bluuebunny/crossref_metadata_2025 huggingface dataset:
IRT Analysis of the Grit-S Scale: Evaluation With Racially/Ethnically Diverse Adolescents in the US
Authors: Farmer Antoinette Y. , Wei Yuhan , Gale Adrian , Peterson N. Andrew
Published: December 2024

Objective: The factor structure of the Grit-S is the subject of much debate. The purpose of this study was to examine the factor structure of the Grit-S and validate its psychometric properties among racially/ethically minoritized adolescents using Item Response Theory (IRT). Method: Data were collected from 651 racially/ethnically minoritized adolescents who were enrolled in a college access program in a U.S. northeastern state. Results: The analysis indicated the Grit-S has a correlated two-factor model, consisting of a Perseverance of Effort (PE) subscale and a Consistency of Interest (CI) subscale, without a higher-order grit factor. Moreover, item information curves indicated the PE subscale has a low precision at the higher level of theta. The concurrent validity with self-efficacy indicated PE has a strong correlation with self-efficacy while CI does not. Conclusions: The Grit-S may need to be revised to assess the concept of grit for racially/ethnically minoritized adolescents. Valid measurement of the grit construct is crucial to applied research and evaluation of interventions specifically designed to promote grit in adolescents. Additional research is needed to examine how racially/ethnically minoritized adolescents understand the concept of grit.
Anti-inflammatory Effect of Commiphora  gileadensis L. Induces Cardiovascular Integrity Markers in Male Diabetic Mice
Authors: Alhazmi Ayman Saeed
Published: December 2024

Background

Cardiovascular disease continues to be a predominant source of morbidity and mortality globally. Commiphora gileadensis L. is a tree under the genus Commiphora.

Purpose

To investigate the anti-inflammatory effect of C. gileadensis L. on cardiovascular and its action in maintaining cardiovascular integrity in Type 1 diabetic mice.

Methods

Fifty male Bagg albino (BALB/c) mice are classified into five groups: control, untreated diabetic, diabetic C. gileadensis L. sap-treated, methanol extract-treated, and acetone extract-treated. For each mouse in five groups body weight, glycated hemoglobin (HbA1c), sodium, potassium, chloride, urea, creatinine, alanine aminotransferase (ALT), lipid profile, aspartate aminotransferase (AST), lactate dehydrogenase (LD), total creatine kinase (CK), creatine kinase-myocardial band (CK-MB), adropin, nitric oxide (NO), endothelin-1, and vascular endothelial growth factor (VEGF) were measured. In addition, total lymphocytes, CD3+, CD4+, CD8+, CD4+ CD25+, and CD8+ CD25+ were measured in all groups.

Results

Compared to the untreated diabetic group, diabetic groups treated with C. gileadensis L. had significantly increased body weight after 6 months ( p < 0.05). Diabetic mice treated with C. gileadensis L. extracts had significantly lower HbA1c levels than the diabetic untreated group ( p < 0.01). Furthermore, C. gileadensis L. extracts lowered serum urea and creatinine in diabetic mice ( p < 0.05). Triglyceride, cholesterol, and low-density lipoprotein (LDL) were reduced in mice treated with C. gileadensis L. extracts, whereas high-density lipoprotein (HDL) was elevated compared with diabetic untreated mice ( p < 0.01). Serum AST and endothelin-1 were significantly decreased in diabetic groups treated with C. gileadensis L. extracts ( p < 0.05), while adropin and NO increased ( p < 0.01). Diabetic mice treated with C. gileadensis L. extracts had significantly lower LD, total CK, CK-MB, and VEGF levels than the untreated diabetic group ( p < 0.01). In addition, C. gileadensis L. reduces CD3+, CD4+, CD8+, while increases CD4+ CD25+, and CD8+ CD25+ subsets in diabetic mice ( p < 0.0001).

Conclusion

C. gileadensis L. induces the levels of cardiovascular integrity markers (adropin and NO) and reduces cardiovascular malfunction markers [endothelin-1 (ET-1) and VEGF] in diabetic mice. The observed properties could be attributed to the antioxidant activity of C. gileadensis L. Furthermore, C. gileadensis L. may help in the prevention of atheroma formation by reducing CD4+ and CD8+ and increasing T regulatory cells (CD4+ CD25+ and CD8+ CD25+).
Comparing Combination vs Monochemotherapy in Late-Elderly Patients With Advanced Pancreatic Cancer: Insights From a Single-Center Study
Authors: Orlandi Elena , Citterio Chiara , Chinelli Rebecca , Dotti Ilaria , Zaffignani Elena , Biasini Claudia , Anselmi Elisa , Cremona Gabriele , Vecchia Stefano
Published: December 2024

Objectives

The incidence of pancreatic ductal adenocarcinoma (PDAC) increases with age and is frequently diagnosed at an inoperable stage, which limits treatment options. There is limited evidence concerning patients over 75 years old, and clinical practice often lacks clear guidance regarding the choice of first-line therapy. The primary objective of this retrospective study was to assess overall survival (OS) in elderly patients receiving first-line monochemotherapy vs combination therapy. Secondary objectives included evaluating progression-free survival (PFS) and safety.

