bluuebunny/crossref_metadata_2025_split huggingface dataset:
Sex-specific Neural Strategies During Fatiguing Work in Older Adults
Authors: Tyagi Oshin , Mehta Ranjana K. 
Published: March 2023

Background Historical biases in ergonomics-related studies have been attributed to lack of participant diversity and sensitivity of measurements to capture variability between diverse groups. We posit that a neuroergonomics approach, that is, study of brain-behavior relationships during fatiguing work, allows for unique insights on sex differences in fatigue mechanisms that are not available via traditional “neck down” measurement approaches. Objective This study examined the supraspinal mechanisms of exercise performance under fatigue and determined if there were any sex differences in these mechanisms. Methods Fifty-nine older adults performed submaximal handgrip contractions until voluntary fatigue. Traditional ergonomics measures, namely, force variability, electromyography (EMG) of arm muscles, and strength and endurance times, and prefrontal and motor cortex hemodynamic responses were recorded. Results There were no significant differences observed between older males and females in fatigability outcomes (i.e., endurance times, strength loss, and EMG activity) and brain activation. Effective connectivity from prefrontal to motor areas was significant for both sexes throughout the task, but during fatigue, males had higher interregional connectivity than females. Discussion While traditional metrics of fatigue were comparable between the sexes, we observed distinct sex-specific neuromotor strategies (i.e., information flow between frontal-motor regions) that were adopted by older adults to maintain motor performance. Application The findings from this study offer insights into the capabilities and adaptation strategies of older men and women under fatiguing conditions. This knowledge can facilitate in the development of effective and targeted ergonomic strategies that accommodate for the varying physical capacities of diverse worker demographics.
Intraoperative feedback: A survey of surgical trainees’ perspective
Authors: Fadelalla Mohammed Gadoora , Elbakri Sabreen , Poon Michael 
Published: March 2023

Introduction Intraoperative feedback can be associated with improved surgical performance. Quality feedback can reduce the time required by trainees to achieve proficiency in psychomotor skills. Operative training time has become increasingly limited, and it has become imperative to use surgical training time effectively. Aim In this survey, we assessed trainees’ perspectives of intraoperative feedback. We included several aspects of feedback including its occurrence, quality, and potential barriers. Methods All surgical trainees in a single centre were invited to complete an electronic questionnaire. Participants were anonymised. We summarised data using descriptive statistics. Results Most trainees (85%) reported they had the opportunity to share their training goals with trainers. Just under three-quarters of trainees felt they always or sometimes got timely feedback. Only half of the trainees were signposted to feedback and 23% felt feedback was not part of their department's culture. Half of the trainees did not always feel comfortable asking for feedback from their trainers stating their reasons as fear of criticism, lack of time and competing clinical commitments. Conclusion There is no denying the importance of feedback on operative performance, however, this survey shows that many of the pillars of quality feedback are poorly adhered to.
Regional Heterogeneity in the Individual Unemployment Vulnerability After COVID-19 Outset
Authors: Lopes Ana Sofia , Sargento Ana 
Published: March 2023

The COVID-19 crisis increased unemployment all over the World, with significant regional heterogeneity. This paper intends to analyze this territorial heterogeneity for the Portuguese case and investigate which regional factors complement personal and job characteristics in explaining individual vulnerability to COVID-19 unemployment. By considering personal, job and regional dimensions, we extended the literature and provided a more comprehensive understanding of this new phenomenon in the immediate and medium-term. Furthermore, this knowledge is essential to support policy suggestions for quick and effective action in preventing job losses in the current and future crises. Detailed information on all individuals that lost their jobs in Portugal 1 year after (and before) the COVID-19 outset was used to estimate three logit models that compare the odds of losing a job after and during the pandemic. Significant territorial heterogeneity of the COVID-19 impact on unemployment is obtained. Along with personal and job characteristics, we conclude that regional characteristics are essential for explaining individual vulnerabilities. In particular, workers are more prompted to lose their jobs if they live in regions with higher population densities, lower pre-crisis unemployment, and more dependable international flow. Conversely, individual and regional human capital investment contributes to protecting employment, revealing the existence of external effects.
Venovenous extracorporeal membrane oxygenation for COVID-19 associated severe respiratory failure: Case series from a Hungarian tertiary centre
Authors: Zöllei Éva , Rudas László , Hankovszky Péter , Korsós Anita , Pálfi Alexandra , Varga Zoltán , Tomozi László , Hegedüs Zoltán , Bari Gábor , Lobozárné Szivós Brigitta , Kiszel Attila , Babik Barna 
Published: March 2023

