bluuebunny/crossref_metadata_2025_split huggingface dataset:
A novel technique for delineating the effect of variation in the learning rate on the neural correlates of reward prediction errors in model-based fMRI
Authors: Chase Henry W. 
Published: December 2023

IntroductionComputational models play an increasingly important role in describing variation in neural activation in human neuroimaging experiments, including evaluating individual differences in the context of psychiatric neuroimaging. In particular, reinforcement learning (RL) techniques have been widely adopted to examine neural responses to reward prediction errors and stimulus or action values, and how these might vary as a function of clinical status. However, there is a lack of consensus around the importance of the precision of free parameter estimation for these methods, particularly with regard to the learning rate. In the present study, I introduce a novel technique which may be used within a general linear model (GLM) to model the effect of mis-estimation of the learning rate on reward prediction error (RPE)-related neural responses.MethodsSimulations employed a simple RL algorithm, which was used to generate hypothetical neural activations that would be expected to be observed in functional magnetic resonance imaging (fMRI) studies of RL. Similar RL models were incorporated within a GLM-based analysis method including derivatives, with individual differences in the resulting GLM-derived beta parameters being evaluated with respect to the free parameters of the RL model or being submitted to other validation analyses.ResultsInitial simulations demonstrated that the conventional approach to fitting RL models to RPE responses is more likely to reflect individual differences in a reinforcement efficacy construct (lambda) rather than learning rate (alpha). The proposed method, adding a derivative regressor to the GLM, provides a second regressor which reflects the learning rate. Validation analyses were performed including examining another comparable method which yielded highly similar results, and a demonstration of sensitivity of the method in presence of fMRI-like noise.ConclusionOverall, the findings underscore the importance of the lambda parameter for interpreting individual differences in RPE-coupled neural activity, and validate a novel neural metric of the modulation of such activity by individual differences in the learning rate. The method is expected to find application in understanding aberrant reinforcement learning across different psychiatric patient groups including major depression and substance use disorder.
Lived experience of Iranian pre-hospital medical staff during the COVID-19 pandemic: a descriptive phenomenological study
Authors: Jafari-Oori Mehdi , Dehi Manigeh , Ebadi Abbas , Moradian Seyed Tayeb , Sadeghi Hajar , Jafari Mojtaba 
Published: December 2023

BackgroundPre-hospital medical staff faced numerous challenges during the COVID-19 pandemic. However, these challenges specific to pre-hospital services have not been thoroughly explored in Iran. This qualitative study aimed to examine the essence of pre-hospital care during the COVID-19 pandemic.MethodsThis phenomenological study was conducted from June to August 2021 in Tehran, Iran. Semi-structured interviews were conducted with pre-hospital medical staff. Data analysis was performed using Colaizzi’s approach, and rigor was ensured by adhering to the consolidated criteria for qualitative reporting research.ResultsA total of 17 pre-hospital medical staff were interviewed, and five themes were extracted from the data: workload and resilience, damage, lack of control, under preparedness, and post-traumatic growth. These themes highlight the resilience demonstrated by pre-hospital medical staff, who faced an unprecedented crisis with limited preparedness and significant damage.ConclusionThe findings of this study indicate that pre-hospital medical staff in Iran encountered challenges during the COVID-19 pandemic due to a lack of preparedness and substantial damage. Despite these adversities, the participants exhibited resilience and experienced post-traumatic growth. The study emphasizes the importance of proper planning and preparedness to enhance the resilience of emergency medical services during pandemics. Furthermore, the results underscore the need to address the challenges faced by pre-hospital medical staff and improve the quality of care provided to patients during crises such as the COVID-19 pandemic.
Independent living, emotional well-being, and quality of life in people with disabilities: the mediator role of self-determination and satisfaction with participation
Authors: Cegarra Blanca , Cattaneo Gabriele , Ribes Alina , Solana-Sánchez Javier , Saurí Joan 
Published: December 2023

