bluuebunny/crossref_metadata_2025 huggingface dataset:
Modern contraceptive utilisation and its associated factors among reproductive age women in high fertility regions of Ethiopia: a multilevel analysis of Ethiopia Demographic and Health Survey
Authors: Belachew Tadele Biresaw , Negash Wubshet Debebe , Bitew Desalegn Anmut , Asmamaw Desale Bihonegn
Published: February 2023

Objective

This study is aimed to assess the magnitude of modern contraceptives utilisation and associated factors among reproductive age women in high fertility regions of Ethiopia.

Design

Cross-sectional study.

Setting

High fertility regions of Ethiopian.

Participants

A total weighted sample of 3822 married reproductive age women.

Methods

In this study, data were obtained from the recent Ethiopian Demographic and Health Surveys. A total weighted sample of 3822 women of reproductive age was included. A multilevel mixed-effect binary logistic regression model was fitted to identify the significant associated factors of modern contraceptive utilisation. Statistical significance was determined using adjusted OR (AOR) with 95% CI.

Results

The overall modern contraceptive utilisation was 29.75% (95% CI 28.2% to 31.2%). Among the factors associated with utilisation were women’s age 25–34 years (AOR 1.3; 95% CI 1.01 to 1.66) and ≥35 (AOR 1.71; 95% CI 1.37 to 2.70), husband’s occupation (AOR 1.49; 95% CI 1.03 to 1.99), number of alive children: 1–4 (AOR 2.20; 95% CI 1.47 to 3.30), 5–8 (AOR 1.74; 95% CI 1.09 to 2.77), husband’s desired number of children (AOR 0.77; 95% CI 0.61 to 0 .96), residency (AOR 2.37; 95% CI 1.20 to 4.67), community media exposure (AOR 1.77; 95% CI 1.01 to 3.08), region (AOR 0.13; 95% CI 0.03 to 0.52) and religion (AOR 0.49; 95% CI 0.36 to 0.66) were significantly associated with modern contraceptive utilisation.

Conclusion

Modern contraceptives utilisation in high fertility regions of Ethiopia was low. Women age, husband occupation, number of living children, husband’s desired number of children, residency, community media exposure, region and religion were significantly associated with modern contraceptive utilisation. Therefore, to improve the utilisation of modern contraceptives, public health policy makers should consider creating awareness through mass media, male involvement in family planning, as well as family planning programmes, should be encouraged in rural areas.
Indication documentation and indication-based prescribing within electronic prescribing systems: a systematic review and narrative synthesis
Authors: Feather Calandra , Appelbaum Nicholas , Darzi Ara , Franklin Bryony Dean
Published: February 2023

Background

Despite recommendations, documentation of indication on prescriptions and inpatient medication orders is not routinely practised. There has been a recent systematic review of indication documentation for antimicrobials, but not for interventions relating to indication documentation for medication more broadly. Our aims were to 1) identify, describe and synthesise the literature relating to effectiveness of interventions aimed at improving indication documentation and/or indication-based prescribing in both primary and secondary healthcare; 2) synthesise participant perspectives to identify barriers and facilitators to these interventions; and 3) make recommendations for both practice and research.

Methods

A systematic literature search was conducted using Medline, Embase and CINAHL using two search concepts: electronic prescribing systems, and indication documentation and/or indication-based prescribing. Qualitative, quantitative and mixed-methods studies were included; outcome measures and results were extracted to produce a narrative synthesis. Quality appraisal by two independent reviewers was undertaken using the Mixed Methods Appraisal Tool.

Results

We identified 21 studies evaluating interventions to aid indication documentation. Indication documentation was either via free-text, selection from a list, or by use of pre-defined indication-based order sentences for individual medications. For a number of outcomes, there was a mostly positive impact, including appropriateness of the medication order (6 of 8 studies), rates of prescribing error (2/2) and some less commonly reported clinical (2/4) and workflow-related outcomes (2/3). There was a less favourable impact on accuracy of indication documentation and rates of medication use, highlighting some unintended consequences that may occur when implementing new interventions. Participant insights from prescribers and other healthcare professionals complemented quantitative study results, highlighting both facilitators and barriers to indication documentation and the associated interventions. For example, barriers included long drop-down lists and the need to use workarounds to navigate approval systems due to time or knowledge constraints. Facilitating factors included the perceived benefits of indication documentation on communication among the healthcare team and with the patient.

Conclusion

Indication documentation has the potential to improve appropriate prescribing and reduce prescribing errors. However, further benefits to the prescriber, multidisciplinary team and patient may only be realised by developing methods of indication documentation that integrate more efficiently with prescriber workflows.

PROSPERO registration number

CRD42021278495.
Patient safety and hospital visiting at the end of life during COVID-19 restrictions in Aotearoa New Zealand: a qualitative study
Authors: Collier Aileen , Balmer Deborah , Gilder Eileen , Parke Rachael
Published: February 2023

Background

Visiting restrictions were enacted in Aotearoa New Zealand to reduce transmission of COVID-19 and protect the healthcare system. This research aimed to investigate the experiences of families and clinicians of hospital visiting for people with palliative and end-of-life care needs during restrictions.

Methods

Semistructured interviews were completed between March and October 2021 with family members and clinicians who had personally experienced enactment of visiting restrictions during pandemic restrictions. A critical realist ontology was used to approach data analysis, sorting and coding to generate themes.

