bluuebunny/crossref_metadata_2025 huggingface dataset:
Knowledge and Motivators Towards Palliative Care Among Cancer Patients in a Tertiary Health Facility in Southwest Nigeria
Authors: Adegbesan Abiodun , Nyirenda Thomas , Akinwale Mukaila , Afolabi Aanuoluwapo Adeyimika , Akingbola Adewunmi
Published: October 2024

Introduction
This study aimed to describe the knowledge and motivators towards palliative care among cancer patients receiving oncology care at a tertiary health facility in Nigeria.
Methods
This cross-sectional study was conducted among 200 adult cancer patients at the University College Hospital, Ibadan, Nigeria across the Radiation oncology, Gynaecological oncology, Otorhinolaryngology, Oral and Maxillofacial surgery, Surgical oncology, and medical oncology departments and/or clinics. Data were collected using the National Cancer Institute’s 2018 Health Information National Trends Survey (HINTS 5) Cycle 2 survey questionnaire. Data were summarised using descriptive statistics. Knowledge scores were computed, and individuals with scores corresponding to < 50% of the composite results were said to have poor knowledge of palliative care. A binary logistic regression model was employed to determine the predictors of good knowledge of palliative care (p < 0.05).
Results
The mean age of the cancer patients was 51.3 ± 4.2 years and the mean length of diagnosis was 11.2 ± 2.3 months. In all, 93 (46.7%) had completed tertiary education, and 144 (72.7%) lived in an urban community. In all, 55 (27.5%) people had good knowledge of palliative care. Overall, 4 (12.9%) cancer patients with primary or no formal education had good knowledge of palliative care compared to 7 (9.5%) with secondary education and 46 (49.5%) with tertiary education (p = < 0.001). Also, 5 (9.3%) of those living in rural areas had good knowledge of palliative care compared to 49 (34.0%) living in urban areas (p = < 0.001). Cancer patients with tertiary education had 25 times higher odds of good knowledge of palliative care compared to those with primary or no formal education (AOR = 24.98, 95%CI = 2.41-258.46, p = < 0.001). Likewise, cancer patients that lived in urban areas had four times higher odds of good knowledge of palliative care compared to those living in rural areas (AOR = 4.39, 95%CI = 1.08–17.85, p = 0.04).
Conclusion
Poor knowledge of palliative care exists among cancer patients. Stakeholders in the governmental and non-governmental agencies should undertake programs and schemes to increase knowledge of palliative care, especially among poorly educated persons and rural dwellers.
Patient-reported Strategies for Prevention and Treatment of Chemotherapy- induced Peripheral Neuropathy
Authors: Hertz Daniel L , Tanay Mary , Tofthagen Cindy , Rossi Emanuela , Bernasconi Davide Paolo , Sheffield Katharine E , Carlson Martha , Nekhlyudov Larissa , Grech Lisa , Von Ah Diane , Mayo Samantha J , Ruddy Kathryn J , Chan Alexandre , Alberti Paola , Lustberg Maryam B
Published: October 2024

Purpose: Chemotherapy-induced peripheral neuropathy (CIPN) is a debilitating toxicity of many drugs used in cancer treatment. There are numerous available strategies for preventing or treating CIPN, but few are guideline-recommended, due to limited evidence of their effectiveness. The primary objective of this survey was to understand what strategies patients used to prevent or treat CIPN, and to understand their perceptions around CIPN prevention and treatment.
Methods: The Multinational Association of Supportive Care in Cancer (MASCC) Neurological Complications Study Group created a cross-sectional online survey to recruit individuals who are currently or had previously received neurotoxic chemotherapy treatment and self-reported peripheral neuropathy. Descriptive statistics were reported.
Results: Most of the 447 survey participants did not use any CIPN prevention strategy (71%), though given options of any strategy the plurality preferred a prescribed medication or supplement (30%). The most common treatment strategy used was exercise (47%), with some patients trying prescription medications including non-guideline recommended gabapentin (33%) or guideline-recommended duloxetine (8%) options. Nearly half of participants (49%) used at least one non-prescribed medication for treating CIPN. Patient’s often followed suggestions of their medical oncology clinical team, but sometimes relied on the internet or other patients to recommend non-prescription strategies.
Conclusion: In the absence of many guideline-recommended strategies for CIPN prevention and treatment, some patients use options with minimal evidence of effectiveness. Additional research is needed to determine which strategies are effective for prevention and treatment so these can be implemented in practice to improve treatment outcomes in patients with cancer.
Psychological Impact of the 2023 Kahramanmaraş Earthquakes on Non-Victims
Authors: Çınaroğlu Metin , Yılmazer Eda , Alpugan Zeynep , Sayar Gökben Hızlı
Published: October 2024

