bluuebunny/crossref_metadata_2025 huggingface dataset:
Application of Telemedicine for Preliminary Screening of Autism Spectrum Disorder
Authors: Qiu Ting , Zhang Heng , Zhou Conghua , Tang Qilong , Wang Lizhen , Ke Xiaoyan
Published: January 2022

Objective

Preliminary screening for autism spectrum disorder (ASD) is mainly performed offline in China. This method is time consuming, labor intensive, inefficient and costly. These complications limit its routine implementation in some hospitals and child health institutions, especially community health service centers. Thus, the present study explored the clinical applicability of an online screening system for ASD detection based on telemedicine technology.

Methods

The online screening system designed based on the WeChat platform and section A of the Chinese-validated version of the checklist for autism in toddlers (CHAT-23-A) and combined with an independent Research and Development (R&D) program. The sensitivity and specificity were 0.92 and 0.90, respectively, and the area under the receiver operating characteristic curve (AUC) values for all 23 items and 7 key items were 0.934 and 0.91, respectively.

Results

The online screening system based on telemedicine technology was not limited by time, space, region, or medical resources and showed high sensitivity, specificity, and diagnostic efficiency for ASD.

Conclusion

The online screening system based on telemedicine technology is suitable for large-scale population ASD screening in childcare institutions.
Standard Echocardiographic View Recognition in Diagnosis of Congenital Heart Defects in Children Using Deep Learning Based on Knowledge Distillation
Authors: Wu Lanping , Dong Bin , Liu Xiaoqing , Hong Wenjing , Chen Lijun , Gao Kunlun , Sheng Qiuyang , Yu Yizhou , Zhao Liebin , Zhang Yuqi
Published: January 2022

Standard echocardiographic view recognition is a prerequisite for automatic diagnosis of congenital heart defects (CHDs). This study aims to evaluate the feasibility and accuracy of standard echocardiographic view recognition in the diagnosis of CHDs in children using convolutional neural networks (CNNs). A new deep learning-based neural network method was proposed to automatically and efficiently identify commonly used standard echocardiographic views. A total of 367,571 echocardiographic image slices from 3,772 subjects were used to train and validate the proposed echocardiographic view recognition model where 23 standard echocardiographic views commonly used to diagnose CHDs in children were identified. The F1 scores of a majority of views were all ≥0.90, including subcostal sagittal/coronal view of the atrium septum, apical four-chamber view, apical five-chamber view, low parasternal four-chamber view, sax-mid, sax-basal, parasternal long-axis view of the left ventricle (PSLV), suprasternal long-axis view of the entire aortic arch, M-mode echocardiographic recording of the aortic (M-AO) and the left ventricle at the level of the papillary muscle (M-LV), Doppler recording from the mitral valve (DP-MV), the tricuspid valve (DP-TV), the ascending aorta (DP-AAO), the pulmonary valve (DP-PV), and the descending aorta (DP-DAO). This study provides a solid foundation for the subsequent use of artificial intelligence (AI) to identify CHDs in children.
Kinsenoside Alleviates Alcoholic Liver Injury by Reducing Oxidative Stress, Inhibiting Endoplasmic Reticulum Stress, and Regulating AMPK-Dependent Autophagy
Authors: Gao Limin , Chen Xingyu , Fu Zeyu , Yin Jie , Wang Yafen , Sun Weiguang , Ren Hong , Zhang Yonghui
Published: January 2022

Background:Anoectochilus roxburghii (Orchidaceae) is a traditional Chinese medicinal herb with anti-inflammatory, antilipemic, liver protective, immunomodulatory, and other pharmacological activities. Kinsenoside (KD), which shows protective effects against a variety types of liver damage, is an active ingredient extracted from A. roxburghii. However, the liver protective effects and potential mechanisms of KD in alcoholic liver disease (ALD) remain unclear. This study aimed to investigate the liver protective activity and potential mechanisms of KD in ALD.

Methods: AML12 normal mouse hepatocyte cells were used to detect the protective effect of KD against ethanol-induced cell damage. An alcoholic liver injury model was induced by feeding male C57BL/6J mice with an ethanol-containing liquid diet, in combination with intraperitoneal administration of 5% carbon tetrachloride (CCl4) in olive oil. Mice were divided into control, model, silymarin (positive control), and two KD groups, treated with different doses. After treatment, hematoxylin–eosin and Masson’s trichrome staining of liver tissues was performed, and serum alanine aminotransferase (ALT) and aspartate transaminase (AST) levels were determined to assess the protective effect of KD against alcoholic liver injury. Moreover, proteomics techniques were used to explore the potential mechanism of KD action, and ELISA assay, immunohistochemistry, TUNEL assay, and western blotting were used to verify the mechanism.

Results: The results showed that KD concentration-dependently reduced ethanol-induced lipid accumulation in AML12 cells. In ALD mice model, the histological examination of liver tissues, combined with the determination of ALT and AST serum levels, demonstrated a protective effect of KD in the alcoholic liver injury mice. In addition, KD treatment markedly enhanced the antioxidant capacity and reduced the endoplasmic reticulum (ER) stress, inflammation, and apoptosis compared with those in the model group. Furthermore, KD increased the phosphorylation level of AMP-activated protein kinase (AMPK), inhibited the mechanistic target of rapamycin, promoted the phosphorylation of ULK1 (Ser555), increased the level of the autophagy marker LC3A/B, and restored ethanol-suppressed autophagic flux, thus activating AMPK-dependent autophagy.

