bluuebunny/crossref_metadata_2025 huggingface dataset:
Traditional herbal medicine use doubled the risk of multi-organ dysfunction syndrome in children: A prospective cohort study
Authors: Teshager Nahom Worku , Amare Ashenafi Tazebew , Tamirat Koku Sisay , Zeleke Mulualem Endeshaw , Taddese Asefa Adimasu
Published: February 2024

Background

Traditional herbal medicine (THM) is frequently used in pediatric populations in many low-income countries as a form of healthcare and has been associated with a range of adverse events, including liver toxicity, renal failure, and allergic reactions. Despite these concerns, its impact on multi-organ dysfunction syndrome (MODS) risk has not been thoroughly investigated.

Objective

This study aimed to investigate the incidence and predictors of MODS in a pediatric intensive care unit (PICU) in Ethiopia, with a focus on the association between THM use and the risk of MODS.

Methods

This was a single-center prospective cohort study conducted at a PICU in the university of Gondar Comprehensive Specialized hospital, Northwest Ethiopia. The study enrolled eligible patients aged one month to 18 years admitted to the PICU during the study period. Data on demographic characteristics, medical history, clinical and laboratory data, and outcome measures using standard case record forms, physical examination, and patient document reviews. The predictors of MODS were assessed using Cox proportional hazards models, with a focus on the association between traditional herbal medicine use and the risk of MODS.

Results

A total of 310 patients were included in the final analysis, with a median age of 48 months and a male-to-female ratio of 1.5:1. The proportion and incidence of MODS were 30.96% (95% CI:25.8, 36.6) and 7.71(95% CI: 6.10, 9.40) per 100-person-day observation respectively. Renal failure (17.74%), neurologic failure (15.16%), and heart failure (14.52%) were the leading organ failures identified. Nearly one-third of patients (32.9%) died in the PICU, of which 59.8% had MODS. The rate of mortality was higher in patients with MODS than in those without. The Cox proportional hazards model identified renal disease (AHR = 6.32 (95%CI: 3.17,12.61)), intake of traditional herbal medication (AHR = 2.45, 95% CI:1.29,4.65), modified Pediatric Index of Mortality 2 (mPIM 2) score (AHR = 1.54 (95% CI: 1.38,1.71), and critical illness diagnoses (AHR = 2.68 (95% CI: 1.77,4.07)) as predictors of MODS.

Conclusion

The incidence of MODS was high. Renal disease, THM use, mPIM 2 scores, and critical illness diagnoses were independent predictors of MODS. A more than twofold increase in the risk of MODS was seen in patients who used TMH. Healthcare providers should be aware of risks associated with THM, and educate caregivers about the potential harms of these products. Future studies with larger sample sizes and more comprehensive outcome measures are needed.
Technology and physical activity for preventing cognitive and physical decline in older adults: Protocol of a pilot RCT
Authors: Kiah Hui Siew Savannah , Yu Junhong , Teo Tat Lee , Chua Kuang Chua , Mahendran Rathi , Rawtaer Iris
Published: February 2024

Background

Cognitive frailty, defined as having both physical frailty and cognitive impairment that does not satisfy the criteria for Major Neurocognitive Disorder, represents an elevated risk for morbidity. Hence, it is crucial to mitigate such risks. Physical activity interventions have been found effective in protecting against physical frailty and cognitive deterioration. This pilot RCT examines if smartwatches and mobile phone applications can help to increase physical activity, thereby improving physical and cognitive outcomes.

Methods

Older individuals (n = 60) aged 60 to 85 years old will have their physical activity tracked using a smartwatch. The subjects will be randomized into two arms: one group will receive daily notification prompts if they did not reach the recommended levels of PA; the control group will not receive prompts. Outcome variables of physical activity level, neurocognitive scores, and physical frailty scores will be measured at baseline, T1 (3 months), and T2 (6 months). Sleep quality, levels of motivation, anxiety, and depression will be controlled for in our analyses. We hypothesize that the intervention group will have higher levels of physical activity resulting in improved cognitive and physical outcomes at follow-up. This study was approved by the National University of Singapore’s Institutional Review Board on 17 August 2020 (NUS-IRB Ref. No.: H-20-038).

Discussion

Wearable sensors technology could prove useful by facilitating self-management in physical activity interventions. The findings of this study can justify the use of technology in physical activity as a preventive measure against cognitive frailty in older adults. This intervention also complements the rapidly rising use of technology, such as smartphones and wearable health devices, in our lives today.

Registration details

This study has been retrospectively registered on clinicaltrials.gov on 5th January 2021 (NCT Identifier: NCT04692974), after the first participant was recruited.
CROS or hearing aid? Selecting the ideal solution for unilateral CI patients with limited aidable hearing in the contralateral ear
Authors: Lively Sarah , Agrawal Smita , Stewart Matthew , Dwyer Robert T. , Strobel Laura , Marcinkevich Paula , Hetlinger Chris , Croce Julia
Published: February 2024

