bluuebunny/crossref_metadata_2025 huggingface dataset:
Using shallow neural networks with functional connectivity from EEG signals for early diagnosis of Alzheimer's and frontotemporal dementia
Authors: Ajra Zaineb , Xu Binbin , Dray Gérard , Montmain Jacky , Perrey Stéphane
Published: October 2023

Introduction

Dementia is a neurological disorder associated with aging that can cause a loss of cognitive functions, impacting daily life. Alzheimer's disease (AD) is the most common cause of dementia, accounting for 50–70% of cases, while frontotemporal dementia (FTD) affects social skills and personality. Electroencephalography (EEG) provides an effective tool to study the effects of AD on the brain.

Methods

In this study, we propose to use shallow neural networks applied to two sets of features: spectral-temporal and functional connectivity using four methods. We compare three supervised machine learning techniques to the CNN models to classify EEG signals of AD / FTD and control cases. We also evaluate different measures of functional connectivity from common EEG frequency bands considering multiple thresholds.

Results and discussion

Results showed that the shallow CNN-based models achieved the highest accuracy of 94.54% with AEC in test dataset when considering all connections, outperforming conventional methods and providing potentially an additional early dementia diagnosis tool.
Effects of six different microbial strains on polyphenol profiles, antioxidant activity, and bioaccessibility of blueberry pomace with solid-state fermentation
Authors: Tian Zhu-Xi , Li Yong-Fu , Long Ming-Xiu , Liang Qian , Chen Xi , Huang Dao-Mei , Ran Yao-Qi
Published: October 2023

To explore the effect of different microbial strains on blueberry pomace with solid-state fermentation (SSF), three fungi strains and three lactic acid bacteria (LAB) strains were utilized to investigate with respect to polyphenol profiles, antioxidant capacities, and bioaccessibility. Different strains exhibited different capacities for metabolizing polyphenolic compounds in blueberry pomace. The contents of 10 phenolic acids and 6 flavonoids (except (+)-catechin) were increased in blueberry pomace fermented by Lactobacillus acidophilus (LA). A similar tendency was observed in blueberry pomace fermented by Aspergillus niger (AN) and Lactobacillus plantarum (LP), where the concentration of 8 phenolic acids and 5 flavonoids was enhanced, with the following exceptions: (+)-catechin, ferulic acid, vanillic acid, and quercitrin. Chlorogenic acid and quercetin were the maximum phenolic acids and flavonoids in blueberry pomace with SSF, upgraded at 22.96 and 20.16%, respectively. Contrary to the growth of phenolic acids and flavonoid compounds, all individual anthocyanins showed a decreased trend. Only in the blueberry pomace fermented by AN, all anthocyanidins exhibit a rising trend. After SSF, 2,2′-azino-bis (3-ethylbenzothiazoline-6-sulfonic acid) (ABTS), 2,2-diphenylpicrylhydrazyl (DPPH), and ferric reducing antioxidant power (FRAP) radical scavenging abilities were increased by up to 33.56, 59.89, and 87.82%, respectively. Moreover, the simulated gastrointestinal digestion system revealed that SSF improved the bioaccessibility of polyphenolic compounds. Compared with other strains, LA, LP, and AN showed better excellent capacities for metabolizing polyphenolic compounds, which led to a greater increase in antioxidant activity and bioaccessibility in fermented blueberry pomace.
Intra-tumoral microbial community profiling and associated metabolites alterations of TNBC
Authors: Wang Yi , Qu Dingding , Zhang Yali , Jin Yiping , Feng Yu , Zhang He , Xia Qingxin
Published: October 2023

Triple-negative breast cancer (TNBC) presents significant challenges to female health owing to the lack of therapeutic targets and its poor prognosis. In recent years, in the field of molecular pathology, there has been a growing focus on the role of intra-tumoral microbial communities and metabolic alterations in tumor cells. However, the precise mechanism through which microbiota and their metabolites influence TNBC remains unclear and warrants further investigation. In this study, we analyzed the microbial community composition in various subtypes of breast cancer through 16S rRNA MiSeq sequencing of formalin-fixed, paraffin-embedded (FFPE) tissue samples. Notably, Turicibacter, a microbe associated with cancer response, exhibited a significantly higher abundance in TNBC. Similarly, mass spectrometry-based metabolomic analysis revealed substantial differences in specific metabolites, such as nutriacholic, pregnanetriol, and cortol. Furthermore, we observed significant correlations between the intra-tumoral microbiome, clinicopathological characteristics, and human epidermal growth factor receptor-2 expression(HER2). Three microbial taxa (Cytophagaceae, Conexibacteraceae, and Flavobacteriaceae) were associated with tumor-infiltrating lymphocytes(TILs), which are indicative of antitumor immunity. This study creatively utilized FFPE tissue samples to assess intra-tumoral microbial communities and their related metabolic correlations, presenting avenues for the identification of novel diagnostic biomarkers, the development of therapeutic strategies, and the early clinical diagnosis of TNBC.
Emerging roles of interactions between ncRNAs and other epigenetic modifications in breast cancer
Authors: Xie Junyuan , Gan Li , Xue Bingjian , Wang Xinxing , Pei Xinhong
Published: October 2023

