bluuebunny/crossref_metadata_2025 huggingface dataset:
Automated segmentation of midbrain nuclei using deep learning and multisequence MRI: A longitudinal study on iron accumulation with age
Authors: Falahati Farshad , Gustavsson Jonatan , Kalpouzos Grégoria
Published: September 2024

Elevated levels of brain iron, particularly within the basal ganglia, have been associated with cognitive and motor impairment in normal aging and neurodegenerative conditions. The subthalamic nucleus (STN), substantia nigra (SN), and red nucleus (RN), despite their high iron content and contribution to motor and cognitive processes, are less frequently studied. This oversight can largely be attributed to the challenges posed by in-vivo assessments of these small, deep-seated midbrain structures. We developed and validated an automated tool for the segmentation of the STN, SN, and RN. Multi-sequence magnetic resonance imaging (MRI) data, including T1-weighted, FLAIR, Quantitative Susceptibility Mapping (QSM) and R2* alongside manual delineation on QSM images of 40 individuals, were used to train segmentation models based on the nnU-Net deep-learning framework. A combination of QSM and FLAIR sequences was found to be optimal for structure segmentation (mean Dice scores of 0.84, 0.91, and 0.94 for STN, SN, and RN, respectively). We next applied the automated segmentation method to an independent 3-year longitudinal dataset, including 175 healthy adults (age range at baseline: 20–79 years old). Structural equation modelling was used to assess iron accumulation over time using age, sex, baseline iron, and regional volume as factors of interest. Cross-sectionally, older age was linearly associated with higher iron load in SN and STN; the association was non-linear in RN. Longitudinally, results indicated significant iron accumulation in the STN (Mean increase = 0.02, p = 0.005) and SN (Mean increase = 0.035, p = 0.001), but not in the RN (Mean increase = 0.015, p = 0.2). Our findings demonstrated high performance of nnU-Net in automated segmentation, and advanced our understanding of iron accumulation in midbrain nuclei in aging.
The Verb in Classical Hebrew
Authors: Isaksson Bo
Published: September 2024

The consecutive tenses are fundamental in all descriptions of Classical Hebrew grammar. They are even basic to the textbooks on Biblical Hebrew. Being fundamental in the verbal system, and part of any beginner’s grammar, they pose a serious problem to a linguistic understanding of the verbal system, since grammars describe an alternation of ‘forms’ or ‘tenses’ in double pairs: wayyiqṭol alternates with its ‘equivalent’ qaṭal, and wə-qaṭal alternates with its ‘equivalent’ yiqṭol.

This ‘enigma’ in the verbal system is handled in the book by recognising that the alternation of the consecutive tenses with other tenses, in the reality of the text, represents a linking of clauses. The ‘consecutive tenses’ are clause-types with a natural language connective wa- directly followed by a finite verbal morpheme, a type of clause that expressed continuity in the earliest stage of Semitic. The commonly held assumption that there is a special ‘consecutive waw’ is unwarranted. The use of the ‘consecutive’ clause-types in order to express discourse continuity indicates that Classical Hebrew has retained the old unmarked declarative word order of Semitic syntax. Seen in the light of recent research on the Tiberian reading tradition, the ‘consecutive’ wayyiqṭol can be analysed as a retention of the old Semitic past perfective *wa-yaqtul, which was pronounced wa-yiqṭol in Classical Hebrew. The ‘consecutive’ wə-qāṭal (pronounced wa-qaṭal in the classical language) constitutes the result of an internal Hebrew development into a construction (in the sense of Joan Bybee) already foreshadowed in the earliest Northwest Semitic languages.

The book understands the ‘consecutive tenses’ as discourse continuity clauses, which typically form chains of main line clauses. Such chains can be interrupted by other types of clauses. This interruption is a clause linking that receives special attention in the interpretation of the Classical Hebrew verbal system. Chapter six presents a regenerated text linguistics founded on the new terminology. A clause linking approach is the central methodological procedure in this book. To this must be added diachronic typology in a comparative Semitic setting. The linguistic examples of clause linking are gathered from a large Classical Hebrew corpus, the Pentateuch and the Book of Judges, and made searchable in a database of 6559 non-archaic text records.
5. The Perfective Formation Qaṭal in CBH
Authors: Isaksson Bo
Published: September 2024

In chapter 5, the identity of qaṭal as perfective grammatical morpheme is established in Classical Hebrew. It is one of the main basic tenses in the theory of consecutive tenses, and it also supplies the basic verbal morpheme in the construction wa-qaṭal (for this see chapter 5). It is therefore important to investigate the grammaticalisation path of qatal(a) in Semitic. The chapter shows that qaṭal originated from a resultative construction in West Semitic. In its relation to the perfective short yiqṭol (in wa(y)-yiqṭol), which is of Proto Semitic origin, qaṭal is new. But considered on its path of grammaticalisation from a resultative construction it is old in Classical Hebrew. The anterior and past perfective uses dominate in the corpus.
The Influence of Anomalous Biomass Emissions on ENSO in CESM2
Authors: Fasullo John T. , Rosenbloom Nan , Buchholz Rebecca
Published: September 2024

