bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Influence of Self-Esteem and Psychological Flexibility on Medical College Students' Mental Health: A Cross-Sectional Study
Authors: Guo Jiamei , Huang Xin , Zheng Anhai , Chen Wanjun , Lei Zhongli , Tang Chenglu , Chen Hongyu , Ma Hongyan , Li Xuemei 
Published: May 2022

BackgroundMental health problems has become a major public health issue among medical students. Self-esteem and psychological flexibility were important associated factors for mental health, but their relations have not been discussed in medical students. The present study aimed to assess the status of mental health problems among medical students and identified whether psychological flexibility had a mediating role in the effects of self-esteem on the top three most common psychological symptoms.MethodsA total of 810 undergraduate students from 18 classes comprised in the sample. Nine dimensions of psychological symptoms was assessed by the Symptom Checklist-90-revised (SCL-90-R). Self-esteem was measured by the Self-esteem Scale (SES) and psychological flexibility was evaluated by the Acceptance and Action Questionnaire 2nd Edition (AAQ-II) and Cognitive Fusion Questionnaire (CFQ-F). Univariate analysis and logistic regression analysis were used to determine the relationship among the top three common psychological symptoms, self-esteem, psychological flexibility, and participants' characteristics. The mediating effect of psychological flexibility between self-esteem and psychological symptoms was detected by bootstrap method.Results57.8% of the medical undergraduate students reported positive at least one of the nine psychological symptom dimensions assessed by the SCL-90-R and 13.8% of students had moderate or more severe symptoms. The symptoms of obsessive-compulsiveness, interpersonal sensitivity, and depression were the three most common psychological symptoms among the medical students. Meanwhile, self-esteem and psychological flexibility were negatively associated to the symptoms of obsessive-compulsiveness, interpersonal sensitivity, and depression. And, almost 50% effects of self-esteem on these three symptoms in medical students exert indirect effects through psychological flexibility.ConclusionsPsychological distress was quite common in the Chinese medical students. The three most common psychological symptoms were successively obsessive-compulsiveness, interpersonal sensitivity, and depression. Low self-esteem and psychological inflexibility might be the risk factors for these top three symptoms, and psychological flexibility might play a mediating role in the effects of self-esteem on these psychological symptoms.
Otitis Media and Its Association With Hearing Loss in Chinese Adults: A Population Based Study of 4 Provinces in China
Authors: Luo Yanan , He Ping , Wen Xu , Gong Rui , Hu Xiangyang , Zheng Xiaoying 
Published: May 2022

ObjectiveOtitis media is a recognized cause of significant hearing loss, particularly in developing countries. This study aimed to investigate the relationship between otitis media and hearing loss in Chinese adults aged 18 years and older.MethodsThe survey was based on WHO Ear and Hearing Disorders Survey Protocol and 36,783 adults at the ages between 18 years and above were selected in this study. Trained local examiners performed pure tone audiometry to screen people with hearing loss, and those who were screened positively for hearing loss were referred to audiologists to make final diagnosis. All participants underwent clinical ENT check-up and otoscopic examination by doctors trained in ENT. Each participant was assigned a single middle ear diagnosis. Diagnoses were assigned as per the WHO classification of ear and hearing disorders.ResultsLogistic regressions showed that higher prevalence of hearing loss was found in participants with otitis media, with an unadjusted odds ratio of 5.67 (95%CI: 4.66, 6.90). The next two models (Model 2–3) had slight impact on ORs. The interaction of residency and otitis media was statistically significant (OR = 1.70, 95%CI = 1.15, 2.53); otitis media patients in rural areas had higher risk of hearing loss. However, this interaction became not significant in 65 years old and above participants.ConclusionsOtitis media was associated with the risk of hearing loss. Compared with urban patients with otitis media, rural patients have the higher risk of hearing loss. Action to reduce the risk of hearing loss in otitis media will require attention to rural-urban disparities.
Assessing the Utility of a Quality-of-Care Assessment Tool Used in Assessing Comprehensive Care Services Provided by Community Health Workers in South Africa
Authors: Babalola Olukemi , Goudge Jane , Levin Jonathan , Brown Celia , Griffiths Frances 
Published: May 2022

