bluuebunny/crossref_metadata_2025 huggingface dataset:
Remote sensing and GIS supported groundwater potential zone mapping for sustainable groundwater management in Fentale district, Ethiopia
Authors: Abera Bereket , Gebreegziabher Teshale
Published: December 2024

Overexploitation of groundwater resources has become more visible and has caused groundwater depletion in many countries. Assessment of groundwater potential is a vital step in enhancing the sustainable management of groundwater resources. This study aimed to identify and locate the groundwater potential zones of the Fentale district by integrating remote sensing and geographic information systems via an analytical hierarchy process. Groundwater potential zones were created using eleven influencing factors, including geology, topographic position index, drainage density, lineament density, rainfall, soil type, soil texture, elevation, slope, topographic wetness index, and land use/land cover. Thematic layers of these influencing factors were then generated in raster format, and given appropriate weightage based on their relative reaction to groundwater occurrence. The groundwater potential zone in the study area was generated and classified into four groups: very low, low, moderate, and high. The very low, low, moderate, and high potential zones were represented by 0.2% (244.73 hectares), 28.754% (34,322.65 hectares), 56.03% (64,309.52 hectares), and 17.164% (20,489.15 hectares), respectively. The final potential zone map aligns well with the weighting and ranking analysis conducted. Based on these findings, almost all inactive wells were found in the low and very low potential zones. Finally, the result obtained was validated using 35 wells yield data, and the receiver operating characteristic curve method from which the accuracy obtained was above 80%, and the area under the curve was found to be 0.813. Given the validated findings, it’s evident that there is a significant possibility for groundwater potential in the district. Concerned bodies should take this opportunity to tackle the water scarcity the aridity of the district and focus on sustainable management of this vital resource.
Anion vacancy-induced photochromism and lattice relaxation in yttrium oxyhydride
Authors: Arslan Halil , Kuzmin Alexei , Kumar Vinoth , Aulika Ilze , Moldarev Dmitrii , Primetzhofer Daniel , Wolff Maximillian , Pudza Inga , Nordseth Ørnulf , Karazhanov Smagul
Published: December 2024

There is significant interest in understanding the mechanism behind the photochromic properties and light-induced structural and chemical alterations in yttrium oxyhydride, which remains unclear. This lack of knowledge hinders our ability to comprehend the causes of degradation, enhance photochromic performance, control color, improve durability, and fully utilize the material's potential applications. In this work, first-principles calculations have revealed that anion vacancies can cause the photochromic effect in yttrium oxyhydride. Such vacancies form deep localized energy levels in the band gap. Absorption of sunlight transfers electrons from the valence band to these defect levels and changes the charge state of the vacancies leading to the photochromic effect and lattice relaxation. This relaxation involves yttrium cations shifting outwards for positively charged vacancies and inward for negatively charged vacancies. These shifts cause lattice relaxation and affect the local environment around yttrium cations by inducing changes in the second coordination shell. Using extended X-ray absorption fine structure spectroscopy (EXAFS) on transparent and photodarkened yttrium oxyhydride films, we concluded that UV light illumination induces lattice relaxation in the second coordination shells of yttrium cations in agreement with the results of first-principles calculations.
FONDUE - Fine-tuned Optimization: Nurturing Data Usability & Efficiency
Authors: Restat Valerie , Diestelkämper Indra , Klettke Meike , Störl Uta
Published: December 2024

To provide good results and decisions in data-driven systems, data quality must be ensured as a primary consideration. An important aspect of this is data cleaning. Although many different algorithms and tools already exist for data cleaning, an end-to-end data quality solution is still needed. In this paper, we present FONDUE, our vision of a well-founded end-to-end data quality optimizer. In contrast to many studies that consider data cleaning in the context of machine learning, our approach focuses on various scenarios, such as when preprocessing and downstream analysis are separated. As an adaptive and easily extendable framework, FONDUE operates similarly to proven methods of database query optimization. Analogously, it consists of the following parts: Rule-based optimization, where the appropriate data cleaning algorithms are selected based on use case constraints, optimizer hints in the form of best practices, and cost-based optimization, where the costs are measured in terms of data quality. Accordingly, the result is an optimized data cleaning pipeline. The choice of different optimization goals enables further flexibility, e.g. for environments with limited resources. As a first building block of FONDUE, we present CheDDaR, which is used to detect errors and measure data quality. Both are important tasks for improving data quality with FONDUE.
Aerodynamic Significance of Mass Distribution on Samara Descent
Authors: Huang Wei-Xi , Hou Zhao-Bang , Zhang Jun-Duo , Li Yun-Da , Jia Yongxia
Published: December 2024

Samaras, a distinct category of fruit, are composed of heavier seeds and lighter wings. Diversity in morphologies and structures subtly contributes to the flight patterns of various seeds, thereby serving as a key factor in the reproductive strategies of plants. To explore the mechanisms underlying various samara flight behaviors, we proposed an effective scheme by manipulating the mass distribution on a plate to mimic various three-dimensional descent behaviors of samaras. Through this framework, we experimentally identified and characterized four distinct flight modes. The three-dimensional vortical structures were then numerically analyzed to gain insights into the samara-inspired flight behaviors. Our study demonstrates how strategic mass distribution in samaras leads to diverse flight behaviors that leverage vortices to enhance seed dispersal, offering a fresh perspective for the design of biomimetic fliers.
Diagnostic efficacy and correlation of Intravoxel incoherent motion (IVIM) and Contrast Enhanced (CE) MRI perfusion parameters in oncology imaging: A systematic review and meta-analysis
Authors: S Abhijith , P Saikiran , V Rajagopal K , Singh Dharmesh , S Priya P , . Priyanka , Pires Tancia , Kumar Dileep
Published: December 2024

