bluuebunny/crossref_metadata_2025 huggingface dataset:
Antenatal Care Visits, Institutional Births, and Associated Risk Factors in Afghanistan: Insights from the Multiple Indicator Cluster Survey 2022‐2023
Authors: Bhowmik Jahar , Gunarathne Lakma , Bhar Sunil , Bhowmik Udayan , Biswas Raaj Kishore
Published: July 2024

Introduction

Insufficient use of antenatal care (ANC) services and institutional births services can elevate the maternal mortality risk in limited resource settings. Hence, the key objective of this study was to evaluate the potential association between the frequency of ANC visits and institutional birth services in Afghanistan, while also identifying other sociodemographic factors that may exert influence. Furthermore, we explored factors associated with the attendance of women at ANC visits during their pregnancy.

Methods

We employed data from the most recent Multiple Indicator Cluster Survey conducted in Afghanistan in 2022 to 2023 with a total of 8096 women aged 15 to 49. A complex survey weight‐adjusted logistic regression model was used to examine factors related to institutional births, and a multinomial logistic regression model was fitted to assess the relationships between sociodemographic factors and ANC visits, adjusting for survey weights, cluster effects, and strata.

Results

Approximately 40% of the sample (n = 3247) had undergone 4 or more ANC visits, and 74.4% (n = 6,022) had opted for institutional birth. Women's higher education was found to be associated with ANC visits. The area of residence, wealth index, education levels of women, ownership of mobile phones, number of children, and number of ANC visits were associated with institutional births. Compared with women with no or one ANC visit, those with more than 3 visits had 31% higher odds (adjusted odds ratio, 1.31; 95% CI, 1.10‐1.57) of accessing institutional births.

Discussion

Our findings indicate a significant association between ANC visits and use of institutional birth care. These findings carry implications for advancing safe motherhood and childbirth by enhancing women's social status.
The effects of APOE4 and familial Alzheimer's disease mutations on free fatty acid profiles in mouse brain are age‐ and sex‐dependent
Authors: den Hoedt Sandra , Crivelli Simone M. , Dorst‐Lagerwerf Kristien Y. , Leijten Frank P. J. , Losen Mario , de Vries Helga E. , Sijbrands Eric J. G. , Verhoeven Adrie J. M. , Martinez‐Martinez Pilar , Mulder Monique T.
Published: July 2024

APOE4 encoding apolipoprotein (Apo)E4 is the strongest genetic risk factor for Alzheimer's disease (AD). ApoE is key in intercellular lipid trafficking. Fatty acids are essential for brain integrity and cognitive performance and are implicated in neurodegeneration. We determined the sex‐ and age‐dependent effect of AD and APOE4 on brain free fatty acid (FFA) profiles. FFA profiles were determined by LC–MS/MS in hippocampus, cortex, and cerebellum of female and male, young (≤3 months) and older (>5 months), transgenic APOE3 and APOE4 mice with and without five familial AD (FAD) mutations (16 groups; n = 7–10 each). In the different brain regions, females had higher levels than males of either saturated or polyunsaturated FFAs or both. In the hippocampus of young males, but not of older males, APOE4 and FAD each induced 1.3‐fold higher levels of almost all FFAs. In young and older females, FAD and to a less extent APOE4‐induced shifts among saturated, monounsaturated, and polyunsaturated FFAs without affecting total FFA levels. In cortex and cerebellum, APOE4 and FAD had only minor effects on individual FFAs. The effects of APOE4 and FAD on FFA levels and FFA profiles in the three brain regions were strongly dependent of sex and age, particularly in the hippocampus. Here, most FFAs that are affected by FAD are similarly affected by APOE4. Since APOE4 and FAD affected hippocampal FFA profiles already at young age, these APOE4‐induced alterations may modulate the pathogenesis of AD.

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Astrocytes facilitate gabazine‐evoked electrophysiological hyperactivity and distinct biochemical responses in mature neuronal cultures
Authors: Ahtiainen Annika , Genocchi Barbara , Subramaniyam Narayan Puthanmadam , Tanskanen Jarno M. A. , Rantamäki Tomi , Hyttinen Jari A. K.
Published: July 2024

Gamma‐aminobutyric acid (GABA) is the principal inhibitory neurotransmitter in the adult brain that binds to GABA receptors and hyperpolarizes the postsynaptic neuron. Gabazine acts as a competitive antagonist to type A GABA receptors (GABAAR), thereby causing diminished neuronal hyperpolarization and GABAAR‐mediated inhibition. However, the biochemical effects and the potential regulatory role of astrocytes in this process remain poorly understood. To address this, we investigated the neuronal responses of gabazine in rat cortical cultures containing varying ratios of neurons and astrocytes. Electrophysiological characterization was performed utilizing microelectrode arrays (MEAs) with topologically controlled microcircuit cultures that enabled control of neuronal network growth. Biochemical analysis of the cultures was performed using traditional dissociated cultures on coverslips. Our study indicates that, upon gabazine stimulation, astrocyte‐rich neuronal cultures exhibit elevated electrophysiological activity and tyrosine phosphorylation of tropomyosin receptor kinase B (TrkB; receptor for brain‐derived neurotrophic factor), along with distinct cytokine secretion profiles. Notably, neurons lacking proper astrocytic support were found to experience synapse loss and decreased mitogen‐activated protein kinase (MAPK) phosphorylation. Furthermore, astrocytes contributed to neuronal viability, morphology, vascular endothelial growth factor (VEGF) secretion, and overall neuronal network functionality, highlighting the multifunctional role of astrocytes.

