bluuebunny/crossref_metadata_2025 huggingface dataset:
Community engagement to improve access to healthcare: A comparative case study to advance implementation science for transgender health equity
Authors: Thompson Hale M. , Clement Allison M. , Ortiz Reyna , Preston Toni Mari , Quantrell Ava L. Wells , Reback Cathy , Hamilton Alison , Milburn Norweeta
Published: March 2022

BackgroundRecent calls to action have been made for Implementation Science to attend to health inequities at the intersections of race, gender, and social injustice in the United States. Transgender people, particularly Black and Latina transgender women, experience a range of health inequities and social injustices. In this study, we compared two processes of transgender community-engagement in Los Angeles and in Chicago. The study addressed inequitable access to care and adapted and extended the Exploration Planning Implementation and Sustainment (EPIS) framework for transgender health equity. MethodsA comparative case method and the EPIS framework were used to examine parallel implementations of transgender community engagement to expand access to care. In order to foster the conceptual development and adaptation of EPIS for trans health equity, the comparative case method required detailed description, exploration, and analyses of the community-engagement processes to expand access to healthcare. In both cities, the unit of analysis was a steering committee made up of local transgender and cisgender stakeholders. ResultsBoth steering committees initiated their exploration processes with World Café-style, transgender community-engaged events in order to assess community needs and structural barriers to healthcare. The steering committees curated activities that amplified the voices of transgender community members among stakeholders, encouraging more effective and collaborative ways to advance transgender health equity. Based on analysis and findings from the Los Angeles town hall, the steering committee worked with a local medical school, extending the transgender medicine curriculum and incorporating elements of transgender community-engagement. The Chicago steering committee determined from their findings that the most impactful intervention on structural racism and barriers to healthcare access would be to design and pilot a transgender employment program. ConclusionIn Los Angeles and Chicago, transgender community-engagement guided exploration, planning, and implementation processes and led to critical insights regarding specific, local structural barriers to healthcare. The steering committee itself represented an important vehicle for individual- and community-level relationship and capacity building. This comparative case study highlights key adaptations of EPIS toward the formation of an implementation science framework for transgender health equity.
Catalyzing Success in Community-based Conservation
Authors: Fariss Brandie , DeMello Nicole , Powlen Kathryn A. , Latimer Christopher E. , Masuda Yuta , Kennedy Christina M.
Published: March 2022

Efforts to devolve rights and engage Indigenous Peoples and local communities in conservation have increased the demand for evidence of the efficacy of community-based conservation (CBC) and insights into what enables its success. We curated a diverse sample of 128 projects reporting both human well-being and environmental outcomes and coded 57 national-level, community-level, project-level, and control variables. We found that over 80% of CBC projects had some positive human well-being or environmental outcomes, but only 32% achieved positive outcomes for both. Applying Random Forest Classification, we found that the best predictors of combined success could be distilled to 17 variables representative of various policy levers and actionable opportunities for conservation practitioners related to national contexts, community characteristics, and the implementation of various strategies and interventions informed by existing CBC frameworks. We found that CBC projects had higher probabilities of combined success when they occurred in national contexts supportive of effective local governance, partnered with socially cohesive communities inclined toward collective action, acknowledged conflict or trust issues that could undermine it, promoted economic diversification, and invested in various capacity-building interventions, providing important insights into how to encourage greater success in CBC.
The effectiveness and safety of cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy for colorectal peritoneal metastasis: a systematic review and meta-analysis
Authors: Xu Zhonghang , Wang Xingbo , Wu Yuanyu , Wang Chengbing , Fang Xuedong
Published: March 2022

Objectives: This systematic review and meta-analysis aimed to evaluate the effectiveness and safety of cytoreductive surgery (CRS) plus hyperthermic intraperitoneal chemotherapy (HIPEC) on colorectal peritoneal metastasis (CRPM) and provide more reliable evidence for clinical practice.Methods: We searched for relevant randomized controlled trials (RCTs), case-control studies and cohort studies in PubMed, Web of Science, Cochrane Library, and Embase databases from their inception to 1 January 2022. Hazard ratio (HR) and odd ratio (OR) with 95% confidence intervals (CIs) were performed a meta-analysis using RevMan 5.3 software.Results: A total of twelve studies, of which three RCTs, eight cohort studies and one case-control study were included, and 3605 participants were involved. The results showed that CRS plus HIPEC was better than other remedial measures at improving the overall survival (OS) (HR=0.46, 95% C1:0.35-0.61, P=0.02). However, the heterogeneity was obvious (P<0.0001, I2=73%). According to different control measures, it is divided into three subgroups of CRS, CRS plus intraperitoneal chemotherapy (IPC) and palliative chemotherapy (PC). The results of subgroup analysis showed that CRS plus HIPEC was better than CRS plus IPC at enhancing the OS (HR=0.58, 95% CI :0.36-0.93, P=0.02) and was more effective than PC at improving the OS (HR=0.29, 95% CI :0.24-0.35, P<0.00001). On the contrary, CRS plus HIPEC was no significant effect than CRS at improving the OS (HR=0.76, 95% CI :0.57-1.01, P=0.06). In addition, CRS plus HIPEC had more adverse events than CRS (OR=1.69, 95% CI : 1.06-2.70, P=0.03). Conclusions: This systematic review and meta-analysis suggests that CRS plus HIPEC might be effective to CRPM in improving the OS. However, compared with CRS alone, the efficacy of CRS plus HIPEC has not improved much, and CRS plus HIPEC may bring more adverse events.
Controlled Drug Release of Modified Mesoporous Silica with Higher Driving Forces Derived from the Accurate Dispersion of Azobenzene Groups
Authors: Xue Yuqing , Zhu Wenqian , Zhao Wenhui , Lv Fengzhu , Guo Sufang , Zhang Yihe
Published: March 2022

