bluuebunny/crossref_metadata_2025 huggingface dataset:
The evaluation of clinical factors affecting oral health impacts on the quality of life of Iranian elderly patients visiting dental clinics: A cross‐sectional study
Authors: Mirhosseini Nazanin , Shoorgashti Reyhaneh , Lesan Simin
Published: March 2024

Background

Iran will soon have an aging population. Healthcare providers must consider factors affecting the quality of life for those 60 and older. Understanding oral health as one of these factors can improve the elderly's quality of life. Oral health‐related quality of life (OHRQoL) is a crucial reflection of individuals' general well‐being and their overall quality of life linked to health. This study aimed to evaluate the OHRQoL among elderly Iranians referring to Azad University of Medical Sciences in Tehran.

Methods

In this cross‐sectional study, 171 individuals over 65 (93 men and 78 women) were evaluated using OHIP‐14 and GOHAI‐12 questionnaires to analyze their quality of life. Gender, age, systemic diseases, using medications and dentures, the number of remaining teeth, and oral lesions were recorded. Salivary flow and xerostomia were analyzed with the spitting method and xerostomia index questionnaire, respectively. Also, four main flavor solutions were used to evaluate the taste perception. Data were analyzed using PASS11 and p value < .05 was the significance level.

Results

Based on OHIP‐14 and GOHAI‐12, Iranian older people's quality of life can be affected by cardiovascular diseases, hypertension, xerostomia, and the number of remaining teeth (p < .05). The results also showed a significant correlation between the OHIP‐14 and GOHAI‐12 scores (p < .001). Both indexes revealed that the number of remaining teeth, xerostomia, salivary flow, and taste perception greatly influenced participants' quality of life. More remaining teeth, improved salivary flow, and better perception of sweetness and sourness were all linked to a higher quality of life, while increased xerostomia, reduced salivary flow, and bitter taste perception were linked to a decline in overall well‐being. Cardiovascular diseases, hypertension, and medication use were also found to significantly impact quality of life.

Conclusion

This study's results indicate that cardiovascular diseases, hypertension, dry mouth, and tooth loss can negatively impact the elderly's quality of life. So, improving both systemic and oral health is vital for enhancing life quality in this age group.
Ischemic preconditioning increases spinal excitability and voluntary activation during maximal plantar flexion contractions in men
Authors: Cruz Rogério , Tramontin Artur Ferreira , Oliveira Anderson Souza , Caputo Fabrizio , Denadai Benedito Sérgio , Greco Camila Coelho
Published: March 2024

The enigmatic benefits of acute limb ischemic preconditioning (IP) in enhancing muscle force and exercise performance have intrigued researchers. This study sought to unravel the underlying mechanisms, focusing on increased neural drive and the role of spinal excitability while excluding peripheral factors. Soleus Hoffmann (H)‐reflex /M‐wave recruitment curves and unpotentiated supramaximal responses were recorded before and after IP or a low‐pressure control intervention. Subsequently, the twitch interpolation technique was applied during maximal voluntary contractions to assess conventional parameters of neural output. Following IP, there was an increase in both maximum normalized force and voluntary activation (VA) for the plantar flexor group, with negligible peripheral alterations. Greater benefits were observed in participants with lower VA levels. Despite greater H‐reflex gains, soleus volitional (V)‐wave and sEMG amplitudes remained unchanged. In conclusion, IP improves muscle force via enhanced neural drive to the muscles. This effect appears associated, at least in part, to reduced presynaptic inhibition and/or increased motoneuron excitability. Furthermore, the magnitude of the benefit is inversely proportional to the skeletal muscle's functional reserve, making it particularly noticeable in under‐recruited muscles. These findings have implications for the strategic application of the IP procedure across diverse populations.
Advanced practice providers in infectious disease: Enhancing the infectious disease team of the future
Authors: Yoke Leah H. , Miller Whitney , Beieler Alison M.
Published: March 2024

As the infectious disease (ID) workforce encounters increasing demand for services with fewer physicians entering the field, advanced practice providers (APPs) in infectious disease offer a unique ability to enhance high‐quality patient care. However, little is known about their incorporation into ID, their utilization in immunocompromised settings, or their future use. This article reviews currently known data on APPs in ID including how some groups have used APPs and provides a framework for thoughtful, deliberate steps to incorporate APPs into the ID medical team, including transplant infectious disease. Highlighted specifically are education and mentorship opportunities with ideas for curriculum development and onboarding approaches. Strategic steps must be taken for APP inclusion as the medical landscape continues to change, patient complexity increases, and the ID team of the future takes shape.
Host‐induced gene silencing in wild apple germplasm Malus hupehensis confers resistance to the fungal pathogen Botryosphaeria dothidea
Authors: Yu Xinyi , Lin Xinxin , Zhou Tingting , Cao Lifang , Hu Kaixu , Li Fangzhu , Qu Shenchun
Published: March 2024

