bluuebunny/crossref_metadata_2025 huggingface dataset:
Optimization of Cassava-Peel Derived Nanostarch Via Sulphuric Acid Hydrolysis Using Taguchi Method
Authors: Kanyiri Jael , Omwoyo Frank , Shem Patrick , Otieno Geoffrey
Published: October 2024

Untreated cassava peel waste generated during harvesting and processing poses significant environmental challenges. Synthesis of starch nanoparticles from cassava peels for various applications offers a sustainable solution to waste reduction and contributes to environmental conservation. The unique characteristics of nanostarch such as thermal stability, high solubility, non-toxicity, and low cost enable its application in the food industry, cosmetics, enhanced oil recovery, and textiles. The current study employed the Taguchi method design to optimize sulphuric acid hydrolysis in synthesizing cassava peel-derived nanostarch. Additionally, the derived cassava peel nanostarch was characterized using Fourier Transform Infrared Spectroscopy (FTIR). Starch was extracted from cassava peels, followed by synthesizing starch nanoparticles via sulphuric acid hydrolysis. Optimization of nanostarch synthesis was based on randomized experimental runs using the Taguchi method generated by the Minitab software, with the experiments conducted in duplicates. The optimum conditions for the experiment were found to be 3 hours, at 25°C using an H2SO4 acid concentration of 2M. These conditions produced a yield of 92.28%. ANOVA analysis identified sulphuric acid concentration as the most significant factor that affected cassava nanostarch yield, with p-values of 0.026 and 0.003 for the signal to noise (S/N) ratios and means, respectively. The least significant factor based on the analysis was the hydrolysis time. However, according to the S/N ratios main effect plot, the most optimum conditions predicted by the Taguchi method design was 9 hours, 25°C using H2SO4 acid concentration of 2M. A confirmation experiment conducted at 25°C, using an H2SO4 acid concentration of 2M for 9 hours gave a nanostarch yield of 97.01%. In conclusion, the Taguchi method design identified sulphuric acid concentration as the most significant factor in synthesizing cassava peel-derived nanostarch via acid hydrolysis.
Extraction of Aluminum Oxide from Local Kaolin Clay Deposits in Ethiopia
Authors: Belay Workie , Melesse Mengisst , Gizmu Amha
Published: October 2024

The need for aluminum is growing worldwide, which has sparked interest in finding alternate ways to make alumina from materials other than bauxite, particularly clays. This article examines the use of sodium carbonate as a leaching agent in the lime sintering process to recover alumina from kaolin. Excavated from Tarmaber, Ethiopia, kaolin clay contains a content of 32.88%, which has a relatively good composition. Collecting and grounding raw kaolin to micrometer-level particle size is the first task. The recovery of kaolin alumina was studied at sintering temperatures of (T1=800°C, T2= 900°C & T3=1000°C) at different sintering times of (t1=1 hr, t2=2 hrs & t3=3 hrs). After the raw material was burned at the given temperatures and times, it was cooled for the night in the furnace and leached with different concentrations of sodium carbonate (M1=50 g/l, M2=60 g/l & M3=70 g/l). The response surface methodology (RSM) in combination with the central composite design was used to optimize the operating parameters. The optimization result shows that the optimal conditions were a calcination temperature of 953.84°C, a sintering time of 2.99 h, and a leaching agent concentration of 70 g/l. At this optimal condition, the yield of Alumina was 1.05 g of 20 g of Kaolin clay. The resulting Alumina was crystalline in structure (from XRD analysis), contains 89.05% Al2O3 (from silicate analysis) and a large broad band between 400-1000 cm-1 is attributed to Al-O-Al stretching of Alumina (from FT-IR analysis). So, it is possible to conclude that alumina production from no bauxite ores is possible.
Psychological Impact of Acne and Post Inflammatory Hyperpigmentation Among Sudanese Women
Authors: Abdelgadir Hiba , Abdelgadir Hind , Ahmed Mosab
Published: October 2024

Introduction: Acne vulgaris is a chronic inflammatory disorder of the skin which often causes a negative impact on a woman's psychological state and quality of life. This study seeks to provide basic data and information about the psychological impact of acne on Sudanese women. Methodology: A cross-sectional questionnaire-based study was conducted during the period from June 2022 to January 2023. A total of 400 females aged 15 years and above were included in this study. These are Sudanese women who had suffered from acne in their lives, and who responded to the online study questionnaire. Cardiff Acne Disability Index (CADI) was used to assess the psychological effect of acne. Results: Seventy one percent of respondents had active acne. Acne scars were observed in (74.8%) of participants, while post-acne hyperpigmentation was observed in (71.3%). Facial acne was the most common, as it was observed in (75.8%) of the respondents. The mean age at acne onset was 15.66 years and ranged between 10 and 36 years. Mild and moderate acne were the most common types, accounting for (37.0%) and (41.5%) of cases, respectively. Acne was found to affect the psychological state of the vast majority of the respondents (89%). Cosmetics or makeup were used by (42.3%) of the respondents to conceal acne and scars. Late onset of acne treatment was reported in (42%) of the cases. Most respondents (72.5%) visited doctors to treat acne. The mean Cardiff Acne Disability Index (CADI) score was 4.55, which reflects mild effects of acne on the quality of life of most of the respondents. The adverse psychological impact was found to be significantly associated with increased acne severity, scarring, and hyperpigmentation as well as with university educated respondents. Conclusion: It was found that acne has mild effects on the quality of life of Sudanese women. Late onset of acne treatment resulted in widespread scarring and post-inflammatory hyperpigmentation in most participants, which was associated with the psychological impact of acne. There is an urgent need to encourage early treatment of acne to reduce the physical sequalae of acne to reduce the psychosocial consequences associated with the disease and the risk of scarring and hyperpigmentation on Sudanese women. Sudanese health authorities and Sudanese doctors can address this issue through education and awareness programs.
Factors Associated with Cesarean Section in Primiparous Women at the Bernard Kouchner Communal Medical Centre in Coronthie, Conakry, Guinea
Authors: Athanase Leno , Ibrahima Conte , Julien Tolno , Mamoudou Magassouba , David Lamah , Theresa Pindou , Telly Sy
Published: October 2024

