bluuebunny/crossref_metadata_2025 huggingface dataset:
Exploring barriers to completing referral appointments for cancer genetic services in a rural state.
Authors: Anderson Eric , DiPalazzo John , Kennes Ashley , Sharp Stephanie , Buchanan Luanna , Bohnhoff James , Frankenfeld Cara , Miesfeldt Susan
Published: September 2024

83

Background:
Genetic counseling and testing promotes awareness and management of hereditary cancer risk. Barriers exist to accessing cancer genetic services, particularly among those with healthcare disparities, i.e., those facing geographic and socioeconomic barriers. These barriers impact not only the ability to obtain a referral but also whether the initial appointment is scheduled and completed. This study explored referrals and what factors were associated with whether appointments were successfully completed in a predominantly rural state (Maine).
Methods:
Medical records were reviewed for patients referred to the state’s largest health system-based cancer genetic program from 2017 through 2023. We evaluated factors that may be associated with referral completion within 90 days. These included: year of referral, patient factors, clinical factors, and health system factors. Associations were examined using univariate logistic regression models.
Results:
A total of 11,643 referrals were placed and examined over the period studied. Despite a steady increase in the number of referrals, the percent of referrals that were successfully completed decreased over time (54.04% in 2017 to 51.06% in 2023). Patients with older age and whose primary language was identified as English had greater likelihood of completing the referral (OR = 1.01; p < 0.001 and OR = 3.37; p < 0.001, respectively). Patients living in isolated rural areas and those without insurance were less likely to complete the referral (OR =0.84 and OR 0.61; p < 0.001, respectively). Patients with a cancer diagnosis were almost three times more likely to complete the referral (OR = 2.93; p < 0.001). Referrals scheduled as telemedicine appointments were less likely to be completed (OR =0.63; p < 0.001); and referrals coming from providers within the health system were twice as likely to be completed (OR = 2.15; p < 0.001).
Conclusions:
Successful completion of referral appointments to cancer genetic services varied by several important patient, clinical, and health system factors. Further multivariate analyses will be conducted. Strategies including language translation, educational materials, and financial assistance might boost the completion rate for structurally vulnerable patients. Systems aimed at streamlining the scheduling process are needed to support all individuals in accessing cancer genetic services, with a focus on those with healthcare disparities.
Dissecting the Significance of Acid Phosphatase 1 Gene Alterations in Prostate Cancer
Authors: Abdallah Nour , Elliott Andrew , Smith Norm , Stanford Stephanie M. , Agarwal Neeraj , Bagrodia Aditya , Garje Rohan , Bottini Nunzio , McKay Rana R.
Published: September 2024

PURPOSE

The acid phosphatase 1 (
ACP1
) gene encodes low-molecular-weight protein tyrosine phosphatase, which is overexpressed in prostate cancer (PC) and a potential therapeutic target. We analyzed
ACP1
expression in primary/metastatic PC and its association with molecular profiles and clinical outcomes.

METHODS

NextGen sequencing of DNA (592-gene/whole-exome sequencing)/RNA(whole-transcriptome sequencing) was performed for 5,028 specimens.
ACP1
-High/
ACP1
-Low expression was defined as quartile (Q4/1) of RNA transcripts per million (TPM). DNA mutational profiles were analyzed for
ACP1
-quartile-stratified samples. Gene set enrichment analysis was used for Hallmark collection of pathways. PD-L1+(≥2+, ≥5%; SP142) was tested by immunohistochemistry. Tumor microenvironment's (TME) immune cell fractions were estimated by RNA deconvolution/quanTIseq. Overall survival (OS) was assessed from initial diagnosis/treatment initiation to death/last follow-up.

RESULTS

We included 3,058 (60.8%) samples from the prostate, 634 (12.6%) from lymph node metastases (LNMs), and 1,307 (26.0%) from distant metastases (DMs).
ACP1
expression was higher in LNM/DM than prostate (49.8/47.9
v
44.1 TPM;
P
< .0001).
TP53
mutations were enriched in
ACP1
-Q4 (37.9%[Q4]
v
27.0%[Q1];
P
< .001) among prostate samples. Pathways associated with cell cycle regulation and oxidative phosphorylation were enriched in
ACP1
-Q4, whereas epithelial-mesenchymal transition and tumor necrosis factor-alpha signaling via nuclear factor kappa-light-chain-enhancer of activated B-cell pathways were enriched in
ACP1
-Q1. Neuroendocrine and androgen receptor signaling was increased in
ACP1
-Q4. M2 macrophages and natural killer cell fractions were increased, whereas T cells and M1 macrophages were decreased in
ACP1
-Q4. While OS differences between
ACP1
-Q1/Q4 were not statistically significant, there was a trend for worse OS among
ACP1
-Q4 prostate samples (Q4
v
Q1: hazard ratio [HR], 1.19 [95% CI, 0.99 to 1.42];
P
= .06) and DM (HR, 1.12 [95% CI, 0.93 to 1.36];
P
= .22) but not LNM (HR, 0.98 [95% CI, 0.74 to 1.29];
P
= .87).

CONCLUSION

ACP1-High tumors exhibit a distinct molecular profile and cold TME, highlighting
ACP1
's potential role in PC pathogenesis and novel therapeutic targeting.
Using a Polygenic Risk Score to Improve the Risk Prediction of Non–Small Cell Lung Cancer in Taiwan
Authors: Lee Po-Hsin , Chen I-Chieh , Chen Yi-Ming , Hsiao Tzu-Hung , Tseng Jeng-Sen , Huang Yen-Hsiang , Hsu Kuo-Hsuan , Lin Ho , Yang Tsung-Ying , Shao Yu-Hsuan Joni
Published: September 2024

PURPOSE

Low-dose computed tomography (LDCT) can help reducing lung cancer mortality. In Taiwan, the existing screening criteria revolve around smoking habits and family history of lung cancer. The role of genetic variation in non–small cell lung cancer (NSCLC) development is increasingly recognized. In this study, we aimed to investigate the potential benefits of polygenic risk scores (PRSs) in predicting NSCLC and enhancing the effectiveness of screening programs.