Up till the present moment, breast cancer is still the leading cause of cancer-related death in women worldwide. Although the treatment methods and protocols for breast cancer are constantly improving, the long-term prognosis of patients is still not optimistic due to the complex heterogeneity of the disease, multi-organ metastasis, chemotherapy and radiotherapy resistance. As a newly discovered class of non-coding RNAs, ncRNAs play an important role in various cancers. Especially in breast cancer, lncRNAs have received extensive attention and have been confirmed to regulate cancer progression through a variety of pathways. Meanwhile, the study of epigenetic modification, including DNA methylation, RNA methylation and histone modification, has developed rapidly in recent years, which has greatly promoted the attention to the important role of non-coding RNAs in breast cancer. In this review, we carefully and comprehensively describe the interactions between several major classes of epigenetic modifications and ncRNAs, as well as their different subsequent biological effects, and discuss their potential for practical clinical applications.
A novel splice donor mutation in DCLRE1C caused atypical severe combined immunodeficiency in a patient with colon lymphoma: case report and literature review
Authors: Zhang Xiaoqing , Jiang Wujun , Jin Zhongqin , Wang Xueqian , Song Xiaoxiang , Huang Shan , Zhang Min , Lu Huigang
Published: October 2023

Introduction

Hypomorphic mutations of DCLRE1C cause an atypical severe combined immunodeficiency (SCID), and Epstein-Barr virus (EBV)-related colon lymphoma is a rare complication.

Case presentation

A teenage boy presented with colon EBV-related colon lymphoma, plantar warts, and a history of recurrent pneumonia. His peripheral blood lymphocyte count and serum level of immunoglobulin (Ig) G were normal, but he exhibited a T+B-NK+ immunophenotype. Genetic analysis by whole exome sequencing revealed compound heterozygous mutations of DCLRE1C (NM_001033855.3), including a novel paternal splicing donor mutation (c.109 + 2T>C) in intron 1, and a maternal c.1147C>T (p.R383X) nonsense mutation in exon 13. Based on his clinical features and genetic results, the diagnosis of atypical SCID with colon lymphoma was established. Our review shows that seven patients, including our patient, have been reported to develop lymphoma, all with hypomorphic DCLRE1C mutations. Among these cases, six had EBV-related B-cell lineage lymphoma, and one had Hodgkin lymphoma with EBV reactivation. Unfortunately, all of the patients died.

Conclusion

Recognizing the radiosensitivity of the disease is critical for the prognosis. Hematopoietic stem cell transplantation before being infected with EBV is an optimal treatment.
C-reactive protein point-of-care testing and complementary strategies to improve antibiotic stewardship in children with acute respiratory infections in primary care
Authors: Staiano Annamaria , Bjerrum Lars , Llor Carl , Melbye Hasse , Hopstaken Rogier , Gentile Ivan , Plate Andreas , van Hecke Oliver , Verbakel Jan Y.
Published: October 2023

This paper provides the perspective of an international group of experts on the role of C-reactive protein (CRP) point-of-care testing (POCT) and complementary strategies such as enhanced communication skills training and delayed prescribing to improve antibiotic stewardship in the primary care of children presenting with an acute illness episode due to an acute respiratory tract infection (ARTI). To improve antibiotics prescribing decisions, CRP POCT should be considered to complement the clinical assessment of children (6 months to 14 years) presenting with an ARTI in a primary care setting. CRP POCT can help decide whether a serious infection can be ruled out, before deciding on further treatments or management, when clinical assessment is unconclusive. Based on the evidence currently available, a CRP value can be a valuable support for clinical reasoning and facilitate communication with patients and parents, but the clinical assessment should prevail when making a therapy or referral decision. Nearly half of children tested in the primary care setting can be expected to have a CRP value below 20 mg/l, in which case it is strongly suggested to avoid prescribing antibiotics when the clinical assessment supports ruling out a severe infection. For children with CRP values greater than or equal to 20 mg/l, additional measures such as additional diagnostic tests, observation time, re-assessment by a senior decision-maker, and specialty referrals, should be considered.
Playing basketball and volleyball during adolescence is associated with higher bone mineral density in old age: the Bunkyo Health Study
Authors: Otsuka Hikaru , Tabata Hiroki , Shi Huicong , Sugimoto Mari , Kaga Hideyoshi , Someya Yuki , Naito Hitoshi , Ito Naoaki , Abudurezake Abulaiti , Umemura Futaba , Tajima Tsubasa , Kakehi Saori , Yoshizawa Yasuyo , Ishijima Muneaki , Kawamori Ryuzo , Watada Hirotaka , Tamura Yoshifumi
Published: October 2023

Introduction: Exercise is beneficial for increasing areal bone mineral density (aBMD) in adolescence and maintaining it in old age. Moreover, high-impact sports are more effective than low-impact sports in increasing aBMD. This study aimed to determine the types of adolescent sports played in school-based sports clubs associated with aBMD in old age.

Methods: In total, 1,596 older adults (681 men and 915 women, age: 65–84 years) living in an urban area of Japan were evaluated for the femoral neck and lumbar spine aBMD using dual-energy X-ray absorptiometry. The association between adolescent sports played in sports clubs and aBMD in old age was analyzed using multiple regression analysis, with femoral neck and lumbar spine aBMD as dependent variables, and sports type and participant characteristics such as age, body weight, and serum 25-hydroxyvitamin D [25(OH)D] level, as independent variables.