Conclusion: This study indicates that KD alleviates alcoholic liver injury by reducing oxidative stress and ER stress, while activating AMPK-dependent autophagy. All results suggested that KD may be a potential therapeutic agent for ALD.
Folic Acid–Functionalized Metal-Organic Framework Nanoparticles as Drug Carriers Improved Bufalin Antitumor Activity Against Breast Cancer
Authors: Zeng Hairong , Xia Chao , Zhao Bei , Zhu Mengmeng , Zhang HaoYue , Zhang Die , Rui Xin , Li Huili , Yuan Yi
Published: January 2022

Bufalin (Buf), an active ingredient of the traditional Chinese medicine Chansu, is known to have anticancer effects for breast cancer. However, its poor solubility, high toxicity, and extensive side effects limit its use. Metal-organic frameworks (MOFs) are a class of promising drug delivery systems known for their high porosity. Here, we designed and constructed pH-sensitive and redox-responsive folic acid–modified MOFs as drug carriers of Buf (FA-MOF/Buf). Moreover, the anticancer activity of nanomedicines was also explored in vitro and in vivo. Compared to free Buf, the FA-MOF/Buf nanoparticles demonstrated improved water solubility and stability, higher intracellular uptake, and enhanced cytotoxicity in breast cancer cells in vitro. Furthermore, it displayed improved accumulation in the tumor site, enhanced anticancer activity, and reduced side effects in vivo. Our results demonstrated that FA-MOF could be developed as a potential delivery system for Buf to improve its antitumor activity for breast cancer treatment.
Comparison of Systemic Treatments for Metastatic Castration-Resistant Prostate Cancer After Docetaxel Failure: A Systematic Review and Network Meta-analysis
Authors: Chen Junru , Zhang Yaowen , Zhang Xingming , Zhao Jinge , Ni Yuchao , Zhu Sha , He Ben , Dai Jindong , Wang Zhipeng , Wang Zilin , Liang Jiayu , Zhu Xudong , Shen Pengfei , Zeng Hao , Sun Guangxi
Published: January 2022

Background: Lacking head-to-head trial, the optimal treatment for patients with metastatic castration-resistant prostate cancer (mCRPC) after docetaxel failure is unclear. This study is to compare the efficacy and safety of systemic treatments in patients who progressed after docetaxel to aid clinical decision-making.

Methods: Databases including MEDLINE, EMBASE, and the Cochrane Library were searched from inception to June 15th, 2021. The outcomes of interest include overall survival (OS), biochemical progression-free survival (bPFS), and serious adverse events (SAEs). The Cochrane risk of bias tools were used to assess study quality. Indirect comparisons of competing treatments were performed via Bayesian network meta-analysis.

Results: Five trials with 3,862 patients comparing four treatments (abiraterone, enzalutamide, cabazitaxel, and radium-223) were identified. All the four treatments were associated with improved OS and bPFS relative to best supportive care. Among them, enzalutamide (hazard ratio [HR] = 0.58, 95% credible interval [Crl]: 0.49–0.69) had the highest probability of ranking first in terms of OS, followed by cabazitaxel (HR = 0.70, 95% Crl: 0.59–0.83), radium-223 (HR = 0.71, 95% Crl: 0.56–0.90) and abiraterone (HR = 0.73, 95% Crl: 0.63–0.84). Similarly, enzalutamide (HR = 0.25, 95% Crl: 0.20–0.31) showed the greatest improvement of bPFS, followed by abiraterone (HR = 0.60, 95% Crl: 0.51–0.71) and cabazitaxel (HR = 0.75, 95% Crl: 0.63–0.89). In terms of safety, treatments ranked from the safest to the least safe were radium-223 (OR = 0.58, 95% Crl: 0.20–1.68), enzalutamide (OR = 0.80, 95% Crl: 0.28–2.29), abiraterone (OR = 0.94, 95% Crl: 0.39–2.27) and cabazitaxel (OR = 2.50, 95% Crl: 0.84–7.44).

Conclusion: For patients with mCRPC who progressed after docetaxel, enzalutamide may offer the most significant survival benefits and satisfying safety. Cabazitaxel is effective in post-docetaxel settings but associated with a high risk of SAEs. Although network meta-analysis provides indirect comparisons and ranking probabilities, the results should be treated with caution as it cannot replace randomized direct comparison.

