bluuebunny/crossref_metadata_2025 huggingface dataset:
Phylogeographic Patterns of the Greater Cane Rat (Thryonomys Swinderianus) Populations from Eastern, Western and Southern Africa and Implications for Wildlife Conservation
Authors: Kilwanila Shadia I. , Lyimo Charles M. , Rija Alfan A. , Makundi Rhodes H.
Published: December 2023

Background and aim: African Greater Cane (ACG) rat populations are widely distributed across Africa but the ancestral origin of populations inhabiting different geographical regions is unknown. There is currently no information available on the genetic differentiation of these populations resulting from long-time geographical isolation, environmental and anthropogenic pressures they face in each region. This limits our ability to understand potential speciation processes in AGC and their implications for their conservation and of other small wild mammals exposed to similar ecological conditions in the savannah biomes in Africa. Methods: We analyzed mitochondrial genes targeting the D-loop region of AGC samples from two blocks of the Eastern Arc Mountains in Tanzania (eastern), three agro-ecological zones in Ghana (western) and four sites in South Africa (southern) to characterize the phylogeographical patterns of the species. Results: AGC populations from Tanzania revealed higher haplotype diversity than those from the two other régions. Analysis of variance (AMOVA) revealed higher genetic variations within than between populations in all geographic regions. Demographic history analysis revealed a negative and significant Tajima’s D for a single southern African population as well as close relatedness with the Eastern Africa populations, suggesting a common ancestral origin. Conclusion: This is the first study to compare maternal lineages of AGC populations from eastern, western and southern Africa and provides a basis for future genetic studies of the species, its evolutionary ecology and the conservation of these populations across their range. Conservation implications: Evidence of recent population size expansion underpinned by high genetic diversity observed in the Uluguru urban (Tanzania) Guinea savannah (Ghana) and Kwazulu Natal (South Africa) populations suggest that the AGC populations are not currently threatened, consistent with the current IUCN status. Also, the distinct haplotypes observed in each region suggest that the populations can be managed as meta-populations, thus providing opportunities for potential local game-farming programs.
Utility of an Artificial Intelligence Language Model for Post-Operative Patient Instructions Following Facial Trauma
Authors: Mohan Suresh , Souza Spenser , Fakurnejad Shayan , Knott P. Daniel
Published: December 2023

Study Design

Qualitative Descriptive Study.

Objective

To evaluate the utility of post-operative instructions (POIs) for facial trauma provided by the language model ChatGPT as compared to those from electronic medical record (EMR) templates and Google search engine.

Methods

POIs for four common facial trauma procedures (mandibular fracture, maxillary fracture, nasal fracture, and facial laceration) were generated by ChatGPT, extracted from EMR templates, or obtained from Google search engine. The POIs were evaluated by a panel of surgeons using the Patient Education Materials Assessment Tool (PEMAT-P).

Results

Average PEMAT-P understandability scores across all 3 sources ranged from 55% to 94%. Actionability scores ranged from 33% to 94%, and procedure-specific scores ranged from 50% to 92%. ChatGPT-generated POIs ranged from 82% to 88% for understandability, 60% to 80% for actionability, and 50% to 75% for procedure-specific items.

Conclusions

ChatGPT has great potential to be a useful adjunct in providing post-operative instructions for patients undergoing facial trauma procedures. Detailed and patient-specific prompts are necessary to output tailored instructions that are accurate, understandable, and actionable.
Understanding, readiness, and response of healthcare professionals in combating falsified medical products in Eritrea: a population-based survey
Authors: Fitsum Yodit , Werede Azania , Mahmud Saleh Abubeker , Tesfamariam Eyasu H. , Magombo Francis , Misghina Freminatos , Yemane Hermella , Bahta Iyassu , Abraham Liya , Bahta Merhawi , Debesai Merhawi , Tesfagaber Meron , Ghirmai Michael , Tesfamariam Sirak , Russom Mulugeta
Published: December 2023

Background:

The circulation of falsified medical products is a global threat and is expected to be higher in low- and middle-income countries.

Objective:

This study was conducted to assess the understanding, readiness, and response of Eritrea’s healthcare professionals (HCPs), and identify potential areas of intervention to combat circulation of falsified medical products.

Design:

This was a nationwide population-based cross-sectional survey, conducted in December 2021.

Methods:

This study enrolled representative samples of HCPs working in public and private health facilities. Two-stage stratified cluster sampling was used to select study participants and data were collected through face-to-face interviews. Descriptive statistics, Mann–Whitney U test, Kruskal–Wallis test along with their post hoc tests, Jonckheere-Terpstra, and logistic regression analyses were performed as appropriate.

