bluuebunny/crossref_metadata_2025 huggingface dataset:
The bergen 4-day treatment for panic disorder: a longer-term follow-up
Authors: Eide Thorstein Olsen , Hansen Bjarne , Hjelle Kay Morten , Solem Stian , Wheaton Michael G. , Björgvinsson Thröstur , Kvale Gerd , Hagen Kristen
Published: February 2025

Introduction

Bergen 4-Day treatment (B4DT) is a form of concentrated exposure-based cognitive behavioral therapy (CBT) in which patients receive treatment over four consecutive days. Previous studies have shown B4DT to be a promising treatment format for panic disorder (PD), although the long-term stability of treatment gains requires additional study.

Aim

The aim of the current study was to evaluate the longer-term effectiveness of B4DT for patients with panic disorder with or without agoraphobia. This study extends a previously published study by providing a long-term follow-up of the same cohort (n = 30), initially assessed at three months post-treatment.

Method

Thirty patients with panic disorder were consecutively included in a retrospect open trial. The primary outcome measure was the Panic Disorder Severity Scale. The secondary outcome measures were the Generalized Anxiety Disorder-7 and the Patient Health Questionnaire-9. Outcomes were assessed at pretreatment, posttreatment, 3-month follow-up, and longer-term follow-up (with a mean time of 18 months).

Results

There was a significant reduction in panic disorder symptoms from pretreatment to longer-term follow-up (d = 5.03, 95% CI [18.55, 21.12] to [1.33, 3.87]). The Panic Disorder Severity Scale (PDSS) mean decreased from 19.83 (SD = 0.64, 95% CI [18.55, 21.12]) before treatment, to 4.37 (SD = 0.64, 95% CI [2.98, 5.76]) post-treatment, followed by further decreases at the 3-month follow-up to a mean of 2.84 (SD = 0.64, 95% CI [1.45, 4.22]), and at the longer-term follow-up to 2.60 (SD = 0.64, 95% CI [1.33, 3.87]). There was no significant difference in symptom severity between the 3-month and 18-month assessments, indicating a sustained improvement (p <.001). At the 18-month follow-up, 90% of the patients were classified as being in remission. There were also significant reductions in symptoms of depression (d = 1.44) and generalized anxiety (d = 1.62) that were maintained at the longer-term follow-up assessment.

Conclusion

The results from the current study indicated that the treatment effects of B4DT are stable over time and that the treatment format appears to be promising for PD. Confirming these preliminary results in rigorous study designs is needed.

Trial registration

The study was approved by the Regional Committee for Medical and Health Research Ethics of Northern Norway (REK Nord-2021/209619).
Mobility, ICT, and health: a built environment investigation of older Chinese migrants’ social isolation and loneliness
Authors: DeJohn Amber , Liu Bochu , Ma Xinlin , Widener Michael J. , Liu Zhilin
Published: February 2025

Background

Social isolation and loneliness have detrimental impacts on health, especially for older adults. During the COVID-19 pandemic, physical access to third places (e.g., coffee shops, libraries) decreased due to the closure of non-essential destinations and personal risk assessments. Older adults reported adopting information and communication technology (ICT) during pandemic lockdowns. ICT-mediated socializing may have different impacts on loneliness than in-person equivalents. Understanding access to social connection and their distinct relationships to the built environment and health for older Chinese migrants is critical to supporting equitable, healthy aging in a post-COVID world.

Methods

Using a survey of older Chinese migrants in the Greater Toronto Area (GTA) during the extended COVID-19 lockdown, we investigate how community mobility and ICT use, two mechanisms of socializing, relate to the built environment and influence loneliness (De Jong Gierveld 6-item scale), as well as mental and physical health (SF-12). Specifically, we use a structural equation model to test a theoretical framework of older adult social isolation.

Results

Our model demonstrates the importance of community mobility for reducing feelings of loneliness, while ICT use is significantly related to better physical health. Both community mobility and ICT use have significant, although opposite, relationships to transit density.

Conclusions

Results indicate that ICT use might have limited ability to reduce loneliness and support mental health when mobility is limited. Addressing older migrants’ barriers to community mobility is critical to reducing feelings of loneliness.
Evaluation of primary health care nurses’ knowledge and neonatal screening performance for phenylketonuria in Alexandria
Authors: El-Samie Ismail Esraa Mohammed Abd , Elarousy Wafaa Mohamed , Badawe Shaymaa Saeed Mohamed , Abohadida Rasha Mohamed
Published: February 2025

Introduction

Nurses play a crucial role in the primary prevention of phenylketonuria (PKU) within national screening programs for newborns. This is achieved through consult with the child’s provider promptly to arrange a PKU test, accurate collection of blood samples at maternal and child health centers, enable early detection of potential cases.

Aim

This study aimed to assess the level of primary health care nurses’ knowledge and neonatal screening performance for phenylketonuria in Alexandria

Methods

A descriptive research design was used. The study included all nurses (50 nurses) who are responsible for obtaining newborn screening test from 5 primary health care centers in Alexandria. Two tools were used to collect the necessary data: nurses’ knowledge regarding phenylketonuria disease assessment sheet and nurses’ performance about newborn screening for phenylketonuria observational checklist.

Results

It was found that the mean age of participant was 42.94 ± 5.0 and 52% of them had completed their technical level of education and the means years of experience was 17.64 ± 4.84. The total mean score of nurses’ knowledge regarding phenylketonuria screening was 16.24 ± 1.99 with the mean percent score of 72.72 ± 8.27. It was also found the total score of nurses’ screening performance was 11.0 ± 0.97 with the mean percent score of 64.71 ± 5.70. A significant positive correlation was found between nurses’ knowledge and their screening performance with P = < 0.001.