The influence of biomass burning (BB) aerosols arising from wildfires and agricultural fires on the transient coupled evolution of El Niño–Southern Oscillation (ENSO) is explored in Community Earth System Model, version 2 (CESM2). For both El Niño and La Niña, two 20-member ensembles are generated from initial states that are predisposed to evolve into ENSO events. For each ENSO phase, one ensemble is forced with the observed BB emissions during satellite-era ENSO events while the other is forced with a climatological annual cycle, with the responses to anomalous BB emissions estimated from interensemble differences. It is found that the regional responses to anomalous BB emissions occur mainly during boreal fall, which is also the time of the climatological seasonal maximum in emissions. Transient responses are identified in precipitation, clouds, and radiation in both the tropics and extratropics. At the onset of El Niño, these include increased precipitation in the northern branch of the intertropical convergence zone (ITCZ) and an enhancement of cloud albedo and amount across the Maritime Continent and eastern subtropical Pacific Ocean. Additional responses are identified through the course of El Niño and successive La Niña events, the net effect of which is to strengthen sea surface temperature (SST) anomalies in the eastern Pacific Ocean during El Niño and warm the tropical Pacific Ocean during La Niña. These responses improve the simulation of ENSO power, diversity, and asymmetry in CESM2.

Significance Statement

Biomass burning emissions from both wildfires and agricultural fires during ENSO act as a climate feedback, as they are both driven by fire weather anomalies tied to ENSO and influence clouds, radiation, and precipitation on a global scale. While the largest biomass burning (BB) emissions emanate mainly from Indonesia, other regions also exhibit systematic responses. When simulated in CESM2, the emissions collectively impact the flows of energy across the tropical Pacific Ocean in a spatially and temporally complex fashion, with the net effect of improving CESM2’s simulation of ENSO events.
Investigating the Mechanisms of an Intense Coastal Rainfall Event during TAHOPE/PRECIP-IOP3 Using a Multiscale Radar Ensemble Data Assimilation System
Authors: Yang Shu-Chih , Chen Shu-Hua , Liu Lawrence Jing-Yueh , Yeh Hao-Lun , Chang Wei-Yu , Chung Kao-Shen , Chang Pao-Liang , Lee Wen-Chau
Published: September 2024

The joint Taiwan-Area Heavy Rain Observation and Prediction Experiment (TAHOPE)/Prediction of Rainfall Extremes Campaign in the Pacific (PRECIP) field campaign between Taiwan and the United States took place from late May to mid-August in 2022. The field campaign aimed to understand the dynamics, thermodynamics, and predictability of heavy rainfall events in the Taiwan area. This study investigated the mechanisms of a heavy rainfall event that occurred on 6–7 June during the intensive observation period 3 (IOP3) of the field campaign. Heavy rainfall occurs on Taiwan’s western coast when a mei-yu front hovers in northern Taiwan. A multiscale radar ensemble data assimilation system based on the successive covariance localization (SCL) method is used to derive a high-resolution analysis for forecasts. Two numerical experiments are conducted with the use of convective-scale (Experiment RDA) or multiscale (Experiment MRDA) corrections in the assimilation of the radial velocity from operational radars at Chigu and WuFen and the additional S-band dual-polarization Doppler radar (S-Pol) deployed at Hsinchu during the field campaign. Compared with RDA, MRDA results in large-area wind corrections, which help reshape and relocate a low-level mesoscale vortex, a key element of this heavy rainfall event, offshore of western central Taiwan and enhances the front intensity offshore of northwestern Taiwan. Consequently, MRDA improves the 6-h heavy rainfall prediction over the coast of western Taiwan and better represents the elongated rainband in northern Taiwan during the 3–6-h forecast. Sensitivity experiments demonstrate the importance of assimilating winds from Chigu and S-Pol radar in establishing low-level mesoscale vortex and convergence zones.
Vascular liver segmentation: a narrative review on methods and new insights brought by artificial intelligence
Authors: Chierici Andrea , Lareyre Fabien , Salucki Benjamin , Iannelli Antonio , Delingette Hervé , Raffort Juliette
Published: September 2024

Liver vessel segmentation from routinely performed medical imaging is a useful tool for diagnosis, treatment planning and delivery, and prognosis evaluation for many diseases, particularly liver cancer. A precise representation of liver anatomy is crucial to define the extent of the disease and, when suitable, the consequent resective or ablative procedure, in order to guarantee a radical treatment without sacrificing an excessive volume of healthy liver. Once mainly performed manually, with notable cost in terms of time and human energies, vessel segmentation is currently realized through the application of artificial intelligence (AI), which has gained increased interest and development of the field. Many different AI-driven models adopted for this aim have been described and can be grouped into different categories: thresholding methods, edge- and region-based methods, model-based methods, and machine learning models. The latter includes neural network and deep learning models that now represent the principal algorithms exploited for vessel segmentation. The present narrative review describes how liver vessel segmentation can be realized through AI models, with a summary of model results in terms of accuracy, and an overview on the future progress of this topic.
Outcomes of Medicaid Rebalancing May Differ Across Enrollee Populations
Authors: Harrison Jordan M. , Friedman Esther M. , Edgington Sarah , Ghosh-Dastidar Bonnie , Siconolfi Daniel , Shih Regina A.
Published: September 2024

