bluuebunny/crossref_metadata_2025 huggingface dataset:
Pilot study of a real-time early agitation capture technology (REACT) for children with intellectual and developmental disabilities
Authors: Khan Nibraas , Plunk Abigale , Zheng Zhaobo , Adiani Deeksha , Staubitz John , Weitlauf Amy , Sarkar Nilanjan
Published: October 2024

Objective

Children and adolescents with intellectual and developmental disabilities (IDD), particularly those with autism spectrum disorder, are at increased risk of challenging behaviors such as self-injury, aggression, elopement, and property destruction. To mitigate these challenges, it is crucial to focus on early signs of distress that may lead to these behaviors. These early signs might not be visible to the human eye but could be detected by predictive machine learning (ML) models that utilizes real-time sensing. Current behavioral assessment practices lack such proactive predictive models. This study developed and pilot-tested real-time early agitation capture technology (REACT), a real-time multimodal ML model to detect early signs of distress, termed “agitations.” Integrating multimodal sensing, ML, and human expertise could make behavioral assessments for people with IDD safer and more efficient.

Methods

We leveraged wearable technology to collect behavioral and physiological data from three children with IDD aged 6 to 9 years. The effectiveness of the REACT system was measured using F1 score, assessing its usefulness at the time of agitation to 20s prior.

Results

The REACT system was able to detect agitations with an average F1 score of 78.69% at the time of agitation and 68.20% 20s prior.

Conclusion

The findings support the use of the REACT model for real-time, proactive detection of agitations in children with IDD. This approach not only improves the accuracy of detecting distress signals that are imperceptible to the human eye but also increases the window for timely intervention before behavioral escalation, thereby enhancing safety, well-being, and inclusion for this vulnerable population. We believe that such technological support system will enhance user autonomy, self-advocacy, and self-determination.
TUMamba: A novel tongue segment methods based on Mamba and U-Net
Authors: Jiang Fan , Zhong Yanmei , Yang Simin
Published: October 2024

Background and Objective

Current tongue segmentation methods often struggle with extracting global features and performing selective filtering, particularly in complex environments where background objects resemble the tongue. These challenges significantly reduce segmentation efficiency. To address these issues, this article proposes a novel model for tongue segmentation in complex environments, combining Mamba and U-Net. By leveraging Mamba’s global feature selection capabilities, this model assists U-Net in accurately excluding tongue-like objects from the background, thereby enhancing segmentation accuracy and efficiency.

Methods

To improved the segmentation accuracy of the U-Net backbone model, we incorporated the Mamba attention module along with a multi-stage feature fusion module. The Mamba attention module serially connects spatial and channel attention mechanisms at the U-Net ’s skip connections, selectively filtering the feature maps passed into the deep network. Additionally, the multi-stage feature fusion module integrates feature maps from different stages, further improving segmentation performance.

Results

Compared with state-of-the-art semantic segmentation and tongue segmentation models, our model improved the mean intersection over union by 1.17%. Ablation experiments further demonstrated that each module proposed in this study contributes to enhancing the model’s segmentation efficiency.

Conclusion

This study constructs a Tongue segmentation model based on U-Net and Mamba (TUMamba). The model effectively extracted global spatial and channel features using the Mamba attention module, captured local detail features through U-Net, and enhanced image features via multi-stage feature fusion. The results demonstrate that the model performs exceptionally well in tongue segmentation tasks, proving its value in handling complex environments.
Defining the growth paths of strategic scientists based on case studies
Authors: Wuyunqiqige  , Yuan Jiangyang
Published: October 2024

In this paper, 18 scientists from China and other countries were selected for consideration as case studies of ‘strategic scientists’. They were chosen according to their involvement in science and technology policy decision-making, development of key and advantageous fields, creation of new disciplines, construction of academic traditions, and intersections between science and industry. On this basis, we found that the growth paths of strategic scientists can be divided into three phases: as talented young scientists, as gatekeepers in related disciplines or research fields, and as consultants for national science and technology decision-making. Based on this trichotomy, we explored the characteristics of strategic scientists and the conditions required for their growth in each phase. Finally, policy suggestions are proposed for the cultivation and use of strategic scientists.
School Climate and Student Mental Health: Conceptions and Experiences of Nonbinary Students
Authors: Ellington Breanna , Westcott Jordan , Grimes Tameka , Kniola David , Lawson Gerard
Published: October 2024

Anti-transgender school policies have proliferated in the United States from 2019 to 2024, impacting school climate for transgender and nonbinary learners. In this quantitative study, we examined differences in the experiences of school climate factors (e.g., safety, mattering, mental health outcomes, etc.) between male, female, and nonbinary high school students in Virginia ( N = 219,233) using a gender minority stress framework. Nonbinary students reported greater exposure to distal and proximal minority stressors and worse mental health outcomes than male or female students. We explore implications for school counselors.
Growing Digital Divide for Expatriates Population in China: A User Perspective Analysis During the COVID-19 Pandemic
Authors: Cheshmehzangi Ali , Zou Tong , Su Zhaohui , Dawodu Ayotunde , Ardakani Saeid Pourroostaei , Sedrez Maycon , Tang Tian
Published: October 2024

