bluuebunny/crossref_metadata_2025 huggingface dataset:
The association between leisure engagement and loneliness before and during the COVID-19 pandemic: A Nordic population-based study
Authors: Nyqvist Fredrica , Nilsson Ingeborg , Näsman Marina , Olofsson Birgitta
Published: May 2023

Aim:

The main aim of this study was to examine leisure engagement and loneliness among older adults before and during the COVID-19 pandemic by analysing population-based data from western Finland and northern Sweden.

Methods:

The data originated from the Gerontological Regional Database (GERDA) postal questionnaire study conducted in 2016 ( n=7996) and 2021 ( n=8148) among older adults aged 65, 70, 75, 80 and 85 years. Associations between loneliness and leisure engagement were analysed using logistic regression.

Results:

In total, 10% and 9% of the older adults reported loneliness in 2016 and 2021, respectively. The results showed that a lack of engagement in socialising and pleasure was independently associated with loneliness in both study years, while a lack of engagement in cultural activities was associated with loneliness in 2016 only. In 2021, the likelihood of experiencing loneliness was higher in the Finnish region than in the Swedish region. In addition, those reporting a decrease in hobby and socialising leisure activities due to the COVID-19 pandemic were more likely to report loneliness.

Conclusions:

Most leisure activities decreased during the pandemic, suggesting an increase in social isolation. However, this did not reflect an increase in loneliness in the studied regions. The evidence suggests that leisure engagement, especially socialising activities, continued to be important for well-being among older adults during the pandemic. Further, loneliness was affected by contextual factors as well as individual-level characteristics. Thus, according to the measures reported here, the pandemic seemed to have a slightly weakened well-being impact in Finland.
Care as (re)capture: Data colonialism and race during times of crisis
Authors: Barabas Chelsea
Published: May 2023

This article examines the role that data-driven technologies play in expanding and reasserting the legitimacy of the US racial state during times of crisis. Specifically, I examine how prison officials used a software called Verus to reinforce the perceived necessity of penal institutions during the COVID-19 pandemic. Government officials used Verus to produce narratives that (1) recast criminalized communities as dangerous and therefore disposable and (2) shielded carceral institutions from liability for systematic neglect. Ultimately, the aim of this article is to contribute to emerging critical concepts such as “data colonialism,” a term that has largely been used to describe the social and economic consequences of parasitic data extraction and monopoly control of digital infrastructure. In addition to these issues, I argue that data-driven technologies are used as vehicles for movement capture and the reproduction of prison logics that enable modes of racialized economic exploitation that extend far beyond the high-tech innovation economy.
Carceral safety in a post-PREA era: An examination of perceptual indicators of safety among incarcerated persons in four southeast prisons
Authors: Ledet Richard , Holland Melanie M , Emeigh Sharon , Givens Somer
Published: May 2023

Since the inception of the 2003 Prison Rape Elimination Act (PREA), its reception has been notably ambivalent among practitioners and scholars. While this policy was promoted as a means of enhancing safety in carceral facilities, some view it as a superfluous inconvenience. Unfortunately, the intended beneficiaries of PREA have been largely excluded from this discourse. The current study addresses this gaping oversight by examining perceptual predictors of safety among those housed across four prisons in a southeastern state. Using survey data collected from more than 1500 incarcerated men, this study examines the relationship between self-reported safety indicators and a variety of policy compliance proxies, facility resource measures, interpersonal relationships between staff and inmates, and other relevant themes. The results of this study reveal that some measures of PREA compliance, specifically investigation efficiency and knowledge of the reporting process, are positively related to the respondent's sense of safety from inmate violence as well as safety from staff violence. Prison resources, staff interactions, exposure to violence, and other notable predictors are also significantly related to safety perceptions. These findings underscore the importance of the quality of PREA implementation in conjunction with resource sufficiency and constructive interactions with staff.
A comprehensive study for the identification of the requirements for an optimal H2 combustion engine
Authors: Laget Olivier , Rouleau Loïc , Cordier Matthieu , Duffour Florence , Maio Giampaolo , Giuffrida Vincent , Kumar Rajesh , Nowak Ludovic
Published: May 2023

As part of the fight against global warming and to achieve greenhouse gas emission targets, it is crucial to reduce the carbon footprint of ground transportation. Mobility needs are continuously growing with increase in population. All these factors will lead to an upsurge in the energy demand for the mobility in the very next future. Consequently, the diversification of low carbon energy sources is urgently required. Hydrogen can be used for mobility solution in its two energy conversion mechanisms: The Fuel Cell technology or the Internal Combustion Engine (ICE). The latter option, studied in the present work, offers the advantages of current fossil fuel engines – existing and proven technology, lifetime, controlled cost – with a very low carbon footprint. The overall objective of the study is to define the specifications of a dedicated Hydrogen direct injection combustion system for ground transportation application with the best fuel efficiency and lower raw emissions, to minimize the aftertreatment needs. A complete experimental and numerical study was carried out to get valuable information on various phenomena occurring throughout the engine cycle. The very first step of the study consisted in performing experimental investigations. For this purpose, an all metal single cylinder engine originally designed for gasoline spark ignited combustion (tumble air motion, gasoline direct injection) was modified for hydrogen direct injection combustion. The gas-gas injection was experimentally studied in the High Pressure/High Temperature vessel available at IFPEN. Those experiments were used to calibrate the 3D CFD numerical approach. Based on a 0D pre-study (boundary conditions) and using the injection modeling calibration introduced before, 3D CFD simulations have been then carried out with specific hydrogen kinetics properties. Finally, this comprehensive study highlights the specificities of ICE running with hydrogen. It provides indications and guidelines for further developments and optimization of hydrogen combustion engines.
Reliability and Concurrent Validity of a Cultural Adaptation and Northern Sotho Translation of the M-CHAT-R/F
Authors: Vorster Carlien , Kritzinger Alta , Coetser Loina , Van der Linde Jeannie
Published: May 2023

