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Hina Yaqoob,1 Xing-Da Ju,1,2 Samrah Jamshaid1 1School of Psychology, Northeast Normal University, Changchun, Jilin, People’s Republic of China; 2Jilin Provincial Key Laboratory of Cognitive Neuroscience and Brain Development, Northeast Normal University, Changchun, Jilin, People’s Republic of ChinaCorrespondence: Xing-Da Ju, School of Psychology, Northeast Normal University, No. 5268, Renmin Street, Changchun, Jilin, 130024, People’s Republic of China, Email juxd513@nenu.edu.cnPurpose: Childbirth represents a significant life event, bringing about both physical and emotional transformations in a woman’s life. Among other psychological aspects associated with childbirth, labor pain, death anxiety, and postpartum depression have garnered significant attention in the field of maternal and reproductive health. This study is intended to evaluate how the effectiveness of hypnobirthing training alleviates labor pain, mitigates death anxiety enhances postpartum well-being reduces labor hours, and how anxiety exacerbates the duration of labor.Methods: Data were collected from (N = 50) young and middle-aged postpartum women in the outpatient obstetrics and gynecology departments of the Civil Hospital, Waseer Gynecology Hospital and Basic Health Unit Jalal Ballagan in Gujranwala, Pakistan, by using the convenience sampling technique. Out of 50, women were divided into a control (N = 25) and an experimental group (N = 25). They were recruited during their 33 weeks of pregnancy until childbirth for hypnobirthing training. Numerical Pain Rating Scale (NPRS), Templer Death Anxiety Scale (TDAS), and Edinburgh Postnatal Depression Scale (EPDS) were used to collect participants’ responses.Results: Findings proved hypnobirthing training as a catalyst in significantly reducing labor pain, death anxiety, and postpartum depression. Furthermore, the analysis indicated that death anxiety exacerbates the labor duration hours and hypnobirthing decreases the labor hours in the experimental group of women.Conclusion: It sheds light on the effectiveness of hypnobirthing training to enhance the birthing process. Findings underscore the significance of collaboration between obstetricians, psychologists, and mental health professionals to develop integrated care plans that address both physical and psychological aspects of childbirth.Keywords: labor pain, death anxiety, postpartum depression, hypnobirthing training, vaginal delivery, first time mothers

Samrah Jamshaid,1,2 Noor Bahadar,3 Kamran Jamshed,4 Misbah Rashid,5 Muhammad Imran Afzal,2 Lv Tian,1 Muhammad Umar,6 Xuechao Feng,7 Imtiaz Khan,8 Minru Zong1 1Department of Rehabilitation, China-Japan Union Hospital of Jilin University, Changchun, Jilin, People’s Republic of China; 2School of Psychology, Northeast Normal University, Changchun, Jilin, People’s Republic of China; 3Department of Transgenic Animals, Changchun WISH Testing Technology & Service Co, Ltd, Building E11, Beihu Science Park B, Changchun, Jilin, People’s Republic of China; 4Business School, Bahria University Islamabad, Islamabad, Pakistan; 5Department of Psychology, Institute of Southern Punjab, Multan, Pakistan; 6Department of Orthopaedics, Shenzhen University General Hospital, Shenzhen, People’s Republic of China; 7Key Laboratory of Molecular Epigenetics, Institute of Genetics and Cytology, Northeast Normal University, Changchun, Jilin, People’s Republic of China; 8Department of Weed Science and Botany, The University of Agriculture Peshawar, Peshawar, KPK, PakistanCorrespondence: Minru Zong, Department of Rehabilitation, China-Japan Union Hospital of Jilin University, No. 126 Xiantai Street, Changchun, Jilin, 130033, People’s Republic of China, Email zongmr@jlu.edu.cnPurpose: International students are highly vulnerable to the risk of mental health worsening before and during the pandemic (COVID-19). This study investigated international students’ mental health pre- and post-pandemic (COVID-19).Methods: It is a longitudinal study, and data were collected online, pre-pandemic (N = 470) and during the pandemic (N = 420). Using a random sampling technique, a self-administered questionnaire was used to measure mental health, including depression and anxiety.Results: Findings show that international students’ mental health was good in pre-pandemic. Meanwhile, international students were found to be more depressed and anxious during the pandemic. Findings also investigated that in the pre-pandemic phase, young students’ and mainly females’ mental health was worsened.Conclusion: This study concluded that students’ mental problems are alarming, so the university should provide psychological services for the student’s mental health. Post-pandemic is leaving long-lasting psychological effects and will require further investigation.Keywords: Covid-19, anxiety, depression, international students, mental health