Intravoxel incoherent motion (IVIM) MRI is a non-contrast technique that estimates diffusion and perfusion parameters using multiple b-values. This systematic review and meta-analysis aimed to compare the diagnostic accuracy of IVIM with contrast-enhanced (CE) perfusion MRI in oncology imaging. Following PRISMA guidelines, a comprehensive literature search across five databases identified studies that compared IVIM and CE MRI in patients with brain, breast, and rectal cancers. Meta-analyses were performed using R software. A total of 18 studies met the inclusion criteria, encompassing 123 gliomas, 231 breast, and 208 rectal cancer lesions. IVIM demonstrated comparable diagnostic performance to dynamic susceptibility contrast (DSC) MRI in gliomas, with a pooled AUC of 0.84, sensitivity of 92.27%, and specificity of 74.06%. In breast cancer, IVIM outperformed dynamic contrast-enhanced (DCE) MRI, with AUCs of 0.856 compared to 0.786. For rectal cancer, IVIM and DCE both showed moderate diagnostic accuracy, with AUCs of 0.62 and 0.64, respectively. Correlation analysis showed moderate relationships between IVIM and DSC/DCE parameters, particularly in gliomas and rectal cancer. IVIM MRI presents a promising non-contrast alternative to CE techniques, especially in gliomas and breast cancer, where it matched or exceeded CE perfusion performance. Further studies are needed to validate IVIM’s efficacy across more cancer types and to strengthen its correlation with CE parameters.
Behavioral Profiles and Social Relationships in Wiedemann-Steiner Syndrome: Parent Reports on 25 Cases
Authors: Yuill Nicola , Elphick Camilla , Marshall Jess , Jones Wendy D , Waite Jane , Viner Hannah
Published: December 2024

Background
Wiedemann-Steiner Syndrome (WSS) is a rare, variable neurodevelopmental condition associated with developmental delay, intellectual disability and congenital abnormalities. There are few investigations into behavioral characteristics. Importantly, parental perspectives are particularly lacking. This study investigated commonalities in the behavioral characteristics through the perspectives of parents’ lived experiences.
Method
We conducted in-depth interviews with 25 parents of children with WSS in the United States and United Kingdom, tapping lived experience and specific examples of behavior, relationships and communication. Responses were analysed using reflexive thematic analysis.
Results
We report three main themes: intense sociability (confirming questionnaire-based research), intense relationships and executive dysregulation (novel findings). We also found previously unreported sensory sensitivities and cognitive patterns of uneven memory and poor comprehension.
Conclusions
These data direct from parent experience reveal novel commonalities in behavior and relationships in this group. Findings should inform clinical assessment and diagnosis, new research questions and choice of patient-focused outcome measures for clinical interventions. The findings also contribute to improved practice in providing care and support for people with WSS and their families and to guidelines for more tailored education and improved healthcare.
3D reconstruction of shallow sea environment using direct system calibration and faint laser line extraction
Authors: Garai Arpan , Kumar Subodh
Published: December 2024

Virtually recreating an underwater scene requires 3D data of its objects. Creating a dense 3D point cloud of shallow underwater objects using a laser in the presence of significant ambient light is challenging. Although several methodologies have been proposed for the same, they essentially work in low-light environments. In particular, current techniques are unable to quickly and effortlessly generate dense point clouds of underwater objects under varying light. This work fills that gap. It is based on triangulating a rotating low-power line-laser. It generates the point cloud online and automatically. It works in sunlight, which tends to washout low-power laser in shallow waters. To reduce the cumulative errors during calibration, our data-centric method calibrates the entire system directly, unlike the existing methods, where multiple parameters are calibrated separately. We also propose an analytical technique to segment faint-laser lines in an underwaterlit environment, which does not depend on the availability of large training data. An evaluation of the performance of the proposed method in different lightingconditions is reported.
Genotypic variation in quinoa's (Chenopodium quinoa Willd.) response to salinity stress: Insights from germination and seedling establishment stages.
Authors: Chikankheni Jonathan Tennson , McInnes Kirsty , George Dave , Zevallos Victor F.
Published: December 2024

Salinity negatively affects plant growth and development, particularly during the seed germination and seedling establishment stages, which are the most vulnerable due to combined osmotic stress and ionic toxicity. This study investigates the effects of salinity, simulated using NaCl, on the germination and early growth of ten quinoa genotypes (Colorado 407D, Rosa Junin, Sayana, Baer, Faro, Titicaca, Negra Collana, 11WAQ, Puno, and Vikinga). The experiment was conducted under controlled conditions with varying salinity levels (50, 100, 200, 300, and 400 mM NaCl). Results revealed that increasing salinity levels significantly reduced germination percentage, seedling shoot length, root length, fresh weight, and dry biomass, while increasing mean germination time, time to 50% germination, chlorophyll A, B, and carotenoid content, and superoxide dismutase, catalase, and peroxidase activities. Genotypes varied in their response to salinity stress, with some showing higher salinity tolerance than others. Genotypes like Colorado 407D, Sayana, Titicaca, Faro, Rosa Junin, and 11WAQ exhibited greater resilience, suggesting their potential for cultivation in salt-affected regions. This study highlights the importance of identifying and cultivating salt-tolerant quinoa genotypes to enhance food security in saline environments.
Coagulation and thyroiditis are factors associated with adverse pathological features in differentiated thyroid cancer:A retrospective cohort study
Authors: Chen Xiao , Wang Han-yu , Yu Lu , Liu Jia-qi , Sun Hui
Published: December 2024