Objective: to analyse the factors associated with Caesarean section in primiparous women. Methods: This was a 12-month (1 January to 31 December 2022) retrospective case-control study conducted at the Bernard Kouchner Communal Medical Centre (CMC) in Coronthie. Correctly completed records of primiparous women with a singleton pregnancy were included, with a live foetus in cephalic presentation having been delivered (by Caesarean section or vaginal delivery) from 28 weeks' gestation with a weight ≥ 1000 g. The "cases" consisted of records from primiparous women who had undergone caesarean section. The "controls" were composed by matching each "case" with the record of a patient who had undergone vaginal delivery, according to the order in the delivery register. Socio-demographic, clinical and obstetric characteristics were analysed and compared. A univariate analysis comparing cases to controls and a multivariate analysis looking for an association between maternal determinants were performed. Results: The prevalence of caesarean section in primiparous women was 31%. The average age of primiparous women was 24 ± 5 years. The 20-24 age group was the most represented in both groups, with 35% of caesareans and 42% of vaginal deliveries. The factors significantly associated with caesarean section in primiparous women were advanced maternal age (OR=1.13 CI=1.07-1.20), prolonged pregnancy (OR=25.1 CI =3.23 - 5.40), arterial hypertension (OR=4.98 CI= 2.24 -11.6), premature rupture of membranes (OR= 4.25 CI: 2.27 - 8.05), haemorrhagic complications (OR=8.56 CI=3.05 - 26.6), foetal distress (OR=68.4 CI=18.3 - 45.1) and macrosomia (OR=12.7 CI= 4.83 - 38.6). Conclusion: correct antenatal care and delivery by qualified personnel could help prevent some of these factors and thus reduce the caesarean section rate among primiparous women in our health facility.
Impact of Ebola Virus Disease and ECOWAS Membership on Intra-Regional Trade in West Africa
Authors: Abban Stanley
Published: October 2024

The West African sub-region bore the brunt of the world's largest Ebola outbreak, significantly impacting the economic activities and trade shares of the affected countries. This study seeks to examine the repercussions of the Ebola Virus Disease (EVD) on the trade shares of affected countries and to explore the potential influence of ECOWAS membership on intra-regional trade in West Africa. Using the Poison Pseudo Maximum Likelihood (PPML) estimation technique, an analysis of the augmented gravity model of international trade was conducted. The findings indicate a two-fold reduction in the trade shares of affected countries with their intra-regional partners due to the Ebola Virus Disease. Additionally, with Mauritania expressing its desire to join the ECOWAS sub-region, there is a need to explore the impact of the Regional Economic Community on intra-regional trade. Furthermore, the study reveals that ECOWAS membership has the potential to double trade levels in West Africa. The findings also suggest that Mauritania stands to gain significant benefits from becoming a member of the ECOWAS. In conclusion, this study highlights the necessity for ECOWAS to proactively respond to disease outbreaks and underscores the importance of increased research investment. Moreover, it emphasizes the need for the ECOWAS to further improve infrastructure to facilitate intra-regional trade, especially in transportation.
Investigating Respiratory Disease Transmission Patterns Around the Figuil Cement Works
Authors: Christophe Kikmo , Patrick Njionou , Samuel Batambock , Jean Nyatte , Andre Abanda
Published: October 2024

The objective of this research is to examine the dissemination of respiratory illnesses, exacerbated by the airborne pollutants emitted by the Figuil cement works, among the local population residing in the vicinity. The primary objective is to examine the impact of pollution, particularly the emission of fine particles and noxious gases, on the transmission of respiratory diseases such as asthma, chronic bronchitis and other lung disorders. The modified SEIR (Susceptible-Exposed-Infected-Recovered) epidemiological model is employed for the analysis of transmission dynamics within the community. This model incorporates environmental, health and demographic variables, thereby enabling the simulation of disease transmission as a function of varying pollution levels. Particular emphasis is placed on vulnerable groups, such as children and the elderly, due to immunosenescence, who are more likely to suffer from the adverse effects of pollution. The results will facilitate the formulation of efficacious strategies, including the implementation of awareness-raising campaigns and the introduction of sophisticated systems for the filtration and capture of pollutants at their source, such as fine particle filters or devices for the reduction of nitrogen oxides (NOx), with the objective of limiting the spread of respiratory diseases in at-risk areas and the formulation of suitable control measures.
Papillary Intralymphatic Angioendothelioma of the Spleen: A Rare Lymphatic Tumour in the Context of a PIK3CA Mutation
Authors: Murray Jacinta , Zafreen Sadia , Goodwin Susie , Driver Christopher , Evans Clair
Published: October 2024