BackgroundFew studies exist on the tools for assessing quality-of-care of community health worker (CHW) who provide comprehensive care, and for available tools, evidence on the utility is scanty. We aimed to assess the utility components of a previously-reported quality-of-care assessment tool developed for summative assessment in South Africa.MethodsIn two provinces, we used ratings by 21 CHWs and three team leaders in two primary health care facilities per province regarding whether the tool covered everything that happens during their household visits and whether they were happy to be assessed using the tool (acceptability and face validity), to derive agreement index (≥85%, otherwise the tool had to be revised). A panel of six experts quantitatively validated 11 items of the tool (content validity). Content validity index (CVI), of individual items (I-CVI) or entire scale (S-CVI), should be &gt;80% (excellent). For the inter-rater reliability (IRR), we determined agreement between paired observers' assigned quality-of-care messages and communication scores during 18 CHW household visits (nine households per site). Bland and Altman plots and multilevel model analysis, for clustered data, were used to assess IRR.ResultsIn all four CHW and team leader sites, agreement index was ≥85%, except for whether they were happy to be assessed using the tool, where it was &lt;85% in one facility. The I-CVI of the 11 items in the tool ranged between 0.83 and 1.00. For the S-CVI, all six experts agreed on relevancy (universal agreement) in eight of 11 items (0.72) whereas the average of I-CVIs, was 0.95. The Bland-Altman plot limit of agreements between paired observes were −0.18 to 0.44 and −0.30 to 0.44 (messages score); and −0.22 to 0.45 and −0.28 to 0.40 (communication score). Multilevel modeling revealed an estimated reliability of 0.77 (messages score) and 0.14 (communication score).ConclusionThe quality-of-care assessment tool has a high face and content validity. IRR was substantial for quality-of-care messages but not for communication score. This suggests that the tool may only be useful in the formative assessment of CHWs. Such assessment can provide the basis for reflection and discussion on CHW performance and lead to change.
Getting Out of the Classroom and Into Nature: A Systematic Review of Nature-Specific Outdoor Learning on School Children's Learning and Development
Authors: Mann Jeff , Gray Tonia , Truong Son , Brymer Eric , Passy Rowena , Ho Susanna , Sahlberg Pasi , Ward Kumara , Bentsen Peter , Curry Christina , Cowper Rachel 
Published: May 2022

Background:The value of natural environments for developing children's self-identity and social skills has been known for some time, and more recently the potential of nature-specific (i.e., excluding built environments) outdoor learning for achieving academic outcomes has been explored. Connecting children with natural spaces has been shown to benefit their physical and mental health; however, the utility of nature-specific outdoor environments as a setting for curricular and non-curricular learning has yet to be clearly established. Our aim was to undertake a narrative synthesis of international evidence of nature-specific outdoor learning and its benefits for personal and social development, wellbeing and academic progress.MethodsThis systematic review searched publications between 2000 and 2020 in nine academic databases for evidence of socio-emotional and academic benefits of nature-specific outdoor learning in school-aged educational settings, using concise search criteria registered with PROSPERO. The total search results of 17,886 records were initially screened by title, and then two reviewers made blind reviews of the title and abstract of 1,019 records.Results147 original research studies meeting the criteria were identified. Learning settings ranged across outdoor adventure education, school gardens, field trips, and traditional school subjects taught in natural environments. Study characteristics were summarized, and risk-of-bias tools assessed quality of research as generally moderate, although with a wide range. The reported benefits of learning in natural outdoor settings include: increased student engagement and ownership of their learning, some evidence of academic improvement, development of social and collaborative skills, and improved self-concept factors.ConclusionsNature-specific outdoor learning has measurable socio-emotional, academic and wellbeing benefits, and should be incorporated into every child's school experience with reference to their local context. Teacher pre-service and in-service education needs to include a focus on how natural settings can be used effectively for learning. Further research is needed to clarify the conditions under which specific forms of outdoor learning are most efficacious for various target outcomes. It is recommended that future studies measuring outdoor learning adopt established methodologies to improve the quality of research in this field.Systematic Review Registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?RecordID=153171.
Research on the Construction and Prediction of China's National Fitness Development Index System Under Social Reform
Authors: Liu Zheng , Zhang Shijia , Li Lingling , Hu Bin , Liu Ran , Zhao Zhao , Zhao Yuanjun 
Published: May 2022

