bluuebunny/crossref_metadata_2025 huggingface dataset:
Cognitive Processes and Legal Capacity in Patients With Bipolar Disorder: A Brief Research Report
Authors: Saffi Fabiana , Rocca Cristiana C. A. , Toschi-Dias Edgar , Durães Ricardo S. S. , Serafim Antonio P.
Published: June 2022

The current study verified the association between cognitive process such as attention, executive functioning, and legal capacity in patients with bipolar disorder (BD). The sample consisted of 72 participants, assorted to episodic patients (n= 21), euthymic patients (n= 22), and healthy controls (HCs) (n= 29). We used the following neuropsychological measures: subtests of the Wechsler Abbreviated Intelligence Scale (WASI): vocabulary and matrix reasoning; Continuous Performance Test (CPT); Five Digit Test (FDT); and Rey–Osterrieth Complex Figure (ROCF). Euthymic patients expressed slower processing speed (FDT) compared to HC. They tended to make more errors with slightly worse discrimination, suggesting more impulsiveness (CPT,p< 0.01). On the contrary, episodic patients showed worse discrimination, committed more omissions, were more inconsistent with regard to response speed (CPT-3,p< 0.01), showed more difficulties in organizing their actions (ROCF: copy,p= 0.03), and were more rigid (FDT: flexibility,p= 0.03). The results suggest that bipolar patients in episode express more cognitive impairments that can compromise the quality of legal capacity. These results highlight the need for more protective support for episodic BD patients regarding legal capacity.
Online Group Music-Making in Community Concert Bands: Perspectives From Conductors and Older Amateur Musicians
Authors: Barbeau Audrey-Kristel , Generale Mariane , Creech Andrea
Published: June 2022

At the beginning of the pandemic, many music ensembles had to stop their activities due to the confinement. While some found creative ways to start making music again with the help of technologies, the transition from “real” rehearsals to “online” rehearsals was challenging, especially among older amateur musicians. The aim of this case study was to examine the effects of this transition on three community band conductors and three older amateur musicians. Specific objectives were to explore (1) intergenerational relationships to support online group music-making; (2) digital literacy and access in later life; and (3) online music-making in a COVID-19 context. Semi-structured interviews were conducted and theoretical thematic analysis was undertaken (Braun and Clarke, 2006). Results were analyzed from the conductors’ and older musicians’ perspectives, and common trends were combined to facilitate interpretation. The first theme showed that being part of an intergenerational ensemble contributed positively to the learning experience online. The second theme demonstrated that because both conductors and musicians were new to the online rehearsals, it contributed to attenuate the age-related digital divide that may have been observed in other studies. Regarding access in later-life, older musicians reported benefits associated with rehearsing online, specifically in terms of distance/commute, time, energy, and cost. However, for those who did not already have internet and electronic devices, the cost of acquiring all the necessary equipment to make music online could have been too high. Finally, the third theme revealed that musicians appreciated the opportunity to make music online and indicated that it was definitely better than having nothing, especially for its social aspects. In conclusion, while participants noted several challenges associated with online music-making (e.g., zoom fatigue and technological issues), they were also appreciative of the opportunity to continue making music at a time when in-person rehearsals were not possible. Pedagogical implications are discussed, specifically the importance of the support network, of meeting people where they are, of learning to adapt, and of collaborative teaching.
Withdrawn Behavior in Preschool: Implications for Emotion Knowledge and Broader Emotional Competence
Authors: Clark Samantha E. , Locke Robin L. , Baxendale Sophia L. , Seifer Ronald
Published: June 2022

The present study investigated the respective roles of withdrawal, language, and context-inappropriate (CI) anger in the development of emotion knowledge (EK) among a subsample of 4 and 5 year-old preschoolers (n = 74). Measures included parent-reported withdrawn behavior, externalizing behavior, and CI anger, as well as child assessments of receptive language and EK. Ultimately, findings demonstrated that receptive language mediated the relationship between withdrawn behavior and situational EK. However, CI anger significantly interacted with receptive language, and, when incorporated into a second-stage moderated mediation analysis, moderate levels of CI anger rendered the indirect effect of withdrawn behavior on situational EK via receptive language insignificant. Cumulatively, these findings demonstrate a mechanism by which withdrawal may impact EK. They also indicate that such an effect may be attenuated in children with moderate levels of CI anger. Implications of these findings are discussed.
Assessing Sensorimotor Synchronisation in Toddlers Using the Lookit Online Experiment Platform and Automated Movement Extraction
Authors: Rocha Sinead , Addyman Caspar
Published: June 2022