A hearing aid or a contralateral routing of signal device are options for unilateral cochlear implant listeners with limited hearing in the unimplanted ear; however, it is uncertain which device provides greater benefit beyond unilateral listening alone. Eighteen unilateral cochlear implant listeners participated in this prospective, within-participants, repeated measures study. Participants were tested with the cochlear implant alone, cochlear implant + hearing aid, and cochlear implant + contralateral routing of signal device configurations with a one-month take-home period between each in-person visit. Audiograms, speech perception in noise, and lateralization were evaluated. Subjective feedback was obtained via questionnaires. Marked improvement in speech in noise and non-implanted ear lateralization accuracy were observed with the addition of a contralateral hearing aid. There were no significant differences in speech recognition between listening configurations. However, the chronic device use questionnaires and the final device selection showed a clear preference for the hearing aid in spatial awareness and communication domains. Individuals with limited hearing in their unimplanted ears demonstrate significant improvement with the addition of a contralateral device. Subjective questionnaires somewhat contrast with clinic-based outcome measures, highlighting the delicate decision-making process involved in clinically advising one device or another to maximize communication benefits.
Groundwater quality characterization using an integrated water quality index and multivariate statistical techniques
Authors: Gautam Vinay Kumar , Kothari Mahesh , Al-Ramadan Baqer , Singh Pradeep Kumar , Upadhyay Harsh , Pande Chaitanya B. , Alshehri Fahad , Yaseen Zaher Mundher
Published: February 2024

This study attempts to characterize and interpret the groundwater quality (GWQ) using a GIS environment and multivariate statistical approach (MSA) for the Jakham River Basin (JRB) in Southern Rajasthan. In this paper, analysis of various statistical indicators such as the Water Quality Index (WQI) and multivariate statistical methods, i.e., principal component analysis and correspondence analysis (PCA and CA), were implemented on the pre and post-monsoon water quality datasets. All these methods help identify the most critical factor in controlling GWQ for potable water. In pre-monsoon (PRM) and post-monsoon (POM) seasons, the computed value of WQI has ranged between 28.28 to 116.74 and from 29.49 to 111.98, respectively. As per the GIS-based WQI findings, 63.42 percent of the groundwater samples during the PRM season and 42.02 percent during the POM were classed as ‘good’ and could be consumed for drinking. The Principal component analysis (PCA) is a suitable tool for simplification of the evaluation process in water quality analysis. The PCA correlation matrix defines the relation among the water quality parameters, which helps to detect the natural or anthropogenic influence on sub-surface water. The finding of PCA’s factor analysis shows the impact of geological and human intervention, as increased levels of EC, TDS, Na+, Cl-, HCO3-, F-, and SO42- on potable water. In this study, hierarchical cluster analysis (HCA) was used to categories the WQ parameters for PRM and POR seasons using the Ward technique. The research outcomes of this study can be used as baseline data for GWQ development activities and protect human health from water-borne diseases in the southern region of Rajasthan.
Sedentary behaviour (especially accumulation pattern) has an independent negative impact on skeletal muscle size and architecture in community-dwelling older adults
Authors: Wullems Jorgen A. , Degens Hans , Verschueren Sabine M. P. , Morse Christopher I. , Grant Dale M. , Onambélé-Pearson Gladys L.
Published: February 2024

Prolonged sedentary behaviour (SB) i.e. longer bouts, is suggested to have a range of negative health effects, independent of habitual light and medium-to-vigorous physical activity (LIPA or MVPA). Any effect on musculoskeletal size, architecture or morphology has seldom been reported in older adults. Moreover, no study has yet determined if any association would persist following adjustment for covariates. Therefore, the aim of the present study was to investigate the associations between SB, and properties of the Gastrocnemius Medialis (GM) muscle, in a cross-sectional sample of older adults using compositional data analysis. 105 healthy older adults (73±6y) wore a thigh mounted tri-axial accelerometer for seven consecutive days, and underwent ultrasound [e.g. muscle length (Lm), anatomical cross-sectional area (ACSA), muscle volume (VM), fascicle length (LF), & physiological cross-sectional area (PCSA)], body composition (e.g. DEXA) and health (e.g. medical history) assessments. In-unadjusted models, SB time was negatively associated with ACSA at 75% of Lm (R2adj = 0.085), VM (R2adj = 0.020), and PCSA (R2adj = 0.039). Standing was positively associated with pennation angle (R2adj = 0.110), which persisted following co-variate adjustment (R2adj = 0.296). In fully adjusted models, both SB & LIPA time were associated with ACSA at 75% of Lm (Both R2adj = 0.393). Standing and light activity time were also associated with LF, VM, & PCSA (R2adj 0.116–0.573). In fully adjusted models, SB pattern parameters (i.e. the manner in which sedentary behaviour is accumulated daily throughout waking hours such as the timing, duration and frequency of sedentary bouts), were associated with GM muscle properties (R2adj 0.156–0.564) including LM, LF, and VM. The pattern, rather than accumulated daily SB time, was associated with the size and architecture of the GM. Our results suggest that regardless of co-existing habitual physical activities, SB bouts should be kept short and frequently interrupted to offset some of the deleterious ageing-related muscle architecture characteristics changes.
Impact of COVID-19 on access to and delivery of sexual and reproductive healthcare services in countries with universal healthcare systems: A systematic review
Authors: Tam Michelle W. , Davis Victoria H. , Ahluwalia Monish , Lee Rachel S. , Ross Lori E.
Published: February 2024

Objectives

The COVID-19 pandemic has caused unforeseen impacts on sexual and reproductive healthcare (SRH) services worldwide, and the nature and prevalence of these changes have not been extensively synthesized. We sought to synthesise reported outcomes on the impact of COVID-19 on SRH access and delivery in comparable countries with universal healthcare systems.