Results

Twenty-seven participants were interviewed, 13 being families who had experienced bereavement of a family member during the restrictions: seven nurses or physicians and seven being non-bereaved family members. Four themes were generated: patient safety—(re)defining the ‘Visitor’; the primacy of SARS-CoV-2—patient safety and negotiating risk; dying alone: enduring harms; and agency, strategies and workarounds.

Conclusion

Visitor rights and visitor policy at the end of life require greater protection during a pandemic. Transparent, coherent, publicly available evidence-based guidelines that key stakeholders, including patients, families and ethicists, are included in producing, are urgently required. We want to avert a legacy of disenfranchised grief in future pandemics.
Main operating room deliveries for patients with high-risk cardiovascular disease
Authors: Albright Catherine M , Steiner Jill , Sienas Laura , Delgado Carlos , Buber Jonathan
Published: February 2023

Background

High-risk cardiovascular disease (CVD) prevalence in pregnant patients is increasing. Management of this complex population is not well studied, and little guidance is available regarding labour and delivery planning for optimal outcomes.

Objective

We aimed to describe the process for and outcomes of our centre’s experience with the main operating room (OR) caesarean deliveries for patients with high-risk CVD, including procedural and postpartum considerations.

Study design

We performed a retrospective evaluation of pregnant patients with high-risk CVD who delivered in the main OR at a large academic centre between January 2010 and March 2021. Patients were classified by CVD type: adult congenital heart disease, cardiac arrest, connective tissue disease with aortopathy, ischaemic cardiomyopathy, non-ischaemic cardiomyopathy or valve disease. We examined demographic, anaesthetic and procedure-related variables and in-hospital maternal and fetal outcomes. Multidisciplinary delivery planning was evaluated before and after formalising a cardio-obstetrics programme.

Results

Of 25 deliveries, connective tissue disease (n=9, 36%) was the most common CVD type, followed by non-ischaemic cardiomyopathy (n=5, 20%). Scheduled deliveries that went as initially planned occurred for six patients (24%). Fourteen (56%) were unscheduled and urgent or emergent. Patients in modified WHO Class IV frequently underwent unscheduled, urgent deliveries (64%). Most deliveries were safely achieved with neuraxial regional anaesthesia (80%) and haemodynamic monitoring via arterial lines (88%). Postdelivery intensive care unit stays were common (n=18, 72%), but none required mechanical circulatory support. There were no in-hospital maternal or perinatal deaths; 60-day readmission rate was 16%. Some delivery planning was achieved for most patients (n=21, 84%); more planning was evident after establishing a cardio-obstetrics programme. Outcomes did not differ significantly by CVD group or delivery era.

Conclusions

Our experience suggests that short-term outcomes of pregnant patients with high-risk CVD undergoing main OR delivery are favourable. Multidisciplinary planning may support the success of these complex cases.
Modeling pulse dynamics of juvenile fish enables the short-term forecasting of population dynamics in Japanese pufferfish: a latent variable approach and hindcasting
Authors: Nishijima Shota , Suzuki Shigenori , Fukuta Ryo , Okada Makoto
Published: February 2023

Short-term forecasting of population dynamics of fish stocks is required for scientific management recommendations such as catch quotas but is difficult to perform accurately because of the inevitable time lag between data collection and management implementation. Here, we developed a method using small-scale survey data for juvenile Japanese pufferfish ( Takifugu rubripes) to shorten this time lag and achieve accurate short-term forecasting. A survey of juvenile pufferfish at a local sandy beach provides data for the strength of year classes before fisheries recruitment; however, use of the raw data is difficult owing to the small sample size and large observation errors. We found that a random-effects model overcame these problems and more accurately predicted pulse patterns of catch rates to derive a standardized recruitment index than a fixed-effects model. A stock assessment model using the standardized recruitment index outperformed models without the standardized recruitment index with respect to hindcasting bias and prediction skill. This study highlights the applicability of a latent variable approach for standardizing small-scale survey data and thereby for unbiased forecasting of short-term fish dynamics.
Digital Economy: Opening Statement: The past, present, and future of the digital economy
Authors: Vuković Maja , Delic Kemal
Published: February 2023

Over time economies advanced from the initial barter exchange of goods and services to the invention of money and rise of the industrial age, morphing into today's modern, web-intensive economy. We are witnessing the rise of the digital economy (DE), where digital technologies are creating, adapting, and consuming goods and services. Entire industries are under pressure to transform and adapt to DE circumstances. In this symposium, authors present an overview of the evolution of digital economy, as well as emerging trends and challenges.
Approximately Socially-Optimal Decentralized Coalition Formation with Application to P2P Energy Sharing
Authors: Chau Sid Chi-Kin , Elbassioni Khaled , Zhou Yue
Published: February 2023