Adapting gross motor movement to match the tempo of auditory rhythmic stimulation (sensorimotor synchronisation; SMS) is a complex skill with a long developmental trajectory. Drumming tasks have previously been employed with infants and young children to measure the emergence of rhythmic entrainment, and may provide a tool for identification of those with atypical rhythm perception and production. Here we describe a new protocol for measuring infant rhythmic movement that can be employed at scale. In the current study, 50 two-year-olds drummed along with the audiovisual presentation of four steady rhythms, using videos of isochronous drumming at 400, 500, 600, and 700 ms IOI, and provided their spontaneous motor tempo (SMT) by drumming in silence. Toddlers’ drumming is observed from video recordings made in participants’ own homes, obtained via the Lookit platform for online infant studies. We use OpenPose deep-learning model to generate wireframe estimates of hand and body location for each video. The vertical displacement of the hand was extracted, and the power and frequency of infants’ rhythmic entrainment quantified using Fast Fourier Transforms. We find evidence for age-appropriate tempo-flexibility in our sample. Our results demonstrate the feasibility of a fully digital approach to measuring rhythmic entrainment from within the participant’s home, from early in development.
COVID-19–Related Trajectories of Psychological Health of Acute Care Healthcare Professionals: A 12-Month Longitudinal Observational Study
Authors: Abegglen Sandra , Greif Robert , Fuchs Alexander , Berger-Estilita Joana
Published: June 2022

The COVID-19 pandemic hit healthcare professionals (HCPs) hard, potentially leading to mental health deterioration. This longitudinal study investigated the 1-year evolution of psychological health of acute care HCPs during the COVID-19 pandemic and explored possible differences between high and low resilient HCPs. From April 2020 to April 2021, a convenience sample of 520 multinational HCPs completed an online survey every 3 months, up to five times. We used mixed linear models to examine the association between resilience and the variation of COVID-19-related anxiety, depressiveness, perceived vulnerability, and psychological trauma symptomatology. We demonstrated “u-shaped” trajectories for all mental health symptoms. We also explored differences in the abovementioned variables between front-line and second-line acute care HCPs. In contrast to HCP.s with lower levels of resilience (-1SD), those with higher levels of resilience (+1SD) showed increased COVID-19 anxiety and perceived vulnerability over time. Front-line and second-line HCPs differed in their depressiveness and psychological trauma variation during the 1-year analysis. High and average resilient second-line HCPs showed steeper depressiveness increases with time than high and average resilient front-line HCPs. Acute care HCPs reported their most elevated clinical symptoms of depressiveness (5–7%) and psychological trauma symptomatology (26–46%) in April 2020. During the first year of the COVID-19 pandemic, second-line HCPs with more resilience showed a steeper worsening of their depressiveness than more resilient front-line HCPs. HCPs with low resilience may benefit from interventions at the beginning of a pandemic, whereas HCPs with high resilience might benefit from resilience-enhancing interventions at later phases.

Trial Registration

The study protocol was pre-registered with the International Standard Randomised Controlled Trial Number (ISRCTN13694948) published (Fuchs et al., 2020).
A Longitudinal Study of Changes in the Shot Characteristics of Women Table Tennis Players: Analysis of the Olympic Semifinals and Finals of Women's Singles
Authors: Wang Jie , Li Mengqi , Xiong Xi
Published: June 2022

This study aims to evaluate the changes in shot characteristics of elite women table tennis players through the longitudinal analysis of women's singles finals and semifinals from 2004 to 2021 Olympic Games. A total of 13 games were selected, and the stroke position, stroke type, ball placement, and stroke efficacy of 5,877 shots were analyzed using the notational analysis method. A chi-square test was used to test whether the shot characteristics had changed between game years, and the adjusted residual was calculated to judge these changes. In the four dimensions, namely, stroke position, stroke type, ball placement, and stroke efficacy, the shot characteristics of women table tennis players have changed with the year of the Olympic Games. The backhand stroke position has an upward trend from 55.0 to 58.1%, and the type of flip stroke has a downward trend from 7.6 to 2.1%. The ball placements of forehand and middle long have two fluctuations first rising from 11.2 to 12.7% and 20.3 to 23.7% and then falling from 12.7 to 5.3% and 23.7 to 16.0%. Moreover, backhand long is being increasingly used. In the year of equipment change, the proportion of neutral stroke increases from 40.0 to 61.5%. Once the players have become adapted to the equipment, the proportion of neutral stroke decreases from 61.5 to 48.5%. The development trend of women table tennis players is that the extreme stroke will be further increasingly used. Results suggest that elite women table tennis coaches and players should focus on the technical training in the forehand and backhand positions, strengthen the practice of topspin and block, and pay attention to the backhand long landing area. Women's table tennis coaches and players also need to pay close attention to the possible impact of changes in rules and equipment and carry out targeted training in advance to minimize the impact on the stroke efficacy of players.
Impact of Parenting Style on Early Childhood Learning: Mediating Role of Parental Self-Efficacy
Authors: Kong Chuibin , Yasmin Fakhra
Published: June 2022