Systematic Review Registration:https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020223040, identifier CRD42020223040.
Targeting Myadm to Intervene Pulmonary Hypertension on Rats Before Pregnancy Alleviates the Effect on Their Offspring’s Cardiac-Cerebral Systems
Authors: Wang Jingrong , Zhang Zirui , Liang Cui , Lv Tingting , Yu Haoying , Ren Shuyue , Lin Peirong , Du Guanhua , Sun Lan
Published: January 2022

Pregnancy with pulmonary hypertension (PH) seriously threatens the life and safety of mothers and infants. Here, the long-term effect of maternal PH on the postpartum growth of rat offspring was focused for the first time, as well as explored the role of Myadm in PH rats before pregnancy based upon the previous findings. Patients with PH are prone to hypoxemia, leading to insufficient placental structure and function, which affects the organ function of fetuses, followed by evidence that differently expressed genes (DEGs) existed in the heart of maternal PH newborn rats and enriched in pathways related to cardiac and nerve development on human infants with similar birth outcome: low birth weight (LBW). LBW was one of the possible birth outcomes of pregnancy with PH, especially severe PH, accompanied by evidence that offspring derived from mothers with PH presented lower birth weights and slower growth rates than those derived from normal control mothers in a rat model. Besides, maternal PH rat offspring showed cardiac remodeling and a significant elevation of the expression levels of hypoxia- and inflammation-related markers in the cerebral cortex at both 10 and 14 weeks of age, respectively. What is more, the previous studies found that the overexpression of Myadm could result in the remodeling of the pulmonary artery. And targeting Myadm to intervene PH before pregnancy could alleviate sustained low weight growth in maternal PH rat offspring, and the pathological changes of the cardiac–cerebral system caused by maternal PH, including enlarged right heart cavity, loss of cardiomyocytes, abnormal heart index, as well as cerebral cortex hypoxia and the inflammatory state as they grew up to a certain extent. The findings show the pathological significance of maternal PH on offspring growth and the cardiac–cerebral development in a rat model, as well as point out the potential treatment target, which may provide a further reference for pregnancy outcomes in women with PH and healthy development of offspring to some extent.
Efficacy and Safety of Vadadustat for Anemia in Patients With Chronic Kidney Disease: A Systematic Review and Meta-Analysis
Authors: Xiong Limei , Zhang Hui , Guo Yannan , Song Yue , Tao Yuhong
Published: January 2022

Background: Vadadustat is a novel drug for treating anemia patients with chronic kidney disease (CKD), but its effect and safety remain uncertain. This study aimed to summarize the evidence for vadadustat in the treatment of CKD patients with anemia.

Methods: PubMed, Ovid Medline, Embase, Cochrane CENTRAL, Wanfang Data, China National Knowledge Infrastructure and an international trial register were searched from their inception to June 2021 for randomized controlled trials (RCTs) comparing the efficacy and safety of vadadustat to those of placebo or erythropoiesis-stimulating agents (ESAs) in treating anemia in CKD patients. Data were pooled in a meta-analysis, with results expressed as the mean difference for continuous outcomes and relative risk for categorical outcomes with 95% confidence intervals (95% CIs). The certainty of evidence was rated according to Cochrane methods and the GRADE approach.

Results: Ten RCTs comparing vadadustat with placebo (4 RCTs) or darbepoetin alfa (6 RCTs) were included (n = 8,438 participants). Compared with placebo, vadadustat increased the hemoglobin (Hb) response rate (risk ratio 5.27; 95% CI: 2.69 to 10.31; p < 0.001; high certainty of evidence) and Hb level from baseline (∆Hb) (mean difference (MD) 1.28; 95% CI: 0.83 to 1.73; p < 0.001; low certainty of evidence). Compared with placebo or darbepoetin alfa, vadadustat decreased hepcidin (MD -36.62; 95% CI: −54.95 to −18.30; p < 0.001) and ferritin (MD −56.24; 95% CI: −77.37 to −35.11; p < 0.001) levels and increased iron-binding capacity (MD 24.38; 95% CI: 13.69 to 35.07; p < 0.001), with a low to moderate certainty of evidence. Moderate to high certainty evidence suggested that compared with placebo or darbepoetin alfa, vadadustat significantly increased the risk of nausea and diarrhea but did not significantly increase the risk of serious adverse events, especially all-cause mortality, cardiac events and nonfatal stroke.

Conclusion: Vadadustat may safely improve Hb levels and promote iron utilization in CKD patients with anemia without increasing the incidence of serious adverse events.
Traditional Chinese Medicine Targeting Heat Shock Proteins as Therapeutic Strategy for Heart Failure
Authors: Wang Yanchun , Wu Junxuan , Wang Dawei , Yang Rongyuan , Liu Qing
Published: January 2022

Heart failure (HF) is the terminal stage of multifarious heart diseases and is responsible for high hospitalization rates and mortality. Pathophysiological mechanisms of HF include cardiac hypertrophy, remodeling and fibrosis resulting from cell death, inflammation and oxidative stress. Heat shock proteins (HSPs) can ameliorate folding of proteins, maintain protein structure and stability upon stress, protect the heart from cardiac dysfunction and ameliorate apoptosis. Traditional Chinese medicine (TCM) regulates expression of HSPs and has beneficial therapeutic effect in HF. In this review, we summarized the function of HSPs in HF and the role of TCM in regulating expression of HSPs. Studying the regulation of HSPs by TCM will provide novel ideas for the study of the mechanism and treatment of HF.
Pathophysiological Consequences of At-Risk Alcohol Use; Implications for Comorbidity Risk in Persons Living With Human Immunodeficiency Virus
Authors: Simon Liz , Edwards Scott , Molina Patricia E.
Published: January 2022