The paradigm of P2P (peer-to-peer) economy has emerged in diverse areas.
P2P energy sharing
is a new form of P2P economy in the energy sector, which allows users to establish longer-term sharing arrangements of their local energy resources (e.g., rooftop PVs, home batteries) with joint optimized energy management. In such a P2P setting, a coalition of users is formed for sharing resources in a decentralized manner by self-interested users based on their individual preferences. A likely outcome of decentralized coalition formation will be a stable coalition structure, where no group of users could cooperatively opt out to form another coalition that induces higher preferences to all its members. Remarkably, there exist a number of fair cost-sharing mechanisms (e.g., equal-split, proportional-split, egalitarian and Nash bargaining solutions of bargaining games) that model practical cost-sharing applications with desirable properties, such as the existence of a stable coalition structure with a small strong price-of-anarchy (SPoA) to approximate the social optimum. In this paper, we provide general results of decentralized coalition formation: (1) We establish a logarithmic lower bound on SPoA, and hence, show several previously known fair cost-sharing mechanisms are the best practical mechanisms with minimal SPoA. (2) We show that the SPoA of egalitarian and Nash bargaining cost-sharing mechanisms to match the lower bound. (3) We derive the SPoA of a mix of different cost-sharing mechanisms. (4) We present a decentralized algorithm to form a stable coalition structure. (5) Finally, we apply our general results to P2P energy sharing and present an empirical study of decentralized coalition formation in a real-world project. We study the empirical SPoA, which is observed within 95% of the social optimal cost with coalitions of 2 and 3 users, via fair cost-sharing mechanisms.
When a Little Nondeterminism Goes a Long Way
Authors: Boker Udi , Lehtinen Karoliina
Published: February 2023

History-deterministic automata are an intermediate automata model, in between deterministic and nondeterministic ones. An automaton is history-deterministic if its nondeterminism can be resolved on-the-fly, by only taking into account the prefix of the word read so far. This restricted form of nondeterminism yields a class of automata that retains some of the algorithmic properties of deterministic automata, while also enjoying some of the power of nondeterminism.

History-determinism has received a lot of attention in the past few years and this article surveys some of the recent developments on the topic. It aims to showcase some of the key constructions and techniques involved in this line of research, while remaining fairly informal.

We begin with a roughly chronological overview of research on history-determinism, intended as a quick reference to some of the main results on the subject. We then move onto a more detailed discussion of what are, in our view, the key aspects of history-determinism, highlighting throughout questions that remain open. Like any survey written on a topic that is actively worked on, this article aspires to be out-of-date as soon as it is published. We hope that it will remain useful as a gentle, if incomplete, introduction to the topic.
Investigation of Xanthan Gum and Carboxymethyl Cellulose Binders for the Silicon Anode of Lithium-Ion Batteries
Authors: Sturman James W. , Yim Chae-Ho , Karkar Zouina , Baranova Elena A. , Toupin Mathieu , Abu-Lebdeh Yaser
Published: February 2023

The binder is known to play an important role in the cycle stability of silicon-based anodes for lithium-ion batteries. Nature-derived biopolymers such as sodium carboxymethyl cellulose (NaCMC) and xanthan gum (XG) are a promising class of binders that offer several advantages over traditional polyvinylidene fluoride (PVDF). Advantages include better contact between silicon particles and the ability to process the electrodes using water as a solvent. While many studies have explored the fundamental properties of these biopolymer binders and their interaction with silicon, there has been little research on the use of these binders under practical loadings (such as ∼2 mg Si cm−2 and <10 wt% binder). Herein, we compare the electrochemical performance of both NaCMC and XG-based silicon electrodes with a low binder content. Si-binder interactions and their role in electrode performance are revealed with XPS, SEM, and EDX. In addition, we report the results of both a high-silicon (80 wt% Si) and a practical low-silicon (20 wt% Si) composite electrode while using silicon nano powder prepared by industrial-scale synthesis. It is found that NaCMC consistently outperforms XG as a binder, which is attributable to superior cohesion within the electrode.
Annealing Temperature-Dependent Structural, Optical, and Electrical Properties of [(Ba1−zCaz)(Zr0.1Ti0.9)O3], (z = 0.155), Films
Authors: Biswas Don , Thapliyal Prashant , Sharma Prolay , Panwar N. S.
Published: February 2023

Thin films were deposited, on quartz and p-Si (100) substrates, by radio frequency (RF) sputtering of ceramic barium calcium zirconate titanate [(Ba1−zCaz)(Zr0.1Ti0.9)O3], (z = 0.155), target. The as-deposited films were annealed for one hour at different temperatures, between 500 °C and 800 °C. The occurrence of film crystallization was observed on annealing at and above 600 °C. However, films peeled out on annealing at 800 °C. The structure, optical transmittance, dielectric constant and leakage current of the prepared films (hereafter referred to as BCZT0.9 films), annealed at different temperatures, were measured. Refractive index and optical bandgap were obtained from the measured optical transmittance of the films deposited on quartz substrates and annealed at different temperatures. The optical bandgap of the BCZT0.9 films was found to reduce from 4.24 to 3.87 eV with the increase in annealing temperature. On crystallization, the leakage current density of the prepared films decreased by order of 3, from ∼10−6 for amorphous to ∼10−9 A cm−2 for crystalline films. The current-voltage variations of the prepared films exhibit different conductions for different annealing treatments. The dielectric constant was obtained maximum, 148 (at 1 MHz), and leakage current density minimum, 3.6 × 10−9 A cm−2 (at 3.0 × 102 kV cm−1 electric field), for the films annealed at 750 °C. Electrical properties were observed to improve for the films annealed at 750 °C than other annealed films.
Modeling the Transmission Dynamics of Hepatitis A with Combined Vaccination and Sanitation Mitigation
Authors: Mwaijande Stephen Edward , Mpogolo Godfrey Edward
Published: February 2023