Papillary intralymphatic angioendothelioma (PILA) is a locally aggressive, rarely metastasising lymphatic tumour that typically arises within the skin and soft tissues. We report a case of PILA arising within the spleen of a 6-year-old boy with megacephaly-capillary malformation (MCAP/MC-M) syndrome. MCAP/MC-M represents part of the phosphatidylinositol-4,5-biphosphate 3 kinase catalytic subunit alpha (PIK3CA) related overgrowth spectrum (PROS). This is the 6th reported case in the literature of a splenic PILA and the 2nd known to have occurred in the context of a confirmed PIK3CA mutation. In reporting this case we review prior reports of PILA occurring within the spleen and discuss the potential role of the PIK3CA mutation in the aetiology of the lesion, and note a theoretical application of mammalian target of rapamycin (mTOR) inhibitors as a possible therapeutic strategy.
Determination of Appropriate Time of Nitrogen Application to Improve Productivity of Sorghum Crops in Assosa Zone, Benishangul Gumuz Region
Authors: Boru Merga , Mengasha Megersa , Dinberu Adisie
Published: October 2024

The research was conducted to determine the appropriate application time of nitrogen fertilizer on yield and yield components of sorghum in Benishangul gumuz region. Treatments consisted of eight application times of nitrogen: all recommended rate of N at planting (T1), ½ at planting + ½ at knee height (T2), Applying 1/2 at planting+1/2 at near flowering (T3), Applying 1/3 at planting+1/3 at knee height+1/3 at near flowering (T4), Applying 1/3 at planting+2/3 at knee height (T5), Applying 1/3 at planting+2/3 at near flowering (T6), Applying 2/3 at planting+1/3 knee height (T7), and Applying 2/3 at planting+1/3 knee height (T8) Days to 50% maturity, plant height, and grain yield were the parameters significantly affected by treatment effect, while, days to heading, and thousand kernel weight showed non-significant. The maximum grain yield was 5658 kg ha-1, in two split applications (1/2 dose at sowing and 1/2 dose at knee height. The use of nitrogen in two split applications (1/2 dose at sowing and 1/2 dose at knee height stage) can be recommended for farmers for production of sorghum in the study area and other areas with similar agro ecological conditions.
Developing a Novel Contact Tracing Mobile Application for Coronavirus Disease 2019 (COVID-19) for Improving Testing Capacity and Controlling the Spread of COVID-19 in Nigeria
Authors: Musa Adesola , Osuolale Kazeem , Salako Abideen , Ifeta Adekunle , Salako Babatunde
Published: October 2024

In this study, a novel contact tracing model that leverages smartphone technology to enhance efficiency, reduce costs, and extend the duration of contact tracing efforts is developed. This model utilizes smartphones as identification systems, collecting data on the proximity of other smartphone users through integrated Bluetooth and GPS technology. The study examines the frequency, duration, and proximity of interactions between smartphone devices in a clinical setting, highlighting potential implications for infectious disease transmission to pilot the mobile application developed. Contact data from six pairs of devices were analyzed, focusing on metrics such as total contacts, total contact time, average contact time, average distance, and the percentage of contacts occurring within 1.5 meters. The results showed varying levels of interaction across device pairs, with Devices 1 & 3 showing the highest number of contacts (175), and Devices 3 & 4 displaying the longest average contact time (20,133,193.01 seconds). Correlation analysis revealed weak and statistically insignificant relationships between total contacts and average distance (r = 0.13, p = 0.81), contact time and the percentage of close contacts (r = -0.15, p = 0.78). These findings suggest that while there are observable trends in contact patterns, the statistical insignificance highlights the need for further investigation to establish stronger associations that could inform infection control practices in healthcare settings.
Synthesis of Montmorillonite-Silica Nanocomposite Using Millet Husk and Montmorillonite Clay and Optimization of Adsorption Parameters for Congo Red Dye Adsorption
Authors: Echeofun Oboyi , Isaac Ernest , Bingong Ishaku , Kpesibe Joseph , John Emmanuel
Published: October 2024

Dyes are substances that, when applied to a substrate provides color by a process that alters, at least temporarily, any crystal structure of the colored substances The discharge of these effluents into the receiving environments results in hazardous health problems as most of these dyes have carcinogenic effects on the living organisms. Generally, dyes are classified into three categories: a) anionic: direct, acid, and reactive dyes; b) cationic: basic dyes; and c) non-ionic: disperse dyes. The chromophores in anionic and non-ionic dyes mostly consist of azo groups or anthraquinone types. However, Congo red, are difficult to biodegrade due to their complex aromatic structures, which provide them with physico-chemical, thermal, and optical stability. This study is aimed at synthesizing Montmorillonite-silica nanocomposite, a cost effective adsorbent from millet husk and Montmorillonite-clay with the determination of its optimum adsorption parameters for Congo Red Dye adsorption. Here, synthesis of Montmorillonite-silica nanocomposite and optimization parameters were carried out using standard procedures. The unbiased result demonstrated that the percentage yield was found to be 94.51 %. The optimum adsorption parameters studied were adsorbent dose, adsorbate concentration, pH and Kinetics studies. The optimum adsorption parameters were found to be 8.0 g/L, 2.0 mg/L, 8 and 30 minutes, respectively. Hence, the synthesized Montmorillonite-silica nanocomposite obtained from montmorillonite clay and millet husk ash can serve as a cost-effective adsorbent for the removal of Congo Red Dye from waste waters.
The Prospective Application of Machine Learning in Turbulence Forecasting over China
Authors: Shao Jingyuan , Zhuang Zibo , Yu Zhenyu , Lin Kunyun , Wu Kaijun , Leung Yan Yu , Chan Pak Wai
Published: October 2024

