bluuebunny/crossref_metadata_2025 huggingface dataset:
Carpometacarpal Osteoarthritis Pain of the Thumb Can Be Relieved by Commercial Beverage Carbonated Water
Authors: Nakajima Masaaki
Published: February 2024

Thumb carpometacarpal (CMC) arthropathy pain is treated using carbonated water—a commercially available beverage. The right hand (affected side) was bathed once daily in carbonated beverage water (37°C) for 20 min. Prior to treatment, the visual analogue scale score of pain was 73 mm; 1 week after the treatment, it was 0 mm. Commercial carbonated water immersion was effective for thumb CMC arthropathy pain. Commercial carbonated water is inexpensive and easy to obtain, making it suitable for home carbonation therapy.
A Preliminary Survey of Medium- and Large-Sized Mammals and Their Conservation Status in the Asimba Forest Priority Area, Semiarid Highlands of Northern Ethiopia
Authors: Girmay Teklay , Tesfay Haylegebriel
Published: February 2024

Mammal species provide vital environmental and economic functions although they globally face numerous threats. Knowledge of the composition and diversity of mammal species provide information for appropriate management interventions. We conducted this study from July 2019 to February 2020 to assess the species composition, diversity, and conservation of medium- and large-sized mammals in the Asimba Forest Priority Area, northern Ethiopia. Data were collected through direct and indirect evidence from three habitat types, namely, natural forest, bushland, and plantation forest. We analyzed the data using descriptive statistics and the Species Diversity Index. We also used χ2 to compare differences in the number of observations and species richness of the mammal species in different habitats between the dry and wet seasons. A total of 263 observations were compiled, and 15 medium- and large-sized mammalian species were recorded in the Asimba Forest Priority Area. The Species Diversity Index and Evenness of the area were H′ = 2.436 and J = 0.899, respectively. Hamadryas baboon (Papio hamadryas) was the most commonly observed species, with 20.7 and 19.2 relative frequencies in the dry and wet seasons, respectively, whereas striped polecat (Ictonyx striatus) was the rarest species, with 3.0 and 0.0 relative frequencies during the dry and wet seasons, respectively. The number of observations (χ2 = 2.298, df = 2, and p=0.316) and species richness (χ2 = 0.115, df = 2, and p=0.943) did not differ significantly in the three habitats. Anthropogenic factors, mainly habitat destruction and overgrazing, were widely observed in the Asimba forest as conservation threats to the mammal species. The current study helps to increase knowledge about the mammal species of the area and is essential for their future conservation strategies.
Breast Cancer Stage and Size Detected with Film versus Digital Mammography in New South Wales, Australia: A Population-Based Study Using Routinely Collected Data
Authors: Farber Rachel , Houssami Nehmat , McGeechan Kevin , Barratt Alexandra , Bell Katy J.L.
Published: February 2024

Background:

Digital mammography has replaced film mammography in breast-screening programs globally, including Australia. This led to an increase in the rate of detection, but whether there was increased detection of clinically important cancers is uncertain.

Methods:

In this population-wide retrospective cohort study in New South Wales, Australia spanning 2004 to 2016 and including 4,631,656 screens, there were 22,965 cancers in women screened with film (n = 11,040) or digital mammography (n = 11,925). We examined the change in tumor characteristics overall and how these rates changed over time, accounting for changes in background rates using an interrupted time-series. Comparisons were made with unscreened women (n = 26,326) during this time.

Results:

We found increased detection of in situ cancer (3.36 per 10,000 screens), localized invasive, and smaller-sized breast cancers attributable to the change in mammography technology, whereas screen-detected intermediate-sized and metastatic breast cancers decreased. Rates of early-stage and intermediate-sized interval cancers increased, and late-stage (−1.62 per 10,000 screens) and large interval cancers decreased. In unscreened women, there were small increases in the temporal trends of cancers across all stages.

Conclusions:

At least some of the increased detection of smaller early-stage cancers may have translated into a reduction in larger and late-stage cancers, indicating beneficial detection of cancers that would have otherwise progressed. However, the increased detection of smaller early-stage and small cancers may also have increased over-diagnosis of lesions that would otherwise have not caused harm.

Impact:

Robust evaluation of potential benefits and harms is needed after changes to screening programs.

See related In the Spotlight, p. 638
COL12A1 Gene Variant and a Review of the Literature: A Case Report of Ullrich Congenital Muscular Dystrophy
Authors: İpek Rojan , Çavdartepe Büşra Eser , Bozdoğan Sevcan Tuğ , Yiş Uluç
Published: February 2024