A mathematical model for the Hepatitis A Virus (HAV) epidemiology with dual transmission mechanisms is developed and presented. The model considers vaccination and sanitation as mitigation strategies. The effective reproductive number was derived and employed to study the stability of the model. Using Routh’s stability criteria, the local stability of a disease‐free equilibrium was determined, whereas the global stability of the endemic equilibrium was attained through a suitable Lyapunov function. Furthermore, bifurcation analysis is carried out using the centre manifold theory to ascertain its nature and implication for disease control. It was revealed that the model exhibits a forward bifurcation indicating the possibility of disease eradication when the effective reproduction number is kept below unity. Numerical results indicate that infection rates decrease quantitatively when at least one control measure is effectively implemented. It was deduced that combining vaccination and sanitation yields even fewer cases, making it the best alternative for eliminating Hepatitis A (HA) infection from the community. A sensitivity analysis was conducted to ascertain the parameters of the strong influence that could significantly affect the system. It was revealed that constant recruitment and vaccination coverage were the most critical parameters affecting the system. In addition, the study found that direct transmission plays an essential role in the occurrence of HA infection. In contrast, indirect transmission contributes marginally but significantly to the prevalence of HA infection.
Association between Serum 25-Hydroxyvitamin D and Abdominal Aortic Calcification: A Large Cross-Sectional Study
Authors: Liu Tao , Zuo Ronghua , Wang Jia , Wang Bing , Sun Lifang , Wang Shasha , Li Baoyin , Yao Jianhui , Huang Conggang , Pan Yesheng , Zhu Zhijian
Published: February 2023

In the American population, the relationship between the standardized serum 25-hydroxyvitamin D (25(OH)D) concentration and the risk of abdominal aortic calcification (AAC) is unclear. The purpose of our study was to investigate the relationship between serum 25(OH)D concentration and AAC risk. Participants from the National Health and Nutrition Examination Survey (NHANES) between 2013 and 2014 were analyzed cross sectionally. An analysis of the relationship between serum 25(OH)D concentration and incident AAC and severe AAC (SAAC) was based on the restricted cubic spline (RCS) and multivariable logistic regression model. In addition, generalized additive models with smooth functions were used to evaluate the relationship between serum 25(OH)D concentration and the degree of AAC. Finally, a subgroup analysis was conducted. There were a total of 3,040 individuals in our study. The serum 25(OH)D concentration was divided into quartiles (Q1: 9.37–50.5 nmol/L; Q2: 50.6–67.2 nmol/L; Q3: 67.3–85.8 nmol/L; and Q4: 85.9–318.0 nmol/L); the lowest quartile served as the reference group (Q1). After adjusting for known confounding variables, compared with the lowest quartile (Q1) of serum 25(OH)D concentration, the odds ratios with 95% confidence intervals for AAC and SAAC across the quartiles (Q2, Q3, and Q4) were (1.042 (0.812, 1.338), 0.863 (0.668, 1.115), and 1.022 (0.787, 1.327)) and (1.48 (0.87, 2.52), 1.70 (1.01, 2.92), and 2.13 (1.19, 3.86)), respectively. As shown by the RCS plot, the serum 25(OH)D concentration was associated with the risk of AAC/SAAC in a U-shaped pattern (

P

for nonlinearity <0.05). In addition, the degree of AAC decreased at first and then increased as the serum 25(OH)D concentration increased. In conclusion, a U-shaped relationship existed between serum 25(OH)D concentration and the risk of AAC and SAAC. Consequently, the risk of AAC and SAAC may be mitigated with regular monitoring and vitamin D supplementation.
A Systematic Review and Meta‐Analysis of the Relationship between Receiving the Flu Vaccine with Acute Cerebrovascular Accident and Its Hospitalization in the Elderly
Authors: Tavabe Nilay Rezaei , Kheiri Soleiman , Dehghani Mohsen , Mohammadian-Hafshejani Abdollah
Published: February 2023

Background and Aims. In recent years, various studies have been conducted worldwide to investigate the relationship between receiving the flu vaccine with acute cerebrovascular accident or stroke and its hospitalization in the elderly; however, the results of these studies are contradictory. Therefore, this study was aimed at investigating the relationship between receiving the flu vaccine with stroke and its hospitalization in the elderly. Methods. This study is a systematic review and meta‐analysis of studies examining the relationship between receiving the flu vaccine with stroke and its hospitalization in the elderly during the years 1980 to 2021 which have been published in ISI Web of Science, Scopus PubMed, Cochrane, Science Direct, Google Scholar, and Embase. All analyses were performed by Stata 15, and the significance level in this study was considered <0.05. Results. In the systematic search, 3088 articles were retrieved, considering the study criteria; finally, 14 studies were included in the meta‐analysis. Based on the results of the meta‐analysis, the odds ratio (OR) of occurrence and hospitalization of stroke compared to the nonvaccinated group in vaccine recipients is equal to 0.84 (95% confidence interval (CI): 0.78‐0.90, P value ≤ 0.001). Publication bias was not observed in this study (P value = 0.101). Conclusion. Getting the flu vaccine can reduce the risk of occurrence and hospitalization of stroke in the elderly by 16% (10%‐22%). Therefore, receiving this vaccine as a preventive intervention for stroke in the elderly may be promising.
Detection of Virulence Factors and Antibiotic Resistance among Klebsiella pneumoniae Isolates from Iran
Authors: Davoudabadi Sara , Goudarzi Mehdi , Hashemi Ali
Published: February 2023

