bluuebunny/crossref_metadata_2025 huggingface dataset:
Breast Cancer Awareness and Uptake of Breast Cancer Screening Services Among Undergraduate Female Students in the Oldest University of Tanzania: A Cross-Sectional Study
Authors: Mally Mary , Tesha Novatus , Anaeli Amani
Published: August 2024

Background:

Breast cancer is the leading cause of cancer-related death among women worldwide. Mortality from breast cancer can be reduced through early detection and prevention. Despite the availability of breast cancer screening methods, the uptake of screening services remains very low, especially in low-resource countries like Tanzania. This low uptake of screening services may be attributed to a lack of awareness regarding the importance of early detection of the disease.

Objectives:

This study was set to determine breast cancer awareness and the uptake of breast cancer screening services among undergraduate female students in Dar es Salaam, Tanzania.

Design:

The study was a descriptive cross-sectional study using the quantitative approach.

Methods:

The sample size calculated for this study was 434 undergraduate female students. The tool used for data collection was self-administered questionnaires, with data collection taking place in July 2022. Data were analyzed using Stata Version 15 and presented using descriptive and inferential statistics.

Results:

We found that most of the participants (92.38%) had heard about breast cancer, and only 39% of the participants were able to correctly identify the risk factors for breast cancer. Participants who had ever used breast cancer screening services by at least 1 method were 37 (9.23%), and the most common screening method practiced by the study participants was breast self-examination (48.65%).

Conclusions:

Most of the participants were not aware of the screening methods for early detection of breast cancer. In addition, they lacked knowledge of some of the risk factors as evidenced by the low uptake of breast cancer screening services among the study participants. This calls for an awareness-raising campaign on the importance of breast cancer screening.
Reflections on co-creating a model for the value assessment of artificial intelligence technologies
Authors: Karlsson Anne Wettergren , Janssens Astrid , Barkler Astrid , Schmidt Thomas , Rasmussen Benjamin Schnack Brandt , Fasterholdt Iben
Published: August 2024

Aims:

A multidisciplinary group of experts and patients developed the Model for ASsessing the value of Artificial Intelligence (MAS-AI) to ensure an evidence-based and patient-centered approach to introducing artificial intelligence technologies in healthcare. In this article, we share our experiences with meaningfully involving a patient in co-creating a research project concerning complex and technically advanced topics.

Methods:

The co-creation was evaluated by means of initial reflections from the research team before the project started, in a continuous logbook, and through semi-structured interviews with patients and two researchers before and after the active co-creation phase of the project.

Results:

There were initial doubts about the feasibility of including patients in this type of project. Co-creation ensured relevance to patients, a holistic research approach and the debate of ethical considerations. Due to one patient dropping out, it is important to foresee and support the experienced challenges of time and energy spent by the patient in future projects. Having a multidisciplinary team helped the collaboration. A mutual reflective evaluation provided insights into the process which we would otherwise have missed.

Conclusions:

We found it possible to create complex and data-intense research projects with patients. Including patients benefitted the project and gave researchers new perspectives on their own research. Mutual reflection throughout the project is key to maximise learning for all parties involved.
Dynamics analysis of a nonlinear system with Bingham model under stochastic excitation
Authors: Kan Zijian , Wang Jun , Zhang Jianchao , Yang Zijian , Wen Shaofang
Published: August 2024

This article examines the stochastic response of a system with a Bingham model magneto-rheological damper under random excitation. The application of the stochastic averaging method yielded the averaged stochastic Itô equation. The system’s steady-state response probability density function (PDF) is obtained by solving the corresponding Fokker–Planck–Kolmogorov equation. Theoretical calculations are confirmed through numerical simulation. Additionally, the study produced graphs depicting the steady-state probability density functions for system energy, amplitude, displacement, and velocity, along with time history graphs, joint probability density functions for displacement and velocity, and continuous wavelet coefficient energy distribution graphs. The paper also examines the impacts of viscous damping, Coulomb damping, and noise intensity on the steady-state response from both time-domain and frequency-domain perspectives. The findings indicate that in this stochastic model, when velocities are relatively low, an equivalent increase in Coulomb damping has a more pronounced effect on the steady-state response than viscous damping. These results provide a theoretical basis for understanding and addressing the behavior of Bingham model magnetorheological dampers in nonlinear systems under stochastic excitation.
The things they are a-changin': reinventing daily objects during the chilean 2019 revolt
Authors: Greene Ricardo , Errazuriz Tomas
Published: August 2024