The 2023 Kahramanmaraş earthquakes, with magnitudes of 7.7 and 7.6, caused extensive destruction and psychological distress across southeastern Turkey. This study explores the psychological impact on non-victims, particularly Istanbul residents, focusing on mental health outcomes and coping mechanisms. A cross-sectional survey was conducted from March to May 2024 with 721 participants from various Turkish cities, including a significant portion from Istanbul. Validated psychological scales such as the Beck Depression Inventory-II (BDI-II), Beck Anxiety Inventory (BAI), Warwick-Edinburgh Mental Well-being Scale (WEMWBS), and PTSD Checklist for DSM-5 (PCL-5) measured depression, anxiety, well-being, and PTSD symptoms. Sociodemographic factors like age, gender, occupation, income, education level, and previous earthquake experience were also analyzed.
Results showed significant psychological distress among non-victims: 51.9% reported high levels of distress, with 24% meeting PTSD criteria, 30% exhibiting moderate to severe depression, and 28% experiencing significant anxiety. Higher income and education levels correlated with better mental health outcomes. Higher education levels were linked to lower PTSD risk (β = -0.20, p < 0.01) and fewer depression symptoms (β = -0.15, p < 0.05). Higher income was associated with lower depression scores (β = -0.20, p < 0.01) and fewer PTSD symptoms (β = -0.15, p < 0.05). Age positively correlated with well-being (r = 0.68, p < 0.001) and negatively with PTSD symptoms (r = -0.15, p < 0.05).
Comparisons with victim studies of major earthquakes, such as the 1995 Great Hanshin-Awaji earthquake, the 1999 Marmara earthquake, the 2008 Wenchuan earthquake, and the 2000 Iceland earthquakes, revealed similar profound psychological impacts. This highlights the need for comprehensive mental health interventions for both direct and indirect exposures. This study underscores the necessity for inclusive mental health strategies to enhance resilience and well-being, ensuring robust recovery after catastrophic events.
The relationship between depression and alcohol use among the Wa ethnic minority in China
Authors: Yang Wanqiu , Young Allan , Liu Junjun , Gaffney Jess Kerr , Jauhar Sameer , Leng Dan , Li Chaoxiao , Li Kunjie , Pu Yongjie , Yang Borui , Wang Yanqing , Zhang Xingang
Published: October 2024

Background
Alcohol use and depression often co-occur; however, little is known about this association with specific ethnic groups. This study aimed to explore the relationship between alcohol use and depression in the Wa ethnic group in China.
Methods
A stage sampling method was utilized to survey respondents from the Wa ethnic group, who have transitioned rapidly from traditional slash-and-burn cultivation to modern societies. The Alcohol Use Disorder Identification Test (AUDIT) and the Patient Health Questionnaire-9 (PHQ-9) to assess their alcohol use and depressive symptoms, respectively. Data were analyzed using generalized additive models and a two-segment logistic regression.
Results
Among the 668 participants, 48.98% (337/668) were current drinkers. Low-risk, high-risk, and probable alcohol-dependence drinkers accounted for 21.4%, 25.4%, and 2.7% of the sample, respectively. Generalized additive models revealed a non-linear association between AUDIT scores and depressive symptoms, with a statistically significant non-linearity (P < 0.001). A-segment logistic regression identified a critical point at an AUDIT of 15. this threshold, each increase in AUDIT score led to a notable 43% increase in the likelihood of experiencing depressive symptoms (OR = 143, 95 CI: 119,1.72, < 0.). while, on the lower end of the threshold, there was no significant association between the AUDIT score and depressive symptoms observed (OR 0.98 95% CI 0.90, 1.05, P = 0.53).
Conclusion
A non-linear relationship between alcohol use and depression was identified in the Wa ethnic group, suggesting a threshold effect. Screening for alcohol use could help identify individuals at risk of depression in ethnic populations.
Diffusion tensor image analysis along the perivascular space in former professional athletes with repetitive mild traumatic brain injury history
Authors: Miyata Mari , Kamagata Koji , Saito Yuya , Uchida Wataru , Takabayashi Kaito , Moriguchi Sho , Momota Yuki , Ichihashi Masanori , Kurose Shin , Endo Hironobu , Tagai Kenji , Kataoka Yuko , Mimura Masaru , Aoki Shigeki , Higuchi Makoto , Takahata Keisuke
Published: October 2024

The long-term changes in the glymphatic system of former professional athletes exposed to repetitive mild traumatic brain injuries remain poorly understood. This study aimed to use diffusion tensor image analysis along the perivascular space (DTI-ALPS) to evaluate the glymphatic system activity and correlate the ALPS-index with neuropsychiatric symptoms in former professional athletes. Thirty former professional athletes and 24 age- and sex-matched controls underwent DTI with 3T magnetic resonance imaging. The ALPS-index (mean, right, and left) in the athlete group was compared with that in controls, and correlations with clinical variables were analyzed. The mean, right, and left ALPS indices in the athlete group were significantly lower than those of the control group (mean: 1.49±0.12 vs. 1.61±0.16, p<0.01; right: 1.51±0.12 vs. 1.61±0.16, p=0.01; and left: 1.47±0.15 vs. 1.60±0.20, p<0.01). The mean and right ALPS indices were positively correlated with the Wisconsin Card Sorting Test performance in the athlete group (mean: r=0.41, p=0.04; right: r=0.43, p=0.03; not significant after Bonferroni correction). In conclusion, a lower ALPS-index in former professional athletes may be associated with impairments in cognitive function, reflected in glymphatic dysfunction.
The Impact of Posterior Root Tears of the Medial Meniscus on Meniscal Extrusion and Cartilage Degeneration
Authors: Zhou Yongwei , He Shan , Kang Jiayu , Yang Qining
Published: October 2024