At-risk alcohol use is a significant risk factor associated with multisystemic pathophysiological effects leading to multiorgan injury and contributing to 5.3% of all deaths worldwide. The alcohol-mediated cellular and molecular alterations are particularly salient in vulnerable populations, such as people living with HIV (PLWH), diminishing their physiological reserve, and accelerating the aging process. This review presents salient alcohol-associated mechanisms involved in exacerbation of cardiometabolic and neuropathological comorbidities and their implications in the context of HIV disease. The review integrates consideration of environmental factors, such as consumption of a Western diet and its interactions with alcohol-induced metabolic and neurocognitive dyshomeostasis. Major alcohol-mediated mechanisms that contribute to cardiometabolic comorbidity include impaired substrate utilization and storage, endothelial dysfunction, dysregulation of the renin-angiotensin-aldosterone system, and hypertension. Neuroinflammation and loss of neurotrophic support in vulnerable brain regions significantly contribute to alcohol-associated development of neurological deficits and alcohol use disorder risk. Collectively, evidence suggests that at-risk alcohol use exacerbates cardiometabolic and neurocognitive pathologies and accelerates biological aging leading to the development of geriatric comorbidities manifested as frailty in PLWH.
The Transition Toward Nitrogen Deprivation in Diatoms Requires Chloroplast Stand-By and Deep Metabolic Reshuffling
Authors: Scarsini Matteo , Thiriet-Rupert Stanislas , Veidl Brigitte , Mondeguer Florence , Hu Hanhua , Marchand Justine , Schoefs Benoît
Published: January 2022

Microalgae have adapted to face abiotic stresses by accumulating energy storage molecules such as lipids, which are also of interest to industries. Unfortunately, the impairment in cell division during the accumulation of these molecules constitutes a major bottleneck for the development of efficient microalgae-based biotechnology processes. To address the bottleneck, a multidisciplinary approach was used to study the mechanisms involved in the transition from nitrogen repletion to nitrogen starvation conditions in the marine diatom Phaeodactylum tricornutum that was cultured in a turbidostat. Combining data demonstrate that the different steps of nitrogen deficiency clustered together in a single state in which cells are in equilibrium with their environment. The switch between the nitrogen-replete and the nitrogen-deficient equilibrium is driven by intracellular nitrogen availability. The switch induces a major gene expression change, which is reflected in the reorientation of the carbon metabolism toward an energy storage mode while still operating as a metabolic flywheel. Although the photosynthetic activity is reduced, the chloroplast is kept in a stand-by mode allowing a fast resuming upon nitrogen repletion. Altogether, these results contribute to the understanding of the intricate response of diatoms under stress.
Self-Regulation in Preschool: Examining Its Factor Structure and Associations With Pre-academic Skills and Social-Emotional Competence
Authors: Korucu Irem , Ayturk Ezgi , Finders Jennifer K. , Schnur Gina , Bailey Craig S. , Tominey Shauna L. , Schmitt Sara A.
Published: January 2022

Self-regulation in early childhood is an important predictor of success across a variety of indicators in life, including health, well-being, and earnings. Although conceptually self-regulation has been defined as multifaceted, previous research has not investigated whether there is conceptual and empirical overlap between the factors that comprise self-regulation or if they are distinct. In this study, using a bifactor model, we tested the shared and unique variance among self-regulation constructs and prediction to pre-academic and social-emotional skills. The sample included 932 preschool children (Mage = 48 months, SD = 6.55; 49% female), their parents, and their teachers in the United States. Children’s self-regulation was assessed using measures of executive function, behavioral self-regulation, and emotion regulation. The bifactor model demonstrated a common overarching self-regulation factor, as well as distinct executive function and emotion regulation factors. The common overarching self-regulation factor and executive function predicted children’s pre-academic (i.e., mathematics and literacy) and social-emotional skills. The emotion regulation factor predicted children’s social-emotional skills. Identifying the shared and unique aspects of self-regulation may have important implications for supporting children’s regulatory skills as well as their success in school.
Size Perception of a Sport Target as a Function of Practice Success Conditions
Authors: Bianchi Krystina , Brillinger Molly , Patterson Jae Todd
Published: January 2022

Superior motor task success has been correlated with participants’ self-reports of a larger-than-actual size of a sport-related target. In the present study, we examined whether a putting practice condition with greater success would differentially impact participants’ self-reported perceptions of the size of the putting hole during acquisition and retention. We randomly assigned participants to one of three different practice conditions (success-early, success-late, and self-controlled success) and had them self-report their perceived size of the putting hole upon completion of each required putting distance (25, 50, 75, 100, 125, 150, 175, 200 cm). Although there were no statistically significant differences between motor task success in the acquisition or retention period for the practice conditions, self-reported perceptions of target size were impacted by practice condition. During the acquisition period, participants in the self-controlled success and success-late conditions self-reported that the putting hole was larger than did participants in the success-early condition. In the retention period, participants in the self-controlled success condition perceived the target as larger than those in the success-early condition. These findings are the first to show that practice condition, independent of task success, differentially impacted self-reported perception of a target size.
Self-Support and Loneliness Among Chinese Primary School Students: A Moderated Mediation Model
Authors: Yao Zhendong , Pang Lu , Yu Huiying , Xiao Hanshi , Peng Biao
Published: January 2022

