bluuebunny/crossref_metadata_2025 huggingface dataset:
A Healthy Conversation Skills intervention to support changes to physical activity and dietary behaviours in community-dwelling older adults during the COVID-19 pandemic
Authors: Zhang J , Bloom I , Westbury LD , Bevilacqua G , Ward KA , Barker M , Lawrence W , Cooper C , Dennison EM
Published: August 2024

Aims:

Physical activity (PA) and nutrition are important determinants of health in late adulthood. However, low levels of PA and poor nutrition are common in older adults and have become more prevalent during the COVID-19 pandemic. We hypothesised that Healthy Conversation Skills could be used to support health behaviour changes beneficial for health in older adults and thus conducted a study nested within the UK Hertfordshire Cohort Study.

Methods:

Between November 2019 and March 2020, 176 participants were visited at home. A trained researcher administered a questionnaire and undertook anthropometric and physical performance tests. A total of 89 participants were randomised to the control group and received a healthy living leaflet; 87 participants in the intervention group were interviewed using Healthy Conversation Skills at the initial visit with follow-up telephone calls at 1, 3, 6 and 9 months. Follow-up at 1 year by postal questionnaire assessed change in PA and diet. In total, 155 participants (79 control and 76 intervention) completed the baseline and 1-year follow-up.

Results:

At baseline, median (lower quartile, upper quartile) age (years) was 83.1 (81.5, 85.5) and median PA time (min/day) from walking, cycling and sports was 30.0 (15.0, 60.0). In total, 95% of participants completed the intervention; the total response rate for postal questionnaires was 94%. There were no statistically significant differences in outcomes between the trial arms. In women, there was a tendency for greater increases in diet quality in the intervention group compared to the control group ( p = 0.075), while among men, there was a tendency for reduced decline in self-reported physical function in the intervention group compared to the control group ( p = 0.081).

Conclusion:

We have shown that it is viable to utilise Healthy Conversation Skills via telephone to promote healthier lifestyles in older adults. Larger appropriately powered studies to determine the efficacy of such an intervention are now warranted.
Pilot evaluation of the effectiveness of an ergonomics awareness educational programme addressed to middle-school children
Authors: Pani Sara M. , Gaccetta Fabrizio , Cadoni Federica , Della Salda Andrea , Liori Arianna , Contu Paolo
Published: August 2024

Background:

Ergonomics programmes addressed to children fit the health-promoting schools (HPS) framework. Beyond the integration of ergonomics in curricula, an important aspect is the effectiveness of the programme. This pilot study aims to evaluate the effectiveness of the programme proposed to a sample of middle-school children (aged 10–13 years) of the metropolitan city of Cagliari.

Methods:

The programme was designed along the lines of the INAIL (Italian National Institute for Insurance against Accidents at Work) scheme and proposed to 260 children. It consisted of three phases: 1) assessment of students’ background with a pre-intervention questionnaire (completed by 142 students); 2) teaching of the ergonomics training modules and evaluation of the weight of a sample of 160 backpacks, and of students’ perception to be able to sit by putting their feet on the ground; 3) evaluation of conceptual understanding of ergonomics concepts with a post-intervention questionnaire (completed by 107 students out of the 142 students who completed phase 1).

Results:

There was a substantial improvement in the percentage of correct responses post-intervention, confirmed by the chi-square test, regarding concepts about ergonomics, backpack weight and handling. Most of the backpacks exceeded the maximum allowed value, and 20% of students were perceived to be unable to sit putting their feet on the ground.

Conclusions:

The practical application of ergonomics pedagogy proved effective in the school setting and should be integrated into school curricula. The prevention technicians can offer a holistic approach, while the teachers are essential to implement the programme on a large scale. Effectiveness evaluation is necessary to guide resource allocation and implement and sustain the HPS approach. A tailored programme has a greater chance of reaching its target audience and maximizing effectiveness.
The 100 highest-cited original articles in large vessel occlusions: A bibliometric analysis
Authors: Shahbandi Ataollah , Holt Matthew , Shlobin Nathan A.
Published: August 2024

Background

Large vessel occlusions (LVO) are a common etiology of morbidity and mortality. The current literature lacks a synthesis of the landscape and trends in research.

Objective

We aimed to conduct a bibliometric analysis of the 100 most cited original articles on LVOs to assess the current state of research.

Methods

Scopus database was queried from inception to December 2022 to identify the most cited original articles from 4506 retrieved records on LVOs. Publication year, country of origin, total and average annual citation count, and type of study were collected for each article. The journal impact factor (JIF) was obtained from the Journal Citation Reports database.

Results

The articles were published between 1994 and 2021, with most ( n = 82) published during the 2011–2020 decade. The median total citation count was 108.5, with an interquartile range (IQR) of 81–149.5. The median (IQR) average annual citation count was 15.9 (11.5–22.9). Half of the articles were published in Stroke ( n = 35) and Journal of NeuroInterventional Surgery ( n = 15), with JIFs ranging from 1.8 to 202.7. The USA was the leading country in contributing to LVO research ( n = 45). Most studies focused on the treatment ( n = 63) and diagnosis ( n = 22) of LVOs.

