bluuebunny/crossref_metadata_2025 huggingface dataset:
Use of assistive technology to assess distal motor function in subjects with neuromuscular disease
Authors: Vincent-Genod Dominique , Roche Sylvain , Barrière Aurélie , de Lattre Capucine , Tinat Marie , Venema Eelke , Lagrange Emmeline , Gomes Lisboa de Souza Adriana , Thomann Guillaume , Coton Justine , Gautheron Vincent , Féasson Léonard , Rippert Pascal , Vuillerot Carole
Published: January 2025

Among the 32 items of the Motor Function Measure scale, 3 concern the assessment of hand function on a paper-based support. Their characteristics make it possible to envisage the use of a tablet instead of the original paper-based support for their completion. This would then make it possible to automate the score to reduce intra- and inter-individual variability. The main objective of the present study was to validate the digital completion of items 18, 19, and 22 by measuring the agreement of the scores obtained using a digital tablet with those obtained using the original paper-based support in children and adults with various neuromuscular diseases (NMD). The secondary objective is to calibrate an algorithm for the automatic items scoring. Design: Prospective, multicentre, non-interventional study. Methods: Ninety-eight subjects aged 5 to 60 years with a confirmed NMD completed MFM items 18, 19, and 22 both on a paper support and a digital tablet. Results: The median age of included subjects was 16.2 years. Agreement between scores as assessed using the weighted Kappa coefficient was almost perfect for the scores of items 18 and 22 (K = 0.93, and 0.95, respectively) and substantial for item 19 (K = 0.70). In all cases of disagreement, the difference was of 1 point. The most frequent disagreement concerned item 19; mainly in the direction of a scoring of 1 point less on the tablet. An automatic analysis algorithm was tested on 82 recordings to suggest improvements. Conclusion: The switch from original paper-based support to the tablet results in minimal and acceptable differences, and maintains a valid and reproducible measure of the 3 items. The developed algorithm for automatic scoring appears feasible with the perspective to include them in a digital application that will make it easier to monitor patients.
Sociodemographic and behavioral factors associated with diet quality among low-income community health center patients with hypertension
Authors: Cheng Jessica , Faulkner Katherine C. , Malone Ashlie , Gu Kristine D. , Thorndike Anne N.
Published: January 2025

Objective

Identify the most important sociodemographic and behavioral factors related to the diet of low-income adults with hypertension in order to guide the development of a community health worker (CHW) healthy eating intervention for low-income populations with hypertension.

Design

In this cross-sectional analysis, dietary recalls were used to assess Healthy Eating Index-2020 (HEI-2020) total (range: 0 to 100 [best diet quality]) and component scores and sodium intake. Self-reported sociodemographic and behavioral data were entered into a Least Absolute Shrinkage and Selection Operator (LASSO) regression model to determine the relative importance of factors related to diet quality.

Setting

Five community health centers in Boston, Massachusetts.

Participants

Adults (>20 years old) with a hypertension diagnosis.

Results

Participants (N = 291) were mostly female (65.0%), on Medicaid (82.8%), food insecure (59.5%), and Hispanic (52.2%). The mean (95% CI) HEI-2020 score was 63.0 (62.3, 65.7) Component scores were low for sodium and whole grains; mean (SE) sodium intake was 2676.9 (45.5) mg/day. The most important factors associated with lower HEI-2020 scores were: not having own housing, male gender, tobacco use, marijuana use, and skipping meals; the most important factors associated with higher HEI-2020 scores were Hispanic ethnicity and receipt of community food resources (5-fold cross-validated R2 = 0.17).

Conclusions

In this population of low-income adults with hypertension, diet quality would be improved by reducing sodium and increasing whole grain intake. Healthy eating interventions among low-income populations should consider providing dietary guidance in the context of behavioral factors (e.g., meal skipping) and substance use (e.g., marijuana) and should address barriers to health eating through referral to community food resources (e.g., food pantries).
Cardiorespiratory demands of firearms training instruction and 15m shuttle tests in British law enforcement
Authors: Warwick Joseph , Cooper Sophie , Ronca Flaminia
Published: January 2025

Objectives

Law enforcement agencies require minimum fitness standards to safeguard their officers and training staff. Firearms instructors (FI) are expected to maintain the same standards as their operational counterparts. This study aimed to quantify the daily physiological demands placed on FI.

Methods

19 FI (45 ± 5 years) completed occupational tasks whilst wearing heart rate (HR) monitors for a minimum 10 days. Maximal oxygen consumption (VO2max) testing was conducted on FI during a treadmill test (TT) and a multistage shuttle test (ST). Linear regression models were used to model the relationship between VO2 and HR throughout the TT. This model was applied to HR data from occupational tasks to infer oxygen consumption. Repeated Measures ANOVAs were used to compare time spent in VO2max equivalent zones throughout.

Results

The VO2max achieved during ST (45.1 ± 5.6 ml/kg/min) was significantly higher than TT (39 ± 3 ml/kg/min) (p = 0.014). Time to exhaustion (TTE) was sooner on ST (06:26 min) compared to TT (13:16 min) (p < .001). FI spent ~85% of occupational time with an oxygen demand ≤20 ml/kg/min (p < .005). The most intense occupational tasks saw FI achieve VO2max ≥30 ml/kg/min, but <40 ml/kg/min.