This study analyzes the spatiotemporal distribution of turbulence in China from 2020 to 2022 using pilot reports. Results reveal a higher frequency of moderate-to-severe turbulence during spring and winter, particularly in January. Spatially, the primary regions of turbulence occurrence are eastern China, Xinjiang Province, Sichuan Province, and the Qiongzhou Strait, with a focus on altitudes at or above 6000 m. Machine learning models, especially random forest and extreme gradient boosting (XGBoost), demonstrate high accuracy in turbulence prediction, notably for high-altitude events. The random forest model shows optimal performance in winter, achieving an area under the curve of 0.92. The study highlights the importance of thermally related diagnostics, indicating a significant presence of convectively induced turbulence in high-altitude turbulence events. This research not only deepens the understanding of turbulence dynamics in the China region but also underscores the potential of machine learning in enhancing turbulence forecasting.
Theoretical analysis of water-droplet condensation and evaporation in prescribed environment with radiation
Authors: Brewster M. Q.
Published: October 2024

A quasi-explicit algebraic solution of the problem of quasi-steady water droplet heat- and mass-transfer with condensation or evaporation in a prescribed environment including radiation has been obtained. The solution is based on the mass-fraction form of Fick’s law of species diffusive mass transport, which allows accounting for variation in gas density through the diffusion layer surrounding the droplet. A new term, the average vapor supersaturation through the diffusion layer, has been included that allows the model to be extended to environmental conditions significantly outside those for which it is theoretically derived (dilute or near-saturation), even to conditions of relatively high temperature, low relative humidity, and low pressure. The latter two have atmospheric significance because evaporative cooling can induce significant decrease in droplet temperature and possibly induce freezing. Basic modeling assumptions are confirmed by comparison with time-dependent temperature and evaporation-rate measurements of a laboratory laser-heated droplet. Accuracy of the new model is assessed by comparison with exact equations. For temperatures between −30 and 0°C and negligible radiation, relative-error magnitudes in droplet temperature and evaporation rate are less than 5%, even for relative humidity down to 10% and pressure down to 60 kPa. This represents an improvement in accuracy over the conventional model, in which property variations of density and supersaturation through the diffusion layer are not taken into account. Differences in predicted evaporation rates between the mass-fraction and the more common partial-density Fick’s laws, which can be significant (>10% above 70% relative humidity) in coupled, implicit equations, are shown to be made negligibly small (<0.5%) by linearizing about the saturation state.
Behavioral Correlates of Caregiver-Reported Oral Health of Children with Cleft Palate with or without Cleft Lip Ages 14 to 48 Months: An Observational Study
Authors: Holland Haley , Pollard Sarah Hatch , Chapman Kathy , Chi Donald L. ,   on behalf of the Cleft Outcomes Research NETwork (CORNET) Consortium
Published: October 2024

To identify behaviors associated with poor caregiver-reported oral health in a population of young children with cleft palate with or without cleft lip (CP ± L).

Observational cross-sectional study.

U.S. Cleft Outcomes Research NETwork (CORNET) Consortium

Eight hundred thirty-four caregivers of US children with CP ± L ages 14 to 48 months who provided demographic and medical information and answered 8 items on oral health behaviors (eg, sugar-sweetened beverage intake frequency, having a regular source of dental care, toothbrushing, and fluoride exposure).

Caregiver-reported oral health status of the child (poor/fair vs good/very good). Logistic regression models were used to generate confounder-adjusted odds ratios (OR) and evaluate associations between oral health behaviors and caregiver-reported oral health status of the child.

The mean age of children was 25.5 ± 7.5 months, 82.7% were white, and 24.1% were Hispanic/Latino. About 16.7% of caregivers reported their child's oral health as fair/poor. Children consuming 2+ servings of juice and/or sugar-sweetened beverages daily (OR: 2.18; 95% confidence interval [CI]: 1.2, 4.0; P = 0.011), those drinking bottled water (OR: 1.75; 95% CI: 1.0, 3.1; P = 0.049), and those consuming 1+ servings of meal replacement drinks daily (OR: 2.86; 95% CI: 1.2, 6.5; P = 0.015) had increased odds of fair/poor caregiver-reported child oral health.