Conclusions

Most articles were published during the past decade, highlighting the impact of the clinical trials of endovascular treatment on the discipline. With several ongoing clinical trials on the horizon, continued growth of the field is anticipated in the upcoming decades.
Lipomatous pseudohypertrophy of the pancreas mimicking liposarcoma: A case report
Authors: Kamimura Tomomi , Katsube Takashi , Nishi Takeshi , Kawabata Yasunari , Tajima Yoshitsugu , Araki Asuka , Kaji Yasushi
Published: August 2024

Lipomatous pseudohypertrophy of the pancreas (LPH) is a rare disease in which the pancreatic parenchyma is replaced with mature adipose tissue. It is an idiopathic condition whose diagnosis is made based on histopathological analyses. Herein, we report the case of a 50-year-old male patient with a lipomatous mass in the head of the pancreas on computed tomography for close examination of a renal tumor. We suspected liposarcoma, and laparotomy was performed. However, histological analyses revealed LPH. Several imaging findings of LPH can enable a noninvasive diagnosis and help its clinical approach.
A Bibliometric Analysis of Interaction Interface Aging Research: From 2003 to 2022
Authors: Zhou Chengmin , Zhang Zixin , Huang Ting , Gu Wenhui , Kaner Jake
Published: August 2024

Taking the motivation of the knowledge aggregation of age-friendly design resources as the starting point, this paper compares the development history of age-friendly design for interactive interfaces, understands the research status, hotspots, and development trend of age-friendly design for interactive interfaces from 2003 to 2022 worldwide, and summarizes and analyses them. This paper explores five aspects of aging-friendly design in the field of interactive interface design extracted from the Web of Science core collection database, including keyword co-occurrence analysis of global research literature, country/region information analysis, fundamental research areas, major research institutions, and future research directions. It explores the design methods, design trends, and design laws of aging-friendly design for interactive interfaces from a multidisciplinary perspective. The results show that: (a) Smart Home, Ambient Assisted Living (AAL), User Experience, Internet of Things (IoT), etc., are the hot topics at the forefront of interface aging design. (b) USA is the world’s leading research site for interface aging design and works closely with China, where the population aging is more serious. (c) The main research areas of interface aging are computer science and engineering ethics. (d) Udice French Research Universities, the primary publishing institution, is worth attention. (e) This review proposes three research hotspots as important development directions for interactive interface aging design, including “smart home product interaction interface aging design will become a hot topic,”“fusion of multi-source data assisted interface aging design,” and “interdisciplinary interface aging design.”
Gender Attitudes Within and Between European Countries: Regional Variations Matter
Authors: Cascella Clelia , Pampaka Maria , Williams Julian
Published: August 2024

The current paper reports systematic variations of people’s attitudes toward gender and gendered roles between countries and regions in Europe, making regional and national comparisons simultaneously visible on the same scale over time. We operationalized the concept of “gender attitudes” by using a fresh combination of items among those administered by the European Values Survey (in 2008 and in 2017) whose sampling strategy is statistically representative at both national and regional level. Then, we validated our proposed measure by using the Rasch model to test its measurement invariance across European countries and regions, and over time. We included regions under the hypothesis that the variability of gender attitudes is primarily attributable to the local sociocultural milieu people live in, and thus that the variability within a country (e.g., at regional level) can be even larger than that between countries, as confirmed by a multilevel analysis. Results confirmed our hypothesis that sub-national variability can be larger than that between countries and suggested that the regional-national issue may be relevant more widely (e.g., for America, South Asia, Australasia) than the European “case” reported here. Therefore, policies promoting equity should account for regional variability to design appropriate interventions. The measure we validated at both national and regional level is ready to be used in further/other research in Social Sciences.
Curriculum Key-Players’ and Industries’ Thoughts: The Relevance of Automotive Case-Based Simulation Apps
Authors: Azid Nurulwahida , Nur Abdul Hamid Busthami , Md-Ali Ruzlan , Che Isa Zaharah , Mei Heong Yee , Tze Kiong Tee
Published: August 2024

TVET in Malaysia is geared toward providing quality education, training, and resources but it still needs to be strengthened and reformed toward producing a more quality and skilled workforce. This study aimed to procure feedback from TVET curriculum key-players’ (automotive) on the integration of automotive case-based simulation (CBS) as TVET future learning strategies. Collective case-study research design was used with purposive sampling design which involved 5 curriculum key-players in vocational college and 16 automotive industries as study respondents. A set of questionnaires and interview protocols were used to gather quantitative and qualitative data. Intra-class correlation coefficient (ICC) was used to obtain an average measure agreement among raters. ATLAS.ti was also used through thematic analysis to produce models. The ICC showed high values of agreement for the process and structure of the CBS. The limitation of this research focused on one program (automotive technology) through the key-players’ and industries’ perspectives toward the implementation of CBS as a tool to enhance students’ soft skills. The collation of both data showed the alignment between both parties against the CBS. The curriculum key-players agreed that CBS fulfilled its requirements as a tool to enrich TVET students’ marketability skills, supported by the automotive industries’ perspective which believed that using CBS would prepare TVET students’ readiness to the workplace. Notably, the CBS provides an opportunity to stimulate thinking and learning preferences among students, in addition to being a learning tool for future TVET learning strategies that connect theory and practice in preparation for job training.
‘Engage and Evade’: A Special Look at Immigration Policy and Structure in the USA
Authors: Geist Meghan
Published: August 2024