The current study assessed the detection of virulence genes and drug resistance among Klebsiella pneumoniae isolates from Iran. During 2018 to 2020, 52 K. pneumoniae isolates were obtained from patients at Iran hospitals. By disk diffusion method, the antimicrobial susceptibility of K. pneumoniae isolates was assessed, and ESBL‐producing K. pneumoniae isolates were detected by CDDT method. PCR analysis was done to detect virulence genes (iucB, iutA, iroN, kfu, allS, fimH, ybtS, mrkD, and entB); ESBL‐encoding genes (blaTEM, blaPER, blaCTX-M, blaVEB, and blaSHV); and class D (blaOXA-48), class B (blaVIM, blaNDM, and blaIMP), and class A (blaKPC and blaGES) carbapenemase genes. Among all isolates, 84.6%, 13.5%, and 1.9% isolates were multidrug‐resistant (MDR), extensively drug‐resistant (XDR), and pandrug‐resistant (PDR), respectively. Also, 84.6% were ESBL‐producing and 71.2%, 53.8%, 40.4%, and 9.6% of all isolates were carrying blaTEM, blaSHV, blaCTX-M, and blaOXA-48 genes, respectively. Six isolates (11.5%) were positive for blaNDM gene. In contrast, no isolates were positive for the presence of blaKPC, blaIMP, and blaVIM. Virulence factor genes including iucB, iutA, iroN, kfu, allS, fimH, ybtS, mrkD, and entB were carried by 24%, 46.2%, 25%, 11.5%, 17.3%, 86.5%, 75%, 88.5%, and 100% isolates, respectively. This study evaluated the distribution and prevalence of virulence factor genes among K. pneumoniae isolates. The treatment of these infections is challenging due to the existence of particular virulence factors and the rise of antibiotic resistance. Therefore, the current study accentuates the necessity of finding new and efficient solutions for stopping the increase of antibiotic resistance.
SLC9A1 Binding mTOR Signaling Pathway-Derived Risk Score Predicting Survival and Immune in Clear Cell Renal Cell Carcinoma
Authors: Wu Dengshuang , Xu Zhipeng , Wang Jianning
Published: February 2023

Objective. Clear cell renal cell carcinoma (ccRCC) is one of the common renal cell carcinomas (RCC) with a high risk of recurrence. Considering that SLC9A1 is involved in various cellular physiological processes and probably mediates the course of mTOR signaling in tumors, this study constructed a risk model for SLC9A1 combined with mTOR signaling in ccRCC, aiming at better predicting the prognosis of patients. Methods. ccRCC expression matrices were downloaded from TCGA and ICGC databases to compare the expression of SLC9A1 in TCGA, and qRT-PCR was adopted to validate the SLC9A1 expression in different RCC cells and normal kidney cells. The CIBERSORT and ESTIMATE algorithms were used to assess samples for immunity. mTOR signaling-associated genes were downloaded from the KEGG website, and then the genes were adopted to screen genes associated with SLC9A1 expression and mTOR signaling pathway colleagues, based on which univariate COX regression and lasso regression Cox analyses were conducted to construct a ccRCC prognostic risk model. ROC curves and nomograms were used to assess the validity of the models. Results. ccRCC tumor samples showed lower SLC9A1 expression than normal samples, as also evidenced by qRT-PCR. The SLC9A1 expression was highly correlated with tumor immunity. Totally, 564 key genes associated with both SLC9A1 expression and mTOR signaling were screened out, and the risk model consisting of 11 gene signatures was constructed in ccRCC based on the 564 genes. Since patients at a high risk had poorer survival outcomes, the high-risk group presented poorer immunotherapy outcomes. Moreover, a higher clinical grade of patients suggested a higher risk score. The risk score can serve as one independent prognostic factor for the prognosis prediction of ccRCC patients. Conclusion. An extremely promising prognostic indicator for ccRCC based on SLCA9A1 and mTOR signaling has been constructed to provide reference for clinical treatment.
CS27109, A Selective Thyroid Hormone Receptor-β Agonist Alleviates Metabolic-Associated Fatty Liver Disease in Murine Models
Authors: Huang Shengjian , Deng Zhou , Wang Wei , Liao Guoqiang , Zhao Yiru , Zhong Hua , Zhang Qian , Liu Jing , Mao Xuhua , Chen Beizhong , Pan Desi , Zhou You
Published: February 2023

Background/Aim. Thyroid hormone receptor-β (THR-β) agonists play crucial roles in dyslipidemia and metabolic associated fatty liver disease (MAFLD). We developed a novel oral and liver-targeted THR-β agonist, CS27109, and evaluated its efficacy in the treatment of metabolic disorders. Materials and Methods. We evaluated in vitro and in vivo efficacy and/or safety of CS27109 along with MGL3196 (a phase III THR-β agonist). Results. CS27109 showed pronounced activity and selectivity to THR-β and favorable PK properties, which was equivalent to MGL3196. In the hamster model, animals treated with a high dose of CS27109 showed equivalent reductions in serum TC and LDL-c with groups treated with MGL3196. In the rat model, CS27109 and MGL3196 reduced serum ALT, TC, TG, LDL-c, liver weight ratio, and liver steatosis. CS27109 simultaneously decreased liver TG and TC, and MGL3196 additionally reduced AST. In the mouse model, CS27109 dose-dependently reduced serum AST, ALT, liver inflammation, and NAS score, and also downregulated TC, LDL-c, liver steatosis, and fibrosis, but not in a dose-dependent manner. MGL3196 revealed an equivalent effect with CS27109 in that model. CS27109 also exhibited tolerable toxicity to the heart. Conclusions. CS27109 shows comparative in vitro and in vivo efficacy with MGL3196, suggesting its potential therapeutic application in the treatment of MAFLD such as dyslipidemia and steatohepatitis.
Predictors of Physical Activity Behavior Transitions in Children and Adolescents: A Systematic Review Based on a Transtheoretical Model
Authors: Sheng Jie , Shi Peng , Sun Jinyue , Feng Xiaosu
Published: February 2023