Conclusion

Using ST to assess cardiorespiratory fitness resulted in a quicker TTE and a higher VO2max. Predominantly, FI occupational tasks are low intensity with sporadic exposures requiring a VO2max of >40 ml/kg/min. To safeguard FI from occupational-related cardiorespiratory or long-term health issues, it is intuitive to suggest fitness standards should exceed a VO2max of 40 ml/kg/min.
Iron deficiency and fatigue in inflammatory bowel disease: A systematic review
Authors: Sartain Stephanie , Al-Ezairej Maryam , McDonnell Martin , Westoby Catherine , Katarachia Vasiliki , Wootton Stephen A. , Cummings J. R. Fraser
Published: January 2025

Background

It is unclear what impact iron deficiency has on fatigue in people with inflammatory bowel disease (IBD). This systematic review examined the evidence of whether iron deficiency, with or without anaemia, was associated with fatigue in IBD. Fatigue is a common symptom in patients with IBD that can be difficult to manage and treat. A greater understanding of the role and contribution of iron deficiency to fatigue may help improve the management of this condition.

Methods

The databases searched were MEDLINE, OVID, CINAHL and Web of Science. Inclusion criteria were studies measuring iron status for iron deficiency (ID) and patient-reported outcome measures (PROMs) for fatigue in patients with IBD of any level of disease activity. Assessment of bias was conducted using the Newcastle Ottawa Scale. Studies were grouped for syntheses according to whether exposure was iron deficiency without anaemia (IDWA) or ID regardless of haemoglobin level.

Results

Two hundred and eighty-five individual database results were identified and screened; 32 complete records were reviewed, from which seven studies with 1425 individuals were deemed eligible for inclusion in the results synthesis. Considerable variation in the methods and statistical analysis used to investigate the relationship between ID and fatigue prevented any quantitative synthesis. Studies varied by population disease activity levels, approaches used to define ID and PROMs used to measure fatigue. Three studies directly compared fatigue scores in IDWA to those not iron deficient, two of which showed patients with IDWA had significantly lower fatigue scores. Four studies used ID irrespective of anaemia as the exposure and reported mixed results on fatigue, with only one study reporting a higher prevalence of fatigue in the ID group.

Conclusions

There was marked heterogeneity between studies in this review. Two studies found evidence of a slight increase in fatigue levels in patients with IDWA. Though this does not explain all fatigue in patients with IBD, iron replacement should be considered to improve fatigue in iron-deficient patients.
Association between depression and the prevalence and prognosis of prediabetes: Data from National Health and Nutrition Examination Survey (NHANES) 2013–2018
Authors: Zhou Jin , Yang Xiaojiao
Published: January 2025

Background

Diagnosis and intervention of prediabetes is an emerging approach to preventing the progression and complications of diabetes. Inflammatory factors and dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis have been suggested as potential mechanisms underlying the pathogenesis of both diabetes and depression. However, the relationship between depression levels and the prevalence of prediabetes and its prognosis remains elusive. This study aimed to explore the relationship between depression and the prevalence of prediabetes and to further explore the all-cause mortality of different levels of depression in patients with prediabetes.

Methods

Our study used a data set from the National Health and Nutrition Examination Survey (NHANES). Participants were initially divided into two groups (depression vs. non-depression) and further stratified by different depression severity levels. We used a weighted multiple logistic regression model to analyze the association between depression and prediabetes prevalence and a Cox regression model to assess all-cause mortality in prediabetic patients.

Results

A total of 4384 participants were included, divided into depression group (n = 1379) and non-depression group (n = 3005). Results showed that people with depression were at higher risk of developing prediabetes. After adjusting for covariates, moderate to severe depression was positively associated with prediabetes (moderate to severe depression vs no depression: OR = 1.834, 95%CI: 0.713–4.721; severe depression vs no depression: OR = 1.004, 95% CI 0.429–2.351). In addition, we explored the relationship between all-cause mortality and depressive status in patients diagnosed with prediabetes (n = 2240) and found that moderate to severe depression (HR = 2.109, 95%CI 0.952–4.670) was associated with higher mortality in patients with prediabetes.

Conclusions

Overall, the findings consistently suggest that depression is positively associated with both the prevalence and mortality risk among individuals with prediabetes. This suggests that depression may be a new and valuable indicator of prediabetes risk. Early treatment of depression improves outcomes in prediabetes.
Trends in the levels, causes, and risk factors of maternal mortality in Pakistan: A comparative analysis of national surveys of 2007 and 2019
Authors: Midhet Farid , Khalid Samina Naeem , Baqai Shehla , Khan Shahzad Ali
Published: January 2025

Background

Maternal mortality ratio (MMR) has decreased worldwide but Pakistan is still striving towards achieving the SDG targets for maternal health. This study highlights the trends in maternal mortality levels and risk factors in Pakistan between 2007 and 2019.

Methods

This study compares the results of secondary data analysis of the Pakistan Maternal Mortality Survey 2019 with the Pakistan Demographic and Health Survey 2007. A nested case-control study was carved to compare maternal deaths with the women who survived a pregnancy, in the same sampling clusters during the same period. Logistic regression was used to estimate odds ratios (OR) for major risk factors of maternal mortality after adjusting for the women’s age, parity, education, and wealth quintile.