BackgroundNational fitness is a development plan formulated by China to promote people's participation in leisure and fitness, enhance people's physique, and realize the general goal of strengthening sports.MethodsBased on combing the development process of China's national fitness after reform and opening up, using the improved “balanced scorecard” method, this article constructs an evaluation index system of the national fitness development index.ResultsThe national fitness development index was established, including 4 first-level indicators, 14 second-level indicators, and 49 third-level indicators. It can calculate the national fitness development index with a total score of 100 points.ConclusionTo verify the feasibility of the evaluation system, the goal current situation evaluation method is used to calculate the national fitness development index during the 14th Five Year Plan period based on the development of national fitness during the 13th Five Year Plan period to provide evaluation tools and theoretical reference for the development of national fitness in China.
Blood Glucose Meter Buying Behavior of Diabetic Patients: Factors Influencing Purchase
Authors: Pan Bai-ling , Pan Yi-tong , Gao Zu-hua , Tung Tao-Hsin 
Published: May 2022

ObjectiveTo understand the blood glucose meter buying behavior of type 2 diabetic patients with poor glycemic control (two or more HbA1c ≥ 8% during visits in one year) and identify factors influencing it.MethodsA survey was conducted among 585 diabetic patients with poor glycemic control who were treated in the outpatient or inpatient clinics of the Department of Endocrinology, Taizhou Hospital, Zhejiang Province from June 2020 to May 2021. The questionnaire collected general information and clinical data, and assessed blood glucose meter buying behavior. Chi-square test was used to compare the essential characteristics and clinical data between buyers and non-buyers of blood glucose meters. Additionally, stepwise logistic regression was used to analyze the factors influencing purchase.ResultsOf the 585 questionnaires distributed, 527 (90.09%) valid questionnaires were collected. Of the 527 respondents, 285 (54.08%) had purchased blood glucose meters. Not receiving insulin therapy (OR: 1.77, 95% CI: 1.13–2.77) and unawareness of self-monitoring of blood glucose (OR: 19.46, 95% CI: 12.51–30.26) were risk factors for non-purchase.ConclusionThere is a need to actively increase the purchase of glucose meters among diabetic patients, by educating them about the importance of self-monitoring of blood glucose.
Research Hotspots and Trends Analysis of Patellar Instability: A Bibliometric Analysis from 2001 to 2021
Authors: Zheng Zitian , Xu Wennan , Xue Qingyun 
Published: May 2022

