bluuebunny/crossref_metadata_2025 huggingface dataset:
Quantitative analysis of the hexamethylenetetramine concentration in a hexamethylenetetramine–acetic acid solution using near infrared spectroscopy: A comprehensive study on preprocessing methods and variable selection techniques
Authors: Chao Hui , Qian Shichuan , Wang Zhi , Sheng Xin , Zhao Xinping , Lu Zhiyan , Li Xiaoxia , Xu Yinguang , Jin Shaohua , Li Lijie , Chen Kun
Published: March 2024

Hexamethylenetetramine (HA) is widely used as a raw material in the medical, chemical, industrial, and military industries, and the fast and quantitative analysis of HA is important for manufacturing processes in these fields. Owing to its efficiency, low cost, nondestructive testing, and convenience, near infrared (NIR) spectroscopy is a powerful technique for quantitatively analyzing the HA concentration in HA–acetic acid (HAc) solutions, demonstrating application potential in the production of hexogen and octogen. A series of preprocessing algorithms and variable selection methods were studied to improve the detection accuracy of the NIR spectroscopic calibration. Forty-six different combinations of standard normal variation (SNV), multiplicative signal correction, first derivative, second derivative, and discrete wavelet transform (DWT) were screened. The effects of four variable selection methods (successive projection algorithm (SPA), uninformed variable elimination, competitive adaptive reweighted sampling, and multiverse optimization (MVO)) were compared. Finally, a model (SPXY-SNV-1stDer-DWT-MVO-RF) was developed by combining sample set portioning based on the joint x–y distance (SPXY) algorithm with the random forest (RF) calibration model, and MVO was combined with the NIR technique for the first time. The model achieved a coefficient of determination for the calibration set (R2), root mean square error of the calibration set (RMSEC), coefficient of determination for the prediction set (r2), and root mean square error of the prediction set (RMSEP) of 1.000, 0.04%, 0.999, and 0.05%, respectively. This study demonstrated the novelty and feasibility of HA quantitative detection by NIR spectroscopy and provided valuable insights for optimizing quantitative analysis models by optimizing algorithms, indicating the great application potential of NIR spectroscopy in related fields.
Study on the clinical and electrophysiological characteristics of nerve function in myasthenia gravis patients in Vietnam
Authors: Anh Pham Tho Kieu , Van Pham Phuong , Dinh Le Tung , Thanh Nguyen Binh , Kien Nguyen Trung , Thanh Tran Tam Thai , Hai Nguyen Sam Phan , Van Le Minh
Published: March 2024

Background:

In Vietnam, there is limited research on the role of nerve conduction in myasthenia gravis and its association with clinical features.

Objective:

This study aims to describe the electrophysiological features in patients with myasthenia gravis.

Methods:

This descriptive study was conducted from September 2019 to December 2021. The study included 33 myasthenia gravis patients who sought medical consultation or received inpatient treatment during this period. The Myasthenia Gravis Foundation of America classifies myasthenia gravis into five groups: I, IIa, IIb, IIIa, IIIb, IVa, IVb, and V. Notably, Group I involves pure ocular weakness, whereas Group a primarily impacts limb and axial muscles, and Group b mainly affects bulbar and respiratory muscles.

Results:

The study revealed that motor and sensory nerve conduction in the upper and lower limbs were within normal limits for the patient group under evaluation. Repetitive nerve stimulation testing at a frequency of 3 Hz showed positive results in 66.7% of myasthenia gravis patients. Myasthenia gravis patients displayed distinct clinical symptoms, with ptosis being the most common (87.9%). Myasthenia Gravis Foundation of America classification indicated the highest proportion in subgroup IIa (24.2%), with myasthenia gravis predominating in limb and axial muscles (Group a) observed in 51.5% of cases. Needle electromyography showed no abnormalities in myasthenia gravis patients. There was an association between acetylcholine receptor antibody titers and the results of the 3 Hz repetitive nerve stimulation test in myasthenia gravis patients, with a significance of p = 0.002.

Conclusion:

Nerve conduction studies should be performed in patients with suspected neuromuscular disorders to aid in differential diagnosis and definitive diagnosis of myasthenia gravis.
Saying “I Do” To a Sustainable Wedding: A Case About Making a Wedding Sustainable
Authors: Deale Cynthia S. , Lee Seung Hyun
Published: March 2024

This case study focuses on how a wedding planner can plan a sustainable wedding by making the ceremony, and the events and items connected with it, sustainable. It briefly describes sustainability, with a focus on the triple bottom line of environmental, sociocultural, and economic sustainability. In addition, it applies the concepts and practices of slow travel and tourism and a sense of place, including neolocalism. The case asks the reader, as a wedding planner, to address the dilemma of how the events associated with a wedding can be sustainable and attuned to the complex aspects involved in engaging in environmental, sociocultural, and economic sustainability.
Tsunami hazard evaluation of river embankment structures incorporating their vulnerability to seismic strong motion
Authors: Imai Kentaro , Nakai Kentaro , Hirai Takashi , Noda Toshihiro , Arai Nobuo , Iwama Shunji , Iwase Hiroyuki , Baba Toshitaka
Published: March 2024