Results

In 2019, Pakistan’s MMR was 186 per 100,000 live births, registering a 33% decline from 2007 (rural 42% vs. urban 11%). The leading causes of maternal mortality were postpartum hemorrhage, hypertensive disease of pregnancy, postpartum infection, and post-abortion complications. Women > 35 years and those expecting their first child were more likely to die from childbirth, while those who had ever used family planning had a lower risk according to the data for both years. In 2007, a distance of > 40 kilometers to a hospital significantly increased the risk of mortality but this association was not significant in 2019. In 2019, women who died were more likely to receive antenatal care than those who survived (adjusted OR 9.3); this association was not significant in 2007.

Conclusion

The modest reduction in MMR can be attributed to improved access to maternal health services in rural areas with increased antenatal care and institutional deliveries. However, most maternal deaths were caused by poor accessibility to quality emergency obstetric care. Lack of family planning remains a major risk factor for high maternal mortality in Pakistan.
Measurement and evaluation of low-carbon tourism development on islands: A case study in Changdao, China
Authors: Wang Mengsha , Zuo Jiayu
Published: January 2025

China’s island tourism is still in the exploratory stage, and the carbon emissions due to island tourism development are still prominent. This study assesses the development of low-carbon tourism on Changdao Island in China. We constructed an evaluation model for low-carbon tourism on islands based on the driver-pressure-state-impact-response model, and the Entropy Weight Method-Analytical Hierarchy Process Method was combined with the weighting method to determine the index weights of ench evaluation-indicator. The annual changes in the development level of low-carbon tourism, the weights of the indicators, the characteristics of the scores, the low-carbon development mode, and key factors of island tourism were analyzed. The results of the study showed that the indicator “impact” was the most influential element of the island’s low-carbon tourism, and the ecological environment value was higher than that of the economic value. Moreover, energy saving and consumption reduction helped tourists to have a better experience, which further enabled island tourism to have a larger market size. The “response” also occupied a crucial position, where the weighted value of government planning was twice as high as that of corporate practice. The other elements were “pressure”, “state”, and “driving forces”, which showed that low carbon emissions are an important criterion for the island tourism environment and economic factors have the greatest effect in terms of the “driving forces”. The study evaluated the level of low-carbon development in island regionals across multiple dimensions, filled the literature gap, and provided a reference for the study of regional low-carbon and sustainable development of tourism.
Rural Roads to cognitive Resilience (RRR): A prospective cohort study protocol
Authors: Besser Lilah M. , Wiese Lisa , Cook Diane J. , Holt Janet , Magzamen Sheryl , Minor Bryan , Mitsova Diana , Park Juyoung , Sablan Olivia , Tourelle Madeleine , Williams Christine
Published: January 2025

Background

Ambient air pollution, detrimental built and social environments, social isolation (SI), low socioeconomic status (SES), and rural (versus urban) residence have been associated with cognitive decline and risk of Alzheimer’s disease and related dementias (ADRD). Research is needed to investigate the influence of ambient air pollution and built and social environments on SI and cognitive decline among rural, disadvantaged, ethnic minority communities. To address this gap, this cohort study will recruit an ethnoracially diverse, rural Florida sample in geographic proximity to seasonal agricultural burning. We will (1) examine contributions of smoke-related fine particulate matter (PM2.5) exposures to SI and cognitive function; (2) determine effects of built and social environments on SI and cognitive function; and (3) contextualize SI and cognitive function among residents from different ethnoracial groups during burn and non-burn seasons.

Methods

We will recruit 1,087 community-dwelling, dementia-free, ≥45-year-olds from five communities in Florida’s Lake Okeechobee region. Over 36 months, participants will complete baseline visits to collect demographics, health history, and health measurements (e.g., blood pressure, body mass index) and 6-month follow-ups assessing cognitive function and social isolation at each visit. A subsample of 120 participants representative of each community will wear smartwatches to collect sensor data (e.g., heart rate) and daily routine and predefined activities (e.g., GPS-captured travel, frequent destinations) over two months. Ecological momentary assessments (EMA) (e.g., whether smoke has bothered participant in last 30 minutes) will occur over two months during agricultural burning and non-burning months. PurpleAir monitors (36 total) will be installed in each community to continuously monitor outdoor PM2.5 levels.

Discussion

We expect to identify individual- and community-level factors that increase the risk for SI and cognitive decline in a vulnerable rural population.
Comparison of a non-invasive point-of-care measurement of anemia to conventionally used HemoCue devices in Gambella refugee camp, Ethiopia, 2022
Authors: Smith Frederica , Woldeyohannes Meseret , Lusigi Millicent , Samson Kaitlyn L. I. , Mureverwi Blessing Tapera , Gazarwa Dorothy , Mohmand Naser , Theuri Terry , Leidman Eva
Published: January 2025