Currently, no culturally and linguistically adapted autism screening tools are available in South Africa. The aim was to determine the reliability and concurrent validity of the adapted English and Northern Sotho–translated Modified Checklist for Autism in Toddlers–Revised with Follow-up (M-CHAT-R/F). Reliability was confirmed with near-perfect agreement ( p < .001) between the checklists in a sample of 158 Northern Sotho/English bilingual mothers of children with a low risk for autism. Concurrent validity between the Northern Sotho M-CHAT-R/F and the communication and socialization sub-domains of the Vineland Adaptive Behaviour Scales–3rd Edition was established with significant association at the 5% level. A third (33.5%) of the children showed a developmental delay. The checklists are valid and reliable, and may improve early identification that will render better long-term outcomes for children with autism in South Africa. Autism screening should be combined with developmental assessment. The study contributes to an emerging body of research on the development of contextually appropriate screening measures.
COVID-19 conspiracy beliefs and vaccinations: A conceptual replication study in Turkey
Authors: Pivetti Monica , Paleari Francesca-Giorgia , Ertan Irem , Di Battista Silvia , Ulukök Esra
Published: May 2023

Pivetti et al. (2021a; 2021b) examined links between COVID-related conspiracy beliefs and acceptance of vaccinations in Italy and Finland in 2020. They found that moral purity negatively predicted confidence in science, whereas political orientation predicted COVID-related conspiracy beliefs. Confidence in science, general conspiracy beliefs, and COVID-related conspiracy beliefs were found to negatively predict support for governmental restrictions and attitudes towards vaccines, and positively predict perceptions of informational contamination. Finally, attitudes towards vaccines in general strongly predicted attitudes towards the COVID-19 vaccine. The current research seeks to replicate these findings conceptually on a predominately Muslim sample (N  =  570, M age  =  26.69, 69.8% females) in Turkey in 2021, when the COVID vaccines were widely available. Measures of religiosity and left, center, and right political orientations were added to the original instrument. Hypothesized serial mediational models were tested using structural equation modelling. Results revealed that left and center political orientations positively predicted COVID-related conspiracy beliefs and confidence in science. Religiosity was negatively related to confidence in science. Confidence in science and COVID-related conspiracy beliefs predicted general attitudes toward vaccines. Conspiracy beliefs predicted COVID-related conspiracy beliefs, which in turn negatively predicted support for government restrictions and positively predicted distrust in mainstream media. Attitudes towards vaccines were strongly and positively related to attitudes toward COVID-19 vaccines.

[This paper was added to the Special Issue on “Conspiracy Theories about Infectious Diseases” in a post-hoc manner. Online publishing allows the addition of new papers to a published special issue, thereby permitting a special issue to grow.]
Detecting disability using self-reported and clinical assessments in early-stage relapsing-remitting multiple sclerosis: Looking for a complementary approach
Authors: Sainz de la Maza Susana , Gómez-Ballesteros Rocío , Borges Mónica , Martín-Martínez Jesús , Sotoca Javier , Alonso Ana , Caminero Ana B , Borrega Laura , Sánchez-Menoyo José L , Barrero-Hernández Francisco J , Calles Carmen , Brieva Luis , Blasco-Quílez María R , Dotor García-Soto Julio , Campo-Amigo María del , Navarro-Cantó Laura , Agüera Eduardo , Garcés-Redondo Moisés , Carmona Olga , Gabaldón-Torres Laura , Forero Lucía , Hervàs Mariona , Medrano Nicolás , Maurino Jorge , Castillo-Triviño Tamara
Published: May 2023

Disability accrual is mainly driven by progression independent of relapse activity, which is present even in early stages of relapsing-remitting multiple sclerosis (RRMS) and sometimes overlooked. This multicenter, non-interventional study evaluated whether patient-reported outcomes measures (PROMs) could capture disability in 189 early-stage RRMS patients (mean age: 36.1 ± 9.4 years, 71.4% female, mean disease duration: 1.4 ± 0.8 years, median EDSS: 1.0). The 9-Hole Peg Test (9-HPT), NeuroQoL Upper Extremity (NeuroQoL-UE), Timed 25-Foot Walk (T25-FW), Multiple Sclerosis Walking Scale (MSWS-12), Symbol Digit Modalities Test (SDMT), and Perceived Deficits Questionnaire (PDQ-5) were used to assess hand function, gait, and cognition, respectively. These functions were at least mildly affected in this early-stage population, finding significant correlations between PROMs and clinical assessments. PROMs could enable early-stage RRMS patients to communicate their perceived disability in different domains, assisting clinicians in disease monitoring and decision making.
Tobacco Knowledge, Attitudes, and Services Among Latino/a Community Health Workers
Authors: Villacis Alvarez Enrique , Nicholson Lian , Villamar Dario , Huard Clarissa , Veluz-Wilkins Anna , Tan Marcia
Published: May 2023

Background:

Tobacco-related illnesses are among the leading preventable causes of death for Latinos/as in the United States. Latino/a groups are less likely to receive advice to quit from health professionals or use tobacco cessation strategies. The position of community health workers (CHWs) warrants further attention to address tobacco-related disparities in Latino/a communities. The objective of this study was to describe CHWs’ roles to inform future smoking cessation training to ensure relevance and accessibility.