BackgroundIn the field of disability and rehabilitation, participation in society has become an important therapeutic objective due to its potential impact on rehabilitation, prognosis, and patient’s mid and long-term well-being. However, only a few studies have explored this issue in relation with the subjective perspective of individuals with disabilities about their decision-making capacity and satisfaction with the activities in which they participate.ObjectiveOur aim is to analyze the relationship between participation in society of people with disabilities and both emotional well-being and quality of life, including variables about subjective perspective of participation (satisfaction) and the ability to decide and pursue their own preferences.MethodThe cross-sectional study presented here includes 424 participants with disabilities over 18-years-old from Spain. This research is part of a larger ongoing longitudinal cohort study called Participa (https://participa.guttmann.com/en/). Participants were asked to complete several on-line surveys to explore quality of life, emotional well-being, participation in society, self-determination, and independent living.ResultsThe results revealed an association between the dimensions of participation satisfaction, self-determination, and levels of independent living with both quality of life and emotional well-being. Mediation models indicated that satisfaction and self-determination partially mediated the relationship between independent living and both quality of life and emotional well-being.ConclusionThe level of independent living, self-determination, and satisfaction with participation are fundamental aspects for promoting a high quality of life and emotional well-being in people with disabilities. These findings carry significant implications for health and social services, as well as policies guidelines, highlighting the need to prioritize empowerment and self-determination in all interventions designed for people with disabilities.
The impact of college experience on female students’ self-perceived employability in STEM majors
Authors: Wen Wen , Zhou Lu , Hu Die , Zhang Mingyu , Yan Zehua , Tang Xiaofeng 
Published: December 2023

IntroductionThe under representation of women in STEM fields is a persistent issue worldwide. In China, although women have made significant progress in pursuing STEM degrees in recent years, they continue to face challenges in the workforce. Given the importance of the self-perceived employability (SPE) of female STEM students in China, the research questions are: How do curriculum experience, extracurricular experience, and faculty supportive activities affect the SPE of female STEM students in Chinese universities? To what extent does university stratification affect the relationship between college experience and female STEM students’ SPE?MethodsWe analyzed the 2018 data of the Chinese College Student Survey (CCSS) consisting of a sample of 59,066 students, and six focus group interviews.ResultsThe findings suggest that curriculum experience, extracurricular experience and faculty supportive activities have a positive impact on the SPE of female students, but the gender gap in SPE is still valid as reflected by the fact that women have lower SPE than men in each tier of universities and that men benefit more in terms of the increase in SPE from most types of college activities and support except academic ones.DiscussionThis study reveals that the different tiers of universities in China affect female students’ SPE in different ways, and provides valuable evidence for academic as well as university administrators and policymakers regarding how college experience affect women and how university stratification can affect female students’ college experience and their career expectations and paths.
Association between attention performance and the different dimensions of DSM-5 depression symptoms
Authors: Taboada Gjorup Ana Lucia , Tolentino Júnior Julio César , van Duinkerken Eelco , Marques André Casarsa , do Carmo Filho Aureo , Joaquim Alan Marques , Neves Vithória Vidotti , Schmidt Sergio Luis 
Published: December 2023

ObjectiveDepressive symptoms can be assessed with self-reported questionnaires, such as the Patient Health Questionary-9 (PHQ-9). Previous studies have suggested that the PHQ-9 items can be grouped into somatic and non-somatic clusters. However, the classification of the PHQ-9 item “concentration difficulties” into somatic or non-somatic is still controversial. This controversy may be explained by difficulties experienced by subjects in accurately evaluating their attention problems. The primary objective of this study was to determine the correlation between objective attentional performance and the two clusters of depressive symptoms in hospital employees working in stressful conditions.MethodsThe participants filled out the PHQ-9 to identify their depressive symptoms. Based on the PHQ-9, the somatic or non-somatic symptoms were measured without considering the question about subjective concentration difficulties. Then, a brief version of the Continuous Visual Attention Test (CVAT) was applied to assess four attentional subdomains. The CVAT is a Go/No-go task that measures number of correct responses (focused attention), number of incorrect responses (behavior-inhibition), average reaction time of correct responses (RT-alertness), and variability of reaction time (VRT-sustained attention). The entire task lasted 90 s. Correlation analyses assessed the relationships between attentional performance and the two dimensions of depressive symptoms.ResultsAfter applying the inclusion/exclusion criteria, 359 individuals were selected. Their age ranged from 20 to 70 years (mean = 40.5, SD = 10.37), and the majority was female (67.6%). A predominance in somatic depressive symptoms was present in 231 (64%) participants, whereas 59 (16%) showed a predominance of non-somatic symptoms. Sixty-nine participants (20%) did not show any predominance. Higher somatic scores were associated with higher RTs, whereas higher non-somatic scores were related to an increase in the number of incorrect responses.ConclusionThe predominance of the somatic cluster was related to lower alertness, whereas the predominance of non-somatic cluster was associated with impulsivity/hyperactivity. This result may explain the difficulties associated with correctly classifying the item concentration difficulties. A brief attentional task can be used as an auxiliary tool to correctly identify the different dimensions of attention that are associated with different clusters of depressive symptoms.
The impact of the peer effect on adolescent drinking behavior: instrumental-variable evidence from China
Authors: Liu Meng , Zhao Wen-Qing , Zhao Qi-Ran , Wang Yu , Li Shun-Guo 
Published: December 2023