Introduction: Mutations in collagen type IV-associated genes lead to Ullrich congenital muscular dystrophy (UCMD) and Bethlem myopathy (BM). COL12A1 gene mutations have rarely been reported in patients with UCMD- and BM-like disorders not involving COL6 mutations. UCMD-2 results from homozygous mutations in the COL12A1 gene on the long arm of chromosome 6. Pathogenic variants in COL12A1 result in a rare congenital connective tissue/myopathy overlap syndrome under the heading of myopathic Ehlers-Danlos syndrome. COL12A1 dominant pathogenic variants have been rarely reported, and the phenotypic spectrum has not yet been identified. Case Presentation: We describe a female patient aged 2 years and 10 months exhibiting a milder phenotype who presented due to pronounced joint hyperlaxity, frequent falls, and skin lesions. Genetic analysis revealed a homozygous c.8903C>T (p.Pro2968Leu) missense variant that had previously been described but concerning which there had been no clinical report, in the COL12A1 gene. Discussion/Conclusion: This report is presented in order to raise awareness of rare mutations in the COL12A1 gene that affect muscle and connective tissue and to add to the literature in defining the phenotypic spectrum.
Evidence in Focus: The Sparse Landscape of Randomized Trials on Retinoblastoma Treatment
Authors: Lavasidis Georgios , Papaioannou Kyriaki , Anagnostou Nikolaos , Ketteler Petra , Bechrakis Nikolaos E. , Ntzani Evangelia
Published: February 2024

Background: Retinoblastoma, although rare, is one of the most common intraocular malignancies worldwide. Its prognosis has improved significantly in the past few decades, thanks to modern treatments, like systemic, intra-arterial, and intravitreal chemotherapy. However, regarding survival, there are significant differences between high- and low-income countries, eye salvage is still a challenge worldwide, and treatment-related toxicity needs to be carefully and sufficiently managed. Summary: To appraise the strength of supporting evidence, we performed a systematic review of randomized controlled trials investigating any therapeutic protocol for retinoblastoma. Four trials with 174 participants (188 eyes) were eligible, all pertaining to different intravenous chemotherapy regimens. Vincristine, etoposide, and carboplatin (VEC) appear superior to a 5-drug combination for stage III retinoblastoma. Moreover, etoposide and carboplatin as neoadjuvant chemotherapy followed by thermochemotherapy seem to offer better local control than vincristine and carboplatin. However, increasing carboplatin dose in the VEC protocol failed to improve treatment efficacy. Key Messages: Retinoblastoma is a success story of modern medicine. However, only intravenous chemotherapy has been studied through randomized trials, while evidence for the most novel retinoblastoma treatments has mainly stemmed from observational studies. International collaborations for multicenter randomized trials could overcome difficulties and increase certainty and precision in the field.
Independent Association between Cognitive Frailty and Cardio-Ankle Vascular Index in Community-Dwelling Older Adults
Authors: Akaida Shoma , Taniguchi Yoshiaki , Nakai Yuki , Kiuchi Yuto , Tateishi Mana , Shiratsuchi Daijo , Takenaka Toshihiro , Kubozono Takuro , Ohishi Mitsuru , Makizako Hyuma
Published: February 2024

Introduction: Although arterial stiffness has been suggested to be associated with poor physical function and mild cognitive impairment (MCI), its association with cognitive frailty (CF), a comorbidity of both, is unclear. This study aims to examine the association between CF and arterial stiffness in community-dwelling older adults. Methods: A cross-sectional analysis of 511 community-dwelling older adults aged 65 years or older (mean age 73.6 ± 6.2 years, 63.6% women), who participated in a community cohort study (Tarumizu Study, 2019), was conducted. Poor physical function was defined as either slowness (walking speed <1.0 m/s) or weakness (grip strength <28 kg for men and <18 kg for women). MCI was defined by the National Center for Geriatrics and Gerontology Functional Assessment Tool as a decline of at least 1.5 standard deviation from age- and education-adjusted baseline values in any one of the four cognitive domains (memory, attention, executive, and information processing). CF was defined as the combination of poor physical function and MCI. Arterial stiffness was measured using the Cardio-Ankle Vascular Index (CAVI), and the average of the left and right sides (mean CAVI) was used. Results: Multinomial logistic regression analysis adjusted for covariates was performed with the four groups of robust, poor physical function, MCI, and CF as dependent variables and mean CAVI as an independent variable. Using the robust group as reference, the poor physical function and MCI groups showed no significant relationship with the mean CAVI. The mean CAVI was significantly higher in the CF group (odds ratio 1.62, 95% confidence interval: 1.14–2.29). Conclusion: A significant association was found between CF and the higher CAVI (progression of arterial stiffness). Careful observation and control of CAVI, which is also an indicator of arterial stiffness, may be a potential target for preventive interventions for CF.
Efficacy of Topical Palmitoylethanolamide (Levagen+) for the Management of Eczema Symptoms: A Double-Blind, Comparator-Controlled, Randomized Clinical Trial
Authors: Rao Amanda , Moussa Amel A. , Erickson Jane , Briskey David
Published: February 2024