Annual surveys of refugees in Gambella, Ethiopia suggest that anemia is a persistent public health problem among non-pregnant women of reproductive age (NP-WRA, 15–49 years). Measurement of anemia in most refugee camp settings is conducted using an invasive HemoCue 301. We assessed the accuracy and precision of a non-invasive, pulse CO-oximeter in measuring anemia among NP-WRA in four Gambella refugee camps. We conducted a population-representative household survey between November 7 and December 4, 2022. Hemoglobin (Hb) concentration was measured by HemoCue 301, using capillary blood, and Rad-67, a novel non-invasive device. We collected four measurements per participant: two per device. We calculated Rad-67 bias and precision of Hb measurements and sensitivity and specificity of detecting anemia. Of the 812 NP-WRAs selected, 807 (99%) participated in the study. Anemia was detected in 39% of NP-WRA as classified by the Rad-67 compared with 47% of NP-WRA as classified by the HemoCue 301. Average bias of Rad-67 measurements was 1.1 ± 1.0 SD g/dL, using HemoCue 301 as a comparator. Absolute mean difference between the first and second measurements was 0.9 g/dL (95% CI 0.8, 0.9) using the Rad-67, compared with 0.6 g/dL (95% CI 0.5, 0.6) using the HemoCue 301. The Rad-67 had 49% sensitivity and 70% specificity for detecting anemia, compared with the HemoCue 301. The Rad-67 can be a useful tool for anemia screening; however, lower accuracy and precision, and poor sensitivity suggest it cannot immediately replace the HemoCue 301 in the study area.
Comparing the effects of computerized versus manual methods of identifying point-specific acupuncture as an adjunct to physiotherapy in the management of knee osteoarthritis: A randomized controlled trial protocol
Authors: Li Lee Chai , Ahmad Mohd Azzuan , Hou Tan Chee , Ann Je Angeline Low , Lin Lee Zi , Ling Tay Yan , Yan Peng
Published: January 2025

Background

Knee osteoarthritis (KOA) is a prevalent condition causing significant pain and functional impairment. Acupuncture has shown promise as an adjunctive therapy, but conventional manual selection of acupoints lacks standardization. The Acugraph system provides a computerized method for identifying acupoints, potentially enhancing treatment precision.

Objective

This study aims to compare the effects of computerized Acugraph-guided acupuncture versus manually selected acupuncture as adjuncts to physiotherapy in managing KOA.

Methods

A randomized, double-blind controlled trial will be conducted with 50 participants diagnosed with mild to moderate KOA. Participants will be randomly assigned to one of two groups: Group 1 Comp-AcuPhysio (n = 25), receiving Acugraph-guided acupuncture with physiotherapy, or Group 2 Man-AcuPhysio (n = 25), receiving manually selected acupuncture with physiotherapy. Both groups will undergo 12 weekly treatment sessions, each lasting 60 minutes. Outcome measures, including the Knee Injury and Osteoarthritis Outcome Score, active knee flexion range, Timed Up and Go test, Visual Analog Scale for pain, Short Form-36 health survey, and Personal Integrated Energetics score, will be assessed at baseline and immediately post-intervention. An intention-to-treat analysis will be applied. Changes from baseline to 12 weeks will be analyzed using repeated measures analysis of variance for both within-group and between-group comparisons.

Results

This study will provide a definitive assessment of the effectiveness of computerized Acugraph-guided acupuncture compared to manually selected acupuncture as supplementary treatments alongside KOA physiotherapeutic rehabilitation.

Conclusion

This trial will offer insights into how incorporating technology-driven approaches, such as Acugraph, with physiotherapy can enhance the customization and effectiveness of KOA management, leading to improved clinical outcomes. These results could advocate for the integration of technological tools in acupuncture to boost treatment precision and efficacy for KOA.

Trial registration

Australian New Zealand Clinical Trials Registry (ACTRN12624000646549p).
Mesenchymal stem cell-derived exosome and liposome hybrids as transfection nanocarriers of Cas9-GFP plasmid to HEK293T cells
Authors: Gharehchelou Behnaz , Mehrarya Mehrnoush , Sefidbakht Yahya , Uskoković Vuk , Suri Fatemeh , Arjmand Sareh , Maghami Farnaz , Siadat Seyed Omid Ranaei , Karima Saeed , Vosough Massoud
Published: January 2025

Exosomes are natural membrane-enclosed nanovesicles (30–150 nm) involved in cell-cell communication. Recently, they have garnered considerable interest as nanocarriers for the controlled transfer of therapeutic agents to cells. Here, exosomes were derived from bone marrow mesenchymal stem cells using three different isolation methods. Relative to filtration and spin column condensation, the size exclusion chromatography led to the isolation of exosomes with the highest purity. These exosomes were then hybridized with liposomes using freeze-thaw cycles and direct mixing techniques to evaluate whether this combination enhances the transfection efficiency of large plasmids. The efficiency of these hybrids in transferring the Cas9-green fluorescent protein plasmid (pCas9-GFP) into the human embryonic kidney 293T (HEK293T) cells was evaluated compared to the pure exosomes. Both Cas9-GFP-loaded exosomes and exosome-liposome hybrids were taken up well by the HEK293T cells and were able to transfect them with their plasmid loads. Meanwhile, the treatment of the cells with plasmids alone, without any vesicles, resulted in no transfection, indicating that the exosome and exosome-liposome hybrids are essential for the transfer of the plasmids across the cell membrane. The pure exosomes and the hybrids incorporating liposomes obtained by the heating method transfected the cells more efficiently than those containing liposomes obtained by the thin film hydration technique. Interestingly, the method of combining exosomes with liposomes (freeze-thaw vs. direct mixing) proved to be more decisive in determining the size of the vesicular hybrid than their composition. In contrast, the liposome component in the hybrids proved to be decisive for determining the transfection efficiency.
Estimating whole-body centre of mass sway during quiet standing with inertial measurement units
Authors: Foulger Liam H. , Reiter Emma R. , Kuo Calvin , Carpenter Mark G. , Blouin Jean-Sébastien
Published: January 2025

