bluuebunny/crossref_metadata_2025_split huggingface dataset:
Numeracy and the Motivational Mind: The Power of Numeric Self-efficacy
Authors: Peters Ellen , Shoots-Reinhard Brittany 
Published: May 2022

Background Objective numeracy appears to support better medical decisions and health outcomes. The more numerate generally understand and use numbers more and make better medical decisions, including more informed medical choices. Numeric self-efficacy—an aspect of subjective numeracy that is also known as numeric confidence—also relates to decision making via emotional reactions to and inferences from experienced difficulty with numbers and via persistence linked with numeric comprehension and healthier behaviors over time. Furthermore, it moderates the effects of objective numeracy on medical outcomes. Purpose We briefly review the numeracy and decision-making literature and then summarize more recent literature on 3 separable effects of numeric self-efficacy. Although dual-process theories can account for the generally superior decision making of the highly numerate, they have neglected effects of numeric self-efficacy. We discuss implications for medical decision-making (MDM) research and practice. Finally, we propose a modification to dual-process theories, adding a “motivational mind” to integrate the effects of numeric self-efficacy on decision-making processes (i.e., inferences from experienced difficulty with numbers, greater persistence, and greater use of objective-numeracy skills) important to high-quality MDM. Conclusions The power of numeric self-efficacy (confidence) has been little considered in MDM, but many medical decisions and behaviors require persistence to be successful over time (e.g., comprehension, medical-recommendation adherence). Including numeric self-efficacy in research and theorizing will increase understanding of MDM and promote development of better decision interventions. Highlights Research demonstrates that objective numeracy supports better medical decisions and health outcomes. The power of numeric self-efficacy (aka numeric confidence) has been little considered but appears critical to emotional reactions and inferences that patients and others make when encountering numeric information (e.g., in decision aids) and to greater persistence in medical decision-making tasks involving numbers. The present article proposes a novel modification to dual-process theory to account for newer findings and to describe how numeracy mechanisms can be better understood. Because being able to adapt interventions to improve medical decisions depends in part on having a good theory, future research should incorporate numeric self-efficacy into medical decision-making theories and interventions.
Development of a deep learning-based auto-segmentation algorithm for hepatocellular carcinoma (HCC) and application to predict microvascular invasion of HCC using CT texture analysis: preliminary results
Authors: Park Sungeun , Kim Jung Hoon , Kim Jieun , Joseph Witanto , Lee Doohee , Park Sang Joon 
Published: May 2022

Background Automatic segmentation has recently been developed to yield objective data. Prediction of microvascular invasion (MVI) of hepatocellular carcinoma (HCC) using radiomics has been reported. Purpose To develop a deep learning-based auto-segmentation algorithm (DL-AS) for the detection of HCC and to predict MVI using computed tomography (CT) texture analysis. Material and Methods We retrospectively collected training data from 249 patients with HCC and validation set from 35 patients. Lesions of the training set were manually drawn by radiologist, in the delayed phase. 2D U-Net was selected as the DL architecture. Using the validation set, one radiologist manually drew 2D and 3D regions of interest twice, and the developed DL-AS was performed twice with a one-month time interval. The reproducibility was calculated using intraclass correlation coefficients (ICC). Logistic regression was performed to predict MVI. Results ICC was in the range of 0.190–0.998/0.341–0.997 in the manual 3D/2D segmentation. In contrast, it was perfect in 3D/2D using DL-AS, with a success rate of 88.6% for the detection of HCC. For predicting MVI, sphericity was a significant parameter (odds ratio <0.001; 95% confidence interval <0.001–0.206; P = 0.020) for predicting MVI using 2D DL-AS. However, 3D DL-AS segmentation did not yield a predictive parameter. Conclusion The auto-segmentation of HCC using DL-AS provides perfect reproducibility, although it failed to detect 11.4% (4/35). However, the extracted parameters yielded different important predictors of MVI in HCC. Sphericity was a significant predictor in 2D DL-AS and 3D manual segmentation, while discrete compactness was a significant predictor in 2D manual segmentation.
Cross-sectional analysis of risk factors for surgical site infection secondary to spinal internal fixation via the posterior approach
Authors: Dong XiangHui , Zhou Yongchun 
Published: May 2022

