bluuebunny/crossref_metadata_2025_split huggingface dataset:
Predictors of psychological risk and resilience among Syrian refugee children
Authors: Popham Cassandra M. , McEwen Fiona S. , Karam Elie , Fayyad John , Karam Georges , Saab Dahlia , Moghames Patricia , Pluess Michael 
Published: July 2022

ObjectivesWar‐exposed refugee children are at elevated risk for mental health problems, but a notable proportion appear resilient. We aimed to investigate the proportion of Syrian refugee children who can be considered resilient, and applied a novel approach to identify factors predicting individual differences in mental health outcomes following war exposure.MethodsThe sample included 1,528 war‐exposed Syrian refugee children and their primary caregiver living in refugee settlements in Lebanon. Children were classed as having low symptoms (LS) if they scored below clinically validated cut‐offs for post‐traumatic stress disorder (PTSD), depression and externalising behaviour problems. Children scoring above any cut‐off were classified as having high symptoms (HS). Each LS child was matched with one HS who reported similar war exposure, to test what differentiates children with similar exposures but different outcomes.Results19.3% of the children met our resilience criteria and were considered LS. At the individual level, protective traits (e.g. self‐esteem; OR = 1.51, 95% CI [1.25, 1.81]) predicted LS classification, while environmental sensitivity (OR = 0.69, 95% CI [0.59, 0.82]), poorer general health (OR = 0.71, 95% CI [0.58, 0.87]) and specific coping strategies (e.g. avoidance; OR = 0.90, 95% CI [0.85, 0.96]) predicted HS classification. Social/environmental predictors included perceived social support (OR = 1.23, 95% CI [1.02, 1.49]), loneliness and social isolation (OR = 0.85, 95% CI [0.80, 0.90]), child maltreatment (OR = 0.96, 95% CI [0.94, 0.97]), and caregiver mental and general health (e.g. caregiver depression; OR = 0.94, 95% CI [0.92, 0.97]).ConclusionsFuture research should take multiple dimensions of functioning into account when defining risk for mental health problems and consider the identified predictors as potential targets for interventions.
Experimental test of selection against hybridization as a driver of avian signal divergence
Authors: Kenyon Haley L. , Martin Paul R. 
Published: July 2022

AbstractSignal divergence may be pivotal in the generation and maintenance of new biodiversity by allowing closely related species to avoid some costs of co‐occurrence. In birds, closely related, sympatric species are more divergent in their colour patterns than those that live apart, but the selective pressures driving this pattern remain unclear. Traditionally, signal divergence among sympatric species is thought to result from selection against hybridization, but broad evidence is lacking. Here, we conducted field experiments on naïve birds using spectrometer‐matched, painted 3D‐printed models to test whether selection against hybridization drives colour pattern divergence in the genus Poecile. To address selection for male colour pattern divergence without the influence of learning or the evolution of female discrimination in sympatry, we simulated secondary contact between Poecile species, and conducted mate choice experiments on naïve, allopatric females. We found that female black‐capped chickadees (Poecile atricapillus) are equally likely to perform copulation solicitation displays to sympatric and allopatric heterospecific congeners when they are paired with conspecifics, but exhibit a strong preference for less divergent males when presented with paired heterospecific congeners. These results suggest that increased colour pattern divergence among sympatric species can reduce the likelihood of mixed mating in some contexts, and therefore should be favoured by selection against hybridization.
The physiotherapy workforce in Nepal: A national survey
Authors: Nepal Govinda Mani , Acharya Ranjeeta S. , Coppieters Michel W. , Bimali Inosha , Poudel Sajana , Chaudhary Bikesh , Sharma Saurab 
Published: July 2022

