bluuebunny/crossref_metadata_2025 huggingface dataset:
The Effectiveness of Interventions on Bullying and Cyberbullying Bystander: A Meta-Analysis
Authors: Chen Qiqi , Lin Wenzhou , Wu Qianru , Chan Ko Ling
Published: November 2024

The role of bystanders in bullying and cyberbullying prevention is crucial. Strategies must be tailored to address the shared and unique factors in online and offline contexts, ensuring that interventions create an environment where bystanders are empowered and feel responsible to act against bullying and cyberbullying. This meta-analysis examines and compares the effectiveness of interventions in enhancing bystander behaviors in bullying and cyberbullying scenarios. A comprehensive search was conducted using databases including PsycINFO, Medline, Sociological Abstracts, Social Service Abstracts, ERIC, and Scopus. Quasi-experimental and randomized controlled trials published before March 31, 2024 that reported that the effects of bystander interventions were included. The synthesis comprised 49 studies, reporting an overall random effect size (Cohen’s d) of 0.25. The results highlight the crucial roles of enhancing knowledge, self-efficacy, and coping skills. Subgroup analysis revealed that the effective bystander interventions include smaller sample sizes (<100 participants), shorter durations (<1 month), targeting college students, and utilizing offline intervention approaches and digital techniques. These findings emphasize the promising effects and tailored characteristics of bystander intervention programs in bullying and cyberbullying contexts. Our review identifies avenues for future research within educational settings to develop more effective bystander behavior interventions to reduce bullying and cyberbullying.
Increasing Hispanic Participation in Cognitive Research: An Examination of a Decade of Web-Based Recruitment into MindCrowd
Authors: Nuño Tomas , Ellingson Katherine D. , Chen Zhao , Both Matt De , Johnson Megan , Venkatachalam Harshini , Carrasco Carolina , Horton Ashleigh , Rubio Melanie , Yang Yunjia , Leito Grace , Nuqui Sean ,   The Precision Aging Network Investigators, Ryan Lee , Coon David W. , Huentelman Matt
Published: November 2024

Introduction: The research community has struggled to successfully recruit and retain Hispanic participants into research studies. The purpose of our study is to describe Hispanic enrollment into our study across the past decade. We sought to identify trends in Hispanic engagement in internet-based recruitment over three distinct time periods including the COVID-19 pandemic. Methods: MindCrowd (MC) is a web-based research study that aims to identify potential factors influencing age-related cognitive decline and disease. The MC platform was launched on 01/2013 and as of 7/2023 has 403,633 participants. To explore Hispanic recruitment, we considered three different cohorts: 01/2013 through 03/2020 labeled as “MC1”, 04/2020 through 05/2022 labeled “MC-C19”, and 07/2022 to 07/2023 labeled “MC2”. We compared these three cohorts and examined the individual cohort demographics. Results: For the entire study, 22,067 (6%) identified as Hispanic. MC2 has demonstrated an increase in percent Hispanic recruitment compared to MC1 (8.0% vs 4.4%, respectively). Hispanic participation by U.S. State has a strong correlation with Hispanic population size in respective U.S. States (R = 0.9). Additionally, Hispanic recruitment during the COVID-19 pandemic increased. Conclusions: Improvement in internet-based Hispanic recruitment over time suggests the potential of innovative strategies to enhance their representation in health research.
‘No work, No pay’: A multimodal discourse analysis of selected online images on industrial actions by Nigerian public universities
Authors: Fifelola Deborah A , Unuabonah Foluke O
Published: November 2024

This study investigates the social semiotics of online images on selected social media platforms, newspaper websites and other internet sites to explore the meaning-making resources used to visualise the 2022 Academic Staff Union of Universities’ strike in Nigeria. Using a multimodal discourse analytic approach, this study conducts qualitative data analysis of 50 purposively selected online images (cartoons and memes) to uncover their underlying themes and discursive strategies. The analysis reveals that the images predominantly depict students as victims of the strike, the government as perpetrators and the Academic Staff Union of Universities as victims and instigators. These depictions highlight the victimisation of Nigerian students while emphasising the negative other-representation of both the government and the union. Through this examination, the paper contributes to current research on cartoons and the broader academic field of memes as tools of dissent by offering valuable insights into how online images convey dissenting messages and engage with socio-political issues within the context of Nigerian public universities’ industrial actions.
Antibiotic prophylaxis reduced broad-spectrum antibiotics and length of stay in ICU patients with alcohol withdrawal induced refractory delirium tremens
Authors: Al-Hashimi Dunia , Kåberg Martin , Krifors Anders , Wanecek Michael , Blennow Ola
Published: November 2024

Background:

Pneumonia is a well-known complication in patients with severe alcohol withdrawal syndrome (SAWS). Antibiotic prophylaxis in ICU treated SAWS patients may be beneficial but data is lacking. The aims of this study were to investigate the effect of introduction of trimethoprim-sulfamethoxazole (TMP-SMX) prophylaxis, on use of broad-spectrum antibiotics and ICU length of stay (LOS) in SAWS patients with refractory delirium tremens (rDT).

