bluuebunny/crossref_metadata_2025 huggingface dataset:
Children’s self-reported exposure to sugary beverage advertisements and association with intake across six countries before and during the COVID-19 pandemic: a repeat cross-sectional study
Authors: Demers-Potvin Élisabeth , Lemieux Simone , Acton Rachel B. , Penney Tarra L. , Sacks Gary , White Christine M. , White Martin , Hammond David , Vanderlee Lana
Published: October 2024

Background

Children’s exposure to sugary beverage advertising may have changed during the COVID-19 pandemic due to shifts in media habits, which could subsequently have influenced intake. This study aimed to examine: 1) children’s frequency and setting of exposure to advertisements of sugary beverages in six countries before and during the COVID-19 pandemic; 2) the association between exposure to sugary beverage advertisements and intake.

Methods

Children aged 10–17 years (n = 28,908) in Australia, Canada, Chile, Mexico, the United Kingdom (UK) and the United States (US) completed online surveys in 2019, 2020 and 2021 as part of the International Food Policy Study using a repeat cross-sectional study design. Respondents self-reported frequency and setting of exposure to sugary beverage advertisements, location of school classes (in-person/online, 2020–2021 only), screen time, and sugary beverage intake. Adjusted weighted logistic and negative binomial regression models stratified by country examined associations between year and reported sugary beverage advertising exposure, and associations between sugary beverage advertising exposure and intake. Differences in reported advertising exposure between students taking online or in-person school classes were explored.

Results

Self-reported exposure to advertisements for sugary beverages at least weekly was relatively stable across years within countries, with differences in settings of exposure. Exposure to sugary beverage advertisements increased on digital media independently of screen time from 2019 to 2021 in Australia, Canada, the UK and US, with a concomitant decrease in exposure in retail settings in all countries except the UK. In Australia and the UK, children attending all classes online were more likely to report at least weekly (vs less than once a week) exposure to sugary beverage advertisements, and children attending all classes online were more likely to report exposure to advertisements on digital media and in other settings (e.g., billboard, magazines) compared to children attending in-person classes in Australia, Canada and the UK. Exposure to sugary beverage advertisements at least weekly (IRR = 1.12,99%CI:1.09–1.15) and in each of the settings was associated with sugary beverage intake.

Conclusions

Exposure to digital advertisements for sugary beverages increased from 2019 to 2021 in most countries, and exposure was associated with sugary beverage intake. Reducing children’s exposure to advertising of less healthy foods, including on digital media, may reduce sugary beverage intake.
A descriptive epidemiological study of the prevalence of self-reported sensory difficulties by age group, sex, education, disability, and migration status in Sweden in 2020
Authors: Badache Andreea-Corina , Mäki-Torkko Elina , Widen Stephen , Fors Stefan
Published: October 2024

Background

The objective of this study is to estimate the prevalence of self-reported hearing difficulties, vision difficulties and combined vision and hearing difficulties in a Swedish adult population that varies according to migration status, sex, age, disability measured by ADL and IADL and educational attainment level.

Methods

The study utilised data from the Survey of Health, Ageing and Retirement in Europe, which consisted of 2257 individuals aged 60 and above that were interviewed in Sweden in the 2019/2020, SHARE wave 8. To determine the prevalence of sensory difficulties (hearing, vision and dual-sensory difficulties) among various subgroups of the population, a multinomial logistic regression was used. The results of these analyses are presented in terms of predicted probabilities.

Results

The study findings indicate that foreign-born older adults experience a lower prevalence of visual difficulties (6.2% [3.3–11.5] in comparison to their Swedish-born counterparts. Moreover, older adults with higher levels of education tend to report a lower prevalence of sensory difficulties overall. Furthermore, sex differences are apparent, with males reporting a higher prevalence of hearing difficulties (18.9% [15.5–22.8] vs. 12.8% [10.7–15.3]) and females reporting a higher prevalence of vision difficulties (12.7% [10.7–15.1] vs. 8.5%[6.8–10.5]).

Conclusion

The findings highlight disparities in the prevalence and type of perceived sensory difficulties experienced by older adults, by factors such as age, sex, education and migration status. It is important to consider these demographic factors in healthcare planning and interventions aimed at mitigating sensory difficulties in the older population.
Exploration of the triceps surae muscle in ambulatory children with cerebral palsy using instrumented measurements of stiffness and diffusion tensor magnetic resonance imaging for muscle architecture
Authors: Åhblom Alexandra , Pontén Eva , Destro Antea , Petersson Sven , von Walden Ferdinand , Wang Ruoli , Lidbeck Cecilia
Published: October 2024

Background

Musculoskeletal alterations causing reduced range of motion of the ankle joint are common in children with cerebral palsy (CP). Objective measurements of passive joint resistance and three-dimensional skeletal muscle volume and muscle architecture can lead to a comprehensive understanding of which factors influence joint range of motion.

Research question

To investigate the relation between the passive dorsiflexion of the ankle joint, biomechanical contributing factors to the passive joint resistance, and muscular architectural properties of the triceps surae muscle in children with CP.