Access to home- and community-based services (HCBS) may prevent or delay nursing home transitions among older adults. Medicaid’s Balancing Incentive Program (BIP) (2011–2015) provided assistance for U.S. states to increase access to HCBS through infrastructure changes and spending benchmarks. We combined longitudinal data from the 2008–2019 Medicare Current Beneficiary Survey and Minimum Data Set and used survival modeling to examine the association between BIP exposure (living in a BIP-participant state vs. not) and time to long-term institutionalization (LTI, defined as a nursing home episode of 90+ days) among dual enrollees ages 65 and older. In the main effects model, BIP exposure was not associated with hazard of LTI. Interaction models showed that BIP exposure was associated with a lower hazard of LTI among Hispanic/Latinx enrollees, while the opposite was true among non-Hispanic White enrollees. Our findings suggest the outcomes of Medicaid rebalancing efforts may differ across enrollee subgroups.
Using Visual Activity Schedules to Improve Transitioning for Students With Emotional and Behavioral Disorders
Authors: Milam Molly E. , Sutton Kimberly Kode
Published: September 2024

Some students with disabilities, particularly those with emotional and behavioral disorders, may struggle with transitions, demonstrating inappropriate behaviors during them. Visual supports, previously determined to be an evidence-based practice for students with autism, is a proactive classroom management strategy addressing transitioning. In this article, we describe the use of visual activity schedules that can be integrated into existing classroom management practices to reduce disruptive behaviors during transitions.
Parents’ experiences of waiting for their child’s transplant: A focus on how healthcare providers can impact the waiting process
Authors: Smith Kristina A , Arbour-Nicitopoulos Kelly P , Widger Kimberley
Published: September 2024

Waiting for a child transplant is a form of suffering for parents, yet little research has explored how parents experience waiting and how healthcare providers can impact their waiting experiences. The purpose of this article is to investigate how parents experienced the process of waiting for their child’s transplant with a specific focus on the impact of healthcare providers on parents’ experience of waiting. Six parents from four different families participated in interviews and observations. Our narrative analysis suggested that parents had no narrative roadmap to navigate waiting and the importance of healthcare providers’ tailoring the amount and type of medical information to a parents’ needs. We discuss how waiting required parents to be hypervigilant and provide continuity of care for their child, and how this “managerial role” could lead to a loss of trust with their healthcare providers. Parents’ accounts were replete with contradictions, and as an extension of this, waiting was full of contradictions. Findings contribute to conceptual, methodological, and practical work exploring how parents live in deep uncertainty about the future, and how healthcare providers can support parents in their child’s transplantation and other life-threatening illness contexts.
Management of iron overload: lessons from transfusion-dependent hemoglobinopathies
Authors: Coates Thomas D.
Published: September 2024

Before the advent of effective iron chelation, death from iron-induced cardiomyopathy and endocrine failure occurred in the second decade in patients with thalassemia major, and this experience has driven expectation of poor outcomes and caused anxiety in all disorders associated with iron loading to this day. To be clear, severe iron overload still causes significant morbidity and mortality in many parts of the world, but current understanding of iron metabolism, noninvasive monitoring of organ-specific iron loading in humans, and effective iron chelators have dramatically reduced morbidity of iron overload. Furthermore, clinical experience in hemoglobinopathies supports iron biology learned from animal studies and identifies common concepts in the biology of iron toxicity that inform the management of iron toxicity in several human disorders. The resultant significant increase in survival uncovers new complications due to much longer exposure to anemia and to iron, which must be considered in long-term therapeutic strategies. This review will discuss the management of iron toxicity in patients with hemoglobinopathies and transfusion-dependent anemias and how iron biology informs the clinical approach to treatment.
Asymptomatic multicentric Castleman disease: a potential early stage of idiopathic MCD
Authors: Zhang Lu , Liu Qin-hua , Zhou Hui , Zhang Hui-lai , Dong Yu-jun , Wang Xiao-bo , Wang Lu-qun , Su Li-ping , Yan Xiao-jing , Li Yan , Zhang Ming-zhi , Ding Kai-yang , Wang Hui-han , Peng Hong-ling , Zhong Li-ye , Yang Lin , Bi Lin-tao , Gao Da , Gao Guang-xun , Huang Liang , Sun Chun-yan , Song Jia , Qian Wen-bin , Huang Wen-rong , Li Zhen-ling , Liu Yao , Li Jian
Published: September 2024

According to the diagnostic criteria for human herpesvirus 8 (HHV-8)–negative/idiopathic multicentric Castleman disease (iMCD) proposed by Castleman Disease Collaborative Network in 2017, there is a group of HHV-8–negative patients with multicentric Castleman disease (MCD) who do not have symptoms and hyperinflammatory state and do not meet the iMCD criteria. This retrospective study enrolled 114 such patients, described as asymptomatic MCD (aMCD), from 26 Chinese centers from 2000 to 2021. With a median follow-up time of 46.5 months (range, 4-279 months), 6 patients (5.3%) transformed to iMCD. The median time between a diagnosis of aMCD and iMCD in these 6 patients was 28.5 months (range, 3-60). During follow-up, 7 patients died; 3 of them died from progression of MCD. Despite that, 37.7% of patients received systemic treatment targeting MCD; this strategy was neither associated with a lower probability of iMCD transformation nor a lower death rate. The 5-year estimated survival of all patients with aMCD was 94.1% (95% confidence interval, 88.8-99.6). Transformation to iMCD was an important predictor of death (log-rank P = .01; 5-year estimated survival, 83.3%). This study suggests that patients with aMCD may represent a potential early stage of iMCD, who may not require immediate treatment but should be closely monitored.
Handling delayed or missed direct oral anticoagulant doses: model-informed individual remedial dosing
Authors: Liu Xiao-Qin , Li Zi-Ran , Wang Chen-Yu , Jiao Zheng
Published: September 2024

