bluuebunny/crossref_metadata_2025_split huggingface dataset:
Disclosure and comfort during genetic counseling sessions with LGBTQ+ patients: An updated assessment
Authors: Valentine Rozalia , Mills Rachel , Nichols Tracy , Doyle Lauren 
Published: February 2023

AbstractDisclosure is the act of sharing a stigmatized identity, and members of the LGBTQ+ community make decisions related to disclosure multiple times throughout their life. Disclosure in medical settings can impact perceptions of care and outcomes for LGBTQ+ patients; however, little is understood about the process of decision‐making regarding disclosure in the genetic counseling setting. As such, this study aimed to explore LGBTQ+ experiences in genetic counseling sessions and their disclosure behaviors. Fifty‐five LGBTQ+ individuals who attended a genetic counseling session and 91 genetic counselors completed online surveys. The patient survey assessed for disclosure behaviors, experiences of discrimination, and comfort in genetic counseling sessions. The counselor survey evaluated comfort with the LGBTQ+ population in a counseling setting, whether counselors facilitate disclosure in sessions, and whether counseling is tailored for the LGBTQ+ population. Eighty‐two percent of genetic counselors “rarely” or “never” ask about sexual orientation, and 69% “rarely” or “never” ask about gender identity. The majority of patients indicated they were not asked about their sexual orientation (87%) or gender identity (80%). Some patients reported experiencing discrimination or homo/transphobia in their genetic counseling sessions, with 6.12% of LGBQ+ patients experiencing discrimination and 24.1% of trans+ patients reporting discrimination. Over half of genetic counselors reported receiving training in LGBTQ+ healthcare and the majority reported comfort with providing care to LGBTQ+ patients. However, discrepancies between patient‐reported experiences and genetic counselors' descriptions of their care for the LGBTQ+ population warrant further research and suggest additional training or changes in practice may be necessary.
Trajectories of re‐engagement: factors and mechanisms enabling patient return to HIV care in Zambia
Authors: Beres Laura K. , Mwamba Chanda , Bolton‐Moore Carolyn , Kennedy Caitlin E. , Simbeza Sandra , Topp Stephanie M. , Sikombe Kombatende , Mukamba Njekwa , Mody Aaloke , Schwartz Sheree R. , Geng Elvin , Holmes Charles B. , Sikazwe Izukanji , Denison Julie A. 
Published: February 2023

AbstractIntroductionWhile disengagement from HIV care threatens the health of persons living with HIV (PLWH) and incidence‐reduction targets, re‐engagement is a critical step towards positive outcomes. Studies that establish a deeper understanding of successful return to clinical care among previously disengaged PLWH and the factors supporting re‐engagement are essential to facilitate long‐term care continuity.MethodsWe conducted narrative, patient‐centred, in‐depth interviews between January and June 2019 with 20 PLWH in Lusaka, Zambia, who had disengaged and then re‐engaged in HIV care, identified through electronic medical records (EMRs). We applied narrative analysis techniques, and deductive and inductive thematic analysis to identify engagement patterns and enablers of return.ResultsWe inductively identified five trajectories of care engagement, suggesting patterns in patient characteristics, experienced barriers and return facilitators that may aid intervention targeting including: (1) intermittent engagement;(2) mostly engaged; (3) delayed linkage after testing; (4) needs time to initiate antiretroviral therapy (ART); and (5) re‐engagement with ART initiation. Patient‐identified periods of disengagement from care did not always align with care gaps indicated in the EMR. Key, interactive re‐engagement facilitators experienced by participants, with varied importance across trajectories, included a desire for physical wellness and social support manifested through verbal encouragement, facility outreach or personal facility connections and family instrumental support. The mechanisms through which facilitators led to return were: (1) the promising of living out one's life priorities; (2) feeling valued; (3) fostering interpersonal accountability; (4) re‐entry navigation support; (5) facilitated care and treatment access; and (6) management of significant barriers, such as depression.ConclusionsWhile preliminary, the identified trajectories may guide interventions to support re‐engagement, such as offering flexible ART access to patients with intermittent engagement patterns instead of stable patients only. Further, for re‐engagement interventions to achieve impact, they must activate mechanisms underlying re‐engagement behaviours. For example, facility outreach that reminds a patient to return to care but does not affirm a patient's value or navigate re‐entry is unlikely to be effective. The demonstrated importance of positive health facility connections reinforces a growing call for patient‐centred care. Additionally, interventions should consider the important role communities play in fostering treatment motivation and overcoming practical barriers.
Persistent bone and joint disease despite current treatments for mucopolysaccharidosis types I, II, and VI: Data from a 10‐year prospective study
Authors: Miller Bradley S. , Fung Ellen B. , White Klane K. , Lund Troy C. , Harmatz Paul , Orchard Paul J. , Whitley Chester B. , Polgreen Lynda E. 
Published: February 2023

