bluuebunny/crossref_metadata_2025 huggingface dataset:
Role of Globalization and Innovation Pattern in Growth of Bank Credit: Evidence From Emerging and Advanced Asia
Authors: Pal Shreya , Mahalik Mantu Kumar
Published: December 2024

This study examines the role of globalization and innovation pattern (i.e., innovation by the residents and non‐residents) in the growth of domestic bank credit across emerging and advanced Asian economies spanning from 1996 to 2022. The bank credit growth model includes economic growth and real interest rate as important control variables. This study employs Cross Sectional‐Autoregressive Distributed Lag (CS‐ARDL) as an appropriate baseline method because of the cointegration, endogeneity, and cross‐sectional dependency present in the data. The long‐run results for emerging Asian economies indicate that globalization exhibits a negative impact on banking credit, contrasting with the positive influence observed in advanced Asian economies due to heightened economic growth and increased credit demand. Residential innovation consistently bolsters banking credit in both sets of economies, albeit with mixed effects stemming from non‐resident innovation. The long‐run results further indicate the positive (negative) impact of economic growth (real interest rate) on bank credit in emerging and advanced Asian economies. These findings are reliable due to the similar results obtained from using Driscoll‐Kraay Robust Standard Errors (DKSEs) as robust method. For policymakers in emerging economies, the imperative policy lies in striking a delicate balance between economic openness and bank credit, while counterparts in advanced economies are poised to bolster bank credit accessibility through foreign innovation while upholding stringent regulatory oversight.
Seven‐year effects of sewage sludge biochar on soil organic carbon pools and yield: Understanding the role of biochar on carbon sequestration and productivity
Authors: Chagas Jhon Kenedy Moura , Nardoto Gabriela Bielefeld , Madari Beata Emoke , de Figueiredo Cícero Célio
Published: December 2024

The increasing need for sustainable agricultural practices and climate change mitigation has driven research into biochar's role in enhancing soil carbon (C) sequestration and fertility. This study aimed to investigate the long‐term effects of sewage sludge biochar (SSB), prepared at different temperatures (300 and 500°C), combined or not with mineral fertilizer application, on soil C stocks and organic matter fractions, addressing whether SSB can improve soil C sequestration. In the first two growing seasons (2015–2016), SSB was applied at 15 t ha−1 (dry weight) per crop and incorporated into the top 0.2 m of soil using a rotary hoe before planting. Over 7 years, soil samples were collected from the 0–0.2 m depth post‐harvest each season to analyse total C, total N, and various organic matter fractions, including easily oxidizable organic C, permanganate‐oxidizable C, non‐oxidizable C, humic substances, particulate C, and mineral‐associated C. Results demonstrate that SSB application enhances soil total C (up to 9.5%) and total N levels (up to 28.8%), indicating improved soil fertility and C sequestration potential. Notably, SSB amendments increased the non‐oxidizable organic C pool (up to 11.9%), contributing to soil organic matter stabilization. While the easily oxidizable organic C pool was increased under SSB at 300°C (up to 7.7%), the permanganate oxidizable C pool was not affected by treatments, suggesting that SSB primarily affects more recalcitrant C fractions, essential for long‐term C sequestration. Additionally, SSB application substantially increased crop yield, with higher grain yield (up to 105.0%) and shoot biomass (up to 75.1%) observed over multiple growing seasons. However, a decline in corn yield from the fourth season onwards in SSB‐only treatments highlights a limited capacity of biochar to sustain long‐term productivity. These findings underscore the effectiveness of SSB in enhancing soil C pools and its potential role in sustainable agricultural practices. Future research should focus on long‐term field studies under various environmental conditions and explore the potential of co‐pyrolysis of sewage sludge with other feedstocks to enhance C stability. The broader adoption of biochar technology could play a vital role in mitigating climate change and promoting sustainable agricultural development.
Implementation of isoniazid preventive therapy among children living with diagnosed pulmonary tuberculosis patients: A mixed methods study from Mumbai, India
Authors: Sreevidya P. A. , Acharya Shrikala , Raul Mayuri Umesh , Prakash Aparna
Published: December 2024

Background

Tuberculosis remains a significant public health issue, particularly among children who are in close contact with tuberculosis patients. India accounts for a large proportion of global tuberculosis cases. Despite global recommendations for Isoniazid Preventive Therapy to prevent latent tuberculosis infection from progressing to active disease, the initiation and adherence to Isoniazid Preventive Therapy remain suboptimal, especially in high‐burden settings. Understanding the barriers to Isoniazid Preventive Therapy implementation is crucial to improving treatment outcomes and achieving tuberculosis elimination goals.

Objectives

This study aimed to quantify the uptake of isoniazid among children under 6 years who were started on Isoniazid Preventive Therapy and to identify the challenges from the perspectives of caregivers and healthcare providers.

Methods

The study was conducted in a slum in Mumbai, India, from June to December 2023, using a mixed‐methods design. The quantitative phase involved a house‐to‐house survey, covering all 96 contacts started on Isoniazid Preventive Therapy in 2022, using a semi‐structured questionnaire. The qualitative phase included key informant interviews with healthcare providers and in‐depth interviews with caregivers. Quantitative data were analysed using Fisher's exact test and chi‐square test, while qualitative data were analysed thematically.