METHODS

We conducted a retrospective cohort study that included participants without prior diagnosis of lung cancer and later received LDCT for lung cancer screening. Genetic data for these participants were obtained from the project of Taiwan Precision Medicine Initiative. We adopted the model of genome-wide association study-derived PRS calculation using 19 susceptibility loci associated with the risk of NSCLC as reported by Dai et al.

RESULTS

We studied a total of 2,287 participants (1,197 male, 1,090 female). More female participants developed NSCLC during the follow-up period (4.4%
v
2.5%,
P
= .015). The only risk factor of NSCLC diagnosis among male participants was age. Among female participants, independent risk factors of NSCLC diagnosis were age (adjusted hazard ratio [aHR], 1.08 [95% CI, 1.04 to 1.11]), a family history of lung cancer (aHR, 3.21 [95% CI, 1.78 to 5.77]), and PRS fourth quartile (aHR, 2.97 [95% CI, 1.25 to 7.07]). We used the receiver operating characteristics to show an AUC value of 0.741 for the conventional model. With the further incorporation of PRS, the AUC rose to 0.778.

CONCLUSION

The evaluation of PRS for NSCLC prediction holds promise for enhancing the effectiveness of lung cancer screening in Taiwan especially in women. By incorporating genetic information, screening criteria can be tailored to identify individuals at higher risks of NSCLC.
Tumor Characteristics Associated With Preoperatively Detectable Tumor-Informed Circulating Tumor DNA in Patients With Renal Masses Suspicious for Renal Cell Carcinoma
Authors: Ben-David Reuben , Alerasool Parissa , Kalola Hitasha , Tillu Neeraja , Almoflihi Mohammed , Tsao Che-Kai , Galsky Matthew D. , Sfakianos John P. , Wiklund Peter , Waingankar Nikhil , Mehrazin Reza
Published: September 2024

PURPOSE

Understanding the specific tumor characteristics associated with detectable circulating tumor DNA (ctDNA) in patients with renal cell carcinoma (RCC) is critical for informing future studies aiming to establish the clinical utility of such testing. We characterized the pathologic and clinical features associated with preoperatively detectable ctDNA in patients with renal masses suspicious for RCC.

METHODS

Consecutive patients who underwent partial or radical nephrectomy for nonmetastatic suspected RCC (cT1b-T3) during 2022-2023 had prospectively collected tumor-informed ctDNA analyses conducted preoperatively and postoperatively. Descriptive statistics and univariate analyses were used to describe the study findings.

RESULTS

Sixty-nine patients with a median age of 62 years (IQR, 51-70) and a median follow-up time of 7 months (IQR, 3-11) had 205 ctDNA samples collected for analysis. Thirty-nine (61%) had preoperative detectable ctDNA of 64 patients. Postoperative ctDNA status was available for 47 patients, and three (6%) had detectable ctDNA. Two had inferior vena cava (IVC) involvement, and one developed metastatic disease. Subgroup analysis of solely malignant RCC (n = 65) revealed that patients with preoperative detectable ctDNA had a higher pathologic stage (
P
= .001), larger tumors (7
v
4.5 cm;
P
= .001), higher tumor complexity (
P
= .022), and increased rates of tumor grades 3-4 (
P
= .038). All patients with gross renal vein or IVC involvement (n = 9) and those with lymphovascular invasion (n = 6) on pathology had detectable preoperative ctDNA. On univariate analysis, high tumor complexity, larger tumors, and tumor grades 3-4 were found to be predictors of preoperatively detectable ctDNA status.

CONCLUSION

Preoperative ctDNA was detectable in 61% of patients with nonmetastatic RCC, and it correlated with clinically relevant features. Clinical trials should consider incorporating both preoperative and postoperative ctDNA analyses to augment prediction of disease recurrence and to refine treatment decision making.
Vitamin D-dependent Rickets Type 1A Mimicking Pseudohypoparathyroidism in Presence of Active Tuberculosis
Authors: Das Sambit , Agarwal Vishal , Prusty Binod , Das Bijay Ketan , Choudhury Arun , Meher Dayanidhi
Published: September 2024

Vitamin D-dependent rickets type 1A is caused by pathogenic variants of CYP27B1 gene, which is inherited in autosomal recessive pattern. These variants lead to defective 1α-hydroxylase enzymatic activity, leading to impaired renal formation of 1,25(OH)2 vitamin D. We report a case of a 16-year-old Asian male patient, with short stature and progressive bone deformity, whose biochemical parameters revealed low levels of 1,25(OH)2 vitamin D, low serum calcium levels, along with high phosphorus and raised levels of intact parathyroid hormone. These biochemical parameters suggested the diagnosis of pseudohypoparathyroidism. The patient also had concurrent extrapulmonary tuberculosis during the time of presentation to our endocrine unit. However, on molecular testing, it was revealed that the patient was harboring pathogenic variants of the CYP27B1 gene, in a compound heterozygous manner, with a novel missense mutation in exon 6 of the CYP27B1 gene, c.1136G > C (p.Arg379Thr), suggesting the diagnosis of vitamin D-dependent rickets type 1A. The cause of high phosphorus at the time of presentation, which led to a diagnostic dilemma of pseudohypoparathyroidism, was later explained by presence of active extra pulmonary tuberculosis. This report describes a case of vitamin D-dependent rickets type 1A, mimicking pseudohypoparathyroidism owing to presence of concurrent illness like extrapulmonary tuberculosis.
A Simple Explanation of Countercyclical Uncertainty
Authors: Bernstein Joshua , Plante Michael , Richter Alexander W. , Throckmorton Nathaniel A.
Published: September 2024