Introduction: Eczema is a debilitating skin disorder clinically characterised by the development of itchy, dry, rough, and scaling skin caused by a series of rudimentary clinical phenotypes. Methods: This double-blind, randomised, comparator-controlled trial evaluated the effectiveness of topical application of a novel palmitoylethanolamide formulation (Levagen+) compared with a standard moisturiser (comparator) to reduce eczema severity and improve patient outcomes. Seventy-two participants aged over 18 years old with atopic eczema (symptoms including redness, dry skin, scaling, and/or itchiness) on their hands or arm were recruited. Participants were randomly allocated to one of two treatment groups (Levagen + or comparator). Treatment was applied to the affected area twice daily for 4 weeks. Outcome measures included Self-Assessed Eczema Area Severity Index (SA-EASI) scoring and Patient-Oriented Eczema Measure (POEM) from baseline to week 4. Results: Levagen+ was effective at alleviating symptom severity of eczema over 4 weeks. Levagen+ significantly reduced redness, dryness, and total POEM score compared to a comparator cream. Conclusion: Levagen+ can significantly reduce eczema symptom severity compared to a comparator product, supporting its use as a potential treatment for eczema. Trial registration: clinicaltrials.gov Identifier: NCT05003453.
Association between Perceived Stress and Motoric Cognitive Risk Syndrome in an Elderly Population: Rugao Longevity and Aging Study
Authors: Cao Yuan-Fei , Shi Guo-Ping , Zhang Hui , Sun Meng-Zhen , Wang Zheng-Dong , Chu Xue-Feng , Guo Jiang-Hong , Wang Xiao-Feng
Published: February 2024

Introduction: Previous studies have indicated a correlation between perceived stress and cognitive decline. However, it remains unknown whether high levels of perceived stress can result in motoric cognitive risk (MCR) syndrome. This study investigated the relationship between perceived stress and MCR in a community-based population. Methods: The study cohort comprised 852 elderly individuals from the Rugao Longitudinal Aging Cohort. Perceived stress was assessed using the 10-item Perceived Stress Scale (PSS-10), while MCR was defined as the coexistence of subjective memory complaints (SMCs) and slow gait speed. Results: The average age of the study participants is 79.84 ± 4.34 years. The mean score of PSS-10 among participants is 10.32 (range = 0–33; [SD] = 5.71), with a median score of 10.00 (6.00, 14.00). The prevalence of MCR is 9.3%. In the logistic regression analysis, for each 1-SD (5.71) increase in the global PSS-10 score, the risk of MCR increased by 40% (95% CI 1.09–1.80). Additionally, in the aspect of two components of MCR, with a 1-SD increase (5.71) in the global PSS-10 score, there was a 50% (95% CI 1.29–1.75) increase in the risk of SMCs and a 27% (95% CI 1.04–1.55) increase in the risk of slow gait speed. In terms of specific walking speed, there was a reverse correlation between the global PSS-10 score and walking speed (r = −0.14, p < 0.001). Conclusions: This study provided preliminary evidence that high levels of perceived stress were associated with the risk of MCR in a community-dwelling population.
The Emergence of Self-Awareness: Insights from Robotics
Authors: Mentzou Aikaterini , Ross Josephine
Published: February 2024

The ability for self-related thought is historically considered to be a uniquely human characteristic. Nonetheless, as technological knowledge advances, it comes as no surprise that the plausibility of humanoid self-awareness is not only theoretically explored but also engineered. Could the emerging behavioural and cognitive capabilities in artificial agents be comparable to humans? By employing a cross-disciplinary approach, the present essay aims to address this question by providing a comparative overview on the emergence of self-awareness as demonstrated in early childhood and robotics. It argues that developmental psychologists can gain invaluable theoretical and methodological insights by considering the relevance of artificial agents in better understanding the behavioural manifestations of human self-consciousness.
Cerebral Artery Overexpression of the NMUR1 Gene Is Associated with Moyamoya Disease: A Weighted Gene Co-Expression Network Analysis
Authors: Pettersson Samuel D. , Koga Shunsuke , Ali Shan , Enriquez-Marulanda Alejandro , Taussky Philipp , Ogilvy Christopher S.
Published: February 2024

Introduction: This study aimed to elucidate mechanisms underlying moyamoya disease (MMD) pathogenesis and to identify potential novel biomarkers. We utilized gene co-expression networks to identify hub genes associated with the disease. Methods: Twenty-one middle cerebral artery (MCA) samples from MMD patients and 11 MCA control samples were obtained from the Gene Expression Omnibus (GEO) dataset, GSE189993. To discover functional pathways and potential biomarkers, weighted gene co-expression network analysis (WGCNA) was employed. The hub genes identified were re-assessed through differential gene expression analysis (DGEA) via DESeq2 for further reliability verification. Additional 4 samples from the superficial temporal arteries (STAs) from MMD patients were obtained from GSE141025, and a subgroup analysis stratified by arterial type (MCA vs. STA) DGEA was performed to assess if the hub genes associated with MMD are expressed significantly greater on the affected arteries compared to healthy ones in MMD. Results: WGCNA revealed a predominant module encompassing 139 hub genes, predominantly associated with the neuroactive ligand-receptor interaction (NLRI) pathway. Of those, 17 genes were validated as significantly differentially expressed. Neuromedin U receptor 1 (NMUR1) and thyrotropin-releasing hormone were 2 out of the 17 hub genes involved in the NLRI pathway (log fold change [logFC]: 1.150, p = 0.00028; logFC: 1.146, p = 0.00115, respectively). MMD-only subgroup analysis stratified by location showed that NMUR1 is significantly overexpressed in the MCA compared to the STA (logFC: 1.962; p = 0.00053) which further suggests its possible localized involvement in the progressive stenosis seen in the cerebral arteries in MMD. Conclusion: This is the first study to have performed WGCNA on samples directly affected by MMD. NMUR1 expression is well known to induce localized arterial smooth muscle constriction and, recently, type 2 inflammation which can predispose to arterial stenosis potentially advancing the symptoms and progression of MMD. Further validation and functional studies are necessary to understand the precise role of NMUR1 upregulation in MMD and its potential implications.
Quintal Agroecológico: Roteiro Didático 3
Authors:   Universidade de São Paulo. Centro de Divulgação Científica e Cultural, Oliveira Alisson Cleiton de , Queiroz Salete Linhares ,   Universidade de São Paulo, Instituto de Química de São Carlos
Published: February 2024

