bluuebunny/crossref_metadata_2025 huggingface dataset:
Social Withdrawal, Solitude, and Existential Concerns in Emerging Adulthood
Authors: Galanaki Evangelia P. , Nelson Larry J. , Antoniou Faye
Published: April 2023

This study aimed to investigate the ways subtypes of social withdrawal and dimensions of solitude are related to existential concerns in emerging adulthood. The links between social withdrawal/solitude and existential well-being are a highly neglected research issue. Participants were 774 emerging adults (50.4% males) aged 18–25 ( M = 20.07) from Greece. They completed measures on social withdrawal, solitude, authenticity, meaning in life, existential anxiety, and existential loneliness. We used structural equation modeling to analyze the data. Results indicated that shyness, avoidance, and isolation were associated with more existential concerns, whereas unsociability was associated with less existential concerns. The solitude dimensions—enlightenment, freedom, intimacy, and loneliness—were differentially associated with existential concerns, with enlightenment exhibiting the most existential benefits. Findings showed that existential well-being is dependent on emerging adults’ quality of withdrawal experiences and ability to make constructive use of solitude.
Lived Experiences of Adult Cancer Patients Undergoing Chemotherapy Treatment at University of Gondar Specialized Hospital, North West Ethiopia, 2021
Authors: Nuru Muhamed Ahmed , Kerie Sitotaw , Biresaw Henok , Zewdie Amare , Habtie Adane , Kassa Anteneh
Published: April 2023

Cancer is a global public health problem and it exposes patients with a wide range of physical, psychological, social, and financial problems. Experiences, feelings and thoughts patients have during the course of the disease are the determining factors of disease management. However, most of the studies analyzing cancer patients’ experiences have been performed only in high-income countries and the situation for cancer patients in Ethiopia is largely unknown. This study aimed to explore the lived experiences of adult cancer patients undergoing Chemotherapy treatment at University of Gondar specialized Hospital, Ethiopia. A phenomenological study design was conducted among adult cancer patients undergoing chemotherapy treatment at University of Gondar specialized Hospital. In-depth interview was conducted with 13 participants by using purposive sampling technique from March 15 to April 15, 2021. The data collection process facilitated by using semi-structured Amharic interview guide. After transcription and translation, data were analyzed by using a thematic analysis method. The ATLAS.ti software version 9 was used for coding and categorization. The result was reported using narrative and mentioned indirect quotation. The findings of the study revealed four main themes: “psychological discomfort,” “functional status impairment,” “experiences about chemotherapy treatment,” and “coping mechanism.” The findings revealed that being diagnosed with cancer is the most traumatic experience and affect all aspect of a patient life. Despite the side effects, the treatment gives hope for a new life. Social and spiritual supports have importance in coping the negative effects of living with cancer. Therefore, health care providers should provide psychosocial care to cancer patients from there diagnosis and in there treatment in dealing with this difficult process.
The Inequity Z: Income Fairness Perceptions in Europe across the Income Distribution
Authors: Kalleitner Fabian , Bohmann Sandra
Published: April 2023

Using data from the European Social Survey, we examine income fairness evaluations of 17,605 respondents from 28 countries. Respondents evaluated the fairness of their own incomes as well as the fairness of the incomes of the top and bottom income deciles in their countries. Depicted on a single graph, these income fairness evaluations take on a Z-shaped form, which we call the “inequity Z”. The inequity Z reveals an extensive level of consensus within each country regarding the degree of unfairness of top and bottom incomes. With rising income, respondents consistently judge their own incomes to be less unfair. Across countries, the gap in fairness ratings between top and bottom incomes rises with income inequality. Perceived underreward of bottom incomes is more pronounced in countries where bottom incomes are objectively lower. Thus, this visualization suggests that, when people are confronted with information about actual income levels, perceived inequity increases with inequality.
Using machine learning to identify spatial market segments. A reproducible study of major Spanish markets
Authors: Rey-Blanco David , Arbués Pelayo , López Fernando A. , Páez Antonio
Published: April 2023

Identifying market segments can improve the fit and performance of hedonic price models. In this paper, we present a novel approach to market segmentation based on the use of machine learning techniques. Concretely, we propose a two-stage process. In the first stage, classification trees with interactive basis functions are used to identify non-orthogonal and non-linear submarket boundaries. The market segments that result are then introduced in a spatial econometric model to obtain hedonic estimates of the implicit prices of interest. The proposed approach is illustrated with a reproducible example of three major Spanish real estate markets. We conclude that identifying market sub-segments using the approach proposed is a relatively simple and demonstrate the potential of the proposed modelling strategy to produce better models and more accurate predictions.
Free Music Notation Software and Web-Based Applications
Authors: Norman Timothy David
Published: April 2023

In this column, I describe some free music notation software and web-based applications that general music educators may find useful.
Study of a constrained finite element elbow prosthesis: the influence of the implant placement
Authors: Nalbone Lorenzo , Monac Francesco , Nalbone Luca , Ingrassia Tommaso , Ricotta Vito , Nigrelli Vincenzo , Ferruzza Massimo , Tarallo Luigi , Porcellini Giuseppe , Camarda Lawrence
Published: April 2023

Background

The functional results of total elbow arthroplasty (TEA) are controversial and the medium- to long-term revision rates are relatively high. The aim of the present study was to analyze the stresses of TEA in its classic configuration, identify the areas of greatest stress in the prosthesis–bone–cement interface, and evaluate the most wearing working conditions.