Results:

The study enrolled 707 HCPs, and 96.6% were successfully surveyed. The majority of the participants (62.5%) encountered products with suspected quality defects and 63.8% claimed that they had reported the incident(s) at least once. About 85% reported that complaints should be submitted to the Eritrean Pharmacovigilance Centre and 74.0% indicated that it should be reported at the earliest time possible even if the reporter lacks details. The standard reporting form for suspected product quality issues was correctly recognized by 13.8%. Overall, the median knowledge and attitude scores were found to be 9 out of 17 (interquartile range, IQR: 4.0) and 30 out of 35 (IQR: 4.0), respectively. Not knowing how to report (55.6%) and what to report (34.9%), no/delayed feedback from the regulatory authority (30.0%), and unavailability of reporting forms (29.0%) were the frequently reported barriers to reporting. In addition, profession ( p = 0.027), no/delayed feedback (adjusted odds ratio [AOR]: 4.70; 95% CI: 2.17–10.18; p < 0.001), and not knowing how to report (AOR: 0.12; 95% CI: 0.05–0.28; p < 0.001) were found to be determinants of reporting suspected product quality defects.

Conclusion:

The readiness and response of Eritrea’s HCPs in detecting and reporting falsified medical products seems promising, although a significant knowledge gap was observed.
Intravenous S-ketamine’s analgesic efficacy in third molar surgery. A randomized placebo-controlled double-blind clinical trial
Authors: Eriksson Lars B , Gordh Torsten , Karlsten Rolf , LoMartire Riccardo , Thor Andreas , Tegelberg Åke
Published: December 2023

Background

In most cases, a combination of paracetamol and ibuprofen are the optimal treatment for postoperative pain in third molar surgery. If stronger analgesia is required, opioids are traditionally administered. In day-case, surgery; however, opioids should be avoided. Thus, the anaesthetic agent S-ketamine in analgesic doses might be preferred.

Methods

The study was designed as a randomized placebo-controlled double-blind clinical trial. The study enrolled healthy subjects according to the American Society of Anaesthesiologists classification; I or II (ASA), aged 18 to 44 years, with a body weight between 50 and 100 kg. The patients were randomized into three groups where two doses of S-ketamine were compared (high: 0.25 mg/kg or low: 0.125 mg/kg) with placebo (saline).

Results

A primary outcome of the study was that VAS at 4 h postoperatively, showed no significant difference between the placebo and high-dose S-ketamine group or in the low-dose group. We found a significant difference between the groups for the first 24 h, with a lower VAS-score in the high-dose S-ketamine group. The time to when 50% had taken their first rescue medication was 12 min later in the high-dose ketamine group.

Conclusions

Pre-emptive S-ketamine 0.25 mg/kg gave a global significant reduction of pain by VAS during the first 24 h postoperatively. The time from end of surgery to first rescue medication were longer in the high-dose ketamine group compared to both low-dose ketamine and placebo groups.
Street Vendor Governance in the Dimensions of Democracy, Collaboration, and Trust
Authors: Kurniadi  , Ibrahim Syafei
Published: December 2023

The City of Bandung has become a trading center, where one of its trades is Street Vendors. The complex problem regarding Street Vendors requires a comprehensive and integrated solution that is carried out democratically, collaboratively, and also mutually trusted by every stakeholder as the New Public Service offers. This research used a mixed-method approach. The determination of the respondents was carried out through purposive sampling. As an analysis unit in this study, the Street Vendors Task Force, Street Vendors organizations, and the street vendors themselves. The research data source consisted of secondary data and primary data. Secondary data was obtained from legal product reviews, planning documents, and budgeting. Meanwhile, primary data was carried out by using two methods, which were qualitative and quantitative methods related to democracy, collaboration, and mutual trust. From the research results, it could be concluded that the governance of street vendors has not yet run ideally. From the democratic aspect, it was shown a process of professional policy shift dynamics. Moreover, it affected the change in attitudes and work ethics of the Special Task Force, which was more humane and oriented toward the public interest. Likewise, law enforcement and policy legitimacy had been carried out more objectively and proportionally, as well as it adjusted to the dynamics within the field. The collaboration aspect was already underway by involving every stakeholder in the Street Vendors’ governance. Meanwhile, from the mutual trust aspect, the facts in the field have not yet been realized, and rigid regulations and behavior still bind each party based on the act of business as usual.
Regulating Discourse: How Children With and Without SEND Internalize the Evaluative Framework of Adults
Authors: Efthymiou Efthymia
Published: December 2023

This study presents a Bakhtinian analysis of discourse among children with Special Educational Needs and Disorders (SEND) in two elementary classrooms, delving into the complicated interaction of voices and perspectives within their communication. The research investigates how the evaluation of peers provides a contextual backdrop for the voices of children with SEND. Conducted as a longitudinal investigation in an English primary school, data were collected over a three-month period to disclose communication dynamics. Notably, the discourse analysis reveals the use of “hybrid constructions” by students, wherein they skillfully blend adult values with their own viewpoints when discussing peers, thus navigating their positioning vis-à-vis institutional norms and their peers. The central question, “Who is taking the lead in the conversation?” undrapes a rich interchange of voices within each dialog excerpt. This interaction encompasses the speaker’s own voice and resonates with reflections of institutional discourse. Importantly, the analysis elucidates how diverse pedagogic discourses contribute to shaping social relationships between teachers and students, as well as amongst the students themselves. By capturing these multifaceted interactions, this study reveals a paramount conduit through which institutional values are communicated and internalized within the discourse of children with SEND. This focused exploration contributes to a nuanced understanding of how children assimilate external voices while communicating and how they forge connections with peers facing unique learning challenges.
Parent-adolescent communication about sexual and reproductive health and its determinants among adolescents: Baseline findings from a Randomized Controlled Trial in Tanzania
Authors: Millanzi Walter C. , Osaki Kalafunja M. , Kibusi Stephen M.
Published: December 2023

