bluuebunny/crossref_metadata_2025 huggingface dataset:
LATERAL TRANSLIGAMENTOUS APPROACH TO THE TALAR DOME
Authors: Lambert L.-A. , Davies M. , Mangwani J. , Molloy A. , Mason L.
Published: May 2024

Introduction

Anatomic reduction of talar body fractures is critical in restoring congruency to the talocrural joint. Previous studies have indicated a maximum of 25% talar body exposure without malleolar osteotomy. The aim of this study was to investigate the percentage talar body exposure when using the lateral transligamentous approach.

Methods

The lateral transligamentous approach to the talus was undertaken in 10 fresh frozen cadaveric specimens by surgeons inexperienced in the approach, following demonstration of the technique. An incision was made on the anterolateral aspect of the ankle augmented by the removal of the anterior talofibular ligament (ATFL) and the calcaneofibular ligament (CFL) from their fibular insertions. A bone lever was then placed behind the lateral aspect of the talus and levered forward with the foot in equinus and inversion.

The talus was disarticulated and high resolution images were taken of the talar dome surface. The images were overlain with a reproducible nine-grid division. Accessibility to each zone within the grid with a perpendicular surgical blade was documented. ImageJ software was used to calculate the surface area exposed with each approach.

Results

The mean percentage area of talar dome available through the transligamentous approach was 77.3 % (95% confidence interval 73.3, 81.3). In all specimens the complete lateral talar process was accessible, along with the lateral and dorsomedial aspect of the talar neck. This approach gives complete access to Zones 1,2, 3,5 & 6 with partial access to Zones 4,8 & 9.

Conclusion

The lateral transligamentous approach to the talus provides significantly greater access to the talar dome as compared to standard approaches. The residual surface area that is inaccessible with this approach is predominantly within Zone 4 and Zone 7, the posteromedial corner.
A theory of policy advisory system quality: Hirschman 2.0 or what makes for good policy advice?
Authors: Migone Andrea , Howlett Michael
Published: May 2024

Not everyone’s ideas count equally in terms of influencing and informing policy design and instrument choices. As the literature on policy advice has shown, such advice arises from many different actors interacting with each other often over relatively long timeframes. Actors within these ‘policy advisory systems’ operate within the confines of an existing set of political and economic institutions and governing norms, and each actor brings with them different interests, ideas and resources. Studying who these actors are, how they act and how their actions affect the overall nature of the advice system and its contents are critical aspects of current public policy research. But not all these elements have been equally well conceptualised or studied, especially those concerning their impact on the quality of policy advice emerging from a system. In this article, the general nature of policy advisory systems is set out, their major components described and a model of individual and organisational behaviour within them outlined inspired by a modification of the ‘exit, voice, loyalty’ rubric of Albert Hirschman. Our findings show how aggregated individual organisational behaviour along the lines suggested by Hirschman can over time result in very different kinds of advice being provided by an advisory system, with predictable consequences for its nature and quality.
Design and optimization of a dual port high gain circularly polarized graphene-ceramic array antenna in a THz regime
Authors: Kumar Kundan , Sadhu Pradip Kumar , Shastri Ravikant , Kumar Brajesh
Published: May 2024

In this paper, a dual port high gain hybrid (silicon graphene) antenna is designed and
investigated. Some of the important qualities of the proposed
radiating structure include the following: (1) XGBoost and Random
Forest-based machine learning (ML) techniques are applied to predict
the reflection coefficient (|S11|) features of the designed radiator to
reduce the simulation time; (2) the use of a cross slot provides the
circularly polarized waves between 4.92 and 5.38 THz; (3) a 1∗2 array structure produces the high
gain, i.e., 10.0 dBi within the operating frequency
range; and (4) the opposite orientation of the aperture provides a
polarization diversity concept, which, in turn, improves the isolation
level to more than 30 dB. After comparing the results obtained
from CST and HFSS, as well as those predicted from the ML algorithm,
it is confirmed that the designed radiator operates from 4.71 to
5.85 THz. The good value of far-field and diversity parameters
affirms the fitness of the designed radiator for wireless power
transfer in the THz regime.
Low-complexity frequency domain frame synchronization for short-reach IM/DD optical fiber transmission systems
Authors: Zhao Zhe , Yang Aiying , Guo Peng , Xu Tianjia , Ji Shaoxi , Yang Meng , Wan Wenkai
Published: May 2024

We propose a low-complexity frequency domain frame synchronization method for short-reach intensity modulation and direct detection (IM/DD) systems. A four-level pulse amplitude modulation-training sequence (PAM4-TS) is specially designed for the proposed method, which has an obvious peak in the amplitude spectrum that is higher than the normal signal. The proposed method comprises a coarse synchronization stage and a fine synchronization stage. Firstly, the coarse synchronization stage takes advantage of the feature of PAM4-TS to obtain the approximate position of the frame head by identifying the peak value in amplitude spectrum of the segmented received signal. Then, the fine synchronization stage calculates the correlation between the coarse synchronization result and PAM4-TS by multiplying the two in the frequency domain. Compared with the traditional sliding window correlation method realized in the time domain, both simulation and experimental results of C-band 50 Gbit/s PAM4 transmission demonstrate that the proposed method reduces the multiplication complexity by up to about 96.01% without any additional performance penalty.
Coupling of photonic topological states and their dynamical control based on liquid crystal
Authors: Jiang Yao , Li Shiqi , Li Haotian , Hu Junzheng , Huang Hui , He Jiangle , Su Guangxu , Liu Fanxin , Zhan Peng
Published: May 2024

