bluuebunny/crossref_metadata_2025 huggingface dataset:
Common difference: Conceptualising simultaneity and racial sincerity in Jewish-Muslim relations in the United Kingdom
Authors: Egorova Yulia
Published: August 2023

Building upon ethnographic research conducted among participants in UK-based initiatives in Jewish-Muslim dialogue, the paper contributes to anthropological literature on the essentialising nature of state-sponsored constructions of minoritised groups. More specifically, I put forward two sets of arguments. Firstly, I suggest a concept of simultaneity that challenges colonially inflected conceptualisations of the relationship between communities and their respective traditions. Activists of Jewish-Muslim inter-community work subvert dominant conceptualisations of intergroup commonalities and divergencies by developing a theorisation of Jewish-Muslim relations that acknowledges group similarities and differences as overlapping categories. Secondly, I contribute to John Jackson's (2005) theorisation of racial sincerity, a notion offering a conceptual challenge to the notion of authenticity. I argue that the complexity of my interlocutors’ thematisations of Jewish-Muslim relations underpinned by the diversity of the sources of knowledge that they rely on could be best understood as an example of this analytic. On a broader theoretical plane, the paper proposes a framework that underscores the agentive power of minority communities and pays close attention to the way they define their positionalities vis-à-vis the majorities and each other in ways that go beyond binaries-based theorisations.
Investigation on the applicability of parameters identification of marine diesel engine SCR kinetic model based on Discrete-Grid algorithm
Authors: Xia Chong , Zhu Yuanqing , Shreka Majed , Zhang Guangwei , Zhou Song , Feng Yongming , Shi Jie
Published: August 2023

Selective catalytic reduction (SCR) technology is the most widely used denitrification method in industry. However, the calibration of its kinetic model is very problematic due to the large number of parameters involved and the nonlinear characteristics, especially for the undesired reactions such as formation-decomposition of ammonium nitrate (AN), ammonium sulfate (AS), ammonium bisulfate (ABS), etc. In this paper, the synthetic gas test bench and the SCR system of WD10 marine diesel engine burning high-sulfur fuel oil (HSFO) and low-sulfur fuel oil (LSFO) are taken as the research objects. Firstly, based on the experimental data obtained from the synthetic gas test bench, the pre-exponential multiplier and activation energy of each reaction were identified using the Discrete-Grid algorithm. In this work, considering that the production of N2O, SO3, AN, AS, and ABS in the undesired reactions is very low, not on the same order of magnitude as that of NO and NH3, it is easy to overlook their reaction characteristics in the optimization process. We have adopted an approach that amplifies the error between the predicted concentration and the observed concentration of the species to solve this problem. Secondly, a detailed and complete SCR kinetic model was constructed. Finally, with the parameter identification results obtained from the synthesis gas bench as initial values, all the kinetic parameters of the WD10 marine engine SCR model was calibrated simultaneously using the Discrete-Grid algorithm. The results showed that the SCR kinetic model derived from the synthetic gas test bench was suitable for the real marine engine SCR system when the range of temperature and space velocity (SV) of the synthetic gas bench test is similar to that of the marine SCR system.
Linguistic racism: Origins and implications
Authors: May Stephen
Published: August 2023

This special issue of Ethnicities focuses on the phenomenon of linguistic racism. Linguistic racism constitutes the intersection of language, race/ism, and in/equality, as seen in racialized discourses on the relative status of languages and bi/multilingual language use, particularly as these are directed toward non-dominant language speakers. The theoretical framings underpinning the contributions in this issue draw on sociological discussions of critical race theory, and sociolinguistic and linguistic anthropological discussions of language ideologies, linguistic racism, and raciolinguistics. Racialized discourses of language (use) are situated within sociohistorical and sociopolitical contexts, grounded in nationalism and colonialism, that privilege dominant national and international languages, public monolingualism, and native-speaker competence in those languages. In contrast, related linguistic hierarchies of prestige pathologize the language uses of non-dominant language – often Indigenous and/or bi/multilingual – speakers and construct their language use in both overtly and covertly racialized terms. The result is regular linguistic discrimination and subordination experienced by non-dominant language speakers, inevitably framed within wider racialized institutional and everyday discursive practices. The contributions herein explore these issues in relation to Indigenous and other non-dominant language use(s), and their (mis)representation, in the media, workplace, and academia, in the contexts of New Zealand, Australia, Bangladesh, Canada, and the United States.
Recommendations toward an antiracist engineering: Informing an institutional agenda to enhance Black engineering student experiences
Authors: Coley Brooke , Maitra Debalina , McClain Trevonte
Published: August 2023

This qualitative study collected recommendations provided by Black doctoral students in engineering to explicitly inform the institutional efforts necessary to enhance their academic experiences. This process has informed what needs to be done to support Black students through their direct accounts that provided in-depth understanding of the impactful yet missing components in their engineering pursuits, and especially, at the Ph.D. level. Situated in the theories of racialized organizations, this community-based participatory action research project conducted semi-structured interviews with n = 24 Black doctoral students enrolled in engineering programs across the United States (and one abroad). Four recommendations themes emerged from our analysis: (1) a vital need for greater representation of Black scholars across roles in engineering communities; (2) capacity for awareness, acknowledgment, and accountability of/for the lived experience of Black scholars in engineering; (3) more intentional institutional efforts to support Black scholar communities and connection; and (4) a need for re-envisioning institutional policies and practices impacting Black scholars. This paper will address that which Black students identify as missing in engineering academic environments that, if addressed, could stand to drastically improve the lived experience of Black engineering students. Institutions must be proactive in their accountability for the wellness and success for all students and can start by taking heed to the recommendations of Black doctoral students, specifically.
Determinants of Career Exits and Career Breaks in Women's Professional Basketball
Authors: Jepsen Christopher
Published: August 2023

