bluuebunny/crossref_metadata_2025 huggingface dataset:
Prevalence and correlates of alcohol use and risky drinking among undergraduate students in Johannesburg, South Africa: a cross-sectional study
Authors: Chen Cassandra , Mpinganjira Mafuno G , Motilal Asha , Matukane Sandile , Letsoalo Relebohile , McKee Tyler , Ntombela Zakithi , Mbulaheni Limuwani , Hargovan Taveer , Francis Joel M
Published: August 2023

Background

Alcohol use and risky drinking are significant public health problem globally. Young people, including university students, are among the most affected populations. We conducted the study to determine the prevalence and correlates of alcohol use and risky drinking among undergraduate students in the Faculty of Health Sciences at the University of the Witwatersrand, South Africa.

Methods

We conducted a cross-sectional study using an anonymous, self-administered online survey in REDCap. The survey questionnaire consisted of socio demographic, and alcohol use questions using the risky drinking identification screening tool (AUDIT-C). We performed descriptive statistics, bivariate and multivariable logistic regression to determine factors associated with alcohol use and risky drinking. The p-value of < 0.05 was considered statistically significant.

Results

The response rate was 15.7%. Most participants were female (69.6%) and majority of the participants were White (38.1%). The prevalence of lifetime use of alcohol was 79.1%, and among the lifetime users; 70.2% reported alcohol use in the last 12-months, 37.1% reported alcohol use in the last 30 days. The prevalence of risky drinking was 54.8% among lifetime drinkers. Factors significantly associated with current alcohol use were siblings alcohol use (aOR = 1.79, 95% CI: 1.02–3.15) and parents alcohol use (aOR = 2.58, 95% CI: 1.39–4.80), white race (aOR = 5.70, 95% CI: 3.12–10.41), and always or daily exposure to alcohol marketing in the media (aOR = 3.31, 95% CI: 1.07–10.24). Factors associated with risky drinking were: Indian/Asian race (aOR = 2.82, 95% CI: 1.09–7.31), White race (aOR = 2.15, 95% CI: 1.14–4.04), and exposure to alcohol marketing in the media as follows, most of the time (aOR = 3.42, 95% CI: 1.29–9.04) and Always/daily exposure (aOR = 3.31, 95% CI: 1.07–10.24).

Conclusion

The reported alcohol use and risky drinking were common amongst undergraduate students at Wits university. There is an urgent need to design, pilot and adapt targeted interventions for this population group.
Self-rated health and quality of life in female sex workers with substance use disorders in Tehran, Iran
Authors: Khoei Effat Merghati , Rezaei Zahed , Parvari Arash , Korte Jeffrey E.
Published: August 2023

Background

While self-rated health (SRH) and quality of life (QoL) has been associated with substance use disorders (SUDs) in sex-working populations, little is known about this association in Iran. This study aimed to assess QoL and SRH in Iranian female sex workers (FSWs) in Tehran.

Method

FSWs were recruited using convenience sampling methods from substance abuse treatment centers in Tehran that exclusively provided services for women. Participants completed an interviewer-administered demographic questionnaire in Persian and the Iranian version of the Short Form Health Survey (SF-36). Descriptive analyses, means and standard deviations; frequency and percentages, t-test and one-way ANOVA, and Chi-square tests were utilized to analyze the data.

Results

The mean age among 161 participants clinically diagnosed with SUD was 34.09 years (SD 7.97; range: 18–57). The total mean QoL score was 41.03 (SD: 12.92). The highest and lowest mean scores were observed in the physical functioning (52.23) and role emotional (26.64) dimensions, respectively. Significant differences (p < 0.05) in QoL were observed according to education and marital status, and the average QoL score was lower in women who reported permanent marriages and women who were illiterate. The average score of QoL was significantly higher in employed women. Overall, 51.6% of the women rated their health as sub-optimal, with divorced participants and women who were illiterate more likely to rate their health as sub-optimal (p < 0.05).

Conclusion

Results emphasize the need for mental, physical, and sexual health screening and gender-specific interventions to improve QoL in this population. Further investigation may elucidate the consequences of poor SRH and QoL on SUD treatment adherence, sexual risk behavior, and morbidity and mortality in FSWs.
Design and evaluation of a Mobile-Based decision support system to enhance lung transplant candidate assessment and management: knowledge translation integrated with clinical workflow
Authors: Abtahi Hamidreza , Shahmoradi Leila , Amini Shahideh , Gholamzadeh Marsa
Published: August 2023

Background

Accurate and timely decision-making in lung transplantation (LTx) programs is critical. The main objective of this study was to develop a mobile-based evidence-based clinical decision support system (CDSS) to enhance the management of lung transplant candidates.

Method

An iterative participatory software development process was employed to develop the ImamLTx CDSS. This study was accomplished in three phases. First, required data and standard clinical workflow were identified according to the literature review and expert consensus. Second, a rule-based knowledge-based CDSS application was developed. In the third phase, this CDSS was evaluated. The evaluation was done using the standard Post-Study System Usability Questionnaire (PSSUQ 18.3) and ten usability heuristics factors for user interface design.