Optical field manipulation inspired by topology theory has recently drawn great research attention in nanophotonic. For flexible and programmable light management, the capacity to dynamically regulate the photonic topological states in fixed optical artificial microstructures is essential. Here, we propose a dynamic light manipulation of a two-dimensional (2D) photonic lattice aided by liquid crystals, which is composed of all-dielectric photonic crystals with distinct topological phases. In brief, by submerging the well-designed photonic lattice into a liquid crystal (LC), the topological edge and corner states can be actively modulated by applying external bias voltage, which offers an electrically switchable tuning capability, enabling the coupling between higher-order topological states in a structurally deterministic photonic structure. As a proof-of-principle, we use the 1D topological edge states and 0D topological corner states in one sample, respectively, to mimic line-waveguides and corner-cavities, and demonstrate their selective couplings with Fano-like profile driven by electric bias. Our work offers an effective and flexible way for light control in the potential active topological photonic devices.
Vector Theory of Optical Nonlinearities in Birefringent Fibers
Authors: Choksi Neel , Qian Li
Published: May 2024

Understanding the effects of optical nonlinearities on wave propagation is crucial for applications such as fiber optic communication, optical signal processing, frequency generation, signal amplification, optical sensing, and quantum optics. While optical nonlinearities such as self-phase modulation, cross-phase modulation, four-wave mixing, Brillouin scattering, and Raman scattering are extensively studied in optical fibers, a comprehensive model considering all of these nonlinearities in the most general case of a birefringent fiber has not been reported. In this paper, we present a vectorial model that considers the effects of these nonlinearities on co-propagating and counter-propagating fields for the most general case of birefringent fibers, i.e., elliptically birefringent fibers. Additionally, unlike previous studies, we represent the vector interaction using the frequency-dependent polarization eigenmodes of the fiber. We then use this model and show how elliptically birefringent fibers enable frequency-dependent control over the nonlinear interaction between counter-propagating fields.
DCM-Spheroid Morphs Express PADs and Citrullinated Cytoskeletal Proteins
Authors: Sadiq Alia , Fert-Bober Justyna
Published: May 2024

During investigating the role of peptidylarginine deiminase (PAD) enzymes in dilated cardiomyopathy (DCM), we observed unique spheroid formation in DCM-myofibroblasts that distinguished them from normal cardiac myofibroblasts. The present study aimed to assess the presence of PADs, the extracellular matrix (ECM), and citrullination in DCM spheroids using immunofluorescence staining and imaging techniques. The results revealed that spheroids derived from DCM-myofibroblasts displayed a more distinctive, tightly packed structure compared with those derived from human cardiac fibroblasts. DCM spheroids showed abundant protein expression of the PAD 2, 3, and 4 enzymes. Notably, increased Ki67 protein expression was associated with increased proliferation in DCM spheroids. Cytoskeletal proteins such as Col-1A, vimentin, α-SMA, and F-actin were highly abundant in DCM spheroids. Furthermore, DCM spheroids contained citrullinated cytoskeletal proteins, mainly citrullinated vimentin and citrullinated fibronectin. These observations supported the occurrence of PAD-mediated citrullination of ECM proteins in DCM spheroids. Collectively, these findings describe the distinctive features of DCM spheroids, representing the cellular characteristics of DCM myofibroblasts. Therefore, DCM spheroids can serve as an in vitro model for further investigations of disease morphology and therapeutic efficacy.
Mapping the ethical landscape of digital biomarkers: A scoping review
Authors: Andreoletti Mattia , Haller Luana , Vayena Effy , Blasimme Alessandro
Published: May 2024

In the evolving landscape of digital medicine, digital biomarkers have emerged as a transformative source of health data, positioning them as an indispensable element for the future of the discipline. This necessitates a comprehensive exploration of the ethical complexities and challenges intrinsic to this cutting-edge technology. To address this imperative, we conducted a scoping review, seeking to distill the scientific literature exploring the ethical dimensions of the use of digital biomarkers. By closely scrutinizing the literature, this review aims to bring to light the underlying ethical issues associated with the development and integration of digital biomarkers into medical practice.
Intermittent preventive treatment with sulphadoxine-pyrimethamine but not dihydroartemisinin-piperaquine modulates the relationship between inflammatory markers and adverse pregnancy outcomes in Malawi
Authors: Cheng Kaylene , Aitken Elizabeth H. , Hasang Wina , Meagher Niamh , Price David J. , Madanitsa Mwayiwawo , Mwapasa Victor , Phiri Kamija S. , Dodd James , ter Kuile Feiko O. , Rogerson Stephen J.
Published: May 2024