Our ability to balance upright provides a stable platform to perform daily activities. Balance deficits associated with various clinical conditions may affect activities of daily living, highlighting the importance of quantifying standing balance in ecological environments. Although typically performed in laboratory settings, the growing availability of low-cost inertial measurement units (IMUs) allows the assessment of balance in the real world. However, it is unclear how many IMUs are required to adequately estimate linear displacements of the centre of mass (CoM) at stance widths associated with daily activities. While wearing IMUs on their head, sternum, back, right thigh, right shank, and left shank, 16 participants stood quietly on a force platform in narrow, hip-width, and shoulder-width stances, each for three two-minute trials. Using a multi-segment biomechanical model, we estimated CoM displacements from all possible combinations of the IMUs. We then calculated the correlation between the IMU- and force platform- CoM estimates to determine the minimal number of IMUs needed to estimate CoM sway. Four IMUs were necessary to accurately estimate anteroposterior (AP) and mediolateral (ML) CoM displacements across stance widths. Using IMUs on the back, right thigh, and both shanks, we found strong correlations between the IMU CoM estimation and the force platform CoM estimation in narrow stance (AP: r = 0.92±0.04, RMSE = 2.39±2.08 mm; ML: r = 0.97±0.02, RMSE = 1.16±0.77 mm), hip-width stance (AP: r = 0.93±0.04, RMSE = 2.00±1.18 mm; ML: r = 0.92±0.06, RMSE = 0.92±0.70 mm), and shoulder-width stance (AP: r = 0.93±0.03, RMSE = 1.95±1.66 mm; ML: r = 0.86±0.13, RMSE = 1.39±1.46 mm). These results indicate that IMUs can be used to estimate CoM displacements during quiet standing and that four IMUs are necessary to do so. Using an algorithm based on a simple biomechanical model, researchers and clinicians can estimate whole-body CoM displacements accurately during unperturbed quiet standing. This approach can improve the ecological validity of standing balance research and opens the possibility for assessing/monitoring patients with standing balance deficits.
Feasibility and resource utilization of nurse-administered subcutaneous immunoglobulin therapy in antibody deficiency: A cross-sectional study
Authors: Ghia Darshee , Thota Pranavi , Ritchie Taylor , Rana Heli , Minhas Ranvir , Moolji Jalal , Ritchie Bruce , Adatia Adil
Published: January 2025

Primary and secondary antibody deficiencies (PAD and SAD) are amongst the most prevalent immunodeficiency syndromes, often necessitating long-term immune globulin replacement therapy (IRT). Both intravenous immunoglobulin (IVIG) and subcutaneous immunoglobulin (SCIG) have demonstrated efficacy in antibody deficiency. Comparative analyses of these two routes of administration are limited to nurse-administered IVIG and home therapy with self-administered SCIG. A third programmatic approach, SCIG administered by nurses in hospital-based outpatient infusion clinics, combines certain advantages of IVIG and home SCIG such as the provision of nursing support and the reduced risk of systemic reactions associated with the subcutaneous route. This cross-sectional study aimed to compare the viability and resource utilization of nurse-administered SCIG with IVIG in patients with antibody deficiency. We hypothesized that nurse-administered SCIG would require a similar amount of infusion clinic time per month as IVIG, despite more frequent dosing, due to shorter individual appointments, while maintaining high patient satisfaction. Information on infusion duration, time in the infusion chair, direct nursing time, and treatment satisfaction using the Life Quality Index was collected. Time measures for each patient were expressed as minutes/4 weeks to account for the more frequent dosing of nurse-administered SCIG compared to IVIG. We determined that the total time, infusion time, and nursing time needed to provide nurse-administered SCIG was comparable to IVIG. The more frequent dosing of SCIG was offset by the shorter times required per infusion. Patients reported favorable treatment satisfaction with both nurse-administered SCIG and IVIG. We conclude that nurse-administered SCIG may be a useful treatment modality for well-selected individuals.
Comparing the technical and individual possession statistics of academy players across different age groups in match-play
Authors: Escreet Emily , Barrett Steve , Toner John , Iga John , Towlson Christopher
Published: January 2025

Background

Youth soccer players in the UK transition into the professional game at 16 years of age. Understanding the differences between youth and professional standards can help coaches and clubs to support player development during this transition.

Objectives

To (i) assess the differences in technical and possession statistics between different age groups (U16, U18, U23) and outfield positions (central defender [CD], wide defender [WD], central midfielder [CM], attacking midfielder [AM], wide midfielder [WM], striker [ST]), within an English academy soccer programme, during match-play.

Methods

All matches were monitored using foot-mounted inertial measurements units (F-IMU; Playermaker™) to quantify the technical (touches and releases from the feet) and individual possession statistics (Time on the ball, Time on the ball per possession) from each match. Teams were instructed to play a 1-4-3-3 formation as part of their clubs playing philosophy, with positions defined per this formation. Data were analysed using a multi-variate ANOVA Two-tailed statistical significance was accepted as p ≤ 0.05 and measures of effect size were calculated using partial eta-squared (η2). Magnitude of the effect sizes were small (0.2<ES<0.6), moderate (0.6<ES<1.2), large (1.2<ES<2) and very large (≥2).