Asad L. Asad, Engage & Evade: How Latino Immigrant Families Manage Surveillance in Everyday Life. Princeton University Press, 2023. ISBN: 9780691182285 (hardcover), $33.00; ISBN 9780691249049 (eBook), $23.10
The Precarity of Women’s Short-Term Migration: A Case Study from Nepal
Authors: Wu Joyce , Kilby Patrick , Mathema Juna , Bhattarai Abhigyna
Published: August 2024

This article explores precarity in short-term women’s migration using the case study of Nepal. Women migrate from Nepal for short-term contract work mostly in the domestic care sector. This research has used both focus group discussions and key informant interviews with returned and prospective migrants, as well as NGO staff and others supporting migration. A picture of the precarity of women’s short-term migration from Nepal to the Middle East has emerged, with the motivation for women’s migration being complex, and while it is primarily financial and for some an economic necessity, there are also broader implications, and the argument that migration can expand women’s choices and opportunities, and possibly be empowering. The research found that this applies to relatively few women migrants. Nepalese women face considerable risks, and migration is precarious due to restrictions and controls along each step of the migration pathway.
Prevalence Rates of Diabetic Retinopathy and Undiagnosed Diabetes Among Delaware Nursing Home and Assisted Living Facility Residents
Authors: Andersson Robert B. Å. , Pelino Carlo , Monaco William A. , Bunin Greta
Published: August 2024

Objectives: To determine the prevalence of diabetic retinopathy and undiagnosed diabetes among Delaware nursing home and assisted care facility residents. Methods: This cross-sectional study involved the statistical analysis of comprehensive eye examination records of 2,063 nursing home residents residing in 18 facilities and 4 assisted living facilities in Delaware from 2005 to 2009. Descriptive statistical analyses were conducted to identify the rates of retinal dot and blot hemorrhages and existing systemic diabetes diagnoses. Results: The mean age of nursing home and assisted care facility residents was 77 years (range 9–104), and 64.4% were over the age of 80. Most residents were female (61.1%) and white (72.5%). 3.6% of the 2,063 nursing home residents had blot or dot hemorrhages in one or both eyes. 32.8% had a type 1 or type 2 diabetes diagnosis. Of the ones with a positive dot and blot hemorrhage finding, 56.8% had a diagnosis of diabetes, and 43.2% did not. Discussion: There was a high prevalence of dot and blot hemorrhages without a systemic diagnosis of diabetes, indicating a need for regular eye care among residents.
Book review: Börje Ljunggren and Dwight H. Perkins (Eds), Vietnam: Navigating a Rapidly Changing Economy, Society and Political Order
Authors: Nguyen Hanh
Published: August 2024

Börje Ljunggren and Dwight H. Perkins (Eds), Vietnam: Navigating a Rapidly Changing Economy, Society and Political Order. Harvard University Press, 2023, 452 pp. ISBN: 9780674291331.
Cultural Imperatives on Indigenous Kinship Care among the Poumai Naga Tribe in Manipur, India
Authors: Angam Newlandson Samuel
Published: August 2024

The increasing scale of human suffering in the world caused by disasters, wars, violence, conflicts, old age problems and other physical ailments has led to a high demand for care providers. Similarly, the demand for care providers in India is no different and arises from poverty, violence, communal riots, ethnic conflicts, development-induced displacements or climate change disasters. The problem of care has penetrated even into the domain of the private life of the family. Social practices associated with caring are highly valued in the sociocultural milieu. It is a new way of thinking about care that can be incorporated into the conception of social pedagogy. This study highlights the absence of intimate parental care due to many sociopolitical circumstances, which creates a vacuum in fostering early childhood care. The objectives were to determine the dilemmas faced by care providers in the limited resources division between their own and their kin’s child and the invisible social stigma associated with the tag of orphans. Kinship care practices among the indigenous Poumai Naga tribe involve alternative relational care to institutional care for children. The descriptive research design involved in-depth interviews with the elders, care receivers and care providers in the community. The article concludes that relational bonds, rather than obligatory senses, are the guiding factor for keeping children with them despite hardships and natural allure of sending them to institutional care.
‘Someone must do it’: multiple views on family’s role in end-of-life care – an international qualitative study
Authors: Tripodoro Vilma A. , Veloso Verónica I. , Víbora Martín Eva , Kodba-Čeh Hana , Bakan Miša , Rasmussen Birgit H. , Zambrano Sofía C. , Joshi Melanie , Hálfdánardóttir Svandis Íris , Ásgeirsdóttir Guðlaug Helga , Romarheim Elisabeth , Haugen Dagny Faksvåg , McGlinchey Tamsin , Yildiz Berivan , Barnestein-Fonseca Pilar , Goossensen Anne , Lunder Urška , van der Heide Agnes
Published: August 2024

Background:

Family is a crucial social institution in end-of-life care. Family caregivers are encouraged to take on more responsibility at different times during the illness, providing personal and medical care. Unpaid work can be overburdening, with women often spending more time in care work than men.