Methods:

Retrospective observational cohort study comparing before (control group) and after the introduction of TMP-SMX prophylaxis in patients admitted to a single center ICU because of alcohol withdrawal induced rDT.

Results:

A total of 108 patients were included, 53 patients in the control group and 55 patients in the TMP-SMX group. Baseline characteristics did not differ between the groups (89% male, median age 52 years). The use of broad-spectrum antibiotics was significantly lower in the TMP-SMX group than in the control group (11 vs 70%, p < 0.001). The only variable associated with decreased use of broad-spectrum antibiotics in multiple logistic regression analysis was receiving TMP-SMX (0.06, 95% CI 0.02, 0.19, p-value: <0.001). Median LOS was shorter in the TMP-SMX group than in the control group (61 vs 72 h, p = 0.004). In multiple linear regression analysis receiving TMP-SMX SMX was associated with shorter LOS (−22.7, 95% CI: −41.3, −4.1, p-value: 0.02) and having one or more comorbidities with longer LOS (37.4, 95% CI: 10.4, 64.5, p-value: <0.01).

Conclusion:

Prophylaxis with TMP-SMX in ICU-treated rDT patients was associated with reduced use of broad-spectrum antibiotics and reduced ICU LOS.
Predicting Epidural Hematoma Expansion in Traumatic Brain Injury: A Machine Learning Approach
Authors: Hasanpour Mohammad , Elyassirad Danial , Gheiji Benyamin , Vatanparast Mahsa , Keykhosravi Ehsan , Shafiei Mehdi , Daneshkhah Shirin , Fayyazi Arya , Faghani Shahriar
Published: November 2024

Introduction

Traumatic brain injury (TBI) is a leading cause of disability and mortality worldwide, with epidural hematoma (EDH) being a severe consequence. This study focuses on identifying factors predicting EDH volume changes in TBI patients and developing a machine learning (ML) model to predict EDH expansion.

Methods

The study includes patients with traumatic EDH between 2019 and 2021. Data were gathered from CT scans performed at the time of admission and 6 hours later, and subsequently analyzed. The data was divided into three cohorts: all cases, adults, and pediatrics. To predict EDH volume changes, we used Logistic Regression (LR), Random Forest (RF), XGBoost, and K-Nearest Neighbors (KNN) models. Data was divided into an 80% training set and a 20% test set. Through a rigorous process of parameter optimization and K-fold cross-validation, focusing on the area under the receiving operating curve (AUROC), we identified the best models in all cohorts. The best models were evaluated on the test sets, reporting AUROC, recall, precision, and accuracy using the youden index threshold.

Results

Results show that age, initial EDH volume, swirl sign, intra-hematoma air bleb, contusion, otorrhagia, subarachnoid hemorrhage, location, and other side extra-axial hematoma have significant effects on changing EDH volume. Based on test AUROC, the best models were RF for adults (82.4%), KNN for pediatrics (90%), and LR for all cases (81.6%).

Discussion

In this study, we identified key features for predicting EDH expansion as well as developing ML models. Using high sensitive models, can assist clinicians in identifying high-risk patients early. This allows for enhanced monitoring and timely intervention, improving patient outcomes by facilitating quicker decisions for follow-up imaging or treatment.
The Los Angeles Motor Scale is independently associated with cerebral blood flow < 30% volume in large vessel occlusions
Authors: Wang Richard , Lakhani Dhairya A , Balar Aneri B , Sepehri Sadra , Luna Licia P , Cho Andrew , Hillis Argye E , Koneru Manisha , Hoseinyazdi Meisam , Lu Hanzhang , Mei Janet , Faizy Tobias , Xu Risheng , Nabi Mehreen , Mazumdar Ishan , Urrutia Victor C , Chen Kevin , Huang Judy , Nael Kambiz , Hyson Nathan , Yedavalli Vivek S
Published: November 2024

Background and Purpose

Mechanical thrombectomy (MT) is the treatment standard for large vessel occlusion (LVO) stroke. Under current guidelines, only patients with smaller ischemic core volumes (ICV) are eligible for MT. Thus, it is of interest to quickly estimate ICV in stroke patients. The Los Angeles Motor Scale (LAMS) is a validated tool used to assess stroke severity directly in the field. This study aims to determine whether LAMS score is also associated with ICV, as defined by the CBF <30% volume on CT perfusion imaging.

Methods

We performed a retrospective, multicenter cohort study of consecutive patients presenting with LVO stroke from 9/1/2017 to 10/1/2023. The inclusion criteria were patients with (1) stroke caused by large vessel occlusion confirmed on CTA and (2) diagnostically adequate, multimodal pretreatment CT imaging. Demographic, clinical, and imaging data was collected through manual chart review. Both univariate and multivariate analyses were applied to assess associations. A p-value <.05 was considered significant.

Results

A total of 283 patients (median age: 69, IQR: 61–78) were included in the study. On multivariate logistic regression analysis, we found that lower admission LAMS score (adjusted OR: 0.511, 95% CI: 0.313–0.834, p = .007) was independently associated with a CBF <30% volume of less than 50cc.

