bluuebunny/crossref_metadata_2025 huggingface dataset:
Food Safety in Developing Countries: Common Foodborne and Waterborne Illnesses, Regulations, Organizational Structure, and Challenges of Food Safety in the Context of Nepal
Authors: Subedi Deepak , Paudel Madhav , Poudel Sandesh , Koirala Niranjan
Published: November 2024

Food safety presents a global challenge, contributing to 600 million cases of foodborne diseases and 420,000 fatalities annually worldwide. In developing countries, such as Nepal, addressing food safety is particularly intricate and arduous because of the prevalent issues of food insecurity, poverty, illiteracy, and regulatory hurdles. The objectives of this comprehensive review are to evaluate the prevalent foodborne and waterborne illnesses, examine the existing regulations and institutional frameworks, and identify the challenges associated with food safety in Nepal. Additionally, this review aims to propose strategies to enhance food safety measures in the country. An electronic search was conducted using relevant keywords to include articles and literature pertinent to the topic. Common foodborne illnesses in Nepal include cholera, typhoid fever, hepatitis, worm infections, and poisoning from mushrooms, heavy metals, and pesticides. While existing rules, regulations, and government infrastructure exist, they often face limitations in effectively addressing these multifaceted challenges. Food safety in developing countries, such as Nepal, faces several challenges, including inadequate regulatory frameworks, limited surveillance and monitoring, rural–urban disparities, and high incidences of foodborne illness. Additional issues stem from weak law enforcement, poor food safety practices, limited infrastructure, informal sector challenges, cross‐border trade, limited access to clean water, and the impacts of climate change. A multisectoral One Health approach involving collaboration among government agencies, food industry stakeholders, consumers, and civil society organizations is imperative to enhance food safety in developing countries such as Nepal.
Influence of milling processing on mineral and proximate composition of maize products
Authors: Asiedu Enoch Sam Sakyi , Kpodo Fidelis Mawunyo , Owusu Nana Kofi , Dzah Courage Sedem , Nyasordzi Juliana , Awude Emelia , Kortei Nii Korley
Published: November 2024

Maize and maize products are major staples consumed worldwide and contain dietary nutrients essential for human nutrition. Processing methods influence the safety and nutritional quality of maize products. This study investigated the effect of different milling processing factors on the mineral and proximate composition of maize products. The study also estimated the contribution of maize products to daily mineral intake. An atomic absorption spectrophotometer was used to determine the mineral content of samples. Proximate composition was determined using methods of the Association of Official Analytical Chemists. A multiple 24‐h dietary recall was used to estimate daily mineral intake of respondents who consume maize products in a cross‐sectional study. The results obtained showed that milling methods influenced the mineral and proximate compositions of the maize products. Mineral content in the milled maize samples followed the order P > Mg > Zn > Fe. The wet milling method retained the highest Fe and P contents, whereas the dried milled sample showed an increased Mg content. The estimated daily mineral intakes of participants were below the World Health Organization recommended standard limits. The respondents were at risk of deficiency of the minerals Fe and Mg. Public health education on sufficient dietary intake of these essential minerals should be intensified.
Characteristics of longitudinal maternal health studies in sub‐Saharan Africa: A systematic mapping of literature between 2012 and 2022
Authors: Solarin Ijeoma , Dumbura Cherlynn , Lakhoo Darshnika Pemi , Chande Kshama , Maimela Gloria , Luchters Stanley , Chersich Matthew ,   for the HEAT Center
Published: November 2024

Background

High maternal mortality rates in sub‐Saharan Africa necessitate the need for aligned research focusing on prevalent causes and neglected conditions in the region.

Objective

This mapping review aimed to describe the characteristics of longitudinal maternal health studies between 2012 and 2022 in sub‐Saharan Africa and identify gaps in priority conditions or geographical locations.

Search Strategy

We identified references through a Medline (PubMed) search covering September 2012 to June 2022.

Selection Criteria

We included prospective cohort or clinical trials that enrolled at least 1000 pregnant women, with a study site in sub‐Saharan Africa, and published in English or French.

Data Collection and Analysis

Screening and data extraction were done in duplicate using EPPI‐reviewer software. Descriptive analysis was used to summarize the results, identifying patterns in studies across time, country, study design, topics, and funders.

Main Results

We identified 213 eligible studies, which were covered in 534 publications. We identified studies in 33 of the 48 sub‐Saharan African countries, with the majority in east and southern Africa. The predominant study topics were HIV (36.4%), nutrition (20%), and malaria (16.3%), with very few publications on hypertensive disorders of pregnancy (6.4%), ante/postpartum hemorrhage (3.7%), and sexually transmitted infections (3.2%). More studies were cohorts (115/213; 54%) than clinical trials. The National Institutes of Health (31.5%), Bill and Melinda Gates Foundation (22.1%), and USAID (10.8%) were the largest research funders.

Conclusion

Identifying research trends and mismatches between research topics and disease burden provides useful information for guiding future research prioritization. In particular, gaps exist for studies on hypertensive disorders of pregnancy and ante/postpartum hemorrhage, among the top causes of maternal mortality in sub‐Saharan Africa.
Machine learning model based on SERPING1, C1QB, and C1QC: A novel diagnostic approach for latent tuberculosis infection
Authors: Li Linsheng , Zhuang Li , Yang Ling , Ye Zhaoyang , Ni Ruizi , An Yajing , Zhao Weiguo , Gong Wenping
Published: November 2024

Background

Latent tuberculosis infection (LTBI) is a significant source of active tuberculosis (ATB), yet distinguishing between them is challenging because specific biomarkers are lacking.

