bluuebunny/crossref_metadata_2025 huggingface dataset:
Associations between urban greenspace (normalized difference vegetation index) and SARS-CoV-2 incidence and severity across three Irish cities
Authors: Hynds Paul , O'Dwyer Jean , Boudou Martin , Garvey Patricia , o'Haiseadha Coilin , Khandelwal Shivam
Published: October 2024

To date, relatively few epidemiological studies have sought to identify and quantify associations between nature and SARS-CoV-2 infection. Likewise, while multiple studies have focused on the clinical factors pre-empting SARS-CoV-2 (e.g., underlying health conditions, age), no Irish research has examined the effect of the natural environmental on SARS-CoV-2 incidence or severity (hospitalization, ICU admission and mortality). Identifying areas and communities at higher risk due to local environmental factors constitutes a knowledge gap for informing mitigation/intervention strategies prior to future similar public health events. Accordingly, the current study focused on three major Irish cities: Dublin, Cork, and Galway. A Normalized Difference Vegetation Index (NDVI) dataset was constructed using the Google Earth Engine Explorer and Sentinel-2 MSI (Multispectral Instrument) open-access software. NDVI values were geographically linked to Small Area (SA) units across all three cities and associated with their respective SARS-CoV-2 incidence and severity rates from March to November 2020, with demographically and socioeconomically delineated (to account for the confounding) generalised linear modelling subsequently employed to identify relationships between greenspace proportion and SARS-CoV-2. Overall, 22,773 symptomatic laboratory-confirmed and georeferenced cases of SARS-CoV-2 were included for analyses. Greenspace proportion was negatively associated with SARS-CoV-2 incidence rates across all three cities (i.e., increased greenspace conurrent with lower incidence of SARS-CoV-2), with these associations remaining significant when models included potential confounders (aORs 0.101–0.501). Likewise, increased greenspace was typically associated with decreased levels of SARS-CoV-2, however, associations were less pronounced or not present in areas characterised by younger populations and/or increasing affluence. Differing levels of association were found with respect to case gender (male cases typically more “responsive”) and city (less populated cities typically more “responsive”). Findings provide a crucial evidence base for researchers, policymakers and healthcare practitioners to appropriately design non-pharmaceutical interventions and engage with communities to successfully promote appropriate health behaviours.
Role of Glucocerebrosidase in Metabolic Reprogramming and Prognosis of Hepatocellular Carcinoma: Insights from a Comprehensive Gene Expression Analysis
Authors: Li Xin , Ma Jie , Wang Kun , Xu Xiaoyu , Li Jiarui , Yang Yanhui , Yang Yi
Published: October 2024

Introduction: Hepatocellular carcinoma (HCC) poses a substantial global public health concern, with its intricate pathogenesis remaining incompletely elucidated. Metabolic reprogramming is pivotal in liver cancer progression. This study investigates the role of the lysosomal enzyme Glucocerebrosidase (GBA) in HCC initiation.
Methods: We analyzed GBA-related gene expressions in 1003 primary liver cancer samples from the GEO database and 433 liver cancer samples from the TCGA database to examine GBA expression patterns and their association with liver cancer prognosis. Additionally, we manipulated GBA and glucosylceramide synthase (UGCG) expressions in the MHCC-97H cell line to investigate their effects on lysosomal and non-lysosomal metabolic genes.
Results: GBA expression was significantly elevated in liver cancer samples and closely associated with poor prognosis. Overexpression of GBA led to upregulation of related lysosomal metabolic genes (NEU1, CTSD, CTSA, GALNS, GLB1) and non-lysosomal metabolic genes (ACOT8, FDPS, PMVK, PIGC, B4GALT3). Non-lysosomal genes were involved in N-acetyl metabolism, fatty acid β-oxidation, and cholesterol synthesis. Co-upregulation of UGCG and GBA resulted in a dose-dependent increase in ACOT family gene expressions (ACOT8, ACOT4, ACOT9, ACOT11). Survival analysis indicated high expression of these genes was related to lower short-term survival rates in liver cancer patients.
Conclusion: Our findings suggest GBA plays a role in the metabolic reprogramming of HCC, influencing disease progression and prognosis by modulating genes involved in N-acetyl metabolism and lysosomal complexes. Downregulating GBA expression may present a potential therapeutic strategy for managing HCC.
Determinants and barriers of modern family planning uptake among postpartum mothers at selected regional referral hospitals in Uganda, October 2023
Authors: Nakkazi Joan , Buhuguru Remmy Nasanairo , Wandui Charles Sebunyo , Looru Mark , Emor Vincent , Misinde Ronald , Ongol Denis , Ocen James , Mwolobi Esther , Yatuwa Jude , Kizito Ali , Nakimuli Cynthia , Nambozo Harriet , Agings Willy , Opira Churchill , Morukileng Job , Nakaweesi Winfred , Elayeete Sarah , Kizito Saudah Namubiru , Ario Alex R. , Bulage Lilian , Gonahasa Doreen Nsimiire , Nansikombi Hildah Tendo
Published: October 2024