Methods

This retrospective study analyzed the records of 150 patients aged 75 or older with confirmed PDAC treated with first-line chemotherapy at Piacenza General Hospital, Italy. Of these, 72 patients received monotherapy, while 78 underwent polychemotherapy. The majority of patients (93.3%) were administered reduced doses, and within this group, 67.9% had their doses reduced by more than 20%. Most patients (80%) presented with comorbidities, predominantly hypertension and diabetes.

Results

The median overall survival was significantly higher in the polychemotherapy group (8.2 months) compared to the monotherapy group (4.7 months), with a P-value of 0.0022. The median PFS was 5.7 months for polychemotherapy and 2.8 months for monotherapy, showing a statistically significant difference ( P = 0.004). In the multivariate analysis, poor performance status, high CA19.9 levels, and monotherapy were significantly associated with worse OS. Patients treated with polychemotherapy had a 37% lower likelihood of death within the year compared to those treated with monotherapy (HR 0.58, P = 0.009).

Conclusion

Polychemotherapy may provide a survival advantage over monotherapy in the late-elderly population, although considerations for dose adjustments due to comorbidities and polypharmacy are necessary. These findings suggest that, when feasible, polychemotherapy could offer a balance between effectiveness and tolerability, potentially improving outcomes in this age group.
Curriculum Development and Evaluation at the William & Mary Center for Gifted Education
Authors: Floyd Chandra B.
Published: December 2024

At the Center for Gifted Education at William & Mary, content-based curriculum development and dissemination of materials for teaching gifted and high-ability learners has always been central to the mission. For over three decades, curriculum materials have been developed using Joyce VanTassel-Baska’s Integrated Curriculum Model (ICM) and field-tested in classrooms around the country. With each revision of current materials and during the development of new materials, every effort is made to hold true to the theoretical underpinnings of the ICM. This article offers a glimpse at our ongoing commitment to the core of this well-researched model.
“Despartares Decoloniales”: The Implications of “Territorio Cuerpo-Tierra” for Studying Women's Embodied Resilience to Trauma in El Salvador, Central America
Authors: Liegghio Maria , Ordóñez Sánchez Sandra Guadalupe
Published: December 2024

We explore the implications of the concept of territorio cuerpo-tierra for conducting research on women's resilience to trauma and post-COVID-19 pandemic recovery in El Salvador, Central America. Cuerpo-territorio forces a reconceptualization of women's realities as bound to the embodiment of the geo-politics of gender, body, and land as territories, and thus, their realities as bound to the histories and temporality of those as territories. Through a series of despartares decoloniales (decolonial awakenings), we postulate that resilience research reproduces narrowly defined understanding of women's realities and responses to both the symbolic and physical conditions and adversities of their lives.
Adverse spinopelvic mobility in patients undergoing total hip arthroplasty is associated with high mobility of the hip in a flexed seated position
Authors: Aubert Thomas , Halle Aurelien , Gerard Philippe , Riouallon Guillaume , Auberger Guillaume , Lhotellier Luc
Published: December 2024

Purpose:

Adverse spinopelvic mobility from a standing to a flexed seated position of more than 20° of the spinopelvic tilt (∆SPT) has been shown to have a high risk of dislocation. If hypermobility of the hip analysed with the pelvic femoral angle (∆PFA) has a high risk of impingement, the correlation between the range of motion of the hip from a standing to a flexed seated position and its implication in adverse spinopelvic mobility has not been described.

Methods:

A series of 337 patients treated with primary THA underwent lateral x-ray in standing and flexed seated positions to analyse ∆SPT, ∆PFA and spinopelvic parameters. The objectives were to establish a ∆PFA threshold associated with a ∆SPT ⩾20° and to subsequently investigate its influence in conjunction with spinopelvic risk factors on the occurrence of adverse spinopelvic mobility.

Results:

The area under the curve was 0.904 (95%CI, 0.864–0.945) for ∆PFA to predict ∆SPT ⩾ 20°; it was predicted by ∆PFA ⩾ 95° with a sensitivity of 91.7% and a specificity of 74.4% at the Youden optimal threshold. Patients with a ∆SPT < 20° (277 patients) had a mean ∆PFA of 83° compared to 110° if ∆SPT ⩾ 20° (60 patients) ( p < 0.001). Patients with a ∆PFA < 95° (203 patients) had a mean ∆SPT of −6° compared to 18° if ∆PFA ⩾ 95° (134 patients) ( p < 0.001). ∆PFA ⩾ 95° rates were 95% (57/60) and 27.8% (77/200) in patients with ∆SPT ⩾ 20° and ∆SPT < 20°, respectively (OR 49.35; CI, 15.01–162.28; p < 0.001).

Conclusions:

High mobility of the hip (∆PFA ⩾ 95°) seems to be a necessary condition for adverse spinopelvic mobility. A preoperative analysis of patients with lower hip mobility, associated with spinopelvic risk factors, might identify patients with abnormal spinopelvic mobility after the restoration of femoral flexion.

