 2018. A total of 10,457 emergency department physicians completed the questionnaire. The structured online questionnaire collected information on socio-demographic characteristics, work-related factors, work-family conflict, and job satisfaction. Student's t-test or ANOVA were used to compare the job satisfaction scores in different characters. The generalized linear model was used to investigate the related factors of job satisfaction among emergency department physicians.

Results

The respondents' job satisfaction average score was 12.2 ± 3.6, of which 42.01% were satisfied of which the job. The results showed that emergency department physicians over 41 years old, with a higher income and working in central and western regions were positively associated with job satisfaction. In contrast, bachelor degree and above, fixed posts, long years of service, a high frequency of night shift, perceived shortage of physicians, perceived medical errors, and higher work-family conflict scores were negatively correlated with job satisfaction among emergency department physicians.

Conclusion

Job satisfaction of emergency department physicians in China is low. It is suggested that hospital administrators could improve the job satisfaction of emergency department physicians by establishing an acceptable shift system, ensuring adequate emergency department staffing, increasing their income appropriately and alleviating work-family conflict.
Validating automated eye disease screening AI algorithm in community and in-hospital scenarios
Authors: Han Ruoan , Cheng Gangwei , Zhang Bilei , Yang Jingyuan , Yuan Mingzhen , Yang Dalu , Wu Junde , Liu Junwei , Zhao Chan , Chen Youxin , Xu Yanwu
Published: July 2022

Purpose:

To assess the accuracy and robustness of the AI algorithm for detecting referable diabetic retinopathy (RDR), referable macular diseases (RMD), and glaucoma suspect (GCS) from fundus images in community and in-hospital screening scenarios.

Methods

We collected two color fundus image datasets, namely, PUMCH (556 images, 166 subjects, and four camera models) and NSDE (534 images, 134 subjects, and two camera models). The AI algorithm generates the screening report after taking fundus images. The images were labeled as RDR, RMD, GCS, or none of the three by 3 licensed ophthalmologists. The resulting labels were treated as “ground truth” and then were used to compare against the AI screening reports to validate the sensitivity, specificity, and area under the receiver operating characteristic curve (AUC) of the AI algorithm.

Results

On the PUMCH dataset, regarding the prediction of RDR, the AI algorithm achieved overall results of 0.950 ± 0.058, 0.963 ± 0.024, and 0.954 ± 0.049 on sensitivity, specificity, and AUC, respectively. For RMD, the overall results are 0.919 ± 0.073, 0.929 ± 0.039, and 0.974 ± 0.009. For GCS, the overall results are 0.950 ± 0.059, 0.946 ± 0.016, and 0.976 ± 0.025.

Conclusion

The AI algorithm can work robustly with various fundus camera models and achieve high accuracies for detecting RDR, RMD, and GCS.
Mifepristone Increases Life Span in Female Drosophila Without Detectable Antibacterial Activity
Authors: Landis Gary N. , Riggan Luke , Bell Hans S. , Vu William , Wang Tianyi , Wang Ina , Tejawinata Felicia I. , Ko Sebastian , Tower John
Published: July 2022

Mifepristone dramatically increases the life span of mated female Drosophila while reducing the expression of innate immune response genes. Previous results indicated that mifepristone also reduced the load of aero-tolerant bacteria in mated females. Experiments were conducted to further investigate the possible role of bacteria in mifepristone life span effects. Life span was assayed in flies grown from sterilized eggs on autoclaved media and in normally cultured controls in two independent assays. Sterilization increased mated female life span (+8.3% and +57%, respectively), and the effect of mifepristone was additive (+53% and +93%, respectively). High-throughput sequencing of 16S sequences revealed that sterilization reduced the abundance of multiple species and the classes Bacteroidia, Bacilli, Actinobacteria, and Cytophagia. By contrast, mifepristone caused no decreases and instead increased the abundance of three species. Five aero-tolerant bacterial species were cultured from extracts of mated female flies, including both Gram-positive and Gram-negative species (Acetobacter sicerae, Enterococcus faecalis, Lactobacillus plantarum, Serratia rubidea, and Paenibacillus glucanolyticus). There was no detectable effect of mifepristone on the growth of these bacteria in vitro, indicating that mifepristone does not have a direct antibiotic effect. To test if antibiotics could mimic the effects of mifepristone in vivo, mated female flies were treated throughout adult life span with high concentrations of the individual antibiotics doxycycline, ampicillin, kanamycin, and streptomycin, in replicate experiments. No significant effect on life span was observed for ampicillin, kanamycin, or streptomycin, and an inconsistent benefit was observed for doxycycline. Finally, supplementation of media with Enterococcus faecalis did not alter adult female life span in the presence or absence of mifepristone. Taken together, the results indicate the life span benefits of mifepristone are not due to an antibiotic effect.
The interactive reading task: Transformer-based automatic item generation
Authors: Attali Yigal , Runge Andrew , LaFlair Geoffrey T. , Yancey Kevin , Goodwin Sarah , Park Yena , von Davier Alina A.
Published: July 2022