Objective
Lymph node metastasis (LNM) and capsular invasion (CI) are the main pathological features leading to poor prognosis of differentiated thyroid cancer (DTC), and there is a lack of effective diagnostic methods before surgery. Therefore, this study was designed to analyze a large number of preoperative clinical features of DTC and identify factors closely related to those two pathological features.
Methods
4557 patients with DTC, postoperative pathological results showed LNM in 2146 cases and CI in 2783 cases were retrospectively included. The preoperative blood, urine, serum laboratory test and ultrasound of thyroid were performed for data collection. A total of 74 clinical features were analyzed by the methods of principal component analysis (PCA), and key principal components were extracted for regression analysis of LNM and CI as well as subgroup analysis.
Results
11 key clinical features were used for principal component analysis, and 6 principal components PC0-PC5 were finally obtained. PC0 is mainly composed of prothrombin time and international normalized ratio, and the score represents better coagulation function and has a protective effect on LNM. PC1 is mainly composed of thyroid peroxidase antibody and thyroid texture, and the score represents the severity of thyroiditis and has a protective effect on LNM and CI.
Conclusion
Thyroiditis and coagulation function were identified by principal component analysis as protective and risk factors for adverse pathology of DTC, meaning they were closely related to tumor metastasis and invasion.
Clinical characteristics and treatment of patients with overlapping MOG and anti-NMDAR encephalitis
Authors: Liu Yutao , Wang Jingjing , Sun Mengyang , Liu Yang , wang limei
Published: December 2024

This study was designed to analyse the clinical manifestations, cerebrospinal fluid (CSF), imaging features, and treatment of patients who were CSF was positive for NMDAR antibodies (NMDAR-ab) and seropositive for MOG antibodies (MOG-ab). The clinical manifestations of thirteen patients with overlapping antibodies and presenting signs and symptoms of general encephalitis, such as fever and headache, impaired consciousness, mental and behavioural disturbances, and seizures, at the initial onset of disease were reviewed. Cranial MRI suggested that the most frequently involved areas were cortical and subcortical, and meningeal enhancement was observed in a few patients. Intravenous methylprednisolone (IVMP) and intravenous immunoglobulin (IVIG) are the mainstays of treatment in the acute phase. The median mRS score was 2 (1, 2.5) before treatment and 1 (0.5, 1) after treatment. Compared with the MOGAD group, the overlapping antibodies group had a greater proportion of adult patients who were admitted to the intensive care unit (ICU), experienced common mental and behavioural disturbances, had cortex or subcortical involvement on cranial MRI, and had less enhancement on gadolinium-enhanced scans (P < 0.05). Compared with the anti-NMDAR encephalitis group, the overlapping antibodies group had lower incidences of mental and behavioural abnormalities and seizures, and the brachium pontis was more prone to abnormal signals on cranial MRI (P < 0.05). Kaplan-Meier survival analysis revealed that during the 6–48 month follow-up period, there was no statistically significant difference in the recurrence rate between the overlapping antibodies group and the MOGAD group or the anti-NMDAR encephalitis group (P > 0.05).
Effect of Iron-Folate Supplementation on Maternal Hematological Parameters among Pregnant Women in Addis Ababa, Ethiopia: An Institutional Multi-center Prospective Follow-up Study
Authors: Admass Zeleke Endalew , Ayalsew Haimanot Andualem , Gessesse Abraham Dessie , Leminie Abebaye Aragaw , Wondimu Diresibachew Haile
Published: December 2024

Background
Iron-folate (IFA) supplementation is a well-established strategy for reducing anemia in pregnant women. Studies on the extent to which it reduces maternal anemia, its effect on leukocytes and platelet count are limited and require further investigation.
Objective
This study aimed to assess effect of iron folate supplementation on maternal hematological parameters among pregnant women in public hospitals in Addis Ababa, Ethiopia.
Methods
An institution-based prospective follow-up study was conducted in public hospitals in Addis Ababa from May 1, 2023, to March 30, 2024, with 410 participants selected through systematic random sampling. Data collection involved interviews, medical record reviews, and laboratory tests. Statistical analysis was performed using SPSS Version 27, including Shapiro-Wilk test, descriptive statistics, paired sample t-tests, and Wilcoxon signed-rank tests. A p-value of less than 0.05 was considered significant.
Results
The RBC count significantly increased in both sets of respondents. In non-anemic individuals, it rose from a baseline of 4.51 ± 0.43 to 4.70 ± 0.54 million cells per microliter (P < 0.001), while in anemic respondents, it increased from 4.05 ± 0.37 to 4.23 ± 0.39 million cells per microliter (P < 0.001). Similarly, the platelet count decreased across both groups. In anemic participants, it dropped from 293.3 ± 37.01 to 285.4 ± 37.83 thousand per microliter (P < 0.01), and in non-anemic pregnant women, it declined from 274.9 ± 56.3 to 254.29 ± 59.07 thousand per microliter (P < 0.001). After supplementation, no significant change in leukocyte count was observed in both anemic and non-anemic pregnant women (p = 0.065 and p < 0.059) respectively.
Conclusion
Iron-folate supplementation significantly increased RBC counts in both anemic and non-anemic pregnant women, with a slight decrease in platelet counts and no change in leukocyte levels. Further research on the effect of iron folate intake on hematological indices is recommended.
Single paternity in the kelp crab Taliepus dentatus despite polyandry
Authors: Pardo Luis M , Narvaez Karla , Rojas-Hernandez Noemi , Chaparro Oscar , Bruning Maria José , Veliz David
Published: December 2024