Background
Postpartum family planning (PPFP) is important in reducing the risk of complications associated with closely spaced pregnancies. Family planning programmes usually promote the use of modern methods rather than traditional methods as the latter have a higher failure rate. However, only 28% of postpartum women in Uganda use modern FP. We identified determinants and barriers of modern FP uptake among postpartum mothers at selected regional referral hospitals (RRH) in Uganda, October 2023.
Methods
We conducted a cross-sectional study among 499 postpartum mothers aged 18–49 years, and attending immunization clinics in seven selected RRH during October 2023. We defined modern FP uptake as use of a contemporary contraception method including: condoms, intrauterine devices (IUD), male or female sterilization, injectables, oral contraceptives and implants. We conducted interviews to collect data on sociodemographic characteristics, reproductive health and obstetric history and modern FP uptake. We summarized participant characteristics using frequency distributions, and identified determinants of uptake using modified Poisson regression.
Results
Among 499 postpartum mothers, most were aged 25–34 years (45%), unemployed (33%), and had attained secondary education (45%). The majority had heard about modern FP (85%), received counselling regarding PPFP (64%), and were using modern FP methods (46%). Mother being formally employed (aPR = 1.5, 95%CI: 1.1–2.1), having an employed partner (aPR = 4.14, 95%CI:1.31–13.05), exclusive breastfeeding (aPR = 0.8, 95%CI: 0.65–0.99), receiving counselling on FP (aPR = 2.9,95%CI: 2.1–4.02) were associated with modern FP uptake. Among 270 mothers who did not take up modern FP, spouse not being around (17%), fear of side effects (13%), and not being decided on method (10%) were the commonest reasons for non-uptake of modern FP.
Conclusion
Uptake of modern FP among postpartum mothers was suboptimal given that all postpartum mothers should be using family planning. Mother being employed, partner employment, exclusive breastfeeding and receiving counselling on FP were associated with uptake of modern FP. Spouse not being around, fear of side effects and not being decided on FP method, were the commonest reasons for non-uptake of modern FP. We recommended intensifying FP counseling services in addition to health education for mothers and their partners on the benefits of using modern FP to improve modern FP uptake among postpartum mothers.
Non-linear Association between Composite Dietary Antioxidant Index and Pulmonary Function: A Cross-Sectional Study Based on NHANES 2007-2012
Authors: Wang Ping , Wang Jiaxin , Jiang Zewei , Liu Bin
Published: October 2024

Background
The relationship between pulmonary function and various diseases was well established; however, limited research has been conducted to examine the association between diet and pulmonary function. Investigating the potential correlation between the composite dietary antioxidant index (CDAI) in diet and pulmonary function could provide valuable insight into the role of diet in improving pulmonary function.
Methods
This cross-sectional population-based study utilized data from National Health and Nutrition Examination Survey (NHANES 2007 - 2012). Weighted multivariate linear regression analysis and stratified analysis were constructed to analyze the association of CDAI and pulmonary function—forced expiratory volume in 1 second (FEV1) and forced vital capacity (FVC). Restricted Cubic Spline was employed to detect the non-linearly association between them.
Results
In total, 8926 individuals from the NHANES dataset represented around 149.48 million non-institutionalized residents of the United States (mean age: 44.08 ± 0.43 years, with females accounting for 50.03%). The weighted multivariable linear regression models showed a positive association between CDAI and pulmonary function, consistent with the sensitive analysis. When compared to the lowest quartile, the beta value (β) and 95% confidence intervals (CIs) for FVC in Q3 and Q4 CDAI groups were 117.18 (55.43, 178.93), and 143.57 (97.23, 189.91), respectively; for FEV1, they were 70.64 (21.21, 120.07), and 76.68 (25.73, 127.63).
Conclusions
Our investigation found that CDAI levels were non-linearly and positively associated to FVC and FEV1. Based on these results, supplementing the combined antioxidants derived from food may be a promising and effective strategy for improving pulmonary function.
First report of invasive mealybug Hypogeococcus pungens Granara de Willink from India
Authors: Joshi Sunil , Rajgopal Nernakallu N. , Amarendra Bellapu , Asritha Chava , Karthik Chiikkabidare M. , Venkatesan Thiruvengadam , Sushil Satya Nand
Published: October 2024

Over the last decade, India has witnessed unintentional entry of five species of invasive species of mealybugs, perhaps due to globalization and global trade, leading to economic and ecological negative consequences. Through this paper, we report the first occurrence of the destructive mealybug Hypogeococcus pungens Granara de Willink in India infesting two nursery plant species of Alternanthera and a wild Portulaca sp. As early detection, identification, and rapid reporting are essential for the successful management of destructive species, we describe in details the field and diagnostic characters of mounted mealybug with help of field and microphotographic images. We also confirmed the identity of the mealybug through molecular studies by sequencing mitochondrial cytochrome c oxidase I (COX I) and 28S ribosomal genes. Information on its host range, natural enemies, and distribution is provided. Management options in the event of an outbreak are discussed briefly. This new arrival warrants special attention in India as it is a potentially damaging plant pest in landscapes, and vertical gardening practiced in offices, commercial complexes, and luxury apartments.
Association between Headache and Mild Cognitive Impairment (MCI) among Middle-aged and Elderly Individuals: Evidence from the China Health and Retirement Longitudinal Study (CHARLS)
Authors: Li Tianjiao , Li Lingxuan , Bai Xiujuan , Xie Hongyang , Ping Rongyu , Guo Yane , Li Dongmei , Zhang Yuwei , Sun Bo
Published: October 2024