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Complications and putative risk factors for cecal or colonic surgery in dogs: 79 cases (2002‐2015)
Authors: James J. C. , O'Neill S. , Moore G. E. , Scotti K. M. , Perry K. L. , Sterman A. A.
Published: July 2024

Objectives

To evaluate the complication rate, mortality rate and putative risk factors for cecal or colonic surgery in dogs.

Materials and Methods

A multi‐institutional retrospective study including dogs that had undergone surgery that involved the cecum or the colon. Medical records from three referral hospitals were reviewed for patient demographics and clinical data. The association between putative risk factors and survival to discharge or complications was assessed using univariable and multivariable analysis.

Results

Seventy‐nine dogs met the criteria to be included in this study. Fifty‐five dogs had full thickness incision surgeries, while 24 dogs had partial thickness surgeries. The complication and mortality rates for full thickness and partial thickness cecal/colonic surgeries were not statistically different. The dehiscence rate of colonic anastomosis in this study was four of 47 (8.5%). On univariate analysis, performing full thickness procedures out of hours had an association with increased complications and mortality. On multivariable analysis, no factors were associated with survival to discharge or complications. There was no association of board‐certified surgeon presence in surgery with complications or mortality.

Clinical Significance

The performance of full thickness cecal/colonic surgery is not associated with a statistically significant increased risk for complications or mortality compared to partial thickness procedures, with a possible increased risk of complications and mortality in full thickness procedures out of hours.
ZMFISC: Zhu‐Ming data set with a convolutional neural network for identifying Indo‐Pacific humpback dolphins (Sousa chinensis)
Authors: Yang Minghao , Wu Zhongrui , Zang Xiqing , Jin Changlong , Zhu Qian
Published: July 2024

The Indo‐Pacific humpback dolphin (Sousa chinensis) is a small‐toothed whale species that inhabits estuaries and shallow coastal waters from the eastern Indian Ocean to the western Pacific, and faces significant negative impacts from anthropogenic activities. The noninvasive Photo‐identification method enables individual identification and abundance estimation based on natural markings of cetaceans without disrupting their natural behaviors. Currently, the identification of S. chinensis using photographs relies primarily on time‐intensive visual recognition by experienced researchers. Through field surveys conducted in the west Huangmao Sea area from 2012 to 2021, we compiled the Zhu‐Ming data set focusing on S. chinensis (ZMSC), consisting of 479 individuals and 5,196 photos. Utilizing the ZMSC, we proposed a Few‐Shot Identification method for S. chinensis (FISC), which achieved 85.93% identification Top‐1 accuracy. The implementation of proper preprocessing steps and data augmentation techniques has significantly enhanced the performance of FISC, while visualizing network weights has improved its interpretability. Despite the remaining challenges of data imbalance and the inability to automatically allocate new labels, ZMFISC alleviates the challenge of the current heavy reliance on time‐intensive visual recognition methods by researchers for individual identification of S. chinensis and provide a valuable tool to enhance future conservation efforts for S. chinensis.
Distribution of Arnoux's beaked whales (Berardius arnuxii)
Authors: Feij Bram , Kühn Susanne , Meijboom André , van Franeker Jan A. , Bornemann Horst , Kelly Nat , Schaafsma Fokje L.
Published: July 2024

Arnoux's beaked whales (Berardius arnuxii) are generally considered to be uncommon to rare, and likely to prefer deep oceanic waters of the Southern Hemisphere. During many top‐predator surveys in the Southern Ocean since 1988 we did not sight the species. However, in April 2022 we encountered three groups in the marginal sea‐ice zone of the Weddell Sea. This study provides detailed descriptions of the sighted animals and their environment and report on unpublished sightings of this species from 1986 to 1998. A search of published information on the distribution of the species revealed 108 documented sightings with a total of 1,125 individuals. In combination these sources of information for the Southern Ocean, suggest a frequent occurrence in ice‐covered waters, often close to the continental coast and edges of fast ice and ice‐shelves. North of 60°S, in the temperate regions of the Southern Hemisphere, the species was also regularly sighted near continents, even far inshore, in fjords surrounded by land.
Cultural humility in international relationship research: Perspectives from an International Section Peer Mentor
Authors: Alvarez Cimmiaron F.
Published: July 2024

Personal Relationships is dedicated to publishing international scholarship. Scholars can submit their work to the International Section if their manuscript reports on data that were collected outside of North America or they examine cross‐cultural investigations. For the last 2 years, I have had the privilege of being an International Section Peer Mentor for Personal Relationships. Working with international scholars conducting international research introduced me to the concept of cultural humility. Cultural humility is a perspective for intercultural interactions that embrace lifelong learning, self‐evaluation, and critique to redress power imbalances. In this commentary, I discuss my experiences as a peer mentor, introduce the concept of cultural humility, and explain lessons that I have learned.
Modified by the Innovative Drugs and Strategies—Pattern of Selected Indications for Pediatric Liver Transplantation
Authors: Jankowska Irena , Socha Piotr , Gliwicz Dorota , Lipiński Patryk , Rokicki Dariusz , Kaliciński Piotr , Danielewska Ewa , Grenda Ryszard
Published: July 2024

Background

Liver transplantation (LTx) constitutes a major life‐saving routine treatment for children with end‐stage liver disease. However, the analysis of LTx registries in children provides much information about changes in the indication profiles in the recent years.