Methods

We analyzed four microarray datasets (GSE19491, GSE37250, GSE54992, GSE28623) from the gene expression omnibus to identify differentially expressed genes (DEGs). Using protein–protein interaction (PPI) networks and LASSO‐SVM algorithms, we selected three candidate biomarkers and evaluated their diagnostic efficacy. The expression levels of core genes were validated by RNA sequencing of healthy, ATB, and LTBI groups in a real‐world cohort. We conducted Gene Ontology and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analyses, predicted shared upstream miRNAs, constructed miRNA–hub and transcription factor (TF)–hub gene networks, and performed immune infiltration analysis.

Results

Three hub genes (SERPING1, C1QC, C1QB) were identified from 45 DEGs by PPI networks and machine learning screening. The diagnostic model based on the three hub genes had an area under the curve (AUC) value of 0.843 in the training set GSE19491 and 0.865 in the validation set GSE28623. Real‐world transcriptome sequencing confirmed the expression trends of the hub genes across healthy, LTBI, and ATB groups. GO analysis showed that the 45 hub genes were primarily associated with immune inflammatory responses and pattern recognition receptors, whereas KEGG analysis indicated enrichment in complement and coagulation cascades. The miRNA–hub and TF–hub gene network analysis identified nine miRNAs and the zinc finger TF GATA2 as potential co‐regulators of SERPING1, C1QC, and C1QB. Immune cell infiltration analysis identified significant differences in the immune microenvironment between LTBI and ATB, with macrophages and natural killer cells showing significant correlations with tuberculosis infection.

Conclusion

The diagnostic model with SERPING1, C1QC, and C1QB shows promise in distinguishing LTBI from ATB, indicating its potential as a diagnostic tool.
Predicting the Early Detection of Breast Cancer Using Hybrid Machine Learning Systems and Thermographic Imaging
Authors: Hosseini Mohammad Mehdi , Mosahebeh Zahra , Chakraborty Somenath , Gharahbagh Abdorreza Alavi
Published: November 2024

Breast cancer is a leading cause of mortality among women, emphasizing the critical need for precise early detection and prognosis. However, conventional methods often struggle to differentiate precancerous lesions or tailor treatments effectively. Thermal imaging, capturing subtle temperature variations, presents a promising avenue for non‐invasive cancer detection. While some studies explore thermography for breast cancer detection, integrating it with advanced machine learning for early diagnosis and personalized prediction remains relatively unexplored. This study proposes a novel hybrid machine learning system (HMLS) incorporating deep autoencoder techniques for automated early detection and prognostic stratification of breast cancer patients. By exploiting the temporal dynamics of thermographic data, this approach offers a more comprehensive analysis than static single‐frame approaches. Data processing involves splitting the dataset for training and testing. A predominant infrared image was selected, and matrix factorization was applied to capture temperature changes over time. Integration of convex factor analysis and bell‐curve membership function embedding for dimensionality reduction and feature extraction. The autoencoder deep neural network further reduces dimensionality. HMLS model development included feature selection and optimization of survival prediction algorithms through cross‐validation. Model performance was assessed using accuracy and F‐measure metrics. HMLS, integrating clinical data, achieved 81.6% accuracy, surpassing 77.6% using only convex‐NMF. The best classifier attained 83.2% accuracy on test data. This study demonstrates the effectiveness of thermographic imaging and HMLS for accurate early detection and personalized prediction of breast cancer. The proposed framework holds promise for enhancing patient care and potentially reducing mortality rates.
Impact of nonsurgical periodontal treatment on arterial stiffness outcomes related to endothelial dysfunction: A systematic review and meta‐analysis
Authors: Polizzi Alessandro , Nibali Luigi , Tartaglia Gianluca Martino , Isola Gaetano
Published: November 2024

Background

To assess the available evidence on whether nonsurgical periodontal treatment (NSPT) improves arterial stiffness outcomes in patients with periodontitis (PD).

Methods

Following the Preferred Reporting Items for Systematic Reviews and Meta‐analyses (PRISMA) guidelines and population, intervention, comparison, outcomes, and study design (PICOS) question, electronic databases were screened for clinical interventional studies addressing the impact of NSPT on pulse wave velocity (PWV), carotid intima‐media thickness (CIMT), and flow‐mediated dilatation (FMD) outcomes in PD patients. Furthermore, the research strategy was implemented using a hand search. Studies were selected, and data were extracted by two independent reviewers. Random effects models were applied to perform a meta‐analysis, and methodological index for nonrandomized studies (MINORS) and Cochrane Rob2 tools were used to assess the risk of bias.

Results

Fifteen articles were finally included for qualitative synthesis. Among them, eight single‐arm cohort studies met the final inclusion criteria for meta‐analysis. The Rob2 analysis evidenced that one randomized clinical trial (RCT) had a low risk, three RCTs raised some concerns, and three RCTs had a high risk of bias, while the MINORS scores ranged from 9 to 14. The meta‐analysis showed that NSPT significantly impacted FMD (p < 0.001) and CIMT (p = 0.004), while changes in PWV were not statistically significant. However, there was high heterogeneity among studies (I2 = 78% for FMD andI2 = 62% for CIMT).