Results

Of the 96 children, 11 (11.45%) completed therapy, with an average treatment duration of 2.5 months. Quantitative findings highlighted fear of side effects and family migration as major reasons for discontinuation. Completion of chemoprophylaxis was significantly associated with factors like male gender, support from extended family, home visits by tuberculosis health staff, and shorter travel time (under 30 min) to the tuberculosis unit. Qualitative data revealed challenges across themes of supply, staff, training, services, and adherence. Key challenges included lack of awareness, unavailability of isoniazid in syrup form, inadequate training for health workers, weak program monitoring, insufficient staffing, and fears related to tuberculosis exposure during outpatient department visits.

Conclusion

Effective counselling, regular follow‐ups, availability of medications in syrup form, increasing staffing based on case burden, timely training of staff, strengthening program monitoring, and ensuring infection control in tuberculosis outpatient departments are critical to achieving successful completion of isoniazid preventive therapy.
Cutaneous epitheliotropic T‐cell lymphoma in a sugar glider (Petaurus breviceps)
Authors: Amati Piercarlo , Dedola Carla , Demontis Roberta , Brachelente Chiara
Published: December 2024

A 3‐year‐old male sugar glider presented with pruritus and alopecia primarily affecting the back and neck regions. Dermatologic diagnostics ruled out common causes. Skin biopsies revealed cutaneous epitheliotropic T‐cell lymphoma, a rare condition in sugar gliders. Despite treatment, the glider's condition worsened, leading to death. This case highlights the importance of thorough diagnostic evaluation in exotic pets.
TITANIUM OXIDE (TIO2) NANOPARTICLE AS ADDITIVE FOR LUBRICANTS: A BIBLIOMETRIC ANALYSIS (1997-2022)
Authors: Kanak Saxena
Published: December 2024

Lubricant is a substance designed to minimize friction between surfaces in direct contact with each other, although it has certain limitations. To overcome these limitations, additives are generally added to the base oil to improve qualities like anti-wear, anti-friction, thermal properties, antioxidant properties, etc. Given this, recent advances have shown the great value of interest in nanoparticles as additives. Titanium dioxide nanoparticles as additives have emerged as a compelling addition to enhance engine efficiency. Its efficacy is evident in significantly reducing the coefficient of friction, antioxidant features, remarkable lubricating properties, cost-effectiveness, and non-toxic nature, along with economical, environmentally friendly and non-volatile characteristics. In this paper, a bibliometric analysis of the trend and application of metal oxide derivatives, i.e., titanium oxide (TiO2) nanoparticles, as an additive for different base oils, has been done. The analysis is done on the data retrieved from Dimensions and Google Scholar, restricted to research articles only. The present analysis discusses various trends and co-relationships among authors, citations, and countries to understand the research trend. A total of 94 articles were examined and mapped using VOSviewer. Most of these articles were published in "Materials Today Proceedings" and the "Wear" journal. China emerged as the leading contributor in this research domain. An article from the "Wear" journal received the highest number of citations (1368). The highest number of articles was published in the year 2021.
MODELLING AND SIMULATION OF AN MR BRAKE BASED ON TORQUE COMPENSATION
Authors: Li Dongheng , Anuar Abu Bakar Saiful , Mohamed Hussein  , Wei Jigan , Tang Jiatian , He Yinhuan
Published: December 2024

A new design for a repetitive compression magnetorheological (MR) brake has been introduced, aiming to enhance both the efficiency and safety of vehicle safety systems, thereby accelerating the commercial adoption of such brakes in the automotive industry. This innovative brake uses a hybrid operational mode, replacing the conventional rotary motion with a unique recessive structure to enhance the braking performance. In the non-braking state, the design maintains the fluidity of the MR fluid, while in the braking state, it leverages the brake disc's recessive movement. Additionally, the study incorporates a temperature compensation mechanism to mitigate potential performance variations due to temperature changes. A three-dimensional static magnetic field analysis confirmed the magnetic circuit design's effectiveness and the suitability of the selected parameters and materials. The simulation showed that the brake's average magnetic field intensity rose by 145.26% when increasing the current from 1A to 4A, achieving a maximum braking torque of 51.4 Nm.
DESIGN AND DEVELOPMENT OF THREE-DEGREES-OF-FREEDOM ROBOTIC ARM FOR ELECTRIC VEHICLE CHARGING STATION
Authors: Muhammad Nor Syamsulyusri Ruslan  , Mohd Nor Nur Safwati , Saputra Hendri Maja
Published: December 2024

The exponential growth of the electric vehicle (EV) industry requires the development of more efficient and easily accessible charging infrastructures. The existing manual charging procedures provide significant difficulties, especially for those with impairments. The objective of this project was to overcome these difficulties by designing and developing a robotic arm that is particularly designed for automating the process of charging electric vehicles. The project aimed to improve operational efficiency and user accessibility by designing a three-degrees-of-freedom robotic arm using CAD software, SOLIDWORKS, and prototyping it using 3D printing technology. The main approaches employed were thorough Finite Element Analysis (FEA) to guarantee the structural integrity to confirm the operational dependability. The primary results indicate that the robotic arm design successfully automates the charging process, resulting in a substantial reduction in the human labor needed from users and an improvement in the accuracy of the charging connection.  These results not only showcase the arm's capacity to completely transform EV charging methods but also emphasize its flexibility in different vehicle settings, indicating a wide range of possible uses in automated systems in the future.
DESIGN AND PERFORMANCE ANALYSIS OF EXPANDER FOR WASTE HEAT RECOVERY APPLICATION
Authors: Jia Zheng Tee , Meng Soon Chiong , Mohammad Mahadhir , Soon Chun Mein
Published: December 2024