Development of coastal areas in Japan for various land uses since the 1960s has contributed to industrial upgrades and improved the efficiency of transportation networks. However, there are concerns about the vulnerability of developments on alluvial plains and reclaimed lands to geological events, like ground subsidence due to liquefaction during large earthquakes. Realistic assessment of earthquake and tsunami hazards and evaluation of possible countermeasures require accurate estimation of the amount of subsidence that can be expected from liquefaction at coastal and riverside sites supporting various structures. In this study, to evaluate the amount a river embankment structure might be expected to settle as a result of strong motion from an assumed Nankai Trough great earthquake, we conducted a numerical simulation using the soil–water coupled finite deformation analysis code GEOASIA. We then investigated the effect of the estimated embankment subsidence on tsunami inundation, which was simulated by using nonlinear shallow-water equations and a grid spacing as fine as 3.3 m. The influence of urban structures on the inundated area was taken into account by using a structure-embedded elevation model (SEM). The results showed that subsidence of river embankments and the collapse of parapet walls on top of them would increase both the depth and area of inundation caused by a tsunami triggered by a Nankai Trough scenario earthquake. Our findings underscore the importance of evaluating not only earthquake resistance but also vulnerability of coastal and riverside structures to strong motion in tsunami hazard analyses. Furthermore, the importance of tsunami inundation analysis using a SEM for predicting the behavior of tsunami flotsam in urban areas was demonstrated.
Impact of race and social determinants of health on outcomes in patients with aggressive B-cell NHL treated with CAR-T therapy
Authors: Karmali Reem , Machhi Rushad , Epperla Narendranath , Shouse Geoffrey , Romancik Jason , Moyo Tamara K. , Kenkre Vaishalee , Ollila Thomas A. , Fitzgerald Lindsey , Hess Brian , David Kevin , Roy Ishan , Zurko Joanna , Chowdhury Sayan Mullick , Annunzio Kaitlin , Ferdman Robert , Bhansali Rahul S. , Harris Elyse I. , Liu Jieqi , Nizamuddin Imran , Ma Shuo , Moreira Jonathan , Winter Jane , Pro Barbara , Stephens Deborah M. , Danilov Alexey , Shah Nirav N. , Cohen Jonathon B. , Barta Stefan K. , Torka Pallawi , Gordon Leo I.
Published: March 2024

Chimeric antigen receptor (CAR) T-cell (CAR-T) immunotherapy is an effective therapy for relapsed/refractory B-cell non-Hodgkin lymphoma (r/r B-NHL). However, data are limited on the impact of the convergence of race and social determinants of health on outcomes for patients treated with CAR-T therapy. We examined the impact of interactions between race and insurance type on health care use and outcomes in patients treated with CAR-T therapy for aggressive B-NHL. Adult patients with r/r B-NHL treated with CD19 CAR-Ts were identified between 2015 and 2021 across 13 US academic centers. Insurance type, demographic, and clinical data were collected and analyzed. In total, 466 adult patients were included in our analysis. Median follow-up after CAR-T therapy was 12.7 months. Median progression-free survival (mPFS) was longer for Caucasians (11.5 months) than for African Americans (3.5 months; hazard ratio [HR], 1.56 [1.03-2.4]; P = .04) or Asians (2.7 months; HR, 1.7 [1.02-2.67]; P = .04). Differences in median overall survival (mOS) were not significant. For Medicare (n = 206) vs Medicaid (n = 33) vs private insurance (n = 219) vs self-pay (n = 7): mPFS was 15.9 vs 4.2 vs 6.0 vs 0.9 months (P < .001), respectively; and mOS was 31.2 vs 12.8 vs 21.5 vs 3.2 months (P < .001), respectively. Our multicenter retrospective analysis showed that race and insurance status can affect outcomes for patients treated with CAR-T therapy.
Role of ferroptosis and ferroptosis-related long non'coding RNA in breast cancer
Authors: Xiang Shasha , Yan Wen , Ren Xing , Feng Jianbo , Zu Xuyu
Published: March 2024

Ferroptosis, a therapeutic strategy for tumours, is a regulated cell death characterised by the increased accumulation of iron-dependent lipid peroxides (LPO). Tumour-associated long non-coding RNAs (lncRNAs), when combined with traditional anti-cancer medicines or radiotherapy, can improve efficacy and decrease mortality in cancer. Investigating the role of ferroptosis-related lncRNAs may help strategise new therapeutic options for breast cancer (BC). Herein, we briefly discuss the genes and pathways of ferroptosis involved in iron and reactive oxygen species (ROS) metabolism, including the XC−/GSH/GPX4 system, ACSL4/LPCAT3/15-LOX and FSP1/CoQ10/NAD(P)H pathways, and investigate the correlation between ferroptosis and LncRNA in BC to determine possible biomarkers related to ferroptosis.
Functional diversity and secondary production of macrofaunal assemblages can provide insights of biodiversity-ecosystem function relationships
Authors: Wang Zhe , Xu Jing , Xu Zhaodong , Liu Xiaoshou
Published: March 2024

Background

Semi-enclosed bays are important links in the material cycle and energy flow between terrestrial and marine ecosystems. They are also areas of intense human activities and heavily influenced by such activities as aquaculture, industrial and agricultural wastewater discharge. The rate of biodiversity loss and changes in ecosystems have prompted research into the relationship between species diversity and ecosystem functioning. Studies have shown that application of functional diversity indices is useful for assessing the status of ecosystem functioning. We quantitatively sampled macrofauna in a semi-enclosed bay in four seasons and analyzed the relationship between species, functional diversity and secondary production, biomass and feeding functional groups of macrofauna.