Methods:

A needs assessment survey, including a 10-item tobacco knowledge questionnaire, was conducted with 29 Latino/a CHWs serving Latino/a communities in a metropolitan area to assess their roles, tobacco related services, attitudes, and knowledge.

Results:

All CHWs were Spanish-speaking and mainly employed part time (55%) in community organizations (67%). They offered various services, primarily health education. Most of the CHWs (58.6%) assessed and discussed tobacco use, yet half (51.7%) reported low confidence in this area. Some CHWs (41%) expressed that their clients/patients would use evidence-based nicotine replacement therapies as a smoking cessation treatment if offered and identified “Financial Cost” (31%) as a deterrent of use. CHWs’ score on a tobacco knowledge questionnaire indicated low knowledge in areas related to tobacco (4.03 out of 10; SD = 1.92).

Conclusions:

CHWs reported low tobacco related knowledge and confidence, and would benefit from tailored tobacco cessation training to decrease tobacco cessation disparities.
The Good, The Bad, and The Ugly – Situational Crisis Communication and the COVID-19 Pandemic Tokyo 2020 Olympic Games
Authors: Wong Donna , Meng-Lewis Yue
Published: May 2023

Affected by the COVID-19 pandemic, the Tokyo 2020 Olympic and Paralympic Games were postponed for a year. While getting through with the organizing of an Olympic Games amid a global pandemic is seen as a success by many (‘The Good’), it was overshadowed by the relentless virus as the Games closed with a muted spectacle in 2021 (‘The Bad’). Pushing on with the Games after the postponement, at the height of the pandemic, has resulted in strong criticisms and caused damage to the organizers (‘The Ugly’). This study seeks to assess the crisis communication strategies implemented by the organizers as they navigated the capricious condition of trudging on with a pandemic era sport spectacle. Through examining the organizers’ crisis communications to the challenges that emerged and public reactions to the strategies, this study seeks to understand the outcome of the strategies on the organizational image and reputation. It also provides reflections on the management of the Games through the COVID-19 pandemic. In this regard, it is argued that the situational crisis communication theory offers a useful framework that can provide theoretical connections between crisis management in a sports mega-event and organizational response strategies.
Enlightened Participation: SME Perspectives about Net Zero on Social Media Using the Action Case Approach
Authors: Hardey Mariann , Ahmed Wasim , Fenton Alex , Koral Chris
Published: May 2023

Aims/Objectives:

This study aims to examine a linked future for a Net Zero global economy. Such a future is examined through network-driven change and informed by co-action and shared business management practices.

Methodology used in the study:

We employ an action case (AC) approach to understand the impact of national and worldwide Net Zero policy for small and medium-sized enterprises (SMEs). We drew upon a qualitative survey with SMEs alongside a social network analysis (SNA) of Twitter data.

Findings:

We discovered a substantial predictive effect of policy support in the SME social media material regarding Net Zero attitudes. Our findings indicate that reinforcing messages on policy support and assisting enterprises in adopting the new objectives may considerably enhance Net Zero accountability and serve as the foundation for an intervention strategy in policy-focused programmes for SMEs.
Do Financial Assets Move in Tandem During High Impact Period of a Crisis: Evidence from Global Financial Crisis and COVID-19 Pandemic Periods
Authors: Shahani Rakesh , Paliwal Riya
Published: May 2023

The present study investigates and compares the co-movement between four asset classes namely Crude, Gold, Nifty 50 Stock Index, and Rupee–Dollar Exchange Rate during the two crisis periods viz. the Global Financial Crisis (GFC) and the COVID-19 Crisis. The methodology employed for ascertaining inter-relationship includes the Johansen Co-integration technique and Toda & Yamamoto Causality model. Besides this, the entire model has been set up under the VAR Framework with Variance Decomposition and Impulse Responses giving useful insight into the relationship among the stated variables. The results of the study, however, failed to identify any co-integration among the assets during any of the two crisis periods, however, there was evidence of short-run cause–effect relation among some of the variables. The causality flow was uni-directional from Nifty 50 to both crude and exchange rate in Period I (GFC Period) while in Period II (COVID-19 Crisis Period) it was bi-directional between Gold and Nifty 50. Causality was also seen from Foreign Exchange to Gold in Period II. Further ADF Breakpoint showed all the variables were I(1) stationary and the VAR Model was also proved stable as shown by AR Characteristics Root Plots. The impulses showed that Period II or COVID-19 Crisis Period retained the innovations of other variables for a longer duration than Period I (GFC Period).
The RISE study protocol: resilience impacted by positive stressful events for people with cystic fibrosis
Authors: van der Heijden Els , van den Bor Rutger M. , van der Ent Cornelis K. , Nijhof Sanne L. , van der Laan Sabine E.I.
Published: May 2023

