bluuebunny/crossref_metadata_2025 huggingface dataset:
Evolving Project ECHO: delivery of pediatric pain core competency learning for interprofessional healthcare providers
Authors: Lalloo C. , Mohabir V. , Campbell F. , Sun N. , Klein S. , Tyrrell J. , Mesaroli G. , Stinson J.
Published: August 2023

Introduction

Healthcare providers (HCPs) practicing in community settings are critical to improving access to pain care, yet there are significant gaps in training opportunities designed for interprofessional learners. Project Extension for Community Healthcare Outcomes (Project ECHO®) is an established model for delivering online HCP education through virtual clinics and cultivating a community of practice. However, to our knowledge, the integration of pain core competency education into the ECHO® model has not been previously attempted. This innovation could enhance the ECHO® model while also addressing the growing calls for more accessible interprofessional pain curricula. This paper describes efforts to implement and evaluate core competency curricula within the context of Pediatric Project ECHO for Pain, one of the first pediatric-pain focused ECHO programs in the world.

Methods

Needs assessments informed curricula development. The first delivered core competency model consisted of synchronous webinar-style sessions while the second model included a mixture of asynchronous (eLearning course) and synchronous (virtual clinical debrief) elements. A convenience sample of HCPs was recruited from ECHO program registrants. Participants completed baseline and follow-up surveys to assess core competency acceptability as well as impact on knowledge and self-efficacy related to managing pediatric pain. Usability of the eLearning platform (model 2 only) was also evaluated. Surveys used 5-point Likert scales to capture outcomes. A priori targets included mean scores ≥4/5 for acceptability and ≥80% of learners reporting knowledge and self-efficacy improvements. The study received local research ethics approval.

Results

The core competency was found to be highly acceptable to interprofessional learners (n = 31) across delivery models, surpassing a priori targets. Specifically, it was characterized as a worthwhile and satisfactory experience that was helpful in supporting learning. The core competency was also associated with improvements in knowledge and self-efficacy by 97% and 90% of learners, respectively. The eLearning platform was reported to have high usability with clinically realistic cases (100% of respondents) that were helpful to inform care delivery (94% of respondents).

Conclusion

The integration of core competency learning within the Project ECHO® model was a successful approach to deliver pediatric pain education to interprofessional HCPs.
Determinants of caregiver's knowledge and practices regarding childhood fever management in a developing setting: a multi-centre cross-sectional assessment
Authors: Ogunyinka Ibrahim A. , Oshikoya Kazeem A. , Yusuff Kazeem B. , Tahir Yusuf , Yahaya Mohammed , Adeniye Sulaiman B. , Oforkansi Innocent E.
Published: August 2023

Introduction

Fever is both a sign of various diseases (chief of which are infectious in nature) and an adverse effect of certain interventions (e.g. vaccines, drugs) in the pediatric population. It elicits anxiety among caregivers and healthcare professionals alike resulting in non-evidence based practices, adverse medication administration events, waste of scarce resources and overutilization of health facilities. The determinants of these practices among caregivers in the domiciliary contexts have not been well characterized in developing settings.

Methods

We assessed the knowledge and practices of childhood fever and their determinants among caregivers in domiciliary settings in Northern Nigeria using a 41-item questionnaire between August 2020 and February 2021.

Results

The questionnaire is reliable (knowledge: Cronbach's Alpha = 0.689; practice: Cronbach's Alpha = 0.814) and collected data on a total of 2,400 caregiver-child pairs, who participated in the study. Over two-third (68.3%; 1,640) of the caregivers expressed fever phobic tendencies. Paracetamol was the most commonly used medication and constituted 31.3% of medication administration adverse events reported by the caregivers. Only one out of every six knowledgeable caregivers engaged in evidence-based home childhood fever management practices (7% vs. 41.6%) with being a primary caregiver [Knowledge: odd ratio (OR): 2.81, 95% CI: 0.38; 5.68; p value: 0.04; Practice: OR: 1.65, 95% CI: 0.09; 7.33; 0.02] and having a child/children aged ≤3 years (knowledge: OR: 7.03, 95% CI: 4.89; 9.67, p value: 0.003; practice OR: 3.11, 95% CI: 1.27; 8.59, 0.007) determining both the knowledge and practices of childhood fever management in a household.

Conclusions

The knowledge and practice of childhood fever management among caregivers were sub-optimal with being a primary caregiver and having a child/children aged ≤3 years being the significant determinants of each domain. These gaps underscore the dire need for targeted strategies aimed at improving childhood fever management by educating caregivers.
Outcomes of MIS-C patients treated with anakinra: a retrospective multicenter national study
Authors: Licciardi Francesco , Covizzi Carlotta , Dellepiane Marta , Olivini Nicole , Mastrolia Maria Vincenza , Lo Vecchio Andrea , Monno Viviana , Tardi Maria , Mauro Angela , Alessio Maria , Filocamo Giovanni , Cattalini Marco , Taddio Andrea , Caorsi Roberta , Marseglia Gian Luigi , La Torre Francesco , Campana Andrea , Simonini Gabriele , Ravelli Angelo , Montin Davide
Published: August 2023

Background

The treatment of multisystem inflammatory syndrome in children unresponsive to first-line therapies (IVIG and/or steroids) is challenging. The effectiveness of IL-1 receptor antagonist, anakinra, is debated.