Materials and methods

By means of a reverse engineering process and using a 3D laser scanner, CAD (computer-aided drafting) models of a constrained elbow prosthesis were acquired. These CAD models were developed and their elastic properties, resistance, and stresses were studied through finite element analysis (finite element method—FEM). The obtained 3D elbow-prosthesis model was then evaluated in cyclic flexion–extension movements (> 10 million cycles). We highlighted the configuration of the angle at which the highest stresses and the areas most at risk of implant mobilization develop. Finally, we performed a quantitative study of the stress state after varying the positioning of the stem of the ulnar component in the sagittal plane by ± 3°.

Results

The greatest von Mises stress state in the bone component for the 90° working configuration was 3.1635 MPa, which occurred in the most proximal portion of the humeral blade and in the proximal middle third of the shaft. At the ulnar level, peaks of 4.1763 MPa were recorded at the proximal coronoid/metaepiphysis level. The minimum elastic resistance and therefore the greatest stress states were recorded in the bone region at the apex of the ulnar stem (0.001967 MPa). The results of the analysis for the working configurations at 0° and 145° showed significant reductions in the stress states for both prosthetic components; similarly, varying the positioning of the ulnar component at 90° (− 3° in the sagittal plane, 0° in the frontal plane) resulted in better working conditions with a greater resulting developed force and a lower stress peak in the ulnar cement.

Conclusion

The areas of greatest stress occur in specific regions of the ulnar and humeral components at the bone–cement–prosthesis interface. The heaviest configuration in terms of stresses was when the elbow was flexed at 90°. Variations in the positioning in the sagittal plane can mechanically affect the movement, possibly resulting in longer survival of the implant.

Level of evidence: 5
Association of estimated glomerular filtration rate and all-cause mortality in acute pancreatitis: a retrospective analysis
Authors: Gong Fang , Zhou Quan , Gui Chunmei , Huang Shaohua
Published: April 2023

Background

Our primary objective was to explore the association between estimated glomerular filtration rate (eGFR) and all-cause mortality in acute pancreatitis (AP) admission to intensive care units.

Methods

This study is a retrospective cohort analysis based on the Medical Information Mart for Intensive Care III database. The eGFR was calculated based on Chronic Kidney Disease Epidemiology Collaboration equation. Cox models with restricted cubic spline functions were used to evaluated the association of eGFR with all-cause mortality.

Results

The mean eGFR was 65.93 ± 38.56 ml/min/1.73 m2 in 493 eligible patients. 28-day mortality was 11.97% (59/ 493), which decreased by 15% with every 10 ml/min/1.73 m2 increase in eGFR. The adjusted hazard ratio (95% confidence interval) was 0.85 (0.76–0.96). A non-linear association was proved between eGFR and all-cause mortality. When eGFR < 57 ml/min/1.73 m2, there was a negative correlation between eGFR and 28-day mortality, hazard ratio (95% CI) was 0.97 (0.95, 0.99). The eGFR was also negatively correlated with in-hospital and in-ICU mortality. Subgroup analysis confirmed that the association between eGFR and 28-day mortality in different characteristics was stable.

Conclusions

The eGFR was negatively correlated with all-cause mortality in AP when eGFR is less than the threshold inflection point.
Mixed infection of three nontuberculous mycobacteria species identified by metagenomic next-generation sequencing in a patient with peritoneal dialysis-associated peritonitis: a rare case report and literature review
Authors: Chen Xiangfeng , Zhu Jie , Liu Zhou , Ye Jun , Yang Liqi , Zhang Zhenhua
Published: April 2023

Background

Peritonitis caused by nontuberculous mycobacteria (NTM) is an infrequent but important complication in patients undergoing peritoneal dialysis (PD). There has been no report of mixed infections with multiple NTM. Peritoneal dialysis-associated peritonitis (PDAP) caused by Mycobacterium abscessus is more common than that caused by M. smegmatis and M. goodii.

Case presentation

This case concerns a patient with PDAP caused by gram-positive bacilli, which could not be identified at the species level in successive detections of initial peritoneal effluent. Later, M. smegmatis was detected with no sensitivity results in bacterial culture. However, metagenomic next-generation sequencing (mNGS) and first whole-genome sequences indicated that there were three species coexisting in the culture, including M. smegmatis (24,708 reads), M. abscessus (9224 reads), and M. goodii (8305 reads). This is the first case of PDAP with specific evidence that conventional detection methods isolated a poorly pathogenic NTM, whereas mNGS and first whole-genome sequences identified multiple NTM. Pathogenic bacteria might not be detected using conventional methods due to their lower abundance. This case report is the first description of mixed infections with more than two species of NTM during PDAP.