Results

Trivial to small effect sizes were observed across age groups for both technical and possession-based statistics during match-play. Across all age groups and positions, CD`s had the highest number of technical actions (touches and releases), whereas ST`s & AM`s, had the highest amount of time in possession of the ball. Further, positional analysis showed ST`s and AM`s had moderate to large decreases in time on the ball per possession at the U23’s age group in comparison to the U16 and U18’s, with no technical differences observed within the same positional analysis.

Conclusion

Attacking players (AM & ST) are required to move the ball quicker as they progress from U16 to U23’s within the current English football academy. Further exploration is required to assess if these changes are context specific given requirements of those age groups.
Forecasting the use of chiropractic services within the Veterans Health Administration
Authors: Bensel Victoria A. , Corcoran Kelsey , Lisi Anthony J.
Published: January 2025

Objective

To model future use of chiropractic services and predict clinical resource needs within the Veterans Health Administration (VA) over the next 5 years.

Methods

A serial cross-sectional analysis of chiropractic use data from VA’s Corporate Data Warehouse for fiscal years (FY) 2017 through 2022 (10/1/2016-9/30/2022). We calculated the proportion of VA chiropractic users–via care provided on-station and/or purchased from Community Care Network (CCN) providers–compared to overall VA healthcare users for each FY. We calculated the historical year-over-year compound annual growth rate (CAGR), which was used to predict use in FY2023 through 2027 (10/1/2022-9/30/2027).

Results

VA’s chiropractic use rate increased from 1.4% in FY2017 to 3.5% in FY2022, at which point 2.0% of VA users received only CCN chiropractic care, 1.3% only on-station, and 0.2% both. During the 6-year observation period, the CAGRs were overall 17.9%, CCN only 23.8%, on-station only 12.4%, and both 27.7%. Using those rates to extrapolate, by the end of FY2027 overall use will be 8.9%, with 5.9% only CCN, 2.3% only on-station, and 0.6% both.

Conclusion

Overall use of VA chiropractic services is projected to more than double from FY 2022 to FY2027. These findings underscore the need for proactive resource planning to address the expected increased use of both CCN and on-station care.
An enhanced Transformer framework with incremental learning for online stock price prediction
Authors: Qian Yiming
Published: January 2025

To address the limitations of existing stock price prediction models in handling real-time data streams—such as poor scalability, declining predictive performance due to dynamic changes in data distribution, and difficulties in accurately forecasting non-stationary stock prices—this paper proposes an incremental learning-based enhanced Transformer framework (IL-ETransformer) for online stock price prediction. This method leverages a multi-head self-attention mechanism to deeply explore the complex temporal dependencies between stock prices and feature factors. Additionally, a continual normalization mechanism is employed to stabilize the data stream, enhancing the model’s adaptability to dynamic changes. To ensure that the model retains prior knowledge while integrating new information, a time series elastic weight consolidation (TSEWC) algorithm is introduced to enable efficient incremental training with incoming data. Experiments conducted on five publicly available datasets demonstrate that the proposed method not only effectively captures the temporal information in the data but also fully exploits the correlations among multi-dimensional features, significantly improving stock price prediction accuracy. Notably, the method shows robust performance in coping with non-stationary and frequently changing financial market data.
Development and validation of the Health Segment Classification of Population Encompassed within Singapore (HealthSCOPES) framework
Authors: Ang Ian Yi Han , Rahman Nabilah , Wong Shing Hei , Ng Sheryl Hui-Xian , Tan Kyle Xin Quan , Eh Ke Xin , Ling Zheng Jye , Lim Andrea Su En , Tan Kelvin Bryan , Toh Sue Anne
Published: January 2025

Introduction

The population is heterogeneous with varying levels of healthcare needs. Clustering individuals into health segments with more homogeneous healthcare needs allows for better understanding and monitoring of health profiles in the population, which can support data-driven resource allocation.

Methods

Using the developed criteria, data from several of Singapore’s national administrative datasets were used to classify individuals into the various health segments. Cross-sectional analysis of healthcare utilization charges was conducted. Validation was done for the framework’s prognostic ability of clinically relevant outcomes measured in the following year.

Results

The framework is comprised of twelve segments classed within four broad groups. The segments comprising individuals with cancer, with transitional care needs, and in the last year of their lives had the highest mean per resident healthcare charges. The segments comprising adults and seniors with complex chronic conditions and with transitional care needs had the highest percentage of individuals historically diagnosed with obesity. The framework was able to distinguish varying tiers of healthcare utilization charges and relative risk of death in the following year.

Discussion

The framework was developed using a hybrid approach, with expert input and comprehensive national data that extended beyond the usual hospital patient population. The framework can be directly applied for use in program or policy design, evaluation, and cost-effectiveness analyses.

