bluuebunny/crossref_metadata_2025 huggingface dataset:
Preoperative sequential short-course radiation therapy and FOLFOX chemotherapy versus long-course chemoradiotherapy for locally advanced rectal cancer: a multicenter, randomized controlled trial (SOLAR trial)
Authors: Kang Min Kyu , Park Soo Yeun , Park Jun Seok , Kim Hye Jin , Kim Jong Gwang , Kang Byung Woog , Baek Jin Ho , Cho Seung Hyun , Seo An Na , Kim Duck-Woo , Kim Jin , Baek Se Jin , Kim Ji Hoon , Kim Ji Yeon , Ha Gi Won , Park Eun Jung , Park In Ja , Kim Chang Hyun , Kang Hyun , Choi Gyu-Seog
Published: November 2023

Background

Preoperative (chemo)radiotherapy has been widely used as an effective treatment for locally advanced rectal cancer (LARC), leading to a significant reduction in pelvic recurrence rates. Because early administration of intensive chemotherapy for LARC has more advantages than adjuvant chemotherapy, total neoadjuvant therapy (TNT) has been introduced and evaluated to determine whether it can improve tumor response or treatment outcomes. This study aims to investigate whether short-course radiotherapy (SCRT) followed by intensive chemotherapy improves oncologic outcomes compared with traditional preoperative long-course chemoradiotherapy (CRT).

Methods

A multicenter randomized phase II trial involving 364 patients with LARC (cT3–4, cN+, or presence of extramural vascular invasion) will be conducted. Patients will be randomly assigned to the experimental or control arm at a ratio of 1:1. Participants in the experimental arm will receive SCRT (25 Gy in 5 fractions, daily) followed by four cycles of FOLFOX (oxaliplatin, 5-fluorouracil, and folinic acid) as a neoadjuvant treatment, and those in the control arm will receive conventional radiotherapy (45–50.4 Gy in 25–28 fractions, 5 times a week) concurrently with capecitabine or 5-fluorouracil. As a mandatory surgical procedure, total mesorectal excision will be performed 2–5 weeks from the last cycle of chemotherapy in the experimental arm and 6–8 weeks after the last day of radiotherapy in the control arm. The primary endpoint is 3-year disease-free survival, and the secondary endpoints are tumor response, overall survival, toxicities, quality of life, and cost-effectiveness.

Discussion

This is the first Korean randomized controlled study comparing SCRT-based TNT with traditional preoperative LC-CRT for LARC. The involvement of experienced colorectal surgeons ensures high-quality surgical resection. SCRT followed by FOLFOX chemotherapy is expected to improve disease-free survival compared with CRT, with potential advantages in tumor response, quality of life, and cost-effectiveness.

Trial registration

This trial is registered at Clinical Research Information under the identifier Service KCT0004874 on April 02, 2020, and at Clinicaltrial.gov under the identifier NCT05673772 on January 06, 2023.
Self-perceived problems of Afghan asylum seekers and refugees and their experiences with a short psychological intervention
Authors: Kantor Viktoria , Weindl Dina , Schiess-Jokanovic Jennifer , Verginer Lucia , Lueger-Schuster Brigitte , Knefel Matthias
Published: November 2023

Background

The present study examined Afghan asylum seekers’ and refugees’ self-perceived problems, and their experiences of treatment with an adapted version of the brief transdiagnostic psychological intervention “Problem Management Plus” (aPM+). Specifically, the study explored which problems trouble them most and how these problems influence their daily functioning. Further, it examined how various standardized outcome measures correlate with these subjectively perceived problems.

Method

This study is part of a larger RCT study (PIAAS study) in which 88 Afghan asylum seekers and refugees were randomly allocated either to aPM + in addition to treatment as usual (aPM+/TAU) or TAU alone. The presented study uses a multi-method approach consisting of two parts: First, we investigated participants’ self-identified problems and subjective functional impairment using quantitative and qualitative assessment in both the aPM+/TAU and TAU group (n = 88). Second, we conducted in-depth qualitative interviews with a subsample of the aPM+/TAU group (n = 24) to gain a deeper understanding of participants’ personal experiences with aPM + and to obtain suggestions for improvement. Spearman correlations were applied for quantitative data, and deductive and inductive approaches of thematic analysis were used for qualitative data.

Results

We identified six main themes of self-perceived problems (primary post-migration living difficulties, general mental health problems, interpersonal stressors, secondary post-migration living difficulties, mental health problems specifically associated with stress, and somatic problems) and their consequences, as well as subjective functional impairment. Standardized measures of general mental health, posttraumatic psychopathology, and quality of life did not correlate with the intensity of self-perceived problems. aPM + was mostly perceived positively, and few participants had recommendations for its improvement.

Conclusion

The study aimed at giving a voice to Afghan trauma survivors to inform service providers and policy makers about their needs. Based on their expertise, future interventions can be tailored to their actual needs and optimized in terms of practical use. aPM + proved to be a positively perceived intervention that reduces subjective symptom burden and facilitates daily functioning. Culture-sensitive treatments within (mental) health services should increase service utilization and improve (mental) health in the long term.
Psychosocial and health behavioural characteristics of longitudinal physical activity patterns: a cohort study from adolescence to young adulthood
Authors: Aira Tuula , Vasankari Tommi , Heinonen Olli J , Korpelainen Raija , Kotkajuuri Jimi , Parkkari Jari , Savonen Kai , Toivo Kerttu , Uusitalo Arja , Valtonen Maarit , Villberg Jari , Vähä-Ypyä Henri , Kokko Sami P
Published: November 2023

Background

The decline in physical activity (PA) during adolescence is well-established. However, while some subgroups of adolescents follow the general pattern of decreased activity, others increase or maintain high or low activity. The correlates and determinants of different PA patterns may vary, offering valuable information for targeted health promotion. This study aimed to examine how psychosocial factors, health behaviours, and PA domains are associated with longitudinal PA patterns from adolescence to young adulthood.