This paper documents that labor search and matching frictions generate countercyclical uncertainty because the inherent nonlinearity in the flow of new matches makes employment uncertainty increasing in the number of people searching for work. Quantitatively, this mechanism is strong enough to explain uncertainty and real activity dynamics, including their correlation. Through this lens, uncertainty fluctuations are endogenous responses to changes in real activity that neither affect the severity of business cycles nor warrant policy intervention, in contrast with leading theories of the interaction between uncertainty and real activity dynamics. (JEL D81, E23, E24, E32, J41, J63, J64)
Automation, Bargaining Power, and Labor Market Fluctuations
Authors: Leduc Sylvain , Liu Zheng
Published: September 2024

We argue that the threat of automation weakens workers’ bargaining power in wage negotiations, dampening wage adjustments and amplifying unemployment fluctuations. We make this argument based on a business cycle model with labor market search frictions, generalized to incorporate automation decisions. In the model, procyclical automation threats create endogenous real wage rigidity that amplifies labor market fluctuations. The automation mechanism is consistent with empirical evidence. It is also quantitatively important for explaining the large volatilities of unemployment and vacancies relative to that of real wages, a puzzling observation through the lens of standard business cycle models. (JEL E13, E24, E32, J31, J63, J64)
Population, Productivity, and Sustainable Consumption
Authors: Pindyck Robert S.
Published: September 2024

How does sustainable consumption depend on productivity growth, the size and growth rate of the population, and uncertainty over these growth rates? I address these questions using a model in which productivity and population growth are stochastic and human lives can have (positive or negative) intrinsic social value. I show how sustainable consumption depends on expected rates of productivity and population growth, the volatility of those rates, and the dependence of welfare on population. For plausible parameter values, sustainable consumption is well below the optimal welfare-maximizing level. This raises a question: given its cost, should sustainability be a social objective? (JEL E21, E22, E23, J11, Q01)
Labor Substitutability among Schooling Groups
Authors: Bils Mark , Kaymak Bariş , Wu Kai-Jie
Published: September 2024

Given worldwide trends in education, wage premium for schooling, and real GDP, we derive a lower bound for the long-run elasticity of labor substitution across schooling groups of around 4, which is far higher than values commonly used in the literature. We exploit our bound to reexamine the importance of human capital in cross-country income differences, including the roles of school quality versus the skill bias of technology in the greater efficiency gains from schooling in richer countries. (JEL E23, E24, I26, J24, J31, O15)
When Interest Rates Go Low, Should Public Debt Go High?
Authors: Brumm Johannes , Feng Xiangyu , Kotlikoff Laurence , Kubler Felix
Published: September 2024

Is deficit finance free when real borrowing rates are routinely lower than growth rates? Specifically, can the government make all generations better off by perpetually taking from the young and giving to the old? We study this in stochastic closed- and open-economy OLG models. Unfortunately, Pareto gains are predicted only for implausible calibrations. Even then, the gains reflect improved inter-generational risk sharing, improved international risk sharing, and beggaring thy neighbor—not intergenerational redistribution, per se. As we show, theoretically and quantitatively, low government borrowing rates suggest state-contingent bilateral transfers between generations––not unconditional, unilateral redistribution from future to current generations. (JEL E43, E62, F41, H55, H63)
Η πορεία εκμάθησης των ειδικευόμενων στο BLES
Authors: Μανιού Ιωάννα
Published: September 2024

Εισαγωγή: Η εκπαίδευση των ειδικευομένων είναι μία βασική προτεραιότητα στην Μονάδα Μαστού της Α΄ Προπαιδευτικής Χειρουργικής Κλινικής του Ιπποκρατείου Νοσοκομείου γι’αυτό και η μελέτη της πορείας εκμάθησης των εκπαιδευόμενων στο BLES αποτέλεσε το θέμα της παρούσας μελέτης, λαμβάνοντας υπόψη ότι η βιβλιογραφία που αναφέρεται στη στερεοτακτική βιοψία είναι περιορισμένη και πολύ περισσότερο στο BLES. Ο σκοπός της έρευνας μας είναι η διερεύνηση τυχόν διαφορών που μπορεί να υπάρχουν στην ασφάλεια των ασθενών, στην ποιότητα και την ταχύτητα των δειγμάτων που λαμβάνονται κατά τη διάρκεια διενέργειας του BLES όταν πραγματοποιείται από εκπαιδευόμενους που επιβλέπονται από εκπαιδευμένους. Υλικό και μέθοδος: Στην παρούσα μελέτη συμμετείχαν γυναίκες που προσήλθαν στην Μονάδα Μαστού της Α΄ Προπαιδευτικής Κλινικής του Ιπποκράτειου Νοσοκομείου και υποβλήθηκαν σε βιοψία χρησιμοποιώντας το σύστημα BLES από τον Απρίλιο του 2014 μέχρι τον Οκτώβρη του 2015. Σύμφωνα με τις διεθνείς οδηγίες, οι ασθενείς που υποβλήθησαν σε βιοψία και συμπεριλήφθησαν στην μελέτη μας, παρουσίαζαν μαστογραφική μη ψηλαφητή αλλοίωση BIRADS. Αποτελέσματα: Συνολικά περιλήφθησαν 368 βιοψίες. Ο χρόνος αφαίρεσης του δείγματος και ο χρόνος τοποθέτησης του clip μειώθηκε στατιστικά σημαντικά από το 2014 στο 2015 για τους εκπαιδευόμενους ιατρούς (p 0,01). Συμπέρασμα: H έρευνα μας μπορεί να έχει διάφορες εφαρμογές στην ιατρική εκπαίδευση. Η εφαρμογή ενός μοντέλου εκπαίδευσης υπό άμεση επίβλεψη μπορεί να διασφαλίσει την ασφάλεια του ασθενή και ταυτόχρονα να βελτιώσει τις ικανότητες του ειδικευόμενου. Το BLES είναι μία μέθοδος βιοψίας που μαθαίνεται εύκολα μέσω από την οργάνωση εκπαιδευτικών προγραμμάτων όπου οι ειδικευόμενοι έχουν την ευκαιρία να πραγματοποιούν αυτό το είδος της βιοψίας σε ένα επαρκή αριθμό ασθενών και με την κατάλληλη επίβλεψη.
Food consumption and adherence to dietary guidelines among Jordanian children and adolescents
Authors: Alkhatib Buthaina , Al Hourani Huda , Al-Shami Islam K. , Al-Jawaldeh Ayoub
Published: September 2024