This study examined the effect of self-support on loneliness, the mediation effect of school belonging, and the moderation effect of self-esteem using a sample comprising 1,126 Chinese mainland primary school students, 621 are boys and 505 are girls, and their mean age was 10.51 years (SD = 1.63, range 8–13). Participants completed questionnaires regarding self-support, loneliness, school belonging and self-esteem. In the model hypothesis, self-support is an independent variable, loneliness is an outcome variable, school belonging is a mediating variable, and self-esteem is a regulatory variable. After controlling the demographic variables, the data were analyzed, and the results showed that: (1) self-support had a significantly negative predictive effect on loneliness; (2) the relation between self-support and loneliness was mediated by school belonging; and (3) the relation between school belonging and loneliness was moderated by self-esteem, supporting the moderated mediation model. Moderated mediation analysis further indicated that the mediated path make loneliness weaker for pupils with higher levels of self-esteem. These results revealed the formation mechanism of loneliness in primary school students and have certain enlightenment significance for the intervention of loneliness in primary school students. These results revealed the formation mechanism of loneliness among primary school students and have significant implications for interventions against loneliness in the primary school context.
The Effect of Emotional Reactivity on Marital Quality in Chinese Couples: The Mediating Role of Perceived Partner Responsiveness
Authors: Yuan Qunming , Fan Zhiguang , Leng Jiaqi
Published: January 2022

This study investigated the mediating role of perceived partner responsiveness in the relationship between emotional reactivity and marital quality among Chinese couples. The survey participants included 550 couples from 28 provinces in the Eastern, Central and Western China. The ages of the husbands range from 39 to 64 years old whose average age is 46.45 years old, while the ages of the wives vary between 32 and 62 years old whose average age is 45.08 years old. The Emotion Reactivity Scale, Perceived Partner Responsiveness Scale, and Quality of Marriage Index were selected for measurement. The results showed that the scores of husbands perceived partner responsiveness and marital quality were significantly higher than those of wives, and there was no significant difference in emotional reactivity between husbands and wives. Correlation analysis showed that emotional reactivity of couples was negatively correlated with perceived partner responsiveness and marital quality, while perceived partner responsiveness was positively correlated with marital quality. Based on the Actor-Partner Interdependence Model (APIM), it was found that the emotional reactivity of both spouses was a significant negative predictor of their marital quality (actor effect). It also significantly negatively predicted the marital quality of the spouse (partner effect). The mediating effect analysis results showed that the husbands’ perceived partner responsiveness played a mediating role in the emotional reactivity of the couples on marital quality of the husbands, and the wives’ perceived partner responsiveness played a mediating role in the emotional reactivity of the couples on marital quality of the husbands. The wives’ perceived partner responsiveness played a mediating role in the effect of the couples’ emotional reactivity on the wives’ marital quality. The results of this study contribute to a better understanding of the mechanism of emotional reactivity of couples affecting marital quality and have a guiding significance for improving marital quality.
A Systematic Review of Reviews of Correctional Mental Health Services Using the STAIR Framework
Authors: Simpson Alexander I. F. , Gerritsen Cory , Maheandiran Margaret , Adamo Vito , Vogel Tobias , Fulham Lindsay , Kitt Tamsen , Forrester Andrew , Jones Roland M.
Published: January 2022

Background

Rising demand for correctional mental health services (CMHS) in recent decades has been a global phenomenon. Despite increasing research, there are major gaps in understanding the best models for CMHS and how to measure their effectiveness, particularly studies that consider the overall care pathways and effectiveness of service responses. The STAIR (Screening, Triage, Assessment, Intervention, and Re-integration) model is an evidence-based framework that defines and measures CMHS as a clinical pathway with a series of measurable, and linked functions.

Method

We conducted a systematic review of the reviews of CMHS elements employing PRISMA guidelines, organized according to STAIR pillars. We assessed the quality of included studies using the AMSTAR-2 criteria. Narrative reviews were read and results synthesized.

Results

We included 26 review articles of which 12 were systematic, metaanalyses, and 14 narrative reviews. Two systematic reviews and seven narrative reviews addressed screening and triage with strong evidence to support specific screening and triage systems. There was no evidence for standardised assessment approaches. Eight systematic reviews and seven narrative reviews addressed interventions providing some evidence to support specific psychosocial interventions. Three systematic reviews and six narrative reviews addressed reintegration themes finding relatively weak evidence to support reintegration methods, with interventions often being jurisdictionally specific and lacking generalizability.

Conclusions

The STAIR framework is a useful way to organize the extant literature. More research is needed on interventions, assessment systems, care pathway evaluations, and reintegration models.
A Sustainability Model for Family-Focused Practice in Adult Mental Health Services
Authors: Allchin Becca , Weimand Bente M. , O'Hanlon Brendan , Goodyear Melinda
Published: January 2022

Background

Translating evidence-based practice to routine care is known to take significant time and effort. While many evidenced-based family-focused practices have been developed and piloted in the last 30 years, there is little evidence of sustained practice in Adult Mental Health Services. Moreover, many barriers have been identified at both the practitioner and organizational level, however sustainability of practice change is little understood. What is clear, is that sustained use of a new practice is dependent on more than individual practitioners' practice.

Design and Method

Drawing on research on sustaining Let's Talk about Children in adult mental health services and in the field of implementation science, this article proposes a model for sustaining family focused practice in adult mental health services.