AbstractThe mucopolysaccharidosis (MPS) disorders have many potential new therapies on the horizon. Thus, historic control data on disease progression and variability are urgently needed. We conducted a 10‐year prospective observational study of 55 children with MPS IH (N = 23), MPS IA (N = 10), non‐neuronopathic MPS II (N = 13), and MPS VI (N = 9) to systematically evaluate bone and joint disease. Annual measurements included height, weight, and goniometry. Mixed effects modeling was used to evaluate changes over time. All participants had been treated with hematopoietic cell transplantation and/or enzyme replacement therapy. Height z‐score decreased over time in MPS IH, MPS II, and MPS VI, but not MPS IA. Adult heights were 136 ± 10 cm in MPS IH, 161 ± 11 cm in MPS IA, 161 ± 14 cm in MPS II, and 128 ± 15 cm in MPS VI. Adult average BMI percentiles were high: 75 ± 30%ile in MPS IH, 71 ± 37%ile in MPS IA, 71 ± 25%ile in MPS II, and 60 ± 42%ile in MPS VI. Every participant had joint contractures of the shoulders, elbows, hips, and/or knees. Joint contractures remained stable over time. In conclusion, despite current treatments for MPS I, II, and VI, short stature and joint contractures persist. The elevation in average BMI may be related, in part, to physical inactivity due to the ongoing bone and joint disease. Data from this longitudinal historical control study may be used to expedite testing of experimental bone and joint directed therapies and to highlight the need for weight management as part of routine clinical care for patients with MPS.
Land footprint and GHG emissions from global food loss
Authors: Abbade Eduardo Botti 
Published: February 2023

AbstractBACKGROUNDEfficient land use represents a global challenge in the context of high levels of food loss (FL) and waste (FLW) and increasing greenhouse gas (GHG) emissions from global agricultural activities. This study aimed to estimate the land footprint (LF) associated with FL worldwide. It also estimated the GHG emissions from crop residues and their burning, and their relationship with food loss for the main crops worldwide. The study analyzed data from the Food and Agriculture Organization of the United Nations (FAO) regarding land use, FL, and global GHG emissions from crop residues.RESULTSThe findings suggest that the average LF associated with FL worldwide is about 69 million ha per year, and the main food items responsible for most of the LF associated with FL are maize, wheat, and rice. The annual average emissions derived from burning crop residues of FL are 48.8 kilotons year−1 of CH4 and 1.26 kilotons year−1 of N2O, and the emission of N2O derived from crop residues of FL is about 24.1 kilotons year−1, considering the three crops.CONCLUSIONFood loss implies high levels of LF and GHG emissions, reinforcing the need for proper public and private initiatives worldwide to reduce FL and waste (FLW). Organizations such as the FAO and the Organisation for Economic Co‐operation and Development (OECD) should incorporate indicators regarding FLW reduction to evaluate and monitor countries’ performance. An international agreement also needs to be addressed to engage the world's nations in the reduction of FLW levels. © 2023 Society of Chemical Industry.
Canada lynx occupancy and density in Glacier National Park
Authors: Anderson Alissa K. , Waller John S. , Thornton Daniel H. 
Published: February 2023