Jasper Vink, Folashade Oyewole, Shiraz Jamshaid, Rohin Patel, Zubair Froogh, Maninder Bhambra Faculty of Medicine, Imperial College London, London, UKWe read with great interest the article by Zaghloul and El Enein and agree with the conclusions made in particular regarding overbooking of outpatient services due to a mismatching of resources and the need for efficient outpatient scheduling. We believe these points to be relevant to the current status of the National Health Service (NHS), which is facing an ever growing demand for its services, leading to increasing waiting times as a result. Across NHS England, 838,600 patients were waiting for a key diagnostic test at the end of November 2015, a 5.6% increase from November 2014. Waiting times have been associated with lower patient satisfaction and reduced clinical outcomes. It is therefore crucial that management teams take an active approach to reducing waiting times. View the original paper by Zaghloul and El Enein

Shiraz Jamshaid,1 Mohammed Farwana,2 Faisal Jamshaid,2 Wasim Jamshaid,1 Reem Farwana,3 Sharaf Sheik-Ali41Imperial College London, School of Medicine, 2Kings College London, School of Medicine, London, 3Birmingham University, School of Medicine and Dentistry, Birmingham,4Barts and the London University, School of Medicine and Dentistry, London, UKWe read with great interest the perspective of peer-assisted learning (PAL) in medical school by Menezes et al and agree with the high importance placed on PAL.1View the original paper by Menezes and colleagues.

Meelad Sayma,1,2 Shiraz Jamshaid,1 Doa'a Kerwat,1,3 Dina Saleh,1 Aaniya Ahmed,1 Folashade Oyewole,1 Abdul Samad Wahid1 1 Imperial College Business School, Imperial College London, London, 2Peninsula College of Medicine and Dentistry, Plymouth, Devon, 3Barts and The London School of Medicine and Dentistry, London, UK We read with great interest the expert opinion of Singagireson et al and agree with the key points raised.1 However, this can be seen to be only one part of the multidimensional foundation program application. It is important to add that we feel there are multiple inequitable components that impact on UK medical students’ foundation program application. The author emphasizes that the situational judgment test (SJT) and medical school performance make up two points of the application performance; however, there are two factors that have a larger-than appreciated impact on the foundation program application – “PubMed-referenced publications” and additional degrees (eg, an intercalated BSc or PhD).2View original article by Singagireson et al

Background: Epistaxis can be life-threatening. Simple first aid management can stem bleeding. This study compared knowledge of first aid management methods of epistaxis between the general public and healthcare workers. Method: A cross-sectional study of 100 healthcare workers and 103 adult members of the public was conducted at a large London teaching hospital. Respondents completed a survey assessing knowledge on nasal pinching site, head tilt and appropriate adjunct treatment use for first aid management of epistaxis. Results: Twenty-four per cent and 68 per cent of healthcare workers compared with 25.2 per cent and 37.9 per cent of the public answered correctly on nasal pinching position and head tilt position, respectively, with a statistical difference for head tilt position. Two per cent, 2 per cent and 24 per cent of healthcare workers mentioned ice use on the nose, ice use in the mouth or ice use but not site, respectively, compared with 0 per cent, 0 per cent and 4.9 per cent of the public, with a statistical difference for ice without site. Conclusion: Healthcare workers and the public lack knowledge on first aid management of epistaxis. Improved education on first aid management is required, targeting healthcare workers and the public. [ABSTRACT FROM AUTHOR]

Herein, the investigation is presented to analyze the structural, electronic, optical, and thermoelectric features of Cs2XAgCl6 (X= Sc, Y) by applying the first principles approach. The confirmation of the stable structure of both compounds is reinforced by the negative values of formation enthalpies. The electronic band gaps (Eg) of 3.78/4.86 eV are computed for Cs2XAgCl6 /Cs2YAgCl6 through Tran-Blaha modified Becke-Johnson (TBmBJ) potential, correspondingly. The tolerance factor(τ) is found as 0.9 for Cs2ScAgCl6 and 1.0 for Cs2XAgCl6 which confirmed the stable cubic nature of both compounds. Optical factors like dielectric-function ε(ω), absorption coefficient α(ω), and others related parameters are analyzed within 0 to 10 eV of energy span. Both compounds demonstrated high absorption in the ultraviolet region, rendering them as well-suited materials for photovoltaic applications. The calculated values of refractive index for Cs2ScAgCl6 and Cs2XAgCl6 indicated super-luminescent characteristics in the ultraviolet region. For thermoelectric (TE) features, electrical conductivity (σ/τ), figure of merit (ZT), power factor (PF), thermal conductivity (k/τ), and Seebeck coefficient (S) are calculated using the BoltzTraP code. According to the findings, both materials are advocated as promising candidates for thermoelectric and optoelectronic applications. [ABSTRACT FROM AUTHOR]

