bluuebunny/crossref_metadata_2025 huggingface dataset:
Obstetric vesico-uterine fistula in nine reference hospitals in the Democratic Republic of the Congo: epidemiological, clinical, and therapeutic aspects
Authors: Paluku Justin Lussy , Furaha Cathy Mufungizi , Bartels Susan A. , Aksanti Barthelemy Kasi , Kataliko Benjamin Kasereka , Kasereka Jonathan ML , Kamabu Eugénie Mukekulu , Kalole Benjamin Kambale , Muteke John Kasereka , Kyembwa Michel Mulyumba , Kabuyanga Richard Kabuseba , Tsongo Zacharie Kibendelwa , Wembonyama Stanis Okitotsho , Mpoy Charles Wembonyama , Juakali Jeannot Sihalikyolo
Published: May 2024

Introduction

With global cesarean section rates rising, there’s concern about increase in obstetric vesico-uterine fistula (OVUF). Very little is known about this anatomoclinical entity of obstetric fistula in Africa in general and in DRC in particular. Our purpose was to describe the epidemiological, clinical, and therapeutic aspects of OVUF in the Democratic Republic of the Congo (DRC).

Methods

This was a descriptive cross-sectional study. Data were collected from patients who presented with OVUF across seven provinces of the DRC (North Kivu, Haut-Uélé, Kasai Central, Kwilu, Maniema, Nord-Ubangi and Sankuru) from January 2017 to December 2022. Study variables were epidemiological, clinical, and therapeutic features.

Results

Of 1,267 patients presenting with obstetric fistulas, 355 (28.0%) had OVUF. The mean age was 32.9 ± 11.6 years, 80.6% of patients (286/355) lived in rural areas, and the majority had a low level of education (40% no formal education, 30.1% primary school, 28.7% secondary school). In total, 64.8% of patients were primiparous (230/355) and in all (100%) cases, OVUF was caused iatrogenically during cesarean delivery. Majority (76.3%) of patients laboured for one day or less (mean duration 1.0 ± 0.5 days) before giving birth, and the fetus died in 58.3% of cases. In 35.8% of cases, the fistula had lasted more than 10 years (mean age 10.1 ± 10.0 years) before repair. A proportion of 88.2% (n = 313) of OVUF was isolated while 11.3% (n = 40) was associated with a uretero-vaginal fistula. In 82.8% (n = 294) of cases the OVUF was single. The average fistula size was 2.4 ± 1.0 cm (range: 0.5 and 5.5 cm) and 274 (77.2%) fistulas measured between 1.5 and 3 cm, with 14.9% (n = 53) of them larger than 3 cm. Fibrosis was present in 65.1% of cases, cervical involvement was absent in 97.7% and post-operative complications were absent in 94.4%. In all cases, the OVUF was surgically repaired abdominally with a success rate of 97.5% (346/355).

Conclusion

The proportion of OVUF is relatively high in the DRC. Most affected patients were young, under-educated, primiparous women living in rural areas. Cesarean section was the sole identified cause of OVUF which was isolated, single, without fibrosis, in majority of cases. Abdominal repair of OVUF was very effective, with good results in almost all cases. Teaching young doctors working mainly in remote areas how to perform safe cesarean section is needed to reduce incidence of OVUF in DRC.
Interpretation of course conceptual structure and student self-efficacy: an integrated strategy of knowledge graphs with item response modeling
Authors: Cao Zhen-Yu , Lin Feng , Feng Chun
Published: May 2024

Background

There is a scarcity of studies that quantitatively assess the difficulty and importance of knowledge points (KPs) depending on students’ self-efficacy for learning (SEL). This study aims to validate the practical application of psychological measurement tools in physical therapy education by analyzing student SEL and course conceptual structure.

Methods

From the “Therapeutic Exercise” course curriculum, we extracted 100 KPs and administered a difficulty rating questionnaire to 218 students post-final exam. The pipeline of the non-parametric Item Response Theory (IRT) and parametric IRT modeling was employed to estimate student SEL and describe the hierarchy of KPs in terms of item difficulty. Additionally, Gaussian Graphical Models with Non-Convex Penalties were deployed to create a Knowledge Graph (KG) and identify the main components. A visual analytics approach was then proposed to understand the correlation and difficulty level of KPs.

Results

We identified 50 KPs to create the Mokken scale, which exhibited high reliability (Cronbach’s alpha = 0.9675) with no gender bias at the overall or at each item level (p > 0.05). The three-parameter logistic model (3PLM) demonstrated good fitness with questionnaire data, whose Root Mean Square Error Approximation was < 0.05. Also, item-model fitness unveiled good fitness, as indicated by each item with non-significantp-valuesfor chi-square tests. The Wright map revealed item difficulty relative to SEL levels. SEL estimated by the 3PLM correlated significantly with the high-ability range of average Grade-Point Average (p < 0.05). The KG backbone structure consisted of 58 KPs, with 29 KPs overlapping with the Mokken scale. Visual analysis of the KG backbone structure revealed that the difficulty level of KPs in the IRT could not replace their position parameters in the KG.

Conclusion

The IRT and KG methods utilized in this study offer distinct perspectives for visualizing hierarchical relationships and correlations among the KPs. Based on real-world teaching empirical data, this study helps to provide a research foundation for updating course contents and customizing learning objectives.