Background Early-life food consumption patterns may affect children’s health by increasing susceptibility to developing non-communicable chronic diseases (NCDs) in adulthood. Aims To evaluate Jordanian children and adolescents’ energy and macronutrient intake and how closely they adhere to dietary recommendations. Methods This cross-sectional study used data from Jordan’s Population-based Food Consumption Survey, a household population-based study conducted in Jordan between 2021 and 2022 (561 children and adolescents 8-19 years). Dietary intake was assessed using the two non-consecutive 24-hour dietary recall methods (24-h DR). The estimated food group and nutrient intakes were compared to nutritional recommendations, including MyPlate dietary guidelines. Results The prevalence of overweight/obese individuals based on body mass index (BMI) was 44%, and the average waist-to-height ratio (WHtR) was 24.7%. Compared to MyPlate dietary guidelines, children and adolescents had a higher added sugar intake (57g/day). Also, consuming vegetables, fruits, and dairy fell short of MyPlate dietary guidelines. The total discretionary calorie intake in children and adolescents was approximately one-third of the total energy intake. Conclusion The food consumption of Jordanian children and adolescents includes high intakes of discretionary calories, with a low intake of fruits, vegetables, and dairy products. The prevalence of overweight/obesity was elevated compared to international norms.
Determinant factors of gross domestic product (GDP) in Association of Southeast Asian Nations (ASEAN) member countries
Authors: Shafrullah Faris , Indrawati Leni , Ismail Solahuddin , Ihsan Faris , Pratiwi Putri Ayu , Karno Karno
Published: September 2024

Background The gross domestic product (GDP) of Association of Southeast Asian Nations (ASEAN) member states can be used to determine their overall economic growth. In order to increase GDP, all emerging nations in Southeast Asia are stating to depend on foreign direct investment (FDI), the tourism industry, international visitors visiting ASEAN member nations banking credit, and low inflation rates. High inflation is a problem that developed and developing countries will definitely face. One of the problems faced by ASEAN member countries is that most of the member countries are in the developing country category. For ASEAN member countries, high inflation levels will encourage economic instability. GDP is less than optimal because of these classic problems in developing countries so that economic growth is not as planned. The ASEAN Economic Community (AEC), which ASEAN established, is seen as a way to reduce unemployment, alleviate poverty by boosting the travel and tourism industry and increasing investment, as well as to offer or distribute credit to businesses at low interest rates in order to boost GDP. The purpose of this study is to investigate and analyze how the GDP of ASEAN member nations is affected by FDI, foreign visitors, bank credit, and inflation. s: We analyzed panel data for seven ASEAN members from 2002 to 2020. FDI, foreign tourists, banking credit, and inflation are the research factors examined as independent variables that have an impact on GDP, the dependent variable. Results The study’s findings indicate that while inflation has a large negative impact on GDP, FDI, foreign tourism, and bank credit have a considerable positive impact on GDP. Conclusions FDI, foreign tourists, bank credit, and inflation have a significant influence on GDP in ASEAN member countries.
Development of Theory of Uncertainty on COVID-19: Theory Derivation Based on Uncertainty in Illness Theory
Authors: Kang Cho Ryok , Yang Sook Ja
Published: September 2024

Purpose: The purpose of this study is to develop the Theory of Uncertainty on COVID-19 using the strategy of theory derivation. Methods: Theory derivation was carried out in the following steps: review the literature to explore the phenomena related to uncertainty on COVID-19; select a parent theory that provides valuable concepts and a useful structure for derivation, and identify the concepts and structure of the parent theory to use in derivation; modify and redefine the concepts and structure of the parent theory to create a derived theory. In the literature review process, relevant findings were synthesized to support the propositions of the derived theory. Results: The Theory of Uncertainty on COVID-19 was derived from the Uncertainty in Illness Theory to make it relevant and applicable to a specific aspect of uncertainty on COVID-19, health-related uncertainty perceived by a person who has not contracted COVID-19. It is a middle-range theory targeting the general population and consists of a linear and unidirectional model centered on three themes: antecedents of uncertainty, appraisal of uncertainty, and coping with uncertainty. Conclusion: The Theory of Uncertainty on COVID-19 will be able to contribute to efforts to manage perceived uncertainty on pandemic diseases and improve individual biopsychosocial health in the future.
Exploring the Prevalence and Influencing Factors of Sexually Explicit Internet Material (SEIM) Consumption among Adolescents and Young Adults in Cambodia
Authors: Cheon Hyunjeong , Yang Youngran
Published: September 2024