Introduction

For people with cystic fibrosis (CF), gaining access to elexacaftor/tezacaftor/ivacaftor (ETI) therapy, a new modulator drug combination, is perceived as a positive life event. ETI leads to a strong improvement of disease symptoms. However, some people with CF experience a deterioration in mental wellbeing after starting ETI therapy. The primary objective of this study is to investigate if and in which direction mental wellbeing of people with CF changes after starting ETI therapy. Our secondary objectives include, among others, investigation of underlying biological and psychosocial factors associated with a change in mental wellbeing of people with CF after starting ETI therapy.

Methods and analysis

The Resilience lmpacted by Positive Stressful Events (RISE) study is a single-arm, observational, prospective longitudinal cohort. It has a timeframe of 60 weeks: 12 weeks before, 12 weeks after, 24 weeks after and 48 weeks after the start of ETI therapy. The primary outcome is mental well-being, measured at each of these four time points. Patients aged ≥12 years at the University Medical Center Utrecht qualifying for ETI therapy based on their CF mutation are eligible. Data will be analysed using a covariance pattern model with a general variance covariance matrix.

Ethics

The RISE study was classified by the institutional review board as exempt from the Medical Research Involving Human Subjects Act. Informed consent was obtained by both the children (12–16 years) and their caregivers, or only provided by the participants themselves when aged ≥16 years.
Mood disorder in idiopathic pulmonary fibrosis: response to pulmonary rehabilitation
Authors: Edwards George D. , Polgar Oliver , Patel Suhani , Barker Ruth E. , Walsh Jessica A. , Harvey Jennifer , Man William D-C. , Nolan Claire M.
Published: May 2023

Background

Pulmonary rehabilitation improves mood disorder in COPD, but there are limited data in idiopathic pulmonary fibrosis (IPF). The aims of this cohort study were to investigate whether pulmonary rehabilitation reduces mood disorder in IPF, and estimate the minimal important difference (MID) of the Hospital Anxiety and Depression Scale (HADS).

Methods

HADS and core pulmonary rehabilitation outcomes were measured in 166 participants before and after an 8-week, in-person, outpatient pulmonary rehabilitation programme. Anchor- and distribution-based methods were used to calculate the MID of HADS-Anxiety (A) and HADS-Depression (D).

Results

Suggestive or probable anxiety and depression (HADS ≥8) were present in 35% and 37% of participants, respectively, at baseline, and this reduced significantly following pulmonary rehabilitation (post-pulmonary rehabilitation: HADS-A 23%, HADS-D 26%). Overall, there was a significant reduction in HADS-D (mean change −1.1, 95% CI −1.6– −0.5), but not HADS-A (−0.6, −1.3–0.15) with pulmonary rehabilitation. Subgroup analysis of those with HADS ≥8 revealed significant improvements in HADS domains (mean change: HADS-A −4.5, 95% CI −5.7– −3.4; median change: HADS-D −4.0, interquartile range −6.0– −1.0). The mean (range) MID estimates for HADS-A and HADS-D were −2 (−2.3– −1.7) and −1.2 (−1.9– −0.5), respectively.

Conclusion

In people with IPF and suggestive or probable mood disorder, pulmonary rehabilitation reduces anxiety and depression.
Inhibition of tumor immune escape by blocking PD-1/PD-L1 engagement with dual-targeting molecularly imprinted polymer layer
Authors: Ji Wenwen , Zhang Bei , Sun Xuetong , Ma Lijuan , Zhang Xiangying , Qian Wenhui , Fu Wenjuan , Li Jianting , Zhu Dong
Published: May 2023

Blocking the binding of PD-1/PD-L1 has become an effective strategy in inhibition of tumor immune escape. At present, it mainly depends on the employment of macromolecular antibodies, which target PD-1/PD-L1 protein through binding one of PD-1 or PD-L1 domains. In this study, we present a different strategy, an aptamer modified molecularly imprinted polymer layer (APD–PD-L1–MIPL), to break PD-1/PD-L1 binding for the inhibition of tumor immune escape. The APD–PD-L1–MIPL is prepared by a MIP layer on the surface of CaCO3 nanospheres using the peptide segment of the PD-L1 protein as a template. The subsequent removal of CaCO3 nanospheres core formats the MIP layer, to ensure high specifically matching capacity and short equilibrium time. A PD-L1 antagonistic DNA aptamer, is modified into the MIP layer to enhance recognition capacity, resulting in dual-targeting functionality. The APD–PD-L1–MIPL is able to bind PD-L1 and allow suppressing the engagement of PD-L1 with PD-1, inducing to block of the downstream signaling pathways and, therefore, restore T cell function and inhibition of cancer growth. The APD–PD-L1–MIPL can quantitatively detect the bound proteins and the LOD of APD–PD-L1–MIPL is 0.003 mg mL−1. This strategy enables provide a new idea for tumor immunotherapy.
Estimating transcriptome complexities across eukaryotes
Authors: Titus-McQuillan James E. , Nanni Adalena V. , McIntyre Lauren M. , Rogers Rebekah L.
Published: May 2023

Background

Genomic complexity is a growing field of evolution, with case studies for comparative evolutionary analyses in model and emerging non-model systems. Understanding complexity and the functional components of the genome is an untapped wealth of knowledge ripe for exploration. With the “remarkable lack of correspondence” between genome size and complexity, there needs to be a way to quantify complexity across organisms. In this study, we use a set of complexity metrics that allow for evaluating changes in complexity using TranD.