Trial registration:

IDRCB 2023-A01390, CNIL MR004 2225508 (07/06/2023), retrospectively registered.
Association between education level and access to disease-modifying treatment in patients with multiple sclerosis in France
Authors: Lefort Mathilde , Dejardin Olivier , Berger Eric , Camdessanché Jean-Philippe , Ciron Jonathan , Clavelou Pierre , De Sèze Jerome , Debouverie Marc , Heinzlef Olivier , Labauge Pierre , Laplaud David Axel , Michel Laure , Lebrun-Frénay Christine , Moreau Thibault , Pelletier Jean , Ruet Aurélie , Thouvenot Eric , Vukusic Sandra , Zephir Hélène , Defer Gilles , Leray Emmanuelle
Published: December 2024

Background:

We hypothesized that differences in access to disease-modifying treatments (DMTs) could explain the association between socioeconomic status and disability progression in multiple sclerosis (MS).

Objective:

This study aimed to analyze the association between education level and DMT use in France.

Methods:

All patients from OFSEP network with MS onset over 1996–2014 and aged ⩾ 25 years at onset were included. Three time-to-event outcomes were investigated using flexible parametric survival regression models: time from MS onset to first DMT (any) and to platform therapy, and time from platform therapy to switch to high-efficacy therapy.

Results:

Overall, 7563 patients were included (mean follow-up 12.6 ± 5.9 years). The percentages of patients aged less than 40 years at MS onset and who initiated treatment before the age of 40 years were significantly higher in the groups with a higher education level. The time-to-event outcomes showed no major difference in DMT practices according to education level, except for women who had a significantly shorter time to DMT initiation in medium to very high education level groups versus low, at 5 years from MS clinical onset.

Conclusion:

Our results suggest that the association between education level and MS disability progression does not solely reflect different therapeutic practices, particularly in men.
On the feasibility of country-specific and country-general explanations for the increase over time in psychosomatic complaints among Nordic adolescents
Authors: Stattin Håkan , Eriksson Charli
Published: December 2024

Aims:

This study examines the evidence for similar increases in psychosomatic complaints among 15-year-olds in the Nordic countries over the period 2002–2022. A distinction is made between the level and shape of these time trends.

Methods:

A dataset from the Health Behaviour in School-aged Children survey from 2002 to 2022 was used. Time trends for psychosomatic complaints were analysed for five Nordic countries: Denmark, Finland, Iceland, Norway and Sweden.

Results:

A significant increase in psychosomatic complaints over the last two decades was found among 15-year-old boys and girls in all countries, especially among girls. The shapes of the time trends were very similar for adolescents in all Nordic countries. There were significant differences in the time trends between the countries. Here, the countries with high or low levels of psychosomatic complaints in 2022 were largely the same as those with high or low levels of psychosomatic complaints years earlier.

Conclusions:

The high degree of similarity observed in the shapes of the time trends for psychosomatic complaints among Nordic adolescents, as evidenced by this study, suggests that explanations for the observed increases in these psychosomatic complaints should be sought in conditions common to the five countries. However, country-specific explanations are more likely to be candidates for understanding differences in the levels of these time trends. The potential for differentiation between shapes and levels using the aggregate technique when comparing countries also provides an opportunity to empirically examine country-general and country-specific explanations for trends in measures in other areas of research.
Forest bathing and tourism: A bibliometric analysis
Authors: Pérez-Calderón Esteban , Miguel-Barrado Vanessa , Rodríguez-Rangel María Cristina
Published: December 2024

The shinrin-yoku activity, or forest bathing, is inspired by a Japanese therapeutic tradition that involves spending time in the forest to improve health. This activity offers various applications for scientific research in different fields such as health, therapy, psychology, or tourism. This work aims to analyze both the current state and the evolution of scientific research on forest bathing activity. Specifically, to discuss the potential of this activity in the dimension of sustainable tourism. For this purpose, using the VOSviewer software, papers published in the Web of Science and Scopus databases between 2008 and 2023 were analyzed. The main results of this research support that forest bathing activity is experiencing progressive growth in the scientific literature, especially from the perspective of health and medicine. However, it is an activity that is little explored from the tourism perspective. The above would be especially interesting in those natural spaces located in rural areas where good tourism management of this activity could be another business opportunity that combats depopulation, socioeconomic underdevelopment, and natural disasters such as fires.
Demographics shaping memorable wellness tourism experiences: A comparative analysis
Authors: Dahanayake Shakila , Wanninayake Bandara , Ranasinghe Ruwan
Published: December 2024