Methods

This prospective study encompassed 254 participants measured at mean ages 15 and 19. Device-measured moderate-to-vigorous PA was grouped into five patterns (activity maintainers, inactivity maintainers, decreasers from moderate to low PA, decreasers from high to moderate PA, increasers) via a data-driven method, K-Means for longitudinal data. Multinomial logistic regression was used to analyse the associations between health behaviours, psychosocial factors, PA domains, and different PA patterns.

Results

A lack of sports club participation characterised inactivity maintainers throughout adolescence. Difficulties in communicating with one’s father at age 15 were associated with higher odds of belonging to inactivity maintainers and to decreasers from moderate to low PA. Lower fruit and vegetable consumption at age 19 was also related to increased odds of belonging to the groups of inactivity maintainers and decreasers from moderate to low PA. Smoking at age 19 was associated with being a decreaser from moderate to low PA.

Conclusions

Diverse factors characterise longitudinal PA patterns over the transition to young adulthood. Sports club participation contributes to maintained PA. Moreover, a father-adolescent relationship that supports open communication may be one determinant for sustained PA during adolescence. A healthier diet and non-smoking as a young adult are associated with more favourable PA development.
Understanding adolescent girls’ experiences with accessing and using contraceptives in Zambia
Authors: Chola Mumbi , Hlongwana Khumbulani , Ginindza Themba G.
Published: November 2023

Background

Globally, the unmet need for contraception among adolescent girls is high and is driven by barriers to access and utilisation of contraceptives. Understanding adolescent girls’ experiences with accessing and using contraceptives is crucial because it influences their decision to use and willingness to continue using health products and services. While determinants of contraceptive use have been extensively researched globally, few studies explore how adolescent girls experience contraceptive use in Zambia using qualitative methods. Therefore, this study aimed to understand Zambian adolescent girls’ experiences using contraceptives.

Methods

Thematic analysis was used to analyse data generated from 7 focus group discussions and three in-depth interviews with adolescent girls aged 15 to 19 years in 4 districts in Zambia. NVivo version 12 pro (QSR International) software was used to manage and organise the data.

Results

Results revealed that adolescents’ experiences concerning contraceptives across the continuum of care are shaped by various factors, including knowledge of contraceptives which comprises sources of information and contraceptives; experience with using contraceptives, challenges with access to contraceptives, and misconceptions about contraceptives; perspectives about existing contraceptives; and preferred types of contraceptives.

Conclusion

The multifactorial interaction relating to adolescents’ personal experience, their community and the environment in which they access contraceptive services all contribute to their overall experience and influence their contraceptive decisions. Therefore, qualitative studies exploring adolescents’ experiences with accessing and using contraceptives are vital for tailoring interventions responsive to the contraceptive needs of this age group.
Relationship of stunting with water, sanitation, and hygiene (WASH) practices among children under the age of five: a cross-sectional study in Southern Punjab, Pakistan
Authors: Batool Munazza , Saleem Javeria , Zakar Rubeena , Butt Muhammad Salman , Iqbal Sanaullah , Haider Shahroz , Fischer Florian
Published: November 2023

Background

Reasons for undernutrition are food insufficiency, impaired child care, limited access to healthcare, and maternal lack of health literacy. In addition, there are several environmental factors, such as drinking water quality, poor sanitation, and hygienic practices that can lead to poor nutritional status in children. The present study aimed to compare household-associated risk factors, including water, sanitation, and hygiene (WASH) practices of mothers, with children’s stunting under the age of five.

Methods

A face-to-face cross-sectional survey was conducted with mothers of children under the age of five in the Dera Ghazi Khan district in southern Punjab, Pakistan. World Health Organization criteria for stunting were used to identify the participants. A sociodemographic questionnaire was used to collect information from consented parents/guardians on children’s age, feeding, and WASH practices. Pearson’s chi-square, simple regression, and hierarchical regression models were applied for data analysis.

Results

A total of 204 mothers of children of both genders participated in this study. The children’s mean (SD) age was 15.67 (± 10.2) months, their weight was 5.44 (± 1.45) kg, their height was 67.69 (± 10.05), and their mid-upper arm circumference was 9.75 (± 1.30) cm. Children’s stunting was mild (z-score > -2) at 17.6%, moderate (z-score − 2 to -3) at 16.7%, and severe (z-score < -3) at 65.7% of participants. A simple regression model showed a strong association, r2 = 0.062, p = 0.013, with age as the most significant sociodemographic factor. The hierarchical regression model showed a combined value of r2 = 0.0128, p = 0.027, with hand pump and tank water as the significant source of drinking water that was related to stunting among children.

Conclusion

Stunting can be associated with several risk factors, including WASH parameters. This study concluded that children aged under five years are susceptible to stunting in southern Punjab, Pakistan. The contamination of hand pumps and tank water resources was found to be the major contributing factor to stunting.
Screening and early diagnosis of chronic obstructive pulmonary disease: a population study
Authors: Tang Wenhui , Rong Yan , Zhang Hongmei , Lin Wenji , Zeng Wenmei , Wu Wenhong
Published: November 2023

Background and objective

Although chronic obstructive pulmonary disease (COPD) is a common disease leading to further morbidity and significant mortality, there is still limited data on screening for COPD. The purpose of this study was to establish an early chronic obstructive pulmonary disease (COPD) screening system for the community and hospitals in Nanshan District in Shenzhen City, to improve the rate of early diagnosis and treatment of patients with COPD.