Waste heat recovery (WHR) is one of the solutions for net zero carbon and decarbonization activity. Currently, the Organic Rankine Cycle is widely studied because of its capability to operate at a wide range of temperatures, scalability, lower operating temperature, and high thermal efficiency. Despite advancements, challenges in expander design and performance analysis limit waste heat recovery. Therefore, the objective is to design and analyse a suitable expander for waste heat recovery and achieve a total-to-total efficiency exceeding 70% with a minimum power output of 30kW at a pressure ratio of 1.4. The design and performance analysis for 3D blade geometry and expander using the ANSYS CFX software. An applied meanline modelling was conducted using MATLAB. The results demonstrated the expander's capability to generate 35.857 kW of power, exceeding the design target. Additionally, a total-to-total efficiency of 74.69% was achieved, surpassing the minimum efficiency threshold of 70%, even after accounting for tip leakage losses. The findings contribute valuable insights for optimizing expander designs and advancing waste heat recovery technologies aligning with global efforts to promote sustainable energy systems.
Muscle Tone and Stiffness Comparison in Ambulatory Children With Unilateral Spastic Cerebral Palsy: Implications for Postural Balance and Functional Mobility
Authors: Akdıkan Melisa , Kara İlke , Çevik Saldıran Tülay
Published: December 2024

Objectives: To compare muscle tone and stiffness in ambulatory children with unilateral spastic cerebral palsy (UCP) with typically developing peers and explore their relationship with postural balance and functional mobility. Methods: Forty ambulatory children with UCP and age-matched typically developing peers were assessed for tone and stiffness of lumbar spinal extensors, gastrocnemius, and hamstring muscles using a myotonometer. Functional mobility was evaluated with the 2-Minute Walk Test, and the Timed Up and Go Test, while postural balance was evaluated using the Pediatric Balance Scale and the Trunk Control Measurement Scale (TCMS). Results: The gastrocnemius muscle tone and stiffness were higher on the affected side in UCP compared with the less affected side and typically developing peers (P < .05). Lumbar spinal extensor tone correlated with improved Trunk Control Measurement Scale scores (P = .003). The gastrocnemius and hamstring muscles’ tone and stiffness did not significantly affect functional mobility measures in UCP (P > .05). Conclusions: Our study highlights the importance of achieving muscle symmetry, particularly in the plantar flexors, for functional mobility in UCP children. While differences in ankle and knee muscle biomechanics were observed, they didn’t significantly impact functional mobility or postural balance. Symmetry in lumbar spinal extensor biomechanics correlated with better outcomes, emphasizing the crucial role of trunk control in rehabilitation strategies for ambulatory children with UCP.
Untrimmed ITS2 metabarcode sequences cause artificially reduced abundances of specific fungal taxa
Authors: Kyle Kathleen E. , Klassen Jonathan L.
Published: December 2024

Advances in DNA metabarcoding have greatly expanded our knowledge of microbial communities in recent years. Pipelines and parameters have been tested extensively for bacterial metabarcoding using the 16S rRNA gene and best practices are largely established. For fungal metabarcoding using the internal transcribed spacer (ITS) gene, however, only a few studies have considered how such pipelines and parameters can affect community prediction. Here, we report a novel bias uncovered during ITS region 2 (ITS2) sequencing of
Trichoderma
-infected ant fungus gardens and confirmed this bias using mock communities. Abnormally low forward read quality caused
Trichoderma
ITS2 reads to be computationally filtered before and during read pair merging, thus almost entirely eliminating
Trichoderma
amplicon sequence variants from the resulting fungal community profiles. Sliding window quality trimming before filtering allowed most of these reads to pass filtering and merge successfully, producing community profiles that now correlated with visual signs of
Trichoderma
infection and matched the composition of the mock communities. Applying such sliding window trimming to a previously generated environmental ITS2 data set increased the detected fungal diversity and again overcame read quality biases against
Trichoderma
to detect it in nearly every sample instead and often at high relative abundances. This analysis additionally identified a similar, but distinct, bias against a second fungal genus
Meyerozyma
. The prevalence of such quality biases against other fungal ITS sequences is unknown but may be widespread. We, therefore, advocate for the routine use of sliding window quality trimming as a best practice in ITS2 metabarcoding analysis.

