bluuebunny/crossref_metadata_2025 huggingface dataset:
Aspergillus population diversity and its role in aflatoxin contamination of cashew nuts from coastal Kenya
Authors: Musangi Colletah Rhoda , Juma Bicko Steve , Mukhebi Dennis Wamalabe , Isoe Everlyne Moraa , Kibiti Cromwell Mwiti , Mbinda Wilton Mwema
Published: January 2024

Cashew nuts are among the main cash crops in coastal Kenya, due in large part to their high nutritional value. Unfortunately, they also make them highly susceptible to mold contamination, resulting in biodeterioration of the nutritional value and potential contamination with toxic secondary metabolites, such as aflatoxins, that cause them to be rejected for sale at the market. We determined the population diversity of the Aspergillus species and their role in aflatoxin contamination in cashew nuts in selected coastal regions of Kenya. Fifty raw cashew nut samples were collected from post-harvest storage facilities across three counties in Kenya’s coastal region and examined for moisture content and the presence of Aspergillus fungi. About 63 presumptive isolates were recovered from the cashew nuts. ITS and 28S rDNA regions were sequenced. The aflD, aflM and aflR genes were amplified to identify the potentially aflatoxigenic from the Aspergillus isolates. The Aflatoxins’ presence on the isolates was screened using UV and the ammonia vapour test on coconut milk agar and validated using ELISA assay. A comparison of cashew moisture content between the three counties sampled revealed a significant difference. Sixty-three isolates were recovered and identified to section based on morphological characters and their respective ITS regions were used to obtain species identifications. Three sections from the genus were represented, Flavi and Nigri, and Terrei with isolates from the section Nigri having slightly greater abundance (n = 35). The aflD, aflM and aflR genes were amplified for all isolates to assess the presence of the aflatoxin biosynthesis pathway, indicating the potential for aflatoxin production. Less than half of the Aspergillus isolates (39.68%) contained the aflatoxin pathway genes, while 22.22% isolates were aflatoxigenic, which included only the section Flavi isolates. Section Flavi isolates identification was confirmed by calmodulin gene. The presence of species from Aspergillus section Flavi and section Nigri indicate the potential for aflatoxin or ochratoxin in the cashew nuts. The study established a foundation for future investigations of the fungi and mycotoxins contaminating cashew nuts in Kenya, which necessitates developing strategies to prevent infection by mycotoxigenic fungi, especially during the storage and processing phases.
Performance analysis: Securing SIP on multi-threaded/multi-core proxy server using public keys on Diffie–Hellman (DH) in single and multi-server queuing scenarios
Authors: Bhatti David Samuel , Sidrat Salbia , Saleem Shahzad , Malik Annas Wasim , Suh BeomKyu , Kim Ki-Il , Lee Kyu-Chul
Published: January 2024

The rapid replacement of PSTN with VOIP networks indicates the definitive phase-out of the PBX/PABX with smartphone-based VOIP technology that uses WLAN connectivity for local communication; however, security remains a key issue, regardless of the communication coverage area. Session initiation protocol (SIP) is one of the most widely adopted VOIP connection establishment protocols but requires added security. On the Internet, different security protocols, such as HTTPS (SSL/TLS), IPSec, and S/MIME, are used to protect SIP communication. These protocols require sophisticated infrastructure and some pose a significant overhead that may deteriorate SIP performance. In this article, we propose the following: i) avoid using Internet bandwidth and complex Internet protocols for local communication within an organization, but harness WLAN connectivity, ii) use multi-threaded or multicore computer systems to handle concurrent calls instead of installing hardware-based SIP servers, and iii) run each thread in a separate core. Cryptography is a key tool for securely transmitting confidential data for long- and short-range communication, and the Diffie-Hellman (DH) protocol has consistently been a popular choice for secret key exchanges. Primarily, used for symmetric key sharing, it has been proven effective in generating public/private key pairs, sharing public keys securely over public channels, and subsequently deriving shared secret keys from private/public keys. This key exchange scheme was proposed to safeguard VOIP communication within WLANs, which rely on the SIP for messaging and multimedia communication. For ensuring an efficient implementation of SIP, the system was rigorously analyzed using the M/M/1 and M/M/c queuing models. We analyze the behavior of SIP servers with queuing models with and without end-to-end security and increase users’ trust in SIP security by providing a transparent sense of end-to-end security as they create and manage their private and public keys instead of relying on the underlying SIP technology. This research implements instant messaging, voice conversation, and secret key generation over DH while implementing and observing the role of multi-threading in multiqueue systems that serve incoming calls. By increasing the number of threads from one to two, the SIP response time improved from 20.23809 to 0.08070 min at an arrival rate of 4250 calls/day and a service rate of three calls/min. Similarly, by adding one to seven threads, the queue length was reduced by four calls/min. Implementing secure media streaming and reliable AES-based signaling for session confidentiality and integrity introduces a minor 8-ms tradeoff in SIP service performance. However, the advantages of implementing added security outweigh this limitation.
Dynamic analysis of slant cracked rotor system considering nonlinear oil film force
Authors: Ding Qiang , Feng Zhiguo , Zhang Yu , Sun Weipeng
Published: January 2024