Results

We ascertain if complexity is increasing or decreasing across transcriptomes and at what structural level, as complexity varies. In this study, we define three metrics – TpG, EpT, and EpG- to quantify the transcriptome's complexity that encapsulates the dynamics of alternative splicing. Here we compare complexity metrics across 1) whole genome annotations, 2) a filtered subset of orthologs, and 3) novel genes to elucidate the impacts of orthologs and novel genes in transcript model analysis. Effective Exon Number (EEN) issued to compare the distribution of exon sizes within transcripts against random expectations of uniform exon placement. EEN accounts for differences in exon size, which is important because novel gene differences in complexity for orthologs and whole-transcriptome analyses are biased towards low-complexity genes with few exons and few alternative transcripts.

Conclusions

With our metric analyses, we are able to quantify changes in complexity across diverse lineages with greater precision and accuracy than previous cross-species comparisons under ortholog conditioning. These analyses represent a step toward whole-transcriptome analysis in the emerging field of non-model evolutionary genomics, with key insights for evolutionary inference of complexity changes on deep timescales across the tree of life. We suggest a means to quantify biases generated in ortholog calling and correct complexity analysis for lineage-specific effects. With these metrics, we directly assay the quantitative properties of newly formed lineage-specific genes as they lower complexity.
A comprehensive analysis of copy number variations in diverse apple populations
Authors: Xu Jinsheng , Zhang Weihan , Zhang Ping , Sun Weicheng , Han Yuepeng , Li Li
Published: May 2023

Background

As an important source of genetic variation, copy number variation (CNV) can alter the dosage of DNA segments, which in turn may affect gene expression level and phenotype. However, our knowledge of CNV in apple is still limited. Here, we obtained high-confidence CNVs and investigated their functional impact based on genome resequencing data of two apple populations, cultivars and wild relatives.

Results

In this study, we identified 914,610 CNVs comprising 14,839 CNV regions (CNVRs) from 346 apple accessions, including 289 cultivars and 57 wild relatives. CNVRs summed to 71.19 Mb, accounting for 10.03% of the apple genome. Under the low linkage disequilibrium (LD) with nearby SNPs, they could also accurately reflect the population structure of apple independent of SNPs. Furthermore, A total of 3,621 genes were covered by CNVRs and functionally involved in biological processes such as defense response, reproduction and metabolic processes. In addition, the population differentiation index ($${V}_{st}$$

V

st

) analysis between cultivars and wild relatives revealed 127 CN-differentiated genes, which may contribute to trait differences in these two populations.

Conclusions

This study was based on identification of CNVs from 346 diverse apple accessions, which to our knowledge was the largest dataset for CNV analysis in apple. Our work presented the first comprehensive CNV map and provided valuable resources for understanding genomic variations in apple.
Comparative short-term and survival outcomes of three specimen extraction techniques in laparoscopic low rectal cancer surgery: does it affect ileostomy closure?
Authors: Chen Haipeng , Huang Fei , Yang Ming , Zhao Zhixun , Guan Xu , Liu Zheng , Jiang Zheng , Liu Qian , Zheng Zhaoxu , Wang Xishan
Published: May 2023

Introduction

This study aimed to compare the short-term and survival outcomes in laparoscopic low rectal cancer surgery with three different specimen extraction techniques, and whether it affects loop ileostomy closure.

Materials and methods

A consecutive series of patients with low rectal cancer who underwent laparoscopic low anterior resection plus protective loop ileostomy (LAR-PLI) were enrolled. Three main techniques, namely specimen extraction through auxiliary incision (EXAI), specimen extraction through stoma incision (EXSI), and specimen eversion and extra-abdominal resection (EVER), were employed. The postoperative short-term and survival outcomes of the three techniques and the impact on loop ileostomy closure were compared.

Results

In all, 254 patients were enrolled in this study: 104 (40.9%) in the EXAI group, 104 (40.9%) in the EXSI group, and 46 (18.1%) in the EVER group. For primary surgery, EXAI group had significantly longer operative time (P < 0.001), more intraoperative bleeding (P < 0.001), longer length of abdominal incision (P<0.001), longer time to first flatus (P < 0.001), longer time to first defecation (P < 0.001), longer time to first eat (P < 0.001), and longer postoperative hospital stays (P = 0.005) than the EXSI and EVER groups. The primary postoperative complication rate in the EXAI and EVER group was significantly higher than in the EXSI group (P = 0.005). In loop ileostomy closure, EXAI group had significantly longer operative time (P = 0.001), more bleeding volume, and longer postoperative hospital stays (P < 0.001) than the EXSI and EVER groups. For survival outcomes, the 3-year local recurrence-free survival (LRFS) is 92.6% for all patients. The 3-year LRFS for patients in EXAI, EXSI, and EVER were 90.1%, 95.4%, and 92.7%, with P = 0.476.