Conclusions

PDAP caused by multiple NTM is rare, and the diagnosis is difficult. When NTM are isolated by conventional tests in patients who are suspected of infection, clinicians should be vigilant, and further tests should be performed to determine the presence of rare or even previously unknown bacteria, for which the quantity is relatively low, but the pathogenicity is high. The rare pathogen may be a primary agent in causing such complications.
Development and validation of a screening questionnaire for early identification of pregnant women at risk for excessive gestational weight gain
Authors: Geyer Kristina , Raab Roxana , Hoffmann Julia , Hauner Hans
Published: April 2023

Background

Excessive weight gain during pregnancy is associated with adverse health outcomes for mother and child. Intervention strategies to prevent excessive gestational weight gain (GWG) should consider women’s individual risk profile, however, no tool exists for identifying women at risk at an early stage. The aim of the present study was to develop and validate a screening questionnaire based on early risk factors for excessive GWG.

Methods

The cohort from the German “Gesund leben in der Schwangerschaft”/ “healthy living in pregnancy” (GeliS) trial was used to derive a risk score predicting excessive GWG. Sociodemographics, anthropometrics, smoking behaviour and mental health status were collected before week 12th of gestation. GWG was calculated using the last and the first weight measured during routine antenatal care. The data were randomly split into development and validation datasets with an 80:20 ratio. Using the development dataset, a multivariate logistic regression model with stepwise backward elimination was performed to identify salient risk factors associated with excessive GWG. The β coefficients of the variables were translated into a score. The risk score was validated by an internal cross-validation and externally with data from the FeLIPO study (GeliS pilot study). The area under the receiver operating characteristic curve (AUC ROC) was used to estimate the predictive power of the score.

Results

1790 women were included in the analysis, of whom 45.6% showed excessive GWG. High pre-pregnancy body mass index, intermediate educational level, being born in a foreign country, primiparity, smoking, and signs of depressive disorder were associated with the risk of excessive GWG and included in the screening questionnaire. The developed score varied from 0–15 and divided the women´s risk for excessive GWG into low (0–5), moderate (6–10) and high (11–15). The cross-validation and the external validation yielded a moderate predictive power with an AUC of 0.709 and 0.738, respectively.

Conclusions

Our screening questionnaire is a simple and valid tool to identify pregnant women at risk for excessive GWG at an early stage. It could be used in routine care to provide targeted primary prevention measures to women at particular risk to gain excessive gestational weight.

Trial registration

NCT01958307, ClinicalTrials.gov, retrospectively registered 9 October 2013.
Cervical cancer survival prediction by machine learning algorithms: a systematic review
Authors: Rahimi Milad , Akbari Atieh , Asadi Farkhondeh , Emami Hassan
Published: April 2023

Background

Cervical cancer is a common malignant tumor of the female reproductive system and is considered a leading cause of mortality in women worldwide. The analysis of time to event, which is crucial for any clinical research, can be well done with the method of survival prediction. This study aims to systematically investigate the use of machine learning to predict survival in patients with cervical cancer.

Method

An electronic search of the PubMed, Scopus, and Web of Science databases was performed on October 1, 2022. All articles extracted from the databases were collected in an Excel file and duplicate articles were removed. The articles were screened twice based on the title and the abstract and checked again with the inclusion and exclusion criteria. The main inclusion criterion was machine learning algorithms for predicting cervical cancer survival. The information extracted from the articles included authors, publication year, dataset details, survival type, evaluation criteria, machine learning models, and the algorithm execution method.

Results

A total of 13 articles were included in this study, most of which were published from 2018 onwards. The most common machine learning models were random forest (6 articles, 46%), logistic regression (4 articles, 30%), support vector machines (3 articles, 23%), ensemble and hybrid learning (3 articles, 23%), and Deep Learning (3 articles, 23%). The number of sample datasets in the study varied between 85 and 14946 patients, and the models were internally validated except for two articles. The area under the curve (AUC) range for overall survival (0.40 to 0.99), disease-free survival (0.56 to 0.88), and progression-free survival (0.67 to 0.81), respectively from (lowest to highest) received. Finally, 15 variables with an effective role in predicting cervical cancer survival were identified.

Conclusion

Combining heterogeneous multidimensional data with machine learning techniques can play a very influential role in predicting cervical cancer survival. Despite the benefits of machine learning, the problem of interpretability, explainability, and imbalanced datasets is still one of the biggest challenges. Providing machine learning algorithms for survival prediction as a standard requires further studies.
Children with severe enterovirus A71 infection
Authors: Wu Wenjuan , Li Baoguang , Xie Tao
Published: April 2023

Background

There are few reports on the timing of onset and the symptoms of enterovirus A71 (EV-A71) infection, which can easily be misdiagnosed. This study aimed to explore the clinical characteristics of children with severe EV-A71 infection.

Methods

This retrospective observational study included children with severe EV-A71 infection admitted to Hebei Children’s Hospital between January 2016 and January 2018.