Methods

The article provides a comprehensive review about the successes, hopes, and challenges related to changing indications for LTx in children based on the literature review and our own experience. Retrospective review of the indications for LTx at a tertiary referral pediatric hospital was also presented.

Results and Conclusions

In the context of the new therapies that have emerged, the need for LTx has decreased in patients with chronic hepatitis B and C infection and tyrosinemia type 1. In primary hyperoxaluria type 1, new RNAi‐based therapy has eliminated the requirement for LTx (both isolated or combined). There is a hope that introduction of ileal bile acid transporter (IBAT) blockers reduces the need for LTx in patients with Alagille syndrome or progressive familial intrahepatic cholestasis. The number of children qualified for LTx with urea cycle disorders (UCDs) as a prophylaxis of neurodevelopmental impairment is increasing.
Unraveling the temporal interplay of slow‐paced breathing and prefrontal transcranial direct current stimulation on cardiac indices of autonomic activity
Authors: Li Zefeng , Schoonjans Emmanuelle , Allaert Jens , De Smet Stefanie , Kappen Mitchel , Houfflyn Joni , Ottaviani Cristina , De Raedt Rudi , Pulopulos Matias M. , Vanderhasselt Marie‐Anne
Published: July 2024

The neurovisceral integration model proposes that information flows bidirectionally between the brain and the heart via the vagus nerve, indexed by vagally mediated heart rate variability (vmHRV). Voluntary reduction in breathing rate (slow‐paced breathing, SPB, 5.5 Breathing Per Minute (BPM)) can enhance vmHRV. Additionally, prefrontal transcranial direct current stimulation (tDCS) can modulate the excitability of the prefrontal region and influence the vagus nerve. However, research on the combination of SPB and prefrontal tDCS to increase vmHRV and other cardiac (heart rate (HR) and blood pressure) and peripheral (skin conductance) indices is scarce. We hypothesized that the combination of 20 min of SPB and prefrontal tDCS would have a greater effect than each intervention in isolation. Hence, 200 participants were divided into four groups: active tDCS with SPB, active tDCS with 15 BPM breathing, sham tDCS with SPB, and sham tDCS with 15 BPM breathing. Regardless of the tDCS condition, the 5.5 BPM group showed a significant increase in vmHRV over 20 minutes and significant decreases in HR at the first and second 5‐min epochs of the intervention. Regardless of breathing condition, the active tDCS group exhibited higher HR at the fourth 5‐min epoch of the intervention than the sham tDCS group. No other effects were observed. Overall, SPB is a robust technique for increasing vmHRV, whereas prefrontal tDCS may produce effects that counteract those of SPB. More research is necessary to test whether and how SPB and neuromodulation approaches can be combined to improve cardiac vagal tone.
The property of goal‐directedness: Lessons from the dispositions debate
Authors: Tugby Matthew
Published: July 2024

The system‐property or ‘cybernetic’ theory of goals and goal‐directedness became popular in the twentieth century. It is a theory that has reductionist and behaviourist roots. There are reasons to think that the system‐property theory needs to be formulated in terms of counterfactuals. However, it proves to be difficult to formulate a counterfactual analysis of goal‐directedness that is counterexample‐free, non‐circular, and non‐trivial. These difficulties closely mirror those facing reductionists about dispositions, though the parallels between the two debates have been overlooked in the literature. After outlining those parallels, the paper considers what goal theorists might learn from the dispositions debate. In particular, the paper discusses the need for a realist, non‐reductionist account of goal‐directedness, and explores the idea that properties of goal‐directedness are themselves dispositions or ‘powers’ of a certain sort.
Meaning‐oriented thematic analysis grounded in reflective lifeworld research—A holistic approach for caring science research
Authors: Lindberg Elisabeth , Palmér Lina , Hörberg Ulrica
Published: July 2024

Background and Aim

The aim of the present article is to describe meaning‐oriented thematic analysis grounded in reflective lifeworld research and to illustrate how the thematic analysis can be integrated in the research process. The article is a methodological paper, including ontological and epistemological assumptions for lifeworld theory. Research based on lifeworld theory is directed towards lived experiences and meanings in everyday life. Research that is founded on the epistemology of the lifeworld can present existential issues important for caring and qualitative research can in particular contribute to existential knowledge needed to understand the world of the patient.

Design

Theoretical paper.

Results

Starting with a phenomenon of relevance for caring science, the article argues for lifeworld interviews as a data collection method that can contribute to depth and meaning, and then presents a description of how structures of meaning can be outlined through a meaning‐oriented thematic analysis. The research of lived experiences in caring science demands an approach that includes a reflective attitude during the methodological considerations. This article highlights the importance of ontological and epistemological considerations when conducting a meaning‐oriented thematic analysis.