Nonadherence to direct oral anticoagulant (DOAC) pharmacotherapy may increase the risk of thromboembolism or bleeding, and delayed or missed doses are the most common types of nonadherence. Current recommendations from regulatory agencies or guidelines regarding this issue lack evidence and fail to consider individual differences. This study aimed to develop individual remedial dosing strategies when the dose was delayed or missed for DOACs, including rivaroxaban, apixaban, edoxaban, and dabigatran etexilate. Remedial dosing regimens based on population pharmacokinetic (PK)-pharmacodynamic (PD) modeling and simulation strategies were developed to expeditiously restore drug concentration or PD biomarkers within the therapeutic range. Population PK-PD characteristics of DOACs were retrieved from previously published literature. The effects of factors that influence PK and PD parameters were assessed for their impact on remedial dosing regimens. A web-based dashboard was established with R-shiny to recommend remedial dosing regimens based on patient traits, dosing schedules, and delay duration. Addressing delayed or missed doses relies on the delay time and specific DOACs involved. Additionally, age, body weight, renal function, and polypharmacy may marginally affect remedial strategies. The proposed remedial dosing strategies surpass current recommendations, with less deviation time beyond the therapeutic range. The online dashboard offers quick and convenient solutions for addressing missed or delayed DOACs, enabling individualized remedial dosing strategies based on patient characteristics to mitigate the risks of bleeding and thrombosis.
In vivodetection of pulmonary mucociliary clearance: present challenges and future directions
Authors: Sher Ada C. , Stacy Mitchel R. , Reynolds Susan D. , Chiang Tendy
Published: September 2024

Pulmonary mucociliary clearance (MCC) is an important defence mechanism of the respiratory system and clears pathogens and foreign particles from the airways. Understanding the effect of disease states, drugs, toxins and airway manipulations on MCC could be beneficial in preventing early pulmonary disease and developing new pulmonary therapeutics. This review summarises the current methods and future efforts to detect pulmonary MCCin vivo.
An innovative, sustainable, and environmentally friendly approach for wheat drought tolerance using vermicompost and effective microorganisms: upregulating the antioxidant defense machinery, glyoxalase system, and osmotic regulatory substances
Authors: Talaat Neveen B. , Abdel-Salam Sameh A. M.
Published: September 2024

Background

Vermicompost contains humic acids, nutrients, earthworm excretions, beneficial microbes, growth hormones, and enzymes, which help plants to tolerate a variety of abiotic stresses. Effective microorganisms (EM) include a wide range of microorganisms’ e.g. photosynthetic bacteria, lactic acid bacteria, yeasts, actinomycetes, and fermenting fungi that can stimulate plant growth and improve soil fertility. To our knowledge, no study has yet investigated the possible role of vermicompost and EM dual application in enhancing plant tolerance to water scarcity.

Methods

Consequently, the current study investigated the effectiveness of vermicompost and EM in mitigating drought-induced changes in wheat. The experiment followed a completely randomized design with twelve treatments. The treatments included control, as well as individual and combined applications of vermicompost and EM at three different irrigation levels (100%, 70%, and 30% of field capacity).

Results

The findings demonstrated that the application of vermicompost and/or EM significantly improved wheat growth and productivity, as well as alleviated drought-induced oxidative damage with decreased the generation of superoxide anion radical and hydrogen peroxide. This was achieved by upregulating the activities of several antioxidant enzymes, including superoxide dismutase, catalase, peroxidase, ascorbate peroxidase, glutathione peroxidase, monodehydroascorbate reductase, dehydroascorbate reductase, and glutathione reductase. Vermicompost and/or EM treatments also enhanced the antioxidant defense system by increasing the content of antioxidant molecules such as ascorbate, glutathione, phenolic compounds, and flavonoids. Additionally, the overproduction of methylglyoxal in water-stressed treated plants was controlled by the enhanced activity of the glyoxalase system enzymes; glyoxalase I and glyoxalase II. The treated plants maintained higher water content related to the higher content of osmotic regulatory substances like soluble sugars, free amino acids, glycinebetaine, and proline.

Conclusions

Collectively, we offer the first report that identifies the underlying mechanism by which the dual application of vermicompost and EM confers drought tolerance in wheat by improving osmolyte accumulation and modulating antioxidant defense and glyoxalase systems.
A molecular epidemiological and transmission analysis of Clostridioides difficile using draft whole-genome sequencing in a single hospital
Authors: Miyazaki Taito , Aoki Kotaro , Maeda Tadashi , Komori Kohji , Yoshizawa Sadako , Ishii Yoshikazu , Urita Yoshihisa , Tateda Kazuhiro
Published: September 2024

Background

The nosocomial transmission of toxin-producing Clostridioides difficile is a significant concern in infection control. C. difficile, which resides in human intestines, poses a risk of transmission, especially when patients are in close contact with medical staff.