Patients and methods

We conducted an anonymous retrospective multicenter study on MIS-C patients treated with anakinra in Italy from January 2020 to February 2021. Our study outcomes included the percentage of patients who required further therapeutic step-up, the percentage of patients who experienced fever resolution within 24 h and a reduction of CRP by half within 48 h, and the percentage of patients who developed Coronary Artery Anomalies (CAA) during follow-up.

Results

35 cases of MIS-C were treated in 10 hospitals. Of these, 13 patients started anakinra while in the ICU, and 22 patients started anakinra in other wards. 25 patients (71.4%) were treated with corticosteroids at a starting dose 2–30 mg/Kg/day plus IVIG (2 g/Kg), 10 patients (28.6%) received only corticosteroids without IVIG. Anakinra was administered intravenously to all patients in Group A (mean dose 8 mg/Kg/day), and subcutaneously in Group B (mean dose 4 mg/Kg/day). Only two patients required further treatment step-up and no patients developed CAA after receiving anakinra. The most commonly observed side effect was an increase in ALT, occurring in 17.1% of patients.

Conclusions

In this retrospective cohort of severe MIS-C patients treated with anakinra we report favorable clinical outcomes with a low incidence of side effects. The simultaneous use of steroids ± IVIG in these patients hinders definitive conclusions regarding the need of IL-1 inhibition in MIS-C treatment.
Posterior urethral hamartoma with hypospadias in a child: a case report and literature review
Authors: Hao Zipeng , Zhanghuang Chenghao , Zhang Kun , Hang Yu , Ji Fengming , Yan Bing , Tang Haoyu
Published: August 2023

Background

Hamartoma is a mass formed by the proliferation and disorder of two or more kinds of cells inherent in normal organs or anatomical parts, which can occur in any part of the body. The most common hamartoma are kidney hamartoma, spleen hamartoma, liver hamartoma, and lung hamartoma. Urethral hamartoma is extremely rare in clinical practice.

Case report

Combined with literature review, the diagnosis and treatment process of a child with posterior urethral hamartoma and hypospadias in our hospital were analyzed. The patient was cured after surgical treatment, the lesion was completely removed, the appearance was satisfactory, and there was no recurrence, urethral stricture, urethral fistula, and other complications. The pathological results of this case support the histological diagnosis of hamartoma, which provides reference for the clinical diagnosis and treatment of congenital malformation and tumor of urogenital in children.

Conclusion

When a child has posterior urethral hamartoma, the symptoms may not be very typical, and it is often combined with urethral malformation. Therefore, it is necessary to perform careful physical examination combined with pathological examination to be able to make an accurate diagnosis. Under normal circumstances, the prognosis of urethral hamartoma is good. However, more cases are needed to be observed for verification, and a long-term effective follow-up after surgery is needed.
What the pediatric endocrinologist needs to know about skeletal dysplasia, a primer
Authors: Legare Janet M. , Basel Donald
Published: August 2023

Children with skeletal dysplasia are frequently referred to pediatric endocrinologists due to short stature. These children may present with disproportionate growth or medical histories that point to a skeletal dysplasia. This primer will discuss when to be concerned about skeletal dysplasia, the initial steps in evaluation for a skeletal dysplasia, and new therapies that are either recently approved or in development.
Hallucinogenic potential: a review of psychoplastogens for the treatment of opioid use disorder
Authors: Hornick Mary G. , Stefanski Ashley
Published: August 2023

The United States is entering its fourth decade of the opioid epidemic with no clear end in sight. At the center of the epidemic is an increase in opioid use disorder (OUD), a complex condition encompassing physical addiction, psychological comorbidities, and socioeconomic and legal travails associated with the misuse and abuse of opioids. Existing behavioral and medication-assisted therapies show limited efficacy as they are hampered by lack of access, strict regimens, and failure to fully address the non-pharmacological aspects of the disease. A growing body of research has indicated the potential of hallucinogens to efficaciously and expeditiously treat addictions, including OUD, by a novel combination of pharmacology, neuroplasticity, and psychological mechanisms. Nonetheless, research into these compounds has been hindered due to legal, social, and safety concerns. This review will examine the preclinical and clinical evidence that psychoplastogens, such as ibogaine, ketamine, and classic psychedelics, may offer a unique, holistic alternative for the treatment of OUD while acknowledging that further research is needed to establish long-term efficacy along with proper safety and ethical guidelines.
Mechanism of Qingchang Suppository on repairing the intestinal mucosal barrier in ulcerative colitis
Authors: Shan Jingyi , Liu Suxian , Liu Haoyue , Yuan Jianye , Lin Jiang
Published: August 2023