Sustainability Model for Family-Focused Practice

An operational model developed from key elements for sustaining Let's Talk about Children identifies six action points for Adult Mental Health Services and their contexts to support the sustainability of family-focused practices. The model aims to support Services to take action in the complexity of real-world sustainability, providing action points for engaging with service users and practitioners, aligning intra-organizational activities, and the wider context.

Conclusion

The model for sustaining family-focused practice draws attention to the importance of sustainability in this field. It provides a practical framework for program developers, implementers, adult mental health services and policy-makers to consider both the components that support the sustainability and their interconnection. The model could be built on to develop implementation guides and measures to support its application.
Translation, Validity, and Reliability of Mental Health Literacy and Help-Seeking Behavior Questionnaires in Indonesia
Authors: Kaligis Fransiska , Ismail R. Irawati , Wiguna Tjhin , Prasetyo Sabarinah , Indriatmi Wresti , Gunardi Hartono , Pandia Veranita , Minayati Kusuma , Magdalena Clarissa Cita , Nurraga Garda Widhi , Anggia Muhammad Fariz , Pamungkas Subhan Rio , Tran Thach D. , Kurki Marjo , Gilbert Sonja , Sourander Andre
Published: January 2022

Background and Aim: Mental health is an integral part of adolescent wellbeing. However, only few adolescents understand the importance of mental health and are aware of the right time to seek help. Lack of knowledge and stigma may impede help-seeking behavior. To assess these aspects, three questionnaires have been developed in the English language. This study aims to assess the validity and reliability of an Indonesian version of the Mental Health Literacy and Help-Seeking Behavior set of questionnaires among adolescents in Indonesia.

Methods: This is a cross-sectional study that used The Mental Health Literacy and Help-Seeking Behavior set of questionnaires developed by Kutcher and Wei. The set consists of three questionnaires: the Mental Health Knowledge, Attitude Toward Mental Health, and Help-Seeking Behavior questionnaire. The study was conducted between October 2020 and January 2021 with 68 first-year medical students at the University of Indonesia, who represented adolescents in a transitional phase. The questionnaires were translated into the Indonesian language by a bilingual psychiatrist and reviewed by 10 expert psychiatrists to determine content validity [Item-Level Content Validity Index (I-CVI) and Scale-Level Content Validity Index (S-CVI)]. Cronbach's alpha values were used to assess internal consistency (reliability).

Results: The content validity test produced positive results with an I-CVI scores of 0.7–1.0 and S-CVI scores of 0.87, 0.90, and 0.99 for the knowledge, attitude, and help-seeking behavior questionnaires, respectively. For the reliability test, Cronbach's alpha values were 0.780 for the attitude questionnaire and 0.852 for the help-seeking behavior questionnaire, while the value for the knowledge questionnaire was 0.521.

Conclusion: The ability to properly measure mental health through the availability of accessible, valid, and understandable tools plays an important role in addressing mental health issues among adolescents. In the current study, the Indonesian translations of all three questionnaires examining knowledge, attitude, and help-seeking behavior were considered to be valid and reliable.
Not a “Get Out of Jail Free Card”: Comparing the Legal Supervision of Persons Found Not Criminally Responsible on Account of Mental Disorder and Convicted Offenders
Authors: Martin Sandrine , Charette Yanick , Leclerc Chloé , Seto Michael C. , Nicholls Tonia L. , Crocker Anne G.
Published: January 2022

Background

The public often perceives the insanity defense as a “get out of jail free card”. Conversely, several studies demonstrate the substantial control imposed upon these defendants. This study compares Review Boards decisions regarding people found not criminally responsible on account of mental disorder (NCRMD) to criminal courts decisions regarding convicted offenders for similar offenses in Canada.

Method

Detention, using logistic regression, and duration under detention and supervision, using Cox regression, were compared between a cohort of 1794 individuals found NCRMD in three Canadian provinces (Quebec, Ontario, and British Columbia) between 2000 and 2005 followed until 2008 from the National Trajectory Project and a national sample of 3,20,919 Canadians convicted of criminal offense from Statistics Canada's Criminal Court Survey.

Results

Individuals found NCRMD are 3.8 times (95% CI 3.4–4.3) more likely to be detained than convicted offenders as well as 4.8 times (95% CI 4.5–5.3) and 2.9 times (95% CI 2.6–3.1) less likely to be released from detention and supervision, respectively. One year after the verdict, 73% of the NCRMD accused were still under legal supervision and 42% were still in detention, whereas these proportions were, respectively, 41 and 1% for their convicted counterparts. Interaction effects show that sex, age, jurisdiction, number of offenses, and severity of crimes committed have a differential impact on decisions applied to NCRMD accused compared to convicted persons.