O Quintal Agroecológico do Centro de Divulgação Científica e Cultural da Universidade de São Paulo (CDCC/USP) ocupa um espaço de 100 m². Visitas ao Quintal Agroecológico passaram a ser oferecidas ao público a partir de 2014, após a adaptação do local a este propósito com apoio do CNPq. Observa-se a tendência de desaparecimento dos quintais, que são sistemas resultantes de conhecimentos acumulados entre diversas gerações. Sendo os quintais relevantes áreas verdes, e possíveis espaços de trocas culturais, os projetos que permitiram a concretização do Quintal Agroecológico como espaço de visitação do CDCC visaram ao resgate da prática de cultivar quintais em residências, como forma de garantir a segurança alimentar, o consumo livre de insumos químicos e o uso consciente dos recursos. No Quintal Agroecológico os visitantes podem conhecer diversas espécies de plantas alimentícias, aprender suas características biológicas e entender processos de produção agroecológicos. Os monitores conduzem debates críticos sobre a sustentabilidade da agricultura convencional e contextualizam a agroecologia enquanto ciência que visa à integração de diversos saberes científicos, em busca de produção sustentável e de desenvolvimento socioeconômico. A agroecologia aplicada em espaços como os quintais domésticos pode significar soberania alimentar para produtores e para famílias, alimentação saudável, sustentabilidade, manutenção de serviços ecossistêmicos em áreas verdes urbanas e a difusão de trocas de saberes culturais e geracionais.
Coexistence of Indian Pangolin Manis crassicaudata (Geoffroy, 1803) (Mammalia: Pholidota: Manidae) and Indian Crested Porcupine Hystrix indica (Kerr, 1792) (Mammalia: Rodentia: Hystricidae) in Purulia District, West Bengal, India
Authors: Sikdar Debosmita , Bhandari Shwetadri , Paira Sanjay
Published: February 2024

The Indian Pangolin Manis crassicaudata and the Indian Crested Porcupine Hystrix indica are subject to extensive poaching in Purulia District (West Bengal, India), diminishing their populations, and making the study difficult. Applying methodologies that include local sightings, field observations, camera trapping, and quadrate analysis, these species were observed to co-occur in rocky cavities in Ajodhya hills at several locations. Evidence for this included fresh pangolin tail drag marks, claw prints, footprints, scales, porcupine quills, teeth marks, and faecal matter in the same locations within the study area. Quadrate analysis showed that the trees housing the target prey species of the Indian Pangolin as well as the trees bearing fruits favoured by the Indian Crested Porcupine, occurred at maximum frequency within the Quadrate area. We hypothesise that pangolins and porcupines co-occupy rocky cavities for protection from poachers, who can easily break into more typical burrows and set traps in front of them. This may be an example of adaption to poaching, which demonstrates the necessity of conservation measures to alleviate severe anthropogenic pressure.
The Accuracy and Precision of Memory for Natural Scenes: A Walk in the Park
Authors: Westebbe Leo , Liang Yibiao , Blaser Erik
Published: February 2024

It is challenging to quantify the accuracy and precision of scene memory because it is unclear what ‘space’ scenes occupy (how can we quantify error when misremembering a natural scene?). To address this, we exploited the ecologically valid, metric space in which scenes occur and are represented: routes. In a delayed estimation task, participants briefly saw a target scene drawn from a video of an outdoor ‘route loop’, then used a continuous report wheel of the route to pinpoint the scene. Accuracy was high and unbiased, indicating there was no net boundary extension/contraction. Interestingly, precision was higher for routes that were more self-similar (as characterized by the half-life, in meters, of a route’s Multiscale Structural Similarity index), consistent with previous work finding a ‘similarity advantage’ where memory precision is regulated according to task demands. Overall, scenes were remembered to within a few meters of their actual location.
The Scaling-up of Agricultural Mechanization Services and the Re-shaping of Small-Scale Household Farming in China
Authors: Chen Yiyuan
Published: February 2024

Taking the case of the agricultural mechanization service industry as an example, this study discusses the dynamics of the transformation of China’s agricultural contracting service industry in the context of the scaling-up of agricultural production, and how the transformation is reshaping small-scale household farming in grain production. With the accelerated growth of farmland transfer, large-scale agricultural producers have been emerging rapidly in different parts of China in the past years. Since their demand for agricultural contracting services is different from that of small-scale household producers, the scaling-up of agricultural production has promoted the scaling-up of agricultural contracting services. Meanwhile, the capital surplus in the agricultural machinery manufacturing industry has created three consequences simultaneously: the excess supply of agricultural mechanization services, the acceleration of agricultural machinery renewal, and the rising cost of machinery purchases. The interactions of these three factors not only raised the threshold of the agricultural machinery service industry, which makes it difficult for part-time service providers to survive market competition, but also shortened the time window for machinery service provision, which makes it difficult for large-scale agricultural producers to balance land operation and machinery service provision. Consequently, large-scale agricultural machinery service organizations are continuously replacing those small-scale part-time service providers. During this process, small-scale household producers engaged in grain production are faced with increasing risks of being excluded from farming, both directly and indirectly, as it is difficult for small producers to deal with large service organizations, and the small-scale part-time service providers that used to serve them are continually being replaced.
Smallholders in Capitalist Agriculture: Persistence and Challenges
Authors: Zhang Qian Forrest
Published: February 2024