The paternity patterns observed in decapods reflect the mating strategies and tactics employed by different species. However, these patterns may be altered by fishery management, particularly through male-biased harvesting, which affects the natural sex ratio and subsequently influences mating success and reproductive success. This study examined the reproductive strategies of the kelp crab Taliepus dentatus, revealing that, unlike other majid crabs, T. dentatus demonstrates a single paternity pattern, apparently unaffected by fishing pressures. Histological analyses supported the sperm economy hypothesis and revealed the seminal receptacle to be non-compartmentalised. Despite this, contrasting mating schemas in laboratory experiments discriminated the impacts of males and females in mating success, revealing that females were receptive approximately 50% of the time, but did not exhibit mate selection during the pre-copulatory period. Additionally, results showed that mating was mostly influenced by the presence of sperm competition, as males rarely mated or displayed guarding behaviour when other males were present. Finally, despite traits promoting multiple paternity, factors such as limited natural encounters, short copulatory durations and full seminal receptacles likely contributed to the observed genetic monogamy in T. dentatus. This species appears to depend on its year-round mating success and sperm storage capabilities to reduce the effects of male-biased fishing pressures. This research emphasises the need 1) to understand reproductive behaviours using multiple approaches (i.e. genetics, behaviour and histology) and 2) to perform contrasting mating experiments in sequential and simultaneous designs.
Isolation, identification and genome analysis of a new Escherichia coli phage XH12 and enhancement of antibacterial activity of its lysozyme by chimeric cationic peptides
Authors: Hou Xuhao , Pu Jiaqi , Li Yu , Xie Wenhai , zhang Limei , Deng Hongkuan
Published: December 2024

Antibiotics are no longer adequate to address the threat of antibiotic resistance, especially Pseudomonas aeruginosa, Acinetobacter baumannii, Escherichia coli and other gram-negative pathogens, which pose a serious threat to human health worldwide. The antibiotic resistance pandemic requires the search for new antimicrobials as alternatives that are effective and less prone to resistance. Phages and its lysozyme become an attractive alternative to currently available antibiotics. However, gram-negative bacteria have outer membrane that acts as a strong barrier, so lysozymes are often used in combination with outer membrane permeator, or are modified to overcome the outer membrane barrier. To combat drug-resistant E. coli, in this study, we used multidrug-resistant E. coli eco-3 as host bacteria, a lytic phage XH12 was isolated from sewages, phage XH12 can lyse about 81% (30/37) of E. coli strains tested. The biological characteristics and genome of phage XH12 were analyzed, and we found that lysozyme Lys12 encoded by phage XH12 combined with ethylenediaminetetraacetic acid (EDTA) had antibacterial activity against E. coli. Two fusion lysozymes were obtained by fusing different amounts of cationic amino acid polypeptides with the C-terminal of Lys12. The fusion lysozymes could improve the antibacterial activity against E. coli from extracellular space. The study of phage XH12 and its lysozyme will provide basic information for further study of the treatment of multidrug-resistant E. coli infection.
Moral resilience among Chinese nursing interns: a cross-sectional study with latent profile analysis
Authors: Shuai Ting , Lin Hang , Tao Xiaoqun , Chen Li , Tian Xu , Yi Lijuan
Published: December 2024

Background: Moral resilience is essential for nursing interns to cope with ethical conflicts during their internships. It is critical to gain insights into the characteristics of moral resilience and understanding its influencing factors to promote professional growth and ethical decision-making skills.
Objectives: This study aims to identify the characteristics of moral resilience in nursing interns and explore its influencing factors from demographic, psychological and moral perspectives.
Methods: A secondary analysis was conducted using data from four published studies on junior colleges in Hunan Province, China, enrolling 467 nursing interns. Data were collected on demographic characteristics, moral resilience, moral courage, moral sensitivity, and professional identify. Latent profile analysis was employed to categorize moral resilience. Univariate analysis and multinominal logistic regression were used to identify influencing factors.
Clinical trial number: not applicable.
Results: The data supported a three-profile model of moral resilience: the "low resilience - high efficacy" group (5.14%), the "medium resilience - medium efficacy" group (67.03%), and the "high resilience -low efficacy" group (27.83%). Factors associated with "medium resilience - medium efficacy" group included higher moral courage (Adjusted Odds Ratio [AOR] = 1.107, P < 0.001). Those with higher moral sensitivity (AOR = 1.053, P = 0.011) and better professional identity (AOR = 0.952, P= 0.026) were more likely to belong to "high resilience -low efficacy" group.
Conclusion: This study emphasizes the heterogeneity of moral resilience and its key influencing factors among nursing interns. The findings underscore the importance of tailored psychological interventions to strengthen moral resilience within this group.
Predictive value of serum lipid in intravenous thrombolysis hemorrhagic transformation of acute cerebral infarction: a single-center prospective study
Authors: Cheng Dongxia , Fu Huawen , Li Xiaofeng , Zhou Ziqi
Published: December 2024