Although economists regularly use sports to study labor-market outcomes, nearly all sports-related studies focus on men. Instead, this paper looks at career breaks and career exits for women's basketball, with a focus on race/ethnicity and country of birth. Data are from the start of the Women's National Basketball Association in 1997 through the 2019 season. White players and foreign-born players have higher likelihoods of leaving the league, conditional on player demographics and productivity.
The medium is accountable: Metacommunication and media ideologies about voice messages in WhatsApp chats
Authors: Sampietro Agnese , König Katharina
Published: August 2023

Voice messages (VMs), which allow users to send recorded messages to other contacts, are a popular feature of instant messaging applications. Despite their popularity, linguistic research on VMs is still in its infancy. This study analyses metacommunication around VMs in mobile messaging conversations among WhatsApp users in Germany and Spain. It focuses on participants’ metacommunicative accounts (such as references, explanations, or motivations) of their preference for audio posting over other forms of communication (e.g. texting). Drawing on recent advances in digital conversation analysis, we examine how accounts placed in different sequential positions in messenger chats (preceding a VM, at the beginning or end of a VM, or after it has been sent) address diverse aspects of voice messaging (from either the sender’s or recipient’s perspective). We demonstrate that accounting accomplishes different social actions, such as framing a VM as something outstanding or worth apologising for. We argue that a sequential analysis of accounting and metacommunication offers rich insights into users’ media ideologies concerning the appropriateness and timing of text and voice messaging. Overall, these findings contribute to a better understanding of the growing importance of voice in mobile communication.
Two New Meroterpenoid Derivatives From Sargassum macrocarpum With Their Anti-Oxidant Activities
Authors: Kim Ji-Yul , Choi Dae-Cheol , Lee Jeong Min , Kim Hyun-Soo , Ki Dae-Won , Ko Seok-Chun , Yim Mi-Jin , Oh Gun-Woo , Kim Kyung Woo , Kim Chul Hwan , Lee Kyung , Baek Kyunghwa , Lee Dae-Sung
Published: August 2023

Objective: The purpose of this study was to search for novel secondary metabolites present in the marine brown alga, Sargassum macrocarpum C. Agardh. Methods: The methanolic extract of S. macrocarpum was partitioned and fractionated using a silica gel column, medium pressure liquid chromatography, and preparative-high performance liquid chromatography to obtain four compounds (1-4). These structures were elucidated using nuclear magnetic resonance spectroscopic and high resolution-electrospray ionization-mass spectroscopy methods. The isolated compounds were evaluated for their anti-oxidant activities using 2,2′-azinobis (3-ethylbenzothiazoline-6-sulfonic acid) (ABTS) and 1,1-diphenyl-2-picrylhydrazyl (DPPH) radicals. Result: Two undescribed meroterpenoid derivatives (1 and 2), together with two known racemic meroterpenoids (3 and 4) were isolated from the methanolic extract of S. macrocarpum. All compounds were confirmed to be meroterpenoid derivatives. All these compounds exhibited ABTS and DPPH radical scavenging activities. Conclusions: The four meroterpenoids (1-4) were isolated from S. macrocarpum. Compound 3 showed the most anti-oxidant effect with IC50 values of 9.9 (ABTS radical) and 22.4 μM (DPPH radical), respectively.
Phenolic Constituents of Elsholtzia blanda Benth
Authors: Dung Duong Thi , Yen Pham Hai , Trang Do Thi , Tai Bui Huu , Kiem Phan Van
Published: August 2023

Objectives: Elsholtzia blanda Benth. is a Vietnamese medicinal plant, used to treat inflammation, cough, and flu. Therefore, this current study focused on the isolation of the active ingredients from this plant and their NO production inhibitory activity. Methods: E. blanda aerial parts were dried, minced, and ultrasonically extracted with methanol and further separated by various chromatographic methods. The chemical structures of isolates were revealed by nuclear magnetic resonance, high resolution lectrospray ionization mass spectrometry, and circular dichroism spectra. The nitric oxide inhibition effects were evaluated in lipopolysaccharide-activated RAW264.7 cells. Results: Ten phenolic components [1 new (1) and 9 known (2-10)] were isolated and their chemical structures determined. Compound 5 (innovanoside, IC50 = 19.23 ± 1.43 µM) and 6 (maltol- O- β-D-glucopyranoside, IC50 = 21.73 ± 1.27 µM) showed the highest activity, and 2-4 showed moderate inhibition (IC50 = 47.36 ∼ 57.29 µM). The other compounds were inactive with IC50 values >100 µM. Conclusions: One previously undescribed and 9 known phenolic components isolated from E. blanda have been screened for their nitric oxide inhibitory activity. Compounds 2-6 showed moderate to significant inhibition with IC50 values of 19.23∼57.29 µM.
A predictive decision support system for coronavirus disease 2019 response management and medical logistic planning
Authors: Atek Sofiane , Bianchini Filippo , De Vito Corrado , Cardinale Vincenzo , Novelli Simone , Pesaresi Cristiano , Eugeni Marco , Mecella Massimo , Rescio Antonello , Petronzio Luca , Vincenzi Aldo , Pistillo Pasquale , Giusto Gianfranco , Pasquali Giorgio , Alvaro Domenico , Villari Paolo , Mancini Marco , Gaudenzi Paolo
Published: August 2023