Regardless of the importance of youth in socio-economic development around the globe, adolescents aged between 10 and 19 years face problems ranging from their basic to Sexual and Reproductive Health economic needs (SRH). This study determined baseline parent-adolescent communication about SRH from a randomized controlled trial of integrated reproductive health materials in a Problem-Based Pedagogy (PBP) for shaping safe sexual behavior among adolescents in Tanzania. The study employed a baseline cross-section survey from a randomized controlled trial of integrated reproductive health materials in a problem-based learning pedagogy for shaping safe sexual behavior among 647 randomly selected adolescents in Tanzanian ordinary-level secondary schools. The response rate of the study was 100% of which 57.5% were females. Totalities of 73.3% of adolescents reported having never communicated with their parents about SRH. Parent-adolescent communication about SRH matters was found to be low and thus, recommends collaborative parent-adolescent interventions to address it accordingly.
Digital Escape Game and Students’ Learning Outcomes in Mathematics: Experience From Brunei
Authors: Pg Abu Bakar Dk Nurul Najiah , Shahrill Masitah , Zakariya Yusuf F.
Published: December 2023

Educational stakeholders in Brunei are not exempted from the search for innovative instructional approaches as a tool to stem the tide of poor performance of students in mathematics. This study was designed to contribute to this national project by examining the impact of a digital escape game intervention on students’ mathematics performance and affective constructs. Using a mixed methods approach, we generated both quantitative and qualitative data from 32 secondary school students who took part in the intervention study. The comparison between the pre-test and post-test scores of students shows a substantial improvement in the performance of students with different ability levels. Further analysis of the generated interview and questionnaire data reveals that the digital escape game reinforces students’ interest in and enjoyment of mathematics, provides an avenue for students’ collaborative learning and enhances students’ communication skills while working together on mathematics tasks. These findings highlight the potential of the digital escape game in not only stemming the tide of poor performance in mathematics but also in enhancing students’ motivational and social skills. In addition to students’ positive perceptions of the digital escape game, there are some reservations about the clarity of instruction and the duration of the intervention. We discuss the implications of these findings for the teaching and learning of mathematics within and outside the Bruneian borders.
Systematic Ranking of NSQIP Surgical Risk Calculator Outputs
Authors: Sitar Nejc , Turoski Staci , McCrory Bernadette , Gardner Caleb T. , Guildner Corey
Published: December 2023

The National Surgical Quality Improvement Program (NSQIP) calculator is a risk-predicting calculator, that predicts the likelihood of postoperative complications. Card sorting methodology was used to capture feedback from expert and non-expert participants regarding the severity of surgical complications. The study result indicated ambiguity of postoperative complications. To overcome this barrier, a proposed order of postoperative complications was developed based on the Borda count ranking performed by surgeon.
Actinomycotic Sinomaxillary Infection in a COVID-19 Patient: A Case Report and Review of the Literature
Authors: Moaddabi Amirhossein , Cernera Mariangela , Armogida Niccolò Giuseppe , Soltani Parisa , Spagnuolo Gianrico
Published: December 2023

Individuals with COVID-19 are prone to a variety of infections due to immune dysregulation. The present report presents a case of actinomycotic infection in the maxillary bone and sinus region in a patient with a history of COVID-19. This case report highlights the importance of considering bacterial infections including actinomycosis when encountering destructive lesions resembling more prevalent fungal infections due to different therapeutic medication protocols. In addition, a literature review of the existing reports of similar post-COVID-19 actinomycotic infection is presented.
Outcome of patients with multivessel occlusion stroke after endovascular treatment
Authors: LeCouffe Natalie E , Treurniet Kilian M , Kappelhof Manon , Jansen Ivo GH , Boers Merel , Marquering Henk A , Beenen Ludo FM , Boiten Jelis , van Zwam Wim H , Yo Lonneke SF , Majoie Charles BLM , Roos Yvo BWEM , Emmer Bart J , Coutinho Jonathan M
Published: December 2023

Introduction:

Little is known about the implications of multivessel occlusions (MVO) in large vessel occlusion stroke patients who undergo endovascular treatment (EVT).

Patients and methods:

We report data from the MR CLEAN Registry: a prospective, observational study on all stroke patients who underwent EVT in the Netherlands (March 2014–November 2017). We included patients with an intracranial target occlusion in the anterior circulation. An MVO was defined as an MCA occlusion (M1/M2) or intracranial ICA/ICA-T occlusion, with a concurrent second occlusion in the ACA or PCA territory confirmed on baseline CTA. To compare outcomes, we performed a 10:1 propensity score matching analysis with a logistic regression model including potential confounders. Outcome measures included 90-day functional outcome (modified Rankin Scale, mRS) and mortality.