It is highly desirable to design delivery systems that can be activated by stimuli to control the release of guest molecules. So in the present paper two kinds of mesoporous silica (m-SiO2) with amino and azobenzene groups accurately dispersed in different position of the pores were prepared based on the reactivity difference of the raw materials and the feeding sequence. The m-SiO2 with the azobenzene groups at the corner of the particles not only had higher loading ability but also could realize high effective light-control release. ~97% of IBU could be released out from the particles under UV irradiation, almost 10 times as much as the m-SiO2 with the azobenzene groups in the out layer of particles with the same composition. The obvious release difference by the two kinds of particles was analyzed based on the arrangement of the segments in the pores of m-SiO2. The conformation change of stack accumulated azobenzene at the core of the particles produced higher driving force for IBU release and decreased the attraction between -NH2 with drug molecules. The afforded mechanism was confirmed by release drug molecules with different length.
DNMT3A low-Expression is Correlated to Poor Prognosis in Childhood B-ALL and Confers Resistance to Daunorubicin on Leukemic Cells
Authors: Li Weijing , Liu Shuguang , Wang Chanjuan , Cui Lei , Zhao Xiaoxi , Liu Wei , Zhang Ruidong , Li Zhigang
Published: March 2022

Background Little is known about DNMT3A expression and its prognostic significance in childhood B cell acute lymphoblastic leukemia (B-ALL). MethodsWe determined DNMT3A mRNA expression in 102 children with B-ALL. Correlations with relapse-free survival (RFS) and common clinical characteristics were analyzed. DNMT3A was stably knocked out by CRISPR/Cas9 gene editing technology in Reh and 697 B-ALL cell lines. Cell proliferation activity after treated with daunorubicin (DNR) was determined by CCK8 assay in DNMT3A KO Reh and 697 cell lines.Results DNMT3A expression in B-ALL patients who were in continuous complete remission (CCR) was higher than in those who got relapse (P=0.0111). Receiver operating characteristic curve showed prognostic significance of DNMT3A expression (P=0.003). Low expression of DNMT3A (<0.197) was significantly correlated with poor RFS (P<0.001) in children with B-ALL. Knock-out of DNMT3A in Reh and 697 cell lines significantly increased IC50 of DNR (P=0.0201 and 0.0022 respectively), indicating elevated resistance to DNR. ConclusionLow expression of DNMT3A associates with poor prognosis in children with B-ALL. Knock-out of DNMT3A confers resistance to DNR on leukemic cells.
Health-related Quality of Life using WHODAS 2.0 and associated Factors 1 year after Stroke in Korea: a Multi-center and Cross-sectional Study
Authors: Lee HeyJean , Song Jung-Kook , Moon Jiyoung , Kim Keonyeop , Park Hyeung-Keun , Kang Gil-Won , Shin Jun-Ho , Kang Jongsoo , Kim Byoung-Gwon , Lee Young-Hoon , Jeong Hye Seon , Lee Heeyoung , Lee Won Kyung , Kim Seongheon , Park Young-Kwon
Published: March 2022

Background: The self-perceived level of disability for stroke survivors in community is little known. We aimed to characterize HRQoL 1 year after stroke and to investigate how socio-demographic and stroke-related factors and medical adherence explain the self-perceived level of disability among a Korean stroke population.Methods: This study was a multi-center and cross-sectional study. A total of 382 ischemic stroke survivors at 1 year after onset recruited from 11 university hospitals underwent a one-session assessment including: socioeconomic variables, the modified Rankin Scale (mRS), various neurological sequelae, the modifed Morisky scale (MMS), and the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) 36-items. The relationship between disability and different variables was analyzed using ordinal logistic regression. Results: The prevalence of disability by global WHODAS 2.0 score was 62.6% (41.6% for mild; 16.0% for moderate; 5.0% for severe) in subjects. Prevalence of severe disability was higher in Participation in society (16.8%) and Getting around (11.8%) than in the other domains. Low MMS motivation was the only factor determining the significant association between all six domains of disability after adjustment. Different predictors for specific domains were age, mRS, dysarthria, trouble seeing, cognition problem and MMS-motivation for Understanding and communicating; age, recurrent stroke, mRS, hemiplegia, facial palsy, general weakness and MMS-motivation for Getting around; age, education, mRS, hemiplegia and MMS-motivation for Self-care; education, recurrent stroke, hemiplegia, dysarthria and MMS-motivation for Getting along with people; age, education, income, mRS, hemiplegia, dysarthria, MMS-knowledge and MMS-motivation for Life activities; living without spouse, mRS, hemiplegia, dysarthria, trouble seeing, cognition problem, general weakness and MMS-motivation for Participation in society.Conclusions: Self-perceived disability by the WHODAS 2.0 had almost double the prevalence compared to hemiplegia, one of the most common neurological sequelae 1 year after stroke. Each domain of disability increased with various associated factors. Interventions promoting medical adherence of motivation seem to help high HRQoL in all domains.
Regional Variation and Factors Associated With Fetal Macrosomia in Ethiopia
Authors: Nugussu Gurmessa , Banbeta Akalu , Abdisa Jaleta , Bedada Dechasa
Published: March 2022