Results

The annual secondary production was 325.01 kJ m−2 year−1. Detritivorous, carnivorous and planktophagous feeders were the main functional groups of macrofauna. Differences in the spatial–temporal distribution of functional groups were influenced by Ruditapes philippinarum and Hemileucon bidentatus. Functional richness had significant negative correlations with macrofaunal biomass and secondary production. Functional divergence, functional dispersion and Rao's quadratic entropy had highly significant negative correlations with macrofaunal biomass and secondary production.

Conclusion

The results showed that high overlap of ecological niches can increase competition for habitat resources, leading to a decline in biomass and secondary production. In addition, aquaculture could promote the use of habitat resources to some extent, while it could increase competition for ecosystem resources (including habitat resources, atmospheric resources, water resources, etc.). Functional diversity is a good indicator for the ecosystem functioning and the competition status for habitat resources, which can provide insights into the current state of ecosystem function.
Immune system modulation & virus transmission during parasitism identified by multi-species transcriptomics of a declining insect biocontrol system
Authors: Inwood Sarah N. , Harrop Thomas W. R. , Shields Morgan W. , Goldson Stephen L. , Dearden Peter K.
Published: March 2024

Background

The Argentine stem weevil (ASW, Listronotus bonariensis) is a significant pasture pest in Aotearoa New Zealand, primarily controlled by the parasitoid biocontrol agent Microctonus hyperodae. Despite providing effective control of ASW soon after release, M. hyperodae parasitism rates have since declined significantly, with ASW hypothesised to have evolved resistance to its biocontrol agent. While the parasitism arsenal of M. hyperodae has previously been investigated, revealing many venom components and an exogenous novel DNA virus Microctonus hyperodae filamentous virus (MhFV), the effects of said arsenal on gene expression in ASW during parasitism have not been examined. In this study, we performed a multi-species transcriptomic analysis to investigate the biology of ASW parasitism by M. hyperodae, as well as the decline in efficacy of this biocontrol system.

Results

The transcriptomic response of ASW to parasitism by M. hyperodae involves modulation of the weevil’s innate immune system, flight muscle components, and lipid and glucose metabolism. The multispecies approach also revealed continued expression of venom components in parasitised ASW, as well as the transmission of MhFV to weevils during parasitism and some interrupted parasitism attempts. Transcriptomics did not detect a clear indication of parasitoid avoidance or other mechanisms to explain biocontrol decline.

Conclusions

This study has expanded our understanding of interactions between M. hyperodae and ASW in a biocontrol system of critical importance to Aotearoa-New Zealand’s agricultural economy. Transmission of MhFV to ASW during successful and interrupted parasitism attempts may link to a premature mortality phenomenon in ASW, hypothesised to be a result of a toxin-antitoxin system. Further research into MhFV and its potential role in ASW premature mortality is required to explore whether manipulation of this viral infection has the potential to increase biocontrol efficacy in future.
Reproductive factors and risk of lung cancer among 300,000 Chinese female never-smokers: evidence from the China Kadoorie Biobank study
Authors: Elbasheer Marwa M. A. , Bohrmann Bastian , Chen Yiping , Lv Jun , Sun Dianjianyi , Wu Xia , Yang Xiaoming , Avery Daniel , Li Liming , Chen Zhengming , Kartsonaki Christiana , Chan Ka Hung , Yang Ling
Published: March 2024

Background

Lung cancer is the leading cause of cancer mortality among Chinese females despite the low smoking prevalence among this population. This study assessed the roles of reproductive factors in lung cancer development among Chinese female never-smokers.

Methods

The prospective China Kadoorie Biobank (CKB) recruited over 0.5 million Chinese adults (0.3 million females) from 10 geographical areas in China in 2004–2008 when information on socio-demographic/lifestyle/environmental factors, physical measurements, medical history, and reproductive history collected through interviewer-administered questionnaires. Cox proportional hazard regression was used to estimate adjusted hazard ratios (HRs) of lung cancer by reproductive factors. Subgroup analyses by menopausal status, birth year, and geographical region were performed.

Results

During a median follow-up of 11 years, 2,284 incident lung cancers occurred among 282,558 female never-smokers. Ever oral contraceptive use was associated with a higher risk of lung cancer (HR = 1.16, 95% CI: 1.02–1.33) with a significant increasing trend associated with longer duration of use (p-trend = 0.03). Longer average breastfeeding duration per child was associated with a decreased risk (0.86, 0.78–0.95) for > 12 months compared with those who breastfed for 7–12 months. No statistically significant association was detected between other reproductive factors and lung cancer risk.