Results

According to expert consensus, fifty-five data items were identified as essential data sets using the Content Validity Ratio (CVR) formula. By integrating information flow in clinical practices with clinical protocols, more than 450 rules and 500 knowledge statements were extracted. This CDSS provides clinical decision support on an Android platform regarding inclusion and exclusion referral criteria, optimum transplant time based on the type of lung disease, findings of initial assessment, and the overall evaluation of lung transplant candidates. Evaluation results showed high usability ratings due to the fact provided accuracy and sensitivity of this lung transplant CDSS with the information quality domain receiving the highest score (6.305 from 7).

Conclusion

Through a stepwise approach, the ImamLTx CDSS was developed to provide LTx programs with timely patient data access via a mobile platform. Our results suggest integration with existing workflow to support clinical decision-making and provide patient-specific recommendations.
A cross-cultural concept analysis of healing in nursing: a hybrid model
Authors: SadatHoseini AkramSadat , Shareinia Habib , Pashaeypoor Shahzad , Mohammadi MohammadMehdi
Published: August 2023

Background

As a familiar yet abstract and vague concept for nurses, healing is affected by the cultural needs of different communities. The concept of healing is nowadays recommended in nursing theories, and its clarification can develop healing-based nursing care. The present study was conducted to objectify and clarify the concept of healing in nursing care.

Methods

The present research employed a hybrid concept analysis model developed by Schwartz-Barcott and Kim. The conceptual analysis model of Walker & Avant was used in the theoretical phase, i.e., literature review, where relevant articles in PubMed, ISI, Google Scholar, Scopus, SID and Magiran were reviewed irrespective of publication time. Unstructured interviews were conducted with ten participants in the field data collection phase. A final analysis was performed by combining the two phases.

Results

The theoretical phase identified healing characteristics such as balancing and hope-making originated from mental and spiritual states. Analyzing the data in the fieldwork stage extracted five main themes, i.e. “comprehensive psychophysical health”, “cure, a small part of healing”, “healing, a spiritual recovery”, “an individual’s own role in healing” and “healing, an unexpected event”. During the patient care process, nurses can help patients heal by establishing appropriate communication and comprehensive understanding of the patients by designing and implementing appropriate interventions and integrating healing strategies into their comprehensive care measures.

Conclusions

The concept of healing in nursing care is a general and complex process, and different people can interpret it differently on their road to health. Properly understanding the concept of healing enables nurses to assist patients in achieving health and healing through proper communication, holistic care, empowering patients to perform self-care and providing spiritual care.
Contradictions hindering the provision of mental healthcare and psychosocial services to women experiencing homelessness in Addis Ababa, Ethiopia: service providers’ and programme coordinators’ experiences and perspectives
Authors: Yohannes Kalkidan , Berhane Yemane , Bradby Hannah , Herzig van Wees Sibylle , Målqvist Mats
Published: August 2023

Background

Mental health conditions are among the health issues associated with homelessness, and providing mental healthcare to people experiencing homelessness is challenging. Despite the pressing issue of homelessness in Addis Ababa, Ethiopia, there is scant research on how service providers address women’s mental health and psychosocial needs. Therefore, we explored service providers’ and programme coordinators’ perceptions and experiences regarding mental healthcare and psychosocial services delivery to women experiencing street homelessness in the city.

Methods

We conducted a descriptive qualitative study with selected healthcare and social support providers and programme coordinators. The study involved 34 participants from governmental and non-governmental organisations in Addis Ababa, Ethiopia. Data were analysed using an inductive thematic approach.

Results

Four themes were derived from the analysis. The first of these was “divergent intentions and actions”. While service providers and programme coordinators showed empathy and compassion, they also objectified and blamed people for their own homelessness. They also expressed opposing views on mental health stigma and compassion for these people. The second theme addressed “problem-solution incompatibility”, which focused on the daily challenges of women experiencing homelessness and the types of services participants prioritised. Service providers and programme coordinators proposed non-comprehensive support despite the situation’s complexity. The participants did not emphasise the significance of gender-sensitive and trauma-informed care for women experiencing street homelessness in the third theme, “the lack of gendered and trauma-informed care despite an acknowledgement that women face unique challenges”. The fourth theme, “mismatched resources,” indicated structural and systemic barriers to providing services to homeless women.

Conclusions

Conflicting attitudes and practices exist at the individual, organisational, and systemic levels, making it challenging to provide mental healthcare and psychosocial services to women experiencing homelessness. An integrated, gender-sensitive, and trauma-informed approach is necessary to assist women experiencing homelessness.
Nigella sativa-chitosan nanoparticles: Novel intestinal mucosal immunomodulator controls and protects against Salmonella enterica serovar Enteritidis infection in broilers
Authors: Ahmad Adel Attia M. , Elmowalid Gamal A. , Abdelhamid Ahmed E. , Mohammad Alaa Abed Elrazak , Abdelwahab Ashraf M. O.
Published: August 2023

Background

Salmonella Enteritidis (SE) propagates in chickens' gastrointestinal surfaces and is transmitted to humans, causing food poisoning. Oral supplementation with natural nanoparticles can overcome the harsh gastrointestinal conditions facing oral vaccines and requires no antibiotic administration to protect against microbial infection. This study was designed to study Nigella sativa-chitosan nanoparticles (CNP-NS) prophylactic immunomodulatory efficacy against SE infection in broiler chicks. The CNP-NS was prepared and characterized, and its in vivo immunomodulatory activities against an avian virulent-MDR SE-induced challenge in chicks were investigated.