Conclusion

The HealthSCOPES framework was developed to segment the entire population in Singapore with similar healthcare needs.
Differential insulin response characteristics of graphene oxide–gold nanoparticle composites under varied synthesis conditions
Authors: Zhang Qian , Pan Yanjun , Pan Jin , Wang Zhichen , Lu Ruyi , Sun Jing , Feng Jingyi
Published: January 2025

The structural alterations in the constituent materials of nanocomposites such as graphene nanocomposites typically induce changes in their properties including mechanical, electrical, and optical properties. Therefore, by altering the preparation conditions of nanocomposites and investigating their responsiveness to basic biomolecules (such as proteins), it is possible to explore the application potentials of the composites and guide development of new nanocomposite preparation. In this study, different composites of graphene oxide and gold nanoparticles (AuNPs/GO) were obtained by varying the volumes of reducing agents used in the one-pot hydrothermal method. Insulin was chosen as a basic protein to study the response characteristics of AuNPs/GO under different preparation conditions. Optical responses of these composites to pure insulin and various commercial insulin types were all explored for the first time. The results indicated that AuNPs/GO could optically respond to insulin, including pure insulin and various types of commercial insulin, and changes in the preparation conditions could really influence this response. Moreover, optimal preparation conditions could be determined by an optical method for the largest responses of the nanocomposites to insulin. Based on previous research and the results of this study, it is speculated that the responses of AuNPs/GO to insulin may attribute to glutamic acids, asparagines, and glutamines on insulin, which may interact with AuNPs/GO, particularly with the AuNPs in the composites. Besides, the AuNPs/GO could exhibit relatively stable responses to various commercial insulin types and detect the concentration of specific branded commercial insulin with smaller errors. In summary, this study demonstrated the application potential of AuNPs/GO in areas such as drug testing and production, while also furnishing an experimental foundation and direction for further applications of AuNPs/GO in biosensing and biomolecule detection.
Tillage type and sentinel insect species affect the relative prevalence of the entomopathogenic fungus, Metarhizium robertsii, in soil
Authors: Tillotson Shea A. W. , Voortman Christina A. , Wallace John M. , Barbercheck Mary E.
Published: January 2025

Because the use of synthetic agrochemicals is generally not allowed in organic crop production systems, growers rely on natural substances and processes, such as microbial control, to suppress insect pests. Reduced tillage practices are associated with beneficial soil organisms, such as entomopathogenic fungi, that can contribute to the natural control of insect pests. The impacts of management, such as tillage, in a cropping system can affect soil biota in the current season and can also persist over time as legacy effects. We investigated the in-season and legacy effects of soil management in four, three-year organic feed grain and forage production systems that varied in number and intensity of soil disturbances on the relative prevalence of the entomopathogenic fungus, Metarhizium robertsii. Employing sentinel bait assays with Tenebrio molitor and Galleria mellonella, we found that relative prevalence, measured as infection rate of sentinel insects, was lowest in systems utilizing a shallow high-speed disk (G. mellonella: 14%; T. molitor: 23%) in the current and previous seasons compared to systems that included inversion and non-inversion tillage (G. mellonella: 22%; T. molitor: 34%) or no-till planting (G. mellonella: 21%; T. molitor: 30%,). There was no difference in prevalence in systems that included the use of a high-speed disk compared to a perennial hay crop (G. mellonella: 16%; T. molitor: 28%). There were no negative legacy effects of inversion tillage on the prevalence of M. robertsii in subsequent crops. Sentinel assays with G. mellonella (19%) produced overall lower estimates of relative prevalence of M. robertsii than T. molitor (29%) but the association of relative prevalence with environmental variables was greater in assays with G. mellonella. We suggest that the use of occasional inversion tillage is not damaging to populations of M. robertsii in soil and that surveys using assays with multiple sentinel insect species will improve our ability to understand the effects of agricultural practices on entomopathogenic fungi.
Induction of stigma-like structures in saffron (Crocus sativus L.): Exploring factors and metabolite analysis
Authors: Mahmoudi Parvaneh , Moieni Ahmad , Khayam Nekouei Mojtaba , Mardi Mohsen , Hosseini Salekdeh Ghasem
Published: January 2025

Saffron (Crocus sativus L.) has held significant cultural and medicinal value since the Greek-Minoan civilization. As a triploid spice with vegetative propagation from the Iridaceae family, the three-branch style of C. sativus flowers, known as saffron, constitutes the most economically valuable part of the plant, renowned for its diverse medicinal properties. This study explores the in vitro induction of stigma-like structures (SLSs) from various explants of the Ghaen ecotype flower. The study found that the optimal sampling time for the majority of explants was the third week of October. Ovary explants exhibiting a prolonged response to hormonal treatments for the production of SLSs. Furthermore, intact, and injury ovary explants were found to be the most effective explant types for inducing SLSs. The explants were cultured on MS, 1/2MS, LS and B5 basal media supplemented with various combinations and concentrations of plant growth regulators. The results indicated that the B5 medium, enriched with 5–10 mg/ L BAP and 5–10 mg/ L NAA was the most effective treatment for inducing SLSs in all types of explants. Quantitative and qualitative analyses of saffron compounds in SLSs indicated similarities with natural saffron, albeit at significant lower concentrations: crocin (up to 10.2 mg/g), picrocrocin (up to 4.8 mg/g), and safranal (up to 9.7 mg/g). The highest accumulation of the three studied secondary metabolites was observed in the SLSs of style (24.4 mg/g), stigma (28.3 mg/g), and ovary (21.4 mg/g) explants, respectively. This study introduces a comprehensive procedure for producing SLSs containing the three most important metabolites of saffron for the first time.
Capacity-building interventions for health extension workers in Ethiopia: A scoping review
Authors: Astale Tigist , Mesele Helina , Pasquino Sarah-Louise , Zewdie Anteneh , Wolka Eskinder , Endalamaw Aklilu , Assefa Yibeltal , Mitike Getnet
Published: January 2025

Introduction

Capacity-building interventions for health extension workers (HEWs) are key to providing quality health services to the community. Since Ethiopia’s Health Extension Program was established, several types of capacity-building interventions have been developed to build HEW competencies. However, no comprehensive study has mapped the types of capacity-building interventions being used or the competencies targeted.