Conclusion

It was concluded that majority of participant nurses had correct knowledge in neonatal screening and many aspects of phenylketonuria disease. However, they still needed support in steps related to infection control.
Comparative experimental anesthesia efficacy study of epidural injection at the sacrococcygeal space using ultrasound guidance versus blindness technique in Egyptian donkeys (Equus asinus)
Authors: Hamed Mohamed A. , Hamouda Hazem , Elmetwally Mohammed , Farrag Foad , Rizk Mohamed Abdo , Abumandour Mohamed M. A. , Hegazy Yamen Mohammed , Samy Alaa
Published: February 2025

The study investigates the effectiveness of blind and ultrasound-guided epidural injections in Egyptian donkeys in the sacrococcygeal region, a topic of limited research, by comparing and assessing their onset in 20 healthy adult donkeys of both sexes. In the first group, we used ten cadaver donkeys that were humanely euthanized. In the second group, we used 10 live, healthy adult donkeys to assess the efficacy and time of analgesia onset for blind and ultrasound-guided epidural injections at the sacrococcygeal region. Cadavers were randomly designated to blind (n = 5) or US-guided (n = 5) epidural injections at the sacrococcygeal region in sternal recumbency in donkeys using Methylene Blue (1%) as a diagnostic marker for caudal epidural injection. The injection criteria were comparatively assessed between the two techniques of injection. Our findings comparing the blind and US-guided injection approaches showed substantially higher needle accuracy penetration to comparatively assess these two injection techniques. Both injection difficulties and trial numbers were significantly greater in blind techniques as opposed to US-guided procedures. US-guided injection procedures revealed the effectiveness of the time needed for perfect placement of the needle was significantly less than with a blind one. A shorter time for the onset of analgesia was achieved with the ultrasound-guided method, although the difference was not statistically significant (P < 0.09). In conclusion, the ultrasound-guided technique of the epidural injection provided a number of benefits over the blind one, including the capacity to directly view the needle and distribute local anesthetic and avoid unintentional vascular damage, in comparison with traditional blind techniques. Our study aims to enhance the accuracy and safety of epidural anesthesia injection at the sacrococcygeal space in Egyptian donkeys using ultrasound guidance in the veterinary surgical field.
Transformation and fate of Fe(III) in petroleum-hydrocarbon-contaminated soil and groundwater
Authors: Elikem Essouassi , Bulmer David , Bradshaw Kris , Hayatifar Ardalan , Lindsay Matthew B. J. , Siciliano Steven D. , Peak Derek
Published: February 2025

In anoxic subsurface environments, low Fe(III) bioaccessibility greatly limits in situ biodegradation of petroleum hydrocarbons (PHCs). Ferric ammonium citrate is a soluble compound that has the potential to increase the bioaccessibility of Fe(III). However, in neutral to alkaline environments, Fe(III) hydrolysis can produce Fe(III) (oxyhydr)oxides that may subsequently transform or recrystallize to relatively stable and less bioaccessible phases. Accordingly, the objective of this study was to elucidate the transformation and fate of Fe(III) contributed by ferric ammonium citrate in a gasoline-contaminated subsurface environment that was undergoing in situ bioremediation. Ferric ammonium citrate, together with sodium tripolyphosphate, magnesium sulphate, and nitric acid, was continuously injected into the contaminated groundwater for about 22 weeks. Colloids in the groundwater (solid particles retained on a 0.45

$$\upmu$$

μ

m filter) and soil cores were collected from the site. Fe speciation in these samples was characterized using X-ray absorption near edge structure (XANES) and Fourier transform infrared (FTIR) spectroscopy. The groundwater colloids (GWCs) contained mostly octahedrally coordinated Fe(III), but the subsoils contained both octahedrally coordinated Fe(III) and Fe(II). The fraction of Fe(II) in the subsoils generally increased after about 22 weeks of continuous amendment injection. Ferric ammonium citrate did not persist in the PHC-contaminated subsurface: the Fe(III) it contained was transformed to solid phases. Fe(III)-organic-matter (Fe(III)-OM) complex/coprecipitate and sulfate green rust were the major phases present in the GWCs; akaganeite, chloride green rust, vivianite, ferrihydrite, Fe(III)-silicate, and magnetite were present as minor phases. The subsoils contained three major phases: Fe(III)-OM complex/coprecipitate, magnetite, and calcium ferric silicate. The presence of major Fe(II) phases in the subsoils strongly indicate that secondary Fe(III) phases (especially Fe(III)-OM complex/coprecipitate) served as terminal electron acceptors during the microbial degradation of PHCs in the contaminated subsurface.
Acceptance and affordability of malaria vaccines: issues relating to hesitancy and willingness to pay amongst Nigerian parents of under-five children
Authors: Adigwe Obi Peter , Onavbavba Godspower
Published: February 2025

Background

With the recent approval of the malaria vaccine by the World Health Organization, it is expected that global acceptance and subsequent uptake of the intervention can help to reduce the burden of the disease in Africa. This study adopted a proactive approach in assessing parents' acceptance of the malaria vaccine, alongside their willingness to pay for the novel public health intervention.

Methods

A national cross-sectional survey was undertaken in Nigeria using a questionnaire as the data collection instrument. The study tool was administered to parents of child-bearing age. Descriptive and inferential statistical analyses were performed using the Statistical Package for Social Sciences (SPSS) software version 25.

