bluuebunny/crossref_metadata_2025 huggingface dataset:
Government Efforts to Boost Rice Farmers' Harvest Yields
Authors: Suwardi Suwardi , Mursyidah Lailul
Published: October 2024

General Background: Economic development in developing countries aims to enhance economic growth, job opportunities, income distribution, and balance the economic structure. Specific Background: Indonesia, known as an agrarian country due to its fertile land, still relies on rice imports despite its agricultural potential. Knowledge Gap: The effectiveness of government roles in increasing rice production remains unclear, especially at the local level, where farmers face challenges with seed and fertilizer assistance. Aims: This study examines the government's role in increasing rice yields in Karangtanjung Village, Candi District, Sidoarjo Regency, focusing on its function as a stabilizer, innovator, pioneer, and implementer. Results: The findings reveal that the government’s role has been implemented but not fully effective. Farmers perceive challenges with assistance, notably in obtaining superior seeds and affordable, environmentally friendly fertilizers. Moreover, government efforts to enhance production through agricultural support face obstacles, including irrigation issues and limited farmer participation in training programs. Novelty: This study highlights the gaps in the current government interventions, emphasizing the need for improved policies to provide superior seeds and sustainable farming practices tailored to the specific conditions of Karangtanjung Village. Implications: For the government to enhance rice production effectively, there must be efforts to address the supply of superior seeds and environmentally friendly fertilizers, tailored training programs, and better irrigation systems to meet the needs of local farmers. This study underscores the importance of a more targeted approach in agricultural policy to ensure sustainable and increased crop yields.
Highlights:

Government acts as a stabilizer, innovator, pioneer, and implementer to support rice farming.
Empowerment programs include providing seeds, fertilizer, irrigation systems, and agricultural machinery.
Challenges remain in distribution, farmer education, and ensuring sustainable farming practices.

Keywords: Government Role, Crop Yield, Rice Farmers, Agricultural Regulation, Village Empowerment
Risk Linkage Model for Cooking Oil Supply Chain
Authors: Arismawati Paramaditya , Vanany Iwan
Published: October 2024

Cooking oil is one of nine elements of Indonesian staple cuisine, also known as basic food. In the middle of 2022, the public will experience cooking oil scarcity, with prices that are significantly higher than before. The price increase of CPO (Crude Palm Oil) raw materials, disruption of distribution channels, low supplies of domestic palm oil raw materials, and some domestic cooking oil producers exporting without permission from the government and violating the law are some of the causes of the rise in cooking oil prices. As a result, the supply that should be available to Indonesians has been curtailed, and there is a lack of cooking oil. One of the palm oil generating sectors involves supply chain activities that include palm oil suppliers, producers converting it into crude oil, and then sending the crude oil to domestic customers who utilize the crude oil as raw material to make the products they want, namely oil. fry. Unwanted risk occurrences will occur as a result of the supply chain activities that are formed. The goal of this study is to identify risk events, analyze the linkage between risks in the cooking oil supply chain using the DEMATEL-ISM-MICMAC fuzzy technique, and develop risk reduction strategies. DEMATEL fuzzy integration approach for developing structural models including complicated cause-and-effect interactions. Then, using graphs, ISM maps and visualizes risk correlations. The MICMAC approach is used to categorize existing elements based on their dependence power and driver power. The findings of this study found eleven risk events, with shipping uncertainty (R8) being the most influential risk event. To combat shipping unpredictability, the recommended mitigation action strategy is to supply alternative shipping partners.
Food Safety Risk Analysis of Songkem Duck Using Failure Mode and Effect Analysis (FMEA) Method
Authors: Anisa Mawadatun , Burhan Burhan , Indarto Cahyo
Published: October 2024

Food safety is an essential aspect of human health. Food processed without paying attention to food safety regulations can harm consumer health. This research aims to 1) identify activities with food safety risks, 2) determine the sequence of food safety risks that will be followed up, and 3) determine appropriate food safety risk mitigation. This research uses the Failure Mode and Effect Analysis (FMEA) method and fishbone diagrams. A case study was conducted on the Songkem pak Soleh Bangkalan duck supply chain. The research results show that activities that pose a food safety risk include receiving raw materials, storing raw material stocks, using raw materials and BTP, sanitizing production facilities, and storing finished products. The priority order of food safety risks in the Songkem duck supply chain is based on the FMEA method: storage of finished products, sanitation of production facilities, and storage of raw material stocks. Risk mitigation can be done to prevent food safety risks in storing raw material stocks and storing finished products, namely by controlling water activity (aw) and acidity factor (pH); and controlling the room's atmosphere. Meanwhile, to prevent risks due to sanitation hygiene, namely holding training to increase awareness of the importance of sanitation hygiene for restaurant employees monitoring and maintaining sanitation hygiene in the production environment.
Hazard Risk Analysis and Cathodic Maintenance Timing With Total Producvtive Maintenance Approach
Authors: Dzulfikar Tegar , Widiasih Wiwin
Published: October 2024