In October 2019, fuelled by a collective discontent with the lifestyles and inequalities generated by the capitalist model, social protests took place in the Chilean streets. People staged massive demonstrations in every city demanding profound changes to the system. Known as the ‘Estallido Social’ (Social Explosion), the demonstrations paralysed an important part of the country and, after a few weeks of revolt, managed to initiate a new Constitution-making process. These events triggered a process in which the country was re-imagined, subjectivities were rewritten and objects and the environment were heavily transformed. This study places its focus on a set of industrially produced objects, whose original functions were subverted in the streets to enable new uses and meanings aligned with the Social Explosion. Kitchen items such as pots and ladles were used to make a lot of noise; road signs and pieces of urban furniture were re-located to block the streets; and gas cylinders and oil drums were reshaped for protection against police forces. While specialized literature generally seeks to recognize the new social forms and models that emerge from the crisis, this essay aims to reflect on the ways in which the relationship with the everyday environment is transformed in the midst of a social crisis, and how operations of resignification and reinterpretation may also be necessary to bring about more profound changes. As such, this study aims to characterize these operations of mutation (of bending, crumpling, scratching, wetting, moving, cutting, twisting, hitting, breaking, cracking, tricking, whipping, throwing, crushing, dragging, drilling and burning), and from there to move towards elucidating the practical and symbolic repercussions that this new material reality has had on the social body and daily life.
Effective alerting for bridge monitoring via a machine learning-based anomaly detection method
Authors: Kang Juntao , Wang Lei , Zhang Wenbin , Hu Jun , Chen Xingxiang , Wang Dong , Yu Zechuan
Published: August 2024

To alert upcoming structural failure is a critical task for structural health monitoring of bridges. Traditional methods mainly rely on thresholds, which are often fixed values and may cause missing or too sensitive reports. Identifying abnormal data, locating the source of anomalies and delivering proportional alerts require new, dynamic, and robust algorithms running on massively streaming monitoring data. This article proposes a new machine learning-based anomaly detection method for historical data mining as well as real-time alerting. The method transforms one-dimensional time series into two-dimensional tensors, enabling the encoder-like model to simultaneously learn the changes in multiple sensors within and between temporal cycles in a two-dimensional space. Training and validation of the proposed method are presented with data from a bridge monitoring system in service, and comparisons against traditional threshold-based alerting method are made. The proposed method can accurately identify abnormalities beyond the traditional thresholds and effectively detect abnormal deviations of sensors, thus constituting as a promising module for real-time alerting systems of bridges.
An efficient bivariate three-point Lagrange interpolation method based on coordinate transformation
Authors: Sheng Xianjun , Zhao Zhijie , Liu Ning , Wang Kexin
Published: August 2024

This paper proposes a bivariate three-point interpolation method based on coordinate transformation. The transformation significantly improves computational efficiency by converting radial sampling points into interpolation nodes, while enabling high-precision computation of coordinates and normal vectors for any surface point. Numerical experiments validate the effectiveness of the bivariate three-point interpolation method based on coordinate transformation. Although its accuracy is slightly lower than that of the NURBS surface method, it still meets the requirement for high precision. In particular, the proposed method drastically reduces the computation time by more than 50% compared to the NURBS surface method. In addition, it seamlessly computes coordinates and normal vectors for any surface point. It is significantly helpful for the improvement of computational efficiency in engineering for the measurement and evaluation of aircraft radomes.
Estimands in clinical trials of complex disease processes
Authors: Cook Richard J , Lawless Jerald F
Published: August 2024

Clinical trials with random assignment of treatment provide evidence about causal effects of an experimental treatment compared to standard care. However, when disease processes involve multiple types of possibly semi-competing events, specification of target estimands and causal inferences can be challenging. Intercurrent events such as study withdrawal, the introduction of rescue medication, and death further complicate matters. There has been much discussion about these issues in recent years, but guidance remains ambiguous. Some recommended approaches are formulated in terms of hypothetical settings that have little bearing in the real world. We discuss issues in formulating estimands, beginning with intercurrent events in the context of a linear model and then move on to more complex disease history processes amenable to multistate modeling. We elucidate the meaning of estimands implicit in some recommended approaches for dealing with intercurrent events and highlight the disconnect between estimands formulated in terms of potential outcomes and the real world.
Media sources, partisanship, and public support for self-defense in Taiwan
Authors: Yeh Yao-Yuan , Lin Hsuan-Yu (Shane) , Wu Charles KS
Published: August 2024

In this study, the authors focus on Taiwan, where citizens are increasingly concerned about the possibility of a Chinese invasion. Specifically, the authors want to know if different media sources would influence citizens’ willingness to engage in self-defense. Additionally, they would like to see if partisans experience a backfire effect when exposed to incongruent political information. To test these hypotheses, they designed and conducted an original survey experiment in Taiwan by creating different vignettes. Their findings reveal two points: firstly, media cues alone did not significantly alter citizens’ overall willingness to engage in self-defense and, secondly, only supporters of the Pan-Green coalition (who are more inclined towards Taiwan’s independence) experienced a backfire effect by becoming more supportive of self-defense when exposed to a pro-China media source than a pro-Taiwan source. In conclusion, the authors provide explanations for the heterogeneous effects among partisans and discuss the theoretical implications of their research.
In the digital trenches: Mapping the structure and evolution of the Islamic State’s information ecosystem (2023–2024)
Authors: Lakomy Miron
Published: August 2024