Objective

Coronavirus disease 2019 demonstrated the inconsistencies in adequately responding to biological threats on a global scale due to a lack of powerful tools for assessing various factors in the formation of the epidemic situation and its forecasting. Decision support systems have a role in overcoming the challenges in health monitoring systems in light of current or future epidemic outbreaks. This paper focuses on some applied examples of logistic planning, a key service of the Earth Cognitive System for Coronavirus Disease 2019 project, here presented, evidencing the added value of artificial intelligence algorithms towards predictive hypotheses in tackling health emergencies.

Methods

Earth Cognitive System for Coronavirus Disease 2019 is a decision support system designed to support healthcare institutions in monitoring, management and forecasting activities through artificial intelligence, social media analytics, geospatial analysis and satellite imaging. The monitoring, management and prediction of medical equipment logistic needs rely on machine learning to predict the regional risk classification colour codes, the emergency rooms attendances, and the forecast of regional medical supplies, synergically enhancing geospatial and temporal dimensions.

Results

The overall performance of the regional risk colour code classifier yielded a high value of the macro-average F1-score (0.82) and an accuracy of 85%. The prediction of the emergency rooms attendances for the Lazio region yielded a very low root mean square error (<11 patients) and a high positive correlation with the actual values for the major hospitals of the Lazio region which admit about 90% of the region's patients. The prediction of the medicinal purchases for the regions of Lazio and Piemonte has yielded a low root mean squared percentage error of 16%.

Conclusions

Accurate forecasting of the evolution of new cases and drug utilisation enables the resulting excess demand throughout the supply chain to be managed more effectively. Forecasting during a pandemic becomes essential for effective government decision-making, managing supply chain resources, and for informing tough policy decisions.
Rectovaginal Fistula Repair Following Vaginoplasty in Transgender Females: A Systematic Review of Surgical Techniques
Authors: Lava Christian X. , Huffman Samuel S. , Berger Lauren E. , Marable Julian K. , Spoer Daisy L. , Fan Kenneth L. , Lisle David M. , Del Corral Gabriel A.
Published: August 2023

Background: Rectovaginal fistula (RVF) remains a complex complication following gender-affirming vaginoplasty. This review aims to evaluate RVF repair techniques and outcomes following vaginoplasty. Methods: A systematic review was performed per PRISMA guidelines. Ovid MEDLINE, Ovid EMBASE, Cochrane, and Web of Science were queried for records pertaining to RVF repair following vaginoplasty. Study characteristics, operative details, and demographics were collected. Outcomes included RVF repair method, recurrence rate, and complications. Results: Among 282 screened citations, 17 articles representing 41 patients were included. Rectovaginal fistula repair methods identified included 4 conservative management approaches (n = 12 patients), primary closure with or without fistulectomy and ostomy (n = 22), 10 reconstructive surgical techniques (n = 18). The most common reconstructive techniques were V-Y full-thickness advancement with rectal flap (n = 5) and infragluteal fasciocutaneous flap (n = 4). Median time to recurrence was 6 months (interquartile range 7.5). Reported RVF repair complications included RVF recurrence (n = 5, 14.7%) and wound complication or dehiscence (n = 2, 5.88%). Three cases of RVF recurred after primary closure with or without fistulectomy and ostomy, while 2 cases of recurrence followed reconstruction. Conclusion: There remains a high level of variability in the approach to RVF repair following vaginoplasty. Reconstructive surgical techniques may be a more optimal solution without necessitating ostomies, but this decision must be considered in the context of RVF location, individual patient expectations, and clinical presentation.
Music Streaming in the P–12 Music Classroom: A Scoping Review
Authors: Sullivan Corey
Published: August 2023

The purpose of this scoping review was to synthesize literature regarding audio streaming in the P–12 music classroom by identifying the varied uses, recommendations for equitable access, and gaps in the knowledge base. A total of 23 publications met the criteria for inclusion. Ensemble and general music classrooms in elementary, middle, and high school contexts were represented in the literature with exemplification of concepts, genres, styles, and techniques evident as the most common usage. YouTube, Spotify, and Pandora were frequently referenced as streaming platforms. Authors cited inexpensive or free platforms and ubiquity of access most frequently when referencing equity and streaming. Most authors made no reference to potential access impediments. I identified gaps in the literature, including the uses of streamed music in jazz classrooms, performer compensation, diversity of content, barriers to student access, potential solutions to equitable access issues, and music perception differences for those with limited access.
Molecular complex detection in protein interaction networks through reinforcement learning
Authors: Palukuri Meghana V. , Patil Ridhi S. , Marcotte Edward M.
Published: August 2023

