bluuebunny/crossref_metadata_2025_split huggingface dataset:
Non-specialist-delivered psychosocial intervention for prenatal anxiety in a tertiary care setting in Pakistan: a qualitative process evaluation
Authors: Atif Najia , Rauf Nida , Nazir Huma , Maryam Hadia , Mumtaz Sidra , Zulfiqar Shaffaq , Shouket Rabail , Rowther Armaan A , Malik Abid , Rahman Atif , Surkan Pamela J. 
Published: February 2023

ObjectivesA manualised cognitive–behavioural therapy-based psychosocial intervention for prenatal anxiety called Happy Mother Healthy Baby is being tested for its effectiveness through a randomised control trial in Pakistan. The aim of this study was to evaluate the intervention delivery process and the research process.DesignQualitative methods were used to explore in depth the intervention delivery and research process.SettingThis process evaluation was embedded within a randomised control trial conducted in a tertiary care facility in Rawalpindi, Pakistan.ParticipantsData were collected through in-depth interviews (n=35) with the trial participants and focus group discussions (n=3) with the research staff. Transcripts were analysed using a Framework Analysis.ResultsThe evaluation of the intervention delivery process indicated that it can be effectively delivered by non-specialist providers trained and supervised by a specialist. The intervention was perceived to be culturally acceptable and appropriately addressing problems related to prenatal anxiety. Lack of awareness of ‘talking’ therapies and poor family support were potential barriers to participant engagement. The evaluation of the research process highlighted that culturally appropriate consent procedures facilitated recruitment of participants, while incentivisation and family involvement facilitated sustained engagement and retention. Lack of women’s empowerment and mental health stigma were potential barriers to implementation of the programme.ConclusionWe conclude that non-specialists can feasibly deliver an evidence-based intervention integrated into routine antenatal care in a tertiary hospital. Non-specialist providers are likely to be more cost effective and less stigmatising. Inclusion of family is key for participant recruitment, retention and engagement with the intervention.Trial registration numberNCT03880032.
MidCog study: a prospective, observational cohort study investigating health literacy, self-management skills and cognitive function in middle-aged adults
Authors: Kim Minjee , Kwasny Mary J , Bailey Stacy C , Benavente Julia Y , Zheng Pauline , Bonham Morgan , Luu Han Q , Cecil Patrick , Agyare Prophecy , O'Conor Rachel , Curtis Laura M , Hur Scott , Yeh Fangyu , Lovett Rebecca M , Russell Andrea , Luo Yuan , Zee Phyllis C , Wolf Michael S 
Published: February 2023

IntroductionThe lack of definitive means to prevent or treat cognitive impairment or dementia is driving intense efforts to identify causal mechanisms. Recent evidence suggests clinically meaningful declines in cognition might present as early as middle age. Studying cognitive changes in middle adulthood could elucidate modifiable factors affecting later cognitive and health outcomes, yet few cognitive ageing studies include this age group. The purpose of the MidCog study is to begin investigations of less-studied and potentially modifiable midlife determinants of later life cognitive outcomes.Methods and analysisMidCog is a prospective cohort study of adults ages 35–64, with two in-person interviews 2.5 years apart. Data will be collected from interviews, electronic health records and pharmacy fill data. Measurements will include health literacy, self-management skills, cognitive function, lifestyle and health behaviours, healthcare use, health status and chronic disease outcomes. Associations of health literacy and self-management skills with health behaviours and cognitive/health outcomes will be examined in a series of regression models, and moderating effects of modifiable psychosocial factors.Finally, MidCog data will be linked to an ongoing, parallel cohort study of older adults recruited at ages 55–74 in 2008 (‘LitCog’; ages 70–90 in 2023), to explore associations between age, health literacy, self-management skills, chronic diseases, health status and cognitive function among adults ages 35–90.Ethics and disseminationThe Institutional Review Board at Northwestern University has approved the MidCog study protocol (STU00214736). Results will be published in peer-reviewed journals and summaries will be provided to the funders of the study as well as patients.
Accuracy of injection pressure measurement at peripheral nerves using high-resolution 40 MHz ultrasound in an anesthetized porcine model
Authors: McLeod Graeme A , Cowie Alistair , Sadler Amy , Watson Fiona , Wasik Paul , Reina Miguel Angel 
Published: February 2023