Conclusions

Admission LAMS is an independent predictor of a CBF <30% volume of less than 50cc. This demonstrates that LAMS can be used to estimate ICV, which will aid in the early triaging of LVO patients to thrombectomy-capable centers.
Case report of Ebstein’s anomaly in a young female
Authors: Dessalegne Rediet , Bekele Yoseph , Getachew Selamawit , Birhanu Mekdelawit
Published: November 2024

Ebstein’s anomaly, also known as Ebstein’s malformation, is a congenital heart defect that occurs in about 0.005% of live births and accounts for 0.3–0.6% of all congenital heart disease. It is due to delamination failure at embryologic state, or displacement of the leaflets from the ventricular myocardium. In people with Ebstein’s abnormality, the tricuspid valve does not close properly, leading to regurgitation. Here is the case report of a 24-year-old female patient who was diagnosed with Ebstein’s anomaly 5 years back and had been on follow-up. However, she missed appointments and discontinued the medication for 3 months. She presented with shortness of breath for 5 days, which occurred at rest, and generalized body weakness. Since she was in critical condition, she was admitted to the intensive care unit of the hospital. Subsequently, baseline and diagnostic investigations were done. The health care team initiated immediate treatment, and all available treatments were administered, and the patient’s condition improved. In this report, the first presentation of the woman was during adulthood and it was with heart failure even though most patients with Ebstein’s anomaly present during the early age of their life and with arrhythmia. Therefore, the main aim of this case report is to show the atypical presentation of Ebstein’s anomaly.
The influence of digital literacy on mHealth app usability: The mediating role of patient expertise
Authors: Durmuş Ayhan
Published: November 2024

Objective

Mobile health (mHealth) applications are emerging as important healthcare technologies that can provide cost savings, better access to care, contribute to improved clinical outcomes, and support public health. An increasing number of mobile health (mHealth) applications are becoming available to download and use on mobile devices. However, unlocking this potential requires ensuring widespread acceptance and adoption of these applications. In this context, the aim of the study is to determine the impact of individuals’ digital literacy levels on mobile health application usability and the mediating role of patient expertise in this impact.

Methods

The population of our study consists of individuals who reside in Yozgat city center and are 18 years old and over. Within the scope of the study, 647 individuals who agreed to participate in the research were reached. A survey form consisting of four sections (Socio-demographic characteristics, Digital Literacy Scale, mHealth App Usability Questionnaire, and Patient Expertise Scale) was used as a data collection tool in the study. Descriptive statistical methods were used to analyze the data and partial least squares path analysis (PLS-SEM) was used to analyze the research model.

Results

Digital literacy affects both patient expertise (β = 0.790, t = 35.560, p = 0.000) and mHealth app usability (β = 0.831, t = 46.020, p = 0.000). Additionally, it has been determined that patient expertise has a mediating role in the effect of digital literacy on mHealth app usability (β = 0.536, t = 17.477, p = 0.000).

Conclusions

It appears that individuals’ digital literacy is an important precursor to the usability of mHealth apps and increases their usage experience. In this sense, it is thought that the concept of digital literacy can be used to increase the usability of mHealth apps for individuals. Overall, the findings provide new evidence for the healthcare context by integrating user diversity, particularly individuals’ digital literacy, mHealth apps, and prior experience with mHealth.
Previous Surgical Exposure and the Onset of Degenerative Cervical Myelopathy: A Propensity-Matched Case-Control Analysis Nested Within the UK Biobank Cohort
Authors: Grodzinski Ben , Stubbs Daniel J. , Davies Benjamin M.
Published: November 2024

Study Design

Case-control study.

Objectives

Degenerative Cervical Myelopathy (DCM) is a progressive neurological condition caused by mechanical stress on the cervical spine. Surgical exposure in the preceding months to a DCM diagnosis is a common theme of Patient and Public Involvement (PPI) discussions. Such a relationship has biological plausibility (e.g. neck positioning, cord perfusion) but evidence to support this association is lacking.

Methods

We analysed UK Hospital Episode Statistics (HES) data for participants in the UK BioBank cohort. We defined cases as those episodes with a primary diagnosis of DCM and generated controls using non-DCM HES episodes. Cases and controls were propensity score-matched by age, sex and date of episode, and a directed acyclic graph was used to robustly control for confounders. We defined the exposure as any surgical procedure under general or regional anaesthetic occurring within the 6-24 months prior to the episode.

Results

We analysed 806 DCM and 2287432 non-DCM hospital episodes. On multivariable logistic regression analysis, the odds ratio (95% CI) for the effect of a binarised (0 vs ≥ 1) exposure on risk of developing DCM was 1.20 (1.02-1.41), and for categorised (0 vs 1 and 0 vs ≥ 2) exposure was 1.11 (0.882-1.39) & 1.33 (1.075-1.65).

