bluuebunny/crossref_metadata_2025 huggingface dataset:
Perceptual-Motor Efficiency and Concussion History Are Prospectively Associated With Injury Occurrences Among High School and Collegiate American Football Players
Authors: Wilkerson Gary B. , Bruce Jeremy R. , Wilson Andrew W. , Huang Neal , Sartipi Mina , Acocello Shellie N. , Hogg Jennifer A. , Mansouri Misagh
Published: October 2021

Background:

After a sport-related concussion (SRC), the risk for lower extremity injury is approximately 2 times greater, and the risk for another SRC may be as much as 3 to 5 times greater.

Purpose:

To assess the predictive validity of screening methods for identification of individual athletes who possess an elevated risk of SRC.

Study Design:

Case-control study; Level of evidence, 3.

Methods:

Metrics derived from a smartphone flanker test software application and self-ratings of both musculoskeletal function and overall wellness were acquired from American high school and college football players before study participation. Occurrences of core or lower extremity injury (CLEI) and SRC were documented for all practice sessions and games for 1 season. Receiver operating characteristic and logistic regression analyses were used to identify variables that provided the greatest predictive accuracy for CLEI or SRC occurrence.

Results:

Overall, there were 87 high school and 74 American college football players included in this study. At least 1 CLEI was sustained by 45% (39/87) of high school players and 55% (41/74) of college players. Predictors of CLEI included the flanker test conflict effect ≥69 milliseconds (odds ratio [OR], 2.12; 90% CI, 1.24-3.62) and a self-reported lifetime history of SRC (OR, 1.70; 90% CI, 0.90-3.23). Of players with neither risk factor, only 38% (29/77) sustained CLEI compared with 61% (51/84) of players with 1 or both of the risk factors (OR, 2.56; 90% CI, 1.50-4.36). SRC was sustained by 7 high school players and 3 college players. Predictors of SRC included the Overall Wellness Index score ≤78 (OR, 9.83; 90% CI, 3.17-30.50), number of postconcussion symptoms ≥4 (OR, 8.35; 90% CI, 2.71-25.72), the Sport Fitness Index score ≤78 (OR, 5.16; 90% CI, 1.70-15.65), history of SRC (OR, 4.03; 90% CI, 1.35-12.03), and the flanker test inverse efficiency ratio ≥1.7 (OR, 3.19; 90% CI, 1.08-9.47).

Conclusion:

Survey responses and smartphone flanker test metrics predicted greater injury incidence among individual football players classified as high-risk compared with that for players with a low-risk profile.
Relevance Interventions in the Classroom: A Means to Promote Students’ Homework Motivation and Behavior
Authors: Flunger Barbara , Gaspard Hanna , Häfner Isabelle , Brisson Brigitte M. , Dicke Anna-Lena , Parrisius Cora , Nagengast Benjamin , Trautwein Ulrich
Published: October 2021

Many students suffer from motivational problems when doing homework. To investigate whether an intervention that effectively promoted value beliefs in mathematics promoted students’ homework motivation and behavior, we analyzed data from a cluster randomized controlled study with two classroom-based relevance interventions (writing a text or evaluating quotes from interviews) with 82 classrooms and 1,978 ninth-grade students. Students’ math-specific homework motivation and behavior were assessed with homework diaries over a period of 4 weeks after the intervention. Latent growth curve analyses revealed that students in the text condition reported higher triggered interest but also lower homework completion than students in the control condition in the first week after the intervention. Students in the quotations condition reported higher utility of homework for future life, and higher homework effort directly after the intervention. The study highlights the potential of classroom-based relevance interventions to foster homework-specific outcomes, when considering situational, behavior-related measures.
Enhancing Value by Continuously Improving Enterprise Culture
Authors: Fisher Nicholas I. , Lunn Peter D. , Sasse Stephen M.
Published: October 2021

An invaluable feature of the approach developed by AT&T to providing superior value to their customers has been the best-practice process that drove the cycle of continuous improvement, based on the concept of a value tree. This process has since lent itself readily to the task of creating superior value for other stakeholders. Culture and its various categories such as safety culture or risk culture are key drivers of value for several different stakeholder groups. The purpose of this article is to show how the same stakeholder value management process, with a judicious adaptation of a value tree, works well when applied to the task of managing culture, and so opens up new pathways for managers to explore in the endless pursuit of business improvement. A comparative analysis demonstrates how it improves on other current methods in widespread use, in particular avoiding a shortcoming in the wide range of methods deriving from the Safety Awareness Questionnaire.
The state of platinum in pyrrhotite: X-ray absorption spectroscopy study and implications for the role of Fe sulfides as platinum carriers
Authors: Filimonova Olga N. , Trigub Alexander L. , Nickolsky Maximilian S. , Chareev Dmitriy A. , Kvashnina Kristina O. , Kovalchuk Elena V. , Vikentyev Ilya V. , Reukov Vladimir L. , Tagirov Boris R.
Published: October 2021