Women in malaria-endemic areas receive sulphadoxine-pyrimethamine (SP) as Intermittent Preventive Treatment in Pregnancy (IPTp) to reduce malaria. While dihydroartemisinin-piperaquine (DP) has superior antimalarial properties as IPTp, SP is associated with superior fetal growth. As maternal inflammation influences fetal growth, we investigated whether SP alters the relationship between inflammation and birth outcomes. We measured C-reactive protein (CRP) and alpha-1-acid glycoprotein (AGP) at enrollment (16–28 gestation weeks (gw)), visit 3 (24–36 gw) and delivery in 1319 Malawian women randomized to receive monthly SP, DP, or DP and single-dose azithromycin (AZ) in the IMPROVE trial (NCT03208179). Logistic regression was used to assess the relationship between adverse outcomes, inflammation, and treatment arm. Elevated AGP at enrollment was associated with adverse birth outcome (aRR 1.40, 95% CI: 1.15, 1.70), with similar associations observed across treatment arms, exceptions being that elevated AGP was associated with low maternal weight gain in SP recipients (aRR 1.94, 95% CI: 1.36, 2.76) and with small for gestational age in DP+AZ recepients (aRR 1.49, 95% CI 1.02, 2.17). At visit 3 there were few associations between inflammation andoutcomes. At delivery, women with elevated AGP receiving either DP or DP+AZ had an increased risk of adverse birth outcomes (aRR 1.60, 95% CI: 1.28, 2.00), including low birth weight, pre-term birth and foetal loss, this was not seen in women receiving SP (aRR 0.82, 95% CI: 0.54, 1.26). The risk of an association between elevated AGP and adverse birth outcome was higher in those receiving DP or DP+AZ compared to those receiving SP (aRR 1.95, 95% CI: 1.21, 3.13). No clear associations between CRP and adverse outcomes were observed. AGP identified women at risk of adverse pregnancy outcomes. SP modifies the relationship between inflammatory biomarkers and adverse outcomes. Our findings provide insights into potential mechanisms by which SP may improve pregnancy outcomes.
Tuberculosis commodities supply chain performance in the WHO African region: A scoping review
Authors: Mhazo Alison T. , Miyango Stanford , Palani Lifton , Maponga Charles C.
Published: May 2024

Procurement and supply chain management [PSM] systems remain a critical pillar for the implementation of Directly Observed Therapy [DOTS] for tuberculosis [TB] and achievement of disease related aspirations such as ‘ending TB by 2030’. We conducted a scoping review of literature using the Arksey and O’Malley [2005] framework to summarize and disseminate the results of available evidence in relation to TB commodities supply chain performance in the WHO African Region. We searched three electronic databases complemented by google search using relevant terms and identified 1,586 sources. Twenty-five studies published between 2009 and 2023 met the eligibility criteria, inclusive of 21 peer reviewed publications and four reports. The strengths we found included the existence of pooled procurement mechanisms [PPM], availability of funding through external sources, existence of logistics management information systems [LMIS] and integration of PSM systems into primary health care. The main challenge was frequent stock outs which mainly affected medicines for treating TB in children and those for preventing TB. Stock outs were found to follow a poverty gradient and pervasively inequitable since they disproportionately affected structurally disadvantaged populations and communities. Countries that rely on domestic mechanisms for procurement tend to be more vulnerable to stock outs due to inadequate and unpredictable financing, delayed disbursements of funds, longer procurement lead times and poor supplier management. We concluded that stock outs remain one of the foremost challenges to ending TB by 2030. We recommend leveraging existing performance-enhancing platforms such as PPMs, including utilization of such mechanisms by countries that utilize domestic resources to procure commodities. We recommend the design of people centric supply chains that are sensitive to the differentiated needs of the population to ensure that composite improvements in PSM performance do not mask underlying disparities. Context-relevant research is needed to inform future strategies for improving PSM performance.
An efficient computational scheme for solving coupled time-fractional Schrödinger equation via cubic B-spline functions
Authors: Mubashir Hayat Afzaal , Abbas Muhammad , Emadifar Homan , Alzaidi Ahmed S. M. , Nazir Tahir , Aini Abdullah Farah
Published: May 2024

The time fractional Schrödinger equation contributes to our understanding of complex quantum systems, anomalous diffusion processes, and the application of fractional calculus in physics and cubic B-spline is a versatile tool in numerical analysis and computer graphics. This paper introduces a numerical method for solving the time fractional Schrödinger equation using B-spline functions and the Atangana-Baleanu fractional derivative. The proposed method employs a finite difference scheme to discretize the fractional derivative in time, while a θ-weighted scheme is used to discretize the space directions. The efficiency of the method is demonstrated through numerical results, and error norms are examined at various values of the non-integer parameter, temporal directions, and spatial directions.
Age-effects of sport education model on basic psychological needs and intrinsic motivation of adolescent students: A systematic review and meta-analysis
Authors: Dai Jing , Chen Jiayong , Huang Zijing , Chen Yuhuan , Li Yezi , Sun Jian , Li Duanying , Lu Min , Chen Jiancai
Published: May 2024

Objective

This study explores the age effects of the sport education model(SEM) on the impact of basic psychological needs (autonomy, competence, relatedness) and intrinsic motivation (interest, enjoyment, satisfaction) among adolescent students.

Method

Retrieval of relevant literature from PubMed, Web of Science, Scopus, and China National Knowledge Infrastructure (CNKI). The search period ranged from the starting year to January 7, 2024. Subsequently, literature screening, data extraction, and quality assessment will be conducted, and data analysis will be performed using "Review Manager 5.4" software.