Objective

To (1) identify and characterize evidence on capacity-building interventions for Ethiopian HEWs, including the competencies measured; (2) clarify evidence gaps in this area; and (3) explore how successful the interventions have been to inform the design of health extension programs and further research.

Methods

We used keywords (health extension workers, capacity building, competencies) and related terminologies to search PubMed, Scopus, and Embase for published studies on capacity-building interventions for Ethiopian HEWs, and Google Scholar for unpublished studies and reports. Our search was limited to studies and reports published in English from 2003 to present. We used the JBI scoping review methodology to conduct this scoping review in a stepwise approach and a categorization approach to synthesize the evidence.

Results

Our search strategy identified 20 articles, all published except for one program report. The most common capacity-building intervention designed for HEWs was training, followed by supportive supervision, performance review and clinical mentoring meetings, and equipment supply; the most salient competency domains investigated were knowledge and skills. The interventions significantly improved immediate outcomes (knowledge, skills, attitude change among HEWs) and intermediate outcomes, such as increased service utilization and health-seeking behavior among community members. Only one study assessed whether capacity-building interventions improved inter- and intra-personal domains of capacity/competency.

Conclusions

Capacity-building interventions for Ethiopian HEWs were found to be effective, but they mainly focused on improving technical competencies, such as knowledge and skills. Little attention has been paid to other competency domains, including motivation, leadership, and communication. Thus, future research could focus on a comprehensive set of capacity-building initiatives that addresses motivation, job satisfaction, communication, commitment, and resource allocation.
Microbiota-derived proteins synergize with IL-23 to drive IL22 production in model type 3 innate lymphoid cells
Authors: Wang Yanling , Allan David S. J. , Gewirtz Andrew T.
Published: January 2025

Microbiota-induced production of IL-22 by type 3 innate lymphoid cells (ILC3) plays an important role in maintaining intestinal health. Such IL-22 production is driven, in part, by IL-23 produced by gut myeloid cells that have sensed select microbial-derived mediators. The extent to which ILC3 can directly respond to microbial metabolites via IL-22 production is less clear, in part due to the difficulty of isolating and maintaining sufficient numbers of viable ILC3 ex vivo. Hence, we, herein, examined the response of the ILC3 cell line, MNK-3, to microbial metabolites in vitro. We observed that fecal supernatants (FS), by themselves, elicited modest levels of IL-22 and synergized with IL-23 to drive robust IL-22 production assayed by qRT-PCR and ELISA. The IL-22 synergistic activity of FS was not mimicked by an array of candidate microbial metabolites but could be attributed to bacterial proteins. Examining how MNK3 cells exposed to IL-23, FS, both, or neither via RNA-seq and immunoblotting indicated that FS activated MNK-3 cells in a distinct pattern from IL-23: FS activates p-38 MAPK while IL-23 activates STAT3 signaling pathways. Collectively, these studies indicate ILC3 sensing of microbiota proteins promotes IL-22 production suggesting the possibility of manipulating microbiota to increase IL-22 without risk of IL-23-mediated chronic inflammatory diseases.
An analytical study of active earth pressure in cohesive soil considering interlayer shear stress
Authors: Liu Qizhuo , Zhong Tianci , Li Daocai , Duan Yuanyuan
Published: January 2025

The impact of interlayer shear stress on the distribution of earth pressure in cohesive soil is notable, but currently, there lacks a comprehensive theory that integrates this factor in the calculation of active earth pressure. Drawing from the Mohr stress circle specific to clay soils, a formula to calculate interlayer shear stress has been derived. Moreover, a robust model has been formulated to compute the active earth pressure in clay soils, incorporating elements such as interlayer shear stress, effects of displacement, soil arching, and the morphology of the sliding surface. To address the challenge of integrating interlayer shear stress in clay soils for an explicit solution, a numerical iteration framework was developed. This framework facilitates the calculation of the strength, resultant force, and point of action for the active earth pressure in cohesive soil. The efficacy of this solution was evaluated by comparing it with the Rankine solution, other existing analytical solutions, and outcomes from standard model tests. Notably, when compared with the experimental findings of the word previous study, this new method exhibited a higher congruence, with discrepancies no greater than 9.8%. This indicates a significant enhancement in accuracy, providing a methodological advancement in calculating earth pressure from static to ultimate active states, inclusive of non-limit active earth pressure during controlled wall displacement scenarios. This novel approach not only supplements but also refines the theoretical framework for earth pressure calculations, offering a more precise computational tool for practical engineering applications.