Methods

We identified individuals at high risk of COPD using a questionnaire survey and analyzed the relevant influencing factors in the early stages of COPD in high-risk groups.

Results

We collected a total of 5,000 COPD screening questionnaires, and a total of 449 patients were diagnosed with COPD by pulmonary function examination. The prevalence of COPD in people aged 20 and above in Nanshan District of Shenzhen City was estimated to be 8.98%, with a base of 5000. The severity classification as per the Global Initiative for Chronic Obstructive Lung Disease (GOLD) criteria was as follows: GOLD I accounted for 34.74%; GOLD II accounted for 37.64%; GOLD III accounted for 16.04%; and GOLD IV accounted for 11.58%. Common features of early COPD that we identified were: (1) patients were mainly males, accounting for 68.0%; (2) COPD was common among people aged 50–59 years, comprising 31%; (3) 96.0% of patients often had severe respiratory symptoms and had frequent coughs when they did not have a cold; (4) 57.2% of patients experienced shortness of breath when walking quickly on level ground or climbing gentle slopes; (5) 72.6% of patients had a family history of bronchial asthma and COPD. Multivariate ordinal multi-classification logistic regression showed that gender, age, shortness of breath, and the use of firewood, grass, and coal stoves were all influencing factors in pulmonary function grading.

Conclusion

A screening questionnaire combined with a pulmonary function test should be adopted as a COPD screening strategy to be implemented at the primary level as a public health priority in China to reduce the incidence, disability, and mortality from COPD.
Clinical characteristics and therapeutic behavior of breast cancer patients using mistletoe therapy consulting a clinic offering integrative oncology: a registry data analysis
Authors: Krüerke Daniel , Schenker Marianne , Matter-Walstra Klazien
Published: November 2023

Motivation

Cancer patients often use complementary and/or alternative medicine, such as mistletoe therapy, alongside conventional cancer therapies. In Switzerland, so far not much is known about treatment patterns of breast cancer patients using integrative oncology. Solid knowledge on complementary care utilization may help to enhance integrative oncology care in Switzerland.

Methods

In this exploratory, descriptive database study, we investigated the treatment pathways of a cohort of breast cancer patients who received mistletoe therapy and were documented in the cancer registry of an anthroposophic Swiss hospital offering integrative oncology treatments.

Results

Patients treated with mistletoe in this cohort are in median 10 years younger than Swiss breast cancer patients as a whole. Only 5.8% of these patients were treated with mistletoe alone, while 60.5% of them supplemented chemotherapy and/or hormone therapy and/or surgery and/or radiation with mistletoe therapy. Nearly 80% of patients started conventional therapy followed by additional mistletoe therapy or started mono mistletoe therapy after completion of conventional therapies. The median time from initial diagnosis to hospital admission (inpatient and/or outpatient) was less than one year. Almost ¾ of the patients were treated in an outpatient setting only.

Conclusion

From our data, it appears that younger breast cancer patients are more likely to use mistletoe therapy simultaneously with or following their conventional medical therapies. The extent to which these patients discuss their mistletoe therapy and eventually other complementary and/or alternative therapies with their primary oncologists is not clear from the data. We therefore recommend that (Swiss) oncologists should openly discuss the desire for integrative oncology therapies, especially with their younger breast cancer patients, in order to find the best holistic care pattern for these patients.
A qualitative study of dental internships in Saudi Arabia: moving beyond perceptions to the reality of the practices of dental interns
Authors: Sarhan Mohammed Mahmoud , Alwadi Maram Ali M.
Published: November 2023

Background

Dental internships are a vital way for recent graduates of undergraduate dentistry courses to bridge the gap between study and clinical practice. Interns’ perceptions of dental internships have been explored in certain studies but the reality of the dental internship and dental interns’ practical performance has not been examined. Therefore, this study aims to explore the reality of the dental internship as a transitional stage after completion of an undergraduate course in dentistry.

Methods

This qualitative research recruited 23 dental interns from Saudi Arabia’s Riyadh Province. To explore the reality of dental internships, the research relied on a performative knowledge approach to examine interns’ practices and performance. Diaries and semi-structured interviews conducted virtually were used to gather data across three months. The data was then subject to thematic analysis that applied an inductive strategy. The data analysis’s credibility and trustworthiness were verified using triangulation techniques, an audit trail and member-checking.

Results

Five key themes concerning dental interns’ practices were identified in this research: exploration, addressing knowledge gaps, responsibilities, decision-making and social connections. The most significant findings reveal that dental internships go beyond clinical work to include certain personal and social aspects that dental interns undertake during their internships.

Conclusion

The findings of this research indicate that more real-world, practical knowledge should be integrated into the curricula of undergraduate dentistry programmes. In sum, this work highlights the need for holistic dental education that encompasses not only the clinical development of interns and students but also other elements such as their personal and social growth. Moreover, this research reveals that a performative knowledge approach can help researchers to identify significant findings regarding the practical experiences of dental interns. This study has implications for dentistry and any other medical speciality education programme that involves an internship.
Knowledge of and attitudes towards medical research ethics among first year doctoral students in Slovenia at the Faculty of Medicine, University of Ljubljana
Authors: Grosek S , Pleterski Rigler D , Podbregar M , Erčulj V
Published: November 2023

Background

Research ethics and attitudes should be the main concern of those who are conducting and publishing research in medicine.