Result

Overall, SEM has a positive and statistically significant impact on the basic psychological needs (MD = 0.36,95% CI [0.22, 0.50]) and intrinsic motivation (MD = 0.75, 95% CI [0.58, 0.93]) of adolescent students (P<0.01). Subgroup analysis revealed age effects on the impact of SEM on the basic psychological needs of adolescent students: pre-peak height velocity (PRE-PHV) (MD = 0.39, 95% CI [0.23, 0.56], I2 = 45%, P<0.01), mid-peak height velocity (MID-PHV) (MD = 0.22, 95% CI [0.01, 0.42], I2 = 82%, P<0.05), post-peak height velocity (POST-PHV) (MD = 1.27, 95% CI [0.79, 1.74], I2 = 0%, P<0.01). Similarly, age effects were found for intrinsic motivation: MID-PHV (MD = 0.86, 95% CI [0.62, 1.11], I2 = 68%, P<0.01), POST-PHV (MD = 0.56, 95% CI [0.40, 0.72], I2 = 0%, P<0.01).

Conclusion

The SEM is an effective approach to enhancing the basic psychological needs and intrinsic motivation of adolescent students. However, it exhibits age effects among students at different developmental stages. Specifically, in terms of enhancing basic psychological needs, the model has the greatest impact on POST-PHV students, followed by PRE-PHV students, while the improvement effect is relatively lower for MID-PHV students. The enhancement effect on intrinsic motivation diminishes with increasing age.
The implementation and impact of non-invasive prenatal testing (NIPT) for Down’s syndrome into antenatal screening programmes: A systematic review and meta-analysis
Authors: Sebire Elinor , Rodrigo Chithramali Hasanthika , Bhattacharya Sohinee , Black Mairead , Wood Rachael , Vieira Rute
Published: May 2024

Background

Non-invasive prenatal testing (NIPT) is a widely adopted maternal blood test that analyses foetal originating DNA to screen for foetal chromosomal conditions, including Down’s syndrome (DS). The introduction of this test, which may have implications for important decisions made during pregnancy, requires continual monitoring and evaluation. This systematic review aims to assess the extent of NIPT introduction into national screening programmes for DS worldwide, its uptake, and impact on pregnancy outcomes.

Methods and findings

The study protocol was published in PROSPERO (CRD42022306167). We systematically searched MEDLINE, CINAHL, Scopus, and Embase for population-based studies, government guidelines, and Public Health documents from 2010 onwards. Results summarised the national policies for NIPT implementation into screening programmes geographically, along with population uptake. Meta-analyses estimated the pooled proportions of women choosing invasive prenatal diagnosis (IPD) following a high chance biochemical screening result, before and after NIPT was introduced. Additionally, we meta-analysed outcomes (termination of pregnancy and live births) amongst high chance pregnancies identified by NIPT. Results demonstrated NIPT implementation in at least 27 countries. Uptake of second line NIPT varied, from 20.4% to 93.2% (n = 6). Following NIPT implementation, the proportion of women choosing IPD after high chance biochemical screening decreased from 75% (95% CI 53%, 88%, n = 5) to 43% (95%CI 31%, 56%, n = 5), an absolute risk reduction of 38%. A pooled estimate of 69% (95% CI 52%, 82%, n = 7) of high chance pregnancies after NIPT resulted in termination, whilst 8% (95% CI 3%, 21%, n = 7) had live births of babies with DS.

Conclusions

NIPT has rapidly gained global acceptance, but population uptake is influenced by healthcare structures, historical screening practices, and cultural factors. Our findings indicate a reduction in IPD tests following NIPT implementation, but limited pre-NIPT data hinder comprehensive impact assessment. Transparent, comparable data reporting is vital for monitoring NIPT’s potential consequences.
The effect of TG2-inhibitory monoclonal antibody zampilimab on tissue fibrosis in human in vitro and primate in vivo models of chronic kidney disease
Authors: Huang Linghong , Bon Helene , Maamra Mabrouka , Holmes Toby , Atkinson John , Cain Katharine , Kennedy Jeff , Kettleborough Catherine , Matthews David , Twomey Breda , Ni Jia , Song Zhizhan , Watson Philip F. , Johnson Timothy S.
Published: May 2024