Results:

Of 2946 included patients, 71 patients (2.4%) had an MVO (87% concurrent ACA occlusion, 10% PCA occlusion, 3% ⩾3 occlusions). These patients were matched to 71 non-MVO patients. Before matching, MVO patients had a higher baseline NIHSS (median 18 vs 16, p = 0.001) and worse collateral status (absent collaterals: 17% vs 6%, p < 0.001) compared to non-MVO patients. After matching, MVO patients had worse functional outcome at 90 days (median mRS 5 vs 3, cOR 0.39; 95%CI 0.25–0.62). Mortality was higher in MVO patients (46% vs 27%, OR 2.11, 95%CI 1.24–3.57).

Discussion and conclusion:

MVOs on baseline imaging were uncommon in LVO stroke patients undergoing EVT, but were associated with poor functional outcome.
Virtual Surgical Planning Facilitates Surgical Resection in Mandibular Osteoradionecrosis and Optimize Reconstructive Outcomes
Authors: Palines Patrick A. , Doran Hannah E. , Schwartzberg Harel G. , Melancon Devin M. , Bartow Matthew J. , Aslam Rizwan , St. Hilaire Hugo , Stalder Mark W.
Published: December 2023

Background:

Mandibular osteoradionecrosis (ORN) is a devastating complication of radiotherapy for oropharyngeal malignancy. Despite advancements in ORN treatment, risk of ORN recurrence remains high following surgical resection. Virtual surgical planning (VSP) for ORN treatment is an evolving application that may not only inform bony reconstruction but also therapeutic surgical margins, which remain inconclusively defined in the literature.

Methods:

A retrospective review was performed of 25 cases in which patients underwent VSP-guided resection of mandibular ORN followed by immediate free fibula flap reconstruction. Surgical margins of 1-cm from radiologically evident disease were taken. VSP accuracy was quantified by comparing measured anatomic parameters between the virtually planned outcomes and the final outcomes on postoperative imaging. Statistical analyses were performed to assess associations between preoperative factors and postoperative complications including ORN recurrence.

Results:

The mandibular body was most frequently affected by ORN in this series of patients. Among risk factors, only the presence of a preoperative orocutaneous fistula was predictive of a complication, specifically partial flap failure (β = 1.41; P = .013). Intended anatomic parameters were achieved with the exception of the intergonial distance (x difference = 0.53 cm; P = .03). Finally, there were no cases of ORN recurrence after a mean follow-up of 27.4 months.

Conclusions:

VSP of free fibula flaps for mandibular reconstruction following ORN is a valid tool for effecting accurate anatomical outcomes. Furthermore, we demonstrate that a 1-cm margin around radiographically evident ORN may effectively implement a curative outcome free from relapse.
Promoting or inhibiting: The role of socio-economic integration on migrant entrepreneurship
Authors: Zou Jing , Yao Liming , Lan Xiaoxuan , Deng Xiaojun
Published: December 2023

Entrepreneurship plays a key role in promoting the global economic growth. However, the association between socio-economic integration and migrant entrepreneurship goes unnoticed. Based on 2017 China Migrants Dynamic Survey (CMDS), using a baseline regression model, Heckman two-stage model and IV Probit model, our research evidences a positive correlation between migrants’ integration into the society and their entrepreneurship. Specifically, for every standard deviation increase in the socio-economic integration level of migrants, the probability of having entrepreneurial engagement increases by 1.4%. Further findings indicates that migrant’s socio-economic integration is negatively correlated with migrant necessity-based entrepreneurship, while indicating a positive relationship between migrants’ socio-economic integration and opportunity-based entrepreneurship. The underlying mechanism of how socio-economic integration impacts migrant necessity-based entrepreneurship is through changes in the perception of difficulty and migrants’ settlement intention. The internal mechanism of how socio-economic integration influences migrant opportunity-based entrepreneurship is by changing localised social capital and migrants’ risk preference. More extensive investigations evidence that the degree of marketisation and the level of information have significant regulatory effect on the relationship between socio-economic integration and migrant entrepreneurship. Heterogeneity analysis shows that the relationship between socio-economic integration and migrant entrepreneurship varies across different levels of human capital, material capital and experience capital.
Whole genome-scale assessment of gene fitness of Novosphingobium aromaticavorans during spaceflight
Authors: Sharma Gayatri , Zee Peter C. , Zea Luis , Curtis Patrick D.
Published: December 2023

