bluuebunny/crossref_metadata_2025 huggingface dataset:
Insulin injection practice and health related quality of life among individuals with diabetes at Tikur Anbessa Specialized Hospital, Ethiopia: a cross-sectional study
Authors: Negash Zenebe , Tadiwos Aklasiya , Urgessa Eliyas Mulatu , Gebretekle Gebremedhin Beedemariam , Abebe Ephrem , Fentie Atalay Mulu
Published: May 2023

Background

Insulin therapy can be inconvenient, painful, burdensome, and restrict patients' daily activities and health related quality of life (HRQOL) due to improper injection techniques or the nature of administration.

Objective

This study aimed to assess insulin injection practice, HRQOL and predictors among patients treated with insulin at Tikur Anbessa Specialized Hospital (TASH).

Methods

An institutional-based cross-sectional study was conducted among diabetes patients on insulin therapy from May to June 2022. A structured questionnaire was used to collect patient characteristics and insulin injection practice. The validated Amharic version of an EQ-5D-5L tool was used to assess the HRQOL. The data was analyzed using SPSS version 26. The patient data were summarized using descriptive statistics. One-way ANOVA using Kruskal–Wallis H tests was used to assess factors that predict insulin handling practice scores. Multivariate linear regression analysis was used to assess factors affecting HRQOL among diabetes patients treated with insulin. The EQ5D-5L utility scores of the patients were calculated using disutility coefficients taken from the Ethiopian general population. Statistical significance was declared at p-value < 0.05.

Results

Of 319 patients who agreed and completed the survey, 51.1% of them were males. Almost half of the participants (n = 158) were > 50 years of age. Among the study participants, 62.1% were only on intermediate acting insulin. A significantly higher proportion of participants 291(91.2%) in this study were taking insulin two times per day. Most of the participants 234(73.4%) had fair practice with a median insulin handling practice score of 38 out of 56. Patient characteristics such as age, educational status, occupation, disease duration, and type of diabetes were significantly association with insulin injection practice (p < 0.05). The mean ± SD utility score of patients were 0.89 ± 0.19 (ranged from -0.04 to 1). Being female (β = -5.42, 95%CI:-8.63,-2.21, p = 0.001) and treated for type-I diabetes mellitus (β =  + 9.04, 95%CI: 4.23,13.85, p-value < 0.0001) were significantly associated with HRQOL of patients on insulin therapy.

Conclusion

The study participants had fair practices in insulin handling, storage, and administration techniques, and it was seen that male and type one diabetes patients have a better quality of life compared to their counterparts.
Small heterodimer partner interacting leucine zipper protein (SMILE) ameliorates autoimmune arthritis via AMPK signaling pathway and the regulation of B cell activation
Authors: Jhun JooYeon , Moon Jeonghyeon , Kwon Ji Ye , Cho Keun-Hyung , Lee Seang Yoon , Na Hyun Sik , Cho Mi-La , Min Jun-Ki
Published: May 2023

Rheumatoid arthritis (RA) is an autoimmune disease that causes joint swelling and inflammation and can involve the entire body. RA is characterized by the increase of pro-inflammatory cytokines such as interleukin (IL) and tumor necrosis factor, and the over-activation of T lymphocytes and B lymphocytes, which may lead to severe chronic inflammation of joints. However, despite numerous studies the pathogenesis and treatment of RA remain unresolved. This study investigated the use of small heterodimer partner-interacting leucine zipper protein (SMILE) overexpression to treat a mouse model of RA. SMILE is an insulin-inducible corepressor through adenosine monophosphate-activated kinase (AMPK) signaling pathway. The injection of a SMILE overexpression vector to mice with collagen induced-arthritis resulted in a milder clinical pathology and a reduced incidence of arthritis, less joint tissue damage, and lower levels of Th17 cells and plasma B cells in the spleen. Immunohistochemistry of the joint tissue showed that SMILE decreased B-cell activating factor (BAFF) receptor (BAFF-R), mTOR, and STAT3 expression but increased AMPK expression. In SMILE-overexpressing transgenic mice with collagen antibody-induced arthritis (CAIA), a decrease in the arthritis score and reductions in tissue damage, the number of B cells, and antibody production were observed. The treatment of immune cells in vitro with curcumin, a known SMILE-inducing agent, led to decreases in plasma B cells, germinal center B cells, IL-17-producing B cells, and BAFF-R-positive B cells. Taken together, our findings demonstrate the therapeutic potential of SMILE in RA, based on its inhibition of B cell activation mediated by the AMPK/mTOR and STAT3 signaling pathway and BAFF-R expression.
Opinion: more mouse models and more translation needed for ALS
Authors: Fisher Elizabeth M.C. , Greensmith Linda , Malaspina Andrea , Fratta Pietro , Hanna Michael G. , Schiavo Giampietro , Isaacs Adrian M. , Orrell Richard W. , Cunningham Thomas J. , Arozena Abraham Acevedo
Published: May 2023