Background
Studies investigating the association between headache and mild cognitive impairment (MCI) are lacking. This study evaluated the independent association between headache and MCI among middle-aged and older Chinese adults using data from the China Health and Retirement Longitudinal Study (CHARLS).
Methods
This prospective cohort study used headache and cognitive data from two waves of the CHARLS collected in 2011 (wave 1) and 2015 (wave 3). The study population consisted of individuals who are 45 years of age or older with complete data on headache and cognitive assessments. We used statistical methods such as linear regression and multiple logistic regression to analyze the data.
Results
The study initially enrolled 12,623 participants with a mean age of 58.9 years; 52.6% were female. Cognitive scores were lower in the headache group across all domains in the cross-sectional analysis (β= -0.39, 95% CI: -0.57~-0.21).
Longitudinally, the headache group had a higher risk of MCI at baseline (OR=2.30, 95% CI: 2.05 to 2.58) and follow-up (OR=2.46, 95% CI: 1.86 to 3.26), with persisting significance after adjustments (baseline adjusted OR=1.32, follow-up adjusted OR=1.42, both p<0.05). In the subgroup analyses, no significant interactions were observed between the groups (p > 0.05).
Conclusions
Participants with headache disorders had lower cognitive scores and had a higher risk of developing MCI in middle-aged and older Chinese population. As headache may increase the risk of MCI, headache prevention and treatment is of vital importance in preventing cognitive impairment, improving the quality of life in middle-aged and older population.
Nivolumab Combined with Chemotherapy in FGFR2 and PD-L1 Co- Expressing Metastatic Gastric Cancer: A Prospective Phase 2 NIVOFGFR2 Study
Authors: Tsimafeyeu Ilya , Musayeva Gunel , Mahmudova Samira , Otkhozoria Nana , Abbasov Bahadur , Kahharov Alisher , Guliyev Fuad
Published: October 2024

Background
Immunotherapy is increasingly significant in treating metastatic gastric cancer. This prospective phase 2 study investigates the efficacy and safety of combining nivolumab with chemotherapy in patients with metastatic gastric cancer co-expressing FGFR2 and PD-L1.
Methods
Eligible patients were aged 18 years or older, with previously untreated HER-2 negative, PD-L1 positive, and FGFR2 positive metastatic gastric adenocarcinoma. Patients received nivolumab (360 mg every 3 weeks) in combination with chemotherapy (CAPOX: capecitabine 1000 mg/m² twice daily on days 1–14 and oxaliplatin 130 mg/m² on day 1, every 3 weeks). Tumor assessments were conducted using RECIST v1.1 every 8 weeks for 48 weeks, then every 12 weeks. The primary endpoint was the 1-year progression-free survival (PFS) rate. Secondary endpoints included median PFS, overall survival (OS), objective response rate (ORR), and grade ≥ 3 adverse events (AEs).
Results
From June 2022 to October 2023, 194 patients were assessed for eligibility, with 23 patients enrolled and treated. At a median follow-up of 17.3 months, the 1-year PFS rate was 30.4%, with a median PFS of 6.0 months (95% CI, 4.3–7.7). The median OS was 15.1 months (95% CI, 13.2–16.8). The ORR was 21.7%, with one complete response and four partial responses. Grade 3 or higher TRAEs were reported in 34.8% of patients, primarily associated with chemotherapy. No treatment-related deaths occurred.
Conclusions
While the primary endpoint of improved 1-year PFS rate was not met, the study offers valuable insights into the potential benefits of combining nivolumab with chemotherapy in FGFR2 and PD-L1 co-expressing metastatic gastric cancer. Future research should optimize patient selection, assess combined immunotherapy and targeted anti-FGFR2 therapy, and further investigate the role of subsequent treatments to maximize therapeutic benefits.
Loss to follow-up of patients after antiviral treatment as an additional barrier to HCV elimination
Authors: Dorota Zarębska-Michaluk , Michał Brzdęk , Olga Tronina , Justyna Janocha-Litwin , Marek Sitko , Anna Piekarska , Jakub Klapaczyński , Anna Parfieniuk-Kowerda , Sobala-Szczygieł Barbara , Magdalena Tudrujek-Zdunek , Łukasz Laurans , Robert Flisiak
Published: October 2024

Background
Eliminating hepatitis C virus (HCV) infections is a goal set by the World Health Organization. This has become possible with the introduction of highly effective and safe direct-acting antivirals (DAA) but limitations remain due to undiagnosed HCV infections and loss of patients from the cascade of care at various stages, including those lost to follow-up (LTFU) before the assessment of the effectiveness of the therapy. The aim of our study was to determine the extent of this loss and to establish the characteristics of patients experiencing it.
Methods
Patients with chronic HCV infection from the Polish retrospective multicenter EpiTer-2 database who were treated with DAA therapies between 2015--2023 were included in the study.
Results
In the study population of 18,968 patients, 106 had died by the end of the 12-week post-treatment follow-up period, and 509 patients did not report for evaluation of therapy effectiveness while alive and were considered LTFU. Among patients with available assessment of sustained virological response (SVR), the effectiveness of therapy was 97.5%. A significantly higher percentage of men (p<0.0001) and a lower median age (p=0.0001) were documented in LTFU compared to the group with available SVR assessment. In LTFU patients, comorbidities such as alcohol (p<0.0001) and drug addiction (p=0.0005), depression (p=0.0449) or other mental disorders (p<0.0001), and and co-infection with human immundeficiency virus (HIV) (p<0.0001) were significantly more common as compared to those with SVR assessment. They were also significantly more often infected with genotype (GT) 3, less likely to be treatment-experienced and more likely to discontinue DAA therapy.
Conclusions
In a real-world population of nearly 19,000 HCV-infected patients, we documented a 2.7% loss to follow-up rate. Independent predictors of this phenomenon were male gender, GT3 infection, HIV co-infection, alcohol addiction, mental illnessess, lack of prior antiviral treatment and discontinuation of DAA therapy.
A Novel Deep Learning Approach for Cervical Vertebral Maturation Classification
Authors: Norman Noraina Hafizan , Rosli Marshima Mohd , Al-Jaf Nagham Mohammed , Mohammad Norhasmira , Yusof Mohd Yusmiaidil Putera Mohd
Published: October 2024

