bluuebunny/crossref_metadata_2025 huggingface dataset:
Chemsex among men who have sex with men during the Mpox health crisis in Brazil: A nationwide web survey
Authors: Santos Guilherme Reis de Santana , Ribeiro Caíque Jordan Nunes , Lima Shirley Verônica Melo Almeida , Neto João Cruz , de Sousa Anderson Reis , Bulcao Carolina da Silva , Dellagostini Pedro Gabriel , Batista Odinea Maria Amorim , de Oliveira Layze Braz , Mendes Isabel Amélia Costa , de Sousa Álvaro Francisco Lopes
Published: March 2024

Objective

To understand the factors associated with the practice of chemsex among MSM in Brazil, especially during the Mpox health crisis, and to design effective prevention and intervention strategies specifically for this population.

Design

A cross‐sectional and analytical study using an electronic survey, conducted from September to December 2022, during the peak of the Mpox outbreak in Brazil.

Sample

A total of 1452 MSM aged 18 and older.

Measurements

Data were collected via the REDCap platform through a survey with 46 questions. These addressed demographic data, sexual affiliations, practices, experiences with Mpox, healthcare service usage, and stigma or fear related to Mpox.

Results

The prevalence of chemsex was 19.42% (n = 282). Multivariate Poisson modeling indicated a high incidence of chemsex among those diagnosed with Mpox and those involved in high‐risk behaviors. The practice of chemsex was six times higher among those diagnosed with Mpox (95% CI: 4.73–9.10). MSM who engage in bugchasing had a prevalence twice that of the main outcome (95% CI: 1.31–3.16).

Conclusion

There is a significant need for targeted interventions for MSM in Brazil, especially given the Mpox outbreak. This study highlights the strong relationships between chemsex, experiences with Mpox, and various sexual behaviors, underscoring the importance of effective public health initiatives.
Reply to: ‘Is continuous positive airway pressure truly superior to high‐flow nasal cannula in managing acute hypoxemic respiratory failure?’
Authors: Nagata Kazuma , Yokoyama Toshiki , Tsugitomi Ryosuke ,   the authors and the JaNP‐Hi Study Investigators
Published: March 2024

See related Letter
Is continuous positive airway pressure truly superior to high‐flow nasal cannula in managing acute hypoxemic respiratory failure?
Authors: Goto Toshiro , Kataoka Yuki
Published: March 2024

See related Reply
C‐reactive protein as a novel biomarker for vitamin D deficiency in alopecia areata
Authors: AbdElneam Ahmed Ibrahim , Al‐Dhubaibi Mohammed Saleh , Bahaj Saleh Salem , Mohammed Ghada Farouk , Alantry Ahmed Kaid , Atef Lina Mohamed
Published: March 2024

Background

Alopecia areata (AA) is an autoimmune condition characterized by sudden and unpredictable hair loss, with a lifetime incidence of 2%. AA can be divided into three categories: patchy alopecia, alopecia totalis, and alopecia universalis. It can affect a person's psychological health and overall quality of life. Elevated C‐reactive protein (CRP) levels in the liver may indicate an inflammatory response in autoimmune diseases. Vitamin D, essential for immune system control and skin health, may be related to AA. Hair follicles contain vitamin D receptors, which control immunological responses in the skin. However, no study has found a relationship between CRP and vitamin D in AA patients in our region.

Subjects and Methods

An analytical cross‐sectional study with a case‐control design research investigation of 82 AA patients and 81 healthy controls was carried out. Both groups’ medical histories were taken. Biochemical analysis was done for both groups as well as the serum vitamin D levels, and CRP. Genetic analysis for CDX2 rs11568820 variant detected by PCR (T‐ARMS‐PCR) method and vitamin D receptor (VDR) gene expression measured by real‐time PCR analysis for both patients and healthy subjects.

Results

CRP levels are higher in AA patients, AA patients with G/G genotypes exhibited higher concentrations of CRP when compared to those with A/A and A/G genotypes while patients with A/A genotypes have higher levels of Serum vitamin D as compared to the A/G and G/G genotypes. G allele was more abundant in AA patients. VDR gene expression was lower in AA compared to control and lower in ophiasis compared to localized and multiple patchy AA. An important inverse linear correlation was observed between vitamin D and CRP levels in ophiasis AA.

Conclusion

CRP concentrations were found to be elevated in AA patients. The considerable accuracy of CRP in the diagnosis of AA is substantiated by a statistically significant al. A noteworthy inverse linear association was observed between serum vitamin D and CRP concentrations in ophiasis AA.
Comparison of conjunctival pedicle flap to corneal fixation strength achieved by Tisseel® fibrin glue, ethyl cyanoacrylate adhesive, ReSure® hydrogel sealant, and conventional suturing with 8‐0 VICRYL® ophthalmic suture
Authors: VerHulst Elodie M. , Galarza Roxanne M. Rodriguez , Herring Ian P. , Ramos Renata Velloso , Kemper Andrew R.
Published: March 2024

Objective

To determine and compare the fixation strength of conjunctival pedicle flaps to cornea achieved via conventional ophthalmic suture and three different adhesive compounds.

Animals Studied

Ex vivo porcine globes.