XYZ is a major player in natural gas distribution in Indonesia, with an extensive pipeline connecting production sources with a wide range of consumers, including households, industries, and power plants. The network ensures an efficient and safe gas supply throughout the region, with good distribution control for reliable service. However, corrosion problems in pipes can threaten the integrity of the system. To overcome this, PT. XYZ implements precautions such as protective coating and cathodic protection. Risk analysis and scheduled maintenance help reduce the impact of corrosion and minimize maintenance costs. The findings of this study reveal that optimal treatment can be established by analyzing potential risks through certain methods. The approach allows for the identification of possible hazards and helps in determining the most effective treatment measures.Thus, organizations can take appropriate precautions to reduce risks and ensure efficient maintenance. Total Productive Maintenance TPM, which recommends that maintenance be carried out every 3 days, has succeeded in reducing the maintenance cost of PT. XYZ Previously, the company incurred maintenance costs from Rp. 60,600,000 to Rp. 55,200,000 per month with an efficiency of 9.78% through the analysis of the maintenance budget. With the right precautions, PT. XYZ ensures efficient maintenance to maintain the smooth distribution of natural gas in a sustainable manner.
Sediment Accumulation Rates and High-Resolution Age-Depth Models
Authors: Hagen Cedric J
Published: October 2024

Sediment accumulation rates are a powerful tool for interpreting the rock record, offering insight into the depositional environment of a given locality and the (in)completeness of a given stratigraphic record. Classic approaches to sediment accumulation rate characterization required large data compilations, but the advent of high-resolution age models enables the use of individual sections and regional composite records to generate a large enough sample size of accumulation rates to estimate stratigraphic completeness. Because of these prior limitations, it is unclear how precisely accumulation rates are known for many stratigraphic sections, with rare and discrete horizon-horizon accumulation rates potentially biasing results. Here, I explore how to leverage high-resolution age-depth models to reveal accumulation rate-duration trends for individual sections and to better understand depositional histories by calculating accumulation rates for every horizon in a given section. First, I demonstrate these analyses on three synthetic age-depth models. I then examine regional composite carbon isotope records from the Ediacaran to test the effectiveness of my method on real data. Based on the accumulation rate–duration relationship, I estimate that the Ediacaran Oman and China stratigraphies are ~22% and ~37% complete at a 1-Myr interval, respectively. I find that accumulation rates drop following the Gaskiers glaciation and are relatively low during the Shuram carbon isotope excursion. Furthermore, the Oman carbon isotope stratigraphy demonstrates increasing accumulation rates across the Ediacaran, peaking near the Ediacaran–Cambrian boundary. Using an iterative technique, I estimate mean accumulation rates and durations, with uncertainty, and demonstrate how iterative-style Sadler plots can be used to interrogate depositional histories. In an effort to facilitate this approach and further quantitative developments across the stratigraphy community, I provide an open-source function that generates the plots herein for any stratigraphic record with an accompanying age-depth model.
Telenfermagem como estratégia para a investigação dos fatores associados à inadequação da adesão da terapia farmacológica no paciente com diagnóstico de angina refratária
Authors: Conceição Marina Maria , Silva Sirlei Cristina da
Published: October 2024

Introdução: A angina refratária (AR) atinge cerca de 5% a 10% dos portadores de doença arterial coronariana, segundo o Grupo de Estudo Conjunto da Sociedade Europeia de Cardiologia (ESC). O tratamento farmacológico compõe os pilares para o manejo da AR, todavia muitos pacientes são considerados não aderentes à terapêutica farmacológica. Compreender a adesão é fundamental para obtenção dos melhores resultados terapêuticos. Objetivo: Utilizar a telenfermagem para investigar os fatores associados à inadequação da adesão da terapia farmacológica no paciente com diagnóstico de AR. Método: Estudo prospectivo descritivo realizado com a participação dos pacientes em acompanhamento na Clínica de Coronariopatia Crônica. Para avaliação da adesão medicamentosa, foi utilizado o instrumento Adherence to Refills and Medications Scale (ARMS). Resultados: Foram acompanhados 13 pacientes em 68 consultas de enfermagem (telenfermagem) com aplicação do formulário ARMS. O escore de adesão médio ao tratamento farmacológico foi de 13,1. A necessidade de compra de medicamentos foi informada em média 63,1% das vezes. A não aquisição de medicamentos relacionada ao alto custo ocorreu em 17%. O custo mensal estimado para aquisição dos medicamentos mais prescritos para o tratamento da AR atinge R$ 385,35, correspondente a 27% do valor do salário mínimo nacional. Conclusão: O presente estudo trouxe à luz o desabastecimento medicamentoso e os custos elevados dos fármacos prescritos como motivadores para a inadequada adesão farmacológica, fator pouco destacado na literatura. Por meio do acompanhamento com telenfermagem, o enfermeiro identificou a situação econômica como motivadora para o comportamento de não adesão terapêutica.
Innovative Solution for the Disposal of the Produced Water in the GoS Province
Authors: Dwiedar M. D.
Published: October 2024