Host‐induced gene silencing (HIGS) is an inherent mechanism of plant resistance to fungal pathogens, resulting from cross‐kingdom RNA interference (RNAi) mediated by small RNAs (sRNAs) delivered from plants into invading fungi. Introducing artificial sRNA precursors into crops can trigger HIGS of selected fungal genes, and thus has potential applications in agricultural disease control. To investigate the HIGS of apple (Malus sp.) during the interaction with Botryosphaeria dothidea, the pathogenic fungus causing apple ring rot disease, we evaluated whether apple miRNAs can be transported into and target genes in B. dothidea. Indeed, miR159a from Malus hupehensis, a wild apple germplasm with B. dothidea resistance, silenced the fungal sugar transporter gene BdSTP. The accumulation of miR159a in extracellular vesicles (EVs) of both infected M. hupehensis and invading B. dothidea suggests that this miRNA of the host is transported into the fungus via the EV pathway. Knockout of BdSTP caused defects in fungal growth and proliferation, whereas knockin of a miR159a‐insensitive version of BdSTP resulted in increased pathogenicity. Inhibition of miR159a in M. hupehensis substantially enhanced plant sensitivity to B. dothidea, indicating miR159a‐mediated HIGS against BdSTP being integral to apple immunity. Introducing artificial sRNA precursors targeting BdSTP and BdALS, an acetolactate synthase gene, into M. hupehensis revealed that double‐stranded RNAs were more potent than engineered MIRNAs in triggering HIGS alternative to those natural of apple and inhibiting infection. These results provide preliminary evidence for cross‐kingdom RNAi in the apple–B. dothidea interaction and establish HIGS as a potential disease control strategy in apple.
Complete genome assembly provides a high‐quality skeleton for pan‐NLRome construction in melon
Authors: Mo Changjuan , Wang Haiyan , Wei Minghua , Zeng Qingguo , Zhang Xuejun , Fei Zhangjun , Zhang Yongbing , Kong Qiusheng
Published: March 2024

Melon (Cucumis melo L.), being under intensive domestication and selective breeding, displays an abundant phenotypic diversity. Wild germplasm with tolerance to stress represents an untapped genetic resource for discovery of disease‐resistance genes. To comprehensively characterize resistance genes in melon, we generate a telomere‐to‐telomere (T2T) and gap‐free genome of wild melon accession PI511890 (C. melo var. chito) with a total length of 375.0 Mb and a contig N50 of 31.24 Mb. The complete genome allows us to dissect genome architecture and identify resistance gene analogs. We construct a pan‐NLRome using seven melon genomes, which include 208 variable and 18 core nucleotide‐binding leucine‐rich repeat receptors (NLRs). Multiple disease‐related transcriptome analyses indicate that most up‐regulated NLRs induced by pathogens are shell or cloud NLRs. The T2T gap‐free assembly and the pan‐NLRome not only serve as essential resources for genomic studies and molecular breeding of melon but also provide insights into the genome architecture and NLR diversity.
National evaluation of DNP students' use of the PICOT method for formulating clinical questions
Authors: Milner Kerry A. , Hays Deana , Farus‐Brown Susan , Zonsius Mary C. , Saska Elizabeth , Fineout‐Overholt Ellen
Published: March 2024

Background

The intent of the PICOT (i.e., Population, Intervention, Comparison, Outcome, Time) method is to formulate focused clinical questions to facilitate the discovery of relevant evidence through systematic searching, with the components of the question serving as the foundation for the search. Doctor of Nursing Practice (DNP) graduates use evidence‐based practices to institute changes in their organizations' systems and policies, thereby yielding positive effects on both patient and system outcomes. Given that the clinical question is the foundation of the evidence‐based practice process, DNP graduates' competence in the PICOT method needs to be better understood.

Aims

This analysis aimed to describe how DNP students used the PICOT method to ask clinical questions in their DNP projects.

Methods

Project questions were retrieved from a subset (n = 129, 60.56%) of an existing national random sample of publicly available DNP projects spanning the years 2010 to 2021 from Commission on Collegiate Nursing Education‐accredited schools (n = 213). Project questions using the PICOT method were further evaluated with a scoring system of 0 = no and 1 = yes for missing elements, formatting, directional outcome, and project purpose. Possible scores ranged from 0 to 8, with higher scores indicating more errors. Discussion among five researchers, until agreement was achieved, yielded consensus.

Results

Although the PICOT method was project author‐identified in 66 (31.0%) projects, only four (6%) followed the PICOT method. All 66 (100%) were intervention questions. There were 2.74 (SD 1.55) mean errors, ranging from 0 to 6. No questions were missing P or O. Specific errors included missing I 3 (4.5%) or missing C 37 (56%), poor formatting 34 (51.5%), directional outcome 44 (66.7%), and project purpose 38 (57.6%). Thirty‐three (50%) of the questions were missing T; however, T is not used for searching, so researchers recalculated the mean error without T (M = 2.24, SD = 1.28, range 0–5).

Linking Evidence to Action

Gaps in the accurate use of the PICOT method to construct clinical questions can lead to biased searches, inaccurate clinical problem identification, and, when used as the project purpose, jumping to non‐evidence‐based solutions. Academic faculty and clinical educators can mitigate these skewed outcomes and enhance their impact on quality outcomes by helping DNP‐prepared nurses shore up this foundational skill.
Non‐pharmacological interventions on quality of life in stroke survivors: A systematic review and meta‐analysis
Authors: Gao Chang , Li Xiaomei , Li Fanling , Li Jin , Zhang Jingjun
Published: March 2024

Background

Non‐pharmacological interventions have been used in the rehabilitation of stroke survivors, but their effects on stroke survivors' quality of life (QoL) are unknown.