Results: For the femoral neck, basketball was associated with aBMD in older men (β = 0.079, p < 0.05) and women (β = 0.08, p < 0.01), whereas current body weight and 25(OH)D level were associated with aBMD in both sexes. For the lumbar spine, volleyball (β = 0.08, p < 0.01) and swimming (β = 0.06, p < 0.05) was significantly associated with lumbar spine aBMD, whereas current body weight, 25(OH)D, and diabetes mellitus were associated with aBMD in older women.

Conclusion: Both men and women who played basketball in adolescence had higher femoral neck aBMD in old age. Moreover, women who played volleyball in adolescence had higher lumbar spine aBMD in old age.
Interactions between corticotropin releasing factor signaling and prophylactic antibiotics on measures of intestinal function in weaned and transported pigs
Authors: McConn Betty R. , Kpodo Kouassi R. , Rivier Jean E. , Behan Dominic P. , Richert Brian T. , Radcliffe John S. , Lay Donald C. , Johnson Jay S.
Published: October 2023

The study objective was to evaluate the interaction between corticotrophin releasing factor (CRF) receptor signaling and prophylactic antibiotic administration on intestinal physiology in newly weaned and transported pigs. Pigs (n = 56; 5.70 ± 1.05 kg) were weaned (20.49 ± 0.64 d), a blood sample was taken, and then pigs were given an intraperitoneal injection of saline (SAL; n = 28 pigs) or a CRF receptor antagonist (CRFA; n = 28 pigs; 30 μg/kg body weight; Astressin B), and then were transported in a livestock trailer for 12 h and 49 min. A second and third intraperitoneal injection was given at 4 h 42 min and 11 h 36 min into the transport process, respectively. Following transport, 4 SAL and 4 CRFA pigs were blood sampled and euthanized. The remaining 48 pigs were individually housed and given dietary antibiotics [AB; n = 12 SAL and 12 CRFA pigs; chlortetracycline (441 ppm) + tiamulin (38.6 ppm)] or no dietary antibiotics (NAB; n = 12 SAL and 12 CRFA pigs) for 14 d post-transport. Blood was collected at 12 h and on d 3, 7, and 14, and then pigs were euthanized on d 7 (n = 24) and d 14 (n = 24) post-weaning and transport. Circulating cortisol was reduced (p = 0.05) in CRFA pigs when compared to SAL pigs post-weaning and transport. On d 7, jejunal villus height and crypt depth was greater overall (p < 0.05) in AB-fed pigs versus NAB-fed pigs. On d 14, ileal crypt depth was reduced (p = 0.02) in CRFA pigs when compared to SAL pigs. Jejunal CRF mRNA abundance tended to be reduced (p = 0.09) on d 7 in CRFA pigs versus SAL pigs. On d 14, jejunal tumor necrosis factor-alpha was reduced (p = 0.01) in AB-fed pigs versus NAB-fed pigs. On d 7, change in glucose short-circuit current tended to be increased (p = 0.07) in CRFA pigs fed the AB diet when compared to CRFA pigs fed the NAB diet. In conclusion, CRFA pigs and pigs fed AB had some similar biological intestinal function measures post-weaning and transport.
Expression in A. thaliana and cellular localization reveal involvement of BjNRAMP1 in cadmium uptake
Authors: Li Ting , Li Yicun , Wang Jiaqi , Peng Jiashi , Liu Lili , Deng Lichao , Zhang Dawei , Yan Mingli
Published: October 2023

Although Brassica juncea has demonstrated potential as a hyperaccumulator crop, it was not entirely clear how cadmium (Cd) accumulates in plants. Here, we found that BjNRAMP1 (Natural Resistance-Associated Macrophage Protein 1) plays a crucial role in the accumulation of Cd and manganese (Mn) through its expression in yeast and Arabidopsis thaliana. The high concentration of Cd exposure could induce the expression of BjNRAMP1. The ectopic expression of BjNRAMP1 in yeast led to higher accumulation of Cd and Mn compared to the vector control. BjNARAMP1 was localized to the plasma membrane and expressed in the vascular system of roots, leaves, and flowers. The overexpression of BjNRAMP1 in A. thaliana resulted in an increased accumulation of Cd in both roots and shoots, which inhibited the normal growth of transgenic lines. Moreover, Mn uptake in roots was activated by the increase in Cd stress. Together, our results indicated that BjNRAMP1 significantly contributes to the uptake of Mn and Cd in B. juncea.
Microdiversity sustains the distribution of rhizosphere-associated bacterial species from the root surface to the bulk soil region in maize crop fields
Authors: Fu Xianheng , Fu Qi , Zhu Xiaozheng , Yang Xian , Chen Huaihai , Li Shiqing
Published: October 2023