Methods

In this cross-sectional observational study, 14 children with spastic CP (bilateral: 5, unilateral: 9, Gross Motor Function Classification System (GMFCS) level I:11, II:3) naïve to intramuscular tone reducing treatment, and 14 TD children were included. The passive dorsiflexion of the ankle was measured with a goniometer. Passive joint resistance and related parameters were estimated based on a biomechanical model and measurements using a motorized device, the Neuroflexor. Three-dimensional muscle architecture was quantified with diffusion tensor magnetic resonance imaging (DT-MRI).

Results

In the CP group, the median [min, max] passive dorsiflexion was decreased in the most affected leg (MAL) compared to the less affected leg (LAL) (2.5° [-25°, 20°] vs. 12.5° [5°, 30°], p = 0.001). The stiffness coefficient (Nm/rad) in the MAL was significantly higher in children with CP compared to TD children (7.10 [3.39, 62.00] vs. 2.82 [1.24, 10.46], p = 0.015). Muscle architecture properties did not differ between CP and TD, except for pennation angle in the medial gastrocnemius (MG) of the MAL (CP 17.64° (2.29) vs. TD 21.46° (3.20), p = 0.017). The stiffness coefficient, in the MAL, correlated negatively to passive dorsiflexion (rs=-0.638) and pennation angle in medial gastrocnemius (rs=-0.964), and the non-linear coefficient (Non-linear 1) correlated negatively to the fascicle length of the medial gastrocnemius (rs=-0.857).

Conclusion

This study shows that stiffness of the plantarflexors is related to decreased passive dorsiflexion of the ankle and muscle structure of the MG in high-functioning children with spastic CP. Assessments of how dynamic components as well as microscopic muscle alterations contribute to joint stiffness in the plantarflexors in individuals with CP are warranted.

Trial registration

Retrospectively registered in ClinicalTrials.gov, NCT05447299. Observational study. Study start: 2019-01-15, register date: 2022-07-01.
Strategy for scheduled downtime of hospital information system utilizing third-party applications
Authors: Jo Inhae , Kim Woojin , Lim Younghee , Kang Eunjeong , Kim Jinung , Chung Hyekyung , Kim Jihae , Kang Eunhye , Jung Yoon Bin
Published: October 2024

Background

The widespread adoption of Hospital Information Systems (HIS) has brought significant benefits in healthcare quality and workflow efficiency. However, downtimes for system maintenance are inevitable and pose a considerable challenge to continuous patient care. Existing strategies, including manual prescription methods, are no longer effective due to increasing reliance on digital systems.

Method

This study implemented two main strategies to mitigate the impact of scheduled downtimes. First, we created an “Emergency query program” that switches to a read-only backup server during downtimes, allowing clinicians to view essential patient data. Second, an “Emergency prescription system” was developed based on the Microsoft Power Platform and integrated into Microsoft Teams. This allows clinicians to perform digital prescriptions even during downtimes.

Results

During a planned 90-minute downtime, 282 users accessed the Emergency Prescription System, resulting in 22 prescriptions from various departments. Average times for prescription confirmation and completion were 8 min and 3 s, and 18 min and 40 s, respectively. A post-downtime evaluation revealed high user satisfaction.

Conclusion

Essential maintenance-induced HIS downtimes are inherently disruptive to patient care process. Our deployment of an emergency query program and a Microsoft Teams-integrated emergency prescription system demonstrated robust care continuity during HIS downtime.
Database of twitter influencers in cryptocurrency (2021–2023) with sentiments
Authors: Jahanbin Kia , Chahooki Mohammed Ali Zare
Published: October 2024

Objectives

With the expansion of social networks such as Twitter, many experts share their opinions on various topics. The opinions of experts, who are also known as influencers, can be very influential. Combining these tweets and the historical prices of cryptocurrencies makes it possible to predict their price trends accurately. A Hybrid of RoBERTa deep neural network and BiGRU has been used for Sentiment Analysis (SA). Sentiments of tweets can be of great help to investors to understand the future behavior of the market and manage the stock portfolio. Unlike the tweets that are only extracted using the cryptocurrency name hashtag, the tweets of this dataset have specialized opinions and can determine the market trend.

Data description

The dataset created in this research concerns the opinions of more than 52 influencers (persons or companies) regarding eight cryptocurrencies. This dataset was collected through the Apify Twitter API for eight months, from February 2021 to June 2023. This dataset contains five Excel files and tweets, compound score, importance coefficient of each tweet, sentiment polarity, and historical prices of four cryptocurrencies: Bitcoin, Ethereum, Binance, and other information. These tweets cover the opinions of 52 influencers on more than 300 cryptocurrencies, although most comments are related to Bitcoin, Ethereum, and Binance. For this reason, three Excel files containing the historical prices of polarity and compound sentiment related to Bitcoin, Ethereum, and Binance cryptocurrencies have been placed separately in the dataset. The polarity of sentiment in these Excel shows the maximum number of polarities by applying the importance coefficient, which determines the dominant polarity of sentiment related to a particular day for the cryptocurrency.
Prescription opioid use in Israel – the tide has risen, but it’s not a tidal wave
Authors: Neumark Yehuda , Rosca Paola
Published: October 2024