Result

To verify the immune-protective activities of the CNP-NS, colony forming units (CFU) in the liver and fecal droppings; intestinal histopathological alterations and immune cell recruitment; MUC-2, TLR-4, cecal cytokines, and specific IgA gene expression levels were assessed. On the 7th and 12th days after the SE challenge, the CNP-NS supplemented chicks showed complete clearance of SE CFU in livers and fecal droppings, as well as an improvement in food conversion rate compared to non-supplemented CNP-NS that revealed the presence of the challenge SE CFU on the same days. A prominent influx of antigen presenting cells and lymphoid aggregates into the intestinal wall, spleen, and liver was detected with improvements in the intestinal villi morphometry of the CNP-NS-supplemented chicks. The changes of INF-γ, IL-1β, and IL-4 cecal cytokines, as well as TLR-4, MUC-2, and IgA mRNA expression levels, confirm CNP-NS immunomodulatory activities and provide a mechanism(s) for its protective actions against the induced SE challenge of the tested chickens.

Conclusion

These findings suggest promising useful insights into CNP-NS supplementation as a safe food additive for poultry meat consumers' and a protective immunomodulator of the chickens' mucosal immune systems. It could be recommended for epidemiological purposes to reduce the risk of SE food poisoning and transmission to humans.
A promising microbial α-amylase production, and purification from Bacillus cereus and its assessment as antibiofilm agent against Pseudomonas aeruginosa pathogen
Authors: Abo-Kamer Amal M. , Abd-El-salam Ibrahim S. , Mostafa Faten A. , Mustafa Abd-El-Rahman A. , Al-Madboly Lamiaa A.
Published: August 2023

Background and aim

The purpose of the current study is to isolate a heavily amylase-producing bacteria of the genusBacillusfrom soil samples, optimize the production of the enzyme, purify it, and evaluate its activity against biofilm-producing bacteria. A total of 12 soil samples were collected and screened for promisingBacillusspecies with good amylolytic activity. Isolation was done by serial dilution and plating technique and amylolytic activity was determined by starch agar plate method. Among the 12Bacillusisolates recovered from soil samples, 7 showed positive α-amylase production. The best isolate that recorded the greatest amylolytic activity was selected for further studies. This isolate was identified by 16S rRNA sequencing asBacillus cereusand registered under gene bank accession number OP811897. Furthermore, the α-amylase enzyme was produced by a submerged fermentation technique using best production media and partially purified by ammonium sulfate and chilled ethanol and molecular weight had been determined by SDS-PAGE gel electrophoresis. The production of α-amylase was optimized experimentally by one-factor at a time protocol and statistically by Plackett–Burman design as well as RSM CCD design. Data obtained from OFAT and CCD revealed that α-amylase activities were 1.5- and twofold respectively higher as compared to un-optimized conditions. The most significant factors had been identified and optimized by CCD design.

Results

Among the eleven independent variables tested by PBD, glucose, peptone, (NH4)2SO4, and Mg SO4were the most significant parameters for α-amylase production with an actual yield of 250U/ml. The best physical parameters affecting the enzyme production were incubation time at 35 °C, and pH 5.5 for 48 h. The partially purified enzyme with 60% ammonium sulphate saturation with 1.38- fold purification showed good stability characteristics at a storage temperature of 4 °C and pH up to 8.5 for 21 days. Antibiofilm activity of purified α-amylase was determined againstPseudomonas aeruginosa(ATCC 35659) by spectrophotometric analysis and CLSM microscopic analysis. Results demonstrated biofilm inhibition by 84% of the formedPseudomonasbiofilm using a microtiter plate assay and thickness inhibition activity by 83% with live/Dead cells percentage of 17%/83% using CLSM protocol.

Conclusions

A highly stable purified α-amylase fromB. cereusshowed promising antibiofilm activity against one of the clinically important biofilm-forming MDR organisms that could be used as a cost-effective tool in pharmaceutical industries.
Shewanella chilikensis MG22 isolated from tannery site for malachite green decolorization in microbial fuel cell: a proposed solution for recirculating aquaculture system (RAS)
Authors: Efraim Abanaoub , Saeed Mai , Elbaz Mariam Ahmed , Alaa Mohamed , Ahmed Noran , Adel Rana , Hazem Yara , Elshatoury Einas , Gomaa Ola M.
Published: August 2023

Malachite Green (MG) dye of the triphenylmethane group is a toxic compound used in the aquaculture industry as an antifungal agent, however, it can accumulate in fish and pose toxicity. The present work aims to remove MG in Microbial Fuel Cell (MFC) as a sustainable and eco-friendly solution. Out of six samples, the highest malachite green degradation was obtained by a sample obtained from Robiki tannery site in agar plates in 24 h at 37 °C. Robiki sample was used to inoculate the anodic chamber in Microbial Fuel cell, the resulting average electricity production was 195.76 mV for two weeks. The decolorization average was almost 88%. The predominant bacteria responsible for MG decolorization and electricity production were identified using 16S rRNA as Shewanella chilikensis strain MG22 (Accession no. OP795826) and formed a heavy biofilm on the anode. At the end of the decolorization process, MG was added again for re-use of water. The results showed efficiency for re-use 3 times. To ensure the sterility of treated water for re-use, both UV and filter sterilization were used, the latter proved more efficient. The obtained results are promising, MFC can be used as recirculating aquaculture system (RAS). The same aquaculture water can be treated multiple times which provides a sustainable solution for water conservation.