The current study examined the impact of parental style on early childhood learning, as well as the role of parental self-efficacy (PSE) as a mediating factor. In the domains of education and psychology, it is increasingly recognized that parents have a considerable impact on their children’s learning and development. Purposive sampling was used and data was gathered over 3 months from school children’s parents. Hypotheses were tested using smart partial least squares-structural equation modeling (PLS-SEM v3.2.8) software. The findings of the present study reveal that an authoritative parenting style is positively associated with learning outcomes among Chinese students. Moreover, the mediating role of parental self-efficacy has been tested and proved to be a potential mediator between parental style and children’s learning outcomes. High PSE is linked to parents’ adoption of a variety of optimum parenting practices throughout childhood, including maternal sensitivity and responsiveness to children’s needs, warm and affectionate parental behavior, and monitoring. Hence, low PSE has been linked to coercive or harsh parenting as well as a proclivity to give up easily when faced with parental difficulties. In China, further study is needed on the relationship between parenting style, parental self-efficacy, and learning outcome. Future parenting programs could also focus on raising parents’ understanding of the need for both parents’ involvement in expressive activities and mentoring. This could help them boost their parenting self-efficacy even more. Lastly, the implications for parents, children, and teachers are discussed.
Improved Regional Homogeneity in Chronic Insomnia Disorder After Amygdala-Based Real-Time fMRI Neurofeedback Training
Authors: Li Zhonglin , Liu Jiao , Chen Bairu , Wu Xiaoling , Zou Zhi , Gao Hui , Wang Caiyun , Zhou Jing , Qi Fei , Zhang Miao , He Junya , Qi Xin , Yan Fengshan , Dou Shewei , Tong Li , Zhang Hongju , Han Xingmin , Li Yongli
Published: June 2022

Background

Chronic insomnia disorder (CID) is a highly prevalent sleep disorder, which influences people's daily life and is even life threatening. However, whether the resting-state regional homogeneity (ReHo) of disrupted brain regions in CID can be reshaped to normal after treatment remains unclear.

Methods

A novel intervention real-time functional magnetic resonance imaging neurofeedback (rtfMRI-NF) was used to train 28 CID patients to regulate the activity of the left amygdala for three sessions in 6 weeks. The ReHo methodology was adopted to explore its role on resting-state fMRI data, which were collected before and after training. Moreover, the relationships between changes of clinical variables and ReHo value of altered regions were determined.

Results

Results showed that the bilateral dorsal medial pre-frontal cortex, supplementary motor area (SMA), and left dorsal lateral pre-frontal cortex had decreased ReHo values, whereas the bilateral cerebellum anterior lobe (CAL) had increased ReHo values after training. Some clinical scores markedly decreased, including Pittsburgh Sleep Quality Index, Insomnia Severity Index, Beck Depression Inventory, and Hamilton Anxiety Scale (HAMA). Additionally, the ReHo values of the left CAL were positively correlated with the change in the Hamilton depression scale score, and a remarkable positive correlation was found between the ReHo values of the right SMA and the HAMA score.

Conclusion

Our study provided an objective evidence that amygdala-based rtfMRI-NF training could reshape abnormal ReHo and improve sleep in patients with CID. The improved ReHo in CID provides insights into the neurobiological mechanism for the effectiveness of this intervention. However, larger double-blinded sham-controlled trials are needed to confirm our results from this initial study.
Differences in Influencing Factors Between Non-suicidal Self-Injury and Suicide Attempts in Chinese Adolescents: The Role of Gender
Authors: Xu Huiqiong , Jiang Zhicheng , Li Shuqin , Zhang Xinyu , Xu Shaojun , Wan Yuhui , Tao Fangbiao
Published: June 2022

Introduction

Non-suicidal self-injury (NSSI) and suicide attempts (SA) are common in adolescents and are important risk factors for suicide deaths. They are related to various psychosocial, behavioral, and biological factors. We aimed to compare the differences on psychological behavior problem and family environment characteristics between NSSI and SA, and the role of gender.

Methods

A multi-center population-based survey was conducted in 29 schools across 4 provinces in China. A total of 14,500 urban and rural adolescents in grades 7–12 completed a structured questionnaire to report their sociodemographic information, psychological and behavioral characteristics, childhood maltreatment, parent-child relationships, NSSI, and SA. Post-hoc tests, pairwise comparisons, and multinomial logistic regression analyses were conducted to explore the differences and similarities between subjects who had engaged in NSSI and SA.

Results

The prevalence of NSSI and SA were 27.3 and 4.9%, respectively, and the co-occurrence of these two behaviors (NSSI + SA) was reported to 2.8%. The NSSI + SA group scored the highest on all study variables, followed by the SA-only group, the NSSI-only group, and the non-self-harm group (p < 0.001). Compared with the non-self-harm group, adolescents who reported either NSSI or SA scored significantly higher on all study variables (p< 0.0083). The comparison between other self-harm groups, this difference have varied in all research variables.

Conclusion

The current study indicate that psychological, behavioral, and family relationships profiles of Chinese adolescents with SA and NSSI are similar, but the measured problematic characteristics were more severe in suicide attempters. In the future, it's necessary to pay more attention to adolescents with more serious psychological and behavioral problems to prevent and early intervene in their self-harm, and actively explore gender differences.
Evaluating the Risk of Suicide and Violence in Severe Mental Illness: A Feasibility Study of Two Risk Assessment Tools (OxMIS and OxMIV) in General Psychiatric Settings
Authors: Beaudry Gabrielle , Canal-Rivero Manuel , Ou Jianjun , Matharu Jaskiran , Fazel Seena , Yu Rongqin
Published: June 2022

Background

Two OxRisk risk assessment tools, the Oxford Mental Illness and Suicide (OxMIS) and the Oxford Mental Illness and Violence (OxMIV), were developed and validated using national linked registries in Sweden, to assess suicide and violence risk in individuals with severe mental illness (schizophrenia-spectrum disorders and bipolar disorders). In this study, we aim to examine the feasibility and acceptability of the tools in three different clinical services.