Pyrrhotite Fe1–xS is the main sulfide component of platinum-group element (PGE) ores and commonly contains from a few tenths to a few dozen ppm of disseminated Pt. Here we report an X-ray absorption spectroscopy investigation into the state of Pt in synthetic pyrrhotite in combination with theoretical spectra modelling. The pyrrhotite crystals were obtained by means of the salt flux technique, using a eutectic mixture of alkali metal halides as the transport media. Analysis of the chemical composition of synthesised crystals showed that an increase of the temperature and sulfur fugacity yields higher concentrations of Pt in pyrrhotite. The Pt content reached 0.6 wt.% at the maximum temperature and sulfur fugacity (t= 720°C, log$f_{{\rm S}_ 2}$= –0.1) achieved in a Pt-saturated system. X-ray absorption near-edge structure (XANES) analysis of PtL3-edge spectra revealed that Pt is present in pyrrhotite in the 4+ and 2+ ‘formal’ oxidation states. Theoretical modelling of XANES and interpretation of extended X-ray absorption fine structure (EXAFS) spectra showed that Pt4+substitutes for Fe in the crystal lattice of pyrrhotite, whereas Pt2+forms PtS-like clusters disseminated in the pyrrhotite matrix. Atoms of isomorphous Pt4+are surrounded by 6 S atoms at a distance of 2.39 ± 0.02 Å. According to theoretical simulations using theFDMNESprogram, the second coordination sphere of the solid-solution Pt contains one vacancy in the Fe sublattice within the Fe-layer. The Pt2+S-like clusters can be considered as a quench product. High sulfur fugacity stabilises the solid-solution Pt and prevents the formation of the PtS-like clusters during cooling. The maximum content of the solid-solution Pt in pyrrhotite is ca. 50 times lower than in pyrite and can be approximated by a straight line in the logC(Pt)vs. 1/Tplot, it increases from 1 ppm at 350°C to 3 wt.% at 900°C.
Quality-improvement project to reduce actual fasting times for fluids and solids before induction of anaesthesia
Authors: Witt Lars , Lehmann Barbara , Sümpelmann Robert , Dennhardt Nils , Beck Christiane E.
Published: October 2021

Background

Despite well-defined recommendations, prolonged fasting times for clear fluids and solids are still common before elective surgery in adults. Extended fasting times may lead to discomfort, thirst, hunger and physiological dysfunctions. Previous studies have shown that prolonged fasting times are frequently caused by patients being misinformed as well as inadequate implementation of the current guidelines by medical staff.

This study aimed to explore how long elective surgery patients fast in a German secondary care hospital before and after the introduction of an educational note for patients and re-training for the medical staff.

Methods

A total of 1002 patients were enrolled in this prospective, non-randomised interventional study. According to the power calculation, in the first part of the study actual fasting times for clear fluids and solids were documented in 502 consecutive patients, verbally instructed as usual regarding the recommended fasting times for clear fluids (2 h) and solids (6 h). Subsequently, we implemented additionally to the verbal instruction a written educational note for the patients, including the recommended fasting times. Furthermore, the medical staff was re-trained regarding the fasting times using emails, newsletters and employee meetings. Thereafter, another 500 patients were included in the study.

We hypothesised, that after these quality improvement procedures, actual fasting times for clear fluids and solids would be more accurate on time.

Results

Actual fasting times for clear fluids were in the median 11.3 (interquartile range 6.8–14.3; range 1.5–25.5) h pre-intervention, and were significantly reduced to 5.0 (3.0–7.2; 1.5–19.8) h after the intervention (median difference (95%CI) − 5.5 (− 6.0 to − 5.0) h). The actual fasting times for solids also decreased significantly, but only from 14.5 (12.1–17.2; 5.4–48.0) h to 14.0 (12.0–16.3; 5.4–32.0) h after the interventions (median difference (95%CI) − 0.52 (− 1.0 to − 0.07) h).

Conclusions

The study showed considerably extended actual fasting times in elective adult surgical patients, which were significantly reduced by simple educational/training interventions. However, the actual fasting times still remained considerably longer than defined in recommended guidelines, meaning further process optimisations like obligatory fluid intake in the early morning are necessary to improve patient comfort and safety in future.

Trial registration

German registry of clinical studies (DRKS-ID: DRKS 00020530, retrospectively registered).
The Modified Hospital Elder Life Program (HELP) in geriatric hospitalized patients in internal wards: A double-blind randomized control trial
Authors: Kojaie-Bidgoli A. , Sharifi F. , Maghsoud F. , Alizadeh-Khoei M. , Jafari F. , Sadeghi F.
Published: October 2021

Background

Hospital Elder Life Program (HELP) provides protocols based on factors for reducing delirium. Due to the lack of geriatric wards and aged care teams in Iran, it seems that some of the original HELP interventions need to be modified through a trial study. Hence, this study was conducted to determine whether the Iranian modified HELP could reduce delirium in geriatric hospitalized patients.

Methods

This double-blind randomized controlled trial was designed and conducted in a hospital at Kashan University of Medical Sciences in Iran. A total of 195 hospitalized patients aged ≥70 years, were 84 in the Intervention Group (IG) and 111 in the Control Group (CG). After assessing delirium risk factors, participants in the IG group received interventions based on the cognitive, vision/hearing, sleep, mobility, feeding, and hydration protocols by nursing students and the CG group received routine care.

Delirium incidence was assessed by the Confusion Assessment Method. Delirium incidence, cognitive and functional abilities, frailty, fall, and length of stay were outcomes.

Results

The mean age of the patients was 78.53(Standard Deviation = 5.87) years. Delirium incidence was higher in the CG comparing to IG (14.71% vs 3.66%).Significant reduction observed in risk incidence of delirium because of interventions [Odds Ratio:0.124, Confidence Interval: 0.03–0.48].

Conclusion

The modified HELP effectively reduced delirium rates in geriatric hospitalized patients.

Trial registration

This study was registered at the Iranian Registry of Clinical Trials IRCT20180910040995N1.
Comparison of the 2010 and 2019 diagnostic criteria for sarcopenia by the European Working Group on Sarcopenia in Older People (EWGSOP) in two cohorts of Swedish older adults
Authors: Wallengren Ola , Bosaeus Ingvar , Frändin Kerstin , Lissner Lauren , Falk Erhag Hanna , Wetterberg Hanna , Rydberg Sterner Therese , Rydén Lina , Rothenberg Elisabet , Skoog Ingmar
Published: October 2021

Background

The operational definition of sarcopenia has been updated (EWGSOP2) and apply different cut-off points compared to previous criteria (EWGSOP1). Therefore, we aim to compare the sarcopenia prevalence and the association with mortality and dependence in activities of daily living using the 2010 (EWGSOP1 and 2019 (EWGSOP2 operational definition, applying cut-offs at two levels using T-scores.