Procedures

Following a 6 mm wide 500‐micron‐restricted depth lamellar keratectomy, conjunctival pedicle flaps were secured to the keratectomy site with either 8‐0 VICRYL® suture or one of three adhesive products, including Tisseel® bioadhesive, ReSure® synthetic adhesive, or ethyl cyanoacrylate adhesive (n = 10 per surgical group). Adhesive application protocol varied by product based upon adhesive biocompatibility. Corneoconjunctival tissues were then harvested, clamped in a tensile testing device, and loaded at a rate of 1 mm/s under video surveillance until the point of failure. Peak load was determined for each test and used to compare fixation strength between samples.

Results

Forty conjunctival flaps were performed, with 6 omitted from evaluation due to dehiscence prior to tensile testing. Of the 34 flaps analyzed, 10 were secured with suture, 10 with cyanoacrylate, 8 with ReSure®, and 6 with Tisseel®. Flaps secured with suture withstood significantly higher applied tensile force compared with cyanoacrylate (p = .02474), ReSure® (p = .00000), and Tisseel® (p = .00002). Flaps secured with cyanoacrylate withstood significantly greater force than those secured with ReSure® and Tisseel® (p = .01194 and 0.01798, respectively). There was no significant difference in fixation strength between ReSure® and Tisseel® glue (p = .95675).

Conclusions

Conjunctival pedicle flap fixation using 8‐0 VICRYL® suture fixation was able to withstand significantly greater maximum tensile force compared to ReSure®, Tisseel®, or cyanoacrylate adhesives. Fixation strength achieved with cyanoacrylate adhesive was significantly greater than that achieved with ReSure® or Tisseel®.
Acoustic cavitation oxidation of ionic liquids: A brief review
Authors: Ashtaputrey Santosh D. , Agrawal Pratibha S.
Published: March 2024

Ionic liquids (ILs) are third‐generation materials with broad industrial applications. However, their toxicity, non‐biodegradability and water solubility render them persistent water pollutants. Consequently, IL degradation from water is an emerging topic of research interest nowadays. Sonolysis is one of the advanced oxidation processes (AOPs) based on ultrasound (US). During sonolysis, acoustic cavitation decomposes water into reactive hydroxyl (•OH) and hydrogen (•H) radicals, which then oxidize IL. This review discussed different AOPs for wastewater treatment reflecting their shortcomings, with a special focus on the operating conditions and effectiveness of US‐based hybrid AOPs for IL degradation. The synergistic effects of US over other AOPs are investigated. Hybid‐sonolysis has proven to significantly enhance IL mineralization in shorter reaction time by generating more reactive‐free radicals in an aqueous medium at experimentally optimized conditions. Finally, this review identifies research gap and proposes future directions of IL degradation. It will serve as a valuable resource for future studies of IL degradation using US techniques.
Monitoring Quality of Soda Black Liquor of Oil Palm Empty Fruit Bunch Fibers in Terms of Storage Time and Temperature
Authors: Ibrahim M. N. Mohamad , Wan Rosli W. D. , Chuah S.B.
Published: March 2024

Kualiti likuor hitam daripada proses pemulpaan tandan buah sawit kosong ditentukan melalui kaedah pemencilan langsung lignin soda dengan asid hidroklorik 10% pada tiga nilai pH iaitu 2, 4 dan 6. Kaedah memusnah seperti pengoksidaan nitrobenzena dan penentuan kandungan abu digunakan dalam kajian ini. pH 2 didapati memberi dapatan lignin yang tertinggi. Melalui ujian pengoksidaan nitrobenzena vanilin adalah sebatian utama yang mewakili 44.9â€“52.1% daripada jumlah produk. Siringaldehid pula merupakan sebatian kedua utama yang mewakili 23.1â€“30.8%, dan seterusnya diikuti pula oleh pâ€“hidroksibenzaldehid. Kelembapan dan kandungan abu bagi sampel lignin yang dipencilkan pada pH 6 adalah yang tertinggi diikuti oleh pH 4 dan pH 2 terutamanya apabila disimpan lama. Kajian ini mendapati, bagi keduaâ€“dua suhu penyimpanan, lignin soda perlu dipencilkan sebelum mencapai tempoh penyimpanan selama 15 hari untuk mengelakkan kadar aktiviti biodegredasi yang tinggi.

Kata kunci: Likuor hitam, lignin, serat tandan buah sawit kosong, masa penyimpanan, suhu penyimpanan

The quality of black liquor from oil palm empty fruit bunch fibers pulping was determined through direct isolation of soda lignin using 10% hydrochloric acid at three pH fractions, i.e. pH 2, pH 4 and pH 6. Destructive methods such as nitrobenzene oxidation and ash contents determination were used in the study. pH 2 was found to be the most preferable fraction due to the highest lignin yield. Nitrobenzene oxidation showed that the predominant compound was vanillin, which was in the range of 44.9â€“52.1% of the total product. Syringaldehyde was the second major compound (ca. 21.5â€“30.8%), followed by pâ€“hydroxybenzaldehyde. The moisture and the ash contents of pH 6 fraction were the highest followed by pH 4 fraction and pH 2 fraction, especially at longer storage time. Soda lignin has to be isolated in less than 15 days of storage regardless of storage temperature to prevent high rate of biodegradation activities.