Method

We employed a two-step mixed-methods approach, by combining quantitative analyses of risk scores of 147 individual patients, and thematic analyses of qualitative data. First, 38 clinicians were asked to use OxMIS and OxMIV when conducting their routine risk assessments in patients with severe mental illness. The risk scores for each patient (which provide a probability of the outcome over 12 months) were then compared to the unstructured clinical risk assessment made by the treating clinician. Second, we carried out semi-structured interviews with the clinicians on the acceptability and utility of the tools. Thematic analysis was conducted on the qualitative data to identify common themes, in terms of the utility, accuracy, and acceptability of the tools. The investigations were undertaken in three general adult psychiatric clinics located in the cities of Barcelona and Sevilla (Spain), and Changsha (China).

Results

Median risk probabilities over 12 months for OxMIS were 1.0% in the Spanish patient sample and 1.9% in the Chinese sample. For OxMIV, they were 0.7% (Spanish) and 0.8% (Chinese). In the thematic analysis, clinicians described the tools as easy to use, and thought that the risk score improved risk management. Potential additions to predictors were suggested, including family history and the patient's support network. Concordance rates of risk estimates between the tools and clinicians was high for violence (94.4%; 68/72) and moderate for suicide (50.0%; 36/72).

Conclusion

Both OxMIS and OxMIV are feasible and practical in different general adult psychiatric settings. Clinicians interviewed found that both tools provide a useful structured approach to estimate the risk of suicide and violence. Risk scores from OxMIS and OxMIV can also be used to assist clinical decision-making for future management.
Catatonia and Cognitive Impairments: A Systematic Review
Authors: Serrat Francesc , Iglesias-Gónzalez Maria , Sanagustin David , Etxandi Mikel , de Pablo Joan , Cuevas-Esteban Jorge
Published: June 2022

Background

Catatonia is an underdiagnosed and undertreated neuropsychiatric syndrome characterized by catalepsy, negativism, mutism, muscular rigidity, and mannerism, often accompanied by autonomic instability and fever. Although there is growing interest in studying cognitive impairments before and after catatonia, little is known about the cognitive features of the syndrome.

Methods

This systematic review was registered at PROSPERO (CRD42022299091). Using a Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) approach, we searched PubMed, ScienceDirect, and PsycArticles using a combination of the terms “Catatonia” and “Cognitive impairment” and “Executive function” and “Frontal lobe” and “Parietal lobe.” Studies included original research articles enrolling patients with catatonic syndrome according to specified criteria. Fourteen studies were deemed relevant for inclusion. The abstraction form included age, assessment during acute episode, associated diagnosis, assessment procedure, and cognitive domains. Outcome measures were extracted.

Results

Executive functions and visuospatial abilities proved to be the most investigated domains. A great heterogeneity has been observed in the assessment tools used among the 14 evaluated studies. Findings showed that catatonic patients had worse performance than healthy and non-catatonic psychiatric patients in frontal and parietal cortical functions.

Conclusion

Because of the small number of studies in such heterogeneous areas and significant methodological limitations, the results should be regarded with caution. Future research assessing cognitive impairments on catatonic patients is needed.

Systematic Review Registration

[https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=299091], identifier [CRD42022299091].
Oral Morphine as an Alternative Substitution Treatment for Opioid Use Disorder, a Rare but Non-risk-free Use
Authors: Bertin Célian , Bezin Julien , Chenaf Chouki , Delorme Jessica , Kerckhove Nicolas , Pariente Antoine , Tournier Marie , Authier Nicolas
Published: June 2022

Background

National health monitoring agencies have reported the alternative use of morphine sulfate painkiller for maintenance treatment of opioid use disorder (OUD), associated with a potential increase in overdose risk.

Objectives

This study sought to assess the prevalence of regular and occasional legally prescribed morphine use in patients treated for OUD and compare their characteristics to those of patients receiving conventional opioid maintenance treatment (OMT), buprenorphine or methadone. Then, we assessed the factors associated with opioid overdose risk.

Methods

Data were extracted from the French national healthcare system database, covering the entire population in 2015. Diagnosis associated with hospital discharge and long-term disease codes were extracted to select the population and identify outcomes and covariates. OUD non-chronic pain patients were divided into regular (≤35 days between dispensing and ≥3 months of continuous treatment duration) morphine users, and occasional users. Their sociodemographic and health characteristics were compared to OMT controls. A multivariate logistic regression model was performed to determine factors associated with opioid overdose.