Based on open-source intelligence, social network analysis and comparative analysis, this study discusses the structure, evolution and most important features of the pro-Islamic State (IS) information ecosystem on the surface web between July 2023 and March 2024. It proves that the core of its propaganda distribution network is surprisingly centralized around three stand-alone domains, including one link directory – Fahras – and two propaganda repositories: I’lam and al-Raud. These webpages constitute the core of the ecosystem, densely interconnected with a broad range of secondary channels designed to lure online audiences to these hotspots of pro-IS communication. This centrality manifests a previously unnoticed shift in IS’s methods of designing and maintaining propaganda distribution networks. The study also shows that, despite frequent claims from stakeholders, IS has not abandoned exploiting mainstream social networks, although only some of them were preferred. On top of this, it proves that the pro-IS media bureaus continued to rely on a broad range of file-sharing services, including the Internet Archive, although the latter proved quite efficient in taking down its productions. Last but not least, IS confirms the continued interest of Daesh in exploiting several types of encrypted communication apps, such as Telegram and Rocket Chat.
Ethical cinematic memory: Responsibility and suffering in Le silence de la mer
Authors: Jones Andrew
Published: August 2024

The title Le silence de la mer evokes a constellation of memories within the complex and intertwined traumas of war, occupation, and genocide in 1940s’ France. This article argues that Melville’s 1949 film adaptation of this story formulates a new mode of ethical memory by mobilizing fictional first-person filmic narration to foreground the subject’s responsibility for the suffering other. To analyze the intersection of fiction and memory within the framework of testimony, I fuse together Hirsch’s notion of affiliative postmemory with the philosophy of Levinas to form a conception of testimony by proximity. By bringing suffering to the screen in such a way, this film implies a personal responsibility that extends beyond the film and its authors to the spectators’ experience through its engagement with collective memory. Its spectators are responsible to bear witness, while maintaining that any response is always already inadequate, and thus the responsibility is ultimately unfulfillable.
Link Between Parent-Emerging Adult Relationship Quality and Emerging Adult Physical Health: An Examination of Mediators and Moderators
Authors: Esparza Kayleigh A. , Criss Michael M. , McGehee Amy L. , Washburn Isaac , Byrd-Craven Jennifer
Published: August 2024

The purpose of this study was to examine the link between parent-emerging adult relationship quality and emerging adult physical health outcomes. In addition, mediators and moderators of these links were explored. The sample consisted of 869 college students (ages 18–25 years) who completed online anonymous surveys. Results indicated that high levels of parent-emerging adult openness were significantly related to low levels of emerging adult health problems. In addition, parental involvement was negatively and significantly related to emerging adult body mass index and health problems. Mediation analyses conducted through structural equation modeling demonstrated that parent-emerging adult relationship quality was indirectly (but not directly) related to youth health outcomes via emerging adult internalizing symptoms (but not via emotion regulation). Moreover, there was no evidence for significant gender differences, therefore the overall pattern of findings were similar for women and men. Implications for interventions focusing on parent-emerging adult relationships and emotion regulation were discussed.
Nurturing a College-Going Identity in Black Emerging Adults
Authors: Anderson Kim M. , Cares Alison C. , Newins Amie R. , Lewis Alexander , Nunes Michael , Copeland Arin A. , Ilesanmi Itunu
Published: August 2024

This qualitative study explored Black college students’ perceptions of developing their postsecondary motivation and aspirations via in-depth qualitative interviews ( N = 14). Use of the grounded theory method produced a three-stage developmental process for nurturing a college-going identity that aligned with the initial phases of the plant life growth cycle. The initial phase for participants occurred during their childhood, with parents planting seeds of college-going aspirations for their children. The second phase of cultivating the soil for postsecondary ambitions occurred during high school, where participants’ self-motivation was bolstered within their familial and educational environments. The third phase also occurred in high school with germinating seedlings that produced concrete college-going plans by delineating potential fields of study and completing college applications. Intervening conditions promoted optimal (i.e., resource access) or adverse (i.e., COVID-19 pandemic) growth environments. Implications include delineating pathways to postsecondary success for Black emerging adults.
Characterizing Midlife-Onset Alcohol Dependence: Implications for Etiology, Prevention, and Healthy Aging
Authors: Khalifeh Lara , Caspi Avshalom , Dent Kallisse R. , Harrington HonaLee , Meier Madeline H. , Poulton Richie , Ramrakha Sandhya , Moffitt Terrie E. , Richmond-Rakerd Leah S.
Published: August 2024