Results

A total of 101 patients were included: 57 males (56.4%) and 44 females (43.6%). They were 1–13 years of age. The symptoms were fever in 94 patients (93.1%), rash in 46 (45.5%), irritability in 70 (69.3%), and lethargy in 56 (55.4%). There were 19 (59.3%) patients with abnormal neurological magnetic resonance imaging [pontine tegmentum (n = 14, 43.8%), medulla oblongata (n = 11, 34.4%), midbrain (n = 9, 28.1%), cerebellum and dentate nucleus (n = 8, 25.0%), basal ganglia (n = 4, 12.5%), cortex (n = 4, 12.5%), spinal cord (n = 3, 9.3%), and meninges (n = 1, 3.1%)]. There was a positive correlation between the ratio of neutrophil count and white blood cell count in cerebrospinal fluid in the first 3 days of the disease (r = 0.415, P < 0.001).

Conclusion

The clinical symptoms of EV-A71 infection are fever and/or skin rash, irritability, and lethargy. Some patients have abnormal neurological magnetic resonance imaging. The white blood cell count in the cerebrospinal fluid of children with EV-A71 infection may increase alongside neutrophil counts.
Depression and anxiety in peruvian military personnel during the pandemic context: a cross-sectional study
Authors: Valladares-Garrido Mario J. , Picón-Reátegui Cinthia Karina , Zila-Velasque J. Pierre , Grados-Espinoza Pamela , Vera-Ponce Víctor J. , Pereira-Victorio César Johan , Valladares-Garrido Danai , Failoc-Rojas Virgilio E.
Published: April 2023

Background

During the COVID-19 pandemic, increased workload and stress could have increased mental health problems (anxiety and depression) in military personnel. However, the number of studies in military members is scarce, especially in regard to mental health. The objective of this study was determine the prevalence and factors associated with depression and anxiety in Peruvian military personnel.

Methods

We undertook an analytical cross-sectional study. The survey was distributed face to face between November 02 and 09, 2021, during the second wave of the COVID-19 pandemic among the military personnel. We used some instruments to measure depression (Patient Health Questionnaire, PHQ-9), anxiety (Generalized Anxiety Disorder, GAD-7), insomnia (Insomnia Severity Index, ISI), food insecurity (Household Food Insecurity Access Scale, HFIAS), physical activity (International Physical Activity Questionnaires, IPAQ-S), resilience (abbreviated CD-RISC), and fear of COVID-19 scale. The exclusion criteria included those who did not completely fill out the evaluation instruments.

Results

We analyzed the data of 615 military personnel that participated in the survey. Of them, 93.7% were male and the median age was 22 years old. There was a prevalence of 29.9% and 22.0% in regard to depression and anxiety symptoms, respectively. In addition, it was found that being married (PR: 0.63; 95% IC: 0.42–0.94), having a relative with mental health problems (PR: 2.16), having experienced food insecurity (PR: 1.48), insomnia (PR: 2.71), fear of COVID-19 (PR: 1.48), and a high level of resilience (PR: 0.65) were factors associated with depression. In regard to anxiety, the factors associated were working for more than 18 months since the beginning of the COVID-19 pandemic (PR: 0.52), a high level of resilience (PR: 0.50; 95% IC: 0.33–0.77), insomnia (PR: 3.32), fear of COVID-19 (PR: 2.43).

Conclusion

We found a prevalence of symptoms of depression and anxiety of 29.9% and 22.0%, respectively. In regard to the factors that attenuate depression, we can mention being married and having resilience; and among the aggravating factors, having a relative with mental health problems, food insecurity, insomnia, and fear of COVID-19. Finally, anxiety increased through working time, insomnia, and fear of COVID-19.
Physician-patient boundaries in palliative care
Authors: Ho Chong Yao , Lim Nicole-Ann , Rahman Nur Diana Abdul , Chiam Min , Zhou Jamie Xuelian , Phua Gillian Li Gek , Ong Eng Koon , Lim Crystal , Chowdhury Anupama Roy , Krishna Lalit Kumar Radha
Published: April 2023

Background

Nurturing effective physician-patient relationships is essential to the provision of patient-centred care. Palliative care physicians may apply boundary-crossings or breaches in professional standards to nurture effective physician-patient relationships. Being highly individualized and shaped by the physician’s narratives, clinical experience, and contextual considerations, boundary-crossings are susceptible to ethical and professional violations. To better appreciate this concept, we employ the Ring Theory of Personhood (RToP) to map the effects of boundary-crossings on the physician’s belief systems.

Methods

As part of the Tool Design SEBA methodology, a Systematic Evidence-Based Approach (SEBA) guided systematic scoping review was employed to guide the design of a semi-structured interview questionnaire with palliative care physicians. The transcripts were simultaneously content and thematically analysed. The themes and categories identified were combined using the Jigsaw Perspective and the resulting domains formed the basis for the discussion.

Results

The domains identified from the 12 semi-structured interviews were catalysts and boundary-crossings. Boundary-crossings attempt to address threats to a physician’s belief systems (catalysts) and are highly individualized. Employ of boundary-crossings depend on the physician’s sensitivity to these ‘catalysts’, their judgement and willingness to act, and their ability to balance various considerations and reflect on their actions and their ramifications. These experiences reshape belief systems, understandings of boundary-crossings and may influence decision-making and practice, underscoring the potential for greater professional breaches when unchecked.