Amyotrophic lateral sclerosis is a complex disorder most of which is ‘sporadic’ of unknown origin but approximately 10% is familial, arising from single mutations in any of more than 30 genes. Thus, there are more than 30 familial ALS subtypes, with different, often unknown, molecular pathologies leading to a complex constellation of clinical phenotypes. We have mouse models for many genetic forms of the disorder, but these do not, on their own, necessarily show us the key pathological pathways at work in human patients. To date, we have no models for the 90% of ALS that is ‘sporadic’. Potential therapies have been developed mainly using a limited set of mouse models, and through lack of alternatives, in the past these have been tested on patients regardless of aetiology. Cancer researchers have undertaken therapy development with similar challenges; they have responded by producing complex mouse models that have transformed understanding of pathological processes, and they have implemented patient stratification in multi-centre trials, leading to the effective translation of basic research findings to the clinic. ALS researchers have successfully adopted this combined approach, and now to increase our understanding of key disease pathologies, and our rate of progress for moving from mouse models to mechanism to ALS therapies we need more, innovative, complex mouse models to address specific questions.
Research note changes in the number of outpatient visits in Japan during the COVID-19 pandemic
Authors: Machida Munehito , Nishioka Yuichi , Noda Tatsuya , Imamura Tomoaki
Published: May 2023

Objective

This study aimed to determine the change in the number of outpatient visits in Japan since the beginning of the COVID-19 pandemic, using data on the outpatient claims submitted by medical institutions to insurers in 2019 and 2020, from the National Database of Health Insurance Claims and Specific Health Check-ups. We calculated the total number of outpatient visits, and number of visits for individual diseases according to the International Classification of Diseases-10 codes on the claim form.

Results

The number of outpatient visits per million people decreased by 9.98% in 2020 compared to 2019. Of the diseases included in the analysis, 71 showed a decrease in the number of visits by ≥ 1%. There were significant decreases in the number of visits related to infectious diseases (influenza, acute bronchitis, and acute laryngitis, etc.), and chronic diseases (hemorrhoids, cystic kidney disease, dyspepsia, and chronic sinusitis, etc.). The observed decreased rate of outpatient visit might have been due to, a decrease in the incidence of disease, a decreased frequency of visit by patients with the disease, or both. Our analysis method using actual health insurance claim data can be applied worldwide, where researchers have access to national information on health insurance claims.
The era of technology in healthcare: an evaluation of telerehabilitation on patient outcomes—a systematic review and meta-analysis protocol
Authors: Jaswal Sharan , Lo Joyce , Sithamparanathan Gobika , Nowrouzi-Kia Behdin
Published: May 2023

Background

The World Health Organization announced the outbreak of the Coronavirus disease as a global pandemic on March 11, 2020. Since then, rapid implementation of telehealth approaches into the healthcare system have been evident. The pandemic has drastically impacted the lives of many around the globe and has detrimentally affected our healthcare systems, specifically with the delivery of healthcare. This has had many implications on rehabilitation services such as, occupational therapy, physiotherapy, and speech therapy. The delivery of mental health services remotely may be referred to as teletherapy, telemental health, telepsychiatry, and telepsychology. Telerehabilitation has become a necessity over the course of the pandemic due to safety concerns with COVID-19 transmission. The primary aim of this systematic review protocol is to evaluate the literature on the effect of telerehabilitation on patient outcomes and propose directives for future research based on the evidence reviewed.

Methods

A systematic review and meta-analysis will be conducted to examine the literature on the effect of telerehabilitation on patient outcomes following the Preferred Reporting Items of Systematic Reviews and Meta-Analyses (PRISMA) guidelines (PRISMA, 2015). The systematic review will use the following databases to examine the literature on telerehabilitation and patient outcomes: APA PsychINFO, Embase (Ovid), MEDLINE (Ovid), CINAHL, and Scopus.

Discussion

The utilization of telerehabilitation and similar telehealth treatments has increased throughout the COVID-19 pandemic. However, much is still unclear regarding the effectiveness of these methods in the delivery and service of healthcare, and their effect on health outcomes. This review will identify and address the knowledge gaps in the literature, which will provide further directions for future research.

Trial registration

This systematic review has been registered with PROSPERO under registration number CRD42022297849.
Early prediction of MODS interventions in the intensive care unit using machine learning
Authors: Liu Chang , Yao Zhenjie , Liu Pengfei , Tu Yanhui , Chen Hu , Cheng Haibo , Xie Lixin , Xiao Kun
Published: May 2023

Background

Multiple organ dysfunction syndrome (MODS) is one of the leading causes of death in critically ill patients. MODS is the result of a dysregulated inflammatory response that can be triggered by various causes. Owing to the lack of an effective treatment for patients with MODS, early identification and intervention are the most effective strategies. Therefore, we have developed a variety of early warning models whose prediction results can be interpreted by Kernel SHapley Additive exPlanations (Kernel-SHAP) and reversed by diverse counterfactual explanations (DiCE). So we can predict the probability of MODS 12 h in advance, quantify the risk factors, and automatically recommend relevant interventions.

Methods

We used various machine learning algorithms to complete the early risk assessment of MODS, and used a stacked ensemble to improve the prediction performance. The kernel-SHAP algorithm was used to quantify the positive and minus factors corresponding to the individual prediction results, and finally, the DiCE method was used to automatically recommend interventions. We completed the model training and testing based on the MIMIC-III and MIMIC-IV databases, in which the sample features in the model training included the patients’ vital signs, laboratory test results, test reports, and data related to the use of ventilators.