We evaluated the developmental epidemiology of midlife-onset alcohol dependence (AD) in the Dunedin Study ( N = 1,037), a population-representative cohort followed across 5 decades. At ages 18, 21, 26, 32, 38, and 45, past-year AD prevalence was 11.0%, 18.4%, 13.6%, 8.1%, 9.6%, and 11.3%, respectively. As expected, relative to never-diagnosed individuals, individuals with early onset AD (first diagnosis at age 18 or age 21, prevalence = 22.9%) were distinguished by a range of early life and adult correlates. Individuals with midlife-onset AD (first diagnosis at age 38 or age 45, prevalence = 5.6%) were distinguished by fewer early life correlates, but exhibited a family history of AD and adolescent dysregulation and marijuana use. They were characterized by an array of adult correlates, including internalizing disorders, mental-health-treatment contact, criminal behavior, perceived stress, coping by drinking, lower likelihood of marriage and parenthood, and reduced preparedness for old age. They also experienced more adult alcohol-related impairment than the early onset group. Results can guide efforts to reduce midlife alcohol-related problems and support healthy aging.
Streamlining the Journey of Research Into Clinical Practice: Making Your Patients and Practice Flourish Optimizing Management and Minimizing Risk of Osteoporotic Vertebral Fractures – Perspectives of the AO Spine KF Trauma and Infection Group Key Opinion Leaders
Authors: Joaquim Andrei F. , Bigdon Sebastian F. , Bransford Richard , Chhabra Harvinder Singh , Yurac Ratko , Kumar Vishal , El-Sharkawi Mohammad , Benneker Lorin M. , Karamian Brian A. , Canseco Jose A. , Scherer Julian , Hassan Ahmed Abdelazim , Schroeder Gregory D. , Öner Cumhur F. , Rajasekaran Shanmuganathan , Vialle Emiliano , Kanna Rishi M. , Vaccaro Alexander R. , Tee Jin , Camino-Willhuber Gaston , Fisher Charles G. , Dvorak Marcel F. , Schnake Klaus J. ,   on behalf of the AO Spine Knowledge Forum Trauma & Infection
Published: August 2024

Study Design

Literature review with clinical recommendations.

Objective

To highlight important studies about osteoporotic spinal fractures (OF) that may be integrated into clinical practice based on the assessment of the AO Spine KF Trauma and Infection group key opinion leaders.

Methods

4 important studies about OF that may affect current clinical practice of spinal surgeons were selected and reviewed with the aim of providing clinical recommendations to streamline the journey of research into clinical practice. Recommendations were graded as strong or conditional following the GRADE methodology.

Results

4 studies were selected. Article 1: a validation of the Osteoporotic Fracture (OF)-score to treat OF fractures. Conditional recommendation to incorporate the OF score in the management of fractures to improve clinical results. Article 2: a randomized multicenter study comparing romosozumab/alendronate vs alendronate to decrease the incidence of new vertebral fractures. Strong recommendation that the group receiving romosozumab/alendronate had a decreased risk of new OF when compared with the alendronate only group only. Article 3: a systematic literature review of spinal orthoses in the management of. Conditional recommendation to prescribe a spinal orthosis to decrease pain and improve quality of life. Article 4: post-traumatic deformity after OF. A conditional recommendation that middle column injury and pre-injury use of steroids may lead to high risk of post-traumatic deformity after OF.

Conclusions

Management of patients with OF is still complex and challenging. This review provides some recommendations that may help surgeons to better manage these patients and improve their clinical practice.
A Rare Case of Cerebral Abscess due to Fusobacterium nucleatum with Native Aortic Valve Infective Endocarditis and Pyogenic Liver Abscess
Authors: Sulaiman Zoheb Irshad , Sharma Divisha , Rivera Salva Juan , Rast Johnathon , Samra Hasan , Askar Gina
Published: August 2024

Fusobacterium nucleatum is a commensal pathogen typically found in the oral cavity, digestive tract, and urogenital system which has been associated with Lemierre’s syndrome, periodontal diseases, sinusitis, endocarditis, and intra-abdominal and brain abscesses. Our case is of a 62-year-old male who presented with headaches, nausea, and vision loss. Brain imaging identified a right occipito-parietal brain abscess. Following surgery and abscess drainage, Fusobacterium nucleatum was isolated from intraoperative cultures, and the infectious disease service was consulted for antibiotic recommendations. Additional history uncovered that he had also been experiencing night sweats, generalized weakness and 40-pound weight loss for 2 months, and had a prior history of colon polyps and diverticulitis. Furthermore, the patient disclosed having substandard oral hygiene practices, particularly in relation to the care of his dental appliances. Despite negative blood cultures, suspicion for hematogenous seeding was high. Imaging ruled out periodontal disease, but identified a colovesical fistula and liver abscesses, indicating potential translocation of bacteria via portal circulation to his liver. Echocardiogram workup revealed a 1-cm mobile vegetation on the aortic valve. His course was complicated by breakthrough seizures, renal failure, and drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome, and he ultimately completed 16 weeks of antibiotics. This case illustrates an uncommon presentation of brain abscess in an immunocompetent adult, with a prior episode of diverticulitis as the probable primary infection source, leading to development of a colovesical fistula and bacterial dissemination to the liver, heart, and brain. It highlights the importance of a comprehensive diagnostic approach, including consideration of atypical pathogens in immunocompetent adults.
Does Knowing the Word Matter for Preschool DLLS? Individualized Vocabulary Words on Phonological Awareness Performance
Authors: Paciga Kathleen A. , Cassano Christina M.
Published: August 2024

