bluuebunny/crossref_metadata_2025 huggingface dataset:
Antibiotic use and consumption among medical patients of two hospitals in Sierra Leone: a descriptive report
Authors: Lakoh Sulaiman , Williams Christine Ellen Elleanor , Sevalie Stephen , Russell James B.W. , Conteh Sarah K. , Kanu Joseph Sam , Barrie Umu , Deen Gibrilla F. , Maruta Anna , Sesay Daniel , Adekanmbi Olukemi , Jiba Darlinda F. , Okeibunor Joseph Chukwudi , Yendewa George A. , Firima Emmanuel
Published: October 2023

Background

Although one of the main drivers of antimicrobial resistance is inappropriate antibiotic prescribing, there are limited resources to support the surveillance of antibiotic consumption in low-income countries. In this study, we aimed to assess antibiotic use and consumption among medical patients of two hospitals in different geographic regions of Sierra Leone.

Methods

This is a cross-sectional study of adult (18 years or older) patients receiving medical care at two hospitals (34 Military Hospital-MH and Makeni Government Hospital-MGH) between March 2021 and October 2021. After admission to the medical or intensive care unit, patients were sequentially recruited by a nurse from each hospital. Demographic and clinical characteristics and information on the dose of antibiotics, their routes, and frequency of administration and duration were collected using a questionnaire adapted from previous studies and encrypted in EpiCollect software (Epic, Verona WI). A physician reviews and verifies each completed questionnaire. Data analysis was done using STATA version 16.

Results

The mean age of the 468 patients evaluated in this study was 48.6 years. The majority were women (241, 51.7%) and treated at MGH (245, 52.0%). Clinical diagnosis of bacterial infection was made in only 180 (38.5%) patients. Regardless of the diagnosis, most (442, 94.9%) patients received at least one antibiotic. Of a total 813 doses of antibiotics prescribed by the two hospitals, 424 (52.2%) were administered in MH. Overall, antibiotic consumption was 66.9 defined daily doses (DDDs) per 100 bed-days, with ceftriaxone being the most commonly used antibiotic (277, 34.1%). The ACCESS and WATCH antibiotics accounted for 18.9 DDDs per 100 bed-days (28.2%) and 48.0 DDDs per 100 bed-days (71.7%), respectively. None of the patients were prescribed a RESERVE antibiotics. The antibiotic consumption was lower in MH (61.3 DDDs per 100 bed-days) than MGH (76.5 DDDs per 100 bed-days).

Conclusion

Antibiotic consumption was highest with ceftriaxone, followed by levofloxacin and metronidazole. Given the high rate of consumption of antibiotics in the WATCH category of the AWaRe classification, there is a need to initiate surveillance of antibiotic consumption and establish hospital-based antibiotic stewardship in these settings.
Effectiveness of elastic band training and group-based dance on physical-functional performance in older women with sarcopenia: a pilot study
Authors: Valdés-Badilla Pablo , Guzmán-Muñoz Eduardo , Hernandez-Martinez Jordan , Núñez-Espinosa Cristian , Delgado-Floody Pedro , Herrera-Valenzuela Tomás , Branco Braulio Henrique Magnani , Zapata-Bastias José , Nobari Hadi
Published: October 2023

Background

Sarcopenia is a syndrome associated with aging that causes progressive loss of skeletal muscle mass and muscle function. In this pilot study, we compared the effectiveness of elastic band training regarding group-based dance on fat mass, fat-free mass, handgrip strength (HGS; dominant and non-dominant hand), leg strength, timed up-and-go (TUG) and walking speed in older women with sarcopenia.

Methods

This is a randomized controlled trial, single-blind, repeated measures of parallel groups (elastic band group: EBG, n = 21; group-based dance: GBD, n = 19), and a quantitative methodology. Three 60-minute sessions per week for 12 weeks were dedicated to the interventions with pre- and post-assessments. A two-factor mixed analysis of variance (ANOVA) model with repeated measures was performed to measure the group×time effect.

Results

A significant interaction revealed for fat-free mass (F1,16= 18.91; p < 0.001; EBG + 10.9% vs. GBD − 1.97%), HGS dominant hand (F1,16= 7.44; p = 0.014; EBG + 10.9% vs. GBD + 0.59%), HGS non-dominant hand (F1,16= 6.41; p = 0.022; EBG + 10.21% vs. GBD + 3.80%), leg strength (F1,16= 17.98; p < 0.001; EBG + 9.1% vs. GBD + 3.83%), TUG (F1,16= 7.52; p = 0.014; EBG − 14.7% vs. GBD − 1.0%) and walking speed (F1,16 = 6.40; p = 0.019; EBG − 7.6% vs. GBD − 4.35%) in favor of EBG.

Conclusion

Elastic band training produces significantly greater responses on physical-functional performance regarding group-based dance in older women with sarcopenia. On the other hand, the EBG revealed a significant improvement in fat-free mass and upper and lower limb muscle strength, as well as a significant decrease time in TUG, and walking speed. Elastic band exercise is a safe, easy, affordable, and effective physical activity strategy, according to the findings.
Explaining the challenges of resources management and its underlying factors in COVID-19 era in Iran: a qualitative study
Authors: Vatandoost Vahid , Tabatabaee Seyed Saeed , Okhovati Maryam , Barooni Mohsen
Published: October 2023

Background

Identifying factors affecting health costs can contribute to formulating the best policies for controlling and managing health costs. To this end, the present study aimed to analyze resource wastage and identify the factors underlying it in COVID-19 management in Iran’s health sector.