Objective This study was performed to investigate the risk factors related to surgical site infection (SSI) secondary to spinal internal fixation via the posterior approach. Methods Patients who had undergone spinal internal fixation via the posterior approach were selected for inclusion in this cross-sectional study. Factors related to SSI were analysed using univariate and multivariate analyses. Results Among 4,350 patients, 66 had SSI (infection prevalence of 1.5%). Multivariate logistic regression analysis demonstrated that age of >60 years, surgical duration of >3 hours, haemoglobin concentration of <80 g/L, serum albumin concentration of <30 g/L, diabetes history, and blood loss of >1,000 mL were significantly correlated with SSI secondary to spinal internal fixation via the posterior approach. Conclusions This study provides information on SSI secondary to spinal internal fixation via the posterior approach. We found that age of >60 years, surgical duration of >3 hours, haemoglobin concentration of <80 g/L, serum albumin concentration of <30 g/L, diabetes history, and blood loss of >1,000 mL are directly correlated with SSI secondary to spinal internal fixation via the posterior approach.
Predicting acute severe toxicity for head and neck squamous cell carcinomas by combining dosimetry with a radiosensitivity biomarker: a pilot study
Authors: Deneuve Sophie , Bastogne Thierry , Duclos Mirlande , Mirjolet Céline , Bois Pascaline , Bachmann Patrick , Nokovitch Lara , Roux Pierre-Eric , Girodet Didier , Poupart Marc , Zrounba Philippe , Claude Line , Ferella Letizia , Iacovelli Nicola Alessandro , Foray Nicolas , Rancati Tiziana , Pereira Sandrine 
Published: May 2022

Objective: Radiotherapy (RT) against head and neck squamous cell carcinomas (HNSCC) may lead to severe toxicity in 30-40% of patients. The normal tissue complication probability (NTCP) models, based on dosimetric data refined the normal tissue dose/volume tolerance guidelines. In parallel, the radiation-induced nucleoshuttling (RIANS) of the Ataxia-Telangiectasia Mutated protein (pATM) is a predictive approach of individual intrinsic radiosensitivity. Here, we combined NTCP with RADIODTECT©, a blood assay derived from the RIANS model, to predict RT toxicity in HNSCC patients. Methods: RADIODTECT© cutoff values (i.e. 57.8 ng/mL for grade⩾2 toxicity and 46 ng/mL for grade⩾3 toxicity) have been previously assessed. Validation was performed on a prospective cohort of 36 HNSCC patients treated with postoperative RT. Toxicity was graded with the Common Terminology Criteria for Adverse Events (CTCAE) scale and two criteria were considered: grade⩾2 oral mucositis (OM2), grade⩾3 mucositis (OM3) and grade⩾2 dysphagia (DY2), grade⩾3 dysphagia (DY3). pATM quantification was assessed in lymphocytes of HNSCC patients. The discrimination power of the pATM assay was evaluated through the Area Under the Receiver Operator Characteristics Curve (AUC-ROC). Two previously described NTCP models were considered, including the dose to the oral cavity and the mean dose to the parotid glands (OM2 and OM3) and the dose to the oral cavity, to the larynx and the volume of pharyngeal constrictor muscles (DY2 and DY3). Results: Combining NTCP models with RADIODTECT© blood test improved the AUC-ROC. Considering the prediction of mucositis, AUC-ROCNTCP+RADIODTECT©=0.80 was for OM2, and AUC-ROCNTCP+RADIODTECT©=0.78 for OM3. Considering the prediction of acute dysphagia, AUC-ROCNTCP+RADIODTECT©=0.71 for DY2 and for DY3. Conclusions: Combining NTCP models with a radiosensitivity biomarker might significantly improve the prediction of toxicities for HNSCC patients.
Information bias in the Canadian occupational performance measure: A qualitative study
Authors: Sawada Tatsunori , Tomori Kounosuke , Ohno Kanta , Takahashi Kayoko , Saito Yuki , Levack William 
Published: May 2022