AbstractBackgroundPhysiotherapy is a relatively young profession in Nepal. Education standards, and workforce organization and representation have improved in recent years, but there is no detailed workforce data to support decision‐making and long‐term planning. Therefore, this study aimed to describe the demographic characteristics, physiotherapy practice areas, settings and employment characteristics of physiotherapists in Nepal; and to document job satisfaction and the factors that influence it.MethodsIn a cross‐sectional survey, we asked Nepali physiotherapists about their sociodemographic characteristics, employment or physiotherapy practice area and settings, and job satisfaction. We assessed the associations between sociodemographic factors and job satisfaction among physiotherapists using univariable and multivariable logistic regressions. We invited all Nepali physiotherapists to participate via email, social media and visits to hospitals.ResultsOf the 1120 physiotherapists who were contacted, 52% (female: 287; male: 293) completed the survey. The majority of the participants (75%) were less than 30 years old. The majority (73%) held a Bachelor of Physiotherapy degree. Eighty percent were employed at the time of data collection; 58% had 1–4 years of experience. The majority (77%) practiced in or near the capital Kathmandu. Most physiotherapist worked either in private hospitals (46%) or in private physiotherapy practices (26%), rehabilitation centres (19%) and 11% practiced in public hospitals. The most common areas of practice were musculoskeletal physiotherapy (90%) and adult neurology (67%). More than half of the physiotherapist (53%) felt that they were underpaid and 41% were not satisfied with their current job status. The majority of the physiotherapists (67%) reported that they participated in continuing professional development activities. Multivariable logistic regression showed that physiotherapists who had a higher remuneration were more likely to be satisfied with their job.ConclusionsThe majority of the physiotherapy workforce in Nepal is well‐educated, young and at an early career stage. Most physiotherapists work in musculoskeletal and adult neurological physiotherapy, in private practices or private hospitals near Kathmandu. Job dissatisfaction was common and was related to low annual income. This first nationwide survey described the current physiotherapy workforce and provides comparison data for future physiotherapy workforce surveys.
The role and mechanisms of the two‐component system EnvZ/OmpR on the intracellular survival of Aeromonas hydrophila
Authors: Du Ziyan , Zhang Mengmeng , Qin Yingxue , Zhao Lingmin , Huang Lixing , Xu Xiaojin , Yan Qingpi 
Published: July 2022

AbstractAeromonas hydrophila infections are common in aquaculture. Our previous studies found that the A. hydrophila B11 strain can survive in fish macrophages for at least 24 h and the two‐component system EnvZ/OmpR may be involved in intracellular survival. To reveal the role and mechanism of the two‐component system EnvZ/OmpR in intracellular survival of A. hydrophila, the genes of envZ/ompR were silenced by shRNAi. The results showed that the survival rates of the envZ‐RNAi and ompR‐RNAi strains were only 2.05% and 3.75%, respectively, which were decreased by 91% and 83.6% compared with that of the wild‐type strain. The escape ability of envZ‐RNAi and ompR‐RNAi was also decreased by 51.4% and 19.7%, respectively. The comparative transcriptome analysis revealed that the functional genes directly related to bacterial intracellular survival mainly included the genes related to anti‐stress capacity, and the genes related to Zn2+ and Mg2+ transport. Further research confirmed that two‐component system EnvZ/OmpR can regulate the expression of the important molecular chaperones, such as groEL, htpG, dnaK, clpB and grpE. The expression of these molecular chaperones in wild‐type strain was up‐regulated with the increase in H2O2 concentrations, while the expression of these molecular chaperones in silent strains did not change significantly. Cells that phagocytosed wild‐type strain had higher ROS content than cells that phagocytosed silent strains. Two‐component system EnvZ/OmpR could also regulate zinc transporter (znuA, znuB, znuC) and zinc efflux protein (zntA) to maintain zinc homeostasis in cells, thus affecting the ability of bacteria to survive in phagocytes. Moreover, two‐component system EnvZ/OmpR could affect the growth and intracellular survival of A. hydrophila by regulating the expression of MgtA, MgtC and MgtE and participating in bacterial Mg2+ homeostasis in fish macrophages.
Impact of the MTHFR C677T polymorphism on blood pressure and related central haemodynamic parameters in healthy adults
Authors: Rooney Martina , Hughes Catherine F. , Strain J. J. , Clements Michelle , McNulty Helene , Ward Mary 
Published: July 2022