Gulf of Suez is one of the largest provinces that produce oil in Egypt and Middle East. GOS oil reserve represents 46 % of Egypt's reserve where GOS oil production represents 23 % of Egypt's production. Water production rate in GOS is 500 Mbbl/day with salinity 80000 – 130000 ppm that represents an environmental hazard. There are different alternatives for disposing this large amount of produced water such as underground disposal, water injection, and using it in tertiary recovery methods. In this research, I will explain the three different alternatives that exist for disposing the produced water accompanying the produced oil in the GOS. Moreover, I will elaborate an innovative solution for this important issue. This solution depends on desalination of produced water using different desalination techniques until getting the desired salinity 40000 ppm that is environmentally accepted and using the large amount of waste brine from desalination to create sodium hydroxide. The brine-to-caustic process is shown to be technically feasible while oﬀering several advantages, that is, the reduced environmental impact of desalination through lessened brine discharge, and the increase in the overall water recovery ratio of the reverse osmosis facility. Additionally, best-use conditions are given for producing caustic not only for use within the plant, but also in excess amounts for potential revenue.
Improving adherence to the Guidelines on Nutritional Support in a Neonatal Intensive Care Unit: Association with an Electronic Health Records Implementation
Authors: Grelon Camille , Yverneau Mathilde , Prodhomme Mathilde , Coursin Arnaud , Delange Boris , Beuchée Alain
Published: October 2024

The aim of the study was to measure compliance with parenteral nutrition guidelines after the implementation of individualized prescription software forextremely low-birth-weight preterm infants and the impact of these guidelines on postnatal growth at 36weeks.
Materials and methods: All newborns with a birthweight of less than 1000 g who were born between January 2012 and December 2015 (period A),between January 2019 and September 2021 (period B), without malformation or congenital anomalies, and admitted to the University Hospital of Rennes within the first 24 hours of life were included. Adherence to the ESPGHAN recommendations wascompared between Periods A and B. Caloric and protein intakes were considered adequate if both the median caloric and protein intakes over days 5 to 7 were in agreement with the 2018 ESPGHAN recommendations. The association between thedelta Z score andweight at birth and at 36 weeks was assessed by multivariate analysis after weighting for the propensity score for adequate early intake.
Results: Following the implementation of individualized prescription software, adherence to the ESPGHAN recommendations significantly increased. In period B, there was 82% adherence tothe protein intake recommendations from D5 to D7 and 63% agreement for total calories. A correlation was observed between inadequate intake and postnatal growth failure.
Conclusion: The deployment of individualized prescription software with responsive calculations of anticipated intakes was associated with an improvement inthe accuracy ofparenteral nutrition guidelines for preterm infants.
Comprehensive analysis of scRNA-Seq and bulk RNA-Seq reveals the non-cardiomyocytes heterogeneity and novel cell populations in dilated cardiomyopathy
Authors: He Siyu , Li Chunyu , Lu Mingxin , Lin Fang , Hu Sangyu , Peng Luying , Li Li
Published: October 2024

Background
Dilated cardiomyopathy (DCM) is one of the most common causes of heart failure. Infiltration and alterations in non-cardiomyocytes of the human heart involve crucially in the progression of DCM and associated immunotherapeutic approaches.
Methods
We constructed a single-cell transcriptional atlas of DCM and normal patients. Then, the xCell algorithm, EPIC algorithm, MCP counter algorithm, and CIBERSORT method were applied to identify DCM-related cell types with a high degree of precision and specificity using RNA-seq datasets. We further analyzed the heterogeneity among cell types, performed trajectory analysis, examined transcription factor regulatory networks, investigated metabolic heterogeneity, and conducted intercellular communication analysis. Finally, we used bulk RNA-seq data to confirm the roles of M2-like2 subpopulations and GAS6 in DCM.
Results
We integrated and analyzed Single-cell sequencing (scRNA-seq) data from 7 DCM samples and 3 normal heart tissue samples, totaling 70,958 single-cell data points. Based on gene-specific expression and prior marker genes, we identified 9 distinct subtypes, including fibroblasts, endothelial cells, myeloid cells, pericytes, T/NK cells, smooth muscle cells, neuronal cells, B cells, and cardiomyocytes. Using machine learning methods to quantify bulk RNA-seq data, we found significant differences in fibroblasts, T cells, and macrophages between DCM and normal samples. Further analysis revealed high heterogeneity in tissue preference, gene expression, functional enrichment, immunodynamics, transcriptional regulatory factors, metabolic changes, and communication patterns in fibroblasts and myeloid cells. Among fibroblast subpopulations, proliferative F3 cells were implicated in the progression of DCM, while myofibroblast F6 cells promoted the transition from DCM to heart failure. Additionally, two subpopulations of M2 macrophages, M2-like1 and M2-like2, were identified with distinct features. The M2-like2 cell subpopulation, which was enriched in glycolysis and fatty acid metabolism, involved in inflammation inhibition and fibrosis promotion. Cell‒cell communication analysis indicated the GAS6-MERTK axis might exhibit interaction between M2 macrophage and M2-like1 macrophage. Furthermore, deconvolution analysis for bulk RNA-seq data revealed a significant increase in M2-like2 subpopulations in DCM, suggesting a more important role for this cell population in DCM.
Conclusions
We revealed the heterogeneity of non-cardiomyocytes in DCM and identified subpopulations of myofibroblast and macrophages engaged in the progression of DCM, which suggested a potential significance of non-cardiomyocytes in treatment of DCM.
Community Support, Self-Management Behavior, and The Effectiveness of Chronic Disease Management: Evidence from China
Authors: Wang Xiaohui , Wang Jingru , Miao Haimin
Published: October 2024