Conclusion

Despite some beneficial effects on FMD and CIMT, due to study limitations, high heterogeneity, and risk of bias, it cannot be concluded that NSPT is effective in improving arterial stiffness. Therefore, further studies are necessary to achieve high‐quality evidence on the effect of NSPT on arterial stiffness outcomes in PD patients.

Trial registration

PROSPERO ID CRD42024501399.

Plain Language Summary

Periodontitis (PD) has been associated with alterations in arterial stiffness outcomes related to early endothelial dysfunction. Based on noninterventional studies, this meta‐analysis indicates that nonsurgical periodontal treatment (NSPT) may reduce cardiovascular disease risk in patients with PD. The moderate evidence derived from the studies that were finally included showed that NSPT had beneficial effects on flow‐mediated dilatation and carotid intima‐media thickness, while this trend was not observed for pulse wave velocity. Moreover, the findings of the present meta‐analysis were characterized by high heterogeneity and risk of bias and were derived from uncontrolled clinical trials or randomized clinical trials with limitations. Therefore, more studies with standardized protocols and homogeneous arterial stiffness outcomes are needed to elevate the quality of the present evidence.
Nuciferine inhibits osteoclast formation through suppressing glycolysis metabolic programming and ROS production
Authors: Guo Wen‐Hui , Zhen Guan‐Qi , Wu Feng , Lv Yun‐Peng , Yan Jing‐Long , Zu Jia‐Ning , Song Cheng‐Chao
Published: November 2024

Nuciferine (NCF) is a bioactive compound from lotus leaves and has been proven to prevent osteoclastogenesis and ovariectomy‐induced osteoporosis by our previous research. However, the underlying mechanism is still unclear. In this research, Raw264.7 cells were induced into osteoclast with or without NCF. CCK‐8 and Edu assays were performed to detect the effects of 30 μM NCF on cell viability and proliferation. TRAP staining and bone resorption assays were performed to observe the role of NCF in osteoclastogenesis and bone resorption. RT‐PCR and Western blot were performed to detect the effects of NCF on osteoclast‐related genes, glycolysis‐related genes, and reactive oxygen species (ROS)‐related genes. Seahorse assays, lactate concentration and glucose consumption were performed to observe cell metabolism change. DCFH‐DA fluorescent probe was used to detect ROS level. In this work, 30 μM NCF could not influence cell viability and cell proliferation. Osteoclast differentiation could be inhibited by 30 μM NCF. Bone resorption assay could also observe that bone resorption ability was successfully inhibited by 30 μM NCF. In seahorse assay, we discovered that NCF could decrease extracellular acid rate and increase oxygen consumption. RT‐PCR and Western blot results showed that NCF could decrease the expression of hexokinase2, pyruvate kinase muscle 2, and lactate dehydrogenase A and that NCF could also weaken the concentration of lactate. However, pyruvate kinase muscle 2 activator (GC69716) and lactate addition could promote osteoclastogenesis and bone resorption and promote the expression of c‐Fos and nuclear factor of activated T cells c1. Besides, NCF could also inhibit the production of ROS. In conclusion, NCF might inhibit osteoclast formation through inhibiting glycolysis metabolism and ROS production.
Exploring the Path of Balanced Development: The Decoupling Evaluation of Agricultural Production Efficiency and Land Carrying Capacity
Authors: Hu Yihang , Zhang Junbiao , Liu Qiqi
Published: November 2024

High‐quality development in agriculture is crucial for maintaining the harmonious balance between human society and the natural environment, and promoting this development model is one of the key measures to alleviate land degradation issues. This study, grounded in the PRED theory (Population, Resources, Environment, and Development theory) framework, establishes an evaluation system for high‐quality agricultural development by selecting 128 cities within the Yangtze River Economic Belt as its samples. It quantifies land carrying capacity, utilizes the Stochastic Frontier Analysis (SFA) model to assess agricultural production efficiency, and applies the Tapio decoupling model to analyze the interplay between these two factors. The results reveal that the land resource carrying index has risen from 1.245 to 1.70, indicating an escalating tension between population and food resources. Furthermore, agricultural production efficiency has seen a 16.56% increase, reflecting positive advancements in agricultural production across the region. Spatial distribution analysis shows that the standard deviation ellipse is concentrated in the mid and lower reaches, centered in Changde, Hunan, and expanding westward, with a broader coverage area and perimeter. Additionally, the decoupling relationship between land carrying capacity and agricultural production efficiency primarily manifests in three forms: strong negative decoupling, weak decoupling, and expansive negative decoupling. This research offers significant insights for effectively mitigating the strain between population growth and resource‐environmental carrying capacity.
Impact of Land Use Conversion on Soil Structure and Hydropedological Functions in an Arid Region
Authors: Han Jingwen , Pan Cunzhen , Sun Yuhang , Chen Zhijun , Xiong Yunwu , Huang Guanhua
Published: November 2024