Ulcerative colitis (UC) is a refractory inflammatory bowel disease, and the outcomes of conventional therapies of UC, including 5-aminosalicylic acid, glucocorticoids, immunosuppressants, and biological agents, are not satisfied with patients and physicians with regard to adverse reactions and financial burden. The abnormality of the intestinal mucosal barrier in the pathogenesis of UC was verified. Qingchang Suppository (QCS) is an herbal preparation and is effective in treating ulcerative proctitis. The mechanism of QCS and its active ingredients have not been concluded especially in mucosal healing. This review elucidated the potential mechanism of QCS from the intestinal mucosal barrier perspective to help exploring future QCS research directions.
Topological data analysis of Chinese stocks’ dynamic correlations under major public events
Authors: Guo Hongfeng , Ming Ziwei , Xing Bing
Published: August 2023

Topological data analysis has been acknowledged as one of the most successful mathematical data analytic methodologies in many fields. Additionally, it has also been gradually applied in financial time series analysis and proved effective in exploring the topological features of such data. We select 100 stocks from China’s markets and construct point cloud data for topological data analysis. We detect critical dates from the Lp-norms of the persistence landscapes. Our results reveal the dates are highly consistent with the transition time of some major events in the sample period. We compare the correlations and statistical properties of stocks before and during the events via complex networks to describe the markets’ situation. The strength and variation of links among stocks are clearly different during the major events. We also investigate the neighborhood features of stocks from topological perspectives. This helps identify the important stocks and explore their situations under each event. Finally, we cluster the stocks based on the neighborhood features, which exhibit the heterogeneity impact on stocks of the different events. Our work demonstrates that topological data analysis has strong applicability in the dynamic correlations of stocks.
Intelligent contour extraction approach for accurate segmentation of medical ultrasound images
Authors: Peng Tao , Wu Yiyun , Gu Yidong , Xu Daqiang , Wang Caishan , Li Quan , Cai Jing
Published: August 2023

Introduction: Accurate contour extraction in ultrasound images is of great interest for image-guided organ interventions and disease diagnosis. Nevertheless, it remains a problematic issue owing to the missing or ambiguous outline between organs (i.e., prostate and kidney) and surrounding tissues, the appearance of shadow artifacts, and the large variability in the shape of organs.

Methods: To address these issues, we devised a method that includes four stages. In the first stage, the data sequence is acquired using an improved adaptive selection principal curve method, in which a limited number of radiologist defined data points are adopted as the prior. The second stage then uses an enhanced quantum evolution network to help acquire the optimal neural network. The third stage involves increasing the precision of the experimental outcomes after training the neural network, while using the data sequence as the input. In the final stage, the contour is smoothed using an explicable mathematical formula explained by the model parameters of the neural network.

Results: Our experiments showed that our approach outperformed other current methods, including hybrid and Transformer-based deep-learning methods, achieving an average Dice similarity coefficient, Jaccard similarity coefficient, and accuracy of 95.7 ± 2.4%, 94.6 ± 2.6%, and 95.3 ± 2.6%, respectively.

Discussion: This work develops an intelligent contour extraction approach on ultrasound images. Our approach obtained more satisfactory outcome compared with recent state-of-the-art approaches . The knowledge of precise boundaries of the organ is significant for the conservation of risk structures. Our developed approach has the potential to enhance disease diagnosis and therapeutic outcomes.
When drought meets heat – a plant omics perspective
Authors: Xu Xiangyu , Fonseca de Lima Cassio Flavio , Vu Lam Dai , De Smet Ive
Published: August 2023

Changes in weather patterns with emerging drought risks and rising global temperature are widespread and negatively affect crop growth and productivity. In nature, plants are simultaneously exposed to multiple biotic and abiotic stresses, but most studies focus on individual stress conditions. However, the simultaneous occurrence of different stresses impacts plant growth and development differently than a single stress. Plants sense the different stress combinations in the same or in different tissues, which could induce specific systemic signalling and acclimation responses; impacting different stress-responsive transcripts, protein abundance and modifications, and metabolites. This mini-review focuses on the combination of drought and heat, two abiotic stress conditions that often occur together. Recent omics studies indicate common or independent regulators involved in heat or drought stress responses. Here, we summarize the current research results, highlight gaps in our knowledge, and flag potential future focus areas.
Are digital natives overconfident in their privacy literacy? Discrepancy between self-assessed and actual privacy literacy, and their impacts on privacy protection behavior
Authors: Ma Shuai , Chen Chen
Published: August 2023