In microgravity, bacteria undergo intriguing physiological adaptations. There have been few attempts to assess global bacterial physiological responses to microgravity, with most studies only focusing on a handful of individual systems. This study assessed the fitness of each gene in the genome of the aromatic compound-degrading Alphaproteobacterium Novosphingobium aromaticavorans during growth in spaceflight. This was accomplished using Comparative TnSeq, which involves culturing the same saturating transposon mutagenized library under two different conditions. To assess gene fitness, a novel comparative TnSeq analytical tool was developed, named TnDivA, that is particularly useful in leveraging biological replicates. In this approach, transposon diversity is represented numerically using a modified Shannon diversity index, which was then converted into effective transposon density. This transformation accounts for variability in read distribution between samples, such as cases where reads were dominated by only a few transposon inserts. Effective density values were analyzed using multiple statistical methods, including log2-fold change, least-squares regression analysis, and Welch’s t-test. The results obtained across applied statistical methods show a difference in the number of significant genes identified. However, the functional categories of genes important to growth in microgravity showed similar patterns. Lipid metabolism and transport, energy production, transcription, translation, and secondary metabolite biosynthesis and transport were shown to have high fitness during spaceflight. This suggests that core metabolic processes, including lipid and secondary metabolism, play an important role adapting to stress and promoting growth in microgravity.
A systematic review of simulation studies which compare existing statistical methods to account for non-compliance in randomised controlled trials
Authors: Abell Lucy , Maher Francesca , Jennings Angus C , Gray Laura J
Published: December 2023

Introduction

Non-compliance is a common challenge for researchers and may reduce the power of an intention-to-treat analysis. Whilst a per protocol approach attempts to deal with this issue, it can result in biased estimates. Several methods to resolve this issue have been identified in previous reviews, but there is limited evidence supporting their use. This review aimed to identify simulation studies which compare such methods, assess the extent to which certain methods have been investigated and determine their performance under various scenarios.

Methods

A systematic search of several electronic databases including MEDLINE and Scopus was carried out from conception to 30th November 2022. Included papers were published in a peer-reviewed journal, readily available in the English language and focused on comparing relevant methods in a superiority randomised controlled trial under a simulation study. Articles were screened using these criteria and a predetermined extraction form used to identify relevant information. A quality assessment appraised the risk of bias in individual studies. Extracted data was synthesised using tables, figures and a narrative summary. Both screening and data extraction were performed by two independent reviewers with disagreements resolved by consensus.

Results

Of 2325 papers identified, 267 full texts were screened and 17 studies finally included. Twelve methods were identified across papers. Instrumental variable methods were commonly considered, but many authors found them to be biased in some settings. Non-compliance was generally assumed to be all-or-nothing and only occurring in the intervention group, although some methods considered it as time-varying. Simulation studies commonly varied the level and type of non-compliance and factors such as effect size and strength of confounding. The quality of papers was generally good, although some lacked detail and justification. Therefore, their conclusions were deemed to be less reliable.

Conclusions

It is common for papers to consider instrumental variable methods but more studies are needed that consider G-methods and compare a wide range of methods in realistic scenarios. It is difficult to make conclusions about the best method to deal with non-compliance due to a limited body of evidence and the difficulty in combining results from independent simulation studies.

PROSPERO registration number

CRD42022370910.
The comparison of an accessible C-shaped partial stapled hemorrhoidopexy (C-PSH) versus circular stapled hemorrhoidopexy (CSH) in patients with grade IV hemorrhoids: a retrospective cohort study
Authors: He Jun , Zhou Meng-Dan , Wu Wen-Jing , Liu Zhi-Yong , Wang Dong , Yang Guan-Gen , Yang Qin-Yan , Shen Zhong
Published: December 2023

Objectives

The objectives of this study were to present an accessible C-shaped partial stapled hemorrhoidopexy (C-PSH) in the treatment of grade IV hemorrhoids and to assess long-term outcomes of this technique compared with circular stapled hemorrhoidopexy (CSH).

Methods

Conventional CSH kits combined with an intestinal spatula were used for performing C-PSH. A total of 256 patients with grade IV hemorrhoids referred to Hangzhou Third People's Hospital between January 2016 and June 2017 were obtained: 122 (47.7%) with C-PSH, and 134 (52.3%) with CSH. After propensity score matching, 222 patients (111 in C-PSH group and 111 in CSH group) were ultimately analyzed. The primary outcome was the five-year recurrence rate of hemorrhoids. Secondary outcomes included intraoperative outcomes, postoperative outcomes and complications.

Results

The operative time in the C-PSH group was slightly longer than that in the CSH group (p < 0.01). The vertical length of rectal mucosa specimen in the C-PSH group was shorter than that in the CSH group (p < 0.01). Compared with the CSH group, fecal urgency incidence and numeric rating scale (NRS) score at first defecation were lower in the C-PSH group (p < 0.05). Major complication rate in the CSH group was higher than that in the C-PSH group (p = 0.03). Five-year recurrence rate between the C-PSH group and CSH group was comparable (p > 0.05). Multivariate Cox regression analysis revealed that constipation was an independent prognostic factor for hemorrhoidal recurrence.

Conclusions

The accessible C-PSH seems to be a safe and effective technique in managing grade IV hemorrhoids. It has advantages in alleviating postoperative pain at first defecation, fecal urgency and major complications compared with CSH. It could be an alternative technique in the treatment of grade IV hemorrhoids.
Technology for dementia care: what would good technology look like and do, from carers’ perspectives?
Authors: Brookman Ruth , Parker Simon , Hoon Leonard , Ono Asuka , Fukayama Atsushi , Matsukawa Hisashi , Harris Celia B.
Published: December 2023

Background

The development of technology in dementia care has largely been without consultation with carers, and has primarily focused on safety, monitoring devices, and supporting activities of daily living. Further, while involving end-users in the design of technology has been recommended, this is yet to become common practice.