Results

The customizable model called SuperLearner, which integrated multiple machine learning algorithms, had the highest authenticity of screening, and its Yordon index (YI), sensitivity, accuracy, and utility_score on the MIMIC-IV test set were 0.813, 0.884, 0.893, and 0.763, respectively, which were all maximum values of eleven models. The area under the curve of the deep–wide neural network (DWNN) model on the MIMIC-IV test set was 0.960, and the specificity was 0.935, which were both the maximum values of all these models. The Kernel-SHAP algorithm combined with SuperLearner was used to determine the minimum value of glasgow coma scale (GCS) in the current hour (OR = 0.609, 95% CI   0.606–0.612), maximum value of MODS score corresponding to GCS in the past 24 h (OR = 2.632, 95% CI 2.588–2.676), and maximum score of MODS corresponding to creatinine in the past 24 h (OR = 3.281, 95% CI   3.267–3.295) were generally the most influential factors.

Conclusion

The MODS early warning model based on machine learning algorithms has considerable application value, and the prediction efficiency of SuperLearner is superior to those of SubSuperLearner, DWNN, and other eight common machine learning models. Considering that the attribution analysis of Kernel-SHAP is a static analysis of the prediction results, we introduce the DiCE algorithm to automatically recommend counterfactuals to reverse the prediction results, which will be an important step towards the practical application of automatic MODS early intervention.
Fixation devices for anterior shoulder instability
Authors: Collins Lacee K. , Cole Matthew W. , Savoie Felix H. , Sherman William F. , O’Brien Michael J.
Published: May 2023

Purpose

Over the past 40 years, advances in the development of anchors and sutures have contributed to the improvement in surgical outcomes for treatment of shoulder instability. Important choices in surgery when treating instability include the use of knotless versus knotted suture anchors, and bony versus soft tissue reconstruction techniques.

Methods

A literature review was conducted to evaluate the history of instability of the shoulder and the results of specific fixation techniques including bony and soft tissue reconstructions as well as knotted and knotless suture anchors.

Results

As knotless suture anchors have continued to grow in popularity since their development in 2001, many studies have compared this newer technique to that of the standard knotted suture anchors. In general, these studies have demonstrated no difference in patient‐reported outcome measures between the two options. Additionally, the choice of bony versus soft tissue reconstructions is patient specific as it depends on the specific pathology or combination of injuries.

Conclusion

In each surgery performed for shoulder instability, it is vitally important that we try to restore normal anatomy. The normal anatomy is best established by knotted mattress sutures. However, loop laxity and tear through by the sutures in the capsule can eliminate this restoration, increasing risk of failure. Knotless anchors may allow better soft tissue fixation of the labrum and capsule to the glenoid, but without complete restoration of normal anatomy.
Hemodiafiltration in Japan: current status and future directions
Authors: Naganuma Toshihide , Takemoto Yoshiaki , Kamada Naohiro , Kawanishi Hideki
Published: May 2023

Hemodiafiltration (HDF) therapy has become standard treatment in Japan and Europe, but evidence from Europe is not directly applicable to HDF in Japan because HDF therapy differs greatly in the two regions. Japanese dialysis membranes vary widely, including use of protein-leaking and non-leaking membranes, and the molecular weight of solutes that can be removed is generally larger in Japan than in Europe. Given the characteristics of pre-dilution, the volume of replacement fluid itself cannot be used as a marker for solute removal, and the relationship of this volume to life prognosis is still unknown. Under these circumstances, the JAMREDS, a multicenter study led by the Japanese Society for Hemodiafiltration, was started in April 2020. The goal of the study is to determine whether α1-microglobulin reduction rate can be used as a marker for the prognosis of hemodialysis patients, including life prognosis and cardiovascular event onset. The JAMREDS is being performed from a new perspective of solute removal by HDF. This research design is reasonable and highly original for HDF in Japan, in view of the wide variety of membrane types and treatment modes, and the results of the study will be of particular interest.
Reducing contrast agent residuals in hospital wastewater: the GREENWATER study protocol
Authors: Zanardo Moreno , Cozzi Andrea , Cardani Rosanna , Renna Laura Valentina , Pomati Francesco , Asmundo Luigi , Di Leo Giovanni , Sardanelli Francesco
Published: May 2023

The potential enviromental impact of iodinated (ICAs) and gadolinium-based contrast agents (GBCAs) have recently come under scrutiny, considering the current nonselective wastewater treatment. However, their rapid excretion after intravenous administration could allow their potential recovery by targeting hospital sewage. The GREENWATER study aims to appraise the effective quantities of ICAs and GBCAs retrievable from patients’ urine collected after computed tomography (CT) and magnetic resonance imaging (MRI) exams, selecting ICA/GBCA per-patient urinary excretion and patients’ acceptance rate as study endpoints. Within a prospective, observational, single-centre, 1-year framework, we will enrol outpatients aged ≥ 18 years, scheduled to perform contrast-enhanced CT or MRI, willing to collect post-examination urine in dedicated canisters by prolonging their hospital stay to 1 h after injection. Collected urine will be processed and partially stored in the institutional biobank. Patient-based analysis will be performed for the first 100 CT and 100 MRI patients, and then, all analyses will be conducted on the pooled urinary sample. Quantification of urinary iodine and gadolinium will be performed with spectroscopy after oxidative digestion. The evaluation of the acceptance rate will assess the “environmental awareness” of patients and will aid to model how procedures to reduce ICA/GBCA enviromental impact could be adapted in different settings.