Background: To explore the impact of the severity of the tear gap caused by medial meniscus posterior root (MMPR) tear on medial meniscus extrusion and bone cartilage based on magnetic resonance imaging (MRI).
Methods: A retrospective analysis was conducted on 153 patients with medial meniscus root tear who were admitted to Jinhua Central Hospital from January 1, 2020, to October 31, 2023. According to the size of the tear gap, they were divided into mild displacement (M) group (≤4mm) and extensive displacement (W) group (>4mm). The M group consisted of 73 cases (70 females, 3 males), aged 52-63 years (mean age 56 years); the W group consisted of 80 cases (75 females, 5 males), aged 55-65 years (mean age 57.5 years). There was no significant difference in age and gender between the two groups (P>0.05). The distances of medial meniscus extrusion and bone cartilage injury in the two groups were compared and analyzed.
Results: In the M group, the average extrusion distance of the medial meniscus was 3.5mm (1.5-5mm), and in the W group, the average extrusion distance of the medial meniscus was 4.53mm (2.5-7.3mm). The comparison between the two groups was statistically significant (P<0.05). The degree of femoral medial condyle cartilage degeneration was more severe in the W group, which was statistically significant compared with the M group (P<0.05). In the W group, bone hyperplasia, subchondral cyst formation, and narrowing of the medial compartment were more common, but there was no significant difference compared to the M group (P>0.05).
Conclusion: The size of the tear gap caused by medial meniscus root tear on MRI is an important risk factor for medial meniscus extrusion and bone cartilage degeneration, which can provide a good idea for predicting the progression of osteoarthritis clinically.
Education with mobile App and educational website in the metabolic control of patients with type 2 diabetes. Protocol study of a Multicenter Clinical Trial
Authors: López Lubia Velázquez , Klünder Miguel Klünder , Gil Jenny Vilchis , Peña Jorge Escobedo de la , Aguila Ignacio Pineda del , Gómez Oswaldo Sinoe Medina
Published: October 2024

Background: Diabetes education is a fundamental pillar for accomplishing metabolic control, improving knowledge about the disease and the lifestyle in the patient with diabetes. The benefit of mHealth has been shown to be an important tool for monitoring, disease care and lifestyle improvement in patients with type 2 diabetes (T2D). In less developed countries, the effect of educational intervention through mHealth is still inconclusive. The objective of this study is to evaluate the effect of an intervention on the metabolic control of the patient with T2D with mHealth intervention and educational website called "I understand my diabetes".
Methods. The study is designed as a randomized controlled trial with a parallel-group design. The total study duration is 12 months with data collection at baseline, 3, 6, 9 and 12 months. We plan to include 480 Mexican adult patients with T2D. Participants will be randomized to one of three interventions: (1) Group with Web education program (2) Group web education program+ mobile App for diet and exercise plan (1) Usual care intervention. The primary outcome is changes in glycated hemoglobin A1c. Other outcome measures include changes in Lipid profile, body composition and anthropometric measurements, quality of life, lifestyle and physical activity.
Discussion: The study has a 12-month follow-up of intervention and will provide knowledge and results of the effect of the use of a mobile app and educational website on the metabolic control of patients with diabetes. The results may be relevant for implementation in public institutions with high demand of patients with type 2 diabetes without severe complications of the disease. Interventions with diabetes education and reinforcement with the healthcare professional with the use of mHealth may be strategies to achieve and maintain metabolic control and disease care in patients with diabetes.
Trial registration number: Clinical Trials.gov. Registry (NCT0627857I). The protocol number: Effect of Education with Mobile App on metabolic control in Patients With type 2 Diabetes. The registration number R-2018-785-100. Instituto Mexicano del Seguro Social. Mexico. Registration date: february 22, 2024.
Clinical and Epidemiological Characteristics of Chikungunya and Dengue Infections in Provincial Hospitals of Davao de Oro, Philippines
Authors: Arce Nestor , Boonak Kobporn , Bernasor Lee Thunder , Salas Christian Joy , Putri Anastasia , Aung Pyae Linn , Imad Hisham Ahmed , Chierakul Wirongrong , Luvira Viravarn , Phonrat Benjaluck , Phumratanaprapin Weerapong , Charunwatthana Prakaykaew
Published: October 2024

Mosquito-borne diseases like dengue and chikungunya are endemic in the tropical region and is a common cause of acute febrile illness in both adults and children. The Philippines, home to over a hundred million residents and visited by several million tourists each year, is one such region where the risk of these diseases is endemic. To better understand the detailed situation, we estimated the proportion of these diseases in the community by conducting a prospective observational study conducted in four provincial hospitals of Davao de Oro, Philippines from February 2019 to February 2020. Serum from 382 study participant was used for laboratory confirmation of dengue or chikungunya either by antigen, antibody or by RT-PCR. Dengue was diagnosed in 57.1%, chikungunya 7.07%, co-infection with both dengue and chikungunya in 7.3%, and the etiology was undetermined in 35.9% of study participants. Common clinical symptoms included fever, headache, and rash, which were overlapping symptoms and clinically indistinguishable at presentation to the hospital, necessitating the need for laboratory diagnostics. The identification of the presence of chikungunya in Davao de Oro calls for increased awareness, improved diagnostics, and integrated disease control measures to manage outbreaks that can occur in dengue endemic regions.
Patient perspectives on health care models in cardiac surgery: A qualiative evaluation
Authors: Schmid Mona Elisabeth , Stumm Jannik , Stock Sina , Girdauskas Evaldas
Published: October 2024