Objectives
This study aims to automatically determine the cervical vertebral maturation staging (CVM) on lateral cephalometric radiograph images using a customized deep convolutional neural network (DCNN) model and to evaluate the classification performance using a custom DCNN model in detecting CVM stages.
Methods
A dataset of 922 digital lateral cephalometric radiographs from individuals aged 7–20 years was collected. Image quality was assessed for artifacts and clarity of C2-C4 vertebrae. CVM staging was independently performed by two orthodontists, with inter-observer reliability assessed using kappa coefficient. Image pre-processing involved random oversampling to address class imbalance and resizing to 128x128 pixels. A custom convolutional neural network was developed, with hyperparameters optimized using random search. The final architecture comprised convolutional layers, global average pooling, dense layers, and dropout. The model was trained for 50 epochs using Adam optimizer and categorical cross-entropy loss. Performance evaluation included accuracy, loss, and confusion matrix analysis on a validation set.
Results
A novel convolutional neural network was developed for the classification of CVM staging. This custom model initially exhibited overfitting, achieving perfect training accuracy but only 57% validation accuracy due to class imbalance. Implementing Random Oversampling (ROS) addressed this issue by balancing the dataset. Hyperparameter tuning optimized the model architecture, resulting in a final validation accuracy of 85.96%. The model demonstrated strong performance in classifying CVMS 1, 2, and 3, with precision and recall exceeding 95%. However, classification of CVMS 4 and 5 posed challenges, with lower precision and recall values. Overall accuracy reached 88.2%, indicating a generally robust model, though further improvements are necessary for CVMS 5.
Conclusion
This study successfully developed a custom deep convolutional neural network for automated cervical vertebral maturation (CVM) staging on lateral cephalometric radiographs. By addressing class imbalance and optimizing hyperparameters, the model achieved a validation accuracy of 88.2%. While demonstrating potential for clinical application, the model’s performance varied across CVM stages, indicating a need for further refinement to improve accuracy and robustness.
Characterization of the Temporal Profile of the Antinociceptive Effects of an Intravenous Bolus of Ketamine Using the Analgesia Nociception Index
Authors: Navarrete Víctor , Ibacache Mauricio , Contreras Víctor , Cortínez Ignacio
Published: October 2024

Purpose
An effect-site target-controlled infusion (TCI) would allow a more precise titration of intravenous analgesics effect. The analgesia nociception index (ANI) continuously monitors the analgesia/nociception balance during general anesthesia. This study aims to derive a PKPD model of ketamine to allow an effect-site TCI administration using the ANI information and previously described pharmacokinetic parameters.
Methods
Twenty adult patients under general anesthesia were prospectively studied. Patients received a single intravenous bolus of ketamine 0.1 mg·kg-1, and the subsequent ANI values were recorded. An effect compartment model incorporating the Domino PK parameter set was used to characterize the time lag between ketamine plasma concentrations and the ANI response. The model was parameterized with a single parameter Ke0. An Emax pharmacodynamic model was used to fit the ANI response data. Model parameters were estimated with NONMEM® 7.5. The minimum objective function value guided the model construction.
Results
After the ketamine administration, basal ANI values increased from 38.5 ± 4.95 to a maximum of 53.5 ± 4.95 with an observed time-to-peak effect of 1.83 ± 0.74 min. Modeling analysis revealed hysteresis between predicted plasma concentrations from the Domino model and observed ANI data. Hysteresis was characterized, incorporating an estimated Keo of 0.238 (CI95% 0.20–0.28) min-1 to the described PK parameters set.
Conclusions
The developed PKPD model, using Domino’s PK parameters and the ANI response data, adequately characterized the temporal profile of ketamine's antinociceptive effect. The current estimated model parameters can be used to perform an effect-site TCI of ketamine for analgesic purposes.
Evaluation of Procalcitonin Versus Conventional Inflammatory Biomarkers for Clinical Severity Grading in Patients with Intra-Abdominal Infection
Authors: Ozen Cihan , Karasoy Deniz , Yalcinkaya Ali , Pedersen Sine Huus , Hindersson Peter , Leutscher Peter Derek Christian , Holte Kathrine
Published: October 2024