Graphical Abstract
3D modeling of in vivo MRI-guided nano-photothermal therapy mediated by magneto-plasmonic nanohybrids
Authors: Tavangari Zahed , Asadi Mohammadreza , Irajirad Rasoul , Sarikhani Abolfazl , Alamzadeh Zahra , Ghaznavi Habib , Khoei Samideh
Published: August 2023

Background

Nano-photothermal therapy (NPTT) has gained wide attention in cancer treatment due to its high efficiency and selective treatment strategy. The biggest challenges in the clinical application are the lack of (i) a reliable platform for mapping the thermal dose and (ii) efficient photothermal agents (PTAs). This study developed a 3D treatment planning for NPTT to reduce the uncertainty of treatment procedures, based on our synthesized nanohybrid.

Methods

This study aimed to develop a three-dimensional finite element method (FEM) model for in vivo NPTT in mice using magneto-plasmonic nanohybrids, which are complex assemblies of superparamagnetic iron oxide nanoparticles and gold nanorods. The model was based on Pennes' bio-heat equation and utilized a geometrically correct mice whole-body. CT26 colon tumor-bearing BALB/c mice were injected with nanohybrids and imaged using MRI (3 Tesla) before and after injection. MR images were segmented, and STereoLithography (STL) files of mice bodies and nanohybrid distribution in the tumor were established to create a realistic geometry for the model. The accuracy of the temperature predictions was validated by using an infrared (IR) camera.

Results

The photothermal conversion efficiency of the nanohybrids was experimentally determined to be approximately 30%. The intratumoral (IT) injection group showed the highest temperature increase, with a maximum of 17 °C observed at the hottest point on the surface of the tumor-bearing mice for 300 s of laser exposure at a power density of 1.4 W/cm2. Furthermore, the highest level of tissue damage, with a maximum value of Ω = 0.4, was observed in the IT injection group, as determined through a simulation study.

Conclusions

Our synthesized nanohybrid shows potential as an effective agent for MRI-guided NPTT. The developed model accurately predicted temperature distributions and tissue damage in the tumor. However, the current temperature validation method, which relies on limited 2D measurements, may be too lenient. Further refinement is necessary to improve validation. Nevertheless, the presented FEM model holds great promise for clinical NPTT treatment planning.
Effective treatment of metastatic sentinel lymph nodes by dual-targeting melittin nanoparticles
Authors: Dai Yanfeng , Yu Xiang , Leng Yuehong , Peng Xingzhou , Wang Junjie , Zhao Yifan , Chen Juan , Zhang Zhihong
Published: August 2023

Sentinel lymph node (SLN) metastasis is an important promoter of distant metastasis in breast cancer. Therefore, the timely diagnosis and precise treatment are crucial for patient staging and prognosis. However, the simultaneous diagnosis of metastasis and the implementation of imaging-guided SLN therapy is challenging. Here, we report a melittin-loaded and hyaluronic acid (HA)-conjugated high-density lipoprotein (HDL) mimic phospholipid scaffold nanoparticle (MLT-HA-HPPS), which dually-target to both breast cancer and its SLN and efficiently inhibit SLN metastasis in the LN metastasis model. The melittin peptide was successfully loaded onto HA-HPPS via electrostatic interactions, and MLT-HA-HPPS possesses effective cytotoxicity for breast cancer 4T1 cells. Moreover, the effective delivery of MLT-HA-HPPS from the primary tumor into SLN is monitored by NIR fluorescence imaging, which greatly benefits the prognosis and treatment of metastatic SLNs. After paracancerous administration, MLT-HA-HPPS can efficiently inhibit primary tumor growth with an inhibition rate of 81.3% and 76.5% relative to the PBS-treated control group and HA-HPPS group, respectively. More importantly, MLT-HA-HPPS can effectively inhibit the growth of the metastatic SLNs with an approximately 78.0%, 79.1%, and 64.2% decrease in SLNs weight than those in PBS, HA-HPPS, and melittin-treated mice, respectively. Taken together, the MLT-HA-HPPS may provide an encouraging theranostic of SLN drug delivery strategy to inhibit primary tumor progression and prevent SLN metastasis of breast cancer.

Graphical Abstract
Distinct developmental trajectories of health-related quality of life for boys and girls throughout childhood and adolescence; a national level longitudinal study
Authors: O’Loughlin Rachel , Hiscock Harriet , Devlin Nancy , Dalziel Kim
Published: August 2023

Background

To identify and describe distinct developmental trajectories of health-related quality of life (HRQoL) in a national level Australian population sample, overall and separately for boys and girls.

Methods

Data were from the Longitudinal Study of Australian Children (LSAC). Participants were children aged 4–5 years recruited in 2004 and followed through to age 16–17 years in 2016, and their caregivers. Group-based trajectory modelling was used to identify groups of children that follow qualitatively distinct developmental trajectories of HRQoL.

Results

Three distinct trajectories were identified for the total sample: (1) high-stable (52.2% of children); (2) middle-stable (38.0%); and (3) low-declining (9.8%). These trajectories differed for boys, who saw increasing HRQoL in the highest trajectory group; a middle-stable trajectory; and declining and rebounding HRQoL in the lowest trajectory group. In contrast, girls saw no increasing or rebounding trajectories; approximately half of girls had high-stable HRQoL and the remaining half had either steadily or rapidly declining HRQoL from age 4–5 to 16–17 years.