Land use conversion critically affects soil structure and associated functions. This study investigated variations in soil structure and hydropedological characteristics across different land use types, that is, uncultivated, cultivated, and abandoned land under an arid condition. Water‐stable aggregates in the uncultivated land were 15.4%–37.1% of those in the cultivated and abandoned lands at depths of 0–60 cm. Reclamation of the uncultivated land enhanced soil aggregate stability, while prolonged tillage led to the loss of binding organic matter, breakdown of large aggregates and decrease in aggregate stability. The mean weight diameter of aggregates at 0–40 cm depth in the cultivated land was 39.0% lower than in the abandoned land. The volume fraction of micropores (< 100 μm) in the cultivated soils was 3.7%–39.7% of that in the uncultivated soils, whereas macropores (> 1000 μm) was 1.4–1.8 times greater. Following the abandonment, soil pore diversity recovered and a hierarchical structure developed. In the abandoned land, the volume fraction of micropores (< 100 μm) was 2.4–18.9 times that of the cultivated lands, while macropores (> 1000 μm) constituted 81.4%–93.9% of those in the cultivated lands. The permeability and longitudinal dispersivity of soils in the cultivated land were significantly lower than in the uncultivated and abandoned lands, particularly at deeper soil layers. The increase in large pores in the abandoned land, important for water movement and solute transport, resulted in an order‐of‐magnitude rise in both permeability and longitudinal dispersivity compared with the cultivated lands. Overall, the abandoned land showed potential for rehabilitation from the perspectives of soil aggregates and pore structure. The findings may provide reference for land reclamation and management in arid regions.
In a cohort of 961 clinically suspected Duchenne muscular dystrophy patients, 105 were diagnosed to have other muscular dystrophies (OMDs), with LGMD2E (variant SGCB c.544A>C) being the most common
Authors: Karthikeyan Priya , Kumar Shalini H. , Khanna‐Gupta Arati , Bremadesam Raman Lakshmi
Published: November 2024

Background

Targeted next generation sequence analyses in a cohort of 961 previously described patients with clinically suspected Duchene muscular dystrophy (DMD) revealed that 145/961 (15%) had variants in genes associated with other muscular dystrophies (OMDs).

Methods

NGS was carried out in DMD negative patients after deletion/duplication analysis followed by WES for No variant cases.

Results

The majority of patients with OMDs had autosomal recessive diseases that included Limb‐Girdle Muscular Dystrophies (LGMDs), Bethlem, Ullrich congenital Myopathies and Emery‐Driefuss muscular dystrophy. 3.5% of patients were identified with other disorders like Charcot‐Marie Tooth and Nemaline myopathy. A small percentage of patients, 0.6% remain undiagnosed. Of a total of 78 genetic variants identified, 44 were found to be novel. Interestingly, a third of patients with OMDs were found to have LGMD2E/R4, a severe form of LGMD that afflicts young children with clinical symptoms similar to DMD. Almost one third of the unrelated LGMD2E/R4 patients had the same point mutation (c.544A>C) in the SGCB gene, suggestive of a founder effect, described here for the first time in India.

Conclusion

This study underscores the need for a complete genetic work up to precisely diagnose patients and to initiate appropriate counseling programs, disease management and prevention strategies.
Assessment of Myocardial Fibrosis in Marfan Syndrome Using Cardiac Magnetic Resonance Imaging
Authors: Demolder Anthony , Devos Dan , De Backer Julie , Muiño‐Mosquera Laura
Published: November 2024

Background

Impaired myocardial function and arrhythmia are important manifestations of Marfan syndrome (MFS). Studies assessing myocardial fibrosis in relation to these manifestations are scarce.

Methods

This cross‐sectional, single‐center study assessed ventricular volumes, ventricular function, and myocardial fibrosis by cardiac magnetic resonance imaging (CMR) in patients with MFS harboring a (likely) pathogenic FBN1 variant. The presence and extent of fibrosis were assessed by late gadolinium enhancement (LGE) and extracellular volume measurement (ECV). Data on 24‐h Holter monitoring and clinical data were extracted from electronic patient records.

Results

The study included 32 unselected patients with MFS (median age 38 years [range 10–69], 41% women). No focal myocardial fibrosis was detected. Six patients (21%) had diffuse fibrosis (ECV > 29%). No association was found between the presence of diffuse fibrosis and clinically relevant myocardial dysfunction. Five patients (16%) had reduced left ventricular ejection fraction (LVEF < 55%). While all of these exhibited mitral annular disjunction (MAD), only two had ECV > 29%. Patients with MAD had increased indexed LV volumes (median end‐diastolic volume, 92 mL/m2 [IQR, 78–100] vs. 78 mL/m2 [IQR, 71–87]; median end‐systolic volume, 31 mL/m2 [IQR, 23–46] vs. 22 mL/m2 [IQR, 21–28]), also after adjusting for the presence of mitral and aortic valve regurgitation. No differences in ECV were seen between patients with and without MAD.

Conclusions

In this cohort of patients with MFS, focal myocardial fibrosis was not detected using CMR. Although diffuse fibrosis was observed in 21% of patients, no evident connection to clinically relevant myocardial dysfunction was found. Further studies should evaluate the impact of diffuse fibrosis on clinical outcome prediction.
Fractional calculus in ecological systems: Bifurcation analysis and continuation techniques for discrete Lotka–Volterra models
Authors: Mahmoudi Mohammadreza , Eskandari Zohreh
Published: November 2024