Aim
We aimed to evaluate the properties of procalcitonin (PCT) as a biomarker for clinical severity grading of intra-abdominal infections (IAI) in hospital-admitted patients presenting with acute abdomen.
Methods
In this retrospective study, median PCT values were compared with conventional inflammatory biomarkers, including leukocyte count (LC), neutrophil count (NC), and C-reactive protein (CRP), within the patient population.
Results
Among the 245 patients included in the study, 58 (23.7%) were diagnosed with appendicitis, 54 (22.0%) with diverticulitis, 34 (13.9%) with calculous cholecystitis, and 21 (8.6%) with pancreatitis. Additionally, 60 (24.5%) were diagnosed with non-specific abdominal pain (NSAP), and 18 (7.3%) with gallstones without cholecystitis. Median PCT levels were significantly higher in patients with calculous cholecystitis (p < 0.0001) and pancreatitis (p < 0.0001) compared to those with NSAP. The proportion of patients with a PCT cut-off ≥ 0.04 µg/L was significantly higher across all IAI subgroups compared to the NSAP group. However, 18 (10.8%) of IAI patients exhibited PCT levels ≥ 0.5 µg/L, indicating systemic infection. Spearman’s rho analysis revealed a significant correlation between PCT and LC, NC, and CRP in patients with IAI (p < 0.0001). Moreover, median PCT levels were significantly higher in perforation/abscess vs. gangrenous appendicitis (p < 0.01), complicated vs. uncomplicated diverticulitis (p = 0.048), and severe vs. mild cholecystitis (p < 0.001).
Conclusion
PCT correlates strongly with conventional inflammatory biomarkers in patients with IAI. However, PCT appears to offer limited additional clinical value for guiding therapeutic decisions concerning the initial diagnosis and/or severity grading of IAI in patients admitted with acute abdomen. Further research is warranted to validate these findings.
In vitro and in silico studies on α-glucosidase inhibitory properties of bioactive components from the rhizomes of Alpinia officinarum Hance
Authors: Dlamini Zakhele Mphatsi , Dlamini Bongani Sicelo , Fu Shih-Han , Chang Ya-Lin , Lin Chi-Chien , Chen Yu-Kuo , Tan Kok-Tong , Chang Chi-I
Published: October 2024

Key digestive enzymes, α-glucosidase and α-amylase, are associated with the occurrence of type 2 diabetes mellitus (T2DM). Inhibition of these important enzymes is one of the important strategies for the treatment of T2DM. In the search for alternative α-glucosidase inhibitors, five compounds (1–5) were obtained from the rhizomes of Alpinia officinarum Hance by chromatographic methods. In vitro enzyme inhibition assays, kinetic analysis and molecular docking studies were conducted to investigate the inhibition mechanism of the isolated compounds against α-glucosidase. Compounds 1, 3, 4 and 5 showed comparable α-glucosidase inhibitory activities to quercetin (IC50 value of 19.77 µM) with IC50 values ranging from 37.48 to 89.08 µM. According to the findings of the kinetic analysis, compounds 1, 2, and 4 were uncompetitive inhibitors, while compound 3 was a competitive inhibitor and compound 5 was a mixed-type inhibitor of α-glucosidase. In the computational investigation, hydrogen bonds served as the primary bond between the compounds and the amino acid residues. The results showed that A. officinarum might be a viable source of α-glucosidase inhibitors and antidiabetic agents.
Colostrum Avoidance and Associated Factors among Postnatal Mothers in Health Facilities in Addis Ababa, Ethiopia: A Mixed Method Study
Authors: Endale Samson Zegeye
Published: October 2024

Background: Colostrum is the first form of milk produced immediately following the delivery of a newborn. It is highly nutritious and contains antibodies to protect the newborn against disease and crucial for the newborn's health Despite its benefits, some mothers avoid giving colostrum to their newborns.
Objective:This study aims to assess the prevalence and factors associated with colostrum avoidance among postnatal mothers in Addis Ababa, Ethiopia.
Methods: A health facility-based mixed-methods of study design was conducted. Both quantitative and qualitative data were collected using pretested questionnaires and key informant interview question guides, respectively.Quantitative data were collected through structured interviews and analyzed using descriptive statistics such as frequencies, means, and standard deviations were performed. Binary logistic regression analysis was employed to assess the associated factors of colostrum avoidance among postnatal mothers at health facilities in study area.Qualitative data were gathered via in-depth interviews and analyzed thematically.
Results: The prevalence of colostrum avoidance was 8.94% (95% CI: 5.9-10.9). Multivariable analysis revealed significant predictors of colostrum avoidance: lack of counseling about colostrum benefits (AOR = 5.802, 95% CI: 2.467-13.647), cesarean delivery (AOR = 3.420, 95% CI: 1.411-8.288), poor maternal knowledge about colostrum (AOR = 13.111, 95% CI: 5.462-31.468), and late initiation of breastfeeding (AOR = 3.330, 95% CI: 1.242-8.926). Qualitative findings echoed these results, with cultural beliefs and misconceptions about colostrum contributing to its avoidance.
Conclusion: The study highlights a significant prevalence of colostrum avoidance among postnatal mothers in Addis Ababa. Key predictors include inadequate counseling, cesarean delivery, poor knowledge about colostrum, and delayed breastfeeding initiation. Interventions aimed at improving maternal education and breastfeeding practices are essential to reduce colostrum avoidance.
A retrospective Analysis of Presentations and Outcomes Traumatic Related Diaphragmatic injury Somalia: Single Center Experience
Authors: Çelık Osman Naci , Yasin Nor Abdi , Ahmed Mohamed Rage , Warsame Ali Mohamed
Published: October 2024