Community support plays a crucial role in community chronic disease management, but there is still a lack of analysis of the role testing mechanism based on the Chinese context. Based on CHARLS (2018), explore the impact of community support on the effectiveness of patient chronic disease management. The results showed that community support significantly promoted the control effect of chronic disease patients, and self-management behavior played a part of the mesomeric effect. Through multidimensional analysis, the mediating role of daily life management is minimal, while professional guidance has the greatest mediating effect. A community chronic disease support system centered on patient self-management should be established, and efforts should be made to improve the health promotion strategies for community chronic disease management.
The tradition of washing hands in a common bowl before eating: a qualitative study of the practice of communal bowl hand rinsing before mealtimes, in rural and urban Mali
Authors: Asamane Evans Atiah , Adams Rachel L , Poole Chloe , Sidibe Cheick , Diarra Youssouf , Diarra Hawa , Yazdani Mariam , Bajaj Mitali , Sfeir Selina , Weber Katinka , Toure Ousmane , Gale Nicola , Manaseki-Holland Semira
Published: October 2024

Background
Diarrhoeal disease is a leading cause of death in children under 5 years old globally, despite being largely preventable. It is widely known that individual handwashing with soap is key in preventing transmission of enteric pathogens. Communal bowl hand rinsing (CB-HR) is the act of two or more people washing hands in a shared bowl of water without the use of soap, and without changing the water between individuals; this remains a commonplace cultural practice in many African countries. It occurs before household mealtimes, at gatherings and in schools. Evidence demonstrates that communal water provides a reservoir for communicable diseases, however there is limited evidence about the motivations including the social and cultural norms underpinning its continued practice. The aim of this study was to gain a better understanding of public perspectives on CB-HR, identifying the reasoning and exploring the beliefs behind the practice and determining factors preventing the improvement of hand hygiene.
Methods
We recorded 59 semi-structured interviews and 26 focus groups, in the local language of Bambara, across both rural and urban communities in Mali. Participants included mothers, fathers, grandmothers and grandfathers. Recordings were transcribed into French, translated into English and analysed using thematic analysis.
Results
CB-HR was commonplace amongst our participants, they confirmed that CB-HR was rooted in tradition for the purposes of social cohesion and family unity. The exact way in which CB-HR was practised varied. There was wide awareness of the infection-related risks associated with CB-HR. Various reasons were given for not practising and maintaining individual handwashing with soap. Ways of combining CB-HR and individual handwashing with soap were described, including the need for role models to maintain motivation.
Conclusion
CB-HR was widespread in our rural & urban sample despite knowledge of its health risks, and access to running water and handwashing equipment (vessels and soap) because of the belief that it maintained social cohesion. Programmes aimed at improving infection control need to address the social and cultural drivers of CB-HR, or to adapt interventions in ways that are not perceived to threaten family unity.
Choroid Plexus Aging: Structural and Vascular Insights from the HCP-Aging Dataset
Authors: Sun Zhe , Li Chenyang , Zhang Jiangyang , Wisniewski Thomas , Ge Yulin
Published: October 2024

Background: The choroid plexus (ChP), a highly vascularized structure within the ventricles, is essential for cerebrospinal fluid (CSF) production and metabolic waste clearance, crucial for neurofluid homeostasis and cognitive function. ChP enlargement is seen in normal aging and neurodegenerative diseases like Alzheimer's disease (AD). Despite its key role of in the blood-CSF barrier (BCSFB), detailed studies on age-related changes in its perfusion and microstructure remain limited.
Methods: We analyzed data from 641 healthy individuals aged between 36 and 90, using the Human Connectome Project Aging (HCP-A) dataset. Volumetric, perfusion, and diffusion metrics of the ChP were derived from structural MRI, arterial spin labeling (ASL), and diffusion-weighted imaging (DWI), respectively. Partial correlations were used to explore age-related ChP changes, and independent t-tests to examine sex differences across age decades. One-way ANOVA was employed to compare perfusion characteristics among ChP, gray matter (GM), and white matter (WM). Relationships between volume, perfusion, and diffusion were investigated, adjusting for age and sex. Additionally, the distribution of cyst-like structures within the ChP and their diffusion/perfusion MRI characteristics were analyzed across different age groups.
Results: The ChP undergoes notable changes with age, including an increase in volume (r2 = 0.2, P < 0.001), a decrease in blood flow (r2 = 0.17, P < 0.001), and elevated mean diffusivity (MD) values (r2 = 0.16, P < 0.001). Perfusion characteristics showed significant differences between the ChP, GM, and WM (P < 0.001). Both the ChP and GM exhibited age-related declines in CBF, with a more pronounced decline in the ChP. A negative correlation was observed between the age-related increase in ChP volume and the decrease in CBF, suggesting compensatory dystrophic hyperplasia in response to perfusion decline. Cyst-like structures in ChP, characterized by lower MD and reduced CBF, were found to be more prevalent in older individuals.
Conclusions: Our findings provide a detailed quantitative assessment of age-related changes in ChP perfusion and diffusion, which may affect CSF production and circulation, potentially leading to waste solute accumulation and cognitive impairment.
Report and analysis of a rare case of missed and mistreated gastrointestinal bleeding secondary to gallbladder pseudoaneurysm
Authors: Zhu Zimo , Zhu Jun , Duan Jintao , Peng Min
Published: October 2024