Conclusions

This study supports the patient narrative of surgery as a risk factor for the development of DCM. The association displays temporality, dose-response relationship, and biological plausibility. Further work is needed to confirm this in other cohorts, explore mediating mechanisms, and identify those at greatest risk.
Seven Years of GST: Time to Move Beyond the Exuberance
Authors: Dwivedi Hari K.
Published: November 2024

The introduction of the Goods and Services Tax (GST) in the country in July 2017 marked a watershed in the history of indirect tax reforms in the country. The dual structure of GST in India, with all its infirmities, has had significant positive outcomes. It has reduced multiplicity of taxes, cascading of tax, created uniform tax structure on a common base, a uniform GST architecture, rules and processes, and seamless flow of credit across different tax jurisdictions, across the country. But like any other major tax reform, GST in India initially had its fair share of glitches, some of them still continue, although to a much lesser degree and intensity. Due to constraints imposed by the federal nature of our polity, the centre and the states opted for an ‘imperfect GST’ in place of ‘flawless GST’, with the hope that the design flaws would be corrected once the GST stabilizes. While we celebrate the success of GST in the country, we need to usher in the second-generation GST reforms that will broadly encompass; first, the rationalization of tax slabs, and second, expansion of the tax base by pruning exemptions and bringing petroleum products, electricity, alcohol and real estate under GST. The feasibility of inclusion of excluded items, which constitute around 43% of the state’s own tax revenues, in GST, remains bleak at this stage as it will greatly impact the fiscal autonomy of the states. A beginning can, however, be made to rationalize the rate structure which will remedy many of the complexities and problems being faced at present. But, to even address the issue of rate rationalization, the trust deficit between the centre and the states that has suffered a huge dent during the intervening years has to be bridged.

JEL Classification: H21, H77
Gender, Age and Victimization Risk Among Missing Persons
Authors: Ferguson Lorna , Eliasson Michelle N.
Published: November 2024

The purpose of this study was to examine the risk of victimization among missing persons and the ways in which gender and age shape this relationship. From a sample of 1,847 missing persons reports, multiple logistic regression was used to estimate victimization risk when missing, disaggregated by gender and age group and including vulnerability factors (i.e., the reasons for victimization risk). Results reveal that female missing persons compared to males and children/youths compared to adults had significantly increased odds of victimization risk. Vulnerability factors statistically significantly associated with victimization risk for females compared to males and children/youths compared to adults included transientness, victimization experiences (e.g., domestic violence, human trafficking), going repeatedly missing and mental health concerns. The findings suggest that victimization risk for missing persons varies along gender and age lines. This study contributes to the literature addressing the paucity of studies that apply exposure and opportunity theories to understand victimization risk when missing split by demographic characteristics. Thus, its novelty lies in advancing the victimology literature to the study of missing persons, and in discovering nuances in the relationship between victimization risk and going missing.
Patient-Specific Blister Packaging of Medications in the Oncology Camp Setting: Optimizing Medication Safety and Dispensing Processes
Authors: Ross Sandra , Drynan-Arsenault Jennifer , Peirce Meghan , Williams Meghan , Alexander Sarah
Published: November 2024

Background: Safe medication delivery is an essential component of medical care in the overnight summer camp setting, especially for children with cancer and medical complexity. Blister packaging of medications is a method that may improve safety in this setting. Method: In this quality improvement project, we implemented and evaluated a system of on-site blister packaging of medications with the goal of optimizing the safety and efficiency of medication delivery at a large overnight summer camp for children with cancer. Data for the number and types of medications delivered and medication errors were described in the summer sessions prior to and post this implementation. Quantitative and qualitative clinician feedback was collected. Results: In the summer of 2023, there were 551 campers, 342 (62%) of whom received at least one medication and with the number of medications per child ranging from 0 to 18. There were 70/551 (20%) of campers who received high-risk medications defined as oral antineoplastic therapy and controlled substances. The frequency of medication errors was very low across all summer sessions. The mean number of errors in the preimplementation period was 1/1,000 errors per medication dispensed (0.1%), whereas in the postimplementation period, it was 0.4/1,000 (0.04%). In postcamp survey, qualitative responses from medical staff described that they perceived blister packaging of medications to improve safety and decrease workload. Discussion: The implementation of on-site blister packaging of medications is a feasible system for optimizing medication safety and delivery in an overnight camp for children with cancer.
Deep learning model using continuous skin temperature data predicts labor onset
Authors: Basavaraj Chinmai , Grant Azure D. , Aras Shravan G. , Erickson Elise N.
Published: November 2024

Background

Changes in body temperature anticipate labor onset in numerous mammals, yet this concept has not been explored in humans. We investigated if continuous body temperature exhibits similar changes in women and whether these changes may be linked to hormonal status. Finally, we developed a deep learning model using temperature patterning to provide a daily forecast of time to labor onset.

Methods

We evaluated patterns in continuous skin temperature data in 91 (n = 54 spontaneous labors) pregnant women using a wearable smart ring. In a subset of 28 pregnancies, we examined daily steroid hormone samples leading up to labor to analyze relationships among hormones and body temperature trajectory. Finally, we applied an autoencoder long short-term memory (AE-LSTM) deep learning model to provide a novel daily estimation of days until labor onset.