Method

This qualitative content analysis study was conducted in Iran’s health sector. The participants were 23 senior, middle, and operational managers in the health sector. The data were collected through semistructured interviews with the managers. The participants were selected using purposive, quota, and snowball sampling techniques. The interviews continued until the data were saturated. The collected data were analyzed using MAXQDA software (version 10).

Results

Following the data analysis, the factors affecting the wastage of health resources were divided into 4 themes and 13 main themes. Vaccines, diagnostic kits, medicines, and human resources were the main factors underlying resource wastage. The identified main themes were open and unused vials, nonuse of distributed vaccines and their expiration, excess supply and decreased demand for vaccines, expiration of diagnostic and laboratory kits and their quantitative and qualitative defects, and the large number of tests. Inefficiency and the expiration of COVID-19 drugs, poor drug supply and consumption chain management, inaccuracy in inventory control and expiration dates, disorganization and inconsistency in the distribution of healthcare staff, low productivity of the staff, and failure to match the staff’s skills with assigned tasks in selected centers were identified as the most important causes of resource wastage.

Conclusion

Given the limited health funds and the increased healthcare costs, effective preparation and planning and making reasonable decisions for unexpected events can minimize unnecessary costs and resource wastage, which requires some revisions in attitudes toward COVID-19 management in the healthcare sector.
Fat infiltration of the posterior paraspinal muscles is inversely associated with the fat infiltration of the psoas muscle: a potential compensatory mechanism in the lumbar spine
Authors: Muellner Maximilian , Haffer Henryk , Chiapparelli Erika , Dodo Yusuke , Shue Jennifer , Tan Ek T. , Zhu Jiaqi , Pumberger Matthias , Sama Andrew A. , Cammisa Frank P. , Girardi Federico P. , Hughes Alexander P.
Published: October 2023

Background

The function of the paraspinal muscles and especially the psoas muscle in maintaining an upright posture is not fully understood. While usually considered solely as a hip flexor, the psoas muscle and its complex anatomy suggest that the muscle has other functions involved in stabilizing the lumbar spine. The aim of this study is to determine how the psoas muscle and the posterior paraspinal muscles (PPM; erector spinae and multifidus) interact with each other.

Methods

A retrospective review including patients undergoing posterior lumbar fusion surgery between 2014 and 2021 at a tertiary care center was conducted. Patients with a preoperative lumbar magnetic resonance imaging (MRI) scan performed within 12 months prior to surgery were considered eligible. Exclusion criteria included previous spinal surgery at any level, lumbar scoliosis with a Cobb Angle > 20° and patients with incompatible MRIs. MRI-based quantitative assessments of the cross-sectional area (CSA), the functional cross-sectional area (fCSA) and the fat area (FAT) at L4 was conducted. The degree of fat infiltration (FI) was further calculated. FI thresholds for FIPPM were defined according to literature and patients were divided into two groups (< or ≥ 50% FIPPM).

Results

One hundred ninetypatients (57.9% female) with a median age of 64.7 years and median BMI of 28.3 kg/m2 met the inclusion criteria and were analyzed. Patients with a FIPPM ≥ 50% had a significantly lower FI in the psoas muscle in both sexes. Furthermore, a significant inverse correlation was evident between FIPPM and FIPsoas for both sexes. A significant positive correlation between FATPPM and fCSAPsoas was also found for both sexes. No significant differences were found for both sexes in both FIPPM groups.

Conclusion

As the FIPPM increases, the FIPsoas decreases. Increased FI is a surrogate marker for a decrease in muscular strength. Since the psoas and the PPM both segmentally stabilize the lumbar spine, these results may be indicative of a potential compensatory mechanism. Due to the weakened PPM, the psoas may compensate for a loss in strength in order to stabilize the spine segmentally.
Atherosclerosis of the iliac arteries for the prediction of erectile dysfunction and epistaxis in men undergoing abdominal CT scan
Authors: Schmid Florian A , Mergen Victor , Bärlocher Timo , Kaufmann Basil , Epprecht Lorenz , Soyka Michael B. , Eberli Daniel , Hötker Andreas M
Published: October 2023

Background

To investigate the association between erectile dysfunction (ED) as well as epistaxis (ES) in relation to the extent of iliac atherosclerosis.

Methods

In this retrospective cross-sectional study, all consecutive male patients treated at our institution from 01/2016 to 12/2020 undergoing abdominal CT scan were evaluated. Patients (n = 1272) were invited by mail to participate in the study in returning two questionnaires for the evaluation of ED (IIEF-5) and ES. Patients who returned filled-in questionnaires within a 3-month deadline were included in the study. The extent of atherosclerosis in the common iliac artery (CIA) and the internal iliac artery (IIA) was assessed by calcium scoring on unenhanced CT. Stratification of results was performed according to reported IIEF-5 scores and consequential ED groups.

Results

In total, 437 patients (34.4% of contacted) met the inclusion criteria. Forty-two patients did not fulfill predefined age requirements (< 75 years) and 120 patients had to be excluded as calcium scoring on nonenhanced CT was not feasible. Finally, 275 patients were included in the analysis and stratified into groups of “no-mild” (n = 146) and “moderate-severe” (n = 129) ED. The calcium score (r=-0.28, p < 0.001) and the number of atherosclerotic lesions (r=-0.32, p < 0.001) in the CIA + IIA showed a significant negative correlation to the IIEF-5 score, respectively. Patients differed significantly in CIA + IIA calcium score (difference: 167.4, p < 0.001) and number of atherosclerotic lesions (difference: 5.00, p < 0.001) when belonging to the “no-mild” vs. “moderate-severe” ED group, respectively. A multivariable regression model, after adjusting for relevant baseline characteristics, showed that the number of atherosclerotic CIA + IIA lesions was an independent predictor of ED (OR = 1.05, p = 0.036), whereas CIA + IIA calcium score was not (OR = 1.00031, p = 0.20). No relevant correlation was found between ES episodes and IIEF-5 scores (r=-0.069, p = 0.25), CIA + IIA calcium score (r=-0.10, p = 0.87) or number of atherosclerotic CIA + IIA lesions (r=-0.032, p = 0.60), respectively.