Background

Proteins often assemble into higher-order complexes to perform their biological functions. Such protein–protein interactions (PPI) are often experimentally measured for pairs of proteins and summarized in a weighted PPI network, to which community detection algorithms can be applied to define the various higher-order protein complexes. Current methods include unsupervised and supervised approaches, often assuming that protein complexes manifest only as dense subgraphs. Utilizing supervised approaches, the focus is not on how to find them in a network, but only on learning which subgraphs correspond to complexes, currently solved using heuristics. However, learning to walk trajectories on a network to identify protein complexes leads naturally to a reinforcement learning (RL) approach, a strategy not extensively explored for community detection. Here, we develop and evaluate a reinforcement learning pipeline for community detection on weighted protein–protein interaction networks to detect new protein complexes. The algorithm is trained to calculate the value of different subgraphs encountered while walking on the network to reconstruct known complexes. A distributed prediction algorithm then scales the RL pipeline to search for novel protein complexes on large PPI networks.

Results

The reinforcement learning pipeline is applied to a human PPI network consisting of 8k proteins and 60k PPI, which results in 1,157 protein complexes. The method demonstrated competitive accuracy with improved speed compared to previous algorithms. We highlight protein complexes such as C4orf19, C18orf21, and KIAA1522 which are currently minimally characterized. Additionally, the results suggest TMC04 be a putative additional subunit of the KICSTOR complex and confirm the involvement of C15orf41 in a higher-order complex with HIRA, CDAN1, ASF1A, and by 3D structural modeling.

Conclusions

Reinforcement learning offers several distinct advantages for community detection, including scalability and knowledge of the walk trajectories defining those communities. Applied to currently available human protein interaction networks, this method had comparable accuracy with other algorithms and notable savings in computational time, and in turn, led to clear predictions of protein function and interactions for several uncharacterized human proteins.
Common antibiotics, azithromycin and amoxicillin, affect gut metagenomics within a household
Authors: Chopyk Jessica , Cobián Güemes Ana Georgina , Ramirez-Sanchez Claudia , Attai Hedieh , Ly Melissa , Jones Marcus B. , Liu Roland , Liu Chenyu , Yang Kun , Tu Xin M. , Abeles Shira R. , Nelson Karen , Pride David T.
Published: August 2023

Background

The microbiome of the human gut serves a role in a number of physiological processes, but can be altered through effects of age, diet, and disturbances such as antibiotics. Several studies have demonstrated that commonly used antibiotics can have sustained impacts on the diversity and the composition of the gut microbiome. The impact of the two most overused antibiotics, azithromycin, and amoxicillin, in the human microbiome has not been thoroughly described. In this study, we recruited a group of individuals and unrelated controls to decipher the effects of the commonly used antibiotics amoxicillin and azithromycin on their gut microbiomes.

Results

We characterized the gut microbiomes by metagenomic sequencing followed by characterization of the resulting microbial communities. We found that there were clear and sustained effects of the antibiotics on the gut microbial community with significant alterations in the representations of Bifidobacterium species in response to azithromycin (macrolide antibiotic). These results were supported by significant increases identified in putative antibiotic resistance genes associated with macrolide resistance. Importantly, we did not identify these trends in the unrelated control individuals. There were no significant changes observed in other members of the microbial community.

Conclusions

As we continue to focus on the role that the gut microbiome plays and how disturbances induced by antibiotics might affect our overall health, elucidating members of the community most affected by their use is of critical importance to understanding the impacts of common antibiotics on those who take them.

Clinical Trial Registration Number NCT05169255. This trial was retrospectively registered on 23–12-2021.
Biofilm stimulating activity of solanidine and Solasodine in Pseudomonas aeruginosa
Authors: Noori Hadi Ghoomdost , Tadjrobehkar Omid , Moazamian Elham
Published: August 2023

Background

Biofilm formation has reported as an important virulence associated properties of Pseudomonas aeruginosa that is regulated by quorum-sensing associated genes. Biofilm and quorum-sensing interfering properties of steroidal alkaloids, Solanidine and Solasodine were investigated in the present study.

Results

Biofilm formation capacity and relative expression level of five studied genes(lasI, lasR, rhlI, rhlR and algD) were significantly increased dose-dependently after treatment with sub-inhibitory concentrations (32 and 512 µg/ml) of the both Solanidine and Solasodine. Biofilm formation capacity was more stimulated in weak biofilm formers(9 iaolates) in comparison to the strong biofilm producers(11 isolates). The lasI gene was the most induced QS-associated gene among five investigated genes.

Conclusion

Biofilm inducing properties of the plants alkaloids and probably medicines derived from them has to be considered for revision of therapeutic guidelines. Investigating the biofilm stimulating properties of corticosteroids and other medicines that comes from plant alkaloids also strongly proposed.
Tracking of serum lipids in healthy children on a year-to-year basis
Authors: Maidowski Ludwig , Kiess Wieland , Baber Ronny , Dathan-Stumpf Anne , Ceglarek Uta , Vogel Mandy
Published: August 2023

Objectives

To assess the stability of lipid profiles throughout childhood and evaluate their onset and dynamic.