Privacy literacy is recognized as a crucial skill for safeguarding personal privacy online. However, self-assessed privacy literacy often diverges from actual literacy, revealing the presence of cognitive biases. The protection motivation theory (PMT) is widely used to explain privacy protection behavior, positing that whether individuals take defensive measures depends on their cognitive evaluation of threats and coping capabilities. However, the role of cognitive biases in this process has been understudied in previous research. This study focuses on Chinese digital natives and examines the differential impacts of subjective and objective privacy literacy on privacy protection behavior, as well as the role of cognitive biases in privacy decision-making. The results show that there is no significant correlation between subjective and objective privacy literacy, and a bias exists. When privacy concern is used as a mediating variable, there are significant differences in the paths through which subjective and objective privacy literacy influence privacy protection behavior. Furthermore, privacy literacy overconfidence moderates the relationship between privacy concern and privacy protection behavior. The findings confirm the influence of cognitive biases in privacy behavior decision-making and extend the PMT. This study also calls for the government to enhance privacy literacy training for digital natives to improve their privacy protection capabilities.
Assessment of risk factors for suicidal behavior: results from the Tehran University of Medical Sciences Employees' Cohort study
Authors: Rezaei Zahed , Mohammadi Samira , Aghaei Abbas , Pouragha Hamidreza , Latifi Arman , Keshavarz-Mohammadi Nastaran
Published: August 2023

Introduction

Suicide is a major issue of concern for public health. It is estimated that suicide accounts for 700,000 deaths every year. A personal history of one or more suicide attempts is the most important determinant of suicide among the general population. This study aimed to assess the major risk factors associated with suicidal behaviors among Iranian employees in a medical setting.

Methods

In this study, 3,913 employees of Tehran University of Medical Sciences who participated in the employees' cohort study conducted by the university were recruited. Suicidal behaviors (SBs) and their associated risk factors were evaluated using the World Mental Health Composite International Diagnostic Interview (CIDI) Version 3.0. Univariate and multivariate logistic regressions were performed to identify the determinants of SBs among the participants, and crude and adjusted odds ratios (ORs) with corresponding 95% confidence intervals (95% CIs) were calculated.

Results

Overall, 49.6% of respondents (n= 1,939) reported that they were tired of life and thinking about death. The lifetime prevalence rate of suicidal ideation (SI) was 8.1% (n= 317), that of suicide planning (SP) was 7.3% (n= 287), and that of suicide attempts (SA) was 3.1% (n= 122). Being female (OR: 1.87, CI: 1.64–2.12), being divorced (OR: 3.13, CI: 1.88–5.22), having a low level of education (OR: 1.57, CI: 1.15–2.14), and working in clinical and medical services (OR: 1.25, CI: 1.09–1.43) were associated with being tired of life and thinking about death. These factors were also associated with SI, SP, and SA.

Discussion

These findings highlight the need to prioritize mental health for suicide prevention, especially for high-risk groups, in workplace mental health promotion programs and policies.
Are relative educational inequalities in multiple health behaviors widening? A longitudinal study of middle-aged adults in Northern Norway
Authors: Ibarra-Sanchez Ana Silvia , Chen Gang , Wisløff Torbjørn
Published: August 2023

Introduction

Educational inequality in multiple health behaviors is rarely monitored using data from the same individuals as they age. The aim of this study is to research changes in relative educational inequality in multiple variables related to health behavior (smoking, physical activity, alcohol intake, and body mass index), separately and collectively (healthy lifestyle), among middle-aged adults living in Northern Norway.

Methods

Data from adult respondents aged 32–87 in 2008 with repeated measurements in 2016 (N = 8,906) were drawn from the sixth and seventh waves of the Tromsø Study. Logistic regression was used to assess the relative educational inequality in the variables related to health behavior. The analyses were performed for the total sample and separately for women and men at both baseline and follow-up.

Results

Educational inequality was observed in all the variables related to health behavior at baseline and follow-up, in both men and women. Higher levels of educational attainment were associated with healthier categories (non-daily smoking, physical activity, normal body mass index, and a healthy lifestyle), but also with high alcohol intake. The prevalence of daily smoking and physical inactivity decreased during the surveyed period, while high alcohol intake, having a body mass index outside of the normal range and adhering to multiple health recommendations simultaneously increased. The magnitude of relative educational inequality measured at baseline increased at the follow-up in all the variables related to health behavior. Differences were larger among women when compared to men, except in physical inactivity.

Conclusion

Persistent and increasing relative disparities in health behavior between the highest education level and lower education levels are found in countries with well-established and comprehensive welfare systems like Norway. Addressing these inequalities is essential for reducing both the chronic disease burden and educational disparities in health.
Perceptions of the health risk from hot days and the cooling effect of urban green spaces: a case study in Xi’an, China
Authors: Zhang Tian , Huang Rong , Yang Mei , Lin Guohua , Ma Xiaoyan , Wang Xuan , Huang Qian
Published: August 2023

Background

Hot days are one of the typical threats to human health and sustainable cities. The exploration of residents’ perceptions of thermal environment and its mitigation measures will support the health risk prevention.

Methods

A survey with a combination of closed-ended and open-ended questions was conducted in July 2021 among 13 urban parks in Xi’an City, China. With the help of ANOVA and ordinal logistic regression, this study investigated the influencing factors both on residents’ health risk perception of hot days and their perception of the effect of urban ecological landscape on reducing the thermal risk. The relationship between health risk perception and residents’ needs of urban ecological construction was also explored.