Conclusions

Our results highlight the importance of considering the distinct trajectories for girls and boys and not relying on population mean levels of HRQoL for decision-making. The presence of developmentally distinct trajectories of HRQoL, and differences in the trajectories faced by boys and girls, should be considered when assessing the effectiveness of treatments and interventions impacting upon HRQoL throughout childhood and adolescence. Failure to account for these pre-existing trajectories may over- or under-estimate treatment effects.
Physical activity and social interaction assessments in schoolyard settings using the System for Observing Outdoor Play Environments in Neighborhood Schools (SOOPEN)
Authors: Hazlehurst Marnie F. , Wolf Kathleen L. , Simmons Cary , Nieto Carolina , Steiner Mary Kathleen , Garrett Kimberly A. , Faino Anna V. , Ubalde López Mònica , López-Toribio María , Tandon Pooja S.
Published: August 2023

Background

The schoolyard environment provides key opportunities to promote physical activity and socioemotional development for children. Schoolyards can also serve as a community park resource outside of school hours. We aimed to: (i) implement and evaluate reliability of the System for Observing Outdoor Play Environments in Neighborhood Schools (SOOPEN), (ii) assess schoolyard use by children during recess and community members of all ages outside of school hours, and (iii) investigate relationships of schoolyard and children´s group characteristics with physical activity levels and prosocial interactions.

Methods

In this cross-sectional study, we observed student and community visitor behavior using SOOPEN at three urban elementary schoolyards in Tacoma, Washington, USA, prior to renovations intended to expand each facility’s use as a community park in neighborhoods with poor park access. We assessed interrater reliability using intraclass correlation coefficients and described current levels of schoolyard use (at the group level), physical activity, and prosocial behavior. Physical activity was assessed on a five-point scale and dichotomized to indicate moderate-to-vigorous physical activity (MVPA). Social interactions were coded as prosocial, antisocial, or neutral. We examined associations of selected schoolyard features and group characteristics with group MVPA and prosocial behavior during recess using modified Poisson regression to estimate prevalence ratios (PR) and 95% confidence intervals (CI).

Results

We observed a total of 981 activity-defined, informal groups in the schoolyards, and achieved good to excellent interrater reliability using SOOPEN. Community use of the schoolyards during evenings and weekends was limited (n = 56 groups). During 26, 25–50 min recess periods (n = 833 groups), 19% of groups were engaged in MVPA. Schoolyard areas with paved surfaces were associated with more MVPA (PR = 1.52, 95% CI: 1.04, 2.23) compared to field/grass areas; supervised groups were associated with less MVPA than groups not directly supervised by an adult (PR = 0.59, 95% CI: 0.36, 0.96). Schoolyard characteristics were not associated with prosocial behavior. Mixed-gender groups were associated with more MVPA and more prosocial behavior.

Conclusions

Our study using SOOPEN, a reliable new activity observation tool, highlights the multi-dimensional dynamics of physical activity and social interactions in schoolyards, which could be leveraged to promote healthy behaviors during and outside of school hours.
Providing a model for financing the treatment costs during biological crises using the fiscal space development approach
Authors: Yaghoubi Maryam , Vahedi Idehlo Masoud , mehdizadeh Parisa , Meskarpour Amiri Mohammad
Published: August 2023

Background

Expanding fiscal space for health can be defined as providing additional budgetary resources for health, which is highly important during biological crises. This study aimed to provide a model for financing the treatment costs during biological crises using the development of the fiscal space approach.

Methods

This study employed a descriptive mixed-method design, consisting of three stages. In the first stage, a systematic review of relevant literature was conducted using multiple databases, including Scopus, PubMed, and Google Scholar. A total of 45 studies that met the inclusion criteria were selected. In the second stage, a panel of 14 experts identified five primary and 32 secondary strategies using an open questionnaire. Any additional strategies not identified during the literature review were added if a consensus was reached by experts. In the final stage, the Best Worst Method (BWM) was used to prioritize the identified strategies and sub-strategies based on their feasibility, effectiveness, quick yield, and fairness.

Results

Five strategies and fifty sub-strategies were identified. The most important strategies were the increase in health sector-specific resources (0.3889), increase in efficiency of health expenditures (0.2778), structural reforms (0.1111), health sector-specific grants and foreign aid (0.1667), and conducive macroeconomic conditions (0.05556). The most important sub-strategies were establishing and increasing earmarked taxes for the health sector (0.0140), expanding Universal Health Coverage (UHC) plans (0.0103), attracting the participation of non-governmental organizations (NGOs) and charitable organizations in the health sector (0.0096), integrating basic social insurance funds (0.0934), and tax exemptions for economic activists in the health sector (0.009303) during the crisis.