Background: Globally, there is an increase in the prevalence of high birth weight. In Sub-Sahara African countries, including Ethiopia, weighting newborns at birth are not well addressed thereby awareness of high birth weight is limited. In this paper, we aimed to assess the between-region variability of the prevalence and identify the associated factors with high birth weight in Ethiopia.Methods: The study is based on the Ethiopian Demographic and Health Survey which is conducted in 2016. A total of 2110 newborns across all regions of Ethiopia are included in the study. The multilevel logistic regression model is applied to identify the associated factors of high birth weight and to evaluate the variation of the prevalence of high birth weight across the regions of Ethiopia. Results: The prevalence of high birth weight in Ethiopia was 10.4%. Based on our analysis, mother's age, residence, mother’s educational level, mother's body mass index gestational age, socio-economic class, and the sex of the newborn baby were the significant factors associated with high birth weight. With inter-class correlation of 14%, there is a significant variation of high birth weight among the regions of Ethiopia.Conclusion: Controlling mother’s BMI, strengthening follow up for elder women and women in high socio-economic class, and prevention of post maturity (≥40 weeks) gestational age could be effective personal and public health measures to combat high birth weight in Ethiopia.
The binding between ROCK1 and KIF2A signals for the centrosome amplification triggered by high glucose, insulin and palmitic acid
Authors: Lee Shao Chin , Zhao Meng Lu , Chen Bin
Published: March 2022

Background: Diabetes increases the risk for various cancers without established mechanisms. Centrosome amplification can initiate tumorigenesis in genetically modified cells. However, the findings from genetically modified experimental models may be far away from reality. We have reported that diabetes promotes the occurrence of centrosome amplification in different types of cells, implicating that centrosome amplification is a candidate mechanism underlying the diabetes-promoted tumorigenesis. In the present study, we investigated the molecular mechanisms of the centrosome amplification triggered by high glucose, insulin and palmitic acid using HCT116 colon cancer cells as an experimental model. Results: We found that KIF2A was localized in the centrosomes. The experimental treatment induced the binding between ROCK1 and KIF2A, although did not increase the protein level of KIF2A. The molecular docking modeling analysis also showed that the two proteins had the binding/interaction potential. We used siRNA of each protein to knockdown their expression level, as a tool to disrupt the ROCK1-KIF2A complex, which attenuated the treatment-induced centrosome amplification. Conclusions: Our results suggest that the binding between ROCK1 and KIF2A signals for the diabetes-associated centrosome amplification. This provides a molecular target for the inhibition of the centrosome amplification, which might be required for assessing the role of centrosome amplification in cancer in the nature, such as cancer in diabetes.
Influence of tannins and mannoproteins products on the improvement of organoleptic characteristics of wines
Authors: Bilko Marina , Gunko Sergiy , Babych Iryna , Doboniy Inna
Published: March 2022

The aim of the work was to establish an influence of oenological tannins and mannoproteins products on the change of the organoleptic parameters of table dry wines, made from grapes of aromatic and non-aromatic varieties. The materials of the researches were wines that had defects or faults, mainly related with changes in wine aroma and taste. Oenological tannins of various botanical origins and mannoproteins products of a company Martin Vialatte (France) were used in the researches. Wines with these additives were mixed intensively, kept during 3 days at a temperature, not exceeding 12 °C and then determined the sensory characteristics of wine. Control samples were wines without additives. The descriptive method of analysis was used to create aromatic profiles of wines. The effectiveness of tannins and mannoproteins products on the sensory characteristics of wines was established. The intensity of the descriptors that made a positive affect on the aroma and taste of the samples was increasing. If, at the beginning tones of oxidation or bitterness were felt in the wines, then after introduction of the additives, these tones decreased in intensity. A difference of the changes of aromatic characteristics of wines from two groups of grapes with different aromatics was established. The action of additives was spread on the tings of descriptors, enriching the aroma of samples from non-aromatic grape varieties together with eliminating faults of taste. The effect of the additives was light in the aromatic varieties of grape that is due to the strong aroma and expressed taste of the grapes of these varieties. The results of the researches can be used to improve the quality of white wines, and further researches should be focused on the expansion of assortments of wines from other varieties, as a result utilizing tannins and mannoprotein products
Enstrophy from symmetry
Authors: Marjieh Raja , Pinzani-Fokeeva Natalia , Yarom Amos
Published: March 2022