The COVID-19 pandemic has influenced many movements of rapid digitization in several sectors/areas used by the public. The three primary sectors/areas affected by such digitization process are identified as healthcare, transportation, and public domain registration. There are only a few studies investigating the impacts of the COVID-19 pandemic on the digital divide for the expatriate population. To fill this research gap, this study investigates these three primary sectors/areas while highlighting the growing digital divide in the expatriate population, using Chinese cities as case studies. The study finds that the emerging barrier is beyond language barriers related to digital access and utilization issues. The study finds that the ongoing digital inequality is related to the autonomy of use, suggesting the urgency for technological upgrades, inclusive digital platforms, and reversing digital design marginalization. This study is sample-based research, using limited samples of expatriate populations in nine major cities in three primary economic clusters in China. The user perspective is assessed against five digital inequalities, namely “technical means,” “autonomy of use,” “social support networks,” “experience,” and “skills.” The analysis is followed by further research on digital divide barriers, addressing how the newly installed digital devices/facilities/services affect the expatriate population beyond the traditional language barriers. The analysis evaluates challenges based on four DDB pillars (i.e., availability, access, renovation, and utilization) and language barrier. The findings show the high correlation between the autonomy of use and digital utilization has led to further disparities and disconnection of the expatriate population from the smart city movements, such as digitized healthcare, transportation, and public domain registration. This study contributes to digital divide research, enhancing awareness of such research related to technological/digital changes and the expatriate populations.
Comparison of Hounsfield Unit, Vertebral Bone Quality, and Dual-Energy X-Ray Absorptiometry T-Score for Predicting Cage Subsidence After Posterior Lumbar Interbody Fusion
Authors: Wang Yunsheng , Zhang Jiali , Tong Tong , Miao Dechao , Wang Feng , Wang Linfeng
Published: October 2024

Study design

Retrospective cohort study.

Objectives

To compare Hounsfield unit (HU), vertebral bone quality (VBQ), and dual-energy X-ray absorptiometry (DEXA) T-score in predicting cage subsidence (CS) after posterior lumbar interbody fusion.

Methods

We retrospectively reviewed patients undergoing PLIF and measured L4 HU and VBQ. Baseline characteristics between CS and non-CS groups were compared. Multiple logistic regression analysis was used to identify risk factors for CS. Receiver operating characteristic (ROC) curves were used to explore the predictive value of variables for CS. Subgroup analysis was conducted for patients with available DEXA results.

Results

Eighty-four patients were analyzed. The subsidence group was older, with lower L4 HU (92.6 (35.4) vs 130.8 (47.8), P < 0.001) and higher VBQ (3.30 (0.64) vs 2.99 (0.63), P = 0.041) compared to the non-CS group. Low L4 HU (OR 0.979, P = 0.022) was an independent risk factor for subsidence, while VBQ was not. ROC analysis indicated that L4 HU (AUC = 0.733, P < 0.001) exhibited superior predictive performance compared to VBQ (AUC = 0.643, P = 0.032). Subgroup analysis in patients with DEXA showed that the femoral neck T-score (AUC = 0.67, P = 0.037) could differentiate CS, with L4 HU exhibiting the highest predictive ability (AUC = 0.778, P < 0.001), both outperforming VBQ (AUC = 0.645, P = 0.075).

Conclusions

Among the three BMD parameters, only low L4 HU could be an independent risk factor for CS. Preoperative HU is mandatory in patients at risk for osteoporosis when undergoing spine surgery.
Single versus dual fixation of distal femur fractures: A retrospective cohort study at a level one trauma centre in New Zealand
Authors: Miller Robyn , Zhang John , Powell Andrew , Chuang Tim
Published: October 2024

Background

The study compares single versus combination fixation of distal femur fractures.

Method

We retrospectively reviewed patients over 60 between January 2016 and December 2022. Union rate, ambulatory status and complication rate were primary outcomes. Secondary outcomes included quality of reduction, operative time and rate of blood transfusion.

Results

A total of 92 patients received single fixation, and 22 patients received combination fixation. There was no difference in rate or time of fracture union. Patients with dual fixation were allowed to weight bear on discharge significantly more than single fixation patients (50% vs. 18.9%, p = 0.003). Intramedullary nail fixation, as a single method or combined with lateral plating, was associated with earlier weight bearing. Immediate post-operative weight bearing significantly increased the likelihood of discharging to home or rehabilitation versus discharging to a transitional care facility ( p < 0.00001). There was no difference in the rate of blood transfusion, complication or mortality. Medial translation of the distal articular block was significantly lower with dual fixation (1.2% vs. 3.4%, p = 0.021). Operation time was longer with combination fixation (183 min vs. 134 min p < 0.001).

Conclusion

Combination fixation allows earlier weight bearing, at the cost of longer operation time.
Pharmacist knowledge, attitude, and practice regarding pharmacy code of practice and ethics in Iraq
Authors: Ibrahim Albaroodi Khansaa A
Published: October 2024

Introduction:

The Iraqi pharmacy code of practice and ethics enables pharmacists to resolve conflicts between the code and patient demands and satisfy their needs. This study evaluates pharmacists’ knowledge, attitude, and practice toward the pharmacy code of practice and ethics.

Design and Methods:

This cross-sectional study was conducted in three different provenances (Baghdad, Al-Diwaniya, and Wasit) from October 1st to December 31st, 2022.

Results:

Among 202 Iraqi pharmacists, the mean age was (30.4 ± 6.8) years old, and about (59%) of the participants were aware of the Iraqi Code of Practice and Ethics; similar results were found regarding their practice. About two-thirds of the participants agreed that modifying the Iraqi Pharmacy Code of Practice and Ethics will enable pharmacists to resolve the conflict between the code and patient demands, satisfy their needs, and raise healthcare standards. More than two-thirds of the participants thought that they don’t need training courses to give vaccines for addiction, smoking cessation, obesity, or sleeping problems.

Conclusion:

According to the study, more than half of the Iraqi pharmacists exhibited good knowledge, attitude, and practice regarding the pharmacy code of practice and ethics. However, it is recommended that Iraqi pharmacists engage in comprehensive training programs covering different aspects of healthcare, such as vaccination and smoking cessation, to further improve their contribution to the healthcare system.
Patient-Identified Treatment Goals for Psoriatic Disease: Results From a US Patient Survey
Authors: Armstrong April , Levit Noah A. , Schneider Beth , Seiden Richard , Shi Linyu , Kaplan Blair , Wu Jashin J.
Published: October 2024

Background

Despite advancements in the treatment landscape for psoriasis (PsO) and psoriatic arthritis (PsA), some patients may not achieve the desired disease improvement due to undertreatment. Understanding patient perspectives on treatment expectations can inform patient-centered decisions and enhance treatment satisfaction.