Methods

A cross-sectional study was conducted using a questionnaire among first year postgraduate doctoral students in Biomedicine at the Faculty of Medicine, University of Ljubljana during the academic year 2022/2023.

Results

There were 54 out of 57 doctoral students included in the study, with a mean age (SD) of 29.7 (4.7) years, with predominantly female doctoral students, 66.7%. The number of correct answers out of 39 considered to illustrate students’ knowledge of medical research ethics was 31, meaning that they gave correct answers to 80% of all the questions. The mean number (SD) of correct answers was 18.9 (5.8), which significantly differed from 31 (p < 0.001). The previous experience of the doctoral students in research was significantly correlated with their knowledge of medical research ethics, even when controlling for the age, gender and workplace of respondents.

Conclusion

This study clearly showed that insufficient knowledge and a poor level of attitudes exist about the main questions pertaining to medical research ethics. Overall knowledge is well below the expected positive answers. Further studies are needed to compare the knowledge of doctoral students with that of their tutors and what implications this might have for further teaching of research ethics.
The association between the volume of the gallbladder based on sonographic findings and demographical data in the PERSIAN Guilan cohort study (PGCS)
Authors: Joukar Farahnaz , Ashoobi Mohammad Taghi , Alizadeh Ahmad , Zeinali Tahereh , Faraji Niloofar , Tabatabaii Mohammadjavad , Mansour-Ghanaei Roya , Naghipour Mohammadreza , Mansour-Ghanaei Fariborz
Published: November 2023

Background

Ultrasound is an important method to determine the volume of the gallbladder and check its structure. Considering the variation in the size and volume of the gallbladder in disease and physiological conditions, determining the volume of the gallbladder is clinically valuable. This study was carried out to evaluate the gallbladder volume and its association with patients’ demographic data in the Prospective Epidemiological Research Studies of Iranian Adults (PERSIAN) Guilan cohort study (PGCS) population.

Methods

In this cross-sectional study, 957 individuals aged 35–70 participated in determining the gallbladder volume by a radiologist based on the ultrasound method. The demographical data were collected using a questionnaire. After fasting for 12 h, the ultrasound was performed with an Ultrasonic device (Sonix SP series) with a 3.5 to 5 MHz probe.

Results

The total frequency of gallbladder lesions was 2.2%. The results showed a significant association between marriage and gender with the presence or absence of lesions in the studied participants (P < 0.05). Also, significant differences were reported between the volume of gallbladder and gender, body mass index (BMI), social and economic status (SES), metabolic equivalent of task (MET), history of cardiovascular disease (CVD), and hypertension (P < 0.05). The results of a linear regression represented a significant association between gender, BMI, MET, and CVD and the mean volume of the gallbladder (P < 0.05). However, there was no significant association between the presence or absence of a lesion and the individuals’ average gallbladder volume (P > 0.05).

Conclusion

According to our results, gender, BMI, MET, and CVD were significantly associated with gallbladder volume.
Study on the influencing factors and evolution of loess bank collapse with physical modelling
Authors: Xuetong Ma , Tonglu Li , Qipeng Li , Changsheng Wang , Debin Gao , Hao Zhang , Changhu Li
Published: November 2023

Background

Reservoir bank collapse in loess areas may lead to the siltation of reservoir and bank retreat. Therefore, the study of reservoir bank collapse has practical significance. Almost of the bank collapse width prediction method were based on the classical graphical method which do not consider the process of bank collapse. But practice shows that this method can overestimate the width of bank collapse. Meanwhile, there are few studies specifically focused on the collapse of loess bank slopes.

Methods

To improve the prediction method of loss bank collapse width, the influence of water depth, dry density and bank slope angle on loess bank collapse was studied by physical modelling. The bank collapse width and the morphology of the bank slope were recorded during the experiment.

Results

The bank collapse width increases with the increase of water depth, increases with the increase of slope angle, and decreases with the increase of dry density. The modeling process shows that the loess bank collapse occurs firstly underwater, the erosion niche will be formed underwater, and then the above water slope is damaged. This process is repeated until the underwater accumulation slope reaches the stable state, and then bank collapse stops. After the bank collapse, the above water slope is polyline, while the underwater slope is curved. When the slope angle is less than 27°, the bank collapse will not occur, and when the slope angle is between 27° and 40°, the bank collapse type is abrasion type. When the slope angle is greater than 40°, the bank collapse type is dumping type or shear type. Based on this, the improved balanced alluvial accumulation approach was proposed, which considers the mechanical equilibrium of above water bank slope and the morphology of underwater slope. The new method can reflect the stage characteristics of loess bank collapse, which is more reasonable than the empirical graphical method.

Conclusions

The experimental results indicate that when predicting the width of loess bank collapse, it is necessary to combine the bank collapse width and process of bank collapse. The relevant conclusions have a certain role in exploring the mechanism of loess bank collapse and bank collapse prediction methods.
Plant-based dietary patterns and fasting insulin: a cross-sectional study from NHANES 2017–2018
Authors: Curlin Dana , Hare Marion E. , Tolley Elizabeth A. , Gatwood Justin
Published: November 2023

Background

Previous studies have created plant-based diet indices to assess the health effects of specific dietary patterns.

Objective

To examine the association between the plant-based content of diet and fasting insulin in adults from the NHANES 2017–2018 database.