Method

We conducted a mixed methods study with the aim of investigating carers’ values and priorities for technology development, including prior experiences, barriers to use, and what they would like technology to do. Importantly, we asked carers for their design ideas and bespoke technology solutions for future development.

Results

Carers of people living with dementia (N = 127), including both unpaid (n = 102) and paid carers (n = 25) residing in Australia, completed an online survey. In addition, a subsample of carers (n = 23) participated in semi-structured interviews. Findings demonstrate that carers want technology to be person-centred, customisable, and to increase opportunities for meaningful social connection. Findings also demonstrate the ability of carers to generate creative design solutions for dementia care.

Conclusions

These findings and implications will be discussed in relation to the importance of co-design with carers and engineers during the design phase of assistive technology. Also, the importance of technology to enhance, not replace, human-to-human social interactions is highlighted.
‘Ageing with an alcohol problem is not what I envision’: reclaiming agency in shaping personal ageing trajectory and recovery from alcohol problems
Authors: Jemberie Wossenseged Birhane , Snellman Fredrik , Eriksson Malin , Hammarberg Anders
Published: December 2023

Background

Eliciting and understanding older persons’ descriptions of their resources for healthy ageing and the interaction of these resources with alcohol use and alcohol problems can facilitate health promotion. It can also inform clinicians when identifying areas of recovery capital that present risks and strength for older people seeking alcohol treatment. The objective of this study was to illuminate the experiences and perspectives of older persons on ageing, alcohol use, treatment, and recovery from alcohol problems, as well as their understanding of healthy ageing.

Methods

Eight men and two women, aged 61 to 73 years, with moderate drinking as a treatment goal and treated at an outpatient alcohol clinic in Sweden, participated in semi-structured audio-recorded virtual interviews. A qualitative content analysis examined the transcribed interviews.

Results

Three themes were identified: “Tipping the balance”, “Staying behind a veil” and “Lifting the vail”. First, participants understood healthy ageing as a personal and multidimensional process that involved actively expanding, maintaining or adjusting to the resources needed to lead an active and meaningful life while preserving autonomy, dignity and independence for as long as possible. Second, most participants viewed moderate alcohol use as a contributor to healthy ageing. They sought treatment when their drinking became unsustainable and an immediate threat to their healthy ageing resources. Stigma, ambivalence and a lack of treatment options, however, contributed to delayed treatment. Third, the participants responded to treatment approaches that elicited their concern, incorporated their expertise and treatment and life goals, appreciated their autonomy and agency, and considered them partners in goal setting and decision making. Reduced drinking helped participants regain their agency and improved their healthy ageing capital which in turn catalyzed continuing recovery.

Conclusions

Older persons in non-abstinent recovery perceive healthy ageing and alcohol recovery as personal and interacting multidimensional processes involving their agency to improve biopsychosocial functioning. Treatment approaches that recognize older persons’ desire for healthy ageing, incorporate their treatment goals and respect their autonomy are likely to be acceptable and effective.
Do glycaemic treatment targets affect the perinatal mental health status of women with gestational diabetes? – Data from the TARGET Trial
Authors: Ohene-Agyei Phyllis , Tran Thach , Harding Jane E. , Crowther Caroline A.
Published: December 2023

Background

Gestational diabetes mellitus is associated with perinatal mental disorders. Effective management may reduce this risk, but there is little evidence on effects of different glycaemic treatment targets. We assessed whether tight glycaemic treatment targets compared with less-tight targets reduce the risk of poor mental health outcomes in women with gestational diabetes.

Methods

This was a secondary analysis of data from women who consented to complete perinatal mental health questionnaires as participants in the TARGET Trial, a stepped-wedge cluster randomized trial in 10 hospitals in New Zealand. All hospitals initially used less tight glycaemic targets for management of gestational diabetes and were sequentially randomized, in clusters of two at 4-monthly intervals, to using tighter glycaemic targets.

Data were collected from 414 participants on anxiety (6-item Spielberger State Anxiety scale), depression (Edinburgh Postnatal Depression Scale), and health-related quality of life (36-Item Short-Form General Health Survey) at the time of diagnosis (baseline), 36 weeks of gestation, and 6 months postpartum. The primary outcome was composite poor mental health (any of anxiety, vulnerability to depression, or poor mental health-related quality of life). Generalized linear mixed models were used to determine the main treatment effect with 95% confidence intervals using an intention-to-treat approach.

Results

We found no differences between randomised glycaemic target groups in the primary outcome at 36 weeks’ (relative risk (RR): 1.07; 95% confidence interval 0.58, 1.95) and 6 months postpartum (RR: 1.03; 0.58, 1.81). There were similarly no differences in the components of the primary outcome at 36 weeks’ [anxiety (RR: 0.85; 0.44, 1.62), vulnerability to depression (RR: 1.10; 0.43, 2.83), or poor mental health-related quality of life (RR: 1.05; 0.50, 2.20)] or at 6 months postpartum [anxiety (RR:1.21; 0.59, 2.48), vulnerability to depression (RR:1.41; 0.53, 3.79), poor mental health-related quality of life (RR: 1.11; 0.59, 2.08)].