AbstractBackgroundThe C677T polymorphism in the gene‐encoding methylenetetrahydrofolate reductase (MTHFR) is associated with an increased risk of hypertension and cardiovascular disease. Riboflavin, the MTHFR cofactor, is an important modulator of blood pressure (BP) in adults homozygous for this polymorphism (TT genotype). The effect of this genetic variant on BP and related central haemodynamic parameters in healthy adults has not been previously investigated and was examined in this study.MethodsBrachial BP, central BP and pulse wave velocity (PWV, SphygmoCor XCEL) were measured in adults aged 18–65 years prescreened for MTHFR genotype. Riboflavin status was assessed using the erythrocyte glutathione reductase activation coefficient assay.ResultsTwo hundred and forty‐two adults with the MTHFR 677TT genotype and age‐matched non‐TT (CC/CT) genotype controls were identified from a total cohort of 2546 adults prescreened for MTHFR genotype. The TT genotype was found to be an independent determinant of hypertension (p = 0.010), along with low‐riboflavin status (p = 0.002). Brachial systolic and diastolic BP were higher in TT versus non‐TT adults by 5.5 ± 1.2 and 2.4 ± 0.9 mmHg, respectively (both p < 0.001). A stronger phenotype was observed in women, with an almost 10 mmHg difference in mean systolic BP in TT versus non‐TT genotype groups: 134.9 (95% confidence interval [CI] 132.1–137.6) versus 125.2 (95% CI 122.3–128.0) mmHg; p < 0.001. In addition, PWV was faster in women with the TT genotype (p = 0.043).ConclusionThis study provides the first evidence that brachial and central BP are significantly higher in adults with the variant MTHFR 677TT genotype and that the BP phenotype is more pronounced in women.
Measurement of mid‐arm circumference as a starting point for nutritional assessment of patients with decompensated cirrhosis: A prospective cohort study
Authors: Saueressig Camila , Luft Vivian C. , Dall'Alba Valesca 
Published: July 2022

AbstractBackgroundThe mid‐arm circumference (MAC) is an accessible, quick, and inexpensive measurement, which can be performed at the bedside only with a measuring tape. In this sense, the present study aims to suggest MAC cut‐off values to assess the nutritional status and its association with mortality of hospitalised patients with decompensated cirrhosis.MethodsA prospective cohort study was performed with decompensated cirrhotic patients. Nutritional status was assessed by MAC and Subjective Global Assessment (SGA). Considering the SGA as the reference standard and based on receiver operating characteristic curve analysis, the MAC cut‐off values with the best sensitivity and specificity were selected. Predictors of mortality were identified using multivariate analysis.ResultsThe study included 100 patients with a mean ± SD age of 60.1 ± 10.3 years. The median follow‐up time was 11.2 months and overall mortality was 60%. Considering malnutrition assessed by SGA as the reference standard, the area under the curve of MAC for women and men was 0.947 (95% confidence interval [CI] = 0.878–1.000) and 0.813 (95% CI = 0.694–0.932). The MAC cut‐off values of ≤ 28 cm for women and ≤ 30 cm for men reached a sensitivity and specificity of 85.5% and 71%, respectively. According to multivariate analysis, a low MAC was significantly associated with mortality (hazard ratio = 2.41; 95% CI = 1.20–4.84).ConclusionsThe MAC cut‐off values had satisfactory accuracy for men and women in predicting malnutrition. Additionally, a low MAC was an independent predictor of mortality. Thus, these MAC cut‐off values can be used as the first step of nutritional assessment to prioritise patients who require more detailed assessment.
Humanization of care in acute psychiatric hospitalization units: A scoping review
Authors: Sanz‐Osorio María T. , Sastre‐Rus Meritxell , Monistrol Olga , Pérez Criado Monica , Vallès Vicenç , Escobar‐Bravo Miguel A. 
Published: July 2022

Accessible SummaryWhat is known on the subject?

Humanizing the world of health is a complex process that includes all the dimensions of the person. When a person has from a mental illness, the humanization of care becomes more important, as the disorder itself prevents the person to participate in their health process, even when showing self‐harm or aggressive behaviours.

These situations jointly with other factors related with professionals (insufficient ratio, inadequate treatment or lack of training) may cause the patient admitted to the acute psychiatric hospitalization unit to require the use of restrictive measures (involuntary admissions, mechanical restraints or forced administration of medication).