Purpose: This study investigates the prevalence and factors associated with the consumption of sexually explicit Internet material (SEIM) among adolescents and young adults in Cambodia. Methods: Utilizing a cross-sectional study design, data were collected through a survey administered to 1,271 participants. The survey focused on measuring SEIM consumption, sexual sensation seeking, perceived reality of SEIM, and sexual attitudes. Findings: The study revealed a SEIM prevalence of 27.2%, with notably higher rates among males (35.5%) than females (18.6%). Significant predictors of SEIM consumption included being male, having a father with a middle-level education, engaging in alcohol or substance consumption, spending more than five hours daily on electronic devices, having friends with sexual experience, frequent thoughts about sex, a heightened interest in sex compared to peers, perceiving SEIM as realistic, and maintaining a permissive attitude towards sex. Conclusions: These findings underscore the importance of implementing education programs to address SEIM consumption and its potential risk factors. Such initiatives are crucial for preventing the use of SEIM among Cambodian youth, promoting a healthier understanding of sexuality, and fostering responsible online behavior.
Mindful Eating in Healthcare: A Concept Analysis
Authors: Han Kuem Sun , Jung Mi Ran , Hwang Dae Won
Published: September 2024

Purpose: This study aims to clarify the concept of mindful eating in healthcare and provide a basis for the development of related interventions in the healthcare field.Methods: This study was conducted according to the framework based on Rodgers' evolutionary view. The initial data of 879 in total were collected through databases (PubMed, CINAHL). included article only written in English and search term was ‘mindful’ and ‘eating’, and ‘health or healthcare or health science or medical or nursing'. There was no restriction on the year of publication and disciplines. In a total of 879 articles, 81 were finally included according to the researcher's selection and exclusion criteria.Results: A total of 4 attributes of mindful eating were identified ('Concentration to food', 'Sustained attention to self', 'Self-regulation', and 'The pursuit of pleasure'). There were 2 Antecedents ('Response to craving' and 'Voluntary will') and 3 Consequences ('Changes in eating habits', 'Physical health', and 'Emotional health') for this.Conclusion: This concept analysis describes mindful eating within the context of healthcare. It is anticipated that this paper will enhance the clarity and precision of its use in future tool development and intervention research, while promoting its broader application in the field of nursing.
Methanization Test of Water Hyacinth and Azolla in Co-digestion and Fertilizing Value of Digestates in Benin (West Africa)
Authors: Janvier Bokossa Hervé Kouessivi , Francine Abiola , Tahirou Hidirou Toro Moussa , Christian Johnson Roch
Published: September 2024

Faced with the need for an alternative energy source following the extreme pressure exerted on woody resources accompanied by the increase of aquatic pests which invade water resources, the construction of mini reactors producing clean energy, biogas based on these invasive plants becomes a challenge. This investigation aims to assess the methane production potential of water hyacinth and Azolla in co-digestion and the fertilizing quality of the digestates obtained. A bio methanization test based on various combinations of organic substrates composed of water hyacinth and Azolla alone or in co-digestion under laboratory conditions at mesophilic temperature and neutral pH after 27 days was carried out. The source of enrichment in anaerobic microorganisms for fermentation processes in micro bioreactors consists of fresh pig manure. It appears that the combination of organic substrates including 75% of water hyacinth generated the maximum quantity of methane which is 1234 liters for one ton of organic substrates. This methane production is 1.93 times greater than that of the bioreactor containing water hyacinth alone, 1.90 times that containing azolla, 1.5 times that containing 25% water hyacinth +75% azolla then 3.04 times that containing the bioreactor composed of a high proportion of crushed Azolla filiculoides. The digestates are rich in N, P, K, Ca and Mg and had an amending power according to the NFU 44051 standard. For the construction of bioreactors with aquatic pests for the benefit of communities, co-digestion with a combination of substrates with a high proportion of water hyacinth is suggested.
Gestational diabetes mellitus: ensuring healthy futures
Authors: Morgan Harriet D , Hamza Malak , Morrison Amy E , Campbell Cathy , Cassar Caroline Borg , Thayyil Sheena , Meek Claire L
Published: September 2024

Gestational diabetes mellitus is the most common medical condition in pregnancy, disproportionately affecting overweight or obese women and those from non-White populations. The lack of standardised screening and diagnostic consensus contributes to varying prevalence. Conventional risk factor-based screening can leave women undiagnosed, leading to increased risk of harm. If diet and lifestyle modifications fail to achieve glycaemic targets, prompt treatment should be initiated to manage glucose levels. A planned birth is crucial to ensure the best outcomes. Postpartum, women need screening for type 2 diabetes and other cardiometabolic risk factors, enrollment in diabetes prevention programmes, and counselling on the increased risk of future cardiometabolic disease for themselves and their offspring, highlighting the importance of ongoing prevention and management strategies.
A day in the life of a maternity unit: immersive simulation for final year midwifery students
Authors: Sanders Ruth , Thorne Jemma
Published: September 2024

Simulation is an established transformational and experiential learning strategy in health education, drawing on creative and innovative teaching techniques. This article discusses a large-scale unfolding case study using real-time simulation with a multiprofessional facilitation team, to explore how using several simulation techniques can provide a rich learning experience for both midwifery students and their facilitators. Many midwifery students find the application of theoretical learning to practice settings a challenge, and report lacking confidence in certain elements of clinical practice, which can become more concerning in the latter stages of their training. By using multiple approaches with a student-centred outlook, this immersive simulation event positively impacted students' clinical confidence and assurance in their assessment skills, and enabled them to feel more fully prepared for everyday midwifery practice.
The Maternity Engagement Project
Authors: Peck Helen
Published: September 2024