Methods

Following PRISMA guidelines, we searched MEDLINE, Embase, PsycInfo, and CINAHL from January 1st, 2020 to June 6th, 2023. Original research was eligible for inclusion if the study reported on COVID-19 and SRH access and/or delivery. Twenty-eight OECD countries with comparable economies and universal healthcare systems were included. We extracted study characteristics, participant characteristics, study design, and outcome variables. The methodological quality of each article was assessed using the Quality Assessment with Diverse Studies (QuADS) tool. The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines were followed for reporting the results. This study was registered on PROSPERO (#CRD42021245596).

Synthesis

Eighty-two studies met inclusion criteria. Findings were qualitatively synthesised into the domains of: antepartum care, intrapartum care, postpartum care, assisted reproductive technologies, abortion access, gynaecological care, sexual health services, and HIV care. Research was concentrated in relatively few countries. Access and delivery were negatively impacted by a variety of factors, including service disruptions, unclear communication regarding policy decisions, decreased timeliness of care, and fear of COVID-19 exposure. Across outpatient services, providers favoured models of care that avoided in-person appointments. Hospitals prioritized models of care that reduced time and number of people in hospital and aerosol-generating environments.

Conclusions

Overall, studies demonstrated reduced access and delivery across most domains of SRH services during COVID-19. Variations in service restrictions and accommodations were heterogeneous within countries and between institutions. Future work should examine long-term impacts of COVID-19, underserved populations, and underrepresented countries.
Generation of epitope-specific hCG aptamers through a novel targeted selection approach
Authors: Ferreira Lauren , Flanagan Shane Patrick , Fogel Ronen , Limson Janice Leigh
Published: February 2024

Human chorionic gonadotropin (hCG) is a glycoprotein hormone used as a biomarker for several medical conditions, including pregnancy, trophoblastic and nontrophoblastic cancers. Most commercial hCG tests rely on a combination of antibodies, one of which is usually specific to the C-terminal peptide of the β-subunit. However, cleavage of this region in many hCG degradation variants prevents rapid diagnostic tests from quantifying all hCG variants in serum and urine samples. An epitope contained within the core fragment, β1, represents an under-researched opportunity for developing immunoassays specific to most variants of hCG. In the study described here, we report on a SELEX procedure tailored towards the identification of two pools of aptamers, one specific to the β-subunit of hCG and another to the β1 epitope within it. The described SELEX procedure utilized antibody-blocked targets, which is an underutilized strategy to exert negative selection pressure and in turn direct aptamer enrichment to a specific epitope. We report on the first aptamers, designated as R4_64 and R6_5, each capable of recognising two distinct sites of the hCG molecule—the β-subunit and the (presumably) β1-epitope, respectively. This study therefore presents a new SELEX approach and the generation of novel aptamer sequences that display potential hCG-specific biorecognition.
Gas concentration mapping and source localization for environmental monitoring through unmanned aerial systems using model-free reinforcement learning agents
Authors: Husnain Anees ul , Mokhtar Norrima , Mohamed Shah Noraisyah Binti , Dahari Mahidzal Bin , Azmi Amirul Asyhraff , Iwahashi Masahiro
Published: February 2024

There are three primary objectives of this work; first: to establish a gas concentration map; second: to estimate the point of emission of the gas; and third: to generate a path from any location to the point of emission for UAVs or UGVs. A mountable array of MOX sensors was developed so that the angles and distances among the sensors, alongside sensors data, were utilized to identify the influx of gas plumes. Gas dispersion experiments under indoor conditions were conducted to train machine learning algorithms to collect data at numerous locations and angles. Taguchi’s orthogonal arrays for experiment design were used to identify the gas dispersion locations. For the second objective, the data collected after pre-processing was used to train an off-policy, model-free reinforcement learning agent with a Q-learning policy. After finishing the training from the training data set, Q-learning produces a table called the Q-table. The Q-table contains state-action pairs that generate an autonomous path from any point to the source from the testing dataset. The entire process is carried out in an obstacle-free environment, and the whole scheme is designed to be conducted in three modes: search, track, and localize. The hyperparameter combinations of the RL agent were evaluated through trial-and-error technique and it was found that ε = 0.9, γ = 0.9 and α = 0.9 was the fastest path generating combination that took 1258.88 seconds for training and 6.2 milliseconds for path generation. Out of 31 unseen scenarios, the trained RL agent generated successful paths for all the 31 scenarios, however, the UAV was able to reach successfully on the gas source in 23 scenarios, producing a success rate of 74.19%. The results paved the way for using reinforcement learning techniques to be used as autonomous path generation of unmanned systems alongside the need to explore and improve the accuracy of the reported results as future works.
Dietary diversity and associated factors among pregnant women in the Southern Province of Rwanda: A facility-based cross-sectional study
Authors: Uwase Aline , Nsereko Etienne , Pillay Nirvana , Levin Jonathan
Published: February 2024