Conclusions

Our single-center results found that in LAR-PLI surgery for low rectal cancer, the short-term outcomes of specimen extraction through the stoma incision or anus were better than that through the auxiliary incision, but the 3-year LRFS was no statistically different.
Changes to physical activity behavior during the COVID-19 pandemic and their associated factors: a cross sectional survey of Mexican women
Authors: Stratton Catherine , Fourtassi Maryam , Ramia Ioana , Pandiyan Uma , Cooper Rory , Hajjioui Abderrazak , Krassioukov Andrei , Peterson Mark D. , Balikuddembe Joseph K , Palomba Angela , Hong Bo-Young , Tripathi Deo Rishi , Tuakli-Wosornu Yetsa A , Muñoz Velasco Laura Paulina
Published: May 2023

Background

On March 24, 2020, the Mexican Government established social distancing measures to address the outbreak of the COVID-19 pandemic. The resulting home confinement affected daily lifestyle habits such as eating, sleeping, and physical activity (PA). The objectives of this study were to determine changes in PA behaviors among Mexican women due to the COVID-19 pandemic and to assess potential factors associated with these changes.

Methods

This was a cross-sectional study based on an anonymous online questionnaire developed by the Task Force on Physical Activity for Persons with Disabilities (PAPD) within the International Society of Physical and Rehabilitation Medicine (ISPRM). Descriptive, quantitative statistics were used for data analysis. A Chi-squared (χ²) test was used to explore associations between dependent and independent variables.

Results

A total of 1882 surveys were completed. Among the respondents, 53.3% declared that their PA was reduced during the pandemic, 26.6% reported similar PA behavior, and 20.1% declared that their PA had increased during the pandemic. Lower PA behavior during the pandemic was associated with lower education levels, stricter pandemic constraints, obesity, and lower self-perceived functioning levels. A statistically significant association between poorer self-perceived mental health and decreased PA behaviors was also found. Respondents who were younger, self-perceived as unimpaired, not overweight, and whose income was not impacted by COVID-19 were associated with higher levels of reported physical and mental health.

Conclusions

The study results identify disparities experienced in PA behavior during the COVID-19 pandemic among Mexican women and highlights the need for social support for PA participation.
An eConsultant versus a hospital-based outpatient consultation for general (internal) medicine: a costing analysis
Authors: Job Jenny , Nicholson Caroline , Donald Maria , Jackson Claire , Byrnes Joshua
Published: May 2023

Background

The eConsultant model of care is an outpatient substitution approach which has been evaluated and implemented extensively internationally. It provides an asynchronous, digital, clinician-to-clinician advice service, giving primary care physicians remote access to specialist support for patient care within 3 business days. Results from initial trials of the eConsultant model in Australia support international evidence of reduced wait times and improved access to specialist input, avoidance of face-to-face hospital outpatient visits, and better integrated care. This study compared the cost of delivery of an eConsultant episode of care with that of a hospital-based outpatient appointment.

Methods

A cost-minimisation analysis, using a decision analytic model, was used to compare the two approaches. eConsultant costs were calculated from specialist reported data (minutes spent preparing the response; the number of patients referred subsequently for a hospital-based outpatient appointment) and administration staff data (time spent recording the occasion-of-service). Outpatient costs were calculated using finance data and information from outpatient clinic managers at the hospital-based outpatient clinic. The primary outcome was incremental cost saving per patient from a hospital system perspective. Uncertainty was explored using one-way sensitivity analyses and characterised with probabilistic sensitivity analysis using 10,000 Monte Carlo simulations.

Results

The traditional referral pathway cost estimate was $587.20/consult compared to $226.13/consult for an eConsultant episode: an efficiency saving of $361.07 per patient. The incremental difference between eConsultant and traditional care was most sensitive to the cost estimate of an outpatient attendance, the time for a specialist to complete an eConsult, and the probability of a patient requiring a face-to-face hospital-based attendance following an eConsult. However, at the upper bounds of each of these estimates, an eConsult remained the most cost-efficient model. In 96.5% of the Monte Carlo simulations eConsult was found to be more cost efficient than the traditional approach.

Conclusions

The eConsultant model of care was associated with a 61.5% efficiency gain, allowing diversion of support to hospital-based outpatient appointments.
Microbial tolerance engineering for boosting lactic acid production from lignocellulose
Authors: Shan Wenwen , Yan Yongli , Li Yongda , Hu Wei , Chen Jihong
Published: May 2023

Lignocellulosic biomass is an attractive non-food feedstock for lactic acid production via microbial conversion due to its abundance and low-price, which can alleviate the conflict with food supplies. However, a variety of inhibitors derived from the biomass pretreatment processes repress microbial growth, decrease feedstock conversion efficiency and increase lactic acid production costs. Microbial tolerance engineering strategies accelerate the conversion of carbohydrates by improving microbial tolerance to toxic inhibitors using pretreated lignocellulose hydrolysate as a feedstock. This review presents the recent significant progress in microbial tolerance engineering to develop robust microbial cell factories with inhibitor tolerance and their application for cellulosic lactic acid production. Moreover, microbial tolerance engineering crosslinking other efficient breeding tools and novel approaches are also deeply discussed, aiming to providing a practical guide for economically viable production of cellulosic lactic acid.
Robustness of radiomics features of virtual unenhanced and virtual monoenergetic images in dual-energy CT among different imaging platforms and potential role of CT number variability
Authors: Zhong Jingyu , Pan Zilai , Chen Yong , Wang Lingyun , Xia Yihan , Wang Lan , Li Jianying , Lu Wei , Shi Xiaomeng , Feng Jianxing , Yan Fuhua , Zhang Huan , Yao Weiwu
Published: May 2023

Objectives

To evaluate robustness of dual-energy CT (DECT) radiomics features of virtual unenhanced (VUE) image and virtual monoenergetic image (VMI) among different imaging platforms.