Trial registration

Not applicable.
Providing insights into health data science education through artificial intelligence
Authors: Rohani Narjes , Gal Kobi , Gallagher Michael , Manataki Areti
Published: May 2024

Background

Health Data Science (HDS) is a novel interdisciplinary field that integrates biological, clinical, and computational sciences with the aim of analysing clinical and biological data through the utilisation of computational methods. Training healthcare specialists who are knowledgeable in both health and data sciences is highly required, important, and challenging. Therefore, it is essential to analyse students’ learning experiences through artificial intelligence techniques in order to provide both teachers and learners with insights about effective learning strategies and to improve existing HDS course designs.

Methods

We applied artificial intelligence methods to uncover learning tactics and strategies employed by students in an HDS massive open online course with over 3,000 students enrolled. We also used statistical tests to explore students’ engagement with different resources (such as reading materials and lecture videos) and their level of engagement with various HDS topics.

Results

We found that students in HDS employed four learning tactics, such as actively connecting new information to their prior knowledge, taking assessments and practising programming to evaluate their understanding, collaborating with their classmates, and repeating information to memorise. Based on the employed tactics, we also found three types of learning strategies, including low engagement (Surface learners), moderate engagement (Strategic learners), and high engagement (Deep learners), which are in line with well-known educational theories. The results indicate that successful students allocate more time to practical topics, such as projects and discussions, make connections among concepts, and employ peer learning.

Conclusions

We applied artificial intelligence techniques to provide new insights into HDS education. Based on the findings, we provide pedagogical suggestions not only for course designers but also for teachers and learners that have the potential to improve the learning experience of HDS students.
Measuring sociocultural engagement of health professions education students: a psychometric study
Authors: Kassab Salah Eldin , Rathan Ramya , Schmidt Henk G. , Hamdy Hossam
Published: May 2024

Background

Sociocultural engagement of students refers to broadening viewpoints and providing awareness of, and respect for, diverse backgrounds and perspectives. However, there are no existing validated instruments in the literature for measuring sociocultural engagement of health professions education (HPE) students. Therefore, the aim of this study is to develop and validate a questionnaire designed to assess sociocultural engagement among HPE students.

Methods

The study included undergraduate HPE students (n = 683) at Gulf Medical University. The initial version of the sociocultural engagement of students’ questionnaire (SESQ) was developed after extensive literature review and guided by the Global Learning Qualifications Framework. We then tested the content validity of the questionnaire by using focus group discussion with subject experts (n = 16) and pilot testing with students (n = 20). We distributed the content-validated version of the SESQ (16 items) to undergraduate students in six HPE colleges. To examine the construct validity and construct reliability of the questionnaire, we conducted exploratory factor analysis, followed by confirmatory factor analysis.

Results

Confirmatory factor analysis supported the two-factor structure which consists of 13 items with good fitness indices (χ2 = 214.35, df = 61, χ 2/df = 3.51, CFI = 0.98, RMSEA = 0.06, SRMR = 0.025, and AIC = 208.00). The two factors were sociocultural interactions (8 items) and sociocultural adaptation (5 items). The construct reliability of the total questionnaire is 0.97 and the two factors were 0.93 and 0.92 for sociocultural interactions and sociocultural adaptation, respectively. In addition, there were significant weak correlations between both factors of sociocultural engagement scores and student satisfaction with the university experience (r = .19 for each, P = .01).

Conclusions

The sociocultural engagement of students’ questionnaire exhibits good evidence of construct validity and reliability. Further studies will be required to test the validity of this questionnaire in other contexts.
The need for cybersecurity self-evaluation in healthcare
Authors: Burke Wendy , Stranieri Andrew , Oseni Taiwo , Gondal Iqbal
Published: May 2024

The Australian healthcare sector is a complex mix of government departments, associations, providers, professionals, and consumers. Cybersecurity attacks, which have recently increased, challenge the sector in many ways; however, the best approaches for the sector to manage the threat are unclear. This study will report on a semi-structured focus group conducted with five representatives from the Australian healthcare and computer security sectors. An analysis of this focus group transcript yielded four themes: 1) the challenge of securing the Australian healthcare landscape; 2) the financial challenges of cybersecurity in healthcare; 3) balancing privacy and transparency; 4) education and regulation. The results indicate the need for sector-specific tools to empower the healthcare sector to mitigate cybersecurity threats, most notably using a self-evaluation tool so stakeholders can proactively prepare for incidents. Despite the vast amount of research into cybersecurity, little has been conducted on proactive cybersecurity approaches where security weaknesses are identified weaknesses before they occur.
Modality-specific effects of threat on self-motion perception
Authors: Hacohen-Brown Shira , Gilboa-Schechtman Eva , Zaidel Adam
Published: May 2024

Background

Threat and individual differences in threat-processing bias perception of stimuli in the environment. Yet, their effect on perception of one’s own (body-based) self-motion in space is unknown. Here, we tested the effects of threat on self-motion perception using a multisensory motion simulator with concurrent threatening or neutral auditory stimuli.

Results

Strikingly, threat had opposite effects on vestibular and visual self-motion perception, leading to overestimation of vestibular, but underestimation of visual self-motions. Trait anxiety tended to be associated with an enhanced effect of threat on estimates of self-motion for both modalities.