Introduction Venovenous extracorporeal membrane oxygenation (V-V ECMO) is recommended for the support of patients with severe COVID-19 associated severe respiratory failure (SRF). We report the characteristics and outcome of COVID-19 patients supported with V-V ECMO in a Hungarian centre. Methods We retrospectively collected data on all patients admitted with proven SARS CoV-2 infection who received V-V ECMO support between March 2021 and May 2022. Results Eighteen patients were placed on ECMO during this period, (5 women, age (mean ± SD) 44 ± 10 years, APACHE II score (median (interquartile range)) 12 (10–14.5)). Before ECMO support, they had been hospitalised for 6 (4–11) days. Fifteen patients received noninvasive ventilation for 4 (2–8) days, two patients had high flow nasal oxygen therapy, for one day each. They had already been intubated for 2.5 (1–6) days. Prone position was applied in 15 cases. On the day before ECMO initiation the Lung Injury Score was 3.25 (3–3.26), the PaO2/FiO2 ratio was 71 ± 19 mmHg. The duration of V-V ECMO support was 26 ± 20 days, and the longest run lasted 70 days. Patients were mechanically ventilated for 34 ± 23 days. The intensive care unit (ICU) and the hospital length of stay were 40 ± 28 days and 45 ± 31 days, respectively. Eleven patients were successfully weaned from ECMO. The ICU survival rate was 56%, the in-hospital survival was 50%. All patients who were discharged from hospital reported a good health-related quality of life Rankin score (0–2) at the 5–16 months follow-up. Conclusions During the last three waves of the COVID-19 pandemic, we achieved a 56% ICU and a 50% hospital survival rate at our low volume centre.
Construction and Initial Validation of the DECCS Questionnaire to Assess How Students Deal with Emotionally Challenging Classroom Situations (Grades 4–7)
Authors: Schlesier Juliane , Raufelder Diana , Moschner Barbara 
Published: March 2023

This paper describes the development and validation of an instrument to assess how students deal with emotionally challenging classroom situations (the DECCS Questionnaire). The questionnaire is based on a vignette with one learning and one performance situation in a classroom, and is intended for students in grades 4 to 7. On a sample of N = 639 students ( M age = 10.6 years; SD = 1.25, 52.4% girls) in northwest Germany, factor analytic procedures for the subdimensions of students dealing with emotionally challenging classroom situations show that two factors can be distinguished each for students’ appraisals, for students’ adaptive behavior, for students’ maladaptive behavior, and for students’ desired teacher behavior. The questionnaire and subscales demonstrate good reliability and validity values. Thus, the DECCS questionnaire shows good psychometric properties and is well suited for determining how students deal with emotionally challenging classroom situations.
Development of a three-dimensional in vitro blood-brain barrier using the chitosan-alginate polyelectrolyte complex as the extracellular matrix
Authors: Bayir Ece 
Published: March 2023

Polyelectrolyte complexes (PECs) consist of a spontaneous assembly of oppositely charged polysaccharides. PECs can be used to obtain a hydrogel tissue scaffold in tissue culture. In this study, it is aimed to use PEC as a blood-brain barrier (BBB) model scaffold. By mixing polycationic chitosan and polyanionic alginate solutions at a certain ratio it was obtained a 3D hydrogel scaffold and mimicked in vivo environment of the tissue. The PEC hydrogel scaffold’s chemical, physical, and mechanical characterizations were performed with FTIR, DSC, DMA, and Micro-CT analyses. In order to develop an in vitro BBB model, the human neuroblastoma cell line (SH-SY5Y) and mouse astrocyte cell line (C8-D1A) were mixed into a hydrogel, which is the abluminal side of the BBB. Human microvascular endothelial cells (HBEC-5i) were seeded on the hydrogel, and it was aimed to mimic the luminal side of the BBB. The characterization of the BBB model was determined by measuring the TEER, observation of the cell morphology with SEM, performing the permeability of Lucifer Yellow, and observation of tight junction proteins with immunofluorescence staining. As a result, HBEC-5i cells expressed tight junction proteins (ZO-1 and Claudin-5), showed TEER of 340 ± 22 Ω.cm2, and the Lucifer Yellow permeability of 7.4 × 10−7 ± 2.7 × 10−7 cm/s, which was suitable for use as an in vitro BBB model. Using a hydrogel PEC composed of chitosan and alginate as an extracellular matrix increased the direct interaction of endothelial cells, astrocytes, and neurons with each other and thus obtained a much less permeable model compared to other standard transwell models. Graphical abstract [Formula: see text]
A Prescription for Wellness in Early PD: Just What the Doctor Ordered
Authors: McDaniels Bradley , Pontone Gregory M. , Keener Adrienne M. , Subramanian Indu 
Published: March 2023