Methods

To investigate the nosocomial transmission of C. difficile in a single center, we analyzed the genetic relationships of the bacteria. This was done using draft whole-genome sequencing (WGS) and examining single nucleotide polymorphisms (SNPs) in core-genome, alongside data regarding the patient’s hospital wards and room changes. Our retrospective analysis covered 38 strains, each isolated from a different patient, between April 2014 and January 2015.

Results

We identified 38 strains that were divided into 11 sequence types (STs). ST81 was the most prevalent (n = 11), followed by ST183 (n = 10) and ST17 (n = 7). A cluster of strains that indicated suspected nosocomial transmission (SNT) was identified through SNP analysis. The draft WGS identified five clusters, with 16 of 38 strains belonging to these clusters. There were two clusters for ST81 (ST81-SNT-1 and ST81-SNT-2), two for ST183 (ST183-SNT-1 and ST183-SNT-2), and one for ST17 (ST17-SNT-1). ST183-SNT-1 was the largest SNT cluster, encompassing five patients who were associated with Wards A, B, and K. The most frequent room changer was a patient labeled Pt08, who changed rooms seven times in Ward B. Patients Pt36 and Pt10, who were also in Ward B, had multiple admissions and discharges during the study period.

Conclusions

Additional culture tests and SNP analysis of C. difficile using draft WGS revealed silent transmission within the wards, particularly in cases involving frequent room changes and repeated admissions and discharges. Monitoring C. difficile transmission using WGS-based analysis could serve as a valuable marker in infection control management.
Access to land and nature as health determinants: a qualitative analysis exploring meaningful human-nature relationships among Indigenous youth in central Canada
Authors: Hatala Andrew R. , Morton Darrien , Deschenes Cindy , Bird-Naytowhow Kelley
Published: September 2024

Background

Human relationships with and connections to nature and the “land” are a commonly accepted Social Determinant of Health. Greater knowledge about these relationships can inform public health policies and interventions focused on health equity among Indigenous populations. Two research questions were explored: (1) what are the experiences of meaningful human-nature relationships among Indigenous youth within central Canada; and (2) how do these relationships function as a determinant of health and wellness within their lives.

Methods

Drawing from three community-based participatory research (CBPR) projects within two urban centers in Saskatchewan and Manitoba, the integrated qualitative findings presented here involved 92 interviews with 52 Indigenous youth that occurred over a period of nine years (2014–2023). Informed by “two-eyed seeing,” this analysis combined Indigenous Methodologies and a Constructivist Grounded Theory approach.

Results

Our integrative analysis revealed three cross-cutting themes about meaningful human-nature relationships: (1) promoting cultural belonging and positive identity; (2) connecting to community and family; and (3) supporting spiritual health and relationships. The experiences of young people also emphasized barriers to land and nature access within their local environments.

Discussion

Policies, practices, and interventions aimed at strengthening urban Indigenous young peoples’ relationships to and connections with nature and the land can have a positive impact on their health and wellness. Public Health systems and healthcare providers can learn about leveraging the health benefits of human-nature relationships at individual and community levels, and this is particularly vital for those working to advance health equity among Indigenous populations.
Association between sexual violence and depression is mediated by perceived social support among female university students in the kingdom of Eswatini
Authors: Fielding-Miller Rebecca , McDougal Lotus , Frost Elizabeth , Masuku Sakhile , Shabalala Fortunate
Published: September 2024

Background

Gender-based violence is a tool that primarily functions to maintain gendered power hierarchies. Manifestations of gender-based violence, sexual assault and street harassment have been shown to have significant effects on mental wellbeing in the global North, however there is little research centering the experiences and consequences of gendered harassment in the Africa region.

Methods

We analyzed a cross-sectional random sample of 372 women attending a major university in Eswatini in 2017 to measure the prevalence of street harassment among female university students and assess the relationship between experiences of sexual assault, sexualized street harassment, and mental health outcomes in this population.

Results

We found that in the previous 12 months, women reported experiencing high levels of sexual assault (20%), street harassment (90%), and depression (38%). Lifetime sexual assault, past 12 months sexual assault, and street harassment were all significantly associated with symptoms of depression. We created a structural model to test hypothesized causal pathways between street harassment, previous experiences of sexual assault, and symptoms of depression, with social support as a potential mediator. We found that a history of sexual violence significantly mediated the association between street harassment and depression, and that social support mediated a large proportion of the association between both forms of gender-based violence and depression.