We study symmetry principles associated with the approximately conserved enstrophy current, responsible for the inverse energy cascade in non relativistic 2+1 dimensional turbulence. We do so by identifying the accidental symmetry associated with enstrophy current conservation in a recently realized effective action principle for hydrodynamics. Our analysis deals with both relativistic and non relativistic effective actions and their associated symmetries.
Molecular Docking in silico Analysis of Brazilian Essential Oils Against Host Targets and SARS-CoV-2 Proteins
Authors: Costa Rêmullo , Martins Regildo , de Lima Gerlane , Stamford Thayza , Tadei Wanderli , Maciel Maria Aparecida , do Rêgo Amália , Xavier-Júnior Francisco
Published: March 2022

The inhibitory activity of thirty-one sesquiterpenes identified from Brazilian essential oils (Copaifera langsdorffii Desf., Croton cajucara Benth. and Siparuna guianensis Aublet.) were analyzed by in silico molecular docking. The compounds were characterized by gas chromatography-mass spectrometry (GC-MS) and gas chromatography with flame-ionization detection (GC-FID), and then, applied against severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) proteins and human angiotensin-converting enzyme 2 (hACE2). Applying molecular docking and AutoDock Vina software, a total of 496 individual interactions were detected for sesquiterpenes along with SARS-CoV-2 proteins and hACE2 human angiotensin converting enzyme-2 protein. The findings showed considerable binding affinity of sesquiterpenes with the tested macromolecules. In that, β-selinene from C. langsdorffii displayed the best energy (-7.2 kcal mol-1) and showed strong interactions with the amino acids of the SARS-CoV-2 M-Pro protein. Spathulenol from C. cajucara strongly interacted with human ACE2, with a binding energy of -7.1 kcal mol-1. Meanwhile, γ-eudesmol from S. guianensis presented the lowest binding energy (-7.5 kcal mol-1) by interacting with the SARS-CoV-2 M-Pro complex. Additionally, measurements were performed aiming to evaluate the best sesquiterpenes binding interactions with the main proteins and its homologue files. According to results, these Brazilian essential oils hold antiviral potential being a rich source for further in vitro and in vivo studies focusing on herbal therapeutic adjuvants against SARS-CoV-2 infections.
Pseudomyxoma Peritonei A Rare Abdominal Tumor
Authors: IQBAL N , SHAHID K , SHOAIB M , ATIQ F , BOKHARI S T , SIDDIQUE K
Published: March 2022

Pseudomyxoma peritonei is a rare abdominal tumor with a reported incidence of approximately I per million per year. It is invariably fatal as the space within the abdomen is eventually replaced by mucinous tumor. We report one case of Pseudomyxoma peritonei.
Coexistence of Recidivans, Mucocutaneous and Osseous Leishmaniasis in an Immunocompromised Patient
Authors: Tariq Hira , Aman Shahbaz , Anwar Ambereen , Ashraf Ameena
Published: March 2022

Leishmaniasis is a parasitic disease caused by the protozoan Leishmania, transmitted by female phlebotomine sandfly. The disease spectrum ranges from limited cutaneous plaques to disseminated nodules, and may involve viscera including liver, spleen and bone marrow. Concurrent occurrence of various patterns of the disease in a single patient is rare. Here, we report a patient with leishmania recidivans and mucocutaneous disease alongwithinvolvement of multiple bones, a combination that has not been reported in Pakistan.
Duodenal Perforation in a Patient with Dengue Fever –A Rare Entity
Authors: Jibril Huzefa , Khanum Iffat
Published: March 2022

A 37-year-old gentleman presented to the emergency with a history of high-grade fever for 2 days and abdominal pain for one day. On arrival at the emergency department, he was hypotensive and tachycardic, while on abdominal examination he had generalized abdominal tenderness. He was started on fluid resuscitation with intravenous crystalloids. The initial impression was of an acute abdomen. The Abdominal X-ray showed air under the diaphragm. He was rushed to the operating room and underwent an emergency laparotomy that revealed a duodenal perforation for which he underwent Graham's patch repair and washout. No obvious cause was identified. He had low platelets for which Dengue NS-1 antigen was sent that came positive. Post-procedure he recovered and was discharged home. To our knowledge, this is the first case in which dengue fever associated with a duodenal perforation is being reported. It is the first case of gastrointestinal perforation in a patient with Dengue Fever to be reported outside of India. In endemic regions, clinicians must recognize such atypical manifestations.
Relationship of Fatigue Severity with Disability, pain and Sleep Disturbance in Patients with Rheumatoid Arthritis and Osteoarthritis: A Cross-Sectional Study
Authors: Khan Zainab Aqeel , Khan Muhammad Saad , Zahoor Al-Wardha
Published: March 2022