This study explores the application of fractional calculus to discrete Lotka–Volterra models, which are fundamental in ecological systems. By incorporating fractional differentiation, we capture the memory effects and long‐range dependencies that are characteristic of real‐world ecological dynamics. Our analysis employs bifurcation analysis and continuation methods to investigate the intricate dynamics that emerge in these systems. We find that the fractional order of differentiation significantly impacts the stability and oscillatory behavior of the ecological system, providing novel insights into the dynamics of predator–prey interactions. Our results demonstrate the enhanced accuracy and applicability of fractional‐order models in ecological modeling, highlighting their potential for more realistic simulations of complex ecological systems.
Synergistic Interplay of Diet, Gut Microbiota, and Insulin Resistance: Unraveling the Molecular Nexus
Authors: Gopal Rajesh Kanna , Ganesh Pitchaipillai Sankar , Pathoor Naji Naseef
Published: November 2024

This comprehensive review explores the intricate relationship between gut microbiota, diet, and insulin resistance, emphasizing the novel roles of diet‐induced microbial changes in influencing metabolic health. It highlights how diet significantly influences gut microbiota composition, with different dietary patterns fostering diverse microbial communities. These diet‐induced changes in the microbiome impact human metabolism by affecting inflammation, energy balance, and insulin sensitivity, particularly through microbial metabolites like short‐chain fatty acids (SCFAs). Focusing the key mediators like endotoxemia and systemic inflammation, and introduces personalized microbiome‐based therapeutic strategies, it also investigates the effects of dietary components—fiber, polyphenols, and lipids—on microbiota and insulin sensitivity, along with the roles of protein intake and amino acid metabolism. The study compares the effects of Western and Mediterranean diets on the microbiota‐insulin resistance axis. Therapeutic implications, including probiotics, fecal microbiota transplantation (FMT), and personalized diets, are discussed. Key findings reveal that high‐fat diets, especially those rich in saturated fats, contribute to dysbiosis and increased intestinal permeability, while high‐fiber diets promote beneficial bacteria and SCFAs. The review underscores the future potential of food and microbiota interventions for preventing or managing insulin resistance.
A Miniaturized SISL Bandpass Filter Based on Deep Hole Drilling Capacitor
Authors: Xu Yun‐Yang , Ma Yi‐Hao , Liu Qi Qiang , Hu Yue , Wang Jing , Zhao Wen‐Sheng
Published: November 2024

In this paper, a quasi‐lumped element‐based bandpass filter is implemented by substrate‐integrated suspended line (SISL) technology. To miniaturize the filter size, a deep hole drilling capacitor (DHDC) structure is proposed. The properties of DHDC are derived by parametric analysis and equivalent circuit analysis. Based on derived properties, a quasi‐lumped element bandpass filter using SISL technology is designed and fabricated. Experimental results demonstrate that the proposed bandpass filter achieves the center frequency of 1.48 GHz, with a fractional bandwidth of 50%. The minimum insertion loss within the passband is 0.96 dB, while the return loss exceeds 23.14 dB. The maximum out‐of‐band suppression is over −50 dB, and the filter size is only 0.172 λg × 0.062 λg.
Design of On‐Chip Multi‐Slot Chalcogenide Waveguide for Mid‐Infrared Methane Sensing
Authors: Ma Ningbo , Qin Zhengkun , Pi Mingquan , Wang Xueying , Zheng Chuantao , Min Yuting , Zhao Huan , Song Mingxing
Published: November 2024

A chalcogenide (ChG) multi‐slot waveguide gas sensor with ChG as the core layer and silicon dioxide (SiO2) as the under‐cladding layer is proposed. Multi‐slot waveguide can be used in the mid‐infrared gas measurement. The optimized power confinement factor (PCF) of the ChG multi‐slot waveguide can be up to 41.3%, which is ∼20% higher than that of the optimized single‐slot waveguide. At the absorption line located at 3.291 μm for methane (CH4) measurement, the limits of detection (LoD) of single‐slot, double‐slot, triple‐slot, quadruple‐slot waveguide sensors are determined to be 68.9, 57.4, 52, 48.6 parts per million (ppm), respectively. Compared with other waveguide sensors in the mid‐infrared, the PCF of the proposed multi‐slot ChG/SiO2 waveguide sensor is enhanced by five times, which has the potential for highly sensitive gas sensing.
Social Return on Investment of Musculoskeletal Physiotherapy in the National Health Service
Authors: Russell Joseph , Innes Sue
Published: November 2024

Background

Social return on investment (SROI) may present a method for demonstrating the social value of healthcare interventions. It has not previously been measured in musculoskeletal (MSK) physiotherapy but is being used in the procurement and performance management of healthcare services. The aim of the study was to measure SROI in one provider of MSK physiotherapy in the United Kingdom's National Health Service (NHS).

Methods

A retrospective single arm online survey‐based service evaluation was carried out to calculate the SROI of an NHS adult MSK physiotherapy service using the Housing Association's Charitable Trust Social Value Calculator.

Results

237 respondents (35.6%) completed the survey and a mean SROI of £4.13 for every £1 invested was demonstrated. There were sub‐group variations based on symptom location and discharge location.

Discussion

This is the first time SROI has been calculated in an MSK physiotherapy setting. This service evaluation raises new questions about the variations observed in subgroups and the applicability of this methodology in individuals with MSK conditions who receive physiotherapy.