Results

Features of temperature change leading up to labor were associated with urinary hormones and labor type. Spontaneous labors exhibited greater estriol to α-pregnanediol ratio, as well as lower body temperature and more stable circadian rhythms compared to pregnancies that did not undergo spontaneous labor. Skin temperature data from 54 pregnancies that underwent spontaneous labor between 34 and 42 weeks of gestation were included in training the AE-LSTM model, and an additional 37 pregnancies that underwent artificial induction of labor or Cesarean without labor were used for further testing. The input to the pipeline was 5-min skin temperature data from a gestational age of 240 days until the day of labor onset. During cross-validation AE-LSTM average error (true – predicted) dropped below 2 days at 8 days before labor, independent of gestational age. Labor onset windows were calculated from the AE-LSTM output using a probabilistic distribution of model error. For these windows AE-LSTM correctly predicted labor start for 79% of the spontaneous labors within a 4.6-day window at 7 days before true labor, and 7.4-day window at 10 days before true labor.

Conclusion

Continuous skin temperature reflects progression toward labor and hormonal change during pregnancy. Deep learning using continuous temperature may provide clinically valuable tools for pregnancy care.
Socio-cultural practices and experience of mothers’ post stillbirth and newborn death: a population-based perspective from India
Authors: Majumder Moutushi , Kumar G Anil , Ali Sarah Binte , George Sibin , Dora Siva Prasad , Akbar Md. , Akhouri Shuchi Sree , Kumari Sweta , Mahapatra Tanmay , Dandona Rakhi ,   ENHANCE 2020 Team, Paul Arpita , Das Arup Kumar , Dandona Lalit , Kumar Vimal , Bhattacharjee Debrupa , Bhatt Dinesh
Published: November 2024

Introduction

We report on post stillbirth and newborn death socio-cultural experience of women from a population-based representative sample in the Indian state of Bihar.

Methods

A state-representative sample of 7,270 births between July 2020 and June 2021 was sampled, including 582 stillbirths and 831 newborn deaths. Detailed confidential interviews were conducted with the consenting women with stillbirth and newborn death to understand their post-birth experience.

Results

A total of 501 (86.1% participation) women with stillbirth and 717 (86.3% participation) with neonatal death provided interview. Able to talk to someone about their baby and receiving support to cope with their loss were reported by 369 (74.2%) and 398 (80.2%) women with stillbirth; these proportions were 76.7% and 77.3% for women with newborn deaths, respectively. More than 80% of these women reported spouses as their main source of support. At least one negative experience was reported by 150 (30.9%) and 233 (32.5%) women with stillbirth and newborn death, respectively. The most commonly reported negative experience was receiving insensitive/hurtful comments about the baby (18.6% for stillbirth and 20.4% for newborn deaths), followed by being blamed for the baby’s death (14.3% for stillbirths and 15.0% for newborn deaths). The majority of women reported being verbally abused by the mother-in-law for both stillbirth (24, 63.2%) and newborn death (49, 64.5%); while 48 (67.6%) and 66 (61.7%) women were blamed by the mother-in-law for stillbirth and neonatal death, respectively. Most women with stillbirth (72.7%) and with neonatal death (77.1%) were asked to forget about their babies as a means to cope with their loss. Naming, seeing, and holding the stillborn were reported by 56 (11.2%), 229 (45.9%), and 64 (12.8%) women with a stillborn.

Conclusion

With one-third women with adverse birth outcome reporting negative experience, this translates into a significant number of women in India as it accounts for high numbers of stillbirths and newborn deaths globally. These population-based data can facilitate in designing interventions to improve post-partum experience for women with adverse birth outcomes in India.
Perceived unmet needs and impact on quality of life of patients living with advanced bladder cancer and their caregivers: results of a social media listening study conducted in five European countries
Authors: Schuck Stephane , Loussikian Paul , Mebarki Adel , Malaab Joelle , Foulquié Pierre , Talmatkadi Manissa , Kearney Mairead
Published: November 2024

Background

Advanced bladder cancer (aBC) is a significant health concern in Europe and has a poor prognosis. Patients with aBC face numerous unmet needs and challenges that significantly impact their quality of life (QoL). This study aims to analyze social media data from five European countries to address gaps in our understanding of the unmet needs, challenges, and impact on QoL in European patients with aBC and their caregivers.

Methods

This retrospective, real-world study includes public social media posts geolocated in France, Italy, Germany, Spain, and the UK, posted between October 2017 and January 2022. To enhance the filtering process, natural language processing methods and specific algorithms were used to remove irrelevant content and retain posts from patients and caregivers. QoL impacts were identified using a deep-learning algorithm, followed by qualitative analysis. Unmet needs were analyzed via annotation of messages and the saturation method.

Results

A total of 1670 posts from 1396 users (699 posts from 546 patients and 971 posts from 850 caregivers) discussing aBC in 91 publicly available online sources were identified. Half of patients were male (n = 272, 49.8%) while more caregivers were female (n = 474, 55.8%), with an average age of 58.2 and 35.2 years, respectively. Patients and caregivers expressed an impact on QoL, wherein 40.0% (558/1396) of users mentioned at least an impact on one aspect of QoL. Among those, 56.8% (317/558) and 48.6% (271/558) of users expressed physical and psychological challenges, respectively. Most unmet needs identified belonged to two main categories: transversal, i.e., arising throughout the patient’s care pathway (307/1092 [28.1%]), and disease specific (295/1092 [27.0%]). Main challenges included worsening of the disease (n = 141, 12.9%), psychological impact (n = 112, 10.3%), and need to share experiences and seek support (n = 94, 8.6%).