The inadequate dietary diversity of pregnant women in low- and middle-income countries, including Rwanda, is rising and leading to macro and micronutrient deficiencies. The extent of dietary diversity and the factors contributing to it are unknown in Rwanda. This cross-sectional study, with 612 women who attended antenatal care services in Rwanda’s Southern Province, identified determinants of dietary diversity among pregnant women. A multistage sampling scheme was used in which four districts were sampled, thereafter one urban and one rural health centre was sampled in each district and finally, a systematic sample of pregnant women was selected in each sampled health centre. Dietary diversity was measured using Minimum Dietary Diversity for Women (MDD-W), and multiple logistic regression models were fitted to identify factors associated with dietary diversity. Only 44.1% (95% confidence interval (CI) of [40.1%, 48.0%]) of participants had adequate dietary diversity. Approximately 95.4% of participants consumed grains, white roots, and tubers. The food groups that were the least consumed consisted of eggs (n = 99, 16.4%), as well as those consisting of milk and milk products (n = 112, 18.5%). The factors which were positively associated with dietary diversity were owning a radio (adjusted odds ratio [aOR] = 1.90 [95% CI 1.27, 2.85]), maternal education (aOR = 1.85 [95% CI 1.28, 2.65]), having a kitchen garden (aOR = 1.69 [95% CI 1.11, 2.57]) and nutrition knowledge score (aOR = 1.45 [95% CI 1.21, 1.74]) for a five-point increase in nutrition knowledge score. The factors negatively associated with dietary diversity include food insecurity, which reduced the odds of dietary diversity (aOR = 0.19 [0.07, 0.50]) per five-unit increase in food insecurity. Furthermore, the odds of adequate dietary diversity were lower among urban residents than rural residents (aOR = 0.69 [0.47, 1.03]). The household size was associated with dietary diversity with the odds of dietary diversity decreasing by 12% for a five-unit increase in household size (aOR = 0.88 [0.79; 0.99]). 23% had poor nutritional status, indicated by their mid-upper arm circumference (MUAC; < 23 cm). Enhanced nutritional education is needed to improve the nutritional knowledge of this population with particular emphasis on the consumption of animal-source foods. Sensitisation activities promoting ownership of kitchen gardens and radios could improve dietary diversity among Rwanda’s pregnant women.
Understanding the extent of and limitations to conscientious objection to abortion by health care practitioners: A hermeneutic study
Authors: Fleming Valerie , Frith Lucy , Maxwell Clare
Published: February 2024

The United Kingdom’s Abortion Act 1967 has attracted substantial controversy, which has centred not only on the regulation of abortion itself, but also on the extent to which conscientious objection should be permitted. The aim of this study was to examine a range of healthcare professionals’ views on conscientious objection and identify the appropriate parameters of conscientious objection to abortion. Gadamer’s hermeneutic was utilised to frame this study. We conducted semi-structured interviews in two UK locations with 18 pharmacists, 17 midwives, 12 nurses and nine doctors, encompassing a mix of conscientious objectors and non-objectors to abortion. A multi-faceted in-depth data analysis led to the development of a hermeneutic of “respecting self and others”. Four major themes of “doing the job”, “entrusting to others”, “acknowledging institutional power” and “being selective” and 18 subthemes contributed to this overarching theme. The complexity of the responses indicates that there is little consistency within and between each profession. They show that participants who were conscientious objectors were accepted by their colleagues and accommodated without detriment to the service, and that in larger hospitals, such as those where our work was carried out, it is possible to be employed in the service areas that include abortion while still being a conscientious objector. Finally, our results indicate that, by respecting of self and others, each profession should be able to accommodate conscience-based objections where individual practitioners seek to exercise them. Conscientious objectors as well as non-objectors have something to contribute to the ongoing development of the maternity and gynaecological services as abortion is only a small part of the work of these services.
Researchers’ experiences of the design and conduct challenges associated with parallel-group cluster-randomised trials and views on a novel open-cohort design
Authors: Surr Claire , Marsden Laura , Griffiths Alys , Cox Sharon , Fossey Jane , Martin Adam , Prevost A. Toby , Walshe Catherine , Walwyn Rebecca
Published: February 2024

Background

Two accepted designs exist for parallel-group cluster-randomised trials (CRTs). Closed-cohort designs follow the same individuals over time with a single recruitment period before randomisation, but face challenges in settings with high attrition. (Repeated) cross-sectional designs recruit at one or more timepoints before and/or after randomisation, collecting data from different individuals present in the cluster at these timepoints, but are unsuitable for assessment of individual change over time. An ‘open-cohort’ design allows individual follow-up with recruitment before and after cluster-randomisation, but little literature exists on acceptability to inform their use in CRTs.

Aim

To document the views and experiences of expert trialists to identify:

a) Design and conduct challenges with established parallel-group CRT designs,

b) Perceptions of potential benefits and barriers to implementation of open-cohort CRTs,

c) Methods for minimising, and investigating the impact of, bias in open-cohort CRTs.

Methods

Qualitative consultation via two expert workshops including triallists (n = 24) who had worked on CRTs over a range of settings. Workshop transcripts were analysed using Descriptive Thematic Analysis utilising inductive and deductive coding.

Results

Two central organising concepts were developed. Design and conduct challenges with established CRT designs confirmed that current CRT designs are unable to deal with many of the complex research and intervention circumstances found in some trial settings (e.g. care homes). Perceptions of potential benefits and barriers of open cohort designs included themes on: approaches to recruitment; data collection; analysis; minimising/investigating the impact of bias; and how open-cohort designs might address or present CRT design challenges. Open-cohort designs were felt to provide a solution for some of the challenges current CRT designs present in some settings.