Results

A total of 1413 valid responses were received with male (49.5%) and female (50.5%) participants represented by similar proportions. Close to two-thirds (62.5%) of the participants were between the ages of 31 and 40 years, and 47.4% of the participants were educated up to national diploma level. More than two-thirds (69.6%) of the participants indicated that they were worried about side effects that may be associated with the malaria vaccine. A strong majority (90%) of the participants indicated that the vaccine should be administered at no cost to citizens, while 46.7% of the respondents were willing to pay for the malaria vaccination. Levels of education attained by the respondents influenced their willingness to pay for malaria vaccination. This variable also underpinned participants'  reasons for non-acceptance of the vaccine. Those who attained only primary and secondary levels of education were significantly more likely to reject the malaria vaccine because they were against vaccines in general (AOR = 6.63; 95% CI = 1.33 – 39.25; p = 0.021).

Conclusion

This study provides critical novel insights which could influence vaccination efforts aimed at reducing the burden of malaria in Nigeria, as well as similar settings.
The distribution and spectrum of thalassemia variants in GUIYANG region, southern China
Authors: Zhao Xuanyin , You Zhiyu , Deng Yunyan , Zhou Yi , Deng Dongyang , Quan Jian , Chen Fang , Yan Zhimei , Qi Ya , Chen Leilei , Xiang Fang , Zheng Weixian , Zhang Ruyi
Published: February 2025

Thalassemia is one of southern China’s most common inherited disorders. This retrospective study analyzed the results of thalassemia gene testing conducted on 20,478 individuals from January 1, 2019, to April 31, 2024 in the First Affiliated Hospital of Guizhou University of Traditional Chinese Medicine. The cohort consisted of 19,733 females and 745 males, with 1401 individuals testing positive for thalassemia. Among the positive cases, 942 had α thalassemia, 431 had β thalassemia, and 25 had variants in both α and β thalassemia genes. Interestingly, a subgroup of individuals with thalassemia variants not previously documented in medical literature was identified. The study highlighted the prevalence of thalassemia among different ethnic groups, with individuals of Han ethnicity being the most affected. Geographical analysis revealed a concentration of cases in Guizhou Province, particularly in Guiyang city, Bijie, and Qiannan Prefecture. These findings provide valuable insights into the epidemiology of thalassemia in the region and the distribution of affected individuals.
Transcriptome atlases of rat brain regions and their adaptation to diabetes resolution following gastrectomy in the Goto-Kakizaki rat
Authors: Brial François , Le Lay Aurélie , Rouch Claude , Henrion Edouard , Bourgey Mathieu , Bourque Guillaume , Lathrop Mark , Magnan Christophe , Gauguier Dominique
Published: February 2025

Brain regions drive multiple physiological functions through specific gene expression patterns that adapt to environmental influences, drug treatments and disease conditions. To generate a detailed atlas of the brain transcriptome in the context of diabetes, we carried out RNA sequencing in hypothalamus, hippocampus, brainstem and striatum of the Goto-Kakizaki (GK) rat model of spontaneous type 2 diabetes, which was applied to identify gene transcription adaptation to improved glycemic control following vertical sleeve gastrectomy (VSG) in the GK. Over 19,000 distinct transcripts were detected in the rat brain, including 2794 which were consistently expressed in the four brain regions. Region-specific gene expression was identified in hypothalamus (n = 477), hippocampus (n = 468), brainstem (n = 1173) and striatum (n = 791), resulting in differential regulation of biological processes between regions. Differentially expressed genes between VSG and sham operated rats were only found in the hypothalamus and were predominantly involved in the regulation of endothelium and extracellular matrix. These results provide a detailed atlas of regional gene expression in the diabetic rat brain and suggest that the long term effects of gastrectomy-promoted diabetes remission involve functional changes in the hypothalamus endothelium.
Modeling and scientific analysis of pediatric medication evaluation based on MDM-DEA-Malmquist model: construction of health management in pediatrics in developing countries
Authors: Fang Kaixian , Xue Shaoqin
Published: February 2025

Background

The developing countries represented by China have huge population potential and child population. However, due to economic and social development constraints, pediatrics need help regarding resources and technology. The level of pediatric medical care remains inadequate.

Methods

This article constructs an MDM matrix framework for the pediatric medical nursing level. Combining the lean model theory, the key indicators of children's medical care are analyzed. Thus, it helps medical institutions scientifically evaluate and guide pediatric nursing. Based on the linkage extension of the MDM model and the DEA-Malmquist model, an evaluation system was established to reflect the current situation of pediatric drug use in China. The study used provincial indicator data on pediatric medication in China from 2015 to 2021.

Results

We found that indicators such as physician literacy, health records, child status, and parental awareness were the most important under different medication cycles and goals. The importance of pre-administration evaluation was as high as 53.5%, and the importance of post-administration evaluation was only 13.7%. The efficacy of pediatric medication in developed provinces was significantly optimized. The input–output structure of pediatric medication in superior provinces was consistent with the feedback sequence of the MDM matrix.

Conclusions

This indicates that the evaluation results of the MDM matrix have guiding significance for optimizing pediatric medication efficacy. This paper aims to help developing countries establish an optimized pediatric medication evaluation system and improve the pediatric healthcare environment.
Single-center experience and evaluation of rare ıntracranial abscesses in childhood
Authors: Yildiz Nihal , Gayretli Aydin Zeynep Gökçe
Published: February 2025

Background

Intracranial abscess (IA) is a rare disorder in childhood. Clinical manifestations of brain abscess include headache, fever, and focal neurological deficits. This study aimed to examine the demographic, clinical, laboratory, and imaging findings in children with IA.