Conclusion

The article places meaning‐oriented thematic analysis in a wider research process, considering all aspects from collection of data to the creation of meaning‐oriented themes.
Hydraulic reconstruction of giant paleolandslide‐dammed lake outburst floods in high‐mountain region, eastern Tibetan Plateau: A case study of the Upper Minjiang River valley
Authors: Ma Junxue , Chen Jian , Xu Chong
Published: July 2024

Landslide‐dammed lakes are potentially hazardous and catastrophic for their possible failures and outburst floods (OFs) that will cause disastrous damage and life‐threatening losses, especially in the alpine areas where seismicity is strong and frequent, such as the eastern margin of the Tibetan Plateau. This study focused on spreading an effective numerical model to reconstruct downstream hazards induced by a giant ancient landslide‐dammed lake outburst flood (LLOF) in the upper Minjiang River valley, eastern Tibetan Plateau based on the integration of the hydraulic characteristics of the upstream dammed lake, dam failure and erosion process, and downstream OF dynamics. The peak discharge levels and paleohydraulics of the LLOF were reconstructed using single‐embankment dam‐break program and one‐dimensional steady hydraulic numerical model. The results reveal that the maximum peak discharge of the Diexi paleo LLOF was 73,060–82,235 m3/s, with an uncertainty bound of 73,000–90,000 m3/s (mean value: 81,500 m3/s). Which inferred that the Diexi paleo LLOF was one of the largest known LLOFs in the view of worldwide scope comparing with other types of floods. Then, the hydraulic characteristics and route evolution of the LLOF were simulated in one‐dimensional unsteady numerical model. The results showed that the Diexi paleo LLOF took 7.47 h to transport from Diexi to Wenchuan within the simulated section of 91.23 km, with an average propagation velocity of 3.39 m/s. At the time of 15.57 h, the simulating section (between Diexi and Wenchuan) reached the maximum extent of inundation which was 664.91 km2, with an average value of 7.29 km2/km. Our modeling supports that the numerical model can be used successfully to reconstruct the hydraulics of a paleo LLOF in deep confined gorge environment. The reconstructed paleo LLOF data are of great significance to enrich the regional megaflood records and provide valuable information for geological hazard controls and OF risk assessment within the upper catchment of Minjiang River at the eastern margin of the Tibetan Plateau.
Brow rhytidectomy with or without Stades‐like procedure for correction of pseudoptosis and trichiasis‐entropion of the upper eyelid in Chow Chow and Shar‐Pei dogs: A retrospective study of 27 dogs (2019–2022)
Authors: Sarfaty Havi , Ezra‐Elia Raaya , Kahane Nili , Sandalon Shai , Segev Yifat , Sebbag Lionel
Published: July 2024

Purpose

Heavy brows in Chow Chow and Shar‐Pei dogs can be associated with pseudoptosis and trichiasis‐entropion of the upper eyelids, causing vision impairment and ocular discomfort. This study describes the outcomes of brow rhytidectomy ± Stades‐like procedure to address these anatomical abnormalities.

Methods

Retrospective medical records review (2019–2022).

Results

Twenty‐seven dogs (n = 15 Chow Chow, n = 12 Shar‐Peis) were included, aged 1.9 ± 1.5 years (0.5–6.5 years). Presenting complaints included recurrent episodes of ocular inflammation (n = 13, 48.1%), blepharospasm (n = 10, 37.0%), corneal ulcers (n = 8, 29.6%), entropion (n = 6, 22.2%), and impaired vision (n = 4, 14.8%). Brow skin was removed as follows: (i) First incision parallel and 10–15 mm dorsal to upper lid, slightly extending beyond medial/lateral canthi; (ii) second incision forming an arc with its apex 15–35 mm dorsal to the first incision; and (iii) standard two or three layers closure. In 22/27 dogs, a Stades‐like procedure was performed by removing a 2–4 mm strip of skin above eyelid margin and leaving it to heal by secondary intention (no sutures). At last recheck (follow‐up 354.5 ± 187.8 days), 19/27 dogs (70.4%) had an adequate eyelid conformation, 7/27 dogs (25.9%) were considered under‐corrected, and 1/27 dogs (3.7%) was over‐corrected. Most owners (81.5%) were satisfied with the surgical results. Most cases (96.3%) had no recurrence of the clinical signs during the entire follow‐up period.

Conclusions

Brow rhytidectomy ± Stades‐like procedure provide good cosmetic and clinical outcomes in Chow Chow and Shar‐Pei dogs, although under correction may occur in severely affected dogs and with advancing time.
Supplemental Material: Evolution and uranium mineralization of the northern Ordos Basin revealed by detrital zircons of the Jurassic strata
Authors: Liu Yuan , Liu Hang , al. et
Published: July 2024

Table S1: Modal Point-Count Data for the sandstones of the Zhiluo Formation in the northern Ordos Basin. Table S2: Detrital zircon U-Pb ages for the Jurassic Zhiluo Formation in the northern Ordos Basin. Table S3: Detrital zircon Lu-Hf isotopes for the Jurassic Zhiluo Formation in the northern Ordos Basin. Table S4: Major and trace elements of sedimentary rocks from the Zhiluo Formation, northern Ordos Basin.
Induction of the PERK-eIF2α-ATF4 Pathway in M1 Macrophages under Endoplasmic Reticulum Stress
Authors: Kolodeeva O. E. , Kolodeeva O. E. , Averinskaya D. A. , Makarova Yu. A.
Published: July 2024

Translation inhibition can activate two cell death pathways. The first pathway is activated by translational aberrations, the second by endoplasmic reticulum (ER) stress. In this work, the effect of ribosome-inactivating protein type II (RIP-II) viscumin on M1 macrophages derived from the THP-1 cell line was investigated. The number of modified ribosomes was evaluated by real-time PCR. Transcriptome analysis revealed that viscumin induces the ER stress activated by the PERK sensor.
Cost-effectiveness analysis of rezvilutamide versus bicalutamide in the treatment of metastatic hormone-sensitive prostate cancer
Authors: Ding Haiying , Li Shujing , Xu Xinglu , Xu Weiben , He Chaoneng , Xin Wenxiu , Zhan ZhaJun , Fang Luo
Published: July 2024

Objectives

The economic implications of combining rezvilutamide with androgen deprivation therapy (ADT) remain uncertain, despite the observed survival advantages compared with bicalutamide plus ADT. Therefore, this study evaluates the cost-effectiveness of rezvilutamide plus ADT as the first-line treatment of metastatic hormone-sensitive prostate cancer (mHSPC) from the perspective of the Chinese healthcare system.