Objective

To describe patient-identified treatment goals and expectations for managing psoriatic disease.

Methods

A cross-sectional study was conducted using a survey through MyPsoriasisTeam, an online social community. The survey was available to its US-based patients aged ≥21 years with self-reported diagnoses of PsO and/or PsA. The study assessed patients’ treatment goals, satisfaction with treatment outcomes, and satisfaction with health care providers (HCPs). Responses were summarized using descriptive statistics.

Results

This analysis included 386 patients (PsO, n = 130; PsA with/without PsO, n = 256). Treatment goals varied by psoriatic disease type. The top 3 treatment goals for PsO were reduce itching (73.1%), reduction in size/thickness (68.5%), and reduction in the number of plaques (63.1), and for PsA, were reducing joint pain (77.7%), lessening fatigue (64.8%), and reducing joint stiffness (62.1%). Patient satisfaction with treatment outcomes was low (extremely/very satisfied: PsO, 7.5%/8.5% and PsA, 9.2%/20.2%). Overall, 73.1% with PsO were treated by a dermatologist, and a dermatologist or rheumatologist treated 74.6% with PsA. Overall, patient satisfaction with HCPs who treated their disease was lacking (PsO, 19.3% and 19.3%; PsA, 27.3% and 33.6% were extremely and very satisfied, respectively).

Conclusion

These findings suggest the need for enhanced communication between patients and HCPs to align treatment goals and expectations and to improve treatment satisfaction and disease management.
Digital Health Tools and Behavioral Strategies to Increase Engagement With Diabetes Self-Management Education and Support: Design and Feasibility of DM-BOOST
Authors: Amante Daniel J. , Shenette Lisa , Wainaina Stacey , Balakrishnan Kavitha , Bhatia Shina , Lee Jung Ae , Lemon Stephenie C. , McManus David , Harlan David M. , Malkani Samir , Gerber Ben S.
Published: October 2024

Purpose

The purpose of the study was to describe the development and feasibility of implementing the DM-BOOST program in support of an established diabetes self-management education and support (DSMES) program.

Methods

A patient panel of 4 adults with type 2 diabetes (T2DM) codesigned DM-BOOST. DM-BOOST is a patient-focused program that includes peer-written text messages about diabetes self-management behaviors and digital health training to improve patient portal use and initiate goal setting prior to a scheduled DSMES appointment. Adults with T2DM and A1C ≥8.0% participated in a 6-month feasibility pilot. Participants were randomly assigned (1:1) to receive either DM-BOOST or usual care. Outcomes included DSMES engagement (scheduled and attended DSMES appointments) and changes in diabetes self-efficacy and treatment satisfaction.

Results

Pilot participants (n = 60) were 60.0% female with mean age 45.5 years (SD 8.3) and A1C 10.1% (SD 1.8%). All DM-BOOST participants (30/30, 100%) had DSMES appointments scheduled compared to 86.7% of usual care (26/30). DM-BOOST participants had fewer DSMES appointment no-shows/cancellations (3/30, 10%) compared to usual care (10/26, 35%). There was greater improvement in diabetes self-efficacy in the DM-BOOST group compared to usual care and no difference in treatment satisfaction.

Conclusions

DM-BOOST, leveraging peer-written text messaging and digital health training, increased DSMES engagement. Implementation of DM-BOOST was determined to be feasible, with several system-level barriers identified, including obtaining provider referrals and scheduling appointments. An effectiveness trial of DM-BOOST is needed to evaluate the impact on clinical outcomes.
Deep brain stimulation of the motor thalamus relieves experimentally induced air hunger
Authors: Chapman Tom P. , Divanbeighi Zand Amir P. , Debrah Emmanuel , Petric Beth , Farrell Sarah M. , FitzGerald James J. , Moosavi Shakeeb H. , Green Alexander L.
Published: October 2024

Research question

We previously reported that deep brain stimulation (DBS) of the motor thalamus, in a patient with post-stroke tremor, relieved breathlessness associated with COPD. This raised the question of whether motor thalamus DBS mitigates the ascending dyspnoea signal. We therefore sought to conduct a fully powered cohort study of experimentally induced air hunger, an uncomfortable urge to breathe in patients with motor thalamus DBS “ON” and “OFF”.

Methods

16 patients (three females) with DBS of the ventral intermediate nucleus (VIM) as treatment for tremor underwent hypercapnic air hunger tests, with DBS ON and OFF. Patients rated air hunger on a visual analogue scale (VAS) every 15 s. Hypercapnia and ventilation were matched for ON and OFF states (end-tidal carbon dioxide tension mean±sd43±4 and 43±4 mmHg, respectively; ventilation 13.7 and 13.4 L·min−1, respectively). Participants’ ventilation was constrained to baseline levels by breathing from a 3-L inspiratory reservoir with fixed flow of fresh gas while targeting their resting breathing frequency to a metronome.

Results

Overall steady-state air hunger was 52±28%VAS for ON and 67±20%VAS for OFF (p=0.002; two-tailed paired t-test). The mean reduction in air hunger during VIM DBS was −14.4%VAS. DBS of the motor thalamus relieved air hunger in 13 patients, heightened air hunger in two and caused no change in one.