IMPORTANCE

Metabarcode sequencing produces DNA abundance profiles that are presumed to reflect the actual microbial composition of their corresponding input samples. However, this assumption is not always tested, and taxon-specific biases are often not apparent, especially for low-abundance taxa in complex communities. Here, we identified internal transcribed spacer region 2 (ITS2) read quality aberrations that caused dramatic reductions in the relative abundances of specific taxa in multiple data sets characterizing ant fungus gardens. Such taxon-specific biases in read quality may be widespread in other environments and for other fungal taxa, thereby causing incorrect descriptions of these mycobiomes.
Essential role of
cis
-encoded mature NS3 in the genome packaging of classical swine fever virus
Authors: Lamp Benjamin , Barth Sandra , Reuscher Carina , Affeldt Sebastian , Cechini Angelika , Netsch Anette , Lobedank Irmin , Rümenapf Till
Published: December 2024

Classical swine fever virus (CSFV) is a member of the genus
Pestivirus
within the family
Flaviviridae
. The enveloped particles contain a plus-stranded RNA genome encoding a single large polyprotein. The processing of this polyprotein undergoes dynamic changes throughout the infection cycle. The release of mature NS3 from the polyprotein is mediated and regulated by the NS2 autoprotease and a cellular co-factor, restricting efficient cleavage to the early phases of infection. NS3 is a multifunctional viral enzyme exhibiting helicase, NTPase, and protease activities pivotal for viral replication. Hence, the release of mature NS3 fuels replication, whereas unprocessed NS2-3 precursors are vital for progeny virus production in later phases of infection. Thus far, no packaging signals have been identified for pestivirus RNA. To explore the prerequisites for particle assembly,
trans
-packaging experiments were conducted using CSFV subgenomes and coreless CSFV strains. Intriguingly, we discovered a significant role of mature NS3 in genome packaging, effective only when the protein is encoded by the RNA molecule itself. This finding was reinforced by employing artificially engineered CSFV strains with duplicated NS3 genes, separating uncleavable NS2-3 precursors from mature NS3 molecules. The model for NS2-3/NS3 functions in genome packaging of pestiviruses appears to be much more complicated than anticipated, involving distinct functions of the mature NS3 and its precursor molecule NS2-3. Moreover, the reliance of genome packaging on
cis
-encoded NS3 may act as a downstream quality control mechanism, averting the packaging of defective genomes and coordinating the encapsidation of RNA molecules before membrane acquisition.

IMPORTANCE

Pestiviruses are economically significant pathogens in livestock. Although genome organization and non-structural protein functions resemble those of other
Flaviviridae
genera, distinct differences can be observed. Previous studies showed that coreless CSFV strains can produce coreless virions mediated by single compensatory mutations in NS3. In this study, we could show that only RNA molecules encoding these mutations in the mature NS3 are packaged in the absence of the core protein. Unlike this selectivity, a pool of structural proteins in the host cell was readily available for packaging all CSFV genomes. Similarly, the NS2-3-4A precursor molecules required for packaging could also be provided in
trans
. Consequently, genome packaging in pestiviruses is governed by
cis
-encoded mature NS3. Reliance on
cis
-acting proteins restricts the acceptance of defective genomes and establishes packaging specificity regardless of RNA sequence-specific packaging signals. Understanding the role of NS3 in pestiviral genome packaging might uncover new targets for antiviral therapies.
Dextran sodium sulfate-induced colitis alters the proportion and composition of replicating gut bacteria
Authors: Beauchemin Eve T. , Hunter Claire , Maurice Corinne F.
Published: December 2024

The bacteria living in the human gut are essential for host health. Though the composition and metabolism of these bacteria are well described in both healthy hosts and those with intestinal disease, less is known about the metabolic activity of the gut bacteria prior to, and during, disease development—especially regarding gut bacterial replication. Here, we use a recently developed single-cell technique alongside existing metagenomics-based tools to identify, track, and quantify replicating gut bacteria both
ex vivo
and
in situ
in the dextran sodium sulfate (DSS) mouse model of colitis. We show that the proportion of replicating gut bacteria decreases when mice have the highest levels of inflammation and returns to baseline levels as mice begin recovering. In addition, we report significant alterations in the composition of the replicating gut bacterial community
ex vivo
during colitis development. On the taxa level, we observe significant changes in the abundance of taxa such as the mucus-degrading
Akkermansia
and the poorly described
Erysipelatoclostridium
genus. We further demonstrate that many taxa exhibit variable replication rates
in situ
during colitis, including
Akkermansia muciniphila
. Lastly, we show that colitis development is positively correlated with increases in the presence and abundance of bacteria
in situ
which are predicted to be fast replicators. This could suggest that taxa with the potential to replicate quickly may have an advantage during intestinal inflammation. These data support the need for additional research using activity-based approaches to further characterize the gut bacterial response to intestinal inflammation and its consequences for both the host and the gut microbial community.

IMPORTANCE

It is well known that the bacteria living inside the gut are important for human health. Indeed, the type of bacteria that are present and their metabolism are different in healthy people versus those with intestinal disease. However, less is known about how these gut bacteria are replicating, especially as someone begins to develop intestinal disease. This is particularly important as it is thought that metabolically active gut bacteria may be more relevant to health. Here, we begin to address this gap using several complementary approaches to characterize the replicating gut bacteria in a mouse model of intestinal inflammation. We reveal which gut bacteria are replicating, and how quickly, as mice develop and recover from inflammation. This work can serve as a model for future research to identify how actively growing gut bacteria may be impacting health, or why these particular bacteria tend to thrive during intestinal inflammation.
Endoscope-assisted vitreous surgery for rhegmatogenous retinal detachment in a patient with a small-aperture IC-8 intraocular lens
Authors: Yoshioka Kazuki , Yokoyama Sho , Kaga Tatsushi
Published: December 2024

We present a case of rhegmatogenous retinal detachment in an eye with an implanted IC-8 intraocular lens (IOL). The IC-8, an extended depth of focus IOL, incorporates pinhole technology with a central 3.23-mm black circular mask and 1.36-mm aperture. The opaque ring can impede visualisation of the posterior segment.