Conclusions

Enhanced vestibular perception under threat might stem from shared neural substrates with emotional processing, whereas diminished visual self-motion perception may indicate that a threatening stimulus diverts attention away from optic flow integration. Thus, threat induces modality-specific biases in everyday experiences of self-motion.
Independent and joint associations of monocyte to high-density lipoprotein-cholesterol ratio and body mass index with cardiorenal syndrome: insights from NHANES 2003–2020
Authors: Lin Junjie , Li Zixin , Xu Jiamin , Pan Mengshan , Yin Tongle , Wang Jiadong , Sun Qinghua , Zheng Weijun , Chen Rucheng
Published: May 2024

Background

With the development of pathophysiology, cardiorenal syndrome (CRS), a complex and severe disease, has received increasing attention. Monocyte to high-density lipoprotein-cholesterol ratio (MHR) and body mass index (BMI) are independent risk factors for cardiovascular diseases, but their association with CRS remains unexplored. This study aims to explore the independent and joint effects of MHR and BMI on CRS.

Methods

We included 42,178 NHANES participants. The determination of CRS referred to the simultaneous presence of cardiovascular disease (identified through self-report) and chronic kidney disease (eGFR < 60 mL/min per 1.73 m²). We employed multivariate weighted logistic regression to evaluate the odds ratio (OR) and 95% confidence interval (CI) for the independent and joint associations of MHR and BMI with CRS. We also conducted restricted cubic spines to explore nonlinear associations.

Results

The prevalence of CRS was 3.45% among all participants. An increase in both MHR and BMI is associated with a higher risk of CRS (MHR: OR = 1.799, 95% CI = 1.520–2.129, P < 0.001, P-trend < 0.001; BMI: OR = 1.037, 95% CI = 1.023–1.051, P < 0.001). Individuals who simultaneously fall into the highest quartile of MHR and have a BMI of 30 or more face the highest risk of CRS compared to those in the lowest MHR quartile with a BMI of less than 25 (OR = 3.45, 95% CI = 2.40–4.98, P < 0.001). However, there is no interactive association between MHR and BMI with CRS.

Conclusions

Higher MHR and BMI are associated with higher odds of CRS. MHR and BMI can serve as tools for early prevention and intervention of CRS, respectively.
BCMA/CD47-directed universal CAR-T cells exhibit excellent antitumor activity in multiple myeloma
Authors: Lu Qizhong , Li Hexian , Wu Zhiguo , Zhu Zhixiong , Zhang Zongliang , Yang Donghui , Tong Aiping
Published: May 2024

Background

BCMA-directed autologous chimeric antigen receptor T (CAR-T) cells have shown excellent clinical efficacy in relapsed or refractory multiple myeloma (RRMM), however, the current preparation process for autologous CAR-T cells is complicated and costly. Moreover, the upregulation of CD47 expression has been observed in multiple myeloma, and anti-CD47 antibodies have shown remarkable results in clinical trials. Therefore, we focus on the development of BCMA/CD47-directed universal CAR-T (UCAR-T) cells to improve these limitations.

Methods

In this study, we employed phage display technology to screen nanobodies against BCMA and CD47 protein, and determined the characterization of nanobodies. Furthermore, we simultaneously disrupted the endogenous TRAC and B2M genes of T cells using CRISPR/Cas9 system to generate TCR and HLA double knock-out T cells, and developed BCMA/CD47-directed UCAR-T cells and detected the antitumor activity in vitro and in vivo.

Results

We obtained fourteen and one specific nanobodies against BCMA and CD47 protein from the immunized VHH library, respectively. BCMA/CD47-directed UCAR-T cells exhibited superior CAR expression (89.13-98.03%), and effectively killing primary human MM cells and MM cell lines. BCMA/CD47-directed UCAR-T cells demonstrated excellent antitumor activity against MM and prolonged the survival of tumor-engrafted NCG mice in vivo.

Conclusions

This work demonstrated that BCMA/CD47-directed UCAR-T cells exhibited potent antitumor activity against MM in vitro and in vivo, which provides a potential strategy for the development of a novel “off-the-shelf” cellular immunotherapies for the treatment of multiple myeloma.

Graphic Abstract
Recent advances in the application of gasotransmitters in spinal cord injury
Authors: Gao Xiang , Jin Bingrong , Zhou Xiaozhong , Bai Jinyu , Zhong Hao , Zhao Kai , Huang Zongrui , Wang Chao , Zhu Jiang , Qin Qin
Published: May 2024

Spinal Cord Injury (SCI) is a condition characterized by complete or incomplete motor and sensory impairment, as well as dysfunction of the autonomic nervous system, caused by factors such as trauma, tumors, or inflammation. Current treatment methods primarily include traditional approaches like spinal canal decompression and internal fixation surgery, steroid pulse therapy, as well as newer techniques such as stem cell transplantation and brain-spinal cord interfaces. However, the above methods have limited efficacy in promoting axonal and neuronal regeneration. The challenge in medical research today lies in promoting spinal cord neuron regeneration and regulating the disrupted microenvironment of the spinal cord. Studies have shown that gas molecular therapy is increasingly used in medical research, with gasotransmitters such as hydrogen sulfide, nitric oxide, carbon monoxide, oxygen, and hydrogen exhibiting neuroprotective effects in central nervous system diseases. The gas molecular protect against neuronal death and reshape the microenvironment of spinal cord injuries by regulating oxidative, inflammatory and apoptotic processes. At present, gas therapy mainly relies on inhalation for systemic administration, which cannot effectively enrich and release gas in the spinal cord injury area, making it difficult to achieve the expected effects. With the rapid development of nanotechnology, the use of nanocarriers to achieve targeted enrichment and precise control release of gas at Sites of injury has become one of the emerging research directions in SCI. It has shown promising therapeutic effects in preclinical studies and is expected to bring new hope and opportunities for the treatment of SCI. In this review, we will briefly outline the therapeutic effects and research progress of gasotransmitters and nanogas in the treatment of SCI.