Background. The transtheoretical model (TTM) views individual behavioral change as a nonlinear, dynamic process, which is consistent with the complex nature of physical activity (PA) in children and adolescents. However, within this theoretical framework, the elements that facilitate the behavioral change in PA in children and adolescents need to be further explored. Objective. A systematic review of research related to TTM‐based exploration of the elements of behavioral change in PA in children and adolescents, an analysis of the strengths and weaknesses in practice, and an outlook for future research. Materials and Methods. After computer searches of the CNKI, Wan‐Fang, VIP, WOS, PubMed, and EBSCO databases, two researchers independently screened articles, extracted information, and evaluated the quality of the articles. Results. A total of 25 articles (26 studies) of medium‐ to high‐quality were included in the systematic review. The meta‐analysis included 30,106 children and adolescents aged 11.24 to 17.7 years. The counter‐conditioning and self‐liberation of the process of change, self‐efficacy and decisional balance are key elements that facilitate the transition of the PA stage in children and adolescents. Extramodel psychological variables such as exercise motivation play a moderate to large role in the PA stage transition. In addition, VPA is an important discriminator of PA stage transition in children and adolescents. Conclusion. It is recommended that interventions be designed according to the key elements of behavioral change in order to better facilitate the PA stage transition of children and adolescents.
Depression and Quality of Life of People Accused of Witchcraft and Living in Alleged Witches’ Camps in Northern Ghana
Authors: Adam Lamnatu , Shani Abdul Kasiru , Yaro Peter Badimak , Adwan-Kamara Lyla , Teg-Nefaah Tabong Philip
Published: February 2023

In Northern and Northeast Ghana, women accused of witchcraft are banished from society to live in special locations designated “witches camps.” The processes leading to their banishment, admission, and living in the camps may affect their psychological wellbeing and quality of life. This study was conducted to determine the prevalence of depression and assess the quality of life of 277 alleged witches in four camps located in these two regions in Ghana. A structured questionnaire was developed and administered using the open data collection kit (ODK). The Patient Health Questionnaire-8 (PHQ-8) and the World Health Organisation Quality of Life (WHOQOL) questionnaires were adopted to measure depression and health-related quality of life, respectively. The data were analysed using STATA version 16. The prevalence of depression among the alleged witches was 52.7%. Out of this, 37.2% had moderate depression, 7.2% had moderate or severe depression whilst 2.9% had severe depression. The sociodemographic factors that have a statistically significant association with depression included gender, marital status, being widowed or separated, and not having biological children. Over 97% of alleged witches have a low or extremely low quality of life. In conclusion, the majority of the people accused of witchcraft have a low or extremely low quality of life with high-probable depression.
Utilization of Nanotechnology and Nanomaterials in Biodiesel Production and Property Enhancement
Authors: Bin Rashid Adib
Published: February 2023

In today’s world, the applications of nanotechnology and nanomaterials are attracting interest in a wide variety of study domains because of their appealing qualities. The use of nanotechnology and nanomaterials in biodiesel processing and manufacturing is a focus of research globally. For accelerating the progress and development of biodiesel production, more focus is being given to the application of advanced nanotechnology for maximum yield in low cost. Hence, this paper will discuss the utilization of numerous nanomaterials/nanocatalysts for biodiesel synthesis from multiple feedstocks. This study will also focus on nanomaterials’ applications in algae cultivation and lipid extraction. Furthermore, the current study will comprehensively overview the nanoadditives blended biodiesel in diesel engines and the significant challenges and future opportunities. Moreover, this paper will also focus on human and environmental safety concerns of nanotechnology-based large-scale biodiesel production. Hence, this review will provide perception for future manufacturers, researchers, and academicians into the extent of research in nanotechnology and nanomaterials assisted biodiesel production and its efficiency enhancement.
Train Service Plan Design under the Condition of Multimodal Rail Transit Systems Integration and Interconnection
Authors: Lin Li , Meng Xuelei , Cheng Xiaoqing , Ma Yangyang , Xu Shichao
Published: February 2023

Multimodal rail transit systems integration and interconnection can solve frequent transfer problems and better adapt to disequilibrium passenger flow and space. It is an inevitable choice in the development of various rail transit systems. Firstly, this paper proposes a novel train service plan design model in the scenario of multimodal rail transit systems integration and interconnection. Our model takes into account the costs of both passengers and enterprises, and passengers travel time is converted into cost using passengers’ nonworking time value coefficient. The model contains some conventional constraints such as passenger flow, station capacity, and line carrying capacity. It also considers whether the transportation capacity of different lines is matched, that is, the constraint of capacity matching degree. Secondly, an improved harmonic search algorithm (IHSA) is designed to solve the problem, and a numerical experiment is used to prove the performance of the proposed method. Our research result shows that the model and algorithm proposed in this paper is effective, which can help overcome the drawbacks of the existing independent operation mode of different rail transit systems. This study is also applicable to the scenario of other kinds of rail transit systems integration and interconnection.
Curcumin Analog, HO‐3867, Induces Both Apoptosis and Ferroptosis via Multiple Mechanisms in NSCLC Cells with Wild‐Type p53
Authors: Wu Ling , Xu Guodong , Li Ni , Zhu Linwen , Shao Guofeng
Published: February 2023