Conclusion

Contrary to popular perceptions, the insanity defense is not a loophole. Differences as to factors influencing the trajectories of the two samples confirm that Review Boards are able to distance their practices from the criminal courts and can set aside, at least in part, the principles of proportionality and punitiveness governing the traditional sentencing practices.
Substance-Specific and Shared Gray Matter Signatures in Alcohol, Opioid, and Polysubstance Use Disorder
Authors: Muller Angela M. , Pennington David L. , Meyerhoff Dieter J.
Published: January 2022

Substance use disorders (SUD) have been shown to be associated with gray matter (GM) loss, particularly in the frontal cortex. However, unclear is to what degree these regional GM alterations are substance-specific or shared across different substances, and if these regional GM alterations are independent of each other or the result of system-level processes at the intrinsic connectivity network level. The T1 weighted MRI data of 65 treated patients with alcohol use disorder (AUD), 27 patients with opioid use disorder (OUD) on maintenance therapy, 21 treated patients with stimulant use disorder comorbid with alcohol use disorder (polysubstance use disorder patients, PSU), and 21 healthy controls were examined via data-driven vertex-wise and voxel-wise GM analyses. Then, structural covariance analyses and open-access fMRI database analyses were used to map the cortical thinning patterns found in the three SUD groups onto intrinsic functional systems. Among AUD and OUD, we identified both common cortical thinning in right anterior brain regions as well as SUD-specific regional GM alterations that were not present in the PSU group. Furthermore, AUD patients had not only the most extended regional thinning but also significantly smaller subcortical structures and cerebellum relative to controls, OUD and PSU individuals. The system-level analyses revealed that AUD and OUD showed cortical thinning in several functional systems. In the AUD group the default mode network was clearly most affected, followed by the salience and executive control networks, whereas the salience and somatomotor network were highlighted as critical for understanding OUD. Structural brain alterations in groups with different SUDs are largely unique in their spatial extent and functional network correlates.
Why so Few, Still? Challenges to Attracting, Advancing, and Keeping Women Faculty of Color in Academia
Authors: Fox Tree Jean E. , Vaid Jyotsna
Published: January 2022

From its earliest beginnings, the university was not designed for women, and certainly not for women of color. Women of color in the United States are disproportionately under-represented in academia and are conspicuous by their absence across disciplines at senior ranks, particularly at research-intensive universities. This absence has an epistemic impact and affects future generations of scholars who do not see themselves represented in the academy. What are the barriers to attracting, advancing, and retaining women faculty of color in academia? To address this question we review empirical studies that document disparities in the assessment of research, teaching, and service in academia that have distinct implications for the hiring, promotion, and professional visibility of women of color. We argue that meaningful change in the representation, equity, and prestige of women faculty of color will require validating their experiences, supporting and valuing their research, creating opportunities for their professional recognition and advancement, and implementing corrective action for unjust assessment practices.
Case Report: Uniportal Video-Assisted Thoracoscopic Parenchymal Sparing Secondary Carinal Resection and Reconstruction for the Treatment of Tracheobronchial Mucoepidermoid Carcinoma
Authors: Hu Yan , Chen Xiaofeng , Ren Siying , Zeng Chao , Wang Li , Xiao Peng , Yu Fenglei , Liu Wenliang
Published: January 2022

Surgical resection is currently the mainstay of treatment for tracheobronchial mucoepidermoid carcinoma (TMEC). The parenchymal sparing secondary carinal resection and reconstruction for TMEC under the uniportal thoracoscopic approach has seldomly been reported in the literature. Here, we report a case of a 42-year-old male patient complaining of the incidental finding of a 1.5 × 1.2 cm neoplasm at the opening of the right bronchus intermedius and a 5.1 × 3.1 cm patchy lesion located at the left upper lobe by chest CT scans in February 2021. This patient successively underwent fiberoptic bronchoscopic biopsy of the bronchial neoplasm and CT-guided biopsy of the left upper lobe lesion. Pathological examination confirmed the diagnosis of the endobronchial mass in the right bronchus intermedius as low-grade mucoepidermoid carcinoma and left upper lobe lesion as tuberculosis. This patient successfully underwent uniportal thoracoscopic parenchymal sparing tumor resection, reconstruction of the secondary carina and lymphadenectomy at our center. Intraoperative frozen section showed no residual cancer at any bronchial stumps. Postoperative pathology indicated that no metastases were seen in any of the resected lymph nodes. The patient recovered well after surgery. He received a 9-month course of anti-tuberculosis treatment postoperatively. He did not complain of any special discomfort and there was no local recurrence at the 9-month postoperative follow-up. Although technical demanding, this case highlights that uniportal video-assisted thoracoscopic parenchymal sparing secondary carinal resection and reconstruction for TMEC is safe and feasible with the preservation of lung function and excellent outcomes.
Construction of a Conceptual Framework for Assessment of Health-Related Quality of Life in Dogs With Osteoarthritis
Authors: Roberts Claire , Armson Bryony , Bartram David , Belshaw Zoe , Capon Hannah , Cherry Georgina , Gonzalez Villeta Laura , McIntyre Shona L. , Odeyemi Isaac , Cook Alasdair J. C.
Published: January 2022