Automatic item generation (AIG) has the potential to greatly expand the number of items for educational assessments, while simultaneously allowing for a more construct-driven approach to item development. However, the traditional item modeling approach in AIG is limited in scope to content areas that are relatively easy to model (such as math problems), and depends on highly skilled content experts to create each model. In this paper we describe the interactive reading task, a transformer-based deep language modeling approach for creating reading comprehension assessments. This approach allows a fully automated process for the creation of source passages together with a wide range of comprehension questions about the passages. The format of the questions allows automatic scoring of responses with high fidelity (e.g., selected response questions). We present the results of a large-scale pilot of the interactive reading task, with hundreds of passages and thousands of questions. These passages were administered as part of the practice test of the Duolingo English Test. Human review of the materials and psychometric analyses of test taker results demonstrate the feasibility of this approach for automatic creation of complex educational assessments.
Comparison of high hydrostatic pressure and thermal processing on microorganisms and quality of anthocyanin-rich fruit puree
Authors: Yang Xuan , Ding Haoyue , Luo Sijia , Sun Xiaojun , Wang Niu , Wang Yongtao
Published: July 2022

High hydrostatic pressure (HHP, 400 MPa/10 min and 500 MPa/8 min) and thermal processing (TP, 90°C/2 min) were comparatively evaluated by examining their impacts on microorganisms, physicochemical characteristics (TSS, pH, color, ascorbic acid, total phenols, total anthocyanins, and particle size distribution), antioxidant activity, endogenous enzyme activity, and sensory quality of the anthocyanin-rich fruit puree during 20 days of storage at 4°C. The count of total aerobic bacteria (TAB) in HHP treated samples was less than 2.02 log10CFU/mL, and yeasts and molds (Y&M) were not detected during storage. Compared with TP treated samples, the total anthocyanins, total phenols, ascorbic acid, antioxidant capacity, and color of HHP treated ones were better maintained. Principal component analysis (PCA) also proved that the original quality of puree could be better preserved by HHP after treatment and during storage. However, the activity of polyphenol oxidase (PPO) and pectin meth esterase (PME) in HHP treated samples were not inactivated totally. In sum, better quality parameters were observed in HHP treated samples, so HHP was a potential way to be applied to fruit puree.
Adaptations to relational facilitation for two national care coordination programs during COVID-19
Authors: Sjoberg Heidi , Kenney Rachael R. , Morgan Brianne , Connelly Brigid , Jones Christine D. , Ali Hebatallah Naim , Battaglia Catherine , Gilmartin Heather M.
Published: July 2022

Background

Adaptations to implementation strategies are often necessary to support adoption and scale-up of evidence-based practices. Tracking adaptations to implementation strategies is critical for understanding any impacts on outcomes. However, these adaptations are infrequently collected. In this article we present a case study of how we used a new method during COVID-19 to systematically track and report adaptations to relational facilitation, a novel implementation strategy grounded in relational coordination theory. Relational facilitation aims to assess and improve communication and relationships in teams and is being implemented to support adoption of two Quadruple Aim Quality Enhancement Research Initiative (QA QUERI) initiatives: Care Coordination and Integrated Case Management (CC&ICM) and the Transitions Nurse Program for Home Health Care (TNP-HHC) in the Veterans Health Administration (VA).

Methods

During 2021–2022, relational facilitation training, activities and support were designed as in-person and/or virtual sessions. These included a site group coaching session to create a social network map of care coordination roles and assessment of baseline relationships and communication between roles. Following this we administered the Relational Coordination Survey to assess the relational coordination strength within and between roles. COVID-19 caused challenges implementing relational facilitation, warranting adaptations. We tracked relational facilitation adaptations using a logic model, REDCap tracking tool based on the Framework for Reporting Adaptations and Modifications-Enhanced (FRAME) with expanded Reach, Effectiveness, Adoption, Implementation, Maintenance (RE-AIM) dimensions, and member checking. Adaptations were analyzed descriptively and for themes using matrix content analysis.