Over the last decade, researchers have paid more and more attention to the natural compound curcumin for its potential application in anticancer therapy. However, the application of curcumin has been limited owing to its rapid metabolism in the body. HO‐3867, a stable curcumin analog, shows potent antitumor activities against various tumor cells. Yet, information on HO‐3867’s impact on non‐small‐cell lung cancer (NSCLC) cells is lacking. Herein, we evaluated the cytotoxicity of HO‐3867 in NSCLC cells. We discovered that HO‐3867 suppressed the viability of NSCLC cells containing wild‐type p53. In NSCLC cells, HO‐3867 promotes both apoptosis and ferroptosis, the latter of which is a newly discovered mode of cell death. Mechanically, HO‐3867‐induced apoptosis relied on the inhibition of Mcl‐1 and Bcl‐2 and the upregulation of Bax. Moreover, NSCLC cells undergo ferroptosis when treated with HO‐3867 via activating the p53‐DMT1 axis and suppressing GPX4. Additionally, HO‐3867 caused an accumulation of reactive oxygen species (ROS) in NSCLC in a way that was dependent on the presence of iron. Our findings point to the possibility that HO‐3867 might be employed as a therapeutic agent for treating NSCLC.
A Deep Learning Fusion Approach to Diagnosis the Polycystic Ovary Syndrome (PCOS)
Authors: Alamoudi Abrar , Khan Irfan Ullah , Aslam Nida , Alqahtani Nourah , Alsaif Hind S. , Al Dandan Omran , Al Gadeeb Mohammed , Al Bahrani Ridha
Published: February 2023

One of the leading causes of female infertility is PCOS, which is a hormonal disorder affecting women of childbearing age. The common symptoms of PCOS include increased acne, irregular period, increase in body hair, and overweight. Early diagnosis of PCOS is essential to manage the symptoms and reduce the associated health risks. Nonetheless, the diagnosis is based on Rotterdam criteria, including a high level of androgen hormones, ovulation failure, and polycystic ovaries on the ultrasound image (PCOM). At present, doctors and radiologists manually perform PCOM detection using ovary ultrasound by counting the number of follicles and determining their volume in the ovaries, which is one of the challenging PCOS diagnostic criteria. Moreover, such physicians require more tests and checks for biochemical/clinical signs in addition to the patient’s symptoms in order to decide the PCOS diagnosis. Furthermore, clinicians do not utilize a single diagnostic test or specific method to examine patients. This paper introduces the data set that includes the ultrasound image of the ovary with clinical data related to the patient that has been classified as PCOS and non-PCOS. Next, we proposed a deep learning model that can diagnose the PCOM based on the ultrasound image, which achieved 84.81% accuracy using the Inception model. Then, we proposed a fusion model that includes the ultrasound image with clinical data to diagnose the patient if they have PCOS or not. The best model that has been developed achieved 82.46% accuracy by extracting the image features using MobileNet architecture and combine with clinical features.
Spatial Transcriptomics Depict Ligand–Receptor Cross-talk Heterogeneity at the Tumor-Stroma Interface in Long-Term Ovarian Cancer Survivors
Authors: Ferri-Borgogno Sammy , Zhu Ying , Sheng Jianting , Burks Jared K. , Gomez Javier A. , Wong Kwong Kwok , Wong Stephen T.C. , Mok Samuel C.
Published: February 2023

Advanced high-grade serous ovarian cancer (HGSC) is an aggressive disease that accounts for 70% of all ovarian cancer deaths. Nevertheless, 15% of patients diagnosed with advanced HGSC survive more than 10 years. The elucidation of predictive markers of these long-term survivors (LTS) could help identify therapeutic targets for the disease, and thus improve patient survival rates. To investigate the stromal heterogeneity of the tumor microenvironment (TME) in ovarian cancer, we used spatial transcriptomics to generate spatially resolved transcript profiles in treatment-naïve advanced HGSC from LTS and short-term survivors (STS) and determined the association between cancer-associated fibroblasts (CAF) heterogeneity and survival in patients with advanced HGSC. Spatial transcriptomics and single-cell RNA-sequencing data were integrated to distinguish tumor and stroma regions, and a computational method was developed to investigate spatially resolved ligand–receptor interactions between various tumor and CAF subtypes in the TME. A specific subtype of CAFs and its spatial location relative to a particular ovarian cancer cell subtype in the TME correlated with long-term survival in patients with advanced HGSC. Also, increased APOE-LRP5 cross-talk occurred at the stroma-tumor interface in tumor tissues from STS compared with LTS. These findings were validated using multiplex IHC. Overall, this spatial transcriptomics analysis revealed spatially resolved CAF-tumor cross-talk signaling networks in the ovarian TME that are associated with long-term survival of patients with HGSC. Further studies to confirm whether such cross-talk plays a role in modulating the malignant phenotype of HGSC and could serve as a predictive biomarker of patient survival are warranted.

Significance:

Generation of spatially resolved gene expression patterns in tumors from patients with ovarian cancer surviving more than 10 years allows the identification of novel predictive biomarkers and therapeutic targets for better patient management.