Background
The implementation of ERAS represents a promising solution to improve treatment efficiency and facilitate patient involvement. This innovative care model aims to optimize recovery processes following surgeries by adopting a holistic, interprofessional approach. At our hospital, ERAS was implemented in minimally invasive heart valve surgery, offering two distinct ERAS models. Additionally, there is also the standard of care without ERAS. The objective of the study is to gain insight into patient satisfaction and perceived differences across these various care models.
Methods
Patients were interviewed using semi-structured interviews approximately two to three months after undergoing surgery. The data were analysed using qualitative content analysis in accordance with the methodology proposed by Kuckartz. Four main categories were established: Preoperative care, postoperative care and communication, patient participation and involvement, and rehabilitation and post-clinical course.
Results
Comprehensive preoperative education and seamless communication throughout the perioperative care journey were identified as fundamental to patient satisfaction and optimal care processes. Patients in the ERAS + model reported higher overall satisfaction with their care compared to patients in the standard of care and ERAS groups.
Conclusion
Preoperative education establishes the foundation for patients' subsequent behaviours and expectations regarding their treatment. Aspects such as physical activity, nutrition, and mental health are of significant importance. The active involvement and participation of patients and their families in the treatment process facilitated superior postoperative care, intensive physiotherapy, mental support, and faster recovery. A functional flow of information throughout the entire care process is of utmost importance. Moreover, having a dedicated point of contact had a beneficial impact on patients´ well-being. The integration of innovative ERAS concepts, which encompass interprofessional preoperative patient education and psychosomatic support, represents a promising approach from a patient perspective, offering benefits to a broad spectrum of cardiac surgical patients.
Assessing Healthcare Cost Changes Associated with Transitioning away from Cigarette Smoking Using Healthcare Claims Data: an Exploratory Study among Adult Male Patients with COPD
Authors: Zhang Mingda , Cheng Hui G. , Noggle Brendan , Janak Jud C. , Richards Megan , Smith David
Published: October 2024

Background: The assessment of potential health effects of switching from cigarette smoking to non-combustible tobacco products has important implications for public health and regulatory decisions. Robust epidemiological evidence requires long-term follow-up of a large number of individuals. Real-world evidence derived from health records has the potential to help fill the gap in the interim. To our knowledge, this is the first study using individual-level healthcare claims data to assess the potential impact of transitioning from cigarette smoking to smokeless tobacco on short-term direct healthcare costs.
Methods: We conducted a retrospective cohort study of adult male patients with COPD who smoked cigarettes at baseline using the MarketScan® Databases. We compared changes in direct healthcare costs between the 12-month periods before (baseline) and after the index date (follow-up) across three cohorts: continued smoking (CS), quit all tobacco (QT), or switched to smokeless tobacco (SW), using a non-linear difference-in-differences model with average marginal effects.
Results: A total of 23,427 COPD patients were included (CS: 11,167; QT: 12,013; SW: 247). At baseline, the QT cohort had the highest total average healthcare costs ($43,771), followed by SW ($38,419), and CS ($27,149). The unadjusted difference-in-differences model revealed no statistically significant differences in total healthcare cost changes when comparing the QT or SW cohorts to the CS cohort (-$1,532 [95% CI: -$3,671, $608] for the QT cohort, and -$452 [95% CI: -$15,415, $14,511] for the SW cohort). After adjusting for Deyo-Charlson Comorbidity Index and COPD exacerbation, the QT cohort had greater reduction in total healthcare costs compared to the CS cohort (-$2,910 dollars [95% CI: -$4,485, $-1,335]) assuming a two-unit increase in comorbidities and COPD exacerbations. The same trend was observed for the SW cohort, although the estimate was not statistically significant (-$5,312 [95%CI: -$11,067, $442], p=0.08).
Conclusions: This study demonstrated the feasibility of using administrative claims to conduct real-world evidence studies on the harm-reduction potential of non-combustible tobacco products and found evidence suggesting reductions in direct healthcare costs after quitting tobacco or switching to smokeless tobacco among patients with COPD. Based on the learnings and limitations identified during the study, we propose concrete recommendations to improve future observational studies by integrating additional real-world healthcare data from multiple data sources.
Regulation of ROS metabolism in macrophage via xanthine oxidase is associated with disease progression in pulmonary tuberculosis
Authors: Liu Ruichao , Zhang Fuzhen , Liu Qiuyue , Pang Yu , Li Liang
Published: October 2024

Backgrond Pulmonary tuberculosis (PTB) exacerbation can lead to respiratory failure, multi-organ failure, and symptoms related to central nervous system diseases. The purpose of this study is to screen biomarkers and metabolic pathways that can predict the progression of pulmonary tuberculosis, and to verify the role of the metabolic enzyme xanthine oxidase in the progression of PTB. Methods To explore the biomarkers and mechanisms underlying the progression of PTB, plasma metabolomics sequencing was conducted on patients with severe PTB, non-severe PTB, and healthy individuals. Screening differential metabolites and metabolic pathways that can predict the progression of pulmonary tuberculosis, and verifying the function and mechanism of action of XO through experiments. Results The purine metabolism, sphingolipid metabolism, and amino acid metabolism between the three groups differ. In patients with severe PTB, the levels of xanthosine and hypoxanthine are increased, while the levels of D-tryptophan, dihydroceramide and uric acid are decreased. Inhibition of XO activity has been observed to reduce the expression levels of tumor necrosis factor (TNF-α), interleukin-1 beta (IL-1β), and interleukin-6 (IL-6), as well as to suppress the production of reactive oxygen species (ROS) and the activation of the NF-κB pathway, while also promoting the growth ofMTB within cells. Conclusion D-tryptophan, xanthosine, and dihydroceramide can be utilized as biomarkers for progression of PTB, assisting in the evaluation of disease progression, and XO stands out as a potential therapeutic target for impeding the progression of PTB.
Revision Total Hip Arthroplasty with Medial Wall Defect using Bone Graft with or without Porous Metal Restrictor
Authors: Do Min Uk , Kang Sang Woo , Lee Sang-Min , Kim Jae Jin , Suh Kuen Tak , Shin Won Chul
Published: October 2024