Conclusion

Sexualized street harassment is associated with increased depressive symptomology for nearly all women, however the effects are especially pronounced for women who have previous experiences of sexual violence. Sexualized street harassment functions as a tool to maintain gendered power hierarchies by reminding women of ongoing threat of sexual violence even in public spaces. Social support and solidarity among women is a potentially important source of resiliency against the physical and mental harms of all forms of gender based violence.
The role of erythropoietin-loaded hydrogel versus adipose derived stem cell secretome in the regeneration of tongue defects
Authors: El-Qashty Rana , Youssef Jilan , Hany Eman
Published: September 2024

Background

Tongue defects have several etiologies and significantly affect the quality of life. This study was conducted to compare the regenerative potential of erythropoietin (EPO)-loaded hydrogel and adipose derived stem cell (ADSC) secretome on tongue dorsum defects focusing on the role of anti-inflammatory M2 macrophage phenotype.

Methods

Rats were subjected to induction of mechanical circular defects on the dorsal surface of the tongue, then divided into three groups; Group I (control): received 0.1 ml phosphate buffered saline, Group II (EPO): received 5000 U/kg EPO-hydrogel, and Group III (ADSC-Secretome): received 0.1 ml ADSC-Secretome. Treatments were injected circumferentially around wound margins after induction. Seven and fourteen days after treatment, specimens were obtained and processed for histological and immunohistochemical staining followed by the relevant histomorphometric and statistical analyses.

Results

Seven days after treatment, groups II and III presented defects with some epithelial regeneration at the lateral margins, while the center of the defect showed granulation tissue with much inflammatory cells. The base of the defects showed some muscle fibers and new blood vessels, however group III showed more enhanced neovascularization. Fourteen days after therapeutic intervention, group II defects were completely covered with epithelium showing a thin keratin layer with regular rete pegs interdigitating with the underlying connective tissue papillae, but tongue papillae were not restored. Group III expressed much better healing with developing filiform papillae. The connective tissue showed more vascularity and well-arranged muscle bundles. Both treated groups showed a significant decrease in defect depth and significant increase in anti-inflammatory macrophages compared to the control group at both time intervals, however there was no significant difference between the two treated groups.

Conclusion

Both treatments showed promising and comparable results in the treatment of tongue defects reducing inflammation and restoring tongue histological architecture with significant upregulation of M2 macrophage.
Advancing sustainable healthcare: a concept analysis of eco-conscious nursing practices
Authors: Shaban Marwa Mamdouh , Alanazi Majed Awad , Mohammed Huda Hamdy , Mohamed Amer Fatma Gomaa , Elsayed Hla Hosny , Zaky Mohammed ElSayed , Ramadan Osama Mohammed Elsayed , Abdelgawad Mohamed Ezzelregal , Shaban Mostafa
Published: September 2024

Background

As the healthcare sector grapples with its environmental footprint, the concept of Eco-conscious Nursing emerges as a pivotal framework for integrating sustainability into nursing practice. This study aims to clarify and operationalize Eco-conscious Nursing, examining its attributes, antecedents, consequences, and providing operational definitions to guide future research and practice.

Methods

Utilizing a systematic literature review across PubMed, Google Scholar, and CINAHL Ultimate, this study identifies and analyzes existing theories, frameworks, and practices related to eco-conscious nursing. Through conceptual analysis, key attributes, antecedents, and consequences of Eco-conscious Nursing are delineated, leading to the formulation of comprehensive operational definitions.

Results

The study reveals Eco-conscious Nursing as a multifaceted concept characterized by environmental stewardship, sustainable healthcare practices, and a commitment to reducing the ecological impact of nursing care. Operational definitions highlight the role of education, awareness, and institutional support as antecedents, with improved environmental health and sustainable healthcare outcomes as key consequences.

Conclusion

Eco-conscious Nursing represents a crucial ethos for the nursing profession, emphasizing the necessity of sustainable practices within healthcare. The operational definitions provided serve as a foundation for embedding eco-conscious principles into nursing, addressing the urgent need for sustainability in healthcare settings. Future research should focus on the empirical application of these definitions and explore the economic and cross-cultural dimensions of eco-conscious nursing.
User profiles in digitalized healthcare: active, potential, and rejecting — a cross-sectional study using latent class analysis
Authors: Knöchelmann Anja , Healy Karl , Frese Thomas , Kantelhardt Eva , Mikolajczyk Rafael , Meyer Gabriele , Schildmann Jan , Steckelberg Anke , Herke Max
Published: September 2024

Background

There is evidence of different use by different groups of people for general health-related applications. Yet, these findings are lacking for digitalized healthcare services. It is also unclear whether typical use patterns can be found and how user types can be characterized.

Methods

The analyses are based on data from 1 821 respondents to the Health Related Beliefs and Health Care Experiences in Germany panel (HeReCa). Digitalized healthcare services, that were used to determine the user types, include for example sick ﻿notes before/after examination and disease related training. User types were determined by latent class analysis. Individual groups were characterized using multinomial logistic regressions, taking into account socioeconomic and demographic factors as well as individual attitudes towards digitalization in the healthcare system.

Results

Three types were identified: rejecting (27.9%), potential (53.8%) and active (18.3%). Active participants were less likely to be employed, less likely to be highly educated and less skeptical of digital technologies. Potential users were the youngest, most highly-educated and most frequently employed group, with less skepticism than those who rejected. Rejecters were the oldest group, more likely to be female and of higher socio-economic status.