Fibrotic remodeling is the primary driver of functional loss in chronic kidney disease, with no specific anti-fibrotic agent available for clinical use. Transglutaminase 2 (TG2), a wound response enzyme that irreversibly crosslinks extracellular matrix proteins causing dysregulation of extracellular matrix turnover, is a well-characterized anti-fibrotic target in the kidney. We describe the humanization and characterization of two anti-TG2 monoclonal antibodies (zampilimab [hDC1/UCB7858] and BB7) that inhibit crosslinking by TG2 in human in vitro and rabbit/cynomolgus monkey in vivo models of chronic kidney disease. Determination of zampilimab half-maximal inhibitory concentration (IC50) against recombinant human TG2 was undertaken using the KxD assay and determination of dissociation constant (Kd) by surface plasmon resonance. Efficacy in vitro was established using a primary human renal epithelial cell model of tubulointerstitial fibrosis, to assess mature deposited extracellular matrix proteins. Proof of concept in vivo used a cynomolgus monkey unilateral ureteral obstruction model of chronic kidney disease. Zampilimab inhibited TG2 crosslinking transamidation activity with an IC50 of 0.25 nM and Kd of <50 pM. In cell culture, zampilimab inhibited extracellular TG2 activity (IC50 119 nM) and dramatically reduced transforming growth factor-β1-driven accumulation of multiple extracellular matrix proteins including collagens I, III, IV, V, and fibronectin. Intravenous administration of BB7 in rabbits resulted in a 68% reduction in fibrotic index at Day 25 post-unilateral ureteral obstruction. Weekly intravenous administration of zampilimab in cynomolgus monkeys with unilateral ureteral obstruction reduced fibrosis at 4 weeks by >50%, with no safety signals. Our data support the clinical investigation of zampilimab for the treatment of kidney fibrosis.
Evaluating digital literacy of health professionals in Ethiopian health sectors: A systematic review and meta-analysis
Authors: Chereka Alex Ayenew , Walle Agmasie Damtew , Kassie Sisay Yitayih , Shibabaw Adamu Ambachew , Butta Fikadu Wake , Demsash Addisalem Workie , Hunde Mekonnen Kenate , Dubale Abiy Tassew , Bekana Teshome , Kitil Gemeda Wakgari , Emanu Milkias Dugassa , Tadesse Mathias Nega
Published: May 2024

Background

Digital literacy refers to the capacity to critically assess digital content, use digital tools in professional settings, and operate digital devices with proficiency. The healthcare sector has rapidly digitized in the last few decades. This systematic review and meta-analysis aimed to assess the digital literacy level of health professionals in the Ethiopian health sector and identify associated factors. The study reviewed relevant literature and analyzed the data to provide a comprehensive understanding of the current state of digital literacy among health professionals in Ethiopia.

Methods

The study was examined by using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) criteria. Evidence was gathered from the databases of Google Scholar, Pub Med, Cochrane Library, Hinari, CINAHL, and Global Health. Consequently, five articles met the eligible criteria for inclusion. The analysis was carried out using STATA version 11. The heterogeneity was evaluated using the I2test, while the funnel plot and Egger’s regression test statistic were used to examine for potential publication bias. The pooled effect size of each trial is evaluated using a random effect model meta-analysis, which provides a 95% confidence interval.

Result

A total of five articles were included in this meta-analysis and the overall pooled prevalence of this study was 49.85% (95% CI: 37.22–62.47). six variables, Monthly incomes AOR = 3.89 (95% CI: 1.03–14.66), computer literacy 2.93 (95% CI: 1.27–6.74), perceived usefulness 1.68 (95% CI: 1.59–4.52), educational status 2.56 (95% CI: 1.59–4.13), attitude 2.23 (95% CI: 1.49–3.35), perceived ease of use 2.22 (95% CI: 1.52–3.23) were significantly associated with the outcome variable.

Conclusion

The findings of the study revealed that the overall digital literacy level among health professionals in Ethiopia was relatively low. The study highlights the importance of addressing the digital literacy gap among health professionals in Ethiopia. It suggests the need for targeted interventions, such as increasing monthly incomes, giving computer training, creating a positive attitude, and educational initiatives, to enhance digital literacy skills among health professionals. By improving digital literacy, health professionals can effectively utilize digital technologies and contribute to the advancement of healthcare services in Ethiopia.
Prevalence of emergency caesarean delivery and its predictors among women who give birth in Ethiopia using further analysis of EDHS 2016 data: A mixed effect model
Authors: Agimas Muluken Chanie
Published: May 2024

Introduction

Emergency caesarean delivery is a surgical procedure that is decided after the labour pain has started. According to the global report of the World Health Organization, the rate of caesarean sections has risen over time. In Ethiopia, the overall caesarean delivery was 18%, which varied between 46% in the private sector and 15% in the public sector. But specifically, the magnitude of emergency caesarean delivery and its predictors are not well addressed in Ethiopia. Therefore, this study was aimed at assessing the prevalence and predictors of emergency caesarean delivery in Ethiopia using EDHS 2016.

Method

A cross-sectional study was used, and a total of 11,022 samples were included in this study. The Ethiopian Demographic Health Survey 2016 data set was used as a data source. The STATA version 17 software was used for descriptive, bi-variable, and multivariable analysis. Multilevel binary logistic regression was used to identify the significant factors at a p-value of <0.05 and a 95% confidence level. Model comparison and goodness of fit was assessed by AIC.

Results

The prevalence of emergency caesarean deliveries in Ethiopia was 1.2% (95% CI: 0.58, 1.78). History of fistula (AOR = 7.82, 95% CI: 1.59–38.4), age ≥ 35 years (AOR = 6.98, 95% CI: 3.33–14.63), and rural residence (AOR = 2.23, 95% CI: 1.25–3.21) were the predictors of emergency caesarean delivery.