Methods

Two birth cohorts, 70 and 85-years-old (n = 884 andn = 157, respectively), were assessed cross-sectionally (57% women). Low grip strength, low muscle mass and slow gait speed were defined below − 2.0 and − 2.5 SD from a young reference population (T-score). Muscle mass was defined as appendicular lean soft tissue index by DXA. The EWGSOP1 and EWGSOP2 were applied and compared with McNemar tests and Cohen’s kappa. All-cause mortality was analyzed with the Cox-proportional hazard model.

Results

Sarcopenia prevalence was 1.4–7.8% in 70-year-olds and 42–62% in 85 years-old’s, depending on diagnostic criteria. Overall, the prevalence of sarcopenia was 0.9–1.0 percentage points lower using the EWGSOP2 compared to EWGSOP1 when applying uniform T-score cut-offs (P <  0.005). The prevalence was doubled (15.0 vs. 7.5%) using the − 2.0 vs. -2.5 T-scores with EWGSOP2 in the whole sample. The increase in prevalence when changing the cut-offs was 5.7% (P <  0.001) in the 70-year-olds and 17.8% (P <  0.001) in the 85-year-olds (EWGSP2). Sarcopenia with cut-offs at − 2.5 T-score was associated with increased mortality (hazard ratio 2.4–2.8,P <  0.05) but not at T-score − 2.0.

Conclusions

The prevalence of sarcopenia was higher in 85-year-olds compared to 70-year-olds. Overall, the differences between the EWGSOP1 and EWGSOP2 classifications are small. Meaningful differences between EWGSOP1 and 2 in the 85-year-olds could not be ruled out. Prevalence was more dependent on cut-offs than on the operational definition.
Establishment of reference intervals of complete blood count for twin pregnancy
Authors: Zeng Yifan , Li Lei , Mao Man , Liang Xinghua , Chen Min , Xia Yong , He Wenyin
Published: October 2021

Background

Twin pregnancy poses a high risk, and its incidence has increased in recent years. Establishment of reference intervals of complete blood count (CBC) for women with twin pregnancies during pregnancy may aid in the prognosis of adverse outcomes.

Methods

The incidence of complications and the intensity associated with adverse outcomes were analyzed in 1153 cases of twin pregnancy. A total of 253 cases in the twin pregnancy reference cohort were screened from all candidates after complications and adverse pregnancy outcomes were excluded. Complete blood count data were collected during the mid- and late-term of pregnancy and analyzed using SPSS to establish the reference intervals for peripheral blood in twin pregnancy.

Results

Premature rupture of the membrane and pelvic inflammatory disease were highly positively correlated with adverse outcomes, with OR values of 3.31 and 3.81, respectively. Within the interval population with normal outcomes, red blood cell (RBC), hemoglobin (HGB), hematocrit (HCT), and platelet (PLT) values were lower in twin-pregnant women during gestation than in healthy nulligravida women, but the levels of white blood cells (WBC), neutrophils (NEU), and the NEU% increased, especially in the mid-term. The reference intervals of late-term pregnancy were validated using 20 twin pregnancies samples, and then utilized to determine the distinctive CBC characteristics in preterm birth (PTB) pregnancy. Absolute WBC and NEU values increased in PTB pregnancy based on our established reference intervals, which suggests that these may might be prognostic indicators of this adverse outcome.

Conclusion

Establishing the reference interval of blood cell-related indicators of normal twin pregnancy is helpful for the monitoring and prognosis of gestation.
Burden of informal care in stroke survivors and its determinants: a prospective observational study in an Asian setting
Authors: Wang Yi , Tyagi Shilpa , Hoenig Helen , Lee Kim En , Venketasubramanian Narayanaswamy , Menon Edward , De Silva Deidre Anne , Yap Philip , Tan Boon Yeow , Young Sherry H. , Ng Yee Sien , Tu Tian Ming , Ang Yan Hoon , Kong Keng He , Singh Rajinder , Merchant Reshma A. , Chang Hui Meng , Ning Chou , Cheong Angela , Koh Gerald Choon-Huat
Published: October 2021

Background

Informal caregiving is an integral part of post-stroke recovery with strenuous caregiving demands often resulting in caregiving burden, threatening sustainability of caregiving and potentially impacting stroke survivor’s outcomes. Our study aimed to examine and quantify objective and subjective informal care burden after stroke; and to explore the factors associated with informal care burden in Singapore.

Methods

Stroke patients and their informal caregivers were recruited from all five tertiary hospitals in Singapore from December 2010 to September 2013. Informal care comprised of assistance provided by informal caregivers with any of the activities of daily living. Informal care burden was measured by patients’ likelihood of requiring informal care, hours of informal care required, and informal caregivers’ Zarit’s Burden Score. We examined informal care burden at 3-months and 12-months post-stroke. Generalized linear regressions were applied with control variables including patients’ and informal caregivers’ demographic characteristics, arrangement of informal care, and patients’ health status including stroke severity (measured using National Institute of Health Stroke Scale), functional status (measured using Modified Rankin Scale), self-reported depression, and common comorbidities.