In this paper, considering the combined effects of nonlinear oil film forces and cracks on the rotor-bearing system, the differential equations of motion with 4 degrees of freedom are established by Lagrangian method. Then, the Lundgren-Kutta method is used to solve them and the results of the model are compared with the experimental data. The study demonstrate that the cracked rotor-bearing system is relatively stable at subcritical speeds, mostly in the period-1 motion. But near 1/3 of the critical speed, there is an inner loop in its whirl orbit and a significant increase in the 2x frequency component. When the system speed rises to the region near 1/2 of the critical speed, though the bifurcation motion and a relatively high 2x frequency can be observed, there are no other reliable fault characteristics. The study proves that the rotor crack fault diagnosis method based on the whirl orbits is convincing for slant cracked rotors.
In-hospital real-time prediction of COVID-19 severity regardless of disease phase using electronic health records
Authors: Park Hyungjun , Choi Chang-Min , Kim Sung-Hoon , Kim Su Hwan , Kim Deog Kyoem , Jeong Ji Bong
Published: January 2024

Coronavirus disease 2019 (COVID-19) has strained healthcare systems worldwide. Predicting COVID-19 severity could optimize resource allocation, like oxygen devices and intensive care. If machine learning model could forecast the severity of COVID-19 patients, hospital resource allocation would be more comfortable. This study evaluated machine learning models using electronic records from 3,996 COVID-19 patients to forecast mild, moderate, or severe disease up to 2 days in advance. A deep neural network (DNN) model achieved 91.8% accuracy, 0.96 AUROC, and 0.90 AUPRC for 2-day predictions, regardless of disease phase. Tree-based models like random forest achieved slightly better metrics (random forest: 94.1% of accuracy, 0.98 AUROC, 0.95 AUPRC; Gradient boost: 94.1% of accuracy, 0.98 AUROC, 0.94 AUPRC), prioritizing treatment factors like steroid use. However, the DNN relied more on fixed patient factors like demographics and symptoms in aspect to SHAP value importance. Since treatment patterns vary between hospitals, the DNN may be more generalizable than tree-based models (random forest, gradient boost model). The results demonstrate accurate short-term forecasting of COVID-19 severity using routine clinical data. DNN models may balance predictive performance and generalizability better than other methods. Severity predictions by machine learning model could facilitate resource planning, like ICU arrangement and oxygen devices.
A phase 2 open-label study of the safety and efficacy of weekly dosing of ATL1102 in patients with non-ambulatory Duchenne muscular dystrophy and pharmacology in mdx mice
Authors: Woodcock Ian R. , Tachas George , Desem Nuket , Houweling Peter J. , Kean Michael , Emmanuel Jaiman , Kennedy Rachel , Carroll Kate , de Valle Katy , Adams Justine , Lamandé Shireen R. , Coles Chantal , Tiong Chrystal , Burton Matthew , Villano Daniella , Button Peter , Hogrel Jean-Yves , Catling-Seyffer Sarah , Ryan Monique M. , Delatycki Martin B. , Yiu Eppie M.
Published: January 2024

Background

ATL1102 is a 2’MOE gapmer antisense oligonucleotide to the CD49d alpha subunit of VLA-4, inhibiting expression of CD49d on lymphocytes, reducing survival, activation and migration to sites of inflammation. Children with DMD have dystrophin deficient muscles susceptible to contraction induced injury, which triggers the immune system, exacerbating muscle damage. CD49d is a biomarker of disease severity in DMD, with increased numbers of high CD49d expressing T cells correlating with more severe and progressive weakess, despite corticosteroid treatment.

Methods

This Phase 2 open label study assessed the safety, efficacy and pharmacokinetic profile of ATL1102 administered as 25 mg weekly by subcutaneous injection for 24 weeks in 9 non-ambulatory boys with DMD aged 10–18 years. The main objective was to assess safety and tolerability of ATL1102. Secondary objectives included the effect of ATL1102 on lymphocyte numbers in the blood, functional changes in upper limb function as assessed by Performance of Upper Limb test (PUL 2.0) and upper limb strength using MyoGrip and MyoPinch compared to baseline.

Results

Eight out of nine participants were on a stable dose of corticosteroids. ATL1102 was generally safe and well tolerated. No serious adverse events were reported. There were no participant withdrawals from the study. The most commonly reported adverse events were injection site erythema and skin discoloration. There was no statistically significant change in lymphocyte count from baseline to week 8, 12 or 24 of dosing however, the CD3+CD49d+ T lymphocytes were statistically significantly higher at week 28 compared to week 24, four weeks past the last dose (mean change 0.40x109/L 95%CI 0.05, 0.74; p = 0.030). Functional muscle strength, as measured by the PUL2.0, EK2 and Myoset grip and pinch measures, and MRI fat fraction of the forearm muscles were stable throughout the trial period.

Conclusion

ATL1102, a novel antisense drug being developed for the treatment of inflammation that exacerbates muscle fibre damage in DMD, appears to be safe and well tolerated in non-ambulant boys with DMD. The apparent stabilisation observed on multiple muscle disease progression parameters assessed over the study duration support the continued development of ATL1102 for the treatment of DMD.