Key words: Black liquor, lignin, oil palm empty fruit bunch fibers, storage time, storage temperature
NIGHT TIME CLOUDS DETECTION ABOVE PERMATAPINTAR OBSERVATORY USING ALL-SKY IMAGERY
Authors: Mohd Azhar Mohammad Afiq Dzuan , Abdul Hamid Nurul Shazana , Wan Mohd Kamil Wan Mohd Aimran , Mohamad Nor Sakinah
Published: March 2024

We proposed a method to detect clouds in a suburban class night sky for the larger purpose of astronomical site testing. A 'threshold criterion' approach was adopted to discriminate between the pixels representing the foreground clouds from the pixels representing the background sky in a single all-sky image. This method was developed based on all-sky images captured at the PERMATApintar Observatory (PpO) in Selangor (2°55'02" N, 101°47'17" E), where the night sky has been categorised as a suburban class night sky. The night sky conditions were divided into three categories depending on the cloud cover: clear, partially cloudy, and overcast skies. Samples of all-sky images for each night sky condition were selected and respective histogram images were generated. These samples were then used to inductively derive the threshold criterion based on the skewness and peak values of the image's histogram. This sky/cloud threshold will enable pixels representing foreground clouds to be discriminated from the pixels representing the background sky under each type of night sky conditions. Our work found that the night sky over PpO requires two thresholds to accurately distinguish between cloud and sky pixels due to the sky glow effect. The first threshold is based on the peak value of the image's histogram. If an image's histogram has a peak value ≥ 80, then the image is considered a clear sky. Otherwise, the image is considered cloudy or overcast sky if the peak value is < 80.
INFLUENCE OF ANATASE TITANIUM DIOXIDE NANOTUBE ARRAYS ON HUMIDITY SENSOR SYNTHESIZED BY ELECTROCHEMICAL ANODIZATION
Authors: Ahmed Azhar Najwa Ezira , Mohammad Jafar Salifairus , Sulimai Nurul Hidah , Malek Mohamad Firdaus , Mamat Mohamad Hafiz , Shariffudin Shafinaz Sobihana , Mohammad Maryam , Eswar Kevin Alvin , Abu Bakar Ahmad Shuhaimi , A. H. Alrokayan Salman , A. Khan Haseeb , Rusop M.
Published: March 2024

Humidity sensors have become increasingly important and widely used to improve the quality of life and industrial processes. Over the past decades, titanium dioxide (TiO2) has received wide attention in many promising areas such as sensors, solar cells, and photocatalytic. However, TiO2 required high operating conditions such as high temperatures to examine the crystalline stability phase. This study focuses on highly ordered titanium dioxide nanotube arrays (TiO2 NTAs) film synthesized using the electrochemical anodization method. Annealing temperature effect on the fabricated TiO2 NTAs was investigated. An electrolyte solution was prepared by mixing ammonium fluoride (0.3 wt%) and ethylene glycol (25 ml) with deionized water (2 vol%). Titanium (Ti) sheet was anodized at 35 V for 120 minutes.  The films were annealed from 350 °C to 550 °C. FESEM images showed the diameter size of TiO2 NTAs film decreases as the annealing temperatures increases. Results had also shown that the average diameter annealed at 450 °C was around ~50.82 nm while the XRD pattern demonstrated TiO2 NTAs exhibiting an anatase phase with a prominent (101) peak recorded for the sample prepared at 450 °C with a high crystallite size of 29.17 nm. The calculated optical band gap annealed at 450 °C (3.24 eV) is comparable with other literature. The current-voltage characteristic of TiO2 NTAs film reported a high current for 450 °C (1.12 x 10-5 A) with a conductivity of 0.048 S.cm-1 and high sensitivity (287.72).
GRAVIMETRIC AND ELECTROCHEMICAL TEST OF ETLINGERA ELATIOR INFLORESCENCE EXTRACT AS GREEN CORROSION INHIBITOR
Authors: Rosli Syahidah Nabila , Kamil Othman Norinsan
Published: March 2024

At present, organic corrosion inhibitors which are commonly used such as silicate and phosphate have a high level of toxicity. It has prompted the search for green corrosion inhibitors because of its eco-friendly properties and has a lower level of toxicity. Therefore, this study has been conducted to investigate the inhibition efficiency (IE%) and corrosion rate of mild steel in 0.5 M HCl acidic medium.  The data obtained through weight loss and the electrochemical method at various concentrations and temperatures. The surface morphologies was observed using Scanning Electron Microscope (SEM). Different experimental conditions were also used such as electrochemical impedance spectroscopy (EIS) and potentiodynamic polarization curves (PPC). EIS findings revealed that the addition of studied inhibitors prevented the degradation of mild steel in HCl solution, hence leading to a high value of polarization resistance compared to the blank solution. Besides that, the PPC results suggested that the tested samples had a mixed-type effect which decreased the anodic and cathodic corrosion reactions. Surface characterization by SEM illustrated a notable decrease in surface roughness of mild steel after the addition of inhibitors. Outcomes from the present study indicates that the Etlingera Elatior inflorescence extract acts as a good corrosion inhibitor for mild steel sample in HCl solution with IE% value above 93.63 %. Formation of the protective layer becomes weaker as the temperature raises.
STATISTICAL ANALYSIS OF THE PERFORMANCE OF YOUNG’S MODULUS OF NATURAL FIBER COMPOSITES AND SYNTHETIC FIBER COMPOSITES
Authors: M. T. Mastura , M. Noryani , C. H Hazliza Aida , M. Nuzaimah , M. A. Shaharuzaman , N. H. Zakaria , Y. F. Loh
Published: March 2024