Conclusions

Open-cohort CRT designs hold promise for addressing the challenges associated with standard CRT designs. Research is needed to provide clarity around definition and guidance on application.
Does digital economy development affect urban environment quality: Evidence from 285 cities in China
Authors: Li Hao , Yang Zihan
Published: February 2024

The impact of the digital economy (DE) on urban environmental quality (EQ) is a critical aspect of China’s economic development. This study investigates the impact of DI on urban EQ using the data from prefecture-level cities spanning the period from 2011 to 2021 and updates some disparate conclusions of related studies. It is discovered that a non-linear correlation exists between DE and urban EQ. Currently, DE can effectively improve local city EQ. This conclusion remains valid even after robustness tests and endogeneity treatment. The impact of DE on improving EQ can be classified as the impact of technological innovation, industrial upgrading, resource allocation, infrastructure construction, environmental governance, and changes in public lifestyle. Heterogeneity analysis reveals that the influence of DE is particularly pronounced in cities located in central and eastern regions of China, those with higher levels of administrative management, resource-based urban areas, and those with more stringent environmental regulations.
Moss bugs shed light on the evolution of complex bioacoustic systems
Authors: Davranoglou Leonidas-Romanos , Hartung Viktor
Published: February 2024

Vibroacoustic signalling is one of the dominant strategies of animal communication, especially in small invertebrates. Among insects, the order Hemiptera displays a staggering diversity of vibroacoustic organs and is renowned for possessing biomechanically complex elastic recoil devices such as tymbals and snapping organs that enable robust vibrational communication. However, our understanding of the evolution of hemipteran elastic recoil devices is hindered by the absence of relevant data in the phylogenetically important group known as moss bugs (Coleorrhyncha), which produce substrate-borne vibrations through an unknown mechanism. In the present work, we reveal the functional morphology of the moss bug vibrational mechanism and study its presence across Coleorrhyncha and in extinct fossilised relatives. We incorporate the anatomical features of the moss bug vibrational mechanism in a phylogeny of Hemiptera, which supports either a sister-group relationship to Heteroptera, or a sister-group relationship with the Auchenorrhyncha. Regardless of topology, we propose that simple abdominal vibration was present at the root of Euhemiptera, and arose 350 million years ago, suggesting that this mode of signalling is among the most ancient in the animal kingdom. Therefore, the most parsimonious explanation for the origins of complex elastic recoil devices is that they represent secondary developments that arose exclusively in the Auchenorrhyncha.
Suboptimal capability of individual machine learning algorithms in modeling small-scale imbalanced clinical data of local hospital
Authors: Li Gang , Li Chenbi , Wang Chengli , Wang Zeheng
Published: February 2024

In recent years, artificial intelligence (AI) has shown promising applications in various scientific domains, including biochemical analysis research. However, the effectiveness of AI in modeling small-scale, imbalanced datasets remains an open question in such fields. This study explores the capabilities of eight basic AI algorithms, including ridge regression, logistic regression, random forest regression, and others, in modeling a small, imbalanced clinical dataset (total n = 387, class 0 = 27, class 1 = 360) related to the records of the biochemical blood tests from the patients with multiple wasp stings (MWS). Through rigorous evaluation using k-fold cross-validation and comprehensive scoring, we found that none of the models could effectively model the data. Even after fine-tuning the hyperparameters of the best-performing models, the results remained below acceptable thresholds. The study highlights the challenges of applying AI to small-scale datasets with imbalanced groups in biochemical or clinical research and emphasizes the need for novel algorithms tailored to small-scale data. The findings also call for further exploration into techniques such as transfer learning and data augmentation, and they underline the importance of understanding the minimum dataset scale required for effective AI modeling in biochemical contexts.
The use of ultraviolet light generated from light-emitting diodes for the disinfection of transvaginal ultrasound probes
Authors: Yasir Muhammad , Willcox Mark D. P.
Published: February 2024

Transvaginal ultrasound probes (TVUS) are used for several gynecological procedures. These need to be disinfected between patient use. In the current study we examine whether UVC delivered using light emitting diodes for 90 seconds can provide sufficient disinfection efficacy. A new UVC device that delivers UVC radiation at 265nm-275nm for 90 seconds was used. TVUS probes were swabbed before and after use in an in vitro fertilization clinic. Microbes on the swabs were cultured and identified. In addition, the ability of the UVC device to provided repeated high-level disinfection was analysed by deliberately contaminating probes with spores of Bacillus subtilis and then performing the UVC disinfection and bacterial culture. 50% of probes were contaminated with bacteria, most commonly Bacillus sp., directly after in vivo use. Whereas 97% were sterile after UVC disinfection for 90 seconds. The UVC treatment resulted in no growth of B. subtilis spores after each of five repeated contaminations with 5–9 x 107 spores on the probes. This study has found that UVC delivered via light emitting diodes for only 90 seconds can produce high level disinfection of transvaginal probes.
Impact of an angulated aorto-septal relationship on cardio-cerebrovascular outcomes in patients undergoing hemodialysis
Authors: Nakayama Takafumi , Yamamoto Junki , Ozeki Toshikazu , Tokoroyama Shigehiro , Mori Yoshiko , Hori Mayuko , Tsujita Makoto , Shirasawa Yuichi , Takeda Asami , Kondo Chika , Murata Minako , Suzuki Shigeru , Kinoshita Yuko , Fukuda Michio , Ueki Tsuneo , Ikehara Noriyuki , Sugiura Masato , Goto Toshihiko , Hashimoto Hiroya , Yajima Kazuhiro , Maruyama Shoichi , Koyama Hiroichi , Morozumi Kunio , Seo Yoshihiro
Published: February 2024