This article analyses the diagnostic and treatment process of a case of chronic gallbladder stone cholecystitis secondary to gallbladder pseudoaneurysm formation and resulting in bleeding from an ulcer in the duodenal bulb with the aim of increasing clinicians' attention to the rupture and bleeding of a ruptured pseudoaneurysm of the gallbladder artery (CAP), diagnosis and timely treatment. Informed consent was obtained from the patient before writing this article.
Establishing Measurable Residual Disease Trajectories for Patients on Treatment for Newly Diagnosed Multiple Myeloma as Benchmark for Deployment of T-cell Redirection Therapy
Authors: Bal Susan , Magnusson Tylan , Ravi Gayathri , Giri Smith , Godby Kelly , Dhakal Binod , Callander Natalie , Silbermann Rebecca , Dholaria Bhagirathbhai , Reddy Vishnu , Costa Luciano
Published: October 2024

Autologous stem cell transplantation (ASCT) has been the prime consolidative strategy to increase the depth and duration of response in newly diagnosed multiple myeloma (NDMM), albeit with short- and long-term toxicities. Minimal residual disease (MRD) is an important early response endpoint correlating with clinically meaningful outcomes and may be used to isolate the effect of ASCT. We report the impact of ASCT on MRD burden and generate a benchmark for evaluation of novel treatments as consolidation. We collected MRD by next generation sequencing (NGS; clonoSEQ®) post induction and post-ASCT in consecutive patients (N = 330, quadruplet, N = 279; triplet, N = 51). For patients receiving quadruplets, MRD < 10− 5 post-induction was 29% (MRD < 10− 6 15%) increasing to 59% post-ASCT (MRD < 10− 6 45%). Among patients with MRD≥10− 5 post-induction, ASCT lowered the MRD burden≥1 log10 for 69% patients. The use of quadruplet induction (vs. triplet) did not reduce the effect of ASCT on MRD burden. Reduction in MRD burden with ASCT was most pronounced in patients with high-risk chromosome abnormalities. This dataset provides granular data to delineate the impact of ASCT on MRD as legacy consolidative strategy in NDMM and provides an important benchmark for evaluation of efficacy of TCRT as experimental consolidative strategy.
Exosomal Manf originated from endothelium regulated osteoclast differentiation by down- regulating NF-κB signaling pathway
Authors: Pi Zhilong , Wu You , Wang Xinyu , Li Pingyue , Wang Renkai
Published: October 2024

Background
Endothelium-derived exosomes has been reported to enhanced osteogenesis. However, the role of endothelial exosomes on osteoclastgenesis is still unknown.
Methods
Human umbilical vein endothelial cells (HUVECs) were used to isolate exosomes. PBS or HUVEC-Exos were used to treat RAW 264.7 cells. Then, the preconditioned RAW 264.7 cells were subjected to TRAP staining and RT-qPCR assays. In vivo, we constracted osteoporosis mice model. PBS or HUVEC-Exos were injected through tail vein after ovariectomy surgery. Bone mass was assessed by micro-CT and TRAP staining. Furthermore, we conducted RNA sequencing and found the genes that were differentially expressed.
Results
Osteoclast differentiation was inhibited by endothelium-derived exosomes in this study. Moreover, HUVEC-Exos demonstrated a specific action on bones to promote in vivo bone resorption. Furthermore, exosomal Manf promoted bone resorption via down-regulating NF-κB signaling, and HUVEC-Exos Manf inhibited osteoclast differentiation in vivo.
Conclusion
HUVEC-exosomal Manf suppressed osteoclastogenesis via down-regulating NF-κB signaling.
The Central Nervous System Tightly Controls Rollator-Supported Transitions Between Sitting and Standing
Authors: Herzog Michael , Krafft Frieder C. , Fiedler Janis , Berger Denise J. , Sloot Lizeth H. , d’Avella Andrea , Stein Thorsten
Published: October 2024