Results

COVID-19's impact within the VA caused barriers for implementing relational facilitation, warranting eight unique adaptations to the implementation strategy. Most adaptations pertained to changing the format of relational facilitation activities (n = 6; 75%), were based on external factors (n = 8; 100%), were planned (n = 8; 100%) and initiated by the QA QUERI implementation team (n = 8; 100%). Most adaptations impacted adoption (n = 6; 75%) and some impacted implementation (n = 2; 25%) of the CC&ICM and TNP-HHC interventions.

Discussion

Systematically tracking and discussing adaptations to relational facilitation during the COVID-19 pandemic enhanced engagement and adoption of two VA care coordination interventions. The impact of these rapid, early course adaptations will be followed in subsequent years of CC&ICM and TNP-HHC implementation.
Developing a Digital Technology System to Address COVID-19 Health Needs in Guatemala: A Scientific Diaspora Case Study
Authors: Alvarado Juan Roberto , Lainfiesta Ximena , Paniagua-Avila Alejandra , Asturias Gabriela
Published: July 2022

Scientific diasporas are organized groups of professionals who work together to contribute to their country of origin. Since the start of the COVID-19 pandemic in 2020, scientific diasporas around the world have focused their efforts to support the public health response in their countries of origin. As the first cases of COVID-19 were reported in Guatemala in March of 2020, a team of four Guatemalan nationals, residing abroad and in-country, started collaborating to tackle COVID-19 misinformation and issues with healthcare services navigation. Their collaboration was facilitated by FUNDEGUA, a Guatemalan nonprofit, which provided a legal framework to establish partnerships and fundraise. The team created a digital technological system called ALMA (Asistente de Logística Médica Automatizada in Spanish). A female character named ALMA was created to personify the digital information services, through social media profiles, an interactive website, a free national multilingual call center, and an artificial intelligence-based chatbot. More members joined the nascent interdisciplinary diaspora through professional/personal references or social media. ALMA provided a platform for Guatemalan nationals to contribute with their skillset to their country during a global crisis through flexible schedules and short- or long-term involvement. As the team grew, the services for query resolution and information dissemination expanded as well. The ALMA initiative shows that scientific diasporas can provide an avenue for professionals to contribute to Guatemala, regardless of their residence and job commitments.
“No Chit Chat!” A Warning From a Physical Versus Virtual Robot Invigilator: Which Matters Most?
Authors: Ahmad Muneeb I. , Refik Reem
Published: July 2022

Past work has not considered social robots as proctors or monitors to prevent cheating or maintain discipline in the context of exam invigilation with adults. Further, we do not see an investigation into the role of invigilation for the robot presented in two different embodiments (physical vs. virtual). We demonstrate a system that enables a robot (physical and virtual) to act as an invigilator and deploy an exam setup with two participants completing a programming task. We conducted two studies (an online video-based survey and an in-person evaluation) to understand participants’ perceptions of the invigilator robot presented in two different embodiments. Additionally, we investigated whether participants showed cheating behaviours in one condition more than the other. The findings showed that participants’ ratings did not differ significantly. Further, participants were more talkative in the virtual robot condition compared to the physical robot condition. These findings are promising and call for further research into the invigilation role of social robots in more subtle and complex exam-like settings.
Menstrual changes after COVID-19 vaccination and/or SARS-CoV-2 infection and their demographic, mood, and lifestyle determinants in Arab women of childbearing age, 2021
Authors: Amer Ahmed A. , Amer Samar A. , Alrufaidi Khaled Masoud , Abd-Elatif Eman Elsayed , Alafandi Bana Zuhair , Yousif Dalia Abdelmonaim , Armi Nadia Toukah , Alkhalaf Atheer Abdulaziz , Shah Jaffer , Ramadan Mohamed Sh
Published: July 2022

Background

By September 2, 2021, over 30,000 COVID-19-vaccinated females had reported menstrual changes to the MHRA's Yellow Card surveillance system. As a result, the National Institutes of Health (NIH) is urging researchers to investigate the COVID-19 vaccine's effects on menstruation. Therefore, this study was conducted to explore the menstrual changes after COVID-19 vaccination and/or SARS-CoV-2 infection and their interrelations with demographic, mood, and lifestyle factors in Arab women of childbearing age (CBA).