We aimed to evaluate whether there were differences in outcomes of revision total hip arthroplasty (THA) with acetabular medial wall defects depending on the use of trabecular metal (TM) augmentation. Between 2009–2021, 130 patients were classified into two groups: 80 patients undergoing only bone grafting (BG group) and 50 patients undergoing both bone grafting and TM augmentation (BG/TM group). We evaluated the postoperative center of rotation (COR) position and changes in vertical and horizontal COR at last follow-up. Additionally, we categorized the fate of the transplanted bone graft into four groups: unchanged, initially changed, resorption-no further intervention, and resorption-revision. The mean horizontal COR changes were − 3.50 mm in the BG group and − 1.07 mm in the BG/TM group (p = 0.005). In the BG/TM group, a higher proportion of the patients showed unchanged or only initial changes when compared to the BG group (88.0% and 65.0%, respectively). The BG/TM group showed more favorable results regarding horizontal changes in the COR and fate of the bone graft. Therefore, for revision THA in patients with severe medial wall defects, the combined use of bone graft and TM augmentation can be a suitable option.
Ultra-Compact Solar Telescope with Wavefront Correction Ability
Authors: Gu Naiting , Chen Hao , Tang Ao , Fan Xinlong , Noda Carlos Quintero , Xiao Yawei , Zhong Libo , Wu Xiaosong , Zhang Zhenyu , Yang Yanrong , Wu Xiaohu , Huang Linhai , Yi Zao , Rao Changhui
Published: October 2024

Solar telescope is the primary means of carrying out high-resolution solar observations and advanced heliophysical research, while adaptive optics has become requisite technology to address the limitations of the atmosphere turbulence in terms of imaging resolution. However, in previous works, the adaptive optics system was designed independently behind the solar telescope, which makes the system large and complex, with low transmittance and significant instrumental polarization, thus limiting the performance of solar telescopes. Here, we develop a novel and ultra-compact solar telescopes with wavefront correction ability, called solar adaptive optics telescope (SAOT), which hides the adaptive optics system into the solar telescope. The proposed full-wavefront measurement method obtains the global tip-tilt and higher-order wavefront aberrations synchronously by using only one Hartmann-Shack wavefront sensor, which are corrected by the only secondary deformable mirror (SDM) simultaneously. As a result, the presented SAOT looks like a simple solar telescope, but it has comprehensive wavefront correction and fine tracking ability, significantly improving system integration, transmission efficiency, and even reliability while reducing instrumental polarization. A 600 mm prototype of SAOT is also built and can realize high-resolution observation of the solar photosphere layer in the sky. The numeric simulations, experiments, and observing results verify the validity and feasibility of the presented SAOT method, and the successful development and observation of SAOT, which marks a significant milestone in the field, offers valuable insights for the future advancement of large solar telescopes.
A framework for understanding the path to achieve high resilience of maritime supply chain: A case study of China shipping industry
Authors: Chen Xiuqian , Chu Liangyong , Wang Mengyao , Chen Qion , Yu Qing
Published: October 2024

In recent years, a significant rise in international sudden risk events has resulted in impacts and disruptions to maritime supply chains. The resilience of maritime supply chains has garnered attention from the academic, industrial, and government sectors. The paper proposes a methodological framework based on the structural equation model (SEM), Necessary Condition Analysis (NCA), fuzzy set qualitative comparative analysis (fsQCA), and utilizes questionnaire data from the maritime industry in China to evaluate the resilience in MSC. The computational results indicate that: (1) The high resilience of MSC is the result of the synergistic interaction among multiple factors, and these factors boost MSC resilience through diverse paths; (2) There are four pathways for high MSC resilience: the 'synergy + carbon reduction + digitization' path, the 'early warning + synergy' path, the 'agility + early warning' path, and the 'carbon reduction' path; (3) Digitization level can play a catalytic role in increasing the resilience of MSC by helping other factors. This paper reveals the multiple routes to enhance the resilience of MSC, which can instruct MSC members to choose the correct resilience management strategies based on their existing resources and situations and can help both practitioners and researchers to understand in more detail of the various dimensions and nuances of resilience in the context of MSC.
Optimal discrimination between mixed models through nature-inspired algorithms
Authors: Casero-Alonso Víctor , López-Fidalgo Jesús , Pozuelo-Campos Sergio , Tommasi Chiara , Wong Weng Kee
Published: October 2024