Results

According to 325 valid questionnaires, the male-female ratio of respondents was found to be 1:0.87, young people aged 18-29 (26.46%), the retirees (27.08%) and the ones with undergraduate education (33.23%) were, relatively, the largest groups. The results show that 92.31% of the respondents believed that their daily lives were under the influence of hot days. Housing types, occupation, cooling equipment at work, and outdoor working hours all had a significant impact on their high temperature perceptions. The proportion of respondents who were under a huge health risk and sought medical treatment due to hot days was 30.16% and 44.92%, respectively. Women were 18.52 and 2.33 times more likely to suffer health threats and experience discomforts than men. Furthermore, 73.23% of the respondents believed that the urban ecological landscapes in Xi’an had an enhanced cooling effect in recent years. Compared with the morphological characteristics, residents’ recognition of the restriction of landscape’s area on its cooling effect was higher, and the residence duration showed a significant influence.

Conclusion

The cooling effect of green spaces and water effectively resisted urban thermal threats, and residents’ needs of the urban ecological landscapes was associated with their health risk perceptions of hot days. In the future, it is necessary to promote the early warning of hot days, meanwhile, the optimization of landscape patterns of green infrastructures should be implemented in urban planning for the purposes of residents’ health risk prevention.
Evolutionary game and stability analysis of elderly care service quality supervision from the perspective of government governance
Authors: Wang Qiangxiang , Liu June , Zheng Yue
Published: August 2023

Objective

The performance of government functions is an important guarantee for the standardized operation of the elderly service market. The objective of this study is to explore the optimal path for the government to govern the elderly care service market.

Methods

The tripartite evolutionary game model is proposed in the paper, which composed of local governments, private elderly care institutions and the public. Furthermore, three mechanisms, i.e. dynamic penalty and static subsidy, static penalty and dynamic subsidy, dynamic penalty and dynamic subsidy, are designed. Under these different mechanisms, the stability of each subject’s strategy choice is analyzed by using system dynamics simulation.

Results

The introduction of dynamic mechanisms can compensate for the inability of static mechanisms to bring the system to a steady state. The dynamic penalty and dynamic subsidy mechanism allows the system to evolve to the desired point of stability. The self-discipline behavior of private elderly care institutions is positively correlated with penalties and reputation gains-losses, negatively correlated with subsidies, and not correlated with supervision rewards. Excessive subsidies will promote the collusion of private elderly institutions.

Conclusion

Only when the local government adopts the dynamic penalty and dynamic subsidy mechanism will private elderly care institutions choose to operate in a fully self-disciplined manner. Reasonable adjustments of penalties, reputation gains-losses and subsidies can not only further optimize the dynamic penalty and dynamic subsidy mechanism, but also help to achieve diversified regulatory objectives of the government. This study would provide a reference for local governments seeking to develop effective regulatory policies for the elderly service market.
Racial and ethnic disparities in telehealth use before and after California's stay-at-home order
Authors: Bustamante Arturo Vargas , Martínez Laura E. , Jalal Siavash , Benitez Santos Nayelie , Félix Beltrán Lucía , Rich Jeremy , Anaya Yohualli Balderas-Medina
Published: August 2023

Introduction

Telehealth can potentially improve the quality of healthcare through increased access to primary care. While telehealth use increased during the COVID-19 pandemic, racial/ethnic disparities in the use of telemedicine persisted during this period. Little is known about the relationship between health coverage and patient race/ethnicity after the onset of the COVID-19 pandemic.

Objective

This study examines how differences in patient race/ethnicity and health coverage are associated with the number of in-person vs. telehealth visits among patients with chronic conditions before and after California's stay-at-home order (SAHO) was issued on 19 March 2020.

Methods

We used weekly patient visit data (in-person (N = 63, 491) and telehealth visits (N = 55, 472)) from seven primary care sites of an integrated, multi-specialty medical group in Los Angeles County that served a diverse patient population between January 2020 and December 2020 to examine differences in telehealth visits reported for Latino and non-Latino Asian, Black, and white patients with chronic conditions (type 2 diabetes, pre-diabetes, and hypertension). After adjusting for age and sex, we estimate differences by race/ethnicity and the type of insurance using an interrupted time series with a multivariate logistic regression model to study telehealth use by race/ethnicity and type of health coverage before and after the SAHO. A limitation of our research is the analysis of aggregated patient data, which limited the number of individual-level confounders in the regression analyses.

Results

Our descriptive analysis shows that telehealth visits increased immediately after the SAHO for all race/ethnicity groups. Our adjusted analysis shows that the likelihood of having a telehealth visit was lower among uninsured patients and those with Medicaid or Medicare coverage compared to patients with private insurance. Latino and Asian patients had a lower probability of telehealth use compared with white patients.