Results

Three hundred and five patients and 263 patients were examined at 3-months and 12-months. Around 35% were female and 60% were Chinese. Sixty three percent and 49% of the patients required informal care at 3-months and 12-months point, respectively. Among those who required informal care, average hours required per week were 64.3 h at 3-months and 76.6 h at 12-months point. Patients with higher functional dependency were more likely to require informal care at both time points, and required more hours of informal care at 3-months point. Female informal caregivers and those caring for patients with higher functional dependency reported higher Zarit’s Burden. While informal caregivers who worked full-time reported higher burden, those caring for married stroke patients reported lower burden at 3-months point. Informal caregivers who co-cared with foreign domestic workers, i.e.: stay-in migrant female waged domestic workers, reported lower burden.

Conclusions

Informal care burden remains high up to 12-months post-stroke. Factors such as functional dependency, stroke severity, informal caregiver gender and co-caring with foreign domestic workers were associated with informal care burden.
Temporomandibular disorders among medical students in China: prevalence, biological and psychological risk factors
Authors: Wu Jing , Huang Zelun , Chen Yong , Chen Yifan , Pan Zhongqiang , Gu Yu
Published: October 2021

Background

The purpose of the present study is to evaluate the prevalence of temporomandibular disorders (TMD) and their associated biological and psychological factors in Chinese university students.

Methods

A total of 754 students were included from Zunyi Medical University, each participant completed questionnaires and clinical examinations according to the Diagnostic Criteria for Temporomandibular Disorders.

Results

The overall prevalence of TMD was 31.7% among medical students. Subjects with TMD had a high prevalence of bruxism, empty chewing, unilateral chewing, chewing gum, anterior teeth overbite, anterior teeth overjet, depression, anxiety, and sleep disturbance. Moreover, sleep bruxism, empty chewing, unilateral chewing, anterior teeth overbite, depression, and anxiety were the strongest risk factors for TMD.

Conclusions

Individuals with TMD have a high prevalence of psychological distress and oral parafunctional habits. Except for the psychological factors associated with TMD, bruxism, abnormal chewing, and malocclusion also shared similar risks for TMD.
Costs and staffing resource requirements for adaptive clinical trials: quantitative and qualitative results from the Costing Adaptive Trials project
Authors: Wilson Nina , Biggs Katie , Bowden Sarah , Brown Julia , Dimairo Munyaradzi , Flight Laura , Hall Jamie , Hockaday Anna , Jaki Thomas , Lowe Rachel , Murphy Caroline , Pallmann Philip , Pilling Mark A. , Snowdon Claire , Sydes Matthew R. , Villar Sofía S. , Weir Christopher J. , Welburn Jessica , Yap Christina , Maier Rebecca , Hancock Helen , Wason James M. S.
Published: October 2021

Background

Adaptive designs offer great promise in improving the efficiency and patient-benefit of clinical trials. An important barrier to further increased use is a lack of understanding about which additional resources are required to conduct a high-quality adaptive clinical trial, compared to a traditional fixed design.

The Costing Adaptive Trials (CAT) project investigated which additional resources may be required to support adaptive trials.

Methods

We conducted a mock costing exercise amongst seven Clinical Trials Units (CTUs) in the UK. Five scenarios were developed, derived from funded clinical trials, where a non-adaptive version and an adaptive version were described. Each scenario represented a different type of adaptive design.

CTU staff were asked to provide the costs and staff time they estimated would be needed to support the trial, categorised into specified areas (e.g. statistics, data management, trial management). This was calculated separately for the non-adaptive and adaptive version of the trial, allowing paired comparisons.

Interviews with 10 CTU staff who had completed the costing exercise were conducted by qualitative researchers to explore reasons for similarities and differences.

Results

Estimated resources associated with conducting an adaptive trial were always (moderately) higher than for the non-adaptive equivalent. The median increase was between 2 and 4% for all scenarios, except for sample size re-estimation which was 26.5% (as the adaptive design could lead to a lengthened study period). The highest increase was for statistical staff, with lower increases for data management and trial management staff.

The percentage increase in resources varied across different CTUs. The interviews identified possible explanations for differences, including (1) experience in adaptive trials, (2) the complexity of the non-adaptive and adaptive design, and (3) the extent of non-trial specific core infrastructure funding the CTU had.

Conclusions

This work sheds light on additional resources required to adequately support a high-quality adaptive trial. The percentage increase in costs for supporting an adaptive trial was generally modest and should not be a barrier to adaptive designs being cost-effective to use in practice.

Informed by the results of this research, guidance for investigators and funders will be developed on appropriately resourcing adaptive trials.
Bone-targeted erythrocyte-cancer hybrid membrane-camouflaged nanoparticles for enhancing photothermal and hypoxia-activated chemotherapy of bone invasion by OSCC
Authors: Chen Hongying , Deng Jiang , Yao Xintong , He Yungang , Li Hanyue , Jian Zhixiang , Tang Yi , Zhang Xiaoqing , Zhang Jingqing , Dai Hongwei
Published: October 2021

Background

Jaw bones are the most common organs to be invaded by oral malignancies, such as oral squamous cell carcinoma (OSCC), because of their special anatomical relationship. Various serious complications, such as pathological fractures and bone pain can significantly decrease the quality of life or even survival outcomes for a patient. Although chemotherapy is a promising strategy for bone invasion treatment, its clinical applications are limited by the lack of tumor-specific targeting and poor permeability in bone tissue. Therefore, it is necessary to develop a smart bone and cancer dual targeting drug delivery platform.