Design

A partitioned survival model was developed to assess the cost-effectiveness of rezvilutamide combined with ADT. Clinical data were obtained from the CHART trial. Costs and utility values were obtained from local estimate and published literature. Only direct medical costs were included in the model.

Interventions

Rezvilutamide was administered at 240 mg daily or bicalutamide at 50 mg daily until progression.

Outcome measures

The main outputs of the model included costs and quality-adjusted life years (QALYs), which were used to determine the incremental cost-effectiveness ratio (ICER). One-way and probabilistic sensitivity analysis (PSA) were used to explore model uncertainties.

Results

The rezvilutamide group showed an expected gain of 2.28 QALYs and an incremental cost of US$60 758.82 compared with the bicalutamide group. The ICER for rezvilutamide group versus bicalutamide group was US$26 656.94 per QALY. The variables with the greatest impact on the model results were the utility for progression-free survival state and the price of rezvilutamide. PSA revealed that rezvilutamide group had 100% probability of being cost-effective at a willingness-to-pay threshold of US$35707.5 per QALY.

Conclusion

Rezvilutamide in combination with ADT is more cost-effective compared with bicalutamide plus ADT as the first-line treatment of mHSPC from the perspective of the Chinese healthcare system.
Demographic, socioeconomic and health determinants of depressive symptoms in adults 50 years and older from Mexico: a secondary data longitudinal analysis from the Mexican Health and Aging Study
Authors: Giraldo-Rodríguez Liliana , Torres-Castro Sara , Roa-Rojas Paloma Arlet , Alvarez-Cisneros Teresa
Published: July 2024

Background

Depression in ageing adults is a public health problem. Worldwide studies have identified social and health risk factors for depressive symptoms. However, little is known about their longitudinal determinants in Mexico.

Objectives and setting

To find the prevalence of depressive symptoms and their longitudinal individual and contextual risk factors in Mexican adults aged 50 and older.

Design

Secondary data of 6460 persons aged 50 years and older from the Mexican Health and Aging Study were analysed using a ‘between-within’ panel data analysis approach.

Results

The prevalence of depressive symptoms increased from 35% in 2003 to 38% in 2015. The significantly longitudinal factors associated with these symptoms were getting older (OR 1.02, 95% CI 1.01 to 1.03), being a woman (OR 2.39, 95% CI 2.16 to 2.64), less time spent in formal education (0 years and less than 6 years OR 1.52, 95% CI 1.32 to 1.75 and OR 1.33, 95% CI 1.19 to 1.50, respectively), lower net worth (OR 1.13, 95% CI 1.08 to 1.17), being recently unemployed (OR 1.25, 95% CI 1.10 to 1.25), increased (OR 1.17, 95% CI 1.10 to 1.25) or increasing number (OR 1.23, 95% CI 1.15 to 1.31) of chronic conditions, poor (OR 4.68, 95% CI 4.26 to 5.15) or worsened (OR 1.71, 95% CI 1.61 to 1.81) self-rated health and having impairments on instrumental activities of daily living (IADLs) (OR 2.94 95% CI 2.35 to 3.67) or a new IADL impairment (OR 1.67, 95% CI 1.48 to 1.89), as well as having impairments on ADLs (OR 1.51, 95% CI 1.23 to 1.86) or a new ADL impairment (OR 1.34, 95% CI 1.21 to 1.48).

Conclusions

The prevalence of depressive symptoms in Mexican adults aged 50 and older is high. Our findings show that they are longitudinally associated with the individual’s demographic, socioeconomic, health and disability characteristics. Efforts in public policy should focus on preventing chronic conditions and disability, as well as fighting inequalities to reduce the prevalence of depressive symptoms.
Burden of non-communicable diseases among women of reproductive age in Kenya: a cross-sectional study
Authors: Okyere Joshua , Ayebeng Castro , Dickson Kwamena Sekyi
Published: July 2024

Objective

To examine the burden of non-communicable diseases (NCDs) among women of reproductive age in Kenya, highlighting the prevalence and risk factors.

Design

Cross-sectional design based on the 2022 Kenya Demographic and Health Survey.

Setting

Kenya.

Primary outcomes

Predict the burden of hypertension, diabetes, heart disease, lung disease, arthritis, depression, anxiety, breast and cervical cancer.

Results

Overall, 15.9% of Kenyan women aged 15–49 years were living with at least one NCD. The most prevalent NCD among this cohort was hypertension (8.7%) followed by arthritis (2.9%) and depression (2.8%). Our findings revealed that increasing age, increasing wealth, being married or formerly married, being overweight or obese, consuming alcohol and some occupations were risk factors of NCDs among women of reproductive age in Kenya.