Conclusion

DBS of the motor thalamus for tremor relief also mitigates the air hunger component of dyspnoea. We posit that DBS of the motor thalamus heightens the gating control of the thalamus modulating the ascending air hunger signal. Extent of relief suggests that thalamic DBS may prove to be a viable therapy for intractable dyspnoea.
Genetic diagnosis and outcomes of intracytoplasmic sperm injection in South Chinese patients with congenital bilateral aplasia of the vas deferens
Authors: Hu Haishan , Zhou Qing , Ma Yanlin , Zhang Lingxiao
Published: October 2024

Background

Obstructive azoospermia commonly is caused by CBAVD(Congenital Bilateral Aplasia of the Vas Deferens), mainly due to the cystic fibrosis transmembrane conductance regulator (CFTR) and adhesion G protein-coupled receptor G2(ADGRG2) mutations. The genetic landscape for Chinese CBAVD patients is unclear, leading to debates over genetic screening, counseling, and assisted reproduction strategies. This study investigates the prevalence of CFTR and ADGRG2 mutations in a southern Chinese cohort of CBAVD patients and evaluates the impact of CFTR mutations on intracytoplasmic sperm injection (ICSI) outcomes.

Results

CFTR mutations were identified in 71.4% (30/42) of CBAVD patients, with a total of 36 CFTR mutation sites across 13 types identified, including two novel mutations. A novel ADGRG2 mutation was also detected. Betweenthe CFTR mutation-CBAVD group and the non-CBAVD OA group, a significant difference was observed only in the 2 Pronuclei(2PN) rate (79.5% vs 86.2%, P = 0.0065), while fertilization rates, pregnancy rates, miscarriage rates, and live birth rates showed no significant differences. Between the CFTR mutation-CBAVD group and the CBAVD group without CFTR mutation, there were no significant differences in fertilization rates, 2PN rates, pregnancy rates, miscarriage rates, or live birth rates.

Conclusion

Chinese CBAVD patients primarily exhibit mutations in the CFTR and ADGRG2 genes. Therefore, targeted gene testing for CFTR and ADGRG2 is more suitable compared to WES for CBAVD patients. Considering that the genetic factors of approximately 30% of CBAVD patients remain unknown, it is recommended to perform massive parallel sequencing for patients who test negative for CFTR and ADGRG2 gene screening. Despite these genetic factors, ICSI outcomes were not adversely affected, except for the 2PN rate. However, genetic counseling remains crucial for Chinese CBAVD patients before undergoing assisted reproduction.
Assisted peritoneal dialysis compared to in-centre hemodialysis – an observational study of outcomes from the Swedish Renal Registry
Authors: Rydell Helena , Segelmark Mårten , Clyne Naomi
Published: October 2024

Background

In-center hemodialysis (IHD) is the most common dialysis modality. Assisted peritoneal dialysis (assPD) is an option for frail and/or incapacitated patients. Both modalities can be used to alleviate uremic symptoms towards the end of life. There are few studies comparing these modalities. The primary aim is to compare hospital admissions between assPD and IHD. The secondary aim is to compare continuation of the dialysis modality and patient survival.

Methods

Patients > 65 years, registered in the Swedish Renal Registry (SRR) and starting dialysis 2010–2017 were eligible for inclusion. Patients starting on assPD were matched with patients starting on IHD according to sex, Charlson Index, age and date for start of dialysis. Data were collected from SRR and other registries.

Results

During the first year, patients on assPD and IHD had in median one (IQR 0–5.0; 0–4.0) hospitalization (p = 0.412). There was no significant difference after two years, in the annual number of days admitted to hospital, in hospitalizations with cardiovascular or infectious disease diagnoses or continuation of the dialysis modality, respectively. However, patients on assPD had a worse median survival (1.1 years IQR 0.6–2.1; IHD 3.1 years IQR 0.2–5.8; p < 0.001).

Conclusion

In this study patients starting assPD, often as a palliative treatment, showed no difference compared to IHD concerning the number of hospitalizations, number of days in hospital/year or continuation of the dialysis modality. Patients on assPD had a worse survival, which is likely due to residual confounding. Without that, patients on assPD would probably have lower number of hospitalizations. Despite limitations due to the retrospective observational design of the study, the results indicate that assPD is a feasible alternative to IHD when self-care dialysis is not possible and/or IHD too arduous.
Understanding the body image perception of pregnant women during their third trimester in a tertiary care setting in Southern India
Authors: Desai Ketaki , Poojari Deepalaxmi Paresh , Shwetha T.S. , Upadhyaya Rajani , Ramachandra Preetha
Published: October 2024

Background

Pregnancy is a known physiological phenomenon characterized by various changes in the body. The physical and physiological changes that occur during pregnancy may impact the body image which may lead to implications such as body image issues or poor eating habits among pregnant women. This study aimed to analyze the body image perception of pregnant women in their third trimester.

Methods

This cross-sectional survey which involved the administration of a Multidimensional Body Self-Relations Questionnaire (MBSRQ), was conducted among pregnant women between 28 and 40 weeks of gestation in a tertiary care setting in Southern India. Descriptive statistics were used to report the demographic characteristics of the respondents. A one-sample t-test was used to analyze the difference between the present sample scores and the published norms of MBSRQ. Univariate Logistic Regression was done to find the association between the demographic variables and subdomains of MBSRQ.

Results

The mean age of the respondents (n = 246) was 29.5 years, and the period of gestation was 33.4 weeks. With mean scores of subscales of MSRQ as reference values, a greater proportion of women had higher scores on appearance orientation (52.44%), health evaluation (56.91%), and illness orientation (55.28%). Respondents scored less on appearance evaluation (52.03%) and body areas satisfaction scale (50.41%). The study found that pre-pregnancy BMI, abdominal circumference, and weight gain during pregnancy were associated with appearance orientation, overweight preoccupation, and self-classified weight. Health evaluation was associated with weight gain and Instagram use, while moderate-intensity physical activity during pregnancy was associated with higher health orientation.

Conclusion

Although pregnant women in our setting during the third trimester were oriented towards their appearance and considered themselves healthy and fit, almost half of the respondents reported dissatisfaction with their changing bodies and appearance. Self-reported physical activity status, body mass index, weight gain, level of education, use of Instagram app, and type of family were factors found to affect pregnant body image perception. Hence, we conclude that body image perception is affected during pregnancy, and healthcare professionals should be aware of this, and the factors associated with it while addressing the health of pregnant women.