Background
Traumatic diaphragmatic injury (TDI) is a rare condition easily missed in an acute clinical setting, resulting in subsequent life-threatening morbidity and mortality. The present is the first study aims to investigate the epidemiological and clinical characteristics and management outcome of blunt and penetrating TDI at a tertiary hospital in Somalia.
Method
This study included 105 patients with a TDI who underwent emergency or elective surgeries and were admitted to the hospital over four years. Demographic and clinical characteristics, mechanism of injury, concomitant injuries, management, and outcomes were reviewed.
Results
The prevalence of TDI was 7.2%, penetrating (75%), and blunt (25%). Among them, 83 (79%) were male, and 22 (21%) were female. The mean patient age was 36 ± 8.5. 725% occurred on the left side, while 25% were on the right. No cases of bilateral injuries were observed. Gunshot injury was the most common cause in 45% of the cases, followed by a stab wound in 20% and road traffic accidents in 15%. Penetrating trauma was experienced in 63% of young patients under 40, while blunt trauma was 42% in the same group (p < 0.002, 95% CI: 0.78–2.64). Eight patients presented late with diaphragmatic hernias; the most common were gastric and spleen. About 62.5% were admitted to the intensive care unit postoperatively. There was a high mortality rate (n = 18, 22.5%); 12 were men, and 8 were women. Patients with penetrating trauma had a greater mortality rate than blunt trauma patients (27.7% vs. 11.5%, p < 0.001, 95% CI: 0.92–4.06). Females had a higher mortality rate than males (57.7% vs. 15%, p < 0.023, 95% CI: 0.83–2.73).
Conclusion
Our study revealed a high prevalence and mortality rate of TDI due to gunshot and explosive injuries. Patients with hemodynamically unstable on admission, those with penetrating trauma, concomitant solid organ injury, and younger age have the highest morbidity and mortality. Our study noticed a higher rate of right-site involvement of TDI compared to the rates reported in the literature. Identifying and treating these patients is critical, yet most patients living in low-income countries face delays due to limited resources.
Anterior Contralateral Cervical Microdiscectomy at C7-T1
Authors: Kahyaoğlu Okan , Can S. Meltem , Çavuşoğlu Halit , Yüce İsmail , Aydin Yunus
Published: October 2024

Purpose: In this retrospective study we reviewed our experience with patients who had disc herniation at cervicothorasic junction (C7-T1) and were treated with anterior contralateral simple microdiscectomy without fusion technique designed by the senior author.
Methods: Between January 2000 and December 2021, 27 patients underwent surgery for C7-T1 disc herniation by one neurosurgeon. Clinical and radiological data were obtained preoperatively and at postoperative 3rd and 24th months. Short form-36 and Neck disability questionnaires were used to assess their quality of life.
Results: All patients were presented with signs and symptoms of radiculopathy. There were 16 male and 11 female patients with a mean age 40 years. The follow-up period was meanly 9.7 years. Short form-36 and Neck disability scores calculated postoperatively were found statistically different from the preoperative values. There was no statically difference between the overall scores obtained at postoperative 3 months and 24 months.
Conclusion: We propose that anterior contralateral microdiscectomy technique without fusion is advantageous for patients with complaint of disc herniation at C7-T1 level.
The Crystal Cargo Reveals the Build-up Phase to Caldera-Forming Mafic Eruptions
Authors: López Mónica Ágreda , Musu Alessandro , Jorgenson Corin , Šala Martin , Giordano Guido , Caricchi Luca , Perugini Diego , Stremtan Ciprian , Petrelli Maurizio
Published: October 2024

The magma accumulation phase preceding caldera-forming eruptions is crucial to identify the signs of an impending catastrophic event. While extensively studied in silicic systems, mafic volcanoes present unique challenges. The high eruptive temperatures of these magmas imply short storage in the cold upper crust and, thus, short periods of unrest preceding eruption, which could challenge our capacity to mitigate the impact of an imminent event. We analyse crystals in erupted magma to reconstruct the lead-up phase to the last caldera-forming eruption of Colli Albani, an active volcano near Rome (Italy). Here, we show that the caldera-forming eruption was preceded by effusive to mildly explosive eruptions fed by multiple crustal magma reservoirs. Following a pause in volcanic activity, magma rose directly from the mantle and accumulated to form a reservoir of a few tens of cubic kilometres. The ascent of one of these pulses ultimately triggered the last caldera-forming eruption of Colli Albani. Our results provide a new framework to identify the processes leading to caldera-forming eruptions in mafic volcanic systems.
Robust Ensemble Classifier for Advanced Synthetic Aperture Radar Target Classification in Diverse Operational Conditions
Authors: Rahman Noor , Khan Muzammil , Khan Imran , Khan Jawad , Lee Youngmoon
Published: October 2024

This study introduces an innovative ensemble technique to enhance synthetic aperture radar (SAR) automatic target recognition (ATR) by integrating the strengths of three diverse classification methods: support vector machine (SVM), template matching, and convolutional neural networks (CNN). The proposed framework leverages the unique advantages of each technique to significantly improve SAR target classification accuracy. CNN, particularly AlexNet, excels in standard operating conditions (SOC), while template matching proves more effective in extended operating conditions (EOCs). SVM, known for handling overfitting in parametric classification, adds robustness to the system. In this approach, binary target regions are extracted and matched to predefined template classes, while 16 target region properties are selected as features and processed through SVM for classification. The final decision is generated using a majority voting technique, ensuring the highest possible accuracy. Experimental validation was conducted using the MSTAR dataset, demonstrating the superior performance of the ensemble method. The combined approach achieved significant improvements in classification accuracy, with average accuracy rising to 90.30% in SOC and 87.22% in EOC-1, outperforming individual classifiers. These results showcase the ensemble's robustness and effectiveness, offering a novel solution for SAR target recognition in varied operational scenarios.
Better targeting treatments against Bovine Respiratory Disease by combining dynamic generalized linear models and mechanistic modelling
Authors: Merca Carolina , Sorin-Dupont Baptiste , Kristensen Anders Ringgaard , Picault Sébastien , Assié Sébastien , Ezanno Pauline
Published: October 2024