Objective: Fatigue is one of the most disabling symptoms of arthritis. The aim of this study was to evaluate fatigue severity in Osteoarthritis and Rheumatoid arthritis, and its correlation with pain, disability and sleep disturbance. Methods: A cross sectional survey was conducted among patients attending a rheumatology and orthopaedic clinic in Karachi. Total 100 participants were included, fifty with osteoarthritis and fifty with rheumatoid arthritis respectively. They were assessed for fatigue, pain, disability and sleep disturbances in both the groups. Fatigue Severity Scale questionnaire was used to evaluate the intensity of fatigue. The disability index was measured by Health Assessment Questionnaire, whereas pain and sleep disturbances was assessed by Visual Analogue Scale. Result: Our result showed osteoarthritis group has significant but weak correlation of fatigue with disability (r=0.45) p-value 0.001, pain (r=0.41) p-value (0.003) and sleep disturbances (r=0.49) p-value
Spectrum and Outcome of Intra-abdominal Tumors in children Under-five in a Pediatric Critical Care Unit of a Tertiary Care Center of Pakistan
Authors: Ahmed Syed Habib , Khan Muhammad Rahil , Khalid Muhammad , Naeem Rubiya , Haq Anwar Ul , Ashraf Muhammad Shamvil
Published: March 2022

Objective: To determine the spectrum and outcome of intra-abdominal tumors in children less than five years admitted in the critical care unit of a tertiary care center of Pakistan. Methodology: This retrospective study included children less than five years with malignant abdominal mass admitted in the pediatric critical care unit of the tertiary care center of Pakistan from July 2015 to June 2019.
Undiagnosed patients or with relapsed or benign abdominal tumors managed in an outpatient or admitted in the critical care for post-operative care only were excluded from the study. Data was entered and analyzed by using SPSS version 21.0. Result: Total 55 patients were included with 69% boys and median age three years (IQR – 2 years). Abdominal distention was the commonest complain (100%). Only 42% children survived (n=23/55). High grade mature Bcell Non Hodgkin Lymphoma was the most common (45%) diagnosis. Advance Stage III/IV was seen in 94%. Combined multiple site metastasis was most common (45.4%). Sepsis (OR-5.30, 95% CI-1.24-22.65, p-0.024), inotropic use (OR-9.00, 95% CI-1.33-60.92, p-0.024) and malnutrition (OR-4.85, 95% CI-1.08-21.63, p-0.039) were identified as the most significant prognostic factors related to high mortality. Conclusion: B-cell Non-Hodgkin Lymphoma was the most common histopathological diagnosis, while sepsis was the commonest reason for admission in critical care unit. Majority presented with advanced stages (stage III/IV) with poor outcome(58% mortality). Sepsis, malnutrition and need of inotropes were found to be the independent risk factors contributing to this high mortality. We recommend for early recognition of abdominal distention as an important sign of cancer with prompt referral to pediatric oncology unit which would definitely decrease the upfront critical care requirement and improve survival.
A Comparative Analysis of Moral Principles: Veracity versus Confidentiality versus Justice
Authors: Mushtaq Khudija , Yaqoob Adnan , Bano Tahmina
Published: March 2022

A number of frameworks can be used to analyze ethical and moral issues objectively whether the act of an individual is ethically good and bad. Health care providers are ethically concerned with clients' confidentiality and veracity in their clinical practice. The current article reveals the ethical dilemma of an infertile couple. Ethical issues affect the human being physical, mentally, and socially. If the Health care provider sustains the confidentiality, contrarily it will be against the principles of veracity therefore, the truthfulness will be the topmost importance.
An Outlook on the COVID-19 Infection Magnitude in Pakistan and Potential Factors Contributing to Low Mortality Rates
Authors: Khan Rizwan Ullah , Mumtaz Sidra , Rashid Muhammad Usman , Malkani Naila
Published: March 2022

Background: COVID-19 has severely affected some countries with a high mortality rate than others. In Pakistan, its mortality rate is lower (2.06%) than neighboring countries and even economically advanced countries. Here we discuss the distinct characteristic of the Pakistani population that might have contributed to this lower mortality. Methods: COVID-19 mortality data were collected from December, 2019 to July, 2020 and studied for population age spectrum, health facilities, immunization profiles, physical activity, and obesity from Pakistan and other countries. Results: Lower COVID-19 related mortality rate was observed in Pakistan (2.06%) as compared to France (18.02%), Italy (14.45%), UK (14.01%), Spain (9.56%), the USA (4.71%), and Iran (4.77%). Small proportion (3.5%) of the elderly population (>65 years of age), exposure to different viral antigens, a higher rate of BCG vaccination, better physical activity practices, and lower obesity prevalence in Pakistani population as compared European and North American population may contribute to lower COVID-19 related mortality rate. Conclusions: Multiple factors may have contributed to this lower mortality rate in Pakistan. Our observations
may facilitate clinicians to identify individuals who may have low risk to COVID-19 related deaths. Comprehensive studies are warranted to address it further.
Evaluating the effectiveness of the Water Resources Master Plan in Campinas, Brazil
Authors: Galbetti Marcus Vinícius , Zuffo Antonio Carlos , Shinma Taís Arriero , Boulomytis Vassiliki Terezinha Galvão , Imteaz Monzur
Published: March 2022