Aim

This review aimed to summarize the existing evidence regarding non‐pharmacological interventions for QoL in stroke survivors and to evaluate the effectiveness of different types of interventions.

Methods

We systematically searched databases including PubMed, Embase, Web of Science, Cochrane Library, China National Knowledge Infrastructure, Chinese BioMedical Literature Database, China Science and Technology Journal Database, and Wanfang data from the earliest available records to March 2023. Randomized controlled trials which explored the effects of non‐pharmacological interventions on QoL in stroke patients were included. The meta‐analysis was conducted to evaluate the effectiveness of different interventions on QoL. The Review Manager 5.3 was used to conduct the meta‐analysis and the revised Cochrane risk‐of‐bias tool was used to assess the methodological quality of trials.

Results

A total of 93,245 records were identified, and 34 articles were reviewed and summarized, of which 20 articles were included in the meta‐analysis. The summary of the findings of the included studies revealed fitness training, constraint‐induced movement therapy (CIMT), physical exercise, music therapy (MT), and art‐based interventions may have positive effects on QoL. The fitness training improved total QoL, especially in physical domains including physical functioning (mean difference [MD] = 10.90; 95% CI [7.20, 14.59]), role physical (MD = 10.63; 95% CI [6.71, 14.55]), and global health (MD = 8.76; 95% CI [5.14, 12.38]). The CIMT had a slight effect on general QoL (standardized mean difference [SMD] = 0.48, 95% CI [0.16, 0.80]), whereas significantly improved strength (MD = 8.84; 95% CI [1.31, 16.38]), activities of daily living/instrumental activities of daily living (ADL/IADL; MD = 10.42; 95% CI [2.98, 17.87]), and mobility (MD = 8.02; 95% CI [1.21, 14.83]). MT had a positive effect on the mental health domain (SMD = 0.54; 95% CI [0.14, 0.94]).

Linking Evidence to Action

Our findings suggest that fitness training and CIMT have a significant effect on improving physical QoL, while MT has a positive effect on improving psychological QoL. Future studies may use comprehensive and multicomponent interventions to simultaneously improve the patients' physical, psychological, and social QoL.
Estimating quality-adjusted life expectancy (QALE) for local authorities in Great Britain and its association with indicators of the inclusive economy: a cross-sectional study
Authors: Höhn Andreas , Lomax Nik , Rice Hugh , Angus Colin , Brennan Alan , Brown Denise , Cunningham Anne , Elsenbroich Corinna , Hughes Ceri , Katikireddi Srinivasa Vittal , McCartney Gerry , Seaman Rosie , Tsuchia Aki , Meier Petra
Published: March 2024

Objectives

Quantifying area-level inequalities in population health can help to inform policy responses. We describe an approach for estimating quality-adjusted life expectancy (QALE), a comprehensive health expectancy measure, for local authorities (LAs) in Great Britain (GB). To identify potential factors accounting for LA-level QALE inequalities, we examined the association between inclusive economy indicators and QALE.

Setting

361/363 LAs in GB (lower tier/district level) within the period 2018–2020.

Data and methods

We estimated life tables for LAs using official statistics and utility scores from an area-level linkage of the Understanding Society survey. Using the Sullivan method, we estimated QALE at birth in years with corresponding 80% CIs. To examine the association between inclusive economy indicators and QALE, we used an open access data set operationalising the inclusive economy, created by the System Science in Public Health and Health Economics Research consortium.

Results

Population-weighted QALE estimates across LAs in GB were lowest in Scotland (females/males: 65.1 years/64.9 years) and Wales (65.0 years/65.2 years), while they were highest in England (67.5 years/67.6 years). The range across LAs for females was from 56.3 years (80% CI 45.6 to 67.1) in Mansfield to 77.7 years (80% CI 65.11 to 90.2) in Runnymede. QALE for males ranged from 57.5 years (80% CI 40.2 to 74.7) in Merthyr Tydfil to 77.2 years (80% CI 65.4 to 89.1) in Runnymede. Indicators of the inclusive economy accounted for more than half of the variation in QALE at the LA level (adjusted R2females/males: 50%/57%). Although more inclusivity was generally associated with higher levels of QALE at the LA level, this association was not consistent across all 13 inclusive economy indicators.

Conclusions

QALE can be estimated for LAs in GB, enabling further research into area-level health inequalities. The associations we identified between inclusive economy indicators and QALE highlight potential policy priorities for improving population health and reducing health inequalities.
Voluntariness of consent in paediatric HIV clinical trials: a mixed-methods, cross-sectional study of participants in the CHAPAS-4 and ODYSSEY trials in Uganda
Authors: Makumbi Shafic , Bajunirwe Francis , Ford Deborah , Turkova Anna , South Annabelle , Lugemwa Abbas , Musiime Victor , Gibb Diana , Tamwesigire Imelda K
Published: March 2024

Objectives

To examine the voluntariness of consent in paediatric HIV clinical trials and the associated factors.

Design

Mixed-methods, cross-sectional study combining a quantitative survey conducted concurrently with indepth interviews.

Setting and participants

From January 2021 to April 2021, we interviewed parents of children on first-line or second-line Anti-retroviral therapy (ART) in two ongoing paediatric HIV clinical trials [CHAPAS-4 (ISRCTN22964075) and ODYSSEY (ISRCTN91737921)] at the Joint Clinical Research Centre Mbarara, Uganda.