Bovine Respiratory Disease (BRD) is a major health challenge for young bulls. To minimize economic losses, collective treatments have been widely adopted. Nevertheless, performing collective treatments involve a trade-off between BRD cumulative incidence and severity, and antimicrobial usage (AMU). Therefore, we propose a proof of concept of a decision support tool aimed at helping farmers and veterinarians make informed decisions about the appropriate timing for performing collective treatment for BRD. The proposed framework integrates a mechanistic stochastic simulation engine for modelling the spread of a BRD pathogen (Mannheimia haemolytica), and a hierarchical multivariate binomial dynamic generalized linear model (DGLM) which provides early warnings based on infection risk estimates. Using synthetic data, we studied 48 scenarios, involving two batch sizes (small and large), four farm risk levels of developing BRD (low, medium, balanced, and high), two batch allocation systems (sorted by risk level or randomly allocated), and three treatment interventions (individual, conventional collective, and DGLM-based collective). In most scenarios, collective treatments triggered by the DGLM were associated with a reduction of BRD cumulative incidence and disease severity. DGLM-based collective treatments typically exhibited either lower or equivalent AMU compared to conventional ones, being particularly advantageous in medium, balanced, and high-risk scenarios. Additionally, DGLM estimates of infection risk aligned well with empirical risks during the first time steps of the simulation. These findings highlight the potential of the proposed decision support tool in providing valuable guidance for improving animal welfare and AMU. Further validation through real-world data collected from on-farm situations is necessary.
Metabolic Syndrome Risk Factors among Mill Workers Exposed to Noise and Respirable Dust
Authors: Kangarlou Marzieh Belji , Saleh Elaheh , Dehdashti Alireza
Published: October 2024

We investigated the association between occupational exposure to noise and dust, and the development of metabolic syndrome (MetS) and its components in flour mill workers. A prospective cohort study monitored 379 flour mill workers from 2007 to 2022. Comprehensive assessments of exposure to respirable dust and noise levels were conducted. Clinical records were reviewed to determine the incidence of MetS and its components (hypertension, hyperglycemia, hypertriglyceridemia, and low HDL-cholesterol). Cox proportional hazards and logistic regression models were used to analyze associations, adjusting for potential confounders including age, smoking, and physical activity. Baseline differences were observed in demographics and family history of Type 2 Diabetes Mellitus (T2DM). Only fasting blood sugar (FBS) differed significantly at baseline (p = 0.049). Significant positive associations were found between respirable dust exposure, weight, body mass index (BMI), and risk of developing hypertension. Additionally, T2DM and age were positively associated with hyperglycemia risk, while LDL and TG levels were risk factors for hypertriglyceridemia. Baseline HDL levels were inversely associated with low HDL-cholesterol risk. The association between exposed group and non-exposed groups was not statistically significant in overall Mets development. While T2DM, age, blood lipid levels significantly influence metabolic health in flour mill workers, further research with larger cohorts is needed to explore the potential contributions of BMI, weight, noise, and dust exposure to MetS development. This study indicates the importance of preventive strategies and health interventions to manage exposure risks and promote metabolic well-being in occupational settings. We suggest further studies concentrate on additional factors that might influence metabolic disorders across diverse work environments.
Usage of modern contraception in context of polygyny in Pakistan with the moderating effect of household wealth status: Evidence from demographic and health survey 2017-18
Authors: Shah Athar , Ibopoto Mukhtiar Hussain
Published: October 2024

Research explores the usage of modern contraception in context of polygyny in Pakistan with the moderating effect of household wealth status. Multiple analytical techniques were applied including logistic regression, margins analysis and Oaxaca blinder decomposition to understand the association between polygyny on the use of modern contraception with the moderating effect of household wealth status. The results reveal that women in polygynous marriages are significantly less likely to use modern contraception as compared to those in monogamous marriages. Household wealth status generally has a positive association with contraception use; however, this positive effect diminishes when interacting with polygyny. Main effect of the household wealth status typically promotes contraceptive use, this trend is not as pronounced among women in polygynous marriages. With the increasing wealth status disparity in modern contraceptive use between polygynous and monogamous families also widens.
Biochar filtration of drug-resistant bacteria and active pharmaceutical ingredients to combat antimicrobial resistance
Authors: Fady Paul-Enguerrand , Richardson Alexandra , Barron Leon , Volpe Roberto , Mason A. James , Barr Meredith
Published: October 2024