This study examines the impact of response and semantic inhibition on scientific reasoning using fNIRS data from 30 students (15 male, 15 female). Utilizing Go/Nogo and Stroop-like tasks within a modified speeded-reasoning task, it was found that inhibition significantly influences scientific reasoning. Specifically, slower responses and lower accuracy on incongruent statements were linked to increased activity in bilateral dorsolateral prefrontal cortex (DLPFC) and pre-supplementary motor area (pre-SMA). The research shows that both DLPFC and pre-SMA are associated with overcoming misconceptions in scientific reasoning. The findings suggest that understanding inhibitory mechanisms can enhance educational strategies to improve critical thinking and scientific literacy.

Penetrating neck injury is associated with significant morbidity due to the several structures (neurological, vascular and aerodigestive) within close proximity to one another. This case highlights an uncommon presentation of an embedded foreign body following penetrating neck trauma and the decision-making required during management., Competing Interests: Competing interests: None declared., (© BMJ Publishing Group Limited 2024. No commercial re-use. See rights and permissions. Published by BMJ.)

Background and Objectives: The ability to comprehend and engage in mathematical reasoning is a fundamental cognitive skill, central to problem-solving and critical thinking. However, the intricate cognitive processes underlying mathematical reasoning, particularly in relation to inhibitory control, have garnered increasing attention in recent research. While previous studies have explored this connection, there remains a need for a more comprehensive understanding of the interplay between inhibitory control and mathematical reasoning. This study explored the contribution of response inhibition and semantic inhibition to scientific reasoning by comparing the brain activation of the speeded-reasoning task of mathematical subdomain concepts with that of the Go/Nogo and Stroop tasks., Method: Using functional near-infrared spectroscopy, oxygenated hemoglobin (oxy-Hb) was recorded in 28 subjects performing Go/Nogo tasks, Stroop tasks and speeded-reasoning tasks. The study was divided into two parts. In one part, subjects performed the Go/Nogo task and the Stroop task, and in the other part, subjects performed speeded-reasoning tasks., Results: The results showed that the subjects had slower responses and lower accuracy when judging incongruent statements. The concentration of oxy-Hb in the brain region related to inhibition was increased. In addition, the oxy-Hb in reasoning incongruent nonmathematical statements was correlated to the Go/Nogo task, whereas the oxy-Hb in reasoning incongruent mathematical statements was correlated to the Stroop task., Conclusion: This result supports the hypothesis that inhibitory control plays a role in the scientific reasoning of mathematical subdomain concepts, and both response inhibition and semantic inhibition are involved in suppressing the interference of mathematical misconceptions.Supplementary Video Abstract, Supplemental digital content 1, http://links.lww.com/WNR/A732., (Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.)

Background: In Pakistan, the fourth wave of COVID-19 is causing an increasing number of positive cases. This fourth wave may be a risky aspect of mental health issues for COVID-19 patients. This quantitative study is designed to understand the stigmatization, and panic disorder and to explore the mediating role of death anxiety among patients of COVID-19 during the fourth wave of novel coronavirus., Methods: The study was conducted using a correlational research design. The survey was carried out by utilizing a questionnaire with a convenient sample technique. The sample of the study was comprised of 139 patients with COVID-19. Data were collected through Stigma Scale for Chronic Illnesses (SSCI), The Panic Disorder Severity Scale (PDSS), and Death Anxiety Inventory., Results: Results show that stigma is significantly positively related to panic disorder and death anxiety. Furthermore, panic disorder is also significantly positively related to death anxiety. Results also indicate that stigmatization is a significant positive predictor for death anxiety and panic disorder. Moreover, results indicate that death anxiety has a mediating role in the relationship between stigmatization and panic disorder with age and gender as covariates., Conclusion: This study would be helpful for people around the world to understand this threatening contagious virus so they wouldn't stigmatize infected ones. Additional research is required for the sustainable improvement of anxiety over time., Competing Interests: Declaration of competing interest All authors declare there are no conflicts of interest., (Copyright © 2023 The Authors. Published by Elsevier B.V. All rights reserved.)