Conclusion

As compared to the previous study, the prevalence of emergency caesarean delivery was low. Women with a history of fistula, from rural residence, and age≥ 35 years were at risk for emergency caesarean delivery. Therefore, interventions need to be encouraged to give attention to rural women whose age is ≥ 35 years and fistula reduction activities, such as avoiding early marriage, to reverse the problem. Early and accurate screening of women for emergency cesarean delivery by encouraging co-services like ANC is also recommended.
Validity of remote live stream video evaluation of the North Star Ambulatory Assessment in patients with Duchenne muscular dystrophy
Authors: P. Lowes Linda , Alfano Lindsay N. , Iammarino Megan A. , Reash Natalie F. , Giblin Kathryn , Hu Larry , Yu Lixi , Wang Shufang , Salazar Rachel , Mendell Jerry R.
Published: May 2024

Conducting functional assessments remotely can help alleviate the burden of in-person assessment on patients with Duchenne muscular dystrophy and their caregivers. The objective of this study was to evaluate whether scores from remote functional assessment of patients with Duchenne muscular dystrophy correspond to in-person scores on the same functional assessments. Remote live stream versus in-person scores on the North Star Ambulatory Assessment (including time [seconds] to complete the 10-meter walk/run and time to rise from the floor [supine to stand]) were assessed using statistical analyses, including intraclass correlation coefficient, and Pearson, Spearman, and Bland-Altman analyses. The remote and in-clinic assessments had to occur within 2 weeks of one another to be considered for this analysis. This analysis included patients with Duchenne muscular dystrophy, aged 4 to 7 years. Participants in this analysis received delandistrogene moxeparvovec (as part of SRP-9001-101 [Study 101; NCT03375164] or SRP-9001-102 [Study 102; NCT03769116]) or were randomized to receive placebo (in Part 1 of Study 102). This study evaluates score reproducibility between live stream remote scoring versus in-person functional assessments as determined by intraclass correlation coefficient, and Pearson, Spearman, and Bland-Altman analyses. The results showed that scores from remote functional assessment of patients with Duchenne muscular dystrophy strongly correlated with those obtained in person. These findings demonstrate congruence between live stream remote and in-person functional assessment and suggest that remote assessment has the potential to reduce the burden on a family by supplementing in-clinic visits.
The impact of digital inclusive financial development on local government expenditure: Evidence from China
Authors: Chen Yuran , Huang Qian , Zhang Qiaoyun
Published: May 2024

This paper investigates the impact of digital inclusive financial development on local government expenditure incentives at the income level. It does so by constructing a multi-level government Dynamic Stochastic General Equilibrium (DSGE) model that incorporates the financial sector. By employing empirical methods that involve uncertainty shocks and counterfactual simulations, the research yields several key findings. Firstly, the development of digital inclusive finance contributes to breaking down the urban-rural dual financial structure, thus facilitating balanced economic development within regions. Secondly, it reduces the proportion of financially excluded areas, accelerates fiscal decentralization, leading to an increase in local government fiscal revenue, and, consequently, an expansion of local fiscal expenditures. Thirdly, at a certain stage of digital inclusive finance development, it tends to crowd out residents’ investment and consumption. Therefore, the decentralization of fiscal power and the expansion of local government expenditure at this stage may paradoxically inhibit regional economic growth. The study’s conclusions validate the significant impact of digital inclusive finance on local government incentives at the income level.
Evaluation of microglia activation related markers following a clinical course of TBS: A non-human primate study
Authors: Aceves-Serrano Lucero , Neva Jason L. , Munro Jonathan , Vavasour Irene M. , Parent Martin , Boyd Lara A. , Doudet Doris J.
Published: May 2024

While the applicability and popularity of theta burst stimulation (TBS) paradigms remain, current knowledge of their neurobiological effects is still limited, especially with respect to their impact on glial cells and neuroinflammatory processes. We used a multimodal imaging approach to assess the effects of a clinical course of TBS on markers for microglia activation and tissue injury as an indirect assessment of neuroinflammatory processes. Healthy non-human primates received continuous TBS (cTBS), intermittent TBS (iTBS), or sham stimulation over the motor cortex at 90% of resting motor threshold. Stimulation was delivered to the awake subjects 5 times a week for 3–4 weeks. Translocator protein (TSPO) expression was evaluated using Positron Emission Tomography and [11C]PBR28, and myo-inositol (mI) and N-acetyl-aspartate (NAA) concentrations were assessed with Magnetic Resonance Spectroscopy. Animals were then euthanized, and immunofluorescence staining was performed using antibodies against TSPO. Paired t-tests showed no significant changes in [11C]PBR28 measurements after stimulation. Similarly, no significant changes in mI and NAA concentrations were found. Post-mortem TSPO evaluation showed comparable mean immunofluorescence intensity after active TBS and sham delivery. The current study suggests that in healthy brains a clinical course of TBS, as evaluated with in-vivo imaging techniques (PET and MRS), did not measurably modulate the expression of glia related markers and metabolite associated with neural viability.
Alarming multidrug resistance in Staphylococcus aureus isolated from raw milk of cows with subclinical mastitis: Antibiotic resistance patterns and occurrence of selected resistance genes
Authors: Haq Ijaz Ul , Kamal Mustafa , Swelum Ayman A. , Khan Shehryar , Ríos-Escalante Patricio R. De los , Usman Tahir
Published: May 2024