Trial registration

Clinical Trial Registration. Australian New Zealand Clinical Trials Registry Number: ACTRN12618000970246.
Density of Aedes aegypti and dengue virus transmission risk in two municipalities of Northwestern Antioquia, Colombia
Authors: Gómez-Vargas Wilber , Ríos-Tapias Paola Astrid , Marin-Velásquez Katerine , Giraldo-Gallo Erika , Segura-Cardona Angela , Arboleda Margarita
Published: January 2024

The high infestation of Aedes aegypti populations in Urabá, Antioquia, Colombia represents a risk factor for increased dengue morbidity and mortality. This study aimed to determine the risk of dengue transmission by estimating the population of Ae. aegypti using entomological indices, density of females per dwelling and inhabitant, and virological surveillance in two municipalities in Colombia. A cross-sectional study was conducted with quarterly entomological surveys in three neighborhoods of Apartadó and Turbo between 2021 and 2022. Aedes indices and vector density per dwelling and per inhabitant were calculated. The Kernel method was used for spatial analysis, and correlations between climatic variables and mosquito density were examined. Virus detection and serotyping in mosquitoes was performed using single-step reverse transcription polymerase chain reaction. The housing, reservoir, and Breteau indices were 48.9%, 29.5%, and 70.2%, respectively. The mean density of Ae. aegypti was 1.47 females / dwelling and 0.51 females / inhabitant. The overall visual analysis showed several critical points in the neighborhoods studied. There was significant correlation of vector density and relative humidity and precipitation in the neighborhoods 29 de noviembre and 24 de diciembre. Additionally, serotypes DENV-1 and DENV-2 were found. The overall indices for dwellings, reservoirs, and Breteau were lower than those recorded in 2014 in Urabá. The vector density results in this study were similar to those reported in other studies conducted in Latin America, and vector infection was detected. The Aedes and density indices are complementary, emphasizing the importance of continuous surveillance of Ae. aegypti to inform appropriate control strategies and prevent future dengue outbreaks in these municipalities.
The impact of county-level factors on meaningful use of electronic health records (EHRs) among primary care providers
Authors: Alexandre Pierre K. , Monestime Judith P. , Alexandre Kessie
Published: January 2024

This study examines the impact of county-level factors on “meaningful use” (MU) of electronic health records (EHRs) for 8415 primary care providers (PCPs) that enrolled in the Florida Medicaid EHR Incentive Program through adopting, improving, or upgrading (AIU) a certified EHR technology. PCPs received incentive payments at enrollment and if they used their EHRs in meaningful ways; ways that benefit patients and providers alike they received additional payments. We conducted a retrospective cohort study of these providers over the 2011–2018 period while linking their records to other state data. We used the core constructs of the resource dependence theory (RDT), a well-established organization theory in business management, to operationalize the county-level variables. These variables were rurality, poverty, educational attainment, managed care penetration, changes in population, and number of PCPs per capita. The unit of analysis was provider-years. For practical and computational purposes, all the county variables were dichotomized. We used analysis of variance (ANOVA) to test for differences in MU attestation rates across each county variable. Odds ratios and corresponding 95% confidence intervals were derived from pooled logistic regressions using generalized estimated equations (GEE) with the binomial family and logit link functions. Clustered standard errors were used. Approximately 42% of these providers attested to MU after receiving first-year incentives. Rurality and poverty were significantly associated with MU. To some degree, managed care penetration, change in population size, and number of PCPs per capita were also associated with MU. Policy makers and healthcare managers should not ignore the contribution of county-level factors in the diffusion of EHRs among physician practices. These county-level findings provide important insights about EHR diffusion in places where traditionally underserved populations live. This county-perspective is particularly important because of the potential for health IT to enable public health monitoring and population health management that might benefit individuals beyond the patients treated by the Medicaid providers.
Comparing glycemic traits in defining diabetes among rural Chinese older adults
Authors: Wang Pin , Li Yuanjing , Wang Mingqi , Song Lin , Dong Yi , Han Xiaolei , Tuomilehto Jaakko , Wang Yongxiang , Du Yifeng , Qiu Chengxuan
Published: January 2024

Background

We sought to identify the optimal cut-off of glycated hemoglobin (HbA1c) for defining diabetes and to assess the agreements of fasting plasma glucose (FPG), fasting serum glucose (FSG), and HbA1c in defining diabetes among rural older adults in China.

Methods

This population-based cross-sectional study included 3547 participants (age ≥61 years, 57.8% women) from the Multidomain Interventions to Delay Dementia and Disability in Rural China from 2018–2019; of these, 3122 had no previously diagnosed diabetes. We identified the optimal cut-off of HbA1c against FPG ≥7.0 mmol/L for defining diabetes by using receiver operating characteristic curve and Youden index. The agreements of FPG, FSG, and HbA1c in defining diabetes were assessed using kappa statistics.

Results

Among participants without previously diagnosed diabetes (n = 3122), the optimal HbA1c cut-off for defining diabetes was 6.5% (48 mmol/mol), with the sensitivity of 88.9%, specificity of 93.7%, and Youden index of 0.825. The correlation coefficients were 0.845 between FPG and FSG, 0.574 between FPG and HbA1c, and 0.529 between FSG and HbA1c in the total sample (n = 3547). The kappa statistic for defining diabetes was 0.962 between FSG and FPG, and 0.812 between HbA1c and FPG.