Conclusions

The number of atherosclerotic lesions in the iliac arteries on nonenhanced abdominal CT scans is associated with the severity of ED. This may be used to identify subclinical cardiovascular disease and to quantify the risk for cardiovascular hazards in the future.

Trial registration

BASEC-Nr. 2020 − 01637.
Oral health, stress and barriers accessing dental health care among war-affected Ukrainian refugees in Germany
Authors: Ponomarenko Maksym , Kaifie Andrea
Published: October 2023

Background

After Russian invasion many Ukrainians fled to European countries including Germany. In this context, the German health care system faced challenges delivering dental care to a displaced population. Recently surfaced obstacles as well as different cultural and medical traits need to be considered in order to deliver appropriate medical care. The aim of this study was to evaluate oral health and hygiene of Ukrainian refugees, identify barriers accessing dental health care and explore the relation to their mental health state.

Methods

This cross-sectional study was conducted using a self-assessment questionnaire, distributed via non-probability snowball sampling method among war-affected Ukrainians, who fled to Germany. The online form was distributed via web-based platforms, the printed version was hand-delivered across diverse local venues. Chi-Square Tests, T-Tests and Mann-Whitney-U Tests were performed. Analysis of variance and Spearman correlation coefficient analysis were also conducted.

Results

From 819 completed questionnaires, 724 questionnaires were included in the analysis with 78 males (10.8%) and 640 females (88.6%) and a mean age of 37.5 years (SD = 10.5). The majority of participants rated their state of teeth (77%) and gums (81%) as average or better. The main problems, caused by state of their teeth, were: “Have avoided smiling because of teeth” (23.6%) or “Felt embarrassed due to appearance of teeth” (22.2%). The most frequent limiting factors to access dental care were finances (82.6%), language (82.2%) and complicated health care system (74.1%). 45.8% of the participants scored 10 or more in the Patient Health Questionnaire and 37.4% in the Generalized Anxiety Disorder 7-item scale, respectively. These participants were more likely to report pain, poor state of teeth and gums and to fail a dental consultation. Overall, 59.6% participants reported not consulting a dentist, when needed. Failed consultations were associated with a poorer reported state of teeth and gums.

Conclusions

Ukrainian refugees reported barriers accessing dental health care in Germany. It is important to improve oral health literacy and dental services for displaced people and provide help and guidance in seeking dental care.
High triglyceride-glucose index predicts cardiovascular events in patients with coronary bifurcation lesions: a large-scale cohort study
Authors: He Jining , Yuan Sheng , Song Chenxi , Song Yanjun , Bian Xiaohui , Gao Guofeng , Dou Kefei
Published: October 2023

Background

Coronary bifurcation lesion, as a complex coronary lesion, is associated with higher risk of long-term poor prognosis than non-bifurcation lesions. The triglyceride-glucose (TyG) index has been shown to predict cardiovascular (CV) events in patients with coronary artery disease (CAD). However, the prognostic value of the TyG index in patients with bifurcation lesions who are at high risk of CV events remains undetermined. Therefore, this study aimed to investigate the association between the TyG index and CV events in patients with bifurcation lesions.

Methods

A total of 4530 consecutive patients with angiography-proven CAD and bifurcation lesions were included in this study from January 2017 to December 2018. The TyG index was calculated as Ln [fasting triglyceride (mg/dL) × fasting plasma glucose (mg/dL)/2]. Patients were assigned into 3 groups according to TyG tertiles (T) (T1: <8.633; T2: 8.633–9.096 and T3: ≥9.096). The primary endpoint was CV events, including CV death, nonfatal myocardial infarction and nonfatal stroke at 3-year follow-up. Restricted cubic spline (RCS) analysis, Kaplan-Meier curves and Cox proportional hazard models were used to investigate the associations between the TyG index and study endpoints.

Results

During a median follow-up of 3.1 years, 141 (3.1%) CV events occurred. RCS analysis demonstrated a linear relationship between the TyG index and events after adjusting for age and male sex (non-linear P = 0.262). After multivariable adjustments, elevated TyG index (both T2 and T3) was significantly associated with the risk of CV events (hazard ratio [HR], 1.68; 95% confidence interval [CI],1.06–2.65; HR, 2.10; 95%CI, 1.28–3.47, respectively). When study patients were further stratified according to glycemic status, higher TyG index was associated with significantly higher risk of CV events in diabetic patients after adjusting for confounding factors (T3 vs. T1; HR, 2.68; 95%CI, 1.17–6.11). In addition, subgroup analysis revealed consistent associations of the TyG index with 3-year CV events across various subgroups. Furthermore, adding the TyG index to the original model significantly improved the predictive performance.