Conclusion

Oral contraceptive use was associated with an increased risk of lung cancer in Chinese female never-smokers. Further studies are needed to assess lung cancer risk related to different types of oral contraceptives in similar populations.
Retinal injury from a laser skin resurfacing device during medical tourism: a public health concern
Authors: Lambert Lester H. , Tompkins Brett L. , Uber Ian C. , Kapoor Kapil G. , Ramsey David J.
Published: March 2024

Background

Laser skin resurfacing is a popular cosmetic procedure for noninvasive skin rejuvenation. Since health insurance plans often do not cover these types of procedures, patients often pay out of pocket. Consequently, there is an incentive to go abroad, where prices are more affordable. However, practitioners in destination countries may lack rigorous training on laser safety, regulatory oversight, or licensing, especially on devices used for “cosmetic” procedures. In certain cases, this can lead to tragic outcomes, especially when underqualified practitioners operate medical-grade laser devices.

Case presentation

A 29-year-old woman suffered a retinal burn from a handheld Q-switched neodymium-doped yttrium aluminum garnet (Nd:YAG) laser pulse device used to perform skin resurfacing treatment at a medical spa in Vietnam. The patient was not adequately informed about the potential risk to her vision and was not provided with any eye protection. A momentary, unintended laser exposure to the patient’s right eye led to irreversible vision loss due to a macular burn. This incident caused immediate pain, followed by the sudden appearance of floaters, along with a retinal and vitreous hemorrhage. Despite treatment with off-label bevacizumab for the development of a choroidal neovascular membrane, vision remained at the level of counting fingers because of the presence of the macular scar.

Conclusion

When utilizing laser-based devices, it is crucial to employ safety measures, such as the wearing of safety goggles or the use of eye shields to protect ocular tissues from potential damage. The growing availability of cosmetic laser devices presents a substantial public health risk, because numerous operators lack adequate training in essential safety standards, or they neglect to follow them. Furthermore, patients seeking services abroad are subject to the regulatory practices of the destination country, which may not always enforce the requisite safety standards. Further research is needed to determine regional and global incidence of laser-related injuries to help direct educational and regulatory efforts.
Long-term real-life outcomes of the Clareon® hydrophobic intraocular lens: the Clarte study in 191 eyes
Authors: Bouvarel Hugo , Agard Emilie , Billant Jérémy , Levron Antoine , Chudzinski Roman , Plas Hélène , Bernier Raphaël , Sejournet Lucas , Chaperon Mayeul , Dot Corinne
Published: March 2024

Background

To describe and analyze the real-life refractive, functional and safety outcomes of the Clareon® intraocular lens (IOL) after 3 years.

Methods

Data was collected retrospectively for observational purposes between July 2017 and December 2019 in the ophthalmology department of Desgenettes military hospital in Lyon, France. Eyes that underwent cataract surgery with Claeron® implantation were consecutively included. Patients with a systemic or ocular condition that could affect the visual outcome were excluded. Postoperative corrected (CDVA) and uncorrected (UDVA) distance visual acuities as well as capsule and IOL transparency were assessed at 1 month and 3 years.

Results

A total of 326 eyes were analyzed at one month and 191 eyes were reassessed at the 3-year follow-up visit. At 3 years, the mean CDVA was 0.003 LogMAR (95% confidence interval [CI]: -0.003 to -0.01) and the mean UDVA was 0.075 (95% CI: 0.054 to 0.095). Three quarters of the patients had an UDVA ≥ 0.097 logMAR (20/25 Snellen equivalent) and 50% had an UDVA ≥ 0 (20/20). The absence of glistening was reported in 95.3% of cases and 4.7% [9] of patients experienced a clinically significant posterior capsular opacification (PCO) for which Nd:YAG treatment was required.

Conclusions

This real-life study reports high-performance and stable long-term refractive outcomes of the Clareon® IOL with good safety in terms of PCO and glistening.
Cross-country variations in the caregiver role: evidence from the ENTWINE-iCohort study
Authors: Zarzycki Mikołaj , Vilchinsky Noa , Bei Eva , Ferraris Giulia , Seddon Diane , Morrison Val
Published: March 2024

Background

Globally, economically developed countries face similar ageing demographics and the challenge of a ‘care gap’, yet they vary due to different care and formal support systems, and different cultural and societal norms around illness and care. The aim of this exploratory study was to examine cross-country variations in caregiver motivations, willingness, values, meaning in life, illness beliefs, and experiences of wellbeing, gain, health-related quality of life, burden and depression, across 6 European countries and Israel. Cross-country differences in the above-mentioned informal caregiver experiences are rarely described.

Methods

An online survey (ENTWINE-iCohort) was conducted using validated measures wherever possible. This paper utilises data from 879 caregivers and seven countries (Greece, Italy, the Netherlands, Poland, Sweden, the UK, and Israel).

Results

No consistent finding supporting the concurrent relationship between caregiver support policies/country culture and caregiver motivations/willingness was found. Caregivers in countries typically characterised by individualist cultures reported lower familism, higher self-enhancement values, and greater perceived illness threat compared to more collectivist countries. Search for meaning was higher in poorer countries than in wealthier countries. Higher negative caregiver experiences (e.g., burden) and lower positive experiences (e.g., wellbeing) were generally observed in countries with underdeveloped caregiver support as compared to countries with more developed formal support systems.