Outcome measures

The outcome measures were the proportion of parents with voluntary consent, factors affecting voluntariness and the sources of external influence. Parents rated the voluntariness of their consent on a voluntariness ladder. Indepth interviews described participants’ lived experiences and were aimed at adding context.

Results

All 151 parents randomly sampled for the survey participated (84% female, median age 40 years). Most (67%) gave a fully voluntary decision, with a score of 10 on the voluntariness ladder, whereas 8% scored 9, 9% scored 8, 6% scored 7, 8% scored 6 and 2.7% scored 4. Trust in medical researchers (adjusted OR 9.90, 95% CI 1.01 to 97.20, p=0.049) and male sex of the parent (adjusted OR 3.66, 95% CI 1.00 to 13.38, p=0.05) were positively associated with voluntariness of consent. Prior research experience (adjusted OR 0.31, 95% CI 0.12 to 0.78, p=0.014) and consulting (adjusted OR 0.25. 95% CI 0.10 to 0.60, p=0.002) were negatively associated with voluntariness. Consultation and advice came from referring health workers (36%), spouses (29%), other family members (27%), friends (15%) and researchers (7%). The indepth interviews (n=14) identified the health condition of the child, advice from referring health workers and the opportunity to access better care as factors affecting the voluntariness of consent.

Conclusions

This study demonstrated a high voluntariness of consent, which was enhanced among male parents and by parents’ trust in medical researchers. Prior research experience of the child and advice from health workers and spouses were negatively associated with the voluntariness of parents’ consent. Female parents and parents of children with prior research experience may benefit from additional interventions to support voluntary participation.
Evaluating the accuracy of the Ophthalmologist Robot for multiple blindness-causing eye diseases: a multicentre, prospective study protocol
Authors: Li Qixin , Tan Jie , Xie He , Zhang Xiaoyu , Dai Qi , Li Zhongwen , Yan Lijing L , Chen Wei
Published: March 2024

Introduction

Early eye screening and treatment can reduce the incidence of blindness by detecting and addressing eye diseases at an early stage. The Ophthalmologist Robot is an automated device that can simultaneously capture ocular surface and fundus images without the need for ophthalmologists, making it highly suitable for primary application. However, the accuracy of the device’s screening capabilities requires further validation. This study aims to evaluate and compare the screening accuracies of ophthalmologists and deep learning models using images captured by the Ophthalmologist Robot, in order to identify a screening method that is both highly accurate and cost-effective. Our findings may provide valuable insights into the potential applications of remote eye screening.

Methods and analysis

This is a multicentre, prospective study that will recruit approximately 1578 participants from 3 hospitals. All participants will undergo ocular surface and fundus images taken by the Ophthalmologist Robot. Additionally, 695 participants will have their ocular surface imaged with a slit lamp. Relevant information from outpatient medical records will be collected. The primary objective is to evaluate the accuracy of ophthalmologists’ screening for multiple blindness-causing eye diseases using device images through receiver operating characteristic curve analysis. The targeted diseases include keratitis, corneal scar, cataract, diabetic retinopathy, age-related macular degeneration, glaucomatous optic neuropathy and pathological myopia. The secondary objective is to assess the accuracy of deep learning models in disease screening. Furthermore, the study aims to compare the consistency between the Ophthalmologist Robot and the slit lamp in screening for keratitis and corneal scar using the Kappa test. Additionally, the cost-effectiveness of three eye screening methods, based on non-telemedicine screening, ophthalmologist-telemedicine screening and artificial intelligence-telemedicine screening, will be assessed by constructing Markov models.

Ethics and dissemination

The study has obtained approval from the ethics committee of the Ophthalmology and Optometry Hospital of Wenzhou Medical University (reference: 2023-026 K-21-01). This work will be disseminated by peer-review publications, abstract presentations at national and international conferences and data sharing with other researchers.

Trial registration number

ChiCTR2300070082.
Biomechanical and neuromuscular characteristics in patients with traumatic anterior shoulder instability undergoing arthroscopic Bankart repair: a clinical prospective cohort study protocol
Authors: Malmberg Catarina , Andreasen Kristine Rask , Bencke Jesper , Kjær Birgitte Hougs , Hølmich Per , Barfod K W
Published: March 2024

Introduction

Traumatic shoulder dislocation is a common shoulder injury, especially among the young and active population. More than 95% of dislocations are anterior, in which the humeral head is forced beyond the anterior glenoid rim. The injury leads to increased joint laxity and recurrence rates are high. There is evidence that the shoulder biomechanics and neuromuscular control change following dislocation, but the existing literature is scarce, and it remains to be established if and how these parameters are useful in the clinical setting. The aim of this exploratory prospective cohort study is to investigate biomechanical and neuromuscular outcomes in patients with traumatic anterior shoulder instability undergoing arthroscopic Bankart repair, to test the hypothesis that examinations of these characteristics are applicable in the clinical setting to assess shoulder instability.

Methods and analysis

This is a prospective multicentre cohort study with repeated measures of 30 patients undergoing arthroscopic Bankart repair. With carefully selected and completely non-invasive examination methods, we will investigate biomechanical and neuromuscular outcomes in the affected shoulders once presurgically and twice post surgically at 6 and 12 months. Patients’ contralateral shoulders are investigated once to establish a preinjury level.