Conclusions

This social media listening study demonstrated the profound emotional and physical burden on patients with aBC and their caregivers, and a genuine need for support and an outlet to discuss their challenges, particularly in terms of managing the illness. These results underscore the importance of enhancing education for both patients and caregivers and the necessity for more effective systemic cancer therapies and better palliative care alternatives.
Parent’s acceptance of advanced behavior management techniques on children during dental treatment
Authors: Salerno Claudia , Cirio Silvia , Maspero Cinzia , Roner Margerita , D’Avola Valeria , Cagetti Maria Grazia
Published: November 2024

Aim

This study explores the acceptance of Advanced Behavior Management Techniques (ABMTs) by parents during their children’s dental treatments, comparing the opinion of parents of neurotypical children with that of parents of children with autism spectrum disorders (ASDs).

Methods

An observational cross-sectional study was conducted involving 440 parents, divided into two groups: 236 parents of neurotypical children and 204 parents of children with ASDs, recruited from pediatricians’ centers and centers for ASDs children in Northern and Southern Italy. A survey assessed their familiarity and acceptance of ABMTs, including protective stabilization, conscious sedation, and deep sedation/general anesthesia. Discrete variables were expressed as absolute and relative frequencies (%) and compared with Pearson’s chi-squared or Fisher’s exact test. Continue variables were expressed as mean ± SD and compared with the one-way ANOVA test. Heatmap and PCA analysis were used to determine possible correlations between items.

Results

Parents of children with ASDs showed a higher acceptance rate of ABMTs compared to parents of neurotypical children. Overall, only 30.68% of parents knew ABMTs before the survey. Differences between the two groups of parents in acceptance of Active Stabilization in emergency settings, Passive Stabilization in routine settings, and Deep sedation/general anesthesia in both settings were observed (p < 0.01). Only 6.82% of parents ever used at least one ABMT on their children. Heatmap analysis revealed that parents who have accepted one of the ABMTs tend to accept the others as well.

Conclusion

Differences in parental acceptance of different ABMTs was noted among the two groups of parents, with greater acceptance of ABMTs observed in the group of parents of children with ASDs. Parents of both groups have significant gaps in their knowledge of ABMTs. Therefore, increased awareness and personalized communication strategies are needed to increase acceptance of the studied techniques and, thus, facilitate access to dental care for uncooperative pediatric patients. Patient-centered behavior management strategies that meet children’s needs and parents’ preferences can contribute to the achievement of good oral health.
De-normalizing sugar-sweetened beverage consumption: effects of tax measures on social norms and attitudes in the California Bay Area
Authors: Altman Emily , Schillinger Dean , Villas-Boas Sofia , Schmidt Laura , Falbe Jennifer , Madsen Kristine A.
Published: November 2024

Background

Social norms can influence individual health behaviors. Shifts in social norms for smoking were critical for the effectiveness of tobacco control efforts such as excise taxes. Sugar-sweetened beverage (SSB) excise taxes have been implemented in municipalities across the United States to reduce SSB intake and improve health. We sought to identify trends in social norms and attitudes about healthfulness of sugar-sweetened beverage (SSB) consumption in the California Bay Area and examine whether social norms and attitudes changed following SSB taxes.

Methods

Data came from annual (2016–2019, 2021) cross-sectional surveys (n = 9128) in lower-income neighborhoods in Oakland, San Francisco, Berkeley, and Richmond. We assessed overall trends and compared pre-post tax changes in Oakland and San Francisco with comparison cities.

Results

We observed a 28% reduction in social norms for SSB consumption (people’s perceptions of peers’ consumption) and variable reductions in attitudes about the healthfulness of SSBs. Relative to comparison cities, post-tax, perceptions of peers’ consumption of sports drinks declined in Oakland; attitudes about the healthfulness of sugar-sweetened fruit drinks declined in San Francisco.

Conclusions

Among lower-income populations, social norms and attitudes towards the healthfulness of SSBs meaningfully declined over time, with smaller tax-related effects. SSB taxes as well as the local media attention they generate appear to affect people’s perceptions of SSBs. Pairing SSB taxes with messaging campaigns may be more effective in de-normalizing SSB consumption.
Menopause knowledge, attitudes and experiences of women in Saudi Arabia: a qualitative study
Authors: AlSwayied Ghada , Frost Rachael , Hamilton Fiona L.
Published: November 2024

Background

Menopause can be seen as a complex phenomenon influenced by an individual’s cultural norms, belief systems, and lifestyle choices. In conservative societies such as Saudi Arabia, some women silently struggle with menopause due to cultural taboos and social stigma, making their experiences invisible and lowering their quality of life. The aim of this study was to explore in-depth the knowledge, attitudes, and experiences of middle-aged Saudi women with menopause.