Results

We designed a dual targeting nano-biomimetic drug delivery vehicle Asp8[H40-TPZ/IR780@(RBC-H)] that has excellent bone and cancer targeting as well as immune escape abilities to treat malignancies in jaw bones. These nanoparticles were camouflaged with a head and neck squamous cell carcinoma WSU-HN6 cell (H) and red blood cell (RBC) hybrid membrane, which were modified by an oligopeptide of eight aspartate acid (Asp8). The spherical morphology and typical core-shell structure of biomimetic nanoparticles were observed by transmission electron microscopy. These nanoparticles exhibited the same surface proteins as those of WSU-HN6 and RBC. Flow cytometry and confocal microscopy showed a greater uptake of the biomimetic nanoparticles when compared to bare H40-PEG nanoparticles. Biodistribution of the nanoparticles in vivo revealed that they were mainly localized in the area of bone invasion by WSU-HN6 cells. Moreover, the Asp8[H40-TPZ/IR780@(RBC-H)] nanoparticles exhibited effective cancer growth inhibition properties when compared to other TPZ or IR780 formulations.

Conclusions

Asp8[H40-TPZ/IR780@(RBC-H)] has bone targeting, tumor-homing and immune escape abilities, therefore, it is an efficient multi-targeting drug delivery platform for achieving precise anti-cancer therapy during bone invasion.

Graphical Abstract
HIV-1 capsid variability: viral exploitation and evasion of capsid-binding molecules
Authors: Saito Akatsuki , Yamashita Masahiro
Published: October 2021

The HIV-1 capsid, a conical shell encasing viral nucleoprotein complexes, is involved in multiple post-entry processes during viral replication. Many host factors can directly bind to the HIV-1 capsid protein (CA) and either promote or prevent HIV-1 infection. The viral capsid is currently being explored as a novel target for therapeutic interventions. In the past few decades, significant progress has been made in our understanding of the capsid–host interactions and mechanisms of action of capsid-targeting antivirals. At the same time, a large number of different viral capsids, which derive from many HIV-1 mutants, naturally occurring variants, or diverse lentiviruses, have been characterized for their interactions with capsid-binding molecules in great detail utilizing various experimental techniques. This review provides an overview of how sequence variation in CA influences phenotypic properties of HIV-1. We will focus on sequence differences that alter capsid–host interactions and give a brief account of drug resistant mutations in CA and their mutational effects on viral phenotypes. Increased knowledge of the sequence-function relationship of CA helps us deepen our understanding of the adaptive potential of the viral capsid.
Multi-dimensional fragmentomic assay for ultrasensitive early detection of colorectal advanced adenoma and adenocarcinoma
Authors: Ma Xiaoji , Chen Yikuan , Tang Wanxiangfu , Bao Hua , Mo Shaobo , Liu Rui , Wu Shuyu , Bao Hairong , Li Yaqi , Zhang Long , Wu Xue , Cai Sanjun , Shao Yang , Liu Fangqi , Peng Junjie
Published: October 2021

Previous studies on liquid biopsy-based early detection of advanced colorectal adenoma (advCRA) or adenocarcinoma (CRC) were limited by low sensitivity. We performed a prospective study to establish an integrated model using fragmentomic profiles of plasma cell-free DNA (cfDNA) for accurately and cost-effectively detecting early-stage CRC and advCRA. The training cohort enrolled 310 participants, including 149 early-stage CRC patients, 46 advCRA patients and 115 healthy controls. Plasma cfDNA samples were prepared for whole-genome sequencing. An ensemble stacked model differentiating healthy controls from advCRA/early-stage CRC patients was trained using five machine learning models and five cfDNA fragmentomic features based on the training cohort. The model was subsequently validated using an independent test cohort (N = 311; including 149 early-stage CRC, 46 advCRA and 116 healthy controls). Our model showed an area under the curve (AUC) of 0.988 for differentiating advCRA/early-stage CRC patients from healthy individuals in an independent test cohort. The model performed even better for identifying early-stage CRC (AUC 0.990) compared to advCRA (AUC 0.982). At 94.8% specificity, the sensitivities for detecting advCRA and early-stage CRC reached 95.7% and 98.0% (0: 94.1%; I: 98.5%), respectively. Promisingly, the detection sensitivity has reached 100% and 97.6% in early-stage CRC patients with negative fecal occult or CEA blood test results, respectively. Finally, our model maintained promising performances (AUC: 0.982, 94.4% sensitivity at 94.8% specificity) even when sequencing depth was down-sampled to 1X. Our integrated predictive model demonstrated an unprecedented detection sensitivity for advCRA and early-stage CRC, shedding light on more accurate noninvasive CRC screening in clinical practice.
Association of anti-oxidative capacity of HDL with subclinical atherosclerosis in subjects with and without non-alcoholic fatty liver disease
Authors: Karami Sara , Poustchi Hossein , Sarmadi Negar , Radmard Amir Reza , Ali Yari Fatemeh , Pakdel Abbas , Shabani Parisa
Published: October 2021

Background

Non-alcoholic fatty liver disease (NAFLD) patients are at a substantial risk for developing cardiovascular disease (CVD). High-density lipoprotein (HDL) is well known to have protective effects against the development of atherosclerotic CVD. One of the major antiatherogenic effects of HDL is its anti-oxidative function.

Objectives

This study investigated the association of anti-oxidative capacity of HDL with subclinical atherosclerosis in NAFLD and non-NAFLD subjects.

Methods

A total of 143 subjects including 51 NAFLD and 92 control subjects were included in this case–control study. HDL oxidative index (HOI) was determined spectrophotometrically using a cell-free method in the presence of a fluorescent substrate dichlorofluorescein diacetate (DCFDA). Paraoxonase 1 (PON1) activity, superoxide dismutase (SOD) activity, and malondialdehyde (MDA) plasma levels were assessed in both groups.