Objectives:

This study explored multiple views on the family’s role in end-of-life care from a critical perspective and a relational autonomy lens, considering gender in a socio-cultural context and applying a relational autonomy framework. It explored patients, relatives and healthcare providers’ points of view.

Design:

This qualitative study was part of the iLIVE project, involving patients with incurable diseases, their relatives and health carers from hospital and non-hospital sites.

Methods:

Individual interviews of at least five patients, five relatives and five healthcare providers in each of the 10 participating countries using a semi-structured interview guide based on Giger–Davidhizar–Haff’s model for cultural assessment in end-of-life care. Thematic analysis was performed initially within each country and across the complete dataset. Data sources, including researchers’ field notes, were translated into English for international collaborative analysis.

Results:

We conducted 158 interviews (57 patients, 48 relatives and 53 healthcare providers). After collaborative analysis, five themes were identified across the countries: family as a finite care resource, families’ active role in decision-making, open communication with the family, care burden and socio-cultural mandates. Families were crucial for providing informal care during severe illness, often acting as the only resource. Patients acknowledged the strain on carers, leading to a conceptual model highlighting socio-cultural influences, relational autonomy, care burden and feminisation of care.

Conclusion:

Society, health teams and family systems still need to better support the role of family caregivers described across countries. The model implies that family roles in end-of-life care balance relational autonomy with socio-cultural values. Real-world end-of-life scenarios do not occur in a wholly individualistic, closed-off atmosphere but in an interpersonal setting. Gender is often prominent, but normative ideas influence the decisions and actions of all involved.
Describing the characteristics and symptom profile of a group of urban patients experiencing socioeconomic inequity and receiving palliative care: a descriptive exploratory analysis
Authors: Moore Harrison , Bablitz Cara , Santos Salas Anna , Morris Heather , Sinnarajah Aynharan , Watanabe Sharon M.
Published: August 2024

Background:

Individuals experiencing socioeconomic inequity have worse health outcomes and face barriers to palliative and end-of-life care. There is a need to develop palliative care programs tailored to this underserved population.

Objectives:

To understand the characteristics and symptom profiles of a group of urban patients experiencing socioeconomic inequity and receiving palliative care.

Design:

Descriptive exploratory analysis of a patient dataset. The patient dataset was generated through a pilot research study with patients experiencing socioeconomic inequity and life-limiting illness who received a community-based palliative care intervention.

Methods:

The intervention took place over 1 year in the Palliative Care Outreach and Advocacy Team, a community-based urban palliative care clinic in Edmonton, Alberta, Canada, serving persons experiencing socioeconomic inequity. Participants had to be at least 18 years of age, be able to communicate in English, require palliative care for a life-limiting illness, and be able to consent to inclusion in the study.

Results:

Twenty-five participants were enrolled. Participants predominantly identified as male and Indigenous, experienced poverty and housing instability, and had metastatic cancer. Our participants rated their pain, shortness of breath, and anxiety as more severe than the broader community-based palliative care population in the same city. Most patients died in inpatient hospices (73%).

Conclusion:

Our analysis provides an in-depth picture of an understudied, underserved population requiring palliative care. Given the higher symptom severity experienced by participants, our analysis highlights the importance of person-centered palliative care. We suggest that socioeconomic inequity should be considered in patients with life-limiting illnesses. Further research is needed to explore palliative care delivery to those facing socioeconomic inequity.
Mid-Atlantic primary care providers’ perception of barriers and facilitators to end-of-life conversation
Authors: Horning Melanie A. , Habermann Barbara
Published: August 2024

Background:

Among the chronically ill, end-of-life conversations are often delayed until emergently necessary and the quality of those conversations and subsequent decision-making become compromised by critical illness, uncertainty, and anxiety. Many patients receive treatment that they would have declined if they had a better understanding of benefits and risks. Primary care providers are ideal people to facilitate end-of-life conversations, but these conversations rarely occur in the out-patient setting.

Objective:

To investigate the self-reported experiences of physicians and advanced practice nurses with conversational barriers and facilitators while leading end-of-life discussions in the primary care setting.

Design:

A qualitative descriptive study.

Methods:

Six physicians and eight advanced practice nurses participated in singular semi-structured interviews. Results were analyzed using a qualitative descriptive design and content analysis approach to coding.

Results:

Reported barriers in descending order included resistance from patients and families, insufficient time, and insufficient understanding of prognosis and associated expectations. Reported facilitators in descending order included established trusting relationship with provider, physical and/or cognitive decline and poor prognosis; and discussion standardization per Medicare guidelines.