Bovine mastitis is a widespread and costly disease that affects dairy farming globally, characterized by mammary gland inflammation. Bovine intramammary gland infection has been associated with more than 135 different pathogens of which Staphylococcus aureus is the main etiology of sub-clinical mastitis (SCM). The current study was designed to investigate the prevalence, antibiotic resistance pattern, and the presence of antibiotic resistance genes (mecA, tetK, aacA-aphD and blaZ) in S. aureus isolated from the raw milk of cows with subclinical mastitis. A total of 543 milk samples were collected from lactating cows such as Holstein Friesian (n = 79), Sahiwal (n = 175), Cholistani (n = 107), and Red Sindhi (n = 182) from different dairy farms in Pakistan. From the milk samples microscopic slides were prepared and the somatic cell count was assessed to find SCM. To isolate and identify S. aureus, milk was streaked on mannitol salt agar (MSA) plates. Further confirmation was done based on biochemical assays, including gram staining (+ coccus), catalase test (+), and coagulase test (+). All the biochemically confirmed S. aureus isolates were molecularly identified using the thermonuclease (nuc) gene. The antibiotic resistance pattern of all the S. aureus isolates was evaluated through the disc diffusion method. Out of 543 milk samples, 310 (57.09%) were positive for SCM. Among the SCM-positive samples, S. aureus was detected in 30.32% (94/310) samples. Out of 94 isolates, 47 (50%) were determined to be multidrug resistant (MDR). Among these MDR isolates, 11 exhibited resistance to Cefoxitin, and hence were classified as methicillin-resistant Staphylococcus aureus (MRSA). The S. aureus isolates showed the highest resistance to Lincomycin (84.04%) followed by Ampicillin (45.74%), while the least resistance was shown to Sulfamethoxazole/Trimethoprim (3.19%) and Gentamycin (6.38%). Polymerase chain reaction (PCR) analysis revealed that 55.31% of the isolates carried blaZ gene, 46.80% carried tetK gene, 17.02% harbored the mecA gene, whereas, aacA-aphD gene was found in 13.82% samples. Our findings revealed a significant level of contamination of milk with S. aureus and half (50%) of the isolates were MDR. The isolated S. aureus harbored various antibiotic resistance genes responsible for the absorbed phenotypic resistance. The alarmingly high prevalence of MDR S. aureus isolates and MRSA strains in these cases possess a serious risk to public health, emphasizes the urgent need to address this issue to protect both human and animal health in Pakistan.
Pottery spilled the beans: Patterns in the processing and consumption of dietary lipids in Central Germany from the Early Neolithic to the Bronze Age
Authors: Breu Adrià , Risch Roberto , Molina Elena , Friederich Susanne , Meller Harald , Knoll Franziska
Published: May 2024

The need to better understand economic change and the social uses of long-ago established pottery types to prepare and consume food has led to the study of 124 distinct ceramic vessels from 17 settlement and funerary sites in Central Germany (present day Saxony-Anhalt). These, dated from the Early Neolithic (from 5450 cal. BCE onwards) to the Late Bronze Age (1300–750 cal. BCE; youngest sample ca. 1000 BCE), include vessels from the Linear Pottery (LBK), Schiepzig/Schöningen groups (SCHIP), Baalberge (BAC), Corded Ware (CWC), Bell Beaker (BBC), and Únětice (UC) archaeological cultures. Organic residue analyses performed on this assemblage determined the presence of vessel contents surviving as lipid residues in 109 cases. These were studied in relation to the changing use of settlement and funerary pottery types and, in the case of burials, to the funerary contexts in which the vessels had been placed. The obtained results confirmed a marked increase in the consumption of dairy products linked to innovations in pottery types (e.g., small cups) during the Funnel Beaker related Baalberge Culture of the 4th millennium BCE. Although the intensive use of dairy products may have continued into the 3rd millennium BCE, especially amongst Bell Beaker populations, Corded Ware vessels found in funerary contexts suggest an increase in the importance of non-ruminant products, which may be linked to the production of specific vessel shapes and decoration. In the Early Bronze Age circum-Harz Únětice group (ca. 2200–1550 BCE), which saw the emergence of a highly hierarchical society, a greater variety of animal and plant derived products was detected in a much more standardised but, surprisingly, more multifunctional pottery assemblage. This long-term study of lipid residues from a concise region in Central Europe thus reveals the complex relationships that prehistoric populations established between food resources and the main means to prepare, store, and consume them.
Exploring physical activity preferences and motivation in long-term cardiac prevention: An Austrian cross-sectional survey
Authors: McGowan Hannah , Gutenberg Johanna , Leitner Veronika , Mühlhauser Kathrin , Breda Aliz , Fischer Michael , Globits Sebastian , Grote Vincent , Kiesl David , Mayr Karl , Muntean Michael , Podolsky Andrea , Niebauer Josef , Crutzen Rik , Kulnik Stefan Tino
Published: May 2024