It is common in the optimal design literature to assume that the model has no random effects and it is known, apart from model parameters. Random effects models are widely applied across all disciplines, particularly in the life sciences and clinical studies. This paper assumes there are several plausible models and we want to find a design that optimally discriminates among models with random effects in them.
A common design criterion for discriminating between models with fixed effects is the Kullback-Leibler (KL) divergence criterion. It is a maximin-type of criterion, not differentiable and is a 3-layer nested optimization problem over very distinct domains. Consequently, optimal designs for discriminating models are notoriously difficult to determine, not only analytically, but also computationally. This paper provides theoretical results for the KL-optimality criterion value for discriminating among random effects models and implements a nature-inspired metaheuristic algorithm to facilitate the search for an optimal discrimination design. Our methodology is quite general and applies to discriminating random effects models with multiple interacting experimental conditions which may be continuous or discrete. We provide two applications; the first finds a design that optimally discriminates among fractional polynomials with a single continuous variable, and the second identifies the best design to discriminate among several multi-factor random effects models.
Anti-drift Preserving Network with UAV ImageSuper-resolution
Authors: S Greeshma M , R Bindu V
Published: October 2024

UAV Image Super-Resolution has become increasingly prominent in recent times, owing to the widespread use of atmosphere monitoring, tracking, and surveillance, which are critical areas of interest. The primary focus of this work revolves around enhancing the resolution of UAV images, utilizing an anti-drift network as a key component. Past endeavours in this domain faced difficult hurdles, primarily attributed to the dynamic characteristics of the target data. This work accelerated the process by conducting experiments on benchmark datasets such as VisDrone and UAVid. These datasets showcase densely populated scenes featuring objects such as people and vehicles, which often undergo significant variations in density; identifying where these density changes occur over varying time intervals presents a complex challenge. To tackle these challenges, we propose a Context-reasoning Swin-transformer Graph Attention Network that employs the Swin transformer,semantic reasoning and context-aware graph attention to modulate context descriptors by semantic reasoning along spatial-channel interaction tensor to extract more global contextual information for UAV SR. Our proposed approach has been thoroughly evaluated through extensive experimental results and ablation studies, showcasing its effectiveness and efficiency. It consistently surpasses state-of-the-art methods by a notable margin, achieving more than 0.5 dB improvements.
Exploring the Physical and Mental Health Challenges of Teenage Pregnancy: A Qualitative Study in the Tamale Metropolis, Ghana
Authors: Tahiru Rafatu , Kona Comfort , Nyari Abiba , Mohammed Tawfik , Pawmang Dorothy Anukem
Published: October 2024

Background
Teenage pregnancy poses significant public health challenges globally, particularly affecting the physical and mental well-being of adolescent girls. Despite a global decline in teenage birth rates, regions like sub-Saharan Africa continue to experience high prevalence. In Ghana's Tamale metropolis, teenage pregnancy rates have shown a concerning rise, underscoring the need for an in-depth exploration of its multifaceted impacts. This study aims to explore the physical and mental health effects of teenage pregnancy in the Tamale metropolis, capturing their personal experiences and coping mechanisms.
Methods
Employing a qualitative exploratory descriptive design, the study conducted a focus group discussion with 10 first-time teenage mothers aged 13–19 whose babies were less than 1 month. Participants were purposively sampled from antenatal records across five Community-based Health Planning and Services (CHPS) compounds. Discussions, guided by the socioecological model, were transcribed, translated, and thematically analyzed using NVivo software.
Results
Participants reported numerous physical health challenges, including severe nausea, vomiting, exhaustion, musculoskeletal pain, and infections like candidiasis. Mental health struggles encompass feelings of sadness, irritability, anxiety, and societal-induced stress. Coping strategies varied, with reliance on trusted individuals, avoidance of social situations, support from healthcare professionals, and family backing emerging as predominant themes.
Conclusion
This study revealed profound physical and mental health challenges compounded by societal stigma and limited resources. Strengthening social support networks, reducing stigma, and promoting patient-centered care are imperative. Targeted interventions are also essential to enhance health outcomes for these young mothers and their children.
Synthesis of ZnO/Zeolite from Coal Fly Ash and its Utilization for Clindamycin Adsorption
Authors: Veronica Jessica , Mora Abraham , Anwar Budiman , Yuliani Galuh
Published: October 2024

This research aims to obtain FA-based zeolites modified with zinc oxide (ZFA-ZnO) to adsorb the antibiotic clindamycin. The method used in this research was hydrothermal synthesis using an autoclave to obtain ZFA-ZnO and a batch system was used for adsorption capacity measurements. ZFA-ZnO was characterized using X-Ray Diffraction (XRD), Fourier Transform Infrared (FTIR), Scanning Electron Microscopy/Energy Dispersive X-Ray Spectroscopy (SEM-EDS). The analyses of the clindamycin solution were conducted using an Ultraviolet-Visible (UV-Vis). Based on the results of XRD and SEM characterization, the best synthesis conditions were obtained at a temperature of 160oC for 9 h as indicated by an increase in the zeolite and ZnO crystal phases and a smaller average particle size. Magnetic ZFA-ZnO at a temperature of 160oC (ZFA-ZnO160 M) is a type of zeolite with the highest adsorption percentage, namely, 89.41%. Adsorption data shows that the optimum pH for adsorbing the antibiotic clindamycin is pH 6 with an adsorption percentage of ZFA160 M of 82.43% and ZFA-ZnO160 M of 94.5%. The adsorption isotherm data for ZFA160 M best fits the Langmuir model, while for ZFA-ZnO160 M fits the Redlich Peterson isotherm model. The adsorption mechanism is thought to occur in a monolayer through the interaction of active Si-O functional groups on the zeolite as proven by functional group absorption analysis using FTIR.
Global PM2.5 Exposure Inequality Hindering Progress Toward Air Quality-Related SDGs
Authors: He Chao , Huang Chaoqing , Zhang Ping , Wu Qian , Wang Yuan , Zeng Zhaoliang , Zhang Lu , Miao Chunping , Yue Fang , Tang Yun , Zhou Jingwei , Zhou Yiqi , Wang Yanwen , Yang Lu , Hong Song , Peng Sha , Gong Xusheng , Chen Wei
Published: October 2024