Methods

Demographic, dietary, lab and clinical data and fasting insulin were obtained from the NHANES 2017–2018 database. From two 24-h dietary recalls, we created a plant-based diet index (PDI) and a healthy plant-based diet index (hPDI). A high PDI score indicated more plants were consumed versus animal foods. A high hPDI score indicated healthier, plant materials (whole grains, whole fruits, vegetables, legumes, vegetable oils, seeds and nuts) were consumed. The relationships between the natural log of fasting insulin, PDI, and hPDI were analyzed using multiple linear regression adjusting for body mass index (BMI) and alanine aminotransferase (ALT).

Results

Analyses were based on 1,714 participants, 897 women and 817 men with a median age of 52 years. In this sample, 610 (35.6%) were white, 407 (23.8%) were black, 231 (13.5%) were Mexican, 207 (12.1%) were Asian, 157 (9.2%) were other Hispanic, and 102 (6%) were other or mixed race. Median fasting insulin was 9.74 μU/mL (IQR: 6.2, 15.56). For every 1 unit increase in PDI, the natural log of fasting insulin decreased 0.0068 ± 0.003 μU/mL (CI: -0.00097, -0.013) (p = 0.02). After adjusting for BMI and ALT, the PDI did not significantly predict fasting insulin as the association was not robust due to multicollinearity. The hPDI was inversely and significantly associated with the natural log of fasting insulin (-0.0027 ± 0.00134, CI: -0.000087, -0.0053) (p = 0.043) in a multivariable model including BMI and ALT.

Conclusion

A healthy plant-based diet is associated with a decrease in fasting insulin levels. Healthfulness of the diet is an important factor when considering the benefit of a plant-based diet.
Determinant of Implanon discontinuation among women in southwest Ethiopia: unmatched case control study
Authors: Ejeta Chibsa Samuel , Bayisa Kenbon , Adem Hussen Mustefa , Tefera Kefeni Bilisumamulifna
Published: November 2023

Background

Over 4.5 million women worldwide have used Implanon. It plays an important role in reducing unwanted conceptions, lowering maternal mortality, and enhancing child survival. As a result, the availability of family planning programmes encourages women to begin using contraception and encourages women who are already using family planning to continue using it. The purpose of this study was to investigate the factors that lead to implanon cessation among women in southwest, Ethiopia.

Methods

A facility-based unmatched case–control study was conducted from February 01 to March 02, 2023. It included 348 participants, 174 cases, and 174 controls. The cases were selected consecutively, and the controls were selected using a systematic random sampling method. Data was collected through a structured, face-to-face interview and entered into Epi-data version 4.6 and SPSS version 25.0 for analysis. The confidence interval (CI) of 95 and the strength of the association were measured using an adjusted odds ratio. A p-value of less than 0.05 was considered statistically significant.

Result

Women whose husbands have formal education [AOR = 0.33, 95% CI (0.121–0.0944)], women who have been counseled individually [AOR = 3.403 (1.390–8.3.32)], women who have been counseled for less than 5 min [AOR = 3.143, 95% CI (1.303–8.046)], and women who discuss Implanon insertion with their partner [AOR = 0.289, 95% CI (0.143–0.585)] were significantly associated with Implanon discontinuation.

Conclusion

Implanon discontinuation was predicted by the husband's education, the number of women counselled alone, the length of counselling, a conversation with the spouse, satisfaction with the service, and implanon side effects. The health care provider should increase counselling services, especially the length of implanon pregnancy, in accordance with the national family planning recommendations, to reduce early implanon removal.
Improving mortality forecasting using a hybrid of Lee–Carter and stacking ensemble model
Authors: Gyamerah Samuel Asante , Mensah Aaron Akyea , Asare Clement , Dzupire Nelson
Published: November 2023

Background

Mortality forecasting is a critical component in various fields, including public health, insurance, and pension planning, where accurate predictions are essential for informed decision-making. This study introduces an innovative hybrid approach that combines the classical Lee–Carter model with advanced machine learning techniques, particularly the stack ensemble model, to enhance the accuracy and efficiency of mortality forecasts.

Results

Through an extensive analysis of mortality data from Ghana, the hybrid model’s performance is assessed, showcasing its superiority over individual base models. The proposed hybrid Lee–Carter model with a stack ensemble emerges as a powerful tool for mortality forecasting based on the performance metrics utilized. Additionally, the study highlights the impact of incorporating additional base models within the stack ensemble framework to enhance predictive performance.

Conclusion

Through this innovative approach, the study provides valuable insights into enhancing mortality prediction accuracy. By bridging classic mortality modeling with advanced machine learning, the hybrid model offers a powerful tool for policymakers, actuaries, and healthcare practitioners to inform decisions and plan for the future. The findings of this research pave the way for further advancements and improvements in mortality forecasting methodologies, thus contributing to the broader understanding and management of mortality risks in various sectors.
Phosphopeptides P140 cause oxidative burst responses of pulmonary macrophages in an imiquimod-induced lupus model
Authors: Zhong Jianghong , Zheng Chanyu , Chen Zhongheng , Yue Hangqi , Gao Haiqiang , Jiang Yunfan , Hui Hui , Tian Jie
Published: November 2023