Conclusions

Cross-country variations can be explained to varying degrees by national policies around care (or their absence) and country cultural contexts. The results emphasise the importance of formal support services for achieving positive caregiver experiences, and help inform the development of policies and measures to support caregivers in Europe and Israel.
Differences in nutritional status and level of physical activity among adolescents living in urban and rural areas of Montenegro - national study
Authors: Vrevic Erol , Malovic Pavle , Bacovic Dragan , Bojanic Danilo , Nokic Aldijana
Published: March 2024

Background

Nutritional status and physical activity are important factors for adolescent health. These factors may vary by the place of residence. This study aims to assess the nutritional status and physical activity levels, as well as their variations by the place of residence.

Methods

The sample consisted of 1503 adolescents (46.3% male; 53.7% female), with a mean age of 15.7 ± 0.7 years. Nutritional status was assessed using Body Mass Index (BMI), Waist-to-Height Ratio (WHtR), and Body Fat Percentage (BF). Physical activity levels were assessed using the PAQ-C questionnaire. Differences in nutritional status among adolescents living in urban and rural areas were analyzed using Chi-square test (p ≤ 0.05), while differences in physical activity levels were analyzed using an independent samples t-test (p ≤ 0.05).

Results

In terms of BMI, 14.7% of males were overweight and 10.1% were obese, while 12% of female adolescents were overweight and 3.1% were obese. There were no differences in nutritional status among adolescents living in urban and rural areas (BMI, WHtR, BF). Male adolescents in rural areas had significantly higher physical activity levels compared to urban areas (p = 0.032). They showed higher activity scores during a spare time (p = 0.002), physical education classes (p = 0.002), little breaks (p = 0.007), and lunchtime (p = 0.034). Female adolescents showed significance only in spare time activity (p = 0.020).

Conclusion

The differences in nutritional status among adolescents living in urban and rural areas were not found. However, male adolescents living in urban areas showed lower physical activity levels than their rural counterparts. Strategies should be implemented to promote physical activity among adolescents in urban areas, and attention should be given to the further urbanization process to create improved conditions for engaging in physical activity.
Preliminary findings on the development of a predictive model for BLCA based on disulfidptosis-associated IncRNAs signature
Authors: Tang Chao , Fan Yanpeng , Zhu Shusheng
Published: March 2024

Background

Bladder urothelial carcinoma (BLCA) is the most common malignancy of the urinary tract, presenting with a wide range of clinical symptoms and prognosis. Disulfidptosis is a newly identified cell death method and closely associated with BLCA progression, prognosis, and treatment outcome. Currently, we need to construct a new prognostic model for disulfidptosis-related long noncoding RNAs (drlncRNAs) to improve the treatment strategy of BLCA.

Methods

The data for BLCA samples were obtained from The Cancer Genome Atlas (TCGA), and then 10 unique genes related to disulfidoptosis (DRGs) were identified from research papers. The differences between the two groups showed in this study were used to create the “disulfidptosis-related long noncoding RNAs score” (disulfidptosis-score) prognostic model.

Results

We identified two groups of drlncRNAs with high and low disulfidptosis scores in this study. Patients with low disulfidptosis scores had a better overall survival rate compared to those with high scores in bladder cancer, and the high disulfidptosis score subtype exhibited more active malignant pathways related to cancer than the low score subtype. We found that the low disulfidptosis-score subgroup had better prognosis than the high disulfidptosis-score subgroup. The expression of mutation burden was much higher in the low disulfidptosis-score group than in the high disulfidptosis-score group. The low disulfidptosis-score subgroup of patients exhibited significantly higher proportions of plasma cells, T cells CD8, and Tregs, while the high-risk subgroup had a greater abundance of Macrophages M0 and Macrophages M2. The disulfidptosis-score showed a strong correlation with the sensitivity of chemotherapeutic drugs, and patients in the low disulfidptosis-score group were more likely to exhibit an immune response and respond positively to immunotherapy. Additionally, we developed a nomogram to enhance the accuracy of the disulfidptosis-clinical score.

Conclusion

Based on our investigation of disulfidptosis-score in BLCA, disulfidptosis-score may have an important role in TME, prognosis, and drug sensitivity. We also investigated the significance of the disulfidoptosis-score in relation to immunotherapy and immune response, providing a basis for improving prognosis and responding to immunotherapy among patients with BLCA.
Utilization of sexual and reproductive health services among construction worker women in southern Ethiopia
Authors: Darebo Tadele Dana , Birhanu Zewudu , Alemayehu Mihretu , Balcha Behailu , Worku Adisu , Assele Desalegn Dawit , Spigt Mark
Published: March 2024

Background

In Ethiopia, the utilization of sexual and reproductive health services (SRH) is alarmingly inadequate, leading to higher rates of maternal and newborn mortality. Disparities in accessing sexual and reproductive health (SRH) services exist among different population groups, with construction worker women at a higher risk of experiencing such issues. We investigated the utilization of sexual and reproductive health services and associated factors among construction worker women in Southern Ethiopia.

Method

We conducted a cross-sectional study among construction worker women (15–49) in Southern Ethiopia from July 1st to July 30th, 2021. The participants were selected randomly using venue-day-time sampling (VDTS). The data were collected by a pretested structured questionnaire using an open data kit (ODK) and exported to Statistical Package for Social Sciences (SPSS) version 25 for analysis. Binary logistic regression analysis was conducted to identify factors associated with sexual and reproductive health service utilization. An adjusted odds ratio with 95% CI was used and statistical significance was declared at p-value < 0.05.