Objective: To investigate the effect of total cholesterol (TC)to high-density lipoprotein cholesterol (T/H) ratio in the acute cerebral infarction (ACI) and intravenous thrombolysis (IVT) hemorrhagic transformation (HT) to reduce the incidence of ACI and the rate of HT by controlling blood lipid levels.
Methods: Collect patients with ACI who received alteplase༈rt-PA༉ from January 1, 2022, to December 31, 2023, and patients with non-acute cerebral infarction༈non-ACI༉ in the same period. Patients were categorized into Group A and Group B according to whether HT occurred after IVT, Group C and Group D according to whether tirofiban was coadministered, and Group E and Group F according to prognosis. The risk factors for ACI、HT, and the predictive value of the T/H ratio for HT were observed using SPSS 27.0 software.
Results: Age, TC, and HDL were risk factors for ACI, T/H, and HDL were statistically significant differences in the HT (P < 0.05); by logistics analysis, there was a correlation between T/H and HT; HT was prone to occur when the T/H was ≥ 3.25. The use of tirofiban after IVT did not increase the risk of HT. This study found that HT, type of HT, age, hypertension, baseline NIHSS score, platelet volume distribution width (PDW), TC, D-dimer, and fibrinogen content (FDP) had a statistically significant difference between the two groups in terms of prognosis. There were statistically significant differences between the baseline NIHSS score and the 90-day prognosis.
Conclusion: Patients with IVT for ACI, especially those with high baseline NIHSS, lower TC, higher HDL, and higher T/H ratio, have a higher risk of HT, which also correlates with long-term outcomes of the patient. The T/H ratio is valuable in predicting HT after IVT.
Maternal Environmental Tobacco Smoke Exposure During Pregnancy and the Risk of Congenital Heart Defects: a Case-control Study in Sichuan, China
Authors: Luo Min , Liu Yuci , Zhang Gang , Liu Weixin , Gao Yan , Zhou Tianjin , Zhao Ziling
Published: December 2024

Studies on the association between maternal environmental tobacco smoke (ETS) exposure during pregnancy and congenital heart defects (CHD) in offspring are limited. In this case-control study, we collected data from 116 fetuses with CHD and 3744 fetuses without any congenital anomalies to examine the association between maternal ETS exposure during different weeks of pregnancy and the duration of exposure with offspring CHD. Our results showed that maternal ETS exposure during pregnancy was associated with an increased risk of CHD in a dose-response gradient. The adjusted odds ratios (AOR) and corresponding 95% confidence intervals (CIs) were 2.97(1.42, 6.17) and 3.19(1.35, 7.50) for ETS exposure of 2-5h/week and >5h/week, respectively. Compared to the unexposed group, the AORs for maternal ETS exposure only in the first trimester and continuous exposure throughout pregnancy were 2.32 and 4.89, respectively. Our findings suggest that maternal ETS exposure during pregnancy may increase the risk of offspring CHD in a dose-response manner, and that ETS exposure during different weeks of pregnancy is associated with an increased risk of CHD among non-smoking pregnant women. These results highlight the importance of preventing ETS exposure throughout pregnancy, particularly during the early stages.
Rurality and relative poverty drive acquisition of a stable and diverse gut microbiome in early childhood in a non-industrialized setting
Authors: Seco-Hidalgo Victor , Witney Adam , Chico Martha E , Vaca Maritza , Arevalo Andrea , Schuyler Alexander J , Platts-Mills Thomas AE , Ster Irina Chis , Cooper Philip J
Published: December 2024

There are limited longitudinal data from non-industrialized settings on patterns and determinants of gut bacterial microbiota development in early childhood. We analysed epidemiological data and stool samples collected from 60 children followed from early infancy to 5 years of age in a rural tropical district in coastal Ecuador. Data were collected longitudinally on a wide variety of individual, maternal, and household exposures. Extracted DNA from stool samples were analyzed for bacterial microbiota using 16S rRNA gene sequencing. Both alpha and beta diversity indices suggested stable profiles towards 5 years of age. Greater alpha diversity and lower beta diversity were associated with factors typical of rural poverty including low household incomes, overcrowding, and greater agricultural and animal exposures, but not with birth mode or antibiotic exposures. Consumption of unpasteurized milk was consistently associated with greater alpha diversity indices. Infants living in a non-industrialized setting in conditions of greater poverty and typically rural exposures appeared to acquire more rapidly a stable and diverse gut bacterial microbiome during childhood.
Examining the teacher readiness gap at the interface of artificial intelligence and medical education: A qualitative study of clinical educators
Authors: Murphy Tim , Vaughn Ginger , Carpenter Rob E. , McKinney Benjamin , McWhorter Rochell
Published: December 2024