This study addresses gaps in literature and empirical research by investigating international wellness tourists in Sri Lanka, segmenting them by memorable wellness tourism experiences (MWTE), and analyzing differences in demographics, travel patterns, and preferred wellness activities among these segments. Data were collected from November 2023 to April 2024 using non-probability convenience sampling, yielding 622 valid responses. SPSS software was employed for data analysis, utilizing factor-cluster methods. The findings revealed three distinct clusters: Professional Authentic Value Wellness Seekers, Holistic Enrichment Wellness Seekers, and Serene Aesthetics Wellness Seekers, each characterized by unique preferences and demographic profiles. Majority of respondents were middle-aged, educated, and employed, predominantly female, and primarily from Europe. Popular wellness activities included Ayurveda, spa treatments, and yoga. Substantial differences in demographics, travel patterns, and wellness activity preferences were identified among the clusters. The study’s originality lies in segmenting Sri Lanka’s international wellness tourists by memorable experiences, revealing new insights into demographics, travel patterns, and preferences. It offers profound insights into an underexplored destination, aiding targeted marketing and strategic development in wellness tourism. Additionally, it advances segmentation theory by integrating memorable experiential dimensions and guiding strategic marketing and product development aligned with these identified segments.
Valproic Acid Inhibits Endoplasmic Reticulum Stress and Reduces Ferroptosis After Traumatic Brain Injury
Authors: Chen Jie , Li Lei , Huang Lei , Zhao Chengyu , Ruan Zhanwei
Published: December 2024

Backgound

Traumatic brain injury (TBI) is a severe neurological disorders, which invloving complicated molecular mechanisms, such as endoplasmic reticulum (ER) stress and ferroptosis. , However, the mechanism underlying TBI remains unclear.

Objectives

The Objective was to determine the effect of VPA on ER stress and ferroptosis, and affirm the relationship between ER stress and ferroptosis. Methods: The expression levels of GRP78, ATF6, CHOP and GPX4 in brain tissues were detected via western blot, histological staining, and immunofluorescence. The effect of VPA on ER stress and ferroptosis on OS cellswas evaluated in vitro and in vivo.

Results

In our study, we found that VPA suppressed ER stress after TBI by inhibiting the GRP78-ATF6-CHOP signaling pathway, which ameliorated ferroptosis by reversing the reduction of the ferroptosis protein GPX4. Furthermore, tissue defects, bleeding, and iron accumulation also reduced. Moreover, 4-phenylbutyric acid was used to further confirm our assumption.

Conclusion

VPA plays a neuroprotective role by inhibiting ER stress levels and subsequently inhibiting ferroptosis.
Splitting Attraction: Differentiating Romantic and Sexual Orientations Among Asexual Individuals
Authors: Winer Canton
Published: December 2024

It is often assumed that sexual and romantic attractions are aligned: that the gender(s) a person is attracted to sexually “matches” the gender(s) to which they are romantically attracted. In this study, I challenge that assumption by centering asexual perspectives on attraction. Drawing on interviews with 77 asexual individuals (a sexual identity referring to those who experience low/no sexual attraction), I find that many frame their attraction as “split.” In this “split attraction” framework, romantic and sexual attractions are treated as having the potential to be unlinked. I examine how this leads some asexual individuals to forge complex identities that draw on both their sexual and romantic orientations, with some using multiple sexual identities simultaneously (e.g., bisexual asexual). I also consider how split attraction frameworks may be applied outside of asexual contexts, arguing that scholars should formulate study designs to accommodate for split attractions and orientations.
Enforced Disappearance as a Border Management Tool: The Case of Border Patrol Detentions of Immigrant and Asylum-Seeking Families in the United States1
Authors: Leal Diego F. , Cadwalader Natalie L.
Published: December 2024

Executive Summary

This study examines the experiences of international migrants and asylum-seeker families recently released from the custody of the United States Border Patrol (BP) to assess their ability to make phone calls while in BP detention. The focus on phone access is critical to determining whether respondents experience enforced disappearance under international law, given that BP custody is usually incommunicado. To determine whether some BP detainees experience enforced disappearance in custody, authors collected and analyzed data from 117 respondents using a novel questionnaire. Respondents were heads of families. These families consisted of at least one adult and at least one minor child who were released to a non-profit short-term shelter in the United States (U.S.). Findings show that 78 percent of the respondents who were in BP custody experienced an enforced disappearance because they were not able to make phone calls and there was no reliable publicly accessible locator system to otherwise locate them.

While this study provides critical context to how one distinct group of individuals released from BP custody (i.e., families released into the U.S.) experienced enforced disappearance, we note the importance of future studies that assess the situation of additional groups, including single adults released from BP into the U.S. and groups and individuals forced back (typically) to Mexico upon release from BP custody. We discuss policy recommendations to mitigate and prevent continued enforced disappearances in BP custody and to prevent additional human rights violations that are facilitated by enforced disappearance, including the right to access counsel, the right to due process, the right to seek asylum, the right of non-refoulment, and that may constitute a grave threat to the right to life.
Efficient small fragment sequencing of human, cattle, and bison miRNA, small RNA, or csRNA-seq libraries using AVITI
Authors: McDonald Anna L. , Boddicker Andrew M. , Savenkova Marina I. , Brabb Ian M. , Qi Xiaodong , Moré Daniela D. , Cunha Cristina W. , Zhao Junhua , Duttke Sascha H.
Published: November 2024

Background

Next-Generation Sequencing (NGS) catalyzed breakthroughs across various scientific domains. Illumina’s sequencing by synthesis method has long been central to NGS, but new sequencing methods like Element Biosciences’ AVITI technology are emerging. AVITI is reported to offer improved signal-to-noise ratios and cost reductions. However, its reliance on rolling circle amplification, which can be affected by polymer size, raises questions about its effectiveness in sequencing small RNAs (sRNAs) such as microRNAs (miRNAs), small nucleolar RNAs (snoRNAs), and many others. These sRNAs are crucial regulators of gene expression and involved in various biological processes. Additionally, capturing capped small RNAs (csRNA-seq) is a powerful method for mapping active or “nascent” RNA polymerase II transcription initiation in tissues and clinical samples.