Conclusion

This study identified five main strategies and 50 sub-strategies for financing the treatment costs during biological crises. The most important strategies were increasing health sector-specific resources, improving efficiency of health expenditures, and implementing structural reforms. To finance health expenditures, harmful and luxury goods taxes can be increased and allocated to the health sector during crises. UHC plans should be improved and expanded, and the capacity of NGOs and charitable organizations should be better utilized during crises.
Calcineurin inhibition protects against dopamine toxicity and attenuates behavioral decline in a Parkinson’s disease model
Authors: Mondal Rupsha , Banerjee Chayan , Nandy Sumangal , Roy Moumita , Chakraborty Joy
Published: August 2023

Background

Parkinson’s disease (PD), a highly prevalent neuro-motor disorder is caused due to progressive loss of dopaminergic (DAergic) neurons at substantia nigra region of brain. This leads to depleted dopamine (DA) content at striatum, thus affecting the fine tuning of basal ganglia. In patients, this imbalance is manifested by akinesia, catalepsy and tremor. PD associated behavioral dysfunctions are frequently mitigated by l-DOPA (LD) therapy, a precursor for DA synthesis. Due to progressive neurodegeneration, LD eventually loses applicability in PD. Although DA is cytotoxic, it is unclear whether LD therapy can accelerate PD progression or not. LD itself does not lead to neurodegeneration in vivo, but previous reports demonstrate that LD treatment mediated excess DA can potentiate neurotoxicity when PD associated genetic or epigenetic aberrations are involved. So, minimizing DA toxicity during the therapy is an absolute necessity to halt or slowdown PD progression. The two major contributing factors associated with DA toxicity are: degradation by Monoamine oxidase and DAquinone (DAQ) formation.

Results

Here, we report that apoptotic mitochondrial fragmentation via Calcineurin (CaN)-DRP1 axis is a common downstream event for both these initial cues, inhibiting which can protect cells from DA toxicity comprehensively. No protective effect is observed, in terms of cell survival when only PxIxIT domain of CaN is obstructed, demonstrating the importance to block DRP1-CaN axis specifically. Further, evaluation of the impact of DA exposure on PD progression in a mice model reveal that LD mediated behavioral recovery diminishes with time, mostly because of continued DAergic cell death and dendritic spine loss at striatum. CaN inhibition, alone or in combination with LD, offer long term behavioral protection. This protective effect is mediated specifically by hindering CaN-DRP1 axis, whereas inhibiting interaction between CaN and other substrates, including proteins involved in neuro-inflammation, remained ineffective when LD is co-administered.

Conclusions

In this study, we conclude that DA toxicity can be circumvented by CaN inhibition and it can mitigate PD related behavioral aberrations by protecting neuronal architecture at striatum. We propose that CaN inhibitors might extend the therapeutic efficacy of LD treatment.
Patient-relevant outcomes following elective, aseptic revision knee arthroplasty: a systematic review
Authors: Sabah Shiraz A. , Hedge Elizabeth A. , von Fritsch Lennart , Xu Joshua , Rajasekaran Raja Bhaskara , Hamilton Thomas W. , Shearman Alexander D. , Alvand Abtin , Beard David J. , Hopewell Sally , Price Andrew J.
Published: August 2023

Background

The aim of this systematic review was to summarise the evidence for the clinical effectiveness of revision knee arthroplasty (rKA) compared to non-operative treatment for the management of patients with elective, aseptic causes for a failed knee arthroplasty.

Methods

MEDLINE, Embase, AMED and PsychINFO were searched from inception to 1st December 2020 for studies on patients considering elective, aseptic rKA. Patient-relevant outcomes (PROs) were defined as implant survivorship, joint function, quality of life (QoL), complications and hospital admission impact.

Results

No studies compared elective, aseptic rKA to non-operative management. Forty uncontrolled studies reported on PROs following elective, aseptic rKA (434434 rKA). Pooled estimates for implant survivorship were: 95.5% (95% CI 93.2–97.7%) at 1 year [seven studies (5524 rKA)], 90.8% (95% CI 87.6–94.0%) at 5 years [13 studies (5754 rKA)], 87.4% (95% CI 81.7–93.1%) at 10 years [nine studies (2188 rKA)], and 83.2% (95% CI 76.7–89.7%) at 15 years [two studies (452 rKA)]. Twelve studies (2382 rKA) reported joint function and/or QoL: all found large improvements from baseline to follow-up. Mortality rates were low (0.16% to 2% within 1 year) [four studies (353064 rKA)]. Post-operative complications were common (9.1 to 37.2% at 90 days).

Conclusion

Higher-quality evidence is needed to support patients with decision-making in elective, aseptic rKA. This should include studies comparing operative and non-operative management. Implant survivorship following elective, aseptic rKA was ~ 96% at 1 year, ~ 91% at 5 years and ~ 87% at 10 years. Early complications were common after elective, aseptic rKA and the rates summarised here can be shared with patients during informed consent.

Systematic review registration

PROSPERO CRD42020196922
A multidisciplinary opioid-reduction pathway for robotic prostatectomy: outcomes at year one
Authors: Manning Michael W. , Whittle John , Fuller Matthew , Cooper Sara H. , Manning Erin L. , Chapman Joe , Moul Judd W. , Miller Timothy E.
Published: August 2023

Background

Opioid use has come under increasing scrutiny, driven in part by the opioid crisis and growing concerns that up to 6% of opioid-naïve patients may become chronic opioid users. This has resulted in a revaluation of perioperative practice. For this reason, we implemented a multidisciplinary pathway to reduce perioperative opioid usage through education and standardization of practice.

Methods

A single-centre retrospective evaluation was performed after 1 year, comparing the outcomes to those of the 2 years prior to pathway implementation. Comparisons were made between pre- vs. post pathway change by 2:1 propensity matching between cohorts. Univariate linear regression models were created using demographic variables with those that were p < 0.15 included in the final model and using post-operative opioid use (in oral morphine equivalents, OME) as the primary outcome.