Sugar-sweetened beverages and meal replacement drinks, as well as bottled water intake, were associated with poorer caregiver-reported oral health for children with CP ± L. Future research should focus on ways to improve beverage-related behaviors in children with CP ± L to prevent dental diseases and promote oral health.
Zanubrutinib, obinutuzumab, and venetoclax for first-line treatment of mantle cell lymphoma with a TP53 mutation
Authors: Kumar Anita , Soumerai Jacob , Abramson Jeremy S. , Barnes Jeffrey A. , Caron Philip , Chhabra Shalini , Chabowska Maria , Dogan Ahmet , Falchi Lorenzo , Grieve Clare , Haydu J. Erika , Johnson Patrick Connor , Joseph Ashlee , Kelly Hailey E. , Labarre Alyssa , Lue Jennifer Kimberly , Martignetti Rosalba , Mi Joanna , Moskowitz Alison , Owens Colette , Plummer Sean , Puccio Madeline , Salles Gilles , Seshan Venkatraman , Simkins Elizabeth , Slupe Natalie , Zhang Honglei , Zelenetz Andrew D.
Published: October 2024

TP53-mutant mantle cell lymphoma (MCL) is associated with poor survival outcomes with standard chemoimmunotherapy. We conducted a multicenter, phase 2 study of zanubrutinib, obinutuzumab, and venetoclax (BOVen) in untreated patients with MCL with a TP53 mutation. Patients initially received 160 mg zanubrutinib twice daily and obinutuzumab. Obinutuzumab at a dose of 1000 mg was given on cycle 1 day 1, 8, and 15, and on day 1 of cycles 2 to 8. After 2 cycles, venetoclax was added with weekly dose ramp-up to 400 mg daily. After 24 cycles, if patients were in complete remission with undetectable minimal residual disease (uMRD) using an immunosequencing assay, treatment was discontinued. The primary end point was met if ≥11 patients were progression free at 2 years. The study included 25 patients with untreated MCL with a TP53 mutation. The best overall response rate was 96% (24/25) and the complete response rate was 88% (22/25). Frequency of uMRD at a sensitivity level of 1 × 10–5 and uMRD at a sensitivity level of 1 × 10–6 at cycle 13 was 95% (18/19) and 84% (16/19), respectively. With a median follow-up of 28.2 months, the 2-year progression-free, disease-specific, and overall survival were 72%, 91%, and 76%, respectively. Common side effects were generally low grade and included diarrhea (64%), neutropenia (32%), and infusion-related reactions (24%). BOVen was well tolerated and met its primary efficacy end point in TP53-mutant MCL. These data support its use and ongoing evaluation. This trial was registered at www.ClinicalTrials.gov as #NCT03824483.
Whole genome sequence analysis of multi-drug resistant and biofilm-forming Staphylococcus haemolyticus isolated from bovine milk
Authors: Ajose Daniel Jesuwenu , Abolarinwa Tesleem Olatunde , Oluwarinde Bukola Opeyemi , Montso Peter Kotsoana , Fayemi Omolola Esther , Aremu Adeyemi Oladapo , Ateba Collins Njie
Published: October 2024

Background

Milk is an excellent growth medium for microorganisms due to its nutritive composition. Microorganisms have been implicated in bovine mastitis (BM) in dairy cows as well as causing infections in animals and humans. Despite extensive endeavours to manage BM, this condition continues to persist as the most prevalent and economically burdensome problem affecting dairy cattle on a global scale. Non-aureus staphylococci (NAS) species such as Staphylococcus haemolyticus, S. epidermidis, and S. xylosus are currently the predominant microbiological agents identified as the main cause of subclinical udder infections and are also considered opportunistic pathogens in cases of clinical mastitis in dairy cows. Therefore, it is crucial to elucidate the genetic profile of these species. The primary objective of this study was to characterise three phenotypically determined multidrug-resistant NAS environmental strains (NWU MKU1, NWU MKU2, and NWU MKS3) obtained from dairy cows milk via whole-genome sequencing.

Results

The results confirmed that the three isolates were S. haemolyticus with genome sizes of 2.44, 2.56, and 2.56 Mb and a G + C content of 32.8%. The genomes contained an array of antibiotic resistance genes that may potentially confer resistance to a range of antibiotic classes, such as macrolides, fluoroquinolones, aminoglycosides, cephalosporins, tetracyclines, peptides, and phenicol. Furthermore, all the genomes carried virulence genes, which are responsible for several functions, such as adhesion, enzyme and toxin production. The genomes of these organisms contained signatures encoding mobile genetic elements such as prophages and insertion sequences.

Conclusion

These findings indicate there is a need for diligent monitoring with improved management practices and quality control strategies on farms to safeguard milk production systems and human health.
Social connection in long-term care homes: a qualitative study of barriers and facilitators
Authors: Chapman Hannah , Bethell Jennifer , Dewan Neha , Liougas Madalena P. , Livingston Gill , McGilton Katherine S. , Sommerlad Andrew
Published: October 2024

Background

Social connection is a basic human need and is essential to quality of life. It is associated with better mental and physical health outcomes for long-term care (LTC) home residents and is a key aspect of quality of care and person-centred care. There are considerations for LTC homes that may present obstacles to and opportunities for social connection. It is therefore important to understand what restricts or enables good social connection in LTC homes, to guide better quality care and future interventions in this population. This qualitative study aims to identify barriers and facilitators to social connection for LTC residents.