BackgroundPatellar instability is a common multifactorial disease in orthopedics, which seriously affects the quality of life. Because of the unified pathogeny, diagnosis and treatment, patellar instability has gradually attracted the interest of more scholars these years, resulting in an explosive growth in the research output. This study aims to summarize the knowledge structure and development trend in the field from the perspective of bibliometrics.MethodsThe data of articles and reviews on patellar instability was extracted from the Web of Science database. The Microsoft Excel, R-bibliometrix, CiteSpace, VOSviewer, Pajek software are comprehensively used to scientifically analyze the data quantitatively and qualitatively.ResultsTotally, 2,155 papers were identified, mainly from North America, Western Europe and East Asia. Until December 31, 2021, the United States has contributed the most articles (1,828) and the highest total citations (17,931). Hospital for Special Surgery and professor Andrew A Amis are the most prolific institutions and the most influential authors respectively. Through the analysis of citations and keywords based on a large number of literatures, “medial patellofemoral ligament construction”, “tibial tubercle-trochlear groove (TT-TG) distance”, “epidemiological prevalence”, “multifactor analysis of etiology, clinical outcome and radiographic landmarks “ were identified to be the most promising research directions.ConclusionsThis is the first bibliometric study to comprehensively summarize the research trend and development of patellar instability. The result of our research provides the updated perspective for scholars to understand the key information in this field, and promote future research to a great extent.
Intestinal Continuity Alleviates Pediatric Intestinal Failure-Associated Liver Disease
Authors: Wang Jinling , Yan Weihui , Lu Lina , Tao Yijing , Huang Liufang , Cai Wei , Wang Ying 
Published: May 2022

BackgroundType I short bowel syndrome (SBS) occurs after a critical reduction in the functional gut mass and resection of intestinal continuity after ileostomy or jejunostomy for necrotizing enterocolitis (NEC), intestinal atresia or other causes. SBS is often accompanied with intestinal failure-associated liver disease (IFALD) who requires long-term parenteral nutrition (PN). Our study aimed to observe the effect of intestinal continuity on the hepatic function of pediatric intestinal failure (IF) patients with type I SBS.MethodsThe pre-and post-anastomosis medical records of 35 pediatric patients with type I SBS from April 2013 to April 2019 were reviewed retrospectively. The average growth (cm/month) in the proximal and distal small bowel lengths was calculated as the growth in intestinal length (cm)/the duration (month) from enterostomy to anastomosis. The changes in hepatic function from enterostomy to anastomosis were evaluated by assessment of hepatic function before anastomosis for 6 weeks and after anastomosis for 4 weeks.ResultsThe average growth in proximal intestinal length was 9.3 cm/month (±7.2) in neonates and 2.8 cm/month (1.3, 11.9) in infants and children, and in distal intestinal length was 1.5 cm/month (0, 2.7) in neonates and 0.4 cm/month (0, 1.4) in infants and children. The incidence of IFALD was 28.6% 1 month before anastomosis and 20.0% 1 month after anastomosis (p &lt; 0.05).ConclusionIn pediatric type I SBS with IFALD, restoration of intestinal continuity may alleviate liver injury. There was an intestinal compensatory effect on the growth in the intestinal length after resection, and better results were seen in neonates in terms of intestinal length growth.
Use of a supercritical fluid treatment to improve switching region in resistive random access memory
Authors: Lin Shih-Kai , Chen Min-Chen , Chang Ting-Chang , Lien Chen-Hsin , Wu Cheng-Hsien , Lin Yu-Shuo , Wu Pei-Yu , Tan Yung-Fang , Huang Wei-Chen , Zhang Yong-Ci , Chou Sheng-Yao , Wu Chung-Wei , Sze Simon M. 
Published: May 2022

Abstract
This work investigates the influence of a supercritical fluid (SCF) treatment on the characteristics of resistive random access memory. A comparison between the experimental results for the device at initial, after the overset process, and after the SCF treatment, shows that the treatment dopes oxygen ions and generates defects in the switching region (SR). Moreover, the changes in the ratio of the components of the SR after the SCF treatment improve memory characteristics, including a lower set/reset voltage (V
SET/V
RESET), and higher resistances at low resistance state and high resistance state.
IGZO synaptic thin-film transistors with embedded AlO
x
charge-trapping layers
Authors: Lee Yeojin , Jo Hyerin , Kim Kooktae , Yoo Hyobin , Baek Hyeonjun , Lee Dong Ryeol , Oh Hongseok 
Published: May 2022