Key points

• Enviromental impact of iodinated and gadolinium-based contrast agents represents a growing point of attention.

• Current wastewater treatment is unable to retrieve and recycle contrast agents.

• Prolonging hospital stay may allow contrast agents retrieval from patients’ urine.

• The GREENWATER study will assess the effectively retrievable contrast agents’ quantities.

• The enrolment acceptance rate will allow to evaluate patients’ “green sensitivity”.
Stingless bee propolis: composition, biological activities and its applications in the food industry
Authors: Rocha Vítor Moreira , Portela Ricardo Dias , dos Anjos Jeancarlo Pereira , de Souza Carolina Oliveira , Umsza-Guez Marcelo Andrés
Published: May 2023

The breeding of stingless bees, known as meliponiculture, can be found throughout the world, and is closely linked to the history of the first human communities in the Americas. This activity provides products of industrial interest (food, cosmetics, pharmaceuticals), and among them propolis stands out. This matrix is a resinous material but being difficult to classify and conceptualize due to its variability according to the environment and producing species. The propolis produced by these bees is a source of compounds with nutritional and functional potential, but the main interest is focused on the phenolic compounds. This potential makes propolis a product that can be used in the prospection of new molecules with antimicrobial and antioxidant activity. Thus, the scientific literature describes propolis activity (generally extracts) against bacteria and fungi, but with a higher microbicidal activity against gram-positive bacteria. The high antioxidant activity of this bee product is a consequence of the presence of several phenolic compounds. The use of propolis from SBP (Stingless bee propolis) is still quite limited, generally restricted to its antioxidant potential, but studies with application in other sectors can benefit this productive sector, as with the propolis produced by the bee Apis mellifera. This work presents and discusses the composition of stingless bee propolis and its consequent biological activities, as well as its potential applications in the food industry.

Graphical Abstract
Nitrogen uptake and remobilization from pre- and post-anthesis stages contribute towards grain yield and grain protein concentration in wheat grown in limited nitrogen conditions
Authors: Sharma Sandeep , Kumar Tarun , Foulkes M. John , Orford Simon , Singh Anju Mahendru , Wingen Luzie U. , Karnam Venkatesh , Nair Lekshmy S. , Mandal Pranab Kumar , Griffiths Simon , Hawkesford Malcolm J. , Shewry Peter R. , Bentley Alison R. , Pandey Renu
Published: May 2023

Background

In wheat, nitrogen (N) remobilization from vegetative tissues to developing grains largely depends on genetic and environmental factors. The evaluation of genetic potential of crops under limited resource inputs such as limited N supply would provide an opportunity to identify N-efficient lines with improved N utilisation efficiency and yield potential. We assessed the genetic variation in wheat recombinant inbred lines (RILs) for uptake, partitioning, and remobilization of N towards grain, its association with grain protein concentration (GPC) and grain yield.

Methods

We used the nested association mapping (NAM) population (195 lines) derived by crossing Paragon (P) with CIMMYT core germplasm (P × Cim), Baj (P × Baj), Watkins (P × Wat), and Wyalkatchem (P × Wya). These lines were evaluated in the field for two seasons under limited N supply. The plant sampling was done at anthesis and physiological maturity stages. Various physiological traits were recorded and total N uptake and other N related indices were calculated. The grain protein deviation (GPD) was calculated from the regression of grain yield on GPC. These lines were grouped into different clusters by hierarchical cluster analysis based on grain yield and N-remobilization efficiency (NRE).

Results

The genetic variation in accumulation of biomass at both pre- and post-anthesis stages were correlated with grain-yield. The NRE significantly correlated with aboveground N uptake at anthesis (AGNa) and grain yield but negatively associated with AGN at post-anthesis (AGNpa) suggesting higher N uptake till anthesis favours high N remobilization during grain filling. Hierarchical cluster analysis of these RILs based on NRE and yield resulted in four clusters, efficient (31), moderately efficient (59), moderately inefficient (58), and inefficient (47). In the N-efficient lines, AGNa contributed to 77% of total N accumulated in grains, while it was 63% in N-inefficient lines. Several N-efficient lines also exhibited positive grain protein deviation (GPD), combining high grain yield and GPC. Among crosses, the P × Cim were superior and N-efficient, while P × Wya responded poorly to low N input.