AbstractProtected areas are the cornerstone of conservation strategies for threatened and endangered species. Because protected areas often are insulated from many anthropogenic threats, and contain substantial topographic relief, they may be particularly important as climatic refugia for cold‐adapted, at‐risk species. Canada lynx (Lynx canadensis) are a cold‐adapted, threatened species, and reach the southern limits of their distribution in the contiguous United States, where they exist in several disjunct populations largely on multiple‐use lands (e.g., national forests). Glacier National Park (GNP) is one of the few, large, protected areas located within Canada lynx range in the contiguous United States, and therefore a potentially important lynx stronghold within the Northern Rockies lynx recovery unit. Despite its potential importance, knowledge of lynx populations within the park is extremely limited. We completed a park‐wide occupancy survey of lynx using an array of motion‐sensitive cameras during summers in 2018–2021. Within a smaller area of the park, we also estimated lynx density by identifying individuals from subtle markings on the inside of the front leg and employing spatially explicit capture‐recapture analysis. Finally, we linked park‐wide predictions of occupancy with local density to estimate lynx population size across GNP. Lynx were distributed across much of the park in summer and occupancy was influenced by a combination of snowshoe hare (Lepus americanus) relative abundance, forest associations, climate, and fire. We were able to successfully identify approximately 75% of lynx captures to individual based on coat markings. Although average park‐wide lynx density was low (1.28/100 km2) compared to populations in the core of the range, park‐wide abundance was substantial for this threatened predator (52; 95% CI = 30–92). Based on our results, we propose that GNP should be considered as a potentially important area for lynx habitat refugia in a warming climate. Moreover, our ability to rapidly assess distribution and density using camera deployments in summer could be useful for long‐term monitoring and recovery assessment.
Critical assessment of approach towards estimation of microplastics in environmental matrices
Authors: Raj Deep , Maiti Subodh Kumar 
Published: February 2023

AbstractMicroplastics (MPs) are the contaminants of growing concern due to their persistent properties in the environment. This review compares the global data on MPs concentration in soil, sediment, salt, sand, biosolids, and water. Previous studies have also developed various methods to estimate MPs for different environmental matrices, which were generally based on salt‐based density separation, physical (microscopy), chemical characterization (spectroscopy), and visual counting for extraction, identification, and quantification, respectively. In most of the existing field‐based studies, MPs are usually identified and detected by microscopic observation and Fourier transform infrared (FTIR) analysis, which maximize the probability of error in the estimation process. A combination of thermogravimetric analysis‐FTIR spectroscopy, Raman microspectroscopy, optical photothermal infrared, and pyrolysis/gas chromatography–mass spectrometry are used for the identification, recognition, and quantification of MPs in the heterogeneous solid and liquid matrices for minimizing the interference and misinterpretation of the other constituents (organic matter) present in the samples, especially soil, sediments, and biosolids.
Resorcinol‐Derived Vitrimers and Their Flax Fiber‐Reinforced Composites Based on Fast Siloxane Exchange
Authors: Debsharma Tapas , Engelen Stéphanie , De Baere Ives , Van Paepegem Wim , Du Prez Filip 
Published: February 2023

AbstractNatural fiber‐reinforced composites are gaining increased interest for their significantly reduced carbon footprint compared to conventional glass or carbon fiber‐based counterparts. In this study, natural fibers are used in a resorcinol‐based epoxy resin that is thermally reshapable at higher temperatures (>180 °C) by using fast exchanging siloxane bonds, catalyzed by 1,5,7‐triazabicyclo[4.4.0]dec‐5‐ene. Stress relaxation times of only about 6 s at 220 °C can be reached. A resorcinol‐based epoxy compound is selected because it can be derived from cellulose, opening ways for more sustainable and reshapable composite materials. In a last step of the research, the low viscosity vitrimer formulation (<200 mPa s) is applied to make a flax fiber‐reinforced composite using an industrially relevant vacuum‐assisted resin infusion process. A section of this composite is successfully reshaped, which allows for envisioning a second life for natural fiber‐reinforced composites.
Long‐Duration Response to Levodopa, Motor Learning, and Neuroplasticity in Early Parkinson's Disease
Authors: Sciacca Giorgia , Mostile Giovanni , Disilvestro Ivano , Donzuso Giulia , Nicoletti Alessandra , Zappia Mario 
Published: February 2023