Abstract
We report the fabrication and characterization of indium gallium zinc oxide (IGZO)-based synaptic thin-film transistors. Radio-frequency magnetron-sputtered AlO
x
thin films are embedded in the IGZO channel as charge-trapping layers to provide synaptic behavior. The voltage pulse introduced at the gate electrodes traps or de-traps charges in the embedded AlO
x
layer thus modulates the channel current, which in turn leads to the ability to mimic biological synaptic behaviors such as excitonic postsynaptic current, paired-pulse facilitation, and potentiation and depression. Simulation results suggest that the device can perform properly as a synaptic unit in an artificial neural network.
إتجاهات الطلبة في فنون الرسم وعلاقتها بانجازهم الفني في الكلية التربوية المفتوحة - دراسة تحليلية
Authors: Assistant Professor Dr.Hazem Aboudi Al-Saeedi  
Published: May 2022

يعنى البحث بدراسة " اتجاهات الطلبة في فنون الرسم وعلاقتها بانجازهم الفني في الكلية التربوية المفتوحة " مركز كربلاء تحديدا بدراسة تحليلية تهدف الى الوقوف على المنجز المنفذ بالرسم بالزيت من حيث بنيته الفنية وبحسب ماتم انجازه من اعمال زيتية للعام الدراسي (2015\2019) لطلبة قسم التربية الفنية في مركز كربلاء تحديدا وذلك لاجل الوصول الى بيانات استغلت في التحليل كمنهج وصفي نوعي.تضمن الفصل الاول عرضا لمشكلة البحث وتلخيصها في امكانية الاجابة عن التساؤل "كيف تمثلت اتجاهات الطلبة في فن الرسم وما القيمة الجمالية المتحققة من ذلك ؟" فضلا عن اهمية دورية لحصر المنتج الفني المتميز للطلبة والسعي الى تفعيل الطروحات الفكرية والفلسفية والجمالية ،اما الفصل الثاني فذهب الى الاطار النظري ومؤشراته التي من شأنها ان تحقق اليات التحليل في الدراسة الحالية ضمن مباحث اولها \المدارس الفنية واتجاهاتها في الرسم وثانيها \ دلالات الرسم وعلاقته بخطاب فلسفة الجمال المبحث الثالث \ بنية المنجز الفني في الرسم والتربية الفنية، في حين جاء الفصل الثالث في اجراءات البحث ومجتمعه المكون من (14) نموذجا وفقا لمنهج تحليل العينة المتكون من (3) فقط اختيرت قصديا واعتماد المنهج الوصفي في تحليل محتوى الاعمال .كما جاء الفصل الرابع شاملا على اهم النتائج والاستنتاجات والتوصيات والمقترحات. ومن النتائج :

يعتبر الرسم تعبيرا عن تلاقح الافكار والثقافات وانه وسيلة اتصال ولغة .

2.هدفت الرسوم الى تسجيل الواقع بأدق تفاصيله العينية

ارتبطت الرسوم بصناعة اللوحة التجارية .

4.هنالك تقارب بيني فيما رسمه الطلبة في التعبير عن خواص اللوحة الفنية .
5. هنالك تأكيد على فهم الاخلاقيات العرفية والسنن في المجتمع العراق
اثر استراتيجية لاحظ - اعكس - اشرح في اكتساب المفاهيم التاريخية لدى طلاب الصف الخامس الادبي في مادة التاريخ
Authors: M. Raad Jaber Shani Al-Zalmi  
Published: May 2022