Methods

We used thematic analysis to describe themes derived from individual and group qualitative interviews from 67 participants (18 residents, 17 staff members and clinicians, 32 family members and friends) recruited from LTC homes in the United Kingdom and Canada.

Results

Themes were grouped into four categories: (1) becoming familiar with life in the LTC home to support social connection; (2) physical and virtual access beyond the LTC home as strategies to maintain contact; (3) getting to know residents to deepen relationships; (4) person-centred approaches to build social connection. ‘Becoming familiar with life in the LTC home to support social connection’ described the benefits of counteracting the institutionalized feel of LTC homes, enabling LTC residents to spend time in meaningful ways, and increasing freedom of mobility around the home. ‘Physical and virtual access beyond the LTC home as strategies to maintain contact’ related to the benefits of outings, providing support with technology, and involving family and friends in LTC home life. ‘Getting to know residents to deepen relationships’ related to the benefits of using routine care and interactions as opportunities for social contact, using family and friend knowledge as a resource, and fostering resident relationships. ‘Person-centred approaches to build social connection’ included considering physical, mental, cognitive, and sensory impairments, accounting for adjustment and sociability, using communal spaces well, and prioritizing psychosocial needs.

Conclusions

This study identifies barriers and facilitators to social connection for LTC residents which can be addressed in care policies, staff selection and training, and can inform policies and interventions to build and maintain social connection in LTC homes.

Clinical trial number

clinicaltrials.gov ID NCT05315960.
Effectiveness of psychoeducation interventions for pregnant women with gestational diabetes mellitus: an integrative review
Authors: Alshammari Mutairah , Lee Regina Lai Tong , Stubbs Michelle , Chan Sally Wai-Chi
Published: October 2024

Background

Gestational diabetes mellitus occurs in approximately 15–17% of pregnant women worldwide and causes high mortality and morbidity for mothers and infants. Pregnant women who are newly diagnosed with gestational diabetes mellitus experience higher levels of stress and anxiety than pregnant women without this condition. Thus, it is important to identify effective interventions to help pregnant women cope with the additional stress and anxiety associated with pregnancy-related complications.

Aim

This integrative review aimed to synthesise evidence on the effects of educational interventions for pregnant women with gestational diabetes mellitus regarding knowledge, self-efficacy, self-care behaviour, anxiety, depression, and birth outcomes.

Methods

An integrative review of articles published between 2009 and 2024, written in English and Arabic. The review followed the Whittemore and Knafl’s 5-stage process framework.

Results

From the 922 abstracts identified using search terms, 16 articles were eligible for this review. Psychoeducational interventions were provided for (1) informational support: information about gestational diabetes mellitus, diabetes mellitus, blood glucose monitoring, exercise management, diet management, and stress; (2) motivational support: setting individual goals, enhancing health behaviours, and motivational messages; (3) emotional support: expression of feelings, enforcement of self-management, and sharing of experiences; and (4) relaxation techniques: breathing exercises, meditation, and mindfulness. In this review, only two studies entirely focused on reducing stress and anxiety through cognitive-behavioural stress management training and mindfulness training. The effects of the interventions on self-efficacy, knowledge, depression, anxiety, and birthing outcomes were inconsistent due to variations in intervention designs and duration. However, consistent positive outcomes were found in self-care behaviours.

Conclusion

This integrative review found informational and motivational support were frequently used by pregnant women. In contrast, emotional support and relaxation techniques were rarely used. Psychoeducational interventions may enhance self-care behaviours, improve self-efficacy, and reduce stress and depression for women with gestational diabetes mellitus. Nurses and midwives play an essential role in providing holistic care through comprehensive psychoeducational interventions for pregnant women.
Enhanced bone cement distribution in percutaneous vertebroplasty using a curved guide wire: a propensity score matching analysis
Authors: Hu Xuyan , Zhang Zijin , Yang Yisong , Zhang Gang , Cao Shen , Yu Bing , Zhang Yubing
Published: October 2024

Background

Osteoporotic vertebral compression fractures (OVCF) severely affect the quality of life in the aged population. Percutaneous vertebroplasty (PVP) alleviates pain and stabilizes vertebrae, but suboptimal bone cement distribution can cause complications. Hence, this study aimed to clarify whether a new technique for PVP, using a curved guide wire, enhances the distribution of bone cement and improves clinical outcomes in patients with OVCF.

Methods

Patients with single-segment OVCF underwent PVP or curved guide wire percutaneous vertebroplasty (C-PVP). Propensity score matching (PSM) was employed to balanced the baseline characteristics. The primary outcomes were the visual analog scale (VAS) and Oswestry disability index (ODI) scores. The secondary outcomes included assessments of bone cement distribution, bone cement injection volume, radiological parameters, and general clinical results. Additionally, Complications and adverse events were documented.

Results

After PSM analysis, each group comprised 54 patients, which significantly reduced baseline differences. The C-PVP group showed better clinical outcomes compared to the traditional PVP group. One month after surgery, the C-PVP group had significantly lower VAS and ODI scores (p < 0.001). These improvements persisted at six months and the final follow-up. Additionally, bone cement distribution scores were better (p < 0.001), injection volume was higher (p = 0.03), leakage was less frequent (p = 0.02), and adjacent vertebral fractures occurred less frequently (p = 0.04) in the C-PVP group. Radiological parameters and overall clinical outcomes revealed no significant differences between the two groups.