Conclusions

The optimal cut-off of HbA1c for diagnosing diabetes against FPG >7.0 mmol/L is ≥6.5% in Chinese rural-dwelling older adults. The agreement in defining diabetes using FPG, FSG, and HbA1c is nearly perfect. These results have relevant implications for diabetes research and clinical practice among older adults in China.

Clinical trial registration

The protocol of MIND-China was registered in the Chinese Clinical Trial Registry (ChiCTR, www.chictr.org.cn; registration no.: ChiCTR1800017758).
Enhanced glucose utilization of skeletal muscle after 4 weeks of intermittent hypoxia in a mouse model of type 2 diabetes
Authors: Zhao Yuqi , Li Chaoqun , Zhou Shi , He Youyu , Wang Yun , Zhang Yuan , Wen Li
Published: January 2024

Background

Intermittent hypoxia intervention (IHI) has been shown to reduces blood glucose and improves insulin resistance in type 2 diabetes (T2D) and has been suggested as a complementary or alternative intervention to exercise for individuals with limited mobility. Previous research on IHI has assessed cellular glucose uptake rather than utilization. The purpose of this study was to determine the effect of a 4-week IHI, with or without an aerobic exercise, on skeletal muscle glucose utilization as indicated by the changes in pyruvate, lactate, NAD+, and NADH, using a mouse model of diet-induced T2D. In addition, the effects of one exposure to hypoxia (acute) and of a 4-week IHI (chronic) were compared to explore their relationship.

Methods

C57BL/6J mice were randomly assigned to normal control and high-fat-diet groups, and the mice that developed diet-induced diabetes were assigned to diabetes control, and intervention groups with 1 hour (acute) or 4 weeks (1 hour/day, 6 days/week) exposure to a hypoxic envrionment (0.15 FiO2), exercise (treadmill run) in normoxia, and exercise in hypoxia, respectively, with N = 7 in each group. The effects of the interventions on concentrations of fasting blood glucose, muscle glucose, GLUT4, lactate, pyruvate, nicotinamide adenine dinucleotide (NAD+), and NADH were measured, and statistically compared between the groups.

Results

Compared with diabetes control group, the mice treated in the hypoxic environment for 4 weeks showed a significantly higher pyruvate levels and lower lactate/pyruvate ratios in the quadriceps muscle, and the mice exposed to hypoxia without or with aerobic exercise for either for 4 weeks or just 1 hour showed higher NAD+ levels and lower NADH/NAD+ ratios.

Conclusions

Exposure to moderate hypoxia for either one bout or 4 weeks significantly increased the body’s mitochondrial NAD cyclethe in diabetic mice even in the absence of aerobic exercise. The hypoxia and exercise interventions exhibited synergistic effects on glycolysis. These findings provide mechanistic insights into the effects of IHI in respect of the management of hyperglycemia.
Physical education and student well-being: Promoting health and fitness in schools
Authors: Sun Hui , Du Cheng-Run , Wei Zhi-Feng
Published: January 2024

The school students are facing mental health issues, and their performance is not improving in China. Health education policies are not implemented at the school level in China. However, scholars focus on college students’ health education, but the school student is neglected. The research’s primary objective is to answer the question: What is the impact of health education on the psychological well-being of school students? A sample of 549 10th grade students is collected from China’s public and private sector institutes. The partial least square–structural equation modelling (PLS-SEM) is employed to analyze the data. The outcomes highlighted that the impact of health education is significant on the psychological well-being of school students in China. Furthermore, the study introduced that the moderating role of sustainable health exercise and sports participation is critical as it positively influences the relationship between health education and psychological wellbeing. This research improves literature as the novel contribution are highlighted in theory. Furthermore, the government education policies must be reframed under the light of this research’ findings to improve students’ health.
Sexual orientation based health disparities in Chile
Authors: Nettuno Laura , Mann Samuel , Gonzales Gilbert
Published: January 2024

Numerous studies from Europe and North America have documented sexual orientation-based health disparities, but due to data limitations, very little is known about the health of sexual minorities (i.e., lesbians, gay men, bisexual individuals, and other non-heterosexual populations) in developing countries. This research note uses newly available nationally representative data from the Chilean Socio-Economic Characterization Survey (CASEN) to explore sexual orientation-based disparities in self-rated health, health insurance coverage, and healthcare utilization in Chile. Our findings indicate that sexual minority respondents report worse self-rated health and greater health care utilization, and that sexual minority men are more likely to have private health insurance relative to heterosexual men. These findings are important in facilitating continued efforts to reduce health disparities in Latin America.
Herpes zoster diagnosis and treatment in relation to incident dementia: A population-based retrospective matched cohort study
Authors: Weinmann Sheila , Rawlings Andreea , Koppolu Padma , Rosales A. Gabriela , Prado Yolanda K. , Schmidt Mark A.
Published: January 2024

Background

Evidence suggests that some infectious diseases, such as herpes zoster (HZ), are associated with elevated risk of subsequent dementia, while certain anti-viral medications are associated with lower risk. We sought to evaluate associations between HZ diagnosis and treatment with incident dementia in a large, retrospective matched cohort.