The devastating human and financial costs of the ongoing global opioid crisis underscore the need for comprehensive public health strategies, effective treatment programs, and robust policy interventions to mitigate its impact. Regarding Israel, numerous reports highlight a steady increase since 2000 in prescription opioid use and the shift to more potent opioids particularly fentanyl, particularly among more marginalized population groups. In response to growing concern in the country about the rise in prescription opioid use and the consequential risk of opioid use disorder, the Israeli government, together with the country’s health service providers, implemented a series of measures to monitor and regulate opioid prescriptions and balance the need for effective pain management with the prevention of opioid abuse and its associated harms. A national opioid data monitoring system is being established, alongside the provision of addiction training for health professionals, the integration of treatment services for opioid use disorder into the nationalized primary healthcare system, and the expansion of harm reduction strategies to mitigate the health risks associated with opioid use. Additional funding for opioid-related research, and for the broader fields of addictions and mental health, is vital. In conclusion, the sum of the evidence suggests that Israel is not facing an “opioid crisis” Continued commitment, resources, and innovative approaches will be crucial to ensure that the rising tide of opioid use in Israel, particularly during and in the aftermath of the ongoing war, will not become a tidal wave.
MediGate: a MedTech product innovation development process from university research to successful commercialization within emerging markets
Authors: Kruachottikul Pravee , Tea-makorn Pinnaree , Dumrongvute Poomsiri , Hemrungrojn Solaphat , Nupairoj Natawut , Junchaya Ornsiree , Vinayavekhin Sukrit
Published: October 2024

This study proposes a comprehensive MedTech product innovation development framework tailored for university research commercialization within emerging markets. The MediGate framework, built on the Augmented Stage-Gate model, addresses the unique challenges of MedTech innovation, including regulatory compliance, stakeholder engagement, and market dynamics. The framework integrates critical decision-making criteria for different types of inventions to drive academic research toward commercialization in clinical settings. Through detailed case studies, including innovations like albumin strip test, 3D-printed patient-specific implant, COVID-19 nasal spray, and AI platform for depression detection, and iterative refinement, the framework provides actionable guidelines for navigating the complexities of product development. These guidelines ensure alignment with clinical needs, regulatory requirements, and market strategies. The research highlights the importance of early-stage valuation, reimbursement strategies, legal and IP considerations, and manufacturing and quality management. By offering a structured pathway, this research contributes to the theoretical and practical understanding of MedTech commercialization, aiming to enhance innovation success and healthcare impact in emerging markets.
Clinical value of SUVpeak-to-tumor centroid distance on FDG PET/CT for predicting neoadjuvant chemotherapy response in patients with breast cancer
Authors: Hong Sun-pyo , Lee Sang Mi , Yoo Ik Dong , Lee Jong Eun , Han Sun Wook , Kim Sung Yong , Lee Jeong Won
Published: October 2024

Background

Since it has been found that the maximum metabolic activity of a cancer lesion shifts toward the lesion edge during cancer progression, normalized distances from the hot spot of radiotracer uptake to tumor centroid (NHOC) and tumor perimeter (NHOP) have been suggested as novel F-18 fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) parameters that can reflect cancer aggressiveness. This study aimed to investigate whether NHOC and NHOP parameters could predict pathological response to neoadjuvant chemotherapy (NAC) and progression-free survival (PFS) in breast cancer patients.

Methods

This study retrospectively enrolled 135 female patients with breast cancer who underwent pretreatment FDG PET/CT and received NAC and subsequent surgical resection. From PET/CT images, normalized distances of maximum SUV and peak SUV-to-tumor centroid (NHOCmax and NHOCpeak) and -to-tumor perimeter (NHOPmax and NHOPpeak) were measured, in addition to conventional PET/CT parameters.

Results

Of 135 patients, 32 (23.7%) achieved pathological complete response (pCR), and 34 (25.2%) had events during follow-up. In the receiver operating characteristic (ROC) curve analysis, NHOCmax showed the highest area under the ROC curve value (0.710) for predicting pCR, followed by NHOCpeak (0.694). In the multivariate logistic regression analysis, NHOCmax, NHOCpeak, and NHOPmax were independent predictors for pCR (p < 0.05). In the multivariate survival analysis, NHOCpeak (p = 0.026) was an independent predictor for PFS along with metabolic tumor volume, with patients having higher NHOCpeak showing worse PFS.

Conclusion

NHOCpeak on pretreatment FDG PET/CT could be a potential imaging parameter for predicting NAC response and survival in patients with breast cancer.
Application of a validated prognostic plasma protein biomarker test for renal decline in type 2 diabetes to type 1 diabetes: the Fremantle Diabetes Study Phase II
Authors: Davis Timothy M. E. , Davis Wendy A. , Bringans Scott D. , Lui James K. C. , Lumbantobing Tasha S. C. , Peters Kirsten E. , Lipscombe Richard J.
Published: October 2024

Background

There are scant data relating to prognostic biomarkers for chronic kidney disease (CKD) complicating type 1 diabetes. The aim of this study was to assess the performance of the plasma protein biomarker-based PromarkerD test developed and validated for predicting renal decline in type 2 diabetes in the context of type 1 diabetes.

Methods

The baseline PromarkerD test score was determined in 91 community-based individuals (mean age 46.2 years, 56.5% males) with confirmed type 1 diabetes recruited to the longitudinal observational Fremantle Diabetes Study Phase II. The performance of the PromarkerD test in predicting the risk of incident CKD (estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73m2 in people without CKD at baseline) or an eGFR decline of ≥ 30% over the next four years was determined. The score can range from 0 to 100%, and is categorized as representing low (< 10%), moderate (10% to < 20%) or high (≥ 20%) risk.