Background Being diagnosed with a neurodegenerative disease is a life-changing event and a critical time to help patients cope and move forward in a proactive way. Historically, the main focus of Parkinson’s disease (PD) treatment has been on the motor features with limited attention given to non-motor and mental health sequelae, which have the most impact on quality of life. Although depression and anxiety have been described at the time of PD diagnosis, demoralization, intolerance of uncertainty, decreased self-efficacy, stigma and loneliness can also present and have negative effects on the trajectory of the disease. Hence, understanding the psychological impact of the diagnosis and how to provide better counselling at this critical time point may be the key to a better long-term trajectory and quality of life. Focus There has been a paradigm shift in the treatment of chronic illness moving beyond the medical model, which focuses on fighting illness with the physician being in charge of the treatment process and the patient being the passive recipient, toward a more holistic (i.e., physical, psychological, social, and spiritual health) biopsychosocial approach that emphasizes behavioral factors with the patient being an active collaborator in their treatment. Hence, we propose that fostering resilience, social support, and psychological flexibility offer promise toward attenuating negative reactions and improving overall well-being. Conclusion Through a proactive wellness approach incorporating lifestyle choices, people with PD (PwP) can not only achieve improved states of health, well-being, and quality of life, but actually thrive.
Monitoring of traffic noise pollution in urban Patna, Bihar, India
Authors: Ranjan Rajeev , Kumar Saurabh , Singh Reena 
Published: March 2023

Road traffic noise is a major environmental issue that has been faced by many people around the world, including in Patna city. There is a need to investigate noise regularly because of the rapidly increasing traffic volume. This study focuses on the estimation of the urban traffic noise level in Patna, Bihar, India. Based on a preliminary survey of traffic volume, 12 stations were selected. A sound meter was used to measure the “A”-weighted noise level. Noise parameters like L10, L50, and L90 were evaluated from the collected noise data. And these noise parameters were used for the calculation of noise pollution indices like Noise Climate (NC), Equivalent Continuous Noise Level (Leq), Noise Pollution Level (NPL), and Traffic Noise Index (TNI). These noise indices compare with the standard limit of the Central Pollution Control Board (CPCB). The equivalent continuous noise level (Leq) measured at different locations in the commercial cum residential zones varies from 77.7 dBA to 92.5 dBA, which is higher than the prescribed noise level limit of the CPCB. Other noise indices, such as the NPL and TNI, are found to range from 88.2 dBA to 111.5 dBA and 77.9 dBA to 125.9 dBA, respectively, at various sampling locations and are also higher than the prescribed limit of the CPCB. The noise level of all stations was found to exceed the prescribed limit of the CPCB. There is a strong correlation exists between NPL with TNI and NC (r > 0.5). Also, there is a strong correlation exists between Leq with NPL (r > 0.5). Using NPL as a dependent variable and TNI, NC, and Leq as independent variables, the regression model was completely validated.
Palliative Care across Settings: Perspectives from Inpatient, Primary Care, and Home Health Care Providers and Staff
Authors: Tietbohl Caroline K. , Dafoe Ashley , Jordan Sarah R. , Huebschmann Amy G. , Lum Hillary D. , Bowles Kathryn H. , Jones Christine D. 
Published: March 2023

Background Early introduction of palliative care can improve patient-centered outcomes for older adults with complex medical conditions. However, identifying the need for and introducing palliative care with patients and caregivers is often difficult. We aim to identify how and why a multi-setting approach to palliative care discussions may improve the identification of palliative care needs and how to facilitate these conversations. Methods Descriptive qualitative study to inform the development and future pilot testing of a model to improve recognition of, and support for, unmet palliative care needs in home health care (HHC). Thematic analysis of semi-structured interviews with providers across inpatient (n = 11), primary care (n = 17), and HHC settings (n = 10). Results Four key themes emerged: 1) providers across settings can identify palliative care needs using their unique perspectives of the patient’s care, 2) identifying palliative care needs is challenging due to infrequent communication and lack of shared information between providers, 3) importance of identifying a clinical lead of patient care who will direct palliative care discussions (primary care provider), and 4) importance of identifying a care coordination lead (HHC) to bridge communication among multi-setting providers. These themes highlight a multi-setting approach that would improve the frequency and quality of palliative care discussions. Conclusions A lack of structured communication across settings is a major barrier to introducing and providing palliative care. A novel model that improves communication and coordination of palliative care across HHC, inpatient and primary care providers may facilitate identifying and addressing palliative care needs in medically complex older adults.
Extreme Symptom Burden for Patients With COVID-19 at the End of Life; Extrapolation of Knowledge Gained to Achieve Sustained Comfort and Dignity for all Patients in Their Last Days of Life1
Authors: Waldron Dympna , Mc Carthy Christine Eileen , Murphy David , Krawczyk Janusz , Kelly Lisa , Walsh Fiona , Mannion Eileen 
Published: March 2023