Recent studies challenge the dogma that a 21-mer phosphopeptide P140 protects against direct cell damage in the phase-III clinical trial (NCT02504645) for lupus, involving reactive oxygen species (ROS)-dependent release of citrullinated histone H3 (H3cit)-linked neutrophil extracellular traps. An open question is the cellular location of ROS production and H3cit formation in lupus. In this study, we examined the effects of P140 peptides on ROS production and H3cit location in lupus with in vivo and situ fluorescence imaging with subcellular resolution. We developed a mouse model of the B6 strain harbouring a bioluminescent reporter under the control of the Lysozyme M promoter. Based on the imiquimod-induced disease model of B6 mice, we used bioluminescent imaging, flow cytometry analysis, and immunohistology staining to study the effects of P140 peptides in lupus. We found a profound accumulation of CX3CR1-positive macrophages in the lungs of lupus mice after the application of P140, accompanied by lung fibrosis formation. The defined P140-mediated macrophage responses were associated with an increase of H3cit in the cytosol, interleukin-1 receptor type 1 on the extracellular membrane, and intracellular production of ROS. Of interest, the disease of imiquimod-induced lupus was prevented with an antioxidant drug apocynin. This study shows that P140 peptides play a role in aggravated murine lupus in a manner dependent on ROS production and H3cit upregulation through pulmonary macrophages.
Why Do Retired Households Draw Down Their Wealth So Slowly?
Authors: French Eric , Jones John Bailey , McGee Rory
Published: November 2023

Retired households, especially those with high lifetime income, decumulate their wealth very slowly, and many die leaving large estates. The three leading explanations for the “retirement savings puzzle” are the desire to insure against uncertain lifespans and medical expenses, the desire to leave bequests to one’s heirs, and the desire to remain in one’s own home. We discuss the empirical strategies used to differentiate these motivations, most of which go beyond wealth to exploit additional features of the data. The literature suggests that all the motivations are present, but has yet to reach a consensus about their relative importance.
Σύνθεση μεσοπορώδων πολυπεπτιδικών υβριδικών νανοσωματιδίων βασισμένα στην πολυ(ιστιδίνη), τη σιλικόνη και το πολυ(αιθυλενοξείδιο) για τον εγκλωβισμό και την αποδέσμευση φαρμάκων
Authors: Αρφαρά Φωτεινή
Published: November 2023

Στην παρούσα Διδακτορική Διατριβή παρουσιάζεται ο σχεδιασμός και η σύνθεση καινοτόμων νανοσωματιδίων πυριτίας (MSN) εμβολιασμένων με αλυσίδες πολυ(αιθυλενοξειδίου) (PEG) και πολυ(ιστιδίνης) (PHis) με τη μέθοδο «εμβολιασμός σε» και με πολυμερισμό διάνοιξης δακτυλίου (ROP), αντίστοιχα. Χρησιμοποιούνται αλυσίδες PEG-σιλανίων για να εμβολιασθεί πολυ(αιθυλενοξείδιο) στην εξωτερική επιφάνεια των MSN και APTES ((3-αμινοπροπυλο)τριεθοξυσιλάνιο) για να εισαχθούν πρωτοταγείς αμινομάδες στην εξωτερική επιφάνεια των MSN που λειτουργούν ως εκκινητές ROP. Τα νανοσωματίδια αποκτούν, έτσι, ιδιότητες stealth και ένα ευαίσθητο στο pH κέλυφος πολυ(ιστιδίνης). Η μέθοδος που εφαρμόζεται για τη λειτουργικότητα των MSN, εγγυάται ότι δεν υπάρχουν εμβολιασμένες αλυσίδες PEO και PHis μέσα στα νανοκανάλια των MSN. Ο επιτυχής εμβολιασμός των αλυσίδων PEO και PHis επιβεβαιώνεται με μεθόδους χαρακτηρισμού, όπως φασματοσκοπία FT-IR, NMR, TEM, SEM και TGA. Η δυναμική σκέδαση φωτός (DLS) και η ανάλυση ζ-δυναμικού χρησιμοποιούνται για να επιβεβαιώσουν την αποκρισιμότητα του συστήματος MSN-PEO-PHis στο pH. Το παραπάνω σύστημα παρουσιάζει την ικανότητα να εγκλωβίζει και να αποδεσμεύει το αντικαρκινικό φάρμακο δοξορουβικίνη με στοχευμένο και ελεγχόμενο τρόπο σε συνθήκες καρκινικού ιστού, όπως επιβεβαιώνεται με in vitro και in vivo μελέτες.
Υφομετρική προσέγγιση γραπτών αποτυπωμάτων ελληνικών τρομοκρατικών οργανώσεων μέσω υπολογιστικών τεχνικών
Authors: Κορασίδη Αδριάνα-Μαρία
Published: November 2023