Early literacy assessment has become commonplace in the preschool years, with phonological awareness constituting one component of emergent literacy targeted by such practices. This within-subjects experimental study examines the role of word familiarity on 93 dual language preschoolers’ performance on phoneme-level awareness tasks in three-phoneme words. A researcher-designed digital tool created individualized test items (foils and target responses) for each child. Half of the items presented target responses that contained familiar words, and half contained unfamiliar words. Results suggest unknown/unfamiliar target words yield lower phonological awareness performance scores.
Public Health Nurses in an Internal Negotiation Process When There Is Concern About the Child’s Care
Authors: Mathisen Haaland Ingrid Elisabeth , Bondas Terese Elisabet
Published: August 2024

The aim of the study was to explore and describe how public health nurses at child health clinics experience and perceive the follow-up of children and families when there is concern about the child’s care. The goal was to contribute to knowledge development to guide health-promoting nursing care for children and their families. Theoretical perspectives included health promotion, child-centered and family-centered care, in addition to nursing care. An exploratory qualitative design informed by a hermeneutic approach was used. Data were collected in 3 focus groups with 16 public health nurses and analyzed using latent content analysis. The findings detail public health nurses’ internal negotiation processes in the follow-up of children and the family, and the ways these negotiation processes were influenced by various prerequisites, the approaches for follow-up, dilemmas that affected public health nurses’ approaches, and prolonged dwellings on past responses to children and families of concern. The lack of routines and goals for follow-up, a dominant parental perspective, and ambiguity related to health promotion and disease prevention, all created challenges for the public health nurses. Based on these findings, a model of public health nurse’s follow-up when there is concern about the child’s care was developed for future research.
Integrating green space measures into future town planning in Zhejiang, China
Authors: Wang Yuanzhao , Guan ChengHe
Published: August 2024

Various spatial indices have been used by scholars to evaluate the built environment of towns. However, previous analysis has fallen short in systematically addressing the distribution of green space in future town planning. This paper fills the gap by integrating green space indices in an expanded urban intensity framework and comparing existing conditions (2018) and future planning schemes (2030) of eleven towns in Zhejiang Province, China. In this paper, we computed spatial indices in ARCGIS and FRAGSTATS, used correlation analysis in STATA for statistical analysis, and adopted demographic, economic, and environmental variables to validate the selected indices. The results show that: (1) The future planning schemes can result in either reduction of green spaces in town centers or uneven distribution of green spaces; (2) Validation of green space indicators reveals observable association with the normalized difference vegetation index (NDVI), which implies that the chosen framework can effectively reflect the condition of greenery; and (3) The regulatory detailed planning does not always improve the future spatial layout of towns, especially after considering green space distributions. These findings emphasize the importance of suitable spatial layouts of green spaces over large monolithic blocks for effective planning. Moreover, achieving optimal urban intensity necessitates a balanced distribution of the built and green spaces. Finally, the integration of green space factors and the adoption of a comprehensive approach, as highlighted in this study, can serve as a valuable guide for town planners and policymakers in different jurisdictions to achieve more desirable spatial layouts.
Occipital nerve stimulation for cluster headache: lessons to learn from the ‘voltage tuners’
Authors: Kollenburg Linda , Arnts H. , Heitkamp M. , Geerts S. , Robinson C. , Dominguez M. , Mulleners W. , Kurt E.
Published: August 2024

Background

Cluster headache (CH) is a significant health concern due to its major socioeconomic consequences and most patients being refractory to conventional strategies. For treatment resistant CH, occipital nerve stimulation (ONS) is considered an effective treatment option. Whereas most patients do not adjust the amplitude of the ONS system, a subset changes the amplitude on a regular basis using their remote control, and are therefore referred to as ‘voltage tuners’. Anxiety and self-control are thought to be central themes to this behavior. Research on this voltage tuning behavior could provide new insights in the use of ONS as acute attack treatment. To date, voltage tuning has not been assessed for CH. Hence this is a unique study aiming to investigate the occurrence and efficacy of voltage tuning in patients with CH and ONS.

Methods

For this analysis, patients with CH who received ONS from 2020–2024, at our university medical center, were included. All patients underwent bilateral ONS implantation. Data on attack frequency, intensity and duration were collected retrospectively. Outcomes on the response, frequency, moment during the day, duration, rationale, sensation, average increase in amplitude, and efficacy of voltage tuning were collected with prospective interviews.