Ethics and dissemination

The study was approved by the Capital Region Ethics Committee (journal-no: H-21027799) and the Capital Region Knowledge Center for Data Reviews (journal-no: P-2021-842) before patient recruitment began. The study results will be published in international peer-reviewed journals, online and in other relevant media, presented at medical conventions and disseminated to clinicians and patients as appropriate.

Trial registration number

NCT05250388.
Effects of opioid-free anaesthesia compared with balanced general anaesthesia on nausea and vomiting after video-assisted thoracoscopic surgery: a single-centre randomised controlled trial
Authors: Bao Rui , Zhang Wei-shi , Zha Yi-feng , Zhao Zhen-zhen , Huang Jie , Li Jia-lin , Wang Tong , Guo Yu , Bian Jin-jun , Wang Jia-feng
Published: March 2024

Objectives

Opioid-free anaesthesia (OFA) has emerged as a promising approach for mitigating the adverse effects associated with opioids. The objective of this study was to evaluate the impact of OFA on postoperative nausea and vomiting (PONV) following video-assisted thoracic surgery.

Design

Single-centre randomised controlled trial.

Setting

Tertiary hospital in Shanghai, China.

Participants

Patients undergoing video-assisted thoracic surgery were recruited from September 2021 to June 2022.

Intervention

Patients were randomly allocated to OFA or traditional general anaesthesia with a 1:1 allocation ratio.

Primary and secondary outcome measures

The primary outcome measure was the incidence of PONV within 48 hours post-surgery, and the secondary outcomes included PONV severity, postoperative pain, haemodynamic changes during anaesthesia, and length of stay (LOS) in the recovery ward and hospital.

Results

A total of 86 and 88 patients were included in the OFA and control groups, respectively. Two patients were excluded because of severe adverse events including extreme bradycardia and epilepsy-like convulsion. The incidence and severity of PONV did not significantly differ between the two groups (29 patients (33.0%) in the control group and 22 patients (25.6%) in the OFA group; relative risk 0.78, 95% CI 0.49 to 1.23; p=0.285). Notably, the OFA approach used was associated with an increase in heart rate (89±17 vs 77±15 beats/min, t-test: p<0.001; U test: p<0.001) and diastolic blood pressure (87±17 vs 80±13 mm Hg, t-test: p=0.003; U test: p=0.004) after trachea intubation. Conversely, the control group exhibited more median hypotensive events per patient (mean 0.5±0.8 vs 1.0±2.0, t-test: p=0.02; median 0 (0–4) vs 0 (0–15), U test: p=0.02) during surgery. Postoperative pain scores, and LOS in the recovery ward and hospital did not significantly differ between the two groups.

Conclusions

Our study findings suggest that the implementation of OFA does not effectively reduce the incidence of PONV following thoracic surgery when compared with traditional total intravenous anaesthesia. The opioid-free strategy used in our study may be associated with severe adverse cardiovascular events.

Trial registration number

ChiCTR2100050738.
NeuroMotion smartphone application for remote General Movements Assessment: a feasibility study in Nepal
Authors: Kukka Antti Juhani , Sundelin Heléne E K , Basnet Omkar , Paudel Prajwal , Upadhyay Subedi Kalpana , Svensson Katarina , Brown Nick , Litorp Helena , Gurung Rejina , Bhattarai Pratiksha , Wrammert Johan , KC Ashish
Published: March 2024

Objectives

To evaluate the feasibility of using the NeuroMotion smartphone application for remote General Movements Assessment for screening infants for cerebral palsy in Kathmandu, Nepal.

Method

Thirty-one term-born infants at risk of cerebral palsy due to birth asphyxia or neonatal seizures were recruited for the follow-up at Paropakar Maternity and Women’s Hospital, 1 October 2021 to 7 January 2022. Parents filmed their children at home using the application at 3 months’ age and the videos were assessed for technical quality using a standardised form and for fidgety movements by Prechtl’s General Movements Assessment. The usability of the application was evaluated through a parental survey.

Results

Twenty families sent in altogether 46 videos out of which 35 had approved technical quality. Sixteen children had at least one video with approved technical quality. Three infants lacked fidgety movements. The level of agreement between assessors was acceptable (Krippendorf alpha 0.781). Parental answers to the usability survey were in general positive.

Interpretation

Engaging parents in screening of cerebral palsy with the help of a smartphone-aided remote General Movements Assessment is possible in the urban area of a South Asian lower middle-income country.
Knowledge, attitude and practice on ovarian reserve function among women of childbearing age: a prospective cross-sectional study in Chongqing and surrounding regions
Authors: Yuan Youfang , Yang Li , Hu Jun , Deng Yu , Zhang Hongying
Published: March 2024

Objectives

To evaluate the knowledge, attitudes and practice (KAP) on ovarian reserve function among women of childbearing age in Chongqing and surrounding regions, China.

Design

Cross-sectional study.

Setting

Chongqing and surrounding regions, China.

Participants

Women of childbearing age (18–48 years) by convenience sampling.

Primary and secondary outcome measures

The demographic characteristics of the respondents and their KAP on ovarian reserve function were collected by administering 38-item questionnaires.