Results

The area under the receiver operating characteristic curve was 0.93 (95% confidence interval 0.87–0.99) for the composite renal endpoint, indicating strong predictive accuracy. The positive and negative predictive values at moderate (10% to < 20%) and high (≥ 20%) risk PromarkerD cut-offs were 46.7–50.0% and ≥ 92.0%, respectively.

Conclusions

These preliminary data suggest that PromarkerD is at least as good a prognostic test for renal decline in type 1 as type 2 diabetes.
Mechanisms for co-designing and co-producing health and social care: a realist synthesis
Authors: Masterson Daniel , Lindenfalk Bertil , Kjellström Sofia , Robert Glenn , Ockander Marlene
Published: October 2024

Objectives

Analyse reported processes of co-design and co-production in the context of health and social care to explore the underlying mechanisms that enable inclusive and reciprocal engagement.

Search strategy

Peer review research was obtained from a prior scoping review searching eight databases consisting of all methodologies relevant to co-design or co-production in the context of health and social care services and involving service-users.

Methods of selection

Articles were included for synthesis if they reported a process of dialogue, with mutuality, insight and clarification in their engagement process. Ninety-three peer-review articles informed our programme theory development.

Analysis

Data relating to co-design and co-production processes were extracted and analysed through inductive, abductive, and deductive analysis leading to the development of an initial programme theory.

Main results

This realist synthesis finds that co-design and co-production can occur at different times, in part or all of the research and participatory process. There is an over reliance on the term ‘co-design’ or ‘co-production’ to convey complex engagement or participatory processes. We identified six mechanisms (intention, assets, dialogue, documentation, interpretation and understanding). Interaction between these six identified mechanisms in context, even if only brief, is important for supporting meaningful engagement, alignment and agreement within a co-design or co-production process.

Implications for practice

The initial programme theory presented in this article provides clarity by identifying essential mechanisms which can guide the design and implementation of a range of participatory approaches. Rather than relying on a single label to convey complex participatory methods or processes, the values and principles of co-design or co-production, in combination with this programme theory, could be applied to guide implementation and reporting of specific activities within a range of research or participatory methods.

Patient and public contribution

The initial programme theory was presented and piloted in a series of collaborative workshops between May 2023 and March 2024 with patient and public contributors, health professionals and researchers. This engagement process is currently underway to refine the programme theory and it is anticipated that this next phase will be completed in September 2024.
A novel drip-irrigative technique for enhanced epiretinal perfluorocarbon liquid clearance during vitreoretinal surgery
Authors: Guo Jingli , Gu Victoria Y. , Zhou Yuhan , Zhao Peiquan , Zhao Dongsheng
Published: October 2024

Purpose

To present a novel intraoperative application technique of basic salt solution (BSS) perfusate to address residual epiretinal perfluorocarbon liquid (PFCL) droplets.

Methods

Following standard liquid-gas exchange and aspiration of visible PFCL using a flute needle, the adjuvant drip-irrigative method is employed. A 2mL needle containing BSS is introduced and maneuvered circumferentially around the posterior pole while injecting BSS intermittently to obviate droplet presence. Subsequently, droplets lying flat to the surface drain via the flute needle, and the process if repeated until no droplets are visible.

Results

Among 112 consecutive patients diagnosed with rhegmatogenous retinal detachment (RDD) with at least 3 months follow-up, 109 patients (109 eyes, [97%]) experienced no PFCL-related complications follow pars plana vitrectomy. Among three patients with PFCL-related complications, two (2 eyes) presented with residual droplets on the retinal surface during silicone oil retrieval, and one (1 eyes) had PFCL migration to the anterior chamber. No patients experienced sub-retinal/ sub-foveal PFCL or iatrogenic injury.

Conclusion

This adjuvant drip-irrigative technique offers enhanced droplet visibility, reduced risk of iatrogenic retinal damage, and ease of application. Findings reported suggest the potential of this approach as a standard practice when using PFCL to mitigate complications.
Insilco vaccine design of spike and hemagglutinin esterase proteins of bovine coronavirus
Authors: Awadelkareem Eman A. , Hamdoun S.
Published: October 2024

Background

Bovine coronavirus (BCoV) is a widespread, fatal illness in cattle that has a large economic impact in particularly disease-prone hosts. BCoV does not have an effective vaccine. As a result, the objective of this study was to use immunoinformatics and computational tools to design a multi-epitope vaccine against Spike and haemagglutinin proteins of Bovine coronavirus. BCoV proteins were also subjected to protein analysis.

Methods

A variety of tools of bioinformatics were used for data analysis. Conserved B and T cell epitopes against BCoV target proteins were predicted using the Immune Epitope Database (IEDB). Proteins were characterized utilizing a variety of servers, including Protparam, PSIPRED and the GOR IV servers. The antigenicity, allergenicity, and toxicity of the anticipated epitopes were assessed as well.