Conclusion

We found no evidence that adoption of tighter glycaemic treatment targets in women with gestational diabetes alters their mental health status at 36 weeks’ gestation and at 6 months postpartum.

Trial registration

The Australian New Zealand Clinical Trials Registry (ANZCTR). ACTRN12615000282583 (ANZCTR—Registration). Date of registration: 25 March 2015.
PSMD1 as a prognostic marker and potential target in oropharyngeal cancer
Authors: Park Hae Chan , Kim Hyojin , Kim Ji-Yeong , Lee Hye-Yeon , Lee Jinyi , Cha WonJae , Ahn Soon-Hyun , Jeong Woo-Jin
Published: December 2023

Background

Despite the diverse genetic mutations in head and neck cancer, the chemotherapy outcome for this cancer has not improved for decades. It is urgent to select prognostic factors and therapeutic targets for oropharyngeal cancer to establish precision medicine. Recent studies have identified PSMD1 as a potential prognostic marker in several cancers. We aimed to assess the prognostic significance of PSMD1 expression in oropharyngeal squamous cell carcinoma (OPSCC) patients using immunohistochemistry.

Methods

We studied 64 individuals with OPSCC tissue from surgery at Seoul National University Bundang Hospital between April 2008 and August 2017. Immunostaining analysis was conducted on the tissue microarray (TMA) sections (4 μm) for p16 and PSMD1. H-score, which scale from 0 to 300, was calculated from each nucleus, cytoplasm, and cellular expression. Clinicopathological data were compared with Chi-squared test, Fisher’s exact test, t-test, and logistic regression. Survival data until 2021 were achieved from national statistical office of Korea. Kaplan–Meier method and cox-regression model were used for disease-specific survival (DSS) analysis.

Results

H-score of 90 in nucleus was appropriate cutoff value for ‘High PSMD1 expression’ in OPSCC. Tonsil was more frequent location in low PSMD1 group (42/52, 80.8%) than in high PSMD1 group (4/12, 33.3%; P = .002). Early-stage tumor was more frequent in in low PSMD1 group (45/52, 86.5%) than in high PSMD1 group (6/12, 50%; P = .005). HPV was more positive in low PSMD1 group (43/52, 82.7%) than in high PSMD1 group (5/12, 41.7%; P = .016). Patients with PSMD1 high expression showed poorer DSS than in patients with PSMD1 low expression (P = .006 in log rank test). In multivariate analysis, PSMD1 expression, pathologic T staging, and specimen age were found to be associated with DSS (P = .011, P = .025, P = .029, respectively).

Conclusions

In our study, we established PSMD1 as a negative prognostic factor in oropharyngeal squamous cell carcinoma, indicating its potential as a target for targeted therapy and paving the way for future in vitro studies on drug repositioning.
Integrative analysis of transcriptomic and metabolomic profiles reveals enhanced arginine metabolism in androgen-independent prostate cancer cells
Authors: Dai Xingchen , Shi Xinyi , Luo Mingxiu , Li Pu , Gao Yujing
Published: December 2023

Background

Prostate cancer is a common solid tumor that affects a significant number of men worldwide. Conventional androgen deprivation therapy (ADT) increases the risk of developing castration-resistant prostate cancer (CRPC). Effective clinical management of patients with CRPC is challenging due to the limited understanding.

Methods

In this study, transcriptomic and metabolomic profiles of androgen-dependent prostate cancer cell line LNCaP and the androgen-independent cells developed from LNCaP cells (LNCaP-ADR) were investigated using RNA-sequencing and LC-MS/MS, respectively. The differentially expressed genes and metabolites were analyzed, and integrative analysis of transcriptomic and metabolomic data was further conducted to obtain a comprehensive understanding of the metabolic characteristics in LNCaP-ADR cells. Quantitative real-time PCR (QPCR) was employed to ascertain the mRNA expression levels of the selected differentially expressed genes.

Results

The arginine and proline metabolism pathway was identified as a commonly altered pathway at both the transcriptional and metabolic levels. In the LNCaP-ADR cells, significant upregulation was observed for metabolites including 5-Aminopentanoic acid, L-Arginine, L-Glutamic acid, N-Acetyl-L-alanine, and Pyrrole-2-carboxylic acid at the metabolic level. At the transcriptional level, MAOA, ALDH3A2, ALDH2, ARG1, CKMT2, and CNDP1 were found to be significantly upregulated in the LNCaP-ADR cells. Gene set enrichment analysis (GSEA) identified various enriched gene sets in the LNCaP-ADR cells, encompassing inflammatory response, 9plus2 motile cilium, motile cilium, ciliary plasm, cilium or flagellum-dependent cell motility, cilium movement, cilium, response to endoplasmic reticulum stress, PTEN DN.V1 DN, SRC UP.V1 UP, IL15 UP.V1 DN, RB DN.V1 DN, AKT UP MTOR DN.V1 UP, VEGF A UP.V1 UP, and KRAS.LUNG.BREAST UP.V1 UP.