Results

The NAFLD patients with impaired HDL anti-oxidative function (HOI  ≥ 1) had higher MDA levels, aspartate amino transferase (AST), liver stiffness (LS), and carotid intima-media thickness (cIMT) values compared to the controls. HDL oxidative index (HOI) was positively correlated with MDA levels and cIMT and negatively correlated with SOD activity.

Conclusions

Higher circulating levels of MDA were associated with the impaired anti-oxidative function of HDL in NAFLD. The impaired anti-oxidative capacity of HDL might be related to NAFLD severity and subclinical atherosclerosis in NAFLD patients.
Evaluating match running performance in elite Australian football: a narrative review
Authors: Wing Christopher , Hart Nicolas H. , Ma’ayah Fadi , Nosaka Kazunori
Published: October 2021

During Australian football (AF) matches, players are subjected to high running loads, which are intermittent in nature. There is a growing body of research that highlights factors which can both positively and negatively affect this match running performance (e.g., the total distance travelled by a player during match-play). In order to appropriately evaluate these factors, a thorough search of MEDLINE, SportDiscus and Web of Science databases was performed, with a total of 17 manuscripts included within the final evaluation. The main findings from this review highlighted that match running performance is increased amongst those playing in midfield and half back/forward positions, in players with lower playing experience, as well as in matches against higher quality opponents, and in losing quarters. Additionally, a well-design interchange-rotation strategy may be able to positively affect match running performance. A decrease in match running performance was evident amongst more experienced players, during periods of acute fatigue (e.g., following periods of high intensity activity), during matches played in higher temperatures and matches with an increased number of stoppages. However, no effect of ground hardness or size, as well as responses to self-reported wellness questionnaires was found. Other factors such as finals series matches, pre-season training load and elements related to the schedule have been shown to have substantial conflicting results within the literature, increasing the difficulty in making generalisable conclusions to their effect on match running performance. Developing a thorough understanding of these factors which affect match running performance can aid practitioners and coaches to gain a greater understanding of a player’s performance as well as inform the development of strategies for its improvement.
Development, implementation and evaluation of the ‘BELIEVE’ program for improving physical activity among women: a mixed method action research study
Authors: Amiri-Farahani Leila , Parvizy Soroor , Mohammadi Eesa , Asadi-Lari Mohsen , Taghizadeh Ziba , Pezaro Sally
Published: October 2021

Background

There is insufficient physical activity among women. Yet the implementation of effective, multilevel, and evidence-based interventions may address this. Since the lifestyle of individuals is formed in many different social, physical and cultural contexts, it will be necessary in designing such interventions to involve many stakeholders. Consequently, the present study took a mixed method action research approach in developing, implementing and evaluating a bespoke program to improve physical activity among women.

Methods

This study was conducted within the Khoramroudi neighborhood of Tehran between 2013 and 2015 utilizing the four main phases of action research. The Mobilizing for Action through Planning and Partnerships (MAPP) process was used to design the study. During the initial phase, participants were organized into three groups; a core support committee, a steering committee, and a study population. Qualitative and quantitative data were also collected during this first phase. During the second phase, interventions were developed and implemented. In the third phase, an evaluation was carried out using both quantitative (Designing a quasi-experimental study) and qualitative methods. During the fourth phase, an exploration of the structure and process of action research was completed with the aim of providing a conceptual model and descriptions of the context.

Results

Three strategic interventions were effective in improving physical activity among women: (1) utilization of sports assistants; (2) Local health promotion and the dissemination of an informational, motivational and culturally competent booklet entitled “Educational content for sport assistants" (3) Group-based cognitive behavioral therapy. Quantitative results [Significant difference between the total score of PA before the intervention, and 1 and 3 months after the intervention (P < 0.001)] and the results of qualitative evaluations were shown to improve physical activity among participants. The newly co-created “adjusted MAPP model” was offered within three action cycles. The structure of this was described to capture the impacts of interactions among a variety of stakeholders.

Conclusion

The comprehensive identification of problems led to the development of collaborative strategies. Strategies of action research can positively affect physical activity among women. To improve physical activity outcomes more generally, the use of MAPP principles and strategies is suggested to meet the specific needs and strengths of all community members.
Criteria prioritization for the sustainable development of second-generation bioethanol in Thailand using the Delphi-AHP technique
Authors: Jusakulvijit Piradee , Bezama Alberto , Thrän Daniela
Published: October 2021

Background

The availability of underexploited agricultural residues in Thailand opens up the opportunity to supply second-generation bioethanol production. The national implementation of residues-to-biofuel can potentially boost the bioeconomy and greenhouse gas mitigation but requires the involvement of multiple stakeholders in the development of effective policy recommendations. This study aims to optimize the implementation of the national strategy through the use of a multi-criteria approach that involves participatory prioritization by current stakeholders in order to evaluate certain aspects and important indicators for second-generation bioethanol development.

Methods

The Delphi-AHP technique was used to analyze the degree of importance of different criteria. The evaluation process was conducted with various stakeholders and used a pairwise comparison of 4 dimensions (main criteria) and 12 indicators (sub-criteria). Participants were asked to rate factors related to technical feasibility, environmental impacts, economic feasibility and social impacts in terms of importance.

Results

Bioethanol stakeholders in Thailand from five different sectors (industry/business, NPO/NGOs, the governmental sector, academic/research institutes and financial institutions/banks) participated in the Delphi survey. The 20 experts’ evaluation of the four dimensions ranked economic feasibility (32.7%) highest in terms of level of importance, followed by environmental impacts (25.1%), technical feasibility (24.9%) and social impacts (17.3%). When assessing the sub-criteria, the participants selected ‘final price per liter’, ‘added value of input materials’ and ‘net energy balance’ as the top three most important indicators among the 12 sub-criteria. In terms of a link between the preferred criteria and the participants’ expertise, the results encouraged taking different backgrounds and affiliations into account in the policy planning phase.