Conclusion

Underlining its longitudinal effects, the Krishna Model underscores the importance of longitudinal support, assessment and oversight of palliative care physicians, and lays the foundation for a RToP-based tool to be employed within portfolios.
Puzzle game-based learning: a new approach to promote learning of principles of coronary artery bypass graft surgery
Authors: Khorammakan Reza , Omid Athar , Mirmohammadsadeghi Mohsen , Ghadami Ahmad
Published: April 2023

Introduction

Since learning with high educational quality requires an advanced intervention. This study seeks to answer how many puzzles game-based training can improve knowledge and cognitive function of surgical technology students in CABG surgery and its sequence, as well as the tools and equipment used in each stage of surgery and the sequence of their preparation.

Materials and methods

This study was carried out as a quasi-experimental single-group pre-test-post-test, during which, after designing a puzzle game including various stages of surgery (from the preparation of the patient for surgical sutures and the necessary equipment to perform each stage), 18 people from third-year surgical technology students who met the inclusion criteria were entered in the study by convenience sampling method and based on the sample size determined using a similar study and they participated in the test of knowledge and cognitive function, that the validity and reliability were measured, before the intervention and 14 days after the intervention (using a puzzle game). Data were analyzed using descriptive and Wilcoxon statistical tests.

Results

After the withdrawal of 2 people, 15 person (93.80 per cent) of the students were female, the average age of students was 21.87 ± 0.71 years, and 50% (8 people) of them were 22 years old. Also, the average score of the end-of-semester exam of the heart surgery technology course was 15.19 ± 2.30 (the lowest score was 11.25, and the highest score was 18.63), and the score of 43.80% (7 people) of them were in the range of 15.01–17.70, and their average of grade point average was 17.31 ± 1.10 (the lowest grade point average is 15 and the highest grade point average is 19.36) and grade point average 75% (11 people) of students were 16–18. The average scores of knowledge(5.75 ± 1.65 vs. 2.68 ± 0.79) and cognitive performance(6.31 ± 2.57 vs. 2.00 ± 1.09) of students in the post-intervention phase were significantly higher than the pre-intervention phase (P < 0.0001).

Conclusion

The results of the present study showed that the use of puzzle games in CABG surgery training led to a significant improvement in the knowledge and cognitive performance of surgical technology students regarding the stages of CABG surgery and its sequence, as well as the tools and equipment used in each stage of surgery and the sequence of their preparation.
Genomic and transcriptomic analyses support a silk gland origin of spider venom glands
Authors: Zhu Bingyue , Jin Pengyu , Zhang Yiming , Shen Yunxiao , Wang Wei , Li Shuqiang
Published: April 2023

Background

Spiders comprise a hyperdiverse lineage of predators with venom systems, yet the origin of functionally novel spider venom glands remains unclear. Previous studies have hypothesized that spider venom glands originated from salivary glands or evolved from silk-producing glands present in early chelicerates. However, there is insufficient molecular evidence to indicate similarity among them. Here, we provide comparative analyses of genome and transcriptome data from various lineages of spiders and other arthropods to advance our understanding of spider venom gland evolution.

Results

We generated a chromosome-level genome assembly of a model spider species, the common house spider (Parasteatoda tepidariorum). Module preservation, GO semantic similarity, and differentially upregulated gene similarity analyses demonstrated a lower similarity in gene expressions between the venom glands and salivary glands compared to the silk glands, which questions the validity of the salivary gland origin hypothesis but unexpectedly prefers to support the ancestral silk gland origin hypothesis. The conserved core network in the venom and silk glands was mainly correlated with transcription regulation, protein modification, transport, and signal transduction pathways. At the genetic level, we found that many genes in the venom gland-specific transcription modules show positive selection and upregulated expressions, suggesting that genetic variation plays an important role in the evolution of venom glands.

Conclusions

This research implies the unique origin and evolutionary path of spider venom glands and provides a basis for understanding the diverse molecular characteristics of venom systems.
The economic burden of RSV-associated illness in children aged < 5 years, South Africa 2011–2016
Authors: Moyes Jocelyn , Tempia Stefano , Walaza Sibongile , McMorrow Meredith L. , Treurnicht Florette , Wolter Nicole , von Gottberg Anne , Kahn Kathleen , Cohen Adam L. , Dawood Halima , Variava Ebrahim , Cohen Cheryl
Published: April 2023

Background

Data on the economic burden of RSV-associated illness will inform decisions on the programmatic implementation of maternal vaccines and monoclonal antibodies. We estimated the cost of RSV-associated illness in fine age bands to allow more accurate cost-effectiveness models to account for a limited duration of protection conferred by short- or long-acting interventions.

Methods

We conducted a costing study at sentinel sites across South Africa to estimate out-of-pocket and indirect costs for RSV-associated mild and severe illness. We collected facility-specific costs for staffing, equipment, services, diagnostic tests, and treatment. Using case-based data we calculated a patient day equivalent (PDE) for RSV-associated hospitalizations or clinic visits; the PDE was multiplied by the number of days of care to provide a case cost to the healthcare system. We estimated the costs in 3-month age intervals in children aged < 1 year and as a single group for children aged 1–4 years. We then applied our data to a modified version of the World Health Organization tool for estimating the mean annual national cost burden, including medically and non-medically attended RSV-associated illness.