Results

Thirty-three patients (M = 20) (42 ± 12.7 years) were included in the current analysis. At 1y follow-up, an overall response rate of 70% (23/33) was found for ONS. In total, 48% (18/33) of patients were defined as voltage tuners. Voltage tuning was performed with an average increase in amplitude of 92 (20–360)%, a frequency of 1–20 times/month and duration of 20 minutes-48 hours. Sensations of voltage tuning were described as “tingling” and/or “pinching”. The rationale for voltage tuning in patients varied from prevention and ceasing to lowering the intensity and enhance control of CH attack.

Conclusions

Outcomes show that voltage tuning may cease and/or terminate CH attacks and therefore raise interests in the use of ONS as acute attack treatment for patients with resistant CH treated with ONS. Future research on the occurrence and potential of voltage tuning will provide valuable insights for achieving optimal efficacy of ONS and quality of life in patients with CH.
Downregulation of Klebsiella pneumoniae RND efflux pump genes following indole signal produced by Escherichia coli
Authors: Salama Galila G. , El-Mahdy Taghrid S. , Moustafa Walaa H. , Emara Mohamed
Published: August 2024

Background

More than a century has passed since it was discovered that many bacteria produce indole, but research into the actual biological roles of this molecule is just now beginning. The influence of indole on bacterial virulence was extensively investigated in indole-producing bacteria like Escherichia coli. To gain a deeper comprehension of its functional role, this study investigated how indole at concentrations of 0.5-1.0 mM found in the supernatant of Escherichia coli stationary phase culture was able to alter the virulence of non-indole-producing bacteria, such as Pseudomonas aeruginosa, Proteus mirabilis, and Klebsiella pneumoniae, which are naturally exposed to indole in mixed infections with Escherichia coli.

Results

Biofilm formation, antimicrobial susceptibility, and efflux pump activity were the three phenotypic tests that were assessed. Indole was found to influence antibiotic susceptibly of Pseudomonas aeruginosa, Proteus mirabilis and Klebsiella pneumoniae to ciprofloxacin, imipenem, ceftriaxone, ceftazidime, and amikacin through significant reduction in MIC with fold change ranged from 4 to 16. Biofilm production was partially abrogated in both 32/45 Pseudomonas aeruginosa and all eight Proteus mirabilis, while induced biofilm production was observed in 30/40 Klebsiella pneumoniae. Moreover, acrAB and oqxAB, which encode four genes responsible for resistance-nodulation-division multidrug efflux pumps in five isolates of Klebsiella pneumoniae were investigated genotypically using quantitative real-time (qRT)-PCR. This revealed that all four genes exhibited reduced expression indicated by 2^−ΔΔCT < 1 in indole-treated isolates compared to control group.

Conclusion

The outcomes of qRT-PCR investigation of efflux pump expression have established a novel clear correlation of the molecular mechanism that lies beneath the influence of indole on bacterial antibiotic tolerance. This research provides novel perspectives on the various mechanisms and diverse biological functions of indole signaling and how it impacts the pathogenicity of non-indole-producing bacteria.
Prevalence of classic and non-classic pain sites of coronary artery disease: a cross-sectional study
Authors: Abdullatef Mayar , Omran Maya , Bitar Anas , Alsaid Bayan
Published: August 2024

Study objective

This study aims to assess the prevalence of both classic and non-classic pain sites in patients with ischemic heart disease, emphasizing the importance of recognizing and not disregarding non-classic symptoms.

Methods

This cross-sectional study included 100 patients diagnosed with coronary artery disease (CAD) who were admitted to two major hospitals in Syria. classic pain was identified as pain located in the precordial area, with or without radiation to the neck, jaw, left shoulder or arm. Patients’ demographics and previous medical history were documented to investigate any potential associations with non-classic pain.

Results

62% of the patients experienced non-classic pain, while 12% had no precordial pain. For those without precordial pain, the most common pain site was the left chest (66.7%). Non-classic pain was significantly associated with smoking, with 72.2% of smokers experiencing non-classic pain compared to 35.7% non-smokers (p = 0.001). Additionally, patients with previous heart disease were more likely to have non-classic pain (71.7%), compared with patients with no history of heart disease (51.1%) (p = 0.03). Other factors such as age, sex, and diabetes were not statistically significant.

Conclusion

Non-classic pain is common, affecting 62% of individuals, primarily in the right shoulder, right arm, and back. This type of pain could be associated with smoking and prior heart disease. Misdiagnosing coronary artery disease can have serious consequences, as patients with non-classic symptoms may miss important pre-hospital procedures like ECG.
Prevalence of heart failure and trends in its pharmacological treatment between 2000 and 2017 among very old people
Authors: Svahn Sofia , Appelblad Leona , Lövheim Hugo , Gustafson Yngve , Olofsson Birgitta , Gustafsson Maria
Published: August 2024

Purpose

The aim of this study was to describe a population of very old people with heart failure (HF), to analyse the use of cardiovascular drugs over time, and to explore factors influencing cardiovascular drug treatment for this group.