Background
Older individuals are at risk of falling. Assistive devices like rollators help to reduce that risk, especially by compensating for decreased leg muscle strength and balance problems. Paradoxically, rollators have been found to be a fall risk as well as being difficult to use. To investigate the causes, this study examines how different levels of rollator support (no assistance, light touch, and full support) and balance demands (standard lab floor, balance pads) affect movement coordination during standing up and sitting down movements.
Methods
Twenty young participants stood up and sat down while full-body kinematics and muscle activity (30 channels) were recorded. Participants stood up and at down using different movement strategies (e.g., forward leaning, hybrid, and vertical rise standing up movement strategies). For each movement strategy, spatial and temporal muscle synergies were extracted from the muscle activity patterns. Temporal muscle synergies provided a more compact, low-dimensional representation than spatial muscle synergies, so they were subsequently clustered with k-means++. The activation duration of the temporal muscle synergies was assessed with full-width at half-maximum at the main peak. Multivariate linear mixed models were used to investigate if the muscle activation vectors associated with the temporal muscle synergies differed across the support conditions.
Results
The activation profiles of the temporal muscle synergy timing, but not the shape, differed across the movement strategies for both types of movement. Across all tasks, temporal muscle synergies showed a narrower width of activation around the time of seat-off and seat-on than at the movement start and end. No support-specific temporal muscle synergies were found, but lower-limb muscle activity decreased while upper-limb muscle activity increased with increased support.
Conclusion
The narrow shape of the temporal synergy activation profiles suggests that the central nervous system controls the movements tightly, especially around seat-off and seat-on and in challenging conditions with increased balance demands. Furthermore, rollator support increases upper-body and decreases lower-body muscle activity, especially around seat-off and seat-on. Future studies may further investigate how the loss of tight movement control may cause falls in older individuals.
Impact of the digital health application ViViRA on spinal mobility, physical function, quality of life and pain perception in patients with seronegative spondyloarthropathies: a randomized controlled trial
Authors: Blaskowitz Paloma Palm von Alten , Bouzas Claudia , Coppers Birte , Liphardt Anna-Maria , Petit Pascal , Vuillerme Nicolas , Bundle Vanessa , Rudolf Sebastian , Knitza Johannes , Raimondo Maria Gabriella , Labinsky Hannah , Hatscher Lukas , Wirsching Andreas , Bohr Daniela , Araujo Elizabeth , Ramming Andreas , Ramming Alina , Schett Georg , Morf Harriet
Published: October 2024

Background: Seronegative spondyloarthropathies (SpA) are a group of common rheumatic diseases that often cause limited mobility and lower back pain. Physiotherapy is an integral part of treatment, but access to physiotherapy limits treatment success. Digital health applications (DHAs) enable home-based physiotherapy and could significantly improve access for SpA patients. The aim is to investigate the clinical effects of the DHA ViViRA compared with those of standard physiotherapy.
Methods: SpA patients with persistent back pain were enrolled in a randomized controlled trial. The intervention group received ViVira DHA, whereas the control group received standard physiotherapy. Pain (verbal rating scale, PAIN-Detect), quality of life (SF-36) and mobility (BASMI) were assessed at baseline and after 12 weeks as the primary outcomes.
Results: Data from 59 participants (71.2% female, mean age 45.2 years) were analyzed. The intervention group showed a significant improvement in mobility (average BASMI score: baseline: 1.12 [range 0.7-1.5]; follow-up: 0.95 [range 0.5-1.4]; p=0.047), whereas the control group showed a significant decrease in mobility (baseline: 1.5 [range 1.1-1.9]; follow-up: 1.8 [range 1.4-2.2]; p=0.002). The intervention group demonstrated significantly lower pain intensity (VRS pain level at week 3.5 ± 2.8) than did the control group (VRS pain level at week 4.5 ± 2) after 12 weeks.
Conclusion: Our results highlight the efficacy of DHAs such as ViViRA in the treatment of lower back pain in SpA patients. Compared with the current gold standard, physiotherapy, DHA use results in superior outcomes. However, further larger studies are needed to confirm these promising results.
Trial Registration: The study is registered in the German clinical trial registry (DRKS) under the following ID: DRKS00031254
Alar slope angle —an alternative perspective for measuring the transsacral screw bone corridor
Authors: Zhao Peishuai , Hoan Nguyen Quoc , Ji Ying , Wang Ning , Huang Jianjia , Ke Jinghui , Li Liang , Bei Chaoyong
Published: October 2024