Results

A total of 510 valid questionnaires were collected. The mean knowledge score of all respondents was 7.56±2.03 (possible range: 0–10), the mean attitude score was 29.12±3.98 (possible range: 8–40) and the mean practice score was 23.45±3.58 (possible range: 6–30). The multivariable analysis showed knowledge level (OR 1.175, 95% CI 1.049 to 1.317, p=0.002), attitude level (OR 1.249, 95% CI 1.167 to 1.337, p<0.001) and eating habits (self-cooked vs eating out, OR 1.958, 95% CI 1.201 to 3.190, p=0.007) were independently associated with better practice level. The structural equation modelling analysis showed that knowledge had a direct influence on attitude (β=0.487, p=0.030) and practice (β=0.312, p=0.012) and an indirect influence on practice (β=0.213, p=0.016). Attitude had a direct influence on practice (β=0.438, p=0.007). The total influence of knowledge on practice was significant (β=0.525, p=0.012).

Conclusions

The women living in Chongqing and surrounding regions had good knowledge, moderate attitude and good practice towards ovarian reserve function. The knowledge aspect can be further improved by education, which in turn might also improve practice among women of childbearing age.
Patient-planetary health co-benefit prescribing in a circumpolar health region: a qualitative study of physician voices from the Northwest Territories, Canada
Authors: Redvers Nicole , Hartmann-Boyce Jamie , Tonkin-Crine Sarah
Published: March 2024

Background

Despite climate change being described as a code red for humanity, health systems have been particularly slow in both climate mitigation and adaptation responses. The effects of climate change on health and health systems will not be felt equally, with underserved and marginalised communities disproportionately impacted. The circumpolar region is warming at 3–4 times the global rate, amplifying already existing socioeconomic barriers and health inequities, with particular amplified effects for the substantial Indigenous population in the area.

Objectives and setting

We therefore sought to explore perspectives of physicians around patient-planetary health (P-PH) co-benefit prescribing in a circumpolar region in the Northwest Territories (NWT), Canada, known to be one of the ground zero levels for climate change.

Methods

Thirteen semi-structured physician interviews were carried out in the NWT region between May 2022 and March 2023 using purposive sampling. Interviews were transcribed verbatim and reflexive thematic analysis was carried out to identify key themes.

Results

There were three main themes identified including (1) current healthcare system does not support planetary health, (2) supporting patient-planetary health is currently difficult for clinicians and (3) considering change in the NWT to support patient-planetary health. Participants noted key opportunities to move planetary health forward, with the NWT having the potential to be an innovative model for planetary health-informed change for other health systems.

Conclusion

The NWT health system has unique features due to its rural and remote nature and smaller population base. Despite this, our study identified some key opportunities for advancing P-PH co-benefit efforts. The identified opportunities may be considered in future intervention, organisational change and policy-making efforts with potential relevance in other settings.
Implementation of an intervention to reduce urine dipstick testing in aged care homes: a qualitative study of enablers and barriers, and strategies to enhance delivery
Authors: Lim Lyn-li , Williams Kate , Francis Jill J , Wroth Melanie , Breen Juanita
Published: March 2024

Objective

The ‘To Dip or Not to Dip’ (TDONTD) intervention aims to reduce antibiotic prescribing for urinary tract infection (UTI) by reducing low-value dipstick testing. The aims of this study were to use a qualitative approach to (1) evaluate potential influences on the delivery of the TDONTD intervention in Australian residential aged care homes (RACHs) by identifying perceived barriers and enablers to delivery and acceptance; and (2) propose intervention strategies to address barriers and enhance enablers.

Design

A qualitative before–after process evaluation of a multisite implementation study using interviews with nurse and pharmacist implementers.

Setting

This study was conducted in 12 Australian RACHs.

Participants

Participants included 17 on-site nurse champions and 4 pharmacists (existing contracted providers).

Intervention

Resources from England’s TDONTD intervention were adapted for an Australian context. Key resources delivered were case-based education, staff training video, clinical pathway and an audit tool.

Results

Key barriers to TDONTD were beliefs about nursing capabilities in diagnosing infection, beliefs about consequences (fear of missing infection) and social influences (pressure from family, doctors and hospitals). Key enablers were perceived increased nurse and carer knowledge (around UTI and asymptomatic bacteriuria), resources from a credible source, empowerment of nurse champions to apply knowledge and skills in delivering operational change initiatives, pharmacist-delivered education and organisational policy or process change. Of TDONTD’s key components, the clinical pathway substituted dipstick testing in diagnosing UTI, delivery of case-based education was enhanced by their attendance and support of the intervention and the antibiotic audit tool generated feedback that champions shared with staff.

Conclusions

Our study confirms the core components of TDONTD and strategies to enhance delivery and overcome barriers. To further reduce barriers to TDONTD, broader advocacy work is required to raise awareness of dipstick testing as a low-value test in older persons and by linking it to healthcare professionals and consumer education.
Kentucky Outreach Service Kiosk (KyOSK) Study protocol: a community-level, controlled quasi-experimental, type 1 hybrid effectiveness study to assess implementation, effectiveness and cost-effectiveness of a community-tailored harm reduction kiosk on HIV, HCV and overdose risk in rural Appalachia
Authors: Young April M , Havens Jennifer R , Cooper Hannah L F , Fallin-Bennett Amanda , Fanucchi Laura , Freeman Patricia R , Knudsen Hannah , Livingston Melvin D , McCollister Kathryn E , Stone Jack , Vickerman Peter , Freeman Edward , Jahangir Tasfia , Larimore Elizabeth , White Carol R , Cheatom Chelsi , Community Staff KyOSK , Design Team KyOSK
Published: March 2024

Introduction

Many rural communities bear a disproportionate share of drug-related harms. Innovative harm reduction service models, such as vending machines or kiosks, can expand access to services that reduce drug-related harms. However, few kiosks operate in the USA, and their implementation, impact and cost-effectiveness have not been adequately evaluated in rural settings. This paper describes the Kentucky Outreach Service Kiosk (KyOSK) Study protocol to test the effectiveness, implementation outcomes and cost-effectiveness of a community-tailored, harm reduction kiosk in reducing HIV, hepatitis C and overdose risk in rural Appalachia.