Purpose The Canadian Occupational Performance Measure (COPM) is designed to measure outcomes from client-centred occupational therapy. We explored clients’ views and experiences of participating in an initial COPM assessment in order to examine the potential information bias which may influence COPM scores. Material and methods We used qualitative methods to analyse semi-structured interviews (qualitative thematic analysis) on clients at a typical Japanese rehabilitation hospital, to examine the potential information bias affecting their scores in their initial COPM assessment. Results 19 of 20 clients (13 men; 7 women, aged 19–84 years) demonstrated potential sources of information bias in their COPM scores. We identified 15 sources of information bias, grouped into three domains: (1) bias during the selection of occupational areas (Misunderstanding client-centeredness, Misunderstanding meaningfulness, Misunderstanding occupation, and Composite occupations), (2) bias during the scoring of performance and satisfaction (Imaginary scores, Confusing scores of performance or satisfaction with importance, Ambiguous scores, Hopeful scores, Target scores, Emotional scores, Considerate scores and Humbleness scores) and (3) bias interfering future scoring (Changes in selected occupation, Forgotten scores, Ceiling effects). Conclusion This study identifies potential sources of bias affecting COPM scores, and taking account of this result would facilitate better collaboration with clients through COPM.
What is the lived experience of mothers in a Level-IV neonatal intensive care unit?
Authors: Nelson Jennifer L , Winston Kristin , Bloch Elise , Craig Jenene Woods 
Published: May 2022

RationaleOccupation-based practice in the neonatal intensive care unit may be impacted by a plethora of contextual factors. There is limited literature of the lived experience mothers have with mothering occupations for the care of premature infants in a Level-IV neonatal intensive care unit.MethodologyA phenomenological design was used to interview mothers of premature infants in a Level-IV neonatal intensive care unit. The eight participants were mothers who had been in the neonatal intensive care unit for at least 1 month. Data was obtained via demographic form, two individual semi-structured interviews for each mother, and fieldnotes.ResultsThematic analysis yielded five themes and two subthemes which were: unanticipated journey to becoming a mother, emotional rollercoaster, mother’s lost voice, subtheme cultural influences, roadblocks to mothering, unexpected layer to mothering occupations and subtheme support for mothering occupations. Each theme described a mother’s experience with mothering.ConclusionThere is an importance for neonatal occupational therapists to provide support for mothering occupations for mothers from a variety of demographic and cultural backgrounds. Occupation-based practice in the neonatal intensive care unit continues to need attention for inclusion of all mothers. The findings showed that cultural humility should be practiced in family-centred care in the neonatal intensive care unit.
Cannula cricothyroidotomy in the impalpable neck: An observational study of simulated ‘can’t intubate, can’t oxygenate’ scenarios by teams following a cannula-first algorithm in live anaesthetised pigs
Authors: Wycherley Alexander S , Debenham Edward M , O’Loughlin Edmond , Anderson James R , Syed Faraz R , Raisis Anthea L 
Published: May 2022

Live animal models can be used to train anaesthetists to perform emergency front-of-neck-access. Cannula cricothyroidotomy success reported in previous wet lab studies contradicts human clinical data. This prospective, observational study reports success of a cannula-first ‘can't intubate, can't oxygenate’ algorithm for impalpable anatomy during high fidelity team simulations using live, anaesthetised pigs. Forty-two trained anaesthesia teams were instructed to follow the Royal Perth Hospital can't intubate, can't oxygenate algorithm to re-oxygenate a desaturating pig with impalpable neck anatomy (mean (standard deviation, SD) 16.2 (3.5) kg); mean (SD) tracheal internal diameter 11 (1.4) mm. Teams were informed that failure would prompt veterinary-led euthanasia. All teams performed percutaneous cannula cricothyroidotomy as the initial technique, with a median (interquartile range, IQR (range)) start time of 42 (35–50 (24–93)) s. First-pass percutaneous cannula success was 29% to both insufflate tracheal oxygen and re-oxygenate. Insufflation success improved with repeated percutaneous attempts (up to three), but prolonged hypoxia time increasingly necessitated euthanasia (insufflation 57%; re-oxygenation 48%). First, second and third percutaneous attempts achieved insufflation at median (IQR (range)) 74 (64–91 (46–110)) s, 111 (95–136 (79–150)) s and 141 (127–159 (122–179)) s, respectively. Eighteen teams failed with percutaneous cannulae and performed scalpel techniques, predominantly dissection cannulation ( n = 17) which achieved insufflation in all cases (insufflation 100%; re-oxygenation 47%). Scalpel attempts were started at median (IQR (range)) 142 (133–218 (97–293)) s and achieved insufflation at 232 (205–303 (152–344)) s. While percutaneous cannula cricothyroidotomy could rapidly re-oxygenate, the success rate was low and teams repeated attempts beyond the recommended 60 s time frame, delaying transition to the more successful dissection cannula technique. We recommend this ‘cannula-first’ can't intubate, can't oxygenate algorithm adopts a ‘single best effort’ strategy for percutaneous cannula, with failure prompting a scalpel technique.
Revisiting the ICHD-3 criteria for headache attributed to mild traumatic injury to the head: Insights from the Toronto Concussion Study Analysis of Acute Headaches Following Concussion
Authors: Langer Laura Kathleen , Bayley Mark Theodore , Lawrence David Wyndham , Comper Paul , Kam Alice , Tam Alan , Saverino Cristina , Wiseman-Hakes Catherine , Ruttan Lesley , Chandra Tharshini , Foster Evan , Gladstone Jonathan 
Published: May 2022