Results

In patients treated for OUD, 2,237 (2.2%) morphine users (1,288 regular and 949 occasional), 64,578 (63.7%) buprenorphine and 34,638 (34.1%) methadone controls were included. The prevalence of regular morphine use among patients treated for OUD regularly receiving an opioid was 1.3%. Compared to users who receive morphine regularly, occasional users had an increased risk of overdose [OR = 2.2 (1.5–3.3)], while the risk was reduced in the buprenorphine group [OR = 0.5 (0.4–0.7)] and not significantly different for methadone [OR = 1.0 (0.7–1.4)]. Other overdose risk factors were low-income, comorbidity, i.e., psychiatric conditions, alcohol use disorder or complications related to intravenous drug use, and coprescription with benzodiazepines or pregabalin. These factors were more frequent in morphine groups.

Conclusions

Patients that were prescribed oral morphine represented a small minority of the treated for OUD. The poorer health condition affected by numerous comorbidities and higher risk of opioid overdose in patients treated with oral morphine compared with OMT controls points toward the need to better supervise the practices of these patients, to strengthen multidisciplinary care and risk reduction measures.
Adaptation and Validation of the Malay Version of the Stress and Anxiety to Viral Epidemics-6 Items Scale Among the General Population
Authors: Pang Nicholas Tze Ping , Tseu Mathias Wen Leh , Gupta Pradeep , Dhaarshini Jaya , Kamu Assis , Ho Chong Mun , Ahmed Oli , Chung Seockhoon
Published: June 2022

The coronavirus disease pandemic has caused untold distress owing to both its physical and psychological sequelae, and such distress is further exacerbated by multiple socioeconomic ramifications. The Stress and Anxiety to Viral Epidemics-6 Items (SAVE-6). Scale was developed to specifically assess the anxiety response of the general population to viral epidemics. This study aimed to establish the psychometric properties of the Malay version of the SAVE-6 Scale in the general population. Herein, a total of 257 individuals participated. World Health Organization instrument validation protocols were used to translate and back-translate the Malay SAVE-6 Scale. Subsequently, the classical test theory and Rasch analysis were used to ascertain the validity and reliability of the scale. Cronbach α was used to measure the internal consistency, which was found to be satisfactory (α = 0.866). The correlations between the SAVE-6 Scale and other scales, including the Generalized Anxiety Disorder-7 Items Scale (r = 0.421, p < 0.001) and Patient Health Questionnaire-9 Items (r = 0.354, p < 0.001) were significant. Taken together, the Malay version of the SAVE-6 Scale is valid and reliable for use in the general population and is psychometrically suitable for assessing stress and anxiety specific to viral epidemics.
Patient Acceptance and Intention to Use e-Consultations During the COVID-19 Pandemic in the Eastern Province of Saudi Arabia
Authors: Althumairi Arwa , Hariri Beyan , Aljabri Duaa , Aljaffary Afnan
Published: June 2022

Background

Over the last decade, the use of digital technology has increased immeasurably and transformed both our personal and professional lives. The medical profession quickly embraced this development, especially after the spread of the COVID-19 pandemic. Medical consultations were transitioned to online settings as a substitute for face-to-face consultations. This exponential acceleration of the use of remote online consultations (e-consultations) was deemed necessary to respond to the impact of the global pandemic. This study identifies the factors that influence actual patient use and the intention to use e-consultations in Saudi Arabia.

Methods

A cross-sectional survey was distributed online via social media platforms targeting the population living in Saudi Arabia from August to December 2020. The questionnaire measured patient perceptions of and attitudes toward utilizing e-consultations using a validated questionnaire informed by the technology acceptance model (TAM). Analyses were performed in SPSS to identify the external factors that influence patients' actual use of e-consultations and to assess the TAM factors (usefulness, social influence, and ease of use) that influence the intention to use e-consultations across both actual users and never-users.

Results

A total of 150 participants completed the questionnaire; the average age was 38 years old, 85% of the participants were females, and 67% reported never using e-consultations. Additionally, motivation, trust, attitude, and social influence were significantly related to participants' intention to use e-consultations.

Conclusion

Participants' trust in and perception of the usefulness of e-consultations were significant factors in their intention to use e-consultation services. Policymakers' attention to those factors could play a role in increasing public acceptance and the use of e-consultations to improve distance medical care.
Epidemiology and Economic Burden of Continuing Challenge of Infectious Diseases in India: Analysis of Socio-Demographic Differentials
Authors: Ram Bhed , Thakur Ramna
Published: June 2022