Results

Several MHCI epitopes were predicted from S and HE proteins. As top epitopes, the peptides 77NMALKGTLL85 and 56SYMDLNPAL65 were proposed from Spike and hemagglutinin proteins, respectively. These epitopes exhibited high scores of antigenicity, no allergenicity, no toxicity, and a strong connection to Bola alleles. Moreover, three epitopes (1204YYYPE1208, 379TCQPQ384, and 720QLQPINY726) from Spike glycoprotein were selected as surface, linear, and antigenic epitopes using B cell scales. The methods dropped to anticipate effective and safe epitope(s) to cover all B cell scales from HE protein.

Conclusion

Three B cell epitopes (1204YYYPE1208, 379TCQPQ384, and 720QLQPINY726) were predicted from Spike protein (S) of BCoV only. MHC I epitopes of S and HE proteins of BCoV predicted two epitopes (77NMALKGTLL85 and 56SYMDLNPAL65 respectively) to have a strong link to Bola alleles, as well as high antigenicity and safety. The predicted epitopes’ activity should be tested experimentally as a multi-epitope vaccine against BCoV using in vitro and in vivo trials.
Laser applications in endodontics: a review article
Authors: Sadony Doaa M. , Moharam Lamiaa M.
Published: October 2024

Background

Different types of dental laser can be used instead of the traditional hand and rotary files in root canal treatment with highly acceptable performance. Laser devices emit an intense and focused light energy, which interacts with biologic tissues, for pulp removal, shaping and cleaning the dentinal walls to be finally sealed with gutta-percha. Various laser devices with different wavelengths such as CO2, Er:YAG, Nd: YAG and Diode present the best laser–tissue interaction. Lasers in root canal treatment show more advantages than traditional treatment. Laser is more accurate than conventional root canal treatment that allow minimal removal of healthy dentinal tissue. Lasers have anti-bacterial effect by reduction of more than 99.7% bacterial counts for root canal sterilization. Laser provides less bleeding, inflammation, pain, discomfort and infection than conventional procedures. Laser treatment of root canals results in a good sealing of gutta-percha to root canal walls to prevent infections.

Conclusions

Laser application is comfortable to the patients by removing the disturbing sounds of drills and decreasing the need for local anesthesia. It decreases the need for suturing in endodontic surgery due to better hemostasis, thus getting clean and well-sealed surgical wounds.
Urban environmental acupuncture as a tool to support nature-based solution implementation: does it deliver what it promises?
Authors: Marie Hemingway Jessica
Published: October 2024

Urban environmental acupuncture (UEA) is a novel approach designed to engage with a variety of stakeholders to successfully implement nature-based solutions in dense urban areas. The Interreg Central Europe project SALUTE4CE piloted this concept through small-scale, low-budget interventions in four cities: Chorzow (Poland), Erfurt (Germany), Alessandria (Italy), and Liptovski Mikulas (Slovakia). The pilot projects were designed to be quickly implementable, utilizing abandoned or undesirable sites, with the potential to catalyze both physical and social transformation. Interviews with local actors in these cities after project implementation provided valuable feedback, which was used to develop principles of urban environmental acupuncture. While the limited number of interviews means these findings offer only initial insights, they are largely supported by existing research. Nevertheless, this perspective provides important lessons that can inform future transformation projects and help evaluate the success of the UEA approach. The key contributions of this work are the introduction of urban environmental acupuncture concept, deriving principles of UEA based on feedback from local stakeholders and offering insights in future design and evaluation of similar nature-based solution initiatives in dense urban environments. This perspective helps to establish the potential of UEA as a tool for engaging diverse stakeholders and catalyzing sustainable urban transformation (specifically expansion of nature-based solutions) through low-cost interventions.
Interobserver and inter-modality concordance of quiescent interval slice selective magnetic resonance angiography and CT angiography in assessment of critical lower limb ischemia
Authors: Abdelzaher Dina Gamal , Elmokadem Ali Hassan , Saleh Gehad Ahmad , Abdelrazek Ahmed Abdelkhalek , Elshafei Amr Mohamed
Published: October 2024

Background

We evaluated the noncontrast MRA as an alternate method to CT angiography in assessment of patients with lower limb ischemia, 30 patients were included in a prospective cohort study; they underwent quiescent interval slice selective magnetic resonance angiography (QISS-MRA) and computed tomographic angiography (CTA). The assessment of images was evaluated by two independent consultants. The overall subjective image quality, interobserver and intermodality concordance were calculated.

Results

The median acquisition time in QISS-MRA was 20 min (range 18–30 min), The overall subjective image quality was rated similarly with QISS-MRA (3.13 [95% CI 2.84–3.42]) and CTA (3.23 [95% CI 2.94–3.52]; p = 0.08) with interobserver concordance for lesion ratings in QISS-MRA reached (κ = 0.987 (SD 0.006)), while for CTA it was (κ = 0.99 (SD 0.006)), while the intermodality concordance between QISS-MRA and CTA in lesion ratings were calculated on a per segment basis and was (κ = 0.944 (SD 0.013)) for reader 1 and (κ = 0.947 (SD 0.013)) for reader 2, with sensitivity 100% and specificity 97.6%

Conclusions

QISS-MRA is a reliable modality for assessment of patients with critical limb ischemia.
Challenges and recommendations for collecting and quantifying implementation costs in practice: a qualitative interview study
Authors: Donovan Thomasina , Carter Hannah E. , McPhail Steven M. , Abell Bridget
Published: October 2024

Background

The cost of implementation is typically not accounted for in published economic evaluations, which determine the relative value for money of health innovations and are important for allocating scarce resources. Despite key papers outlining relevant implementation costs, they continue to be under reported in the literature and often not considered in practice. This study sought to understand and outline current practices for capturing the costs associated with implementation efforts, with examples from the digital health setting.