Clinical trial registration details

The study was registered under the Clinical Trials Registry- India: CTRI/2023/08/056524. https://ctri.nic.in/Clinicaltrials/rmaindet.php?trialid=89771&EncHid=39880.12369&modid=1&compid=19.
Trends and predictors of severe and moderate anaemia among children aged 6–59 months in India: an analysis of three rounds of National Family Health Survey (NFHS) data
Authors: Preethi Vegi , Hemalatha Vegi , Arlappa N. , Thomas MB. , Jaleel Abdul
Published: October 2024

Background

Childhood anaemia remains a significant public health problem in India, as it adversely affects child development and overall health outcomes. This study aimed to analyse the prevalence of severe and moderate anaemia among children aged 6–59 months and identify consistent predictors of this condition over the past 15 years.

Methods

Data from the three most recent rounds of the NFHS were used for this analysis. The final weighted sample included 40,331 children from the NFHS-3 (2005–2006), 200,093 from the NFHS-4 (2015–2016), and 178,909 from the NFHS-5 (2019–2021). Descriptive and bivariate analyses were conducted, followed by binary logistic regression to identify factors associated with severe and moderate anaemia in children aged 6–59 months. All statistical analyses were performed using Stata version 14.

Results

Over the past 15 years, the prevalence of severe and moderate anaemia among children in India has shown a slight decline. However, the influence of various predictors has changed over time. Young children (aged 6–23 months), those from Scheduled Caste (SC) and Scheduled Tribe (ST) communities, and children born to mothers with high parity and low educational attainment remain particularly vulnerable to anaemia. Additionally, short-term illness significantly increases the risk of anaemia. Furthermore, women’s autonomy, indicated by higher education and lower fertility rates, along with maternal nutrition education, have emerged as key factors in reducing anaemia burden in the future. Notably, children whose mothers had no education were 1.4 times more likely to suffer from severe or moderate anaemia. Similarly, children born to mothers with four to five children (OR 1.1, p < 0.05) and those with six or more children (OR 1.2, p < 0.05) had an elevated risk of anaemia.

Conclusion

The findings highlight three key areas for programmatic focus to accelerate anaemia reduction in India: [1] targeting young children (aged 6–23 months); [2] ensuring the inclusion of SC and ST communities in all relevant interventions; and [3] promoting women’s autonomy. These strategies are essential for reducing the burden of anaemia across the country.
Don’t forget to mind the mind: a prospective cohort study over 12 months on mental health symptoms in active professional male footballers
Authors: Pillay Lervasen , van Rensburg Dina C. Janse , Ramkilawon Gopika , Andersen Thor Einar , Kerkhoffs Gino , Gouttebarge Vincent
Published: October 2024

Aims

We examined the prevalence and incidence of mental health symptoms (MHS) in active professional male footballers over a 12-month period and investigated if MHS was associated with severe injuries or surgeries.

Participants and methods

Football Players Worldwide (FIFPRO) affiliated national unions invited active professional male football players to participate in the study. MHS was operationalised in symptoms of anxiety, disordered eating, depression, distress, sleep disturbance, alcohol misuse and drug misuse, all being assessed with validated questionnaires.

Results

Of the 101 participants enrolled, the prevalence of distress was 53% and MHS was between 6% for drug misuse and 48% for alcohol misuse. The incidence of distress was 29% and MHS ranged from 1% for anxiety to 11% for sleep disturbance. At baseline, players suffering from injury/surgery were more likely to report depression (OR 1.35; 95%CI 1.10–1.70) and disordered eating (OR 1.22; 95%CI 1.02–1.47). At follow-up, players who suffered injury or surgery were inclined to report distress (OR 2.15; 95%CI 1.26–4.31) and drug misuse (OR 2.05; 95%CI 1.01–4.04).

Conclusion

There seems to be a greater prevalence of MHS in active professional male footballers than in the global population and other sports. After severe injury/surgery, the risk of developing MHS is increased, confirming that healthcare professionals should be aware of the mental health of injured players.
Proline metabolism is essential for alkaline adaptation of Nile tilapia (Oreochromis niloticus)
Authors: Wang Minxu , Yan Yuxi , Liu Wei , Fan Jinquan , Li Erchao , Chen Liqiao , Wang Xiaodan
Published: October 2024

Background

Saline-alkaline water aquaculture has become a key way to mitigate the reduction of freshwater aquaculture space and meet the increasing global demand for aquatic products. To enhance the comprehensive utilization capability of saline-alkaline water, it is necessary to understand the regulatory mechanisms of aquatic animals coping with saline-alkaline water. In this study, our objective was to elucidate the function of proline metabolism in the alkaline adaptation of Nile tilapia (Oreochromis niloticus).

Results

Expose Nile tilapia to alkaline water of different alkalinity for 2 weeks to observe changes in its growth performance and proline metabolism. Meanwhile, to further clarify the role of proline metabolism, RNA interference experiments were conducted to disrupt the normal operation of proline metabolic axis by knocking down pycr (pyrroline-5-carboxylate reductases), the final rate-limiting enzyme in proline synthesis. The results showed that both the synthesis and degradation of proline were enhanced under carbonate alkalinity stress, and the environmental alkalinity impaired the growth performance of tilapia, and the higher the alkalinity, the greater the impairment. Moreover, environmental alkalinity caused oxidative stress in tilapia, enhanced ion transport, ammonia metabolism, and altered the intensity and form of energy metabolism in tilapia. When the expression level of the pycr gene decreased, the proline metabolism could not operate normally, and the ion transport, antioxidant defense system, and energy metabolism were severely damaged, ultimately leading to liver damage and a decreased survival rate of tilapia under alkalinity stress.