Unlike other low- and middle-income countries, infectious diseases are still predominant, and non-communicable diseases (NCDs) are emerging without replacing the burden of infectious diseases in India, where it is imposing a double burden of diseases on households in the country. This study aimed to analyse the socio-economic and demographic differentials in the magnitude of economic burden and coping strategies associated with health expenditure on infectious diseases in India. National Sample Survey Organization (NSSO) data on “Key Indicators of Social Consumption in India: Health, (2017–18)” have been employed in this study. The findings of the study revealed that more than 33% of the individuals are still suffering from infectious diseases out of the total ailing population in India. Based on the various socio-economic and demographic covariates, infectious diseases are highly prevalent among individuals with marginalized characteristics, such as individuals residing in rural areas, females, 0–14 age groups, Muslims, illiterates, scheduled tribes (STs), and scheduled castes (SCs), large family households, and economically poor people in the country. The per capita out-of-pocket (OOP) expenditure on infectious diseases is INR 7.28 and INR 29.38 in inpatient and outpatient care, respectively. Whereas, monthly per patient OOP expenditure on infectious diseases by infection-affected populations is INR 881.56 and INR 1,156.34 in inpatient and outpatient care in India. The study found that people residing in rural areas, SCs followed by other backward classes (OBCs), illiterates, poor, and very poor are more dependent on borrowings, sale of assets, and other distressed sources of financing. However, under National Health Policy 2017, many initiatives, such as “Ayushman Bharat,” PM-JAY, and National Digital Health Mission (NDHM) in 2021, have been launched by the government of India in the recent years. These initiatives are holistically launched for ensuring better health facilities, but it is early to make any prediction regarding its outcomes; hopefully, the time will define it over the passing of a few more years. Finally, the study proposed the need for proper implementations of policy initiatives, awareness against unhygienic conditions and contamination of illnesses, immunisations/vaccination campaigns, subsidized medical facilities, and the country's expansion of quality primary health-care facilities.
Clinical Characteristics, Prognostic Factor and a Novel Dynamic Prediction Model for Overall Survival of Elderly Patients With Chondrosarcoma: A Population-Based Study
Authors: Tong Yuexin , Cui Yuekai , Jiang Liming , Pi Yangwei , Gong Yan , Zhao Dongxu
Published: June 2022

Background

Chondrosarcoma is the most common primary bone sarcoma among elderly population. This study aims to explore independent prognostic factors and develop prediction model in elderly patients with CHS.

Methods

This study retrospectively analyzed the clinical data of elderly patients diagnosed as CHS between 2004 and 2018 from the Surveillance, Epidemiology, and End Results (SEER) database. We randomly divided enrolled patients into training and validation group, univariate and multivariate Cox regression analyses were used to determine independent prognostic factors. Based on the identified variables, the nomogram was developed and verified to predict the 12-, 24-, and 36-month overall survival (OS) of elderly patients with CHS. A k-fold cross-validation method (k=10) was performed to validate the newly proposed model. The discrimination, calibration and clinical utility of the nomogram were assessed using the Harrells concordance index (C-index), receiver operating characteristic (ROC) curve and the area under the curve (AUC), calibration curve, decision curve analysis (DCA), the integrated discrimination improvement (IDI) and net reclassification index (NRI). Furthermore, a web-based survival calculator was developed based on the nomogram.

Results

The study finally included 595 elderly patients with CHS and randomized them into the training group (419 cases) and validation group (176 cases) at a ratio of 7:3. Age, sex, grade, histology, M stage, surgery and tumor size were identified as independent prognostic factors of this population. The novel nomogram displayed excellent predictive performance, which can be accessible by https://nomoresearch.shinyapps.io/elderlywithCHS/, with a C-index of 0.800 for the training group and 0.789 for the validation group. The value AUC values at 12-, 24-, and 36-month of 0.866, 0.855, and 0.860 in the training group and of 0.839, 0.856, and 0.840 in the validation group, respectively. The calibration curves exhibited good concordance from the predicted survival probabilities to actual observation. The ROC curves, IDI, NRI, and DCA showed the nomogram was superior to the existing AJCC staging system.

Conclusion

This study developed a novel web-based nomogram for accurately predicting probabilities of OS in elderly patients with CHS, which will contribute to personalized survival assessment and clinical management for elderly patients with CHS.
Case Report: Training Monitoring and Performance Development of a Triathlete With Spinal Cord Injury and Chronic Myeloid Leukemia During a Paralympic Cycle
Authors: Quittmann Oliver J. , Lenatz Benjamin , Bartsch Patrick , Lenatz Frauke , Foitschik Tina , Abel Thomas
Published: June 2022

Introduction

Paratriathlon allows competition for athletes with various physical impairments. The wheelchair category stands out from other paratriathlon categories, since competing in swimming, handcycling, and wheelchair racing entails substantial demands on the upper extremity. Therefore, knowledge about exercise testing and training is needed to improve performance and avoid overuse injuries. We described the training monitoring and performance development throughout a Paralympic cycle of an elite triathlete with spinal cord injury (SCI) and a recent diagnosis of chronic myeloid leukemia (CML).

Case Presentation/Methods

A 30-year-old wheelchair athlete with 10-years experience in wheelchair basketball contacted us for guidance regarding testing and training in paratriathlon. Laboratory and field tests were modified from protocols used for testing non-disabled athletes to examine their physical abilities. In handcycling, incremental tests were used to monitor performance development by means of lactate threshold (POBLA) and define heart rate-based training zones. All-out sprint tests were applied to calculate maximal lactate accumulation rate (V˙Lamax) as a measure of glycolytic capabilities in all disciplines. From 2017 to 2020, training was monitored to quantify training load (TL) and training intensity distribution (TID).

Results

From 2016 to 2019, the athlete was ranked within the top ten at the European and World Championships. From 2017 to 2019, annual TL increased from 414 to 604 h and demonstrated a shift in TID from 77-17-6% to 88-8-4%. In this period, POBLA increased from 101 to 158 W and V˙Lamax decreased from 0.56 to 0.36 mmol·l−1·s−1. TL was highest during training camps. In 2020, after he received his CML diagnosis, TL, TID, and POBLA were 317 h, 94-5-1%, and 108 W, respectively.