Results

We found that intraoperative opioid use was significantly decreased 38.2 mg (28.3) vs. 18.0 mg (40.4) oral morphine equivalents (OME), p < .001, as was post-operative opioid use for the duration of the hospitalization, 46.3 mg (49.5) vs. 35.49 mg (43.7) OME, p = 0.002. In subgroup analysis of those that received some intraoperative opioids (n = 152) and those that received no opioids (n = 34), we found that both groups required fewer opioids in the post-operative period 47.0 mg (47.7) vs. 32.4 mg (40.6) OME, p = 0.001, + intraoperative opioids, 62.4 mg (62.9) vs. 35.8 mg (27.7) OME, p = 0.13, - intraoperative opioids. Time to discharge from the PACU was reduced in both groups 215 min (199) vs. 167 min (122), p < 0.003, + intraoperative opioids and 253 min (270) vs. 167 min (105), p = 0.028, - intraoperative opioids. The duration of time until meeting discharge criteria from PACU was 221 min (205) vs. 170 min (120), p = 0.001. Hospital length of stay (LOS) was significantly reduced 1.4 days (1.3) vs. 1.2 days (0.8), p = 0.005. Both sub-groups demonstrated reduced hospital LOS 1.5 days (1.4) vs. 1.2 days (0.8), p = 0.0047, + intraoperative opioids and 1.7 days (1.6) vs. 1.3 days (0.9), p = 0.0583, - intraoperative opioids. Average pain scores during PACU admission and post-PACU until discharge were not statistically different between cohorts.

Conclusions

These findings underscore the effectiveness of a multidisciplinary approach to reduce opioids. Furthermore, it demonstrates improved patient outcomes as measured by both shorter PACU and almost 50% reduction in perioperative opioid use whilst maintaining similar analgesia as indicated by patient-reported pain scores.
Modelling the timing of migration of a partial migrant bird using ringing and observation data: a case study with the Song Thrush in Italy
Authors: Ambrosini Roberto , Imperio Simona , Cecere Jacopo G. , Andreotti Alessandro , Serra Lorenzo , Spina Fernando , Fattorini Niccolò , Costanzo Alessandra
Published: August 2023

Background

The study of the timing of migration is fundamental to the understanding of the ecology of many bird species and their response to climate change, and it has important conservation and management implications e.g., for assessing the hunting seasons according to the EU Directive 2009/147/EC (Birds Directive).

Methods

We developed a new method for the analysis of ringing data (both first capture and re-encounters) and citizen science observations, to assess the timing of pre- and post-nuptial migration of birds. This method was tested on the Song ThrushTurdus philomelos, using i) the Bird Ringing Database hosted by the ISPRA Italian Ringing Centre from the whole Italian peninsula, the three closest large islands (Sicily, Sardinia and Corsica), and Canton Ticino (Switzerland) and ii) the eBird data for the same study area.

Results

The results from both datasets consistently showed that pre-nuptial migration starts during the first 10-day period of January (Jan 1) in some central and southern areas of the Italian peninsula, in central Sicily, southern Sardinia, and Corsica. The onset of migration occurs on Jan 2 in the rest of central and southern Italy, Sicily and Sardinia, and western Liguria, while it starts later in the north-eastern Alps, up to Mar 3. The end of post-nuptial migration is more synchronous, occurring on Nov 1 across most of Italy, slightly earlier (Oct 3) in northern Italy and later (Nov 2) in Sicily. The uncertainty of the estimated dates was < 2 days in most cases.

Conclusion

This method represents a novel and valuable tool for the analyses of the timing of migration using ringing and citizen science data and provides an important contribution to the Key Concepts Document of the EU Birds Directive, where migration timings are considered and used to define the hunting period of birds.
I like language assessment: EFL learners’ voices about self-assessment, self-efficacy, grit tendencies, academic resilience, and academic demotivation in online instruction
Authors: Wicaksono Bayu Hendro , Ismail Sayed M. , Sultanova Shakhnoza Akmalovna , Abeba Dejen
Published: August 2023

Self-awareness and self-evaluation are at the heart of both core of self-assessment, self-efficacy, and grit tendencies. Although there is a lot written about self-assessment, self-efficacy, and grit tendencies, academic resilience, and motivation, very little is known about how self-assessment, self-efficacy, and grit tendencies contribute to the academic resilience and academic demotivation of the learners, especially in online English as a foreign language (EFL) assessment. Therefore, the purpose of this study was to investigate a structural model of core of self-assessment, self-efficacy, grit tendencies, academic resilience, and academic demotivation among EFL students. Consequently, 385 EFL students took surveys measuring their language-learning endeavors using the Core of Self-assessment Questionnaire (CSAQ), the Self-Efficacy Scale (S-ES), the language-domain-specific grit scale (L2-Grit S), the Academic Resilience Scale (ARS), and the Academic Demotivation Scale (ADS). Structural equation modeling (SEM) findings revealed that highly resilient and motivated EFL students had high core of self-assessment. Additionally, grit tendencies and self-efficacy displayed effectiveness in elevating academic resilience and motivation in online assessment. The results of this study may have worthwhile pedagogical implications for incorporating technologically enhanced learning and assessment into the classroom.
Identification of ancient glass categories based on distance discriminant analysis
Authors: Wu Shuyu , Zhong Jingyang , Ye Hui , Kang Xusheng
Published: August 2023