Fiber-reinforced composites are widely used in a wide range of applications due to their lightweight, low cost, environmentally friendly, and reliable properties. Natural fiber and synthetic fiber are the two main types of fiber. These two fiber groups have distinct features that require a methodical approach for material selection. The distinct properties of both fibers resulted in a wide range of strength that was computed in accordance with the desired performance of material engineers. Synthetic fibers are known to be stronger than natural fibers, however due to sustainability concerns, natural fibers are commonly used with some fiber modifications and hybridization to enhance the strength of natural fiber composites. Statistical analysis is employed in this study to determine Young's modulus of each fiber group. Hypothesis testing was used to confirm the performance of the fiber's Young's modulus. All synthetic fibers have a substantially greater Young's modulus than natural fiber based on the P-value score. Aramid had the highest score for synthetic fibers, while flax fiber had the highest score for natural fiber groups, with 424.8 GPa and 57.3 GPa, respectively. Ultimately, hybridization has the potential to overcome the limitations of both synthetic and natural fibers. This statistical approach may be used to validate the hypothesis about the properties of both fibers.
What Training Do Foundation Doctors Feel They Require to Develop as Clinical Teachers?
Authors: Pierce Hannah , Kermack Alex , Foley Vikki
Published: March 2024

PurposeTo explore the teaching that foundation doctors at the University Hospital of North Midlands undertake and what training they believe is necessary to develop as clinical educators.MethodsA mixed methods approach consisting of questionnaires and focus group discussions (FGDs), following an explanatory sequential design. FGD data was thematically analysed.ResultsThirty-four responses to the questionnaire were analysed. 97% respondents felt that teaching was an important part of their job role. The amount of time spent teaching each week varied from no time to more than two hours, and on average 25% of this teaching occurred outside of clinical hours.Foundation doctors enjoy teaching and want to help others. Challenges described were lack of time, shortage of opportunities and others’ perceptions of their ability to teach. Foundation doctors requested tailored training and formalised feedback to facilitate their development as teachers.ConclusionThis study has shown that foundation doctors undertake a significant amount of teaching and there is a clear desire for additional training. These doctors utilise different teaching methods to their seniors and therefore any training should focus on ad hoc sessions, ward supervision and bedside teaching. Local trusts, medical schools and the UK foundation programme could do more to support foundation doctors’ development as educators by giving them protected time and formalised feedback opportunities. Foundation doctors could be an untapped resource to support the medical school expansion plan in educating the increased numbers of medical students over the coming years.
Factors Affecting the Capacity of Millennial Farmers to Maintaining Business Existence in the Agricultural Sector, East Java Indonesian
Authors: Romadi Ugik , Warnaen Andi , Nurlaili Nurlaili
Published: March 2024

Millennial farmers are the main actors in Indonesia's future agricultural development. Therefore, these millennial farmers need to increase their capacity to survive in doing agriculture business. This study aims to describe the characteristics of millennial farmers; describe the capacity level of millennial farmers in maintaining their existence in the agriculture business; analyse factors that influence the capacity of millennial farmers in maintaining the existence in the agriculture business; and developing a Millennial Farmer Capacity Building model. The method used is the sector research method. The study results show that millennial farmers can identify opportunities in farming. They could be more vital to access quality assurance, such as certification of agricultural products to increase the added value and competitiveness. Factors significantly affecting millennial farmers' capacity are the sociocultural environment, support from private institutions, and personal characteristics. The capacity of millennial farmers also substantially affects the existence of their businesses in agriculture. The role of extension agents only significantly influences the presence of millennial farmer businesses. The capacity of millennial farmers to maintain the existence of businesses in the agricultural sector can be increased through the sociocultural environment, support from private institutions, and personal characteristics.
Permeability Data Treatment from Analogous Outcrop for Use in Three-Dimensional Reservoir Model
Authors: Albuquerque Camila Faria de , Silva Aline Theophilo , Mello Claudio Limeira
Published: March 2024

Over the past forty years, the study of analogous outcrops has become a common practice in the petroleum industry to access more comprehensive geological datasets and better parameterize various geological features. As most reservoirs do not outcrop and all the data obtained are restricted to those collected from wells located in areas of major interest or from indirect measurements, the study of analogous outcrops has brought important contributions to improve the production routines and still represents a helpful information resource. The use of data from analogous outcrops permits, for example, to estimate the sedimentary facies distribution in true reservoirs, and thus to improve on the reliability of fluid flow modeling during the oil field exploration. However, such data must be processed to become equivalent to the data collected under the reservoir conditions and the results obtained to be more realistic. This work presents the statistical method used to make permeability data obtained from an outcrop compatible with the subsurface conditions of poorly consolidated and tectonically deformed sandstone reservoirs. The studied outcrop is predominantly composed of Eocene fluvial sandstones (Resende Formation) of the Volta Redonda Basin, located in the Central Segment of the Continental Rift of Southeastern Brazil. These deposits are affected by deformation bands and faults. From statistical analysis, it was intended that the permeability data become more suitable to be used, in the next phase of the studies, to build a 3D flow model, in which it will be possible to test the potential of different tectonic structures acting as hydraulic barriers in poorly consolidated and deformed reservoirs. The methodological approach applied in this study made it possible to turn compatible the permeability data obtained in conditions of no confining pressures from the outcrop with reservoir conditions under confinement pressures of 2,000 psi. Such pressure conditions are frequently observed in important Maastrichtian reservoirs found in the Brazilian Southeastern Margin.
The Dad and the Lad: Who Is My Client?
Authors: Whitfield Scott , Wadsworth Nick , Butt Joanne
Published: March 2024