Over the years, the microbial community of maize (Zea mays) rhizosphere has been extensively studied; however, the role of microdiversity sustain rhizosphere-associated microbial species distribution from root surface to bulk soil in mature maize is still unclear. Although operational taxonomic units (OTUs) have been used to classify species, amplicon sequence variants (ASVs) have been shown to be effective in representing microdiversity within OTUs at a finer genetic scale. Therefore, the aim of this study was to examine the role of microdiversity in influencing the distribution of rhizosphere-associated microbial species across environmental gradients from root surface to bulk soil at the OTU and ASV levels. Here, the microbial community structures of bulk, loosely bound, and tightly bound soil samples from maize rhizosphere were examined at OTU and ASV levels. The results showed that OTU and ASV methods exhibited similar microbial community structures in rhizosphere. Additionally, different ecotypes with varying distributions and habitat preferences were observed within the same bacterial OTU at the ASV level, indicating a rich bacterial microdiversity. In contrast, the fungal community exhibited low microdiversity, with no significant relationship between fungal microdiversity and persistence and variability. Moreover, the ecotypes observed within the bacterial OTUs were found to be positively or negatively associated with environmental factors, such as soil organic carbon (SOC), NO3−–N, NH4+–N contents, and pH. Overall, the results showed that the rich microdiversity could sustain the distribution of rhizosphere-associated bacterial species across environmental gradients from root surface to bulk soil. Further genetic analyses of rhizosphere-associated bacterial species could have considerable implications for potential mediation of microdiversity for sustainable crop production.
Unraveling the evolutionary dynamics of the TPS gene family in land plants
Authors: Yan Xue-Mei , Zhou Shan-Shan , Liu Hui , Zhao Shi-Wei , Tian Xue-Chan , Shi Tian-Le , Bao Yu-Tao , Li Zhi-Chao , Jia Kai-Hua , Nie Shuai , Guo Jing-Fang , Kong Lei , Porth Ilga M. , Mao Jian-Feng
Published: October 2023

Terpenes and terpenoids are key natural compounds for plant defense, development, and composition of plant oil. The synthesis and accumulation of a myriad of volatile terpenoid compounds in these plants may dramatically alter the quality and flavor of the oils, which provide great commercial utilization value for oil-producing plants. Terpene synthases (TPSs) are important enzymes responsible for terpenic diversity. Investigating the differentiation of the TPS gene family could provide valuable theoretical support for the genetic improvement of oil-producing plants. While the origin and function of TPS genes have been extensively studied, the exact origin of the initial gene fusion event - it occurred in plants or microbes - remains uncertain. Furthermore, a comprehensive exploration of the TPS gene differentiation is still pending. Here, phylogenetic analysis revealed that the fusion of the TPS gene likely occurred in the ancestor of land plants, following the acquisition of individual C- and N- terminal domains. Potential mutual transfer of TPS genes was observed among microbes and plants. Gene synteny analysis disclosed a differential divergence pattern between TPS-c and TPS-e/f subfamilies involved in primary metabolism and those (TPS-a/b/d/g/h subfamilies) crucial for secondary metabolites. Biosynthetic gene clusters (BGCs) analysis suggested a correlation between lineage divergence and potential natural selection in structuring terpene diversities. This study provides fresh perspectives on the origin and evolution of the TPS gene family.
Markers of schizophrenia at the prosody/pragmatics interface. Evidence from corpora of spontaneous speech interactions
Authors: Saccone Valentina , Trillocco Simona , Moneglia Massimo
Published: October 2023

The speech of individuals with schizophrenia exhibits atypical prosody and pragmatic dysfunctions, producing monotony. The paper presents the outcomes of corpus-based research on the prosodic features of the pathology as they manifest in real-life spontaneous interactions. The research relies on a corpus of schizophrenic speech recorded during psychiatric interviews (CIPPS) compared to a sampling of non-pathological speech derived from the LABLITA corpus of spoken Italian, which has been selected according to comparability requirements. Corpora has been intensively analyzed in the Language into Act Theory (L-AcT) frame, which links prosodic cues and pragmatic values. A cluster of linguistic parameters marked by prosody has been considered: utterance boundaries, information structure, speech disfluency, and prosodic prominence. The speech flow of patients turns out to be organized into small chunks of information that are shorter and scarcely structured, with an atypical proportion of post-nuclear information units (Appendix). It is pervasively scattered with silences, especially with long pauses between utterances and long silences at turn-taking. Fluency is hindered by retracing phenomena that characterize complex information structures. The acoustic parameters that give rise to prosodic prominence (f0 mean, f0 standard deviation, spectral emphasis, and intensity variation) have been measured considering the pragmatic roles of the prosodic units, distinguishing prominences within the illocutionary units (Comment) from those characterizing Topic units. Patients show a flattening of the Comment-prominence, reflecting impairments in performing the illocutionary activity. Reduced values of spectral emphasis and intensity variation also suggest a lack of engagement in communication. Conversely, Topic-prominence shows higher values for f0 standard deviation and spectral emphasis, suggesting effort when defining the domain of relevance of the illocutionary force. When comparing Topic and Comment-prominences of patients, the former consistently exhibit higher values across all parameters. In contrast, the non-pathological group displays the opposite pattern.
Developing sustainable service user involvement practices in mental health services in Sweden: the “Userinvolve” research program protocol
Authors: Markström Urban , Näslund Hilda , Schön Ulla-Karin , Rosenberg David , Bejerholm Ulrika , Gustavsson Anneli , Jansson Mårten , Argentzell Elisabeth , Grim Katarina , Engdahl Patrik , Nouf Faten , Lilliehorn Sara , Svedberg Petra
Published: October 2023

Background

The purpose of this paper is to outline the protocol for the research program “UserInvolve,” with the aim of developing sustainable, service user involvement practices in mental health services in Sweden.

Methods

This protocol outlines the knowledge gap and aim of the UserInvolve-program. It further provides an overview of the research infrastructure, with specific focus on the organization and management of the program as well as the design of the six underlying research projects. These six research projects form the core of the UserInvolve-program and will be carried out during a six-year period (2022–2027). The projects are focused on examining articulations of experiential knowledge in user collectives, on four specific user involvement interventions (shared decision-making, peer support, user-focused monitoring, and systemic involvement methods) and on developing theory and method on co-production in mental health research and practice.

