bluuebunny/crossref_metadata_2025_split huggingface dataset:
Mediating Role of Self-Disclosure in the Relationship between Attitudes towards Online Counselling and Perception of Social Stigma due to Receiving Psychological Help
Authors: Buyruk-Genc Arzu , Kara Ece 
Published: April 2021

<p style="text-align:justify">People have needed mental health services more and more during Coronavirus disease (COVID-19) pandemic. Due to the contagious nature of the COVID-19 virus, online counseling has been preferred more during the COVID-19 pandemic. Those who need such mental health services might take actions to seek help by demanding psychological assistance from psychological counselors or mental health institutions. However, these people might avoid seeking and receiving such help when they think that they have a weak personality or they somehow will be criticized by the society or experience social stigma because they seek psychological help. This study aims to examine the mediating role of self-disclosure between attitudes towards online counselling and perception of social stigma due to receiving psychological help. Participants of the study consist of 519 adults who live in Turkey and are older than 18 years old. The data for the study were collected through “Distress Disclosure Index”, “Online Counseling Attitudes Scale (OCAS)”, “Stigma Scale for Receiving Psychological Help (SSRPH)” and “Personal Information Form”. The hypothetical model developed in order to determine whether self-disclosure mediates in the relationship between perception of social stigma due to receiving psychological help and online psychological counselling attitudes was tested through SEM (Structural Equation Modeling). The results of the study revealed that self-disclosure play partial mediating role between perception of social stigma and value of online counselling and discomfort with online counselling.</p>
Advanced oxidation protein products induce inflammatory responses and invasive behaviour in fibroblast-like synoviocytes via the RAGE-NF-κB pathway
Authors: Lou Aiju , Wang Le , Lai Weinan , Zhu DingJi , Wu Weirong , Wang Zhao , Cai Zihong , Yang Min 
Published: April 2021

AimsRheumatoid arthritis (RA), which mainly results from fibroblast-like synoviocyte (FLS) dysfunction, is related to oxidative stress. Advanced oxidation protein products (AOPPs), which are proinflammatory mediators and a novel biomarker of oxidative stress, have been observed to accumulate significantly in the serum of RA patients. Here, we present the first investigation of the effects of AOPPs on RA-FLSs and the signalling pathway involved in AOPP-induced inflammatory responses and invasive behaviour.MethodsWe used different concentrations of AOPPs (50 to 200 µg/ml) to treat RA-FLSs. Cell migration and invasion and the expression levels of tumour necrosis factor-alpha (TNF-α), interleukin-6 (IL-6), matrix metalloproteinase-3 (MMP-3), and MMP-13 were investigated. Western blot and immunoﬂuorescence were used to analyze nuclear factor-κB (NF-κB) activation.ResultsAOPPs promoted RA-FLS migration and invasion in vitro and signiﬁcantly induced the messenger RNA (mRNA) and protein expression of TNF-α, IL-6, MMP-3, and MMP-13 in dose- and time-dependent manners. Moreover, AOPPs markedly activated the phosphorylation of nuclear factor-κB (NF-κB) p65 protein, which triggered inhibitory kappa B-alpha (IκBα) degradation, NF-κB p65 protein phosphorylation, and NF-κB p65 translocation into the nucleus. Furthermore, treatment with a neutralizing antibody specific to receptor for advanced glycation end products (RAGE) signiﬁcantly suppressed aggressive behaviour and inflammation, decreased TNF-α, IL-6, MMP-3, and MMP-13 expression, and blocked AOPP-induced NF-κB pathway activation.ConclusionThe results indicate that AOPPs can enhance aggressive behaviour and the inflammatory response in RA-FLSs via the RAGE–NF-κB pathway. These results present AOPPs as a new class of potentially important mediators of progressive disease in RA patients. Cite this article: Bone Joint Res 2021;10(4):259–268.
Examining peer learning as a strategy for advancing uptake of evidence-based practices: a scoping review
Authors: Worton S. Kathleen , Furman Ellis 
Published: April 2021