Materials and methods

Lipid markers were longitudinally measured in more than 1300 healthy children from the LIFE Child study (Germany) and categorized into normal, at-risk, or adverse. Year-to-year intra-person persistence of the categories during follow-ups was examined and Pearson’s correlation coefficient was calculated.

Results

We found strong positive correlations for TC, LDL-C and ApoB (r > 0.75, p < 0.001) from the age of four years. Correlations were lowest during the first two years of life. Most children with normal levels also had normal levels the following year. Children with at-risk levels showed a tendency towards normal levels at the follow-up visit. Adverse levels of TC, LDL-C, ApoB (all ages), and HDL-C (from age 15) persisted in more than half of the affected children. Age-dependent patterns of stability were most pronounced and similar for TC, LDL-C, and ApoB.

Conclusions

Normal levels of serum lipids show high stability and adverse levels stabilized in early childhood for TC, LDL, and ApoB. At-risk and adverse levels of TC, LDL-C or ApoB may warrant further or repeated diagnostic measurements with regards to preventing CVD in the long run.
Improving paramedic responses for patients dying at home: a theory of change-based approach
Authors: Simpson Jane , Remawi Bader Nael , Potts Kieran , Blackmore Tania , French Maddy , Haydock Karen , Peters Richard , Hill Michael , Tidball Oliver-Jon , Parker Georgina , Waddington Michelle , Preston Nancy
Published: August 2023

Background

Paramedics are increasingly being called to attend patients dying from advanced incurable conditions. However, confidence to deal with such calls varies, with many feeling relatively unskilled in this aspect of their role. A number of interventions have been piloted to improve their skills in end-of-life care (EoLC) but without a fully specified theoretical model. Theory of Change models can provide theoretical and testable links from intervention activities to proposed long-term outcomes and indicate the areas for assessment of effectiveness. This study aimed to develop an intervention for improving paramedic EoLC for patients in the community.

Methods

A Theory of Change approach was used as the overarching theoretical framework for developing an intervention to improve paramedic end-of-life skills. Nine stakeholders - including specialist community paramedics, ambulance call handlers and palliative care specialists - were recruited to five consecutive online workshops, ranging between 60 and 90 min. Each workshop had 2–3 facilitators. Over multiple workshops, stakeholders decided on the desired impact, short- and long-term outcomes, and possible interventions. During and between these workshops a Theory of Change model was created, with the components shared with stakeholders.

Results

The stakeholders agreed the desired impact was to provide consistent, holistic, patient-centred, and effective EoLC. Four potential long-term outcomes were suggested: (1) increased use of anticipatory and regular end-of-life medications; (2) reduced end-of-life clinical and medication errors; (3) reduced unnecessary hospitalisations; (4) increased concordance between patient preferred and actual place of death. Key interventions focused on providing immediate information on what to do in such situations including: appraising the situation, developing an algorithm for a treatment plan (including whether or not to convey to hospital) and how to identify ongoing support in the community.

Conclusions

A Theory of Change approach was effective at identifying impact, outcomes, and the important features of an end-of-life intervention for paramedics. This study identified the need for paramedics to have immediate access to information and resources to support EoLC, which the workshop stakeholders are now seeking to develop as an intervention.
Evaluating and improving real-world evidence with Targeted Learning
Authors: Gruber Susan , Phillips Rachael V. , Lee Hana , Concato John , van der Laan Mark
Published: August 2023

Background

The Targeted Learning roadmap provides a systematic guide for generating and evaluating real-world evidence (RWE). From a regulatory perspective, RWE arises from diverse sources such as randomized controlled trials that make use of real-world data, observational studies, and other study designs. This paper illustrates a principled approach to assessing the validity and interpretability of RWE.

Methods

We applied the roadmap to a published observational study of the dose–response association between ritodrine hydrochloride and pulmonary edema among women pregnant with twins in Japan. The goal was to identify barriers to causal effect estimation beyond unmeasured confounding reported by the study's authors, and to explore potential options for overcoming the barriers that robustify results.

Results

Following the roadmap raised issues that led us to formulate alternative causal questions that produced more reliable, interpretable RWE. The process revealed a lack of information in the available data to identify a causal dose–response curve. However, under explicit assumptions the effect of treatment with any amount of ritodrine versus none, albeit a less ambitious parameter, can be estimated from data.

Conclusions

Before RWE can be used in support of clinical and regulatory decision-making, its quality and reliability must be systematically evaluated. The TL roadmap prescribes how to carry out a thorough, transparent, and realistic assessment of RWE. We recommend this approach be a routine part of any decision-making process.
Safety and feasibility of transcutaneous vagus nerve stimulation in mild cognitive impairment: VINCI-AD study protocol
Authors: Dolphin Helena , Dyer Adam H. , Dukelow Tim , Finucane Ciaran , Commins Sean , Kennelly Sean P
Published: August 2023

Background

Over 55 million adults are living with dementia globally, which is projected to reach 157 million by 2050. Mild cognitive impairment (MCI), a syndrome of memory impairment with intact activities of daily living, may precede dementia by several years. Around 5–15% of individuals with MCI convert to dementia annually. Novel treatments which delay progression of MCI to dementia are urgently needed. Transcutaneous vagal nerve stimulation (tVNS) is a non-invasive neuromodulation technique that targets the vagus nerve. Importantly, tVNS has been shown to improve cognition in healthy volunteers, but has not been extensively examined as a potential therapeutic approach in MCI. VINCI-AD will examine the safety and feasibility of tVNS in older adults with MCI.