Methodology

A cross-sectional study was conducted during October 2021 using an Arabic validated and self-administrated questionnaire. In total, 1,254 Women of CBA in the Arabic Population (15–50 y) with regular menstrual cycles were randomly selected from five countries (Saudi Arabia, Egypt, Syria, Libya, and Sudan).

Results

The mean (SD) age of the 1,254 studied females was 29.6 (8.5) years old. In total, 634 (50%) were married, 1,104 (88.0%) had a University education or above, 1,064 (84.4%) lived in urban areas, and 573 (45.7%) had normal body weight. Moreover, 524 (41.8%) were COVID-19 cases and 98 women (18.7%) reported menstrual changes (MCs). The 1,044 (83.5%) vaccinated females reported 418 (38.5%) MCs after being vaccinated, and these MCs resolved in 194 women (55.1%) after more than 9 months. Statistically significant relationships were observed between the reported MCs and the following variables: age, marital status, level of education, nationality, residence, and BMI. MCs were reported at 293(80.6) after the 2nd dose, and were mainly reported after 482 (46.1) Pfizer, 254 (24.3) Astrazenica, and 92 (8.8) Senopharm.

Conclusion

MCs among women of CBA after COVID-19 infection and vaccination are prevalent and complex problems, and had many determinates.
Resolving Radiant: Combining Spatially Resolved Longwave and Shortwave Measurements to Improve the Understanding of Radiant Heat Flux Reflections and Heterogeneity
Authors: Merchant Coleman , Meggers Forrest , Hou Miaomiao , Aviv Dorit , Schneider Florian Arwed , Middel Ariane
Published: July 2022

We introduce and demonstrate new measurement and modeling techniques to fully resolve the spatial variation in shortwave and longwave radiant heat transfer in the outdoor environment. We demonstrate for the first time a way to directly resolve the shortwave radiant heat transfer from terrestrial reflected and diffuse sky components along with the standard direct solar radiation using an adapted thermopile array and ray-tracing modeling techniques validated by 6-direction net radiometer. Radiant heat transfer is a major component of heat experienced in cities. It has significant spatial variability that is most easily noticed as one moves between shade and direct solar exposure. But even on a cloudy and warm day the invisible longwave infrared thermal radiation from warm surfaces makes up a larger fraction of heat experienced than that caused by convection with surrounding air. Under warm or hot climate conditions in cities, radiant heat transfer generally accounts for the majority of heat transfer to people. Both the shortwave (visible/solar) and the longwave (infrared/thermal) have significant spatial variation. We demonstrate sensor methods and data analysis techniques to resolve how these radiant fluxes can change the heat experienced by >1 kWm−2 across small distances. The intense solar shortwave radiation is easily recognized outdoors, but longwave is often considered negligible. Longwave radiation from heat stored in urban surfaces is more insidious as it can cause changes invisible to the eye. We show how it changes heat experienced by >200 Wm−2. These variations are very common and also occur at the scale of a few meters.
Inversions of Stellar Structure From Asteroseismic Data
Authors: Buldgen Gaël , Bétrisey Jérôme , Roxburgh Ian W. , Vorontsov Sergei V. , Reese Daniel R.
Published: July 2022

The advent of space-based photometry missions in the early 21st century enabled the application to asteroseismic data of advanced inference techniques until then restricted to the field of helioseismology. The high quality of the observations, the discovery of mixed modes in evolved solar-like oscillators and the need for an improvement in the determination of stellar fundamental parameters such as mass, radius and age led to the development of sophisticated modelling tools, amongst which seismic inversions play a key role. In this review, we will discuss the existing inversion techniques for the internal structure of distant stars adapted from helio-to asteroseismology. We will present results obtained for various Kepler targets, their coupling to other existing modelling techniques as well as the limitations of seismic analyses and the perspectives for future developments of these approaches in the context of the current TESS and the future PLATO mission, as well as the exploitation of the mixed modes observed in post-main sequence solar-like oscillators, for which variational formulations might not provide sufficient accuracy.
Improving tumble turn performance in swimming—the impact of wall contact time and tuck index
Authors: David Sina , Grove Tamara , Duijven Myrna v. , Koster Paul , Beek Peter J.
Published: July 2022