Aortic and valvular calcification are well-known risk factors for cardio-cerebrovascular events in patients undergoing hemodialysis. We investigated the clinical impact of an angulated aorto-septal angle as a result of aortic elongation due to aortic calcification on cardio-cerebrovascular outcomes in patients undergoing hemodialysis. We investigated 306 patients (mean age 65.4 years, 68% male) who underwent pre-scheduled routine echocardiography between April and September 2018. The angle between the anterior wall of the aorta and the ventricular septal surface (ASA) was quantified. We determined aortic and mitral valve calcification scores based on calcified cardiac changes; the aortic and mitral valve scores ranged between 0–9 and 0–6, respectively. The primary endpoint was a composite including cardio-cerebrovascular events and cardio-cerebrovascular death. The mean duration of dialysis among the patients in this analysis was 9.6 years. The primary endpoint was observed in 54 patients during the observational period (median 1095 days). Multivariable Cox proportional hazards analyses identified left ventricular ejection fraction (per 10% increase: hazard ratio [HR] 0.67; 95% confidential interval [CI] 0.53–0.84, P = 0.001), left ventricular mass index (per 10 g/m2 increase: HR 1.14; 95% CI 1.05–1.24, P = 0.001), ASA (per 10 degree increase: HR 0.69; 95% CI 0.54–0.88; P = 0.003), and aortic valve calcification score (HR 1.15; 95% CI 1.04–1.26, P = 0.005) as independent determinants of the primary endpoint. Kaplan-Meier analysis showed a higher incidence of the primary endpoint in patients with ASA <119.4 degrees than those with ASA ≥119.4 degrees (Log-rank P < 0.001). An angulated aorto-septal angle is an independent risk factor for cardio-cerebrovascular events and cardio-cerebrovascular death in patients undergoing hemodialysis.
Surgical treatment in the chronic phase for uncomplicated Stanford type B aortic dissection
Authors: Matsushita Akihito , Tabata Minoru , Hattori Takashi , Mihara Wahei , Sato Yasunori
Published: February 2024

Background

The most appropriate surgical method for patients with uncomplicated type B aortic dissection (UTBAD) in the chronic phase remains controversial. This study evaluated the outcomes of patients with UTBAD who needed aortic treatment as well as the impact of the treatment method or indication criteria on their prognosis.

Methods

This retrospective review of 106 consecutive patients with aortic events in the chronic phase who underwent initial treatment for UTBAD between 2004 and 2021 comprised three groups: 19 patients who underwent endovascular repair (TEVAR), 38 who underwent open aortic repair and the medication group that included 49 patients. Aortic events were defined as a late operation or indication for operation for dissected aorta, aortic diameter (AD) ≥ 55 mm, rapid aortic enlargement (≥5 mm/6 months), and saccular aneurysmal change. The endpoint was all-cause death. We assessed the association between treatment methods or surgical indication criteria and mortality using a Cox regression analysis.

Results

The 5-year actuarial mortality rates were 27.1% in the TEVAR group, 19.6% in the open aortic repair group, and 38.4% in the medication group (p = 0.86). Moreover, the 5-year actuarial mortality rates in patients who had AD ≥ 55 mm were significantly higher than those patients with other surgical indication criteria (41.2% vs. 18.7%, p < 0.01). Multivariable analysis revealed a significant difference in AD ≥ 55 mm (hazard ratio [HR]: 2.88, 95% confidence interval [CI] 1.38–6.02, p < 0.01) and age (HR: 1.09, 95% CI 1.05–1.13, p < 0.01).

Conclusions

Under the existing surgical indication criteria, there was no difference in mortality rates among patients with UTBAD based on their surgical treatment.
Knowledge, attitude and practice of home management of diarrhea among under-five children in East Africa: A systematic review and meta-analysis
Authors: Abate Biruk Beletew , Zemariam Alemu Birara , Wondimagegn Addis , Abebe Gebremeskel Kibret , Araya Freweyni Gebreegziabher , Kassie Ayelign Mengesha , Bizuayehu Molla Azmeraw
Published: February 2024

Introduction

Diarrhea is particularly prevalent in low-income or marginalized populations because these groups have less access to clean water sources, hygienic conditions, and healthcare. Dehydration due to electrolyte and fluid loss is the main cause of deaths associated with diarrhea. An especially important factor in this death from dehydration is the caregivers’ knowledge, attitude, and diarrhea management techniques. While a number of research have been done on managing diarrhea at home, the results tend not to be consistent. This systematic review and meta-analysis aimed to assess the pooled estimate of knowledge, attitude and practice of home-based management of diarrhea in East Africa.