Design

VINCI-AD is an investigator-led, single-site, single-blind, sham-controlled crossover pilot study which aims to assess the safety and feasibility of tVNS in 40 participants with amnestic MCI. All participants will attend for three consecutive study visits during which they will be randomised to receive no stimulation (baseline), active tVNS stimulation (stimulation at cymba conchae of left ear) or sham tVNS stimulation (at earlobe). Safety will be primarily assessed by ascertainment of adverse events. Further safety assessment will examine the impact of acute tVNS on subjective (orthostatic symptoms), peripheral (finometry-based blood pressure) and central (assessed via Near Infrared Spectroscopy [NIRS]) haemodynamic responses to active stand. Feasibility will be determined using a custom-designed occupational assessment of device usability. Exploratory secondary analysis in VINCI-AD will examine the potential impact of acute tVNS on associative memory, spatial memory and inhibitory control to inform sample size estimates for future trials of tVNS in older adults with MCI.

Discussion

VINCI-AD will report on the safety (adverse events/haemodynamic responses to active stand) and feasibility of tVNS as a potential therapeutic option in MCI. Detailed reporting of study eligibility and completion rates will be reported. Exploratory analysis will examine the potential cognitive benefits of acute tVNS on cognitive function in MCI to report potential effect sizes that may inform future clinical trials in this cohort.

Trial registration

https://clinicaltrials.gov/ct2/show/NCT05514756. Trial Registration Number NCT05514756 (24th August 2022 for this protocol, version 1.0.)
Predicting adverse outcomes in pregnant patients positive for SARS-CoV-2: a machine learning approach- a retrospective cohort study
Authors: Young Dylan , Houshmand Bita , Tan Chunyi Christie , Kirubarajan Abirami , Parbhakar Ashna , Dada Jazleen , Whittle Wendy , Sobel Mara L. , Gomez Luis M. , Rüdiger Mario , Pecks Ulrich , Oppelt Peter , Ray Joel G. , Hobson Sebastian R. , Snelgrove John W. , D’Souza Rohan , Kashef Rasha , Sussman Dafna
Published: August 2023

Background

Pregnant people are particularly vulnerable to SARS-CoV-2 infection and to ensuing severe illness. Predicting adverse maternal and perinatal outcomes could aid clinicians in deciding on hospital admission and early initiation of treatment in affected individuals, streamlining the triaging processes.

Methods

An international repository of 1501 SARS-CoV-2-positive cases in pregnancy was created, consisting of demographic variables, patient comorbidities, laboratory markers, respiratory parameters, and COVID-19-related symptoms. Data were filtered, preprocessed, and feature selection methods were used to obtain the optimal feature subset for training a variety of machine learning models to predict maternal or fetal/neonatal death or critical illness.

Results

The Random Forest model demonstrated the best performance among the trained models, correctly identifying 83.3% of the high-risk patients and 92.5% of the low-risk patients, with an overall accuracy of 89.0%, an AUC of 0.90 (95% Confidence Interval 0.83 to 0.95), and a recall, precision, and F1 score of 0.85, 0.94, and 0.89, respectively. This was achieved using a feature subset of 25 features containing patient characteristics, symptoms, clinical signs, and laboratory markers. These included maternal BMI, gravidity, parity, existence of pre-existing conditions, nicotine exposure, anti-hypertensive medication administration, fetal malformations, antenatal corticosteroid administration, presence of dyspnea, sore throat, fever, fatigue, duration of symptom phase, existence of COVID-19-related pneumonia, need for maternal oxygen administration, disease-related inpatient treatment, and lab markers including sFLT-1/PlGF ratio, platelet count, and LDH.

Conclusions

We present the first COVID-19 prognostication pipeline specifically for pregnant patients while utilizing a large SARS-CoV-2 in pregnancy data repository. Our model accurately identifies those at risk of severe illness or clinical deterioration, presenting a promising tool for advancing personalized medicine in pregnant patients with COVID-19.
Predicting maternal healthcare seeking behaviour in Afghanistan: exploring sociodemographic factors and women’s knowledge of severity of illness
Authors: Tawfiq Essa , Azimi Mohammad Daud , Feroz Aeraj , Hadad Ahmad Shakir , Soroush Mohammad Samim , Jafari Massoma , Yaftali Marzia Salam , Saeedzai Sayed Ataullah
Published: August 2023

Background

Little is known whether women’s knowledge of perceived severity of illness and sociodemographic characteristics of women influence healthcare seeking behavior for maternal health services in Afghanistan. The aim of this study was to address this knowledge gap.

Methods

Data were used from the Afghanistan Health Survey 2018. Women’s knowledge in terms of danger signs or symptoms during pregnancy was assessed. The signs or symptoms were bleeding, swelling of the body, headache, fever, or any other danger sign or symptom (e.g., high blood pressure). A categorical variable of knowledge score was created. The outcome variables were defined as ≥ 4 ANC vs. 0–3 ANC; ≥ 4 PNC vs. 0–3 PNC visits; institutional vs. non-institutional deliveries. A multivariable generalized linear model (GLM) was used.