AbstractBackgroundLong‐duration response (LDR) to levodopa and motor learning could be involved in changes in neuroplasticity of cortical excitability in Parkinson's disease (PD). P300, motor evoked potentials (MEPs), and Bereitschaftspotential (BP) are neurophysiological surrogate markers of neuroplasticity.ObjectiveWe aimed to define in PD the effects of LDR and motor learning on neurophysiological parameters involved in neuroplasticity.MethodsDrug‐naive PD patients underwent a 15‐day treatment with levodopa/carbidopa 250/25 mg daily. Achievement of LDR was assessed on the 15th day of treatment (T15). Patients were grouped based on the achievement of a sustained LDR (LDR+) or no LDR (LDR−) and to the assignment of a learning motor exercise (LME) or no motor exercise (NME). Patients underwent clinical and neurophysiological (P300, MEPs, and BP) assessments at baseline (T0) and on T15.ResultsForty‐one PD patients and 24 age‐ and sex‐matched normal controls (NCs) were enrolled. Neurophysiological parameters differed between untreated PD patients and NCs. Four groups of patients were obtained at the end of treatments: trained patients with a sustained LDR (LDR + LME group), untrained patients with a sustained LDR (LDR + NME group), trained patients without LDR (LDR‐LME group), and untrained patients without LDR (LDR‐NME group). At baseline, no differences in clinical and neurophysiological parameters were evident among the groups. After the treatments, significant improvements in neurophysiological parameters were observed in the LDR + LME group. No modifications were found in the groups without LDR.ConclusionsThe achievement of a sustained LDR may act synergistically with motor learning to induce adaptive changes in neuroplasticity in basal ganglia and cortical networks. Our findings support LDR as a pharmacological outcome possibly facilitating the action of motor learning on neuroplasticity in early PD. © 2023 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.
A neural ordinary differential equation model for visualizing deep neural network behaviors in multi‐parametric MRI‐based glioma segmentation
Authors: Yang Zhenyu , Hu Zongsheng , Ji Hangjie , Lafata Kyle , Vaios Eugene , Floyd Scott , Yin Fang‐Fang , Wang Chunhao 
Published: February 2023

AbstractPurposeTo develop a neural ordinary differential equation (ODE) model for visualizing deep neural network behavior during multi‐parametric MRI‐based glioma segmentation as a method to enhance deep learning explainability.MethodsBy hypothesizing that deep feature extraction can be modeled as a spatiotemporally continuous process, we implemented a novel deep learning model, Neural ODE, in which deep feature extraction was governed by an ODE parameterized by a neural network. The dynamics of (1) MR images after interactions with the deep neural network and (2) segmentation formation can thus be visualized after solving the ODE. An accumulative contribution curve (ACC) was designed to quantitatively evaluate each MR image's utilization by the deep neural network toward the final segmentation results.The proposed Neural ODE model was demonstrated using 369 glioma patients with a 4‐modality multi‐parametric MRI protocol: T1, contrast‐enhanced T1 (T1‐Ce), T2, and FLAIR. Three Neural ODE models were trained to segment enhancing tumor (ET), tumor core (TC), and whole tumor (WT), respectively. The key MRI modalities with significant utilization by deep neural networks were identified based on ACC analysis. Segmentation results by deep neural networks using only the key MRI modalities were compared to those using all four MRI modalities in terms of Dice coefficient, accuracy, sensitivity, and specificity.ResultsAll Neural ODE models successfully illustrated image dynamics as expected. ACC analysis identified T1‐Ce as the only key modality in ET and TC segmentations, while both FLAIR and T2 were key modalities in WT segmentation. Compared to the U‐Net results using all four MRI modalities, the Dice coefficient of ET (0.784→0.775), TC (0.760→0.758), and WT (0.841→0.837) using the key modalities only had minimal differences without significance. Accuracy, sensitivity, and specificity results demonstrated the same patterns.ConclusionThe Neural ODE model offers a new tool for optimizing the deep learning model inputs with enhanced explainability. The presented methodology can be generalized to other medical image‐related deep‐learning applications.
Challenge, threat, coping potential: How primary and secondary appraisals of job demands predict nurses' affective states during the COVID‐19 pandemic
Authors: Fernandez De Henestrosa Martha , Sischka Philipp E. , Steffgen Georges 
Published: February 2023