Cardiac rehabilitation (CR) patients often do not sustain physical activity (PA) behaviour in the long run, once they progress into a self-management stage of secondary prevention. This study aimed to explore former CR patients’ PA preferences, determinants (i.e., influencing factors) and motivation for sustained PA engagement. We conducted a cross-sectional multi-centre survey using an original questionnaire based on prior qualitative interviews with cardiac patients. Five CR centres in Austria posted 500 questionnaires to former CR patients who had completed CR approximately three years prior, and 117 patients (23%) responded. Descriptive analysis was used to analyse closed-ended questions, and self-determination theory (SDT) was applied as a qualitative framework to analyse open-ended questions concerning motivation for PA engagement. Patients were generally physically active, but the majority (75.3%) did not fulfil the World Health Organisation’s recommendations for aerobic PA and muscle strengthening. Most patients preferred being physically active outdoors (70%), engaging in aerobic-related (95%), individual and non-competitive exercises, with cycling (52%), walking (32%) and hiking (25%) among the most popular activities. Main determinants of PA were health, pain and motivation for 80%, 68%, 67% of patients, respectively. A subset of patients (77%) expanded on their motivations behind PA. According to SDT, most reasons (90%) were regulated by autonomous motivation (either extrinsically autonomously-regulated or intrinsic motivation) and stemmed mostly from health-related goals (e.g., fitness, general health, weight control), future quality-of-life aspirations (e.g., self-sufficiency in old age, presence for loved ones, preserving mobility) and enjoyment of PA. Patients’ responses underscore the importance of promoting not only general PA, but also muscle strengthening training in CR interventions to maximise optimal health benefits. Our data further suggest that interventions which are aligned to patients’ health goals and foster autonomous motivation may be particularly beneficial in increasing adherence to PA in the long-term.
Nonlinear modeling of oral glucose tolerance test response to evaluate associations with aging outcomes
Authors: Schumock Grant , Bandeen-Roche Karen , Chia Chee W. , Kalyani Rita R. , Ferrucci Luigi , Varadhan Ravi
Published: May 2024

As people age, their ability to maintain homeostasis in response to stressors diminishes. Physical frailty, a syndrome characterized by loss of resilience to stressors, is thought to emerge due to dysregulation of and breakdowns in communication among key physiological systems. Dynamical systems modeling of these physiological systems aims to model the underlying processes that govern response to stressors. We hypothesize that dynamical systems model summaries are predictive of age-related declines in health and function. In this study, we analyze data obtained during 75-gram oral-glucose tolerance tests (OGTT) on 1,120 adults older than 50 years of age from the Baltimore Longitudinal Study on Aging. We adopt a two-stage modeling approach. First, we fit OGTT curves with the Ackerman model—a nonlinear, parametric model of the glucose-insulin system—and with functional principal components analysis. We then fit linear and Cox proportional hazards models to evaluate whether usual gait speed and survival are associated with the stage-one model summaries. We also develop recommendations for identifying inadequately-fitting nonlinear model fits in a cohort setting with numerous heterogeneous response curves. These recommendations include: (1) defining a constrained parameter space that ensures biologically plausible model fits, (2) evaluating the relative discrepancy between predicted and observed responses of biological interest, and (3) identifying model fits that have notably poor model fit summary measures, such as R pseudo 2, relative to other fits in the cohort. The Ackerman model was unable to adequately fit 36% of the OGTT curves. The stage-two regression analyses found no associations between Ackerman model summaries and usual gait speed, nor with survival. The second functional principal component score was associated with faster gait speed (p<0.01) and improved survival (p<0.01).
How different of the rhizospheric and endophytic microbial compositions in watermelons with different fruit shapes
Authors: Xiao Jian , Huang Jinyan , Xiao Kezhuo , Li Guifen , Yang Shangdong , He Yi
Published: May 2024

Fruit shape is an important character of watermelon. And the compositions of rhizospheric and endophytic microorganisms of watermelon with different fruit shape also remains unclear. To elucidate the biological mechanism of watermelon fruit shape formations, the rhizospheric and endophytic microbial community compositions between oval (OW) and circular watermelons (CW) were analyzed. The results showed that except of the rhizospheric bacterial richness (P < 0.05), the rhizospheric and endophytic microbial (bacterial and fungal) diversity were not statistically significant between OW and CW (P > 0.05). However, the endophytic microbial (bacterial and fungal) compositions were significantly different. Firstly, Bacillus, Rhodanobacter, Cupriavidus, Luteimonas, and Devosia were the unique soil dominant bacterial genera in rhizospheres of circular watermelon (CW); In contrast, Nocardioides, Ensifer, and Saccharomonospora were the special soil dominant bacterial genera in rhizospheres of oval watermelons (OW); Meanwhile, Cephalotrichum, Neocosmospora, Phialosimplex, and Papulaspora were the unique soil dominant fungal genera in rhizospheres of circular watermelon (CW); By contrast, Acremonium, Cladosporium, Cryptococcus_f__Tremellaceae, Sodiomyces, Microascus, Conocybe, Sporidiobolus, and Acremonium were the unique soil dominant fungal genera in rhizospheres of oval watermelons (OW). Additionally, Lechevalieria, Pseudorhodoferax, Pseudomonas, Massilia, Flavobacterium, Aeromicrobium, Stenotrophomonas, Pseudonocardia, Novosphingobium, Melittangium, and Herpetosiphon were the unique dominant endophytic bacterial genera in stems of CW; In contrast, Falsirhodobacter, Kocuria, and Kineosporia were the special dominant endophytic genera in stems of OW; Moreover, Lectera and Fusarium were the unique dominant endophytic fungal genera in stems of CW; By contrast, Cercospora only was the special dominant endophytic fungal genus in stems of OW. All above results suggested that watermelons with different fruit shapes exactly recruited various microorganisms in rhizospheres and stems. Meanwhile, the enrichments of the different rhizosphric and endophytic microorganisms could be speculated in relating to watermelon fruit shapes formation.