BackgroundFluid injection pressure measurement is promoted as a marker of needle tip position that discriminates between tissue layers. However, clinical ultrasound has insufficient resolution to identify the exact position of the needle tip. Our primary objective was to use 40 MHz ultrasound in anesthetized pigs in order to precisely locate the tip of the needle and measure opening injection pressure in muscle, at epineurium and in subepineurium.MethodsWe surgically exposed the axillae of four anesthetized pigs. Two operators placed a 40 MHz ultrasound transducer over the pectoral muscle and imaged axillary, median and radial nerves. Injections (0.5 mL) were randomized to in-plane and out-of-plane needle trajectories and flow rates of 1, 6 and 12 mL/min.ResultsWe identified 541 fascicles in 23 nerves. The ratio of fascicle area to nerve area remained constant at ~0.30 for all nerves. Axillary nerves were smaller than median and radial nerves, difference in diameter (95% CI) 1.61 (0.87 to 2.36) mm, p<0.001 and 1.59 (0.82 to 2.36) mm, p=0.001, respectively. Axillary nerves had less fascicles per nerve than median nerves, difference 7.63 (2.43 to 12.83) and radial nerves, difference 9.02 (3.64 to 14.40). We visualized the circumneurium and injection within the subcircumneural compartment. Intraneural injection increased nerve area (SD) from 5.7 (2.2) mm2to 13.7 (5.5) mm2, difference 8.0 (5.4–10.6) mm2, p<0.001. Mean injection pressure was greater in subepineurium compared with muscle, geometric ratio 2.29 (1.30 to 4.10), p<0.001; and greater on epineurium compared with muscle, geometric ratio 1.73 (1.03 to 3.00), p=0.01. Twenty-two out of 23 injections in muscle, 14 out of 23 injections at epineurium and 11 out of 22 injections in subepineurium were <138 kPa (20 psi).ConclusionNeedle tip position was not discernible using pressure monitoring. The circumneurium and subcircumneural injection compartment were observed but not intrafascicular injection.
Implementation of palliative care day hospital for outpatients with advanced cancer
Authors: Thery Laura , de Stampa Matthieu , Burnod Alexis , Seban Romain , Laouisset Céline , Marchal Timothée , Bouleuc Carole 
Published: February 2023

ObjectivesTo describe the population of a palliative care day hospital (PCDH) in oncology and analyse the end-of-life trajectory.MethodsMonocentric retrospective cohort study of all referred patients for the first time to PCDH over an 8-month period with the data collected in all PCDH in their pathway care.Results116 patients were included for 319 stays in PCDH. At first referral PCDH, 62 (53.4%) patients had ongoing anticancer therapy. Twenty-four (20.7%) and 63 (54.3%) patients were in an unstable and deteriorating phase, respectively. Mean (SD) Eastern Cooperative Oncology Group performance status score was 2.8 (0.7). Mean (SD) stay per patient was 2.8 (2.2). For all stays, mean (SD) of joint intervention of palliative care team and oncologist was 1.2 (1.2) per patient. Mean (SD) of technical acts performed was 0.2 (0.6) per patient. Among the 109 deceased patients, 16 patients (14.7%) and 7 patients (6.4%) had received chemotherapy in the last month and 15 days before death, respectively.ConclusionOur PCDH is a suitable place for a complex population still living at home. The reported patients’ demographics and PCDH’s organisation lead to a hybrid outpatient intervention between outpatient clinics and hospice care services. A randomised multicentric trial is ongoing to explore the impact of PCDH on patients’ trajectory and the use of resources.
Cryptographic Engineering a Fast and Efficient SIKE in FPGA
Authors: Elkhatib Rami , Koziel Brian , Azarderakhsh Reza , Mozaffari Kermani Mehran 
Published: February 2023