It is crucial for archaeological investigations to identify the category of cultural relics by analyzing their chemical composition. This study analyzed the chemical composition distribution of glass cultural relics and applied distance discriminant analysis methods to classify them into two categories. Through stepwise regression, four key feature factors (

$${SiO}_{2}, {K}_{2}O, PbO$$

SiO

2

,

K
2

O
,
P
b
O

, and the presence of weathering on the artifact's surface) were selected from a total of 15 features, including surface weathering. Aside from using columnar table analysis to determine weathering on the surface of the artifact and correlations between categories, and using Spearman correlation coefficients to select key feature factors such as

$${SiO}_{2}, {K}_{2}O, PbO, BaO, and \,SrO$$

SiO

2

,

K
2

O
,
P
b
O
,
B
a
O
,
a
n
d

S
r
O

from 14 total feature factors (excluding weathering on the surface), we established a Mahalanobis distance discriminant model to differentiate unknown glass artifacts. Results indicate that Spearman-Mahalanobis distance discrimination outperformed stepwise regression-Mahalanobis distance discrimination, with an overall accuracy of 99.10% for the former and 98.69% for the latter in identifying high-potassium glass or lead-barium glass.
Comparison of corneal aberrations from anterior segment swept source OCT versus Placido-topography combined spectral domain OCT in cataract patients
Authors: Georgiev Stefan , Ruiss Manuel , Dana-Fisus Andreea , Leitgeb Rainer A. , Findl Oliver
Published: August 2023

Background

To comprehensively evaluate the agreement of component corneal aberrations from the newly updated wavefront analysis software of a swept-source optical coherence tomographer (SS-OCT) and a referential Placido-topography combined OCT device in elderly cataract patients.

Methods

Retrospective study including 103 eyes from 103 elderly patients scheduled for cataract surgery that were measured on the same day with a SS-OCT (Heidelberg Engineering, Germany) device and a Placido-topography combined OCT device (CSO, Italy). Anterior, total, and posterior corneal wavefront aberrations were evaluated for their mean differences and limits of agreement (LoA) via Bland-Altman plots. Vector analysis was additionally employed to compare corneal astigmatism measurements in dioptric vector space.

Results

Mean differences of all corneal aberrometric parameters did not exceed 0.05 μm. Total corneal aberrations were not significantly different from 0 except for vertical coma (− 0.04 μm; P = 0.003), spherical aberration (− 0.01 μm, P < 0.001), and root mean square (RMS) higher-order aberration (HOA) (0.03 μm, P = 0.04). The 95% LoA for total corneal aberration parameters between both devices were − 0.46 to 0.42 μm for horizontal astigmatism, − 0.37 to 0.41 μm for oblique astigmatism, − 0.19 to 0.17 μm for oblique trefoil, − 0.33 to 0.25 μm for vertical coma, − 0.20 to 0.22 μm for horizontal coma, − 0.22 to 0.20 μm for horizontal trefoil, − 0.11 to 0.08 μm for spherical aberration, and − 0.22 to 0.28 μm for RMS HOA. Vector analysis revealed no statistically significant mean differences for anterior, total, and posterior corneal astigmatism in dioptric vector space.

Conclusion

In eyes undergoing cataract surgery with a regular elderly cornea, corneal wavefront analysis from the SS-OCT device showed functional equivalency to the reference device. Nevertheless, clinically relevant higher order aberration parameters should be interpreted with caution for surgical decision-making.
Postoperative Choroidal Vascular Biomarkers in Eyes with Rhegmatogenous Retinal Detachment-Related Giant Retinal Tears
Authors: Quiroz-Reyes Miguel A. , Quiroz-Gonzalez Erick A. , Quiroz-Gonzalez Miguel A. , Lima-Gomez Virgilio
Published: August 2023

Purpose

Choroidal vascularity index (CVI) and choriocapillaris flow area (CFA) are perfusion biomarkers relevant to retinal disease management. There is limited knowledge regarding these biomarkers in eyes that have been successfully treated for rhegmatogenous retinal detachment (RRD) due to giant retinal tears (GRTs). This study aimed to analyze the relationship between choroidal perfusion biomarkers and functional outcomes in surgically treated eyes with GRT-associated RRD and their fellow eyes.

Methods

A total of 33 GRT eyes and 29 fellow eyes were included in this study. All RRD-GRT eyes were treated with vitrectomy and categorized into two groups based on whether additional scleral buckles (SB) were placed. Visual and choroidal features were compared between the groups.

Results

The subjects had an average age of 55.18 years, a mean time of 2.36 weeks before surgery, and a mean follow-up time of 25.9 months. Best-corrected visual acuity (BCVA) was substantially worse in GRT eyes (1.9 logMAR) than in fellow control eyes (0.23 logMAR) but substantially improved after surgery (0.59 logMAR). There were no differences in the presurgical characteristics and BCVA between the eyes that did and did not undergo SB. Long-term CVI and CFA were lower in eyes with GRT than in their fellow eyes. Among eyes with GRT, those with SB had significantly lower CVI and CFA. Correlation analysis revealed that the CVI and CFA were positively correlated with visual outcomes (negative correlation with logMAR).

Conclusion

Despite successful surgical repair, long-term functional and choroidal evaluations showed permanent changes in eyes with GRT. Positive correlations between perfusion biomarkers and visual function suggest that better choroidal vasculature is associated with better visual outcomes. The results of this study highlight the benefits of analyzing choroidal vasculature biomarkers and the relationship between the choroidal anatomy and vision.