Conclusions

We propose that traits favouring pre- or post-anthesis biomass accumulation and pre-anthesis N uptake may be targeted for breeding to improve grain-yield under limited N. The lines with positive GPD, a first report of genotype-dependent GPD associated with both AGNpa and AGNa in wheat, may be used as varieties or genetic resources to improve grain yield with high GPC for sustainable development under limited N conditions.
Treatment options and their uptake among women with symptoms of perinatal depression: exploratory study in Norway and Portugal
Authors: Fonseca Ana , Branquinho Mariana , Monteiro Fabiana , Araújo-Pedrosa Anabela , Bjørndal Ludvig D. , Lupattelli Angela
Published: May 2023

Background

Perinatal depression is the most undertreated clinical condition during the perinatal period. Knowledge about women's decision-making in seeking and receiving treatment is scarce.

Aims

To investigate and compare treatment option uptake in perinatal women with depressive symptoms in Portugal and Norway, and to identify sociodemographic and health-related factors associated with treatment uptake.

Method

Participants were women resident in Portugal or Norway (≥18 years) who were pregnant or had given birth in the past 12 months, who presented with active depressive symptoms (Edinburgh Postnatal Depression Scale score ≥10). In an electronic questionnaire, women reported treatment received and sociodemographic and health-related factors.

Results

The sample included 416 women from Portugal and 169 from Norway, of which 79.8% and 53.9%, respectively, were not receiving any treatment. Most Portuguese women were receiving psychological treatment, either alone (45.2%) or combined with pharmacological treatment (21.4%). Most Norwegian participants were receiving only pharmacological (36.5%) or combined treatment (35.4%). Compared with the Portuguese sample, a higher proportion of Norwegian women started treatment before pregnancy (P < 0.001). In Portugal, lower depressive symptoms and self-reported psychopathology were significantly associated with higher likelihood of receiving treatment.

Conclusions

We found that, in both Norway and Portugal, a substantial number of perinatal women with depressive symptoms do not receive any treatment. Differences exist regarding the chosen treatment option and timing of treatment initiation in the two countries. Only mental health-related factors were associated with treatment uptake for perinatal depression in Portugal. Our results highlight the importance of implementing strategies aimed to improve help-seeking behaviours.
Factors Influencing the Experience of Breast and Cervical Cancer Screening Among Women in Low- and Middle-Income Countries: A Systematic Review
Authors: Akoto Edem J. , Allsop Matthew J.
Published: May 2023

PURPOSE

The persistent high morbidity and mortality from breast and cervical cancer in low- and middle-income countries (LMICs) may be influenced by global disparities in the uptake of screening services. This review sought to synthesize existing evidence to determine factors that influence the experience of women relating to breast and cervical screening in LMICs.

METHODS

A qualitative systematic review of the literature identified through Global Health, Embase, PsycInfo, and MEDLINE. Eligible studies included those outlining primary qualitative research or mixed-method studies with reporting of qualitative findings, detailing women's experiences of involvement with programs for breast or cervical cancer screening. Framework synthesis was used to explore and organize findings from primary qualitative studies and the Critical Appraisal Skills Programme checklist used for quality assessment.

RESULTS

Database searches yielded 7,264 studies for title and abstract screening and 90 full-text articles for screening, with qualitative data from 17 studies and a total of 722 participants included in this review. Four stages influencing experiences of women were generated across both breast and cervical cancer screening approaches, with individual (eg, knowledge of cancer), social (eg, religion, cultural beliefs), and health system (eg, accessibility) factors identified that influence women's initial and subsequent engagement.

CONCLUSION

This study synthesizes existing evidence of factors that influence engagement with breast and cervical cancer screening in LMICs. Evidence-informed recommendations are proposed that may improve the experience of cancer screening in LMICs, with further research necessary to explore their operationalization and impact on cancer care delivery.
Glucagon-Like Peptide-1 Is Involved in the Thermic Effects of Dietary Proteins in Male Rodents
Authors: Ochiai Keita , Muto Asuka , Seok Bong Soo , Doi Yuta , Iwasaki Yusaku , Okamatsu-Ogura Yuko , Drucker Daniel J , Hira Tohru
Published: May 2023

Protein intake potently increases body temperature and energy expenditure, but the underlying mechanism thereof remains incompletely understood. Simultaneously, protein intake potently stimulates glucagon-like peptide-1 (GLP-1) secretion. Here, we examined the involvement of GLP-1 in the thermic effects of dietary proteins in rodents by measuring rectal temperature and energy expenditure and modulating GLP-1 signaling. Rectal temperature of rats or mice fasted for 4 or 5 hours were measured using a thermocouple thermometer before and after an oral administration of nutrients. Oxygen consumption after oral protein administration was also measured in rats. Rectal temperature measurements in rats confirmed an increase in core body temperature after refeeding, and the thermic effect of the oral administration of protein was greater than that of a representative carbohydrate or lipid. Among the five dietary proteins examined (casein, whey, rice, egg, and soy), soy protein had the highest thermic effect. The thermic effect of soy protein was also demonstrated by increased oxygen consumption. Studies using a nonselective β-adrenergic receptor antagonist and thermal camera suggested that brown adipose tissue did not contribute to soy protein–induced increase in rectal temperature. Furthermore, the thermic effect of soy protein was completely abolished by antagonism and knockout of the GLP-1 receptor, yet potentiated via augmentation of intact GLP-1 levels through inhibition of dipeptidyl peptidase-4 activity. These results indicate that GLP-1 signaling is essential for the thermic effects of dietary proteins in rats and mice, and extend the metabolic actions of GLP-1 ensuing from nutrient ingestion to encompass the thermic response to ingested protein.
The Prices in the Crises: What We Are Learning from 20 Years of Health Insurance in Low- and Middle-Income Countries
Authors: Das Jishnu , Do Quy-Toan
Published: May 2023