Methods

All participants with information regarding HF diagnosis were selected from the Umeå 85+/Gerontological Regional Database (GERDA). The people in GERDA are all ≥85 years old. Trained investigators performed structured interviews and assessments. Information regarding medications and diagnoses was obtained from the participants and from medical records. Medical diagnoses were reviewed and confirmed by an experienced geriatrician.

Results

In this very old population, the prevalence of HF was 29.6% among women and 30.7% among men. Between 2000 and 2017, there was an increase in the use of renin-angiotensin (RAS) inhibitors (odds ratio [OR] 1.107, 95% confidence interval [CI] 1.072–1.144) and beta-blockers (BBs) (OR 1.123, 95% CI 1.086–1.161) among persons with HF, whereas the prevalence of loop diuretics (OR 0.899, 95% CI 0.868–0.931) and digitalis (OR 0.864, 95% CI 0.828–0.901) decreased (p < 0.001 for all drug classes). Higher age was associated with lower use of RAS inhibitors and BBs.

Conclusion

In this HF population, the use of evidence-based medications for HF increased over time. This may be a sign of better awareness among prescribers regarding the under-prescribing of guidelines-recommended treatment to old people. Higher age associated with a lower prevalence of RAS inhibitors and BBs. This might indicate that further improvement is possible but could also represent a more cautious prescribing among frail very old individuals.
Determining behavioral intention and its predictors toward preconception care use among reproductive age women in Arba Minch town, Southern Ethiopia, 2022: a cross-sectional study based on the theory of planned behavior
Authors: Tena Habtamu Alemu , Fikadu Kassahun , Birgoda Gebremariam Temesgen , Cherkos Abel Belete , Hadaro Tesfahun Simon , Lahole Begetayinoral Kussia
Published: August 2024

Background

Preconception care is a highly effective, evidence-based intervention aimed at promoting the health of reproductive-age women and reducing adverse pregnancy-related outcomes. The Ethiopian Ministry of Health plans to integrate preconception care services into the country’s existing healthcare system. However, women’s preferences may be influenced by their values and customs. Therefore, this study used the theory of planned behavior to assess women’s intention toward preconception care use and its predictors among reproductive-age women in Arba Minch town, southern Ethiopia.

Methods

A community-based cross-sectional study was conducted in Arba Minch town from May 1 to 30, 2022. A simple random sampling technique was employed to select 415 study participants for data collection. Data were collected through a face-to-face interview using a pretested, structured questionnaire. Epi Data version 4.6 and SPSS version 26 were used for the entry and analysis of data, respectively. Multiple linear regression was performed to identify independent predictors of intention to use preconception care. The standardized β-coefficient was used as a measure of association. A P value of less than 0.05 was used to declare statistical significance.

Results

This study had 415 participants, giving a response rate of 98.3%. The mean age of the participants was 28.4 (SD 5.18). The mean intention to use preconception care was 21.43 (SD 2.47). Direct perceived behavioral control (β = 0.263, p < 0.001), direct attitude (β = 0.201, p = 0.001), direct subjective norm (β = 0.158, p = 0.006), and age (β=-0.115, p = 0.023) were significant predictors of women’s behavioral intention to use preconception care.

Conclusion

The study identified perceived behavioral control as the strongest predictor, followed by attitude and subjective norms, influencing the intention to use preconception care. These findings underscore the importance of integrating these predictors into health intervention programs aimed at promoting the implementation of preconception care services.
War and peace in public health education and training: a scoping review
Authors: Wandschneider Lisa , Nowak Anna , Miller Marta , Grün Anina , Namer Yudit , Bochenek Tomasz , Balwicki Lukasz , Razum Oliver , Cunningham Colette
Published: August 2024

Background

Armed conflict and war are public health disasters. Public health action has a crucial role in conflict-related emergencies and rehabilitation but also in war prevention and peace promotion. Translating this into public health training and competencies has just started to emerge, especially in Europe.

Methods

We conducted a Scoping Review to map and identify the role of public health education and training of public health workforce relating to the prevention of war and promoting peace, as reflected in the scientific literature. We searched in PubMed, CINAHL, PsycINFO, Embase, Web of Science Core Collections as well as the reference list of included material in English, German and Polish. Focusing initially on the European region, we later expanded the search outside of Europe.

Results

We included 7 publications from opinion pieces to an empirical assessment of curricula and training. The educational programs were predominantly short-term and extra-curricular in postgraduate courses addressing both public health professionals in conflict-affected countries as well as countries not directly affected by war. Publications focused on public health action in times of war, without specifying the context and type of war or armed conflict. Competencies taught focused on emergency response and multi-disciplinary collaboration during emergencies, frequently drawing on experience and examples from natural disaster and disease outbreak management.