Methods

Using ICD-9 and ICD-10 diagnosis codes in electronic medical records, we identified members of Kaiser Permanente Northwest age 50 and older from 2000–2019 with a HZ diagnosis during this period. A comparison group without HZ diagnosis was individually matched 3:1 on age at HZ diagnosis date (index date), sex, and membership length prior to index date. We excluded subjects with dementia diagnosed before the index date. Antiherpetic medication was identified using pharmacy fills 1 month before to 12 months after the index date. We employed survival analysis to examine the associations between dementia and HZ diagnosis and antiherpetic medication, adjusting multivariable models for demographic and clinical factors. We stratified on age and sex and conducted a sensitivity analysis with a 5-year lag period.

Result

The study included 101,328 persons, 25,332 with HZ. Over a median follow-up of 4.8 years, 6,000 developed dementia. HZ diagnosis was not associated with higher hazard of dementia (hazard ratio (HR) = 0.99, 95% CI 0.93–1.05) in the primary analysis. Among persons with HZ diagnoses, the HR for receipt of any antiherpetic medication was 0.79 (95% CI 0.70–0.90) in univariate analysis and 0.88 (95% CI 0.77–1.00) after adjustment for demographic and clinical factors. Dementia was not associated with trends in duration of medication use or cumulative dose.

Conclusions

We found little evidence for an association between HZ diagnosis and dementia overall. Antiherpetic medication prescribed around the time of HZ diagnosis was statistically associated with lower risk of subsequent dementia in some but not all analyses and subgroups.
Exploring the relation between Interleukin-6 and high-sensitive cardiac troponin T in asymptomatic hemodialysis patient: A cross-sectional study
Authors: Ibrahim Leen , Yasin Katreen , Abbas Leen , Ismael Yahya , Mousa Ahmed , Alkarajeh Mohammad , Hamdan Zakaria , Nazzal Zaher
Published: January 2024

Background

High-sensitive cardiac troponin T (h-cTnT), which serves as a marker for myocardial damage, has also been linked to adverse outcomes in asymptomatic hemodialysis patients. This study aims to explore the correlation between interleukin-6 (IL-6) and h-cTnT in asymptomatic hemodialysis patients to unravel the relationship between inflammation and cardiovascular risk.

Methods

A cross-sectional study involving 81 patients was conducted from November 2022 to March 2023 at An-Najah National University Hospital in Palestine. We gathered clinical data, including comorbidities, and obtained blood samples for measuring IL-6 and h-cTnT levels. We performed statistical analyses, including correlation tests and linear regression, to assess the associations between these variables.

Results

The study revealed a notable increase in both h-cTnT and IL-6 levels, and a significant correlation between the two (rho = 0.463, P<0.001) in asymptomatic hemodialysis patients. Likewise, h-cTnT levels displayed positive correlations with age (rho = 0.519, P<0.001) and negative correlations with albumin (rho = -0.297, p = 0.007) and transferrin saturation (rho = -0.227, P = 0.042). IL-6 levels exhibited correlations with age (rho = 0.422, P<0.001), albumin (rho = -0.389, P<0.001), iron (rho = -0.382, P<0.001), and transferrin saturation (rho = -0.362, P = 0.001). Notably, higher h-cTnT levels were associated with diabetes, hypertension, a history of coronary artery disease, cerebrovascular accidents, older age, and male gender.

Conclusion

This study underscores the significant association between the inflammatory marker IL-6 and h-cTnT in asymptomatic hemodialysis patients, suggesting that inflammation may play an essential role in the elevation of h-cTnT levels. This association may have implications for predicting cardiovascular events and guiding interventions to reduce cardiovascular disease morbidity and mortality in hemodialysis patients.
Harms and benefits of mammographic screening for breast cancer in Brazil
Authors: Migowski Arn , Nadanovsky Paulo , Manso de Mello Vianna Cid
Published: January 2024

Introduction

In the absence of evidence on the effect of mammographic screening on overall mortality, comparing the number of deaths avoided with the number of deaths caused by screening would be ideal, but the only existing models of this type adopt a very narrow definition of harms. The objective of the present study was to estimate the number of deaths prevented and induced by various mammography screening protocols in Brazil.

Methods

A simulation study of cohorts of Brazilian women screened, considering various age groups and screening interval protocols, was performed based on life tables. The number of deaths avoided and caused by screening was estimated, as was the absolute risk reduction, the number needed to invite for screening—NNS, the net benefit of screening, and the ratio of “lives saved” to “lives lost”. Nine possible combinations of balances between benefits and harms were performed for each protocol, in addition to other sensitivity analyses.