Methods

Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines was used to search articles from electronic databases (Cochrane library, Ovid platform (Medline, Embase, and Emcare), Google Scholar, CINAHL, PubMed, and institutional repositories in East Africa countries. The last search date was on 01/06/ 2023 Gregorian Calendar. The authors extracted year of publication, country, study design, knowledge level, attitude level and practice level of home-based management of diarrhea. A weighted inverse variance random-effects model was used to estimate the pooled prevalence of knowledge, attitude and practice of home-based management of diarrhea. Subgroup analysis was done by country, and sample size. Publication bias and sensitivity analysis were also done.

Results

A total of 19 articles with (n = 7470 participants) were included for the final analysis. From the random-effects model analysis, the pooled prevalence of good practice, good knowledge and favorable attitude towards home based management of diarrhea in East Africa was found to be 52.62% (95% CI: 45.32%, 59.92%) (95% CI: I2 = 78.3%; p < 0.001), 37.44% (95% CI: 26.99%, 47.89%) (95% CI: I2 = 89.2%; p < 0.001) and 63.05% (95% CI: 35.7%, 90.41%) (95% CI: I2 = 97.8%; p < 0.001) respectively.

Conclusion and recommendations

The level of good knowledge, attitude and practice of home based management of diarrhea in East Africa is found to be low. A collaborative effort from different stakeholders to enhance the knowledge, attitude and practice is needed to tackle the burden of diarrhea and its consequences.
Validation of the Italian version of the Dark Tetrad at Work scale
Authors: Marcatto Francesco , Di Blas Lisa , Ferrante Donatella , Hipel Isaiah , Kelloway Kevin
Published: February 2024

This study presents and validates the Italian adaptation of the Dark Tetrad at Work (DTW) scale, an instrument for assessing four socially aversive personality traits (narcissism, Machiavellianism, psychopathy and sadism) in the context of the workplace. A total of 300 Italian-speaking participants (50% female, M age = 32 years ± 9.2) and 253 English-speaking participants (38% female, M age = 39 years ± 12.1) were recruited via an online survey platform. The Italian-speaking sample was used to test the factorial structure, reliability and criterion-related validity of the Italian version of the DTW, whereas the English-speaking sample was used to test cross-language measurement invariance. Results from confirmatory factor analysis showed that the original four-factor model provided the best fit to the data. The Italian DTW scale demonstrated acceptable internal consistency, with reliability coefficients of ω = .77 for narcissism, ω = .80 for Machiavellianism, and ω = .81 for both psychopathy and sadism. Concurrent associations between the DTW scales and negative and positive workplace outcomes supported the criterion validity of the scale. Machiavellianism, psychopathy, and sadism positively correlated with counterproductive work behaviors and workplace bullying, and negatively with organizational citizenship behaviors and affective organizational commitment. In contrast, narcissism exhibited a unique pattern: It correlated positively with positive workplace behaviors and negatively with counterproductive behaviors toward the organization, but it was also found to be a significant predictor of workplace bullying. This finding may reflect multidimensional nature of narcissism, but a note of caution is warranted in interpreting this result, as all measurements relied on self-report instruments, introducing the possibility of socially desirable associations influencing the outcomes. Finally, the comparison with the English sample established configural, full metric and partial scale invariance, allowing for valid cross-language comparisons between Italian and English-speaking populations in the future. Preliminary Italian normative data were provided to offer a benchmark for the interpretation of DTW values. This study provides a reliable and valid instrument tailored to the Italian workforce, enhancing our understanding of dark personality traits within organizational contexts and providing organizations with an effective means to address and manage dark personality traits for a healthier workplace culture.
Sublethal thermal stress promotes migration and invasion of thyroid cancer cells
Authors: Kuo Chi-Yu , Tsai Chung-Hsin , Wu Jun Kui , Cheng Shih-Ping
Published: February 2024

Objective

Radiofrequency ablation is a viable option in the treatment of benign thyroid nodules. Some reports suggest that thermal ablation may also be safe for the management of low-risk thyroid cancer. In this study, we applied transient heat treatment to thyroid cancer cells to mimic clinical scenarios in which insufficient ablation leads to incomplete eradication of thyroid cancer.

Methods

Differentiated thyroid cancer cell lines B-CPAP, TPC-1, and FTC-133 were subjected to heat treatment at different temperatures for 10 min. Effects on cell growth, clonogenicity, wound healing assay, and Transwell invasion were determined.

Results

Heat treatment at 45°C or higher reduced cell growth, whereas viability of thyroid cancer cells was not changed after heat treatment at 37, 40, or 42°C. Heat treatment at 40°C increased the number of colony formations by 16% to 39%. Additionally, transient heat treatment at 40°C resulted in a 1.75-fold to 2.56-fold higher migratory activity than treatment at 37°C. Invasive capacity was increased after heat treatment, ranging from 115% to 126%. Expression of several epithelial-mesenchymal transition markers, including ZEB1, N-cadherin, and MMP2, was upregulated following heat treatment at 40°C.