Discussion

TL and TID demonstrated similar values when compared with previous studies in para-swimming and long-distance paratriathlon, respectively. In contrast, relative TL during training camps exceeded those described in the literature and was accompanied by physical stress. Increased volumes at low intensity are assumed to increase POBLA and decrease V˙Lamax over time. CML treatment and side effects drastically decreased TL, intensity, and performance, which ultimately hindered a qualification for Tokyo 2020/21. In conclusion, there is a need for careful training prescription and monitoring in wheelchair triathletes to improve performance and avoid non-functional overreaching.
A Prediction Model for Various Treatment Pathways of Upper Extremity in Tetraplegia
Authors: Bersch Ines , Krebs Jörg , Fridén Jan
Published: June 2022

Upper extremity function is essential for the autonomy in patients with cervical spinal cord injuries and consequently a focus of the rehabilitation and treatment efforts. Routinely, an individualized treatment plan is proposed to the patient by an interprofessional team. It dichotomizes into a conservative and a surgical treatment pathway. To select an optimal pathway, it is important to define predictors that substantiate the treatment strategy. Apart from standard assessments (Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI), the manual muscle test (MRC), and lower motoneuron integrity of key actuators for hand function performed by motor point (MP) mapping might serve as a possible predictor. Type of damage (upper motor neuron (UMN) or lower motor neuron (LMN) lesion) influences hand posture and thus treatment strategy as positioning and splinting of fingers, hands, arms, and surgical reconstructive procedures (muscle-tendon or nerve transfers) in choice and timing of intervention. For this purpose, an analysis of a database comprising 220 patients with cervical spinal cord injury is used. It includes ISNCSCI, MRC, and MP mapping of defined muscles at selected time points after injury. The ordinal regression analysis performed indicates that MP and ASIA impairment scale (AIS) act as predictors of muscle strength acquisition. In accordance with the innervation status defined by MP, electrical stimulation (ES) is executed either via nerve or direct muscle stimulation as a supplementary therapy to the traditional occupational and physiotherapeutic treatment methods. Depending on the objective, ES is applied for motor learning, strengthening, or maintenance of muscle contractile properties. By employing ES, hand and arm function can be predicted by MP and AIS and used as the basis for providing an individualized treatment plan.
Autonomous Shipborne In Situ Reflectance Data in Optically Complex Coastal Waters: A Case Study of the Salish Sea, Canada
Authors: Wang Ziwei , Costa Maycira
Published: June 2022

Present limitations on using satellite imagery to derive accurate chlorophyll concentrations and phytoplankton functional types arise from insufficient in situ measurements to validate the satellite reflectance, Rrs0+. We installed a set of hyperspectral radiometers with autonomous solar tracking capability, collectively named SAS Solar Tracker (Satlantic Inc./Sea-Bird), on top of a commercial ferry, to measure the in situ reflectance as the ferry crosses the Salish Sea, Canada. We describe the SAS Solar Tracker installation procedure, which enables a clear view of the sea surface and minimizes the interference caused by the ship superstructure. Corrections for residual ship superstructure perturbations and non-nadir-viewing geometry are applied during data processing to ensure optimal data quality. It is found that the ship superstructure perturbation correction decreased the overall Rrs0+ by 0.00055 sr−1, based on a black-pixel assumption for the infrared band of the lowest acquired turbid water. The BRDF correction using the inherent optical properties approach lowered the spectral signal by ∼5–10%, depending on the wavelength. Data quality was evaluated according to a quality assurance method considering spectral shape similarity, and ∼92% of the acquired reflectance data matched well against the global database, indicating high quality.
Analysis of the Temporal Evolution of Ice Aprons in the Mont-Blanc Massif Using X and C-Band SAR Images
Authors: Kaushik Suvrat , Cerino Bastien , Trouve Emmanuel , Karbou Fatima , Yan Yajing , Ravanel Ludovic , Magnin Florence
Published: June 2022

This paper investigates the backscatter evolution and surface changes of ice aprons (IAs) by exploiting time series of X- and C-band SAR images from PAZ and Sentinel-1 satellites. IAs are extremely small ice bodies of irregular shape present on steep slopes and complex topographies in all the major high-Alpine environments of the world. Due to their small size and locations in complex topographies, they have been very poorly studied, and very limited information is known about their evolution and responses to climate change. SAR datasets can provide handy information about the seasonal behaviour of IAs since physical changes of IA surfaces modify the backscattering of RaDAR waves. The analysis of the temporal variations of the backscatter coefficient illustrates the effects of increasing temperatures on the surface of the IAs. All IAs considered in the analysis show a strong decrease in backscatter coefficient values in the summer months. The backscattering patterns are also supported by the annual evolution of the coefficient of variation, which is an appropriate indicator to evaluate the heterogeneity of the surface. Higher mean backscatter values in the X-band than in the C-band indicate surface scattering phenomena dominate the IAs. These features could provide key information for classifying IAs using SAR images in future research.
Clinical Needs Discovery in Pediatric Urology: Utilizing the Biodesign Process
Authors: Luff Marie K. , Zarrin David A. , Zhou Li , Sahoo Astha , Desai Sophia , Iyer Neha , Starr Savannah L. , Sturm Renea M.
Published: June 2022

Introduction

Biodesign innovation processes provide a needs-driven approach to medical innovation, empowering both medical trainees and health care providers to take action in addressing the shortcomings of health care encountered in daily clinical practice. Our objective was to uncover the most pressing unmet clinical needs within a specific clinical setting, pediatric urology at UCLA.