Results and conclusions

The most efficient protocol was biennial screening from 60 to 69 years of age, with almost three times more deaths avoided than biennial screening from 50 to 59 years of age, with a similar number of deaths avoided by biennial screening from 50 to 69 years of age and with the greatest net benefit. Compared with the best scenario of annual screening from 40 to 49 years of age, the NNS of the protocol with biennial screening from 60 to 69 years of age was three-fold lower. Even in its best scenario, the addition of annual screening from 40 to 49 years of age to biennial screening from 50 to 69 years of age results in a decreased net benefit. However, even in the 50–69 year age group, the estimated reduction in breast cancer mortality for Brazil was half that estimated for the United Kingdom.
Multiphysics simulation of magnetoelectric micro core-shells for wireless cellular stimulation therapy via magnetic temporal interference
Authors: Narayanan Ram Prasadh , Khaleghi Ali , Veletić Mladen , Balasingham Ilangko
Published: January 2024

This paper presents an innovative approach to wireless cellular stimulation therapy through the design of a magnetoelectric (ME) microdevice. Traditional electrophysiological stimulation techniques for neural and deep brain stimulation face limitations due to their reliance on electronics, electrode arrays, or the complexity of magnetic induction. In contrast, the proposed ME microdevice offers a self-contained, controllable, battery-free, and electronics-free alternative, holding promise for targeted precise stimulation of biological cells and tissues. The designed microdevice integrates core shell ME materials with remote coils which applies magnetic temporal interference (MTI) signals, leading to the generation of a bipolar local electric stimulation current operating at low frequencies which is suitable for precise stimulation. The nonlinear property of the magnetostrictive core enables the demodulation of remotely applied high-frequency electromagnetic fields, resulting in a localized, tunable, and manipulatable electric potential on the piezoelectric shell surface. This potential, triggers electrical spikes in neural cells, facilitating stimulation. Rigorous computational simulations support this concept, highlighting a significantly high ME coupling factor generation of 550 V/m·Oe. The high ME coupling is primarily attributed to the operation of the device in its mechanical resonance modes. This achievement is the result of a carefully designed core shell structure operating at the MTI resonance frequencies, coupled with an optimal magnetic bias, and predetermined piezo shell thickness. These findings underscore the potential of the engineered ME core shell as a candidate for wireless and minimally invasive cellular stimulation therapy, characterized by high resolution and precision. These results open new avenues for injectable material structures capable of delivering effective cellular stimulation therapy, carrying implications across neuroscience medical devices, and regenerative medicine.
Exploring the relationship between regional tourism development and land use efficiency: A case study of Guangxi Zhuang Autonomous Region, China
Authors: Meng Qiuli , Pi Hongwen , Xu Tao , Li Lihua
Published: January 2024

The utilization efficiency of land resources is an essential embodiment of economic development, social development, and ecological development and is a critical core to measure how to maximize the efficiency of land resources under limited conditions. The land is an important content and essential carrier of the research of tourism development level. This paper selects Panel Data from 2010 to 2019 to research the Guangxi regional tourism development. The entropy weight method and stochastic frontier production function (SFA) model were used to evaluate the development level of urban-rural tourism and the utilization efficiency of land resources in Guangxi. This paper uses the Panel Vector Autoregression (PVAR) model to analyze the internal relationship between urban-rural tourism development. The results show that: (1) Guangxi has a good level of tourism development and a high land use efficiency. (2) There is a reciprocal causation relationship between the regional tourism development level and land use efficiency in Guangxi, with significant levels of 0.005 and 0.034 respectively, indicating high credibility. This indicates that there is a mutual promotion and interaction between the two, which rely on and drive each other, promoting the joint sustainability of tourism development and land use efficiency. (3) . The tourism development level is greatly influenced by itself, with impact values all above 0.99. At the same time, land use also has a significant self-impact, with impact values all above 0.87. Their internal optimization system is solid and endogenous impetus is robust, which can drive their development. Establishing an effective strategy for developing and protecting land use is beneficial to promote the long-term effectiveness of sustainable tourism development, enhancing high-quality development of the tourism economy and improving people’s living standards and quality.
Developing an observation protocol for online STEM courses
Authors: Horvitz Brian S. , DeCamp Whitney , Mitchell Regina Garza , Kowalske Megan , Singleton Cherrelle
Published: January 2024

The use of online instruction for undergraduate STEM courses is growing rapidly. While researchers and practitioners have access to validated instruments for studying the practice of teaching in face-to-face classrooms, analogous tools do not yet exist for online instruction. These tools are needed for quality design and control purposes. To meet this need, this project developed an observational protocol that can be used to collect non-evaluative data for the description, study, and improvement of online, undergraduate STEM courses. The development of this instrument used a sequential exploratory mixed methods approach to the research, design, pilot-testing, refinement and implementation of the protocol. Pairs of researchers tested the final version of this instrument, observing completed online undergraduate STEM courses. Across 2,394 pairs of observations, the observers recorded the same indication (yes or no to the presence of some course element) 1,853 times for an agreement rate of 77.4%, falling above the 75% threshold for an acceptable level of agreement. There was a wide range in the inter-rater reliability rates among items and further revisions were made to the instrument. This foundational work-in-progress instrument should be further developed and used by practitioners who are interested in learning about and reflecting on their online teaching practice.
Antimicrobial stewardship capacity and antibiotic utilisation practices in the Cape Coast Teaching Hospital, Ghana: A point prevalence survey study
Authors: Agyare Elizabeth , Acolatse Joseph Elikem Efui , Dakorah Mavis Puopelle , Akafity George , Chalker Victoria J. , Spiller Owen B. , Schneider Kristan Alexander , Yevutsey Saviour , Aidoo Nana Benyin , Blankson Sophia , Mensah-Acheampong Frederick , Incoom Robert , Kurdi Amanj , Godman Brian , Ngyedu Eric Kofi
Published: January 2024

Introduction

Antimicrobial resistance (AMR) is a global threat that necessitates coordinated strategies to improve antibiotic prescribing and reduce AMR. A key activity is ascertaining current prescribing patterns in hospitals to identify targets for quality improvement programmes.