Results

The study revealed that 54.4% of women of reproductive age had used at least one sexual and reproductive health service in the past year. About 66.7% of women experienced sexual harassment at work, with sex discrimination (86.9%) and sexist hostility (57.9%) being the most common. Aged over 20 years, married women, living with husbands, friends, and boyfriends, within 30 min of health facilities, and having a favorable attitude were significantly associated with SRH service utilization.

Conclusion

Nearly half of construction workers in southern Ethiopia are not using sexual and reproductive health services, indicating a concerning lack of access to such services. Over two-thirds of women experience sexual harassment in construction site. Therefore, to ensure universal access to SRH services, it is essential to design a new approach including outreach programs specifically tailored to reach such vulnerable groups.
Incorporating a situational judgement test in residency selections: clinical, educational and organizational outcomes
Authors: Saxena Anurag , Desanghere Loni , Dore Kelly , Reiter Harold
Published: March 2024

Background

Computer-based assessment for sampling personal characteristics (Casper), an online situational judgement test, is a broad measure of personal and professional qualities. We examined the impact of Casper in the residency selection process on professionalism concerns, learning interventions and resource utilization at an institution.

Methods

In 2022, admissions data and information in the files of residents in difficulty (over three years pre- and post- Casper implementation) was used to determine the number of residents in difficulty, CanMEDS roles requiring a learning intervention, types of learning interventions (informal learning plans vs. formal remediation or probation), and impact on the utilization of institutional resource (costs and time). Professionalism concerns were mapped to the 4I domains of a professionalism framework, and their severity was considered in mild, moderate, and major categories. Descriptive statistics and between group comparisons were used for quantitative data.

Results

In the pre- and post- Casper cohorts the number of residents in difficulty (16 vs. 15) and the number of learning interventions (18 vs. 16) were similar. Professionalism concerns as an outcome measure decreased by 35% from 12/16 to 6/15 (p < 0.05), were reduced in all 4I domains (involvement, integrity, interaction, introspection) and in their severity. Formal learning interventions (15 vs. 5) and informal learning plans (3 vs. 11) were significantly different in the pre- and post-Casper cohorts respectively (p < 0.05). This reduction in formal learning interventions was associated with a 96% reduction in costs f(rom hundreds to tens of thousands of dollars and a reduction in time for learning interventions (from years to months).

Conclusions

Justifiable from multiple stakeholder perspectives, use of an SJT (Casper) improves a clinical performance measure (professionalism concerns) and permits the institution to redirect its limited resources (cost savings and time) to enhance institutional endeavors and improve learner well-being and quality of programs.
Treatment approaches and costs associated with diabetes clinical metrics as measured by Healthcare Effectiveness Data and Information Set (HEDIS)
Authors: Alkhaddo Jamil , Rung Jillian M. , Khowaja Ameer , Yin Yue , Richards Shannon B. , Drury-Gworek Charlotte , Afreen Samina , Rossi Caitlan , Manzi Susan
Published: March 2024

Background

The clinical outcomes of diabetes can be influenced by primary care providers’ (PCP) treatment approaches. This study explores the association between PCP approaches to management and performance measured by established diabetes metrics and related costs.

Methods

In phase one, Electronic Medical Records were used to extract diabetes related metrics using Healthcare Effectiveness Data and Information Set (HEDIS), for patients with diabetes who had office visits to 44 PCP practices from April 2019 to March 2020. Using those metrics and scoring system, PCP practices were ranked and then categorized into high- and low-performing groups (top and bottom 25%, n = 11 each), with a total of 19,059 clinic visits by patients with a diagnosis of diabetes. Then extensive analysis was performed to evaluate a correlation between treatment approaches and diabetes outcomes across the top and bottom performing practices. In phase 2, patients with diabetes who were attributed to the aforementioned PCP practices were identified in a local health plan claims data base (a total of 3,221 patients), and the allowed amounts from their claims were used to evaluate differences in total and diabetes-related healthcare costs by providers’ performance.

Results

Comparing 10,834 visits in high-performing practices to 8,235 visits in low-performing practices, referrals to certified diabetes care and education specialists and provider-to-provider electronic consults (e-consults) were higher in high-performing practices (Z = 6.06, p < .0001), while traditional referrals were higher in low-performing practices (Z = -6.94, p < .0001). The patient-to-provider ratio was higher in the low-performing group (M = 235.23) than in the high-performing group (M = 153.26) (Z = -2.82, p = .0048). Claims data analysis included 1,825 and 1,396 patients from high- and low-performing providers, respectively. The patient-to-provider ratio was again higher in the low-performing group (p = .009, V = 0.62). Patients receiving care from lower-performing practices were more likely to have had a diabetes-related hospital observation (5.7% vs. 3.9%, p = .02; V = 0.04) and higher diabetes-related care costs (p = .002; d = − 0.07); these differences by performance status persisted when controlling for differences in patient and physician characteristics. Patients seeing low-performing providers had higher Charlson Comorbidity Index scores (Mdn = 3) than those seeing high-performing providers (Mdn = 2).