Initially, a 25-gauge 3-port pars plana core vitrectomy was performed using a Constellation Vision System and a Resight 700 wide-viewing system. However, poor visibility around the retinal breaks necessitated endoscopic visualisation for the subsequent procedures. Under endoscopic guidance, vitrectomy around the retinal breaks, peripheral vitrectomy, subretinal fluid drainage and retinal photocoagulation was completed successfully. Notably, the IC-8’s opaque ring did not impair endoscopic observations.

This case highlights the enhanced safety and adaptability of vitreous surgery in eyes with IC-8 IOLs, demonstrating the effectiveness of both wide-angle viewing and endoscopic systems in challenging ophthalmic procedures.
Fahr’s syndrome as a manifestation of autoimmune polyendocrinopathy syndrome and its unusual presentation with seizures
Authors: Rehman Bushra , Akbar Abida , Nuzhat Humayun Khadija , Jafri Sidra Kaleem , Arif Muzna
Published: December 2024

Fahr’s syndrome is a rare neurodegenerative disease characterised by symmetric calcifications in basal ganglia, cerebellum and cerebral cortex, secondary to genetic, infectious and autoimmune aetiologies. It has a wide range of clinical presentations including neurological and psychiatric symptoms leading to cognitive impairment and behavioural changes. In this case report, an adolescent boy with a unique sequence of different manifestations of APS-1 is described who eventually developed Fahr’s syndrome secondary to hypoparathyroidism. The child developed insulin-dependent diabetes mellitus in infancy followed by mucocutaneous candidiasis and then hypoparathyroidism with the clinical and radiological manifestations consistent with Fahr’s syndrome. He was treated for the biochemical abnormalities of Fahr’s syndrome, which led to clinical improvement. APS-1 manifests in early life and affects the endocrine and non-endocrine systems, however, the age of different manifestations varies widely. This case highlights the importance of considering Fahr’s syndrome as a possible cause in patients with polyendocrinopathies having neurological symptoms.
Mediastinal haematoma following permanent pacemaker insertion
Authors: Singh Ashishpreet , Dhillon Navdeep Singh , Kumar Suraj , Singh Bhupinder
Published: December 2024

Mediastinal haematoma post permanent pacemaker insertion (PPI) is a rare complication. We report the case of a woman in her 60s with symptomatic complete heart block, who developed symptoms of respiratory distress following the PPI procedure. Radiological investigations revealed a large mediastinal haematoma. An iatrogenic venous injury must have caused its development. Conservative management led to gradual improvement of symptoms and resolution of haematoma. The patient remained normal on follow-ups. This case underscores the importance of prompt recognition and management of this complication. Mediastinal haematoma following venous injuries has a good prognosis with conservative treatment. Clinicians should be vigilant for this rare complication to ensure timely intervention and favourable outcomes.
Modern perspective of the Rice Diet for hypertension and other metabolic diseases
Authors: Sommerfeld Romeo , Ermler Paul , Fehr Jana , Bergner Benjamin , Lopez David , Sanoff Scott , Neelon Francis A , Kuo Anthony , McDowell William , Li Yi-Ju , Fox Smilla , Ghajar Abdullatif , Gensch Elena , Lorenz Cedric , Preiss Martin , Richter Tom , Luft Friedrich C , Klemmer Philip , Bohannon Anastacia , Lippert Christoph , Lin Pao-Hwa
Published: December 2024

Background

In the early 1940s, before antihypertensive drugs were available, the Rice Diet Programme (RDP) was developed to treat severe hypertension and, later, diabetes and obesity. Despite significant advancements in dietary management for these conditions since then, debates remain regarding the proper guidelines for sodium and macronutrients intakes. The patient care records of RDP offer a unique source of longitudinal examination of a very low sodium (<10 mmol/day), fat, cholesterol and protein diet on blood pressure (BP), other health markers and survival.

Methods

In 2019, the Rice Diet Database Project (RDDP) digitised handwritten patient care records and retinal photographs of 17 487 RDP participants, establishing a digital database for analyses. Manual transcription accuracy exceeded 97%. We used regression models to investigate the impact of dietary adherence on systolic BP (SBP) and body weight. Further, we performed Kaplan-Meier survival analysis to compare 5-year survival probability of participants defined by baseline level of SBP.

Results

The database encompasses a wide array of health markers, including BP, weight, urine chloride (UCl) concentration and retinal features that offer a unique resource for studying the impact of the RDP on hypertension, diabetes and obesity. Initial analysis shows reductions in BP and weight as well as improved survival in participants with severe hypertension, underscoring the effectiveness of the diet. The data also permit examining the safety of extreme dietary sodium reduction.

The database has numerous strengths (large patient population; extensive, long-term measurements and the use of UCl excretion to document dietary adherence) and limitations (missing data; temporal changes in methodologies over 50 years and lack of control subjects).