Conclusions

High TyG index was associated with CV events in patients with bifurcation lesions, suggesting the TyG index could help in risk stratification and prognosis in this population.
The utilization and delivery of safer smoking practices and services: a narrative synthesis of the literature
Authors: Tapper Abigail , Ahern Catherine , Graveline-Long Zoe , Newberger Noam G. , Hughto Jaclyn M. W.
Published: October 2023

Background

Providing sterile drug smoking materials to people who use drugs can prevent the acquisition of infectious diseases and reduce overdose risk. However, there is a lack of understanding of how these practices are being implemented and received by people who use drugs globally.

Methods

A systematic review of safer smoking practices was conducted by searching PubMed, PsycInfo, Embase for relevant peer-reviewed, English-language publications from inception or the availability of online manuscripts through December 2022.

Results

Overall, 32 peer-reviewed papers from six countries were included. 30 studies exclusively included people who use drugs as participants (n = 11 people who use drugs; generally, n = 17 people who smoke drugs, n = 2 people who inject drugs). One study included program staff serving people who use drugs, and one study included staff and people who use drugs. Sharing smoking equipment (e.g., pipes) was reported in 25 studies. People who use drugs in several studies reported that pipe sharing occurred for multiple reasons, including wanting to accumulate crack resin and protect themselves from social harms, such as police harassment. Across studies, smoking drugs, as opposed to injecting drugs, were described as a crucial method to reduce the risk of overdose, disease acquisition, and societal harms such as police violence. Ten studies found that when people who use drugs were provided with safer smoking materials, they engaged in fewer risky drug use behaviors (e.g., pipe sharing, using broken pipes) and showed improved health outcomes. However, participants across 11 studies reported barriers to accessing safer smoking services. Solutions to overcoming safer smoking access barriers were described in 17 studies and included utilizing peer workers and providing safer smoking materials to those who asked.

Conclusion

This global review found that safer smoking practices are essential forms of harm reduction. International policies must be amended to help increase access to these essential tools. Additional research is also needed to evaluate the efficacy of and access to safer smoking services, particularly in the U.S. and other similar countries, where such practices are being implemented but have not been empirically studied in the literature.
Letrozole-stimulated endometrial preparation protocol is a superior alternative to hormone replacement treatment for frozen embryo transfer in women with polycystic ovary syndrome, a cohort study
Authors: Wang Xiaojuan , Li Yuan , Tan Hongzhuan , Cai Sufen , Ma Shujuan , Peng Yangqin , Guo Hui , Li Xiaofeng , Tang Yi , Zhang Shunji , Lin Ge , Gong Fei
Published: October 2023

Background

The current routine endometrial preparation protocol for women with polycystic ovary syndrome (PCOS) is hormone replacement treatment (HRT). Letrozole is rarely used in frozen embryo cycles. Evidence confirming whether letrozole-stimulated (LS) protocol is suitable for frozen embryo transfer in patients with PCOS and for whom is suitable remains lacking.

Methods

This was a retrospective cohort study involving all frozen embryo transfer cycles with LS and HRT for PCOS during the period from Jan 2019 to December 2020 at a tertiary care center. Multivariate Logistic regression was used to analyze the differences in clinical pregnancy rate, live birth rate, miscarriage rate, the incidence of other pregnancy and obstetric outcomes between LS and HRT protocols after adjusting for possible confounding factors. Subgroup analysis was used to explore the population for which LS protocol was suitable.

Results

The results of multivariate logistic regression showed that LS was significantly associated with a higher clinical pregnancy rate (70.9% vs. 64.4%;aOR:1.41, 95%CI: 1.18,1.68), live birth rate (60.5% vs. 51.4% aOR:1.49, 95%CI: 1.27,1.76), and a lower risk of miscarriage (14.7% vs. 20.1% aOR: 0.68, 95%CI: 0.53,0.89), hypertensive disorders of pregnancy (6.7% vs. 8.9% aOR: 0.63, 95%CI: 0.42,0.95), and gestational diabetes mellitus (16.7% vs. 20.7% aOR:0.71, 95%CI: 0.53,0.93) than HRT. There were no significant differences in other outcomes such as preterm birth, cesarean delivery, small for gestational age, or large for gestational age between the two endometrial preparation protocols. Subgroup analysis showed that LS had higher live birth rates than HRT in most of the subgroups; in the three subgroups of maternal age ≥ 35 years, menstrual cycle < 35 days, and no insulin resistance, the live birth rates of the two endometrial preparation protocols were comparable.

Conclusions

LS protocol could improve the live birth rate and reduce the incidence of miscarriage, hypertensive disorders of pregnancy and gestational diabetes mellitus in patients with PCOS. LS protocol is suitable for all types of patients with PCOS. LS should be considered the preferred endometrial preparation protocol for women with PCOS.
Adherence to treatment and parents’ perspective about effectiveness of melatonin in children with autism spectrum disorder and sleep disturbances
Authors: Sadeh Hadar , Meiri Gal , Zigdon Dikla , Ilan Michal , Faroy Michal , Michaelovski Analya , Sadaka Yair , Dinstein Ilan , Menashe Idan
Published: October 2023

Objective

Melatonin is considered an effective pharmacological treatment for the sleep disturbances that are reported in > 50% of children with autism spectrum disorder (ASD). However, real-life data about the long-term course and effectiveness of melatonin treatment in children with ASD is lacking.

Methods

In this retrospective cohort study, we assessed the adherence to melatonin treatment and parents’ perspective of its effect on sleep quality and daytime behavior in children with ASD via a parental phone survey of children in the Azrieli National Center for Autism and Neurodevelopment Research (ANCAN) database. Cox regression analysis was used to assess the effect of key demographic and clinical characteristics on treatment adherence.