Conclusions

Referrals to the CDCES and e-Consult were associated with better measured diabetes outcomes, as were certain aspects of cost and types of hospital utilization. Higher patients to providers ratio and patients with more comorbidities were observed in low performing group.
Coupling of nanostraws with diverse physicochemical perforation strategies for intracellular DNA delivery
Authors: Jiang Juan , Liu Jing , Liu Xinmin , Xu Xingyuan , Liu Zhengjie , Huang Shuang , Huang Xinshuo , Yao Chuanjie , Wang Xiafeng , Chen Yixin , Chen Hui-jiuan , Wang Ji , Xie Xi
Published: March 2024

Effective intracellular DNA transfection is imperative for cell-based therapy and gene therapy. Conventional gene transfection methods, including biochemical carriers, physical electroporation and microinjection, face challenges such as cell type dependency, low efficiency, safety concerns, and technical complexity. Nanoneedle arrays have emerged as a promising avenue for improving cellular nucleic acid delivery through direct penetration of the cell membrane, bypassing endocytosis and endosome escape processes. Nanostraws (NS), characterized by their hollow tubular structure, offer the advantage of flexible solution delivery compared to solid nanoneedles. However, NS struggle to stably self-penetrate the cell membrane, resulting in limited delivery efficiency. Coupling with extra physiochemical perforation strategies is a viable approach to improve their performance. This study systematically compared the efficiency of NS coupled with polyethylenimine (PEI) chemical modification, mechanical force, photothermal effect, and electric field on cell membrane perforation and DNA transfection. The results indicate that coupling NS with PEI modification, mechanical force, photothermal effects provide limited enhancement effects. In contrast, NS-electric field coupling significantly improves intracellular DNA transfection efficiency. This work demonstrates that NS serve as a versatile platform capable of integrating various physicochemical strategies, while electric field coupling stands out as a form worthy of primary consideration for efficient DNA transfection.
OCTN2- and ATB0,+-targeted nanoemulsions for improving ocular drug delivery
Authors: Tang Bo , Wang Qiuxiang , Zhang Guowei , Zhang Aiwen , Zhu Lu , Zhao Rongrong , Gu Hongwei , Meng Jie , Zhang Junfang , Fang Guihua
Published: March 2024

Traditional eye drops are administered via topical instillation. However, frequent dosing is needed due to their relatively rapid precorneal removal and low ocular bioavailability. To address these issues, stearoyl L-carnitine-modified nanoemulsions (SC-NEs) were fabricated. The physicochemical properties of SC-NEs in terms of size, morphology, zeta potential, encapsulation efficiency, and in vitro drug release behavior were characterized. The cellular uptake and mechanisms of SC-NEs were comprehensively studied in human corneal epithelial cells and the stearoyl L-carnitine ratio in SC-NEs was optimized. The optimized SC-NEs could target the novel organic cation/carnitine transporter 2 (OCTN2) and amino acid transporter B (0 +) (ATB0,+) on the corneal epithelium, which led to superior corneal permeation, ocular surface retention ability, ocular bioavailability. Furthermore, SC-NEs showed excellent in vivo anti-inflammatory efficacy in a rabbit model of endotoxin-induced uveitis. The ocular safety test indicated that the SC-NEs were biocompatible. In general, the current study demonstrated that OCTN2 and ATB0,+-targeted nanoemulsions were promising ophthalmologic drug delivery systems that can improve ocular drug bioavailability and boost the therapeutic effects of drugs for eye diseases.

Graphical Abstract
Bulk RNA sequencing for analysis of post COVID-19 condition in adolescents and young adults
Authors: Sommen Silke Lauren , Zhao Zhi , Segtnan Sunniva , Stiansen-Sonerud Tonje , Selvakumar Joel , Beier Havdal Lise , Gjerstad Johannes , Wyller Vegard Bruun Bratholm , Lund Berven Lise
Published: March 2024

Background

Post COVID-19 condition (PCC) is a complication of SARS-COV-2 infection and can lead to long-term disability.

Methods

The present study was designed to analyse the gene expression patterns of PCC through bulk RNA sequencing of whole blood and to explore the potential molecular mechanisms of PCC. Whole blood was collected from 80 participants enrolled in a prospective cohort study following SARS-CoV-2 infected and non-infected individuals for 6 months after recruitment and was used for bulk RNA sequencing. Identification of differentially expressed genes (DEG), pathway enrichment and immune cell deconvolution was performed to explore potential biological pathways involved in PCC.

Results

We have found 13 differentially expressed genes associated with PCC. Enriched pathways were related to interferon-signalling and anti-viral immune processes.

Conclusion

The PCC transcriptome is characterized by a modest overexpression of interferon-stimulated genes, pointing to a subtle ongoing inflammatory response.
Contextual determinants of generational continuation of female genital mutilation among women of reproductive age in nigeria: analysis of the 2018 demographic and health survey
Authors: Oni Tosin Olajide , Okunlola David Aduragbemi
Published: March 2024

Background

Female genital mutilation (FGM) has negative health implications and has long been recognised as violating sexual rights. Despite the huge efforts expended on eradicating FGM, generational continuation of the practice, i.e. the act of mutilated women also mutilating their daughters, persists in Nigeria. This study investigated the individual, household, and community factors associated with generational continuation of FGM among women in Nigeria.