This article discusses an applied case study with a young footballer and his father. Contacted initially to offer psychological support to the athlete, after conducting his needs analysis, the practitioner was left questioning who his client really was. This paper outlines how the practitioner arrived at the decision to work with the father rather than the athlete, before reflecting on how his own experience as a young athlete fueled his commitment to work with this case. Drawing upon acceptance and commitment therapy, the intervention’s aim was to increase the father’s psychological flexibility and explore ways he could better support his son. The evaluation suggested that working alongside the practitioner helped the father (a) gain clarity with regard to what was important to him as a parent and (b) begin to behave in a manner that was more aligned to his son’s needs. By virtue of the changes he observed in his father, the young athlete also discussed the implications this had for his own mindset and performance.
Female Collegiate Gymnasts’ Perceptions and Beliefs on Preventative Training Programs
Authors: Martinez Jessica C. , Alexander Ja’Naya M. , Pagnotta Kelly D.
Published: March 2024

Gymnastics has the highest injury rate of all women’s collegiate sports, most occurring to the lower extremity. Preventative training programs (PTPs) effectively reduce lower-extremity injury rates. This study aimed to determine the perceptions and beliefs of female collegiate gymnasts regarding PTPs. Participants reported that they would be more likely to participate in a PTP if it resulted in fewer injury risk factors (p < .001), less likely to suffer an anterior cruciate ligament injury (p < .001), and fewer leg injuries (p < .001). Marketing and education of PTPs should be targeted and focus on what is most important to stakeholders to increase compliance.
Lower-Extremity Visuomotor Reaction Time Is Not Different Between Males and Females Following Anterior Cruciate Ligament Reconstruction
Authors: Genoese Francesca M. , Walaszek Michelle C. , Collins Katherine , Reiche Elaine , Triplett Ashley , Harkey Matthew S. , Kuenze Christopher , Baez Shelby E.
Published: March 2024

Visuomotor reaction time (VMRT) is predictive of lower-extremity musculoskeletal injury and may be a modifiable anterior cruciate ligament (ACL) injury risk factor that affects the incidence of primary and secondary ACL injuries in females. However, it is unknown if females with ACL reconstruction (ACLR) experience diminished VMRT compared with their male counterparts. The purpose of this study was to compare lower-extremity VMRT (LEVMRT) between males and females with ACLR. Female (n = 40) and male (n = 20) participants who were between 4 and 12 months after primary, unilateral ACLR completed a LEVMRT task with each limb using a series of wireless light discs. Mann–Whitney U tests were used to compare between-group differences for LEVMRT (in milliseconds). No statistically significant sex differences were observed for LEVMRT when the ACLR limb deactivated the light discs (females = 509.5 [132.5], males = 507.0 [79.8]; p = .77) or when the ACLR limb was stabilizing while the nonsurgical limb deactivated the light discs (females = 528.5 [105.3], males = 546.0 [92.5]; p = .77). Both males and females may benefit from visual motor training to improve VMRT after ACLR.
Where Are Czech Adolescents Active? The Patterns of Movement and Transport Behavior in Different Active Living Domains
Authors: Vorlíček Michal , Stewart Tom , Dygrýn Jan , Rubín Lukáš , Mitáš Josef , Burian Jaroslav , Duncan Scott , Schipperijn Jasper , Pratt Michael
Published: March 2024

To understand the environmental determinants of physical activity (PA), precise spatial localization is crucial. This cross-sectional study focuses on the spatiotemporal distribution of PA among Czech adolescents (n = 171) using Global Positioning System loggers and accelerometers. The results showed that adolescents spent most of their time in sedentary behavior, with 57.2% and 58.5% of monitored time at home and school, respectively. The park and playground had the lowest proportion of sedentary behavior but also the lowest amount of moderate to vigorous PA (MVPA). However, when considering the time spent in each domain, the highest proportion of MVPA was seen in publicly accessible playgrounds (13.3% of the time). Chi-square analysis showed that the relative distribution of different PA intensities did not differ across spatial domains. Based on these results, the authors propose 2 key strategies for increasing MVPA in adolescents: Increase the time spent in activity-supportive environments, such as parks and playgrounds, and design techniques to increase MVPA at home and school settings.
A Survey of New York State Physical Educators’ Use of Game-Based Approaches in K–12 Physical Education
Authors: Seymour Clancy M. , Garrison Mark , Lindauer Jeffrey R. , Harvey Stephen
Published: March 2024

Background/Purpose: The purpose of this study was to investigate physical educators’ self-reported use, understanding, and confidence with game-based approaches (GBAs) in their K–12 physical education programs. Method: A survey of New York State physical education professionals was conducted that yielded quantitative data on how they used game-based approaches. Data were analyzed using Observation Oriented Modeling (version 5.4.2022), a tool well suited for survey data, especially teachers’ reports of game-based lesson sequences. Results: Physical educators reported both awareness and confidence with various GBAs spending most physical education game-based lessons teaching invasion games with emphasis on the psychomotor domain. Respondents’ typical game lesson sequences did not match model GBA lesson sequences. Conclusions: Findings from this study indicate respondents do not use GBAs for their game-based lessons. Beyond teacher preparation, intentional professional development should address conceptual, pedagogical, cultural, and political obstacles, and may help practitioners become more pedagogically fluent with GBAs.
Biasing microglia to help, not hurt
Authors: Ferrarelli Leslie K.
Published: March 2024