Conclusions

The results indicated that proline metabolism plays an important role in the alkaline adaptation of Nile tilapia and is a key regulatory process in various biochemical and physiological processes.
Prevalence of psychosocial findings and their correlation with TMD symptoms in an adult population sample
Authors: Iodice Giorgio , Michelotti Ambra , D’Antò Vincenzo , Martina Stefano , Valletta Rosa , Rongo Roberto
Published: October 2024

Background and aim

Some studies suggested an association between Temporomandibular Disorders (TMD) and psychosocial status, but most of them are focused on samples of patients looking for treatment or present limits of sample representativeness. The aim of the present study was to evaluate the psychosocial status in a large sample of adult population, further than to assess its association to TMD symptoms, oral behaviours, and self-reported facial trauma.

Results

the study sample included 4299 subjects older than 18 years randomly recruited from general population in public spaces during their daily life (1700 Males, 2599 Females mean ± SD age = 40.4 ± 18.1). Psychosocial status and pain-related disability were assessed by means of Patient Health Questionnaire 4 (PHQ-4) and Graded Chronic Pain Scale (GCPS). TMD symptoms were assessed by RDC/TMD and validated screening tools for TMD pain. Oral Behaviours Checklist was used to investigate on oral behaviours. Logistic regression model was used to evaluate the association of the psychosocial status, TMD symptoms, trauma, and oral behaviours. The association was tested using both univariate and multivariate models. The PHQ4 evaluation showed a severe impairment in 4.6% of our sample, moderate in 18.8% and mild in 32.5%. We found a Characteristic Pain Intensity (CPI) level and Interference Score greater that 30 respectively in 36.2% and 22.2% of the study sample. The GCPS status revealed a high disability with severe limitation in 2.5% of the sample, high disability with moderate limitation in 7.0%, low disability high pain intensity in 7.4% and low disability low pain intensity in 37.8%. Anxiety and depression’s levels were significantly associated with gender, TMD pain, coexistence of TMD Pain and sound, and oral behaviours. GCPS status was significantly associated with age, TMD Pain, coexistence of TMD pain and sound, trauma, and oral behaviours.

Conclusions

In the general population, psychosocial impairment is associated to TMD pain, female gender, and report of oral behaviours. Hence, in adults with TMD accompanied by pain, psychosocial status should also be evaluated.
Visual and patient reported outcomes provided by a refractive multifocal intraocular lens based on continuous transitional focus
Authors: Alió Jorge L. , Martínez-Abad Antonio , Ruiz-Mesa Ramón , Kim Hyo Myung , Mendicute Javier , Ribeiro Filomena J. , Holzer Mike P. , Cantó-Cerdán Mario
Published: October 2024

Purpose

To analyze the quality of vision of patients implanted bilaterally with the multifocal Precizon Presbyopic intraocular lens (IOL), as well as to evaluate the visual performance provided by the lens.

Setting

Vissum Miranza Alicante.

Design

Prospective multicenter study.

Methods

56 patients (mean age 65.0 ± 8.7 years old) underwent bilateral implantation with multifocal Precizon Presbyopic IOL. The quality of vision was assessed by a quality of vision questionnaire at 6 months after the implantation procedure, a complete eye examination was also performed including visual and refractive measurements, defocus curve and contrast sensitivity assessment. Visual and refractive variables were compared in preoperative, 3-month postoperative and 6-month postoperative visits by Wilcoxon test.

Results

The quality of vision analysis showed the absence of severe glare and severe haloes in all evaluated patients. Likewise, non-symptoms of glare, haloes and starbursts were seen in 75%, 68%, and 55% of subjects, respectively. Efficacy and safety index was 1.26 and 1.42, respectively. The 6-month postoperative binocular uncorrected distance visual acuity and near uncorrected visual acuity were 0.00 ± 0.09 and 0.20 ± 0.13 logMAR, respectively. Mean spherical equivalent was 0.29 ± 0.45 D.

Conclusions

The Precizon Presbyopic NVA IOL (OPHTEC BV) provides a suitable quality of vision with a low rate of disturbance photic phenomena induction, as well as an excellent visual performance at main distances of sight accomplishing the visual demands of the majority of patients.
Experimental study on the buffering mechanism of EPS bead-sand cushions under single and multiple impacts
Authors: Ren Feifan , Liu Jiahao , Huang Qiangqiang , Ding Huan , Hu Zhipeng , Wang Guan
Published: October 2024

As a main functional component of rock sheds in rockfall protection projects, traditional sand cushions have shortcomings such as heavy weight and weak buffering capacity. EPS bead-sand cushion can effectively solve these problems, but its buffering mechanism has not been fully revealed. In this study, a series of impact tests were carried out to investigate the performance of EPS bead-sand cushions with different EPS bead contents, and the evolutions of rockfall impact force, penetration depth, earth pressure, and slab vibration under single impact and multiple impacts were comparatively analyzed. The results show that with the addition of EPS beads, the maximum impact force, the peak earth pressure, and the vibration acceleration are significantly reduced. However, the cushion with high EPS bead content is at risk of being penetrated under high energy or multiple impacts, leading to excessive concentration of impact stresses. Furthermore, the EPS beads can alleviate the hardening of the sand cushion under impact through their deformation coordination, but excessive penetration should be prevented in the design of EPS bead-sand cushions. On this basis, combined with traditional sand cushion design theory, an estimation method for the maximum impact force applicable to EPS bead-sand cushion was proposed. The research results can provide a reference for the design and optimization of cushions in actual projects.
Lessons for expert psychiatric witnesses from recent judgments and updated procedural rules
Authors: Bhatti Abiha , Rix Keith
Published: October 2024

The past 5 years have seen numerous court judgments and changes to rules and procedures that relate to the work of expert psychiatric witnesses in the British Isles. This article outlines these changes, pointing out their implications for the expert witness, and highlights pertinent judgments in over 100 court and tribunal cases.
Determining unmet need: clinical relevance of suspected neurodivergence in first-episode psychosis
Authors: Nikolić Nikola , Sculthorpe Catherine , Stock Jessica , Stevens Dan , Eccles Jessica
Published: October 2024

Aims and method

We explored the prevalence of autism and attention-deficit hyperactivity disorder in first-episode psychosis. Through service evaluation involving 509 individuals, detailed analyses were conducted on neurodevelopmental traits and patterns of service utilisation.