Conclusions

Socio-demographic and socio-economic differences were identified among three user types. It can therefore be assumed that not all population groups will benefit from the trend towards digitalization in healthcare. Steps should be taken to enhance access to innovations and ensure that everyone benefits from them.
The impact of Bacillus thuringiensis var. israelensis (Vectobac® WDG) larvicide sprayed with drones on the bio-control of malaria vectors in rice fields of sub-urban Kigali, Rwanda
Authors: Munyakanage Dunia , Niyituma Elias , Mutabazi Alphonse , Misago Xavier , Musanabaganwa Clarisse , Remera Eric , Rutayisire Eric , Ingabire Mamy Muziga , Majambere Silas , Mbituyumuremyi Aimable , Ngugi Mathew Piero , Kokwaro Elizabeth , Hakizimana Emmanuel , Muvunyi Claude Mambo
Published: September 2024

Background

The core vector control tools used to reduce malaria prevalence are currently long-lasting insecticidal nets (LLINs), and indoor residual spraying (IRS). These interventions are hindered by insecticide resistance and behavioural adaptation by malaria vectors. Thus, for effective interruption of malaria transmission, there is a need to develop novel vector control interventions and technologies to address the above challenges. Larviciding using drones was experimented as an innovative tool that could complement existing indoor interventions to control malaria.

Methods

A non-randomized larviciding trial was carried out in irrigated rice fields in sub-urban Kigali, Rwanda. Potential mosquito larval habitats in study sites were mapped and subsequently sprayed using multirotor drones. Application of Bacillus thuringiensis var. israelensis (Bti) (Vectobac® WDG) was followed by entomological surveys that were performed every two weeks over a ten-month period. Sampling of mosquito larvae was done with dippers while adult mosquitoes were collected using CDC miniature light traps (CDC-LT) and pyrethrum spraying collection (PSC) methods. Malaria cases were routinely monitored through community health workers in villages surrounding the study sites.

Results

The abundance of all-species mosquito larvae, Anopheles larvae and all-species pupae declined by 68.1%, 74.6% and 99.6%, respectively. Larval density was reduced by 93.3% for total larvae, 95.3% for the Anopheles larvae and 61.9% for pupae. The total adult mosquitoes and Anopheles gambiae sensu lato collected using CDC-Light trap declined by 60.6% and 80% respectively. Malaria incidence also declined significantly between intervention and control sites (U = 20, z = − 2.268, p = 0.023).

Conclusions

The larviciding using drone technology implemented in Rwanda demonstrated a substantial reduction in abundance and density of mosquito larvae and, concomitant decline in adult mosquito populations and malaria incidences in villages contingent to the treatment sites. The scaling up of larval source management (LSM) has to be integrated in malaria programmes in targeted areas of malaria transmission in order to enhance the gains in malaria control.
Whole-genome sequencing of major malaria vectors reveals the evolution of new insecticide resistance variants in a longitudinal study in Burkina Faso
Authors: Kientega Mahamadi , Clarkson Chris S. , Traoré Nouhoun , Hui Tin-Yu J. , O’Loughlin Samantha , Millogo Abdoul-Azize , Epopa Patric Stephane , Yao Franck A. , Belem Adrien M. G. , Brenas Jon , Miles Alistair , Burt Austin , Diabaté Abdoulaye
Published: September 2024

Background

Intensive deployment of insecticide based malaria vector control tools resulted in the rapid evolution of phenotypes resistant to these chemicals. Understanding this process at the genomic level is important for the deployment of successful vector control interventions. Therefore, longitudinal sampling followed by whole genome sequencing (WGS) is necessary to understand how these evolutionary processes evolve over time. This study investigated the change in genetic structure and the evolution of the insecticide resistance variants in natural populations of Anopheles gambiae over time and space from 2012 to 2017 in Burkina Faso.

Methods

New genomic data have been generated from An. gambiae mosquitoes collected from three villages in the western part of Burkina Faso between 2012 and 2017. The samples were whole-genome sequenced and the data used in the An. gambiae 1000 genomes (Ag1000G) project as part of the Vector Observatory. Genomic data were analysed using the analysis pipeline previously designed by the Ag1000G project.

Results

The results showed similar and consistent nucleotide diversity and negative Tajima’s D between An. gambiae sensu stricto (s.s.) and Anopheles coluzzii. Principal component analysis (PCA) and the fixation index (FST) showed a clear genetic structure in the An. gambiae sensu lato (s.l.) species. Genome-wide FST and H12 scans identified genomic regions under divergent selection that may have implications in the adaptation to ecological changes. Novel voltage-gated sodium channel pyrethroid resistance target-site alleles (V402L, I1527T) were identified at increasing frequencies alongside the established alleles (Vgsc-L995F, Vgsc-L995S and N1570Y) within the An. gambiae s.l. populations. Organophosphate metabolic resistance markers were also identified, at increasing frequencies, within the An. gambiae s.s. populations from 2012 to 2017, including the SNP Ace1-G280S and its associated duplication. Variants simultaneously identified in the same vector populations raise concerns about the long-term efficacy of new generation bed nets and the recently organophosphate pirimiphos-methyl indoor residual spraying in Burkina Faso.