Methods

The study employed qualitative methods using semi-structured interviews with middle-aged women undergoing menopause in Saudi Arabia from February to May 2023. The interviews were conducted online in Arabic, recorded and transcribed verbatim. The data were analysed inductively using thematic analysis.

Results

A total of twenty-nine women, aged 40–64 years, were interviewed. Three key themes were identified: mixed emotions towards menopause; experiencing biopsychosocial changes; and adapting to the transition. Overall, most participants had mixed perspectives on menopause. Negative aspects included feelings of uncertainty and the loss of fertility while positive aspects included a sense of relief from menstruation and the newfound freedom to engage in religious activities at any time. Notably, during the interviews, many participants reconsidered their initial negative views and voiced predominantly positive perspectives. Several women reported inconvenient menopausal symptoms, such as hot flashes, night sweats, disturbed sleep, and fatigue. Concerns about being perceived as less attractive led many to keep their symptoms private, and societal expectations played a significant role in influencing how women managed these symptoms and sought help. Many women opted to seek information discreetly online rather than seeking support from others. Self-care practices were favoured for managing menopause, with medical care being undervalued or at times deemed unsatisfactory.

Conclusion

In Saudi Arabia, menopause is generally seen as a natural phase of life. Many women appreciate the positive aspects it brings, such as relief from menstrual pain and an enhanced ability to participate in religious practices. However, they also encounter challenges, including hot flashes and concerns about perceived decreases in attractiveness. A notable trend is the preference for self-care strategies over medical interventions or hormone replacement therapy (HRT). There is a need to raise awareness about menopausal symptoms to reduce negative perceptions and experiences and to develop health promotion and educational interventions to support and empower women during this transition. Future research with healthcare professionals would extend these findings.
Challenges facing physicians in death certification of under-five mortality in Egypt
Authors: Aziz Mirette M , Dous Nevein
Published: November 2024

Background

Improving death certification of Under 5 Mortality (U5M) is an important pre-requisite for improving child health. This study aimed to obtain a clear and comprehensive understanding of the process of death registration of U5M and address the challenges of accurate certification faced by physicians at hospitals and health offices.

Methods

A qualitative descriptive study was performed by conducting 10 Focus Group Discussions (FGDs) with physicians who are actively involved in the certification of U5M. Physicians were invited to participate from primary health care units, health offices, district and general hospitals in Cairo, Giza and Assiut Governorates. Field visits of health offices were performed to observe the procedure of death registration, visualize a sample of the hospitals’ Death Notification Forms (DNFs) and death certificates of U5M, and explore the used electronic system of death registration. Data analysis was performed using inductive thematic analysis.

Results

The study clarified the procedure of death certification of U5M, starting from hospitals and ending at health offices. It was evident that there is a considerable deficiency in the system of registration and coding causes of death. Physicians of hospitals had a negative attitude regarding death registration. They were found to have deficient knowledge about standards of death certification. They had difficulty defining and reporting the chain of events leading to death. Poor diagnostic facilities hindered physicians from accurately reporting COD. Fear of legal accountability was a cause of avoiding detailed COD. For physicians in the health offices, other challenges were mentioned such as assigning junior physicians to manage the task of writing DNFs, poor quality of hospital reports and the unrealistic ICD-10 codes.

Conclusion

Improving the accuracy of writing DNFs in hospitals is essential for providing reliable U5M statistics. Practical training of physicians, especially the junior ones, on ICD-10 classification and on identification and writing direct and indirect COD in the allocated lines in the death certificates is a priority. Establishing an audit system to assess the quality of the process of certification and updating the software of the electronic system for data entry would have a great impact.
Rapid and non-invasive analysis of paracetamol overdose using paper arrow-mass spectrometry: a prospective observational study
Authors: Zhou Yufeng , Dliso Silothabo , Craske Jennie , Gill Andrea , Bracken Louise , Landa Kiran , Arnold Philip , Walker Laura , Grasim Ionela , Seddon Gabrielle , Chen Tao , Davison Andrew S. , Sham Tung-Ting , Smith Barry , Hawcutt Daniel B. , Maher Simon
Published: November 2024

Background

Paracetamol is the most consumed medicine globally. Its accessibility contributes to common overdose. Paracetamol overdose is responsible for > 50% of acute liver failure cases, making it the second most common reason for a liver transplant. Rapid quantitation of paracetamol is crucial to guide treatment of paracetamol overdose. Current tests require invasive sampling and relatively long turnaround times. Paper arrow-mass spectrometry (PA-MS) combines sample collection, extraction, separation, enrichment and ionisation onto a single paper strip, achieving rapid, accurate, cost-effective and eco-friendly analysis direct from raw human saliva.

Methods

To validate PA-MS against an established test, 17 healthy adults were recruited. Samples were collected before and at 15, 30, 60, 120 and 240 min after ingesting 1 g of paracetamol. Plasma measured with an established clinical test served as the reference standard to validate PA-MS with three biofluids—plasma, resting saliva (RS) and stimulated saliva (SS). Participants’ views of blood, RS and SS sampling procedures were assessed qualitatively. Cross-validation was assessed using Lin’s concordance correlation coefficients (CCC), Bland–Altman difference plots, and ratios of PA-MS to the reference standard test.