Governments in many low- and middle-income countries are developing health insurance products as a complement to tax-funded, subsidized provision of healthcare through publicly-operated facilities. We discuss two rationales for this transition. First, health insurance would boost fiscal revenues for healthcare, as post-treatment out-of-pocket payments to providers would be replaced by pre-treatment insurance premia to health ministries. Second, increased patient choice and carefully designed physician reimbursements would increase quality in the healthcare sector. Our essay shows that, at best, these objectives have only been partially met. Despite evidence that health insurance has provided financial protection, consumers are not willing to pay for unsubsidized premia. Health outcomes have not improved despite an increase in utilization. We argue that this is not because there was no room to improve the quality of care but because behavioral responses among healthcare providers have systematically undermined the objectives of these insurance schemes.
Achieving Universal Health Insurance Coverage in the United States: Addressing Market Failures or Providing a Social Floor?
Authors: Baicker Katherine , Chandra Amitabh , Shepard Mark
Published: May 2023

The United States spends substantially more on health care than most developed countries, yet leaves a greater share of the population uninsured. We argue that incremental insurance expansions focused on addressing market failures will propagate inefficiencies and will fail to facilitate the active policy decisions needed to achieve socially optimal coverage. By instead defining a basic bundle of services that is publicly financed for all, while allowing individuals to purchase additional coverage, policymakers could both expand coverage and maintain incentives for innovation, ensuring universal access to innovative care in an affordable system.
Arrangement of Practice-Oriented Learning at the Department of Engineering Graphics RTU MIREA
Authors: Vyshnyepolskiy Vladimir , Boykov A. , Efremov A. , Kadykova Nina
Published: May 2023

The article discusses the organization of practice-oriented learning at the Department of Engineering Graphics of the RTU MIREA, the essence of which is the development of not only design documentation, but also the production of a prototype device for which design documentation has been made. Geoinformatics students create 3D models of terrain objects: buildings, terrain and vegetation based on photo and video data from drones. The course project serves as the basis for a deeper study of geometric and graphic disciplines in the form of competitive works, scientific reports and publications, or can serve as the basis for the final qualification work. As part of the course work, students of the Institute of Radio Electronics and Informatics perform a multi-level study of an electronic device - a sensor using "smart home" technology. Not only a significant amount of design documentation is developed with the help of circuitry and design CAD: diagrams, printed circuit boards with tracing, assembly drawings, specifications and other text documents, but also a working prototype of the sensor is made. As part of the course work, chemists-technologists design a workshop for large- and medium-tonnage chemical production and develop a complete set of design documentation for one of the main apparatuses of this workshop. Based on the created 3D models, students print a model of the apparatus on a 3D printer. As part of the "Fundamentals of Design" course, some students develop design documentation and make one of the two printed circuit boards of a dog robot based on it. Another part of the students creates 3D models of robot parts and prints them on a 3D printer. Both groups jointly assemble and program a robot dog.
A conference invite from the British Association of Neuroscience Nurses and the European Association of Neuroscience Nurses
Authors: Braine Mary
Published: May 2023

With 2023 flying by, both the European Association of Neuroscience Nurses (EANN) and the British Association of Neuroscience Nurses (BANN) are fast approaching their annual conferences. Mary Braine, President of BANN and committee member of EANN, provides more detail on what can be discovered at the two conferences this year.
Effects of physical fitness training on the mental and physical health of stroke survivors
Authors: Benedetto Valerio , Christian Danielle Louise , McLoughlin Alison Sarah Rachel , Smith Eleanor , Miller Colette , Hill James Edward , Lightbody Catherine Elizabeth , Watkins Caroline Leigh
Published: May 2023

After a stroke, physical activity can be key in enhancing the rehabilitation of patients and preventing a secondary stroke. In this commentary, the authors critically appraise a systematic review that investigated how different types of physical fitness training impact on the mental and physical conditions of stroke survivors. Cardiorespiratory, resistance and mixed training (especially when including walking) can improve key outcomes, such as the balance and mobility of stroke survivors, but the most suitable type of training depends on the individual needs and aims of the rehabilitation process. More research is needed to understand how the effects of the different types of training vary by considering the time between stroke and intervention onset, stroke severity, and the dose of intervention.
Impact of the built environment on stroke inpatient rehabilitation
Authors: Harris Catherine , Gibbon Bernard , Hill James Edward
Published: May 2023

Guidance recommends that people with disability following a stroke should receive rehabilitation in a dedicated stroke inpatient unit. Previous research has indicated that aspects of the built environment of the inpatient setting can impact on patient wellbeing and experience. This article evaluates and discusses the findings of a systematic review that explored the effect of environmental and design factors on stroke rehabilitation.
In their element
Authors: Mountain Julie
Published: May 2023