Conclusions

These findings highlight the substantial association between the arginine and proline metabolism pathway and CRPC, emphasizing the need to prioritize strategies that target dysregulated metabolites and differentially expressed genes as essential interventions in the clinical management of CRPC.
Epidemiological and clinical profile of pediatric hepatitis B virus infections in Wuhan: a retrospective cohort study
Authors: Wang Jun , Huang Yong-guo , Zeng Ye , Cai Qin-zhen , Wu Mo , Shen Xin , Tuo Wen-bin , Xie Si , Ma Xiang , Xiang Yun , Yuan Chun-hui , Yao Cong
Published: December 2023

Background

Hepatitis B virus (HBV) remains a substantial public health safety concern drawing considerable attention in China and globally. The detection of HBV serological markers can enable the assessment of HBV infection and replication status in vivo and evaluate the body’s protection against HBV. Therefore, this study aims to identify the epidemiological and clinical characteristics of HBV infection in children to prevent and control HBV infection in Wuhan areas.

Methods

We conducted an extensive retrospective cohort analysis of 115,029 individuals aged 0–18 years who underwent HBV serological markers detection for HBV infection in hospital between 2018 and 2021 using Electrochemiluminescence immunoassay. We generated descriptive statistics and analysed HBV infection’s epidemiological and clinical characteristics between different sex and age groups.

Results

The overall positive detection rates of HBsAg, HBsAb, HBeAg, HBeAb, and HBcAb in all participants were 0.13%, 79.09%, 0.17%, 2.81%, and 5.82%, respectively. The positive rate of HBeAb and HBcAb in males was significantly lower than that in females (2.64% vs. 3.13%, 5.56% vs. 6.29%) (P < 0.05). Twenty-two distinct HBV serological expression patterns were revealed. Among them, 8 common expression patterns accounted for 99.63%, while the remaining 14 uncommon expression patterns were primarily observed in neonatal patients with HBV infection. There are no significant differences in serological patterns based on sex (P < 0.05). The overall HBV infection detection rate was 5.82% [range 5.68–5.95] and showed a declining yearly trend. The rate in females was higher than that in males 6.29% [6.05, 6.35] vs. 5.56% [5.39, 5.59]. The overall HBV diagnostic rate over 4 years was 0.20% [0.17, 0.22], and the rate declined yearly. The prevalence of acute infection was higher than that of other infection types before 2019, but the incidence of unclassified infection showed a significant upward trend after 2019.

Conclusions

While the overall HBV infection detection rate in children has decreased year by year, the infection rate remains high in children under one year and between 4 and 18 years. This continued prevalence warrants heightened attention and vigilance.
Spatio-temporal modeling of human leptospirosis prevalence using the maximum entropy model
Authors: Shirzad Reza , Alesheikh Ali Asghar , Asgharzadeh Mojtaba , Hoseini Benyamin , Lotfata Aynaz
Published: December 2023

Background

Leptospirosis, a zoonotic disease, stands as one of the prevailing health issues in some tropical areas of Iran. Over a decade, its incidence rate has been estimated at approximately 2.33 cases per 10,000 individuals. Our research focused on analyzing the spatiotemporal clustering of Leptospirosis and developing a disease prevalence model as an essential focal point for public health policymakers, urging targeted interventions and strategies.

Methods

The SaTScan and Maximum Entropy (MaxEnt) modeling methods were used to find the spatiotemporal clusters of the Leptospirosis and model the disease prevalence in Iran. We incorporated nine environmental covariates by employing a spatial resolution of 1 km x 1 km, the finest resolution ever implemented for modeling Human Leptospirosis in Iran. These covariates encompassed the Digital Elevation Model (DEM), slope, displacement areas, water bodies, and land cover, monthly recorded Normalized Difference Vegetation Index (NDVI), monthly recorded precipitation, monthly recorded mean and maximum temperature, contributing significantly to our disease modeling approach. The analysis using MaxEnt yielded the Area Under the Receiver Operating Characteristic Curve (AUC) metrics for the training and test data, to evaluate the accuracy of the implemented model.

Results

The findings reveal a highly significant primary cluster (p-value < 0.05) located in the western regions of the Gilan province, spanning from July 2013 to July 2015 (p-value < 0.05). Moreover, there were four more clusters (p-value < 0.05) identified near Someh Sara, Neka, Gorgan and Rudbar. Furthermore, the risk mapping effectively illustrates the potential expansion of the disease into the western and northwestern regions. The AUC metrics of 0.956 and 0.952 for the training and test data, respectively, underscoring the robust accuracy of the implemented model. Interestingly, among the variables considered, the influence of slope and distance from water bodies appears to be minimal. However, altitude and precipitation stand out as the primary determinants that significantly contribute to the prevalence of the disease.

Conclusions

The risk map generated through this study carries significant potential to enhance public awareness and inform the formulation of impactful policies to combat Leptospirosis. These maps also play a crucial role in tracking disease incidents and strategically directing interventions toward the regions most susceptible.