AbstractAimThe COVID‐19 pandemic has led to a rapid raise of work‐related stress among nurses, affecting their emotional well‐being. This study examined how nurses appraise job demands (i.e. time pressure, emotional demands and physical demands) during the pandemic, and how primary (i.e. challenge and threat) and secondary appraisals (i.e. coping potential) of job demands predict nurses' affective states (i.e. positive affect, anger and anxiety).DesignA cross‐sectional online survey.Methods419 nurses completed self‐report measures of job demands and related appraisals. Data analyses comprised correlation analysis, factor analysis, hierarchical linear regression analysis and dominance analysis.ResultsEmotional and physical demands correlated exclusively with threat appraisal, while time pressure correlated with challenge and threat appraisal. Time pressure, emotional demands and threat appraisals of job demands predicted negative affective states, while challenge appraisals of emotional and physical demands predicted positive affect. Coping potential was identified as the most important predictor variable of nurses' affective states.Public ContributionThe current study identified statistically significant risk and protective factors in view of nurses' affective states experienced during the COVID‐19 pandemic.
Occupational well‐being of the work community in social and health care education during the COVID‐19 pandemic—A cross‐sectional study
Authors: Vauhkonen Anneli , Honkalampi Kirsi , Hult Marja , Hujo Mika , Saaranen Terhi 
Published: February 2023

AbstractAimTo evaluate factors related to the occupational well‐being of social and health care educators' work communities during the COVID‐19 pandemic.DesignA cross‐sectional study was conducted among social and health care educators in Finland 2020.MethodsData (n = 552) were collected through a questionnaire containing continuous, Likert scale and categorical variables. Descriptive, exploratory factor analysis and multiple regression modelling were used for analysing the data.ResultsEducators regarded their work as meaningful and experienced collegiality. Age and work experience were related to experiences on work community subscales and community occupational well‐being. Personal occupational well‐being and activities promoting occupational well‐being on the community level were most related to experiences of the work community and its well‐being. The activities that promote occupational well‐being on the work community level should be emphasized.
Perceptions of healthcare professional about the “PACE Steps to Success” palliative care program for long‐term care: A qualitative study in Switzerland
Authors: Charmillot Pierre‐Alain , Van den Block Lieve , Oosterveld‐Vlug Mariska , Pautex Sophie 
Published: February 2023

AbstractAimThis study aimed to examine the healthcare professionals' perceptions after implementing the “PACE Steps to Success” program in the French‐speaking part of Switzerland.DesignA qualitative descriptive study.MethodsThematic analysis of semi‐structured face‐to‐face and group interviews with health professionals, PACE coordinators, and managers purposely invited in the four long‐term home facilities that had previously participated in the PACE cluster randomized clinical trial intervention group.ResultsThe PACE program implementation has improved communication with residents regarding end‐of‐life issues and helped identify patients' needs. The introduction of codified tools can complete internal tools and support decision‐making. In addition, the training has promoted inter‐professional collaboration, particularly in the case of care assistants, by defining each profession's specific responsibilities in providing care for older adults.
The lived experience of family members of older people who have died by suicide in rural China
Authors: Chen Mengyun , Zhang Xiubin , McCormack Brendan 
Published: February 2023

AbstractAimThe aim of the study is to provide insight and facilitate a deeper understanding of family members who have experienced their older family member's suicide.DesignInterpretative phenomenological analysis (IPA) study.MethodsSemi‐structured individual interviews with five family members of older people who died by suicide recruited from a rural area of Shanxi Province, China. Smith's (2009) six steps of IPA was used for data analysis.ResultsThree main themes emerged from the study: (a) Initial psychological reactions; (b) Long‐term life effects; (c) Social attitudes. The study shows how the family members of older people who died by suicide have experienced stigmatization and felt largely ignored. A suicide event poses a challenge to the future living quality of the family members. The study also highlights that it is necessary to pay attention to families of older people who died by suicide and providing support is required to improve the quality of life of these family members in rural China.ConclusionThe study adds to the understanding of the lived experience of family members of older people who died by suicide in less economically developed rural areas.Patient or Public ContributionPatients and the public were not involved in the design, conduct or reporting of this study. Participants of this study helped with recruitment via snowball sampling.