Methods

Children admitted to the pediatric infection service with a diagnosis of IA between 2011 and 2022 were included in the study. Abscesses were divided into two groups: infratentorial and supratentorial. Demographic characteristics of the patients, complaints, MRI findings, and follow-up data were recorded and compared between the two groups.

Results

The study included a total of 23 patients, 9 (39.1%) of whom were male, with a mean age at diagnosis of 79.3 ± 65.4 months. The most common complaints were headache (39.1%), fever (91.3%), focal neurological deficits (60.9%), seizures, loss of consciousness (26.1%), and meningitis findings (60.9%). The most frequent etiology was post-operative procedures (30.4%), followed by a history of meningomyelocele (13%), and congenital heart disease (8.7%). On MRI, 68.7% of the supratentorial abscesses were multiple and commonly localized in the frontal and parietal regions. Treatment included ceftriaxone (82.6%), vancomycin (65.2%), meropenem (43.5%), metronidazole (34.8%), and linezolid (17.4%). The median hospitalization duration for patients was 32 days (range: 14–150). Of the patients, 34.8% were hospitalized and followed in the intensive care unit, and neurosurgery performed surgical interventions in 60.9% of cases, with evacuation in 21.7% of cases. In cultures, the causative agent was identified on average within 4 ± 1.3 days. Recurrence of abscess occurred in three (13%) cases, and 13% of cases had residual sequelae.

Conclusions

Intracranial abscess is a rare infectious disease that can result in long-term neurological deficits requiring extended follow-up and treatment. A correct and effective approach also positively impacts the prognosis of patients.
Digital twins as global learning health and disease models for preventive and personalized medicine
Authors: Li Xinxiu , Loscalzo Joseph , Mahmud A. K. M. Firoj , Aly Dina Mansour , Rzhetsky Andrey , Zitnik Marinka , Benson Mikael
Published: February 2025

Ineffective medication is a major healthcare problem causing significant patient suffering and economic costs. This issue stems from the complex nature of diseases, which involve altered interactions among thousands of genes across multiple cell types and organs. Disease progression can vary between patients and over time, influenced by genetic and environmental factors. To address this challenge, digital twins have emerged as a promising approach, which have led to international initiatives aiming at clinical implementations. Digital twins are virtual representations of health and disease processes that can integrate real-time data and simulations to predict, prevent, and personalize treatments. Early clinical applications of DTs have shown potential in areas like artificial organs, cancer, cardiology, and hospital workflow optimization. However, widespread implementation faces several challenges: (1) characterizing dynamic molecular changes across multiple biological scales; (2) developing computational methods to integrate data into DTs; (3) prioritizing disease mechanisms and therapeutic targets; (4) creating interoperable DT systems that can learn from each other; (5) designing user-friendly interfaces for patients and clinicians; (6) scaling DT technology globally for equitable healthcare access; (7) addressing ethical, regulatory, and financial considerations. Overcoming these hurdles could pave the way for more predictive, preventive, and personalized medicine, potentially transforming healthcare delivery and improving patient outcomes.
Swedish version of the Pregnancy Physical Activity Questionnaire (PPAQ-SWE), translation and cultural adaptation
Authors: Ekdahl Annika Svahn , Mikkelsen Viana , Frenell Heléna , Lood Qarin , Westgård Theresa , Fuller Joanne M. , Mikkelsen Andrea , Gutke Annelie
Published: February 2025

Objective

Physical activity has well-known health benefits in all stages of life and may also reduce the risk for pregnancy-related complications, but many pregnant women do not reach the recommended activity levels. Tailored advice is often provided by healthcare professionals to promote physical activity during pregnancy. To provide such advice, assessment of the actual level of physical activity is necessary, but there are currently no standardized methods for this. The Pregnancy Physical Activity Questionnaire (PPAQ) is a self-administered instrument, designed to determine physical activity during pregnancy but a Swedish version of the questionnaire is not yet available.

Result

The PPAQ was translated and culturally adapted into a Swedish version, i.e., PPAQ-SWE according to the process described by Beaton et al. Several minor linguistic adjustments were needed, that mainly concerned semantic and cultural adaptations, such as adding, removing, or replacing words to match Swedish cultural aspects. For instance, “gestational week” was used instead of “trimester,” and “older person” replaced “older adult.” The reference to a “1-gallon milk jug” was replaced with “3–4 liters of milk” to fit the metric system used in Sweden. Two questions regarding bicycling, a common form of transportation in Sweden, and one free-text comment option was added.
The decision-making process and experiences of women returning to work after parental leave: a qualitative systematic review protocol
Authors: Sahin Safiye , Dunbar Sabine S. , Sehgal Gurmeet , Roberts Lisa R. , Nick Jan M.
Published: February 2025

Objective

To investigate the decision-making process of women returning to work after maternity leave or parental leave and explore the influence of cultural norms and societal expectations on their choices. Additionally, we seek to understand the lived experiences of the women in this context.

Introduction

Cultural norms and societal expectations significantly affect women’s decisions regarding post-childbirth employment. However, a comprehensive understanding of these influences on women’s experiences returning to work after parental leave is lacking.

Inclusion criteria

We will include qualitative studies examining women’s decision-making processes and experiences of returning to work after parental leave, with a focus on the influence of cultural norms and societal expectations. Studies from diverse cultural and geographical settings, including peer-reviewed journals and gray literature, will be considered without restrictions on publication date or language.