Under the framework of the United Nations Sustainable Development Goals (SDGs), mitigating global PM2.5 exposure inequality has become a worldwide task. However, the relationship between PM2.5 exposure inequality and the SDGs remains poorly understood. In this study, we evaluated the spatial distribution of global PM2.5 exposure inequality from 2000 to 2019 on a global scale and investigated the interactions between PM2.5 exposure inequality and the SDGs. The results indicate that global PM2.5 exposure inequality is increasingly worsening. Compared with high-income and low-income regions, middle- and lower-income regions have higher levels of PM2.5 exposure inequality and face greater risks of PM2.5 exposure and associated health impacts. Our analysis of the relationship between PM2.5 exposure inequality and the SDGs reveals that the positive impact of air-SDGs related to air pollution and health, such as SDG3, SDG5, SDG8, and SDG13, on global PM2.5 exposure inequality is becoming increasingly significant. In contrast, the negative impact of SDG2, SDG7, and SDG10 on global PM2.5 exposure inequality has been growing annually. These findings provide valuable insights into the complex interactions between PM2.5 exposure inequality and the SDGs and offer a reference for future efforts to build healthier and more equitable urban air environments.
Intentions to use PrEP among a national sample of transgender and gender-expansive youth and emerging adults: Examining gender minority stress, substance use, and gender affirmation.
Authors: Cluesman Sabrina R. , Gwadz Marya , Cleland Charles M.
Published: October 2024

Transgender and gender-expansive youth/emerging adults ages 13–24 years, experience disproportionate HIV risk, yet have among the lowest US PrEP uptake rates (< 10%). Still, factors that promote or impede PrEP outcomes for this population are poorly understood. This study examines the effects of gender minority stressors, gender affirmation, and heavy substance use on their PrEP outcomes. Data were drawn from the CDC’s 2018 START study, which included transgender and gender-expansive youth/emerging adults indicated for PrEP (N = 972). We developed a conceptual model integrating the gender minority stress and gender affirmation models. We mapped START items onto it, including distal (family rejection, medical discrimination) and proximal (internalized transphobia, perceived TGE-stigma) gender minority stressors, heavy substance use, background factors, and gender affirmation across five domains. Structural equation modeling (Mplus-8.9) was used to examine factors related to PrEP intentions. Most participants were 18–24 (68%), trans-female (46%) and White (45%). Additionally, 40% reported heavy substance use behaviors. Medical discrimination increased internalized transphobia (b = 0.097, SE = 0.034, p = 0.005) and perceived stigma (b = 0.087, SE = 0.034, p = 0.010). Family rejection also increased perceived stigma (b = 0.181, SE = 0.032, p < 0.001) and heavy substance use (b = 0.260, SE = 0.053, p < 0.001), and perceived stigma (b = 0.106, SE = 0.037, p = 0.004) increased heavy substance use. Notably, perceived stigma (b = -0.085, SE = 0.027, p = 0.002) and heavy substance use (b = -0.161, SE = 0.031, p < 0.001) decreased intentions to take PrEP, while gender affirmation increased PrEP intentions (b = 0.045, SE = 0.019, p = 0.020). Moreover, a 1-point increase in gender affirmation reduced the risk of heavy substance use by -0.179 (SE = 0.030; p < 0.001) in the presence of family rejection, and by -0.074 (SE = 0.041; p = 0.074) when perceived TGE stigma was present. This study underscores the importance of addressing heavy substance use among transgender/gender-expansive young people as a potential barrier to PrEP uptake. Future research could explore how gender affirmation acts as a protective factor against the negative impact of family rejection and perceived stigma on heavy substance behaviors among these populations.
Active aldehydes accelerate CD8+ T cell exhaustion through metabolic alteration in tumor microenvironment
Authors: Chamoto Kenji , Haku Yasuharu , Kitaoka Koji , Wang Jun , Ichimaru Koki , Ito Katsuhiro , Kozuki Tomohiro , Yurimoto Keiko , Menju Toshi , Date Hiroshi , Kobayashi Takashi , Omori Koichi , Yaguchi Tomonori , Honjo Tasuku
Published: October 2024