Blocking complement signaling biases microglia to destroy amyloid aggregates, not neuronal synapses.
Epitope(s) involving amino acids of the fusion loop of Japanese encephalitis virus envelope protein is(are) important to elicit protective immunity
Authors: Fan Yi-Chin , Chen Jo-Mei , Chen Yi-Ying , Ke Yuan-Dun , Chang Gwong-Jen J. , Chiou Shyan-Song
Published: March 2024

Dengue vaccine candidates have been shown to improve vaccine safety and efficacy by altering the residues or accessibility of the fusion loop on the virus envelope protein domain II (DII
FL
) in an
ex vivo
animal study. The current study aimed to comprehensively investigate the impact of DII
FL
mutations on the antigenicity, immunogenicity, and protective efficacy of Japanese encephalitis virus (JEV) virus-like particles (VLPs) in mice. We found the DII
FL
G106K/L107D (KD) and W101G/G106K/L107D (GKD) mutations altered the binding activity of JEV VLP to cross-reactive monoclonal antibodies but had no effect on their ability to elicit total IgG antibodies in mice. However, JEV VLPs with KD or GKD mutations induced significantly less neutralizing antibodies against JEV. Only 46% and 31% of the KD and GKD VLPs-immunized mice survived compared to 100% of the wild-type (WT) VLP-immunized mice after a lethal JEV challenge. In passive protection experiments, naïve mice that received sera from WT VLP-immunized mice exhibited a significantly higher survival rate of 46.7% compared to those receiving sera from KD VLP- and GKD VLP-immunized mice (6.7% and 0%, respectively). This study demonstrated that JEV DII
FL
is crucial for eliciting potently neutralizing antibodies and protective immunity against JEV.

IMPORTANCE

Introduction of mutations into the fusion loop is one potential strategy for generating safe dengue and Zika vaccines by reducing the risk of severe dengue following subsequent infections, and for constructing live-attenuated vaccine candidates against newly emerging Japanese encephalitis virus (JEV) or Japanese encephalitis (JE) serocomplex virus. The monoclonal antibody studies indicated the fusion loop of JE serocomplex viruses primarily comprised non-neutralizing epitopes. However, the present study demonstrates that the JEV fusion loop plays a critical role in eliciting protective immunity in mice. Modifications to the fusion loop of JE serocomplex viruses might negatively affect vaccine efficacy compared to dengue and zika serocomplex viruses. Further studies are required to assess the impact of mutant fusion loop encoded by commonly used JEV vaccine strains on vaccine efficacy or safety after subsequent dengue virus infection.
Microbiota from human infants consuming secretors or non-secretors mothers’ milk impacts the gut and immune system in mice
Authors: Gurung Manoj , Schlegel Brent Thomas , Rajasundaram Dhivyaa , Fox Renee , Bode Lars , Yao Tianming , Lindemann Stephen R. , LeRoith Tanya , Read Quentin D. , Simecka Christy , Carroll Laura , Andres Aline , Yeruva Laxmi
Published: March 2024

Maternal secretor status is one of the determinants of human milk oligosaccharides (HMOs) composition, which, in turn, influences the gut microbiota composition of infants. To understand if this change in gut microbiota impacts immune cell composition, intestinal morphology, and gene expression, 21-day-old germ-free C57BL/6 mice were transplanted with fecal microbiota from infants whose mothers were either secretors (SMM) or non-secretors (NSM) or from infants consuming dairy-based formula (MFM). For each group, one set of mice was supplemented with HMOs. HMO supplementation did not significantly impact the microbiota diversity; however, SMM mice had a higher abundance of genus
Bacteroides
,
Bifidobacterium
, and
Blautia
, whereas, in the NSM group, there was a higher abundance of
Akkermansia
,
Enterocloster
, and
Klebsiella
. In MFM, gut microbiota was represented mainly by
Parabacteroides
,
Ruminococcaceae_unclassified
, and
Clostrodium_sensu_stricto
. In mesenteric lymph node, Foxp3+ T cells and innate lymphoid cells type 2 were increased in MFM mice supplemented with HMOs, while in the spleen, they were increased in SMM + HMOs mice. Similarly, serum immunoglobulin A was also elevated in MFM + HMOs group. Distinct global gene expression of the gut was observed in each microbiota group, which was enhanced with HMOs supplementation. Overall, our data show that distinct infant gut microbiota due to maternal secretor status or consumption of dairy-based formula and HMO supplementation impacts immune cell composition, antibody response, and intestinal gene expression in a mouse model.