Results

The estimated mean annual cost of RSV-associated illness in children aged < 5 years was US dollars ($)137,204,393, of which 76% ($111,742,713) were healthcare system incurred, 6% ($8,881,612) were out-of-pocket expenses and 13% ($28,225,.801) were indirect costs. Thirty-three percent ($45,652,677/$137,204,393) of the total cost in children aged < 5 years was in the < 3-month age group, of which 52% ($71,654,002/$137,204,393) were healthcare system incurred. The costs of non-medically attended cases increased with age from $3,307,218 in the < 3-month age group to $8,603,377 in the 9–11-month age group.

Conclusions

Among children < 5 years of age with RSV in South Africa, the highest cost burden was in the youngest infants; therefore, interventions against RSV targeting this age group are important to reduce the health and cost burden of RSV-associated illness.
User fee exemption and malaria treatment-seeking for children under five in a Cameroonian health district: a cross-sectional study
Authors: Nzalie Rolf Nyah Tuku , Palle John Ngunde , Nsagha Dickson Shey
Published: April 2023

Background

In Cameroon, malaria contributes significantly to the morbidity and mortality of children under 5 years old. In order to encourage adequate treatment-seeking in health facilities, user fee exemptions for malaria treatment have been instituted. However, many children are still brought to health facilities in the late stage of severe malaria. This study sought to determine the factors affecting the hospital treatment-seeking time of guardians of children under 5 years within the context of this user fee exemption.

Methods

This was a cross-sectional study conducted at three randomly selected health facilities of the Buea Health District. A pre-tested questionnaire was used to collect data on the treatment-seeking behaviour and time of guardians, as well as potential predictors of this time. Hospital treatment sought after 24 h of noticing symptoms was denoted as delayed. Continuous variables were described using medians while categorical variables were described using percentages. A multivariate regression analysis was used to determine the factors affecting malaria treatment-seeking time of guardians. All statistical tests were done at a 95% confidence interval.

Results

Most of the guardians made use of pre-hospital treatments, with self-medication being practiced by 39.7% (95% CI 35.1–44.3%) of them. A total of 193 (49.5%) guardians delayed seeking treatment at health facilities. Reasons for delay included financial constraints and watchful waiting at home, during which guardians waited and hoped their child could get better without requiring medicines. Guardians with estimated monthly household incomes denoted as low/middle were significantly more likely (AOR 3.794; 95% CI 2.125–6.774) to delay seeking hospital treatment. The occupation of guardians was another significant determinant of treatment-seeking time (AOR 0.042; 95% CI 0.003–0.607). Also, guardians with tertiary education were less likely (AOR 0.315; 95% CI 0.107–0.927) to delay seeking hospital treatment.

Conclusions

This study suggests that despite user fee exemption, other factors such as educational and income levels of guardians affect malaria treatment-seeking time for children aged under five. Therefore, these factors should be considered when enacting policies aimed at increasing access of children to health facilities.
Nonlinear analysis of heart rate variability signals in meditative state: a review and perspective
Authors: Deka Bhabesh , Deka Dipen
Published: April 2023

Introduction

In recent times, an upsurge in the investigation related to the effects of meditation in reconditioning various cardiovascular and psychological disorders is seen. In majority of these studies, heart rate variability (HRV) signal is used, probably for its ease of acquisition and low cost. Although understanding the dynamical complexity of HRV is not an easy task, the advances in nonlinear analysis has significantly helped in analyzing the impact of meditation of heart regulations. In this review, we intend to present the various nonlinear approaches, scientific findings and their limitations to develop deeper insights to carry out further research on this topic.

Results

Literature have shown that research focus on nonlinear domain is mainly concentrated on assessing predictability, fractality, and entropy-based dynamical complexity of HRV signal. Although there were some conflicting results, most of the studies observed a reduced dynamical complexity, reduced fractal dimension, and decimated long-range correlation behavior during meditation. However, techniques, such as multiscale entropy (MSE) and multifractal analysis (MFA) of HRV can be more effective in analyzing non-stationary HRV signal, which were hardly used in the existing research works on meditation.

Conclusions

After going through the literature, it is realized that there is a requirement of a more rigorous research to get consistent and new findings about the changes in HRV dynamics due to the practice of meditation. The lack of adequate standard open access database is a concern in drawing statistically reliable results. Albeit, data augmentation technique is an alternative option to deal with this problem, data from adequate number of subjects can be more effective. Multiscale entropy analysis is scantily employed in studying the effect of meditation, which probably need more attention along with multifractal analysis.