Background: Continued evolution of knowledge-to-action (KTA) theories requires increased attention to dynamics of power and ways to integrate multiple forms of knowledge. Peer learning – a process through which knowledge users interact with other learners – is a valuable but largely unexamined strategy for integrating practice-based knowledge in the KTA process.
Aims and objectives: This study undertakes a scoping review to examine how peer-learning strategies have been used to advance knowledge users’ capacity for implementing evidence-based practices.
Methods: A search of ten online databases and a manual search of five journals was conducted to identify studies published between 2001 and 2018. Selected publications included 26 studies conducted in Canada, the US, the UK, Australia, and the Netherlands. Studies utilised peer learning as a capacity-building strategy to advance the uptake or implementation of evidence-based practices among professionals in social services, education, or health/mental health sectors.
Findings: Links between peer-learning strategies and multiple individual and/or collective capacities for implementing evidence-based practices were identified from selected studies. Individual capacities linked to peer learning include knowledge of the practice, attitudes (for example, motivation and ‘buy-in’), and practical skills. Collective capacities supported through peer learning included knowledge exchange, knowledge generation, relationship development, networking, and resource/tool sharing. Peer learning was often paired with didactic or expert-led activities.
Discussion and conclusions: This scoping review identifies how peer learning has been used as a capacity-building strategy in implementation initiatives. Peer-learning activities provide a means to help integrate multiple forms of knowledge in the KTA process.
768-ary Laguerre-Gaussian-mode shift keying free-space optical communication based on convolutional neural networks
Authors: Luan Haitao , Lin Dajun , Li Keyao , Meng Weijia , Gu Min , Fang Xinyuan 
Published: April 2021

Beyond orbital angular momentum of Laguerre-Gaussian (LG) modes, the radial index can also be exploited as information channel in free-space optical (FSO) communication to extend the communication capacity, resulting in the LG- shift keying (LG-SK) FSO communications. However, the recognition of radial index is critical and tough when the superposed high-order LG modes are disturbed by the atmospheric turbulences (ATs). In this paper, the convolutional neural network (CNN) is utilized to recognize both the azimuthal and radial index of superposed LG modes. We experimentally demonstrate the application of CNN model in a 10-meter 768-ary LG-SK FSO communication system at the AT of

C
n
2

= 1e-14 m−2/3. Based on the high recognition accuracy of the CNN model (>95%) in the scheme, a colorful image can be transmitted and the peak signal-to-noise ratio of the received image can exceed 35 dB. We anticipate that our results can stimulate further researches on the utilization of the potential applications of LG modes with non-zero radial index based on the artificial-intelligence-enhanced optoelectronic systems.
The association of child maltreatment and systemic inflammation in adulthood: A systematic review
Authors: Kerr Daniel M. , McDonald James , Minnis Helen 
Published: April 2021

Introduction
Child maltreatment (CM) is associated with mental and physical health disorders in adulthood. Some studies have identified elevated markers of systemic inflammation in adult survivors of CM, and inflammation may mediate the association between CM and later health problems. However, there are methodological inconsistencies in studies of the association between CM and systemic inflammation and findings are conflicting. We performed a systematic review to examine the association of CM with systemic inflammation in adults.

Methods
A pre-registered systematic review was performed following PRISMA guidelines. Medline, Embase, Scopus and PsychInfo were searched for studies of the association of CM with blood markers of inflammation in adults. Quality was assessed using the Crowe Critical Appraisal Tool. We had intended to perform a meta-analysis, but this was not possible due to variation in study design and reporting.

Results
Forty-four articles met criteria for inclusion in the review. The most widely reported biomarkers were C-Reactive Protein (CRP) (n = 27), interleukin-6 (IL-6) (n = 24) and Tumour Necrosis Factor-alpha (TNF-a) (n = 17). Three studies were prospective (all relating to CRP) and the remainder were retrospective. 86% of studies were based in high income countries. In the prospective studies, CM was associated with elevated CRP in adulthood. Results of retrospective studies were conflicting. Methodological issues relating to the construct of CM, methods of analysis, and accounting for confounding or mediating variables (particularly Body Mass Index) may contribute to the uncertainty in the field.