Conclusion

The RDDP database allows exploration of the effects of a diet extremely low in sodium, protein, fat and cholesterol on health indicators and patient survival. This report highlights the database’s potential for detailed and intricate future analyses.
How does the level of functional impairment vary in individuals with non-communicable disease and comorbidity? Cross-sectional analysis of linked census and administrative data in Aotearoa New Zealand
Authors: Teng Andrea M , Underwood Lisa , Bowden Nicholas , Jamieson Hamish , Milne Barry
Published: December 2024

Objectives

This study examines national patterns of functional impairment, and how they vary by the presence of non-communicable disease (NCD), type of health condition, comorbidity, age, sex, ethnicity, deprivation and living situation.

Design

A cross-sectional examination using a national research database of linked administrative and survey data sets including census, tax and health data.

Setting

Aotearoa New Zealand

Participants

All individuals living in NZ on 30 June 2018, identified by the Statistics NZ Integrated Data Infrastructure estimated residential population (4.79 million individuals). Nine NCDs among these individuals were identified from national health data sets using existing and adapted algorithms.

Primary and secondary outcome measures

Functional impairment was assessed via hospitalisations, comorbidities (Elixhauser index), activity limitations (census) and income support.

Results

Three-tenths (29%) of the population had at least one NCD. Functional impairment was strongly patterned by NCD prevalence (3% activity limitation in people without any NCDs, 13% if one or more NCDs and 25% if two or more NCDs). Activity limitation was most common in individuals with dementia (68% activity limitation), stroke (42%) and coronary heart disease (26%). After age stratification, there was also a high level of activity limitation and income support in people with mental health conditions. Māori and Pacific peoples and people living in deprived areas or alone were more likely to have functional impairment.

Conclusions

Functional impairment was strongly patterned by NCD type. NCD prevention efforts and disability supports are needed to reduce the burden of disability experienced.
Comparison of preference-based health-related quality of life measures for chronic neck pain: a pooled analysis of data from three RCTs
Authors: Lee Seong Min , Kim Soo-Jin , Nam Dongwoo , Park Yeon Cheol , Kim Eun-Jung , Ha In-Hyuk , Lee Yoon Jae
Published: December 2024

Objectives

This study aimed to identify a preference-based health-related quality of life (HRQOL) measure that best reflects disease-specific features in patients with neck pain by comparing the characteristics of the instruments.

Design

Pooled data from three multicentre randomised controlled clinical trials (RCTs) on neck pain were included for analysis in this study.

Setting

All three RCTs were conducted between 2017 and 2020 in Korea, and patients were recruited from four hospitals and one university teaching hospital.

Participants

In total, 313 patients with neck pain were included in the three RCTs.

Primary and secondary outcome measures

A correlation analysis was conducted using Spearman’s correlation coefficients between preference-based HRQOL scores (EuroQol-5 Dimension 5 Levels (EQ-5D-5L) and Short-Form 6-Dimension version 1 (SF-6Dv1)) and the disease-specific measures for pain and function (Numerical Rating Scale (NRS), Visual Analogue Scale (VAS), Neck Disability Index (NDI) and Northwick Park Questionnaire).

Results

Spearman’s correlation analyses (p value <0.01 for all) showed that EQ-5D-5L exhibited slightly stronger negative correlations with pain-related measures (VAS: −0.277, NRS: −0.262) compared with SF-6Dv1 (VAS: −0.207, NRS: −0.182). For functional outcomes, EQ-5D-5L demonstrated stronger negative correlations with function-related measures such as NDI (−0.636 to −0.711) compared with SF-6Dv1 (−0.506 to −0.579). In patients with moderate-to-severe neck pain (VAS>5), EQ-5D-5L appeared to better capture functional and pain aspects. Despite these differences, both instruments consistently reflected treatment-related improvements in pain and function. Distribution analysis further indicated that EQ-5D-5L and SF-6Dv1 were not fully interchangeable due to variations in domain-level scoring patterns and ceiling effects observed in EQ-5D-5L.

Conclusions

EQ-5D-5L showed stronger negative correlations with both pain and functional outcomes compared with SF-6Dv1, suggesting that it may better capture the functional aspects of chronic neck pain, particularly in moderate-to-severe conditions. However, the ceiling effect observed in EQ-5D-5L warrants caution when interpreting results in patients with mild neck pain. These findings provide practical guidance for selecting preference-based HRQOL measures in economic evaluations of musculoskeletal conditions, supporting more informed healthcare decision-making.

Trial registration number

NCT03294785, Post-results;NCT03558178, Results;NCT04035018, Post-results.
Effect of electroacupuncture versus sham electroacupuncture on postoperative ileus after laparoscopic surgery for left-sided colorectal cancer: study protocol for a multicentre, randomised, sham-controlled trial
Authors: Zhou Yan , Zhang Mingming , Yang Chen , Li Shu-Hao , Guixing Xu , Zihan Yin , Sun Ming-Sheng , Yang Jiao , Wang Yang-Yang , Dai Wei , He Yueyi , Han Lin , Lin Jie , Liang Fan-rong , Liu Fang
Published: December 2024

Introduction

Postoperative ileus (POI) is an inevitable complication after abdominal surgery, often hindering recovery and prolonging hospital stay. Despite the increasing use of electroacupuncture (EA) as an alternative treatment for gastrointestinal dysfunction, its effectiveness for POI is still controversial. This study aims to verify the efficacy and safety of EA in alleviating POI.