Methods

The biodesign process involves a sequential process of identifying, validating, and prioritizing unmet needs, followed by solution landscaping and prototyping for the most promising needs. Opportunities for medical innovation were first identified through six weeks of clinical immersion, which involved both clinical observation and interview-based insight extraction. Interviews were conducted with 35 stakeholders, including patients, patient families, and health care staff by a medical student participant in Sling Health LA, a program which provides innovation training and incubation for ideas. Follow-up interviews with key stakeholders were performed to validate needs. Priority scores were then assigned to each validated need using a series of pre-determined and weighted criteria. Finally, genealogy maps were constructed and used to guide subsequent solution landscaping for the top three needs.

Results

33 unmet clinical needs were identified throughout the clinical immersion phase, 27 of which were validated. Following coarse needs prioritization, five needs emerged as top contenders. After fine needs prioritization, three top needs were selected. The first top need arising from this ethnographic study was that “parents and children need a faster (<3 months to resolution) treatment option for resolving nocturnal enuresis that also prevents incontinence during the treatment phase”. Other discovered top needs included “parents and physicians need an accurate method to monitor retractile testes at-home and in the outpatient setting to reduce unnecessary surgical referrals and procedures”, and “a hospital system need to reduce complications and readmissions associated with post-operative catheter obstruction after urologic procedures”. A preliminary solution concept was generated for the top clinical need, nocturnal enuresis treatment.

Conclusion

Biodesign processes offer a standardized method for identifying pressing unmet clinical needs and informing solution development. The top three needs discovered within pediatric urology through this ethnographic investigation represent promising innovation targets for further solution prototyping and design.
A Comparison Between Global Nutrient Retention Models for Freshwater Systems
Authors: Zhou Jinhui , Scherer Laura , van Bodegom Peter M. , Beusen Arthur H. W. , Mogollón José M.
Published: June 2022

Against the backdrop of increasing agricultural production, population, and freshwater/coastal eutrophication, studies are aiming to understand the behavior of nitrogen (N) and phosphorus (P) in the global freshwater system. Global nutrient models are typically used to quantify the nutrient amount and content in freshwater systems across different river orders and catchments. Such models typically use empirically derived nutrient retention equations for predicting nutrient fate, and these equations may be derived using data from a specific region or environment or for a specific context. Here we used IMAGE-GNM, a spatially explicit nutrient model at a half-degree resolution, to examine the performance of several well-known empirical equations by comparing the respective model outcomes with observed data on a global scale. The results show that (1) globally, the empirical retention equations work better for predicting N fate than P fate; (2) hydraulic drivers are the most important factor affecting the residual of total N and P concentrations, compared with the functional forms and the coefficients in the empirical equations. This study can aid in assessing the variability and accuracy of various retention equations from regional to global scales, and thus further strengthen our understanding of global eutrophication.
Investigating Farmer Perspectives and Compost Application for Soil Management in Urban Agriculture in Mwanza, Tanzania
Authors: Esmail Shefaza , Oelbermann Maren
Published: June 2022

African countries are urbanizing at a rapid rate. Research on urban agriculture may be key to ensuring urban food and soil security. This study aimed to evaluate pathways for integrated soil fertility management using a mixed methods approach to consider both social perspectives and soil quality in the city of Mwanza, Tanzania. The social component of urban agriculture was explored using semi-structured interviews with urban farmers (n=34), through judgement and snowball sampling. Qualitative analyses showed that urban farmers range in age and gender, as well as in experiences and cultivation practices, though all use hand tools. Farmers reported reliance on rainy seasons for cultivating. However, farmers also raised concerns about a changing climate and unpredictability of rain, which impacts crop productivity. Most interviewed farmers (82%) would like to improve their soils, and many use manure as an amendment stating that animal manure is the best way to improve soil. Additionally, most urban farmers (62%) have not tried any form of food waste compost but responded positively to try it if they had access and were taught how to use it. For the second aspect of this study a field trial was conducted to evaluate and compare the effects of organic and inorganic amendments on soil quality and crop productivity over the short-term. The results from the field trial determined that organic amendments (poultry manure and food waste compost) improved soil water holding capacity by 14 to 19% and enhanced microbial biomass 1.7 to 4 times compared to treatments with inorganic nitrogen fertilizer. Crop productivity with organic amendments was comparable to that in treatments with nitrogen fertilizer. We conclude that urban agriculture is an integral aspect of Mwanza City, and the application of organic amendments improves urban soil quality compared to the application of inorganic fertilizer, which has implications for urban soil security, land use planning, and food sovereignty in developing countries.