BackgroundGovernments around the world have taken measures to limit adolescent drinking, however, rates are still alarmingly high. However, most of these measures ignore the peer effect of drinking among adolescents. Previous studies have not sufficiently considered the reciprocal relationship between adolescent alcohol consumption and peer alcohol consumption, which may lead to an overestimation of the peer effect and mask underlying issues. Good instrumental variables are powerful but rare tools to address these issues.ObjectiveThis paper aims to correctly estimate the peer effect of drinking on adolescent drinking behavior in China.MethodsOwing to the detailed information of household background in the dataset of our survey, we were able to use the drinking behaviors of peers’ fathers and their beliefs about the health risks of alcohol as instrumental variables, which are more powerful than school-average instrumental variables. We collected data from the 2017 Health and Nutrition Panel survey, which surveyed 10,772 primary school students from 59 urban migrant and 60 rural public schools.ResultsThe instrumental variable method estimation revealed that peer drinking significantly influences adolescent drinking behavior, with adolescents who have peers who drink alcohol being 10.5% points (2 stage least square, i.e., 2SLS, full sample estimation) more likely to engage in drinking compared to those without such peers. Furthermore, the effect differs significantly between migrant and rural adolescents.ConclusionThe study found that parental care plays a significant role in the degree of peer effect, with the absence of parental care being a key factor in the presence of the peer effect.
Late onset psychosis treatment with adjunctive medicines
Authors: Boksha Irina , Savushkina Olga , Sheshenin Vladimir , Tereshkina Elena , Prokhorova Tatyana , Pochueva Valeriya , Burbaeva Gulnur 
Published: December 2023

BackgroundA number of studies have shown the feasibility of using adjunctive drugs in late onset psychosis (LOP).AimTesting hypothesis that among LOP people treated with antipsychotics and antidepressants, basing on certain clinical characteristics a subgroup of patients might be distinguished, for whom adjunctive therapy is advantageous. This subgroup might be identified by measurement of blood biochemical parameters.Methods59 in-patients with LOP, treated neuroleptics and antidepressants, were included, and followed in real clinical practice. Database containing demographic, clinical data (scores by PANSS, CDSS, CGI-S, HAMD-17), prescribed therapy, adverse effects of antipsychotic and antidepressant treatment, and blood biochemical parameters (enzymatic activities of glutamate- and glutathione metabolism enzymes in platelets and erythrocytes) at baseline and after the treatment course was created.ResultsThree groups of patients (Gr1, Gr2, and Gr3), based on the adjunctive therapy usage were identified: Gr1 (n = 16) was without adjunctive therapy, two other groups (Gr2 and Gr3) were with adjunctive medicines, such as 2-ethyl-6-methyl-3-hydroxypyridine succinate (EMHS; Gr2, n = 20), or other drugs, such as citicoline, cerebrolysin, cortexin, actovegin, gliatilin (choline alfoscerate; Gr3, n = 23). The enzymatic activities were assessed also in the matched control group (n = 38). In all three patient groups, as compared with controls, activity of erythrocyte glutathione reductase was decreased at baseline and after the treatment course. In Gr2, unlike Gr1 or Gr3, there was a significant decrease in baseline glutamate dehydrogenase and glutathione-S-transferase activities. Certain clinical criteria were also elucidated for prescription of EMHS as adjunctive therapy for patients of Gr2. Glutamate dehydrogenase and glutathione-S-transferase activities returned closer to control levels after the treatment course in Gr2, unlike Gr1, where they declined yet more after psychotropic treatment without adjunctive medicine. Different significant links between biochemical parameters and scores by clinical scales were observed in Gr1, Gr2, and Gr3, some having predictive value for evaluation of antipsychotic treatment efficacy.ConclusionWe demonstrate the validity of adjunctive neuroprotective medicines’ usage in addition to antipsychotic and antidepressant therapy in distinct subgroups of patients suffering with LOP, especially those who have prominent side effects accompanying their psychotropic treatment. Returning of biochemical parameters to control range following the treatment course observed in patients of the subgroup treated with adjunctive EMHS is evidence for their metabolism normalization.
Significant burden of post-COVID exertional dyspnoea in a South-Italy region: knowledge of risk factors might prevent further critical overload on the healthcare system
Authors: Resta Emanuela , Cuscianna Eustachio , Pierucci Paola , Custodero Carlo , Solfrizzi Vincenzo , Sabbà Carlo , Palmisano Chiara Maria , Barratta Federica , De Candia Maria Luisa , Tummolo Maria Grazia , Capozza Elena , Lomuscio Sonia , De Michele Lucrezia , Tafuri Silvio , Resta Onofrio , Lenato Gennaro Mariano 
Published: December 2023