Conclusion:

Recommendations for improving the end-of-life conversational process in the primary care setting include further research regarding end-of-life conversational facilitators within families, the improvement of patient/family education about hospice/palliative care resources and examining the feasibility of longer appointment allotment.1
Exploring the link between toxic metal exposure and ADHD: a systematic review of pb and hg
Authors: Farmani Reyhane , Mehrpour Omid , Kooshki Alireza , Nakhaee Samaneh
Published: August 2024

Introduction

Attention-Deficit/Hyperactivity Disorder (ADHD) is a recognized neurodevelopmental disorder with a complex, multifactorial origin. Lead (Pb) and mercury (Hg) are highly toxic substances that can potentially impair brain development and have been implicated in the development of ADHD. This systematic review aims to analyze the epidemiological literature regarding the association between Pb and Hg exposure and the diagnosis of ADHD.

Methods

From November 1983 to June 2, 2023, a comprehensive search was conducted in multiple databases and search engines, including PubMed, Web of Science, Scopus, and Google Scholar. Observational studies (case-control, cohort, and cross-sectional) measuring Pb and Hg levels in various biological samples (blood, hair, urine, nail, saliva, teeth, and bone) of children with ADHD or their parents and their association with ADHD symptoms were included.

Results

Out of 2059 studies, 87 met the inclusion criteria and were included in this systematic review. Approximately two-thirds of the 74 studies investigating Pb levels in different biological samples reported associations with at least one subtype of ADHD. However, most studies examining Hg levels in various biological samples found no significant association with any ADHD subtype, although there were variations in exposure periods and diagnostic criteria.

Conclusion

The evidence gathered from the included studies supports an association between Pb exposure and the diagnosis of ADHD, while no significant association was found with Hg exposure. Importantly, even low levels of Pb were found to elevate the risk of ADHD. Further research is needed to explore the comprehensive range of risk factors for ADHD in children, considering its significance as a neurodevelopmental disorder.
Homocysteine, blood pressure and gene–diet interactions in relation to vascular function measures of black South Africans
Authors: du Plessis Jacomina P , Lammertyn Leandi , Schutte Aletta E. , Nienaber-Rousseau Cornelie
Published: August 2024

Background and Aims

We investigated circulating homocysteine (Hcy), a cardiovascular disease (CVD) risk factor, examining its dietary associations to provide personalized nutrition advice. This study addressed the inadequacy of current dietary interventions to ultimately address the disproportionately high incidence of CVD in Black populations. Methods and Results: Cross-sectional analyses of 1,867 Black individuals of the PURE-SA study allowed the identification of dietary intake and cardiovascular measure interactions on three sub-categories: (1) normal blood pressure (BP), hypertension or Hcy-related hypertension (H-type), (2) low, normal or high Hcy concentrations, and (3) Hcy-related genetic combinations. Favorable body composition, but adverse dietary intake and cardiovascular determinants, were observed in higher Hcy categories. H-types, compared to regular hypertensives, had higher alcohol and lower macronutrient and micronutrient consumption. Inverse associations with carotid-radial pulse wave velocity were evident between monounsaturated fatty acid (FA) consumption and H-type hypertension as well as polyunsaturated FA and CBS883/ins68 TT carriers. Energy intake was positively associated with vascular cell adhesion molecule-1 (VCAM-1) in variant CBST883C/ins68 and CBS9276 GG carriers. VCAM-1 was also positively associated with plant protein intake in CBS9276 GG and MTR2756 AA carriers and negatively with total protein intake and CBS9276 GG carriers. Alcohol intake was positively associated with intercellular adhesion molecule-1 in MTR2756 minor allele carriers. Conclusion: Because Hcy gene-diet interactions are evident, personalized nutrition, by adjusting diets based on genetic profiles (e.g., CBS and MTR variations) and dietary interactions (e.g., FAs and proteins), can enhance cardiovascular outcomes by managing Hcy and related hypertension in genetically susceptible individuals.
Hybrid fragment-SMILES tokenization for ADMET prediction in drug discovery
Authors: Aksamit Nicholas , Tchagang Alain , Li Yifeng , Ombuki-Berman Beatrice
Published: August 2024

Background:

Drug discovery and development is the extremely costly and time-consuming process of identifying new molecules that can interact with a biomarker target to interrupt the disease pathway of interest. In addition to binding the target, a drug candidate needs to satisfy multiple properties affecting absorption, distribution, metabolism, excretion, and toxicity (ADMET). Artificial intelligence approaches provide an opportunity to improve each step of the drug discovery and development process, in which the first question faced by us is how a molecule can be informatively represented such that the in-silico solutions are optimized.

Results:

This study introduces a novel hybrid SMILES-fragment tokenization method, coupled with two pre-training strategies, utilizing a Transformer-based model. We investigate the efficacy of hybrid tokenization in improving the performance of ADMET prediction tasks. Our approach leverages MTL-BERT, an encoder-only Transformer model that achieves state-of-the-art ADMET predictions, and contrasts the standard SMILES tokenization with our hybrid method across a spectrum of fragment library cutoffs.

Conclusion:

The findings reveal that while an excess of fragments can impede performance, using hybrid tokenization with high frequency fragments enhances results beyond the base SMILES tokenization. This advancement underscores the potential of integrating fragment- and character-level molecular features within the training of Transformer models for ADMET property prediction.
Random forests for the analysis of matched case–control studies
Authors: Schauberger Gunther , Klug Stefanie J. , Berger Moritz
Published: August 2024

Background

Conditional logistic regression trees have been proposed as a flexible alternative to the standard method of conditional logistic regression for the analysis of matched case–control studies. While they allow to avoid the strict assumption of linearity and automatically incorporate interactions, conditional logistic regression trees may suffer from a relatively high variability. Further machine learning methods for the analysis of matched case–control studies are missing because conventional machine learning methods cannot handle the matched structure of the data.