Graphical Abstract
Aβ42 and ROS dual-targeted multifunctional nanocomposite for combination therapy of Alzheimer’s disease
Authors: Zhang Liding , Cao Kai , Xie Jun , Liang Xiaohan , Gong Hui , Luo Qingming , Luo Haiming
Published: May 2024

Amyloid-β (Aβ) readily misfolds into neurotoxic aggregates, generating high levels of reactive oxygen species (ROS), leading to progressive oxidative damage and ultimately cell death. Therefore, simultaneous inhibition of Aβ aggregation and scavenging of ROS may be a promising therapeutic strategy to alleviate Alzheimer’s disease pathology. Based on the previously developed antibody 1F12 that targets all forms of Aβ42, we developed an Aβ42 and ROS dual-targeting nanocomposite using biodegradable mesoporous silica nanoparticles as carriers to load ultra-small cerium oxide nanocrystals (bMSNs@Ce-1F12). By modifying the brain-targeted rabies virus glycoprotein 29 (RVG29-bMSNs@Ce-1F12), this intelligent nanocomposite can efficiently target brain Aβ-rich regions. Combined with peripheral and central nervous system treatments, RVG29-bMSNs@Ce-1F12 can significantly alleviate AD symptoms by inhibiting Aβ42 misfolding, accelerating Aβ42 clearance, and scavenging ROS. Furthermore, this synergistic effect of ROS scavenging and Aβ clearance exhibited by this Aβ42 and ROS dual-targeted strategy also reduced the burden of hyperphosphorylated tau, alleviated glial cell activation, and ultimately improved cognitive function in APP/PS1 mice. Our findings indicate that RVG29-bMSNs@Ce-1F12 is a promising nanodrug that can facilitate multi-target treatment of AD.
Application and advances of biomimetic membrane materials in central nervous system disorders
Authors: Liao Weiquan , Lu Zhichao , Wang Chenxing , Zhu Xingjia , Yang Yang , Zhou Youlang , Gong Peipei
Published: May 2024

Central nervous system (CNS) diseases encompass spinal cord injuries, brain tumors, neurodegenerative diseases, and ischemic strokes. Recently, there has been a growing global recognition of CNS disorders as a leading cause of disability and death in humans and the second most common cause of death worldwide. The global burdens and treatment challenges posed by CNS disorders are particularly significant in the context of a rapidly expanding global population and aging demographics. The blood-brain barrier (BBB) presents a challenge for effective drug delivery in CNS disorders, as conventional drugs often have limited penetration into the brain. Advances in biomimetic membrane nanomaterials technology have shown promise in enhancing drug delivery for various CNS disorders, leveraging properties such as natural biological surfaces, high biocompatibility and biosafety. This review discusses recent developments in biomimetic membrane materials, summarizes the types and preparation methods of these materials, analyzes their applications in treating CNS injuries, and provides insights into the future prospects and limitations of biomimetic membrane materials.
Sexual lives and reproductive health outcomes among persons with disabilities: a mixed-methods study in two districts of Ghana
Authors: Seidu Abdul-Aziz , Malau-Aduli Bunmi S. , McBain-Rigg Kristin , Malau-Aduli Aduli E. O. , Emeto Theophilus I.
Published: May 2024

Introduction

People with disabilities (PwDs) constitute a large and diverse group within the global population, however, their sexual and reproductive health (SRH) needs are often neglected, particularly in low-and middle-income countries. This may result in adverse outcomes, such as sexually transmitted infections (STIs), unintended pregnancies, and experience of interpersonal violence (IV). This study aimed to assess the factors that influence the sexual lives of PwDs in two districts of Ghana.

Methods

A sequential explanatory mixed-methods study design was used to collect data from PwDs. Quantitative data were obtained from 402 respondents using a pretested questionnaire, and qualitative data gathered from 37 participants using in-depth interviews. The quantitative data were analysed using descriptive and inferential statistics, while the qualitative data were analysed using inductive thematic analysis.

Results

Most PwDs (91%) reported that they have ever had sex, which was associated with age, disability severity, and household size. The prevalence of poor SRH status, STIs, unintended pregnancy, pregnancy termination, and unsafe abortion were 10.5%, 5.7%, 6.4%, 21.6%, and 36.9% respectively. These outcomes were influenced by education, income, health insurance subscription, and proximity to a health facility. The prevalence of IV was 65%, which was related to disability type and severity. The qualitative data revealed five main themes: curiosity to engage in sexual activities, feelings of despair and insecurity with abled partners, preference for sexual relationships with other PwDs, IV and its perpetrators, and adverse SRH outcomes.