Methods

A qualitative study of semi-structured interviews with purposefully sampled experts in implementation science, health economics and/or digital health was conducted. The interview guide was informed by a literature review and was pilot tested. Interviews were digitally recorded and transcribed. A hybrid inductive/deductive framework analysis was conducted using thematic analysis to elicit key concepts related to the research question.

Results

Interviews were conducted with sixteen participants with specialist expertise in implementation science (n = 8), health economics (n = 6), and/or digital health (n = 8). Five participants were experienced in more than one field. Four key themes were elicited from the data: difficulty identifying and collecting implementation cost data; variation in approaches for collecting implementation cost data; the value of implementation costs; and collaboration enables implementation costing. Broadly, while interviewees recognised implementation costs as important, only some costs were considered in practice likely due to the perceived ill-defined boundaries and inconsistencies in terminology. A variety of methods were used to collect and estimate implementation costs; the most frequent approach was staff time tracking. Multidisciplinary collaboration facilitated this process, but the burden of collecting the necessary data was also highlighted.

Conclusions

In current practice, standardised methods are not commonly used for data collection or estimation of implementation costs. Improved data collection through standardised practices may support greater transparency and confidence in implementation cost estimates. Although participants had industry exposure, most were also academic researchers and findings may not be representative of non-academic industry settings.
CMOS optoelectronic spectrometer based on photonic integrated circuit for in vivo 3D optical coherence tomography
Authors: Agneter Anja , Muellner Paul , Nguyen Quang , Seyringer Dana , Rank Elisabet A. , Vlaskovic Marko , Kraft Jochen , Sagmeister Martin , Nevlacsil Stefan , Eggeling Moritz , Maese-Novo Alejandro , Morozov Yevhenii , Schmitner Nicole , Kimmel Robin A. , Bodenstorfer Ernst , Cipriano Pietro , Zimmermann Horst , Leitgeb Rainer A. , Hainberger Rainer , Drexler Wolfgang
Published: October 2024

Photonic integrated circuits (PICs) represent a promising technology for the much-needed medical devices of today. Their primary advantage lies in their ability to integrate multiple functions onto a single chip, thereby reducing the complexity, size, maintenance requirements, and costs. When applied to optical coherence tomography (OCT), the leading tool for state-of-the-art ophthalmic diagnosis, PICs have the potential to increase accessibility, especially in scenarios, where size, weight, or costs are limiting factors. In this paper, we present a PIC-based CMOS-compatible spectrometer for spectral domain OCT with an unprecedented level of integration. To achieve this, we co-integrated a 512-channel arrayed waveguide grating with electronics. We successfully addressed the challenge of establishing a connection from the optical waveguides to the photodiodes monolithically co-integrated on the chip with minimal losses achieving a coupling efficiency of 70%. With this fully integrated PIC-based spectrometer interfaced to a spectral domain OCT system, we reached a sensitivity of 92dB at an imaging speed of 55kHz, with a 6dB signal roll-off occurring at 2mm. We successfully applied this innovative technology to obtain 3D in vivo tomograms of zebrafish larvae and human skin. This ground-breaking fully integrated spectrometer represents a significant step towards a miniaturised, cost-effective, and maintenance-free OCT system.
Artesunate-driven autophagy: a shield against liver hypoxia/reoxygenation insult in rats via modulation of GLP1R, the chief metabolic kinase AMPK, mTOR, ULK1, P70S6K, cyclin D1, Akt, and GSK3β
Authors: Ghoneim Mai El-Sayed , El-Abhar Hanan S. , Abdallah Dalaal M.
Published: October 2024

Background

Hepatic hypoxia/reoxygenation (H/R) insult is a critical issue in hepatic transplant and surgeries, profoundly influencing postoperative prognosis. One crucial pathomechanism in this condition is impaired autophagy flux, which disrupts liver homeostasis. Artesunate, an antimalarial drug, has shown potential in providing hepatoprotection against H/R injury; however, whether it can modulate disrupted autophagy to enhance hepatoprotection remains unclear.

Purpose of the study

Accordingly, we delved into the potential mechanism(s) through which artesunate modulates the autophagy process in a hepatic H/R injury model.

Methods and results

Rats were categorized into three groups, viz. sham operated, H/R, and artesunate-treated (50 mg/kg, i.p). Disease regression was evaluated microscopically, and molecular alternations were assessed biochemically using ELISA and western blotting techniques. Mechanistic analysis revealed that artesunate administration at reperfusion time significantly upregulated the gene expression of GLP1R protein expression of p-AMPK, accompanied by a downregulation in those of p-mTOR, and its target molecule p-ULK1, presenting the first trail to initiate autophagy. Additionally, artesunate reduced H/R-induced hepatic upregulated protein expression of p-mTOR/P70S6K cue, and cyclin D1 content, which positively correlated with the mTOR/P70S6K axis. Moreover, artesunate sharply upregulated active p-Akt, which in turn phosphorylated/inactivated GSK3β, a cascade that indirectly promotes autophagy. Consequently, artesunate increased the hepatic beclin-1 and LC3-II to further uphold its autophagic capacity. The hepato-therapeutic effectiveness of artesunate was further evidenced by reduced serum ALT and AST levels, along with diminished hepatic histopathological alterations.