Η τρομοκρατία στην Ελλάδα αν και έχει μελετηθεί ως πολιτικό και κοινωνιοψυχολογικό φαινόμενο, ωστόσο ποτέ δεν μελετήθηκε εκτενώς από γλωσσική άποψη από την αρχή της «επίσημης» εμφάνισής της στον ελληνικό χώρο μέχρι και σήμερα. Η παρούσα διατριβή φιλοδοξεί να διερευνήσει γλωσσικά ένα αντιπροσωπευτικό δείγμα των γραπτών αποτυπωμάτων διαφόρων ελληνικών τρομοκρατικών οργανώσεων (προκηρύξεων) με την χρήση υπολογιστικών τεχνικών και τη συστηματική μελέτη του ύφους των συντακτών τους, κυρίως από ποσοτική σκοπιά που μπορεί να παρέχει ενδείξεις περαιτέρω ποιοτικής διερεύνησης. Ο απώτερος σκοπός της ερευνητικής αυτής εργασίας είναι η εξαγωγή του διακριτού υφομετρικού αποτυπώματος των συγγραφέων, η αναζήτηση συγγραφικής πατρότητας και ο καθορισμός του προφίλ και της συναισθηματικής κατάστασης των ατόμων που έχουν εμπλακεί στην συγγραφή τους, καθώς και η σύγκριση της ελληνικής περίπτωσης με τα πορίσματα της διεθνούς βιβλιογραφίας σχετικά με τον τρομοκρατικό «νου». Μέσα από την ενδελεχή υφομετρική και υφολογική επεξεργασία των συγκεκριμένων κειμένων θα μπορέσουμε να φωτίσουμε έστω και έμμεσα τις ψυχολογικές παραμέτρους που επενεργούν κατά τη διάρκεια της παραγωγής κειμένων τα οποία άλλοτε αναλαμβάνουν την ευθύνη για κάποια ενέργεια και άλλοτε αιτιολογούν ή διευκρινίζουν τις συνθήκες τέλεσης μίας τρομοκρατικής δράσης. Τα ποσοτικά, στοιχεία θα μελετηθούν ως έναν βαθμό ποιοτικά υπό το πρίσμα των κοινωνικών και ιδεολογικών παραμέτρων που ερμηνεύουν και ερμηνεύονται από τον λόγο αποβλέποντας στην πρώτη απόπειρα δημιουργίας ενός «γλωσσικού» και κατ’ επέκταση ιδεολογικού χάρτη της τρομοκρατίας στην Ελλάδα. Η παρούσα διατριβή μπορεί να θεωρηθεί ως συμβολή στον ευρύτερο διεπιστημονικό κλάδο της της δικανικής/εγκληματολογικής γλωσσολογίας, καθώς τεκμηριώνεται η αναγκαιότητα χρήσης της γλωσσολογικής ανάλυσης ως μέρος των νομικών αποδείξεων σε περιπτώσεις εγκληματολογικού/δικαστικού ενδιαφέροντος.
Expert support
Authors: Rawstrone Annette
Published: November 2023

An award scheme is helping early years practitioners to support children with speech, language and communication delay. Annette Rawstrone finds out how it has improved practice and outcomes at one setting in London
HR Guru: Neonatal Leave
Authors: Edmunds Imogen
Published: November 2023

Imogen Edmunds, managing director of Redwing Solutions, which specialises in HR for early years settings, on maternity rights.
Market View: Sector Views
Authors: Kanwar Arun
Published: November 2023

Arun Kanwar, managing partner at Cairneagle, on key findings from the firm's survey of early years providers
Out of hours
Authors: Jozwiak Gabriella
Published: November 2023

Should early years settings allow their staff members to carry out babysitting work for parents in their own time? Gabriella Jozwiak asks our panel
Antibiotic resistance in patients with liver cirrhosis: Prevalence and current approach to tackle
Authors: Liakina Valentina
Published: November 2023

Type 2 diabetes mellitus (T2DM), which is distinguished by increased glucose levels in the bloodstream, is a metabolic disease with a rapidly increasing incidence worldwide. Nevertheless, the etiology and characteristics of the mechanism of T2DM remain unclear. Recently, abundant evidence has indicated that the intestinal microbiota is crucially involved in the initiation and progression of T2DM. The gut microbiome, the largest microecosystem, engages in material and energy metabolism in the human body. In this review, we concentrated on the correlation between the gut flora and T2DM. Meanwhile, we summarized the pathogenesis involving the intestinal flora in T2DM, as well as therapeutic approaches aimed at modulating the gut microbiota for the management of T2DM. Through the analysis presented here, we draw attention to further exploration of these research directions.
Simultaneous lateral and subxiphoid access methods for safe and accurate resection of a superior vena cava aneurysm: A case report
Authors: Kim Sang Pil , Son Joohyung
Published: November 2023

Type 2 diabetes mellitus (T2DM), which is distinguished by increased glucose levels in the bloodstream, is a metabolic disease with a rapidly increasing incidence worldwide. Nevertheless, the etiology and characteristics of the mechanism of T2DM remain unclear. Recently, abundant evidence has indicated that the intestinal microbiota is crucially involved in the initiation and progression of T2DM. The gut microbiome, the largest microecosystem, engages in material and energy metabolism in the human body. In this review, we concentrated on the correlation between the gut flora and T2DM. Meanwhile, we summarized the pathogenesis involving the intestinal flora in T2DM, as well as therapeutic approaches aimed at modulating the gut microbiota for the management of T2DM. Through the analysis presented here, we draw attention to further exploration of these research directions.
Ultrafast power Doppler imaging for ischemic encephalopathy: A case report
Authors: Huang Li-Jie , Jiao Jian-Feng , He Qiong , Luo Jian-Wen , Guo Yi
Published: November 2023

Type 2 diabetes mellitus (T2DM), which is distinguished by increased glucose levels in the bloodstream, is a metabolic disease with a rapidly increasing incidence worldwide. Nevertheless, the etiology and characteristics of the mechanism of T2DM remain unclear. Recently, abundant evidence has indicated that the intestinal microbiota is crucially involved in the initiation and progression of T2DM. The gut microbiome, the largest microecosystem, engages in material and energy metabolism in the human body. In this review, we concentrated on the correlation between the gut flora and T2DM. Meanwhile, we summarized the pathogenesis involving the intestinal flora in T2DM, as well as therapeutic approaches aimed at modulating the gut microbiota for the management of T2DM. Through the analysis presented here, we draw attention to further exploration of these research directions.
Intermittent spontaneous ovulation in patients with premature ovarian failure: Three case reports and review of literature
Authors: Zhang Wan-Yu , Wang Han-Bi , Deng Cheng-Yan
Published: November 2023