Race time can be shortened by improving turn performance in competitive swimming, but this requires insight into the optimal turn technique. The aim of the present study was to examine the effect of Wall Contact Time (WCT) and Tuck Index on tumble turn performance and their interrelations by experimentally manipulating both variables, which has not been done in previous research. Eighteen Dutch national level swimmers (FINA points 552 ± 122) performed tumble turns with three different WCTs (shorter, preferred, longer) and three different Tuck Indices (higher, preferred, lower), which were recorded by four underwater cameras and a wall-mounted force plate. Linear kinematic and kinetic variables, including the approach velocity (Vin), wall adaptation time (Tadapt), percentage of active WCT (aWCT), peak push-off force (FPeak) and exit velocity (Vexit), were extracted from the recordings and analyzed statistically, using the 5 m round trip time (5mRTT) as performance measure. The results indicated that the WCT should be sufficiently long to generate a high push-off force at the end of wall contact when the body is in a streamlined position. This led to a significantly shorter 5mRTT than a shorter or longer WCT. A linear mixed effect model yielded negative significant effects of WCT (−4.22, p < 0.001), FPeak (−2.18, p = 0.04), Vin (−4.83, p = 0.02), Tadapt (−2.68, p = 0.002), and Vexit (−9.52, p < 0.001) on the 5mRTT. The best overall turning performance was achieved with a Tuck Index of 0.7, which suggests that some of the participating swimmers could benefit from adapting their distance to the wall while turning, as was exemplified by calculating the optimal Tuck Index for individual swimmers. These results underscore the importance of WCT and Tuck Index vis-à-vis tumble turn performance, as well as their interrelations with other performance determining variables in this regard.
Learning Agroecology Online During COVID-19
Authors: Félix Georges F. , Sanfiorenzo Andre
Published: July 2022

Since March 2020, the COVID-19 pandemic propelled the “stay-at-home” policy worldwide under public health uncertainty, resulting in increased individualization, as well as an increased reliance or dependency on digital communication technology. Based on a review of existing literature alongside a reflection on personal fieldwork experiences, we aim to: (1) describe major elements of agroecological pedagogy, (2) explore adaptation pathways to combine digitalization and participatory action-learning, and (3) briefly discuss opportunities and challenges for agroecologists beyond COVID-19. Agroecological pedagogy is deeply embedded in the praxis, the scientific knowledge and ways of knowing (academic or not), and in the politics and agency of food movements. In line with Freire's liberation pedagogy, seeing what already exists (e.g., in: ecosystems, home-gardens, fields, farms, and watersheds) through participation and volunteering. Alongside a critical analysis to explain and explore certain phenomena, causes and consequences will likely result in the act leading to the implementation of transformative practices and novel designs that improve the state of any situation being addressed. Participatory action research/learning methods are strategic in agroecological pedagogy. Overall, the lockdown period led to increased societal digitalization of human interactions. During lockdown, however, the implementation of strategies for remote agroecology participatory action-learning were hampered, but not vanquished. Key changes to agroecology education projects “before” and “during” lockdown include an increased reliance on digital and remote strategies. Creative adaptations in the virtual classrooms were designed to nurture, deepen, and foster alternatives in favor of diverse knowledges and ways of knowing for food system transformations.
Surgery for bilateral vocal fold paralysis: Systematic review and meta-analysis
Authors: Titulaer Kai , Schlattmann Peter , Guntinas-Lichius Orlando
Published: July 2022

Objectives

To determine the decannulation rate (DR) and revision surgery rate after surgery for bilateral vocal fold paralysis (BVFP).

Data Sources

Five databases (MEDLINE, PubMed, Embase, Web of Science, Scopus) were searched for the period 1908–2020.

Methods

The systematic literature review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Data were pooled using a random-mixed-effects model. Randomized controlled trials and non-randomized studies (case-control, cohort, and case series) were included to assess DR and revision surgery rate after different surgical techniques for treatment of BVFP.