Conclusion

The use of curved guide wire in PVP significantly improves bone cement distribution and injection volume, resulting in better clinical efficacy in patients with OVCF.
The Western Australian medical schools mindfulness project: a randomised controlled trial
Authors: Moore S. , Mavaddat N. , Auret K. , Hassed C. , Chambers R. , Sinclair C. , Wilcox H. , Ngo H.
Published: October 2024

Background

Evidence for the longer-term benefits of online mindfulness training for medical students, including in the reduction of stress and improved wellbeing, is limited. This study aimed to evaluate the impact of a novel online mindfulness training program on trait mindfulness, wellbeing and study engagement of medical students at program completion and 6-month follow-up.

Methods

This was a randomised waitlist control study of an 8-week, online, mindfulness-based intervention versus normal curriculum alone for medical students (N = 114). The primary outcome measures were the changes from baseline to program completion at Week 8 for self-reported trait mindfulness (Freiburg Mindfulness Inventory), perceived stress (Perceived Stress Scale), self-compassion (Self-Compassion Scale) and study engagement scores (Utrecht Work Engagement Scale for Students). The secondary outcome measures were these score changes from baseline to 6-month follow up. Intervention and control students completed surveys at all three time points. Program adherence (Mindfulness Adherence Questionnaire) was also measured in the intervention group.

Results

The intervention group experienced modest but statistically significant improvements in mindfulness (9%, p = 0.0002), self-compassion (5%, p = 0.026), and study engagement (4%, p = 0.035) from baseline to Week 8. They also reported a sustained improvement of 5% (p = 0.017) in mindfulness scores at 6 months. The control group reported no significant changes at Week 8 or 6 Months. Between-group comparisons showed that compared to the control group, the intervention group improved significantly more in mindfulness (p = 0.0076), and statistically marginally more in study engagement (p = 0.0534) at Week 8. No statistically significant between-group differences were observed at 6 months.

Conclusions

These results add to the small but growing body of evidence suggesting that online mindfulness-based interventions with minimal contact can improve, albeit in modest magnitude, mindfulness and possibly study engagement in medical students for the duration of a mindfulness program. Further refinements to the program may be important to maintain improvements in the longer-term.

Trial registration

Registration number ACTRN12624000783527.
Home-based guidance training system with interactive visual feedback using kinect on stroke survivors with moderate to severe motor impairment
Authors: Lu Hsuan-Yu , Wang Xiaoyi , Hu Chengpeng , Lau Cathy Choi-Yin , Tong Raymond Kai-Yu
Published: October 2024

The home-based training approach benefits stroke survivors by providing them with an increased amount of training time and greater feasibility in terms of their training schedule, particularly for those with severe motor impairment. Computer-guided training systems provide visual feedback with correct movement patterns during home-based training. This study aimed to investigate the improvement in motor performance among stroke survivors with moderate to severe motor impairment after 800 min of training using a home-based guidance training system with interactive visual feedback. Twelve patients with moderate to severe stroke underwent home-based training, totaling 800 min (20–40 min per session, with a frequency of 3 sessions per week). The home-based guidance training system uses Kinect to reconstruct the 3D human body skeletal model and provides real-time motor feedback during training. The training exercises consisted of six core exercises and eleven optional exercises, including joint exercises, balance control, and coordination. Pre-training and post-training assessments were conducted using the Fugl-Meyer Assessment-Upper Limb (FMA-UE), Fugl-Meyer Assessment-Lower Limb (FMA-LE), Functional Ambulation Categories (FAC), Berg Balance Scale (BBS), Barthel Index (BI), Modified Ashworth Scale (MAS), as well as kinematic data of joint angles and center of mass (COM). The results indicated that motor training led to the attainment of the upper limit of functional range of motion (FROM) in hip abduction, shoulder flexion, and shoulder abduction. However, there was no improvement in the active range of motion (AROM) in the upper extremity (U/E) and lower extremity (L/E) joints, reaching the level of the older healthy population. Significant improvements were observed in both left/right and superior/inferior displacements, as well as body sway in the mediolateral axis of the COM, after 800 min of training. In conclusion, the home-based guidance system using Kinect aids in improving joint kinematics performance at the level of FROM and balance control, accompanied by increased mediolateral body sway of the COM for stroke survivors with moderate to severe stroke. Additionally, spasticity was reduced in both the upper and lower extremities after 800 min of home-based training.
Psychological morbidity among coal miners compared to other occupations in Appalachia
Authors: Blanc Paul D. , Trupin Laura , Yelin Edward H. , Katz Patricia P.
Published: October 2024

Objectives

Depressive symptoms, anxiety, and post-traumatic stress disorder (PTSD) are common morbidities among coal miners, but the risk of these morbidities has not been analyzed relative to other occupations taking into account relevant covariates.

Methods

Using random digit dialing, we surveyed men aged 50 or over with a history of employment who resided in counties in Appalachia with high coal workers’ pneumoconiosis (CWP) mortality rates. We used the Primary Care Post-Traumatic Stress (PTSD) Screen and the Brief Trauma Questionnaire to query specific traumatic experiences. We used the Patient Health Questionnaire scale to assess depression symptoms and the Generalized Anxiety Disorder questionnaire to measure anxiety. Multivariable logistic regression analyzed associations between coal mining and depression, anxiety, and PTSD, adjusting for trauma, smoking and demographics.