Objective: Transsacral screws are commonly utilized in clinical settings for addressing vertical instability injuries of the posterior pelvic ring and fragility fractures in elderly patients. Nevertheless, the potential stenosis of the bone corridor resulting from dysmorphism in the upper sacral segment poses challenges in the insertion of S1 through the transsacral screw, increasing the risk of significant complications such as screw misalignment and neurovascular injury. The purpose of this study was to more effectively identify whether the sacrum was deformed by reformatting CT scan, as well as search for novel indications for predicting the possibility of the S1 segment being fixed with transsacral screws and guiding the selection of appropriate internal fixations.
Questions/purposes: (1) which imaging features have a greater correlation with sacral dysmorphism? (2) whether the sacral wing slope angle can be utilized as a new imaging feature to aid in the determination of sacral dysmorphism? (3) whether the S2 transsacral screw-bone corridor can be used as an alternative when the S1 transsacral screw-bone corridor is restricted?
Patients and Methods: Pelvic Computed Tomography (CT) data from 106 normal individuals (65 males and 41 females) was imported into Mimics software, which generated a virtual representation of the pelvic outlet view in order to identify seven qualitative markers of sacral dysmorphism. The distance between the bilateral iliac spine line and the upper endplate of S1(D-IS) as well as the left and right alar slope angles (LASA/RASA) on the coronal plane, were measured as new measurement indicators after the CT scan plane parallel to the posterior border of S1 was reformatted. On the basis of a standard sacrum lateral view and a three-dimensional virtual model of the pelvis, the maximal circle diameter of the transverse bone corridor of S1 and S2 (MCD-S1/MCD-S2) has been calculated. Sacral dysmorphism was classified as an MCD-S1 measurement of less than 8 mm.
Results: Out of the total cases, 46 (43.40%) were classified as having sacral dysmorphism. The sacral dysmorphism group had a significantly higher angle than the normal sacral group, and there was a statistical difference between the two groups (p<0.001), as well as different LASA/RASA values (12.71±5.57 vs. 27.00±3.86, 13.95±5.36 vs. 27.93±3.82, respectively). The study of the receiver operating characteristic (ROC) curve revealed that the LASA/RASA values for sacral dysmorphism were 21.08 (with a sensitivity of 0.93 and specificity of 0.98) and 21.09 (with a sensitivity of 0.98 and specificity of 0.92), respectively.
Conclusion: When the angle of the alar slope exceeds 21 degrees, it is suggested to consider oblique iliosacral screw fixation or S2 transsacral screws fixation due to the narrowing of the bone corridor.
Clinical Characteristics and Survival of Patients With De Novo Metastatic Prostate Cancer Treated With Androgen Deprivation Therapy and Taxane-based Chemotherapy in Uganda: a Retrospective Cohort Study
Authors: Bakenga Alex , Natukunda Barbra , Okuku¹ Fred , Mubiru Kelvin Roland , Kakungulu Edward , Kyagulanyi Eddy , Orem¹ Jackson
Published: October 2024

Background: Prostate cancer is the second most common cancer among men worldwide. Mortality is highest among patients in resource-limited settings, in part due to late-stage disease. Among patients with metastatic prostate cancer (mPCa), studies have shown significant improvement in overall survival with the use of androgen deprivation therapy (ADT) and taxane-based chemotherapy. However, outcome data among patients treated with chemo-endocrine therapy are scarce in many resource-limited settings (RLSs). The aim of this study was to determine the clinical characteristics and 5-year overall survival (OS) of patients with de novo mPCa treated at the Uganda Cancer Institute (UCI).
Methods: A retrospective cohort study was conducted between 2015 and 2019, and the data of patients with histologically confirmed prostate cancer and radiological evidence of metastasis were reviewed. Data on clinical and laboratory characteristics, overall survival, and predictors of survival were extracted. P<0.05 was considered to indicate statistical significance.
Results: A total of 300 patients were enrolled over the 5-year study period. The median age was 68 (IQR 61.5-74) years. At presentation, lower urinary tract symptoms were reported in nearly all patients (96.7%, n=290), and 40% (n=120) of patients had grade 5 histological scores. In addition to receiving ADT, the majority of patients (70.3%, n=211) received at least 6 cycles of chemotherapy. Overall survival at one year was 92.4% (95% CI: 88.6%-94.9%), but it declined to 45.2% (95% CI: 36.8%-53.2%) at 5 years. A high Gleason score, the presence of visceral metastasis and receiving <6 cycles of chemotherapy were predictors of poor outcomes.
Conclusion: Patients with de novo mPCa in Uganda present with high histologic grades and high baseline PSA levels but have improved 5-year overall survival with a combination of chemotherapy and ADT as a first-line treatment. We recommend interventions to reduce late presentation and prospective studies to evaluate treatment efficacy in this population.
Human poisonings with neonicotinoid pesticides – frequency and severity show public health risks, regulatory failures
Authors: Sass Jennifer B. , Raichel Daniel
Published: October 2024

Background - Neonicotinoid pesticides (‘neonics’) – imidacloprid, thiamethoxam, clothianidin, acetamiprid, dinotefuran - are the most widely used class of insecticides in the world. They have a neurotoxic mechanism of action, similar to nicotine. They are detected in food, waterways, tap water, and breast milk. In addition to environmental pollution, neonics are the pesticides most frequently reported as associated with human poisonings. Methods - We make use of the non-occupational human pesticide poisoning reports in the U.S. Environmental Protection Agency (EPA) online Incident Data System (IDS). Note that IDS reports are predominantly self-reported information of varying and often low level of detail and are not routinely validated or verified by EPA. Results - We reviewed 842 non-occupational human poisoning incidents associated with neonics in the IDS from 2018 through 2022. There are four human fatality reports, two associated with clothianidin and two with acetamiprid. Major illnesses such as seizures were reported in several cases, including with dinotefuran cockroach bait product, and an imidacloprid lawn product. Moderate poisonings make up 88% of the total poisonings (740 of 842), with most of those associated with imidacloprid (547 incidents) or dinotefuran (102 incidents). Common reported symptoms classified as moderate often included two or more of the following: headaches; dizziness; lethargy; eye or throat irritation; skin itching and rash; chemical burns and skin peeling; face swelling; muscle weakness or tremors; vomiting; diarrhea; pain and tightness in chest; open sores; and general pain. These incidents stem mainly from residential uses, such as lawn and garden insect repellents, home pest treatments for bed bugs or roaches, and products used to treat pets for fleas and ticks. Conclusion - Given the evidence of neurotoxicity, EPA should use its legal authority to cancel unsafe products and unnecessary uses – including from seed treatments, and residential pet and lawncare products - to prevent further human suffering.
Adipocytokine levels in Chronic Periodontitis and Type 2 Diabetes Mellitus after Nonsurgical Periodontal Therapy
Authors: Abraham Dax , Puri Aakansha , Gupta Alpa , Duraisamy Arun Kumar , Mrinalini Mrinalini , Malhotra Rajeev Kumar
Published: October 2024