Postpartum depression (PPD) can predispose to physical and mental health problems in Pakistani women. However, PPD is associated with health and perceived social support, yet their causal relationship is unclear. Therefore, this study intended to evaluate the association of PPD with insomnia, mental health, and physical health. The convenience sampling technique was used to collect data from 320 (52.8%) young and middle-aged postpartum women, at the outpatient departments of obstetrics and gynecology of the Government Maula Bakhsh Hospital, District Head Quarter in Sargodha, Pakistan. The Edinburgh Postnatal Depression Scale, Pittsburgh Sleep Quality Index, Warwick-Edinburgh Mental Well-being Scale, patient health questionnaire, and Multidimensional Scale of Perceived Social Support were used to measure study variables. The results revealed a significant positive relationship between PPD and physical health (r = 0.45, p = 0.001), negative relationships with insomnia (r = -0.24, p < 0.001), and perceived social support (r = -0.38, p = 0.001). Results further confirmed that perceived social support played a moderating role ( β = 0.97, p = 0.01) in the relationship between PPD and mental health among Pakistani women. This study concluded that perceived social support has an important role in PPD and the health of Pakistani women. The study also concluded that poor health is a risk indicator for the identification of aid in the early stages of postpartum among Pakistani women.

A substantial portion of drug abuse research has concentrated on people with a single-substance-use disorder (SSUD), but many people abuse more than one drug. Studies have yet to examine how those with polysubstance-use disorder (PSUD) differ from those with an SSUD on the risk of relapse, self-evaluative emotions (e.g., shame and guilt), and personality factors (e.g., self-efficacy). Eleven rehab facilities in Lahore city, Pakistan were randomly chosen to provide a sample of 402 males with PSUD. For comparison, 410 age-matched males with SSUD were enlisted using a demographic form with eight questions, the State Shame and Guilt Scale, and the General Self-Efficacy Scale. Mediated moderation analysis was performed using Hayes' process macro. The results demonstrate that shame-proneness is positively associated with relapse rate. Guilt-proneness mediates the relationship between shame-proneness and relapse rate. Self-efficacy buffers the influence of shame-proneness on relapse rate. Although the mediation and moderation effects were found in both study groups, these effects were significantly stronger among people with PSUD than those with SSUD. To be more specific, people with PSUD reported a higher overall score on shame, guilt, and relapse rate. Additionally, people with SSUD indicated a higher score on self-efficacy than those with PSUD. The findings of this study suggest that drug rehab facilities should implement a variety of strategies to raise drug users' levels of self-efficacy, which will help to reduce their risk of relapse.

A novel, facile, and efficient Lewis-acid-catalyzed [4 + 1] annulation protocol for the construction of functionalized polycyclic-fused furans is developed. This methodology is free of transition metals and ligands and provides a rapid synthetic route to divergently orientated polycyclic furans in good yields. In addition, this protocol can also be used to synthesize multisubstituted furans.

A facile and efficient In(OTf) 3 - and BF 3 ·OEt 2 -catalyzed direct transformation of 3-formylindoles with diazo esters has been developed for synthesizing diverse and functionalized indolyl acrylates. This one-pot protocol furnishes various ( Z )-α-hydroxy-β-indolyl acrylates, ( E )-β-(2-alkoxy-2-oxoethoxy)-α-indolyl acrylates, and ( Z )-3-hydroxy-2-indolyl acrylates by a catalyst- and substituent-controlled, regio- and stereoselective cascade reaction. The protocol has several advantages, including low loading of the catalyst, mild reaction conditions, broad scope, and high functional group tolerance. The synthesized compounds can be further converted into diversely functionalized materials.