Results

Prevalence of neurodivergence in first-episode psychosis was 37.7%. Neurodivergent individuals used urgent mental health services more frequently (Mann–Whitney U = 25925, Z = −2.832, P = 0.005) and had longer hospital stays (Mann–Whitney U = 22816, Z = −4.886, P ≤ 0.001) than non-neurodivergent people. Neurodivergent people spend more than twice as long in mental health hospitals at a time than the non-neurodivergent people (Mann–Whitney U = 22 909.5, Z = −4.826, P ≤ 0.001). Mediation analysis underscored indirect impact of neurodivergence on hospital stay durations through age at onset of psychosis and use of emergency services.

Clinical implications

Prevalence of neurodevelopmental conditions in first-episode psychosis is underestimated. Neurodivergent individuals show increased utilisation of mental health services and experience psychosis earlier. Early assessment is crucial for optimising psychosis management and improving mental health outcomes.
Exceptional racism at the dawn of scientific psychiatry in Brazil: the curious case of Juliano Moreira
Authors: Almeida-Filho Naomar , Schwarcz Lilia , Mari Jair
Published: October 2024

Twenty years ago, the British Journal of Psychiatry published an editorial regarding racism and psychiatry. Three decades ago, the journal published a lecture by Professor Michael Sheperd about Kraepelin's contributions to racist degeneration theories. A century ago, Albert Einstein visited the Brazilian Academy of Sciences, where he was hosted by Juliano Moreira [1872–1933], one of the most distinguished Brazilian scientists of that time. The only son of a former enslaved woman, he is regarded as one of the founding fathers of scientific psychiatry in Brazil. Moreira may have been a case of ‘exceptional racism’, the strategy of praising outstanding people from oppressed groups as a way of denying or covering up processes of structural racism.
The Effect of Multi-Ingredient Protein versus Collagen Supplementation on Satellite Cell Properties in Males and Females
Authors: WAGEH MAI , FORTINO STEPHEN A. , PONTELLO RILEY , MAKLAD AHMED , MCGLORY CHRIS , KUMBHARE DINESH , PHILLIPS STUART M. , PARISE GIANNI
Published: October 2024

Introduction

Skeletal muscle satellite cells (SC) contribute to the adaptive process of resistance exercise training (RET) and may be influenced by nutritional supplementation. However, little research exists on the impact of multi-ingredient supplementation on the SC response to RET.

Purpose

We tested the effect of a multi-ingredient supplement (MIS) including whey protein, creatine, leucine, calcium citrate, and vitamin D on SC content and activity as well as myonuclear accretion, SC and myonuclear domain compared with a collagen control (COL) throughout a 10-wk RET program.

Methods

Twenty-six participants underwent a 10-wk linear RET program while consuming either the MIS or COL supplement twice daily. Muscle biopsies were taken from the vastus lateralis at baseline and 48 h after a bout of damaging exercise, before and after RET. Muscle tissue was analyzed for SC and myonuclear content, domain, acute SC activation, and fiber cross-sectional area (fCSA).

Results

MIS resulted in a greater increase in type II fCSA following 10 wk of RET (effect size (ES) = 0.89) but not myonuclear accretion or SC content. Change in myonuclei per fiber was positively correlated with type I and II and total fiber hypertrophy in the COL group only, indicating a robust independent effect of MIS on fCSA. Myonuclear domain increased similarly in both groups, whereas SC domain remained unchanged following RET. SC activation was similar between groups for all fiber types in the untrained state but showed a trend toward greater increases with MIS after RET (ES = 0.70).

Conclusions

SC responses to acute damaging exercise and long-term RET are predominantly similar in MIS and COL groups. However, MIS can induce greater increases in type II fCSA with RET and potentially SC activation following damage in the trained state.
Πόλεμος και ανδρισμός: η κατασκευή του ανδρισμού σε συνάρτηση με το σύστημα του πολέμου στη νεοελληνική λογοτεχνία
Authors: Χωλίδης Κλήμης-Δημήτριος
Published: October 2024