Discussion

To address access to chronic care management through telehealth, we suggest targeting efforts on uninsured adults and those with Medicare or Medicaid coverage, who may benefit from increased telehealth use to manage their chronic care.
Social interaction trajectories and all-cause mortality in older adults: the Otassha study
Authors: Kawai Hisashi , Ejiri Manami , Ito Kumiko , Fujiwara Yoshinori , Ihara Kazushige , Hirano Hirohiko , Sasai Hiroyuki , Kim Hunkyung , Obuchi Shuichi
Published: August 2023

Introduction

This longitudinal study aimed to identify aging trajectory patterns of social interaction by sex and determine the association between these patterns and all-cause mortality.

Methods

Participants were 4,065 community-dwelling older adults (1849 men) in Japan, aged 65–89 years, who responded twice or more to a mail survey conducted between 2012 and 2020. Social interaction was examined through the frequency of face-to-face and non-face-to-face contact with non-resident family and friends. The aging trajectories of the social interaction scores were identified using group-based trajectory modeling.

Results

Two groups were identified among both men and women. Among men with high-frequency interaction, a rapid decrease in the frequency of social interaction was observed after 80 years of age. Conversely, among women, the frequency tended to remain the same, even after 80 years of age. The social interaction score among those aged 65 years in the low-frequency group was approximately 4 points for men and 6 points for women. Among men, no decrease was observed; however, it tended to decline after 85 years of age among women. Among men, the factors associated with the low-frequency group were instrumental activities of daily living score, perceived financial status, and social participation, while among women, they were self-rated health and social participation. The adjusted hazard ratio in the low-frequency group for all-cause mortality was 1.72 (95% confidence interval, 1.27–1.72) for men and 1.45 (95% confidence interval, 0.98–2.14) for women.

Discussion

In the low-frequency group, men had a higher risk of all-cause mortality than women. Daily social interaction from mid-age is important to reduce the risk of social isolation and all-cause mortality in later life.
Learning and reasoning with graph data
Authors: Jaeger Manfred
Published: August 2023

Reasoning about graphs, and learning from graph data is a field of artificial intelligence that has recently received much attention in the machine learning areas of graph representation learning and graph neural networks. Graphs are also the underlying structures of interest in a wide range of more traditional fields ranging from logic-oriented knowledge representation and reasoning to graph kernels and statistical relational learning. In this review we outline a broad map and inventory of the field of learning and reasoning with graphs that spans the spectrum from reasoning in the form of logical deduction to learning node embeddings. To obtain a unified perspective on such a diverse landscape we introduce a simple and general semantic concept of a model that covers logic knowledge bases, graph neural networks, kernel support vector machines, and many other types of frameworks. Still at a high semantic level, we survey common strategies for model specification using probabilistic factorization and standard feature construction techniques. Based on this semantic foundation we introduce a taxonomy of reasoning tasks that casts problems ranging from transductive link prediction to asymptotic analysis of random graph models as queries of different complexities for a given model. Similarly, we express learning in different frameworks and settings in terms of a common statistical maximum likelihood principle. Overall, this review aims to provide a coherent conceptual framework that provides a basis for further theoretical analyses of respective strengths and limitations of different approaches to handling graph data, and that facilitates combination and integration of different modeling paradigms.
Rural barriers and facilitators of lung cancer screening program implementation in the veterans health administration: a qualitative study
Authors: Lewis Jennifer A. , Bonnet Kemberlee , Schlundt David G. , Byerly Susan , Lindsell Christopher J. , Henschke Claudia I. , Yankelevitz David F. , York Sally J. , Hendler Fred , Dittus Robert S. , Vogus Timothy J. , Kripalani Sunil , Moghanaki Drew , Audet Carolyn M. , Roumie Christianne L. , Spalluto Lucy B.
Published: August 2023

Introduction

To assess healthcare professionals' perceptions of rural barriers and facilitators of lung cancer screening program implementation in a Veterans Health Administration (VHA) setting through a series of one-on-one interviews with healthcare team members.

Methods

Based on measures developed using Reach Effectiveness Adoption Implementation Maintenance (RE-AIM), we conducted a cross-sectional qualitative study consisting of one-on-one semi-structured telephone interviews with VHA healthcare team members at 10 Veterans Affairs medical centers (VAMCs) between December 2020 and September 2021. An iterative inductive and deductive approach was used for qualitative analysis of interview data, resulting in the development of a conceptual model to depict rural barriers and facilitators of lung cancer screening program implementation.

Results

A total of 30 interviews were completed among staff, providers, and lung cancer screening program directors and a conceptual model of rural barriers and facilitators of lung cancer screening program implementation was developed. Major themes were categorized within institutional and patient environments. Within the institutional environment, participants identified systems-level (patient communication, resource availability, workload), provider-level (attitudes and beliefs, knowledge, skills and capabilities), and external (regional and national networks, incentives) barriers to and facilitators of lung cancer screening program implementation. Within the patient environment, participants revealed patient-level (modifiable vulnerabilities) barriers and facilitators as well as ecological modifiers (community) that influence screening behavior.