BackgroundExertional dyspnoea in post-COVID syndrome is a debilitating manifestation, requiring appropriate comprehensive management. However, limited-resources healthcare systems might be unable to expand their healthcare-providing capacity and are expected to be overwhelmed by increasing healthcare demand. Furthermore, since post-COVID exertional dyspnoea is regarded to represent an umbrella term, encompassing several clinical conditions, stratification of patients with post-COVID exertional dyspnoea, depending on risk factors and underlying aetiologies might provide useful for healthcare optimization and potentially help relieve healthcare service from overload. Hence, we aimed to investigate the frequency, functional characterization, and predictors of post-COVID exertional dyspnoea in a large cohort of post-COVID patients in Apulia, Italy, at 3-month post-acute SARS-CoV-2 infection.MethodsA cohort of laboratory-confirmed 318 patients, both domiciliary or hospitalized, was evaluated in a post-COVID Unit outpatient setting. Post-COVID exertional dyspnoea and other post-COVID syndrome manifestations were collected by medical history. Functional characterization of post-COVID exertional dyspnoea was performed through a 6-min walking test (6-mwt). The association of post-COVID exertional dyspnoea with possible risk factors was investigated through univariate and multivariate logistic regression analysis.ResultsAt medical evaluation, post-COVID exertional dyspnoea was reported by as many as 190/318 patients (59.7%), showing relatively high prevalence also in domiciliary-course patients. However, functional characterization disclosed a 6-mwt-based desaturation walking drop in only 24.1% of instrumental post-COVID exertional dyspnoea patients. Multivariate analysis identified five independent predictors significantly contributing to PCED, namely post-COVID-fatigue, pre-existing respiratory co-morbidities, non-asthmatic allergy history, age, and acute-phase-dyspnoea. Sex-restricted multivariate analysis identified a differential risk pattern for males (pre-existing respiratory co-morbidities, age, acute-phase-dyspnoea) and females (post-COVID-fatigue and acute-phase-dyspnoea).ConclusionOur findings revealed that post-COVID exertional dyspnoea is characterized by relevant clinical burden, with potential further strain on healthcare systems, already weakened by pandemic waves. Sex-based subgroup analysis reveals sex-specific dyspnoea-underlying risk profiles and pathogenic mechanisms. Knowledge of sex-specific risk-determining factors might help optimize personalized care management and healthcare resources.
Evaluating the effect of the plan of national syphilis control in controlling the syphilis epidemic in Jiangsu, China 2010–2020
Authors: Shi Lingen , Chen Liping , Liu Xiaoyan , Hu Haiyang , Chen Yuheng , Chen Yunting , Zhang Zhi , Zhou Ying , Lu Jing , Yang Dandan , Guan Wenhui 
Published: December 2023