Conclusions

The stakeholder survey indicated the importance of economic aspects, highlighting the need to take governmental driven policy into consideration. However, implementation scenarios have to be embedded in a broader range of aspects because all the dimensions were rated as being highly impactful. For future sustainable bioenergy, the inclusion of stakeholders’ opinions can result in multifaceted scenarios that can be linked to social acceptance and benefits for all relevant players when developing policy recommendations for advanced bioenergy.
Antibiotic consumption in long-term care facilities in Poland and other European countries in 2017
Authors: Wojkowska-Mach Jadwiga , Brudło Michał , Topolski Mariusz , Bochenek Tomasz , Jachowicz Estera , Siewierska Małgorzata , Różańska Anna
Published: October 2021

Introduction

The aim of this research study was to compare the situation concerning the use of microbiology testing, the epidemiology of healthcare-associated infection (HAI) and antimicrobial consumption (AMC) in Polish long-term care facilities (LTCFs) with other European countries, using the most recent findings available in the European databases. Furthermore, this study aimed to highlight several basic factors that contribute to the observable differences in AMC between countries participating in the HALT-3 study, especially the relationship with demographic indicators, as well as the health care resources utilization rates.

Patients and methods

The most recent HAIs in Long-Term care facilities Point Prevalence Survey (HALT PPS) was carried out in EU/EEA countries in 2016–2017, and in Poland it was carried out in April–June 2017 in 24 LTCFs. AMC data was collected with use of methodology of the Anatomical Therapeutic Chemical (ATC) classification system of the WHO.

Results

In total total in HALT-3 study on the day of the PPS, 5035 out of the 102,301 eligible residents received at least one antimicrobial agent, with prevalence of 4.9%, and in Poland 3.2%. The most common HAIs in the countries included into the study was urinary tract infection with relative frequency of 32%, in Poland it was skin infection, 30.4%. The respiratory tract infections, excluding pneumonia (PNU) were observed in 29.5% of residents in total, in Poland 17.4%, the prevalence rate of PNU were 1.4% and 5.4%, respectively. The lack of microbiological results of HAIs testing concerned the vast majority of all HAIs, 75.8% in total and 81.5% in Poland. The most frequently used antibacterial for systemic use were beta-lactams and the most frequently prescribed antimicrobial agent was ‘amoxicillin and enzyme inhibitor’. AMC was closely correlated with the age of the general population (65 years of age and more) and the availability of doctors in general population.

Conclusions

A significant problem observed in LTCFs was the empirical use of antibiotics and the scarcity of microbiological testing. In the studied Polish LTCFs, where the age of residents was low, also the AMC was found to be lower.
Human Milk output among mothers previously treated for severe acute malnutrition in childhood in Democratic Republic of Congo
Authors: Murhima’Alika Christine Chimanuka , Balemba Ghislain Maheshe , Lyabayungu Pacifique Mwene-Batu , Mulume’oderhwa Guy Mulinganya , Munthali Grace , Owino Victor , Tambwe Albert Mwembwo , Dramaix Michèle , Donnen Philippe , Balaluka Ghislain Bisimwa
Published: October 2021

Background

Malnutrition is a public health problem, as wasting affects 7.5% of children worldwide. The harmful effects of severe acute malnutrition (SAM) can last a lifetime, but how SAM in childhood affects later breastfeeding ability is not clear. In the present study, we assessed the human milk output and body composition among mothers with a history of childhood SAM.

Methods

This retrospective cohort study was carried out in Miti-Murhesa Health Zone (Democratic Republic of Congo) from January 15 to March 17, 2020. We selected lactating mothers with breastfed infants aged 2–12 months. Two categories of mothers were included: those who had been treated for SAM during their childhood (years 1988–2003; n = 39) and a community control with no history of SAM (n = 40). The weight, height, and mid-upper arm circumference were measured and body mass index (BMI) calculated as weight/height2. Body composition and human milk output were assessed using standard deuterium dilution methods. Student t and chi2 tests ware applied to compare two groups.

Results

The mean age ± standard deviation of the mothers was 24.4 ± 5.1 and 26.0 ± 6.1 years for the SAM and control groups, respectively (p = 0.186). The age of their infants was 5.4 ± 2.3 months in both groups (p = 0.962). In the SAM and control groups, the mean maternal BMI was 23.8 ± 2.3 and 23.6 ± 3.7 kg/m2 (p = 0.849), mean Fat Mass 27.1% ± 5.0 and 27.1% ± 5.8% (p = 0.708), and the mean Fat Free mass 72.9% ± 5.0 and 72.9% ± 5.8% (p = 0.998), respectively. Human milk output was 833.7 ± 152.1 g/d in SAM group and 827.4 ± 171.4 g/d in the control group (p = 0.864).

Conclusions

We found no significant difference in human milk output and body composition in mothers treated for SAM during childhood compared to community controls.
How West African countries prioritize health
Authors: Adebisi Yusuff Adebayo , Alaran Aishat , Badmos Abubakar , Bamisaiye Adeola Oluwaseyi , Emmanuella Nzeribe , Etukakpan Alison Ubong , Oladunjoye Iyiola Olatunji , Oluwaseyifunmi Oladipo , Musa Shingin Kovona , Akinmuleya Temiwunmi , Olaoye Omotayo Carolyn , Olarewaju Obafemi Arinola , Lucero-Prisno Don Eliseo
Published: October 2021

Background

The goal of Universal Health Coverage (UHC) is to ensure that everyone is able to obtain the health services they need without suffering financial hardship. UHC remains a mirage if government health expenditure is not improved. Health priority refers to general government health expenditure as a percentage of general government expenditure. It indicates the priority of the government to spend on healthcare from its domestic public resources. Our study aimed to assess health priorities in the Economic Community of West African States (ECOWAS) using the health priority index from the WHO’s Global Health Expenditure Database.