Methods

The review will adhere to the JBI approach for qualitative systematic reviews. Major academic databases and search engines, such as CINAHL, PubMed, and Google Scholar, will be used. Study selection will involve screening titles and abstracts for relevance, followed by a full-text assessment against inclusion criteria by two independent reviewers. Critical appraisal using the JBI Critical Appraisal Checklist for Qualitative Research will evaluate study rigor. Data extraction will be conducted by two independent reviewers, using the standardized JBI data extraction tool within JBI SUMARI, to identify key themes and findings related to the women’s decision-making process and lived experiences of returning to work after parental leave. The meta-aggregation approach will be utilized to synthesize findings, with confidence assessed through study quality and consistency. Any methodological deviations will be documented. Findings will be graded using the ConQual approach and presented in a summary of findings table.

Discussion

By synthesizing data from different cultural contexts, this review will help bridge the gap in understanding how these factors influence women’s choices. Rigor in the review will be ensured through the process of study selection, appraisal, and synthesis using the JBI approach. The findings will provide challenges faced by women and inform policies to help support their transition back to work.

Systematic review registration

PROSPERO CRD42024546633.
The rapid detection of a neonatal unit outbreak of a wild-type Klebsiella variicola using decentralized Oxford Nanopore sequencing
Authors: White Rhys T. , Balm Michelle , Burton Megan , Hutton Samantha , Jeram Jamaal , Kelly Matthew , Macartney-Coxson Donia , Sinha Tanya , Sushames Henrietta , Winter David J. , Bloomfield Maxim G.
Published: February 2025

Background

Klebsiella variicola has been implicated in neonatal intensive care unit (NICU) outbreaks previously and can be misidentified as Klebsiella pneumoniae. An increased incidence of K. pneumoniae bacteremia on the NICU of our institution was notified to the infection prevention and control (IPC) team in May 2024. The four isolates involved displayed wild-type susceptibility, so had not been detected via multidrug-resistant organism surveillance. This triggered investigation with a nanopore-based decentralized whole-genome sequencing (dWGS) system in operation at our laboratory.

Methods

Since early 2022, the hospital laboratory at Wellington Regional Hospital has been performing dWGS using the Oxford Nanopore MinION device. This allows for prospective genomic surveillance of certain hospital-associated organisms, but also rapid reactive investigation of possible outbreaks. Isolates are sequenced in the hospital laboratory and undergo multilocus sequence typing (MLST). If transmission events are suspected, sequence data are transferred to the reference laboratory, the Institute for Environmental Science and Research (ESR) for high-resolution bioinformatic analysis.

Results

Within 48 h of notification isolates had been subcultured and sequenced. This showed that three of four isolates were in fact K. variicola, and two of these were sequence type (ST)6385. This sequence type had not been seen previously at our institution, so transmission was suspected. Environmental sampling revealed K. variicola ST6385 in two sink traps on the unit, and prospective sequencing of all K. pneumoniae isolates from NICU samples revealed two further infants with K. variicola ST6385. Subsequent phylogenetic analysis at ESR using original sequence data showed tight clustering of these isolates, confirming an outbreak. Sink traps were disinfected, environmental cleaning procedures were updated, and a strict focus on hand hygiene was reinforced on the ward. No further isolates were detected, and the outbreak was closed after two months.

Conclusions

Access to dWGS at the level of the local hospital laboratory permitted rapid identification of an outbreak of an organism displaying no unusual antimicrobial resistance features at a point where there were only two known cases. This in turn facilitated a rapid IPC response.
Aligning policy for success in developing countries: evidence from the poultry sector of Ghana
Authors: Zamani Omid , Chibanda Craig , Boimah Mavis , Asante-Addo Collins
Published: February 2025

This paper examines policy coherence in Ghana's poultry sector by assessing potential interactions between policy objectives. Using panel simultaneous equation models and the data-driven synthetic control method, we analyze the effects of policy interventions on domestic poultry production during 1999–2019. Our findings underscore the impact of policies enacted during this period on the growth of domestic poultry production. However, growth in production remains notably lower than the escalating imports of frozen poultry meat. Our coherence analysis identifies lowering production costs and enhancing productivity as crucial policy objectives that could positively affect food security and rural development. Nonetheless, we caution against prioritizing one objective over others, as this may adversely affect overall policy coherence and outcomes. Specifically, our study emphasizes the importance of striking a balance between fostering domestic production and ensuring food security.
Prognostic utility of neutrophil gelatinase-associated lipocalin (NGAL) levels for cardiovascular events in patients with stable coronary artery disease treated with percutaneous coronary intervention: a prospective longitudinal cohort study
Authors: Lin Ting-Yu , Leu Hsin-Bang , Wu Yen-Wen , Tseng Wei-Kung , Lin Tsung-Hsien , Yeh Hung-I , Chang Kuan-Cheng , Wang Ji-Hung , Yin Wei-Hsian , Wu Chau-Chung , Huang Chun-Yao , Lin Shing-Jong , Hsu Chien-Yi , Chen Jaw-Wen
Published: February 2025

Introduction

Neutrophil gelatinase-associated lipocalin (NGAL) modulates the enzymatic activity of matrix metalloproteinase-9, which is an important mediator of plaque instability in atherosclerosis. High NGAL levels can independently predict all-cause mortality and major adverse cardiac events (MACE) in patients with acute myocardial infarction (AMI). However, studies that have measured NGAL levels in patients with stable coronary artery disease (CAD) are limited. Furthermore, no significant prognostic predictive value between NGAL levels and stable CAD has been established.

Hypothesis

We aimed to investigate the prognostic role of NGAL levels in a prospective cohort study of patients with stable CAD treated with percutaneous coronary intervention (PCI).