Results

Of 1,428 participants, 233 (16.3%) reported coal mining employment. Coal mining was associated with increased odds of depression (OR 1.6; 95% CI 1.1 to 2.4) and anxiety (OR 1.7; 95% CI 1.1 to 2.7). Among those with any trauma (n = 711), coal mining was not associated with increased risk of PTSD (OR 0.80; 95% CI 0.5 to 1.3]. Non-coal trauma was associated with three-fold increased odds of anxiety (OR 3.2; 95% CI 2.0 to 5.1); for coal trauma, anxiety was associated with six-fold increased odds (OR 6.0; 95% CI 2.9 to 12.4).

Conclusions

Appalachian region coal miners carry an increased burden of depression and anxiety. This should be recognized by clinicians and at a population level, as worthy of individual and public health intervention.
Bovine pulp extracellular matrix hydrogel for regenerative endodontic applications: in vitro characterization and in vivo analysis in a necrotic tooth model
Authors: Elnawam Hisham , Thabet Abdelrahman , Mobarak Ahmed , Khalil Nesma Mohamed , Abdallah Amr , Nouh Samir , Elbackly Rania
Published: October 2024

Background

Regenerative endodontic procedures (REPs) offer the promise of restoring vitality and function to a previously necrotic and infected tooth. However, the nature of regenerated tissues following REPs remains unpredictable and uncontrollable. Decellularized extracellular matrix scaffolds have gained recent attention as scaffolds for regenerative endodontics.

Objectives

Preparation and characterization of a bovine dental pulp-derived extracellular matrix (P-ECM) hydrogel for regenerative endodontic applications. Biocompatibility and regenerative capacity of the prepared scaffold were evaluated in vivo in a canine animal model.

Methods

Fifteen freshly extracted bovine molar teeth were used to prepare P-ECM hydrogels following approval of the institutional review board of the faculty of dentistry, Alexandria University. Decellularization and lyophilization of the extracted pulp tissues, DNA quantification and histological examination of decellularized P-ECM were done. P-ECM hydrogel was prepared by digestion of decellularized pulps. Prepared scaffolds were evaluated for protein content and release as well as release of VEGF, bFGF, TGF-β1 and BMP2 using ELISA. Rabbit dental pulp stem cells’ (rDPSCs) viability in response to P-ECM hydrogels was performed. Finally, proof-of-concept of the regenerative capacity of P-ECM scaffolds was assessed in an infected mature canine tooth model following REPs versus blood clot (BC), injectable platelet-rich fibrin (i-PRF) or hyaluronic acid (HA). Statistical analysis was done using independent t test, the Friedman test and chi-square tests (p value ≤ 0.05).

Results

DNA was found to be below the cut-off point (50 ng/mg tissue). Histological evaluation revealed absence of nuclei, retention of glycosaminoglycans (GAGs) and collagen content, respectively. P-ECM hydrogel had a total protein content of (493.12 µg/µl) and protein release was detected up to 14 days. P-ECM hydrogel also retained VEGF, bFGF, TGF-β1 and BMP2. P-ECM hydrogel maintained the viability of rDPSCs as compared to cells cultured under control conditions. P-ECM hydrogel triggered more organized tissues compared to BC, i-PRF and HA when used in REPs for necrotic mature teeth in dogs. Periapical inflammation was significantly less in HA and P-ECM groups compared to blood-derived scaffolds.

Conclusion

Bovine dental pulp-derived extracellular matrix (P-ECM) hydrogel scaffold retained its bioactive properties and demonstrated a promising potential in regenerative endodontic procedures compared to conventional blood-derived scaffolds.
Uncertainties in evaluating the health-related quality of life and disease burden of people with rare diseases and their caregivers in NICE HST submissions
Authors: Looby Alissa , Dymond Amy , Green William , Wentzel Hannah , Malottki Kinga
Published: October 2024

Background and aims

The NICE Highly Specialised Technology (HST) programme evaluates interventions for very rare conditions within the UK. This review aimed to analyse previous NICE HST appraisals and determine commonly used methods to overcome uncertainties relating to health-related quality of life (HRQoL) and disease burden for people with rare diseases and their caregivers. The review also aimed to identify areas where further methodological development is required.

Approach and results

A targeted review of all previous NICE HST appraisals published by the 28th February 2022, in which at least one committee meeting had taken place, was conducted. A total of 24 appraisals were included (17 fully completed and seven ongoing). Data were extracted by one reviewer. The evidence review group (ERG) and committee comments were compared against the NICE reference case and synthesised to identify the following methodological uncertainties that occurred most commonly: using alternatives to the EuroQol-5 Dimension (EQ-5D), sourcing HRQoL data from single-arm studies, measuring caregiver disutilities and estimating disease burden.

Conclusions

This review has highlighted the need for new methodology to reflect the impact of the diseases on people with rare diseases and their families. The review identified the following methodological requirements: alternative approaches that should be used when EQ-5D is not appropriate, methods to evaluate paediatric HRQoL and methods to quantify disease burden. This review also highlights the need to establish clear recommendations on the estimation of utilities across different rare diseases.