Methods and design

The study is a multicentre, randomised, sham-controlled trial. A total of 174 patients undergoing laparoscopic surgery for left‐sided colorectal cancer will be randomly assigned to an EA group and a sham acupuncture group at a ratio of 1:1. Treatment for both groups will commence on the first day after the operation and continue once a day for four consecutive days. The primary outcome is time to first defecation. Secondary outcomes include time to first flatus, time to first tolerance to liquid and semiliquid diet, Functional Assessment of Cancer Therapy-Colorectal (FACT-C, V.4.0), postoperative nausea and vomiting, postoperative pain and abdominal distension, the Gastrointestinal Quality of Life Index, Self-Rating Depression Scale, Self-Rating Anxiety Scale, Gastrointestinal Symptom Rating Scale, length of the postoperative hospital stay, time to first postoperative ambulation, evaluation of the expected value of acupuncture, and satisfaction evaluation.

Ethics and dissemination

The results will be disseminated through peer-reviewed publications. This study protocol (V.2.0, 1 October 2023) involves human participants and has been approved by the Ethics Committee of Sichuan Cancer Hospital (number KY-2023-041-01), Meishan Hospital of Traditional Chinese Medicine (number 2024LC001) and The Seventh People’s Hospital of Chengdu (number KY2024-001-01). Each individual who agrees to participate in the research will provide written informed consent after the objectives and procedures of this study are explained to them.

Trial registration number

ChiCTR2400079645. Registered on 8 January 2024.
Cross-sectional study on behavioural determinants associated with sugary foods and beverages and their correlates with body mass index among adolescents in Nagarjun municipality, Nepal
Authors: Gautam Laxmi , Thapa Milan , Pokhrel Poonam , Sapkota Parash Mani , Bhatt Anjali , Paudel Kiran
Published: December 2024

Objectives

This study was conducted to determine the status of and factors associated with behavioural determinants (knowledge, attitude and practice) of sugary foods and beverages among adolescents in Kathmandu, Nepal.

Design

Cross-sectional study.

Setting

The study was done at educational institutions located in Nagarjun municipality, Kathmandu, Nepal.

Participants

In this study, 768 adolescents from grades 8, 9 and 10 were selected using a multistage random sampling technique.

Primary and secondary outcome measures

Knowledge regarding sugary foods and beverages was assessed using 9 questions, attitude was measured through 13 Likert scale statements and consumption was assessed using 9 questions through a semi-structured questionnaire. Body mass index (BMI) was calculated based on anthropometric measurements. Pearson’s χ2test and logistic regression were used to assess factors associated with those behavioural determinants, along with their correlates with BMI. A p value of <0.05 was considered statistically significant.

Result

Adequate level of knowledge was found among 84.11% (95% CI: 81.52% to 86.70%) of the adolescents. Awareness of the health risks and inclination to adopt healthier behaviours was seen among 60% of the adolescents (95% CI: 56.55% to 63.49%). The percentage of adolescents consuming sugary foods and beverage items was 84.50% (95% CI: 81.94% to 87.07%). The odds of having adequate knowledge among respondents was twice (adjusted OR (AOR)=2.05, 95% CI: 1.12 to 3.76) more likely for those who were living with their parents. Female adolescents (AOR=2.51, 95% CI: 1.61 to 3.89), whose mothers are homemakers (AOR=1.99, 95% CI: 1.04 to 3.58) and fathers are engaged in foreign employment (AOR=2.09, 95% CI: 1.04 to 4.21), were more likely to consume sugary items. Prevalence of overweight and obesity was seen among 6.38% (95% CI: 4.64% to 8.11%) of respondents. Consumption was seen to be significant to the model overweight/obesity versus normal (OR=11.95 (95% CI: 1.61 to 88.42)).

Conclusion

Adequate knowledge alone was insufficient for influencing food selection and choices. Family-indulged interventions can be useful as familial factors seem to be impacting behavioural characteristics. Sugary foods and beverages consumption was linked to being overweight/obese, highlighting the importance of dietary discipline in reducing this risk.
Association between prenatal tobacco exposure and attention-deficit/hyperactivity disorder related characteristics at 6 and 8 years: a birth cohort in Japan
Authors: Itoh Mariko , Kobayashi Sumitaka , Nishihara Shinkichi , Miyashita Chihiro , Yamazaki Keiko , Tamura Naomi , Suyama Satoshi , Ikeda Atsuko , Itoh Sachiko , Ait Bamai Yu , Yamaguchi Takeshi , Masuda Hideyuki , Hanley Sharon , Kishi Reiko
Published: December 2024

Objectives

To examine the association between maternal plasma cotinine concentrations during pregnancy and attention-deficit/hyperactivity disorder (ADHD) related characteristics in children.

Design

Prospective birth cohort study from the Hokkaido Study on Environment and Children’s Health.

Setting

Hokkaido, Japan.

Participants

A total of 7217 children were included in the analysis. Their mothers were recruited to this study between 2003 and 2012 during early pregnancy. Blood samples of mothers in their third trimester of pregnancy were obtained.