From 2013 to 2015, the Brazilian southeast region experienced the most severe and intense drought recorded, the Water Crisis. This outstanding drought led the government to make efforts toward an adequate water resources management. In Campinas, the third most populous city of the State of São Paulo, the government proposed the Campinas Water Resources Master Plan (CWRMP), the main objective of which was to ensure the quantity and quality of water, reducing water vulnerability in the municipality. In this study, we evaluated the effectiveness of this plan through the major guidelines into four actions: (1) increase the permeability rate and the soil infiltration capacity, (2) increase the vegetation cover, (3) improve the sanitation services, and (4) minimize the number of contaminated areas. For Actions 1 and 2, we inferred that the aforementioned parameters have increased after the CWRMP enactment. About the Action 3, we found that Campinas has historically provided good sanitation services to the population, regardless of the CWRMP promulgation. However, more improvements should be given to waste collection and recycling services. The underground water consumption also has to be regulated, as significant exploitation has no legal permit. Finally, considering Action 4, the number of contaminated areas was reduced in the available data period. Therefore, the CWRMP was considered a valuable initiative to support an integrated and sustainable use of water, improving the water resources management in Campinas.
Adsorption of Congo red and tetracycline onto water treatment sludge biochar: characterisation, kinetic, equilibrium and thermodynamic study
Authors: He Liwenze , Chen Yu , Li Yanjun , Sun Fei , Zhao Yuting , Yang Shunsheng
Published: March 2022

In this study, readily available inexpensive water treatment sludge (WTS) was used to prepare adsorbent for the removal of Congo red (CR) and tetracycline (TC) from aqueous solutions. The structural characteristics and adsorption properties of WTS biochar were characterised via scanning electron microscope, energy dispersive X-ray spectroscopy, Brunauer-Emmett-Teller and Fourier Transform infrared spectroscopy. In batch experiments, the adsorption factors, kinetics, isothermal curves and thermodynamics of the adsorption properties were investigated. The optimum preparation condition of WTS biochar was 400 °C for 4 h under O2-limited pyrolysis, which exhibited increased specific surface area and pore structures. The best adsorption was observed when the pH of the CR and TC solutions was 7 and 4, respectively. The adsorption process followed the pseudo-second-order model, indicating that the main control step was the chemical adsorption process. Isotherm data were best described by the Langmuir model, and the maximum adsorption capacities for CR and TC were 116.4 and 58.5 mg·g−1, respectively. Thermodynamic parameters revealed that the adsorption process was spontaneous and endothermic. According to the analysis, the adsorption mechanism of CR could be attributed to electrostatic attraction, π–π conjugation and hydrogen bonding, whereas that of TC was potentially associated with cation exchange, complex precipitation, π–π conjugation and hydrogen bonding.
A Digital Screening System for Alzheimer Disease Based on a Neuropsychological Test and a Convolutional Neural Network: System Development and Validation
Authors: Cheah Wen-Ting , Hwang Jwu-Jia , Hong Sheng-Yi , Fu Li-Chen , Chang Yu-Ling , Chen Ta-Fu , Chen I-An , Chou Chun-Chen
Published: March 2022

Background

Alzheimer disease (AD) and other types of dementia are now considered one of the world’s most pressing health problems for aging people worldwide. It was the seventh-leading cause of death, globally, in 2019. With a growing number of patients with dementia and increasing costs for treatment and care, early detection of the disease at the stage of mild cognitive impairment (MCI) will prevent the rapid progression of dementia. In addition to reducing the physical and psychological stress of patients’ caregivers in the long term, it will also improve the everyday quality of life of patients.

Objective

The aim of this study was to design a digital screening system to discriminate between patients with MCI and AD and healthy controls (HCs), based on the Rey-Osterrieth Complex Figure (ROCF) neuropsychological test.

Methods

The study took place at National Taiwan University between 2018 and 2019. In order to develop the system, pretraining was performed using, and features were extracted from, an open sketch data set using a data-driven deep learning approach through a convolutional neural network. Later, the learned features were transferred to our collected data set to further train the classifier. The first data set was collected using pen and paper for the traditional method. The second data set used a tablet and smart pen for data collection. The system’s performance was then evaluated using the data sets.

Results

The performance of the designed system when using the data set that was collected using the traditional pen and paper method resulted in a mean area under the receiver operating characteristic curve (AUROC) of 0.913 (SD 0.004) when distinguishing between patients with MCI and HCs. On the other hand, when discriminating between patients with AD and HCs, the mean AUROC was 0.950 (SD 0.003) when using the data set that was collected using the digitalized method.

Conclusions

The automatic ROCF test scoring system that we designed showed satisfying results for differentiating between patients with AD and MCI and HCs. Comparatively, our proposed network architecture provided better performance than our previous work, which did not include data augmentation and dropout techniques. In addition, it also performed better than other existing network architectures, such as AlexNet and Sketch-a-Net, with transfer learning techniques. The proposed system can be incorporated with other tests to assist clinicians in the early diagnosis of AD and to reduce the physical and mental burden on patients’ family and friends.
Web-Based Skin Cancer Assessment and Classification Using Machine Learning and Mobile Computerized Adaptive Testing in a Rasch Model: Development Study
Authors: Yang Ting-Ya , Chien Tsair-Wei , Lai Feng-Jie
Published: March 2022

Background

Web-based computerized adaptive testing (CAT) implementation of the skin cancer (SC) risk scale could substantially reduce participant burden without compromising measurement precision. However, the CAT of SC classification has not been reported in academics thus far.

Objective

We aim to build a CAT-based model using machine learning to develop an app for automatic classification of SC to help patients assess the risk at an early stage.