Methods

A phantom with sixteen clinical-relevant densities was scanned on ten DECT platforms with comparable scan parameters. Ninety-four radiomic features were extracted via Pyradiomics from VUE images and VMIs at energy level of 70 keV (VMI70keV). Test–retest repeatability was assessed by Bland–Altman analysis. Inter-platform reproducibility of VUE images and VMI70keV was evaluated by coefficient of variation (CV) and quartile coefficient of dispersion (QCD) among platforms, and by intraclass correlation coefficient (ICC) and concordance correlation coefficient (CCC) between platform pairs. The correlation between variability of CT number radiomics reproducibility was estimated.

Results

92.02% and 92.87% of features were repeatable between scan–rescans for VUE images and VMI70keV, respectively. Among platforms, 11.30% and 28.39% features of VUE images, and 15.16% and 28.99% features of VMI70keV were with CV < 10% and QCD < 10%. The average percentages of radiomics features with ICC > 0.90 and CCC > 0.90 between platform pairs were 10.00% and 9.86% in VUE images and 11.23% and 11.23% in VMI70keV. The CT number inter-platform reproducibility using CV and QCD showed negative correlations with percentage of the first-order radiomics features with CV < 10% and QCD < 10%, in both VUE images and VMI70keV (r2 0.3870–0.6178, all p < 0.001).

Conclusions

The majority of DECT radiomics features were non-reproducible. The differences in CT number were considered as an indicator of inter-platform DECT radiomics variation.

Critical relevance statement: The majority of radiomics features extracted from the VUE images and the VMI70keV were non-reproducible among platforms, while synchronizing energy levels of VMI to reduce the CT number value variability may be a potential way to mitigate radiomics instability.

Graphical Abstract
Ultrasound imaging of the axilla
Authors: Cocco Giulio , Ricci Vincenzo , Ricci Costantino , Naňka Ondřej , Catalano Orlando , Corvino Antonio , Boccatonda Andrea , Serafini Francesco Lorenzo , Izzi Jacopo , Vallone Gianfranco , Cantisani Vito , Iannetti Giovanni , Caulo Massimo , Ucciferri Claudio , Vecchiet Jacopo , Pizzi Andrea Delli
Published: May 2023

Axilla is a pyramidal-in-shape “virtual cavity” housing multiple anatomical structures and connecting the upper limb with the trunk. To the best of our knowledge, in the pertinent literature, a detailed sonographic protocol to comprehensively assess the axillary region in daily practice is lacking. In this sense, the authors have briefly described the anatomical architecture of the axilla—also using cadaveric specimens—to propose a layer-by-layer sonographic approach to this challenging district. The most common sonographic pathological findings—for each and every anatomical compartment of the axilla—have been accurately reported and compared with the corresponding histopathological features. This ultrasound approach could be considered a ready-to-use educational guidance for the assessment of the axillary region.

Critical relevance statement

Axilla is a pyramidal-in-shape “virtual cavity” housing multiple anatomical structures and connecting
the upper limb with the trunk. The aim of this review article was to describe the anatomical
architecture of the axilla, also using cadaveric specimens, in order to propose a layer-by-layer
sonographic approach to this challenging district.

Graphical abstract
Microbial community structure and diversity in fish-flower (mint) symbiosis
Authors: Wang Jianglong , Xie Yufen , Zhang Guangdi , Pan Lin
Published: May 2023

The fish-flower symbiosis model is an eco-friendly sustainable farming technology combining plants, fish and microorganisms in a recirculating aquaculture system. However, there are few studies on the structure and diversity of microbial communities in fish intestines, culture water and plant roots during fish-flower symbiosis. Here, we cultured carp (Cyprinus carpio), crucian carp (Carassius auratus) and grass carp (Ctenopharyngodon idella) with mint (Mentha spicala L.) and extracted total genomic DNA from intestinal microorganisms, culture-water microorganisms and root microorganisms for each fish species for high-throughput sequencing of 16S rRNA genes. Analysis of microbial community structure and diversity revealed changes in abundance of microbial genera in the intestines and culture water of each fish species, including changes in the dominant taxa. Pirellula, Truepera, Aquincola, Cetobacterium and Luteolibacter were widespread in the fish intestine, culture water and mint root system. This study revealed the effects of mint feeding on the structure and diversity of microbial communities of fish, water bodies and the mint root system during fish-flower symbiosis, providing a theoretical reference for the promotion and application of fish-flower (mint) symbiosis technology and healthy fish culture technology.
One health insights into pastoralists’ perceptions on zoonotic diseases in Ethiopia: perspectives from South Omo Zone of SNNP Region
Authors: Alemu Samuel Tefera , Ero Debebe , Mor Siobhan M.
Published: May 2023