Results

Here, we report a new protocol for seamlessly sequencing short fragments on the AVITI and demonstrate that AVITI and Illumina sequencing technologies equivalently capture human, cattle (Bos taurus), and bison (Bison bison) sRNA or csRNA sequencing libraries, increasing confidence in both sequencing approaches. Additionally, analysis of generated nascent transcription start site (TSS) data for cattle and bison revealed inaccuracies in their current genome annotations, underscoring the potential and necessity to translate small and nascent RNA sequencing methodologies to livestock.

Conclusions

Our accelerated and optimized protocol bridges the advantages of AVITI sequencing with critical methods that rely on sequencing short fragments. This advance bolsters the utility of AVITI technology alongside traditional Illumina platforms, offering new opportunities for NGS applications.
Unveiling the antibacterial action of ambroxol against Staphylococcus aureus bacteria: in vitro, in vivo, and in silico investigation
Authors: Abdelaziz Ahmed A. , Abo-Kamar Amal M. , Ashour Alaa E. , Shaldam Moataz A. , Elekhnawy Engy
Published: November 2024

It is critical to find novel therapeutic approaches owing to the dissemination of multidrug resistance (MDR) in pathogenic bacteria, particularly Staphylococcus aureus. FDA-drug repurposing is an important therapeutic tactic to fight MDR bacteria. Here, we inspected the antibacterial activity of ambroxol against clinical MDR S. aureus isolates. Using the broth microdilution method, ambroxol revealed minimum inhibitory concentrations (MICs) of 0.75 to 1.5 mg/mL. Also, it revealed antibiofilm action on 42.17% of the isolates by crystal violet assay. A scanning electron microscope was employed to study the antibiofilm action of ambroxol. It revealed that the association between the cells was interrupted by ambroxol, and the biofilm construction was devastated. Moreover, qRT-PCR was utilized to elucidate the consequence of ambroxol on the gene expression of efflux and biofilm. Remarkably, ambroxol has downregulated the expression of cna, fnb A, ica, nor A, nor B genes. Ambroxol’s in vivo antibacterial action was investigated using S. aureus infected burn infection. Interestingly, ambroxol has improved the histological features of the skin tissues, significantly diminished the bacterial burden, and increased the wound healing percentage. Also, it revealed a significant reduction in the immunohistochemical staining of tumor necrosis factor-alpha. Finally, the in silico investigations were performed to elucidate the potential of ambroxol on five possible targets of S. aureus. Ambroxol showed good affinities on the five investigated targets in S. aureus, with CrtM being the highest, proposing its probable role in the mechanisms for ambroxol’s action on S. aureus.
Understanding the impact of covariates on the classification of implementation units for soil-transmitted helminths control: a case study from Kenya
Authors: Puranik Amitha , Diggle Peter J. , Odiere Maurice R. , Gass Katherine , Kepha Stella , Okoyo Collins , Mwandawiro Charles , Wakesho Florence , Omondi Wycliff , Sultani Hadley Matendechero , Giorgi Emanuele
Published: November 2024

Background

Soil-transmitted helminthiasis (STH) are a parasitic infection that predominantly affects impoverished regions. Model-based geostatistics (MBG) has been established as a set of modern statistical methods that enable mapping of disease risk in a geographical area of interest. We investigate how the use of remotely sensed covariates can help to improve the predictive inferences on STH prevalence using MBG methods. In particular, we focus on how the covariates impact on the classification of areas into distinct class of STH prevalence.

Methods

This study uses secondary data obtained from a sample of 1551 schools in Kenya, gathered through a combination of longitudinal and cross-sectional surveys. We compare the performance of two geostatistical models: one that does not make use of any spatially referenced covariate; and a second model that uses remotely sensed covariates to assist STH prevalence prediction. We also carry out a simulation study in which we compare the performance of the two models in the classifications of areal units with varying sample sizes and prevalence levels.

Results

The model with covariates generated lower levels of uncertainty and was able to classify 88 more districts into prevalence classes than the model without covariates, which instead left those as “unclassified”. The simulation study showed that the model with covariates also yielded a higher proportion of correct classification of at least 40% for all sub-counties.

Conclusion

Covariates can substantially reduce the uncertainty of the predictive inference generated from geostatistical models. Using covariates can thus contribute to the design of more effective STH control strategies by reducing sample sizes without compromising the predictive performance of geostatistical models.
Non-alcoholic fatty liver disease and the gut microbiota in adolescents: is there a relationship?
Authors: Amrousy Doaa El , Ashry Heba El , Maher Sara , Elsayed Yousef , Hasan Samir
Published: November 2024

Background

Despite the increasing prevalence of nonalcoholic fatty liver disease (NAFLD), the pathophysiology is still not fully understood. Recent evidence suggests that the gut microbiota may play a role in the pathophysiology of NAFLD and may also offer new therapeutic options.