Conclusion

MSK physiotherapy is an intervention which offers a positive SROI across a range of MSK conditions and contributes towards improved wellbeing. This is the first study to use the HACT Social Value Calculator when evaluating a physiotherapy service and further research is required to validate the results.
The uncertain death. Estimating mortality structure by random sampling
Authors: Moser Daria , Pichler Sandra L. , Santos Ana Luisa , Klimscha Florian , Fuchs Katharina
Published: November 2024

Imprecise data produced by commonly applied osteological age‐at‐death estimations profoundly affect all research on age‐dependent mortality in past societies. With uncertain death estimation (UCD), we propose a novel approach to estimating the mortality structure from imprecise data and present a corresponding R package for simple application. Through repeated random sampling of imprecise age‐at‐death ranges, UCD estimates the mortality structure of a given skeletal sample. We demonstrate the applicability of UCD in a proof‐of‐principle study on two samples with known age at death (Bass‐Mercyhurst Collection and Coimbra Identified Skeletal Collection). Two case studies of German Neolithic skeletal material illustrate UCD's applicability to archeological samples with dissimilar states of preservation. To comparatively quantify the accuracy of UCD, maximum likelihood estimations, Kaplan–Meier survival estimations, and age‐category mortality profiles were calculated for all four study samples. UCD outperforms similar existing procedures while incorporating the uncertainty inherent in osteological data. The proof‐of‐principle study produced significantly more accurate mortality profiles from UCD than from maximum likelihood estimation and Kaplan–Meier survival estimation. Both archeological case studies indicate UCD's ability to provide meaningful new insight into age‐dependent mortality in past societies. UCD allows for comparative studies into age‐dependent mortality in past societies without requiring a large sample of precise age‐at‐death estimations. UCD provides an opportunity for fast and simple analysis of mortality structures on a large dataset without neglecting the information contained in the raw data, thereby facilitating a critical study of patterns in age‐dependent mortality on a large scale.
Electrochemically Induced, Metal Free Synthesis of 2‐substituted chroman‐4‐ones
Authors: Monirialamdari Mohsen , Podlaska Aleksandra , Pomikło Dominika , Albrecht Anna
Published: November 2024

Electrochemically induced, decarboxylative functionalization of chromone‐3‐carboxylic acids by N‐hydroxyphthalimide esters as alkyl radical precursors was studied. Electrochemical protocol offers a sustainable and green approach, obviating the need for catalysts, relying on the direct reduction of NHPI esters using electric current. Developed protocol provides a straightforward route to the synthesis of diverse molecules with potential biological activity.
Can Catering to Local Area Needs Through CSR Reduce Firm Risk?
Authors: Prasad Krishna , Prasad M Durga
Published: November 2024

This paper examines the effect of corporate social responsibility (CSR) spending to cater to the local area's needs (the area of business operations) in reducing the firm's risk in the mandatory CSR setting. Using a sample of 1677 Indian firms spanning the financial year 2009–2022, we present several interesting results. First, we demonstrate that the risk of the firms eligible under mandatory CSR law is higher than those not qualifying. Second, we find that the risk of firms that focus their CSR on the local area's needs is lower. In an additional analysis, we demonstrate that firms with higher spending on the local area experience lower contingent liability, legal expenses, and audit fees. We illustrate that focusing on the local area's needs in CSR efforts retains signaling value under a mandatory CSR regime.
Investigation on tribo‐properties of twaron pulp‐reinforced brake friction composites
Authors: Kılıç Halil , Güney Bekir
Published: November 2024

Determining the appropriate formulation in designing and developing brake friction materials is one of the most complex tasks. This study investigates the synergistic effect and optimization of twaron fiber on the fade and recovery performance of brake friction composites. For this purpose, a series of friction materials containing varying amounts of twaron between 1 and 9 wt% were developed, and their characterization and tribo evaluation were carried out. The tribo performance of the composites was evaluated in a Krauss‐type friction test machine in line with the ECE R90 procedure in terms of their fade and recovery behaviors. It was noted that the fade‐recovery friction response of composites was affected when fiber is added; that is, an increase in fiber content improved the fade performance, friction fluctuations decreased, and a higher recovery response was observed. The fade and average coefficient of friction were found to be the main determinants, while recovery was found to be the stabilizer. Analytical hierarchy process (AHP) was used to determine the priority of importance of criteria in the performance evaluation, and VIKOR (multi‐criteria optimization compromise solution) was used for ranking evaluation. The formulation with a concentration of twaron 7 wt% was found to have exhibited an optimal braking performance. The worn surfaces scanning electron microscope (SEM) study confirms the general friction and wear mechanisms of friction layers with fiber content.

Highlights

Development of twaron pulp‐reinforced eco‐friendly brake friction composites.

Use of MCDM approach in the development of BFCs for braking applications.

VIKOR optimization positioned 7 wt% twaron‐addition BFC as the optimal choice.

It was observed that fiber amount is effective on the behaviors of composites.
Update and narrative review of avian influenza (H5N1) infection in adult patients
Authors: Aldhaeefi Mohammed , Rungkitwattanakul Dhakrit , Saltani Ilyas , Muirhead Antoinette , Ruehman Alexander J. , Hawkins W. Anthony , Daftary Monika N.
Published: November 2024