Helen Peck discusses the Twins Trust project to improve care for women pregnant with multiples in a Lincolnshire hospital trust
Improving the Word Recognition Skills of Children Learning to Read in a Second Language Through Podcasts
Authors: Amadi Eugenia Ada , Nnamani Amuche Patricia , Ossai Rosemary Chidimma
Published: September 2024

Failure in visual word recognition brings about frustration and failure in reading which impinge on the achievement and reading progress of learners. In order to contribute towards assisting every child to achieve minimum proficiency in reading, this investigation examined the impact of podcasts on the abilities of second language learners in sight word recognition. The study which is quasi-experimental, made use of the pre-test post-test nonequivalent groups method. The study participants who were purposively sampled from a privately owned primary school in Enugu urban, South East, Nigeria comprise thirty elementary two learners. Pre-and post-tests were administered to the participants who were grouped into intervention and control groups. The intervention group listened to podcasts in word recognition skills while the control group learned word recognition through the usual method. Statistical tools such as means, standard deviation and analysis of covariance (ANCOVA) were utilized to analyze the data collected. The research question was answered through Standard Deviation and the learners’ mean achievement scores, while the hypothesis, which was set at <0.05 level of significance, was tested with the ANCOVA. The results of the investigation showed that podcasts facilitated improvement in the word recognition skills of English as a second language (ESL) learners. The study concluded that the use of podcast proves to be an efficient instructional media capable of promoting achievement in word recognition skills of learners in an ESL classroom. On the basis of the results, exploring the use of podcasts in the teaching of word recognition skills among ESL learners was recommended.
Predictive Factors for Recurrence of Fistula-in-Ano After Surgery: A 10-year Experience in a Single Center Study
Authors:   Department of Surgery, Faculty of Medicine, Chiang Mai University, Thailand, Supatrakul Ekkarin , Kanthawanna Thanakan ,   Department of Surgery, , Faculty of Medicine, Chiang Mai University, Thailand, Vipudhamorn Witcha ,   Department of Surgery, Faculty of Medicine, Chiang Mai University, Thailand, Sanmae Suwan ,   Department of Surgery,, Faculty of Medicine, Chiang Mai University, Thailand, Siriwittayakorn Paisit ,   Department of Surgery, , Faculty of Medicine, Chiang Mai University, Thailand, Sutharat Pawit ,   Department of Surgery, Faculty of Medicine, Chiang Mai University, Thailand
Published: September 2024

OBJECTIVE This study aimed to evaluate the recurrence rate of fistula- in-ano treatment and factors associated with recurrence. METHODS A retrospective cohort study was performed of cryptoglandular-cause fistula-in-ano patients who underwent surgery between January 2010 and June 2020. Cox’s regression analysis was used to identify predictive factors for recurrence FIA. RESULTS The study included 282 patients of whom 233 (82.6%) were male, 76 (27.0%) had previous anal fistula surgery, 77 (27.3%) had a complex type of fistula, 72 (25.5%) were high transphincteric, 3 (1.0%) were suprasphincteric, and 2 (0.7%) were extrasphincteric. Five types of operations were performed: 106 (37.6%) fistulotomies, 43 (15.2%) fistulectomies, five (1.8%) setons, six (2.1%) endorectal advancement flaps (ERAF), and 122 (43.3%) ligations of the intersphincteric fistula tract (LIFT). The recurrence rate was 20.1% (57 patients) among whom 54 (94.0%) were detected at follow- up within 12 months, 2 patients were detected in the second year, and 1 patient was detected in the third year. Four independent factors associated with the recurrence of FIA after surgery were identified: female gender (HR 2.67; 95% CI 1.34-5.34), BMI >25 kg/m2 (HR 2.47; 95% CI 1.38-4.44), complex type of fistula (HR 2.02; 95% CI 1.02-3.97), and anterior opening (HR 2.14; 95% CI 1.12-4.10). Compared to the LIFT procedure, fistulotomy was the protective factor (HR 0.12; 95% CI 0.03-0.46) while ERAF had a higher rate of recurrence (HR 6.12; 95% CI 1.87-20.03). CONCLUSIONS Patients with high BMI and female patients should be advised of the higher chance of recurrence after anal fistula surgery. More complex fistula-in-ano and sphincter-preserving surgery was also associated with a higher recurrence rate. The complete healing of the surgery should be monitored for two years after surgery. KEYWORDS predictive factors, recurrence, fistula-in-ano, anal fistula
The Association of Lifestyle Factors and Attention Problems in Adolescents
Authors:   Department of Pediatrics, Faculty of Medicine, Chiang Mai University, Thailand, Boonchooduang Nonglak , Likhitweerawong Narueporn ,   Department of Pediatrics, Faculty of Medicine, Chiang Mai University, Thailand, Louthrenoo Orawan ,   Department of Pediatrics, Faculty of Medicine, Chiang Mai University, Thailand
Published: September 2024