Methods

This prospective cross-sectional study included 100 consecutive newly diagnosed obese patients (BMI ≥ 95th percentile), aged 14–18 years with NAFLD (confirmed by ultrasound), persistently elevated levels of alanine aminotransferase (ALT) greater than 60 U/L for 1–6 months, and 100 healthy controls. We evaluated changes in the gut microbiota in NAFLD adolescents compared with healthy controls.

Results

According to the multiple logistic regressions, the variables associated with NAFLD were the presence of Clostridium difficile, the presence of Salmonella spp., a greater abundance of Bifidobacterium and Prevotella, and a lower abundance of Lactobacillus.

Conclusion

Changes in the gut microbiota occur in adolescents with NAFLD compared with healthy individuals, which may be useful for identifying youths who are amenable to gut microbiota-based interventions.

Clinical trial number

Not applicable.
Putting measurement-based care into action: a multi-method study of the benefits of integrating routine client feedback in coordinated specialty care programs for early psychosis
Authors: Meyer-Kalos Piper , Owens Grace , Fisher Melissa , Wininger Lionel , Williams-Wengerd Anne , Breen Kimberleigh , Abate Josephine Pita , Currie Ariel , Olinger Nathan , Vinogradov Sophia
Published: December 2024

Background

Measurement-based care (MBC) is an effective tool in the delivery of evidence-based practices (EBPs). MBC utilizes feedback loops to share information and drive changes throughout a learning healthcare system. Few studies have demonstrated this practice in team-based care for young people with early psychosis. This paper describes the development of a personalized feedback report derived from routine assessments that is shared with clients and clinicians as part of a MBC process.

Methods

We used a multi-method approach to evaluate the implementation of a personalized feedback report at 5 early psychosis coordinated specialty care programs (CSC). We compared clients enrolled in CSC who did and did not receive a feedback report over the first 6 months of treatment. The sample included 204 clients: 146 who did not receive the feedback report (treatment as usual, TAU) and were enrolled over 2 years, and 58 who received the feedback report. A subset of 67 clients completed measures at both intake and 6-month follow-up, including 42 who received the personalized feedback report and 25 who did not. We compared the two groups with regard to self-reported symptoms, likelihood of completing treatment, and perception of shared decision making. We conducted qualitative interviews with 5 clients and 5 clinicians to identify the benefits and challenges associated with the personalized feedback report.

Results

The total sample showed significant improvements in shared decision-making and in their intent to complete the program. Post hoc analyses revealed significant increases in the personalized feedback group, and non-significant changes in the TAU group, although group-by-time interactions did not reach statistical significance. The feedback report group engaged in significantly more sessions of Supported Employment and Education (SEE), case management, and peer support, and fewer medication visits over the first 6 months of treatment. Both groups showed significant improvement in symptoms and functioning. Results from the qualitative analysis indicated that the experience of receiving the reports was valuable and validating for both patients and clinicians.

Conclusions

A personalized feedback report was integrated into standard of care for early psychosis programs. This process may improve shared decision-making, strengthen the likelihood to stay in treatment, and increase treatment attendance in psychosocial interventions. We posit that this process facilitates recovery-oriented care, strengths-focused treatment planning, enhances intrinsic motivation, and strengthens the therapeutic alliance.
Familial resemblance in dietary intake among singletons, twins, and spouses: a meta-analysis of family-based observations
Authors: Teymoori Farshad , Akbarzadeh Mahdi , Norouzzadeh Mostafa , Kazemi Jahromi Mitra , Farhadnejad Hossein , Saber Niloufar , Ahmadirad Hamid , Jahangiri Mina , Habibi Danial , Riahi Parisa , Mokhtari Ebrahim , Zarkesh Maryam , Daneshpour Maryam S. , Mirmiran Parvin , Vafa Mohammadreza
Published: November 2024

Background

Familial dietary intake can be influenced by both genetic and environmental factors; the current study aimed to examine the role of these two factors on dietary intake by investigating the resemblance in energy, nutrient, and food group intake among spouses and siblings in twin and family-based studies.

Methods

The online literature databases, including PubMed, Scopus, Web of Science, and Cochrane Library were systematically searched up to September 2024. The pooled correlation coefficient (r) of studies was calculated using Fisher’s z and standard error (SE) of z’s of all studies and our final results were reported in six groups including non-twin siblings, monozygotic (MZ) twins, dizygotic (DZ) twins, all-twins, all siblings, and spouse.

Results

Our findings on 30 observational studies indicate that siblings, especially MZ twins, tend to have similar dietary intake, with high correlations for vegetables (r: 0.59), red meat (r: 0.58), and fruits (r: 0.56). Among DZ twins, the lowest correlations were observed for eggs (r: 0.07), soft drinks (r: 0.14), and daily intake of simple carbohydrates (r: 0.17). DZ twins did not show significant differences in dietary resemblance compared to non-twin siblings. Among spouses, the highest correlations for dietary intake were found for polyunsaturated fats (r: 0.41), saturated fats (r: 0.40), and total fats (r: 0.39), while the lowest correlation was for protein intake (r: 0.24).