The avian influenza is a serious infection caused by influenza virus that is native to birds. Avian influenza remains a global challenge due to high transmission and mortality rates. The highly pathogenic strain of H5N1 resulted in significant outbreaks and deaths globally since the late 1800s. The most recent outbreaks in wild birds, domestic birds, and cows with some genetic variations and mutations among H5N1 strains has raised major concerns about potential transmission and public health risks. Symptoms range from asymptomatic to mild flu‐like illness to severe illness that requires hospitalization. There are multiple vaccines in development for humans to protect against avian influenza, specifically the H5N1 virus. This includes a cell‐based vaccine approved by the FDA for people aged 6 months and older who are at higher risk of exposure to the H5N1 virus called Audenz. Chemoprophylaxis against avian influenza following a suspected exposure should be started as soon as possible or no later than 48 h, and it is recommended to be continued for 7 days. The majority of avian influenza viruses are susceptible to neuraminidase inhibitors and cap‐dependent endonuclease inhibitor. Neuraminidase inhibitors are the mainstay of the avian influenza treatment and includes oseltamivir, peramivir, and zanamivir. Baloxavir marboxil is a cap‐dependent endonuclease inhibitor. This clinical review aims to highlight the background, epidemiology, clinical presentation, complications and current treatment and prevention strategies for avian influenza H5N1.
Effect of Behavioral Activation on Stigma and Quality of Life in Patients With Advanced Esophageal and Gastric Cancer: A Randomized Controlled Trial
Authors: Huang Runze , Ge Han , Nie Guodong , Li Anlong , Liu Lijun , Cheng Ling , Zhang Mingjun , Cheng Huaidong
Published: November 2024

Background

Esophageal cancer and gastric cancer patients require researchers' attention to address and resolve the issue of stigma. The aim of this study was to investigate whether behavioral activation (BA), an emerging psychosocial intervention method, can mitigate the stigma experienced by these patients and enhance their quality of life (QoL).

Methods

One hundred fifty‐three patients with advanced esophageal cancer and gastric cancer were recruited and randomly assigned to either the BA plus care as usual group (BA + CAU group) or the care as usual group (CAU group). Pre‐ and post‐intervention questionnaires, including the Social Impact Scale (SIS), as well as all functional areas and global health and QoL modules from the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ‐C30, version3).

Results

Generalized estimating equation analysis revealed that compared to usual care alone, combining BA with usual care significantly reduced stigma (time‐by‐group interaction, T1: β = −10.584, p < 0.001; T2: β = −22.619, p < 0.001) while improving physical, role, emotional, social functioning and global health and QoL particularly at T2 time point. Additionally, it also has the potential to decelerate the progressive decline of cognitive functioning. Furthermore, correlation analysis demonstrated a significant association between stigma levels and all functional areas as well as global health and QoL.

Conclusion

The issue of stigma among esophageal cancer and gastric cancer patients warrants increased attention due to its close relationship with patient QoL. This study presents a promising psychosocial intervention approach suitable for clinical application that deserves further promotion among cancer patients.

Trial Registration

NCT06348940.
Personality Feedback With Tailored Self‐Care Recommendations Improves Self‐Efficacy for Cancer Management: A Randomized Controlled Trial
Authors: Perry Laura M. , Mossman Brenna , Garcia Sofia F. , Kircher Sheetal M. , Dunn Addison , Alonzi Sarah , Easwar Sanjana , Hoerger Michael
Published: November 2024

Objective

To test whether a personality feedback intervention improves three domains of cancer self‐management: self‐awareness, self‐efficacy, and positive affect.

Methods

From 11/2020‐02/2021, 372 adults diagnosed with cancer participated in a randomized controlled trial (RCT) of an intervention that entailed reading a brief personality‐related excerpt during an online survey. Eligibility included self‐reported age ≥ 18 years, current or past cancer diagnosis, and ability to read English. The survey included a baseline assessment with a personality questionnaire, then randomized participants to one of two groups. The intervention group (n = 184) received a personality feedback report with tailored self‐care tips, whereas the control group (n = 188) received a generic reading on personality theory. At the end of the survey, participants completed outcome measures of self‐awareness (primary), self‐efficacy for illness management, and positive affect. General linear models tested between‐group differences in changes from baseline to post‐test on each outcome.

Results

There was no intervention effect on self‐awareness (primary outcome) or positive affect. However, compared to controls, intervention participants experienced a greater increase in self‐efficacy for illness management (d = 0.33, p = 0.002), including in 2 of 3 constituent domains: self‐efficacy for managing symptoms (d = 0.36, p < 0.001) and self‐efficacy for managing treatments/medication (d = 0.22, p = 0.035).

Conclusion

Despite the primary outcome's null results, this was the first RCT of a personality feedback intervention to show improvements in self‐efficacy for managing chronic illness. Given the important role of self‐efficacy in self‐management, the intervention has implications for other cancer outcomes. Follow‐up studies on longer‐term outcomes such as health behaviors and quality of life should be explored.

Trial Registration

NCT04625439
Pilot Randomized Controlled Trial of IN FOCUS: A Mind‐Body Resiliency Intervention for Fear of Cancer Recurrence
Authors: Hall Daniel L. , Yeh Gloria Y. , O'Cleirigh Conall , Wagner Lynne I. , Peppercorn Jeffrey , Denninger John , Hirschberg April M. , Lee Hang , Markwart Michaela , Siefring Emma , Mizrach Helen R. , Li Raissa , Mian Zainab , Tsuchiyose Erika , Wen Angela , Bullock Andrea J. , Park Elyse R.
Published: November 2024

Introduction

Fear of cancer recurrence (FCR) is prevalent and distressing among survivors of cancer. Evidence‐based mind‐body and cognitive‐behavioral skills lack integration and testing in scalable formats.

Objective

This pilot randomized controlled trial (NCT04876599) tested a synchronous, virtual mind‐body group resiliency intervention for FCR (IN FOCUS).