Conclusions

The scientific discourse on competences in public health education for times of war and for the promotion of peace, predominately focuses on immediate emergency response actions. The prevention of war and the promotion of peace are missing foci, that need to feature more prominently in public health training. Public Health Education and training should ensure that war prevention and peace promotion, as well as public health action in times of war, are included in their competencies for public health professionals.
Predictors of enrollment in a virtual diabetes prevention program among women veterans: a retrospective analysis
Authors: Malone Allyson , Clair Kimberly , Chanfreau Catherine , Bean-Mayberry Bevanne , Oberman Rebecca , Lesser Rachel , Knight Cody , Finley Erin , Hamilton Alison , Farmer Melissa M. , Moin Tannaz
Published: August 2024

Background

The Diabetes Prevention Program (DPP) is a nationally disseminated lifestyle intervention shown to prevent type 2 diabetes (diabetes). However, enrollment in the program remains variable. We sought to identify patient characteristics associated with enrollment in a virtual DPP program among women Veterans to inform ongoing diabetes prevention efforts.

Methods

We conducted a retrospective analysis of 2021–2024 Department of Veterans Affairs (VA) data collected through the VA Enhancing Mental and Physical Health of Women through Engagement and Retention (EMPOWER) 2.0 Program, an effectiveness-implementation trial to expand access to preventative health services for women Veterans. We included women meeting DPP eligibility criteria (BMI ≥ 25 kg/m2 [or ≥ 23 if Asian] with ≥ 1 risk factor for diabetes [e.g., prediabetes]) who received care at six VA sites implementing virtual DPP. We used logistic regression to examine the association between DPP enrollment and prior use of VA preventive services for weight management or diabetes prevention including the VA MOVE! clinic, Whole Health visits, nutrition visits, weight loss medications, and/or metformin. We adjusted for sociodemographic factors, comorbidities, number of DPP recruitment contacts, and site.

Results

A total of 1473 women Veterans received DPP outreach. On average, their age was 53 years (range 20–96), BMI 34 kg/m2, HbA1c 5.9%, 0.7% were Asian, 44% Black, 2% Hispanic, and 44% White. In our adjusted models, prior use of VA preventative services was not significantly associated with DPP enrollment. Younger women (OR:0.97, p = 0.002) and those who received more recruitment contacts (OR:2.63, p < 0.001), were significantly more likely to enroll in DPP. Women with housing instability were significantly less likely to enroll (OR:0.44, p = 0.029).

Conclusions

We found no difference in women Veterans’ enrollment in DPP based on prior use of VA weight management and prevention services. Frequency of outreach by VA sites may increase engagement in lifestyle interventions. Virtual DPP may support engagement in preventive lifestyle interventions for diverse groups of women Veterans, as a first program or as a complement to other VA services.

Trial registration

ClinicalTrials.gov, NCT05050266. Registered on 20 September 2021.
Influence of an iron dextran injection in various diseases on hematological blood parameters, including serum ferritin, neonatal dairy calves
Authors: Sickinger Marlene , Joerling Jessica , Büttner Kathrin , Roth Joachim , Wehrend Axel
Published: August 2024

Background

Feeding milk substitutes with low iron content or whole milk without iron supplementation is considered a major factor in developing iron-deficiency anemia in neonatal dairy calves. Young calves are often supplemented with iron dextran injections on the first day of life to prevent anemia. However, the effects of preventive treatment and the presence of disease on serum iron (Fe) concentrations, serum ferritin levels, and hematological blood parameters during the early neonatal stages have not been examined in detail. Therefore, we examined and evaluated the effects of iron dextran injections and health status on the development of hematocrit (Ht), red blood cells (RBC), hemoglobin concentration (Hb), erythrocyte indices (mean corpuscular volume, mean corpuscular hemoglobin, mean corpuscular hemoglobin concentration), Fe, and serum ferritin concentrations in dairy calves within the first 10 days of life. The suitability of serum ferritin as a reliable indicator of anemia in very young calves was evaluated by correlating ferritin concentrations with known laboratory diagnostic parameters of anemia.

Results

Iron supplementation significantly increased Fe levels (P = 0.048) but did not affect serum ferritin levels in neonatal calves. Fe concentrations were significantly lower in diseased than healthy calves (P = 0.0417). Iron supplementation significantly affected the health status, as observed in Ht (Ptreat=0.0057; Phealth=0.0097), RBC (Ptreat=0.0342; Phealth=0.0243), and Hb (Ptreat=0.0170; Phealth=0.0168). Serum ferritin levels did not significantly correlate with Fe levels. Both groups showed marked differences in ferritin levels, with the highest levels measured on day 2. Fe concentrations showed weak negative correlations with Hb and Ht levels on day 3 (ρ=-0.45; P = 0.0034 and ρ=-0.045; P = 0.0032, respectively). RBC count showed strong positive correlations with Hb and Ht levels (ρ = 0.91 and ρ = 0.93; P < 0.001).

Conclusion

Iron dextran injections increased Fe concentrations but reduced Ht level, RBC count, and Hb level. The presence of diseases led to a reduction in Fe and higher values of Ht, RBC, and Hb in moderate disease than in severe disease. Due to physiological fluctuations during the first 3 days of life, serum ferritin level seems unuseful for evaluating iron storage before day 4 of life.