Methods

Scientific databases, namely PubMed, Google Scholar, Web of Science, Scopus were searched to obtain the literature on “HRV analysis during meditation by nonlinear methods”. Following an exclusion criteria, 26 articles were selected to carry out this scientific analysis.
Correlates of intimate partner violence among pregnant and parenting adolescents: a cross-sectional household survey in Blantyre District, Malawi
Authors: Nwafor Juliet Amarachukwu , Chamdimba Elita , Ajayi Anthony Idowu , Ushie Boniface Ayanbekongshie , Munthali Alister C. , Thakwalakwa Chrissie , Kabiru Caroline W.
Published: April 2023

Background

Despite efforts from the government and developmental partners to eliminate gender-based violence, intimate partner violence (IPV) remains a pervasive global health and human rights problem, affecting up to 753 million women and girls globally. Few studies on IPV have focused on pregnant and parenting adolescent (PPA) girls in Africa, although the region has the highest rates of adolescent childbearing. This limited attention results in the neglect of pregnant and parenting adolescents in policies and interventions addressing IPV in the region. Our study examined IPV prevalence and its individual, household, and community-level correlates among pregnant and parenting adolescent girls (10–19 years) in Blantyre District, Malawi.

Methods

We collected data from a cross-section of pregnant and parenting adolescent girls (n = 669) between March and May 2021. The girls responded to questions on socio-demographic and household characteristics, lifetime experience of IPV (i.e., sexual, physical, and emotional violence), and community-level safety nets. We used multilevel mixed-effect logistic regression models to examine the individual, household, and community-level factors associated with IPV.

Results

The lifetime prevalence of IPV was 39.7% (n = 266), with more girls reporting emotional (28.8%) than physical (22.2%) and sexual (17.4%) violence. At the individual level, girls with secondary education (AOR: 1.72; 95% CI: 1.16–2.54), who engaged in transactional sex (AOR: 2.29; 95% CI: 1.35–3.89), and accepted wife-beating (AOR: 1.97; 95% CI: 1.27–3.08) were significantly more likely to experience IPV compared to those with no education/primary education, who never engaged in transactional sex and rejected wife beating. Girls aged 19 (AOR: 0.49; 95% CI: 0.27–0.87) were less likely to report IPV than those aged 13–16. At the household level, girls with fair and poor partner support had higher odds of experiencing IPV, but the effect size did not reach a significant level in the parsimonious model. A high perception of neighborhood safety was associated with a lower likelihood of experiencing IPV (AOR: 0.81; 95% CI: 0.69–0.95).

Conclusion

Intimate partner violence is rife among pregnant and parenting adolescent girls in Malawi, underscoring the need for appropriate interventions to curb the scourge. Interventions addressing IPV need to target younger adolescents, those engaging in transactional sex, and those having weaker community-level safety nets. Interventions to change social norms that drive the acceptance of gender-based violence are also warranted.
Inhibition of NLRP1 inflammasome improves autophagy dysfunction and Aβ disposition in APP/PS1 mice
Authors: Li Xuewang , Zhang Han , Yang Liu , Dong Xianan , Han Yuli , Su Yong , Li Weiping , Li Weizu
Published: April 2023

Increasing evidence has shown that the NOD-like receptor protein 1 (NLRP1) inflammasome is associated with Aβ generation and deposition, which contributes to neuronal damage and neuronal-inflammation in Alzheimer's disease (AD). However, the specific mechanism of NLRP1 inflammasome in the pathogenesis of AD is still unclear. It has been reported that autophagy dysfunction can aggravate the pathological symptoms of AD and plays an important role in regulating Aβ generation and clearance. We hypothesized that NLRP1 inflammasome activation may induce autophagy dysfunction contributing to the progression of AD. In the present study, we observed the relationship between Aβ generation and NLRP1 inflammasome activation, as well as AMPK/mTOR mediated-autophagy dysfunction in WT 9-month-old (M) mice, APP/PS1 6 M and APP/PS1 9 M mice. Additionally, we further studied the effect of NLRP1 knockdown on cognitive function, Aβ generation, neuroinflammation and AMPK/mTOR mediated autophagy in APP/PS1 9 M mice. Our results indicated that NLRP1 inflammasome activation and AMPK/mTOR mediated-autophagy dysfunction are closely implicated in Aβ generation and deposition in APP/PS1 9 M mice, but not in APP/PS1 6 M mice. Meanwhile, we found that knockdown of NLRP1 significantly improved learning and memory impairments, decreased the expressions of NLRP1, ASC, caspase-1, p-NF-κB, IL-1β, APP, CTF-β, BACE1 and Aβ1-42, and decreased the level of p-AMPK, Beclin 1 and LC3 II, and increased the level of p-mTOR and P62 in APP/PS1 9 M mice. Our study suggested that inhibition of NLRP1 inflammasome activation improves AMPK/mTOR mediated-autophagy dysfunction, resulting in the decrease of Aβ generation, and NLRP1 and autophagy might be important targets to delay the progression of AD.
Multidisciplinary rehabilitation intervention on mobility and hemodynamics of joint contracture animal model
Authors: Maimaiti Palida , Aisilahong Guhaer , Shu Jiao Jiao , Rozi Parhat , Keqike Nuerbiya , Miao Tianyu , Wang Ningning
Published: April 2023

Background

Joint contracture causes a decrease in range of motion (ROM), which severely affects activities of daily living of patients. We have investigated the effectiveness of a multidisciplinary rehabilitation on joint contracture by rat model.