Methods and analysis

KyOSK is a community-level, controlled quasi-experimental, non-randomised trial. KyOSK involves two cohorts of people who use drugs, one in an intervention county (n=425) and one in a control county (n=325). People who are 18 years or older, are community-dwelling residents in the target counties and have used drugs to get high in the past 6 months are eligible. The trial compares the effectiveness of a fixed-site, staffed syringe service programme (standard of care) with the standard of care supplemented with a kiosk. The kiosk will contain various harm reduction supplies accessible to participants upon valid code entry, allowing dispensing data to be linked to participant survey data. The kiosk will include a call-back feature that allows participants to select needed services and receive linkage-to-care services from a peer recovery coach. The cohorts complete follow-up surveys every 6 months for 36 months (three preceding kiosk implementation and four post-implementation). The study will test the effectiveness of the kiosk on reducing risk behaviours associated with overdose, HIV and hepatitis C, as well as implementation outcomes and cost-effectiveness.

Ethics and dissemination

The University of Kentucky Institutional Review Board approved the protocol. Results will be disseminated in academic conferences and peer-reviewed journals, online and print media, and community meetings.

Trial registration number

NCT05657106.
A data compilation of antibiotic treatments in Canadian finfish aquaculture from 2016 to 2021 and the cumulative usage of antibiotics and antiparasitic drugs at marine sites
Authors: Jonah L. , Hamoutene Dounia , Kingsbury M. , Johnson L. , Fenton A.J.
Published: March 2024

Antibiotics can be introduced from aquaculture facilities into marine sediments, where they may affect benthic communities and generate antimicrobial resistance (AMR). Antibiotics can be used in tandem with antiparasitics, and the effects of their combined usage could affect AMR patterns and transmit antibiotic resistance genes. This study compiles patterns of antibiotic and antiparasitic drug usage from 2016 to 2021 in British Columbia, New Brunswick, Newfoundland and Labrador, and Nova Scotia (Canada) and compares them internationally. There is an overall reduction in rates of antibiotic use per fish produced in Canadian aquaculture sites from 2016 to 2021. Compared to other salmon-producing countries, Canadian antibiotic rates per tonne of fish are lower than in Chile, but higher, on average, than in Norway and Scotland. Florfenicol (FLO) and oxytetracycline (OTC) are the prevalent antibiotics used in most salmon-producing countries, including Canada. We also note that <30% of sites used two drugs per year and <18% of sites used three drugs, with most of these sites using one antibiotic and one antiparasitic. There is an increase in FLO and a decrease use in OTC use in Canada, which could be positive environmentally considering FLO's lower dose and environmental persistence. The east and west coasts show comparable antibiotic rates, with an average rate of 78 mg/kg in BC and 76 mg/kg in the Atlantic provinces; however, they have differences in the type of antibiotic (average use of OTC: BC 38 mg/kg vs. Atlantic 214 mg/kg; average use of FLO: BC 40 mg/kg vs. Atlantic 10 mg/kg). Other distinctions between coasts include variation in the timing of treatments, with seasonal use in the Atlantic provinces (May–November) and year-round use in BC. This pattern is likely influenced by differences in water temperature and, subsequently, potential susceptibility to aquatic diseases. Disease prevalence and veterinarian choice/preferred treatments are factors that, we hypothesize, may impact treatment choice; however, additional information is required to adequately comment on this point. This data compilation includes spatial descriptions that could be used for area prioritization in future studies.
Recursive construction for expansions of tree Yang–Mills amplitudes from soft theorem
Authors: Hu Chang , Zhou Kang
Published: March 2024

In this paper, we introduce a fundamentally different approach, based on a bottom-up methodology, for expanding tree-level Yang–Mills (YM) amplitudes into Yang–Mills-scalar (YMS) amplitudes and bi-adjoint-scalar (BAS) amplitudes. Our method relies solely on the intrinsic soft behavior of external gluons, eliminating the need for external aids such as Feynman rules or CHY rules. The recursive procedure consistently preserves explicit gauge invariance at every step, ultimately resulting in a manifest gauge-invariant outcome when the initial expression is already framed in a gauge-invariant manner. The resulting expansion can be directly analogized to the expansions of gravitational (GR) amplitudes using the double copy structure. When combined with the expansions of Einstein–Yang–Mills amplitudes obtained using the covariant color-kinematic duality method from existing literature, the expansions presented in this note yield gauge-invariant Bern–Carrasco–Johansson (BCJ) numerators.
Invariant mass reconstruction of heavy gauge bosons decaying to $$\tau $$ leptons using machine learning techniques
Authors: Krishnan M. B. Vinaya , Nayak Aruna Kumar , Radhakrishnan Asrith Krishna
Published: March 2024