Methods

We extracted data from a population-based Australian cohort study of SC risk (N=43,794) using the Rasch simulation scheme. All 30 feature items were calibrated using the Rasch partial credit model. A total of 1000 cases following a normal distribution (mean 0, SD 1) based on the item and threshold difficulties were simulated using three techniques of machine learning—naïve Bayes, k-nearest neighbors, and logistic regression—to compare the model accuracy in training and testing data sets with a proportion of 70:30, where the former was used to predict the latter. We calculated the sensitivity, specificity, receiver operating characteristic curve (area under the curve [AUC]), and CIs along with the accuracy and precision across the proposed models for comparison. An app that classifies the SC risk of the respondent was developed.

Results

We observed that the 30-item k-nearest neighbors model yielded higher AUC values of 99% and 91% for the 700 training and 300 testing cases, respectively, than its 2 counterparts using the hold-out validation but had lower AUC values of 85% (95% CI 83%-87%) in the k-fold cross-validation and that an app that predicts SC classification for patients was successfully developed and demonstrated in this study.

Conclusions

The 30-item SC prediction model, combined with the Rasch web-based CAT, is recommended for classifying SC in patients. An app we developed to help patients self-assess SC risk at an early stage is required for application in the future.
Social Media for ImpLementing Evidence (SMILE): Conceptual Framework (Preprint)
Authors: Zhao Junqiang , Harvey Gillian , Vandyk Amanda , Gifford Wendy
Published: March 2022

BACKGROUND

Social media has become widely used by individual researchers and professional organizations to translate research evidence into health care practice. Despite its increasing popularity, few social media initiatives consider the theoretical perspectives of how social media works as a knowledge translation strategy to affect research use.

OBJECTIVE

The purpose of this paper is to propose a conceptual framework to understand how social media works as a knowledge translation strategy for health care providers, policy makers, and patients to inform their health care decision-making.

METHODS

We developed this framework using an integrative approach that first involved reviewing 5 long-standing social media initiatives. We then drafted the initial framework using a deductive approach by referring to 5 theories on social media studies and knowledge translation. A total of 58 empirical studies on factors that influenced the use of social media and its messages and strategies for promoting the use of research evidence via social media were further integrated to substantiate and fine-tune our initial framework. Through an iterative process, we developed the Social Media for ImpLementing Evidence (SMILE) framework.

RESULTS

The SMILE framework has six key constructs: developers, messages and delivery strategies, recipients, context, triggers, and outcomes. For social media to effectively enable recipients to use research evidence in their decision-making, the framework proposes that social media content developers respond to target recipients’ needs and context and develop relevant messages and appropriate delivery strategies. The recipients’ use of social media messages is influenced by the virtual–technical, individual, organizational, and system contexts and can be activated by three types of triggers: sparks, facilitators, and signals.

CONCLUSIONS

The SMILE framework maps the factors that are hypothesized to influence the use of social media messages by recipients and offers a heuristic device for social media content developers to create interventions for promoting the use of evidence in health care decision-making. Empirical studies are now needed to test the propositions of this framework.
A Digital Screening System for Alzheimer Disease Based on a Neuropsychological Test and a Convolutional Neural Network: System Development and Validation (Preprint)
Authors: Cheah Wen-Ting , Hwang Jwu-Jia , Hong Sheng-Yi , Fu Li-Chen , Chang Yu-Ling , Chen Ta-Fu , Chen I-An , Chou Chun-Chen
Published: March 2022

BACKGROUND

Alzheimer disease (AD) and other types of dementia are now considered one of the world’s most pressing health problems for aging people worldwide. It was the seventh-leading cause of death, globally, in 2019. With a growing number of patients with dementia and increasing costs for treatment and care, early detection of the disease at the stage of mild cognitive impairment (MCI) will prevent the rapid progression of dementia. In addition to reducing the physical and psychological stress of patients’ caregivers in the long term, it will also improve the everyday quality of life of patients.

OBJECTIVE

The aim of this study was to design a digital screening system to discriminate between patients with MCI and AD and healthy controls (HCs), based on the Rey-Osterrieth Complex Figure (ROCF) neuropsychological test.

METHODS

The study took place at National Taiwan University between 2018 and 2019. In order to develop the system, pretraining was performed using, and features were extracted from, an open sketch data set using a data-driven deep learning approach through a convolutional neural network. Later, the learned features were transferred to our collected data set to further train the classifier. The first data set was collected using pen and paper for the traditional method. The second data set used a tablet and smart pen for data collection. The system’s performance was then evaluated using the data sets.

RESULTS

The performance of the designed system when using the data set that was collected using the traditional pen and paper method resulted in a mean area under the receiver operating characteristic curve (AUROC) of 0.913 (SD 0.004) when distinguishing between patients with MCI and HCs. On the other hand, when discriminating between patients with AD and HCs, the mean AUROC was 0.950 (SD 0.003) when using the data set that was collected using the digitalized method.