Results or conclusion

The knowledge gained through the co-production approach will be disseminated throughout the program years, targeting service users, welfare actors and the research community. Based on these research activities, our impact goals relate to strengthening the legitimacy of and methods for co-production in the mental health research and practice field.
Regional catastrophic health expenditure and health inequality in China
Authors: Wang Xinyue , Guo Yan , Qin Yang , Nicholas Stephen , Maitland Elizabeth , Liu Cai
Published: October 2023

Background

Catastrophic health expenditures (CHE) can trigger illness-caused poverty and compound poverty-caused illness. Our study is the first regional comparative study to analyze CHE trends and health inequality in eastern, central and western China, exploring the differences and disparities across regions to make targeted health policy recommendations.

Methods

Using data from China's Household Panel Study (CFPS), we selected Shanghai, Henan and Gansu as representative eastern-central-western regional provinces to construct a unique 5-year CHE unbalanced panel dataset. CHE incidence was measured by calculating headcount; CHE intensity was measured by overshoot and CHE inequality was estimated by concentration curves (CC) and the concentration index (CI). A random effect model was employed to analyze the impact of household head socio-economic characteristics, the household socio-economic characteristics and household health utilization on CHE incidence across the three regions.

Results

The study found that the incidence and intensity of CHE decreased, but the degree of CHE inequality increased, across all three regions. For all regions, the trend of inequality first decreased and then increased. We also revealed significant differences across the eastern, central and western regions of China in CHE incidence, intensity, inequality and regional differences in the CHE influencing factors. Affected by factors such as the gap between the rich and the poor and the uneven distribution of medical resources, families in the eastern region who were unmarried, use supplementary medical insurance, and had members receiving outpatient treatment were more likely to experience CHE. Families with chronic diseases in the central and western regions were more likely to suffer CHE, and rural families in the western region were more likely to experience CHE.

Conclusions

The trends and causes of CHE varied across the different regions, which requires a further tilt of medical resources to the central and western regions; improved prevention and financial support for chronic diseases households; and reform of the insurance reimbursement policy of outpatient medical insurance. On a regional basis, health policy should not only address CHE incidence and intensity, but also its inequality.
In response to the Saudi healthcare reform: a cross-sectional study of awareness of and attitudes toward the public health model among health students
Authors: Almalki Mohammed J. , Elamin Ali , Jabour Abdulrahman M. , Varghese Joe , Alotaibi Amani A. , Almalki Sami M. , Hamdan Mohammed E. , Bajawi Maram S. , Alamer Taym A. , Alshammakhi Bashaier M. , Alabsi Hamdah H. , Hassan Duaa H. , Moafa Hassan N
Published: October 2023

Background

Saudi Arabia’s health sector is experiencing a significant transformation toward an emphasis on the public health model. This model is a population-based approach to preventing and controlling disease, and its importance becomes evident during infectious outbreaks and pandemics, such as COVID-19. This study aimed to assess the awareness and attitudes of health students in Jazan toward the public health model.

Methods

This study applied a cross-sectional online survey. Data were collected from 3–18 November 2020 using Google Forms. A convenience sampling method was used with a final sample of 425 participants.

Results

Most participants (71%) were aware of the public health model, with an average score of 11.36 out of 16. Multiple regression analysis revealed a significant association between the awareness level of the public health model and participants’ demographics, namely, gender, major of study, year of study, and prior training in public health. Participants who completed public health training (β = 0.220) had higher awareness scores than others. On the other hand, participants from public health (β = −0.342), medicine (β = 0.164), and nursing in Jazan (β = 0.128) had higher awareness of the public health model than the reference group (Nursing at Addayer College). Addayer is an area located in the rural northeast of the Jazan region. In addition, final-year students (β = 0.113) had higher awareness of the public health model than the reference group (year 2 pre-final students). Female participants (β = −0.142) had lower awareness of the public health model than male participants. Most participants (95.3%) believed that the clinical care and public health models are essential for promoting people’s health. However, 4.7% of participants believed that clinical health care is more important than public health.

Conclusion

Health students, who are future healthcare professionals, must understand and value the public health model to support the planned health system reforms. It is recommended to evaluate how the education and training of students in public health, medicine, and nursing in Jazan impact the understanding and views of this cohort on the public health model compared to those of students in other health-related majors.
Explaining pretrained language models' understanding of linguistic structures using construction grammar
Authors: Weissweiler Leonie , Hofmann Valentin , Köksal Abdullatif , Schütze Hinrich
Published: October 2023

Construction Grammar (CxG) is a paradigm from cognitive linguistics emphasizing the connection between syntax and semantics. Rather than rules that operate on lexical items, it posits constructions as the central building blocks of language, i.e., linguistic units of different granularity that combine syntax and semantics. As a first step toward assessing the compatibility of CxG with the syntactic and semantic knowledge demonstrated by state-of-the-art pretrained language models (PLMs), we present an investigation of their capability to classify and understand one of the most commonly studied constructions, the English comparative correlative (CC). We conduct experiments examining the classification accuracy of a syntactic probe on the one hand and the models' behavior in a semantic application task on the other, with BERT, RoBERTa, and DeBERTa as the example PLMs. Our results show that all three investigated PLMs, as well as OPT, are able to recognize the structure of the CC but fail to use its meaning. While human-like performance of PLMs on many NLP tasks has been alleged, this indicates that PLMs still suffer from substantial shortcomings in central domains of linguistic knowledge.
A review of the explainability and safety of conversational agents for mental health to identify avenues for improvement
Authors: Sarkar Surjodeep , Gaur Manas , Chen Lujie Karen , Garg Muskan , Srivastava Biplav
Published: October 2023