Zoonotic diseases negatively impact pastoral communities in Ethiopia. In addition to impacts on human health, the interaction between people, livestock and environment which is so fundamental to the pastoralist way of life, means zoonoses pose additional challenges to social bonds and protection networks. These challenges are compounded by adverse impacts from climate change, poor health care services, market problems and cultural practices that increase pastoralists’ vulnerability to zoonotic diseases. This research adopted a grounded theory approach and attempted to capture the perception of Hamer and Dassenetch pastoralists on zoonotic diseases and rangeland health through focus group discussions and key informant interviews. Involved in the research were human and animal health experts, and woreda (Woreda is a third level of administrative unit in Ethiopia following region and zone) level government officials. Thematic framework analysis was used to analyse the data. Zoonotic diseases are a significant public health concern and have a substantial economic burden on local livelihoods. Poor access to human and livestock health services contributed towards the widespread transmission of zoonotic pathogens. In most cases, pastoralists were aware of the possibility of zoonotic disease transmission from livestock to humans and were cognizant of infections contracted from animals. However, the level of risk perception from zoonotic diseases and the subsequent measures of protection was poor. In almost all cases, despite pastoralists’ awareness of zoonotic diseases, they did not consider zoonoses as harmful to human health as they are to animals. It was evident that the burden of zoonotic diseases was high in livestock camps away from settlements in Hamer while for Dassenetch the resettlement clusters created a conducive environment for transmission. This research underscored the importance of engaging with local communities on the risk implications of zoonotic diseases including those related to their food habits and practices.
Dual roles of R-loops in the formation and processing of programmed DNA double-strand breaks during meiosis
Authors: Liu Chao , Xu Wei , Wang Liying , Yang Zhuo , Li Kuan , Hu Jun , Chen Yinghong , Zhang Ruidan , Xiao Sai , Liu Wenwen , Wei Huafang , Chen Jia-Yu , Sun Qianwen , Li Wei
Published: May 2023

Background

Meiotic recombination is initiated by Spo11-dependent programmed DNA double-strand breaks (DSBs) that are preferentially concentrated within genomic regions called hotspots; however, the factor(s) that specify the positions of meiotic DSB hotspots remain unclear.

Results

Here, we examined the frequency and distribution of R-loops, a type of functional chromatin structure comprising single-stranded DNA and a DNA:RNA hybrid, during budding yeast meiosis and found that the R-loops were changed dramatically throughout meiosis. We detected the formation of multiple de novo R-loops in the pachytene stage and found that these R-loops were associated with meiotic recombination during yeast meiosis. We show that transcription-replication head-on collisions could promote R-loop formation during meiotic DNA replication, and these R-loops are associated with Spo11. Furthermore, meiotic recombination hotspots can be eliminated by reversing the direction of transcription or replication, and reversing both of these directions can reconstitute the hotspots.

Conclusions

Our study reveals that R-loops may play dual roles in meiotic recombination. In addition to participation in meiotic DSB processing, some meiotic DSB hotspots may be originated from the transcription-replication head-on collisions during meiotic DNA replication.
Addressing health inequalities in Europe: key messages from the Joint Action Health Equity Europe (JAHEE)
Authors: Bucciardini Raffaella , Zetterquist Pi , Rotko Tuulia , Putatti Vania , Mattioli Benedetta , De Castro Paola , Napolitani Federica , Giammarioli Anna Maria , Kumar Bernadette N. , Nordström Charlott , Plantz Christina , Zarneh Yvette Shajanian , Olsson Gabriella , Ahrne Malin , Kilpeläinen Katri , Lopez-Acuña Daniel , Vantarakis Apostolos , Marra Michele , Nessi Cecilia , Costa Giuseppe
Published: May 2023

Health inequalities within and between Member States of the European Union are widely recognized as a public health problem as they determine a significant share of potentially avoidable mortality and morbidity. After years of growing awareness and increasing action taken, a large gap still exists across Europe in terms of policy responses and governance. With the aim to contribute to achieve greater equity in health outcomes, in 2018 a new Joint Action, JAHEE, (Joint Action Health Equity Europe) was funded by the third EU Health Programme, with the main goal of strengthening cooperation between participating countries and of implementing concrete actions to reduce health inequalities. The partnership led by Italy counted 24 countries, conducting actions in five policy domains: monitoring, governance, healthy living environments, health systems and migration, following a three-step implementation approach. Firstly, specific Policy Frameworks for Action (PFA) collecting the available evidence on what practice should be done in each domain were developed. Second, different Country Assessments (CAs) were completed to check the country’s adherence to the recommended practice in each domain. The gap between the expected policy response (PFA) and the present policy response (CA) guided the choice of concrete actions to be implemented in JAHEE, many of which are continuing even after the end of JA. Final recommendations based on the best results achieved during JAHEE were elaborated and agreed jointly with the representatives of the involved Ministries of Health. The JAHEE initiative represented an important opportunity for the participating countries to work jointly, and the results show that almost all have increased their level of action and strengthened their capacities to address health inequalities.