What the paper adds to existing knowledge?

We identify the relevance of the perception the patient and family have regarding the care received, as well as the relevance of factors related to the professionals, among which the attitude, the staff ratio, the nursing time of direct dedication, and the therapeutic environment and safety of the patient and the professionals. All patients must be treated with dignity, respect, regardless of the aggressive manifestations caused by their pathology.

What are the implications for practice?

A greater understanding of the care offered to admitted people affected by a mental disorder, their families and professionals who care for them in acute mental health units, giving greater importance to “caring” and not exclusively to “curing.”

AbstractIntroductionHumanization in Mental Health refers to give the same relevance to the clinical needs and to the social, emotional and psychological needs.AimTo identify the published knowledge on current care models related to the humanization of care in acute psychiatric units.MethodScoping review based on the methodological model of Arksey and O'Malley, and PRISMA methodology. Database searches (Pubmed, Cinahl, Virtual Library, Cuiden, Academic Google and PsycInfo) with the terms: “Humanization,” “Hospitals Psychiatric,” “Emergency Psychiatric,” “Psychiatric Service” and “Psychiatric intensive care units.”ResultsTwenty‐two articles met the inclusion criteria. Four thematic units were identified: aspects related to (i) patient perceptions; (ii) Government policies and hospitality organizational culture; (iii) external factors such as the environment, family or associations; and (iv) safety and security.DiscussionOnly one of the articles mentions the concept analysed, although all of them contribute with key aspects of healthcare humanization, such as the empowerment of the patient, the care model, the staff ratio, the therapeutic relationship, the nursing time of direct dedication to the patient, the therapeutic environment, safety and patient and staff perception of feeling safe.Implications for PracticeThe present study can help to improve the care offered in acute mental health units.
In search of a better CPAP interface: A network meta‐analysis comparing nasal masks, nasal pillows and oronasal masks
Authors: Chen Li‐Yang , Chen Yung‐Hsuan , Hu Shih‐Wen , Lin Ming‐Tzer , Lee Pei‐Lin , Chiang Ambrose A. , Tu Yu‐Kang 
Published: July 2022

SummaryUntil now, no study has directly network meta‐analysed the impact of nasal masks, nasal pillows and oronasal masks on continuous positive airway pressure therapy in patients with obstructive sleep apnea. This study aimed to meta‐analyse the impact of three kinds of nasal interfaces with both network meta‐analysis and pairwise comparison. PubMed, EMBASE, CENTRAL and ClinicalTrials.gov were systematically searched from inception to December 2020 for studies that compared the three types of nasal interfaces for treating obstructive sleep apnea with continuous positive airway pressure. The outcomes were residual apnea–hypopnea index, continuous positive airway pressure, and nightly average usage. The network meta‐analysis was conducted using multivariate random‐effects in a frequentist framework where three interfaces were ranked with the surface under the cumulative ranking probabilities. The pairwise comparison was conducted using random‐effects meta‐analysis. Twenty‐nine articles comprising 6378 participants were included. The pairwise comparison showed both nasal masks and nasal pillows were associated with lower residual apnea–hypopnea index, lower continuous positive airway pressure, and higher continuous positive airway pressure adherence compared with oronasal masks. The surface under the cumulative ranking confirmed that nasal masks were associated with the lowest residual apnea–hypopnea index and highest adherence, while pillows were associated with the lowest continuous positive airway pressure. The meta‐regression identified that lower pretreatment apnea–hypopnea index and continuous positive airway pressure determined during continuous positive airway pressure titration (versus determined during continuous positive airway pressure therapy) was associated with lower continuous positive airway pressure with nasal masks and nasal pillows. In conclusion, compared with oronasal masks, nasal masks and nasal pillows are better interfaces, especially in patients with lower pretreatment apnea–hypopnea index and those with the therapeutic pressure determined during continuous positive airway pressure titration.
Efficacy of tadalafil on symptom‐specific bother in men with lower urinary tract symptoms
Authors: Hirahara Naoki , Harikai Shunji , Fujihara Atsuko , Yamada Yasuhiro , Ushijima So , Ukimura Osamu ,   KPUM‐LUTS Research Group
Published: July 2022