Recent attacks have shown that SIKE is not secure and should not be used in its current state. However, this work was completed before these attacks were discovered and might be beneficial to other cryptosystems such as SQISign. The primary downside of SIKE is its performance. However, this work achieves new SIKE speed records even using less resources than the state-of-the-art. Our approach entails designing and optimizing a new field multiplier, SIKE-optimized Keccak unit, and high-level controller. On a Xilinx Virtex-7 FPGA, this architecture performs the NIST Level 1 SIKE scheme key encapsulation and key decapsulation functions in 2.23 and 2.39 ms, respectively. The combined key encapsulation and decapsulation time is 4.62 ms, which outperforms the next best Virtex-7 implementation by nearly 2 ms. Our implementation achieves speed records for the NIST Level 1, 2, and 3 parameter sets. Only our NIST Level 5 parameter set was beat by an all-out performance implementation. Our implementations also efficiently utilize the FPGA resources, achieving new records in area-time product metrics for all parameter sets. Overall, this work continues to push the bar for accelerating SIKE computations to make a stronger case for SIKE standardization.
Abatacept/Ruxolitinib and Screening for Concomitant Respiratory Muscle Failure to Mitigate Fatality of Immune-Checkpoint Inhibitor Myocarditis
Authors: Salem Joe-Elie , Bretagne Marie , Abbar Baptiste , Leonard-Louis Sarah , Ederhy Stéphane , Redheuil Alban , Boussouar Samia , Nguyen Lee S. , Procureur Adrien , Stein Frederic , Fenioux Charlotte , Devos Perrine , Gougis Paul , Dres Martin , Demoule Alexandre , Psimaras Dimitri , Lenglet Timothee , Maisonobe Thierry , De Chambrun Marc Pineton , Hekimian Guillaume , Straus Christian , Gonzalez-Bermejo Jesus , Klatzmann David , Rigolet Aude , Guillaume-Jugnot Perrine , Champtiaux Nicolas , Benveniste Olivier , Weiss Nicolas , Saheb Samir , Rouvier Philippe , Plu Isabelle , Gandjbakhch Estelle , Kerneis Mathieu , Hammoudi Nadjib , Zahr Noel , Llontop Claudia , Morelot-Panzini Capucine , Lehmann Lorenz , Qin Juan , Moslehi Javid J. , Rosenzwajg Michelle , Similowski Thomas , Allenbach Yves 
Published: February 2023

Abstract

Immune-checkpoint-inhibitor (ICI)–associated myotoxicity involves the heart (myocarditis) and skeletal muscles (myositis), which frequently occur concurrently and are highly fatal. We report the results of a strategy that included identification of individuals with severe ICI myocarditis by also screening for and managing concomitant respiratory muscle involvement with mechanical ventilation, as well as treatment with the CTLA4 fusion protein abatacept and the JAK inhibitor ruxolitinib. Forty cases with definite ICI myocarditis were included with pathologic confirmation of concomitant myositis in the majority of patients. In the first 10 patients, using recommended guidelines, myotoxicity-related fatality occurred in 60%, consistent with historical controls. In the subsequent 30 cases, we instituted systematic screening for respiratory muscle involvement coupled with active ventilation and treatment using ruxolitinib and abatacept. The abatacept dose was adjusted using CD86 receptor occupancy on circulating monocytes. The myotoxicity-related fatality rate was 3.4% (1/30) in these 30 patients versus 60% in the first quartile (P &lt; 0.0001). These clinical results are hypothesis-generating and need further evaluation.

Significance:
Early management of respiratory muscle failure using mechanical ventilation and high-dose abatacept with CD86 receptor occupancy monitoring combined with ruxolitinib may be promising to mitigate high fatality rates in severe ICI myocarditis.
See related commentary by Dougan, p. 1040.
This article is highlighted in the In This Issue feature, p. 1027
Comparison between Traditional Classroom and Flipped Classroom on Student’s Engagement and Satisfaction
Authors: Sarker Pramath Chandra , Siddique Md. Nur-E-Alam , Sultana Sabina , Pal Subrata Kumer 
Published: February 2023