Conclusion

We conclude that hypertension is the most prevalent NCD among women of reproductive age in Kenya. The findings underscore the multifaceted nature of NCD risk factors in Kenya, emphasising the importance of targeted interventions that consider age, economic status, education, marital status, occupation and lifestyle factors.
Efficacy and safety of butylphthalide in patients with mild cognitive impairment: a multicentre, randomised, double-blind, placebo-controlled trial (EBMCI study)
Authors: Wang Pin , Sun Wenxian , Gong Jin , Han Xiaodong , Xu Chang , Chen Yufei , Yang Yuting , Luan Heya , Li Shaoqi , Li Ruina , Wen Boye , Lv Sirong , Wei Cuibai
Published: July 2024

Introduction

The efficacy of multitarget neuroprotective drug DL-3-n-butylphthalide (NBP) in improving cognitive function has been confirmed in patients with vascular cognitive impairment without dementia. However, its efficacy in patients with symptomatic predementia phase of Alzheimer’s disease remains uncertain. This study aims to evaluate the efficacy and safety of NBP in improving cognitive function in patients with mild cognitive impairment (MCI) through a clinical randomised controlled trail.

Methods and analysis

This study is a 12-month, randomised, double-blind, placebo-controlled, multicentric trial, involving 270 patients with MCI. Subjects are randomly assigned to receive either NBP soft capsule (200 mg, three times per day) or placebo with an allocation ratio of 1:1. The efficacy and safety of NBP are assessed by comparing the results of neuropsychological, neuroimaging and laboratory tests between the two groups. The primary endpoint is the change in Alzheimer’s Disease Assessment Scale-Cognitive Subscale after 12 months. All patients will be monitored for adverse events.

Ethics and dissemination

This study involving human participants has been reviewed and approved by Ethics Committee of Xuan Wu Hospital (No.2017058). The participants provide their written informed consent to participate in this study. Results will be published in peer-reviewed medical journals and disseminated to healthcare professionals at local and international conferences.

Protocol version

V 3.0, 3 September 2022.

Trial registration number

ChiCTR1800018362.
Defining indicators for disease burden, health outcomes, policies and barriers and facilitators to health services for migrant populations in the Middle East and North African region: a protocol for a suite of systematic reviews
Authors: Seedat Farah , Evangelidou Stella , Abdellatifi Moudrick , Bouaddi Oumnia , Cuxart-Graell Alba , Edries Hassan , Elafef Eman , Maatoug Taha , Ouahchi Anissa , Mathilde Pampiri Liv , Deal Anna , Arias Sara , Abdelkhalek Adel , Arisha Ahmed Hamed , Assarag Bouchra , Bani Ibrahim Ahmed , Chaoui Aasmaa , Chemao-Elfihri Wafa , Hassouni Kenza , Hilali Mahmoud , Khalis Mohamed , Mansour Wejdene , Mtiraoui Ali , Wickramage Kolitha , Zenner Dominik , Requena-Mendez Ana , Hargreaves Sally , Migrant Health Working Group MENA
Published: July 2024

Introduction

The Middle East and North African (MENA) region is characterised by high and complex migration flows, yet little is known about the health of migrant populations, their levels of underimmunisation and access to healthcare provision. Data are needed to support regional elimination and control targets for key diseases and the design and delivery of programmes to improve health outcomes in these groups. This protocol describes a suite of seven systematic reviews that aim to identify, appraise and synthesise the available evidence on the burden and health outcomes, policies and access (barriers and facilitators) related to these mobile populations in the region.

Methods

Seven systematic reviews will cover three questions to explore the: (1) burden and health outcomes, (2) policies and (3) healthcare barriers and facilitators for the following seven disease areas in migrants in the MENA region: tuberculosis, HIV and hepatitis B and C, malaria and neglected tropical diseases, diabetes, mental health, maternal and neonatal health, and vaccine-preventable diseases. We will search electronic databases for studies in any language (year 2000–2023), reference-check relevant publications and cross-check included studies with experts. We will search for grey literature by hand searching key databases and websites (including regional organisations and MoH websites) for country-specific guidelines and talking to our network of experts for local and regional reports and key datasets. We will assess the studies and policies for their quality using appropriate tools. We will meta-analyse the data by disease outcome if they are of sufficient volume and similarity. Where meta-analysis is not possible and where data are on policy or access, we will narratively synthesise the evidence using summary tables, figures and text.

Dissemination

We anticipate disseminating the findings through peer-reviewed publications, conferences and other formats relevant to all stakeholders. We are following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and protocols will be registered on International Prospective Register of Systematic Reviews.
Exploring the literature on racism and health practitioner regulation: a scoping review protocol
Authors: Chiu Patrick , Louie-Poon Samantha , Leslie Kathleen , Kung Janice Y
Published: July 2024

Introduction

Racism in healthcare leads to significant harm to healthcare professionals and the clients, families and communities they serve. Increasingly, health practitioner regulators—responsible for protecting the public and ensuring practitioner competence—are recognising the importance of reforming policies and practices to contribute to antiracist regulatory approaches. Examples of this work include developing specific standards of practice related to antiracism and antidiscrimination, supporting education and training, re-evaluating discriminatory licensure policies for internationally educated professionals and reforming internal governance structures to address unconscious bias. An understanding of the current state of literature can help identify knowledge gaps and inform the development of research agendas that can build the evidence base required to improve health practitioner regulators’ approaches to addressing racism.

The objective of this scoping review is to explore the nature, extent and range of literature focused on racism and health practitioner regulation and identify gaps in the literature.