This paper posits that the majority of “smallholders” in contemporary China are commodity producers who must engage in various commodity exchanges to carry out agricultural production and accomplish their social reproduction. Consequently, “smallholder” refers to a family-based economic operation model, rather than a social identity or psychological identification. Within this framework, the study focuses on the intricate relationships between smallholders, various commodity markets, and other market participants. Specifically, it examines two aspects: the relationship between smallholders and capitalized large-scale producers and other agriculture-related capital entities, and the relationship between smallholders and the commodified labor force. The paper argues that the interaction between smallholders and capitalized large-scale producers is not a zero-sum game of mutual replacement; except in certain areas, smallholders are not driven out of agricultural production by large-scale capitalized producers, but coexist and interact with them in various ways. On the other hand, smallholders heavily rely on short-term hired labor for their agricultural production, and many also become wage earners themselves, participating in the agricultural production of other producers and earning wage income. Compared to the expansion of capitalized large-scale production, the most significant challenge facing China’s smallholder economy, as this paper contends, is the intergenerational reproduction crisis brought about by the aging of the labor force and the urbanization of the younger generation.
Government mechanism in waste electrical and electronic equipment recycling among prospect theory and evolutionary game theory
Authors: Sui Yujiao , Sun Qiang , Li Shuhao
Published: February 2024

Improper disposal of waste electrical and electronic equipment (WEEE) poses challenges for resource loss and public environmental pollution. Government policies are required to regulate WEEE recycling. To better explore the governance mechanism in the WEEE recycling network, a tripartite evolutionary game model composed of the government, recyclers, and manufacturers under bounded rationality and uncertainty was established using evolutionary game theory and prospect theory by underscoring the WEEE processing fee (WPF) exemption to adjust the behaviour of the WEEE recycling network participants. The research found that nine equilibrium points and eight possible ESSs exist and that the evolutionary stability strategies of tripartite decisions mainly depend on the trade-off between costs and revenues. Through numerical simulations, it was observed that the psychological perception of risk for recyclers and manufacturers can affect the behaviour and strategies of WEEE recycling stakeholders in uncertain environments. As WEEE recycling stakeholders increase their pursuit of safety risks, both recyclers’ and manufacturers’ willingness to engage in green behaviour is increasing. In addition, under the WPF exemption, the government can achieve the goal of encourage recyclers and manufacturers to choose green behaviour at a relatively low cost. We suggest that the government should strive to establish a stable WEEE recycling environment, establish an appropriate WPF exemption mechanism, and fully consider the cross-impact of recyclers and manufacturers to promote the green behaviour and efficiency of WEEE recycling.
Partly linear single-index cure models with a nonparametric incidence link function
Authors: Lee Chun Yin , Wong Kin Yau , Bandyopadhyay Dipankar
Published: February 2024

In cancer studies, it is commonplace that a fraction of patients participating in the study are cured, such that not all of them will experience a recurrence, or death due to cancer. Also, it is plausible that some covariates, such as the treatment assigned to the patients or demographic characteristics, could affect both the patients’ survival rates and cure/incidence rates. A common approach to accommodate these features in survival analysis is to consider a mixture cure survival model with the incidence rate modeled by a logistic regression model and latency part modeled by the Cox proportional hazards model. These modeling assumptions, though typical, restrict the structure of covariate effects on both the incidence and latency components. As a plausible recourse to attain flexibility, we study a class of semiparametric mixture cure models in this article, which incorporates two single-index functions for modeling the two regression components. A hybrid nonparametric maximum likelihood estimation method is proposed, where the cumulative baseline hazard function for uncured subjects is estimated nonparametrically, and the two single-index functions are estimated via Bernstein polynomials. Parameter estimation is carried out via a curated expectation-maximization algorithm. We also conducted a large-scale simulation study to assess the finite-sample performance of the estimator. The proposed methodology is illustrated via application to two cancer datasets.
Regression analysis of longitudinal data with random change point
Authors: Zhang Peng , Chen Xuerong , Sun Jianguo
Published: February 2024

A great deal of literature has been established for regression analysis of longitudinal data and in particular, many methods have been proposed for the situation where there exist some change points. However, most of these methods only apply to continuous response and focus on the situations where the change point only occurs on the response or the trend of the individual trajectory. In this article, we propose a new joint modeling approach that allows not only the change point to vary for different subjects or be subject-specific but also the effect heterogeneity of the covariates before and after the change point. The method combines a generalized linear mixed effect model with a random change point for the longitudinal response and a log-linear regression model for the random change point. For inference, a maximum likelihood estimation procedure is developed and the asymptotic properties of the resulting estimators, which differ from the standard asymptotic results, are established. A simulation study is conducted and suggests that the proposed method works well for practical situations. An application to a set of real data on COVID-19 is provided.
Decolonising archaeology in South Africa: two decades after the National Heritage Resources Act of 1999
Authors: P Reddy Kerry-Leigh , Russell Thembi
Published: February 2024