OBJECTIVE This study aims to explore the associations between lifestyle factors such as physical activity, sleep patterns, media usage, and diet, and attention problems in adolescents. METHODS This cross-sectional study involved 4,370 adolescents aged 13-18 years in Chiang Mai, Thailand. Lifestyle factors were assessed using the Youth Risk Behavior Surveillance System questionnaire, while attention problems were evaluated with the Youth Self-Report (YSR) Attention Problems subscale. Associations were analyzed using univariable and multivariable regression analysis. RESULTS Media use exceeding two hours per day was significantly asso-ciated with clinical attention problems (aOR = 3.21, 95% CI: 1.81-5.71). Additionally, increased media use (b = 0.24, 95% CI: 0.19-0.28, p < 0.01), and high soft drinks consumption (b = 0.19, 95% CI: 0.12-0.26, p < 0.01) were positively associated with higher attention problem scores. Conversely, active physical activity (b = -0.09, 95% CI: -0.13 to -0.05, p < 0.01), adequate sleep (b = -0.26, 95% CI: -0.33 to -0.19, p < 0.01), regular breakfast intake (b = -0.09, 95% CI: -0.12 to -0.05, p < 0.01), vegetable consumption (b = -0.07, 95% CI: -0.13 to -0.02, p = 0.01), and milk consumption (b = -0.06, 95% CI: -0.11 to -0.01, p = 0.03) were negatively associated with attention problems scores. CONCLUSIONS The study highlights the significant impact of lifestyle factors on attention problems among adolescents. These findings support the integration of lifestyle modifications into the assessment and manage-ment of attention issues in this age group, particularly emphasizing the need to reduce excessive media use. KEYWORDS lifestyle factors, dietary patterns, attention problems, ADHD, adolescence
Stage-Affected Quality of Life in Endometrial Cancer Patients
Authors:   Faculty of Medicine, Chiang Mai University, Thailand, Meksuwan Chindanai , Suppagornmongkol Nattapol ,   Faculty of Medicine, Chiang Mai University, Thailand, Prompruk Nattakan ,   Faculty of Medicine, Chiang Mai University, Thailand, Tawan Wanwanut ,   Faculty of Medicine, Chiang Mai University, Thailand, Tantipalakorn Charuwan ,   Department of Obstetrics and Gynecology, Faculty of Medicine, Chiang Mai University, Thailand, Suradom Chawisa ,   Department of Psychiatry, Faculty of Medicine, Chiang Mai University, Thailand, Jeerakornpassawat Dhammapoj ,   Department of Obstetrics and Gynecology, Faculty of Medicine, Chiang Mai University, Thailand
Published: September 2024

OBJECTIVE This study aims to compare the aspects of quality of life between early and advanced-stage endometrial cancer patients. METHODS From January to February 2021, women diagnosed with endometrial cancer and treated at Maharaj Nakorn Chiang Mai Hospital were invited to participate. Two qualities of life questionnaires, the European Organization for Research and Treatment of Cancer Quality of Life QLQ-C30 questionnaire (EORTC QLQ-C30) and the CMU Endometrial Cancer Quality of Life (gastrointestinal, urinary, lymphatic, sexual, and hormonal domains) were used. The chi-squared test, the Mann-Whitney U test, and multivariable linear regression were used for statistical analysis. RESULTS A total of 103 participants were divided into two groups: 65 individuals with early-stage disease and 38 with advanced-stage disease. All participants completed the quality-of-life questionnaires. The two groups were comparable in terms of global health status/QoL for EORTC QLQ-C30. However, the early-stage group had significantly higher functional scales and quality-of-life summary scores than the advanced-stage group. As for the CMU endometrial cancer QoL, the advanced-stage group had more negative issues related to the gynecologic and hormonal system compared to the early-stage group. CONCLUSIONS Women with endometrial cancer generally have a good quality of life. Survivors of advanced stages may have a quality of life similar to those in the early stage but with a higher incidence of gastrointestinal, sexual, and hormonal complications. KEYWORDS chemotherapy, endometrial cancer, oncology, quality of life
Occupational Characteristics and Working Hours of Stroke and Myocardial Infarction Patients at a Hospital in Bangkok: A Descriptive Study
Authors:   Occupational and Environmental Medicine Institute, Nopparat Rajathanee Hospital, Thailand, Chongchitpaisan Pakanaporn , Piemnithikul Premyot ,   Occupational and Environmental Medicine Institute, Nopparat Rajathanee Hospital, Thailand, Chongchitpaisan Wanna ,   Occupational and Environmental Medicine Institute, Nopparat Rajathanee Hospital, Thailand
Published: September 2024

OBJECTIVE The aim of this study was to investigate occupational risk factors, particularly focusing on working hours, in the patients with cerebrovascular diseases and cardiovascular diseases to help reduce the incidence of those diseases in the future. METHODS This descriptive study was conducted retrospectively. Patients age 18 to 65 with a first diagnosis of acute stroke and acute myocardial infarction in the years 2019 to 2022 were included. Demographic data were obtained from in-patient records. Occupational data, including working hours and other missing data, were obtained through telephone interviews with the patients. RESULTS After excluding individuals who were unemployed at the time of the disease incident, deceased, unwilling or unreachable to participate, a total of 146 patients were included in this study. Of those, 115 participants (78.8%) were first diagnosed with acute stroke and 31 participants (21.2%) were first diagnosed with acute myocardial infarction during the study period. The median and interquartile range of weekly working hours of all participants, participants with acute stroke, and participants with acute myocardial infarction were 56 (25), 56 (35), and 59 (27) hours per week, respectively. The range of working hours per week was from 4 to 112 hours. The majority of participants reported not engaging in dangerous work as defined by Thailand’s Ministry of Labour, reported no significant occupational hazards, stated they had minimal stress and that they had control over their own job. CONCLUSIONS The results indicate that the majority of stroke and myocardial infarction patients from this center worked ≥ 55 hours per week. Although the majority reported having no significant occupational factors, recognizing and incorporating a history of occupational factors could be beneficial in disease diagnosis, disease prevention, prevention of recurrence, and aiding the return-to-work process of the patients. KEYWORDS overwork, cerebrovascular disease, cardiovascular disease, myocardial infarction, stroke, occupational disease, long working hours
Effect of Grain Coating by Natural Materials on the Aroma Quality of KDML105 Rice
Authors:   Department of Chemistry, Faculty of Science, Chiang Mai University, Chiang Mai 50200, Thailand, Angsuwarangoon Woraluk , Pripdeevech Patcharee ,   School of Science, Mae Fah Luang University, Chiang Rai 57100, Thailand, Bennett Chonlada ,   Department of Chemistry, Faculty of Science, Chiang Mai University, Chiang Mai 50200, Thailand,   Atmospheric Research Unit, National Astronomical Research Institute of Thailand (Public Organisation), Chiang Mai 50180, Thailand, Sookwong Phumon ,   Department of Chemistry, Faculty of Science, Chiang Mai University, Chiang Mai 50200, Thailand,   The Functional Food Research Center for Well-being, Multidisciplinary Research Institute, Chiang Mai University, Chiang Mai 50200, Thailand, Mahatheeranont Sugunya ,   Department of Chemistry, Faculty of Science, Chiang Mai University, Chiang Mai 50200, Thailand,   The Functional Food Research Center for Well-being, Multidisciplinary Research Institute, Chiang Mai University, Chiang Mai 50200, Thailand,   Center of Excellence for Innovation in Chemistry, Faculty of Science, Chiang Mai University, Chiang Mai 50200, Thailand
Published: September 2024