Methods

We used 60 Wistar rats in this study. The rats were divided into five groups as follows: group 1 was the normal control group; except the group 1, we created left hind limb knee joint contracture using Nagai method for other four groups. The joint contracture modeling group 2 was the model control group for monitoring the spontaneous recovery, and other three groups were given different rehabilitation treatments; for example, group 3 was treadmill running group; group 4 was medication group; group 5 was treadmill running plus medication group. The left hind limbs knee joint ROM and the femoral blood flow indicators (FBFI) including PS, ED, RI, and PI were measured right before and after the 4 weeks of rehabilitation.

Result

After 4 weeks of rehabilitation treatments, the measured values of ROM and FBFI are compared with the corresponding values of group 2. Firstly, we did not see clear difference in the values of ROM and FBFI for group 2 before and after 4 weeks spontaneous recovery. The improvement of left lower limb ROM for group 4 and group 5 as compared to the group 2 was statistically significant (p < 0.05), whereas a less recovery for group 3 was observed. However as compared to the group 1, we did not observe full recovery in ROM of group 4 and group 5 after 4 weeks of rehabilitation. The PS and ED level for rehabilitation treatment groups was significantly higher than those modeling ones (Tables 2, 3,  Figs. 4, 5), while the RI and PI values show the contrary trends (Tables 4, 5, Figs. 6, 7).

Conclusion

Our results indicate that multidisciplinary rehabilitation treatments had a curative effect on both contracture of joints and the abnormal femoral circulations.
Exploiting the power of UPLC in separation and simultaneous determination of pholcodine, guaiacol along with three specified guaiacol impurities
Authors: Mohamed Hager M. , Zaazaa Hala E. , Abdelkawy M. , Tantawy Mahmoud A.
Published: April 2023

Pholcodine and guaiacol are widely used together in pharmaceutical syrups for cough treatment. On the other hand, the Ultra Performance Liquid Chromatographic technique is characterized by having the power of increasing chromatographic efficiency and decreasing run time compared to the traditional High Performance Liquid Chromatographic one. In this work, this power was exploited for the simultaneous determination of pholcodine, guaiacol along with three guaiacol impurities, namely; guaiacol impurity A, guaiacol impurity B, and guaiacol impurity E. Good separation was achieved by employing Agilent Zorbax C8 column (50 × 2.1 mm) as the stationary phase, and acetonitrile: phosphate buffer pH 3.5 (40: 60, by volume) as a mobile phase. The proposed method was validated as per International Council for Harmonisation guidelines. Linear relationships, at ranges of 50–1000 µg mL−1 for pholcodine and 5–100 µg mL−1 for guaiacol and the three related impurities, were established. Finally, the proposed method was applied for pholcodine and guaiacol determination in Coughpent® syrup and compared favorably to the reported one.
Experimental feeding of Sergentomyia minuta on reptiles and mammals: comparison with Phlebotomus papatasi
Authors: Ticha Lucie , Volfova Vera , Mendoza-Roldan Jairo Alfonso , Bezerra-Santos Marcos Antonio , Maia Carla , Sadlova Jovana , Otranto Domenico , Volf Petr
Published: April 2023

Background

Sergentomyiaminuta (Diptera: Phlebotominae) is an abundant sand fly species in the Mediterranean basin and a proven vector of reptile parasite Leishmania (Sauroleishmania) tarentolae. Although it feeds preferentially on reptiles, blood meal analyses and detection of Leishmania (Leishmania) infantum DNA in wild-caught S.minuta suggest that occasional feeding may occur on mammals, including humans. Therefore, it is currently suspected as a potential vector of human pathogens.

Methods

A recently established S.minuta colony was allowed to feed on three reptile species (i.e. lizard Podarcissiculus and geckos Tarentolamauritanica and Hemidactylusturcicus) and three mammal species (i.e. mouse, rabbit and human). Sand fly mortality and fecundity were studied in blood-fed females, and the results were compared with Phlebotomuspapatasi, vector of Leishmania (L.) major. Blood meal volumes were measured by haemoglobinometry.

Results

Sergentomyiaminuta fed readily on three reptile species tested, neglected the mouse and the rabbit but took a blood meal on human. However, the percentage of females engorged on human volunteer was low in cage (3%) and feeding on human blood resulted in extended defecation times, higher post-feeding mortality and lower fecundity. The average volumes of blood ingested by females fed on human and gecko were 0.97 µl and 1.02 µl, respectively. Phlebotomuspapatasi females readily fed on mouse, rabbit and human volunteer; a lower percentage of females (23%) took blood meal on the T.mauritanica gecko; reptilian blood increased mortality post-feeding but did not affect P.papatasi fecundity.

Conclusions

Anthropophilic behaviour of S.minuta was experimentally demonstrated; although sand fly females prefer reptiles as hosts, they were attracted to the human volunteer and took a relatively high volume of blood. Their feeding times were longer than in sand fly species regularly feeding on mammals and their physiological parameters suggest that S.minuta is not adapted well for digestion of mammalian blood. Nevertheless, the ability to bite humans highlights the necessity of further studies on S.minuta vector competence to elucidate its potential role in circulation of Leishmania and phleboviruses pathogenic to humans.

Graphical abstract