Conclusions
There is some robust evidence from prospective studies that CM is associated with elevated CRP in adulthood. We have identified significant methodological inconsistencies in the literature and have proposed measures that future researchers could employ to improve consistency across studies. Further prospective, longitudinal, research using robust and comparable measures of CM with careful consideration of confounding and mediating variables is required to bring clarity to this field.
Metformin and N-terminal pro B-type natriuretic peptide in type 2 diabetes patients, a post-hoc analysis of a randomized controlled trial
Authors: Top Wiebe M. C. , Lehert Philippe , Schalkwijk Casper G. , Stehouwer Coen D. A. , Kooy Adriaan 
Published: April 2021

Background
Beyond antihyperglycemic effects, metformin may improve cardiovascular outcomes. Patients with type 2 diabetes often have an elevated plasma level of N-terminal pro B-type as a marker of (sub) clinical cardiovascular disease. We studied whether metformin was associated with a reduction in the serum level of N-terminal pro B-type natriuretic peptide (NT-proBNP) in these patients.

Methods
In the HOME trial 390 insulin-treated patients with type 2 diabetes were randomized to 850 mg metformin or placebo three times daily. Plasma samples were drawn at baseline, 4, 17, 30, 43 and 52 months. In a post-hoc analysis we analyzed the change in NT-proBNP in both groups. We used a longitudinal mixed model analysis adjusting for age, sex and prior cardiovascular disease. In a secondary analysis we assessed a possible immediate treatment effect post baseline.

Results
Metformin did not affect NT-proBNP levels over time in the primary analysis (-1% [95%CI -4;3, p = 0.62]). In the secondary analysis there was also no sustained time independent immediate treatment effect (initial increase of 17% [95%CI 4;30, p = 0.006] followed by yearly decrease of -4% [95%CI -7;0, p = 0.07]).

Conclusions
Metformin as compared to placebo did not affect NT-proBNP plasma levels in this 4.3-year placebo-controlled trial. Potential cardioprotective effects of metformin cannot be explained by changes in cardiac pressures or volumes to the extent reflected by NT-proBNP.
Risk factors for delirium among hospitalized patients in Zambia
Authors: Banerdt Justin K. , Mateyo Kondwelani , Yan Yan , Liu Dandan , Zuo Yi , Di Gravio Chiara , Thome Julia C. , Riviello Elisabeth D. , Saylor Deanna , Ely E. Wesley , Heimburger Douglas C. 
Published: April 2021

Objective
To identify risk factors for delirium among hospitalized patients in Zambia.

Methods
We conducted a prospective cohort study at the University Teaching Hospital in Lusaka, Zambia, from October 2017 to April 2018. We report associations of exposures including sociodemographic and clinical factors with delirium over the first three days of hospital admission, assessed using a modified Brief Confusion Assessment Method (bCAM).

Findings
749 patients were included for analysis (mean age, 42.9 years; 64.8% men; 47.3% with HIV). In individual regression analyses of potential delirium risk factors adjusted for age, sex and education, factors significantly associated with delirium included being divorced/widowed (OR 1.64, 95% CI 1.09–2.47), lowest tercile income (OR 1.58, 95% CI 1.04–2.40), informal employment (OR 1.97, 95% CI 1.25–3.15), untreated HIV infection (OR 2.18, 95% CI 1.21–4.06), unknown HIV status (OR 2.90, 95% CI 1.47–6.16), history of stroke (OR 2.70, 95% CI 1.15–7.19), depression/anxiety (OR 1.52, 95% CI 1.08–2.14), alcohol overuse (OR 1.96, 95% CI 1.39–2.79), sedatives ordered on admission (OR 3.77, 95% CI 1.70–9.54), severity of illness (OR 2.00, 95% CI 1.82–2.22), neurological (OR 7.66, 95% CI 4.90–12.24) and pulmonary-system admission diagnoses (OR 1.91, 95% CI 1.29–2.85), and sepsis (OR 2.44, 95% CI 1.51–4.08). After combining significant risk factors into a multivariable regression analysis, severity of illness, history of stroke, and being divorced/widowed remained predictive of delirium (p<0.05).