Conclusions

While the greatest similarity in dietary intake was observed among MZ twins, no significant difference in dietary intake similarity was noted between DZ twins and non-twin siblings. Furthermore, spouses exhibited a significant degree of similarity in their dietary consumption. Therefore, dietary intake is shaped by a complex interplay of genetic and environmental factors, warranting further investigation to validate these observations.
Experiences with COVID-19 economic relief measures among low-wage worker families: a qualitative study
Authors: Caspi Caitlin E. , Gombi-Vaca Maria , Antrum Curtis , Gudaf Salma , De Marco Molly , Welle Emily , Sheppard Brett , Fordyce Kristi , Pratt Rebekah
Published: November 2024

Background

Economic stability is a core social determinant of health and a necessary condition for maintaining food security, housing stability, and both physical and mental health. Using a qualitative approach, we identified barriers, facilitators, and participant perceptions about utilizing these relief measures. This study aimed to understand experiences with COVID-19 economic relief measures among low-wage worker households with children during the COVID-19 pandemic.

Methods

The study conducted semi-structured qualitative interviews from low-wage workers in households with children in two U.S. cities in 2022 (n = 40). The sample was recruited from a larger study which included survey measures of demographics and receipt or utilization of a range of relief measures with both broad and narrow eligibility criteria (e.g., Economic Impact Payments, expanded Supplemental Nutrition Assistance Program (SNAP), Pandemic Electronic Benefit Transfer (P-EBT), expanded Child Tax Credit, expanded unemployment insurance, and the eviction moratorium). A thematic analysis of 40 interviews was conducted using a constructivist approach to grounded theory, from which barriers, facilitators, and participant perceptions were identified.

Results

Interviews identified burdensome administrative processes, administrative errors, and a lack of information as barriers to access among those who were eligible; automatic processes for distributing benefits was identified as a facilitator. Participants expressed positive perceptions about benefits, mixed with some ambivalence about the need to receive them and concern over their discontinuation.

Conclusions

A segment of the population at risk of economic instability identified both barriers and facilitators to receiving an array of economic relief measures during the COVID-19 pandemic. Findings suggest that providing automatic processes for enrollment and reliable information streams for learning about benefits can bolster benefit receipt among those at risk of economic instability. These findings can contribute to the base of knowledge for policymakers involved in responding to the next public health emergency.
Exploring student perceptions on virtual reality in anatomy education: insights on enjoyment, effectiveness, and preferences
Authors: Al-Hor Mohammed , Almahdi Hamad , Al-Theyab Majed , Mustafa Ayman G. , Seed Ahmed Mohammed , Zaqout Sami
Published: December 2024

Background

The dynamic landscape of medical education demands innovative teaching methods. This study introduces virtual reality (VR) technology to anatomy courses at Qatar University, aiming to assess students’ receptiveness to virtual anatomy dissection and its potential transformative impact.

Methods

The study utilized a comprehensive survey and the 3D-Organon VR anatomy software to explore students’ perceptions and acceptance of VR in comparison with traditional anatomy learning tools during practical sessions. Fisher’s exact test for independence was performed to gauge shifts in students’ attitudes and preferences towards different educational modalities.

Results

The findings reveal a generally positive reception towards VR, with many students indicating a preference for VR over traditional methods. The study noted significant improvements in understanding and memorization attributed to the use of VR. Exposure to a variety of educational modalities led to notable shifts in student perceptions, particularly an increase in positive perceptions regarding the understanding of anatomy lectures and a heightened preference for VR as a learning method.

Conclusions

The study underscores the evolving and adaptable attitudes of students towards VR, emphasizing the significant role that diverse learning experiences play in shaping their receptiveness. It provides valuable insights into how medical education can be reshaped through a blended approach that integrates technological innovation with traditional learning methods. These findings advocate for the strategic incorporation of VR in anatomy courses to enhance learning outcomes.
Addressing the gap in health data management skills: an online self-guided course for researchers and health professionals
Authors: Waithira Naomi , Mutinda Brian , Shah Kehkashan , Kestelyn Evelyne , Bull Susan , Boggs Liam , Lang Trudie , Cheah Phaik Yeong
Published: November 2024

Background

The healthcare sector is rapidly evolving with the rise of digital technology and data-driven decision-making. However, traditional medical education has yet to fully integrate training on managing health-related information, resulting in a significant skills gap among medical and research professionals. This gap is pronounced in low- and middle-income countries (LMICs), where data privacy concerns and inadequate infrastructure hinder efforts to utilise and share health data.

Aims

To address this gap, we developed an online, modular course aimed at providing foundational skills on capturing, storing and sharing health data.

Methods

The course was developed using the ADDIE(Analyze, Design, Develop, Implement, Evaluate) instructional design model. A needs assessment workshop involving 25 global health proffesionals identified key training gaps which informed the curriculum’s development. A multidisciplinary team from six institutions developed the modules. The course was piloted in a face-to-face setting with 37 participants and later adapted for online delivery via the Global Health Network platform. We evaluated the course using Level 1 of Kirkpatrick’s model for training evaluation.