Conclusion

The study findings indicate that most adult PwDs have ever had sex and they face various challenges in their sexual lives. They experience multiple forms of abuse and neglect from different perpetrators at different levels of society, which have negative impacts on their well-being. There is a need for comprehensive and inclusive interventions that address the SRH needs of PwDs, as well as the underlying social and structural factors that contribute to their vulnerability. Further research is recommended to explore the perspectives of stakeholders on how to improve the SRH outcomes of PwDs.
Progressive Supranuclear palsy (PSP) disease progression, management, and healthcare resource utilization: a retrospective observational study in the US and Canada
Authors: Nysetvold Ella , Lopez Lauren N. , Cogell Ashley N. , Fryk Henrik , Pace Nelson D. , Taylor Sara Snell , Rhoden Joyce , Nichols Caitlin A. , Pillas Demetris , Klein Alexander , Gasalla Teresa , Scowcroft Anna
Published: May 2024

Background

Progressive supranuclear palsy (PSP) is a rare neurodegenerative brain disease with rapid progression and currently limited treatment options. A comprehensive understanding of disease progression, management, and healthcare resource utilization is limited, and further research is challenging due to the small population of patients. To address these challenges in conducting PSP research, individuals with PSP were recruited using a multichannel approach tailored specifically to the PSP community. We performed a retrospective observational study using data abstracted from participant medical records collected from multiple patient care centers.

Results

Seventy-two individuals with PSP were eligible for inclusion. On average, 144 medical documents per participant were collected from an average of 2.9 healthcare centers per participant, with a mean study period of 7.9 years. Among participants with a date of symptom onset documented in the medical records, the median time for the onset of the first fall was 2.0 years (IQR 3.2) before diagnosis, the median onset of unsteady gait or gait impairment was 1.2 years (IQR 1.8) before diagnosis, and the median onset of mobility problems was 0.8 years (IQR 1.8) before diagnosis. The most widely utilized healthcare resources, with at least 85% of participants using each of these resources at some point during the disease course, were medications (100%), imaging (99%), assistive devices (90%), supportive care (86%), and surgeries and procedures (85%).

Conclusions

This retrospective study adds to the current understanding of PSP symptoms, comorbidities, and healthcare resource utilization (HRU) across the disease journey. By involving individuals with PSP and their caregivers or legally authorized representatives in the research process, this study was unique in its approach to participant recruitment and enabled individuals to participate in research without the need for travel. We collected medical documents from multiple healthcare centers, allowing for broad data collection covering the entire disease journey. This approach to the collection of real-world data may be used to generate valuable insights into many aspects of disease progression and management in PSP and many other rare diseases.
Towards optimized scheduling and allocation of heterogeneous resource via graph-enhanced EPSO algorithm
Authors: Zhang Zhen , Xu Chen , Xu Shaohua , Huang Long , Zhang Jinyu
Published: May 2024

Efficient allocation of tasks and resources is crucial for the performance of heterogeneous cloud computing platforms. To achieve harmony between task completion time, device power consumption, and load balance, we propose a Graph neural network-enhanced Elite Particle Swarm Optimization (EPSO) model for collaborative scheduling, namely GraphEPSO. Specifically, we first construct a Directed Acyclic Graph (DAG) to model the complicated tasks, thereby using Graph Neural Network (GNN) to encode the information of task sets and heterogeneous resources. Then, we treat subtasks and independent tasks as basic task units while considering virtual or physical devices as resource units. Based on this, we exploit the performance adaptation principle and conditional probability to derive the solution space for resource allocation. Besides, we employ EPSO to consider multiple optimization objectives, providing fine-grained perception and utilization of task and resource information. It also increases the diversity of particle swarms, allowing GraphEPSO to adaptively search for the global optimal solution with the highest probability. Experimental results demonstrate the superiority of our proposed GraphEPSO compared to several state-of-the-art baseline methods on all evaluation metrics.
Mandatory nutrition attributes labeling and consumer demand: a structural approach analysis of the US soft drink market
Authors: Codjia Clement O. , Woods Timothy A. , Zheng Yuqing
Published: May 2024

While soft drinks stand out as a major cause of obesity and overweight worldwide, the USA is the country most concerned with this problem. To reverse the situation, experts have agreed that labels and taxes represent promising policy tools. Focusing on the soda market, this paper investigates how consumer demand for nutrient contents responds to the US revised nutrition facts label policy implemented in 2020. Relying on retail scanner data, the study finds after estimation of a discrete choice logit demand model that the change in nutrition labels caused consumers to modify their purchasing behavior. However, they did not systematically switch from unhealthy beverages to healthy ones. The analysis finds evidence that the label revision policy was mostly impactful in decreasing consumers’ preference for soda with superhigh calories and high sugar content. Surprisingly, the joint effect of label and tax did not decrease the sampled consumers’ preference for unhealthy nutrient contents. They still preferred buying soft drinks superhigh in calorie content inside US cities with a tax on sugar-sweetened beverages (SSB), despite the revision of the facts label. Finally, the new nutrition label has improved the average surplus of consumers and total welfare. However, the gain is lower within the cities implementing the sugar tax.
Identification of the mutual gliding locus as a factor for gut colonization in non-native bee hosts using the ARTP mutagenesis
Authors: Meng Yujie , Zhang Xue , Zhai Yifan , Li Yuan , Shao Zenghua , Liu Shanshan , Zhang Chong , Xing Xin-Hui , Zheng Hao
Published: May 2024

Background

The gut microbiota and their hosts profoundly affect each other’s physiology and evolution. Identifying host-selected traits is crucial to understanding the processes that govern the evolving interactions between animals and symbiotic microbes. Current experimental approaches mainly focus on the model bacteria, like hypermutating Escherichia coli or the evolutionary changes of wild stains by host transmissions. A method called atmospheric and room temperature plasma (ARTP) may overcome the bottleneck of low spontaneous mutation rates while maintaining mild conditions for the gut bacteria.