CONCLUSIONS

The automatic ROCF test scoring system that we designed showed satisfying results for differentiating between patients with AD and MCI and HCs. Comparatively, our proposed network architecture provided better performance than our previous work, which did not include data augmentation and dropout techniques. In addition, it also performed better than other existing network architectures, such as AlexNet and Sketch-a-Net, with transfer learning techniques. The proposed system can be incorporated with other tests to assist clinicians in the early diagnosis of AD and to reduce the physical and mental burden on patients’ family and friends.
Work-Focused Versus Generic Internet-Based Interventions for Employees With Stress-Related Disorders: Randomized Controlled Trial (Preprint)
Authors: Persson Asplund Robert , Asplund Sofia , von Buxhoeveden Helene , Delby Hanna , Eriksson Karin , Svenning Gerhardsson Maurits , Palm Joachim , Skyttberg Thea , Torstensson Julia , Ljótsson Brjánn , Carlbring Per , Andersson Gerhard
Published: March 2022

BACKGROUND

In recent decades, stress-related disorders have received more attention, with an increasing prevalence, especially within the working population. The internet provides new options for broad dissemination, and a growing body of evidence suggests that web-based interventions for stress might be effective. However, few studies have examined the efficacy of interventions in clinical samples and work-related outcomes.

OBJECTIVE

The aim of this study was to evaluate the efficacy of an internet-based cognitive behavioral intervention for stress-related disorders integrating work-related aspects (work-focused and internet-based cognitive behavioral therapy [W-iCBT]), compared with a generic internet-based cognitive behavioral therapy (iCBT) group and a waitlist control (WLC) group.

METHODS

In this trial, 182 employees, mainly employed in the health care, IT, or educational sector, who fulfilled the criteria for a stress-related disorder, were randomized to a 10-week W-iCBT (n=61, 33.5%), generic iCBT (n=61, 33.5%), or WLC (n=60, 33%). Self-rated questionnaires on perceived stress, burnout, exhaustion, and other mental health– and work-related outcomes were administered before and after the treatment and at 6- and 12-month follow-ups.

RESULTS

Compared with the WLC group, participants of the W-iCBT and iCBT groups showed an equal and significant reduction in the primary outcome (Shirom-Melamed Burnout Questionnaire [SMBQ]) from pretreatment to posttreatment assessment (Cohen d=1.00 and 0.83, respectively) and at the 6-month follow-up (Cohen d=0.74 and 0.74, respectively). Significant moderate-to-large effect sizes were also found in the secondary health- and work-related outcomes. The W-iCBT was the only group that exhibited significant effects on work ability and short-term sickness absence. Short-term sickness absence was 445 days lower than the WLC group and 324 days lower than the iCBT intervention group. However, no significant differences were found in terms of work experience or long-term sick leave.

CONCLUSIONS

The work-focused and generic iCBT interventions proved to be superior compared with the control condition in reducing chronic stress and several other mental health–related symptoms. Interestingly, effects on work ability and short-term sickness absence were only seen between the W-iCBT intervention and the WLC groups. These preliminary results are promising, indicating that treatments that include work aspects may have the potential to accelerate recovery and reduce short-term sickness absence because of stress-related disorders.

CLINICALTRIAL

ClinicalTrials.gov NCT05240495; https://clinicaltrials.gov/ct2/show/NCT05240495 (retrospectively registered)
Effects of Music on Attention-Deficit/Hyperactivity Disorder (ADHD) and Potential Application in Serious Video Games: Systematic Review (Preprint)
Authors: Martin-Moratinos Marina , Bella-Fernández Marcos , Blasco-Fontecilla Hilario
Published: March 2022

BACKGROUND

Attention-deficit/hyperactivity disorder (ADHD) has a considerable impact on an individual’s daily life. Some difficulties with timing deficits may be associated with deficiencies in attention, reading, language skills, or executive function. Music therapy, either active (playing an instrument) or passive (listening to music) has demonstrated its efficacy in reducing symptomatology in many disorders. Video games may prove to be a useful assessment and treatment tool in compensating for the difficulties with multimodal treatment in ADHD.

OBJECTIVE

The aim of the study is to (1) analyze the evidence that music is beneficial in reducing the symptomatology of ADHD using systematic review and (2) propose the application of music in video games following music therapy strategies.

METHODS

Searches were conducted in PubMed, Embase, PsycINFO, Cochrane, and gray literature (Google Scholar and WorldCat). We used the following search syntax: ((music[Title/Abstract]) or (music therapy[Title/Abstract])) and (attention deficit disorder[MeSH or thesaurus term]).

RESULTS

Of the 70 records identified, 17 provided findings that music can be beneficial in various domains of ADHD. Active music therapy improves hemispheric synchrony, social skills, aggressivity, and impulsivity. Passive music therapy improves academic skills like arithmetic, drawing, and reading comprehension, as well as attention and disruptive behaviors. The effects depend on the music genre, tempo, or task difficulty. Music in video games was generally found to be beneficial for people with ADHD. Music improves immersion and flow while playing video games. Using rhythm may also improve timing skills and immersion in patients with ADHD. Regarding the proposed application of aspects of music to therapeutic video games for ADHD, some paradigms in timing and music therapy were considered in the proposed design of video games.

CONCLUSIONS

Improving ADHD treatment through the application of music in video games is proposed.

CLINICALTRIAL

PROSPERO CRD42021288226; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=288226