Results

A random forest method for the analysis of matched case–control studies based on conditional logistic regression trees is proposed, which overcomes the issue of high variability. It provides an accurate estimation of exposure effects while being more flexible in the functional form of covariate effects. The efficacy of the method is illustrated in a simulation study and within an application to real-world data from a matched case–control study on the effect of regular participation in cervical cancer screening on the development of cervical cancer.

Conclusions

The proposed random forest method is a promising add-on to the toolbox for the analysis of matched case–control studies and addresses the need for machine-learning methods in this field. It provides a more flexible approach compared to the standard method of conditional logistic regression, but also compared to conditional logistic regression trees. It allows for non-linearity and the automatic inclusion of interaction effects and is suitable both for exploratory and explanatory analyses.
Overexpression of MtIPT gene enhanced drought tolerance and delayed leaf senescence of creeping bentgrass (Agrostis stolonifera L.)
Authors: Ai Ye , Chen Yinglong , Wang Ning , Li Jiaxing , Liu Jinnan , Shen Liangying , Sun Xinbo , Han Liebao , Chao Yuehui
Published: August 2024

Background

Isopentenyltransferases (IPT) serve as crucial rate-limiting enzyme in cytokinin synthesis, playing a vital role in plant growth, development, and resistance to abiotic stress.

Results

Compared to the wild type, transgenic creeping bentgrass exhibited a slower growth rate, heightened drought tolerance, and improved shade tolerance attributed to delayed leaf senescence. Additionally, transgenic plants showed significant increases in antioxidant enzyme levels, chlorophyll content, and soluble sugars. Importantly, this study uncovered that overexpression of the MtIPT gene not only significantly enhanced cytokinin and auxin content but also influenced brassinosteroid level. RNA-seq analysis revealed that differentially expressed genes (DEGs) between transgenic and wild type plants were closely associated with plant hormone signal transduction, steroid biosynthesis, photosynthesis, flavonoid biosynthesis, carotenoid biosynthesis, anthocyanin biosynthesis, oxidation-reduction process, cytokinin metabolism, and wax biosynthesis. And numerous DEGs related to growth, development, and stress tolerance were identified, including cytokinin signal transduction genes (CRE1, B-ARR), antioxidase-related genes (APX2, PEX11, PER1), Photosynthesis-related genes (ATPF1A, PSBQ, PETF), flavonoid synthesis genes (F3H, C12RT1, DFR), wax synthesis gene (MAH1), senescence-associated gene (SAG20), among others.

Conclusion

These findings suggest that the MtIPT gene acts as a negative regulator of plant growth and development, while also playing a crucial role in the plant’s response to abiotic stress.
Understanding women’s and men’s perspectives on cervical cancer screening in Uganda: a qualitative study
Authors: Bouskill Kathryn , Wagner Glenn J. , Gizaw Mahlet , Matovu Joseph KB , Juncker Margrethe , Namisango Eve , Nakami Sylvia , Beyeza-Kashesya Jolly , Luyirika Emmanuel , Wanyenze Rhoda K.
Published: August 2024

Background

Cervical cancer remains a significant but preventable threat to women’s health throughout much of the developing world, including Uganda. Cervical cancer screening and timely treatment of pre-cancerous lesions is a cost-effective means of mitigating cervical cancer morbidity and mortality. However, only 5% of women in Uganda have ever been screened. Barriers to screening, such as social stigma and access to safe conditions, have been previously identified, but insights into the role of male spouses in encouraging or discouraging screening have been limited. To our knowledge, no studies have compared barriers and facilitators among women who had or had not yet been screened and male partners of screened and unscreened women.

Methods

To resolve this gap, we conducted 7 focus groups– 3 among women who had been screened, 3 among those who had not been screened, and 1 among men whose female partners had or had not been screened. We performed qualitative thematic analysis on the focus group data.

Results

We identified several important factors impacting screening and the decision to screen among women, ranging from stigma, availability of screening, false beliefs around the procedure and side effects, and the role of spousal support in screening promotion. Male spousal perspectives for screening ranged from full support to hesitancy around male-performed exams and possible prolonged periods without intercourse.

Conclusion

This exploratory work demonstrates the importance of dialogue both among women and their male partners in enhancing screening uptake. Efforts to address screening uptake are necessary given that it is an important means of mitigating the burden of cervical cancer. Interventions along these lines need to take these barriers and facilitators into account in order to drive up demand for screening.
Skill enactment and knowledge acquisition among community users of digital mental health interventions: qualitative study with thematic analysis
Authors: Jackson Hayley M. , Batterham Philip J. , Ohan Jeneva L. , Calear Alison L. , Farrer Louise M.
Published: August 2024

Background

The acquisition of knowledge and use of skills from digital mental health interventions (DMHIs) are considered important for effectiveness. However, our understanding of user experiences implementing skills learned from these interventions is limited, particularly outside of research trials. This qualitative study aimed to investigate how community users learn and apply knowledge and skills from DMHIs based on cognitive behavioural therapy (CBT) in daily life. The study also examined factors influencing the selection and use of skills and explored perceived changes in mental health resulting from the intervention.