Methods

A total of 2,238 stable patients with CAD and a previous PCI were enrolled in a multicenter prospective observational study (The National Taiwan Biosignature Research, NTBR) in Taiwan. The primary outcome was the occurrence of MACE (cardiovascular death, nonfatal myocardial infarction, and ischemic stroke). The secondary outcome was a composite of cardiovascular events (cardiovascular death, nonfatal MI, nonfatal stroke, and hospitalization for heart failure).

Results

During the mean follow-up period of 4.6 ± 1.7 years, 441 patients reached the primary endpoints. Kaplan-Meier analysis showed that event-free survival was significantly different between the first and third tertile groups (log-rank test, p < 0.001) in subjects categorized by NGAL levels. In a multivariate Cox proportional hazard regression analysis, plasma NGAL levels were independently associated with an increased risk of MACE [adjusted hazard ratio (aHR) = 1.35; 95% confidence interval (CI) = 1.18–1.54, p < 0.001], AMI (aHR = 1.34; 95% CI = 1.12–1.59, p < 0.001), and target vessel revascularization (aHR = 1.35; 95% CI = 1.19–1.53, p < 0.001). Addition of serum NGAL levels to the traditional risk model improved its prediction value for future cardiovascular events.

Conclusions

High plasma NGAL levels were independently associated with the occurrence of MACE and composite cardiovascular events in patients with stable PCI-treat CAD.
The causal effects between low back pain and cerebrospinal fluid metabolites: a two-sample Mendelian randomization study
Authors: Peng Run , Wang Xiaoxin , Wang Wei , Li Zeqin , Sun Yuze , Yang Mingliang
Published: February 2025

Background

Observational studies have shown an association between cerebrospinal fluid (CSF) metabolites and low back pain (LBP), but the causal relationship between these factors remains unclear.

Methods

We performed a two-sample Mendelian randomization (MR) analysis to examine whether there is a causal relationship between CSF metabolites and LBP. We applied several MR methods, including inverse variance weighting, weighted median, MR-Egger, Wald ratio, and MR-PRESSO, to test the causal relationship and conducted a sensitivity analysis to assess the robustness of the results.

Results

We identified a total of 12 CSF metabolites significantly associated with LBP, of which Bilirubin, 5,6-dihydrothymine, Erythronate, Mannitol/sorbitol, and Butyrate have a potential inhibitory causal effect on LBP risk (p < 0.05). Meanwhile, 2-hydroxyadipate, Gamma-glutamyl-alpha-lysine, Indoleacetate, N-acetylputrescine, Palmitoyl dihydrosphingomyelin, S-methylcysteine, and 2,3-dihydroxy-5-methylthio-4-pentenoate play a causal role in increasing the risk of LBP (p < 0.05). No significant estimates of heterogeneity or pleiotropy were detected.

Conclusion

Our study emphasizes the causal relationship between CSF metabolites and LBP risk, providing reference for clinical treatment and prognosis of LBP.
Effect of arm-ergometry versus treadmill supervised exercise on health-related quality of life and mental health in patients with peripheral artery disease: secondary outcomes from the ARMEX trial
Authors: Magalhães Sandra , Santos Mário , Viamonte Sofia , Ribeiro Fernando , Martins Joana , Schmidt Cristine , Cyrne-Carvalho Henrique
Published: February 2025

Background

Peripheral artery disease (PAD) negatively affects walking performance, health-related quality of life (HRQoL) and mental health. Exercise training is recommended as a first-line treatment for PAD, with potential impact on all these outcomes, but the optimal program design is not completely ascertained. The aim of this study was to compare arm-ergometry (AEx) and treadmill supervised exercise training (TEx) on HRQoL and mental health in patients with PAD.

Methods

This was an ancillary study of the ARMEX trial, a single-center, single-blinded, parallel group, randomized clinical trial, enrolling symptomatic PAD patients referred to a cardiovascular rehabilitation program (CRP). Participants were randomized (1:1) to a 12-week AEx or TEx, along with the core components of a CRP (nutritional and psychological support). Participants completed the short form 36 Health Survey and the Hospital Anxiety and Depression scale before and after the intervention. Differences between groups in the change from baseline to the end of the study were analyzed using ANCOVA, adjusted for baseline values, or the Mann-Whitney U test.

Results

Fifty-six patients (66 ± 8.4 years; 87.5% male) were included: AEx (n = 28) and TEx (n = 28). Physical functioning, role-physical, bodily-pain, general health, mental health and physical component summary (PCS) significantly improved in AEx group. In the TEx group, physical functioning, role-physical, bodily-pain, vitality, social functioning, role-emotional and PCS significantly improved. Role-physical and role-emotional improved more in TEx, with no between-group differences in the other domains. Changes in PCS were significantly associated with changes in walking distances. Hospital Anxiety and Depression scale scores improved in both groups, without between-group differences. This improvement was associated with self-reported walking distance.

Conclusion

Both exercise protocols improved HRQoL and mental health in patients with symptomatic PAD, highlighting exercise-based programs as important treatment strategies for this population.

Trial registration number

ISRCTN54908548 (retrospectively registered).
Laminoplasty vs laminectomy in the surgical management of spinal intradural extramedullary tumors
Authors: Singh Deepak Kumar , Sharma Prevesh Kumar , Chand Vipin Kumar , Mohammad Kaif , Yadav Kuldeep , Singh Neha
Published: February 2025

Background

Laminectomy and laminoplasty have been widely used for patients with spinal cord tumors. Spinal tumors comprise around 5–10% of all central nervous tumors, with 70–80% of these being intradural extramedullary in location. Surgery is the main treatment modality for spinal tumors. In this case series, we aimed to compare the laminectomy and laminoplasty procedure in the surgical management of intradural extramedullary spinal tumors and analyze the advantages and disadvantages of both the procedures.