Results

Melatonin was recommended for ~ 8% of children in the ANCAN database. These children were characterized by more severe symptoms of autism. The median adherence time for melatonin treatment exceeded 88 months, with the most common reason for discontinuation being a lack of effectiveness (14%). Mild side-effects were reported in 14% of children, and 86%, 54%, and 45% experienced improvements in sleep onset, sleep duration and night awakenings, respectively. Notably, melatonin also improved the daytime behaviors of > 28% of the children. Adherence to treatment was independently associated with improvements in night awakenings and educational functioning (aHR = 0.142, 95%CI = 0.036–0.565; and aHR = 0.195, 95%CI = 0.047–0.806, respectively).

Conclusions

Based on parents’ report, melatonin is a safe and effective treatment that improves both sleep difficulties and daily behavior of children with ASD.
The mediation role of resilience and postpartum traumatic stress disorder on parental attachment and the maternal-infant bonding
Authors: Nie Rong , Pan Mengxia , Liu Xinwen
Published: October 2023

Aims

This study aimed to evaluate the correlation between parental attachment, resilience, postpartum traumatic stress disorder (PTSD), and maternal-infant bonding at 1 to 3 months postpartum. The mediation effect of resilience and PTSD on the postpartum parental attachment and maternal-infant bond was also evaluated.

Design

A cross-sectional research design was used.

Methods

A total of 400 postpartum women examined at a tertiary hospital in Wuhan from January 2021 to June 2021 were enrolled in the study. At about 1 to 3 months after giving birth, the women were asked to complete the Postpartum Bonding Questionnaire (PBQ), Connor-Davidson Resilience scale(CD-RISC), PTSD CheckList-Civilian version (PCL-C), and the Parental Bonding Instrument (PBI). The data were summarized using descriptive statistics. Mediation analyse and the Spearman correlation (r) were used to correlate the resilience and PTSD questionnaire scores.

Results

The care attachment dimension was significantly associated with resilience (r = 0.24, p < 0.01), PTSD (r = − 0.27, p < 0.01), and maternal-infant bonding (r = 0.10, p < 0.01), and the overprotection attachment dimension was significantly associated with resilience (r = − 0.11, p < 0.01), PTSD (r = 0.33, p < 0.01), and maternal-infant bonding (r = 0.16, p < 0.01). Resilience and PTSD can mediate the relationship between attachment and maternal-infant bonding.

Conclusion

Parental attachment, resilience, and PTSD significantly affect maternal-infant bonding at 1 to 3 months postpartum.

Impact

This study demonstrated that new interventions aimed at addressing PTSD symptoms and improving resilience might increase parental attachment and maternal-infant bonding after birth. However, further research is required to evaluate the success of these interventions.
Examination of head versus body heading may help clarify the extent to which animal movement pathways are structured by environmental cues?
Authors: Gunner Richard M. , Wilson Rory P. , Holton Mark D. , Bennett Nigel C. , Alagaili Abdulaziz N. , Bertelsen Mads F. , Mohammed Osama B. , Wang Tobias , Manger Paul R. , Ismael Khairi , Scantlebury D. Michael
Published: October 2023

Understanding the processes that determine how animals allocate time to space is a major challenge, although it is acknowledged that summed animal movement pathways over time must define space-time use. The critical question is then, what processes structure these pathways? Following the idea that turns within pathways might be based on environmentally determined decisions, we equipped Arabian oryx with head- and body-mounted tags to determine how they orientated their heads – which we posit is indicative of them assessing the environment – in relation to their movement paths, to investigate the role of environment scanning in path tortuosity. After simulating predators to verify that oryx look directly at objects of interest, we recorded that, during routine movement, > 60% of all turns in the animals’ paths, before being executed, were preceded by a change in head heading that was not immediately mirrored by the body heading: The path turn angle (as indicated by the body heading) correlated with a prior change in head heading (with head heading being mirrored by subsequent turns in the path) twenty-one times more than when path turns occurred due to the animals adopting a body heading that went in the opposite direction to the change in head heading. Although we could not determine what the objects of interest were, and therefore the proposed reasons for turning, we suggest that this reflects the use of cephalic senses to detect advantageous environmental features (e.g. food) or to detect detrimental features (e.g. predators). The results of our pilot study suggest how turns might emerge in animal pathways and we propose that examination of points of inflection in highly resolved animal paths could represent decisions in landscapes and their examination could enhance our understanding of how animal pathways are structured.
Chatbots and robots: a framework for the self-management of occupational stress
Authors: Yorita Akihiro , Egerton Simon , Chan Carina , Kubota Naoyuki
Published: October 2023

We have developed a stress management framework aimed at helping healthcare professionals manage occupational stress. A chatbot is used to gather pertinent information from a user through regular conversation which is processed via a fuzzy inference model to derive their level of occupational Comprehensibility, Manageability, Meaningful and overall occupational Sense of Coherence (SOC). This analysis feeds into a Peer Support model which selects the best intervention aimed at enhancing a user’s stress-coping abilities and reducing their levels of occupational stress. A trial has been conducted with working adults, and the results were examined using a questionnaire supported by Technology Acceptance Model, which showed that the chatbot could recognize the user's SOC, but left a challenge: few users wanted to continue using it in their daily lives.
Comparison of digital and traditional skin wound closure assessment methods in mice
Authors: Huang Coco X. , Siwan Elisha , Fox Sarah L. , Longfield Matilda , Twigg Stephen M. , Min Danqing
Published: October 2023