Discussion

Understanding rural barriers to and facilitators of lung cancer screening program implementation as perceived by healthcare team members points to opportunities and approaches for improving lung cancer screening reach, implementation and effectiveness in VHA rural settings.
Ear Tubes: When Do We Need Them?
Authors: Jekic Danica , Wagner Siobhan , Perdigon Veronica
Published: August 2023

The human ear is a fascinating organ that allows us to hear and process all kinds of sounds. It is divided into three sections: the outer, middle, and inner ear. Sometimes, the middle ear can become filled with fluid due to ear infections or structural problems, which makes it difficult to hear sounds. To fix this, doctors called ear, nose, and throat specialists might perform a simple surgery to insert small ear tubes into the eardrum, to drain the fluid behind it. After surgery, the tubes allow children to hear properly, but they must continue to take care of their ears and protect them from germs. The process may seem scary to kids, but it can be very easy as long as they are prepared!
Microclimate characteristics and multi-effect analysis of facade and rooftop agriculture based on in-situ observation and meta-analysis
Authors: Li Yazhe , Ma Enpu , Liao Liuwen , Li Jiaqi , Zhu Shuxuan , Zhang Qiyue
Published: August 2023

Facade and rooftop agriculture has great potential in regulating urban local microclimate, building energy conservation and carbon emission reduction. This study aims to address the limitation that the existing studies lack multi-effect simulations of integrated implementation of facade and rooftop agriculture. It takes into account the variability and complexity of thermal coefficients in planting layers during the simulations. By analyzing in-situ observations, the study examines the regulatory impact of integrated agriculture on urban microclimate. Furthermore, it uses observed data instead of DeST temperature database data to simulate the energy-saving effect and carbon emission reduction. In order to analyse the average economic efficiency of rooftop and facade agriculture in China, the study conducts a meta-analysis of existing cases in China. The results of the study are as follows: (1) The thermal insulation efficiency of the facade and rooftop integrated agriculture varies with weather conditions and diurnal variations. It reaches the strongest (1.68°C) on sunny days and around noon, (2) The integrated implementation of facade and rooftop agriculture on a normal home building in Changsha can save a total of 12,226.30 kW·h (5%) of electricity per year, and thus reducing 2,809.26 kg of carbon emissions, and (3) Based on meta-analysis and LCA calculation, the average net present value of the project in China for 40a is RMB -937712.18. The economic efficiency needs to be optimized. The results of this study reveal the ideal ecological benefits of facade and rooftop agriculture and the economic efficiency that hinders their implementation, providing a theoretical basis for building energy conservation and renovation, and the economic efficiency optimization in the regions with hot summer and cold winter.
How to reduce the impact of contaminated seafood on public health with the discharge of Fukushima nuclear wastewater
Authors: Bai Yuntao , Yuan Xiaolong , Wang Lan
Published: August 2023

As wastewater from the Fukushima nuclear disaster continues to drain into the sea, the supply system for healthy seafood is being seriously challenged. To protect public health, it is necessary to restructure the seafood supply mode. The seafood supply mode is divided into the original mode, land farming mode, and strengthen monitoring mode. To derive the applicable scope of the various modes of the seafood supply chain and to provide recommendations for the safety and sustainability of seafood supply chains for governments and enterprises, three differential game models are constructed in this study. Then, the equilibrium results obtained by the models are compared and analyzed. Based on the findings, the health impact of seafood pollution is relatively small, and the government tends to choose the original supply mode. As the health impact of seafood grows, governments tend to prefer land-based farming. The social benefit to the government is directly proportional to the monitoring cost of seafood. To protect public health, enterprises tend to choose the mode of strengthen monitoring if the proportion of unqualified seafood is low. In addition, if sea products show a high degree of adaptation to the land environment, they tend to choose land farming.
The Association Between Urinary Concentrations of Organophosphate Metabolites and Asthma-Related Outcomes Among Schoolchildren From Informal Settlements
Authors: Mthethwa Mashudu , Jeebhay Mohamed , Olaniyan Toyib , Wiesner Lubbe , Parker Bhawoodien , Leaner Joy , Röösli Martin , Dalvie Mohamed Aqiel
Published: August 2023

Objectives: There is inconsistent evidence on the relationship between pesticide exposure and childhood respiratory outcomes in non-agricultural settings. This study investigated the association between organophosphate (OP) pesticide exposure and asthma-related outcomes in children residing in four informal settlements.

Methods: The study was a longitudinal study of 590 schoolchildren, with a 12 months follow-up period. A standardised questionnaire adopted from the International Study of Asthma and Allergies in Childhood was administered to caregivers for child’s respiratory symptoms and household characteristics. Spirometry and fractional-exhaled nitric oxide, including a phadiatop test (atopy status) and urinary dialkyl phosphate (DAP) metabolites were measured at baseline and follow-up. DAP metabolites included diethylphosphate (DEP) and dimethyl phosphate (DMP) measured at baseline and follow-up and dimethylthiophosphate (DMTP) measured only at baseline.

Results: The mean ages of schoolchildren were 9.9 ± 0.91 years and the overal incidence proportions of new doctor diagnosed asthma was 2.2%. No consistent patterns of increased risk of asthma outcomes with increasing DAP concentrations was found in multivariate analysis.