Main outcome measures

ADHD-related characteristics screened by the ADHD-Rating Scale (ADHD-RS) in children at 6 and 8 years of age.

Results

The mothers were classified into three groups according to plasma cotinine levels (median=0.22 ng/mL)—non-smokers (≤0.21 ng/mL), passive smokers (0.22–11.48 ng/mL) and active smokers (≥11.49 ng/mL). ADHD was suspected in 302 (8.6%), 334 (10.9%) and 90 (14.5%) children in the non-smoker, passive smoker and active smoker groups, respectively. Children born to mothers in the smoking group had a statistically significant increased risk of ADHD-related characteristics (adjusted RR=1.49, 95% CI=1.19–1.86 and adjusted RR=1.20, 95% CI=1.03–1.40 for the active and passive smoking groups, respectively).

Conclusion

This large Japanese cohort study suggests an association between smoking during pregnancy and the risk of ADHD in children 6 and 8 years of age.
Association between exposure to gender and sexual diversity in media (GSDM) and Thai adolescents’ attitude towards LGBT individuals: a cross-sectional study in Bangkok schools
Authors: Sookpornsawan Rudeemas , Kiatrungrit Komsan , Seree Patcharin , Korpaisarn Sira , Arunakul Jiraporn
Published: December 2024

Objective

In recent years, global media has increasingly represented lesbian, gay, bisexual and transgender (LGBT) individuals, contributing to greater societal acceptance of diverse sexualities and gender identities. However, in Thailand, negative attitudes towards LGBT individuals remain prevalent, and media portrayals, both positive and negative, play a critical role in shaping public perceptions. These portrayals can significantly influence how different groups, particularly adolescents, view LGBT individuals. Given the importance of media in shaping attitudes, this study aims to explore the association between Thai adolescents’ exposure to gender and sexual diversity in media (GSDM) and their stigmatising attitudes towards LGBT individuals.

Setting

A cross-sectional survey was conducted during the first and second semesters of the academic year 2021 in eight schools located in Bangkok, Thailand.

Participants

Adolescents from these schools completed a survey assessing demographics, exposure to GSDM, and stigmatising attitudes towards LGBT individuals. The LGBTQ stigma scale was used for attitudes, and media exposure was measured using a researcher-developed questionnaire. Linear regression analysis was conducted to test the association between exposure to GSDM and stigmatising attitudes.

Results

Out of 553 participants, with an average age of 16.34 years (ranging from 14 to 20 years), a third identified as LGBT (34.72%). Participants had moderate exposure to both positive and negative GSDM content (PGSDM and NGSDM, respectively), with those assigned female at birth more exposed to PGSDM than those assigned male at birth, and exhibiting lower levels of stigmatisation. Adolescents assigned female at birth and those who identified as LGBT displayed significantly lower stigmatisation than those assigned male at birth and non-LGBT individuals. Adolescents overall exhibited generally low stigmatisation towards LGBT individuals, with higher levels of stigmatisation linked to exposure to NGSDM (β=0.80, 95% CI 0.35 to 1.25). In contrast, PGSDM exposure was associated with reduced stigmatisation (β=−2.73, 95% CI −3.10 to −2.35).

Conclusions

Thai adolescents generally exhibit low levels of stigmatisation towards LGBT individuals. The study found an association between positive GSDM exposure and lower levels of stigmatisation, while negative exposure was linked to higher levels of stigmatisation. These findings suggest that media literacy programmes emphasising positive portrayals of gender diversity may be beneficial in promoting acceptance and reducing bias.
Exploring the effects of climate change on child malnutrition: protocol for a scoping review
Authors: Klapka Cecília Stanzani , Barbosa Brena Barreto , Magalhães Arthur Ramalho , Carioca Antônio Augusto Ferreira , Lourenço Barbara Hatzlhoffer , Gomes Sávio Marcelino , Martins de Carvalho Aline
Published: December 2024

Introduction

Rapid climate changes in the early 21st century have triggered a global syndemic intertwining obesity, undernutrition and climate change, profoundly affecting health, especially children. Despite increasing research, a significant gap persists in understanding the mechanisms linking climate change to child malnutrition, particularly in children under 5 years old. This protocol proposes a scoping review to address this gap, with the aim of mapping the available evidence on the relationship between climate change and malnutrition among children under 5 years old.

Methods and analysis

This scoping review will be conducted according to the Joanna Briggs Manual for Evidence Synthesis, and the results will be reported in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) checklist to ensure a replicable process. The search will be conducted using MEDLINE (PubMed), Web of Science, Scopus and Embase databases. The studies to be included will be selected according to the inclusion and exclusion criteria defined based on the Population, Concept and Context technique. The study population will consist of children under 5 years old, with a focus on examining the impact of climate change on health outcomes related to nutrition, obesity and undernutrition. Original articles in English, Spanish and Portuguese will be selected without any restrictions on the publication year. Two researchers will independently select the articles and extract the data. The results will be presented through narrative synthesis.

Ethics and dissemination

This study relies on analysing existing scientific literature and does not require ethical approval. The outcomes of this scoping review will be submitted for publication in a peer-reviewed journal, with a preference for open access.

Study registration

OSF (osf.io/swt4b).