Methods

Thirteen adults aged 26 to 66 years (10 females) were recruited using social media advertising and participated in semi-structured interviews by telephone or videoconference. All participants were living in Australia and had used a digital CBT program within the past 3 months. Interviews lasted on average 45 min. Transcripts were analysed using theoretical thematic analysis.

Results

Participants demonstrated high levels of program engagement. Findings were organised into three topics with six major themes. Participants reported that their chosen intervention reinforced existing knowledge and fostered new skills and insights (Topic 1, Theme 1: knowledge consolidation). Most described actively applying skills (Topic 1, Theme 2: active approach to skill enactment), although the extent of learning and range of skills enacted varied across participants. Influences on skill selection included the perceived relevance of intervention strategies to the user’s needs and personal characteristics (Topic 2, Theme 1: relevance of intervention strategies), as well as the perceived or experienced effectiveness of those strategies (Topic 2, Theme 2: perceived and experienced benefit). Challenges to ongoing skill enactment included time scarcity, prioritisation difficulties, and lack of motivation (Topic 2, Theme 3: navigating time constraints and low motivation). Improvements in mental health were generally modest and attributed mainly to participants’ proactive efforts (Topic 3, Theme 1: perceived changes).

Conclusions

DMHIs may reinforce existing understanding of psychotherapeutic strategies, offer new knowledge, and encourage the application of skills in everyday life among community users who actively engage with these interventions. Future research should prioritise personalising DMHIs and investigating methods to optimise the acquisition, retention, and sustained application of knowledge and skills.
Are equine-assisted services beneficial for military veterans with post-traumatic stress disorder? A systematic review and meta-analysis
Authors: Provan Maisy , Ahmed Zubair , Stevens Andrew R. , Sardeli Amanda V.
Published: August 2024

Background

Equine-assisted services (EAS) involves the use of horses within therapy, learning or horsemanship sessions and has been used with military veterans suffering from post-traumatic stress disorder (PTSD). This study systematically reviewed existing research on the use of EAS in the treatment of PTSD in military veterans and evaluated its effectiveness.

Methods

A systematic review was performed, in May 2023, with searches and data extraction carried out from three separate databases (PubMed, JSTOR and Science Direct) related to testing the effect of EAS on PTSD outcomes in veterans. A risk of bias assessment of included studies was conducted and meta-analysis of outcomes performed when two or more studies reported the same outcomes. Other effects of EAS on veterans’ health were also discussed.

Results

A total of 13 studies were identified based on our inclusion and exclusion criteria with 11 originating from the US and the remaining two from Australia and Israel. There were 344 participants amongst all of the studies with a mean age of 47 years and a male:female ratio of 19:6. Eight out of the 13 studies reported PTSD scores, as measured by either PTSD Checklist for DSM-5 (PCL-5) or PCL-Veteran/-Military versions (PCL-V/-M), and results suggested a reduction in PTSD score after EAS treatment of 22.6%. A meta-analysis confirmed that EAS favored a significantly lower PTSD score after treatment, with a mean difference of 12.46, 95% CI [9.03,15.88], p < 0.00001. However, only one study had low risk of bias whilst all the rest of the studies had some concerns to high risk of bias.

Conclusions

EAS appeared to have a positive influence on PTSD symptoms in military veterans, significantly reducing PTSD severity scores. Other benefits of EAS may be peer support, social integration, learning new skills and bonding. However, the results of this systematic review must be interpreted with caution as almost all of the studies were of low quality. Therefore, further rigorous research is required with larger participants to be able to draw conclusions about the benefits of EAS on PTSD severity.
Assessing patient satisfaction and healthcare delivery amidst the COVID-19 pandemic: insights from Jammu and Kashmir, India
Authors: Koul Arunima , Saeed Shazina , Kaur Karuna Nidhi , Niazi Farah
Published: August 2024

Introduction

Amidst the challenges posed by Covid-19, assessing healthcare quality in India is crucial, particularly through patient satisfaction levels.

Methodology

A cross-sectional survey of 277 participants in Jammu and Kashmir was conducted, utilizing a semi-structured questionnaire and PSQ-18. Data analysis was performed using SPSS (v25) including Chi-Square tests and Descriptive analysis.

Results

Out of 277 participants, 70.8% expressed high satisfaction with medical care. Majority (70%) agreed that doctors explained medical tests well. Additionally, 70% strongly agreed that their doctor’s office was well-equipped. Dissatisfaction factors were notably low. Significant associations were found between age and alcohol use (p = 0.041), gender and alcohol use (p = 0.007), gender and tobacco use (p = 0.032), and education level and vaccination (p = 0.001).