Objectives: To explore the barriers and facilitators to patients achieving death at home., Methods: In-depth, semistructured interviews with end-of-life care experts were conducted to develop an insight into the barriers and facilitators to achieving death at home. Thirty-three interviews were conducted compromising of a mixture of face-to-face and tele interviews. Experts included healthcare professionals working in the community, hospital and policy/academic settings. Thematic analysis was undertaken on interview transcripts., Results: Three overarching themes, further divided into a total of 12 subthemes were identified. The three themes were 'managing people', 'education' and 'planning'. The 'managing people' theme included subthemes of patient preferences and family influences; the 'education' theme encompassed knowledge and training, perceptions of death and communication and the 'planning' theme contained seven subthemes including 'coordination', 'resources' and 'cost'., Conclusions: Multiple barriers and facilitators to achieving death at home were identified in this study. Of particular significance was the identification of the fear and stigma associated with death among doctors, patients and their families serving as a barrier to home death, not previously identified in the literature. Additionally, the importance of social networks and resource provision were highlighted as key in influencing patient death at home., Competing Interests: Competing interests: None declared., (© Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2020. All rights reserved. No commercial use is permitted unless otherwise expressly granted.)

Background: Survival advantage following trans-arterial chemoembolization (TACE) is variable in patients with hepatocellular carcinoma (HCC). We combined pre-TACE radiologic features to derive a novel prognostic signature in HCC., Methods: A multi-institutional dataset of 98 patients was generated from two retrospective cohorts from United Kingdom (65%) and Italy (36%). The prognostic impact of a number baseline imaging parameters was assessed and factors significant on univariate analysis were combined to create a novel radiologic signature on multivariable analyses predictive of overall survival (OS) following TACE., Results: Median OS was 15.4 months. Tumour size > 7 cm (p < 0.001), intra-tumour necrosis (ITN) (p = 0.02) and arterial ectatic neovascularisation (AEN) (p = 0.03) emerged as individual prognostic factors together with radiologic response (p < 0.001) and elevated alpha-fetoprotein (AFP) (p = 0.01). Combination of tumour size > 7 cm, ITN and AEN identified patients with poor prognosis (p < 0.001)., Conclusions: We identified a coherent signature based on commonly available imaging biomarkers likely to be reflective of differential patterns of relative hypoxia and neovascularisation. Large tumours displaying AEN and ITN are characterised by a shorter survival after TACE.

Background: In many countries, achieving a home death represents a successful outcome from both a patient welfare and commissioning viewpoint. Significant variation exists in the proportion of home deaths achieved internationally, with many countries unable to meet the wishes of a large number of patients. This review builds on previous literature investigating factors influencing home death, synthesising qualitative research to supplement evidence that quantitative research in this field may have been unable to reach., Aim: To identify and understand the barriers and facilitators influencing death at home., Design: Meta-ethnography., Data Sources: The review adhered to the PRISMA guidelines. A systematic literature search was conducted using five databases: PubMed, EMBASE, Ovid, CINAHL and PsycINFO. Databases were searched from 2006 to 2016. Empirical, UK-based qualitative studies were included for analysis., Results: A total of 38 articles were included for analysis. Seven overarching barriers were identified: lack of knowledge, skills and support among informal carers and healthcare professionals; informal carer and family burden; recognising death; inadequacy of processes such as advance care planning and discharge; as well as inherent patient difficulties, either due to the condition or social circumstances. Four overarching facilitators were observed: support for patients and healthcare professionals, skilled staff, coordination and effective communication., Conclusion: Future policies and clinical practice should develop measures to empower informal carers as well as emphasise earlier commencement of advance care planning. Best practice discharge should be recommended in addition to addressing remaining inequity to enable non-cancer patients greater access to palliative care services.

Background: Hepatocellular carcinoma (HCC) is increasingly prevalent in people living with HIV. Systemic inflammation is a prognostic factor requiring validation in HIV-associated HCC., Aims: Using a multi-centre database of consecutive HCC cases, we investigated the prognostic role of a panel of inflammatory markers, including neutrophil to lymphocyte ratio (NLR), using univariate and multivariate survival analyses., Results: Fifty-nine patients with HIV-associated HCC secondary to hepatitis C (69%) or B virus infection (32%) were identified. The median survival was 22 months. A raised NLR independently predicted patients' survival and was correlated with advanced Barcelona Clinic Liver Cancer stage (p = 0.003) and poor performance status (p < 0.001) but not with HIV RNA or CD4 counts., Conclusion: Systemic inflammation, as measured by NLR, is a prognostic determinant associated with adverse pathological features of malignancy, but not coexisting HIV infection, suggesting a tumour-promoting role of the innate immune response that warrants further investigation in mechanistic studies., (© 2017 S. Karger AG, Basel.)