Method

Adults with elevated FCR (FCR Inventory severity ≥ 16; 16–21 = elevated, 22–36 = clinically elevated) after completing primary treatment for non‐metastatic cancer were randomly assigned (1:1) to eight weekly sessions of IN FOCUS or usual care (UC; synchronous, virtual community group support referral). Feasibility metrics included ≥ 70% retention per arm (primary outcome), ≥ 75% attendance in ≥ 6 sessions, ≥ 75% adherence to relaxation skills practice ≥ 3 days per week and by delivery fidelity (% content covered in video‐recorded sessions). Acceptability was assessed quantitatively via ratings of enjoyableness, convenience, helpfulness, odds of future use, and satisfaction (benchmark ≥ 80% of ratings ≥ 4 on 1–5 Likert scale) and qualitatively via individual exit interviews. Linear mixed models explicated slopes in FCR (secondary) and resiliency (exploratory; Current Experiences Scale) from baseline to 2 months (primary endpoint) and 5 months using intention‐to‐treat.

Results

From July 2021 to March 2022, 64 survivors enrolled (25–73 years old, M = 7 years since diagnosis). IN FOCUS was feasible and acceptable (91% retention; attendance median = 7 sessions, 97% relaxation practice adherence, 95% content fully covered; 82% of acceptability ratings ≥ 4). Interviews (n = 59) revealed benefits in both arms. By 2 months, compared to UC, IN FOCUS reduced FCR to a medium‐to‐large effect (Mdiff = −2.4; 95% CI = −4.2, −0.7; d = 0.66). By 5 months, FCR effects had attenuated (Mdiff = −0.16, 95% CI −1.97, 1.65; d = −0.04), although levels of resiliency had increased with a medium‐to‐large effect (Mdiff = 10.0; 95% CI = 4.9, 15.1; d = 0.78).

Conclusions

For survivors of non‐metastatic cancer, a synchronous, virtual mind‐body resiliency program for FCR is feasible, acceptable, and seemingly beneficial compared to a community group referral.
Structural insights into the recognition of tetrapyrrole substrates by ancestral class II chelatase CfbA
Authors: Ogawa Shoko , Hikita Masahide , Fujishiro Takashi
Published: November 2024

Nickel‐chelatase CfbA, unlike descendant chelatases, is an ancestral class II chelatase with a symmetric active site architecture. CfbA utilizes sirohydrochlorin (SHC) as a physiological substrate in the biosynthesis of coenzyme F430. CbiXS, a structural analog of CfbA, can use uroporphyrin III (UPIII) and uroporphyrin I (UPI) as non‐physiological substrates. Owing to the broad tetrapyrrole specificity of the unique active site of ancestral class II chelatases, the substrate recognition mechanism of CfbA has garnered interest. Herein, we conducted an X‐ray crystallographic analysis of CfbA in complex with UPIII and UPI. Interestingly, the binding sites for UPIII and UPI were distinct. UPI was bound at the entrance of the active site, whereas UPIII was bound deep inside the active site cavity in a manner similar to SHC. Despite the difference in the binding positions of UPIII and UPI, Ser11 at the active site provided critical polar interactions for recognizing UPIII and UPI. Several CfbA variants with a Ser11 mutation were studied to confirm the significance of Ser11's position in the context of tetrapyrrole recognition. The CfbA S11T variant showed Ni2+‐chelatase activity against coproporphyrin I (CPI), which is a more hydrophobic tetrapyrrole than UPIII and UPI. Using a CPI‐docked model of the S11T variant, we proposed that balancing the hydrophobic/polar interactions at residue 11 could alter substrate selectivity. The structural and mutational analyses reported here highlight the importance of polar and hydrophobic interactions at the entry region of the active site for substrate tetrapyrrole recognition by ancestral and descendant class II chelatases.
Disulfide‐mediated oligomerization of mutant Cu/Zn‐superoxide dismutase associated with canine degenerative myelopathy
Authors: Shino Yuki , Muraki Norifumi , Kobatake Yui , Kamishina Hiroaki , Kato Ryuichi , Furukawa Yoshiaki
Published: November 2024

A homozygous E40K mutation in the gene coding canine Cu/Zn‐superoxide dismutase (cSOD1) causes degenerative myelopathy (DM) in dogs. A pathological hallmark of DM with the cSOD1 mutation is the aggregation of mutant cSOD1 proteins in neurons. The amino acid substitution E40K disrupts a salt bridge between Glu40 and Lys91 and is considered to destabilize the native state of cSOD1; however, the mechanism by which mutant cSOD1 aggregates remains unclear. Here, we show that mutant cSOD1 losing a copper and zinc ion forms oligomers crosslinked via disulfide bonds. The E40K substitution was found to result in the increased solvent exposure of the Cys7 side chain, which then attacked the disulfide bond (Cys57–Cys146) in cSOD1 to form disulfide‐linked oligomers. We also successfully prevented the Cys7 exposure and thus the oligomerization of mutant cSOD1 by a fragment antibody that specifically recognizes the region around the mutation site. The fragment antibody covered the β‐plug region, reinforcing the interactions compromised by the E40K substitution and thus contributing to the maintenance of the structural integrity of the β‐barrel core of cSOD1. Taken together, we propose that the Cys7 exposure in cSOD1 upon the salt bridge disruption plays a central role in the aggregation mechanism of DM‐associated mutant cSOD1.