Background

Chronic skin wounds are a common complication of many diseases such as diabetes. Various traditional methods for assessing skin wound closure are used in animal studies, including wound tracing, calliper measurements and histological analysis. However, these methods have poorly defined wound closure or practical limitations. Digital image analysis of wounds is an increasingly popular, accessible alternative, but it is unclear whether digital assessment is consistent with traditional methods. This study aimed to optimise and compare digital wound closure assessment with traditional methods, using a diabetic mouse model. Diabetes was induced in male C57BL/6J mice by high-fat diet feeding combined with low dose (65 mg/kg of body weight) streptozotocin injections. Mice fed normal chow were included as controls. After 18 weeks, four circular full-thickness dorsal skin wounds of 4 mm diameter were created per mouse. The wounds were photographed and measured by callipers. Wound closure rate (WCR) was digitally assessed by two reporters using two methods: wound outline (WCR-O) and re-epithelialisation (WCR-E). Wounded skin tissues were collected at 10-days post-wounding and wound width was measured from haematoxylin and eosin-stained skin tissue.

Results

Between reporters, WCR-O was more consistent than WCR-E, and WCR-O correlated with calliper measurements. Histological analysis supported digital assessments, especially WCR-E, when wounds were histologically closed.

Conclusions

WCR-O could replace calliper measurements to measure skin wound closure, but WCR-E assessment requires further refinement. Small animal studies of skin wound healing can greatly benefit from standardised definitions of wound closure and more consistent digital assessment protocols.
Future of Treatment of Adolescents and Young Adults With ALL: A Vision for Collaboration and Equity
Authors: Newman Haley , Hunger Stephen P.
Published: October 2023

Over the past several decades, survival of children with ALL has improved dramatically with treatment regimens refined through cooperative group trials. Despite aggressive treatment and iterative therapy changes for adolescents and young adults (AYAs), improvement has not been as promising. Comparisons between pediatric and adult clinical trials have consistently demonstrated superior outcomes for AYAs treated on pediatric ALL protocols, leading to the implementation of pediatric-inspired ALL protocols by several groups worldwide and/or expansion of the age limit of pediatric trials to include the full spectrum of the AYA population. Despite these efforts, AYAs in both pediatric and adult settings continue to have inferior survival compared with younger children with ALL. Real-world data suggest that uptake of pediatric-style treatment is variable, and even with identical pediatric-style treatment, AYAs still fare worse than younger children. As we enter an era of immunotherapy and precision medicine for newly diagnosed ALL, now is an opportune time to consider how best to approach future therapy for AYA patients. Comparisons of pediatric and adult treatment approaches and subanalyses of AYA patients will help guide harmonization of treatment. The focus of the next stage of ALL therapy for AYA should not only involve novel treatment approaches but also standardization and optimization of supportive care measures, psychosocial support, adherence interventions, oncofertility treatment, and survivorship care. All these efforts should simultaneously work to address health disparities to ensure that a future of improved outcomes is experienced equitably for all AYA patients.
Targeted Epidural Blood Patch Injection Through a Mini-Open Approach for Treatment of Spontaneous Intracranial Hypotension
Authors: Abboud Tammam , Behme Daniel , Schatlo Bawarjan , Rohde Veit , von der Brelie Christian
Published: October 2023

BACKGROUND AND OBJECTIVES:

Spontaneous intracranial hypotension is recognized as a cause for refractory headache. Treatment can range from blind blood patch injection to microsurgical repair of the cerebrospinal fluid (CSF) leak. The objective of the study was to investigate the safety and efficacy of the targeted blood patch injection (TBPI) technique through a mini-open approach in treatment of refractory intracranial hypotension.

METHODS:

We retrospectively reviewed cases of 20 patients who were treated for spontaneous intracranial hypotension at our institute between 2011 and 2022. Head and spine MRI and whole-spine myelography were performed in an attempt to localize the CSF leak. All patients underwent implantation of two epidural drains above and beneath the index level through a minimally invasive interlaminar microsurgical approach under general anesthesia. Then, blood patch was injected under clinical surveillance. Treatment success and surgical complications were evaluated postoperatively and at follow-up.

RESULTS:

Patients presented with orthostatic headache, vertigo, sensory deficits, and hypacusis (95%, 15%, 15%, and 10%, respectively). Subdural effusions were present in 65% of the cases. A CSF leak was identified in all patients. The exact site of the CSF leak could be identified in 80% of cases. TBPI was performed with an average blood amount of 37.5 mL. A significant improvement of symptoms was reported in 90% of the cases. A total of 15% of the patients showed recurrent symptoms and underwent a second TBPI, resulting in symptom relief. No therapy-related complications were reported.

CONCLUSION:

TBPI is a safe and efficient treatment for spontaneous intracranial hypotension. It is performed in a minimally invasive procedure and can be repeated, if necessary, with a very low-risk profile.
Anemonefishes: A model system for evolutionary genomics
Authors: Herrera Marcela , Ravasi Timothy , Laudet Vincent
Published: October 2023

Anemonefishes are an iconic group of coral reef fish particularly known for their mutualistic relationship with sea anemones. This mutualism is especially intriguing as it likely prompted the rapid diversification of anemonefish. Understanding the genomic architecture underlying this process has indeed become one of the holy grails of evolutionary research in these fishes. Recently, anemonefishes have also been used as a model system to study the molecular basis of highly complex traits such as color patterning, social sex change, larval dispersal and life span. Extensive genomic resources including several high-quality reference genomes, a linkage map, and various genetic tools have indeed enabled the identification of genomic features controlling some of these fascinating attributes, but also provided insights into the molecular mechanisms underlying adaptive responses to changing environments. Here, we review the latest findings and new avenues of research that have led to this group of fish being regarded as a model for evolutionary genomics.
Case Report: Placental site trophoblastic tumor revealed by a clinical pelvic abscess
Authors: Nesrine Souayeh , Bettaieb Hajer , Mbarki Wael , Ehsen Ben Brahim , Imen Helal , Mehdi Ben Nasr , Hedhili Oueslati , Najeh Hsayaoui , Mbarki Chaouki
Published: October 2023