What do settings with good outdoor spaces have in common? In this series, Julie Mountain visits past champions of the Nursery World Awards
physical development on a budget: On the couch
Authors: Manners Lala
Published: May 2023

We don't associate sofas with exercise, but their size, shape, weight and softness mean there are many creative options for supporting movement, finds Dr Lala Manners
Love Food: Partnership Content
Authors: Weber Rupert
Published: May 2023

Rupert Weber, general manager at apetito, talks about the importance of young children enjoying their food when it comes to nursery mealtimes.
Off the mark?
Authors: Rawstrone Annette
Published: May 2023

With inspections back in full swing post-pandemic, some early years settings are voicing serious concerns about the process and are calling for change. By Annette Rawstrone
Potassium adsorption on substrates formulated with vermiculite and peat
Authors: Leal Bruno de Paula , Thebaldi Michael Silveira , Silva Yasmin Fernandes , Pinto Pâmela Rafanele França , Martins Ivani Pose , Sales Ronan Souza
Published: May 2023

The substrates composition can take place from different raw materials, being an influencer of the water and nutrient retention capacity, an important dynamic in the management of the cultivation in containers due to the possibility of nutrient leaching. It was aimed to quantify the Potassium adsorption to substrates with different proportions of vermiculite and peat, in addition to determining adsorption isotherms which would best fit the observed adsorption data, for contact periods of one and seven days. We carried out batch adsorption essays, using as an adsorbent media substrate prepared with different proportion of vermiculate and peat, and as adsorbate, solutions with concentrations of 0, 25, 50, 75 and 100 mg/L of K. The substrate that showed the highest adsorption capacity, then less leaching potential, was the one constituted with the largest amount of peat. The Freündlich’s isotherm best represents the K adsorption phenomenon in all the studied treatments.
Structural identification of novel pyrimidine derivatives as epidermal growth factor receptor inhibitors using 3D QSAR, molecular docking, and MMGBSA analysis: a rational approach in anticancer drug design
Authors: Jana Pradip , Agarwal Shivangi , Kashaw Varsha , Das Ratnesh , Dixit Anshuman , Kashaw Sushil Kumar
Published: May 2023

Non-small cell lung cancer (NSCLC) has evolved into the deadliest in the present scenario. The progression of NSCLC is mainly due to the dysregulation of the tyrosine kinase family's epidermal growth factor receptor (EGFR). Thus, EGFR has been widely studied as a major target in the treatment of NSCLC, but the lack of selectivity and drug resistance limit the use of existing therapeutic agents. Considering the urgent necessity for the advanced development of EGFR inhibitors, we have implemented a three-dimensional structure-activity relationship (3D QSAR), molecular docking, and MMGBSA studies on a series of pyrimidine derivatives. In the 3D QSAR, the comparative molecular field analysis model (CoMFA) was obtained with a correlation coefficient (r2) = 0.698, cross-validated correlation coefficient (q2) = 0.541, and predictive r2 (r2pred) = 0.509. The comparative molecular similarity indices analysis (CoMSIA) model also displayed similar results with r2 = 0.72, q2 = 0.586, and r2pred= 0.495. The statistical parameters fulfill the acceptability criteria of the models. Docking studies revealed the binding interactions of the pyrimidine derivatives with double mutant EGFRL858R/T790M. Docking scores of the top two selected compounds 29 and 34 were 92.99 and 92.13, respectively. Analyzing 3D QSAR contour plots and docking results reviewed some important structural attributes of EGFR L858R/T790M selective inhibitors, which directed the designing of some new molecules. The designed compounds showed good predictive activity and exhibited higher binding interactions with EGFRL858R/T790M than the reference ligand gefitinib. Moreover, to evaluate the binding of selected top hits from docking and designed compounds, MMGBSA (Molecular Mechanics-Generalized Born Surface Area) analysis was performed, which revealed that the designed compound (N7) showed a good binding affinity with EGFRL858R/T790M (dG = -68.59 kcal/mol) as compared to other compounds. Further, in silico ADME predictions revealed the drug-likeness of the designed compounds. Thus, this work will guide researchers in future developments of pyrimidine derivatives as EGFR inhibitors.
Redefining safety: a narrative review of literature on the underground and open or ‘Dutch’ models of refuge
Authors: Allen Katherine , Adisa Olumide , Hermolle Megan
Published: May 2023

This article synthesises literature on the evolution of domestic abuse (DA) refuges, with particular attention to the development of two models: the conventional or ‘underground’ refuge (UR) and the open or ‘Dutch’ refuge. The article will detail what the available evidence says about the benefits and drawbacks of these models and explore their implications for the DA sector in England, with reference to extending women’s space for action and meeting the needs of underserved victim-survivors.