The integration of Artificial Intelligence (AI) into healthcare is transforming medical education, reshaping how diagnostic skills, treatment approaches, and patient care methods are taught. This study investigates the interface of AI and medical education, focusing on the preparedness and views of clinical educators. Using the Unified Theory of Acceptance and Use of Technology as a framework, this research assesses the factors influencing AI adoption in medical training, including performance expectancy, effort expectancy, social influence, and facilitating conditions. Through an inductive-to-deductive methodology, we conducted semi-structured interviews with 15 clinical educators from the south-central region of the United States who oversee third-year medical students. Key findings of teacher readiness at the interface of AI and medical education centered around 1) the technological learning curve, 2) the need for hands-on, action-based learning, 3) the critical role of institutional support, 4) mentorship as a crucial support system, 5) balancing human elements with AI integration, and 6) divergent comfort levels between generational cohorts. While AI holds promise to reform medical education by fostering adaptive, personalized learning environments, it also raises challenges in preserving essential human elements of patient care. Addressing these challenges demands a strategic, institutionally supported shift in medical pedagogy to ensure that AI integration is both effective and sustainable. The study’s insight into clinical educators' perspectives lay the groundwork for developing AI-ready educational models that balance technical expertise with core humanistic values, supporting a comprehensive approach to medical training in the AI-driven future.
Using a GP prescribed, internet-based self-help program "My Symptoms" for patients with persistent physical symptoms: A qualitative study on patient experiences (the eASY study)
Authors: Frumer Michal , Rask Mette Trøllund , Frostholm Lisbeth , Rosendal Marianne
Published: December 2024

Background
Digital self-help programs are increasingly seen as essential in the transformation of healthcare in response to changing demographics and increasing demands for health care services. While assisted internet-based psychological treatments show promising results, integrating self-help programs into routine care poses challenges. Understanding the interactions between the program and patients is particularly important. This study focuses on an internet-based self-help program for patients with persistent physical symptoms (PPS) prescribed by general practitioners (GPs). The aim was to explore how patients received, utilized, and adopted this program named “My Symptoms”.
Methods
Using a sociomaterial approach, the study focuses on how patients engage with the self-help program “My Symptoms” in their everyday lives. Data was generated through 22 in-depth semi-structured interviews with primary care patients offered the program. Interviews were audiotaped, transcribed verbatim, and analysed with inspiration from a thematic approach focusing on patient use and experiences.
Results
The analytical process led to the identification of four central themes. 1) Engagement and timing: Patients engaged with “My Symptoms” in diverse ways with significant variation in usage. This variation was linked to individual circumstances and the timing of the prescription of the program. 2) Processes of translation: Translating general advice into personal situations and actual behaviour change proved complex. 3) Relational support: Patients faced challenges with the self-care aspect of the program, expressing a need for relational support and guidance to stay motivated and prioritizing program elements. 4) Structuring effects: Patients described that the program provided an incentive and stimulus for change, helping them make small concrete improvements in daily practices.
Conclusions
The study deepens the understanding of patient experiences and use of self-help interventions in primary care and highlights broader challenges of the digitized healthcare system, noting that patients may also need relational support. This emphasizes the importance of ensuring individualised access for different patient populations to counteract health inequalities.
Immunization Without Records: Examining the Impact of Missing Vaccine Cards on Caregiver Recall and Associated Factors Among Public School Children in Rural Nigeria
Authors: Ogbuagu Ifechukwu , Ifemeje Anthonia Ifeyinwa , Odiakosa Alfred , Nri-Ezedi Chisom Adaobi
Published: December 2024

Background
Immunization remains a cornerstone of public health, yet maintaining accurate vaccination records is a challenge in rural communities where vaccine cards are often missing. In such settings, caregivers’ recall of their ward’s vaccination history may be the only available source of information, potentially leading to discrepancies in immunization status. This study aims to evaluate the availability of vaccine cards, assess caregiver recall, and identify factors associated with the absence of vaccination records among public school students in a rural Nigerian community.
Methods
A cross-sectional study was conducted among 2780 public school students and their caregivers in a rural community in Anambra State, Nigeria. Data on vaccination card availability, caregiver recall of vaccines, and demographic characteristics were collected through structured interviews. Logistic regression was employed to identify factors associated with the presence of vaccination cards, with odds ratios (ORs) and 95% confidence intervals (CIs) used to quantify associations, with the following adjustments.
Results
Majority (88.7%) of the subjects did not have a vaccination card. Following adjustments, male students were 36% less likely to have a vaccine card compared to females (aOR: 0.638, 95% CI: 0.443–0.918, p = 0.0155). Older students were also less likely to have a vaccine card (aOR: 0.881 per year increase in age, 95% CI: 0.827–0.938, p < 0.001). Higher caregiver recall percentages were associated with a slightly decreased likelihood of having a vaccine card (aOR: 0.960, 95% CI: 0.947–0.974, p < 0.001).
Conclusion
This study revealed significant gaps in immunization record-keeping in rural Nigeria, where a majority of children lack vaccination cards, and caregiver recall remains unreliable. These findings underscore the urgent need for enhanced record-keeping practices and innovative digital solutions to accurately track vaccination status. Strengthening these systems is crucial for improving vaccine coverage, supporting public health initiatives, and protecting children from preventable diseases in resource-limited settings.
Could Urinary Amino Acids Be as New Biomarkers for Detection of Sarcopenia?
Authors: Sivritepe Rıdvan , Basat Sema Uçak , Gökmen Neslihan , Duygu Aydın , Siyer Özge Kıran , Tiril Serhat Mert
Published: December 2024