IMPORTANCE

Early life factors like neonatal diet modulate gut microbiota, which is important for the optimal gut and immune function. One such factor, human milk oligosaccharides (HMOs), the composition of which is determined by maternal secretor status, has a profound effect on infant gut microbiota. However, how the infant gut microbiota composition determined by maternal secretor status or consumption of infant formula devoid of HMOs impacts infant intestinal ammorphology, gene expression, and immune signature is not well explored. This study provides insights into the differential establishment of infant microbiota derived from infants fed by secretor or non-secretor mothers milk or those consuming infant formula and demonstrates that the secretor status of mothers promotes Bifidobacteria and Bacteroides sps. establishment. This study also shows that supplementation of pooled HMOs in mice changed immune cell composition in the spleen and mesenteric lymph nodes and immunoglobulins in circulation. Hence, this study highlights that maternal secretor status has a role in infant gut microbiota composition, and this, in turn, can impact host gut and immune system.
Policies for type 2 diabetes and non-communicable disease management during the COVID-19 pandemic in Kenya and Tanzania: a desk review and views of decision-makers
Authors: Mohamed Shukri F , Kisia Lyagamula , Mashiashi Irene , Mair Frances , Wisdom Jennifer P , Bunn Christopher , Gray Cindy , Kibe Peter M , Sanya Richard E , Karugu Caroline H , Mtenga Sally M , Binyaruka Peter , Asiki Gershim
Published: March 2024

Background

The COVID-19 pandemic caused disruptions in care that adversely affected the management of non-communicable diseases (NCDs) globally. Countries have responded in various ways to support people with NCDs during the pandemic. This study aimed to identify policy gaps, if any, in the management of NCDs, particularly diabetes, during COVID-19 in Kenya and Tanzania to inform recommendations for priority actions for NCD management during any future similar crises.

Methods

We undertook a desk review of pre-existing and newly developed national frameworks, policy models and guidelines for addressing NCDs including type 2 diabetes. This was followed by 13 key informant interviews with stakeholders involved in NCD decision-making: six in Kenya and seven in Tanzania. Thematic analysis was used to analyse the documents.

Results

Seventeen guidance documents were identified (Kenya=10; Tanzania=7). These included pre-existing and/or updated policies/strategic plans, guidelines, a letter, a policy brief and a report. Neither country had comprehensive policies/guidelines to ensure continuity of NCD care before the COVID-19 pandemic. However, efforts were made to update pre-existing documents and several more were developed during the pandemic to guide NCD care. Some measures were put in place during the COVID-19 period to ensure continuity of care for patients with NCDs such as longer supply of medicines. Inadequate attention was given to monitoring and evaluation and implementation issues.

Conclusion

Kenya and Tanzania developed and updated some policies/guidelines to include continuity of care in emergencies. However, there were gaps in the documents and between policy/guideline documents and practice. Health systems need to establish disaster preparedness plans that integrate attention to NCD care to enable them to better handle severe disruptions caused by emergencies such as pandemics. Such guidance needs to include contingency planning to enable adequate resources for NCD care and must also address evaluation of implementation effectiveness.
Precise infliximab exposure and pharmacodynamic control to achieve deep remission in paediatric Crohn’s disease (REMODEL-CD): study protocol for a multicentre, open-label, pragmatic clinical trial in the USA
Authors: Minar Phillip Paul , Colman Ruben J , Zhang Nanhua , Mizuno Tomoyuki , Vinks Alexander A
Published: March 2024

Introduction

The only biologic therapy currently approved to treat moderate to severe Crohn’s disease in children (<18 years old) are those that antagonise tumour necrosis factor-alpha (anti-TNF). Therefore, it is critically important to develop novel strategies that maximise treatment effectiveness in this population. There is growing evidence that rates of sustained corticosteroid-free clinical remission, endoscopic healing and drug durability considerably improve when patients receive early anti-TNF dose optimisations guided by reactive or proactive therapeutic drug monitoring and pharmacodynamic monitoring. In response, our team has developed a personalised and scalable infliximab dosing intervention that starts with dose selection and continues throughout maintenance to optimise drug exposure. We hypothesise that a precision dosing strategy starting from induction and targeting dose-specific pharmacokinetic and pharmacodynamic endpoints throughout therapy will significantly improve outcomes compared with a conventional dosing strategy.

Methods and analysis

Conduct a clinical trial to assess rates of deep remission between Crohn’s disease patients receiving infliximab with precision dosing (n=90) versus conventional care (n=90). Patients (age 6–22 years) will be recruited from 10 medical centres in the USA. Each centre has been selected to provide either precision dosing or conventional care dosing. Precision dosing includes the use of a clinical decision support tool (RoadMAB) from the start of infliximab to achieve specific (personalised) trough concentrations and specific pharmacodynamic targets (at doses 3, 4 and 6). Conventional care includes the use of a modified infliximab starting dose (5 or 7.5 mg/kg based on the pretreatment serum albumin) with a goal to achieve maintenance trough concentrations of 5–10 µg/mL. The primary endpoint is year 1 deep remission defined as a combination of clinical remission (paediatric Crohn’s disease activity index<10 (child) or a Crohn’s disease activity index<150 (adults)), off prednisone>8 weeks and endoscopic remission (simple endoscopic severity-Crohn’s disease≤2).

Ethics and dissemination

). The study protocol has been approved by the Cincinnati Children’s Hospital Medical Centre Institutional Review Board. Study results will be disseminated in peer-reviewed journals and presented at scientific meetings.

Trial registration number

NCT05660746.
Impact of clinical supervision on the mental health nursing workforce: a scoping review protocol
Authors: McDonough Joshua Henry , Rhodes Kate , Procter Nicholas
Published: March 2024

Introduction

Mental health nurses work in potentially unpredictable, stressful and complex environments that can lead to burn-out and high staff turnover. Clinical supervision is a formal and professional agreement between two or more people that aims to strengthen individuals’ competencies and organisational strengths. Effective clinical supervision has been noted as a method of reducing workplace issues within mental health nursing, but there is not currently a synthesis of evidence in this area. The key objective of this scoping review is to identify, map and analyse the available evidence reporting on the impact of clinical supervision on workforce outcomes for mental health nurses.