Results

Data were used from 9,190 ever-married women, aged 13–49 years, who gave birth in the past two years. It was found that 56%, 22% and 2% of women sought healthcare for institutional delivery, ≥ 4 ANC, ≥ 4 PNC visits, respectively, and that women’s knowledge is a strong predictor of healthcare seeking [odds ratio (OR)1.77(1.54–2.05), 2.28(1.99–2.61), and 2.78 (2.34–3.32) on knowledge of 1, 2, and 3–5 signs or symptoms, respectively, in women with ≥ 4 ANC visits when compared with women who knew none of the signs or symptoms. In women with ≥ 4 PNC visits, it was 1.80(1.12–2.90), 2.22(1.42–3.48), and 3.33(2.00–5.54), respectively. In women with institutional deliveries, it was 1.49(1.32–1.68), 2.02(1.78–2.28), and 2.34(1.95–2.79), respectively. Other strong predictors were women’s education level, multiparity, residential areas (urban vs. rural), socioeconomic status, access to mass media (radio, TV, the internet), access of women to health workers for birth, and decision-making for women where to deliver. However, age of women was not a strong predictor.

Conclusion

Our findings suggest that pregnant women’s healthcare seeking behaviour is influenced by women’s knowledge of danger signs and symptoms during pregnancy, women’s education, socioeconomic status, access to media, husband’s, in-laws’ and relatives’ decisions, residential area, multiparity, and access to health workers. The findings have implications for promoting safe motherhood and childbirth practices through improving women’s knowledge, education, and social status.
Successful post-term pregnancy in scared bicornuate uterus: case report
Authors: Moltot Tebabere , Lemma Tesfanesh , Silesh Mulualem , Sisay Moges , Tsegaw Birhan
Published: August 2023

Pregnancies in the bicornuate uterus are usually considered high-risk because of their association with poor reproductive outcomes such as recurrent pregnancy loss, cervical insufficiency, low birthweight, preterm birth, malpresentation, cesarean delivery, and uterine rupture. The objective of the report was to show that patients with a scared bicornuate uterus at post-term could have successful pregnancy outcomes. We are presenting a 28-year-old gravida III para II lady with a bicornuate scared uterus at post-term. She has a history of early third-trimester pregnancy loss, and her second pregnancy was delivered via cesarean section. In her first pregnancy, the patient's uterus was not identified as bicornuate. However, an ultrasound during her second pregnancy revealed that she had a bicornuate uterus, which led to the diagnosis. At term, the lady had a successful cesarean section. Lastly, for the current post-term pregnancy she had no prenatal check-up. Even though this, she was coming at the latent first stage of labor and an emergency cesarean section was done.

Conclusion Successful outcomes could be achieved in patients with the bicornuate uterus at post-term gestation.
Two-sample Mendelian randomization study does not reveal a significant relationship between cytomegalovirus (CMV) infection and autism spectrum disorder
Authors: Zhang Mengna , Ming Ying , Du Yunling , Xin Ziyuan
Published: August 2023

Background

Autism spectrum disorder (ASD) is a neurodevelopmental disorder affecting ~ 2% of children worldwide and is characterized by repetitive, stereotypical behaviours and impaired expressive communication. Cytomegalovirus (CMV) is considered a risk factor for ASD; however, published studies are usually limited by covering too few events and have different conclusions, indicating that the relationship between CMV infection and ASD remains elusive.

Methods

To investigate the association between CMV infection and ASD, we conducted this 2-sample Mendelian randomization (MR) study using genome-wide association studies (GWAS) summary data from FinnGen and the IEU Open GWAS project.

Results

Our results showed no significant relationship between all 3 CMV infections (unspecified cytomegaloviral diseases, anti-CMV IgG levels, and maternal CMV) and ASD.

Conclusions

Our results indicate that CMV infection does not significantly increase ASD risk. These results show that the relationship between CMV infection and ASD remains elusive and needs to be further clarified.
Mental well-being and patient activation during the first eight months of the COVID-19 pandemic in Denmark - a cohort study among 710 Danish adults with chronic conditions
Authors: Nielsen Berit Kjærside , Nielsen Pernille Bjørnholt , Mejdahl Caroline Trillingsgaard , Nielsen Lise Arnth , Nielsen Camilla Palmhøj , Maindal Helle Terkildsen , Wolf Michael
Published: August 2023

Background

COVID-19 has highlighted the importance of patient activation in managing chronic conditions and promoting resilience during times of crisis. Patient activation refers to an individual’s knowledge, skills, and confidence in managing their own health and healthcare. Previous research has shown that people with higher levels of patient activation are better prepared to navigate the challenges of chronic illness and are more likely to engage in healthy behaviors. However, the impact of patient activation on COVID-19-related concerns and mental well-being among people with chronic conditions during the pandemic remains unclear. This study aims to investigate the possible role of patient activation in shaping COVID-19-related concerns and to describe changes in mental well-being among Danish adults with one or more chronic conditions during the early months of the pandemic.