Method

We extracted and analysed data on health priority in the WHO’s Global Health Expenditure Database across the 15 members of the ECOWAS (Benin, Burkina Faso, Cabo Verde, Cote d'Ivoire, The Gambia, Ghana, Guinea, Guinea-Bissau, Liberia, Mali, Niger, Nigeria, Senegal, Sierra Leone, and Togo) from 2010 to 2018 to assess how these countries prioritize health. The data are presented using descriptive statistics.

Results

Our findings revealed that no West African country beats the cutoff of a minimum of 15% health priority index. Ghana (8.43%), Carbo Verde (8.29%), and Burkina Faso (7.60%) were the top three countries with the highest average health priority index, while Guinea (3.05%), Liberia (3.46%), and Guinea-Bissau (3.56%) had the lowest average health priority in the West African region within the period of our analysis (2010 to 2018).

Conclusion

Our study reiterates the need for West African governments and other relevant stakeholders to prioritize health in their political agenda towards achieving UHC.
High-pressure study of thermodynamic parameters of diamond-type structured crystals using interatomic Morse potentials
Authors: Nguyen Duc Ba , Trinh Hiep Phi
Published: October 2021

In this work, we have determined the mean square relative displacement, elastic constant, anharmonic effective potential, correlated function, local force constant, and other thermodynamic parameters of diamond-type structured crystals under high-pressure up to 14 GPa. The parameters are calculated through theoretical interatomic Morse potential parameters, by using the sublimation energy, the compressibility, and the lattice constant in the expanded X-ray absorption fine structure spectrum. Numerical results agree well with the experimental values and other theories.
Μετανάστευση και Εκπαίδευση
Authors: Ταμπάκη Παρασκευή
Published: October 2021

Η μελέτη αυτή εστιάζει στο φαινόμενο της μετανάστευσης στον ελλαδικό χώρο από τη δεκαετία του ΄80 και μετά. Η Ελλάδα φιλοξενούσε μετανάστες και παλιννοστούντες και πριν τη δεκαετία αυτή αλλά με τρόπο συντεταγμένο και σχετικά ελεγχόμενο. Οι «νέοι» μετανάστες από τις πρώην σοσιαλιστικές χώρες εισρέουν ασύντακτα και ξαφνικά και η ελληνική πολιτεία καλείται να αντιμετωπίσει με συστηματικό και στρατηγικό τρόπο τις νέες αυτές μαζικές μεταναστευτικές ροές. Ο χώρος της εκπαίδευσης επηρεάζεται έντονα από τη νέα κοινωνική πραγματικότητα, καθώς μεγάλος αριθμός παιδιών, διαφορετικής πολιτισμικής προέλευσης έρχεται να φοιτήσει στο ελληνικό σχολείο. Στη συγκεκριμένη έρευνα επιλέγεται η πληθυσμιακή ομάδα των Ποντίων μεταναστών/στριών που κατάφερε να φτάσει στο κατώφλι της ελληνικής τριτοβάθμιας εκπαίδευσης παρ’ όλες τις δυσκολίες που αντιμετώπισαν και τη δυσοίωνη εκπαιδευτική τους απαρχή στο ελληνικό εκπαιδευτικό σύστημα. Η ομάδα των Ποντίων μεταναστών/στριών στην κατηγορία του παλιννοστούντα -ομογενή με τη διττή της φυσιογνωμία, αυτή του «ξένου» και του «ντόπιου», αποτελεί προνομιακή πληθυσμιακή ομάδα για την καλύτερη κατανόηση του νεώτερου μεταναστευτικού φαινομένου και την ανάδειξη δυσδιάκριτων πτυχών της μετανάστευσης/παλιννόστησης, όπως αυτή αντανακλάται στην εκπαιδευτική τους διαδρομή. Ο ίδιος ο ρευστός χαρακτήρας της μεταναστευτικής πραγματικότητας υποδεικνύει τη βιογραφική προσέγγιση του θέματος. Κοινωνικός σχηματισμός, εκπαιδευτικές δομές και υποκειμενικοί προσανατολισμοί και δράσεις αναλύονται στη μεταξύ τους διαλεκτική σχέση. Με τη βιογραφική μέθοδο επιχειρείται η ανίχνευση, η καταγραφή και η ερμηνεία των κοινωνικών επικαθορισμών και των προσωπικών στρατηγικών των υποκειμένων της έρευνας στην προσπάθειά τους να φοιτήσουν στην ελληνική τριτοβάθμια εκπαίδευση. Η επεξεργασία και η διερεύνηση του αφηγηματικού υλικού των συνεντεύξεων εμπλουτίζει το θεωρητικό υπόβαθρο της ερευνήτριας παράγοντας παράλληλα νέα ευρήματα και γνώση. Η επιτυχημένη πρόσβαση στο πανεπιστήμιο δεν ερμηνεύεται απλά ως επιτυχία στις εισαγωγικές εξετάσεις, αλλά ως εκπαιδευτική διαδικασία που αντανακλά προσδοκίες, κίνητρα, στάσεις και αξίες όπως αυτές εκφράζονται στο πλαίσιο των δομικών δυνατοτήτων και περιορισμών της υποκειμενικής βιογραφίας. Επιπλέον, η επικαιροποίηση δέκα αφηγηματικών συνεντεύξεων στις συνθήκες του τώρα, συμβάλλει προσθετικά στην κυκλική ανάλυση και ερμηνεία του πρωταρχικού υλικού.