We report an uncommon clinical presentation of a placental site trophoblastic tumor. The patient presented initially with abdominal pain with, fever, bleeding and pelvic mass on ultrasonography leading to the wrong diagnosis of a pelvic abscess. Dilation and curettage were performed and pathological examination confirmed the diagnosis. of placental site trophoblastic tumor. Therefore, she underwent abdominal hysterectomy. Four years after surgery, the patient is still disease free. Gestational trophoblastic diseases should be considered in every patient presenting abnormal uterine bleeding after delivery or pregnancy loss despite the associated symptoms being very unusual.
Unit Commitment Problem with Energy Storage Under Correlated Renewables Uncertainty
Authors: Cordera Felipe , Moreno Rodrigo , Ordoñez Fernando
Published: October 2023

Unit Commitment Problem with Energy Storage Under Correlated Renewables Uncertainty” introduces a novel approach to address the challenges of renewable integration. The study acknowledges the growing variability and correlation in power availability due to renewable generation and proposes a day-ahead unit commitment (UC) problem formulation that incorporates energy storage and considers multistage correlated uncertainty. Using a variant of the stochastic dual dynamic programming (SDDP) method, which can handle temporal correlations effectively, the researchers solve the complex UC problem. Results obtained from the IEEE 118-bus system demonstrate the significant advantages of considering multistage uncertainty and correlations. Applying their approach to the Chilean power system, the researchers present superior UC solutions that adapt generation to changing uncertainty at a lower cost. Additionally, they propose a more efficient deterministic UC solution that outperforms current industry practices. These advancements promise to enhance the integration of renewable energy sources, enabling a more sustainable and environmentally friendly future.
Pelatihan Video Editing untuk Menunjang Pengembangan Perangkat Live Streaming Studio Portable Cerdas di Pondok Pesantren Qomaruddin Gresik
Authors: Mardiyanto Ronny , Hutagalung Ruth Johana , Yunardi Riky Tri , Agung Riza , Muharom Syahri , Purwanto Djoko , Dikairono Rudy , Rivai Muhammad , Attamimi Muhammad , Mujiono Totok , Kuswidiastuti Devy
Published: October 2023

Permasalahan yang ada di beberapa pondok pesantren di Jawa Timur, khususnya di Pondok Pesantren Qomaruddin Gresik adalah adanya kesenjangan teknologi dan potensi daerah yang belum dikelola secara profesional. Metode dakwah yang selama ini dilakukan masih menggunakan metode konvensional, yaitu berkumpul di sebuah tempat (masjid/mushola), kemudian para santri menyimak ajaran-ajaran yang disampaikan oleh seorang Kiai atau Ustaz. Digitalisasi setiap kajian/pengajian akan menyebarkan nilai media dakwah menjadi lebih luas. Monetisasi melalui platform seperti Youtube, Facebook, atau media lain dapat menjadi pemasukan tambahan bagi pondok pesantren. Pengabdian kepada masyarakat ini yaitu memberikan pelatihan video editing yang akan mendukung pengembangan perangkat live streaming studio portable cerdas dan menggali Informasi untuk memastikan solusi yang diterapkan tepat dan relevan dengan kebutuhan yang ada. Kegiatan ini telah dilakukan pada hari Selasa, 11 Juli 2023 di Pondok Pesantren Qomaruddin Gresik. Hasil survei kepuasaan menunjukkan bahwa kegiatan ini sangat bermanfaat dan perlu dilanjutkan.
Starting to unravel the mystery behind necroptosis in Alzheimer's disease: the role of MEG3
Authors: Palmer Sarah Jane
Published: October 2023

The mystery surrounding Alzheimer's disease leaves many questions surrounding the neuroscientific underpinnings of the disease trajectory and the exact process by which cell death occurs. We are one step closer to finding out some answers to the many questions about these fundamental issues, thanks to Balusu et al (2023) whose paper has been recently published in Science.
Using data to understand neurology services
Authors: Thomas Sue , Lawton George
Published: October 2023

Data, information and research are key to understanding health services and identifying areas for improvement. Without reliable, up-to-date data on activity, outcomes and spending, health and care services cannot be effectively monitored and held to account. Sue Thomas and George Lawton outline how data is currently used, giving examples of how one type of data, Hospital Episode Statistics, can be used. The current transformation of NHS services will require everyone to be data aware. In neurology, the launch of a new online national adult neurology data dashboard will support integrated care boards (ICBs) to monitor key neurological conditions. This is one of the ICB tools being developed for the NHS neurology transformation agenda, which will raise greater awareness of the need for ICBs to ensure neurology has a much greater profile in the future.
Research Roundup
Authors: McLoughlin Alison
Published: October 2023

Alison McLoughlin provides a synopsis and brief review of a selection of recently published research articles that are of interest to neuroscience nurses, highlighting key points to keep you up to date; a full reference is provided for those who wish to read the research in more detail
8. Sınıf Matematik Ders Kitaplarının Zihnin Geometrik Alışkanlıklarına Göre Karşılaştırmalı Analizi
Authors: CANAVCI Halil , ÇONTAY Emine Gaye
Published: October 2023