Methods

Danish adults with chronic conditions (e.g. diabetes, coronary heart disease, obstructive pulmonary lung disease, cancer) who had participated in a municipal health education program prior to the COVID-19 outbreak were asked to participate in this prospective questionnaire study in May 2020 and November 2020. Sociodemographic (sex, age, living status, educational attainment, employment status) and disease-related information (diagnosis, one or more chronic conditions) along with the Patient Activation Measure were collected before the outbreak and were obtained from a clinical database used for monitoring and evaluation of municipal health education programs. In contrast, the two questionnaires collected six months apart consisted of single items related to concerns about COVID-19 and the WHO-5 well-being index.

Results

A total of 710 people with chronic conditions (mean age 60.9 years; 55.8% female) participated at both time points. In bivariate analyses, patient activation was associated with COVID-19-related concern and well-being. At follow-up, participants experienced a significant decrease in well-being. The decrease was associated with poorer well-being measured six months earlier, a greater perception that it had become more challenging to take care of one’s health due to the pandemic, and finally, feeling lonely. The association between patient activation and well-being ceased to be significant in the multivariate regression model.

Conclusions

A considerable proportion of people with chronic conditions participating in this study have been mentally burdened during COVID-19. Although lower levels of patient activation were associated with greater COVID-19-related concerns, it did not have a significant impact on mental well-being over time.
Sexual behavior and self-declaration of sexual orientation among people 18–64 years in Brazil: results from the Knowledge, Attitudes, and Practices survey, 2013 and the National Health Survey, 2019
Authors: Szwarcwald Célia Landmann , Pascom Ana Roberta Pati , de Souza Júnior Paulo Roberto Borges , Damacena Giseli Nogueira , Castilho Euclides Ayres
Published: August 2023

Background

Population surveys involving the monitoring of high-risk sexual behavior have been recognized as important public health tools to control the HIV epidemic and other sexually transmitted infections (STIs).

Methods

Using data from the Knowledge, Attitudes, and Practices survey (PCAP-2013) and from the National Health Survey (PNS-2019), indicators of sexual behavior were compared according to sociodemographic characteristics among individuals aged 18–64 years, including size (%) estimates of men who have sex with men (MSM) and women who have sex with women (WSW). Specifically, the PNS-2019 prevalence estimates of homosexual, bisexual, heterosexual males and females were compared with those from the PCAP-2013. To compare PCAP and PNS proportional distributions, the Pearson's chi-square test, adjusted by the Rao-Scott’s correction, was applied.

Results

Size (%) estimates of MSM and WSW obtained by direct questions from the PCAP-2013, showed higher homosexuality prevalence estimates than those resulting from the PNS-2019 self-declared sexual orientation. Significant differences were found between the MSM proportions according to the PCAP-2013 (3.7%; 95% CI 3.1–4.4%) and to the PNS-2019 (2.2%; 95% CI 1.9–2.5), and between the WSW proportions (4.6%; 95% CI 4.0–5.4%) and (2.1%; 95% CI 1.8–2.4), respectively. Results from both surveys showed MSM and WSW prevalence estimates increase with educational level, decrease with age, and is larger among people who do not live with partner, live in urban areas and in state capitals. Regarding condom use at last sexual intercourse, no differences between the PCAP-2013 and the PNS-2019 estimates were found at the national level, but significant improvements were found for MSM, people aged 18–24 and 25–34 years, and individuals not living with a partner.

Conclusions

The underestimation of MSM and WSW prevalence by self-declared sexual orientation suggests that sexual minorities face many difficulties related to disclosing their sexuality and reinforces the importance of developing public health interventions for changing population attitudes and promoting sexual orientation disclosure. Moreover, the low use of condoms in both surveys (PCAP-2013 and PNS-2019) carried out 6 years apart highlights the need of public policies to expand prevention strategies for HIV infection and other STIs.
Characteristics of older patients with postmenopausal osteoporosis who developed loss of muscle mass during the COVID-19 pandemic – a case–control study
Authors: Tanaka Masaru , Kanayama Masahiro , Hashimoto Tomoyuki , Oha Fumihiro , Shimamura Yukitoshi , Tsujimoto Takeru , Hasegawa Yuichi , Endo Tsutomu , Nojiri Hidetoshi , Ishijima Muneaki
Published: August 2023

Background

Under the restriction of social activities during the coronavirus disease 2019 (COVID-19) pandemic, there was concern about the loss of muscle mass due to a decrease in physical activity for the elderly. The purpose of this study was to investigate the characteristics of older patients with postmenopausal osteoporosis who developed loss of muscle mass during the COVID-19 pandemic in Japan.

Methods

A total of 54 patients with postmenopausal osteoporosis were evaluated in this study. Whole-body dual-energy X-ray absorptiometry was performed pre- and post-COVID-19 pandemic to measure trunk and lower limb muscle mass. At the time of the post-COVID-19 pandemic, we conducted a survey to compare lifestyle before pandemic (the frequency of going out, the frequency of meeting acquaintances or families living apart, regular exercise habits, walking time, family structure), and comorbidities between the muscle mass loss (ML) group and the muscle mass maintenance (MM) group. The ML group consisted of patients with at least a 5% decrease in lower limb muscle mass or trunk muscle mass.

Results

A significant difference was found only for the family structure (P = 0.0279); in the ML group, those living alone were the largest group, while in the MM group they were the smallest group.

Conclusions

The ML group was significantly more likely to live alone than the MM group. The current study showed that loss of muscle mass was more common in patients living alone.