Conclusion
Among hospitalized adults at a national referral hospital in Zambia, severity of illness, history of stroke, and being divorced/widowed were independently predictive of delirium. Extension of this work will inform future efforts to prevent, detect, and manage delirium in low- and middle-income countries.
The impact of Tai Chi and mind-body breathing in COPD: Insights from a qualitative sub-study of a randomized controlled trial
Authors: Gilliam Elizabeth A. , Cheung Tina , Kraemer Kristen , Litrownik Daniel , Wayne Peter M. , Moy Marilyn L. , Yeh Gloria Y. 
Published: April 2021

PurposeChronic obstructive pulmonary disease (COPD) is associated with multiple psychosocial and behavioral factors. Prior research suggests that mind-body interventions may support the development and maintenance of healthy behaviors and improve health-related quality-of-life in such patients. We sought to qualitatively explore cognitive, psychosocial, and behavioral changes in patients with COPD who participated in two different mind-body interventions compared to an education control.MethodsWe analyzed semi-structured qualitative exit interviews from a prospective, randomized pilot trial (N = 123) investigating 12-weeks of Tai Chi (TC) vs. mind-body breathing (MBB) vs. education (EDU) control in patients with moderate-severe COPD. TC involved traditional movements, that integrate meditative breathing, while MBB focused mainly on meditative breathing techniques alone. Interviews were audio-recorded and transcribed verbatim. Qualitative analysis of randomly selected transcripts was performed by two independent reviewers using an iterative process to identify emergent themes informed by grounded theory methods until thematic saturation was reached.ResultsA total of 66 transcripts were reviewed (N = 22 TC, N = 22 MBB, N = 22 EDU). Participants were mean age = 68.1 years, GOLD Stage = 2.3, baseline FEV11percent predicted mean (SD): 58% (13.4), 42.4% female. We identified six frequently mentioned themes: 1) overall awareness and understanding, 2) self-care knowledge, skills and behaviors, 3) behavior-related neurocognitive concepts, 4) physical function, 5) psychological well-being, and 6) social support/social function. Compared to EDU, more participants in TC and MBB noted improvements in awareness of self and the mind-body connection (e.g., body and breath awareness), knowledge of breathing techniques and integration of self-care skills with daily activities, self-efficacy for symptom management (particularly managing anxiety and dyspnea), acceptance of disease, physical function improvements (e.g., endurance, dyspnea, fatigue), and psychological well-being (particularly relaxation, emotion regulation and decreased reactivity). Compared to MBB, those in TC shared more intention to continue with self-care behaviors, physical activity self-efficacy, and improved flexibility. All three groups, including EDU, noted increased social support and knowledge of disease. Those in EDU, however, had fewer mentions of processes related to behavior change, and less concrete changes in neurocognitive, psychological, and physical function domains.ConclusionsMind-body interventions including meditative breathing may impact behavior-related neurocognitive and emotional factors that improve self-care management and support positive behavioral changes in patients with COPD.Trial registrationThis trial is registered in Clinical Trials.gov, ID numberNCT01551953.
What is the lived experience of anxiety for people with Parkinson’s? A phenomenological study
Authors: Lovegrove Christopher J. , Bannigan Katrina 
Published: April 2021

PurposeAnxiety is a common non-motor symptom of Parkinson’s and there is no specific pharmacological intervention for people with Parkinson’s who experience anxiety. Yet there is little specific research documenting how individuals with this condition experience anxiety. It is important to explore the experiences of people with Parkinson’s to identify potential issues in developing future non-pharmacological interventions. This study explored the lived experience of anxiety for people with Parkinson’s.Materials and methodsSix participants were recruited into a descriptive phenomenological study, through the charity Parkinson’s UK, using a maximum variation sampling strategy. Face to face interviews were conducted. Data analysis employed thematic analysis.ResultsThree key themes encapsulated the data: Finding ways to cope to “Try not to let it rule your life”, Amplifies symptoms “It’s emotionally draining it it’s also physically draining” and “Anxiety is a funny thing” experienced in myriad ways. A model of the experience of PWP experience of anxiety is proposed.ConclusionsAnxiety is a complex experience constructed of interlinked parts affecting people with Parkinson’s in myriad ways. Researchers and healthcare professionals should take these findings into account when designing future studies and interventions.
Rotavirus disease burden pre-vaccine introduction in young children in Rural Southern Mozambique, an area of high HIV prevalence
Authors: Acácio Sozinho , Nhampossa Tacilta , Quintò Llorenç , Vubil Delfino , Garrine Marcelino , Bassat Quique , Farag Tamer , Panchalingam Sandra , Nataro James P. , Kotloff Karen L. , Levine Myron M. , Tennant Sharon M. , Alonso Pedro L. , Mandomando Inácio 
Published: April 2021