هدف البحث التعرف (أثر استراتيجية لاحظ - اعكس - اشرح في اكتسـاب المــــــــفاهيم التاريخية لدى طلاب الصف الخامس الادبي في مادة التــــــــاريخ ) ولتحقيق ذلك اختار الباحث تصميما تجريبيا ذا الضبط الجزئي للمجــــــموعتين التجريبية والضابطة ذوات الاختبار البعدي واختار الباحث عــشوائيا طلاب الصف الخامس الادبي في مدرسة ثانوية الفارابي للبنين حــيث تكونت العينة من (60 ) طالبا بواقع (30) طالبا في المجموعة التجريبية التي يدرس طـــــلابها على وفق استراتيجية لاحظ - اعكس - اشرح ، و(30) طالبا في المجموعة الضابطة التي يدرس طلابها على وفق الطريقة الاعتيادية ؛ وكافا الباحث بين مجموعتي البحث في ( العمر الزمني للـــــــطلاب محسوبا بالأشهر , ودرجات التحصيل السابق في مادة التاريخ , ومتغير الذكاء ) بعدها تم تحديد المادة العلمية والتي شملت الفصول الاربعة الاخيرة من كتاب التاريخ الحــــــــديث والمعاصر للصف الخامس الادبي , وصاغ اهدافا سلوكية اعتمدت على تصنيف بــــلوم للمستويات الست ( معرفة , فهم , التطبيق , التحليل , التركيب , التقويم ) عــــــــددها (126) هدفا , واعد مجموعة من الخطط التدريسية للموضوعات في مادة التاريخ , وتماشيا مع هــــــــدف البحث اعد الباحث اختبار اكتساب المفاهيم التاريخية من نوع الاختيار من متعدد تكون بصورته النهائية من (45) فقرة تم التحقق من صدقها الظاهري بعرضها على مجموعة من المحكــــــمين والمتخصصين في طرائق التدريس وتم استخراج معامل الصعوبة والقوة التميزية لفقراتـــــه فضلا عن بيان مدى فعالية البدائل واستخرج ثبات الاختبار بطريقة التجزئة النصفية وصــــحح بمعادلة بيرسون ومن ثم معادلة سبيرمان براون , وفي نهاية التجربة طبق الاختبار على طلاب مجموعتي البحث واعتمد الاختبار التائي لعينيتين مستقلتين لمعالجة البيــــانات احصائيا اذ اظهرت النتائج تفوق المجموعة التجريبية التي درست باستراتيجية لاحظ - اعكس - اشرح عـــــلى المجموعة الضابطة التي درست بالطريقة الاعتيادية في اختبار اكتساب المفاهيم التاريخية , وفي ضوء ذلك اوصى الباحث باستعمال استراتيجية لاحظ - اعكس - اشرح في تدريس مادة التاريـــــخ
Decentralized Aggregation for Energy-Efficient Federated Learning via Overlapped Clustering and D2D Communications
Authors: S. Al-Abiad Mohammed , Obeed Mohanad , Hossain Md. Jahangir , Chaaban Anas 
Published: May 2022

<p>Federated learning (FL) has emerged as a distributed machine learning (ML) technique to train models without sharing users' private data. In this paper, we propose a decentralized FL scheme that is called \underline{f}ederated \underline{l}earning \underline{e}mpowered \underline{o}verlapped \underline{c}lustering for \underline{d}ecentralized aggregation (FL-EOCD). The introduced FL-EOCD leverages device-to-device (D2D) communications and overlapped clustering to enable decentralized aggregation, where a cluster is defined as a coverage zone of a typical device. The devices located on the overlapped clusters are called bridge devices (BDs). In the proposed FL-EOCD scheme, a clustering topology is envisioned where clusters are connected through BDs, so as the aggregated models of each cluster is disseminated to the other clusters in a decentralized manner without the need for a global aggregator or an additional hop of transmission. Unlike the star-based FL, the proposed FL-EOCD scheme involves a large number of local devices by reusing the RRBs in different non-adjacent clusters. To evaluate our proposed FL-EOCD scheme as opposed to baseline FL schemes, we consider minimizing the overall energy-consumption of devices while maintaining the convergence rate of FL subject to its time constraint. To this end, a joint optimization problem, considering scheduling the local devices/BDs to the CHs and computation frequency allocation, is formulated, where an iterative solution to this joint problem is devised. Extensive simulations are conducted to verify the effectiveness of the proposed FL-EOCD algorithm over FL conventional schemes in terms of energy consumption, latency, and convergence rate.</p>