Materials and method

The clinical and radiological data of patients who underwent laminectomy or laminoplasty for spinal cord tumors were retrospectively analyzed. Out of the 56 patients undergoing surgery for spinal IDEM, “En-bloc osteoplastic laminoplasty” with titanium microplates was performed in 26 patients, while 26 patients had laminectomy without disrupting the facet joints, and 4 patients required fusion with screws and rods along with laminectomy. All these patients were followed for one year. Patient data, including surgical time, blood loss, length of hospital stay, post-operative complications, post-operative neurological status, post-operative pain, and preoperative and post-operative deformity, were gathered and analyzed in both the laminectomy and laminoplasty groups.

Results

Of the total, there were 23 males and 33 females, with a mean age of 39.47 ± 13.65 years in the laminectomy group and 37.23 ± 12.03 in the laminoplasty group. The average operative time for laminectomy procedures was 138.86 ± 10.90 min, while it was 145.19 ± 9.54 in the laminoplasty group. The average length of hospital stay in the laminectomy group was 6.50 ± 2.01 days, and 5.08 ± 1.47 days in the laminoplasty group. The mean blood loss in laminectomy group was 118 ± 15.05 ml, whereas in laminoplasty group the mean blood loss was around 110 ± 12.46 ml. Also, laminoplasty group had a lower incidence of post-operative deformity.

Conclusions

Laminoplasty is a constructive technique in the management of intradural extramedullary spinal tumors, associated with fewer post-operative complications, lower incidence of new post-operative deformities or worsening of preoperative deformities, and a shorter duration of post-operative pain. Additionally, it alleviates the need for additional instrumentation, thereby avoiding an extra financial burden while enhancing the quality of life for the patient. A high-quality randomized controlled trial with long-term follow-up is necessary to validate the findings of this innovative technique.
Association between CAPN-10 gene variant and diabetes mellitus in Nigeria: a review
Authors: Adebo David Olufemi , Olaniyan Mathew Folaranmi , Ugege Christian Onosetale , Odegbemi Odekunle Bola
Published: February 2025

Background

Type 2 Diabetes Mellitus (T2DM) is a significant global health concern characterised by insulin resistance and chronic hyperglycemia. Genetic factors, particularly variations in the CAPN-10 gene, have been implicated in T2DM susceptibility across diverse populations.

Aim and objective

This study aimed to conduct a meta-analysis to investigate the associations of single nucleotide polymorphisms (SNPs) in the CAPN-10 gene with T2DM among various populations, focusing specifically on Nigerian cohorts.

Materials and methods

A comprehensive literature search yielded 150 studies, from which 45 met inclusion criteria, encompassing approximately 25,000 individuals, including 10,000 diagnosed with T2DM. Statistical analyses assessed the association between CAPN-10 SNPs (UCSNP-43, UCSNP-19, UCSNP-63) and T2DM risk.

Results

A significant association was observed for UCSNP-43 (rs3792267) with T2DM (OR 1.50; 95% CI 1.28–1.75; p < 0.001), particularly in urban Nigerian populations. UCSNP-19 (rs3842570) also showed a moderate association (OR 1.35; 95% CI 1.10–1.66; p = 0.01), especially in South-West Nigeria. No significant association was found for UCSNP-63 (OR 1.15; 95% CI 0.90–1.45; p = 0.30).

Conclusion

The findings indicate that CAPN-10 SNPs, particularly UCSNP-43 and UCSNP-19, contribute to T2DM susceptibility in Nigerian populations, emphasising the importance of genetic screening for personalised interventions in diabetes management.
Repetitive transcranial magnetic stimulation as a modality of treatment in patients with fibromyalgia
Authors: Shahat Rawan M. El , Sebaie Mona A. El , Ahmed Sahar F. , Fawaz Shereen I. , Kamel Marwa A. , Nassef Marwa A.
Published: February 2025

Background

Fibromyalgia is characterized by widespread musculoskeletal pain and tenderness. It is also frequently associated with mood disorders, tiredness, sleep disturbances, and cognitive dysfunction. Repetitive transcranial magnetic stimulation (rTMS) is an emerging nonpharmacological therapeutic option for fibromyalgia. rTMS involves an electromagnetic coil placed on the scalp that is rapidly turned on and off to generate short magnetic pulses to the brain (2).

rTMS can reduce chronic pain by triggering inhibitory neural pathways at the level of the dorsal horn of the spinal cord. It can improve motor function and alleviate psychiatric symptoms, including depression and anxiety, in many diseases (7).

Aim of the work

The study aimed to evaluate the role of repetitive transcranial magnetic stimulation (rTMS) in treating fibromyalgia.

Results

Highly significant improvement in feel-good and work-missed scores by FIQ being lower in the case group compared to the control group (p-values 0.008 and 0.003 respectively). On comparing the control and case groups regarding anxiety and depression using the HADS questionnaire and fatigue assessment using the SF36 questionnaire after rTMS sessions, there was a statistically significant lower depression score in the case group compared to the control group (p-value of 0.024), and statistically significant higher energy/fatigue scores in the case group compared to the control group with (p-value = 0.004).