BackgroundRotavirus vaccines have been adopted in African countries since 2009, including Mozambique (2015). Disease burden data are needed to evaluate the impact of rotavirus vaccine. We report the burden of rotavirus-associated diarrhea in Mozambique from the Global Enteric Multicenter Study (GEMS) before vaccine introduction.MethodsA case-control study (GEMS), was conducted in Manhiça district, recruiting children aged 0–59 months with moderate-to-severe diarrhea (MSD) and less-severe-diarrhea (LSD) between December 2007 and November 2012; including 1–3 matched (age, sex and neighborhood) healthy community controls. Clinical and epidemiological data and stool samples (for laboratory investigation) were collected. Association of rotavirus with MSD or LSD was determined by conditional logistic regression and adjusted attributable fractions (AF) calculated, and risk factors for rotavirus diarrhea assessed.ResultsOverall 915cases and 1,977controls for MSD, and 431 cases and 430controls for LSD were enrolled. Rotavirus positivity was 44% (217/495) for cases and 15% (160/1046) of controls, with AF = 34.9% (95% CI: 32.85–37.06) and adjusted Odds Ratio (aOR) of 6.4 p< 0.0001 in infants with MSD compared to 30% (46/155) in cases and 14% (22/154) in controls yielding AF = 18.7%, (95% CI: 12.02–25.39) and aOR = 2.8, p = 0.0011 in infants with LSD. The proportion of children with rotavirus was 32% (21/66) among HIV-positive children and 23% (128/566) among HIV-negative ones for MSD. Presence of animals in the compound (OR = 1.9; p = 0.0151) and giving stored water to the child (OR = 2.0, p = 0.0483) were risk factors for MSD; while animals in the compound (OR = 2.37, p = 0.007); not having routine access to water on a daily basis (OR = 1.53, p = 0.015) and washing hands before cooking (OR = 1.76, p = 0.0197) were risk factors for LSD.ConclusionThe implementation of vaccination against rotavirus may likely result in a significant reduction of rotavirus-associated diarrhea, suggesting the need for monitoring of vaccine impact.
Cardiovascular disease subtypes, physical disability and workforce participation: A cross-sectional study of 163,562 middle-aged Australians
Authors: Bin Sayeed Muhammad Shahdaat , Joshy Grace , Paige Ellie , Banks Emily , Korda Rosemary 
Published: April 2021

Background
Workforce participation is reduced among people with cardiovascular disease (CVD). However, detailed quantitative evidence on this is limited. We examined the relationship of CVD to workforce participation in older working-age people, by CVD subtype, within population subgroups and considering the role of physical disability.

Methods
Questionnaire data (2006–2009) for participants aged 45–64 years (n = 163,562) from the population-based 45 and Up Study (n = 267,153) were linked to hospitalisation data through the Centre for Health Record Linkage. Prior CVD was from self-report or hospitalisation. Modified Poisson regression estimated adjusted prevalence ratios (PRs) for non-participation in the workforce in people with versus without CVD, adjusting for sociodemographic factors.

Results
There were 19,161 participants with CVD and 144,401 without. Compared to people without CVD, workforce non-participation was greater for those with CVD (40.0% vs 23.5%, PR = 1.36, 95%CI = 1.33–1.39). The outcome varied by CVD subtype: myocardial infarction (PR = 1.46, 95%CI = 1.36–1.55); cerebrovascular disease (PR = 1.92, 95%CI = 1.80–2.06); heart failure (PR = 1.83, 95%CI = 1.68–1.98) and peripheral vascular disease (PR = 1.76, 95%CI = 1.65–1.88). Workforce non-participation in those with CVD versus those without was at least 21% higher in all population subgroups examined, with PRs ranging from 1.75 (95%CI = 1.65–1.85) in people aged 50–55 years to 1.21 (95%CI = 1.19–1.24) among those aged 60–64. Compared to people with neither CVD nor physical functioning limitations, those with physical functional limitations were around three times as likely to be out of the workforce regardless of CVD diagnosis; participants with CVD but without physical functional limitations were 13% more likely to be out of the workforce (PR = 1.13, 95%CI = 1.07–1.20).

Conclusions
While many people with CVD participate in the workforce, participation is substantially lower, especially for people with cerebrovascular disease, than for people without CVD, highlighting priority areas for research and support, particularly for people experiencing physical functioning limitations.