Background There is limited prospective data on the prevalence, timing of onset, and characteristics of acute headache following concussion/mild traumatic brain injury. Methods Adults diagnosed with concussion (arising from injuries not related to work or motor vehicle accidents) were recruited from emergency departments and seen within one week post injury wherein they completed questionnaires assessing demographic variables, pre-injury headache history, post-injury headache history, and the Sport Concussion Assessment Tool (SCAT-3) symptom checklist, the Sleep and Concussion Questionnaire (SCQ) and mood/anxiety on the Brief Symptom Inventory (BSI). Results A total of 302 participants (59% female) were enrolled (mean age 33.6 years) and almost all (92%) endorsed post-traumatic headache (PTH) with 94% endorsing headache onset within 24 hours of injury. Headache location was not correlated with site of injury. Most participants (84%) experienced daily headache. Headache quality was pressure/squeezing in 69% and throbbing/pulsing type in 22%. Associated symptoms included: photophobia (74%), phonophobia (72%) and nausea (55%). SCAT-3 symptom scores, Brief Symptom Inventory and Sleep and Concussion Questionnaire scores were significantly higher in those endorsing acute PTH. No significant differences were found in week 1 acute PTH by sex, history of migraine, pre-injury headache frequency, anxiety, or depression, nor presence/absence of post-traumatic amnesia and self-reported loss of consciousness. Conclusions This study highlights the very high incidence of acute PTH following concussion, the timing of onset and characteristics of acute PTH, the associated psychological and sleep disturbances and notes that the current ICHD-3 criteria for headaches attributed to mild traumatic injury to the head are reasonable, the interval between injury and headache onset should not be extended beyond seven days and could, potentially, be shorted to allow for greater diagnostic precision.
Exploring the antihyperglycemic potential of tetrapeptides devised from AdMc1 via different receptor proteins inhibition using in silico approaches
Authors: Mustafa Ghulam , Mahrosh Hafiza S , Zafar Muddassar , Attique Syed A , Arif Rawaba 
Published: May 2022

Introduction: Diabetes mellitus is a heterogenous group of chronic metabolic disorders that results due to deficiency in insulin secretion and signalling. Multiple factors held responsible for onset of diabetes due to defects in glucose metabolism and cellular signalling mechanism. Over the past few years, many plant derived bioactive compounds have been recorded with increased efficacy and fewer side-effects against variety of diseases. Methods: In the current study, molecular docking and molecular dynamics simulation approaches were employed to evaluate the tetrapeptides devised from AdMc1 protein of Momordica charantia. Due to unavailability of appropriate template for modelling of 3D structure of AdMc1 protein, I-TASSER server was employed for prediction of good quality tertiary structure. Predicted model was refined by GalaxyRefine Web and evaluated by Verify 3D, ERRAT and Ramachandran plot analysis. Next, a ready-to-dock library of fifty tetrapeptides as potent inhibitors was prepared and docked against aldose reductase (AR), protein tyrosine phosphatase 1B (PTP1B), α-glucosidase, α-amylase and glycogen synthase kinase 3-beta as receptor proteins. Molecular dynamics (MD) simulation was performed on Schrodinger’s Desmond Module to check stability of the best docking complex. Results: Top five ligands were selected against each receptor protein based on their binding pattern and docking scores. Among selected ligands (i.e. VEID, TVEV, AYAY, EEIA, ITTV, TTIT, LPSM, RGIE, TTVE and EIAR) followed all parameters in drug scanning and ADMET screening tests. The MD simulations confirmed that the best selected peptide (i.e. VEID) docked with AR and PTP1B was structurally stable. Conclusion: In the light of overall results of all analyses employed in this study, the selected ligands could be further processed as potential hypoglycaemic drug candidates.
Suicide and Self-Harm Among Physicians in Ontario, Canada
Authors: Sood Manish M. , Rhodes Emily , Talarico Robert , Gérin-Lajoie Caroline , Simon Christopher , Spilg Edward , McFadden Taylor , Kyeeremanteng Kwadwo , T. Myran Daniel , Grubic Nicholas , Tanuseputro Peter 
Published: May 2022