See related commentary by Kelliher and Lengyel, p. 1383
Psychometric Performance of the Memory Complain Scale among Colombian Individuals of 60 Years and Older
Authors: Campo-Arias Adalberto , Reyes-Ortiz Carlos Alfonso
Published: February 2023

Introduction: The Memory Complaint Scale (MCS-15) is a 15-item instrument to explore frequent forgetfulness in daily life in people with possible cognitive impairment. However, knowledge about its psychometric performance is limited. Objective: The objective of this study was to know the dimensionality and internal consistency of the MCS-15 in Colombian older adults. Methods: A probabilistic sample of 1,957 older adults from the general Colombian population was taken, aged between 60 and 98 years (mean = 71.0 ± 7.9), and 62.2% were women. Internal consistency (Cronbach’s alpha and McDonald’s omega) and dimensionality (exploratory and confirmatory factor analysis) were calculated for the original and ten-item versions. Results: The 15-item version showed Cronbach’s alpha and McDonald’s omega of 0.91, and one dimension accounted for 45.3% of the variance. A version of ten items showed Cronbach’s alpha and McDonald’s omega of 0.89 and a single factor that explained 50.9% of the variance with better indicators in the confirmatory factor analysis. Convergence with the shortened Mini-Mental State Examination was rs = 0.43 (p < 0.001), and the Montreal Cognitive Assessment test was rs = 0.38 (p < 0.001). The nomological validity with the geriatric depression scale was rs = 0.44 (p < 0.001), and women scored higher than men (p < 0.001). Conclusions: The MCS-15 shows high internal consistency with poor dimensionality. However, a ten-item version shows high internal consistency and a clear one-dimensional structure. More research is needed: testing the performance against a structured interview for major cognitive impairment.
An Autopsy Case of Elderly Onset Brainstem Acute Disseminated Encephalomyelitis
Authors: Takai Yasuyuki , Tobisawa Shinsuke , Funai Asuka , Komori Takashi , Takahashi Kazushi
Published: February 2023

Acute disseminated encephalomyelitis (ADEM), which is a disease that causes multifocal inflammatory demyelination of the central nervous system, occurs predominantly in children and young adults. We report an autopsy case of an elderly man with brainstem ADEM that progressed over a period of about 3 months. An 82-year-old man developed disturbance of consciousness, dysphagia, and ataxic gait over a period of about 3 months. He was admitted to another hospital for aspiration pneumonia and recovered but was transferred to our hospital due to prolonged disturbance of consciousness. The patient was able to follow simple commands but had a tendency to somnolence. In addition to meningeal stimulation signs, the patient had left-dominant upper and lower limb ataxia and right-dominant limb spasticity. Brain FLAIR/T2-weighted imaging showed high-intensity lesions from the brainstem to the middle cerebellar peduncle bilaterally, medulla oblongata and upper cervical spinal cord, and T1-weighted imaging revealed contrast-enhanced lesions in the left middle cerebellar peduncle and cervical spinal cord. Although spinal fluid examination revealed elevated proteins, other laboratory tests indicated no evidence of infection, vasculitis, collagen diseases or tumors, and anti-ganglioside, anti-AQP4 and anti-MOG antibodies were negative. After admission, the patient again developed aspiration pneumonia, which progressed to acute respiratory distress syndrome, and he died on the 15th day of hospitalization. Autopsy findings indicated acute and subacute demyelination mainly in the brainstem and cerebellum, and perivascular lymphocyte and macrophage infiltration in the areas of demyelination. A postmortem diagnosis of ADEM was made based on the generally monophasic course of the disease and the absence of regenerating myelinated sheaths. There are very few reports of elderly patients with brainstem ADEM. ADEM should be considered as a differential diagnosis in patients with brainstem encephalitis.
PsoPlus: An Integrated Practice Unit for Psoriasis
Authors: Hilhorst Niels , Deprez Elfie , Roman Erin , Borzée Joke , De Beule Dirk , Dullaers Christel , Hoorens Isabelle ,   Lambert
Published: February 2023

There is a need to revise the current healthcare organization due to the ever-rising costs and variation in quality of delivered care. Over the past decades there have been several strategic frameworks attempting to tackle this problem. Value-based healthcare (VBHC) is one of those frameworks which has gained increasing popularity the last years. The framework is formulated on the premise that the healthcare sector should deliver integrated care, using integrated practice units (IPUs), and strive to maximize the value created. Value in this context is defined as the health outcomes achieved per costs made. We have designed a lean IPU called PsoPlus in which psoriasis patients are managed by a multidisciplinary team which has all the expertise and skill to manage psoriasis and its associated conditions. In addition, we have developed and implemented guidelines for the management of psoriasis-associated comorbidities, enabling us to deliver integrated care in the Belgian healthcare setting. Finally, we have designed a supporting information technology platform, called PsoSmart, which brings data from patients and healthcare providers together and provides actionable insights for clinical decision making. The created value is documented and captured using a value-based outcome set. Cost assessments at the individual patient level are also performed. To conclude, we describe here a comprehensive IPU setting for psoriasis which incorporates the VBHC principles. This IPU goes further and delivers a higher level of integrated care than other multidisciplinary psoriasis clinics. Monitoring outcomes and costs provides us with further insights to optimize psoriasis care. In addition, a software program designed to enhance psoriasis care is being developed further; however, advances in healthcare technology are needed.