Background We describe two complex cases in the setting of COVID-19 at the End of Life, to enhance learning for all patients. Case Presentation Maintenance of sustained comfort in two cases required multiple drugs, specifically selected for symptoms that necessitated three separate pumps delivering continuous 24-hour subcutaneous infusion. Case Management Management of sustained comfort included opioid, midazolam, anti-secretory, diclofenac for intractable temperature, phenobarbital for extreme agitation, in one, where seizure activity was present, while insomnia, was a prominent feature of another. Management of Akatasia was also required. Case Outcome Attention to each individual patient’s rapidly evolving symptoms, during the dying phase, with a thorough differential diagnosis, wa s vitally important in the context of a ‘Good Death’. This was achieved in both cases, reflected by evidence at the bedside of comfort and a minimum need for ‘as required’ drugs in the last days of life. Conclusions COVID-19 being a new illness, we need to prospectively study the symptom burden/clustering at End of Life and learn from management of this new disease for other illnesses also. Further research is required to develop protocols on; when does Midazolam dose reach tolerance and when should an alternative drug such as phenobarbital for sustained Gamma-Aminobutyric Acid effects be initiated; examine the optimal approach to sustained temperature control; be cognisant of extrapyramidal side effects of drugs used at End of Life and consider looking at a lack of need for ‘as required’ drugs in the last days of life as an outcome measure of sustained comfort.
Youth Reported Perpetrators of Victimization Within a Foster Care Sample
Authors: Bennett Amanda , Clement Alex , Walton Rachel , Jackson Yo , Gabrielli Joy 
Published: March 2023

Maltreatment type, severity, and chronicity are predictors of poor youth outcomes, yet youth reported perpetrators of abuse have gone largely unstudied. Little is known about variation in perpetration across youth characteristics (e.g., age, gender, placement type) and abuse features. This study aims to describe youth reported perpetrators of victimization within a foster care sample. 503 youth in foster care (ages 8–21 years) reported on experiences of physical, sexual, and psychological abuse. Follow up questions assessed abuse frequency and perpetrators. Mann-Whitney U Tests were used to compare central tendency differences in number of perpetrators reported across youth characteristics and victimization features. Biological caregivers were commonly endorsed perpetrators of physical and psychological abuse, though youth also reported high levels of peer victimization. For sexual abuse, non-related adults were commonly reported perpetrators, however, youth reported higher levels of victimization from peers. Older youth and youth residing in residential care reported higher numbers of perpetrators; girls reported more perpetrators of psychological and sexual abuse as compared to boys. Abuse severity, chronicity, and number of perpetrators were positively associated, and number of perpetrators differed across abuse severity levels. Perpetrator count and type may be important features of victimization experiences, particularly for youth in foster care.
Ethical Dilemmas Facing Substance Use Counselors During the COVID-19 Pandemic
Authors: McCuistian Caravella , Fokuo J Konadu , Dumoit Smith Jaime , Sorensen James L , Arnold Emily A 
Published: March 2023

Introduction: During the COVID-19 pandemic, substance use disorder (SUD) treatment settings experienced several abrupt changes, including decreased admissions, reduction in services, and modified requirements for medication for substance use disorder. While these changes were implemented to facilitate the maintenance of important treatment options, the ethical consequences of such changes remained unknown. The current study aimed to explore ethical issues related to COVID-19-related changes reported by counselors in SUD treatment facilities. Method: From May to August 2020, we conducted 60 to 90 minutes in-depth interviews with 18 front-line staff in 1 residential and 1 outpatient treatment program, exploring issues drawn from the ethical principles of the national organization representing SUD counselors. Counselors volunteered to participate via phone or email, and participation was confidential. Interviews were conducted via videoconferencing. Topics included day-to-day experiences of ethical dilemmas in the workplace, particularly during the COVID-19 era. Interviews were recorded, transcribed, and checked for accuracy and a trained team of analysts then coded transcripts using thematic analysis. Results: As a result of the COVID-19 pandemic, SUD treatment programs quickly modified procedures to adhere to public health mandates while also continuing to offer care to clients. SUD counselors reported several ways their programs adapted new and creative procedures to reduce the risk of COVID-19 transmission. SUD counselors also identified several novel ethical dilemmas that occurred during the COVID-19 pandemic, often resulting from the counselor balancing the needs for responding to public health mandates with providing services to clients. There were several ways that COVID-19 related changes resulted in therapeutic challenges for some clients, and the SUD counselors highlighted ways that changes resulted in more flexible services for other clients. Conclusions: This study highlights the quick response to COVID-19 that occurred within SUD treatment. While these changes resulted in novel ethical dilemmas, they also offered more flexible and client-centered approaches to treatment.