Bu araştırmada 2013 ve 2018 matematik öğretim programları kapsamında kullanılan Millî Eğitim Bakanlığı onaylı iki farklı 8. sınıf matematik ders kitabının geometri ve ölçme öğrenme alanlarında yer alan örneklerde Zihnin Geometrik Alışkanlıkları (ZGA) kullanımı bakımından karşılaştırılması amaçlanmıştır. 2013 öğretim programı kapsamında 2016-2017 eğitim öğretim yılında kullanılan, 2018 öğretim programı kapsamında ise 2022-2023 eğitim öğretim yılında kullanılan bir 8. sınıf matematik ders kitabı seçilerek incelenmiştir. Doküman incelemesi yöntemiyle gerçekleştirilen çalışmada ders kitaplarının geometri ve ölçme öğrenme alanında yer alan toplam 185 örnek zihnin geometrik alışkanlıkları alt bileşenlerine (ilişkilendirme, geometrik fikirleri genelleme, değişmezleri araştırma, keşfetme ve yansıtma dengesi kurma) göre sınıflandırılmıştır. Araştırma sonucunda iki farklı öğretim programı kapsamında kullanılan ders kitabındaki örneklerde en çok ilişkilendirme, en az geometrik fikirleri genelleme alışkanlığının kullanıldığı görülmüştür. Ders kitaplarının üçgenler, eşlik ve benzerlik, geometrik cisimler alt öğrenme alanlarındaki örneklerde ZGA kullanımı benzer dağılım gösterirken dönüşüm geometrisi alt öğrenme alanındaki dağılımın farklılık gösterdiği tespit edilmiştir. Birden fazla ZGA gözlenen ve ZGA gözlenmeyen örneklerin oranı da farklı bulunmuştur.
Synthesis and Crystal Structure of Novel [(u-OCH6) (u-Cl) bis-[(bipy) (Cl)Cu(II)]]Complex
Authors: Ghalbuoun Fatima A. , Abuhmaiera Ramadan G. , Treish Fathia A. , Alakrash Wedad A. , Elmehdawi Ramadan Mohamed
Published: October 2023

A novel title complex [(µ-chlorido)(µ-methoxido- O)bis-[(2,2´-bipy-k2N,N´)(chlorido) Copper(II)]] crystallizes in the monoclinic space group C2/c with unit cell parameters, a = 14.4775(2)Å, b =11.118(2)Å, c = 13.1617(2)Å, α= 90º, β=92º and γ= 90º,have two very similar distorted square-pyramidal [Cu2(2,2´-bpy)2Cl3(OCH6)] (1) chromophores adopting 4+1 geometrical arrangement. The u-OCH6 and u-Cl bridges occupy a crystallographic inversion center. The novelty of this complex stems from the occupancy site (s.o.f = 0.5) of the unusual six H-atoms of the methoxy bridging group. The bridging Cl-atom occupied the axial site of the distorted square-pyramidal, which is significantly longer than the rest of the other four-basal sites. Due to axial site occupation by Cl-bridging, the two bpy-ligands lie almost perpendicular to each other. The packing structure of the title complex reveals that this structure contains inter-and intra-molecular H-bonds and ꙥ-ꙥ- intermolecular interactions.
Situating halal: religiosity, identity and lifestyle in halal consumption in the United Kingdom and United Arab Emirates
Authors: Miele Mara , Lever John , Evans Adrian , Fuseini Awal
Published: October 2023

In this paper we draw on a study of Muslim consumer perceptions and concerns about halal labels and certification practices in two affluent countries: the United Kingdom (UK) (where Muslims are a minority of the population) and United Arab Emirates (UAE) (where Muslims are the majority). The study looked at a stratified sample of 330 Muslim consumers in each country. Our analysis points to a growing demand for variety alongside increasing concern for the presence of food additives, genetically modified organisms (GMOs), and alcohol in both cases. Expanding demands to label food and other commodities suitable for Muslims with information about quality and standards of production (Gauthier, 2021) are globalising trends, which Muslims everywhere engage with through ‘an Islamic lens – halal’ (Turaeva and Brose, 2020: 301). Our paper wants to address the gap in the literature that very little is known about how consumers perceive the halal concept regarding foodstuffs (see Demirci et al, 2016), and we argue that the expansion and segmentation of halal markets suggests that religious consumerism is affected by religious groups, and also by supply chain actors, and that these markets cannot be controlled by religious authorities. Our research findings provide fresh insight into the existing understanding of religion and consumption, pointing to the geographical specificities of processes of politicisation of halal consumption: the rise of new Muslim youth subcultures in the UK and the coexistence of growing processes of secularisation with ‘halalisation’ in the UAE.
Regresos a la Iberia Queer
Authors: Mérida Jiménez Rafael M.
Published: October 2023

Abstract: El presente artículo ofrece una aproximación al foro "Return to Queer Iberia," publicado en La corónica en 2001, y a la compilación que lo suscitó en primera instancia, Queer Iberia: Sexualities, Cultures, and Crossings from the Middle Ages to the Renaissance (1999). El propósito de estas páginas es brindar un conjunto de reflexiones sobre la originalidad de ambas publicaciones, el papel desempeñado por los estudios queer en los estudios hispánicos medievales y contemporáneos y su impacto a lo largo de estas dos décadas, de la mano de algunas aportaciones significativas, tanto en España como en Estados Unidos.