Background: The implications of flipped classrooms are increasing day by day around the world for better benefits compared to traditional classrooms. But the application and research about this field are insufficient in Bangladesh Objective: The present study was conducted to investigate the effectiveness of the flipped classroom learning environment on students’ engagement and satisfaction compared to a traditional classroom. Methods: Result showed a significant difference in student engagement and satisfaction with flipped classroom being favored over traditional classroom. A cross-sectional survey research was conducted using a 5-point Likert-type questionnaire to measure student engagement and satisfaction, respectively, on both the traditional classroom and the flipped classroom. Data were collected from 79 participants from the traditional classroom and 61 participants from the flipped classroom. After six weeks of intervention on flipped classroom method, again a survey was carried out to discover student engagement and satisfaction. The obtained data were analyzed by employing descriptive statistics, t-test, and correlation by SPSS version 26, Microsoft Excel version 19, and an online t-test calculator. Results: The study's findings revealed a significant mean difference in student engagement and satisfaction between the traditional and flipped classrooms. The outcomes also showed that students were more engaged and satisfied with flipped classrooms than with traditional classrooms. Another outcome to note is that the flipped classroom was also able to differentiate students based on class activity and regularity, while the traditional classroom could not. Conclusion: The findings suggest that the flipped classroom model has the potential to be the ideal education system in the 21st century and to address the 4th Industrial Revolution. Further investigation, assessment, and modification are necessary for widespread implementation.
Composite Measures of Brain Activation Predict Individual Differences in Behavioral Stroop Interference
Authors: Smith Louisa L. , Snyder Hannah R. , Hankin Benjamin L. , Banich Marie T. 
Published: February 2023

Abstract
The goal of the current study was to interrogate aspects of the cascade-of-control model [Banich, M. T. Executive function: The search for an integrated account. Current Directions in Psychological Science, 18, 89–94, 2009; Banich, M. T. The Stroop effect occurs at multiple points along a cascade of control: Evidence from cognitive neuroscience approaches. Frontiers in Psychology, 10, 2164, 2019], a neurocognitive model that posits how portions of pFC interact in a cascade-like manner to overcome interference from task-irrelevant information, and to test whether it could be used to predict individual differences in cognitive control outside the scanner. Participants (n = 62) completed two fMRI Word–Picture Stroop tasks, one containing emotional stimuli and one containing non-emotional stimuli, as well as a behavioral out-of-scanner Color–Word Stroop task at each of two time points. In a departure from the traditional approach of using a single task contrast to index neural activation across all ROIs, the current study utilized specific ROI by contrast pairings selected based on the specific level of control hypothesized by the cascade-of-control model to occur within that region. In addition, data across both tasks and both time points were combined to create composite measures of neural activation and of behavior. Consistent with the cascade-of-control model, individual differences in brain activation for specific contrasts within each of the three ROIs were associated with behavioral interference on the standard Color–Word Stroop task. Testing of alternative models revealed that these brain–behavior relationships were specific to the theoretically driven ROI by contrast pairings. Furthermore, such relationships were not observed across single-task and single-time point measures, but instead emerged from the composite measures. These findings provide evidence that brain activation observed across multiple regions of frontal cortex, each of which likely exerts cognitive control in a differential manner, is capable of predicting individual differences in behavioral performance.
Investigating the Relationship between Air Pollution, Meteorology, and COPD Trends in Pokhara Metropolitan City, Nepal
Authors: Prox Lauren 
Published: February 2023

Abstract
Spanning 464.24 km2, Pokhara Metropolitan City is Nepal’s largest city by area. With over 400 000 residents, it is also Nepal’s second most populous city. This research investigated a biometeorological system present within Pokhara Metropolitan City concerning air pollution, meteorological conditions, and health. Different aspects of this system are more or less influential in various regions of the city, and understanding these relationships can assist with future health interventions for limiting exposure to pollutants. This research was completed using datasets published in government records and scientific literature, showcasing what can be accomplished with open-source data. Key findings were a positive correlation between air pollution levels and chronic obstructive pulmonary disease (COPD) hospital admissions to Pokhara’s Western Regional Hospital and a negative correlation between meteorological measurements and hospital admissions. These findings aligned with the general body of literature on risk factors for COPD hospitalizations. Multivariate regressions yielded better predictions for hospital admissions using both mean low and high temperatures as opposed to using one temperature variable, which implied both daily low and high temperatures are related to hospital admissions. Results also revealed air pollution levels for pollutants ≤ 10 and > 2.5 μm were better predictors of hospital admissions than air pollutants sized 2.5 μm and below. Findings prompted questions about the relationships between different pollutant sizes and their correlations to COPD hospitalizations. Findings also yielded questions about health interventions and Pokhara’s built environment, which may be investigated in future research.
Morphological and mechanical properties of foamed thick-walled Wood-Plastic-Composite structures
Authors: Moritzer Elmar , Flachmann Felix 
Published: February 2023