Conclusion

Artesunate protected liver by triggering autophagy partly by modulating the GLP1R/AMPK/mTOR/ULK1, GLP1R/AMPK/mTOR/P70S6K, cyclin D1, and Akt/GSK3β trajectories providing a significant therapeutic potential in managing hepatic H/R insult.
Exploring the optimal plateau durations of tone burst to elicit masseteric vestibular evoked myogenic potentials: a within-subjects study
Authors: Bhagat Sanket , Neupane Anuj Kumar
Published: October 2024

Objective

The purpose of the present study was to explore the effect of plateau duration in eliciting masseter vestibular evoked myogenic potentials (mVEMPs) in healthy individuals with hearing sensitivity ≤ 15dBHL.

Method

A within-subjects design was utilized in the study. Therefore, ipsilateral tone burst evoked mVEMPs were obtained from 30 healthy individuals using the zygomatic montage at 500 Hz tone bursts. Self-monitoring biofeedback was given during the procedure to confirm the tension of the masseter muscle. mVEMPs were recorded across three different plateau duration from 0 to 2 ms with rise/fall time of 2 ms at 95dBnHL. Hence the median and interquartile range were calculated for descriptive analysis of the data followed by non-parametric inferential statistics.

Results

Tone burst evoked mVEMPs were found to be 100% present across all three plateau durations for both ears at 95 dBnHL. P11 and N21 latencies increased with longer plateau durations in both ears. There were no significant differences in P11-N21 peak-to-peak amplitude or interaural amplitude ratio (IAAR) observed across different plateau durations. IAAR was lowest for a 2 ms plateau duration in the 2–2-2 cycle. No significant variations were found across the three plateau durations.

Conclusion

Significant differences in P11 and N21 latencies were observed across the three stimulus cycles, while no significant differences were found for P11N21 amplitude and IAAR. Yet, there was found to have the highest amplitude and lowest IAAR for 2–2-2 cycle than 2–0-2 and 2–1-2, suggesting it to be the optimal stimulus among the three of them.
Parametric study for shear failure of bearing pads due to hurricane-induced wave loadings
Authors: Iqbal Waqas , Head Monique
Published: October 2024

The increasing frequency of extreme weather events, such as hurricanes and rising sea levels due to climate change, presents significant challenges to coastal infrastructure. With 42% of bridges in the United States exceeding 50 years of age, which surpasses their intended service life, there is a pressing need to assess their structural integrity, especially in coastal regions. This study focuses on evaluating the structural performance of bearing pads in coastal bridges under hurricane-induced wave loadings. Utilizing a combination of physics-based models (PBM), nonlinear modal time history analysis, and numerical validation, the research examines the hysteresis response of eight distinct bearing pad configurations. The findings indicate that reinforced circular bearing pads exhibit significantly greater shear displacements compared to plain elastomeric pads, underscoring the critical influence of shape factors on shear response. Fragility functions developed in the study illustrate the probability of shear failure, with reinforced circular pads showing a 28% higher likelihood of exceedance compared to rectangular plain pads. These results highlight the necessity for advanced design methodologies specifically for bearing pads to enhance the resilience of coastal infrastructure against severe hydrodynamic forces induced by hurricanes.
Compression rates of microbial genomes are associated with genome size and base composition
Authors: Bohlin Jon , Pettersson John H.-O.
Published: October 2024

Background

To what degree a string of symbols can be compressed reveals important details about its complexity. For instance, strings that are not compressible are random and carry a low information potential while the opposite is true for highly compressible strings. We explore to what extent microbial genomes are amenable to compression as they vary considerably both with respect to size and base composition. For instance, microbial genome sizes vary from less than 100,000 base pairs in symbionts to more than 10 million in soil-dwellers. Genomic base composition, often summarized as genomic AT or GC content due to the similar frequencies of adenine and thymine on one hand and cytosine and guanine on the other, also vary substantially; the most extreme microbes can have genomes with AT content below 25% or above 85% AT. Base composition determines the frequency of DNA words, consisting of multiple nucleotides or oligonucleotides, and may therefore also influence compressibility. Using 4,713 RefSeq genomes, we examined the association between compressibility, using both a DNA based- (MBGC) and a general purpose (ZPAQ) compression algorithm, and genome size, AT content as well as genomic oligonucleotide usage variance (OUV) using generalized additive models.

Results

We find that genome size (p < 0.001) and OUV (p < 0.001) are both strongly associated with genome redundancy for both type of file compressors. The DNA-based MBGC compressor managed to improve compression with approximately 3% on average with respect to ZPAQ. Moreover, MBGC detected a significant (p < 0.001) compression ratio difference between AT poor and AT rich genomes which was not detected with ZPAQ.