AbstractIntroductionThis multicenter and prospective study was performed to evaluate the efficacy of tadalafil on patient‐reported bother for each symptom in men with lower urinary tract symptoms (LUTS).MethodsMen with LUTS received 5 mg of tadalafil daily for 4 weeks. We assessed change in symptom severity using both international prostate symptom score (IPSS), and overactive bladder symptom score (OABSS), as well as patient‐reported quality of life (QOL: bother or satisfaction) for each symptoms using IPSS‐visual analog scale (IPSS‐VAS) and OABSS‐VAS.ResultsWe found significant improvements in total IPSS (P < 0.001), including voiding symptoms (P < 0.001), storage symptoms (P < 0.001), and QOL (P < 0.001). All VAS measures corresponding to symptoms in IPSS and OABSS also significantly improved (P < 0.001). The most bothersome symptoms for each patient at baseline evaluated by VAS measures significantly improved (P < 0.001). Patients whose most bothersome symptoms at baseline included IPSS‐Q7 (nocturia) showed significantly smaller improvement of VAS measure after treatment than those without it (P = 0.024).ConclusionsDaily tadalafil significantly improved not only symptom severity of LUTS but also patient‐reported QOL on each symptom.
Concurrent effect of crown‐of‐thorns starfish outbreak and thermal anomaly of 2020 on coral reef communities of the Spratly Islands (South China Sea)
Authors: Tkachenko Konstantin S. , Hoang Duong Thuy 
Published: July 2022

AbstractThe Spratly Islands are a remote group of more than 150 coral reefs and islands scattered in the south‐central South China Sea and representing a biodiversity hotspot in the region. An integrative anthropogenic impact and increased frequency of thermal anomalies have increasingly been threatening these unique reef ecosystems over the last three decades. The repetitive surveys conducted on four coral reef sites within the Spratly Islands in 2018–2019 and in 2021 revealed a significant decrease of coral cover, particularly of acroporids, a decrease of species diversity and an outbreak of crown‐of‐thorns starfish (COTS) Acanthaster planci (the variation of starfish abundance was 1–18 starfish/100 m2). Moreover, one of two additional sites, located within the same study reefs, revealed a coral‐killing photoautotrophic cyanosponge Terpios hoshinota, covering 56.9% of all dead scleractinian colonies on the reef slope of this site. Analysis of sea surface temperature dynamics during the last 4 years (2018–2021) in the Spratly area allowed suggesting the concurrent negative effect of the COTS outbreak and the thermal anomaly of 2020 on local coral communities. This effect may have contributed to the general trends in coral reef decline in the area of the Spratly archipelago under the condition of repetitive thermal stress and increasing anthropogenic impact.
The benefits, challenges and impacts of accessing social media group support for breastfeeding: A systematic review
Authors: Morse Holly , Brown Amy 
Published: July 2022

AbstractBreastfeeding support is a key component in meeting the public health responsibility of increasing breastfeeding rates, with access to individualised, convenient and linked support across services central to improved outcomes. With the rise of new technology and the COVID‐19 pandemic, social media (SM) support for breastfeeding has become increasingly popular and it is important to understand how and why mothers access such support, and from whom, to optimise services and to meet mothers’ needs. Increasing research is building on women's use and experience of SM for breastfeeding, although there is a paucity of UK data. This systematic review aimed to understand the impacts of SM support for breastfeeding, including benefits and challenges, to establish the evidence for wider provision within maternity services. The search was limited to studies published in English and focused on the self‐directed use of social media groups for breastfeeding (defined as platforms that facilitate group support via interactivity, allowing for user‐generated content and subsequent responses). Of 327 papers retrieved, 13 studies were included for review. The six themes identified were: breastfeeding context, including factors impacting women's decision making; the relational impact of belonging to an online community; increased self‐efficacy; critiques of SM; the nature and types of support commonly sought and received; and breastfeeding duration as an outcome. The findings confirm that mothers value SM groups for community support, which normalises breastfeeding and provides the support they attribute to improved outcomes, and highlight that UK research focused on provision linked to wider services is needed.