Methods and analysis

The review will be conducted in accordance with the Joanna Briggs Institute guidelines for scoping reviews. Database searches will include OVID MEDLINE, EMBASE, CINAHL, Scopus and Web of Science Core Collection. The review will include papers that discuss how health practitioner regulation can contribute to and perpetuate interpersonal and institutional racism, and how regulatory policies and practices can help address racism. We will also search for grey literature using the websites of leading regulatory organisations. Data will be analysed using descriptive statistics and conventional content analysis. Findings will be presented using evidence tables and a narrative summary. Reporting will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews.

Ethics and dissemination

Ethics approval is not applicable to this review protocol. Findings will be disseminated through presentations, meetings with health practitioner regulators and a publication in a peer-reviewed journal.
Therapeutic options for children and young people with moderate-to-severe ulcerative colitis
Authors: Ashton James , Lee Kwang Yang , Thangarajah Anthi , Rodrigues Astor , Kammermeier Jochen
Published: July 2024

There are ever-increasing therapeutic options for patients with ulcerative colitis (UC), but licensing and availability for children and young people are often years behind those aged >18 years. ‘Advanced therapies’, including biologics and small molecules, now target numerous different inflammatory pathways but continue to have a therapeutic ceiling with only 30–60% of patients responding to initial therapies, although with patients achieving mucosal healing having improved long-term outcomes. Within this review, we synthesise the paediatric evidence for the medicines, including anti-tumour necrosis factor, anti-integrin, anti-interleukin-12/23 monoclonal antibodies, alongside Janus kinase (JAK)-inhibitors and Sphingosine-1-phosphate inhibitors, used in moderate-to-severe UC, and extrapolate the adult literature where paediatric data are lacking. Finally, we look at the potential for optimal use and sequencing of these therapies when they are used in an empirical algorithm and consider some of the longer-term implications of loss of response.
International Classification of Disease based Injury Severity Score (ICISS): a comparison of methodologies applied to linked data from New South Wales, Australia
Authors: Berecki-Gisolf Janneke , Rezaei-Darzi Ehsan , Fernando D Tharanga , DElia Angelo
Published: July 2024

Background

The International Classification of Disease Injury Severity Score (ICISS) provides an efficient method to determine injury severity in hospitalised injury patients. Injury severity metrics are of particular interest for the tracking of road transport injury rates and trends. The aims of this study were to calculate ICISS using linked morbidity and mortality datasets and to compare predictive ability of various methods and metrics.

Methods

This was a retrospective analysis of Admitted Patient Data Collection records from New South Wales, Australia, linked with mortality data. Using a split sample approach, design data (2008–2014; n=1 035 174 periods of care) was used to derive survival risk ratios and calculate various ICISS scales based on in-hospital death and 3-month death. These scales were applied to testing data (2015–2017; n=575 306). Logistic regression modelling was used to determine model discrimination and calibration.

Results

There were 12 347 (1.19%) in-hospital deaths and 29 275 (2.83%) 3-month deaths in the design data. Model discrimination ranged from acceptable to excellent (area under the curve 0.75–0.88). Serious injury (ICISS≤0.941) rates in the testing data varied, with a range of 10%–31% depending on the methodology. The ‘worst injury’ ICISS was always superior to ‘multiplicative injury’ ICISS in model discrimination and calibration.

Conclusions

In-hospital death and 3-month death were used to generate ICISS; the former is recommended for settings with a focus on short-term threat to life, such as in trauma care settings. The 3-month death approach is recommended for outcomes beyond immediate clinical care, such as injury compensation schemes.
High early mortality following percutaneous nephrostomy in metastatic cancer: a national analysis of outcomes
Authors: Dosanjh Amandeep , Coupland Benjamin , Mytton Jemma , King Dominic Stephen , Mintz Harriet , Lock Anna , Nanton Veronica , Mariappan Param , Trudgill Nigel , Patel Prashant
Published: July 2024

Objectives

To assess the outcomes of percutaneous nephrostomy in England for renal decompression, in the context of metastatic cancer.

Methods

Retrospective observational study of all patients undergoing nephrostomy with a diagnosis of metastatic cancer from 2010 to 2019 in England, identified and followed up within Hospital Episode Statistics.

The primary outcome measure was mortality (14-day and 30-day postprocedure). Secondary outcomes included subsequent chemotherapy or surgery and direct complications of nephrostomy.

Results

10 932 patients were identified: 58.0% were male, 51.0% were >70 years old and 57.7% had no relevant comorbidities (according to Charlson’s criteria, other than cancer).

1 in 15 patients died within 14 days of nephrostomy and 1 in 6 died within 30 days. Factors associated with higher 30-day mortality were the presence of comorbidities (Charlson score 1–4 (OR 1.27, 95% CI 1.08 to 1.50, p=0.003), score 5+ (OR 1.29, 95% CI 1.14 to 1.45), p<0.001)); inpatient nephrostomy (OR 3.76, 95% CI 2.75 to 5.14, p<0.001) and admitted under the care of specialities of internal medicine (OR 2.10, 95% CI 1.84 to 2.40, p<0.001), oncology (OR 1.80, 95% CI 1.51 to 2.15, p<0.001), gynaecology/gynaeoncology (OR 1.66, 95% CI 1.21 to 2.28, p=0.002) or general surgery (OR 1.62, 95% CI 1.32 to 1.98, p<0.001)), compared with urology.