Results

We established an experimental symbiotic system with gnotobiotic bee models to unravel the molecular mechanisms promoting host colonization. By in vivo serial passage, we tracked the genetic changes of ARTP-treated Snodgrassella strains from Bombus terrestris in the non-native honeybee host. We observed that passaged isolates showing genetic changes in the mutual gliding locus have a competitive advantage in the non-native host. Specifically, alleles in the orphan mglB, the GTPase activating protein, promoted colonization potentially by altering the type IV pili-dependent motility of the cells. Finally, competition assays confirmed that the mutations out-competed the ancestral strain in the non-native honeybee gut but not in the native host.

Conclusions

Using the ARTP mutagenesis to generate a mutation library of gut symbionts, we explored the potential genetic mechanisms for improved gut colonization in non-native hosts. Our findings demonstrate the implication of the cell mutual-gliding motility in host association and provide an experimental system for future study on host-microbe interactions.
Malaria epidemiology, surveillance and response for elimination in Lao PDR
Authors: Rotejanaprasert Chawarat , Malaphone Vilayvone , Mayxay Mayfong , Chindavongsa Keobouphaphone , Banouvong Virasack , Khamlome Boualam , Vilay Phoutnalong , Vanisavaeth Viengxay , Maude Richard J
Published: May 2024

Background

Lao PDR has made significant progress in malaria control. The National Strategic Plans outline ambitious targets, aiming for the elimination of Plasmodium falciparum and P. vivax malaria from all northern provinces by 2025 and national elimination by 2030. This article presents an overview of malaria epidemiology, surveillance, and response systems in Lao PDR, emphasizing experiences and achievements in transmission reduction.

Methods

Data on surveillance, monitoring and evaluation systems, human resources, infrastructure, and community malaria knowledge during 2010–2020 were systematically gathered from the national program and relevant documents. The collected information was synthesized, and discussions on challenges and future prospects were provided.

Results

Malaria control and elimination activities in Lao PDR were implemented at various levels, with a focus on health facility catchment areas. There has been significant progress in reducing malaria transmission throughout the country. Targeted interventions, such as case management, vector control, and community engagement, using stratification of control interventions by catchment areas have contributed to the decline in malaria cases. In elimination areas, active surveillance strategies, including case and foci investigation, are implemented to identify and stop transmission. The surveillance system has facilitated timely detection and response to malaria cases, enabling these targeted interventions in higher-risk areas.

Conclusions

The malaria surveillance and response system in Lao PDR has played a crucial role in reducing transmission and advancing the country towards elimination. Challenges such as importation, drug resistance, and sustaining support require ongoing efforts. Further strengthening surveillance, improving access to services, and addressing transmission determinants are key areas of focus to achieve malaria elimination and enhance population health in Lao PDR.
Rotenone activates the LKB1-AMPK-ULK1 signaling pathway to induce autophagy and apoptosis in rat thoracic aortic endothelial cells
Authors: Chang Xiaoyu , Li Zeyuan , Tian Mi , Deng Ziwei , Zhu Lingqin , Li Guanghua
Published: May 2024

Background

The specific mechanism by which rotenone impacts thoracic aortic autophagy and apoptosis is unknown. We aimed to investigate the regulatory effects of rotenone on autophagy and apoptosis in rat thoracic aortic endothelial cells (RTAEC) via activation of the LKB1-AMPK-ULK1 signaling pathway and to elucidate the molecular mechanisms of rotenone on autophagy and apoptosis in vascular endothelial cells.

Methods

In vivo, 60 male SD rats were randomly selected and divided into 5 groups: control (Con), DMSO, 1, 2, and 4 mg/kg groups, respectively. After 28 days of treatment, histopathological and ultrastructural changes in each group were observed using HE and transmission electron microscopy; Autophagy, apoptosis, and LKB1-AMPK-ULK1 pathway-related proteins were detected by Western blot; Apoptosis levels in the thoracic aorta were detected by TUNEL. In vitro, RTAEC were cultured and divided into control (Con), DMSO, 20, 100, 500, and 1000 nM groups. After 24 h of intervention, autophagy, apoptosis, and LKB1-AMPK-ULK1 pathway-related factors were detected by Western blot and qRT-PCR; Flow cytometry to detect apoptosis levels; Autophagy was inhibited with 3-MA and CQ to detect apoptosis levels, and changes in autophagy, apoptosis, and downstream factors were detected by the AMPK inhibitor CC intervention.