Background
Sarcopenia is one of the syndromes that cause falls, fractures, and morbidity in geriatric patients. Early diagnosis of sarcopenia is important as it is known that muscle functions improve with early intervention. We aimed to investigate whether urinary amino acid levels are a biomarker of sarcopenia.
Methods
The study included ninety-one patients aged 45–65 who applied to our outpatient clinic. The patients underwent physical examinations, blood tests and sixteen different urine amino acid levels were analyzed. Anthropometric measurements were made. Physical performances were evaluated. Muscle strengths were measured. Muscle masses were analyzed. Patients were divided into 4 groups: pre-sarcopenic, sarcopenic, severe sarcopenic and non-sarcopenic. Statistical significance level was determined as p < 0.05.
Results
A total of ninety-one patients, fifty-three female and thirty-eight males, were included in the study. Three patients had pre-sarcopenia, eleven had sarcopenia, and two met the criteria for severe sarcopenia, while seventy-five patients were non sarcopenic. A significant difference was found between the sarcopenia and non-sarcopenia groups in terms of glutamine and valine levels (p < 0.001 for both). In the ROC analysis, the cut-off value of glutamine and valine levels in detecting sarcopenia was determined as 492 micromole/L and 209 micromole/L (AUC:0.875;0.968 respectively). In correlation analysis between urine amino acid levels and muscle strength-mass a negative correlation was found between leucine and muscle strength and muscle mass.
Conclusions
We found that patients with sarcopenia had high urinary glutamine and valine levels and that urinary leucine levels were associated with both muscle strength and muscle mass.
Caffeine supplementation does not enhance jump performance: a placebo and nocebo study
Authors: Sousa Victor , Azevedo Vitor Assis Marques , Azevedo Henrique Assis Marques , Loturco Irineu , Azevedo Paulo Henrique Silva Marques
Published: December 2024

Purpose: There is evidence that caffeine supplementation improves jump performance in studies where the design is randomized, counterbalanced and placebo-controlled. However, there is recent evidence that this outcome is expectation-dependent. Here, we applied a method to nullify the expectancy. Therefore, we aimed to check whether caffeine supplementation improves jump performance when nullifying the positive expectation for performance improvement.
Methods: Thirty-four women participated. Participants performed squat jump and countermovement jump in four days. The first day was a control day. In the last three days, we gave the participants caffeine (6 mg. kg-1). However, we informed them that randomly and blindly, participants would receive caffeine (ergogenic), placebo (ineffective) or lactic acid (ergolytic).
Results: Jump performance neither improves along the days (P>0.05) nor through different expectations (P>0.05). Still, there is a moderate chance (>75%) to observe similar performance between control and supplementation days or different expectancies.
Conclusion: We conclude that caffeine supplementation does not improve jump performance in women when positive expectation is nullified.
Radiation Dosimetry and Fasting-Dependent Hepatobiliary Clearance of the VAChT- Specific PET radioligand 18F-VAT in Humans
Authors: Norris Scott A , Goldman Noah L , Hamdi Mahdjoub , Moerlein Stephen M , Laforest Richard , Karimi Morvarid , Perlmutter Joel S , Tu Zhude
Published: December 2024

Background
The vesicular acetylcholine transporter ligand (-)-(1-((2R,3R)-8-(2-[(18)F]fluoro-ethoxy)-3-hydroxy-1,2,3,4-tetrahydronaphthalen-2-yl)piperidin-4-yl)(4-fluorophenyl)-methanone (18F -VAT) enables positron emission tomography PET quantification of cholinergic dysfunction in neurologic and psychiatric disorders. Determining its bio-distribution and dose exposure in humans is essential for clinical implementation, particularly given hepatobiliary clearance observed in pre-clinical models. Based on pre-clinical data, eight healthy subjects (4 males, 4 females) received 385–533 MBq 18F-VAT immediately followed by three sequential whole-body PET/CT scans. PET data were collected under three different fasting conditions relative to administration of Ensure®Plus oral supplement and PET image acquisition: 1) complete fasting (n = 3), 2) oral partial fasting (n = 3), or 3) non-fasting (n = 2). We defined volumes of interest (VOIs), and generated organ time-activity curves (TACs). Organ radiation dosimetry was calculated using OLINDA/EXM v1.1 software.
Results
There were no adverse events after 18F-VAT dosing. Radioactivity accumulated predominantly in the brain, hepatobiliary system, small intestine, bone, and urinary bladder. Across all fasting states, organ dosimetry revealed gallbladder as the critical organ (135.8 µSv/MBq) followed by liver (50.9 µSv/MBq), with a gender averaged effective dose of 15.6 ± 3.4 µSv/MBq (17.8 and 13.3 µSv/MBq for males and females, respectively.) Mean gallbladder time integrated activity significantly differed among non-fasting (29.6 TBq*h, 116 µSv/MBq) and partial fasting (30.2 TBq*h, 120.7 µSv/MBq) combined with fasting PET acquisition (49.3 TBq*h, 164 µSv/MBq) (Kruskal-Wallis H 5, p = 0.03).
Conclusions
Human bio-distribution data showed high retention of 18F-VAT in the gallbladder and liver, where rat dosimetry studies do not accurately predict a safety profile given lack of gallbladder. Human dosimetry data appear different from fasting non-human primate data, indicating that up to 368 MBq (10 mCi) of 18F-VAT can be administered without exceeding a maximum dose to the gallbladder of 50 mSv (5 rem). Oral supplementation just prior to 18F-VAT administration accelerates gallbladder clearance, reducing critical organ radiation exposure and permitting an administered dose of 18F-VAT to 431 MBq (11.6 mCi) without exceeding a gallbladder dose of 50 mSv (5 rem).
Epidemiology of Pre-cancerous Cervical Lesions Among Women in Adama, Ethiopia
Authors: Lema Tadesse Fikre
Published: December 2024