Virtual Mental Health Assistants (VMHAs) continuously evolve to support the overloaded global healthcare system, which receives approximately 60 million primary care visits and 6 million emergency room visits annually. These systems, developed by clinical psychologists, psychiatrists, and AI researchers, are designed to aid in Cognitive Behavioral Therapy (CBT). The main focus of VMHAs is to provide relevant information to mental health professionals (MHPs) and engage in meaningful conversations to support individuals with mental health conditions. However, certain gaps prevent VMHAs from fully delivering on their promise during active communications. One of the gaps is their inability to explain their decisions to patients and MHPs, making conversations less trustworthy. Additionally, VMHAs can be vulnerable in providing unsafe responses to patient queries, further undermining their reliability. In this review, we assess the current state of VMHAs on the grounds of user-level explainability and safety, a set of desired properties for the broader adoption of VMHAs. This includes the examination of ChatGPT, a conversation agent developed on AI-driven models: GPT3.5 and GPT-4, that has been proposed for use in providing mental health services. By harnessing the collaborative and impactful contributions of AI, natural language processing, and the mental health professionals (MHPs) community, the review identifies opportunities for technological progress in VMHAs to ensure their capabilities include explainable and safe behaviors. It also emphasizes the importance of measures to guarantee that these advancements align with the promise of fostering trustworthy conversations.
Lateral-flow assays for bovine paratuberculosis diagnosis
Authors: Alonso-Hearn Marta , Ballesteros Ana , Navarro Alejandra , Badia-Bringué Gerard , Casais Rosa
Published: October 2023

Mycobacterium avium subsp. paratuberculosis (MAP) causes bovine paratuberculosis (PTB). PTB is responsible for significant economic losses in dairy herds around the word. PTB control programs that rely on testing and culling of test-positive cows have been developed. Current diagnostics, such as ELISA for detecting MAP antibodies in serum samples and PCR detecting MAP DNA in feces, have inadequate sensitivity for detecting subclinical animals. Innovative “omics” technologies such as next-generation sequencing (NGS) technology-based RNA-sequencing (RNA-Seq), proteomics and metabolomics can be used to find host biomarkers. The discovered biomarkers (RNA, microRNAs, proteins, metabolites) can then be used to develop new and more sensitive approaches for PTB diagnosis. Traditional approaches for measuring host antibodies and biomarkers, such as ELISAs, northern blotting, quantitative reverse-transcriptase polymerase chain reaction (RT-qPCR), cDNA microarrays, and mass spectrometry are time-consuming, expensive, and sometimes exhibit poor sensitivity. With the rapid development of nanotechnology, low-cost monitoring devices for measuring antibodies against MAP proteins in point-of-care (POC) settings have been developed. Lateral flow assays (LFAs), in particular, are thought to be appropriate for the on-site detection of antibodies to MAP antigens and/or host biomarkers. This review aims to summarize LFAs that have recently been developed to accurately detect antibodies against MAP antigens, as well as the benefits that host biomarkers linked with MAP infection give to PTB diagnosis. The identification of these novel biomarkers could be the basis for the development of new LFAs. The dairy industry and producers are likely to benefit from reliable and rapid technologies capable of detecting MAP infection in situ to establish a quick and sensitive PTB diagnosis.
Clinical spectrum of COVID-19 at a national referral hospital in western Kenya during the period 2020–2021
Authors: Ogalo Edith A. , Gudu Edwin , Andale Thomas , Korir Daisy , Ndege Samson , Simiyu Tabu , Olekuyo Richard , Mwangi Henry , Kimaiyo Sylvester , Aruasa Wilson
Published: October 2023

Introduction

We describe the clinical spectrum of COVID-19 cases in western Kenya from 6 April 2020 to 31 May 2021, providing baseline data for further studies into COVID-19 in Kenya.

Methods

We did a retrospective chart review of laboratory and inpatient files of patients diagnosed and managed for COVID-19 at the Moi Teaching and Referral Hospital in Kenya and analyzed the data using Stata® version 16 (StataCorp LP, College Station, TX, USA) and calculated measures of association at 95% CI.

Results

The patients (n = 1,770) had a mean age of 43 years (SD 20 years) and 55.4% were male. Close to 70% had asymptomatic disease, with the symptomatic cases largely being respiratory in nature. One-quarter had comorbidities. The case fatality rate was 13.6% (n = 240). Male sex increased the odds of mortality by 1.69 (95% CI 1.27–2.25; p ≤ 0.001), and the presence of comorbidities increased the odds of mortality by 3.16 (95% CI 2.38–4.18; p ≤ 0.001). Those aged 59 years and above were 18 times more likely to die from COVID-19 than those below 15 years of age (95% CI 1.61–90.66; p = 0.015).