This study evaluated the effectiveness of different coating formulas in preserving the aroma quality of Khao Dawk Mali 105 (KDML 105) rice grains, particularly focusing on the key aroma compound, 2-acetyl-1-pyrroline (2AP). Initially, thirteen coating formulas were tested, and gum arabic was found to be the most effective in maintaining rice appearance and preventing mold growth during storage. In a subsequent experiment, rice coated with carnauba wax, gum arabic, and a 1:1 mixture of both was analyzed for 2AP content over 10 weeks using SHS-GC, under storage conditions of ambient temperature (25 °C) and 4 °C in polyethylene and laminated bags. The 10% gum arabic coating was the most effective at retaining 2AP after 10 weeks. Additionally, the study included a comparison with a 5% rice gel coating and a mixture of 5% gum arabic and 5% rice gel. The results indicated rice stored at 4 °C in laminated bags exhibited a 2-3% reduction in 2AP content after 6 weeks, while at ambient temperature, a reduction of 44-64% was observed. After 10 weeks, the 2AP contents in the 10% gum arabic coated rice were the highest at an average of 38-40% compared to those of the control group. Furthermore, the rancid compounds, including hexanal, heptanal, octanal, nonanal, and 2-pentylfuran, increased significantly in all coated rice samples at ambient temperature, with the highest hexanal content found in rice coated with a mixture of 5% gum arabic and 5% rice gel, showing approximately 22-55% increase compared with those of the uncoated rice. Overall, gum arabic coating was the most effective in preserving 2AP for at least 10 weeks, and storage at 4 °C provided the best conditions for aroma retention and rancid prevention.
Nivel de conflicto, implicación del profesorado y defensa de la diversidad sexual en los centros de educación secundaria
Authors: Huerta Ricard , Alfonso-Benlliure Vicente
Published: September 2024

INTRODUCCIÓN. El presente trabajo afronta una realidad poco abordada hasta ahora en las investigaciones sobre comportamientos del alumnado y el profesorado en los centros de secundaria. Se analiza aquí el nivel de conflicto relacionado con la convivencia y la falta de respeto a la diversidad sexual en los centros, y se estudia la relación entre dicho conflicto, y la sensibilidad del profesorado hacia cuestiones LGTBI, la existencia de determinadas estrategias de prevención y solución del conflicto, de determinados recursos para prevenir-solucionar estos, el tamaño de los centros, el tipo de centro, etc. MÉTODO. La metodología utilizada es fundamentalmente cuantitativa. Un total de 124 profesores de 31 centros educativos de educación secundaria obligatoria participaron en la investigación. Se trataba de centros tanto públicos como privados y concertados (laicos y religiosos). El profesorado respondió a cuestionarios sobre su grado de sensibilidad a la DS, así como a diversas cuestiones en relación a las características de su centro de trabajo (e. g., grado de conflicto, estrategias y recursos…). RESULTADOS. Los resultados ponen de manifiesto que en los centros con menor nivel de conflicto el profesorado muestra mayores niveles de sensibilidad hacia la diversidad sexual, especialmente en cuestiones relativas a la implicación activa y la superación de prejuicios hacia las personas LGTBI. También destacan la relevancia de estrategias preventivas como el control de los mensajes explícitos que se transmiten en el centro (verbales, visuales) o la existencia de protocolos de acción claros una vez el conflicto aparece. Entre los recursos más útiles, destacan las tutorías específicas por encima del resto. DISCUSIÓN. Finalmente, se discuten estos resultados y las ventajas de contar con una descripción sobre cómo son y cómo funcionan los centros en los que los niveles de conflicto son menores y cómo utilizarlos como referentes y guías para el resto.
Dual-spherical-wave optical scanning holographic microscopy with resolution enhancement and an extended depth of field
Authors: Liu Jung-Ping , Huang Chen-Hsiang
Published: September 2024

Conventional optical scanning holographic microscopy (OSHM) is realized by using a plane wave and a spherical wave as the illumination. The resolution of the conventional OSHM is limited by the numerical aperture of the spherical wave and cannot exceed the Rayleigh limit. In this paper, the OSHM by using dual spherical waves as the illumination is studied. The model of a Gaussian wave, together with the constraints on the signal strength and the visibility, are considered in the analysis of the dual-spherical-wave (DS) OSHM. For an object located at the symmetry plane of the DS-OSHM, the resolution can slightly exceed the Rayleigh limit, and the depth of field (DoF) is extended significantly. For a transparent object, the noise in the DS-OSHM is less than that of the conventional OSHM, thanks to the highly divergent scanning beam. If the object is off the symmetry plane, the resolution is still enhanced, but the extension of the DoF is limited. In addition, a clear reconstructed image will be observed not only at the original object plane, but also at its mirror plane. To the best of our knowledge, this phenomenon is reported for the first time.