Results

Gavage in SD rats for 28 days, some degree of damage was observed in the thoracic aorta and heart of the rotenone group, as well as the appearance of autophagic vesicles was observed in the thoracic aorta. TUNEL analysis revealed higher apoptosis in the rotenone group’s thoracic aorta; RTAEC cultured in vitro, after 24 h of rotenone intervention, showed increased ROS production and significantly decreased ATP production. The flow cytometry data suggested an increase in the number of apoptotic RTAEC. The thoracic aorta and RTAEC in the rotenone group displayed elevated levels of autophagy and apoptosis, and the LKB1-AMPK-ULK1 pathway proteins were activated and expressed at higher levels. Apoptosis and autophagy were both suppressed by the autophagy inhibitors 3-MA and CQ. The AMPK inhibitor CC reduced autophagy and apoptosis in RTAEC and suppressed the production of the AMPK downstream factors ULK1 and P-ULK1.

Conclusions

Rotenone may promote autophagy in the thoracic aorta and RTAEC by activating the LKB1-AMPK-ULK1 signaling pathway, thereby inducing apoptosis.
Analysis of mosaic mortars from the Roman, Byzantine and Early Islamic periods sourced from Gerasa’s Northwest Quarter
Authors: Ball Richard J. , Ansell Martin P. , Su-Cadirci Tuğçe Büşra , Baki Vahiddin Alperen , Fletcher Philip J. , Lichtenberger Achim , Raja Rubina , Wootton Will
Published: May 2024

This study analyses and compares around 650 years of mosaic mortar production spanning the Roman, late Roman and Umayyad periods, at Gerasa/Jerash in Jordan, offering a better understanding of composition, structural features, and manufacturing processes. It assesses the value of optical and electron microscopy examination of morphological and textural features, pore structure using MIP, and composition studies using EDX, XRD, FTIR, TGA, and Raman spectroscopy. The study indicated high density lime adhesive was used compared to other mortars. Wood was used as a fuel when producing the lime and natural fibres were incorporated when manufacturing mortars. Aggregates were primarily calcitic with a small proportion of silica-based aggregates. Key outcomes of the study conclude that early Roman mortars were of highest quality, which was demonstrated through the careful selection of materials including different stone for lime and tesserae, and differences between layers. Late Roman mortars used the same slaked lime plus fibres and charcoal. Mortars dating from the Umayyad period also had the same higher lime content than late Roman, but higher porosity with fibres and charcoal. In general, the mortars showed slight differences in content and aggregate; different stone for lime and tesserae. The research attests to underlying traditions as well as changes in mortar mixes and methods according to context and time. The resulting data is contextualized within local and regional approaches.
Demonstration of an energy-efficient Ising solver composed of Ovonic threshold switch (OTS)-based nano-oscillators (OTSNOs)
Authors: Lee Young Woong , Kim Seon Jeong , Kim Jaewook , Kim Sangheon , Park Jongkil , Jeong YeonJoo , Hwang Gyu Weon , Park Seongsik , Park Bae Ho , Lee Suyoun
Published: May 2024

As there is an increasing need for an efficient solver of combinatorial optimization problems, much interest is paid to the Ising machine, which is a novel physics-driven computing system composed of coupled oscillators mimicking the dynamics of the system of coupled electronic spins. In this work, we propose an energy-efficient nano-oscillator, called OTSNO, which is composed of an Ovonic Threshold Switch (OTS) and an electrical resistor. We demonstrate that the OTSNO shows the synchronization behavior, an essential property for the realization of an Ising machine. Furthermore, we have discovered that the capacitive coupling is advantageous over the resistive coupling for the hardware implementation of an Ising solver by providing a larger margin of the variations of components. Finally, we implement an Ising machine composed of capacitively-coupled OTSNOs to demonstrate that the solution to a 14-node MaxCut problem can be obtained in 40 µs while consuming no more than 2.3 µJ of energy. Compared to a previous hardware implementation of the phase-transition nano-oscillator (PTNO)-based Ising machine, the OTSNO-based Ising machine in this work shows the performance of the increased speed by more than one order while consuming less energy by about an order.
Prognostic and predictive value of interstitial lung abnormalities and EGFR mutation status in patients with non-small cell lung cancer
Authors: Xu Xiaoli , Zhu Min , Wang Zixing , Li Jialu , Ouyang Tao , Chen Cen , Huang Kewu , Zhang Yuhui , Gao Yanli L.
Published: May 2024

Background

To determine the predictive value of interstitial lung abnormalities (ILA) for epidermal growth factor receptor (EGFR) mutation status and assess the prognostic significance of EGFR and ILA in patients with non-small cell lung cancer (NSCLC).

Methods

We reviewed 797 consecutive patients with a histologically proven diagnosis of primary NSCLC from January 2013 to October 2018. Of these, 109 patients with NSCLC were found to have concomitant ILA. Multivariate logistic regression analysis was used to identify the significant clinical and computed tomography (CT) findings in predicting EGFR mutations. Cox proportional hazard models were used to identify significant prognostic factors.

Results

EGFR mutations were identified in 22 of 109 tumors (20.2%). Multivariate analysis showed that the models incorporating clinical, tumor CT and ILA CT features yielded areas under the receiver operating characteristic curve (AUC) values of 0.749, 0.838, and 0.849, respectively. When combining the three models, the independent predictive factors for EGFR mutations were non-fibrotic ILA, female sex, and small tumor size, with an AUC value of 0.920 (95% confidence interval[CI]: 0.861–0.978, p < 0.001). In the multivariate Cox model, EGFR mutations (hazard ratio = 0.169, 95% CI = 0.042–0.675, p = 0.012; 692 days vs. 301 days) were independently associated with extended overall survival compared to the wild-type.