Twenty-four years ago, the National Heritage Resources Act, No. 25 of 1999 (NHRA) was enacted in South Africa. This was a moment of change, when the heritage of those marginalised during the colonial and Apartheid eras would finally be given its rightful place on the national heritage list. There was a sense of optimism amongst politicians that the African past was finally to be recognised in an inclusive and representative future. This was echoed in archaeology, given its central role in uncovering and telling the story of precolonial South Africa. The discipline slowly opened its doors to academics of all ethnic groups and new perspectives were identified. But an examination of the practical consequences and impact of this progressive legislation for transforming officially declared heritage in the past 24 years shows surprisingly little change in the overall body of recognized, listed heritage. Recent studies of transformation in South African archaeology have focussed on institutional transformation; possible transformation of the types and frequency of sites declared as national and provincial heritage sites has not yet been examined. It is this issue which our paper addresses. The paper presents analysis that relies on the South African Heritage Resources Information System (SAHRIS) database covering the period 1936 to mid-2022. Whilst sites associated with European colonialism still predominate, there has been a change in the frequency of types of heritage declared since 1999, with an increase in sites associated with the Black liberation struggle. Yet the list remains very unbalanced, with only a single heritage site connected to the precolonial past of Black South Africans having been declared as a national heritage site since 1999. We discuss and classify the types of heritage declared since 1999 and suggest reasons for the distortion.
Faculty Retention Dynamics: Investigating the Role of HR Climate, Trust, and Organizational Commitment in Higher Education Context
Authors: Verma Sahil , Kaur Gurvinder
Published: February 2024

With economies and business becoming knowledge intensive, the role of education industry has immensely risen in significance. This has given rise to a highly competitive landscape in higher education, with faculty retention as a major challenge for the institutions leading to negative consequences in terms of education quality, stakeholder satisfaction and rankings. This paper discusses the factors influencing faculty retention in HEIs in India within the framework of Social Exchange Theory. The sub dimensions of HR climate were explored using Principal Components Analysis. The relative importance of sub dimensions in forming the overall climate was estimated and the effect of HR climate on faculty retention was studied with Organizational Commitment and Organizational Trust as mediators employing a hierarchical components model in the PLS-SEM analysis. The results indicate that HR climate has a significant positive effect on faculty retention through organizational commitment and organizational trust as partial complementary mediators. Findings have significant theoretical as well as practical implications in extending the present knowledge regarding the subdimensions and effect of HR climate on faculty retention and the suggested measures to be taken in implementing effective HR Management systems in the Higher Education Institutions.
Causes of infant and under-five (under-5) morbidity and mortality among hospitalized patients in Southern Nigeria: A hospital based study
Authors: Okoroiwu Henshaw Uchechi , Edet Uwem Okon , Uchendu Ikenna Kingsley , Echieh Chidiebere Peter , Nneoyi-Egbe Ada Francesca , Anyanwu Stanley Obialor , Umoh Ekementeabasi Aniebo , Nwaiwu Ndidi Patience , Mbabuike Ikenna Uchechukwu
Published: February 2024

Background:

Rate and pattern of under-five mortality is a reflection of a society’s healthcare system and quality of life. This study is aimed at reviewing the causes of infants and under-five morbidity and mortality in Calabar, Southern Nigeria.

Methods:

This study used retrospective descriptive cross-sectional design. We did a retrospective collation of data on under-five morbidity and mortality from 2012 to 2017 of under-five patients admitted or died while in admission in University of Calabar Teaching Hospital. The causes of morbidity and mortality were reported based on International Classification of Diseases 10 (ICD-10). The morbidity, mortality and fatality rates were computed.

Results:

A total of 11,416 under-five admissions and 391 deaths were recorded within the study period giving a fatality rate of 3.4%. Age 1–4 years category represented 50.5% of the admissions while infants (<1 year) constitute majority of the deaths (64.7%). There were 5652 infant admissions and 253 infant deaths giving fatality rate of 4.5% within the study period. Males constituted majority (55.8%) of under-five morbidity whereas females constituted majority (51.2%) of the deaths. Conditions originating from perinatal period; and infectious and parasitic diseases were the leading broad cause of under-five mortality. Specific disease analysis showed sepsis/septicemia; congenital infectious and parasitic diseases; slow fetal growth, malnutrition and short gestation as the chief causes of both infant and under-five mortality.