Conclusion

These findings highlighted the benefit of genomic surveillance of malaria vectors for the detection of new insecticide resistance variants, the monitoring of the existing resistance variants, and also to get insights into the evolutionary processes driving insecticide resistance.
An economic model to understand the cost-effectiveness of olanzapine orally dispersible tablets (ODT) and olanzapine film coated tablets as a group compared with other oral atypical antipsychotics for treating schizophrenia in Morocco
Authors: Tazi Ahmed , Errachidi Faouzi , Sonawane Dipesh , Tahri Ghizlane , Rao Sameer , Mehta Suyog
Published: September 2024

Background

Antipsychotic medications are the primary treatment for schizophrenia, with olanzapine being an effective medication for schizophrenia. The economic cost for each individual with schizophrenia is high, with antipsychotic medication being a major expense. This study aims to develop an economic decision model that compares different treatment options for schizophrenia patients, including olanzapine Orally Dispersible Tablets (ODT), olanzapine [ODT + Standard Oral Tablet (SOT)], risperidone (ODT + SOT), and aripiprazole (ODT + SOT), to determine their cost-effectiveness with an objective to optimize healthcare resource allocation in Morocco.

Methods

The study used published medical literature and a clinical expert panel to develop a decision analytic model. This model was designed to capture parameters such as adherence levels, treatment discontinuation, relapse with and without hospitalization, quality-adjusted life years (QALYs), treatment-related adverse events, healthcare resource utilization, and associated costs. The main outcomes of interest included the total annual direct cost per treatment, QALYs, and incremental cost-effectiveness ratio (ICER) per 1 QALY gained. One-way and probabilistic sensitivity analyses were employed to account for parameter uncertainty.

Results

According to the simulation model, the ODT and ODT + SOT as a group form of olanzapine was the most effective treatment option in terms of the lowest percentages of inpatient relapse, and patients who remained stable (11% and 79% respectively) than risperidone (19% and 62% respectively) and aripiprazole ODT (26% and 50% respectively) and ODT + SOT formulation groups. Olanzapine (ODT + SOT) therapy group was cost-effective when compared to the combined group of ODT + SOT forms of risperidone [ICER: Moroccan Dirham (MAD) 103,907], and aripiprazole (ICER: MAD 65,047). Additionally, olanzapine ODT was found to be cost-effective compared to olanzapine SOT with an ICER of MAD 3921, risperidone ODT with an ICER of MAD 1,02,298, risperidone SOT with an ICER of MAD 31,088, and aripiprazole ODT or SOT formulations. All the above ICERs fall under the willingness-to-pay threshold in Morocco of MAD 250,832.40. Sensitivity analyses confirmed the reliability of the findings.

Conclusions

The model concluded that olanzapine ODT is the most cost-effective first-line treatment option for schizophrenia in Morocco when compared to other atypical antipsychotic medications in ODT and SOT formulations.
Risk factors for traumatic intracranial hemorrhage in mild traumatic brain injury patients at the emergency department: a systematic review and meta-analysis
Authors: Yang Li Jin , Lassarén Philipp , Londi Filippo , Palazzo Leonardo , Fletcher-Sandersjöö Alexander , Ängeby Kristian , Thelin Eric Peter , Rubenson Wahlin Rebecka
Published: September 2024

Background

Mild traumatic brain injury (mTBI), i.e. a TBI with an admission Glasgow Coma Scale (GCS) of 13–15, is a common cause of emergency department visits. Only a small fraction of these patients will develop a traumatic intracranial hemorrhage (tICH) with an even smaller subgroup suffering from severe outcomes. Limitations in existing management guidelines lead to overuse of computed tomography (CT) for emergency department (ED) diagnosis of tICH which may result in patient harm and higher healthcare costs.

Objective

To perform a systematic review and meta-analysis to characterize known and potential novel risk factors that impact the risk of tICH in patients with mTBI to provide a foundation for improving existing ED guidelines.

Methods

The literature was searched using MEDLINE, EMBASE and Web of Science databases. Reference lists of major literature was cross-checked. The outcome variable was tICH on CT. Odds ratios (OR) were pooled for independent risk factors.

Results

After completion of screening, 17 papers were selected for inclusion, with a pooled patient population of 26,040 where 2,054 cases of tICH were verified through CT (7.9%). Signs of a skull base fracture (OR 11.71, 95% CI 5.51–24.86), GCS < 15 (OR 4.69, 95% CI 2.76–7.98), loss of consciousness (OR 2.57, 95% CI 1.83–3.61), post-traumatic amnesia (OR 2.13, 95% CI 1.27–3.57), post-traumatic vomiting (OR 2.04, 95% CI 1.11–3.76), antiplatelet therapy (OR 1.54, 95% CI 1.10–2.15) and male sex (OR 1.28, 95% CI 1.11–1.49) were determined in the data synthesis to be statistically significant predictors of tICH.

Conclusion

Our meta-analysis provides additional context to predictors associated with high and low risk for tICH in mTBI. In contrast to signs of a skull base fracture and reduction in GCS, some elements used in ED guidelines such as anticoagulant use, headache and intoxication were not predictive of tICH. Even though there were multiple sources of heterogeneity across studies, these findings suggest that there is potential for improvement over existing guidelines as well as a the need for better prospective trials with consideration for common data elements in this area.

PROSPERO registration number CRD42023392495.