Methods

The study analysed data from the 2018 Nigeria Demographic and Health Survey (NDHS). A weighted sample of 3835 women with FGM history and who had given birth to female children was analysed. Models were estimated using mixed-effects multilevel logistic regression with Stata 16.0.

Results

The results showed that 40.0% of women continued FGM for their daughters. Regional prevalence of FGM continuation ranged from 14.9% in the South-South (the lowest) to 64.3% in the North-West (the highest). Women aged 15–24 years (uaOR = 0.40; 95% CI:0.28–0.57) and rich (uaOR = 0.44; 95% CI:0.35–0.56) had the least likelihood of generational continuation of FGM. In communities with low proportions of women unexposed to the media, the likelihood of FGM continuation was significantly higher (uaOR = 1.85; 95% CI:1.35–2.53). Generational continuation of FGM was significantly lower in communities with moderate proportions of uneducated mothers (aOR = 0.6; 95% CI:0.42–0.86).

Conclusion

FGM continuation was high in Nigeria, and it was most common among older and poor mothers and in communities with large proportions of uneducated women and those unexposed to the media. Existing National Policy and Plan on FGM elimination should be strengthened to target these characteristics.
Efficacy of different doses of corticosteroids in treating severe COVID-19 pneumonia
Authors: zhang Ge , Su Lin , Wu Wenwen , Qiao Qing , Gao Shuncui , Zhang Yan , Zhang Yanmei
Published: March 2024

Background

To investigate the efficacy of different doses of corticosteroids in treating severe coronavirus disease 2019 (COVID-19) pneumonia.

Methods

Between May 01, 2023, and June 20, 2023, 48 patients with severe COVID-19 pneumonia were treated at the Department of Respiratory and Critical Care Medicine of Jinan Fourth People's Hospital. The observation group (21 patients) received standard care and high-dose corticosteroids, (high-dose group). The control group (27 patients) received standard care and low-dose corticosteroids (low-dose group). We collected baseline data and recorded inflammatory marker levels after 3 days of treatment, body temperature recovery time, length of stay, and 28-day all-cause mortality. The results of outpatient follow-up were recorded after 1 month.

Results

There were no significant differences in 28-day mortality and length of stay. The number of days it took for body temperature to return to normal in the high-dose group was less than in the low-dose group. The high-dose group had significantly more reduced inflammatory factors (C-reactive protein (CRP), interleukin-6 (IL-6). A total of 20 discharged patients were given 8–16 mg of methylprednisolone, depending on chest computed tomography (CT) and clinical symptoms after 1 month; in all discharged patients using oral corticosteroids, CT features improved.

Conclusion

High-dose corticosteroids had a significantly positive effect on the reduction of inflammatory factors and shortening body temperature recovery time. In the treatment of severe COVID-19 pneumonia, early administration of high-dose, short-course corticosteroids should be implemented.
Lymphangioleiomyomatosis in patients with tuberous sclerosis: a national centre audit
Authors: Johnson Jan , Somerfield Wendy , Johnson Simon R.
Published: March 2024

Background

Lymphangioleiomyomatosis (LAM) is common in tuberous sclerosis complex (TSC) yet under recognised with management mostly based upon evidence obtained from patients with sporadic LAM. We performed a prospective audit of patients with TSC-LAM attending a national referral centre to inform management guidelines.

Methods

The UK LAM Centre was established in 2011 and conducts a prospective audit of pre-defined quality outcomes for all subjects. Audit data are reported on all patients with TSC-LAM and a comparator population of patients with sporadic LAM.

Results

Between 2011 and 2022, 73 patients were seen with TSC-LAM. All were women with a mean (SD) age of 39 (12) years. Referral rates were similar over the study period including after the introduction of CT screening. Median age of diagnosis with TSC was 11 years (range 0–70) with one third diagnosed with TSC as adults. Compared with all TSC patients in the ‘TOSCA’ registry, TSC-LAM patients tended to have been diagnosed with TSC at an older age, had fewer neuro-cognitive manifestations and were more likely to have angiomyolipoma. The most common presentations of TSC-LAM were following workup for angiomyolipoma, pneumothorax or dyspnoea with only one fifth detected after CT screening. Baseline FEV1 and DLCO at first assessment were reduced to 77 and 63% predicted respectively and were similar to patients with sporadic LAM. During follow-up, FEV1 fell by a mean of 81 ml/year and DLCO fell by 0.309 mmol/ml/kPa/year in patients not being treated with an mTOR inhibitor. 55% required treatment with either sirolimus or Everolimus for LAM or angiomyolipoma respectively. For those treated with an mTOR inhibitor, mean FEV1 fell by 3 ml/year and DLCO increased by 0.032 mmol/ml/kPa/year and was similar to sporadic LAM. Risk of death due to LAM or need for lung transplant in patients with TSC-LAM was 0.67%/year.

Conclusions

Despite screening recommendations, LAM is often diagnosed in TSC after symptoms develop which may delay treatment. Complications including pneumothorax and loss of lung function are significant and similar to sporadic LAM. Work is needed to implement the recommended CT screening for LAM and improve respiratory care for TSC-LAM.