Η διατριβή αποσκοπεί στη διερεύνηση της κατασκευής του στρατιωτικού ανδρισμού σε νεοελληνικά λογοτεχνικά κείμενα που αφορούν τον Δεύτερο Παγκόσμιο Πόλεμο (Οκτώβριος 1940-Απρίλιος 1941). Το Πρώτο Μέρος πραγματεύεται θεωρητικά ζητήματα. Στα δύο πρώτα κεφάλαια παρουσιάζεται μια σύντομη επισκόπηση του πεδίου των κριτικών σπουδών πάνω στους άνδρες και του ανδρισμούς και ένα αναλυτικό θεωρητικό πλαίσιο για τη σύγχρονη κοινωνιολογική θεωρία της κοινωνικής κατασκευής του κοινωνικού φύλου. Στο τρίτο κεφάλαιο η θεωρία του κοινωνικού φύλου συνδυάζεται με την ανθρωπολογική προσέγγιση της διαπολιτισμικής σύνδεσης μεταξύ πολέμου και κοινωνικού φύλου. Βάσει αυτού του συνδυασμού προτείνεται, στο τέταρτο κεφάλαιο, ένα σχέδιο ανάγνωσης της λογοτεχνίας. Το Δεύτερο Μέρος τοποθετεί τον πόλεμο και τον ανδρισμό σε συγκεκριμένα ιστορικά συμφραζόμενα. Στο πέμπτο κεφάλαιο δίνονται ορισμένα ιστορικά στοιχεία σχετικά με τον Δεύτερο Παγκόσμιο Πόλεμο στην Ευρώπη και τον πόλεμο της Ιταλίας και της Γερμανίας εναντίον της Ελλάδας. Συνδυάζοντας τη θεωρία του κοινωνικού φύλου και την ανθρωπολογική προσέγγιση της σύνδεσης του πολέμου με το κοινωνικό φύλο, το έκτο κεφάλαιο περιγράφει τη συμμόρφωση των Ελλήνων ανδρών με τον ηγεμονικό ανδρισμό της κοινωνίας τη δεδομένη περίοδο, τον ανδρισμό του πολεμιστή, και τη συμμόρφωση των γυναικών με την εμφατική (κυρίαρχη) θηλυκότητα, την υποστήριξη της πολεμικής προσπάθειας των ανδρών. Στο έβδομο κεφάλαιο παρουσιάζεται μια επισκόπηση της νεοελληνικής πεζογραφίας με θέμα τον πόλεμο από τον 19ο ως τις αρχές του 20ου αι. (τη δεκαετία του 1940), εστιάζοντας, στο τέλος, στα επιλεγμένα κείμενα: Το Μνήμα της Γρηάς (Άγγελος Σ. Βλάχος, 1945), Απρίλης (Άγγελος Τερζάκης, 1946), Ιερά Οδός (Γιώργος Θεοτοκάς, 1950). Το Τρίτο Μέρος αφορά την ερμηνευτική προσέγγιση των κειμένων. Κύριο μεθοδολογικό εργαλείο συνιστά η έννοια του ηγεμονικού ανδρισμού και η τυπολογία των πολλαπλών ανδρισμών της R.W.Connell, που εφαρμόζονται στα κείμενα με έναν πειραματικό και καινοτόμο τρόπο. Τα κείμενα απεικονίζουν τη στρατιωτική ζωή σε καιρό πολέμου από τρεις διαφορετικές θέσεις: την πρώτη γραμμή του (αλβανικού και μακεδονικού) μετώπου, τη δεύτερη γραμμή του μετώπου (υποστηρικτικές, μη μάχιμες στρατιωτικές μονάδες και στρατιωτικά γραφεία) και ένα κέντρο εκπαίδευσης στρατιωτών στην πόλη. Οι τρεις θέσεις συνεπάγονται διαφορετικές σχέσεις των ανδρών που υπηρετούν με τον ηγεμονικό (στρατιωτικό) ανδρισμό, σε συλλογικό και ατομικό επίπεδο, καθώς και διαφορετικό τρόπο και βαθμό συμβολής της στρατιωτικής εμπειρίας και του πολέμου στη διαμόρφωση του ανδρισμού του
Η ιστορία του ελληνικού φαρμακείου μετά την ίδρυση του ελληνικού κράτους
Authors: Πανταζόγλου Ευαγγελία
Published: October 2024

Η διατριβή εστιάζει στην ιστορική εξέλιξη του ελληνικού φαρμακείου μετά την ίδρυση του ελληνικού κράτους και την απελευθέρωση όλων των σκλαβωμένων από τους Τούρκους περιοχών, εξετάζοντας τον ρόλο του φαρμακοποιού στην υπηρεσία της κοινωνίας και τον χώρο του φαρμακείου ως τόπο συνάθροισης και κοινωνικής συζήτησης. Ταυτόχρονα όμως περιγράφει και την υπάρχουσα πρότερα κατάσταση. Η έρευνα προσπαθεί να συνοψίσει την υπάρχουσα βιβλιογραφία και να αναλύσει τα ιστορικά δεδομένα που σχετίζονται με το ελληνικό φαρμακείο από την ίδρυση του κράτους μέχρι τις σύγχρονες μέρες. Η ιστορία της φαρμακευτικής επιστήμης και η καθημερινότητα των φαρμακείων τον 19ο, 20ο αιώνα και το πρώτο τέταρτο του 21ου αιώνα, παρουσιάζονται με τη χρήση βιβλιογραφικών πηγών και φαρμακευτικών περιοδικών, αποτελώντας μια ολοκληρωμένη μελέτη του ελληνικού φαρμακείου ως πρωτοβάθμιου χώρου φροντίδας υγείας, εφαρμογής της φαρμακευτικής επιστήμης, άσκησης ιατρικών πράξεων, των τεχνών και του απελευθερωτικού αγώνα. Πολλά στοιχεία λήφθηκαν από τον Πανελλήνιο Φαρμακευτικό Σύλλογο και τους Φαρμακευτικούς Συλλόγους της Ελλάδας, αλλά και από ιστορικά φαρμακεία που συνεχίζουν απρόσκοπτα τη λειτουργία τους. Οι Έλληνες φαρμακοποιοί στους χώρους των φαρμακείων τους, πολλές φορές υποκατέστησαν την πρωτοβάθμια περίθαλψη, όπως φάνηκε στους επαναστατικούς αγώνες αλλά και πρόσφατα στην πανδημία του COVID-19.Με τη μελέτη περιγράφεται η σημαντική εξέλιξη των φαρμακείων στην Ελλάδα. Η επιβολή προδιαγραφών και η εκπαίδευση των φαρμακοποιών με ευρωπαϊκά πρότυπα συνέβαλε στη δημιουργία ποιοτικών φαρμακείων. Οι νόμοι που θεσπίστηκαν βοήθησαν στην ίδρυση των φαρμακείων σε όλη τη χώρα. Όμως η δημιουργία περισσότερων φαρμακείων στα αστικά κέντρα και η ανάγκη για διατήρηση υγιούς ανταγωνισμού αποτελούν προκλήσεις.