Results

PA-MS using stimulated saliva offers a reliable alternative to intravenous blood sampling. The CCC is 0.93, the mean difference with the reference test is − 0.14 mg/L, and the ratios compared to the reference test are 0.84–1.27 from correlated samples collected at 5 intervals over 4 h for each participant.

Conclusions

Paracetamol detection from SS with PA-MS provides a reliable result that can aid timely treatment decisions. Differences between paracetamol concentration in resting and stimulated saliva were also identified for the first time, highlighting the importance of standardising saliva collection methods in general. This study marks a major milestone towards rapid and convenient saliva analysis.
Increased cytoplasmic expression of PETase enzymes in E. coli
Authors: Carter Luke M. , MacFarlane Chris E. , Karlock Samuel P. , Sen Tridwip , Kaar Joel L. , Berberich Jason A. , Boock Jason T.
Published: November 2024

Background

Depolymerizing polyethylene terephthalate (PET) plastics using enzymes, such as PETase, offers a sustainable chemical recycling route. To enhance degradation, many groups have sought to engineer PETase for faster catalysis on PET and elevated stability. Considerably less effort has been focused toward expressing large quantities of the enzyme, which is necessary for large-scale application and widespread use. In this work, we evaluated several E. coli strains for their potential to produce soluble, folded, and active IsPETase, and moved the production to a benchtop bioreactor. As PETase is known to require disulfide bonds to be functional, we screened several disulfide-bond promoting strains of E. coli to produce IsPETase, FAST-PETase and Hot-PETase.

Results

We found expression in SHuffle T7 Express results in higher active expression of IsPETase compared to standard E. coli production strains such as BL21(DE3), reaching a purified titer of 20 mg enzyme per L of culture from shake flasks using 2xLB medium. We characterized purified IsPETase on 4-nitrophenyl acetate and PET microplastics, showing the enzyme produced in the disulfide-bond promoting host has high activity. Using a complex medium with glycerol and a controlled bioreactor, IsPETase titer reached 104 mg per L for a 46-h culture. FAST-PETase was found to be produced at similar levels in BL21(DE3) or SHuffle T7 Express, with purified production reaching 65 mg per L culture when made in BL21(DE3). Hot-PETase titers were greatest in BL21(DE3) reaching 77 mg per L culture.

Conclusions

We provide protein expression methods to produce three important PETase variants. Importantly, for IsPETase, changing expression host, medium optimization and movement to a bioreactor resulted in a 50-fold improvement in production amount with a per cell dry weight productivity of 0.45 mgPETase gCDW−1 h−1, which is tenfold greater than that for K. pastoris. We show that the benefit of using SHuffle T7 Express for expression only extends to IsPETase, with FAST-PETase and Hot-PETase better produced and purified from BL21(DE3), which is unexpected given the number of cysteines present. This work represents a systematic evaluation of protein expression and purification conditions for PETase variants to permit further study of these important enzymes.
Intersectional inequalities in mental health by education, income, gender, and age before and during the COVID-19 pandemic in the Netherlands: a longitudinal study
Authors: Verra Sanne E. , Evans Clare , Oude Groeniger Joost , de Wit John , Poelman Maartje P. , Kamphuis Carlijn B. M.
Published: November 2024

Background

It remains unclear how COVID-19 has disproportionately affected the mental health of different vulnerable groups. This study explores how mental health inequalities changed between 2014 (pre-COVID-19) and 2021 (during COVID-19) in the Netherlands across intersectional social strata defined by interplays of educational attainment, income level, gender, and age.

Methods

Using 2014 and 2021 self-reported cohort data on health and living conditions of the adult population of Eindhoven and surroundings (N = 1,157), a Multilevel Analysis of Individual Heterogeneity and Discriminatory Accuracy (MAIHDA) was applied to explore intersectional inequalities in mental health in 2014, 2021, and in mental health changes (2014–2021). We examined this using the Mental Health Inventory-5 across 53 intersectional social strata based on interplays of education, income, gender, and age in 2014.

Results

There were substantial differences in mental health trajectories across social strata. Between-stratum mental health inequalities were patterned additively, indicating that inequality patterns along one axis (such as income) tended to be consistent across other axes of comparison. Additive trends revealed that women with a low income were at highest risk of poor mental health in 2014 and 2021, and people over 65 were at highest risk of mental health setbacks over time. Nonsignificant educational inequalities were found in 2014 and 2021. Income inequalities persisted, but slightly decreased in 2021 due to stronger mental health setbacks among those with high incomes. Women experienced persisting disadvantages that slightly flattened over time, and the mental health advantages of older age diminished over time.

Conclusions

Inequalities in mental health add up for those who experience multiple axes of disadvantage, such as women and those with low incomes, but no disproportionate intersectional interaction effects were found. Effort is needed to ensure that mental health support is accessible for all, especially those with low incomes. Given the especially strong mental health declines among those over 65, responses to future crises need to include measures to protect the mental health of the elderly. Future research should investigate intersectional inequalities along other axes of disadvantage, such as ethnicity, employment and family status.