Glycolysis and mitochondrial fatty acid oxidation (FAO) regulate CD8+ T cell differentiation fate. However, how glycolysis and FAO balance are associated with T-cell exhaustion remains unknown. PD-1 signal inhibits glycolysis and enhances FAO. We find that CD8+ T cells in the tumors adhered to glycolysis with attenuated FAO despite high PD-1 expression, which was defined as “metabolic exhaustion.” Active aldehydes, final products of lipid peroxidation, accumulate in CD8+ T cells in proportion to their exhaustion depth in mouse and human tumor tissues. Active aldehydes strongly promote glycolysis and inhibit the FAO activity in T cells. Mice deficient for an FAO enzyme, specifically in T cells, generate more active aldehydes, enhancing T-cell exhaustion and attenuating anti-tumor immunity. Super-resolution microscopy analysis reveals that active aldehydes are primarily generated from mitochondria in the exhausted T cells, which is associated with mitochondrial damage. Inhibitors of lipid peroxidation or active aldehydes enhanced the anti-tumor effect of the PD-1 blockade therapy by rectifying metabolic exhaustion. Therefore, active aldehydes resulting from FAO impairment cause a vicious cycle of metabolic imbalance that leads to T cell exhaustion.
Racial Disparities in Pain Between Non-Hispanic Whites and Asian Americans with Knee Osteoarthritis: The Role of Pain Catastrophizing
Authors: Lee Chiyoung , Kwoh Kent , Park Juyoung , Park Lindsay , Ahn Hyochol
Published: October 2024

Background: Although a few studies have delineated the disparities in knee osteoarthritis (OA) pain between non-Hispanic Whites (NHWs) and Asian Americans, a significant research gap persists in elucidating the mechanisms underlying these differences.
Objective: This pilot study aimed to examine psychological factors, specifically pain catastrophizing and negative affect, as potential explanatory mechanisms for these dissimilarities.
Methods: Forty community-dwelling participants aged 50–70 years with self-reported knee OA pain, including 20 NHWs and 20 Asian Americans, were recruited. Clinical knee OA pain intensity was assessed using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and Short -Form-McGill Pain Questionnaire-2 (SF-MPQ-2). Quantitative sensory testing was used to measure experimental sensitivity to heat- and mechanically induced pain. Pain catastrophizing was evaluated using the Coping Strategies Questionnaire-Revised Pain Catastrophizing subscale, while negative affect was assessed using the Positive and Negative Affect Schedule. Bayesian mediation analyses were employed to examine both direct and indirect effects (mediation) between variables.
Results: Asian Americans exhibited higher pain catastrophizing scores than NHWs. Pain catastrophizing, at high levels, contributed to WOMAC- and SF-MPQ-2-measured clinical pain, and it fully mediated the relationship between race and these pain measures. However, race had no indirect effects on experimental pain sensitivity through pain catastrophizing. While Asian Americans yielded higher negative affect scores and greater experimental pain sensitivity than NHWs, race exerted no indirect effects on all pain measures via negative affect.
Conclusions: Pain catastrophizing appears crucial in addressing racial disparities in clinical knee OA pain between NHWs and Asian Americans. The lack of indirect effects of race on experimental pain sensitivity through pain catastrophizing suggests the need to explore other factors, such as genetic and biological influences. Further research using larger sample sizes is essential to validate our findings and clarify the role of negative affect.
Dopamine alters functional gradients in Parkinson’s disease
Authors: Orlando Isabella F , Tan Joshua B , Taylor Natasha L , Medel Vicente , Wainstein Gabriel , Lewis Simon J.G. , Shine James M , O'Callaghan Claire
Published: October 2024

Neuromodulators regulate large-scale brain network topology to support adaptive behaviour. Disease models offer a unique window into how neuromodulatory systems impact large-scale brain network organisation. Here, we take advantage of Parkinson’s disease – with its profound dopaminergic loss and pro-dopaminergic treatment strategies – to inform how dopamine may influence large-scale brain organisation. In 27 people with Parkinson’s disease, resting-state scans were obtained on their regular dopamine medication and following overnight withdrawal of medication. Nineteen matched controls provided normative data. Gradients of brain organisation were examined using dimensionality reduction techniques. For single gradients, when individuals were on their dopamine medication, we observed a shift in higher-order networks towards somatomotor anchors. When interrogated in the multi-dimensional gradient space, we found that dopamine medication enhanced separation between functionally discrete sensory and higher-order networks. This increase in dispersion was dependent on an individual’s dopamine dose level, and increased dispersion was more apparent in regions enriched with dopamine receptor (DRD2) gene expression. Together these findings substantiate a role for dopamine in modulating large-scale functional brain organisation. Our findings further confirm that medication targeting the dopamine system may achieve its benefit by restoring aspects of network topology, and suggest new hypotheses about how dopamine medication is influencing large-scale functional brain organisation in Parkinson’s disease.
AL- NILAI AL-MA'RŪF DALAM AL-QUR’AN TENTANG PERCERAIAN
Authors: Yusuf Muhammad Rifky
Published: October 2024

Al-Ma'rūf value is a fundamental principle in marriage. Besides, this principle must be also applied in divorce proceeding. This article aims to describe comprehensively about al-ma'rūf in al-Qur'an, therefore the value of the word can be found. This research uses library research that uses a normative approach. This article is analyzed by using al-munāsabah al-Qur'an theory. This article reveals, there are 10 verses in al-Qur'an containing al-ma'rūf value in theme verses of divorce. These repeated words indicate that al-Qur'an pays attention of al-ma'rūf value seriously in divorce proceeding. This value is sometimes neglected by the husband who divorced her. The outline of this article is, al-ma'rūf value is a treatment that include in frame of Islamic guidance, common senses, compatible with attitude of virtuous people, and appropriate with custom. Al-Ma'rūf value is Islamic guarantee and protection for women, who often get injustice and arbitary. Therefore, it can be concluded that Islam is very much fighting for women's rights, especially in divorce proceeding.