Conclusion

This study demonstrated that rTMS relieved pain, reduced anxiety, depression, and fatigue and enhanced quality of life in patients with fibromyalgia.
Quantitative Volumetric Computed Tomography Density Predicts Basal Ganglia Hemorrhage Expansion and Enhances Spot Sign Diagnostic Accuracy
Authors: Kashkoush Ahmed , Winkelman Robert , Achey Rebecca , Davison Mark A. , Kshettry Varun R. , Moore Nina , Hassett Catherine E. , Gomes Joao , Bain Mark
Published: February 2025

BACKGROUND AND OBJECTIVES:

Identifying patients with basal ganglia intracranial hemorrhage (ICH) at risk of hematoma expansion (HE) may better define selection criteria for early surgical evacuation. The aim of this study was to use automated radiographic feature extraction to improve risk stratification for basal ganglia ICH expansion.

METHODS:

A single-center retrospective review was performed to identify patients with basal ganglia ICH between 2013 and 2024. ICH volumes were automatically segmented from the initial noncontrast computed tomography (CT) of the head using a custom-trained convolutional neural network. Features were quantified from the segmented ICH including stereotactic location, normalized volumetric CT density (nv-CTD, measured as mean ICH CT density divided by the background parenchymal CT density), volume, orientation, and border irregularity. HE was defined as an increase in hemorrhage volume of 10 mL or at a rate of 1.7 mL/h.

RESULTS:

A total of 108 patients (median age 55 years, 62% male) were included. HE occurred in 24 patients (22%) and was associated with shorter duration between symptom onset and initial CT (median 1 vs 3 hours, P = .006), a lower nv-CTD (median 2.0 vs 2.2, P = .011), and a positive spot sign (41% vs 5%, P < .001). nv-CTD was positively associated with time to presentation (R
2 = 0.13, P < .001) and was negatively associated with HE in spot-sign–negative patients (median 2.0 vs 2.1, P = .016). Multivariate logistic regression modeling using nv-CTD and spot sign as inputs demonstrated improved diagnostic accuracy compared with that of the spot sign alone (area under the receiver operating characteristic curve 0.80 vs 0.68, P = .008). The area under the receiver operating characteristic curve of nv-CTD alone was 0.67 (95% CI: 0.56-0.78), which was statistically similar to that of the spot sign alone (0.68, 95% CI: 0.54-0.82) (P = .819).

CONCLUSION:

nv-CTD is a measure of bgICH acuity and can augment spot-sign bgICH expansion risk stratification.
Μελέτη των πολυμορφισμών του γονιδίου που κωδικοποιεί την πρωτεΐνη Adamts 13 σε έγκυες γυναίκες και συσχέτισή τους με την εμφάνιση προεκλαμψίας
Authors: Βέτσιου Ευαγγελία
Published: February 2025

Η προεκλαμψία είναι μια πολυσυστηματική διαταραχή της κύησης που χαρακτηρίζεται από πρωτεϊνουρία, υπέρταση και δυσλειτουργία οργάνων μετά την 20η εβδομάδα της κύησης. Η βαρύτερη εκδήλωση της προεκλαμψίας είναι το σύνδρομο HELLP. Σκοπός της μελέτης αυτής είναι η διερεύνηση των πολυμορφισμών του γονιδίου της ADAMTS13 και της επίδρασής τους στη δραστικότητα της πρωτεΐνης, καθώς και η συσχέτιση της ADAMTS13 με τον παράγοντα vWf, με το σύστημα συμπληρώματος και την προεκλαμψία. Στη μελέτη συμμετείχαν 30 έγκυες γυναίκες με προεκλαμψία και 15 υγιείς έγκυες γυναίκες. Ελήφθησαν δείγματα αίματος από όλες τις συμμετέχουσες για την αξιολόγηση της δραστικότητας της ADAMTS13, του παράγοντα vWf, του συμπληρώματος και την ανάλυση των γενετικών πολυμορφισμών(MiniSeq System, Illumina). Για την εκτίμηση της ενεργοποίησης του συμπληρώματος χρησιμοποιήθηκε η μέθοδος του τροποποιημένου Ham test και μετρήθηκαν τα επίπεδα του διαλυτού C5b-9. Από τα αποτελέσματα βρέθηκε ότι η ομάδα με προεκλαμψία παρουσίασε σημαντικά μειωμένη δραστικότητα της ADAMTS13 σε σχέση με την ομάδα ελέγχου, κι αυξημένα επίπεδα C5b-9. Τα επίπεδα του vWfAg παρουσίασαν σημαντική συσχέτιση με τη δραστικότητα της ADAMTS13 (r = 0.497, p = 0.003 ). Επίσης βρέθηκαν γενετικές παραλλαγές που σχετίζονται με την εμφάνιση της προεκλαμψίας στα γονίδια ADAMTS13, C3, CFH, CFB, θρομβομοντουλίνης και MASP2, οι οποίες σχετίζονται με την ενεργοποίηση του συμπληρώματος. Συμπερασματικά, τα αποτελέσματα υποδεικνύουν ότι η μειωμένη δραστικότητα της ADAMTS13 και η αυξημένη ενεργοποίηση του συστήματος συμπληρώματος σχετίζονται με την εμφάνιση της προεκλαμψίας. Οι γενετικές παραλλαγές που ανιχνεύθηκαν ενδέχεται να χρησιμεύσουν ως αξιόπιστοι βιοδείκτες για την πρόγνωση και τη διάγνωση της νόσου στο μέλλον. Απαιτείται περαιτέρω έρευνα για να επιβεβαιωθούν αυτά τα ευρήματα και να αναπτυχθούν νέες θεραπευτικές προσεγγίσεις που θα στοχεύουν στη ρύθμιση της δραστικότητας της ADAMTS13 και της ενεργοποίησης του συμπληρώματος.