Conclusion

COVID-19 had a significantly high mortality rate in western Kenya. Male sex and the presence of comorbidities increased the risk of severe disease and mortality.
Implementation of the Automated Medication Dispensing System–Early Lessons From Eswatini
Authors: Williams Victor , Haumba Samson , Ngwenya-Ngcamphalala Fikile , Mafukidze Arnold , Musarapasi Normusa , Byarugaba Hugben , Chiripashi Simbarashe , Dlamini Makhosazana , Maseko Thokozani , Dlamini Nkhosikhona Advocate , Nyapokoto Clara , Kibwana Sharon , Bongomin Pido , Mazibuko Sikhathele , Bhembe Fortunate , Ojoo Sylvia , Okello Velephi , Bazira Deus
Published: October 2023

Objectives: This article describes the implementation of an automated medication dispensing system (AMDS) in Eswatini to increase medication access and presents the early lessons from this implementation.

Methods: The AMDS was installed at four health facilities across two regions through collaborative stakeholder engagement. Healthcare workers were trained, and clients who met the inclusion criteria accessed their medications from the system. Each step of the implementation was documented and summarised in this article.

Results: Early lessons suggest that implementation of the AMDS is acceptable and feasible to clients and healthcare workers and that phased introduction of medication classes, commencing with antiretroviral therapy (ART) and incorporating other medications in later phases is feasible. Additionally, improved client-centred messaging and communication, consistent power supply and internet network connectivity, and scheduling medication pickup with other services increase AMDS system utilisation.

Conclusion: Eswatini has many clients living with HIV and non-communicable diseases (NCDs). Easy, convenient, quick, non-stigmatising and client-centred access to ART and medication for NCDs is critical in addressing retention in care and achieving optimal treatment outcomes.
Care Cascades for Hypertension in Low-Income Settings: A Systematic Review and Meta-Analysis
Authors: Lamloum Demetrio , Fassio Federico , Osetinsky Brianna , Tediosi Fabrizio
Published: October 2023

Objective: High blood pressure is the leading risk factor for cardiovascular disease. The hypertension care cascade (HCC) is increasingly being used to evaluate the effectiveness of interventions. This systematic review aims to examine HCC in low-income settings.

Methods: The search strategy included articles published between January 2010 and April 2023. We excluded studies with incomplete HCC, on fragile patients or aged <18 years, reviews. We used the MOOSE guideline. Five researchers retrieved data on the survey year, country, population, HCC and diagnostic methods for hypertension. We used JBI Critical Appraisal Tools for quality assessment.

Results: Ninety-five articles were analyzed. Average hypertension prevalence was 33% (95% CI: 31%–34%), lower in LICs than in LMICs (25% vs. 34%). The overall mean awareness of hypertension was 48% (95% CI: 45%–51%), its treatment was 35% (95% IC: 32%–38%) and its control 16% (95% CI: 14%–18%). In almost all steps, percentages were lower in LICs and in Sub-Saharan Africa.

Conclusion: Trends in HCC vary between countries, with poorer performance in LICs. This review highlights the need for interventions tailored to low-income settings in order to improve hypertension care.
Updated Checklist of the Freshwater Shrimps (Decapoda: Caridea: Atyidae) of Mindoro Island, the Philippines, with a Description of a New Species of Caridina
Authors: de Mazancourt Valentin , Freitag Hendrik , von Rintelen Kristina , Manuel-Santos Marivene , von Rintelen Thomas
Published: October 2023

Following recent expeditions to Mindoro Island, the Philippines, numerous samples of atyid shrimps were collected and then studied in an integrative taxonomy framework. A total of 16 species belonging to 4 genera are hereby reported, including 8 new records for the island and/or the Philippines: Atydina atyoides, Caridina bruneiana, C. celebensis, C. elongapoda, C. papuana, C. parvirostris, C. typus, C. zhujiangensis, and one new species, Caridina leptopoda sp. nov. Sequences of 16S rRNA have been produced for all of the species and taxonomical notes are provided. To account for the morphological variability across its range, C. bruneiana Choy, 1992 is herein re-described based on specimens from Mindoro. All of the species reported here from Mindoro have small eggs and are considered amphidromous, which suggests that they all potentially occur in other localities. This contrasts with other islands of the Philippines such as Bohol or Luzon where endemic species with large eggs can be found.
Optimization of a Cost-Constrained, Hydraulic Knee Prosthesis Using a Kinematic Analysis Model
Authors: Galey Lucas , Beckmann Guillermo , Ramos Ethan , Rangel Frances A. , Gonzalez Roger V.
Published: October 2023

Approximately 82% of amputees prefer microprocessor knees (MPKs) to the passive alternatives. However, the cost of these devices makes them inaccessible for many patients. The aim of this research is to develop an affordable MPK that allows for stumble reduction and flexion dampening at a fraction of the cost of similar devices. The GKnee was developed by a sophisticated mathematical model that can effectively calculate geometric configuration and simulate forces transferred through a prosthetic knee at any given point through the gait cycle. With a median error of 6%, the mathematical model was developed to the point of reasonable accuracy for determining component placement and force interactions. The model served as a valuable tool to assist in the iterative design process of the GKnee, influencing component selection for the hydraulic system and frame design. This model was then validated using a compression rig and a mock GKnee prototype. The GKnee was then evaluated for its ability to perform under expected loading conditions, using compression testing and dynamic flexion testing. This research led to the development of a sub USD 500 microprocessor prosthetic, while remaining under 2.27 kg.
Comprehensive Analysis of DNA Methyltransferases Expression in Primary and Relapsed Ovarian Carcinoma
Authors: Papakonstantinou Efthymia , Pappa Ioanna , Androutsopoulos Georgios , Adonakis Georgios , Maroulis Ioannis , Tzelepi Vasiliki
Published: October 2023