Type 2 diabetes mellitus (T2DM), which is distinguished by increased glucose levels in the bloodstream, is a metabolic disease with a rapidly increasing incidence worldwide. Nevertheless, the etiology and characteristics of the mechanism of T2DM remain unclear. Recently, abundant evidence has indicated that the intestinal microbiota is crucially involved in the initiation and progression of T2DM. The gut microbiome, the largest microecosystem, engages in material and energy metabolism in the human body. In this review, we concentrated on the correlation between the gut flora and T2DM. Meanwhile, we summarized the pathogenesis involving the intestinal flora in T2DM, as well as therapeutic approaches aimed at modulating the gut microbiota for the management of T2DM. Through the analysis presented here, we draw attention to further exploration of these research directions.
Malignant peripheral nerve sheath tumor with hemophilic syndrome and bone marrow fibrosis: A rare case report
Authors: Li Hui , Wang Li , Wu Ying-Hong , Chen Gang , Li Hong-Xia , Fan Li-Fen , Gu Min , Jiang Cai-Hong
Published: November 2023

Type 2 diabetes mellitus (T2DM), which is distinguished by increased glucose levels in the bloodstream, is a metabolic disease with a rapidly increasing incidence worldwide. Nevertheless, the etiology and characteristics of the mechanism of T2DM remain unclear. Recently, abundant evidence has indicated that the intestinal microbiota is crucially involved in the initiation and progression of T2DM. The gut microbiome, the largest microecosystem, engages in material and energy metabolism in the human body. In this review, we concentrated on the correlation between the gut flora and T2DM. Meanwhile, we summarized the pathogenesis involving the intestinal flora in T2DM, as well as therapeutic approaches aimed at modulating the gut microbiota for the management of T2DM. Through the analysis presented here, we draw attention to further exploration of these research directions.
Ultrasonographic identification of lateral femoral cutaneous nerve anatomical variation in persistent meralgia paresthetica: A case report
Authors: Park Hyeong-Woo , Ji Kyung-Suk , Kim Jun-Hyung , Kim Li-Na , Ha Kang-Wook
Published: November 2023

Type 2 diabetes mellitus (T2DM), which is distinguished by increased glucose levels in the bloodstream, is a metabolic disease with a rapidly increasing incidence worldwide. Nevertheless, the etiology and characteristics of the mechanism of T2DM remain unclear. Recently, abundant evidence has indicated that the intestinal microbiota is crucially involved in the initiation and progression of T2DM. The gut microbiome, the largest microecosystem, engages in material and energy metabolism in the human body. In this review, we concentrated on the correlation between the gut flora and T2DM. Meanwhile, we summarized the pathogenesis involving the intestinal flora in T2DM, as well as therapeutic approaches aimed at modulating the gut microbiota for the management of T2DM. Through the analysis presented here, we draw attention to further exploration of these research directions.
Isolated axillary tumor deposit consistent with primary breast carcinoma: A case report
Authors: Li Tian , Zhang Wei-Hong , Liu Juan , Mao Yi-Ling , Liu Sheng
Published: November 2023

Type 2 diabetes mellitus (T2DM), which is distinguished by increased glucose levels in the bloodstream, is a metabolic disease with a rapidly increasing incidence worldwide. Nevertheless, the etiology and characteristics of the mechanism of T2DM remain unclear. Recently, abundant evidence has indicated that the intestinal microbiota is crucially involved in the initiation and progression of T2DM. The gut microbiome, the largest microecosystem, engages in material and energy metabolism in the human body. In this review, we concentrated on the correlation between the gut flora and T2DM. Meanwhile, we summarized the pathogenesis involving the intestinal flora in T2DM, as well as therapeutic approaches aimed at modulating the gut microbiota for the management of T2DM. Through the analysis presented here, we draw attention to further exploration of these research directions.
Women’s issues, critical actors and the media: substantive representation of women and gendered media coverage in South Korea
Authors: Shim Jaemin
Published: November 2023

The article investigates whether media coverage varies for male and female legislators with regards to their activities in promoting women’s interests. To test this, 30 key women’s-issue-promoting legislators in South Korea are selected, primarily based on their legislative significance within a women’s-issue bill co-sponsorship network between 2004 and 2016, and their various substantive representation efforts are analysed by examining 45 news outlets. Findings reveal that while receiving less media coverage than their male counterparts overall, female legislators have higher odds of receiving a more focused spotlight concerning women’s-issue-promotion efforts. However, the gendered media coverage was only driven by women’s issues with strong stereotypically feminine policy characteristics, for example, abortion, contraception and sexual harassment, and not by those with both feminine and masculine policy characteristics, such as childcare support and maternity leave. The article demonstrates the importance of media-bias conditionality and thus calls for a more nuanced approach to be taken in future research.
The Western through a Monocle: Fritz Lang's Examination of Western Mythology
Authors: Roberts Justin J.
Published: November 2023

abstract: In his Westerns The Return of Frank James (1940), Western Union (1941), and Rancho Notorious (1952), director Fritz Lang interrogated Western genre tropes. By examining the theatricality of Westerns, the presentation of Native Americans in Westerns, and the frames used by Western storytellers, Lang questioned the nature of Hollywood Westerns. Later filmmakers, particularly Sergio Leone and Clint Eastwood, have shown their debt to Lang's films by alluding to them in their own films.