Results

The search yielded 857 publications, of which 102 with 2802 patients were included. DR after different types of surgery was: arytenoid abduction (DR 0.93, 95%-confidence interval [CI], 0.86–0.97), endolaryngeal arytenoidectomy (DR 0.92, 95%-CI, 0.86–0.96), external arytenoidectomy (DR 0.94; 95%-CI, 0.71–0.99), external arytenoidectomy and lateralisation (DR 0.87; 95%-CI, 0.73–0.94), laterofixation (DR 0.95; 95%-CI, 0.91–0.97), posterior cordectomy (DR 0.97, 95%-CI, 0.94–0.99), posterior cordectomy and arytenoidectomy (DR 0.98, 95%-CI, 0.93–0.99), posterior cordectomy and subtotal arytenoidectomy (DR 0.98, 95%-CI, 0.88–1.00), posterior cordotomy (DR 0.96, 95%-CI, 0.84–0.99), reinnervation (0.69, 95%-CI, 0.12–0.97), subtotal arytenoidectomy (DR 1.00, 95%-CI, 0.00–1.00) and transverse cordotomy (DR 1.0, 95%-CI, 0.00–1.00). No significant difference between subgroups for DR could be found (Q = 15.67, df = 11, p = 0.1540). The between-study heterogeneity was low (τ2 = 2.2627; τ = 1.5042; I2 = 0.0%). Studies were at high risk of bias.

Conclusion

BLVP is a rare disease and the study quality is insufficient. The existing studies suggest a publication bias and the literature review revealed that there is a lack of prospective controlled studies. There is a lack of standardized measures that takes into account both speech quality and respiratory function and allows adequate comparison of surgical methods.
Evaluation of the learning curve for robotic single-anastomosis duodenal–ileal bypass with sleeve gastrectomy
Authors: Wang Lun , Yu Yang , Wang Jinfa , Li Shixing , Jiang Tao
Published: July 2022

Background

The robotic surgical system is being used in various bariatric procedures. However, only a few studies with very small sample size are present on robotic single-anastomosis duodenal–ileal bypass with sleeve gastrectomy (SADI-S). Moreover, to date, the learning curve of robotic SADI-S has been poorly evaluated yet.

Objective

This retrospective study aimed to estimate the learning curve of robotic SADI-S.

Methods

102 consecutive patients who underwent robotic SADI-S between March 2020 and December 2021 were included. Textbook outcome standard was performed to comprehensively evaluate clinical outcome of robotic SADI-S. Based on the textbook outcome, we evaluated the learning curve of robotic SADI-S by the cumulative sum (CUSUM) method.

Results

The mean operative time was 186.13 ± 36.91 min. No conversion to laparotomy or deaths occurred during the study period. The rate of complications was 6.9% (n = 7), of which major complications were identified in 2.9% (n = 3), including 2 gastric leakages and 1 respiratory failure. A total of 60 patients reached the textbook outcome standard. The rate of textbook outcome was positive and was steadily increasing after the number of surgical cases accumulated to the 58th case. Taking the 58th case as the boundary, all the patients were divided into the learning stage group (the first 58 patients) and mastery stage group (the last 44 patients). The rate of complications, proportion of abdominal drainage tubes and postoperative hospital stay were significantly higher in the learning stage group compared with the mastery stage group (P < 0.05). No significant difference was observed between the two groups in terms of patient demographic data, operative times, reoperations and readmission.

Conclusion

Robotic SADI-S is a feasible and reproducible surgical technique with a learning curve of 58 cases.
Brazil’s Regulatory Context for Using New Approach Methodologies (NAMs) on the Registration of Products
Authors: Villela Izabel Vianna , Machado Miriana da Silva
Published: July 2022

New Approach Methodologies (NAMs) are any non-animal-based approaches that can provide information in the context of chemical hazard and safety assessment. The goal is to develop information with equivalent or better scientific quality and relevance than that provided by traditional animal models. Starting with ethical issues, these approaches are gaining regulatory relevance in different global agencies. Since 2008, with the enactment of the Arouca Law—the first Brazilian legislation dedicated to laboratory animals, NAMs are gathering pace in Brazil’s regulations. Specific regulations from different sectors include the acceptance of these new methods. However, some regulation is controversial about what is needed to address specific toxicological endpoints. The resulting regulatory uncertainty induces companies to keep on adopting the traditional methods, slowing NAM’s development in the country. This work brings a perspective on the regulatory acceptance of NAMs in Brazilian Legislation for the registration of pharmaceuticals, medical devices, food/supplements, and agrochemical products. This text discusses the main issues of NAM adoption for each specific regulation. Therefore, legal acceptance of NAMs results in Brazil is still a process in progress. A collective effort including regulators, industry, contract research organizations (CROs), and the academic environment is needed to build regulatory confidence in the use of NAMs.