Conclusion

Non-fibrotic ILA independently predicts the presence of EGFR mutations, and the presence of EGFR mutations rather than non-fibrotic ILA serves as an independent good prognostic factor for patients with NSCLC.
Emergency right lower lobectomy for severe pulmonary abscess in a pregnant woman at the 25th week of gestation: a case report
Authors: Hino Haruaki , Yasuhara Yuki , Nakahata Katsutoshi , Utsumi Takahiro , Maru Natsumi , Matsui Hiroshi , Taniguchi Yohei , Saito Tomohito , Tsuta Koji , Okada Hidetaka , Murakawa Tomohiro
Published: May 2024

Background

Pulmonary abscess is a severe infection commonly seen in patients with chronic obstructive pulmonary disease, interstitial pneumonia, immune deficiency disease, drug-induced immunocompromised state, and congenital pulmonary disease. The treatment strategy in pregnant women with a pulmonary abscess is considered challenging since adverse effects on the fetus must be avoided to ensure safe delivery.

Case presentation

A 34-year-old female patient at 24 weeks of gestation (G2P1) was admitted to the Department of Obstetrics and Gynecology due to sudden right chest pain. The patient had no significant medical history, including congenital anomalies, and no history of drug addiction or smoking. Laboratory data indicated high levels of inflammation (white blood cell 12,000/µL, C-reactive protein 16.0 mg/dL), and computed tomography demonstrated a large intrapulmonary cyst located in the middle of the right lower lobe, with some fluid collection. As the patient had no medical history of congenital pulmonary anomalies, she was initially diagnosed with a pulmonary cyst infection and treated with intravenous antibiotics. However, the infection did not resolve for over a week, and a spike in fever developed after admission. There was no definitive evidence concerning the risk of preterm delivery and fetal abortion during non-obstetric surgery. However, to control the severely infected pulmonary abscess that was refractory to antibiotics and obtain a pathological diagnosis while saving the life of both the mother and fetus, we elected to perform an emergent right lower lobectomy by open thoracotomy with a fissureless maneuver after receiving informed consent. Postoperatively, the infection gradually improved, and the patient was discharged on the 16th postoperative day without any major complications in the mother or fetus. Although she later experienced coronavirus disease-19 at 29 weeks of gestation, a boy was born at 40th weeks of gestation without any complications. Pathologically, no infectious agents, malignancies, or congenital anomalies other than lung abscesses associated with the pulmonary infarction were observed. The mother and child were healthy 1 year postoperatively.

Conclusions

We experienced a rare case of a pulmonary abscess in a pregnant woman who needed an emergent right lower lobectomy to control the severe infection and obtain a correct pathological diagnosis. Under cooperation from an obstetrician and anesthesiologist, emergency pulmonary resection can be performed safely for serious abscess formation even for pregnant women who have several months left until delivery.
Associations between maternal dietary intake and nutritional status with fetal growth at 14 to 26 weeks gestation: a cross- sectional study
Authors: Kabahenda Margaret Kiiza , Stoecker Barbara J.
Published: May 2024

Background

Maternal undernutrition during pregnancy is currently estimated at 23.5% in Africa, which is worrying given the negative impacts of malnutrition on maternal and fetal birth outcomes. The current study aimed at characterizing the associations of maternal dietary intake and nutritional status with fetal growth at 14–26 weeks gestation. It was hypothesized that maternal dietary intake was positively associated with maternal nutritional status and fetal growth both in early and late pregnancy.

Methods

This was a cross-sectional survey of 870 pregnant women in mid-western Uganda conducted in August 2013. Data were collected on women’s dietary intake (indicated by women’s dietary diversity and the diet quality score) and nutritional status (indicated by hemoglobin level and mid-upper arm circumference) at 14–26 weeks gestation. Fetal growth was determined by symphysis-fundal height Z-scores processed using the INTERGROWTH-21st calculator. Associations between maternal dietary intake and nutritional status with fetal growth were determined using correlations and chi-square tests.

Results

Overall, only 25% had adequate dietary diversity and the most utilized food groups were White tubers, roots and starchy vegetables; Pulses, nuts and seeds; Cereals and grains, Dark green leafy vegetables, and Fats and oils. A larger proportion of younger women (15–29 y) were classified as anemic (20.4% versus 4.4%) and underweight (23.7% versus 5.0%) compared to older women (30–43 y). Additionally, women aged 15 to 24 years had significantly lower mean SFH-for-gestation age Z-scores than women 36–43 years (F4, 783 = 3.129; p = 0.014). Consumption of legumes nuts and seeds was associated with reduced risk of anemia while consumption of dairy products (mostly milk) was positively associated with better fetal growth. Surprisingly, low Hb level was positively associated with normal fetal growth (rP = -0.133; p = 0.016) after 20 weeks gestation, possibly indicating normal fetal growth paralleled with physiologically necessary hemodilution.

Conclusions

Sub-optimal dietary patterns, characterized by limited dietary diversity and low protein intake, are likely to compromise maternal nutrition and fetal growth in limited resource settings. Improving pregnant women’s access to cheaper but nutrient-dense protein sources such as pulses, nuts and dairy products (mostly milk) has potential to improve women’s nutritional status and enhance fetal growth.