Conclusion: Future studies with longer follow-up periods and repeated OP biomonitoring are recommended.
Reliability Evaluation Based on the Colored Petri Net Converted from AADL Models for the Wheel Brake System of Aircraft
Authors: Huang Mingyuan , Cheng Dawei , Zhou Jia , Lu Zhong
Published: August 2023

Traditional reliability analysis methods such as Reliability Block Diagram, Fault Tree Analysis, and Markov Analysis are all subjective methods whose results significantly depend on the analysts’ skills and experiences. A model-based reliability method is proposed for the wheel brake system by using the architectural analysis and design language (AADL). The wheel brake system is modeled based on the AADL, and the AADL Error Model Annex is applied to describe the fault propagation of the system. An information extraction approach is proposed for the AADL-based model, and rules for transforming AADL-based models to colored Petri nets are given according to the information extracted. The reliability analysis of the wheel brake system is conducted in terms of the Colored Petri Nets. Through Monte Carlo simulation and linear regression, it is inferred that the lifetime of the wheel brake system follows a Weibull distribution with shape parameter 1.303 and scale parameter 9.992 × 103, and the accuracy of the method has been verified. In this study, the reliability analysis results are generated via the system model automatically; they do not depend on the analysts’ experiences and skills, and ambiguity among different analysts can be avoided.
Engineering and Purification of Microcin C7 Variants Resistant to Trypsin and Analysis of Their Biological Activity
Authors: Yang Guangxin , Shang Lijun , Liu Lu , Li Zeqiang , Zeng Xiangfang , Ding Xiuliang , Huang Jinxiu , Qiao Shiyan , Yu Haitao
Published: August 2023

Microcin C7 (McC) as a viable form of antimicrobial has gained substantial attention due to its distinctive antimicrobial activity, by targeting aspartyl tRNA synthetase. McC can be a potential solution against pathogenic microbial infections in the postantibiotic era. However, considering that degradation by digestive enzymes can disrupt the function of this peptide in the gastrointestinal tract, in this study, we attempt to design McC variants to overcome several barriers that may affect its stability and biological activity. The mccA gene encoding the McC peptide precursor was mutated and 12 new McC variants with trypsin resistance were found. The Yej+rimL− strain was used as an indicator to determine the minimum inhibitory concentrations (MICs). The results showed that three variants, including R2A, R2T and R2Q, among 12 variants formed by the replacement of the second arginine of the McC peptide with different amino acids, were resistant to trypsin and had an outstanding antimicrobial ability, with MIC values of 12.5, 25, and 25 μg/mL, respectively. Taken together, our findings show that the engineering of the site-directed mutagenesis of McC significantly enhances McC trypsin resistance and maintains a great antimicrobial activity.
Existence of Solutions of Impulsive Partial Hyperbolic Differential Inclusion of Fractional Order
Authors: Tadema Ayokunle J. , Ogundiran Micheal O.
Published: August 2023

This paper is concerned with the existence of solutions of a class of Cauchy problems for hyperbolic partial fractional differential inclusions (HPFD) involving the Caputo fractional derivative with an impulse whose right hand side is convex and non-convex valued. Our results are achieved within the framework of the nonlinear alternative of Leray-Schauder type and contraction multivalued maps. A detailed example was provided to support the theorem.
Neural Plasticity Changes Induced by Motor Robotic Rehabilitation in Stroke Patients: The Contribution of Functional Neuroimaging
Authors: Bonanno Lilla , Cannuli Antonio , Pignolo Loris , Marino Silvia , Quartarone Angelo , Calabrò Rocco Salvatore , Cerasa Antonio
Published: August 2023

Robotic rehabilitation is one of the most advanced treatments helping people with stroke to faster recovery from motor deficits. The clinical impact of this type of treatment has been widely defined and established using clinical scales. The neurofunctional indicators of motor recovery following conventional rehabilitation treatments have already been identified by previous meta-analytic investigations. However, a clear definition of the neural correlates associated with robotic neurorehabilitation treatment has never been performed. This systematic review assesses the neurofunctional correlates (fMRI, fNIRS) of cutting-edge robotic therapies in enhancing motor recovery of stroke populations in accordance with PRISMA standards. A total of 7, of the initial yield of 150 articles, have been included in this review. Lessons from these studies suggest that neural plasticity within the ipsilateral primary motor cortex, the contralateral sensorimotor cortex, and the premotor cortices are more sensitive to compensation strategies reflecting upper and lower limbs’ motor recovery despite the high heterogeneity in robotic devices, clinical status, and neuroimaging procedures. Unfortunately, the paucity of RCT studies prevents us from understanding the neurobiological differences induced by robotic devices with respect to traditional rehabilitation approaches. Despite this technology dating to the early 1990s, there is a need to translate more functional neuroimaging markers in clinical settings since they provide a unique opportunity to examine, in-depth, the brain plasticity changes induced by robotic rehabilitation.