Antimicrobial resistance (AMR) is a major cause of death worldwide, with 1.27M direct deaths from bacterial drug-resistant infections as of 2019. Dissemination of multidrug-resistant (MDR) bacteria in the environment, in conjunction with pharmapollution by active pharmaceutical ingredients (APIs), create and foster an environmental reservoir of AMR. Creative solutions are required to mitigate environmental AMR, while taking into consideration other aspects of the planetary “Triple Crisis” of pollution, biodiversity loss, and climate change. Waste lignocellulosic biomass (LCB), a byproduct of agriculture and forestry, is the largest stream of non-edible biomass globally. Through pyrolysis, waste LCB can be converted into biochars, which have excellent attributes for adsorption of pollutants–though no studies have yet reliably correlated production conditions with efficacy, nor considered adsorption of human pathogens. By leveraging a bespoke pyrolysis reactor with precisely controlled parameters, we show that production conditions substantially affect sequestration of clinical bacterial isolates, removing up to 94% of Pseudomonas aeruginosa RP73 and 85% of Staphylococcus aureus EMRSA-15. In addition, we show that chars produced at higher peak pyrolysis temperatures (450°C) can remove up to 91% of the antibiotic clarithromycin from wastewater, as well as significant proportions of many other APIs with varied physicochemical characteristics. These findings provide a first-in-kind insight into how production conditions affect the ability of biochars to mitigate environmental AMR.
Sociodemographic factors associated with the place of death of the Brazilian population and regional variations
Authors: Marcucci Fernando , Corradi-Perini Carla , Rodrigues Luis Fernando , Pastrana Tania
Published: October 2024

Understanding the factors associated with the death and dying process, such as the place of occurrence and the sociodemographic influences, can support the definition of health assistance and public policies. Limited information is available for middle-income countries, like Brazil. This study identified and compared the association of sociodemographic factors (age, sex, ethnic/skin color identification, educational level and marital status) with the place of death in Brazil and its regions, in a population level research. In Brazil, death at hospital was more frequently associated with socioeconomic privilege groups (white people, higher educational level, more developed regions). Older age groups, male, unmarried groups and lower education level were related with higher odd to death at home, which raises concerns about unassisted or limited support in these occurrences. The debate on social demands, public policies and bioethical challenges associated with the assistance offered on death occurrences is need.
Chrysophanol attenuates cognitive impairment, neuroinflammation, and oxidative stress by TLR4/ NFκB -Nrf2/HO-1 signaling in ethanol induced neurodegeneration
Authors: Khan Jehan Zeb , Zainab Syeda Rida , Shah Fawad Ali , Tipu Muhammad Khalid
Published: October 2024

Ethanol-induced neurodegeneration refers to the progressive loss of structure and function of neurons caused by chronic ethanol consumption. According to the World Health Organization (WHO), over 2.3 billion people globally consume alcohol. This contributes to a significant number of alcohol-related brain damage. This study evaluated the effect of chrysophanol in ethanol-induced neurodegeneration. Mice were administered with 10mg/kg i.p chrysophanol, 30 minutes after administration of 2g/kg i.p injection of ethanol for 11 days. Y-maze, Morris water maze (MWM), and novel object recognition (NOR) test were carried out to analyze learning and memory impairment. Analysis of antioxidant levels, histopathological examinations, measurement of COX-2 & NLRP3 using ELISA, and gene expression analysis of TLR4, NFκB, IL-1β, TNF-α, Caspase-3 and Nrf-2, HO-1, and in hippocampus and cortex using RT-PCR as well as DNA damage by comet assay were carried out. Chrysophanol has shown remarkable impact in reversing cognitive decline and spatial memory. It effectively boosted antioxidant levels such as GSH, GST, and CAT, while simultaneously reducing the levels of MDA and NO. The histopathological analysis also showed improvement in overall morphology and survival of neurons. Chrysophanol treatment effectively showed an increase in the expression of HO-1 and Nrf-2 with a decrease in TLR4, NFκB, IL-1β, TNF-α, and Caspase-3 expression confirmed through RT-PCR. Production of inflammatory cytokines, and apoptotic gene expression was successfully reversed after chrysophanol treatment. COX-2 & NLRP3 levels were decreased and improvement in DNA damage were observed after chrysophanol treatment. In conclusion, chrysophanol demonstrated remarkable neuroprotective activity against ethanol-induced neurodegeneration.
Evaluation of innovative policy for Nature-based Solutions: Analysis from three European city case studies
Authors: Petersen Carolyn Jane , Russel Duncan John , Jensen Anne , Pedersen Anders Branth , Kirsop-Taylor Nick
Published: October 2024

Addressing the current unprecedented climate and environmental challenges and stimulating sustainable development in our urban areas and beyond entails experimentation and innovation in policy making, instead of the siloing that has often been the status quo. Nature-based Solutions (NBS) are well suited to fostering integrated and multi-functional policy solutions to current challenges but are subject to complex governance influences. Through a comparative analysis of interview and policy workshop data in three European city case studies with differing governance structures, this paper examines the external, societal and governing influences on NBS innovation, and the governance structures from which innovation and experimentation in NBS are likely to occur—including the political side of NBS which has hitherto been relatively unexplored. The results indicate a number of important facilitating and hindering factors across the range of governing, societal and external influences, and show some association between NBS innovation and decentralized policy making. They highlight the importance of policy coherence of NBS initiatives with government policy strategy; and of the willingness by policy makers / local government officials to engage with and appeal strategically to political decision-makers regarding external policy drivers—e.g. climate adaptation and health. The data also indicates that where citizen participation and consultation were built into NBS projects, this brought both innovation and additionality—in terms of the design, quality, biodiversity, multi-functionality and co-benefits of green / blue spaces. Key differences that led to differing NBS outcomes included size and complexity of the urban area, and characteristics of the governing architecture.