BackgroundStarting in 2010, the Chinese government initiated a 10-year syphilis control plan, called the national syphilis control plan (NSCP), to address the emerging threat of syphilis. We aimed to evaluate the effect of the NSCP plan on syphilis control in Jiangsu, China.MethodsThe temporal trends of syphilis incidence, prevalence and rate of condom use were estimated by Joinpoint regression with average annual percent change (APC) and average annual percentage (APPC). A Chi-square test was conducted to analyze the outcomes in different subgroups. ArcGIS was used to analyze the spatiotemporal distribution of syphilis incidence.ResultsGeographically, early and congenital syphilis incidence decreased significantly in all areas of the province during the period of NSCP. Early syphilis incidence decreased from 21.1 to 8.8 (APC: −7.5, 95%CI: −8.6, −6.5, p &lt; 0.001) per 100,000 people, and congenital syphilis decreased from 63.6 to 4.1 (APC: −14.8, 95%CI: −20.8, −8.4, p &lt; 0.01) per 100,000 newborns from 2010 to 2020. Also, syphilis prevalence reduced from 13.4 to 3.8% (APC: −8.7, 95%CI: −12.1, −5.0, p = 0.001) among men who have sex with men, from 5.3 to 1.7% (APC: −7.9, 95%CI: −11.7, −3.8, p = 0.002) among female sex workers and remained under 1.0% with slight variations among pregnant women (APC: 0.3, 95%CI: −4.3, 5.1, p = 0.877) from 2010 to 2020. 0.2% (2,436) of pregnant women who received free syphilis testing during pregnancy were diagnosed with current syphilis infection, and 97.0% (2,555) of newborns in the province were delivered to women diagnosed with syphilis. 91.8% (2,346) of live babies and about 90% of diagnosed patients received complete standard syphilis diagnosis and treatment services.ConclusionTrends of early syphilis incidence and syphilis prevalence show a considerable decreasing trend among almost all the key populations after implementing NSCP. Congenital syphilis has significantly decreased as well and hence, the NSCP program should be sustained and strengthened to control the syphilis epidemic in China further.
Supporting health education policies: translation, cross-cultural adaptation and validation of a health literacy instrument, in French
Authors: Clément Céline , Lvovschi Virginie-Eve , Verot Elise , du Sartz de Vigneulles Benjamin , Darlington-Bernard Adeline , Bourgeois Denis , Lamure Michel , Vitiello Flavia , Dussart Claude , Carrouel Florence 
Published: December 2023

BackgroundOral health is a fundamental human right and is inseparable and indivisible from overall health and well-being. Oral Health Literacy (OHL) has been proved to be fundamental to promoting oral health and reducing oral health inequalities. To our knowledge, no OHL instrument to evaluate OHL level is currently validated in French language despite the fact it is the fifth most widely spoken languages on the planet. The Oral health literacy Instrument (OHLI) appears to be the most interesting OHL instrument to adapt into French because it is already available in English, Spanish, Russian, Malaysian, and it contains both reading comprehension and numeracy sections. Its psychometric properties have been rated as adequate.ObjectiveThe aim of this study was to translate and adapt cross-culturally the OHLI into French, to evaluate its psychometric properties and to compare its results to oral health knowledge.MethodThis study followed and applied well-established processes of translation, cross-cultural adaptation and validation, based on the recommendations of the World Health Organization guidelines and on the Consensus-Based Standards for the Selection of Health Measurement Instruments (COSMIN) study design checklist for patient-reported outcomes. Two psychometric assessments were planned, the comparison of OHLI-F scores according to education level and frequency of dental visits, and the test–retest reliability of the OHLI-F.ResultsA total of 284 participants answered the OHLI-F. The OHLI-F scores were significantly different between participants with different levels of education and frequency of dental visits (p &lt; 0.001). Participants with an education level lower than the baccalaureate, and those who never visit the dentist or only in case of pain, had significantly lower OHLI-F scores. Internal consistency was excellent (Cronbach’s alpha = 0.881–0.914). Test–retest reliability was very high (intraclass correlation = 0.985 to 0.996).ConclusionThe OHLI-F has demonstrated adequate psychometric properties and can therefore be used to measure oral health literacy in French-speaking populations.