The article argues that multiple models of provision are needed to meet the intersecting, complex and at times competing needs of different victim-survivors, and that available evidence provides preliminary support for the viability of the open model as part of a wider suite of responses to DA. Further research is needed to extend the evidence base on the open model, and to develop a whole system approach which can meet the needs of a wider range of victim-survivors.
Experimental development of a gated UV-induced spectroscopic lidar for the daytime study of plant ecology and photosynthesis: multi-modal measurement of fluorescence of trees growing in a field and Mie–Raman–fluorescence of the surrounding atmosphere
Authors: Saito Yasunori , Doi Akira
Published: May 2023

A gated UV-induced spectroscopic lidar operational during daylight was developed to better understand the plant growth status in real time and the influence from the surrounding atmosphere chemical environment. Initial indoor experiments and short-range (100 m) field measurements were very positive. The lidar worked as a vegetation fluorescence lidar, as well as an atmospheric Mie–Raman–fluorescence lidar. A UV (355 nm) laser was effective to induce fluorescence and Raman scattering, and a synchronous detection technique made it possible to detect weak signals, even in daytime. Tree spectra containing chlorophyll fluorescence of tree leaves offered information about the growth status of trees. Atmospheric spectra containing aerosol Mie scattering, N2, O2, H2O Raman scattering, and pollutant fluorescence helped us to learn about atmospheric circumstances surrounding trees. The multi-modal information is useful for comprehensive understanding of plant ecology.
Plastic side flow and elastic recovery influences on optical diffraction effect of diamond turning: theoretical simulation and experimental verification
Authors: Zhuang Guilin , Liu Hanzhong , Zong Wenjun
Published: May 2023

Spherical/aspherical mirrors are widely used in optical systems and
imaging systems, but their reflectivity is affected by the surface
roughness. In this study, the effects of plastic side flow and elastic
recovery on the diffraction phenomenon and reflectivity are analyzed
systematically. The energy ratio of an ultra-precision turning surface
is calculated by rigorous coupled-wave method, the influence of
aberration on diffraction efficiency is considered in combination with
the specific structural parameters of spherical/aspherical surface,
and the appropriate measuring beam diameter is selected. Through
predicted results and experimental observations, it can be found that
with the increase of plastic side flow height, the energy ratio of
zero-order diffracted light reduces, the brightness weakens, and the
diffraction light spots become more obvious. This is because large
plastic side flow height leads to more complex three-dimensional
surface topography and great roughness P-V value. The influence of
elastic recovery on the reflectivity is different from that of plastic
side flow. As the elastic recovery increases, the roughness P-V value
lessens. As a result, the energy ratio of zero-order diffracted light
enlarges, and the brightness strengthens. This paper provides a
theoretical basis for machining of spherical/aspheric mirrors with
high reflectivity.
Underwater image quality assessment
Authors: Yang Xieliu , Li Jianping , Liang Wenfeng , Wang Dan , Zhao Jinbao , Xia Xiaohua
Published: May 2023

To obtain high-visual-quality underwater images by image post-processing, many underwater image restoration and enhancement methods have been proposed. Underwater image quality assessment (UIQA) methods have been developed to compare these restoration and enhancement methods. This paper comprehensively summarizes the subjective and objective UIQA methods, metrics, and datasets. Experiments are conducted on two underwater image datasets to analyze the performance of several typical UIQA metrics. Suggestions for further research directions are put forward as well.
Surface magneto-optics in yttrium iron garnets
Authors: Dash Sushree S. , Levy Miguel
Published: May 2023

We report a study of surface reconstruction effects in yttrium iron garnets using density functional theory. This work responds to the need to explain the physical basis of recent experimental results showing a significant enhancement in Faraday rotation in iron garnets. These materials are extensively used in the telecom industry for nonreciprocal device applications. Understanding the physical basis of the heightened Faraday response at the surface is important for the development of ultrathin nonreciprocal devices. Our results show that the bandgap near the surface is significantly reduced compared to that of the bulk, and that spin-orbit coupling effects become more important near the surface. We find that the decrease in band gap results in an enhancement and change in direction in the Faraday rotation in the visible range all the way to the deep red. Electronic transition matrix elements for surface-sensitive ultra-thin layers are calculated and compared to those of bulk samples, leading to the conclusion that the octahedrally-oxygen-coordinated iron sublattice in these ferrimagnetic materials is more strongly affected by surface reconstruction than the other, anti-ferromagnetically coupled, tetrahedral sublattice. We explain how these changes contribute to the enhancement in magneto-optic response near the surface as compared to the bulk.
A new non-invasive method for assessment of inflammation
Authors: Fine Ilya , Kaminsky Ilya , Shenkman Ilya , Agbaria Muhamad
Published: May 2023

This article examines the potential for non-invasive measurement of elevated levels of erythrocyte aggregation in vivo, which are linked to a higher risk of inflammatory processes. The study proposes the use of a dynamic light scattering approach to measure aggregability. The mDLS sensor modules consist of VICEL and two photodiodes, and two of these modules are placed on an inflatable transparent cuff. The cuff is then fitted to the subject's finger root, with one sensor module placed on each side of the root. Blood flow is temporarily halted for one minute using over-systolic inflation of the cuff, and signals from both sensors are recorded. Three groups of subjects were studied: a control group of 65 individuals, a group of 29 hospitalized COVID-19 patients, and a group of 34 hospitalized patients with inflammatory diseases. The experimental results demonstrated significant differences in signal kinetic behavior between the control group and the other two groups. These differences were attributed to the rate of RBC aggregation, which is associated with inflammation. The study underscores the potential for non-invasive diagnostic tools to assess inflammatory processes by analyzing RBC aggregation.