25.4% received subsequent chemotherapy. Receiving chemotherapy was associated with younger patients (eg, age 18–29 (OR 4.04, 95% CI 2.66 to 6.12, p<0.001) and age 30–39 (OR 3.07, 95% CI 2.37 to 3.97, p<0.001)) and under the care of oncology (OR 1.60, 95% CI 1.40 to 1.83, p<0.001) or gynaecology/gynaeoncology (OR 1.64, 95%CI 1.28 to 2.10, p<0.001) compared with urology.

43.8% had subsequent abdominopelvic surgery. Not receiving surgery was associated with inpatient nephrostomy (OR 0.82, 95%CI 0.72 to 0.95,p=0.007): non-genitourinary cancers (eg, gynaecology/gynaeoncology cancer (OR 0.86, 95% CI 0.74 to 0.99, p=0.037)); and under the care of a non-surgical specialty (medicine (OR 0.69, 95% CI 0.63 to 0.77, p<0.001), oncology (OR 0.58, 95% CI 0.51 to 0.66, p<0.001)).

24.5% of patients had at least one direct complication of nephrostomy: 12.5% required early exchange of nephrostomy, 8.1% had bleeding and 6.7% had pyelonephritis.

Conclusions

The decision to undertake nephrostomy in patients with poor prognosis cancer is complex and should be undertaken in a multidisciplinary team setting. Complication rates are high and minimal survival benefit is derived in many patients, especially in the context of emergency inpatient care.
Circular orbits and accretion disk around AdS black holes surrounded by dark fluid with Chaplygin-like equation of state
Authors: Mustafa G. , Maurya S. K. , Ditta A. , Ray Saibal , Atamurotov Farruh
Published: July 2024

In the present work we study the geodesic motion and accretion process of a test particle near an Anti-de Sitter (ADS) BH surrounded by a dark fluid with a Chaplygin-like equation. Within the defined paradigm, we investigate on the equatorial plane and examine circular geodesics along with their features related to stabilities, radiation energy flux, oscillations and orbits. The general form of the fluid accretion onto the AdS BH through dynamical analysis and mass expansion also has discussed in a depth. Additionally, a few more interesting topics, e.g. the effective potential, angular momentum, specific energy, radiation energy and epicyclic frequencies have also been examined thoroughly. All the attributes are physically acceptable within the observational signatures and ranges.
Investigation of full-charm and full-bottom pentaquark states
Authors: Azizi K. , Sarac Y. , Sundu H.
Published: July 2024

The continuous advancement of experimental techniques and investigations has led to observations of various exotic states in particle physics. Each addition to this family of states not only raises expectations for future discoveries but also focuses attention on such potential new states. Building upon this motivation and inspired by recent observations of various traditional and exotic particles containing an increased number of heavy quarks, our study provides a spectroscopic search for potential pentaquark states with spin-parity $$\frac{3}{2}^-$$

3
2

-

and composed entirely of charm or bottom quarks. We predict the masses for full-charm and full-bottom pentaquark states as $$m = 7628 \pm 112$$

m
=
7628
±
112

 MeV and $$m = 21,982 \pm 144$$

m
=
21
,
982
±
144

 MeV, respectively. We also compute the current couplings of these states to vacuum, which are main inputs in investigations of their various possible decays.
Why insect swarms seem unduly complicated
Authors: Reynolds Andy M.
Published: July 2024

Mating swarms of flying male insects are a form of collective behaviour, albeit one different from flocks and schools as they do not display ordered collective movements. In recent years, much progress has been made in uncovering the emergent mechanical-like and thermodynamic-like of such swarms. Nonetheless, two basic properties of this swarming behaviour remain unexplained. Namely, why do individual insects have erratic rather than regular flight patterns? And why are the swarms elliptical rather than circular? Here I account for this seemingly undue complexity. I show that regular flight patterns weaken an individual’s attraction to the swarm centre, making swarms less resilient to the presence of environmental disturbances. I then show that the elliptical shape of swarms of the non-biting midge Chironomus riparius optimizes the trade-off between maximizing swarm size (target size for females) and maximizing swarm stability. Finally, I show that the observed excess velocity kurtosis of swarming C. riparius maximizes swarm cohesiveness. Taken together the new results provide the first tentative evidence for fine-tuning in insect mating swarms driven by selection pressure for advantageous behaviours.

Graphic abstract
Concept Evolution Detecting over Feature Streams
Authors: Zhou Peng , Guo Yufeng , Yu Haoran , Yan Yuanting , Zhang Yanping , Wu Xindong
Published: July 2024

The explosion of data volume has gradually transformed big data processing from the static batch mode to the online streaming model. Streaming data can be divided into instance streams (feature space remains fixed while instances increase over time), feature streams (instance space is fixed while features arrive over time), or both. Generally, online streaming data learning has two main challenges: infinite length and concept changing. Recently, feature stream learning has received much attention. However, existing feature stream learning methods focus on feature selection or classification but ignore the concept changing over time. To the best of our knowledge, this is the first work that studies concept evolution detection over feature streams. Specifically, we first give the formal definition of concept evolution over feature streams, which include three different types: concept emerging, concept drift, and concept forgetting. Then, we design a novel framework to detect the concept evolution over feature streams that consists of a sliding window, an improved density peak-based clustering algorithm, and a weighted bipartite graph-based concept detecting method. Extensive experiments have been conducted on several synthetic and high-dimensional datasets to indicate our new method’s ability to cluster and detect concept evolution over feature streams.