Methods

A scoping review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses-Scoping Review Extension method will be conducted exploring clinical supervision for mental health nurses. A search for academic literature from Medline, CINAHL, Embase and PsycINFO will be combined with grey literature sourced through Google to identify potentially relevant studies. Studies identified by the search strategy will be managed using Covidence, and two authors will screen all identified articles. Reference lists of included studies will be handsearched to identify any potentially relevant studies missed by the search strategy.

Analysis

A summary tool including predefined categories (such as author, date published, workforce outcome measured) will be used to summarise the included studies in this scoping review. Additionally, a narrative synthesis approach will be used to report the outcomes of included studies and provide further analysis.

Ethics and dissemination

This scoping review protocol described research that will use secondary analysis of publicly available information, and therefore, does not require ethics approval. The findings of this research will be disseminated through publication in a peer-reviewed academic journal and relevant conference presentations.
Association between body mass index and delirium incidence in critically ill patients: a retrospective cohort study based on the MIMIC-IV Database
Authors: Fu Jianlei , Zhang Xuepeng , Zhang Geng , Wei Canzheng , Fu Qinyi , Gui Xiying , Ji Yi , Chen Siyuan
Published: March 2024

Objectives

Delirium is a form of brain dysfunction with high incidence and is associated with many negative outcomes in the intensive care unit. However, few studies have been large enough to reliably examine the associations between body mass index (BMI) and delirium, especially in critically ill patients. The objective of this study was to investigate the association between BMI and delirium incidence in critically ill patients.

Design

A retrospective cohort study.

Setting

Data were collected from the Medical Information Mart for Intensive Care-IV V2.0 Database consisting of critically ill participants between 2008 and 2019 at the Beth Israel Deaconess Medical Center in Boston.

Participants

A total of 20 193 patients with BMI and delirium records were enrolled in this study and were divided into six groups.

Primary outcome measure

Delirium incidence.

Results

Generalised linear models and restricted cubic spline analysis were used to estimate the associations between BMI and delirium incidence. A total of 30.81% of the patients (6222 of 20 193) developed delirium in the total cohort. Compared with those in the healthy weight group, the patients in the different groups (underweight, overweight, obesity grade 1, obesity grade 2, obesity grade 3) had different relative risks (RRs): RR=1.10, 95% CI=1.02 to 1.19, p=0.011; RR=0.93, 95% CI=0.88 to 0.97, p=0.003; RR=0.88, 95% CI=0.83 to 0.94, p<0.001; RR=0.94, 95% CI=0.86 to 1.03, p=0.193; RR=1.14, 95% CI=1.03 to 1.25, p=0.010, respectively. For patients with or without adjustment variables, there was an obvious U-shaped relationship between BMI as a continuous variable and delirium incidence.

Conclusion

BMI was associated with the incidence of delirium. Our results suggested that a BMI higher or lower than obesity grade 1 rather than the healthy weight in critically ill patients increases the risk of delirium incidence.
Clinical practice guideline recommendations to improve the mental health of adult trauma patients: protocol for a systematic review
Authors: Bérubé Mélanie , Bradley Nori , O'Donnell Meaghan , Stelfox Henry Thomas , Garraway Naisan , Vasiliadis Helen-Maria , Turcotte Valerie , Perreault Michel , Menear Matthew , Archambault Léonie , Haagsma Juanita , Provencher Hélène , Genest Christine , Gagnon Marc-Aurèle , Bourque Laurence , Lapierre Alexandra , Khalfi Amal , Panenka William
Published: March 2024

Introduction

Mental disorders are common in adult patients with traumatic injuries. To limit the burden of poor psychological well-being in this population, recognised authorities have issued recommendations through clinical practice guidelines (CPGs). However, the uptake of evidence-based recommendations to improve the mental health of trauma patients has been low until recently. This may be explained by the complexity of optimising mental health practices and interpretating CGPs scope and quality. Our aim is to systematically review CPG mental health recommendations in the context of trauma care and appraise their quality.

Methods and analysis

We will identify CPG through a search strategy applied to Medline, Embase, CINAHL, PsycINFO and Web of Science databases, as well as guidelines repositories and websites of trauma associations. We will target CPGs on adult and acute trauma populations including at least one recommendation on any prevention, screening, assessment, intervention, patient and family engagement, referral or follow-up procedure related to mental health endorsed by recognised organisations in high-income countries. No language limitations will be applied, and we will limit the search to the last 15 years. Pairs of reviewers will independently screen titles, abstracts, full texts, and carry out data extraction and quality assessment of CPGs using the Appraisal of Guidelines Research and Evaluation (AGREE) II. We will synthesise the evidence on recommendations for CPGs rated as moderate or high quality using a matrix based on the Grading of Recommendations Assessment, Development and Evaluation quality of evidence, strength of recommendation, health and social determinants and whether recommendations were made using a population-based approach.

Ethics and dissemination

Ethics approval is not required, as we will conduct secondary analysis of published data. The results will be disseminated in a peer-reviewed journal, at international and national scientific meetings. Accessible summary will be distributed to interested parties through professional, healthcare quality and persons with lived experience associations.

PROSPERO registration number

(ID454728).