Conclusion

As lack of compressibility is equivalent to randomness, our findings suggest that smaller and AT rich genomes may have accumulated more random mutations on average than larger and AT poor genomes which, in turn, were significantly more redundant. Moreover, we find that OUV is a strong proxy for genome compressibility in microbial genomes. The ZPAQ compressor was found to agree with the MBGC compressor, albeit with a poorer performance, except for the compressibility of AT-rich and AT-poor/GC-rich genomes.
‘Once you've opened that can of worms’: qualitative study to understand why liaison psychiatry staff are not asking about domestic abuse following self-harm
Authors: Knipe Duleeka , Gregory Alison , Dangar Sarah , Woodhouse Tim , Padmanathan Prianka , Kapur Nav , Moran Paul , Derges Jane
Published: October 2024

Background

Domestic abuse is a significant risk factor for self-harm and suicide. A large proportion of people presenting to healthcare services following self-harm have experienced domestic abuse. In the UK, routine enquiry for domestic abuse is recommended for people who present having self-harmed, but evidence indicates that this is not happening.

Aims

An exploratory qualitative study to explore liaison psychiatry staff experiences of asking about domestic abuse, including the barriers and challenges to asking.

Method

Semi-structured qualitative interviews with active adult liaison psychiatry staff in the UK. Recruitment was via online platforms and professional networks. A reflexive thematic analysis of the narratives was carried out.

Results

Fifteen participants were interviewed across a variety of disciplines (ten nurses, four doctors, one social worker). The generated themes include the following: asking about domestic abuse – the tension between knowing and doing; ‘delving deeper’ and the fear of making things worse; the entanglement of shame, blame and despondency; domestic abuse was different from other clinical problems (mental illness/substance misuse); and biases, myths and misassumptions guiding practice. Participants indicated the need for better training and education, and clear protocols for eliciting and acting on disclosures.

Conclusion

There is a clear need to improve the support offered to victim-survivors of domestic abuse who self-harm and present to healthcare services. National implementation of education and training to better equip liaison psychiatry teams with the skills and knowledge to sensitively support victim-survivors of domestic abuse is required.
Plasma Renin: A Useful Marker for Mineralocorticoid Adjustment in Patients With Primary Adrenal Insufficiency
Authors: Piazzola Cécilia , Dreves Bleunn , Albarel Frédérique , Nakache Jérémie , Morera Julia , Joubert Michaël , Brue Thierry , Reznik Yves , Castinetti Frédéric
Published: October 2024

Context

Renin is a marker of blood volume. There is no consensus on the validity of plasma renin measurement for adjusting mineralocorticoid (MC) substitution in patients with primary adrenal insufficiency (PAI).

Objective

This work aimed to investigate if plasma renin could be used to adjust MC substitution in patients with PAI.

Methods

A total of 150 patients with at least one measurement of plasma renin followed for PAI at 2 tertiary expert centers between 2008 and 2022 were retrospectively included. As supraphysiological hydrocortisone might have additional MC activity, we integrated the individual hydrocortisone dose to obtain the MC equivalent dose (Eq-MC). Renin less than 20 mIU/L was considered oversubstituted, renin between 20 and 60 mIU/L as correctly substituted, and renin over 60 mIU/L as undersubstituted.

Results

The mean dose of fludrocortisone was 82.3 ± 46 μg/day. Plasma renin was abnormal in 56.7% of cases (7 patients oversubstituted and 78 patients undersubstituted). Abnormalities in electrolyte levels were observed in only 12.7% of patients. Plasma renin correlated negatively with sodium (P < .01) and systolic blood pressure (P = .026), and positively with potassium (P < .01). Doses changes in Eq-MC had a statistically significant effect on renin levels (P = .0037), with an increase of MC dose correlating with a decrease in renin level and vice versa; no correlation was observed using electrolytes or blood pressure.

Conclusion

Plasma renin correlates with electrolytes and blood pressure. While dose changes significantly alter renin levels, electrolytes and blood pressure do not, suggesting that renin may provide more information about MC replacement therapy than electrolytes and blood pressure.
Something old, something new: the origins of an unusual renal cell underpinning a beetle water-conserving mechanism
Authors: Beaven Robin , Koyama Takashi , Naseem Muhammad T. , Halberg Kenneth V. , Denholm Barry
Published: October 2024

Tenebrionid beetles have been highly successful in colonising environments where water is scarce, underpinned by their unique osmoregulatory adaptations. These include a cryptonephridial arrangement of their organs, in which part of their renal/Malpighian tubules are bound to the surface of the rectum. Within the cryptonephridial tubules, an unusual cell type, the leptophragmata, plays a key physiological role underpinning water conservation. Nothing was known about the developmental mechanisms or evolution of these unusual renal cells. Here, we investigate mechanisms underpinning leptophragmata development in Tribolium castaneum. We find that leptophragmata express and require the Tiptop transcription factor, similar to secondary renal cells in Drosophila melanogaster, which express Teashirt and Tiptop, despite Drosophila lacking a crypronephridial arrangement. An additional transcription factor, Dachshund, is required to establish leptophragmata identity and to distinguish them from the secondary cells in the non-cryptonephridial region of renal tubule of Tribolium. Dachshund is also expressed in a sub-population of secondary cells in Drosophila. Leptophragmata, which are unique to the beetle lineage, appear to have originated from a specific renal cell type present ancestrally and to be specified by a conserved repertoire of transcription factors.