Conclusion:

The leading causes of under-five deaths in the studied population are amenable. Improved healthcare and antenatal will be of immense benefit.
Using transfer learning-based plant disease classification and detection for sustainable agriculture
Authors: Shafik Wasswa , Tufail Ali , De Silva Liyanage Chandratilak , Apong Rosyzie Anna Awg Haji Mohd
Published: February 2024

Subsistence farmers and global food security depend on sufficient food production, which aligns with the UN's “Zero Hunger,” “Climate Action,” and “Responsible Consumption and Production” sustainable development goals. In addition to already available methods for early disease detection and classification facing overfitting and fine feature extraction complexities during the training process, how early signs of green attacks can be identified or classified remains uncertain. Most pests and disease symptoms are seen in plant leaves and fruits, yet their diagnosis by experts in the laboratory is expensive, tedious, labor-intensive, and time-consuming. Notably, how plant pests and diseases can be appropriately detected and timely prevented is a hotspot paradigm in smart, sustainable agriculture remains unknown. In recent years, deep transfer learning has demonstrated tremendous advances in the recognition accuracy of object detection and image classification systems since these frameworks utilize previously acquired knowledge to solve similar problems more effectively and quickly. Therefore, in this research, we introduce two plant disease detection (PDDNet) models of early fusion (AE) and the lead voting ensemble (LVE) integrated with nine pre-trained convolutional neural networks (CNNs) and fine-tuned by deep feature extraction for efficient plant disease identification and classification. The experiments were carried out on 15 classes of the popular PlantVillage dataset, which has 54,305 image samples of different plant disease species in 38 categories. Hyperparameter fine-tuning was done with popular pre-trained models, including DenseNet201, ResNet101, ResNet50, GoogleNet, AlexNet, ResNet18, EfficientNetB7, NASNetMobile, and ConvNeXtSmall. We test these CNNs on the stated plant disease detection and classification problem, both independently and as part of an ensemble. In the final phase, a logistic regression (LR) classifier is utilized to determine the performance of various CNN model combinations. A comparative analysis was also performed on classifiers, deep learning, the proposed model, and similar state-of-the-art studies. The experiments demonstrated that PDDNet-AE and PDDNet-LVE achieved 96.74% and 97.79%, respectively, compared to current CNNs when tested on several plant diseases, depicting its exceptional robustness and generalization capabilities and mitigating current concerns in plant disease detection and classification.
The safety of preoperative carbohydrate drinks in extremely elderly patients assessed by gastric ultrasonography: a randomized controlled trial
Authors: Chen Lingyang , Wang Nana , Xie Guohao , Wang Mingcang , Yu Yulong , Wang Huiqin , Fang Xiangming
Published: February 2024

Background

Modern perioperative guidelines encourage drinking oral carbohydrates 2 h before management. Nevertheless, research on the safety of preoperative carbohydrate drinks, particularly in extremely elderly patients is lacking. We aimed to evaluate the safety of carbohydrate drinks 2 h before surgery in extremely elderly patients (≥ 80 years) using gastric ultrasonography.

Methods

We conducted a randomized prospective comparative study of 70 patients aged over 80 years who were scheduled for total knee arthroplasty, hip fracture or humerus fracture surgery. These patients were randomly assigned to the carbohydrate group (n = 35), which fasted from midnight, except for drinking 355 mL of a carbohydrate-containing fluid 2 h before surgery, or the fasting group (n = 35), which fasted from midnight and drank no fluid before surgery. The primary outcome of the study was the cross-sectional area (CSA) of the gastric antrum in the right lateral decubitus position (RLDP) before surgery. The secondary outcomes included CSA in the supine position, intraoperative blood glucose levels and their variability coefficients, Perlas grade, and the visual analog scale of subjective feelings.

Results

The CSA in the RLDP and supine positions revealed no differences between the carbohydrate and fasting groups at 0 h preoperatively (P > 0.05). In the qualitative assessment, preoperative 0-h Perlas grading did not differ significantly between the groups (P > 0.05). From 2 h before surgery to transfer out of the post-anesthesia care unit, the average blood glucose level of patients in the carbohydrate group was significantly higher than that in the fasting group (P < 0.001) but remained within the normal range. Moreover, the blood glucose variability coefficient was significantly lower in the carbohydrate group than in the fasting group (P = 0.009). Oral intake of 355 mL carbohydrates before surgery significantly relieved patients’ feelings (P < 0.001).

Conclusion

Preoperative consumption of carbohydrate drinks 2 h before surgery is safe in “healthy” extremely elderly patients. In addition, preoperative drinking has potential value in maintaining ideal blood glucose levels and stable blood glucose fluctuations perioperatively and improving subjective perceptions of preoperative preparation. This finding warrants further investigation in clinical practice.

Trial registration

Chinese Clinical Trial Registry (Registration Number ChiCTR1900024812), first registered on 29/07/2019.
The effects of low-dose IL-2 on Th17/Treg cell imbalance in primary biliary cholangitis mouse models
Authors: Wang Zilong , Liu Zhicheng , Zheng Jiarui , Huang Linxiang , Jin Rui , Wang Xiaoxiao , Chen Dongbo , Xie Yandi , Feng Bo
Published: February 2024

Background/aims

Primary biliary cholangitis (PBC) is a chronic cholestatic liver disease. The imbalance of Th17/Treg cells has been reported in PBC patients. Low-dose IL-2 can alleviate disease severity through modulating CD4 + T cell subsets in patients with autoimmune diseases. Hence, the present study aimed to examine the effects and mechanism of low-dose IL-2 in PBC mouse models.