Background: Despite recent advances in epithelial ovarian carcinoma (EOC) treatment, its recurrence and mortality rates have not improved significantly. DNA hypermethylation has generally been associated with an ominous prognosis and chemotherapy resistance, but the role of DNA methyltransferases (DNMTs) in EOC remains to be investigated. Methods: In the current study, we systematically retrieved gene expression data from patients with EOC and studied the immunohistochemical expression of DNMTs in 108 primary and 26 relapsed tumors. Results: Our results showed that the DNMT1, DNMT3A, DNMT3B and DNMT3L RNA levels were higher and the DNMT2 level was lower in tumors compared to non-neoplastic tissue, and DNMT3A and DNMT2 expression decreased from Stage-II to Stage-IV carcinomas. The proteomic data also suggested that the DNMT1 and DNMT3A levels were increased in the tumors. Similarly, the DNMT1, DNMT3A and DNMT3L protein levels were overexpressed and DNMT2 expression was reduced in high-grade carcinomas compared to non-neoplastic tissue and low-grade tumors. Moreover, DNMT1 and DNMT3L were increased in relapsed tumors compared to their primaries. The DNMT3A, DNMT1 and DNMT3B mRNA levels were correlated with overall survival. Conclusions: Our study demonstrates that DNMT1 and DNMT3L are upregulated in primary high-grade EOC and further increase in relapses, whereas DNMT3A is upregulated only in the earlier stages of cancer progression. DNMT2 downregulation highlights the presumed tumor-suppressor activity of this gene in ovarian carcinoma.
Urethral Injury in Rectal Cancer Surgery: A Comprehensive Study Using Cadaveric Dissection, Imaging Analyses, and Clinical Series
Authors: Planellas Pere , Cornejo Lídia , Ehsan Aram , Reina Francisco , Ortega-Torrecilla Nuria , Maldonado Eloy , Codina-Cazador Antoni , Osorio Margarita , Farrés Ramon , Carrera Anna
Published: October 2023

Male urethral injury during rectal cancer surgery is rare but significant. Scant information is available about the distances between the rectourethral space and neighboring structures. The aim of this study is to describe the anatomical relations of the male urethra. This three-pronged study included cadaveric dissection, retrospective MRI analysis, and clinical cases. Measurements included the R-Mu distance (shortest distance between the rectum and the membranous urethra), R-Am distance (distance from the anterior rectal wall to anal margin nearest to the membranous urethra), and the anal canal–rectum axis angle. The clinical study analyzed the incidence of urethral injury and associated factors among 244 consecutive men from January 2016 to January 2023. The overall incidence of urethral injury in our series was low (0.73%), but in men with tumors < 10 cm from the anal margin, it was 4% in abdominoperineal resection and 3.2% in TaTME. On preoperative MRI, the median R-Mu distance was 1 cm (IQR, range, 0.2–2.3), the median R-Am distance was 4.3 cm (range, 2–7.3), and the median anorectal angle was 128° (range, 87–160). In the cadaveric study (nine adult male pelvises), the mean R-Mu distance was 1.18 cm (range 0.8–2), and the mean R-Am distance was 2.64 cm (range 2.1–3). Avoiding urethral injury is crucial. The critical point for injury lies 2–7.3 cm from the anal margin, with a 0.2–2.3 cm distance between the rectum and the membranous urethra. Collaborating with anatomists and radiologists improves surgeons’ anatomy knowledge.
Novel Therapeutic Strategies Exploiting the Unique Properties of Neuroendocrine Neoplasms
Authors: Safari Maryam , Scotto Luigi , Litman Thomas , Petrukhin Lubov A. , Zhu Hu , Shen Min , Robey Robert W. , Hall Matthew D. , Fojo Tito , Bates Susan E.
Published: October 2023

Background: Over the last few decades of treatment, the outcomes for at least some subsets of neuroendocrine neoplasms (NENs) have improved. However, the identification of new vulnerabilities for this heterogeneous group of cancers remains a priority. Methods: Using two libraries of compounds selected for potential repurposing, we identified the inhibitors of nicotinamide phosphoribosyltransferase (NAMPT) and histone deacetylases (HDAC) as the agents with the highest activity. We validated the hits in an expanded set of neuroendocrine cell lines and examined the mechanisms of action. Results: In Kelly, NH-6, and NCI-H82, which are two neuroblastoma and one small cell lung cancer cell lines, respectively, metabolic studies suggested that cell death following NAMPT inhibition is the result of a reduction in basal oxidative phosphorylation and energy production. NAMPT is the rate-limiting enzyme in the production of NAD+, and in the three cell lines, NAMPT inhibition led to a marked reduction in the ATP and NAD+ levels and the catalytic activity of the citric acid cycle. Moreover, comparative analysis of the mRNA expression in drug-sensitive and -insensitive cell lines found less dependency of the latter on oxidative phosphorylation for their energy requirement. Further, the analysis of HDAC and NAMPT inhibitors administered in combination found marked activity using low sub-lethal concentrations of both agents, suggesting a synergistic effect. Conclusion: These data suggest NAMPT inhibitors alone or in combination with HDAC inhibitors could be particularly effective in the treatment of neuroendocrine neoplasms.