Background Studies of occupation-associated suicide suggest physicians may be at a higher risk of suicide compared to nonphysicians. We set out to assess the risk of suicide and self-harm among physicians and compare it to nonphysicians. Methods We conducted a population-based, retrospective cohort study using registration data from the College of Physicians and Surgeons of Ontario from 1990 to 2016 with a follow-up to 2017, linked to Ontario health administrative databases. Using age- and sex-standardized rates and inverse probability-weighted, cause-specific hazards regression models, we compared rates of suicide, self-harm, and a composite of either event among all newly registered physicians to nonphysician controls. Results Among 35,989 physicians and 6,585,197 nonphysicians, unadjusted suicide events (0.07% vs. 0.11%) and rates (9.44 vs. 11.55 per 100,000 person-years) were similar. Weighted analyses found a hazard ratio of 1.05 (95% confidence interval: 0.69 to 1.60). Self-harm requiring health care was lower among physicians (0.22% vs. 0.46%; hazard ratio: 0.65, 95% confidence interval: 0.52 to 0.82), as was the composite of suicide or self-harm (hazard ratio: 0.70, 95% confidence interval: 0.57 to 0.86). The composite of suicide or self-harm was associated with a history of a mood or anxiety disorder (odds ratio: 2.84, 95% confidence interval: 1.17 to 6.87), an outpatient mental health visit in the past year (odds ratio: 3.08, 95% confidence interval: 1.34 to 7.10) and psychiatry visit in the preceding year (odds ratio: 3.87, 95% confidence interval: 1.67 to 8.95). Interpretation Physicians in Ontario are at a similar risk of suicide deaths and a lower risk of self-harm requiring health care relative to nonphysicians. Risk factors associated with suicide or self-harm may help inform prevention programs.
Optimization of compressive property for the development of triply periodic minimal surface lattice structure on polylactic acid polymeric material
Authors: Palaniyappan Sabarinathan , Veeman Dhinakaran , Sivakumar Narain kumar , Shanmugam Ragavanantham 
Published: May 2022

The present study deals with the process optimization of printing parameters for fabricating gyroid TPMS (triply periodic minimal surface) lattice structure incorporated compression samples on the polylactic Acid polymeric material for obtaining the maximum compressive strength. The design of experiments is followed for the process parameter optimization. The experiment was carried out by varying three printing process parameters and four levels such as printing speed (10 mm/sec, 20 mm/sec, 30 mm/sec, and 40 mm/sec), layer height (0.10 mm, 0.15 mm, 0.20 mm, and 0.25 mm), and nozzle temperature (190°C, 200°C, 210°C, and 220°C). The L16 orthogonal array is employed for the experimental procedure and the Taguchi optimization technique is utilized for the optimization of the printing process parameters for obtaining maximum compressive strength for the fabricated gyroid TPMS lattice structure incorporated compression samples. The experimental results confirm that printing speed and layer height have major influence of 57.28% and 30.92% on the compressive properties of the fabricated samples. Based on the regression analysis results, it can be concluded that the proposed mathematical model has observed an error percentage of 2.1% and a good fit has been observed with the experimental results. The macroscopic view of the fractured samples depicts that the sample fabricated at a nominal printing speed of 20 mm/sec and layer height of 0.10 mm has obtained the highest compressive strength and lower buckling during compression test. The optimized combination of printing process parameters for obtaining maximum compressive strength is 20 mm/sec, 0.10 mm, and 210°C.