Objective: A thorough meta-analysis was used to assess the levels of 4 adipocytokines in the gingival crevicular fluid(GCF) of individuals with chronic periodontitis (CP) linked to Type 2 Diabetes Mellitus (T2DM) before and after non-surgical periodontal therapy (NSPT).
Sources: PubMed, Scopus, and EBSCOhost databases were exhaustively searched.
Study selection: The three databases and Gray literature were searched for studies that fit the inclusion and exclusion criteria. The Joanna Briggs Criteria were used to assess the study's level of quality. The meta-analysis was performed for the GCF levels of adipocytokines and clinical parameters clinical attachment level(CAL), gingival index(GI), periodontal Index(PI), periodontal probing depth(PPD) to further analyze the effect of the NSPT on the same. After thoroughly reviewing the full texts, abstracts, and removal of duplicates, seventeen papers were identified and included for systematic analysis. Upon further critical evaluation, only seven publications qualified for the meta-analysis. The levels in the test and control groups were analyzed using meta-analysis since the results were in mean + standard deviation.
Conclusion: The results indicate that nonsurgical periodontal therapy significantly reduces the levels of adipocytokines in GCF of patients with CP and T2DM. Further, there is a significant improvement in the clinical parameters of periodontal disease after NSPT.
Effect of an Educational Program on Nurses’ Level of Knowledge about Pain Assessment and Management: A Quasi-Experimental Study
Authors: Alomari Hussein , Allobaney Nabeel F. , Swallmeh Esmat , Macaaly Rosario A. , AL-Husban Raya Yousef
Published: October 2024

Background Pain is universally acknowledged as one of the most distressing experiences individuals encounter, often leading to significant psychological and physical implications. Effective pain management is essential in healthcare, and it is imperative that nursing professionals possess the requisite knowledge and skills to assess and manage pain effectively. This study aimed to evaluate the impact of a structured educational program on nurses' performance levels in pain assessment and management.
Methods A quasi-experimental, one-group pre- and post-test intervention design was used to facilitate this investigation. The research was conducted in the inpatient medical and surgical units in a main tertiary governmental hospital in Jordan. A total of 106 male and female nurses who provided direct nursing care in medical and surgical wards voluntarily participated in the study. Two instruments were utilised for data collection. A questionnaire was designed to assess nurses' knowledge regarding pain assessment and management, and an observational checklist was used to evaluate the practical application of pain management techniques by nurses.
Results The study focused on a sample predominantly comprising female nurses, most of whom held a Bachelor of Science in Nursing degree and had 2–5 years of clinical experience. Notably, 88.7% of participants had not previously attended educational sessions centred on pain assessment and management. Following an educational intervention, statistical analysis revealed a significant improvement in the mean knowledge scores (P<0.001). Furthermore, all dimensions of nursing practices related to pain management showed statistically substantial enhancement after the training, demonstrating a strong correlation between knowledge and practice levels before and after the educational program.
Conclusion The educational program's implementation resulted in more thanhalf of the participating nurses achieving a commendable level of knowledge and satisfactory practices in pain assessment and management. This underscores the program's effectiveness in enhancing both theoretical knowledge and practical skills. It is recommended that nursing professionals engage in ongoing training and educational opportunities focused on pain assessment and management to further refine their competencies and improve patient outcomes.
AI for Enhancing Psychiatric Outcomes in Clinical Practice
Authors: Singh Dharmendra , Alex Cijo , Mathew Philip , Varghese Saritha Susan , Sharma Natwar , Pattanaik Priya Ranjan , Borthakur Rajlakshmi
Published: October 2024

The study assessed the effectiveness of an AI-enabled platform called Xaant (pronounced as ‘Shaant’) for automatically identifying Generalized Anxiety Disorder (GAD), Depressive Disorder, Mixed State (co-morbid anxiety and depressed state) and the Neutral State in a clinical setting. By utilizing non-invasive sensors to monitor the Autonomic Nervous System (ANS), the Xaant Platform analyzed 15-minute rest-state data from 170 participants, generating comprehensive mental health reports, predicting the subjects’ Current Medical Condition (CMC). The platform’s diagnostic outcomes were compared with those of Principal Investigators (PIs) and the subjects’ self-reported assessments. An agreement of 91.23% between the platform’s and PIs findings were recorded, with a strong inter-rater reliability (κ = 0.838). Significant differences in physiological markers between the control and the subject groups provided objective support for the platform’s diagnostic abilities. The results indicate that AI tools like Xaant can serve as a valuable complement to traditional clinical assessments, potentially enhancing diagnostic accuracy and improving patient outcomes in clinical practice.