Methods

PBC models were induced in female C57BL/6 mice by two immunizations with 2OA-BSA at two-week intervals, and poly I: C every three days. PBC mouse models were divided into the IL-2 treated and untreated groups and low-dose IL-2 was injected at three different time points. Th17 and Tregs were analyzed by flow cytometry, and the related cytokines were analyzed by ELISA. Liver histopathology was examined by H&E and immunohistochemical staining.

Results

Twelve weeks after modeling, the serum AMA was positive and the ALP was significantly increased in PBC mouse models (P<0.05). The pathology showed lymphocyte infiltration in the portal area, damage, and reactive proliferation of the small bile duct (P<0.05). The flow cytometric showed the imbalance of Th17/Treg cells in the liver of PBC mouse models, with decreased Treg cells, increased Th17 cells, and Th17/Treg ratio (P < 0.05). After the low-dose IL-2 intervention, biochemical index and liver pathologies showed improvement at 12 weeks. Besides, the imbalance of Th17 and Treg cells recovered. Public database mining showed that Th17 cell differentiation may contribute to poor response in PBC patients.

Conclusion

Low-dose IL-2 can significantly improve liver biochemistry and pathology by reversing the imbalance of Th17 and Treg cells, suggesting that it may be a potential therapeutic target for PBC.
The molecular epidemiology and clinical implication of methicillin-resistant Staphylococcus aureus (MRSA) sequence types in pediatric bacteremia: a restrospective observational study, 2016–2021
Authors: Kim Gahee , Lee Sanghoon , Lee Yonghee , Kim Jung Hwa , Lee Jina
Published: February 2024

Background

While there is a high burden of methicillin-resistant Staphylococcus aureus (MRSA) infections among pediatric patients, studies on the molecular epidemiology of MRSA infections in Korean children since the 2010s are lacking. This study aimed to investigate the molecular genotypes and clinical characteristics of MRSA isolates from children with MRSA bacteremia at Asan Medical Center Children’s Hospital from 2016 to 2021.

Methods

Clinical data were retrospectively reviewed, and the molecular types of MRSA were determined using multilocus sequence typing (MLST) and Staphylococcal cassette chromosome mec (SCCmec) typing.

Results

The overall methicillin resistance rate of S. aureus bacteremia was 44.8% (77/172); 49.5% in the period 2016–2018 (period 1) and 37.3% in the period 2019–2021 (period 2) (P = 0.116). Community-acquired infections accounted for only 3.9% of cases. The predominant ST group was ST72 group (67.6%), followed by ST5 group (18.9%) and ST1 group (5.4%). The proportion of ST5 was significantly lower in period 2 compared to period 1 (P = 0.02). Compared to the ST5 and ST1 groups, the ST72 group exhibited lower overall antibiotic resistance and multidrug-resistant (MDR) rates (12.0% [6/50] in ST72 group vs. 100.0% [14/14] in ST5 group vs. 50.0% [2/4] in ST1 group; P < 0.001). In the multivariate analysis, the ST1 group was an independent risk factor for 30-day all-cause mortality (aOR, 44.12; 95% CI, 3.46–562.19).

Conclusion

The ST72-MRSA strain remained the most frequently isolated genotype in Korean children, while the ST1 group emerged as an independent risk factor for 30-day all-cause mortality in pediatric MRSA bacteremia. Ongoing efforts to uncover the evolving epidemiology of MRSA are essential for developing effective strategies for prevention and treatment.
Intimate partner violence and postpartum healthcare access in Kenya: a cross-sectional study
Authors: Woofter Rebecca , Mboya John , Golub Ginger , Sudhinaraset May
Published: February 2024

Background

Intimate partner violence (IPV) impacts physical health, mental health, and healthcare use. IPV during pregnancy, in particular, is associated with lower rates of antenatal care, but no studies have assessed the association between IPV and postpartum healthcare. This study aims to examine the link between IPV (emotional, physical, and sexual) and two outcomes: postpartum healthcare use and access to family planning.

Methods

This study uses data from a cross-sectional survey of 859 women in Nairobi and Kiambu counties in Kenya who gave birth during the COVID-19 pandemic in 2020.

Results

In this sample, 36% of women reported ever experiencing IPV. Of those, 33% indicated the frequency of IPV stayed the same or increased during COVID-19. Nearly 17% of women avoided postpartum healthcare and 10% experienced issues accessing family planning. Those who experienced any form of IPV during pregnancy had approximately twice the odds of avoiding postpartum healthcare compared to those who did not experience any form of IPV. Compared to those who did not experience IPV during pregnancy, experiencing sexual IPV was associated with 2.25 times higher odds of reporting issues accessing family planning. Additionally, reporting fair or poor self-rated health was associated with both avoiding postpartum healthcare and reporting issues accessing family planning. Experiencing food insecurity was also associated with avoiding postpartum healthcare.

Conclusions

To our knowledge, this is the first study to establish the link between IPV during pregnancy and postpartum healthcare access. During COVID-19 in Kenya, postpartum women who had experienced IPV were at increased risk of disengagement with healthcare services. Women should be screened for IPV during pregnancy and postpartum in order to better support their healthcare needs. In times of crisis, such as pandemics, policymakers and healthcare providers must address barriers to healthcare for postpartum women.