Results

Six foundational modules were developed: Introduction to Data Management, Data Quality, Data Repositories, Ethics of Data Sharing, Data Governance, and Costing for Data Management. Between December 2020 and April 2024, 6,384 individuals from 90 countries completed the course. Of these, 32% were from Africa, 15% from Asia, 16% from South/Central America and the Caribbean, and 24% from Europe. Summative evaluations, based on voluntary post-module surveys, demonstrated high relevance to participants’ learning needs (96.6%) and strong intentions to apply the skills gained (88.3%). Key motivators for enrollment included the course’s free access, relevance to professional or academic needs, and trust in the organizations and authors behind the content.

Conclusions

The high enrolment and broad geographical reach demonstrates the potential of online training as a cost-effective tool to equip health practitioners and researchers with data literacy skills. Future evaluations will assess its impact on participants’ knowledge, behavior, and data-sharing and reuse practices.
Improving medical certification of cause of death in Assiut University Children Hospital: an intervention study
Authors: El-Gibaly Omaima , Elela Mohamed Gamil Mohamed Abo , Rizk Yasser Farouk Abdel-Raheem , Mahmoud Shimaa Hosny Hassan
Published: November 2024

Introduction

Death certification is a health indicator and a public health surveillance tool. High-quality death certificate ensures reliability of mortality statistics used to direct the arranging of health-related programs and leading assessments of research and proper healthcare outcomes. The World Health Organization (WHO) puts Egypt in the group of ‘low quality’ death registration data. The aim of this study was to evaluate the impact of composite training and audit intervention on accurate completion of death notification forms (DNFs) in Assiut University Children Hospital (AUCH) that has an average monthly mortality of 120 children’s deaths.

Methods

A Quasi-experimental study design was conducted among residents of AUCH. The intervention consisted of 1- Preparing training material with basic information on how to report causes of death according to WHO criteria and case scenarios extracted from the medical records of children who died at AUCH, 2- One hundred residents of the AUCH were trained in one day workshops in 4 groups, with a pre-post knowledge assessment questionnaire. 3- A weekly audit of a sample of 10–15 DNFs was done for six months with reporting of findings to quality assurance director of the hospital.

Results

Eighty- nine physicians completed the pre-post knowledge assessment with significant increase in knowledge score after the intervention (15.7 ± 3.2 vs. 11.9 ± 2.8). There was a significant decrease in the errors of reporting on the DNFs. The main improvement was in decrease from 90 to 18% in reporting the mechanism of death, and significant decline in writing cause of death in Arabic language only.

Conclusion

Accurate reporting of the medical cause of death can be achieved by educational intervention targeting physicians with institutionalizing of audit system for continuous quality improvement.
Investigation of treatment delay in a complex healthcare process using physician insurance claims data: an application to symptomatic carotid artery stenosis
Authors: van Gaal Stephen Christopher , Alimohammadi Arshia , Karim Mohammad Ehsanul , Zhang Wei , Sutherland Jason
Published: November 2024

Background

Delays in diagnostic and therapeutic processes are a potentially preventable cause of morbidity and mortality. Process improvement depends on accurate knowledge about as-is processes, historically collected from front-line workers and summarized in flowcharts. Such flowcharts can now be generated by process discovery algorithms supplied with chronological records from real-world cases. However, these algorithms may generate incomprehensible flowcharts when applied to complex unstructured processes, which are common in healthcare. The aim of this study is to evaluate methods for analysing data from real-world cases to determine causes of delay in complex healthcare processes.

Methods

Physician insurance claims and hospital discharge data were obtained for patients undergoing carotid endarterectomy at a single tertiary hospital between 2008 and 2014. All patients were recently symptomatic with vision loss. A chronological record of physician visits and diagnostic tests (activities) was generated for each patient using claims data. Algorithmic process discovery was attempted using the Heuristic Miner. The effect of activity selection on treatment delay was investigated from two perspectives: activity-specific effects were measured using linear regression, and patterns of activity co-occurrence were identified using K means clustering.

Results

Ninety patients were included, with a median symptom-to-surgery treatment time of 34 days. Every patient had a unique sequence of activities. The flowchart generated by the Heuristic Miner algorithm was uninterpretable. Linear regression models of waiting time revealed beneficial effects of emergency and neurology visits, and detrimental effects of carotid ultrasound and post-imaging follow-up visits to family physicians and ophthalmologists. K-means clustering identified two co-occurrence patterns: emergency visits, neurology visits and CT angiography were more common in a cluster of rapidly treated patients (median symptom to surgery time of 18 days), whereas family physician visits, carotid ultrasound imaging and post-imaging follow-up visits to eye specialists were more common in a cluster of patients with treatment delay (median time of 57 days).

Conclusions

Routinely collected data provided a comprehensive account of events in the symptom-to-surgery process for carotid endarterectomy. Linear regression and K-means clustering can be used to analyze real-world data to understand causes of delay in complex healthcare processes.