Many analyses are performed by the LHC experiments to search for heavy gauge bosons, which appear in several new physics models. The invariant mass reconstruction of heavy gauge bosons is difficult when they decay to $$\tau $$
τ
leptons due to missing neutrinos in the final state. Machine learning techniques are widely utilized in experimental high-energy physics, in particular in analyzing the large amount of data produced at the LHC. In this paper, we study various machine learning techniques to reconstruct the invariant mass of $$Z^{\prime }~\rightarrow ~\tau \tau $$

Z
′

→

τ
τ

and $$W^{\prime }~\rightarrow ~\tau \nu $$

W
′

→

τ
ν

decays, which can improve the sensitivity of these searches.
Quasinormal modes of Einstein–scalar–Gauss–Bonnet black holes
Authors: Paul Prosenjit
Published: March 2024

In this paper, we investigate quasinormal modes of scalar and electromagnetic fields in the background of Einstein–scalar–Gauss–Bonnet (EsGB) black holes. Using the scalar and electromagnetic field equations in the vicinity of the EsGB black hole, we study nature of the effective potentials. The dependence of real and imaginary parts of the fundamental quasinormal modes on parameter p (which is related to the Gauss–Bonnet coupling parameter $$\alpha $$
α
) for different values of multipole numbers l are studied. We analyzed the effects of massive scalar fields on the EsGB black hole, which tells us the existence of quasi-resonances. In the eikonal regime, we find the analytical expression for the quasinormal frequency and show that the correspondence between the eikonal quasinormal modes and null geodesics is valid in the EsGB theory for the test fields. Finally, we study grey-body factors of the electromagnetic fields for different multipole numbers l, which deviates from Schwarzschild’s black hole.
Prediction of industrial electricity consumption based on grey cluster weighted Markov model
Authors: Chen Huimin , Sun Xiaoyan , Fu Liqin , Chen Bokui
Published: March 2024

Accurate prediction of industrial electricity consumption is not only beneficial to maintaining the steady development of the economy but also to conserving energy. To improve the prediction accuracy of industrial electricity consumption, a grey cluster weighted Markov model is proposed. It is applied to predict the industrial electricity consumption in four different regions in China. The prediction results are compared with the traditional discrete grey prediction model, which shows that the present model is more effective in these aspects of prediction accuracy, stability and extensibility. The research can provide theoretical references for the “West-East electricity transmission project” in China.
AN EMPIRICAL TAKE ON THE “PLUCKING” MODEL
Authors: SUAH JING LIAN
Published: March 2024

Traditional estimates of potential output based on the symmetric business cycle (boom–bust) view are prone to large retrospective revisions. The plucking view, which is supported by empirics, offers possible respite. Serious attempts to estimate the output ceiling in the plucking view, analogous to potential output in the traditional view, are scarce. This paper has three parts. The first estimates the output ceiling in a computationally simple approach. The second analyzes the relationship of the resultant output gap with inflation and with the unemployment rate. A comparison is made against output gap estimates based on prevailing methods. The third uses a vector autoregression (VAR) to analyze responses to supply and demand shocks. The paper finds that the plucking model offers three points of improvement over prevailing methods based on the boom–bust view. First, boom–bust estimates are prone to large retrospective revisions when two-sided filters are used, while the plucking estimates are not. Second, output gap estimates from both views do not correlate well with core inflation. This absence of evidence for a Phillips curve is problematic for the boom–bust view. The plucking estimates correlated well with the unemployment rate but the boom–bust estimates did not. Third, the output ceiling from the plucking model responded only to supply (oil price) shocks and not demand (interest rate) shocks, hence fits the description of a supply measure. This paper provides a template to estimate the output ceiling of the plucking model in other countries using publicly available macroeconomic data.
Detection of Dense Built-Up Area in Low-Resolution Satellite Images Using Deep Learning and DBSCAN Approaches
Authors: Chatterjee Shambo , Bhattacharyya Soumya , Saha Sourav , Halder Anindya , Mahapatra Priya Ranjan Sinha
Published: March 2024

Recent developments in satellite image processing tend to eliminate the need for intensive on-site surveys of urban or rural areas for infrastructure allocation planning. In particular, the detection of buildings in satellite images can significantly aid in rural or urban planning. However, detecting individual buildings in low-resolution satellite images is challenging due to a lack of visual clarity. In order to address this problem, we propose a computer vision-based hybrid framework to detect densely constructed building regions in low resolution satellite images, which can also serve as an assistive framework for automated geo-spatial survey of various sites. Our hybrid framework is comprised of three modules, namely the Mask R-CNN module, an ANN-based refinement module, and a DBSCAN based refinement module. The Mask R-CNN is employed to predict probable clustered building regions in the satellite image, whereas the ANN-based refinement module is applied to remove homogeneous regions (e.g. vegetation area) from the Mask R-CNN-detected clustered building region. Finally, a DBSCAN-based refinement module removes non-congested built-up regions so that densely constructed built-up areas can be identified with better precision. Our experimentation using publicly accessible satellite image datasets (AIRS dataset-Kaggle) establishes the effectiveness of the proposed hybrid framework in identifying densely populated building areas in low-resolution satellite images. The outcomes of the proposed framework demonstrated an approximately 5–10% improvement over various Mask R-CNN and U-Net-based approaches in terms of achieving better precision value of the detection.