Methods

The World Health Organisation point prevalence survey methodology was used to assess antibiotic prescribing in the Cape Coast Teaching Hospital. All core variables identified by the methodology were recorded.

Results

A total of 78.8% (82/104) patients were prescribed at least one antibiotic, with the majority from adult surgical wards (52.14%). Significantly longer hospital stays were associated with patients who underwent surgery (p = 0.0423). “Access” antibiotics dominated total prescriptions (63.8%, 132/207) with ceftriaxone, cefuroxime, and ciprofloxacin being the most prescribed “Watch” antibiotics. The most common indications were for medical prophylaxis (59.8%, 49/82) and surgical prophylaxis (46.3%, 38/82). Over one-third of surgical prophylaxis (34.2%, 13/38) indications extended beyond one day. There was moderate documentation of reasons for antibiotic treatment in patient notes (65.9%, 54/82), and targeted therapy after samples were taken for antimicrobial susceptibility testing (41.7%, 10/24). Guideline compliance was low (25%) where available.

Conclusions

There was high use of antibiotics within the hospital which needs addressing. Identified quality targets include developing surgical prophylaxis guidelines, reviewing “Watch” antibiotic prescribing, and assessing antibiotic durations for patients on two or more antibiotics. Organizational-level deficiencies were also identified that need addressing to help instigate ASPs. These can be addressed by developing local prescribing protocols and antibiotic stewardship policies in this hospital and wider in Ghana and across Africa.
Type 3 secretion system induced leukotriene B4 synthesis by leukocytes is actively inhibited by Yersinia pestis to evade early immune recognition
Authors: Brady Amanda , Sheneman Katelyn R. , Pulsifer Amanda R. , Price Sarah L. , Garrison Taylor M. , Maddipati Krishna Rao , Bodduluri Sobha R. , Pan Jianmin , Boyd Nolan L. , Zheng Jing-Juan , Rai Shesh N. , Hellmann Jason , Haribabu Bodduluri , Uriarte Silvia M. , Lawrenz Matthew B.
Published: January 2024

Subverting the host immune response to inhibit inflammation is a key virulence strategy ofYersinia pestis. The inflammatory cascade is tightly controlled via the sequential action of lipid and protein mediators of inflammation. Because delayed inflammation is essential forY.pestisto cause lethal infection, defining theY.pestismechanisms to manipulate the inflammatory cascade is necessary to understand this pathogen’s virulence. While previous studies have established thatY.pestisactively inhibits the expression of host proteins that mediate inflammation, there is currently a gap in our understanding of the inflammatory lipid mediator response during plague. Here we used the murine model to define the kinetics of the synthesis of leukotriene B4 (LTB4), a pro-inflammatory lipid chemoattractant and immune cell activator, within the lungs during pneumonic plague. Furthermore, we demonstrated that exogenous administration of LTB4prior to infection limited bacterial proliferation, suggesting that the absence of LTB4synthesis during plague contributes toY.pestisimmune evasion. Using primary leukocytes from mice and humans further revealed thatY.pestisactively inhibits the synthesis of LTB4. Finally, usingY.pestismutants in the Ysc type 3 secretion system (T3SS) andYersiniaouter protein (Yop) effectors, we demonstrate that leukocytes recognize the T3SS to initiate the rapid synthesis of LTB4. However, several Yop effectors secreted through the T3SS effectively inhibit this host response. Together, these data demonstrate thatY.pestisactively inhibits the synthesis of the inflammatory lipid LTB4contributing to the delay in the inflammatory cascade required for rapid recruitment of leukocytes to sites of infection.
BHLHE40 drives protective polyfunctional CD4 T cell differentiation in the female reproductive tract against Chlamydia
Authors: Mercado Miguel A. B. , Li Qiang , Quick Charles M. , Kim Yejin , Palmer Rachel , Huang Lu , Li Lin-Xi
Published: January 2024

The protein basic helix-loop-helix family member e40 (BHLHE40) is a transcription factor recently emerged as a key regulator of host immunity to infections, autoimmune diseases and cancer. In this study, we investigated the role of Bhlhe40 in protective T cell responses to the intracellular bacterium Chlamydia in the female reproductive tract (FRT). Mice deficient in Bhlhe40 exhibited severe defects in their ability to control Chlamydia muridarum shedding from the FRT. The heightened bacterial burdens in Bhlhe40-/- mice correlated with a marked increase in IL-10-producing T regulatory type 1 (Tr1) cells and decreased polyfunctional CD4 T cells co-producing IFN-γ, IL-17A and GM-CSF. Genetic ablation of IL-10 or functional blockade of IL-10R increased CD4 T cell polyfunctionality and partially rescued the defects in bacterial control in Bhlhe40-/- mice. Using single-cell RNA sequencing coupled with TCR profiling, we detected a significant enrichment of stem-like T cell signatures in Bhlhe40-deficient CD4 T cells, whereas WT CD4 T cells were further down on the differentiation trajectory with distinct effector functions beyond IFN-γ production by Th1 cells. Altogether, we identified Bhlhe40 as a key molecular driver of CD4 T cell differentiation and polyfunctional responses in the FRT against Chlamydia.
Pánico identitario: la cuestión demográfica en el discurso de Vox
Authors: Polo-Artal Alba
Published: January 2024