Conclusion

We for the first time demonstrate that sublethal thermal stress may increase clonogenicity, migration, and invasion of thyroid cancer cells.
Modern and traditional cooking methods affect the antioxidant activity and phenolic compounds content of Trachystemon Orientalis (L.) G. Don
Authors: Demirel Ozbek Yagmur , Saral Ozlem , Turker Perim Fatma
Published: February 2024

Trachystemon orientalis (L.) G. Don is a medicinal plant with beneficial effects on human health. Its antioxidant and phenolic compound content is higher than most natural plants. This is the first study on the cooking of this consumed plant. This study investigated how different cooking methods and times affect the antioxidant activity and phenolic compound content of Trachystemon orientalis (L.) G. Don. The Folin-Ciocalteu method (FCR), ferric-reducing antioxidant power (FRAP), copper-reducing antioxidant capacity (CUPRAC), and 2,2-diphenyl-1-picrylhydrazyl (DPPH) radical scavenging activity were used to evaluate the antioxidant activity and total phenolic content (TPC). Phenolic compounds were also determined by high-performance liquid chromatography (HPLC). Microwave cooking, stir-frying and sous vide increased TPC and antioxidant activity (p<0.05). Steaming decreased TPC and antioxidant activity (p<0.05). It was determined that the best cooking method and time was stir-frying for 15 minutes (TPC, CUPRAC and FRAP values 45.18±3.91 mg GAE/g DW, 15559.39±106.90 mmol Troloks/g DW and 555.10±24.05 μmol Fe (II)/g DW, respectively). Raw Trachystemon orientalis (L.) G. Don was detected with caffeic acid (31.53±0.25 mg/100 g DW). New phenolic compounds (protocatechuic acid and p-coumaric acid) were formed by boiling, stir-frying, microwaving, and sous vide methods. In conclusion, regarding antioxidant activity and phenolic compounds of Trachystemon orientalis (L.) G. Don; the best cooking methods are microwave, stir-frying, and sous vide (p<0.05). The most wrong cooking method is steaming (p<0.05).
Research on factors affecting the spread of dust pollution in conveyor belt workshop and research on wet dust reduction technology
Authors: Jing Deji , Ma Jichuang , Dong Zhe , Bai Luyue , Kan Qisheng
Published: February 2024

At this stage, there are many dust-hazardous industries, and occupational pneumoconiosis has a high incidence for a long time. To solve the dust pollution problem in coal processing plant workshops, the dust particle field and liquid droplet particle field were numerically simulated using computational fluid dynamics (CFD), and the influences of the induced airflow and corridor wind speed on the internal airflow field of the workshop were investigated to derive the dust pollution mechanism in the coal plant workshop under the change in the wind flow field. In this study, it was shown that the wind flow rate in the coal processing plant workshop is mainly affected by the corridor wind speed, and the higher the corridor wind speed is, the higher the wind flow rate. The induced airflow mainly affected the direction of the wind flow field in the workshop. According to the conclusions obtained from the simulations, a spray dust reduction system was designed for the coal processing plant workshop and applied in the Huangyuchuan coal processing plant. On-site measurement revealed that the dust reduction effect inside the coal processing plant workshop is obvious, and the overall dust reduction efficiency in the workshop reaches more than 94%, which meets the requirements of environmentally sustainable development and clean production.
Sequences at gene segment termini inclusive of untranslated regions and partial open reading frames play a critical role in mammalian orthoreovirus S gene packaging
Authors: Dhar Debarpan , Mehanovic Samir , Moss Walter , Miller Cathy L.
Published: February 2024

Mammalian orthoreovirus (MRV) is a prototypic member of the Spinareoviridae family and has ten double-stranded RNA segments. One copy of each segment must be faithfully packaged into the mature virion, and prior literature suggests that nucleotides (nts) at the terminal ends of each gene likely facilitate their packaging. However, little is known about the precise packaging sequences required or how the packaging process is coordinated. Using a novel approach, we have determined that 200 nts at each terminus, inclusive of untranslated regions (UTR) and parts of the open reading frame (ORF), are sufficient for packaging S gene segments (S1-S4) individually and together into replicating virus. Further, we mapped the minimal sequences required for packaging the S1 gene segment into a replicating virus to 25 5′ nts and 50 3′ nts. The S1 UTRs, while not sufficient, were necessary for efficient packaging, as mutations of the 5′ or 3′ UTRs led to a complete loss of virus recovery. Using a second novel assay, we determined that 50 5′ nts and 50 3′ nts of S1 are sufficient to package a non-viral gene segment into MRV. The 5′ and 3′ termini of the S1 gene are predicted to form a panhandle structure and specific mutations within the stem of the predicted panhandle region led to a significant decrease in viral recovery. Additionally, mutation of six nts that are conserved across the three major serotypes of MRV that are predicted to form an unpaired loop in the S1 3′ UTR, led to a complete loss of viral recovery. Overall, our data provide strong experimental proof that MRV packaging signals lie at the terminal ends of the S gene segments and offer support that the sequence requirements for efficient packaging of the S1 segment include a predicted panhandle structure and specific sequences within an unpaired loop in the 3′ UTR.
Editorial
Authors: Gowar Mick , Moore Amber
Published: February 2024

This editorial is a brief summary of the articles, interviews and reviews contained in issue Volume 13, Issue 2 of Book 2.0 (BTWO), an interdisciplinary peer-reviewed journal primarily concerned with book creation and publication, including writing, illustration and design and the theoretical and practical study of books, literature, creative writing, storytelling, languages and cultures. Contents for this issue include articles, interviews and reviews mainly focusing on collaboration and cooperation between creative practitioners, scholars and in publishing.