Background
Cervical pre-cancer is a distinct change in the epithelial cells of the transformation zone of the cervix; the cells begin developing in an abnormal fashion in the presence of persistent or long-term human papillomavirus infection. It is estimated that out of women infected with human papillomavirus, 10% will develop pre-cancerous changes in their cervical tissue. About 8% of the women who develop these changes will develop pre-cancer limited to the outer layers of the cervical cells, and about 1.6% will develop invasive cancer. The main purpose of the study was to determine the epidemiology of pre-cancerous cervical lesions among women in Adama, Ethiopia.
Method
A cross-sectional study was carried out from April to July 2023. Interviewer administered, structured questionnaire was employed, and visual inspection with acetic acid applied for screening of the cervix. Systematic sampling technique was used to collect data from 383 participants. Data was entered into Epi Info version 7, and analysed using Statistical Package for Social Science version 26. Binary logistic regression for bivariate and multivariate analyses with adjusted odds ratios and 95% CIs were used to identify factors associated with the development of pre-cancerous cervical lesions. The level of significance of association was determined as a p-value < 0.05.
Results
The overall prevalence of pre-cancerous cervical lesions was 12.5%. Post-coital bleeding (AOR = 25.34: 95% CI: 6.22, 103.20), age at first sex (AOR = 3.96: 95% CI: 1.24, 12.69), lifetime sexual partner (AOR = 8.37: 95% CI: 1.00, 70.14) and HIV sero-status (AOR = 10.96: 95% CI: 2.25, 53.37) were identified as independent factors significantly associated with the development of pre-cancerous cervical lesions.
Conclusions
There was high prevalence of pre-cancerous cervical lesions among participants. Conduct health education to the public on avoidance of identified cervical cancer risk factors. Multiple factors were identified as independent factors significantly associated with the development of pre-cancerous cervical lesions. Awareness creation campaigns and educational programs about the prevention of pre-cancerous cervical lesions and associated risk factors need to be implemented in the community
Evaluating the implementation of measurement-based care in child and adolescent mental health services as part of a learning health system
Authors: McCabe Erin , Bajgain Bishnu , Hindmarch Whitney , Dyson Michele , McNeil Deborah , Ortega Iliana , Arnold Paul D. , Dimitropoulos Gina , Clements Ryan , Zwicker Jennifer D. , Santana Maria J.
Published: December 2024

Background
Mental health conditions affect one in seven young people and research suggests that current mental health services are not meeting the needs of many children and youth. Learning health systems are an approach to enhancing mental health services through rapid, routinized cycles of continuous learning and improvement. Patient-reported outcome measures (PROMs) provide a key data source for learning health systems. PROMs also improve outcomes for patients when integrated into routine clinical care - an approach often referred to as measurement-based care (MBC) in mental health services. However, implementing MBC into health systems is challenging. The purpose of this study was to evaluate the implementation of MBC in a child and adolescent mental health centre in Calgary, Canada. Our specific objectives were to assess implementation outcomes, and identify barriers and facilitators to implementation.
Methods
This study is a mixed-methods, formative evaluation using the Consolidated Framework for Implementation Research. The child and adolescent mental health centre has three services: single session Walk-in service, Day Hospital and Intensive Community Treatment Services. Participants included managers, clinicians, administrative support, embedded researchers at the centre, and youth and caregivers who have accessed the centre’s services. Surveys, PROM and administrative data, as well as semi-structured interview data were analyzed to evaluate implementation outcomes (acceptability, appropriateness, penetration, fidelity), as well as assess barriers and facilitators to implementation of MBC.
Results
Clinicians (n = 14), managers (n = 3), administrative support (n = 6), and embedded research team members (n = 4) participated. Acceptability of MBC was high, perceptions of appropriateness varied by service. Penetration and fidelity metrics were high in intensive community treatment services, mixed in Day Hospital and low in the Walk-in service. Key facilitators identified include leadership support, a culture of innovation, the design of MBC, and clinician self-efficacy with standardized assessment tools. Key barriers included the platform for administering MBC, inconsistent engagement with clinical staff, and the policies of the large health services provider operating the centre.
Conclusion
This study described implementation outcomes and identified determinants of successful implementation of MBC in child and adolescent mental health services. The findings will be useful in designing implementation strategies in similar settings.