El auge de las formaciones de ultraderecha ha suscitado una serie de investigaciones desde diferentes disciplinas, incluido el enfoque crítico del discurso. Sin embargo, apenas hay investigaciones sobre la cuestión demográfica atendiendo a la intersección entre el género y la raza y a la representación que hace el partido de este tema. Por ello, la investigación tiene como objetivo, por un lado, comprobar la presencia de la cuestión demográfica en el discurso de Vox y analizar su enmarcado; y, por otro lado, determinar las estrategias discursivas a través de las cuales (re)construye el enmarcado. Este análisis resulta pertinente para comprender los discursos de la ultraderecha española y observar cómo se están activando una serie de marcos vinculados a la teoría del reemplazo demográfico, fortaleciendo el orden de género y racial, (re)construyendo feminidad y masculinidad patriarcal para el endogrupo, y produciendo diferenciación racial desde la otredad amenazante. El presente trabajo analiza los tuits publicados en las cuentas del partido de derecha radical español, Vox, así como de dos militantes activos del partido: el eurodiputado Jorge Buxadé y la diputada Rocío de Meer, durante el periodo del 15 de mayo de 2021 hasta el 16 de enero de 2023. Para el análisis, se recurre al enfoque crítico del discurso de Wodak, Van Dijk y Jäger, prestando especial atención a los instrumentos empleados en las estrategias de referenciación, predicación y argumentación.
Isolation of bacteriophages specific to bovine mastitis-causing bacteria and characterization of their lytic activity in pasteurized milk
Authors: Imklin Napakhwan , Patikae Patinya , Poomirut Peekarn , Arunvipas Pipat , Nasanit Rujikan , Sajapitak Somchai
Published: January 2024

Background and Aim: Bovine mastitis is one of the most serious issues in dairy production. It is caused by contagious and coliform pathogens such as Staphylococcus spp., Escherichia coli, and Klebsiella pneumoniae. In addition, the emergence of drug-resistant bacteria raises urgent concerns in the field of drug treatment, thus requiring the exploration of alternative treatments. Bacteriophage therapy has been shown to be a promising alternative approach for the control of antibiotic-resistant pathogens. In this study, we aimed to isolate phages specific to contagious mastitis and coliform mastitis, characterize the isolated phages, and examine their ability to lyse bacteria in pasteurized milk samples. Materials and Methods: The Staphylococcus phage vB_Sau-RP15 isolated from raw milk in our previous study was used in this study. Other three phages, vB_Eco-RN12i1, vB_Kpn-RN14i1, and vB_Ssc-RN20i3, were isolated from wastewater using E. coli 5823, K. pneumoniae 194, and Staphylococcus sciuri MM01 as hosts, respectively. The host range and efficiency of plating (EOP) were determined following phage isolation. Moreover, the lysis activities of these phages against their hosts were investigated in pasteurized milk using a multiplicity of infections (MOIs) of 10 and 100 at 37°C. Phages were applied using individual and combination phages. Results: According to the EOP results, all phages showed high specificity to their respective hosts. They are tailed phages with distinct morphologies. Individual phage treatments in spiked pasteurized milk with their respective bacterial hosts significantly reduced the bacterial counts in both MOI conditions during the first 2 h of the treatment (approximately 1–8 log reduction compared to the control). Although these phages specifically infected only their hosts, the phage cocktail resulted in a better result compared to the use of individual phage. However, bacterial regrowth was observed in all experiments, which may be related to the development of phage-insensitive mutants. Conclusion: Our findings suggest that the application of phages could be used to treat bovine mastitis. Phage cocktail is suitable to promote the efficacy of phage treatment in pasteurized milk. However, when considering the use of phages in dairy cows, certain phage properties in raw milk and in vivo and ex vivo should be highlighted to ensure their effectiveness as biocontrol agents for bovine mastitis treatment. Keywords: bovine, Escherichia coli, Klebsiella pneumoniae, mastitis, phage, Staphylococcus.
Recurrence of Drug-Induced Lupus Secondary to Vedolizumab Use in a Patient With Crohn's Disease
Authors: Rodriguez Vanessa I. , Mathavan Akshay , Mathavan Akash , Rodriguez Diana N. , Alvarez Catalina Sanchez , Pham Angela
Published: January 2024

Drug-induced lupus is an autoimmune phenomenon characterized by the development of systemic lupus erythematosus–like clinical features after drug exposure. The entity is a clinical diagnosis. Evaluation consists of recognizing systemic lupus erythematosus–like features, identifying an appropriate causative agent, observing elevations of characteristic autoantibodies, and obtaining positive response with drug discontinuation. Vedolizumab is an anti-α4β7 antibody used in the treatment of ulcerative colitis and Crohn's disease. We report a novel case of drug-induced lupus recurrence secondary to vedolizumab use in a patient with Crohn's disease, emphasizing diagnostic evaluation, and provide a brief review of the published literature.