Microcellular wood fiber reinforced polymers offer the possibility to reduce the use of fossil raw materials. In particular, thick-walled structures with thicknesses greater than 6 mm offer a high potential for weight savings. This study investigates the cell structures and mechanical properties of injection-molded test specimens. The influence of different thicknesses (6–10 mm) along with different chemical blowing agents (endothermic, exothermic) with varying dosages (0–2 wt%) is analyzed. The investigations reveal that exothermic chemical blowing agents form finer cells consistently to thin-walled structures than endothermic ones. Higher foaming agent content leads to higher pore fractions, with many small cells coalescing into a large open-pore cell network. The mechanical properties depend mainly on the pore content of the sample. The specific tensile properties deteriorate with the use of chemical blowing agents (CFA), whereas the sandwich structure produced with compact edge layers has a positive influence on the specific flexural properties.
Friction stir welding of polypropylene based graphene nanocomposites fabricated with 3-D printing: An investigation on the microstructure and mechanical properties
Authors: Afshari Mahmoud , Hardani Hatam , Hamounpeyma Mahdi , Samadi Mohammad Reza 
Published: February 2023

Polymer nanocomposites find diverse applications in the aerospace, automobile and electronic industries due to good corrosion resistance, high specific strength and excellent processing ability. However, the production of complex and larger parts typically requires welding technology. In this research, fused filament fabrication technique was used to prepare polypropylene nanocomposite reinforced with graphene nanoplates. The polypropylene/graphene nanocomposites were then joined using the friction stir welding. Afterward, different analyses such as thermogravimetric analysis, differential scanning calorimetry, scanning electron microscopy, tensile testing and hardness testing were applied to examine the effects of the process parameters on the microstructure and mechanical properties of the nanocomposite. The results of thermal analysis indicated that the addition of graphene nanoplates improved the melting point and crystallinity percentage of the polypropylene nanocomposite. Mechanical characterization of the welded samples indicated that the increase of rotational speed from 500 to 750 rpm enhanced the tensile strength of weld joint, while it reduced the hardness. Moreover, an increase in the welding speed from 10 to 30 mm/min resulted in a reduction in the tensile strength and an improvement in the hardness. The highest tensile strength of the weld was obtained by addition of 1 wt% graphene to polypropylene, whereas the hardness of the weld was maximized by addition of 2 wt% graphene. Nevertheless, the desirable combination of the process parameters for simultaneous enhancement of tensile strength and hardness was achieved by rotational speed of 667 rpm, welding speed of 16 mm/min and graphene content of 1.5 wt%.
Mental Health and Recovery Needs Among Women Substance Use Disorder Treatment Clients With Stalking Victimization Experiences
Authors: Logan TK , Cole Jennifer 
Published: February 2023

This study examined mental health and recovery needs at substance use disorder (SUD) program entry and at follow-up ( n = 2064) among: (1) women with no stalking victimization; (2) women with lifetime stalking victimization experiences; and (3) women with recent stalking victimization experiences (within 12 months of program entry). Stalking can be defined as a repeated pattern of behavior that creates fear or concern for safety or extreme emotional distress in the target. Women who experienced any stalking victimization, and particularly recent stalking victimization at program entry, had more recovery needs and increased mental health symptoms. At follow-up, women with any stalking victimization experiences continued to have more recovery needs with few differences between the lifetime and recent stalking victimization groups. Stalking victimization experiences were significantly associated with depression and anxiety symptoms in the multivariate analysis. Addressing stalking victimization during SUD treatment may be important to facilitate recovery.