An owner's ability to detect changes in the behavior of a dog afflicted with osteoarthritis (OA) may be a barrier to presentation, clinical diagnosis and initiation of treatment. Management of OA also relies upon an owner's ability to accurately monitor improvement following a trial period of pain relief. The changes in behavior that are associated with the onset and relief of pain from OA can be assessed to determine the dog's health-related quality of life (HRQOL). HRQOL assessments are widely used in human medicine and if developed correctly can be used in the monitoring of disease and in clinical trials. This study followed established guidelines to construct a conceptual framework of indicators of HRQOL in dogs with OA. This generated items that can be used to develop a HRQOL assessment tool specific to dogs with OA. A systematic review was conducted using Web of Science, PubMed and Scopus with search terms related to indicators of HRQOL in dogs with osteoarthritis. Eligibility and quality assessment criteria were applied. Data were extracted from eligible studies using a comprehensive data charting table. Resulting domains and items were assessed at a half-day workshop attended by experts in canine osteoarthritis and quality of life. Domains and their interactions were finalized and a visual representation of the conceptual framework was produced. A total of 1,264 unique articles were generated in the database searches and assessed for inclusion. Of these, 21 progressed to data extraction. After combining synonyms, 47 unique items were categorized across six domains. Review of the six domains by the expert panel resulted in their reduction to four: physical appearance, capability, behavior, and mood. All four categories were deemed to be influenced by pain from osteoarthritis. Capability, mood, and behavior were all hypothesized to impact on each other while physical appearance was impacted by, but did not impact upon, the other domains. The framework has potential application to inform the development of valid and reliable instruments to operationalize measurement of HRQOL in canine OA for use in general veterinary practice to guide OA management decisions and in clinical studies to evaluate treatment outcomes.
Capacity Building Efforts for Rabies Diagnosis in Resource-Limited Countries in Sub-Saharan Africa: A Case Report of the Central Veterinary Laboratory in Benin (Parakou)
Authors: Djegui Fidelia , Gourlaouen Morgane , Coetzer Andre , Adjin Rachidatou , Tohozin Rogatien , Leopardi Stefania , Mauti Stephanie , Akpo Yao , Gnanvi Corneille , Nel Louis H. , De Benedictis Paola
Published: January 2022

Rabies has been listed as a priority zoonotic disease in many African countries and the countdown to reach the goal of eliminating dog-mediated human rabies deaths by 2030 means that disease control measures need to be applied fast. In this context, an essential pillar of any national plan to control rabies is the implementation of reliable diagnostic techniques to ensure the success of field surveillance systems. Although many African countries have received international support for the control of rabies–some countries, like Benin, have not received a similar level of support. Indeed, until 2018, Benin was not able to diagnose rabies and rabies diagnosis in animals as well as humans relied solely on observed clinical symptoms. Although the Central Veterinary Laboratory (CVL) of Parakou had the equipment to implement two recommended tests, the lack of specific reagents and skills prevented the implementation of a rabies diagnostic service. Here we present the joint efforts of the national authorities in Benin, intergovernmental agencies, and non-governmental organizations to assess the strengths and weaknesses of the government's rabies control efforts. We have applied the Stepwise Approach toward Rabies Elimination (SARE) analysis, implemented rabies diagnostic capacities at the CVL of Parakou, characterized strains of rabies virus circulating in Benin, and finally integrated an inter-laboratory comparison program.
Evaluation of Real-Time Quaking-Induced Conversion, ELISA, and Immunohistochemistry for Chronic Wasting Disease Diagnosis
Authors: Holz Carine L. , Darish Joseph R. , Straka Kelly , Grosjean Nicole , Bolin Steven , Kiupel Matti , Sreevatsan Srinand
Published: January 2022

Chronic wasting disease (CWD) is a transmissible prion disorder, primarily affecting free-ranging and captive cervids in North America (United States and Canada), South Korea, and Europe (Finland, Norway, and Sweden). Current diagnostic methods used in the United States for detection of CWD in hunter harvested deer involve demonstration of the causal misfolded prion protein (PrPCWD) in the obex or retropharyngeal lymph nodes (RLNs) using an antigen detection ELISA as a screening tool, followed by a confirmation by the gold standard method, immunohistochemistry (IHC). Real-time quaking-induced conversion (RT-QuIC) assay is a newer approach that amplifies misfolded CWD prions in vitro and has facilitated CWD prion detection in a variety of tissues, body fluids, and excreta. The current study was undertaken to compare ELISA, IHC, and RT-QuIC on RLNs (n = 1,300 animals) from white-tailed deer (WTD) in Michigan. In addition, prescapular, prefemoral and popliteal lymph nodes collected from a small subset (n = 7) of animals were tested. Lastly, the location of the positive samples within Michigan was documented and the percentage of CWD positive RLNs was calculated by sex and age. ELISA and RT-QuIC detected PrPCWD in 184 and 178 out of 1,300 RLNs, respectively. Of the 184 ELISA positive samples, 176 were also IHC positive for CWD. There were seven discordant results when comparing IHC and ELISA. RT-QuIC revealed that six of the seven samples matched the IHC outcomes. One RLN was negative by IHC, but positive by ELISA and RT-QuIC. RT-QuIC, IHC, and ELISA also detected PrPCWD in prescapular, prefemoral and popliteal lymph nodes. CWD infection heterogeneities were observed in different age and sex groups, with young males having higher CWD prevalence. All, except one, CWD positive RLNs analyzed were from ten Counties geographically located in the West Michigan region of the Lower Peninsula. Taken together, we show evidence that the RT-QuIC assay is comparable to ELISA and IHC and could be helpful for routine CWD detection in surveillance programs. RT-QuIC also demonstrated that CWD prions are distributed across lymph nodes in a variety of anatomic locations. A multi-laboratory validation on blinded sample panels is underway and is likely to help to provide insight into the variability (lab-to-lab), analytical sensitivity, and specificity of gold standard diagnostics vs. RT-QuIC assay.