Conclusion

The study highlights high patient satisfaction during the pandemic. Improving accessibility and quality of primary healthcare and community centres is essential to meet patient needs effectively.
The option of transosseous distal suture placement during minimally invasive Achilles tendon repair for high-risk patients can improve outcomes, however does not prevent re-rupture
Authors: Carmont Michael R. , Nilsson-Helander Katarina , Carling Malin
Published: August 2024

Purpose

Achilles tendon ruptures (ATRs) close to the insertion, in high-level athletes, and in patients at high risk of re-rupture, may be better suited to operative repair. Minimally Invasive Repair (MIR) of the Achilles tendon has excellent outcome and low complication rates. Traditionally MIR has showed lower repair strength, failing due to suture pull-out from the distal tendon stump. The aim of this study was to describe the outcome of ATR patients who received transosseous distal suture placement using a standard technique as a reference.

Methods

Following ATR, patients were evaluated for pre-injury activity level, body weight, location of the tear and size of the distal Achilles tendon stump. Patients considered to be at high-risk of re-rupture: Tegner level ≥ 8, body weight ≥ 105Kg and distal ATR, received transosseous (TO) distal suture placement (n = 20) rather than the usual transtendinous (TT) technique (n = 55). Patient reported outcome measures and functional evaluation was performed at 12 months following repair.

Results

At 12 months follow up both methods resulted in good median (IQR) Achilles tendon Total Rupture Score TO 83.8 (74-88.3) vs. TT 90 (79–94), low increased relative Achilles Tendon Resting Angle TO -3.5˚ (3.6) vs. TT -3.5˚ (3.3) and mean (SD) Single leg Heel-Rise Height Index TO 88.2% (9.9) vs. TT 85.6% (9.9) (n.s.). There were 4 re-ruptures in the high-risk group and 2 in the group receiving TT distal suture placement. All but one of these were traumatic in nature. The mode of failure following TO distal suture placement was proximal suture pull out.

Conclusions

To distal suture placement during minimally-invasive Achilles tendon repair for higher-risk patients can lead to results equivalent to those in lower-risk patients treated with a standard TT MIR technique, except for the re-rupture rate which remained higher. There may be factors that have greater influence on outcome other than suture placement following ATR.
ARAP1-AS1: a novel long non-coding RNA with a vital regulatory role in human cancer development
Authors: Wang Jialing , Luo Hongliang , Yang Lu , Yuan Huazhao
Published: August 2024

Long non-coding RNAs (lncRNAs) have garnered significant attention in biomedical research due to their pivotal roles in gene expression regulation and their association with various human diseases. Among these lncRNAs, ArfGAP With RhoGAP Domain, Ankyrin Repeat, And PH Domain 1 - Antisense RNA 1 (ARAP1-AS1) has recently emerged as an novel oncogenic player. ARAP1-AS1 is prominently overexpressed in numerous solid tumors and wields influence by modulating gene expression and signaling pathways. This regulatory impact is realized through dual mechanisms, involving both competitive interactions with microRNAs and direct protein binding. ARAP1-AS1 assumes an important role in driving tumorigenesis and malignant tumor progression, affecting biological characteristics such as tumor expansion and metastasis. This paper provides a concise review of the regulatory role of ARAP1-AS1 in malignant tumors and discuss its potential clinical applications as a biomarker and therapeutic target. We also address existing knowledge gaps and suggest avenues for future research. ARAP1-AS1 serves as a prototypical example within the burgeoning field of lncRNA studies, offering insights into the broader landscape of non-coding RNA molecules. This investigation enhances our comprehension of the complex mechanisms that govern the progression of cancer.
A yearly measure of heat-related deaths in France, 2014–2023
Authors: Pascal Mathilde , Wagner Vérène , Lagarrigue Robin , Casamatta Delphine , Pouey Jérôme , Vincent Nicolas , Boulanger Guillaume
Published: August 2024

Climate change’s impact on health, specifically increasing temperatures, has become a prominent field of study worldwide. Although its importance is growing, decision makers still have little knowledge on the subject. Developing indicators to monitor spatial and temporal trends of health impacts due to climate change is a vital advancement needed to encourage policy adaptations. This research proposes an approach to producing annual estimates for heat-related mortality as an indicator to support these policies. The first step was to develop temperature-mortality relationships for each of the 96 metropolitan French departments, for the summer months (June–September) between 2014 and 2022. Several approaches were tested to control for a possible influence of the COVID-19 pandemic since 2020. The temperature-mortality relationships were used to compute the annual mortality attributable to heat for the same years, and for 2023.

Heat-related risks were slighly higher after the pandemic; an increase from 19.8 °C to 28.5 °C was associated with a relative risk of 1.25 [CI 95% 1.21:1.30] in 2004–2019, and 1.31 [1.24:1.38] in 2020–2022. Between 2014 and 2023, 37,825 deaths [IC 95% 34,273: 40,483] were attributable to heat. The largest impacts were observed in 2022 (6,969 [6277: 7445]), 2023 (5167 [4587; 5551]), and 2019 (4441 [4086: 4717]). The annual indicator of heat-related mortality documents the mortality impact of heat during the summer and during extreme heat waves. It shows that the impact is increasing, despite major prevention efforts. This call for a more ambitious, transformative adaptation to climate change.